I have been getting in and out of ambulances for over 20 years now. That means just what it does. Twenty years ago my knees and back and all my bones and joints were twenty years younger than they are today. I’m in good shape, but still, I find now when I get out of the back of the ambulance when we arrive at the hospital my partners tend to offer me their hand to help me down. I ignore their help of course, but I do admit I’m not jumping down as spryly as I used to.
I read this article -- As Doctors Age, Worries About Their Ability Grow in the New York Times this week and it made me think for a moment in the same way I think for a moment when I read the “Will you have enough Money for Retirement?” articles. I think I can put worrying about this off for awhile longer, but I sense that someday these articles will be my front page stories. Just not yet.
The physical deterioration of these years is slow, but undeniable. When I went to nursing school a couple years ago, I found I had to buy a pair of reading glasses so I could see the fine markings on the insulin syringe so I could draw up just the exact amount before handing it to my examiner to verify. On calls now, sometimes I squint to see the tiny vein I am trying to thread a 24 into in. A month or so go when I intubated a patient, I, for a moment saw two sets of vocal chords side by side. During cardiac arrests now I have learned not to relay on my view of the monitor beyond two arms length. What may look like asystole, if examined may actually be a defined rhythm with low voltage. I make it a practice now to print or have the strip printed out and handed to me so I can verify it.
When it comes to hearing, I have always been annoyed with patients who don’t speak up when I ask them questions, but lately I have found myself saying “Huh?" and “What?” more often than before, and finally asking them to please speak up blaming my difficulty hearing on the noise of the engine.
I used to love breaking into locked homes to rescue patients unable to get to their doors to let us in,. I'd divehead first into windows (while getting a boost from my partner) or climb up onto roofs to access second story bedrooms. Now, just as with carrying our heavier equipment, I sometimes defer to stronger more agile partners or responders on scene.
A few times I have seen a tremble in my hand and asked, is this the first hint of a condition that will change my life or am I merely suffering from lack of sleep or caffeine withdrawal? (A reassurance, I just checked both hands, and today as I sit in front of the computer, each hand is as steady as a gunfighter’s, although quite lacking the gunfighter’s speed).
One of my partners is ten years older than I am. Sometimes his slow deliberate way is frustrating to me. His scene clock is slower than mine, but then when I work with younger people, I sense they may feel the same about my pace. I like to think that I move quickly when I have to, but as in a game of softball, I no longer have the reflexes to snare a blazing line drive in the infield.
A few years back I came on the scene of a rollover, a car on its side with a women still in there, although with only minor injuries. While I pondered what to do, considering the best approach, another medic arrived on the scene, and was in the car before I could even say “good day” to him.
I like to think my approach was mature, deliberate and proper, but I do wonder if someday it will tick past the mature deliberate safe response and into the doddering greys of early dementia.
My hearing is not so bad that I can’t at a distance hear the tick tick tick of the finite clock that beats for all of us.
