Florida

My brother and I went to Florida for this past weekend to see our father. I left on Friday and came back on Monday. My father had a back operation in December, and while he didn't want us to come see him then, he finally agreed, now that he is up and walking around, to have us visit in March.

Since last July I have been working basically two full-time jobs. Forty hours a week as a medic and then fifty-six hours every two weeks as a clinical coordinator -- a routine that leaves me with one day off every fourteen. I like both jobs (particularly in this economy), but I really did need some time off.

I hadn't flown for several years so the tube of Suntan lotion I bought the night before I had to pitch at the entrance to the security gate because it was an 8 ounce tube and not the smaller permissible size. And then since they went to e-ticketing, it seems they no longer save the exit rows for tall people to request at the gate so I was stuck with my legs pressed up against the seat in front of me.

For food, there was no TV-type dinner, just a tiny bag of peanuts. The stewardess actually gave me two bags and a foil wrapped cookie. I also got half a Diet Coke from the other stewardess. I guess they are called flight attendants now or uniformed flight crew.

At least I had several newspapers and magazines to pass the time. I buy Men's Health, Time, Entertainment Weekly and Rolling Stone when I fly along with USA Today, the New York Times and the local paper. On a three hour flight I get a good sense of what is going on in the county. I learned what "twittering" was. I had never heard of it before, but it was mentioned in nearly every publication. I did get a little depressed in reading the cover story of the Rolling Stone about the cast of a TV show called Gossip Girl, and how the cast members were complaining of lack of anonymity. Well, I am out of touch, I could have been sitting next to one of them on the plane and not know it. But that wasn't nearly as depressing as reading about the AIG scandal. I don't even want to go there.

It was good flight, and I was glad to see my Dad and my brother. We went out to eat twice (I had two beers on the first night, two beers on the second and then three and a half with dinner on the last night when we went to a sports bar(the half was finishing my brother's third). I love drinking beer, but working everyday I just don't anymore. I would have gladly had more, but the occasion wasn't right).

We went to a spring training game where it rained steadily for three hours before they started the game. We left after two hours. Just going to the ballpark and having a hot dog was good enough. I managed to go running twice -- it was more humid than Connecticut, but I managed to do four miles on my last run. I am slowly getting back into shape after a long chest cold this winter.

On the last day, we went to the beach where there was crazy surf. There were 100 surfboarders and no swimmers -- at least until I arrived. One of my few talents is that of a body surfer (due mainly to my thin 6'8" frame). I did hesitate before entering the water. It was rough out there, and since it had been a few years since I had been in the ocean, I wondered if maybe my bones were now to frail for the onslaught of the waves, if I would get caught up in a rip tide and carried out to see. But I ventured forth anyway and did battle with the waves, crashing through them, or diving under them, or jumping over them, and when just the right wave came, I'd dive in front of it, my arms outstretched, my head tucked down, and caught up in the powerful wave, I'd ride in to the beach till the wave stranded me on the sand, and then I'd turn and run back out. I caught quite a few good rides, and felt refreshed and alive.

We watched a lot of basketball on TV and talked about the stock market. The market has been rough on people with fixed incomes. My father was a cautious investor and seems to have protected himself okay with more bonds and declining amount of stocks as he has gotten older. He had some stories to tell about heavily invested neighbors looking for work in their seventies. Me, I don't think I'll have to worry about retiring too soon and living off my portfolio. I expect to be working into my seventies even with a good stock market if we have one again (which I expect we will as all things are cyclical). I don't see much other choice. I do not play the lottery.

It was a nice trip. We laughed over old times and promised that next time we would bring our girls down. While my father enjoys Florida and his wife clearly loves her golf and bridge groups, I think he misses the grandchildren and going to kid's soccer and baseball games. I definitely need to make some time to get down there and bring the grandchildren to him.

The flight back was a little rough on the landing and left me a little queasy, but the 28 degree air snapped me out of that. I was tired when I got home, but there was no better sight than being met at the top of the stairs by my fourteen month old, who was jumping up and down and saying Dada. Later when we read books, I was delighted to see that she had added a monkey imitation to her already prodigious collection of animal impersonations (cow, tiger, snake, wolf.)

So here I am today back at work. It was good to get away. I feel like a better paramedic than I was when I left.

An EMS Mark Twain

Stephen "Kelley" Grayson's book "Life, Death and Everything in Between" has been rewritten and published in hardcover by Kaplan Books as "En Route: A Paramedic's Stories of Life, Death, and Everything in Between."

The book covers Grayson's long career from day one EMT rookie to established paramedic. It is told in short chapters that are stand alone stories in themselves. On one hand, you want to read the book right to the end, on the other, you want to take it slowly, a chapter a day to make the enjoyment (and often laughter) last.

Grayson is an EMS Mark Twain -- a gifted humorist who packs a serious punch. He does a great job of describing what it is like to be in EMS -- the good and the bad, the high points and the lows.

It is absolutely one of the best books about EMS I have read. Highly recommended.



Grayson is also the author of the popular blog: A Day in the Life of an Ambulance Driver.

For those who live in New England, Grayson will be delivering the opening lecture at the Connecticut EMS Conference this Friday, March 20.

Empty Shoe

“How much morphine?!” the nurse asks.

I see across the room in the faces of the ten staff gathered around looks ranging from shock to disbelief to not certain they heard right.

“Seventeen,” my preceptee says.

Again some looks, understandably. 17 milligrams of morphine is a lot, but after all we are in the trauma room and the patient does have an open fracture.

That fracture isn’t apparent to everyone. All they can see is a big pillow wrapped around the ankle with toes visible. They haven’t undone it yet to. The patient can wiggle his toes on command and he does. The toes are warm to touch, the resident notes.

The head doctor enters the room now and looks at the grimace on the man’s face and say, “Let’s get him some dilaudid.”

He is told about how much morphine the man has already received. “Well, it doesn’t seem to be doing the job, does it?”

I stay in the room, while my preceptee goes to write up the report describing how the patient’s leg was snapped when the refrigerator fell on him, and how after we had given all we could by standing order, we had to call for permission to give more morphine. I stay for one reason, I want to see their faces when the splint is undone. They have already cut off all his clothes and rolled him to examine his back.

“Let’s get a look at this,” the doctor says approaching the splint.

They are all there – doctors, medical students, nurses, paramedic students, x-ray techs, registrars. All waiting to get a peek.

The pillow is undone, the trauma dressing unrolled. There is the foot -- looking more like a shoe without a leg in it. It just hangs there by a big several inch flap of skin. From the rip protruding out about five inches are the bloody distal ends of the tibia and fibula. In other words, the leg bones are intact, but completely exposed to the air – an open dislocation. The impressiveness of the injury is confirmed by the grimaces.

“Let’s add some fentanyl,” the doctor says.

And pass the bottle of percocets for everyone else.