Yet Another Day

Although I do appreciate that I am healthy and have the ability to be a productive citizen of this great US of A, I am getting a little distraught at the fact that it feels like I am never making headway. Being riddled with debt and in the middle of selling a home just aggravates this fact. I know that my wife and I will make it past this bump in the road in time but how much longer do I have to wait to pursue my interest? I can’t help but ponder that question. It may be the self-centered side of my personality shining through or just a bit of momentary disgust at our current situation.



I am sure it’s only a brief thought because all in all I am a happy person. I just have this nagging drive that continually tells me to drop everything and go back to school now so that I can apply to medical school sooner. I wish I could do that but until our finances are secure I can’t and this depends greatly on my spouse’s graduation date. Unfortunately, this date is elusive.



You see, in the sciences, graduate education is very dynamic. Many factors influence when you earn your three letters instead of the completion of classes or a set amount off training. This is yet another reason for me to pursue medicine instead of a graduate degree in science.



However, I do have a keen interest in History and plan on learning more and more about it as my studies progress. My ideal degree would be a history major, biochemistry minor with graduate work in public health and of course a medical degree. I think that would spring board me into my passion of humanitarian and maybe even academic medicine.



Although idealistic as it sounds, I fully expect to reach these goals and the only way I can reach them is by putting in the grunt work now. -Current pain for future gain- I hate (well not really) it but it is how it is and there is nothing I can do about it. Every one else has put in the time and now it is my turn. I just have to continue to remind myself of this great truth.



Which brings to my reason for this blog entry. As my description explains I do work in other places when hungry… i.e. broke and in debt. Now is one of those times and yes I have returned to one of my prior employers for part time work. I actually managed a portion of the laboratory during my time there. As you can imagine it is a little odd for me to return to find that some of the individuals that I assisted in hiring are now running the show; however, it hasn’t been so bad. I was able to fit in doing a job I am very comfortable with, which is very good for part time work.



So yet another job to add to my duties over the course of this year. Just for an update, this week I will tally 82 hours in the next five days. That’s an average of 16.5 hours per day.



Thank goodness I was able to ride my mountain bike this Sunday.

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Mountain Biking

Mountain biking is one the best stress reducing activities I am aware of. Nothing frees my mind like being in the woods and pushing myself to the limit on two wheels.  My wife and I rode for three and half hours yesterday and had a blast. The weather was phenomenal and the trails were perfect. My Haro flew through some pretty technical stuff yesterday, I was really proud. Who needs full suspension anyway? One of the trays dubbed downhill that has a warning at the beginning "Expert Level or Above," which begs the question of what is above an expert, had an excellent technical downhill that screams. We rode down and caught some really long air and didn't break the first bone. I was impressed at how our hard tail bikes stuck to the rock, rooty, washboardy terrain. Although the entire trail wasn't nearly as technically as this section it still was excellent. Here I am at the beginning of a new week and all I can think about is "when can I ride next."



Well, maybe that isn't all I can think about. Right now I am hungry and can't wait for 7PM to roll around so I can truck it home to fix big fat burgers and homemade  sweet potato french fries. Oh, my belly is growling!

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The Medical Blog

I've read some interesting articles on medical blogs and their ability to incite fear in the hearts of hospital administrators. I do not blog to embarrass or to brag about other people or patients. I blog because I enjoy writing and the release that it affords me. Yes, I could write in a journal but a blog gives me an opportunity to share my thoughts to others very easily. It also pushes me to improve my written communication and obviously I do need the practice. By the way, any suggestions are appreciated. With that being said, I reserve the right to post anything I want as long as it doesn't harm anyone.

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What the patients don't tell us

Why are so many people programmed to lie about their health?

A brief war story is in order to explain what I am talking about. Last shift we picked up a lady who had a nasty roll-over car accident. The whole time we were cutting her out of the car she was hysterical; kicking, screaming, swearing and generally acting like someone who was hit really hard in the head. So we give her the benefit of the doubt and assume she has a bad closed head injury and treat her accordingly. As we were removing her from the car she stopped talking and moving. She failed to respond to anything we asked and didn’t even flinch during a sternal rub. Ok, I am convinced at that point. We drive fast and do all of the necessary things that has to be done for significant trauma patients. All is well except for the fact that she is in and out of consciousness. One minute she is screaming and not responding the next. About five minutes before we arrived at the hospital she becomes completely flaccid. We rolled up to the ER and wheel her in with all of the theatrics that she deserved. I gave the nurse a rushed report indicating that I really didn't want her to die on my stretcher. Of course that went over well. We transfer her to a hospital bed and by this time several spectators had congregated in the room and were helping us. With all of this going on around her she remained unresponsive until we lifted her up and set her onto the hospital bed. Miraculously she wakes up, completely lucid, and begins to explain everything that happened this evening to the doctors? The nurses begin laughing and everyone files out of the room while the patient is calmly dialing a phone to call a family member and tell them what happened. I don't get it?

This is certainly not the normal “I’ve lied to you” situation but it just portrays how inconsistent care can be. Of course once that happened everyone in the ER assumes this patient has nothing wrong with her even though her mental status had changed like Tennessee weather. Not only is this bad for this patient, it is bad for the next patient I bring in because the ER staff is going to assume I am full of shit. Unfortunately, this doesn’t just happen to me or prehospital providers in general. I think to some extent it happens every time another provider comes in contact with the same patient. Just like in grade school when the teacher would whisper a phrase to one person and ask them to pass it on until everyone heard it. The phrase always became distorted. I am not sure if there is a fix to this but in the future if someone’s report doesn’t match what I am seeing I’ll not automatically assume the report is wrong.

The devil in a white shirt

I had an interesting encounter this morning with a patient that really gave me the hee-bee-jeebies. My partner and I, totally different partner since this is an extra shift, were called into another zone because of a woman experiencing hallucinations. It took us several minutes to get there thus giving the first responders ample time to drive this lady completely over the deep end. When we drove up we were met by a fireman who looked kind of scared. I thought he was going to open the door to the ambulance and drag me out he was so upset. He then proceeded to rattle off that they were holding here down and she keeps calling them devils. "Oh this is going to be interesting I thought." I immediately called the appropriate people so that I could restrain the patient before making contact. Just as we were stepping into the home husband walks out dripping in sweat and appearing exhausted. "I just make it worse" He said as he continue down the steps into the yard and not stopping. By this time the yelling was audible and it wasn't difficult to find the patient. As I stepped up and assessed her I was surprised by the fact that the patient appears healthy and neat in appearance. However, she was very agitated and screaming the same things over and over. Interestingly she did not even acknowledge the fact that we had entered the room. I reached out to touch her wrist and asked the fireman to let her go for a moment. I received a very apprehensive stare as you might imagine. When they let go of her she stood up and as I was taking her pulse, which was rapid, she began to walk with me. "This is good" I thought, so we just sauntered together, the devil and the patient, all of the way to the ambulance without any question. As we were walking two police officers stepped out of the front the house carrying large leather restraints and very serious looks. Apparently the first responders were going to restrain this lady a chair or someone I didn't want to ask. We continued to the truck and was able to sit the patient down and apply the normal straps that keep patient's from lying to and fro around inside the ambulance. the patient didn't mind at all but she was beginning to breath very very rapidly. It was obviously self initiated and not secondary to any medical condition we could help without Haldol. She then began screaming about how she had to look away but continued to stare at me. At this point everyone was thinning out and it was just the patient and me in the back of a very small ambulance. This made me rethink my decision to not restrain her. As we were beginning our one hour drive she continued to scream about looking away and also continued to stare at me. By this time I began to get a little weirded out by this and could understand why the first responders wanted to tie this lady up before she really did flip out. I continued to speak to her calmly but it really didn't change the situation. I placed a NRB mask on her in hopes of her not spitting on me. That's another war story altogether. I checked her BGL and it was normal. That nearly became a fight when I pricked her finger. Because of this I did not even begin to start an IV. The cardiac monitor wasn't a problem after the BGL though. As we continued her antics became louder and weirder and I suddenly was the devil and that was why she had to look away. Apparently it isn't prudent to stare the devil in the eyes. How weird can you get. I think her eyes became larger and larger as we drove and the stare was wearing me down. All I could think about was the movie Excorist that gave me nightmares for most of my childhood. We finally made it to the hospital but not until I made the ritualistic call via radio to the ed to let them know we were coming. The entire report was masked by the continually "you are the devil I can't look" scream which did get us a bed at the ER quicker than I have seen in a while.

Crazy.

Bored again

It's not such a bad thing to be bored at work. If I am bored then no one is experiencing an emergency. However, when I am bored I not only eat everything I also think way to much about things like the future and school and mostly debt. I am not sure I have covered my debt situation on this blog and I guess now is a good a time as any. Since my wife and I got married four years ago at the end of this month we have accumulated a huge amount of consumer debt. In case you didn't know my wife is a graduate student. She actually makes pretty good money but we haven't been the best stewards of the money we make and this has gotten us into a situation that many people are all to familiar with. It's like a restraint on everything we try to do. I can't continue my education until we are out of debt. Originally our plan was for me to go on to school after she finished and that is now compromised because of the way we have abused credit cards. It's not all bad because we are going down the write path, albeit late, to get out of debt. Putting our home up for sale is the first very large step in that process. If we can make enough from the sale then our situation will dramatically improve. If not, well lets just say I will be working many more 48 hour shifts over the next few months. As it stands now I will have three days off over for the rest of this month. I think going to school and studying three or our hours a day will be a breeze compared to what I am doing now.

Typical boredom. Here I go pondering over how bad things are and not focusing on the good. Hey, at least I am healthy enough to work three jobs. At least three different employers will allow me to work. We will dig out of this hole I am sure of it and when we do it will be most rewarding.

Ugh

After drinking a little to much last night I finally settled down to sleep about ten or so. I don’t understand alcohol but it is a vice that I have difficulty with at times. My biggest concern today was the fact that this morning I could still taste the wine I drank last night. That’s alarming especially when I am beginning a very long shift this morning. I am certainly going to pay for last night as these days progress. I guess that is my punishment for a lack of self-control. Well, I shouldn’t drink again for a while because it slows me down and I can’t be slowed down. I’ve to many goals and plans to take care of and alcohol doesn’t fit. I have been a social drinker for a while but have never been a big partier. For the most part I haven’t overdone my alcohol consumption but this morning when I could taste wine I couldn’t help to think that I my performance at work may be affected. I only drank two beers and two glasses of wine starting at six in the evening and ending around 8:30. Theoretically I should have metabolized all of the alcohol by at least 11PM and I don’t feel like I am hung over. Maybe it was just the type of wine I drank or the fact that I mixed it. Ugh, that was probably it. Well, in my normal fashion I am over analyzing this. You know, I quit drinking altogether for about 7 months until I went to Baton Rouge for a conference about a month ago and since then I have drank it up. Yea, it’s time to quit again. It’s time for another nap as I wait for the next emergency to occur. (Hopefully it won’t).

Once again I find myself writing a little and thinking about what I have accomplished today. Nothing, well something, money was made. Other than that I didn’t work toward any future goals. With that said, I need to begin either studying or working out more during my shifts. Both would be even better. Study Spanish or Chemistry or any other subject even literature would be OK. So, what will it be? Obviously I have no clue especially tonight. Stream of thought writing may not be easy to read but it does clear the mind some anyway. Stop changing the damn channel. I am sitting here with my partner, the same one that I wrote about the other day, and he has the remote. In the last hour he has probably changed the TV channel one hundred times. I am going to go through the roof. He does drive me insane sometimes.

American Idol

Well, we are moved. It wasn't easy and there were many steps involved but we did it. On the other hand is our house and it is no were near being ready to sell. It is a little odd, I have always joked about having a house in the country and an apartment in the city. I never dreamed that it would happen at 25 even though it is bittersweet. My salary is strained as you may imagine and my wife's student income is spread like butter on really hot bread. However, if we could sell in this slow market really quickly then all will be well? Never mind all of the worries. Right now I am sitting in front of the TV watching American Idol and drinking a glass of chardonnay. This is the first show that I have watched this season and so far I am not very impressed. I am just interested in who will win and whether or not it will be the hometown girl. Pink is singing right now and I think she is stoned. There is no other explanation for someone acting like she is. I don't think I have ever heard of her? She's pretty good though. Maybe I'll check out some of her other work. I just checked out the website and it is extremely over done. Anyway, enough bashing. Work, I dread it. Tomorrow I began a 48 hour shift and it is going to be hell. Wait a minute, the more I dread it the worse it will be. So, it should be really ok. I'll be working at two different stations but they are pretty slow most of the time. Hopefully no one will die or get tore up in a car. It will be fine, if it happens I'll put them back together the best I can and whether or not they life will be up to our maker. Well, nothing exciting to speak about tonight. I guess it is time to check out all of the other blogs on my list and see what they have to say. Peace.

Krystal's

I ate six krystal’s with cheese today and a few French fries, well, one regular order of French fries. I washed that down with some Coke, the real deal, not diet. It was so good but so bad. What’s not good about a dinner role, piece of “meat”, pickle, mustard and a big piece of cheese? I don’t want to think about how unhealthy it was because every once in a while a little bad eating keeps everyone motivated. Anyway, my training is going well. I have added swimming and biking to my 20 or so miles of running a week so that I can complete a triathlon early next year. Interestingly enough I have been much more hungry over this past week. I will need to be more mindful of my caloric intake until my training levels out.



That’s enough about training. Work so far today has been moderately busy. One call in particular sticks out in my mind. This morning just as I was getting out of my car at the Fire hall the tones go off. Apparently someone wrecked in a curve just a quarter mile below the hall. No one likes to get a call at shift change and for this reason I try to get to work about 30 minutes before my shift begins. Luckily, this morning wasn’t any different. I ran in and signed for the narcotics very quickly without counting them, which is against all narcotic protocols that we have. My partner drove up as we were pulling out of the station so we were able to relieve the crew that had been on for 24 hours. As we leave the hall we could see the accident down a small hill in a sharp curve. This is a normal place for accidents when it rains as it did this morning. When we arrived, just as the engine, one woman was sitting in her car that was slid off of the road with no damage. I approached the car and asked if she was ok and she looked at me with a very blank stare and said “no habla English.” I was able to find out that she wasn’t hurt and assisted her out of the ditch into the back of our ambulance. Luckily, one of the PD officers could speak fluid Spanish and helped us out. It turns out that she was driving her sons car and the only ID she had was a voter registration from Mexico. The funny part of the story was when the officer asked her what her address was. She pulled a Chik-fil-a pay stub from her pocket, which had her name on it and someone else’s SSN. After she signed our paperwork the officer took her and more than likely took her to jail and began deportation. Luckily no one was hurt and she did not do any damage to the vehicle. After thinking about this call I wondered how I would feel if I was out of the US with my mother and she had an accident and was hauled off to jail without notifying. That must have been very scary for her.  It only brings the current changes to immigration into my life more than I would like it. Now I really disagree with hauling off someone without any regard to his or her situation. Yes, she was an illegal alien but she is still a person. Unfortunately we as Americans are more concerned with the dollar sign that is expended on this person than why they are in the US or what their life is like at home. If I knew I could double or triple my income by just crossing a border and working so that my family life could improve I would do it in a heartbeat. Can you say visiting worker program?

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My Motivation

Once again I sit in front of my computer writing about what I should be doing. I am sure that if I write more and think more then more things will be accomplished? Right? No really, I am the type of person who has to plan each and every thing that I do. My wife and I are moving this weekend and I should be packing things up and cleaning around the house. My schedule is far less restricting so I should be shouldering the majority of the burden of this move. I know this and still I can't get past the lack of motivation. So what do I do? I sit at my desk and create a list of things that I must get done and attach a certain time schedule to it. Usually this is all I need to do because the list becomes my goal and I have something to work toward that is planned. Maybe I am over thinking this issue and should stop typing and get to work. Yea, I think that's it.

Holy shit

Let me tell you about someone I work with. I know, not such a good idea to openly bash coworkers on the internet but who cares? This guy is such an ass for the most part. First of all he constantly has to say something to someone in order to appear in charge. No matter what type of situation we are in he just can't keep his fucking mouth shut even when he has no idea what he is talking about and more often than not he has no clue what is going on. For instance, his level of medical training is mediocre at best- first responder like- but he has been in prehospital care for probably fifteen years or so. That in itself throws up red flags in my mind because who does that for fifteen years? When we arrive onscene of an emergency he continually rushes into the house and begins speaking to the patient and the family as if he has any idea of what is going on. Anyway, this is a bitch post with lots of profanity. He really isn't that bad of guy he just has an enormous chip on his shoulder. It's as if he needs everyone to know that he knows more than he should if that makes sense. Generally, he means well but it almost always pisses my off when he starts running his mouth about rules and treatment and how long he has been in EMS. Who cares big guy? I am glad I am a tolerant individual with a blog to vent. Otherwise, I would probably go completely Ya-Ya on this guy. You know what's funny? Most of the time we get along really well and I regard him as one of my best friends. Crazy how that works?