Sunday, February 10
Men's Health Belly Off Challenge!!!
I have decided it's time to join the Men's Health Belly Off Challenge. Over the past few years I have gained way to much weight. Now it is time to do something about it. Tomorrow is my first day of workouts and I commit to doing the workouts and eating like I know I should. My current weight is 227 and my goal is to reach 185 by the end of the year. That's very ambitious but doable and flexible if I need more time. I am excited and willing to sacrifice the french fries for better health.
Saturday, September 15
A Great Time To Remember
It's cooler outside these days. I walked down the few concrete steps outside of my domicile this morning and was refreshed by a cool earthy fall breeze. It made my early morning journey much better even though I would have much rather been upstairs with my wife who was probably falling back to sleep with our two muts filling my absence with fur.
Each step I took I felt better about the days ahead but I couldn't help but think about days past. It's funny how the weather brings back memories. I reminisced about walking across a long field at daylight to sit in a tree stand and about stepping into a cold river at the beginning of a cathartic day of fishing. I do miss those days when the fall brought expectations of long evenings shooting the breeze with friends after being outside all day swinging a hammer and listening to country music. Not that I would trade them, I am happy now, but nostalgia overcomes me periodically especially this time of year. I've missed the crispness of the air and the crunch of fallen leaves.
It's so been so hot and stifling over the past couple of months I had almost forgotten that fall was around the corner. I've been caught up in the everyday business of living that I haven't taken the time to just stop and absorb what makes life so wonderful.
I finally arrived at my car and set down to start the engine. It whined a little and sputtered but, as it has for a while now, performed without fault as I drove from the parking lot. I rolled down the windows and let the wind fill the cab with yet another opportunity to remember the past.
Each step I took I felt better about the days ahead but I couldn't help but think about days past. It's funny how the weather brings back memories. I reminisced about walking across a long field at daylight to sit in a tree stand and about stepping into a cold river at the beginning of a cathartic day of fishing. I do miss those days when the fall brought expectations of long evenings shooting the breeze with friends after being outside all day swinging a hammer and listening to country music. Not that I would trade them, I am happy now, but nostalgia overcomes me periodically especially this time of year. I've missed the crispness of the air and the crunch of fallen leaves.
It's so been so hot and stifling over the past couple of months I had almost forgotten that fall was around the corner. I've been caught up in the everyday business of living that I haven't taken the time to just stop and absorb what makes life so wonderful.
I finally arrived at my car and set down to start the engine. It whined a little and sputtered but, as it has for a while now, performed without fault as I drove from the parking lot. I rolled down the windows and let the wind fill the cab with yet another opportunity to remember the past.
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Friday, September 14
It's Been A While
My blogging has suffered over the past few weeks. My personal, off-line, journal and my workout running biking whatever journal has also been neglected. I have had some interesting experiences on the front lines of emergency medicine but I haven't been compelled to write about them. I feel as if I am in a slump of some sort. It seems to be like quicksand or a flushing toilet. The longer I remain in the slump the deeper and more consuming it becomes. I am sure every person experiences this from time to time.
I just watched President Bush give his speech on Iraq. It was actually a compelling speech and most of it was probably true. It is a shame we live in a world that settles conflict with guns and bombs. I wonder where this behavior originated. Do you think the Geico cavemen duked it out over who got the biggest bone?
They probably did.
I just watched President Bush give his speech on Iraq. It was actually a compelling speech and most of it was probably true. It is a shame we live in a world that settles conflict with guns and bombs. I wonder where this behavior originated. Do you think the Geico cavemen duked it out over who got the biggest bone?
They probably did.
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Sunday, August 26
My Experience
I began volunteering at a local rescue squad at the ripe young age of 13 and became proficient in the art of ambulance washing very quickly. As I washed the one ambulance in our squad I listened to the over-inflated stories that became more gory and self gratifying the longer they were told. I was hooked, I wanted to start IV's and intubate and shock a dying heart. I couldn't wait to pull a person out of a burning car or hang from a cliff while dragging a bus load of bleeding hemophiliacs out of the grips of death.
I enrolled in the first EMT night class I could a few months after I turned sixteen. I excelled for two nights a week. My boring high school classes suffered dramatically but I really didn't care about the Cartesian Coordinates or literature.
I progressed through EMT intermediate and then paramedic shortly after graduating high school. High school came and went, much to fast, and I was out in the world. I worked in construction during the day and volunteered at the rescue squad at night. I even began telling some of my own war stories. Many of them growing from a small sprout of truth into a tree of exaggeration. I did learn from some of the best.
My love for pre-hospital care continued to grow and I was lucky enough to be hired by a large urban service in North Carolina. Prior to beginning there I had never met someone who went to school with the intent of becoming a paramedic and nothing more. I assumed everyone volunteered during their free time and was ecstatic to be paid for something they loved. I was wrong, actually I was extremely wrong. Many of the paramedics were unhappy with their job, their life and especially their role in the health care system. My enthusiasm dwindled quickly, sadly much like my naivety. I learned that the stories that were told, out of fun I thought, were really a way to vent frustration and prop up fragile egos. My hobby, my passion, had become a job and my job quickly began to frustrate me.
I quickly experienced burn out, my attitude turned nasty and I was rude to patient's more often than I would like to admit. I formed my own opinion of what an emergency was and unfortunately no one met my criteria.
Looking back at this time in my professional life I realize just how negative I was. It was so easy to feed of off everyone else and mimic their poor attitudes. At least I now have those experiences. The gift of hind sight is priceless.
My passion has returned and I enjoy the medical field once again, thankfully. So much so that I plan to return to school and learn those things that I neglected in high school so that I can progress into a leader in medicine. How knows, I may have the opportunity to improve pre-hospital care for the sick and injured and maybe even those who take care of them.
This post has completely veered away from what I originally intended. Oh well, better luck next time.
I enrolled in the first EMT night class I could a few months after I turned sixteen. I excelled for two nights a week. My boring high school classes suffered dramatically but I really didn't care about the Cartesian Coordinates or literature.
I progressed through EMT intermediate and then paramedic shortly after graduating high school. High school came and went, much to fast, and I was out in the world. I worked in construction during the day and volunteered at the rescue squad at night. I even began telling some of my own war stories. Many of them growing from a small sprout of truth into a tree of exaggeration. I did learn from some of the best.
My love for pre-hospital care continued to grow and I was lucky enough to be hired by a large urban service in North Carolina. Prior to beginning there I had never met someone who went to school with the intent of becoming a paramedic and nothing more. I assumed everyone volunteered during their free time and was ecstatic to be paid for something they loved. I was wrong, actually I was extremely wrong. Many of the paramedics were unhappy with their job, their life and especially their role in the health care system. My enthusiasm dwindled quickly, sadly much like my naivety. I learned that the stories that were told, out of fun I thought, were really a way to vent frustration and prop up fragile egos. My hobby, my passion, had become a job and my job quickly began to frustrate me.
I quickly experienced burn out, my attitude turned nasty and I was rude to patient's more often than I would like to admit. I formed my own opinion of what an emergency was and unfortunately no one met my criteria.
Looking back at this time in my professional life I realize just how negative I was. It was so easy to feed of off everyone else and mimic their poor attitudes. At least I now have those experiences. The gift of hind sight is priceless.
My passion has returned and I enjoy the medical field once again, thankfully. So much so that I plan to return to school and learn those things that I neglected in high school so that I can progress into a leader in medicine. How knows, I may have the opportunity to improve pre-hospital care for the sick and injured and maybe even those who take care of them.
This post has completely veered away from what I originally intended. Oh well, better luck next time.
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Wednesday, August 22
More Difficult Than I Thought
I began a series of post a short time ago with the intent of having a completed work of.. uh.. art by now. I have came to realize that the more I research pre-hospital care the more fragmented and disappointing I have found it to be. More to come...
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Sunday, August 12
Compensation
As we all know, one of the most important aspects of any job or career is compensation. On average, in the US, a paramedic makes 36,970 $ Per year according to Salary.com. Some may say that is good money and others may look at it and laugh. More than likely you will begin laughing pretty soon.
The average paramedic also works 24 hour shifts every third day. That equals out to 10 shifts per month. Before you say, "you only work 10 days a month" here me out. It's not all roses, actually there are no roses involved at all. On average that is 52 hours per week. In actuality every third week will be a 48 hour week and the rest are 72. The bread and butter in this profession is overtime, as you can see. The first forty hours are compensated at a very dismal hourly rate that is as low as 9$ per hour and only after the second shift in a week does the pay increase by one half. This makes it imperative to work every shift because any vacation time that is received completely negates the necessary overtime pay and decreases take home pay dramatically. This can quickly lead to milk and bread shortages (and maybe even beer).
Of course they are other ways that paramedics are paid. One of my favorite is something I dub Chinese Overtime. This method is based on a salary type pay scale but has some really nasty consequences. The pay is set at a yearly amount with the thought that the paramedic will work every shift without time off. If there is unscheduled overtime the base rate is divided in half and the paramedic receives comp time. This is basically a nice way of screwing people while they are asleep and unsuspecting. Overall, the more hours that are worked the less the medic makes per hour until they are no longer increasing their take home pay. The other nasty part is the fact that the comp time that is received is compensated at the base rate so you lose the overtime and are basically working 72 hours a week at the dismal base rate mentioned above.
One more pay method and I will stop. This method is used more with firefighters luckily and not paramedics but it sucks nonetheless. In short, the 24 hour shift is broken into a 16 hour block and an 8 hour block. You are paid for the 16 hours of "Awake" time but are not compensated for the 8 hours of "Sleep" time after midnight. Basically, you are asked to sleep in a foreign bed and remain ready to run an emergency call at any time with the expectation that you will be awake and in the ambulance rolling out of the station within one minute WITHOUT being compensates. Ugly, I know.
So that is how and how much a paramedic is paid. Tune in next week to see what they are paid to do.
Wikipedia's definition of paramedic: a medical professional, usually a member of the emergency medical service, who responds to medical and trauma emergencies in the pre-hospital
environment, provides emergency treatment and, when appropriate,
transports a patient to definitive care, such as a hospital, for
further assessment or follow-up care.
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Tuesday, July 31
What is a Paramedic?
I have often been asked this question in so many words. Sometimes it's "what do you do?" or "What's the difference between an EMT and a Paramedic?" or "do you just drive fast?" I have even had the occasional "hey, are you an idiot" question threw at me especially after explaining the crazy schedule an average paramedic works.
I would wager that some of you reading this can't even explain the role of a paramedic in todays healthcare system.
Lucky for you. I have decided to begin a series of post on the true nature of a paramedic. This isn't going to be a rambling journey through war stories but a true attempt to explain the profession I am currently in and also some conjecture on where I would like to see this profession progress.
I would wager that some of you reading this can't even explain the role of a paramedic in todays healthcare system.
Lucky for you. I have decided to begin a series of post on the true nature of a paramedic. This isn't going to be a rambling journey through war stories but a true attempt to explain the profession I am currently in and also some conjecture on where I would like to see this profession progress.
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Monday, July 23
Not Worth a Title
Sigh....
I find it very difficult, most if not all of the time, to control my cravings for food. I am not an obese person but I do eat things that I shouldn't. Not only is this bad for my body but it is bad for our bottom line too. It is nearly impossible to eat out for Supper, or even lunch for that matter, under ten dollars a person. This is a very bad thing when I kind of have the money but kind of don't and a craving for Mu-Shu-Vegetables or a fish sandwich take complete control over my brain. What am I supposed to do? I just can't control the urge.
I don't consider myself a weak person by no means but this is certainly my vice. I guess I will wonder through life forever afraid of my overwhelming cravings.
I find it very difficult, most if not all of the time, to control my cravings for food. I am not an obese person but I do eat things that I shouldn't. Not only is this bad for my body but it is bad for our bottom line too. It is nearly impossible to eat out for Supper, or even lunch for that matter, under ten dollars a person. This is a very bad thing when I kind of have the money but kind of don't and a craving for Mu-Shu-Vegetables or a fish sandwich take complete control over my brain. What am I supposed to do? I just can't control the urge.
I don't consider myself a weak person by no means but this is certainly my vice. I guess I will wonder through life forever afraid of my overwhelming cravings.
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Thursday, July 19
Just Fucking Stop
Got your attention?
I do not understand what motivates someone to call 911 while driving down a residential street to explain that a person "seems to be having a heat stroke" but doesn't stop and speak to that person. Is it that hard to pull over and say "Hey, what's your problem?" Are you afraid that the person will ask for help or does the simple call to 911 make you feel like a good Samaritan. Because if it does you are badly mistaken! Badly. Mind your own business or actually help. Don't be a half-ass just to stroke your ego.
On another note. The past week or so has been stressful. I have changed partners, not by choice, and we get along well enough but there is still a learning curve. My previous partner and I worked together for a year. When we were taking care of patient's most of the time we didn't have to even speak. During emergencies it is important to bring order to chaos and it's much easier when you can predict the actions of the person that you are working with. I am having a hard time predicting this guy. I know the more we work together the better it will go but this week we have been thrown to the fire.
About an hour before shift change ( I was still asleep) the tones blared and we responded to a possible DOA. We arrived and soon found out that the patient had not died long ago and we made a futile attempt at resuscitation. Unfortunately, the area we working doesn't have very effective first responders especially in the mornings. Basically, we ended up working the entire code by ourselves.
Other than that I have been putting way to many hours in at my part-time job. I am probably averaging 80 hour work weeks. This alone can be very stressful. One year left.
I do not understand what motivates someone to call 911 while driving down a residential street to explain that a person "seems to be having a heat stroke" but doesn't stop and speak to that person. Is it that hard to pull over and say "Hey, what's your problem?" Are you afraid that the person will ask for help or does the simple call to 911 make you feel like a good Samaritan. Because if it does you are badly mistaken! Badly. Mind your own business or actually help. Don't be a half-ass just to stroke your ego.
On another note. The past week or so has been stressful. I have changed partners, not by choice, and we get along well enough but there is still a learning curve. My previous partner and I worked together for a year. When we were taking care of patient's most of the time we didn't have to even speak. During emergencies it is important to bring order to chaos and it's much easier when you can predict the actions of the person that you are working with. I am having a hard time predicting this guy. I know the more we work together the better it will go but this week we have been thrown to the fire.
About an hour before shift change ( I was still asleep) the tones blared and we responded to a possible DOA. We arrived and soon found out that the patient had not died long ago and we made a futile attempt at resuscitation. Unfortunately, the area we working doesn't have very effective first responders especially in the mornings. Basically, we ended up working the entire code by ourselves.
Other than that I have been putting way to many hours in at my part-time job. I am probably averaging 80 hour work weeks. This alone can be very stressful. One year left.
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Saturday, July 7
Blogsphere Sample
Not much going on today so I thought I would amass some samples from various blogs, so here goes.
- Creating the God Complex answers some questions from his readers on his installment of Questionable Admit.
- The Girl With The Blue Stethoscope relays her thoughts on hard-core textbooks using childish cartoons in Adult textbooks + cartoons...WHY???
- Caprese Salad, just looks good. What else can I say.
- The Surgeonsblog, which happens to be one of my favorites, crawls onto a large box of soap and delves into health care reform on More Solutions, Long Post
- If you are inclined to reading blogs with a heavier clinical back bone then head on over to Scapel or Sword and check out "Emergency" Management of Elevated INR's.
- For a little airier read check out Sara in Israel. She's tackling some interesting things from the viewpoint of a helicopter and it does sound like Sometimes, its cool to be me.
- Must read: The Science Behind Beer Goggles.
- Panda Bear, MD eloquently and maybe even daintily describes the intern year in a marine's Welcome to Intern Year.
- Up for a challenge? Swing by NY EMERGENCY MEDICINE and take a shot at the VizD challenge of the week. Try this one for starters: Answer: VizD Challenge Week of 7/2/2007.
- Midwife With A Knife conjures up some OB wisdom on a regular basis. A New Approach to Call affords a sneak peek into the dreaded delivery room and beyond.
- P4P, the new buzz term. You'll just have to read it.
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Friday, July 6
Road Bike
I am buying a road bike. A Caloi to be exact. It's the model that was built for the Motorola bike team in the mid 1990's. Some of you may recognize the team probably because Lance Armstrong began his racing career with them during the time this bike was used. triathlons here I come!
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Wednesday, July 4
Little Old Lady
The computer screen shows an ekg. The phone rings and a woman answers. She sounds frail, old and intimidated. The technology she holds and wears is unfamiliar and the technician who is on the other end of the line is indifferent.
Earlier today she felt a "flutter" in her chest while riding a crowded bus and it scared her. She lives by herself and she couldn't help but wonder what she would do if this happened when she was home. She finds herself afraid much more often now since her husband of 50 years died.
She called her doctor's office and they made an appointment for her immediately. Everyone on the bus said she should go straight to he ER because they were scared for her but she wanter to see HER doctor not a stranger in an overcrowded ER.
She changed her plans and continued on the bus until she arrived at her doctor's office. As she walked into the non-assuming building she felt much calmer and she even looked forward to seeing someone she new would listen.
The receptionist seen her coming and rolled her eyes as she spoke under her breath "I don't have time for this."
As the glass door opened the lady behind the counter curtly explained that she should sign in and because she was a "call in" it would be a while before anyone could see her.
The frail lady stepped into a crowded waiting room and sat down. An obese lady sitting next to her coughs and looks uncomfortable in the small seat. A small child walks by wiping his nose on his shirt while his mother grabs him by the arm and scolds him for not "acting sick."
The needy continue to file through the door and briefly pass the sliding glass window and continue to their seat, to wait.
"Ms Big Pants" the nurse calls and the obese lady stands, coughs loudly, and slowly makes her way through another door where she expects to feel better.
"I've never waited this long before" the little lady thinks but she still is confident in the fact that her doctor will be there to comfort her and tell her she is going to be ok.
Finally, a nurse steps out and calls her name. She stands, shaky, and walks through the door into a white, quiet hall that has several generic wooden doors. The nurse stops, opens a door, and ask her to have a seat on the table. The nurse takes her blood pressure and pulse then walks out. No one has spoken.
A nurse practitioner opens the door and begins to speak. She takes a history and asks questions while she types on her laptop. Little old lady tells her story and the NP leaves the room while the lady waits for her doctor.
A technician enters the white room with a picture of a beach hanging on the wall. The tech puts one of a thousand heart monitors on the old lady and explains that she should call the number written on the front of the monitor and ask them what to do next.
He turns and shows the lady the way out. "Don't forget to stop and pay your co-pay on the way out" he instructs and opens another generic wooden door disappearing into the white.
Fifty dollars later she steps out into the street with no purpose. Luckily, it is only July 3rd and she has a few more dollars in her pocket to get her home. She takes the bus because there is no one to call.
The monitor she is wearing begins to beep and she remembered that she was supposed to call the number on the front of it and decides to as soon as she gets home.
"I wonder where my doctor was today" she thought. Disappointed and looking for someone to speak with, she begins to look forward to calling this number in hopes of speaking with someone that will explain why she couldn't see her doctor today.
The bus drops her off and she steps onto her yard and into her home.
she picks up the phone and calls the number and begins to ask the person on the other end why she didn't she HER doctor today. Before she can finish the question the technician explains that they don't work for her doctor and they don't have a clue why?
Earlier today she felt a "flutter" in her chest while riding a crowded bus and it scared her. She lives by herself and she couldn't help but wonder what she would do if this happened when she was home. She finds herself afraid much more often now since her husband of 50 years died.
She called her doctor's office and they made an appointment for her immediately. Everyone on the bus said she should go straight to he ER because they were scared for her but she wanter to see HER doctor not a stranger in an overcrowded ER.
She changed her plans and continued on the bus until she arrived at her doctor's office. As she walked into the non-assuming building she felt much calmer and she even looked forward to seeing someone she new would listen.
The receptionist seen her coming and rolled her eyes as she spoke under her breath "I don't have time for this."
As the glass door opened the lady behind the counter curtly explained that she should sign in and because she was a "call in" it would be a while before anyone could see her.
The frail lady stepped into a crowded waiting room and sat down. An obese lady sitting next to her coughs and looks uncomfortable in the small seat. A small child walks by wiping his nose on his shirt while his mother grabs him by the arm and scolds him for not "acting sick."
The needy continue to file through the door and briefly pass the sliding glass window and continue to their seat, to wait.
"Ms Big Pants" the nurse calls and the obese lady stands, coughs loudly, and slowly makes her way through another door where she expects to feel better.
"I've never waited this long before" the little lady thinks but she still is confident in the fact that her doctor will be there to comfort her and tell her she is going to be ok.
Finally, a nurse steps out and calls her name. She stands, shaky, and walks through the door into a white, quiet hall that has several generic wooden doors. The nurse stops, opens a door, and ask her to have a seat on the table. The nurse takes her blood pressure and pulse then walks out. No one has spoken.
A nurse practitioner opens the door and begins to speak. She takes a history and asks questions while she types on her laptop. Little old lady tells her story and the NP leaves the room while the lady waits for her doctor.
A technician enters the white room with a picture of a beach hanging on the wall. The tech puts one of a thousand heart monitors on the old lady and explains that she should call the number written on the front of the monitor and ask them what to do next.
He turns and shows the lady the way out. "Don't forget to stop and pay your co-pay on the way out" he instructs and opens another generic wooden door disappearing into the white.
Fifty dollars later she steps out into the street with no purpose. Luckily, it is only July 3rd and she has a few more dollars in her pocket to get her home. She takes the bus because there is no one to call.
The monitor she is wearing begins to beep and she remembered that she was supposed to call the number on the front of it and decides to as soon as she gets home.
"I wonder where my doctor was today" she thought. Disappointed and looking for someone to speak with, she begins to look forward to calling this number in hopes of speaking with someone that will explain why she couldn't see her doctor today.
The bus drops her off and she steps onto her yard and into her home.
she picks up the phone and calls the number and begins to ask the person on the other end why she didn't she HER doctor today. Before she can finish the question the technician explains that they don't work for her doctor and they don't have a clue why?
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Sunday, July 1
Rated R
What's your rating? Check out this website and rate your blog.
I got the big R and I am proud of it.
I got the big R and I am proud of it.
Mingle2 - Online Dating
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It's Not My Problem
I had the opportunity to shadow an ER physician the other day. Before shadowing him I was always impressed by his ability to quickly identify and prioritize emergencies and care for them appropriately. I even liked him personally. Don't get me wrong I still like and respect him because he is a good person as well as an excellent EM doc. However, I did see something that made me question not only his thought processes but EM in general.
"It's not really my problem, it's not an emergency."
The patient was in his mid-thirties complaining of severe groin pain that hasd smoldered over the past couple of days and peaked earlier today prompting this ED visit. Dr. Cool explained that the emergent condition, the one he could treat, was a testicular torsion, however his gut feeling told him that it was Epididymitis.
In this case, luckily for the patient, it was not a torsion. He would get an antibiotic and be on his way. In and out, that's the goal.
In the mean time Dr. C ordered some blood test and an ultrasound of the guys nuts. We wandered around and seen a couple of other patient's. Finally, after the blood test and the ultra sound returned everything was reviewed and a dx was made. It was in fact epididymitis, the testicle wasn't injured and it also had unimpeded blood flow. However, the patient's creatine was threw the roof. Dr. Cool looked back at the patient's past history and noted that the patient was not having problems urinating and never had.
He then discharged the patient without mentioning the fact that his blood test were not normal.
Is this a big deal?
I personally trust this doctor and believe that he would not do something to harm someone. What bothers me is the fact that we all know that even the best doctors can become indifferent when so much pressure is put on them to move people in and out like cattle.
From someone looking in from the outside it almost felt like Dr. Cool was ignoring something because it may increase his workload just because it may not have been an emergency.
On one hand I completely understand why this happens and the patient's health beyond a life threatening condition is their problem. However, I do think the test results should have been relayed to the patient with hopes that the patient would follow-up with their primary care provider.
"It's not really my problem, it's not an emergency."
The patient was in his mid-thirties complaining of severe groin pain that hasd smoldered over the past couple of days and peaked earlier today prompting this ED visit. Dr. Cool explained that the emergent condition, the one he could treat, was a testicular torsion, however his gut feeling told him that it was Epididymitis.
In this case, luckily for the patient, it was not a torsion. He would get an antibiotic and be on his way. In and out, that's the goal.
In the mean time Dr. C ordered some blood test and an ultrasound of the guys nuts. We wandered around and seen a couple of other patient's. Finally, after the blood test and the ultra sound returned everything was reviewed and a dx was made. It was in fact epididymitis, the testicle wasn't injured and it also had unimpeded blood flow. However, the patient's creatine was threw the roof. Dr. Cool looked back at the patient's past history and noted that the patient was not having problems urinating and never had.
He then discharged the patient without mentioning the fact that his blood test were not normal.
Is this a big deal?
I personally trust this doctor and believe that he would not do something to harm someone. What bothers me is the fact that we all know that even the best doctors can become indifferent when so much pressure is put on them to move people in and out like cattle.
From someone looking in from the outside it almost felt like Dr. Cool was ignoring something because it may increase his workload just because it may not have been an emergency.
On one hand I completely understand why this happens and the patient's health beyond a life threatening condition is their problem. However, I do think the test results should have been relayed to the patient with hopes that the patient would follow-up with their primary care provider.
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Monday, June 25
Decompression
It's nothing like an hour of running with my wife and dogs, good vegetarian food and North Carolina Cabernet to relieve stress.
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Wednesday, June 20
A White Bowl
"I seem a small table with a white bowl and I was so afraid"
My grandmother told me. I new she was talking about a recent surgery she had to endure for oral cancer but I did not have a clue what she was referring to.
She began to cry as she explained, "I heard something that sounded like a horse trotting toward me and it kept getting louder and louder but I knew if I could just get my hands into the white bowl then I would be safe."
She continued to cry as my aunt explained that during her stay in the ICU granny's "heart went bad and all of the white coats came in."
Granny was very close to death that night and suddenly I realized she was explaining to me what she experienced during that time. How fragile is life and how enduring is death when our mind continues even when our bodies have given up.
Wednesday, June 6
Death
I enjoy reading the thoughts of other bloggers, especially others in the medical field. I have been reading one this morning, Surgeons Blog,that was especially good. He has written a series of post that detail a specific surgery that I especially enjoy. He also writes about death earlier in his blog that struck a note in my mind. Although my current training in medicine is limited to a very small set of actions and treatments that are provided in an emergency, I do have the unfortunate job of witnessing death often. The perspective of a physician seems to be in tune with how I attempt to rationalize death. (In the future after I have completed further medical training I hope to return to this is to see if I was right.) I do feel when my patient's die that I somehow failed them especially when a certain set of skills are "supposed" to make a difference when executed correctly and they do not. It is very difficult, nearly impossible, to not blame oneself in these instances. Unfortunately, the very high turnover or "burnout" rate that is seen in the prehospital health profession can be attributed to the guilt felt when a patient's outcome isn't satisfactory. I can't help but think that a physician must feel the same guilt because death is certainly universal.
As for me, each person that I come in contact with in life is unique whether it is a patient or their family member. In the unfortunate situations I sometimes find myself, I always attempt to explain to the patient and the family as clearly as possible what I believe is happening and the possibilities that can occur. Although I don't always have the luxury of time, as my profession hinges on crisis and not prevention. It would be much more difficult for me to get to know a person and watch them deteriorate slowly over a coarse of care that I had planned. Certainly that will be a tremendous change for me in the future. But for now, I must be content in the fact that life, as a great circle, must be completed by death and sometimes there is no cure or quick treatment. I can only become the best at the small set of skills that I am afforded and make sure that when the call comes I can perform as the patient deserves, flawlessly.
As for me, each person that I come in contact with in life is unique whether it is a patient or their family member. In the unfortunate situations I sometimes find myself, I always attempt to explain to the patient and the family as clearly as possible what I believe is happening and the possibilities that can occur. Although I don't always have the luxury of time, as my profession hinges on crisis and not prevention. It would be much more difficult for me to get to know a person and watch them deteriorate slowly over a coarse of care that I had planned. Certainly that will be a tremendous change for me in the future. But for now, I must be content in the fact that life, as a great circle, must be completed by death and sometimes there is no cure or quick treatment. I can only become the best at the small set of skills that I am afforded and make sure that when the call comes I can perform as the patient deserves, flawlessly.
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Tuesday, June 5
Complaints
I am not sure what to write this morning. A couple of interesting things have happened in my life over the past few days. Nothing spectacular just the same old same old really.
I had a complaint filled against me. That's generally an awesome thing to learn about. The other morning I had a whining rich teenager who was riding in a large SUV and crashed into a rock pole. It was a very minor accident and he was one of three people in the vehicle and the ONLY person complaining of neck pain. So, we took all of the necessary precautions; putting a C-collar on him and placing a long spine board to his back and taking him down from a standing position without moving his neck or back. It was just a taxi to the hospital after that.
This scenario happens all of the time. More likely than not when we arrive at the hospital the patient is sent to triage after their C-spine is cleared to wait there turn. But, at 0300 in the morning there obviously was nothing to do in the ed. When we arrived their were several nurses and doctors waiting in their main trauma room. We wheeled our patient in the room and placed him on their cot. I begin telling the story, or giving a report, and the doctor began speaking over me. At that point I gained a signature from one of the nurses and left the room. Yes, I could have stayed and gave a more detailed report after the doctor cut me off but I didn't. I felt that a brief explanation of the incident would suffice because it was very minor.
The next day as I am sitting at my second job when my phone rings. It's the assistant director of the ambulance service. He called me, on my day off, to explain that the doctor contacted him and was upset because I did not give an adequate report.
Looking back I try to take my ego out of the equation because it has no place in patient care. I probably should have stopped and explained over and over again that the accident was minor and the only complaint the patient had was neck pain. No obvious trauma was noted and he was mainly afraid that his mother was going to ground him forever. The neck pain was probably an attempt at sympathy on the patient's part anyway.
I just can't believe something so trivial went as far as it did. I also can't help to think that if this patient was a minority and not from an influential family that he would have been immediately dismissed and the staff would have cared less what I said or did prior to bringing him to the hospital.
What a crock of shit.
By the way the patient was discharged with no injuries.
I had a complaint filled against me. That's generally an awesome thing to learn about. The other morning I had a whining rich teenager who was riding in a large SUV and crashed into a rock pole. It was a very minor accident and he was one of three people in the vehicle and the ONLY person complaining of neck pain. So, we took all of the necessary precautions; putting a C-collar on him and placing a long spine board to his back and taking him down from a standing position without moving his neck or back. It was just a taxi to the hospital after that.
This scenario happens all of the time. More likely than not when we arrive at the hospital the patient is sent to triage after their C-spine is cleared to wait there turn. But, at 0300 in the morning there obviously was nothing to do in the ed. When we arrived their were several nurses and doctors waiting in their main trauma room. We wheeled our patient in the room and placed him on their cot. I begin telling the story, or giving a report, and the doctor began speaking over me. At that point I gained a signature from one of the nurses and left the room. Yes, I could have stayed and gave a more detailed report after the doctor cut me off but I didn't. I felt that a brief explanation of the incident would suffice because it was very minor.
The next day as I am sitting at my second job when my phone rings. It's the assistant director of the ambulance service. He called me, on my day off, to explain that the doctor contacted him and was upset because I did not give an adequate report.
Looking back I try to take my ego out of the equation because it has no place in patient care. I probably should have stopped and explained over and over again that the accident was minor and the only complaint the patient had was neck pain. No obvious trauma was noted and he was mainly afraid that his mother was going to ground him forever. The neck pain was probably an attempt at sympathy on the patient's part anyway.
I just can't believe something so trivial went as far as it did. I also can't help to think that if this patient was a minority and not from an influential family that he would have been immediately dismissed and the staff would have cared less what I said or did prior to bringing him to the hospital.
What a crock of shit.
By the way the patient was discharged with no injuries.
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