Standby for Tones

Standby for Tones

Featured Writings by

Crystal Wallin, NREMT-P, CCEMT-P, FTO

La Crosse, Wisconsin

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  • Wednesday, July 19, 2017 7:36 AM | PAAW Administrator (Administrator)
    It’s hot, and she’s not dressed for it. Sweatshirt and sweatpants, tee shirt and socks with laced up tennies. She’s currently sitting in the rear of a squad car, guzzling on a bottle of Sprite that is sweating only slightly less than she is.

    Passersby found her, she was down on the ground and it was pretty clear she’d fallen. Someone helped her up, but then she fell again. So they called it in, the nice officer who responded scoped out the clothing situation and her speech, and activated EMS non-emergent. Now we’re here, and I lead my student across the street from our parking spot towards the black and white. My partner updates MedComm that we are on location, and brings up the rear. On this initial evaluation we’ve got the cardiac monitor. The bag is feet away should we need anything.

    The lady was assisted out of her sweatshirt by the officer prior to our arrival. Pink and white camouflage, it’s more at home in a rural environment than here in the city but I guess you never know where people hail from originally. Little bits of home from all over converge in any metropolis, and you get what you get. The only constant is that the kaleidoscope keeps moving, the bits and pieces keep on tumbling.

    Her speech is softly rounded, not in the drawl of the southlands but in a gently slurred sort of way. Her facial features are a little slack, and in the first few minutes while my student assesses her, I wonder if she has some cognitive delays. Soon we have the first vitals, she’s hypotensive and my partner brings the cot right to her side. She’s still seated mostly on that rear seat with the door open, one leg in, and one leg out. Her cane is leopard print, and I grin at her style. Pink camo and leopard print – lady’s got flair.

    Securely fastened to the cot, we wheel her to our truck and the automated system whirs her into the air conditioned truck. The doors kathunk shut behind us and we survey the situation. Then she says, in that soft speech, “I believe it’s a low volume issue, I’m dehydrated and forgot my cooling shirt at home.” I cock my head and evaluate her again. She tells me she has MS.

    She tells me she used to be a nurse. Before the disease progressed.

    The remainder of our contact is wonderful. She encourages my student thru the IV start, she matter of factly discusses her evening schedule of HCTZ and why it is taken then, the need to schedule it so far apart from her diuretics. She’s a smart lady. The day didn’t seem that hot when she set out to walk for a snack. She became over heated. My student informs me after we’re in station, later, that increased body temperature in an MS patient decreases the ability of the non-myelanated sheaths to conduct impulses. So with no one to help her out of the sweatshirt, and the increasing heat making her co ordination worse, she was on a downhill sled with no trees in sight.

    We take good care of her, and after my student gives report at the receiving facility, we shake her hand and inform the young nurse taking care from us that this patient is a nurse. The patient softly corrects me, “WAS a nurse.” I think of how she welcomed my student, walked her through a failed IV and told her that learning takes time. I think of her gentle patience on scene, her grace in the face of adversity of a cruel disease.

    I bend down, and softly say, “you taught me as much today as my nursing instructors. You are once a nurse, always a nurse. Thank you for today’s teachable moment.”

    She didn’t say much, but her eyes shined a little brighter as a smile spread across her face. I walked down the hall and thought to myself, teachable moments, indeed.

  • Wednesday, May 24, 2017 8:07 AM | PAAW Administrator (Administrator)
    I’m 27, and I have no idea how profoundly this class will affect me. The ways in which it morphs who I am into a better version of myself. The people I will be honored to care for, the things I will witness. The ways those things I witness will impact me for months and years to come. I have no inkling that my appreciation for life itself will grow, deepen and become a nearly measurable entity.

    I simply know that I am taking a class, an EMT-Basic class. It meets two evenings a week, from 6-10pm in a town roughly half an hour away from the bank at which I then worked. A nice customer from the bank also is taking the class, and we carpool. His wife is funny and kind and I look forward to those visits at their house before we hit the road, off to class. One day we get to town a little earlier than usual, and we swing by a used car lot just to kill some time. Before you can say SAMPLE, I’m the owner of a lipstick red Camaro just a few days later. In my young mind I think it’s funny to pay extra for a license plate that reads CTCH ME.

    We graduate, I continue banking. But something has changed. As the pager I’m given goes off, my heart rate accelerates in a sympathetic nervous system response, and now that I mention it, I’m not certain it’s ever quite gone back to normal. The more I see, the more I am frustrated by the limited ways in which I can help. I want to learn more, I want to help more. It’s not enough, the need is too great and so soon I leave the bank. I’m working now for an interfacility ambulance company. A few years pass and I’m working in a small town ER – and dispatching for an air medical service and the largest ground transport service in our area. I’m meeting paramedics, and the more of their air I breathe, I know – I simply must learn what they know.

    I’m back in school, I’m now non-traditionally old. I find it amusing then but I will find it even more amusing later. I learn more procedures, more skills, more drugs, and I drink in the knowledge like water. I can do more, I’m in heaven.

    The years go by and the calls accumulate. Back in the volunteer EMT days, I once asked an experienced first responder who was a nurse, “When do your hands stop shaking?” She smiled and said, “In time.” I volunteer no more, I work 24, 36, sometimes a rare 48 hour shift. I sometimes struggle with exhaustion of the empathetic kind, and that’s when I know that the overtime needs to rest. But those mornings when you hold the hand of a spouse after pronouncing time of death, or those midnight kitchens when the patient’s lungs are struggling to move air across the alveolar membrane in spite of the obstructive fluid impeding the process – that’s when I’m more alive than I can describe to anyone who’s never dropped everything when the tones go off.

    Then I’m 40 and I’m in nursing school. Now, boys and girls, I am decidedly non-traditional. Now I’m an older student, because after all that’s what non-traditional is kindly saying, all along. The calls and the years and the patients never stop coming. That old country song by one of the highwaymen has a line in it that reads, “the road goes on forever and the party never ends.” I’m used to this lifestyle and yet it’s wearing on me. I’m giving a talk one day to a group of paramedics and afterward, one comes up to me.

    “You really love this job” he says, “don’t you?” Without hesitation I answer, “of course.” He asks me then, how can I be leaving it? I think about it then, and for the first time I verbalize what I guess I’d been rolling around in my mind the whole time in my nursing classes. Rolling it around like you roll a hard candy in between your teeth and your cheek. Sometimes you hold it there until it makes the skin of your cheek get all funny feeling from the concentration of the sugar.

    “I’m not leaving” is what I say. “It’s who I am.” And I mean every word of it. As long as my body can respond from a dead sleep to wheels turning in under that two minute mark, as long as I can lift and pivot and hustle a cardiac monitor and backpack up three flights of stairs to an overdose at the end of a hallway, I know I can’t give away the radio. The pager is gone, now. Replaced by a nice Kenwood and a Boston strap. But the tones still activate the sympathetic response, and the drive to help, to revel in the autonomy of the street at 2am, the back roads lighting up with the red and white lights, the way the dispatch information activates the training and the street knowledge and my mind begins to run down algorithms and dosages on the way to the scene…no other profession can meet the speed at which this paramedic’s heart rate has come to love. There’s no other drug quite like the rush of a hand squeeze from an elderly patient whose breathing you’ve eased, or the never-fail feel good call of a diabetic wakeup when the family sighs with relief.

    I walked out in the garage the other day. The weather has finally warmed, and I opened both garage doors to let the sun shine in and the fresh air swirl around the stale dust. The sunlight gleamed off that lipstick red Camaro parked crosswise in the rear of the garage, back behind the everyday cars. Her license plate is current, paid and valid. It still reads CTCH ME. I think of EMS like that. Lipstick red. Always another road, RPMs just begging to be elevated like a heartrate.

    We are here for our patients, our communities, those we know and those we’ve never met. We’re on our way when help is needed. Always – in service. Because it’s who we are, it’s more than a profession. It’s a choice, a lifestyle, a calling, a gratification, an honor and a joy.

    Happy EMS Week 2017.

  • Wednesday, May 17, 2017 8:03 AM | PAAW Administrator (Administrator)
    The children outside are curious, playing but in a sense of studied nonchalance. Not that any of them look old enough to know the nuance of the word, but innate in them as in all of us lays the gist of the word’s implication

    The fire apparatus is already curbside ahead of us, lights silently announcing to anyone watching that activity is happening within this building, this day. My partner takes the cardiac monitor from me and I keep the jump bag over my right shoulder. Dropping their pretense of play, the children fall still, openly checking out our accoutrements. One brave boy calls out, “hey, whatcha got there? What’s that big bag for?” My partner returns, “helping people”. Simplified, yet valid.

    Inside, a middle aged man with an air of importance around him meets us, gives us a short layman’s report.  It is remarkably succinct, and with nearly all necessary components I could’ve asked for if making a list. We continue on in the direction indicated, where ahead a small group of people can be seen gathered in the cafeteria. It’s after hours, at this school, and yet the gathering is modest. I see fire ahead, and a slight woman with grey hair barely visible in the middle of the navy shirts, suspenders attached to turnout pants, and male muscles.

    I greet the lieutenant by name and make my way around the far end of the cafeteria tables arranged in neat rows. The patient has the gathering of firemen around her as well as a couple elderly ladies and amidst all of these, a few more assorted small humans, watching with grave interest. The lieutenant was a new fireman when I was a new medic and he gives report after greeting me by name.

    “Patient was getting up, caught her sneaker” <I remember thinking, “Jimmy said sneaker, who says sneaker? Have to tease him later on at some point”>  “on the bench and fell, hitting her head. She did lose consciousness. Her blood pressure is low; she was very pale when we got here. Her heart rate is very slow, blood sugar is 92.”

    The patient is discussing her last meal, her certainty that she is just fine, and I make my way over to her side. Seating myself on the bench of the cafeteria table so that we are near one another, I introduce myself. I speak quieter than is necessary, in this big echoing space full of people and conversations. She quiets, to hear me. Excellent. I need her to divert her attention now to the things I must know, some of them repeats of what fire have told me. This helps me to ascertain that she is remembering and maintaining not only the events about which I will ask, but that she continues to give the same version of events. I’m ruling out not only an obvious injury with this method, but also considering the all too often seen brushing under rugs of significant events by patients who fear a loss of independence. My concern in the here and now is her welfare and immediate medical issues. Independence and living arrangements, while not likely to be impacted by this event, are always concerns on the far horizon, handled by other professionals. We am mindful always, however, as this fear in the mind of a patient can result in a skewed version of events as relayed to us on scene.

    She is clear on her events, clear in her gaze, and calm in her recitation of events just as the lieutenant described to me. While I ask and listen, I place cardiac monitor on her and am greeted by a sedate normal sinus rhythm out for a Sunday drive at the slow pace of 52. She’s still hypotensive, but not as markedly as fire’s initial vitals. We go over past medical history (not much to speak of, hypertension for which she is compliant with her medication regimen), and the regular familiar rolling questionnaire of intake, output, new medication changes recently, dizzy or weak before the fall, syncope of falls within the last few months, symptoms now, any pain, day, year, president and so on. She denies anything of note during all of this, her answers accurate and remaining oriented.

    A few minutes later we have her on the cot, I’m handing for her purse near her when she asks me for her Bible. I spy it on the table, zipped neatly in the black leather case that is exactly like the ones in which my dad and mama always kept their Bibles. I pick it up, and the reassuring familiar heft of it is like an old friend. I grin at the familiar comfort of a memory as old as my childhood here in this moment, and ask her if they were having Bible study here. She shakes her head and with a smile, tells me as we walk to the truck about the program they have with the children here, points awarded for verses memorized. The children watch solemnly as we walk out, the man who I’m now almost certain is a pastor finalizes disposition of the patient’s car, and soon we are at the back of my truck. Opening the doors is a senior fireman who I haven’t seen in a while, and I feel the glad smile on my face. He says, “how ya doing, Crystal? Up here on the north side, tonight!” and we chat briefly while my partner loads the patient with the new power load cot. Then the back doors shut, I climb in the side door and it’s us ladies, in the back. I reattach the cables and begin another blood pressure.

    She sighs, then, smiles and says to me, “all of this….” Her voice trails off. I nod and respectfully offer that we do need to think of the implications of things like a loss of consciousness after hitting a head, especially as we think of ages when our bodies don’t handle injuries as they once did. Cervical spine was cleared on scene, she has no obvious outward injuries and we pull away from the curb after she politely declines an IV. En route to the hospital, she checks in on a lady who she has taken in, tells me earnestly of her story. She elaborates on the program with the children, and when I enter the demographic data into my patient care report, I double check the date of birth in surprise. She assures me that I am correct, and with a twinkle in her eye tells me she works out.  In fact, she prefers weight training the most. I cock an eyebrow and tell her perhaps the heart rate in the mid- 50s isn’t quite as out of the norm in her case.

    Report given, signature obtained, we walk into the bright lights of the emergency room, wheeling the cot. Two care techs I’ve never seen help us transfer the patient, and a nurse I’ve never met takes report. I walk down the hall a few minutes later, thinking of ladies who lift weights at twice my 40 years, and the equally preservative nature of small humans, taken once weekly, q Wednesday night. Repeat as needed for a life of service and happiness.

    And wear sneakers, no matter the age.

  • Monday, March 27, 2017 9:57 AM | PAAW Administrator (Administrator)
    They only moved here a month ago, she says. It’s quite dark outside and you can’t tell it’s foggy unless you catch a glimpse of the misty haze in the glow of the passing small town streetlights. From another part of the state, they loved the topography of the bluffs that line the mighty Mississippi in our driftless region. The coulees stretch fingers up among the gentle swells of the bluffs, and in the warmer months the surface of the water is glassy and rippling, in turns. They knew exactly where they wanted to move when they retired, and just under a month ago they made my region of Wisconsin their permanent home. When she speaks of the views she enjoys from their new home, her face lights up and she beams. The joy is incongruous in its juxtaposition next to the ecchymosis evident on her eyelid and surrounding tissues which occlude her vision on one side.

    The Badgers played awhile back and lost the game to the Gators in the last 4 seconds. She and her hubby haven’t really met anyone here yet, so they enjoyed a couple beers at home. Unused to the unfamiliar home, she stumbled in the dusk afterward and lost her footing. A retired healthcare provider, she chalked up her subsequent pain and stiffness as just a result of tumbling down some stairs. Time went by, the sun rose, she began to admit that it was more than pain and stiffness. Listening to her history of the events, I’m struck by her strength. The paperwork accompanying her lists a fracture as well as an anteriorly displaced shoulder dislocation – in the same upper extremity as the ecchymosis. A reduction attempted was unsuccessful due to some myoclonus and trismus evidenced after administration of etomidate. I’m currently transporting her to a larger facility for further care.

    As so often happens in the back of my ambulance, the paperwork is forgotten and the patient care report is neglected as a human connection is formed. I read each patient and if they wish to close their eyes and rest during an interfacility transport, I respect that. On those transports, my report is 90% complete before we arrive at our receiving facility. Some patients are nervous about the reason behind the need for transferring to the larger facilities, some are really sick and I’m busy with managing their medical presentations throughout the transport. But some, like this wonderful lady on this drizzly foggy night, are just warm and naturally want to connect with their care provider.

    She tells me a little bit about her life, that’s how I learn of the retirement. She is no stranger to the environment of medicine, and she uses “our” language. We frankly discuss the trismus, we both evaluate her hypotension and work to find a semi-comfortable position for the upper extremity that’s now so painful. She rates her pain an honest high score, but says she can handle it. She doesn’t like her hypotension and neither do I. We discuss the hypotension as perhaps transient and lingering due to the medications she was given prior to the expected shoulder reduction: Fentanyl, 4 doses of 50mcgs each, Etomidate, Ketamine. She states Ketamine helped her pain not at all. Ketamine would be my medication of choice right now, I tell her, due to its analgesia without systemic effects to blood pressure etc. She nods and says she agrees but in the ER it did nothing. We discuss pressors, discuss the possible surgery ahead, the rebound hypertension when all the ER meds wear off. She states frankly that she has no symptoms, and I can measure none objectively either – other than her blood pressure. I give her a 500cc fluid bolus and the systolic comes up where I’d like it. She grins and says it’s probably the bumps in the road more than the bolus. We tried to position her with head down and feet elevated during the bolus but that is too painful with the still dislocated shoulder. She is grateful it’s displaced anteriorly rather than posteriorly – we both shake our heads at the rough ride of the ambulance with a shoulder displaced to the posterior. It is certainly easier to protect a shoulder displaced anterior, in this environment.

    The ride through the wet velvet black night rolls on. She begins to tell me of her love of sewing, how this is going to put a damper in the wedding gown she’s making for her daughter. I tell her my mother-in-law loves to sew, too. I tell her of the large quilting machine that sews designs onto quilts and my patient knows the name of it right off the top of her head.

    My patient tells me she went back to school when she was in her late 30s. I tell her I’m currently in nursing school and just turned 40. She is encouraging about changing life directions no matter your age. We discuss education for a while, noting the similarities in our choices. She tells me then about her childhood some. Her mother taught her German, despite her grandfather’s wishes that his grandchildren never know German. I cock my head and she explains. Her grandparents emigrated here in the late 1920s. They never spoke German in public because of the negative opinions held by many at the time regarding Germans. She tells me her uncle married a Jewish girl, who ultimately did not survive the concentration camps. He, wracked with grief, stepped in front of a train. The family was afraid to appear too German here in America, even to the point of abandoning their native language. The isolation and loss of culture, coupled with a new country and personal grief must’ve been profound. This personal account of the horrors most of us have only been exposed to through a history book or class is striking. I listen with respect as she tells family tales, the ambulance parting the fog on the road like a knife in the darkness.

    We approach our destination. The monitor takes another blood pressure and we watch for the results. Better. I take the mic off the hook and give report. Arriving, we make our way to the team waiting to take over her care from here. I shake the wrong hand, her good hand, and thank her for her encouragement and sharing her life with me, the lessons she’s had along the way. She smiles that smile with the one eye out of sight under the truly impressive ecchymosis – and tells me it was good to find a friend in this new part of the state she’s made her home.

    My partner is new but quick, and he’s gone by now with our cot, off to strip it and remake the linens. I walk down the familiar hall with my boots the only sound echoing. The lights shine off the floor and I’m reminded for the hundredth time how no matter the day, the weather, the circumstances – the human connection is surprisingly often unimpeded by situation. People in the most dire straits, or with pain levels that have to be significant, are calmed by being heard, knowing they matter. A thank you from a patient sustains and uplifts us through an entire shift.

    Perhaps the walls we tend to put up to do the job aren’t helpful at all. Perhaps the walls we put up only serve to isolate us from the human connection we were born to have. No man is an island, isn’t that what John Donne said? (although, as a child I heard the adults say that once and wondered for days after why there was no mayonnaise in Ireland.)

    The trust our patients put in us, the hours we give up to be there for them – those are no small things. I’ve said it before and it still holds true for me – the front row seat to the human experience never grows old.

    “Sometimes our light goes out, but is blown again into instant flame by an encounter with another human being.” – Albert Schweitzer

  • Saturday, February 25, 2017 1:39 PM | PAAW Administrator (Administrator)
    He’s seen a few presidents, and he’s known a few good decades. Right now, he’s hanging out with me, because his head laceration is impressive. Fire did a great job of bandaging the wound up, but no one’s addressed the puddle of blood just yet. His speech is slurred, refined but slurred. I’m making his acquaintance as I put on my three lead, take my first blood pressure, scope out the oxygen saturation level. Everything checks out within normal parameters, so I press on. No odor of alcohol, blood sugar also within what I’d like to see. He cocks his head, then, looks at me.

    “I sound funny.”

    “Funny ha, ha?” I ask lightly, carefully watching him. 

    “My words – like I’ve been drinking. I haven’t been.”

    There it is, then. Altered from his baseline – and he knows it. Assessment continues, he denies loss of consciousness, denies any neck pain, CMS is intact, on down the line. Cervical collar in place, we assist him to a standing position and with the cot positioned behind, guide him to be seated. Securing him with straps, wheeling him to the truck, loading him within. Once inside, transport begins as secondary assessment shows no new findings. Eyes equal, round and reactive to light – I go on down the familiar road of assessment. I keep up a light banter about the weather, the circumstances surrounding the purpose of my arrival at his home today. I circle back around some details so he ends up re-answering questions he’s already answered. His answers remain on point, consistent.

    Radio report complete, we walk inside wheeling the cot and I give report at bedside; turn over care. We remake the cot, get the face sheet, scan it in the system, mop the floor where the cot wheels left their salty tracks, return to service. Rolling out the opening garage doors into the bright sunlight, I blink and reach for my sunglasses. My partner is telling a story of a shift a few days ago, and as the cab fills with our laughter, I tell myself I’ll follow up on this slurred speech head laceration gentleman.

    When I return later, no one from that shift is still on. No one can tell me the outcome. The patient isn’t in the room anymore.

    I walk down the hall and the sense of sand shifting beneath my feet is so incongruous in Wisconsin winter.

    *~*~*~*~*~*~*~*~*~*~*

    We’re heating up our leftovers from home and the station is filling with good smells. Well, you know what happens then, so often as it does now. Overhead, “bleedle bleedle bleedle, 302 you have a call at blah blah blah, female ate some fish, now feeling gaggy.”

    I look at him, he looks at me and I imagine my face looks much like his.

    “Gaggy?”

    Food back in containers hastily, containers in fridge. Grab a water bottle in case I don’t see the station again for a few hours, throw the radio strap over my left shoulder and hook it on my right rear belt loop. I climb in, hit the garage door and hold my key fob up to the ignition until it beeps so the on board system knows who’s driving. Door goes up and we wheel right, then right again.

    “MedComm, 302 updated, en route.”

    “302, blah blah blah address, female ate some fish earlier, now feeling gaggy. This will be a non-emergent response, room X”  

    The address, once a motel now month by month rental residence, one room and bathroom equaling one tenant’s allotted space. We arrive just behind fire. The patient is ambulatory outside as my partner puts the truck in park. Fire is making contact, clipboard in hand – but she’s headed straight for the side door of the truck. My partner has care on this call, I’m just the driver. He directs her to the captain’s seat and assists her with the seatbelt. I determine receiving facility from fire, chit chat with them a few minutes and then we’re on our way down the street. In back, the conversation:

    “So what’s going on tonight, what made you call 911?”

    “My neighbor, he made some fish, I had some. Now I’m feeling so….gaggy.”

    “Did you throw up, then? Diarrhea?” 

    “No. Just feel a little gaggy, like maybe I could puke if I smelled it again.”

    My partner falls silent then. I put on my blinker, turn, continue down the familiar dog track route to one of the two receiving facilities in the city. In back, he attempts again.

    “So, do you have a medical history of any problems associated with GI issues? Problems I should know about so I can tell the doctor? What made this necessitate an ambulance tonight, ma’am?”

    “No medical problems, I just can’t afford a taxi and I wanted something to stop feeling gaggy.”

    Silence ensues. We arrive, I park, the three of us walk in together. I break off before the entrance doors to the Emergency Room itself, find the ladie’s restroom. Washing my hands, staring in the mirror. Trying not to think about the status red I heard while we were getting out of the truck as she met us outside her residence. The call holding because there were no trucks to send. That caller needing help, then the call pending, waiting for a truck to clear.

    I hope they’re ok. I hope a truck was able to get to them in time.

    ~*~*~*~*~*~*~*~*~*~*~*

    We’re sitting at the posting parking lot, and we’ve got the giggles. Somehow it came up that neither of us are much good without a map, or a GPS, even after all this time. He’s been a medic somewhere around the two-decade mark. Me, seven years – but I dispatched this service in this town for six years before that. But once he lost his partner inside a house while he circled the block in their truck as the partner gave him directions, and once my partner and I loaded and transported our patient in another crew’s truck without noticing for a solid ten minutes. We have snacks, though, so we decide if we get hopelessly lost, at least we won’t starve.  We spoof off this until we have tears from laughing so hard.

    It’s the middle of the night, we’re 18 hours into our 24-hour shift. We’re the only truck left in the city, and whatever happens next for a range of maybe 40 miles – it’s mine. I’m up for care. My legs want out of the cab, but I’m not willing to brave the cold to oblige them with a walk outside. An occasional car passes on its way to the interstate on-ramp half a mile to our north, the only movement except for a forgotten Cheetos bag mournfully bopping thru the snirt as the puny wind half-heartedly backhands it. I ate clean all week, but in my guilty hands I hold without apology one chocolate milk, and one cheese filled Danish.

    Today lies in the dust behind us. I’ve already forgotten the name of the man with slurred speech. I can still smell the urine wiped off the captain’s chair from the gaggy lady, though. A hundred more just like them, and nothing like them, I’ve met, treated, cut the cord of one, called time of death on a number I don’t care to retain.

    Autonomy. Empathy. Tact. Tongues bitten in half and an ear to listen, a partner to laugh with at two o’clock in the morning and gas station food, lest we get too lofty an opinion of ourselves.

    These are drops in the ocean of paramedicine. This job that weaves itself into you until you can’t remember who you were, before. We witness and echoes linger sometimes for an hour, sometimes for years.

    I am the sum of my experiences – and theirs. I am 911.

  • Monday, January 09, 2017 7:51 AM | PAAW Administrator (Administrator)
    The address was straightforward enough – until we got in the neighborhood. The streets curved around and the numerics visible all were for the cross street. We had been told the patient would meet us in the parking lot, then updated information from MedComm was that he was advised to wait in his apartment. Inquiring for an apartment number, we were told the dispatcher would call back to find out. Updated information? The subject was indeed waiting in the parking lot; we were to go to the rear of the building. Finding the alley, we rolled slowly along, our right flood lights illuminating the successive row of apartment buildings. The problem with this method was that the rear of apartment buildings – including these – often does not have numerics displayed. We’d rolled along behind half a dozen when the radio came to life again. “301, caller is on the line again, advises you to come out of alley, take a left and you will see him outside.” We acknowledge, follow directions and emerge from the alley to find a front light across the street furiously winking on, off, on and off again. I flick our floods on and off in acknowledgement but the furious winking does not subside. Driving up alongside the curb directly in front of the door where the light lives does not make it stop, either. Directly beneath the light, cast by turns into stark relief and pitch blackness in paroxysms of the continuing on, off – is our caller. I roll my window down and he barks with extreme agitation, “I said to tell ya, go around back! AROUND BACK!” “Yes, sir, we…..” “GO AROUND BACK!” “yes, sir.”

    We go around back, the light collapses in relief I’m sure, as the door closes and darkness falls, for good. Blinking amid the stars dancing in front of my eyes as my partner navigates Around Back, I see a cramped stretch where the woods have been beaten back into grudging submission.  In this stretch are numerous vehicles and a dumpster taking up more than its rightful share of space. As we advance cautiously, I see a man hanging back in the shadows against the building. He withdraws further from our headlight beams. He is not the patient, and of this I am certain as a furiously walking man approaches directly towards our front bumper. He is pushing a walker almost as an affront to the air ahead of him. He appears to not need its assistance; rather, it seems an unwilling participant in a charge of righteous indignation. Almost as an avoidance of a certain collision, my partner puts the truck in park. I open my door, place the first boot on my running board.

    “YOU SHOULDN’T HAVE PARKED HERE! ICE!” My partner opens her mouth to ask “where-“ he cuts her off “IT’S FINE, LET’S GET GOING!” I tip my head, put a carefully submissive smile on and put myself in the path of the walker. “Sir, my name is-“ he stops me, “JUST GET ME TO THE HOSPITAL”. I open the side door and he collapses the walker, tosses it inside, and is seated on the captain’s chair before I can say a word. Our nature of the call at time of dispatch was “can’t change dressings, sores on legs” so I am not as alarmed as I would’ve been if someone with an unknown problem was so desperate to begin transport. For a moment I think of the man drawing back into the shadows, of the dumpster partially obstructing egress, of the dark strip of woods immediately behind this strip of apartments who’ve seen better days. But I don’t think the patient appears afraid, and I climb inside behind him.

    My partner hands me the monitor and I try again. “Sir, my name is Crystal-“ and again I am cut off. He reiterates “LET’S GO” so glancing at my partner and her raised eyebrows, I nod. Maybe I’ll have better luck establishing rapport and getting some information once the truck is in motion. She navigates her way out and I begin to apologize for the slight delay with the address. Mollified now that we are moving, the patient waves aside my apology. Apparently this is not his first transport by our service, as he tells me this happens every time.  “Screwed up address. What’s that? I don’t need any of that crap. Just need a ride.” I’m holding the blood pressure cuff and I explain that I do need to ask him a few questions and take some vitals. He isn’t loving it, but he sticks an arm in my direction. His eyes are rolling hard enough to scrape the back of his skull but they return to me quickly as I say, putting the cuff on “I’m really sorry you’re having such a bad night, sir. I’m Crystal, not sure if you caught my name, but I’d sure like to hear how I can try to help. What’s been going on?”

    His face softens a smidge and his shoulders sag forward. The hand on the arm I’m taking the blood pressure on is bandaged, seeping yellow – spots dried in concentric circles and new ones visibly damp. The fingers remind me of when I was in elementary school and we would put our fingers in Elmer’s glue, then peel it off when it dried. He tells me in a softer voice that he’s been battling cellulitis on his legs, and he is supposed to change his dressings every three days. Today is day four, and his hands are getting worse. He shows me the other hand, painfully red and swollen to what appears to be maybe twice it’s normal size, judging by the wrist and arm above it. He tells me in this soft voice – still with his brusque, staccato cadence – that both hands have been like that but yesterday the one got “real bad”. He looks at it and then I see it on his face, under the gruff exterior – fear.

    “I just can’t even change my leg dressings now, sorry I was such a – well, you know. My right leg is just raw meat, I stink, and it stinks, now my hand-“his voice catches. I shake my head in sympathy but careful not to offend him with any pity. I reach out and hold his hand in my gloved ones. He needs some empathy more than anything I can find in this state of the art truck, so I give him that. I inspect the hand, tell him it looks painful. Ask him how he’s been dealing with the pain. He earnestly describes the non-stop burning, his dwindling independence and his fear that the other hand is soon to follow. His blood pressure taken, I sit back in my seat, computer ignored, and give him a human who will listen.

    He tells me he was a HazMat trained first responder at a local business, tells me with pride that he loved learning how to help others. There’s a pause, then, and he looks down at his old boots. In an even quieter voice, he tells me how he couldn’t help his brother though. Hanging out with his brother one night, the brother told him he was not feeling good. Couldn’t catch his breath just right. My patient advised his brother they should go to “the doc”, get it checked out. His brother said if he wasn’t feeling better by morning, he would go. My patient got up every two hours throughout the night. His brother seemed ok, not great but ok. When my patient went in at 7am to see if he was ready to go, his brother was cold – gone.

    My patient takes a minute, then. Purses his lips. Nods to himself. Looks up at me. “Of all the people I shoulda helped….ya know?” Somewhere I register in surprise that this patient understands something few people do. I get it – it’s that wish, no matter how many strangers you help, that you could’ve helped a family member. If only you could go back in time. I buried a father at 14 and a brother at 21 but I don’t say any of that. I simply nod, and he nods, watching me. “Yeah, you do know, dontcha?” He says that his brother’s autopsy showed a pulmonary embolism.

    After an appropriate amount of respectful time, I turn the conversation to more stable ground. We both love to watch Game of Thrones, it turns out and the remainder of our time is spent laughing about TV shows and actors. Who’d have guessed it? My patient is conversant in Hollywood gossip!

    Report given to receiving facility via radio, upon arrival my patient straightens his spine, follows me out the side door. Briskly he pops open the walker and sets off at a furious pace past the nurse meeting us in the garage. The patient told me en route that he brought his own bandages and indicated his trusty walker. He just needed a wound nurse, he said – and he is clearly out to find one. The charge nurse directs him to the triage room, I obtain a signature and bid him farewell. His mask firmly in place again, he nods curtly and says as I leave, “thank ya, lady.”

    Waiting for my face sheet at the registration lady’s desk, I’m half listening to her cheerful voice telling me about her Christmas – and half wondering what it must be like to have one halfway healthy limb, out of four.

    And that flash of understanding I just shared with a human being almost completely opposite of me in every way. Aren’t we all so very the same, underneath it all? And why does that keep on surprising me after these years on a truck?

    Happy Holidays, Happy New Year. May you often in this coming year have someone cross your path that makes you stop, and look at life a little differently.

    “I truly believe that everything that we do and everyone that we meet is put in our path for a purpose. There are no accidents; we're all teachers - if we're willing to pay attention to the lessons we learn.”  -Marla Gibbs, Actress, 1931-?

  • Monday, November 21, 2016 7:45 AM | PAAW Administrator (Administrator)
    He called 911 when the symptoms began. He explained that he was a diabetic and he was not feeling well. By the time we were knocking on his door along with the fire rescue crew, things had gone downhill. When there was no response, we opened the door and entered. And stopped, all of us. Three firemen, my partner, and finally myself. I recall walking directly into the back of my partner as he abruptly stopped. Peering around him, I saw that the group of firemen had all stopped as well. Peering further, I saw the source of our sudden collective halt.

    His dog was very large, and very protective, and very unhappy with the group of strangers who had just entered her human’s house. Her human who would not wake up. She stood over him, and the low sound in her throat didn’t need any extra volume. It meant business. The caller, our patient, was now unresponsive. I was thanking God I did not have care on this call, and that my partner that day was a senior medic. Unhurried in speech and manner, he was just the ticket to teach the brand new medic that I was on this winter day. Eight months in to my career, I stood, dumb struck at this spectacle in front of me.

    “Weeeeeelllll” my partner began, “I suppooooooose…..” his voice trailed off. I looked at him hopefully but he was standing, hands on hips, feet apart, brow furrowed. He offered nothing further in the way of wisdom. The brindle dog growled again, low and with a distinct tone of impatience. The patient was pink and skin appeared dry, no sheen of moisture noted from my location. His chest rose and fall in a rate that was normal, and chest wall excursion also appeared adequate. It wasn’t a lot, but at least we knew he was breathing. So there was that, at least.

    A fireman took a step forward and the rumbling in the brindle dog’s throat revved up in volume and irritation. She lowered her head. The fireman stepped back out of my view. Out of my view because I was behind the closest fireman to me, at this point. Strategizing began between my partner and the firemen. I was a blank. I wanted to help the patient but I would rather pull off my own pinky fingernail than approach that beautiful, enormous dog who was guarding her human. Maybe some of you have read my column about Mr. Whiskers – I was thinking of how his little bite hurt, and how much this dog could remove of me with one chomp.

    Finally a fireman, an older, gruff and generally quiet man, took off his turnout coat. He instructed another fireman to open the bedroom door and slam it shut when told. The second fireman agreed. The first fireman lifted the coat, approached the dog rapidly and threw the coat over her, picking her up in the same fell swoop. Two huge steps and he tossed the dog into the room onto the bed. The second fireman slammed the door. We all took a moment. The sound from inside the bedroom was spectacular. I watched the bedroom door from behind the third fireman, my hand on the doorknob of the exterior door. Just in case the scene became less safe, you know….

    The door to the bedroom held. We all exhaled. My partner approached the patient. Behind me someone knocked on the door. I answered, and the neighbor asked if everything was OK. I assured her it was. Fire and my partner were getting a blood sugar, putting on the three leads and establishing an IV line.  Underlining the whole scene was the sound of a very unhappy dog in the bedroom. The neighbor regarded all of this, brow furrowed, from the front steps. Then she slowly and carefully said, “They have a newborn baby, is the baby here with him?”

    All faces swivel to look at her, then at the bedroom door. On the table, a cell phone comes to life. No one moves, until I reach out and answer it, hoping it is the mother of the baby. Things go quickly from bad to worse when my “hello?” is first greeted by silence, then “who in the HECK are YOU?! And why are you answering my husband’s phone?!!”

    Ten minutes later we are en route to the hospital, navigating the snow plowed streets. The sun is blinding in its brightness and the patient is beginning to answer questions, riding in the back with my partner. His blood sugar was quite low but relatively fixable with an amp of dextrose in his IV. The wife is placated and on her way to meet us at the hospital with the baby, who she had with her. The neighbor was very helpful in verifying that I was who I said I was, after I handed her the phone.

    As the diesel idles in front of the garage door entrance to the hospital, my eyes squinting in adjustment to the dark interior – it occurs to me.

    That turnout coat is still in the bedroom.

  • Wednesday, August 17, 2016 6:36 AM | PAAW Administrator (Administrator)
    It’s hot, and we’re a small group in a parking lot waiting for a group of strangers who are on a wonderful mission. The National EMS Bike Ride is coming thru La Crosse today and the riders will be going to visit the UW Health MedFlight memorial bench at Gundersen Health Systems.

    On May 10, 2008 MedFlight lifted off from refueling at the La Crosse airport and sustained an impact with terrain while flying under visual flight rules. There were no survivors. UW Madison Hospital has a beautiful memorial and Gundersen – the receiving facility for the last transported patient flown by the crew that night – has a peaceful garden with a memorial bench.

    The National EMS Memorial Bike Ride web page states “The National EMS Memorial Bike Ride, Inc. (NEMSMBR) honors Emergency Medical Services personnel by organizing and implementing long distance cycling events that memorialize and celebrate the lives of those who serve every day, those who have become sick or injured while performing their duties, and those who have died in the line of duty.”

    Years ago in the early 2000’s as a rural volunteer EMT, I was fortunate enough to hear the humorous and always moving Steve Berry speak at the Wisconsin EMS Association conference.  That was the first time I’d heard of the Memorial Ride, and it’s “Muddy Angels”.

    Flash forward to today – June 28, 2016 – and we’re waiting for the riders taking part in the Midwest leg of this year’s ride. The lead vehicles start to arrive and we’re soon surrounded by brightly clad cyclers. We’re outside Mayo Clinic Health Systems main campus and their security approaches us to let us know there is an inbound aircraft. He tells us this because the bikes are propped up and wash from the tail rotor will be coming from the helipad is in our immediate proximity. Word is passed around and everyone nods in understanding.

    Arrangements are being made with my supervisors on scene regarding the route we will take from this hospital’s parking lot to the memorial bench at Gundersen’s main campus. Once there, a small service will take place.

    During these discussions, the familiar far off drone of a helicopter is heard. Soon the noise intensifies and looking overheard, my breath catches in my throat as I see the belly of the aircraft overheard. Bucky Badger is in town, and the approaching aircraft is the familiar red and white of UW Health’s MedFlight service. I feel like time slows to a crawl, and the memories come racing back.

    It’s May 10, 2008 and I’m just sitting in the dispatch chair to settle in for a night shift like any other. I’ve thought of going back to school to get my paramedic degree, but I feel as if I’m too old to go back to school. I also work for and with a phenomenal group of individuals and perhaps that’s good enough.

    Not long into that shift, the phone rang and the world changed forever. La Crosse EDC was calling to ask for one of our ambulances to standby in the township of Medary. Reports had come in from multiple residents in that area with some concerning reports.

    Due to the fog and drizzle in the dark, the search was night-long. My partner and myself are kept busy by the usual call volume as well as hourly check-ins with the MedFlight communications specialist in Madison. We know his voice from all the times our flight services flies into Madison. There is a point in that flight where our communications center can no longer reach our aircraft by radio. We can monitor the latitude and longitude which updates every 30 seconds on our flight following program. This particular Comm Spec will call us to say he has radio contact and again to tell us when they land. We do the same for him. That night he called to say he had an overdue aircraft who was not “pinging”, or transmitting its location anymore. We were at his side via phone thru that long night. We helped as best we could, which is to say, we couldn’t do anything but feel his pain and sit helplessly by, hours away.

    So many memories I have of that long foggy drizzly night. Our Post Accident Incident Plan open on the round table as we offer our services to the MedFlight Comm Spec every hour. Learning that the emergency locate on the aircraft wasn’t being picked up by searchers on the ground, that it had to be picked up from the air. Calling Volk Field, calling anyone we could think of. Same answer repeated – weather conditions are not amenable to a search aircraft assisting. Listening to the ground parties walking grids. Telling our flight team. Answering tearful phone calls from a few UW nurses as word got out, inquiring if we knew who was on the flight, any word yet? Listening to the radio traffic as ground searchers attempted to use cell phone triangulation from the MedFlight crew cell phones. Driving home blindly in the stark morning light, no news. Waking mid-morning to hear they’d found the wreckage. Meeting the MedFlight Comm Spec at the memorial service for two of the crew members, his bear hug, his face to finally put with that voice. Standing atop Monona Terrace, listening to the wife of one crew member speak, hearing her say “if you want to honor my husband, serve others as he did.” Watching the helicopter flyover tribute. Enrolling in the paramedic program one month later.

    So Bucky Badger comes over the rooftop of the hospital and it’s 2016. I’m standing in a uniform with a gold paramedic patch on my right shoulder and as the dust settles and the rotors slow, I realize the lump in my throat is shared by my coworkers standing around me. The riders at first do not realize the significance of this flight service coming to La Crosse and landing in the middle of this group. MedFlight does not come to La Crosse very frequently, so this is a very amazing coincidence.  I walk around my truck a bit and standing out of sight behind it, I look up. The sun is bright, the traffic going by is very busy, there are some unconcerned birds lazily spinning overhead in the blue summer sky. I smile up and I think to myself, I’m pretty certain three men are grinning somewhere.

    After they had transferred their patient, our clinical manager caught up with the crew and told them why these brightly colored people with bikes were gathered in the parking lot on this hot day. MedFlight allowed the crew on that mission to accompany the memorial bike ride to the bench. During the service that followed, the flight physician spoke of his memories of the lost crew members. A list of names lost was read, including the MedFlight crew as well as our dispatch supervisor who we lost a few months after the crash. A bell tolled after every name, and the moment seemed a fitting closure to that first phone call from the night so long ago.

    And I know he’ll never know, but every time I put on this uniform, I remember the brave words of a wife as the wind blew over Monona Terrace. The wife of one flight team member I only knew from a wave to our security camera as they walked across our helipad and boarded that aircraft to go refuel and fly home that night. The sound of the bagpipes has long since faded – but the names of those three crew members remain on a bench in La Crosse, on a wall in Madison, and in the hearts of so many.

    Isn’t it an amazing measure of a man, the lives touched even when they’re gone? 

    Godspeed – all these years later MedFlight 1 - N135UW – 5/10/2008

    Darren, Steve, Mark

  • Monday, July 25, 2016 7:16 AM | PAAW Administrator (Administrator)
    Her hair is flaming orange-red, eyes bright and lively and her baby a masterpiece of tiny humanity. Barely hitting the five foot mark, she has on an emerald dress, black simple shoes and a white bonnet perched atop the sunset that are her locks. The baby girl is wearing a miniature navy blue dress with the same simple lines. Even the wee puffed sleeves are the same as her mama’s – and (I can hardly bear the overload of cute) her tiny head has an impossibly adorably tiny white bonnet.

    But I’m here for the husband, and I tear my eyes away with what I hope is professionalism as I continue introducing myself to everyone behind the curtain in bay 6. Curly hair tops his face and the beard of a married Amish man fringes his chin. Homemade black pants, simple black shoes and a teal shirt also handmade complete his traditional garb. His right hand is elevated and wrapped within an inch of its life. Bright red blood has soaked thru a patch roughly one inch by one inch.

    He tells the story of slipping at work – work is in a local shop crafting the traditional Amish furniture us English people are happy to pay good money for, knowing it will last for generations upon generations. With a crooked grin, he denies pain. I tell him there is no shame in pain medicine, and point out that he is slightly pale. He feigns astonishment and points to his chest with eyes exaggeratedly elevated. She giggles. His top lip curls as he waves away an imaginary syringe. He’s fine.

    Once he’s on the cot, we turn to the idea of transporting the wife and baby. Feeling foolish (do Amish use car seats? I think not?) But needing to ask, I receive a shake of the head in reply. A nurse offers to run upstairs to OB and borrow a car seat. Returning, the nurse and my partner take the mama and baby to our truck in the garage.

    I wheel the cot with my very entertaining patient to the nurse’s station and get the transfer paperwork, then head to the truck. The diminutive little mama is standing outside with her hands folded, the side door is open and there are now three adults inside securing the car seat to the seat chosen inside. I look at her, she looks at me. I ask her “how many English does it take to put in a car seat?” and she laughs a big belly laugh.

    Soon after, the sleeping baby is fastened inside the car seat straps, the car seat solidly in place, mama buckled nearby in case the baby isn’t fond of her new contraption and the patient and I joining them – we’re on our way.

    Heading down the road, I do the usual routine of putting the blood pressure cuff and cardiac leads as well as pulse oximeter on my patient, then begin entering demographic details into the tablet. All the while I keep up a patter like usual, asking for a pain rating, asking if he gets carsick, asking if he’s nauseous now or has been since he’s been in the ER. I tell him the blood pressure cuff will inflate every ten minutes and when he asks about the pulse oximeter, I tell him in plain language what it does. He wants to know how. I tell him. He’s fascinated, and so is his wife. Then she asks about the three wires, how they tell me about his heart? I tell them, again utter fascination. He points to the blood pressure cuff and asks why it gets tight. I tell them blood pressure is measured that way – blank looks. I outline briefly how the top number – I point to the monitor display of his last reading – tells me the pressure in his vessels that the heart pumps against when it squeezes, or beats. The bottom number - heads swivel back to the monitor – is the pressure in his vessels when his heart is at rest. They ask what’s good? And we talk about what’s good. They ask, what if it is lower or higher? And we talk about passing out, we talk about damage to the heart over time if the numbers are high for long periods of time like months or years. They are bright, quick thinking and soaking everything in like sponges.

    I finally tell them that their baby girl is quite honestly one of the cutest babies I have ever seen. Her miniature nose and mouth are perfect, her eyelashes long and sweeping as she sleeps without objection in her English car seat. The bonnet framing her face is no more than 5 inches wide and I can’t imagine the loving care those tiny stitches took.

    The redheaded mama beams and says, “yes, she’s our cutest baby yet” and upon further conversing I find out that they have six more small children at home. Neither one of them are yet 30. He is teasing her and she is giving it right back. They are laughing and I comment on how great it is that he is so composed despite donating part of at least two fingers to a saw back at the shop. He says “aww, it ain’t my first time, naw!” and she rolls her eyes at me. “Ja, he’s not kidding you”. She tells me he used to write her beautiful love letters when they were courting, that they didn’t see each other often. I ask if they lived far apart. Yes, she answers, they lived 17 miles apart.

    He’s grinning and nodding, interjecting that he did write very good love letters, that she was the prettiest little thing he’d seen and he wanted her to think of him often and so writing often helped that. He tells me dynamite comes in small packages, and she playfully lightly kicks the back of his upright head of the cot. He grins wider and tells me, “see?!”

    We’re leaving the second small town we pass thru on our way to the city, and the specialty care he’s going to need to make that hand useful again. He tells me how funny it is to watch the countryside receding in reverse. Then his jocularity falls aside, he raises the worn, strong, unharmed hand and points to the back door of the ambulance. Outside, the setting sun is painting warm pastels across the cornfields, and his face softens. Tipping his head, he asks me, “Do you ever wonder how people can’t believe there’s a Creator with a sunset like that?” He shakes his head and says, “I’m glad He made all of this and gave me my redheaded girl”. Her head ducks, but even the flaming hair beneath the bonnet can’t hide her smile.

    I lean my head back against the wall of the ambulance and I look at their exquisite baby girl – their 7th child – and I smile in peaceful delight at their simple, happy, wonderful life. Love letters and babies, hard work and faith, struggles and pain and teasing and flirting even after more than half a dozen children. Ten days earlier in this same truck I’d worked the cardiac arrest of a very different Amish baby, and her white lifeless body just wouldn’t come back to us. Now, on this night, the simple faith and peaceful energy replaced the dread I’d felt to some degree each time I’d climbed into the back of this truck.

    Ebb and flow, life and death – my mind remembered Verve Pipe from the 90s – “it’s a bittersweet symphony that’s life”. Let it wash over you, let it take nothing, oh – but let it leave shining moments such as these, driving down the road with this beautiful simple little family full of love. I’m better for the conversation I had in those 40 minutes driving down a summer two lane road in Wisconsin with a redheaded little lady, her precious baby girl, and her head over heels in love husband with a penchant for slipping into saws.

    I needed that.

  • Friday, June 03, 2016 7:28 AM | PAAW Administrator (Administrator)

    The officer meets us in the garage, and fills us in. It’s my partner, the medic student I’m precepting today, and myself.

    The patient inside is 96 years old and fell around noon. It’s nearly 4pm now, and the officer is concerned about not just the skin tear on the elbow after the fall, he’s concerned about the heat of the house’s interior. He’s worried the patient may have dehydration issues. He tells us that the patient’s wife is a resident of a local nursing home and he always goes to see her at 12:30pm. Every day. For the entire four years since she became a resident there. Today, 12:30 came and went and he did not appear. Staff members became concerned, and went to the house. The officer got them inside, and together the three of them discovered our patient on the floor.

    We enter the garage and make our way past the large four door mid 1980s sedan parked sedately inside. Winding our way past paneled walls, we climb the three stairs from the finished garage stall to the vintage kitchen. Spotless. Everything our eyes touch, from the countertops and cabinets of the kitchen, to the antiquated appliances and on into the bedspread visible through the doorway off the kitchen – every single thing is pristine, and centered. Meticulously up kept. Winding our way past more paneling to the front living room of the shotgun home, we find our patient.

    And Marcy. And Deanna.

    Seated on the floor and leaning against a davenport (I am certain even in the first few moments of this call that it is not called a “couch”, not in this home) is the gentleman in question. Two ladies in scrubs are bent over him solicitously, and they stand upright as we enter. My student begins the assessment, and I listen in. The patient remembers falling, he hit his head a bit but he doesn’t take blood thinners anymore. The blood thinners were only aspirin, but he hasn’t had to take them since they kept giving him nasty nosebleeds. He just couldn’t get up without some help. So while he thought of what to do, after a couple hours, help came in the form of his wife’s caretakers, Marcy and Deanna.

    Concern etched on their faces, they list his health status (very good) and clue us in to his UTI diagnosed last evening. They know him well, and the caring inherent in their body language, the tender tone of voice they use, and their careful explanations to us soften my heart enough that for a moment I’m concerned my eyes might leak a bit. Their absolute certainty that something was wrong led them to the house, and if not for them, the two grown daughters from out of town might’ve had a very different weekend at some point. The skin tear on the elbow serves as a stamp of sorts, so that his efforts across the ivory carpet are visible.

    As we complete our necessary arrangements, vital signs obtained, cardiac monitor examined and cot positioned, I remove the small notebook from my right cargo pocket and click my pen open. I carefully record their names and numbers, as they worriedly ask our patient to call them before he comes home. They want to bring him home and see that he is settled properly. He answers them with dignity and affection, and as we take our leave I look back. The police officer stops with me and looks. They are down on their knees with some cleaning supplies, and they are working on removing the bloodstains from the ivory carpet.

    The officer’s eyes met mine and he coughed brusquely. I nodded and murmured about my allergies acting up, too. We went down the hall of the beautiful vintage home, locking the door as we left. I made up my mind that come Tuesday, Marcy and Deanna’s supervisor is going to get a call from this medic. I have no doubt that the work ethic of these two angels in scrubs won’t be new news to the supervisor, but I have to express my admiration at just what exemplary employees these two women are.

    Thank God for Marcy and Deanna, may we all be a lot more like them.

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About the Author


Years ago my neighbor John from down the road told me there was a volunteer first responder class being held evenings. Since my bank job ended at 4pm he figured I could probably swing the time, and volunteers were needed badly. From those years of responding in a private car with a pager, to volunteering 30 miles away as an EMT-B, the EMS bug took hold. Roles over the years have included working for a private inter-facility transport service, rural emergency room EMT for five years, emergency medical dispatcher for helicopter and ground EMS for six years, then on to the paramedic classroom and critical care licensure. The more I learn, the more I see I have yet to be taught. The more people I meet, the more stories I'm told. The front row seat to the human experience never grows old.


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