Rx: Divine Intervention

The discharge paperwork was still warm from the printer when I arrived at the patient’s bedside. Her work-up was simple; something that easily could have been treated at her PCP’s. But she couldn’t go to her PCP, because she was new to the area, or she didn’t like her doctor, or she was between doctors, or she called them up and they couldn’t fit her in until April 2032…I forget. Something like that. I digress…

I began reading over the doctor’s notes, created using that new “speech-to-text” dictation program. Simple patient, simple assessment, simple treatment, simple discharge. Right?

“…if the infection does not improve over the next few days, please return and we will…” I paused. I stifled a giggle, bit my lip, and excused myself from the room. I scurried back to the nurses’ station, taking a seat next to the doctor and passing him his discharge notes.

“Really, Doc? Seems a little desperate, don’t you think?” I asked. He shot me a confused look. “Discharge notes, at the bottom. Read.”

“‘If the infection does not improve over the next few days, please return and we will…ask the Catholics’?? What? No! I said ‘Prescribe Keflex.’ Damn software…”

“I was gonna say, I didn’t think her infection was quite that bad yet.”

Doctors Say The Darnedest Things

Patient: “Oh! Look what we have here! Are you the good doctor?”

Doctor: “Well, I’m not the bad one…”

Poetic Juxtaposition in a Small Town

Working in a small town provides a glimpse at some truly beautiful, near-poetic things. There are the smiles and friendly waves of townspeople as you walk around downtown in your uniform. There’s the warm food, donated by generous local restaurants that volunteered to open in the middle of cold, brutal nights; provided to the victims and responders of a local tragedy. There are the “Thank you” cards that are proudly and thoughtfully tacked to the station cork boards. There’s that pristine hour after clearing an end-of-shift call, where new morning sun filters through the mist, and reflects softly off still ponds. There’s the privilege of being allowed inside of those small, sleepy townhouses and cabins; the same ones that seep curly plumes of sweet woodsmoke into crisp morning air. There’s the sanctity of caring for the people we see every day; those we grew up with and know well, and those who are familiar strangers.

That familiarity–that close-knit bond unique to those who work and live in a small town–can provide for the most inspiring, speechless joy; and unfortunately brilliant sorrow. Sometimes, you are called into those small, sleepy townhouses and cabins, and you witness and participate in the recovery of not just an illness, but a life that weaves frequently into yours within this little town. Other times, you are called around the stoves’ hearths that seep those curly plumes of sweet woodsmoke, and you are asked, demanded, begged to fix something that cannot be fixed; cure something that cannot be cured. Then, that particular thread of life is missing from the usual, comfortable tapestry of every day.

It’s hard to tell a family, “I’m sorry, but she’s passed away.” It’s hard to stop pushing on the chest of someone you’d known, either close or from afar. It’s hard when a family member cries into your uniform as you try to console them with a hug. It’s hard when they watch you pick up the trash, pack up the equipment; and leave them with their sorrow, the whirlwind of funeral directors and arrangements, and the shell of their loved one. What’s harder is when you can’t put the call to the back of your mind, filed away somewhere along with the other codes and unfortunate calls you’d been a part of–when you are forced to face the aftermath of what you couldn’t help. When you are required to attend this person’s funeral.

I was uncomfortable as we waited for the services to start. I kept my head down, chin tucked against the lump in my throat. Part of me hoped I wouldn’t be recognized by the survived who were there on that day my partner and I were called to try. I prayed I wouldn’t be asked once again by a distraught family member, “Why didn’t you save her?” Because it was too late. Because the odds were astronomical. Because it was her time. Because I couldn’t. I would never say those out loud. They wouldn’t alleviate the pain. What’s more, it doesn’t answer question they really want answered: Why did she have to go now?

I focused so intently on trying to find comfort in this awkward, sad situation; trying to be both present and invisible. I was focused so intently, I almost didn’t recognize the man who had taken the seat beside me. He turned and chatted with a friend and coworker of mine. Then, my shoulder was tapped.

“Do you remember that code a while back?” My friend started. I squinted my eyes and thought as he described the house, the room, the circumstances. It all flooded back to me, back from the corner of my mind where the code that resulted in this funeral should be. I nodded. “This is him. This was your patient.”

I looked into those bright, sea-glass green eyes. The last time I looked into them, I was breathing for him. He was cool, gray, limp. Now, his handshake was strong and warm. There was such a life about him. Every blink, every smile, every word out of his mouth seemed so completely miraculous and wonderful. I wanted to talk to him all day, if for no other reason that to truly be in awe of life and every little thing we take for granted.

We sat next to each other during the ceremony. I sat beside a man whose life I helped save, whose thread I helped preserve; while mourning the loss of a life I couldn’t save, the newest uneasy void in our local community’s tapestry. The juxtaposition was beautifully, inspiringly, sadly, uniquely poetic; leaving me with a deeper, greater appreciation for my life and work in this small town.

Another Day In The Life

Nursing Assistant: Can you bring in the patient through the employee entrance? I’ll meet you on the other side. Just knock, and I’ll open the door.

P2P: No problem. We’ll scoot right over.

(20 seconds later…)*knockknockknock*

Nursing Assistant (surprised): Who is it?

P2P (also surprised): Uh…ambulance?

P2P’s Partner: Housekeeping! You want mint on your pillow?

I Guess We’ll Find Out

I’ve officially passed in my last final. The backseat of my car still has my duffel bag full of extra scrubs. A dozen or so textbooks and study guides are still sitting on the kitchen table. A few beat up notebooks full of lecture notes are still loaded into my backpack. My laptop is still loaded up with old PowerPoints. And my brain is still guilt-tripping me for indulging in fun things. But, slowly, it’s starting to dawn on me that the year has come to an end.

I’m still reflecting over everything that’s happened. Obviously, I’ve learned a lot about physiology and nursing care. But, as cliche as it may sound, I’ve learned so much about myself, and I’ve grown into a much stronger person.

At the beginning of the year, I found myself crying. Like, a lot. There were two main reasons for this: academic work, and social challenges.

For the most part, school has just been something I’ve been fairly good at. Some people can learn in a classroom, and others can’t. I could, and without too much difficulty. For the first time in my life, I’ve had to really really work at something academically. I couldn’t breeze into the lecture hall on exam day and crank out a decent test score. I spent hours upon hours of studying, hoping to get a grade that would somewhat reflect all the work I’d been putting in.

Like I’ve ranted about so many times before, many of the students were just plain mean. As a pretty sociable person, I’d always been able to make at least one friend wherever I was. But for much of that first semester, I was struggling to even find people to be friendly with. Nursing school was far more cutthroat than I’d anticipated. It ranged from petty name-calling, to blatant verbal attacks. I’m a pretty sensitive person…and suddenly, there was all of this stress and drama, and I had no one to lean on. Well…no one to lean on but myself. But I didn’t realize that at the time.

Many all-nighters, tears, and near-breakdowns later, and I find myself almost finished with this year. One day, right before lecture started up, a few students asked the professor about an assignment that they felt was being graded unfairly. I’ll spare you the boring details, but it basically boiled down to a discrepancy in the rubric. I attempted to help explain the confusion to the professor. As I was the last one who had spoken, the teacher looked directly at me, and, in front of a lecture hall full of students, said this:

“You know, it’s a nurse’s ability to look at the tiny details and draw conclusions. It sounds to me like you’re unable to do this. I don’t know, but I’m not sure how you’re going to make it in the real world without that skill.”

The entire classroom went silent. The professor probably felt attacked, which was totally unintentional. A few months earlier, I would have probably teared up right there, and bowed my head in an ashamed silence, panicked self-doubts running through my head. But, for some unquantifiable, unnameable reason, the past few months had built me into a stronger person. I’m not sure how or when it happened, but it all culminated in that moment. The moment when a crooked half-smile pushed onto my mouth, and I evenly said:

“I guess we’ll find out.”

Somehow, my skin had gotten thicker. My doubts, while still there, were quieter. The process by which this happened was painful. It was exhausting. It was draining. Worse, it wasn’t just that way for me, but for anyone who knew me. Anyone who I trusted enough to share the details of my crippling doubts. To many, I boldly declared that I wanted out of this school; this program that I worked so hard to get into. I came up with a thousand reasons why I didn’t belong, why I couldn’t do it, why I’d never be good enough. I lunged at these opportunities to work in another field, quickly polished them up, held them high and said, “No, this is what I really want to do. I’d much rather do this. I’m going to quit nursing school and do this instead.” But these confidants, they knew me better. They calmed me down. They smoothed out my ruffled feathers. They pulled me into their strong shoulders and let me cry. They listened to me rant about all the “mistreatments” I’d been “enduring,” and spew out self-pitying statements. And, they gave me some little thing to hold onto. They gave me a little push, a little spark, to keep me going just a little bit further. Just when I’d swear I was through and wouldn’t budge one more inch, they’d convince me to take one more baby step. Soon (probably not soon enough for them), I was taking these steps by myself. I’d tell a story or two about school when they asked, but not much more. I learned to rely on myself. I learned to motivate myself, believe in myself, and get through this on my own. And I can’t thank those people enough for what they’ve done. You know who you are.

To all of you who stayed with me throughout this crazy year, to all of you who posted an encouraging word, to all of you who liked or shared one of these posts, and to all of you who contacted me privately…thank you. You’ve helped me grow, strengthen, and change in ways I’m not sure I could ever truly explain. You guys are the best.

As I decompress over the next few days and start to soak in my newfound freedom, I’m sure I’ll come up with more self-examining posts. It’s been a hell of a ride so far, and I haven’t beaten this dead horse nearly enough.

So, again, thank you.

Kids Say The Darnedest Things

Observations and opinions of one of my pedi patients…

Junior: Do you have any kids?

P2P: Nope.

Junior: Oh. That’s too bad. You’re nice, like my mom. I think you’d be a good mom.

P2P: (totally taken aback and blushing): Oh…Thank you, that’s very kind of you.

Junior: Are you married?

P2P: Nope.

Junior: Do you want to get married?

P2P: Someday, I think I would like to.

Junior: Why don’t you want to get married now?

P2P: Just haven’t found the right person yet.

Junior: How old are you?

P2P: Twenty.

Junior: Jeez…you’re running out of time.

 

Thanks, kid.

I gave him a sticker anyway. He still won the “Coolest Patient of the Day” award.

Interesting Patient Conversation

There was still 30 minutes left in our transport, and the patient was incredibly stable. Not knowing what else to really do, we struck up a conversation. He was an interesting fellow…one of these laid-back, intellectual types with a dry sense of humor and a fierce wanderlust. He made insightful remarks, and smiled these dashing crooked smiles that made me frantically wonder what subtle irony or quiet punchline I’d missed. We’d talked about weather, family, and the best way to make stuffed peppers. He told me about the traveling he’s done, and how he never stays in one place for too long. Sooner or later, the urge to find a change of scenery and pace plucks him from one community and pushes him to another.

“You know, way back in the day, I was a photographer. Well, I still am, but I did it commercially. I worked for this company, and I primarily went to schools and did school portraits. I like portraits. If you look at a good one, you can know the person without ever meeting them,” He told me, occasionally offering a small, knowing grin, or raising his eyebrows.

“But I was bored at this job. It was just one grumpy child forcing a fake smile after another. I was taking this young lady’s picture once…she was pretty, definitely. But she just wouldn’t smile. She wouldn’t even fake one. So I asked her why. What was wrong? Well, she rolled her eyes at me and told me she was bored. She was bored with school. So I told her, ‘Bored people tend to be boring.’ She took offense to that, I guess.

It just seemed so painfully obvious, really. You’re bored? Then do something. Find something that entertains you. Change something. If you’re bored, then you get boring. And then what are you doing with your life? And then it dawns on me…I was boring. I was bored with my job. Bored with that town. Bored with doing the same thing all the time. So I left. About a week later, I packed up all of my things, got in my car, and just drove. I found some little town in Wyoming, and lived there for a few months. I’ve been something of a traveler ever since. I don’t like to be bored.”

The Breakdown (And The People Who Helped)

My mind was swirling with a nauseating soup of questions and uncertainties. I felt this sickening pull in my stomach. Yet, it was all muted. I was manipulating red hot emotions through thick welder’s gloves. I couldn’t name it, I couldn’t identify it, but I knew it didn’t sit well with me. I quietly engaged in superficial and meaningless conversation with my partner as we backed into the ambulance bay. I was just politely filling in the silence, while simultaneously trying to figure out what was happening to me internally.

Numb, I climbed out of the ambulance, paperwork in hand. I returned the other crews’ greetings, and headed into the kitchen to grab a glass of water. An officer nonchalantly followed me into the kitchen, and quietly asked, “Are you okay?”

I looked at him, confused. “I don’t really know. I think so,” I mumbled. He patiently waited, watching my face as my eyes nervously shifted around the room. How could I not even know what was going on inside of my own head? I sighed, “I know I’m going to need one of the quieter rooms to write this report. There are phone calls that need to be made about this one.”

His eyes widened, almost imperceptibly, before nodding once. He set me up with a computer in a room away from the commotion of the common area. “If you need anything…let me know. I don’t care what it is…someone to talk to–”

“No,” I fiercely interrupted. “No, I’m fine. I don’t know what my problem is. I’m probably just tired or something.”

“I’ve seen you tired. That’s not it,” He said, looking me dead in the eyes. I broke his gaze, fidgeting with my paperwork. He knew me too well. His tone softened, “If you need anything. Someone to talk to…food…music…I don’t care what. Whatever you need, let me know, and we’ll get it squared away.”

He left me to take care of what I needed to. I didn’t realize it at the time, but he was already working on helping me–even before I properly understood myself. Those strange, detached feelings continued to stir in my head as I went through the familiar monotony of creating the report. And out of nowhere, I just started to cry.

What is wrong with you? I asked myself, disgusted. There was nothing on that call that should elicit that response. I’d run plenty of calls just like that one. This wasn’t some horrendous, gory trauma. This wasn’t a call where the patient was rapidly deteriorating before my eyes. This wasn’t about playing catch-up, or not being able to do a single thing right. Why this time? Why this patient? Why now? Why are you reacting like this? How can you see people horribly mangled and not bat an eye, and then lose it over something like this??? What is the matter with you?

My narrative was getting incredibly long and unruly. While blinking away tears, I wrote about every, single, last, detail I could possibly remember. About halfway through, I just propped my elbows on the table, and rested my head in my hands. I was giving up on holding it together, and figuring out why I couldn’t.

My phone buzzed against the table. Taking a deep, steadying breath, I tried to compose myself and answer it as evenly as possible.

“You sound like hell. What happened to you?” The chief officer on the other end of the line asked. Apparently it’s pretty hard to shake the sound of an unexpected melt down from your voice. Particularly at 1:30 in the morning. I stammered, dismissed, and evaded. He was having none of it. Finally, I got him to hang up. I figured I’d won.

By 2 a.m., there were three of the highest ranking officers at my department were sitting in that room with me–in their pajamas, no less. I offered smiles, thanked them, and tried to dismiss them. But they stayed with me for more than an hour. They told me stories of their distressing calls from back in the day, and the seemingly inexplicable breakdowns.

“That call, for whatever reason, touched you. And it’s okay to be sad. It’s okay to be angry. It’s okay to be confused. It’s the strangest, smallest details of a call sometimes that just hits you. It doesn’t have to be these obviously traumatic calls,” One told me.

I was given heartfelt compliments. I was given reassurance that this call didn’t make me weak or stupid. It didn’t mean the end of my career if I didn’t want it to be. They gave me their personal cell phone numbers, and was given instructions to call them whenever I needed to. They gave me hugs. But most importantly, they gave me their time–even in the dead of night. They gave me confidence, compassion, and understanding.

I don’t know many high-ranking managers that would go to the lengths that these individuals did. They went above and beyond. It’s something I will never forget, and will always be grateful of. Managers or officers, especially those that go out of their way to take care of their own…I can’t thank you enough.

Just An Ordinary Day

There wasn’t too much remarkable about that day, at least when it started. I woke up to a typical light overcast outside my window. I did my usual morning routine. I didn’t put a whole lot of thought into my ordinary “day off” attire…boots, jeans, a t-shirt and a jacket. I threw my worn bag into the passenger seat of my unassuming car, sang along to the radio in my usual off-key pitch, and parked in the supermarket parking lot. It was, by all means, an ordinary day.

I grabbed a shopping basket, and meandered through the aisles. The other patrons milled around in their usual way. An older lady with a blue scarf was sorting through the produce, trying to pick the best tomatoes of the bunch. A boy in a Spiderman t-shirt was fruitlessly pleading for his father to buy him the big bag of Reese’s. Some woman with glasses was spelling out her coworker’s name for a baker to write on a cake. I was making that time old decision: chicken or beef. There was really nothing to take notice of. Which is why I’ll never be quite sure what caught my eye and redirect my focus.

It was just a man, chatting with a friend he happened to bump into. I returned to deciding what I was going to do for dinner, when my memory started to stir. I glanced back at the man out of the corner of my eye. He looked familiar, but I couldn’t immediately place it…no…it couldn’t be…I tried really hard not to stare in disbelief.

I remember everything about the last time we’d met. I remember the weather, the time, the place, and everyone that was there. I remember the furniture, the pictures around the room, and the clock on the wall. I remember someone dancing from foot to foot, deciding whether they wanted to watch or not. I remember someone trying not to cry. I remember trying to speak lowly so I wouldn’t cause even more emotional trauma to everyone there. Funny thing is, I doubt he remembers our encounter, even though I treated him kind of roughly.  See, the last time we met, he was dead. My partners and I were pounding on his still, pale chest. We were squeezing each breath into his lungs. All in the hopes of converting that rhythm into something more life-sustaining.

His skin glowed now with a radiant life. His cheeks were much rosier than in my memory. He had a quick mind behind his sharp eyes, as evidenced by the laughter of his friend. A deep chuckle came forth from the man’s wry smile.

The feeling that built in my chest was one that defies words. The man that stood only a few yards away from me was so alive. He was doing normal, every day things. To anybody else, this scene was average. Just an average man, wearing plain clothes, running ordinary errands, talking about typical things with his friend. And yet, there was something so extraordinary about it. Just the whole notion of being alive is such an incredible thing all of the sudden. Every blink, every breath, every heart beat was such an amazing thing. Every movement, every chore, every interaction, every joke…it all suddenly carried so much more weight. He was a man who’d beaten the odds. And, in my small way, I had helped him do it. And that just felt…incredible.

I wanted to savor that moment, that feeling, forever. Where the gravity of the things I do for a living really sets in, but in the most surreal way. Where suddenly everything was brilliant, and nothing was taken for granted. I walked past him, offering him a big, genuine smile. He smiled back at me, a little confused as to why I’d be grinning like that. He would probably  never know, and oddly, that is fine with me.

I continued on down the aisle, back to my every day life. He carried on with his. And that makes all the difference.

How’d You Get Into EMS?

Like most of the best things in my life, I came into EMS completely unintentionally.

Prior to EMS, I had a particular fondness for swimming. At 17, I was preparing to start my 10th season of competitive swimming, and my fourth season of 10-&-under coaching, when I got a phone call from my head coach. Enrollment was down for the upcoming season, and it looked like I won’t be coaching the little kids after all.

Well. That greatly opened up my summer schedule.

To most people, that would hardly be a bad thing. But I had spent my adolescence as one of those annoying over-achievers that burnt the candle at both ends. In high school, I spent my afternoons, evenings, and weekends darting around to my 13 extra-curricular activities. If I had down time, I was in a panic, trying to remember what project, assignment, meeting, practice, rehearsal, game, meet, or activity I was supposed to be doing. I couldn’t relax during my “time off.” It actually made me more anxious.

So I began my job hunt. Unfortunately, it seemed that every attempt to find a local job ended in “Thanks, but no thanks.” Each small store already had their seasonal adolescent workers hired. Not giving up yet, I figured if I couldn’t get paid to do work, well, maybe I could volunteer. Seeing how I was starting college in the fall for my biology/pre-med degree, I decided I’d give the hospital a call and see how I could volunteer there.

“Sorry,” I was told. My heart started to sink. “We only take volunteers in the ER if they’re EMT students.”

EMT student, huh? That sounds kind of fun. I could learn more about healthcare, get some practice actually treating patients, and ride around in an ambulance. There’s no harm in at least seeing what it’s about, right? And if it’ll be a gateway to get me to work at the hospital–even better!

I set up a meeting with a fire department officer later that week. He had a paramedic take me to do a truck check on one of the ambulances. I sat on the bench seat, and listened intently to his explanation of the equipment, what EMT’s can do, and the EMS culture. I was awestruck.

By the end of that hour, I was so completely in love with EMS. I don’t know what did it, but sitting in that truck just felt right. I didn’t want to leave.

It didn’t matter how much I had to learn. It didn’t matter how long it would take. It didn’t matter that I had no idea how I was going to deal with things like guts, gore, and death. I would figure all of it out in time. For the first time in my life, I knew I could do something. I mean, just knew it. On the days I had my doubts, there was always this determined little whisper in the back of my mind that said that I could get through this.

That night, I researched EMS blogs, almost desperate to find someone’s story or opinion that would take this dreamy glow off of my newest and strongest aspiration. As it turns out, it only deepened my love for the field. The next day, I was enrolled in a local First Responder class, and began my EMS apprenticeship at the fire department.

And the rest, as they say, is history.