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.”

Dyspnea, Orthopnea, Eupnea

I had to take a Medical Terminology class to fulfill the requirements for my degree. I thought it was kind of silly and somewhat of a waste of time, but, hey, I can’t argue with an easy A.

My class was online. However, we had to call the instructor once per week to read medical words from a vocabulary list she’d emailed to us. When I called her for the first time, she went off on this huge tangent about how she has all this experience in the medical field, but she never specifically discussed what job(s) she held.

One day, I called her to complete this assignment. I was reading down the list, not thinking much of it.

“Hypoglycemia,” I’d announce.

“Good.”

“Humerus.”

“Good.”

“Dyspnea.”

“Um….try that again.”

 

I was kind of surprised. I didn’t think I’d mispronounced anything.

“Disp-nee-uh,” I tried a little slower.

“No. Minus 5 points. It’s pronounced dis-pee-nee-uh. You need to pronounce the ‘P’. Next.”

Huh?

“Um…ok…orthopnea.” (Orth-op-nee-uh)

“Again, pronounce the ‘P’. Minus Five again. Orth-o-pee-nee-uh. Next.”

“………….Eupnea.”

“Pronounce. The. P. Ee-you-pee-nya.”

“Interesting,” I said, carefully choosing my words. “I’ve never heard it pronounced like that before.”

“Well, when you’re in the business for a long time, you pick up on these things.”

“I see.”

 

Maybe I–and everyone I’ve ever worked with or been exposed to in the medical field–is wrong? But I’m willing to bet you all (y’all, yous guys, etc.) pronounce it the same as I do, despite the differences in our colloquialisms. That’s just me though. Feel free to correct me if I’m wrong. Because she definitely did. 15 points worth of it, actually.

Awkward Report

P2P: Hey! So, this is Mr. So-and-so. He’s doing alright. Been hemodynamically stable for the whole trip.

Nurse Unsure: Good, good. How were his vital signs?

P2P: ….Yeah. Uh…yeah, those were good too.

 

So…there’s that.

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.

“Wait…Did He Just Pull Over?”

I have one of those cars that the passengers always complain about. It rides much closer to the ground than most vehicles. I’m no statistician, but I’d say approximately 90.125% of my passengers, upon entering or exiting my vehicle, make some sort of negative muttered exclamation, some gasping or disgruntled puffing/sighing noise, and then loudly remark that my car was designed for children or mice or contortionists or something. This means that where my dash meets the windshield comes up to approximately bumper level on most of the vehicles in this area. (I’m only slightly exaggerating here.)

Now, I don’t use crazy amounts of lights on my car. I have exactly one, small, removable light that I can stick on my dash. It has a grand total of three light bulbs in it. I really only have it because I live so far away from the station–and even so, I seldom use it. I never use it during the day, and only rarely use it at night–mainly because nobody sees it. I could grumble and say that nobody ever pulls over because they’re all mean, distracted, selfish jerks. But in truth, it’s probably because my light shines directly into their tailpipe, and they never realize I’m a responding vehicle.

One night, for whatever reason, I did use my light while responding. Maybe it was just so that I mentally felt like I was going to get to the station quicker…even though I wasn’t going any faster than the posted speed limit, and even though I know nobody ever pulls over or does anything helpful when I have my light on. Who knows. I saw a vehicle up ahead, and tapped my brakes, because I’m a good driver and want to give myself ample room to stop so I don’t rear-end him in case he decides to do something crazy and unexpected.

And, right on cue, he does something crazy and unexpected. He jams on the brakes and swerves to the side of the road. My first thought was, “WHOA! Looks like somebody’s a little intoxicated tonight, just swerving off the road for no apparent reason.” Briefly after that, I figured he must’ve stopped and swerved for a deer or something. So I came to a stop, watching the road carefully for any wildlife that happened to stumble into the street. After about 10 seconds, I saw nothing. I then realized…”Holy crap. I have my light on…and that guy actually pulled over for me??”  People pulling over for lights? Now that’s just unheard of.

Then I continued on my merry way, and probably saved a bus load of children from being attacked by a herd of vicious bear-sharks.

That Awkward Moment When…

Ever have one of those awkward moments where you really wish you hadn’t said/done that? Me too. More than most people, it seems. Anyway, here’s a “Aren’t you glad you weren’t her?” moment a relative emailed me about.

I dropped by the gas station on my way home, as I sometimes do. I’m about to go in to buy myself a soda, when I see this guy struggling with some bags. (For the record, I also thought it was weird that ANYONE buys BAGS of stuff from convenience stores, but, okay.) So, being the awesome and caring person that I am, I instinctively go to help him. And I say, “Would you like a hand?”

And I’m not even joking….turns out the guy was an AMPUTEE. He was actually missing a HAND. 

He stared at me like I was the world’s biggest asshole, ever.

Here’s to hoping your day is better than mine.

Quote of the Day

My professor during my maternity lecture:

“Let me just tell you now that I really don’t recommend Googling ‘nipple pinch test.’ I had a very specific result in mind…and it certainly wasn’t what came up.”

So A Celiac and some EMT’s go into a restaurant…

When some friends and I try to go out to dinner after work…

P2P: I have a severe allergy to gluten, which means I can’t–

Waitress: –Ohh, do you mean glucose?

P2P: No. I mean gluten. Anyway, I can’t have–

Waitress: Y’know. Glucose. Like sugar.

P2P: Nope. No, it’s gluten. Not glucose.

Waitress: Are you sure?

P2P: …what?

EMT Friend: Of course she’s sure. It’s her medical history.

Waitress: I know how tough it is. My cousin had an allergy to glucose. We have a few sugar-free things on our menu.

EMT Friend: Okay, well, that’s nice. We better be going.

And that is why I don’t go out to eat. Also why I love having friends that look out for me.

On another note…Sweetheart…if your cousin had an allergy to glucose, they probably wouldn’t be alive…what with that whole glucose-being-necessary-in-metabolism issue.

Scared Myself Half to Death

It was quittin’ time. That mid-winter evening darkness had consumed the world outside the station. I tugged on my bright EMS coat, preparing for January’s frigid bite once I left the warmth of the building. I grabbed my keys, wished the new crew well, and headed into the bay.

It was chilly and dark there. A few flickering fluorescent bulbs seemed to provide more shadows than light. I edged my way between the back bumpers of the trucks and the racks of turn-out gear. The smell of old, sooty fires hung in the air. All was quiet, except for the occasional clicking within the settling and cooling engines, and a slow, periodic drip of water onto the concrete floor. I rounded the corner of a fire truck, intending to walk the aisle between the fire engine and the ambulance, make my out of the station and into the night. I didn’t take two paces before the dim light illuminated the silhouette. My heart briefly stopped in my chest. My breath caught in my throat, just before letting out a terrified cry.

The flickering light provided just enough backlighting to make it out. Black boots hung at my eye level. The figure was still. The only movement came from the slow, occasional drip of melting ice off the boot’s soles. I covered my mouth, trying to stifle the scream. This couldn’t be happening.

The door to the living space of the station opened on the other side of the bay. My partner’s voice shouted out my name in concern, followed by the thudding of heavy boots running on the concrete floor.

I broke my gaze from the legs of the figure, and saw another slumped figure only a few yards away. And there was another. And another?

As the crew drew nearer, they flicked on the rest of the lights. In the brilliant light, we could see what had actually happened.

The red cold water exposure suits were hung from a clothesline high above our heads. They had been taken out and used for training purposes that morning, and then hung out to dry overnight. A half-dozen red suits, complete with black rubber boots and gloves, were strung up along this little alleyway. Laughter shattered the unnecessarily horror-filled silence.

Well. At least my reaction was highly amusing to the relief crew. You’re welcome, guys.

 

Damn You Autocorrect!

When you work in the middle of nowhere, you get sent on transfers to far-away places on a regular basis. “Far away” meaning one-way transport times that exceed an hour…sometimes it’s more like 2.5 hours. We find ways to keep ourselves entertained on the journey back to the station. We listen to the radio. We sing/screech along with the radio. We play a game called “find a radio station that comes in enough that we can pick out a few notes among the static.” We talk. We complain. We vent. We play long-car-ride games. Activities that, although fun, aren’t terribly productive. If we had a computer in the truck, we’d probably be more apt to do our reports on it…or at least get the narrative written up.

Every few weeks, we get those days that are absolutely ridiculous, and we are completely swamped in reports. So, some brave souls try to get the narratives done on some document software on their personal tablets or phones during the drive home. I’m not one of those brave souls. Partly because my stomach doesn’t like it when I try to read in moving vehicles. And partly because I am not very good at technology.

That whole speech-to-text thing never works out for me. If I say, “The patient complained of 7/10 sub-sternal chest pain after being chased by the fuzz for three blocks,” my speech-to-text would end up something like, “Patient blames several of them sub colonel apps for chest pain after dealing haste by the buzz funky hops.” And thanks to our good friend autocorrect, typing that same sentence would look like, “The patting complained of u/10 sub-streak chest pain after brunner. Badged. Y the fuzz for then blocks.” *

Being a young adult, there’s sort of this expectation that you just automatically know how to work these gadgets. I seriously don’t. It’s a miracle I can get my smart phone to do the things I can get it to do. I’m lucky I can find Facebook, my email, and write blog posts. Technology just isn’t my game. And recently, we found out that not all of my coworkers are infallible tech gods.

One medic wrote a report on some device that uses autocorrect. He meant to write, “18 gauge IV started in the right AC. Applied tegaderm.” Thanks to autocorrect, we got a version with much more bang, pop, and drama to it.

“18 gauge IV started in the right AC. Applied MEGADEATH.”

 

 

*Okay, so THAT might have been a smidge worse than usual.