lucid

It truly amazes me...

2011-03-18T19:37:00.000-06:00

that one can be totally intimate with a man...

who has blood on his hands from the war on the streets...
while safe behind a badge....

and then another, with blood on his hands from the confusion of a war...
a thousand miles away...

and later, another...a virgin pure and clean...

and there is no measurable difference between the three.

Nevermind.

2010-06-26T20:01:00.001-06:00

I'm taking a 911 Dispatch gig.

ICU

2010-06-09T21:34:00.000-06:00

I just got offered a position as a full-time ICU tech and I'm taking it.

I'm very excited, nervous, etc. One of the things that has struck me is that in the next few months I will almost certainly work a code... something I have never done before. I will be boning up on my BLS, among many other things.

I've been reading around on nursing forums, and the advice one seasoned ICU nurse/former CNA had for a ICU tech struck me... "don't be intimidated of all the tubes and machines... don't be scared... but RESPECT them."

Will keep in mind.

Go ahead fake commenters

2010-06-09T00:07:00.001-06:00

With names of Chinese characters. Post your fake commentary.

And yet it lingers...

2010-05-31T00:01:00.000-06:00

If I'm no worse for wear, if I lived through it to tell the story, if I'm better off now, if I've moved on and found love elsewhere, if I'm not hurt or angry....

Then why on Earth does it fester like a nasty wound?

Thoughts on Hospice and Other Things

2010-05-09T08:24:00.004-06:00

(This was a journaling assignment for the CNA program I just completed)

Hugging a woman, tearfully grateful that no one was hurt when her house burned down one Christmas taught me that I am, in fact, not the center of the universe (a shocker when you are 17).

Hunters found the body of a sweet old veteran with Alzheimer’s who had gone missing out in the sticks a month after we had called off the long, extensive search for him. When the coroner's report revealed he had likely been alive during the days I had been working on the search, I cried my heart out. The “what-ifs” bothered me for a while, but I came to believe that we can only do our best for people, and even then, we can’t save them all.

Having “situational awareness” and “keen observation skills” drilled in to me during my training as a search and rescue volunteer and EMT soon seeped into my daily life, immersing me in all the beautiful little details of life that many people are too busy to notice.

I learned to wear my seatbelt, never smoke, use a helmet, avoid drugs, practice safe sex, and never drink and drive the hard way: by taking care of good people who suffered the consequences, in the ambulance, the ER, the OB-GYN clinic, the spinal cord injury / traumatic brain injury rehab hospital, hospice. As a result, though, I have a deep-seated, emotional commitment to those rules that is very difficult to break.

Feeding an older man struggling with Parkinson’s who had accomplished things in his lifetime such as interviewing Martin Luther King Jr. reminded me to respect the wisdom and dignity of those who’ve been here for a while.

I witnessed grace beyond anything I could ever imagine attaining, in a nun embracing her last moments on Earth.

Sitting by wives, husbands, children, brothers, sisters and friends as they spent their final few hours and days with their loved ones, inspired me to make a conscious effort to never take someone I care about for granted.

And in the last minutes of my last hospice clinical, sitting alone with a woman in the still silence of her room, holding her hand as she took her last peaceful breaths, affirmed that death is not to be feared. Walking out the hospice doors and back in to my own life, reminded me that the world goes on without us.

They say we are in a profession of giving. I believe it is an honor and privilege to help those who invite us in to the most private aspects of their lives; to have them trust us, our skills, our hands, our minds, and most importantly our hearts when they need help the most. I believe that in giving care as your life’s work, you receive so much more back.

Near the end of my first shift at hospice, walking out of a room as the sun dipped, beautiful, rich singing suddenly filled the hall. It was coming from one of my patient’s rooms. Curious, I knocked and entered. I realized it was a woman singing prayers in Hebrew, emanating from a stereo on the bedside table.

The patient’s daughter, sitting at her side, explained that the woman with the otherworldly voice was her own daughter – the patient’s (we’ll call her Eileen from now on) granddaughter. She was an opera singer and college student. When she flew in to visit a week before, she sang these Jewish blessings for her grandmother. Although Eileen was nearing death, suffering severe dementia, and often incoherent… she made one thing clear to her family and grandchild… “blessings,” she had repeated over and over again. So the granddaughter sang for her for hours. Before she had to depart back to school, the family recorded a long CD of her singing for Eileen to enjoy over and over again.

Later I returned to Eileen’s room with dinner. Her daughter had gone home for the evening so it was just her and I. She required total assistance, likely would only have a few bites, and was down to just saying the word “yes” at this point. I paused as I uncovered her meal. It was Friday evening - Shabbat eve. Friday evening and Saturday comprise the Jewish sabbath. I grew up in a Jewish household, and knew that this meal held special significance to this woman who clearly valued her faith.

“Eileen, you know, my father is Jewish. I even got close to my bat mitzvah. I remember some of the blessings, but it’s been a long time. Would you like me to try to say a blessing over dinner?”

“Yes,” which was her invariable reply now. I wondered if she comprehended what I was talking about, and if she did, if she really intended to say “yes.” I reasoned that at worst, she’d think I was crazy, and at best, I’d help a dying woman uphold an important spiritual ritual.

I went ahead, held her hand, and let the prayer loose in the sing-songy nature of Hebrew blessings. I hoped that I didn’t butcher it as we sat in silence for a moment or two afterward. I was probably eleven years old the last time I had recited it.

“Perfect,” Eileen whispered – the only time I’d heard her say anything besides “yes” in my 24 hours with her as a patient.

No one had died during my first shift. Midway in to my second shift, I heard the toll of the bell, marking the passing of a patient, out in the hall while caring for someone. Although it was not our patient, I asked to help with postmortem care since I hadn’t seen it yet. One of the nurses guided me and explained the process. The patient who had passed was in her mid-fifties. I noticed that both the nurse and the CNA were about the same age. I wondered if they ever mulled it over… if it ever bothered them to see people their age die or if it just made them grateful to be well. It was striking to watch the healthy, able-bodied nurse deftly attend to her duties, standing over a deceased woman of the same age whose body had been ravaged by cancer for years.

“You put up one hell of a fight, Jill.” the nurse said reminiscently as she pulled the sheet over her face. We closed the door and went back to work.

In the last hour of my last shift, the CNA I was following pulled me in to one of our patient’s rooms. Her condition had rapidly declined in the few hours since I’d seen her last. The CNA said she thought she was very close to passing, and since the woman was alone, asked me to stay with her. I sat by her side as I talked to her softly, just letting her know I was there and she wasn’t alone. She had a bible at her bedside, so I read a few passages.

Her hands and arms were cold, she had no radial or brachial pulse, and her carotid pulse was so weak and irregular it was hard to detect. I followed the pattern of her breath as I smoothed her hair from her forehead. She would be apneic for as long as 20 seconds, give a few labored breaths, and stop breathing again. Cheyne-Stokes? She did have congestive heart failure, among other things of course.

It struck me that I could assess this woman all I wanted, name her conditions, consider the pathophysiology going on, whatever, but the best thing I could do for her is sit by her side and just be present. I don’t think many people want to die alone. As the last minutes of my shift drew near, the CNA returned to the room with a stack of charts.

“I’m going to finish my charting up in here,” she said, and it was understood between us why. I was so grateful that I didn’t need to leave this woman alone in her final moments. I said goodbye to the patient, thanked the CNA for all of her help, took a deep breath and walked out the door as I heard her soft voice offering comfort to the dying woman.

A year is a long time...

2010-04-07T20:29:00.004-06:00

If I were to tell you that since I've last posted, I've fallen in love and moved out of the house with my boyfriend, would you believe me?

It's hard to believe myself, especially looking back at where I was a year ago... but it's true.

Soon after my last appearance, I began working as an EMT at a local amusement park's ALS-level first aid. It was a fantastic experience. All of the other EMTs and Paramedics had their different "day jobs" in a garden variety of places and organizations... from the ER to the fire service to the private ambulances. I made a ton of new friends and connections, and learned so much from people bringing their huge breadth of experience to the table.

In particular, there was this cute, athletic EMT with big ears, blonde hair, and gray-blue eyes. We talked a lot whenever we worked together. We'll call him Ryan.

He was clearly a bit shy but we chatted vigorously over our passion for nerdy physics/disaster shows on Discovery and History. He watched "How It's Made" out of curiosity. I watched it to lull myself to sleep.

He lived in a rural community pretty far away and his day job was in a grocery store... produce department. He goes to school full-time and recently started volunteering at his local fire department. He wants to be a firefighter/paramedic someday.

One day he was scheduled to work, but was no where to be found. After 45 minutes, I called his phone number from the posting on the wall. I woke him up. His alarm hadn't gone off. He apologized repeatedly as I heard him running around getting dressed and ready. I laughed as he hung up. When he ran in embarrassed and disheveled, still apologizing, I officially decided I had a crush on him.

He was the "taken" type, though. I never bothered to ask. I was too wrapped up in the absolutely awful, disgusting experience of falling for someone with too much PTSD for their own good.

One day, I was manning the water park first aid booth when a cute guy came to ask for a bandaid. We started chatting for a while. He was a firefighter and EMT from almost 400 miles away, but he actually worked with a good friend of mine. He mentioned coming back for a bandaid later after he swam and walked off. I kicked myself for not getting his number, being desperate to find a reason to detach from Army-Jerk.

Thinking he might come back for a bandaid, I wrote my name and phone number on one and saved it for him in my pocket. He never came, though. What can you do?

Several weeks later Rob, we'll call him, called me. That coworker of his that I know... yeah. He got my number from him. We talked every day for hours on end. Being desperate to get out of town and away from the ghost of Army-Jerk anyways, I decided to take the haul out to his place for a weekend. I loved driving anyways, and nothing felt more amazing than traversing the Rocky Mountains on the open road in summer, belting out songs in the car alone.

We spent the whole weekend together in his dorm on the sticky-hot Western Slope. I liked him a lot. I wouldn't have liked as much if my heart wasn't currently being torn to pieces by some other guy, but hindsight is 50/50. He still had to work... he was a tech in the local ER too... so I spent my days wandering around town and wading in the Colorado River. Honestly, I had an amazing time, alone and with him equally.

I felt like I was leaving a dream when I came home. Back to work, and all of the people and places that brought back Army-Jerk's legacy.

I just realized I haven't followed up on what happened between Army-Jerk and I. He flew out here before being discharged, we had an amazing weekend of "love" and connection... I flew out to Nashville and helped him move out of his apartment... another amazing weekend. Then he completely fucked me over. He went on a several-month long road trip wandering across the US, sleeping in his car. Among his varied activities, he fucked hookers and never bothered to tell me until after we had been together when he came back. The first time I've ever had my heart broken. I should've seen that one coming. You live and you learn... don't fall for jerks with a gnarly case of PTSD.

Fortunately, he soon left the US for the summer, allowing me to cry, scream, punch and/or burn things, listen to heart-broken country songs, date openly and generally get over it. It was a rough, rough road.

Back to Rob and I... over the next month or two we continued our little long-distance relationship. We went camping, I met his family. He asked me to make it official after I impressed the hell out of them. I reluctantly agreed. He had plans to move out to my area soon anyways. The whole thing only lasted a few more weeks though, before I got sick of the long-distance thing and I realized I wasn't that in to him.

One of my coworkers from the amusement park was having a birthday get-together with several other people from work at a nice restaurant. I got there early and sat at a bench outside waiting for others to show up. Ryan appeared, and reluctantly sat next to me... and we started talking shyly.

Back

2010-04-07T20:15:00.003-06:00

It's been over a year since I've posted.

Yesterday I got a text from a random friend who had somehow discovered my blog through surfing the web, and instantly recognized the writer behind the posts. He essentially yelled at me for quitting.

I will cut to the chase and finish the story of the last patient we visited in Complications, before I even go on to explain where the hell I've been for a year.

Dr. Green, Dr. Lee and I found the surgery floor and they updated the front desk staff on the situation. Since this was Dr. Green's patient, she wanted to take care of her herself in the OR. The staff started doing their "thang" on the computer system to get the ball rolling.

"Do you operate here?" the woman behind the desk asked.

"No," Dr. Green replied, "but I keep up my credentials here in case of emergency situations like this next door."

The woman stared at the screen, punched keys, wiggled the mouse. "I'm not finding you."

The two doctors I stood next to were clearly outraged. Dr. Green began to stutter out how she had just put in more paperwork for credentialing here and received a letter confirming... Dr. Lee, in a manner only a surgeon could project stopped it all.

"I'm the head chair of the Credentialing Board here. If I need to, I approve her. Now."

Awkward silence. The lady looks confused... "I'll do what I can."

Soon Dr. Green whisks away behind the doors to start scrubbing up and I'm on my way back to the clinic. It's strange to go about the day after such an incident. I apologize to my patients for the delay, but don't want to scare them by describing why the doctor won't be able to see them for a bit.

Dr. Green returns later. She reports that she was able to manage the hemorrhage easily in the OR, without hysterectomy or any lasting concerns. Her and I return to the hospital to visit the patient in the PACU. She is post-surgically woozy, with the attentive PACU nurses at her side eager to make her comfortable. But she's ok. Dr. Green talks to her for a bit, and I don't have much to say but I squeeze her hand and move some hair from her face.

She goes home that night to her children and husband. And I go back to work the next day.

Complications, continued

2009-03-19T18:18:00.007-06:00

So there I was - standing in the exam room of a regular doctor's office with a hemorrhaging patient, an attending, "Dr. Green," wrapped up in fixing the problem, and a half-stunned intern gripping an ultrasound with bloody gloveless hands.

"I need 4 misoprostol right now... and bring a runner with you" I stepped out of the room and ran to get the meds, breathlessly telling the other MA "this is not good, we need you in here" as I passed.

Immediately Dr. Green told the other MA to grab another doctor in the office, "Dr. Lee." The doc, an OB GYN as tall as tree, walked in calm and smiling, and Dr. Green showed him the image of the patient's uterus on the ultrasound screen after briefly introducing her.

"See this... on the anterior wall. I don't like it. I think this is accretia. We need to get her into the OR. Can you set that up for me?"

He gazed at the slightly fluxing screen, his eyes scrunched as he deliberated, "Will do, how are we going to get her there?"

"She's going to need a stretcher. I don't know how we're going to work that. Can you get you us a stretcher?"

"I'll borrow one. We'll figure it out." He quickly stepped out of the room. The intern flashed me a wide-eyed glance that I could read as if the words were scrawled on her face... "Can you believe this is happening?"

The office building is located across the street from a medium-sized hospital, and connected to it by a pedestrian bridge. Our practice is actually a satellite of a different hospital and is only at this particular location twice a week, so our doctors are pretty unfamiliar with this neighboring hospital. Fortunately, Dr. Lee works on L&D there all the time and knows it like the back of his hand.

Finally, Dr. Green had a chance to fully explain what the hell was going on to the patient.

"I think that the pregnancy implanted itself into the scar from your c-sections. Now you're bleeding quite a bit. I'm going to have to finish this in the operating room, where I'll have light and all the resources I need, and we can put you under anesthesia so you won't be in so much pain. Ok?"

The patient, who hadn't said a word during this entire ordeal, moaned weakly and replied, "ok."

There was a strong knock at the door moments later, and a stretcher waiting outside the door. We couldn't fit it into the exam room, so the doctor and I supported the patient as she slowly half-stumbled to the stretcher, spattering blood all over the floor as she went and leaving a trail from the exam table to the stretcher. She had probably lost about 2 units in the exam room al0ne. We covered her the best we could and took off, following Dr. Lee's lead.

Rushing across the pedestrian bridge over to the adjacent L&D floor elevator, we nearly ran into a hospital food service guy, who froze and watched us pass in utter shock.

In the elevator, Dr. Green explained to the patient, who wanted 2 more children, that a hysterectomy may be necessary to stop the bleeding and save her life. However, she added, "I'm going to do everything in my power to save you and save your fertility. I'm going to get you home to your kids and hopefully make sure you can have more kids in the future." The patient cried silently... I can't even imagine how surreal and scary this whole thing must have been.

We reached the ER. They were expecting us and had a room ready, and the nurses were obviously anxious and a little excited. It's a small ER with no trauma services, so God knows when they last had a hemorrhage on their hands.

As a million new people did a million things to my patient at once, I briefly stood at the head of the bed and rubbed her shoulder, "they're going to take great care of you." I looked into her eyes but felt she was not really there. The nurses shot me a hundred questions, and it felt strange giving a hand-off report after not doing one for so long.

I met Dr. Green and Dr. Lee outside the room as they were talking to the ER doc, but soon we were following Dr. Lee as he led us up to surgery.

[To be continued, yet again. Sorry guys... ]

Complications

2009-03-17T21:32:00.007-06:00

It was a routine dilation and evacuation for a miscarriage. I was assisting the doc, passing off instruments and keeping an eye on the patient. It sounds strange but I like working with miscarriage patients, because it feels like one of the few patient populations that I can really make a difference with. They're going through a rough time, and it seems to me that having a supportive, caring but unintrusive caregiver means a lot to them.

Everything was fairly routine. The doc was a tad concerned that the patient had 3 c-sections and no vaginal deliveries - which meant she really had none of the advantages of being multiparous. If she had given birth vaginally her cervix would have been much more pliable, and we needed to dilate her to about 6 mm. I wasn't aware that the doctor had another concern in mind. We did the procedure under ultrasound guidance by the resident, which is pretty unusual. Usually no ultrasound is needed.

So we're humming along and everything is going normally... until we start applying the suction. The patient started yelping in pain. Now, pain in a D&E is normal and expected. But that little alarm went off in my head and I couldn't really decide whether the woman was just overly expressive or was experiencing an abnormally high level of pain.

I spoke to her softly and tried to soothe her - which is hard to do without physical contact, but I couldn't do that with a pair of gloves on and the doctor constantly needing me to pass off sterile surgical equipment. She continued howling.

Then, by the doctor's facial expression and the way she seemed agitated and rushed when she asked for more 4x4s or more suction or this or that... it became obvious this was far from routine... it became glaringly obvious when we started reaching about double the amount of blood and tissue I'd expect from a 6-7 week miscarriage in the suction containers.

The doctor removed the suction from the cannula in the woman's cervix, and blood started flowing out of it as if it was a kitchen sink faucet at about half of it's max flow. And it didn't stop. At this point, I snapped in to the mode. That zone you get it in when you realize you have a sick patient on your hands and you have to do something about it or they may die.

[I'll finish this later, I need to study for midterms. So I'll leave you with that cliffhanger.]

You're Trouble.

2009-02-06T17:35:00.006-07:00

Background: we met at the SAR team's Christmas party. He was a member about 6 years ago, and he's the best friend of the firefighter I had that brief stint with at the beginning of the summer. We didn't talk much at the party. I was pretty mesmerized though. He is disarmingly attractive... with icy blue eyes that make you get that funny feeling in your stomach. An army guy, he was on leave at the time. We didn't talk again until he was back on base, far far away in another state. We started casually chatting online.

And somehow we ended up here, about a month after we first started talking. Through several 4 hour long phone conversations and days spent texting back and forth... we're strangely infatuated. It's completely unbelievable, exciting, and terrifying. I've never found it so easy to talk to someone, and I find myself thinking about him all the time. Most of the time it just feels natural and I don't even think twice about it. But occasionally I stop, take a step back and think "what the fuck is going on?" Sometimes I want to slap myself for it.

We're in this constant tug of war because there's that weird attachment but then there's the fact that we've never really hung out. We've spent all of 2 minutes face-to-face. More importantly, he's fresh from 27 months in Iraq and just about to get out of the army. Talk about a transitional period in life. He's not ready to settle down into some big commitment when he's just trying to sort out what he's going to do now that he's out.

He's getting out late February, and was going to drive around the country a bit before finally making it back home. So we were counting on finally hanging out mid-March. Until he completely surprised me tonight with a flight itinerary. He's coming this weekend. I ran around my house like a little girl jumping and squealing.

Because I know you're reading this -

Hi there. I can't wait. :)

Maybe each of us alone has enough crazy for the both of us.

2009-02-06T00:24:00.006-07:00

Today I cried over a boy for the first time in nearly 3 years. If you asked me to explain why, I couldn't give you a good reason.

He could give you all the reasons in the world why right now isn't right. And he is right. I know it. Does it matter? It doesn't make it any easier. He has his personal demons to sort out and I respect that. I'm not trying to complicate the life of someone who is simply trying to get his mental health on track after a long, long time at war. But fuck. Fuck.

Didn't you think about that at all when you told me all the things you did? I didn't get this attached on my own, damn it. I didn't. And honestly, I kind of hate you for fucking with my head so much. It's nice and all that you were courteous enough to stop before it got really bad... but why did you even start?

I know you'll read this eventually...

2009-01-27T00:09:00.001-07:00

"It's been a long time since I talked about so much nothingness and so much somethingness with someone."

I want you to know that you somehow manage to simultaneously enthuse, scare and soothe me. I don't know what this all means or where we're going to go with it. All I know is that I want to be around you and I want to know what you think. I want to know where you've been and where you want to go. I want to know what makes you tick - what song you listen to when you want to feel something, what stretch of road you drive when you just feel compelled to drive somewhere, where you go when you want to feel that divine vacancy - that "Ahhhhh".

I know the timing isn't perfect and you have a lot of shit to sort out in your mind. Just know I'm here. I'll listen to you and give you a shoulder to cry on if that's all you need. If you need to disappear, I'll let you go. I don't expect anything from you. I just hope that I can have some of your time. If you need to take your time, I'll wait.

You are one hell of a creature and I know I'll never really understand some of the misery you've been through. I hope that you find some solace. From the bottom of my heart.

Ethics

2009-01-25T19:41:00.002-07:00

I'm taking "Intro to Ethics and Society" this semester, a philosophy course. After one day of class, and about 25 pages of reading, my brain already hurts in a good way. I'm trying to think of a way to sum up my general system of values and ethics. It's hard to define. I typed up this general manifesto a year or so ago, and it sums up some of my values, I suppose.

Altruism is the only answer to hostility. Passion is the only answer to apathy. Curiosity is the only answer to ignorance.
The harder I work now, the stronger I'll be when it counts - when people are relying on me or when I have no one to rely on but myself.
People are always worth trying to love, or at least understand.
Worry is a worthless disease.
Cowards say "fuck the system" and run from it. The brave integrate themselves and change it.
Teach all you can and learn all you can from every person and experience.
Embrace the undefinable as is.
"These things that I do... so that others may live."

I'm agnostic and spiritual. Therefore, as far as the basis for my values, I try to live my life in a way that in the least does not harm others and at most makes the world a little bit better. My justification is selfish. I feel the most fulfilled when I am benefiting others. It's really as simple as that.

I believe that if there is no higher power, no afterlife, no mystical force behind why we are here, my life will have been worth something if I have made some sort of positive impact, no matter how small. Am I even truly dead as long as my actions have made life better for someone who is still living?

If there is a higher power, and God knows if there is, I have faith that he/she/it will be just, and keep me in their good graces despite the fact that I do not go to church, did not save myself for marriage, and was never baptized.

I believe in the sanctity of life, but I do believe there are circumstances in which taking a life is justified. If a person is suffering, there is no end in sight, and they want to die, let them die for the love of God. It's selfish to keep them here when they would rather be elsewhere. I believe that certain people who have displayed complete disregard for the lives of others, who cause more harm than good by simply existing, deserve to die.

I see the world in existentialist terms. I do not believe there is one right path. Some speak of existentialist angst and the existential dilemma... "Why am I here?! What is my purpose?!". I say it's a waste of time. I value resourcefulness and believe that in absence of a God-given purpose, one should invent a purpose for themselves, whatever that purpose may be as long as it does not involve harming others. I cannot justify why human life has such inherent value. It's just there.

Getting Away

2009-01-16T00:20:00.004-07:00

I've had this overwhelming urge to load up my pack, drive to the middle of Nowhere Backcountry, USA and spend some time out alone in the wilderness. That wanderlust. It's nagging. Is it my age? My SAR instincts tell me that this is a terrible idea, though.

Life is all there for the taking, it's a matter of taking the plunge.

The simple, overwhelming joy of existing.

2009-01-15T00:43:00.005-07:00

Today I was driving home, listening to a good song (Windmills, by Toad the Wet Sprocket, if you must know) when the sky seemed to suddenly explode into this beautiful sunset. The Rockies, craggy and defined by snow, were dripped in this ethereal orange haze. I had to consciously refocus my attention on the road. I gripped the leather of the steering wheel and forgot about everything. I have a lot to be thankful for in my life, but at that moment I let it all go and just existed in the moment. It felt so overwhelmingly miraculous to just exist. God knows what it all may mean, or how it came to be, but the simple act of living is beautiful.

My 2 seconds of "fame"

2009-01-13T00:58:00.003-07:00

Here's the aforementioned news clip. I'm pretty much the only person not wearing a black and gray jacket, with the sexy blue/green gloves.

And no, for those who are newish to my blog, I am not in high school. I recently "graduated" the team but continue to volunteer in the field and act as an instructor. I was a lieutenant during my tenure as a regular, high school student member, but officer positions are filled by youth only (except for the chief staff) and they are completely in charge in the field. So officers automatically lose their rank the fall after graduating high school. It's pretty crazy, but it works well. The leadership is continually refreshed and it brings new blood in command constantly, which can be difficult but has definite advantages. Anyways. It's pretty cool. Kudos to our Chief - he deserves that award. Kudos to his wife as well - who you can see playing patient in the clip.

When the world is watching

2009-01-11T18:42:00.002-07:00

Our Chief was honored with some "heroes" award by a major local TV news station. They wanted to film a segment of us running through a quick training, so we staged a search and carryout for them.

I was the primary medical - just treating a simple isolated tibfib fx. I felt like I did a good job, but it was only after the fact that it really hit me. This segment is going to run 6 times on a major network. Hundreds of thousands of people are going to see me. It's not the laypeople that make me nervous, it's the idea of hundreds of EMTs, medics, nurses, etc watching me. Scrutinizing my every move. What if I made some small f-up and didn't even realize it, or they edit it in a way that makes me look bad?

It airs in 3 hours. I'm glad they aren't using my name.

Ignorance would be bliss.

2008-12-18T19:01:00.003-07:00

2 months ago or so, when I was going through the whole sudden, significant spike in blood pressure crisis (by the way, it apparently resolved itself within 2 weeks, my BP is now back down to normal) my GP ran my blood and urine. Bloods were normal, but he said I had microalbumin in my urine. He said it warranted further investigation, but believed my multivitamins may have somehow given a false positive.

Anyways, I decided to do my own Chemstrip dipstick urine at the clinic last week. No microalbumin or albumin, but:

Sample had the highest readable specific gravity of the strip. Pretty sure I'm not dehydrated, either.
Positive for occult blood at a moderate level.
Positive for bilirubin.

I don't have any symptoms. I'm sure if I thought long and hard about it, I could think some up... like the weird morning stomachaches, but I know they're all really benign (I'm pretty darn sure I get those stomachaches because I often eat right before bed). I'm afraid I'm becoming a hypochondriac or something, but I definitely wasn't hallucinating the results on the strip... I even had a coworker double-check them. Who knows? I'm not worrying about it yet, but it's on the back of my mind.

Anomalies.

2008-12-15T00:37:00.003-07:00

As I take my patient back from the waiting room, I can see she is struggling to choke back tears. Her husband hovers behind her with anxiety-brimmed eyes.

I speak quietly and move quickly. I tend to walk too fast.

Once we're in the quiet of the exam room, the tears begin to flow. I know why she's here, so I'm not surprised, but I never quite know what to do in these situations at first. Do I offer a hug? A hand on the shoulder? Nothing at all?

"I'm sorry. I just... I'm sorry," she says.

I get down to her level and offer a kleenex. "No, no don't worry."

My heart is breaking. For her and her husband, who is as vulnerable and anxious as I've ever seen any man, standing in the corner like an injured animal.

I take her vital signs and ask a few questions. I hate a few of the questions I have to ask. She keeps apologizing for crying. I keep trying to reassure her. The husband adds on to many of her answers and asks more questions than she does; he's so concerned about his wife that I'm simultaneously heart-warmed and heart-broken.

The absolute joy of their first pregnancy was shattered by an ultrasound a week ago. At 10 weeks gestation, her OB GYN diagnosed their baby with anencephaly. It's a cruel death sentence: the neural tube of the fetus fails to close, leaving them without major portions of the cerebrum and head. Those who make it to term are often stillborn, and those who survive birth die within days. When it's diagnosed early in pregnancy, therapeutic abortion is often recommended. And that's what brought my patient in.

The D&E is awful and unreal. The room is heavy with pain and silence save the patient's whimpers. When it's all over, the doctor leaves the room with the tissues to go make sure she's got everything and I return to tend to my patient. I check her vitals, fetch her water, and let her recover.

Once she's dressed I do her discharge, and she hugs me. I feel relieved, and we just stand there holding each other for a while. She sounds better. She's not crying anymore, and I catch a sad smile. I'd like to think that although devastated, she left the office in recovery. There's the crisis, and then there's the recovery.

Fun with avalanche rescue.

2008-12-08T11:27:00.002-07:00

I know I haven't written in a while. This weekend I was up in the mountains for an avalanche rescue training. I'll write a full post soon, but in the meanwhile check out this classic shot of myself with one of the avalanche rescue dogs.

Great animals. They have a program in which they drop these dogs, their handlers, and another avalanche rescue technician into slide zones by helicopter if they suspect people may have been buried. As with any avalanche, recovery is much more common than rescue, but the dogs are very successful and greatly reduce the time and personnel needed to find a buried victim. It's also safer for the rescuers, considering with this method you only need 2 people and a dog on the ground in a potentially dangerous area as opposed to 20-30 or more needed for probe line recoveries.

Another pursuit

2008-11-28T01:55:00.003-07:00

I finally completed my application for DMAT/NMRT.

Should be good stuff. I'm extremely interested in disaster medicine. I like how in the wake of a disaster, you have some trauma patients but a ton of public health issues. It's really fascinating how the medical conditions resulting from a disaster evolve and change over time. You've got everything from the blast injuries of the first few seconds to the PTSD that may begin to rear its ugly head a couple of months down the line.

Oh, and to give you an idea of how awesome this team is:

"The NMRT-Central is now the only “all hazard” team within NDMS and deploys with 60 medical and non-medical specialists capable of decontaminating up to 1000 patients an hour or treating up to 200 patients a day in a medical setting."

"Currently a DMAT can provide care including cardiac resuscitation, basic to mid level trauma care, basic clinic operations, and now providing radiological services with portable x-rays. "

Good stuff. You know, people freak out and think that the government is incompetent and unprepared for disaster, but when you look at the whole picture they do a pretty damn good job. Admittedly there's weak spots in the system, but what the heck do you expect? They're trying to prepare for and manage catastrophic, unpredictable events at the national level.

XY XY XY XY XY... XX (and then there's me)

2008-11-24T01:33:00.004-07:00

An abnormally large portion of my life has been spent around men. I was raised by a single father, my first best friend was a boy, and now all of my close friends (minus 1) are male. I spend my free time with a group of about 5 guys, ages 18-21. We go to school together, search together, rescue together, eat together, hang out together, work out together...

It's an interesting dynamic.

I am, essentially, "one of the guys". I am subject to all of the highlights of male friendships, like farting, inappropriate gestures, ridiculous pranks, a constant stream of sexual innuendo and sexist jokes, and random wrestling matches.

But I know that I will never, ever truly be "one of the guys," and that's not a bad thing. I'm just different. As my friend Code once put it, with good intentions, "You're an ARP (SAR team) girl. You're not female. You're not male. You're basically genderless."

They still open doors for me and act protectively and gentlemanly, when warranted. But it's more than that. By listening to them converse in the group, I know for a fact that each of them tells me much more about their personal lives than they tell each other.

When it's just one of them and me, I hear about deadbeat alcoholic brothers, dying dogs, distant girlfriends, crazy moms, jealous exes...

These are things that, apparently, the boys do not discuss in depth, if at all, with each other. Maybe it's relieving to have a woman's nonjudgmental, sympathetic ear to release these deeply personal tensions on.

Although there are unique connections, there are also rituals I won't break into. My boys are top-notch skiers and major powderhounds, and even though they'd let me come if I could ski worth a lick, I don't think I would try to invade on their special testosterone time anyways. They need it.

The things I treasure most.

2008-11-22T01:34:00.007-07:00

Adventure. Going new places, trying new things, challenging myself to step outside my comfort zone.
Laughter. Being with friends and laughing so hard it feels like we did 100 sit-ups the next morning. Generally laughing my way through the little slip-ups and setbacks of life.
Sex. Indulging in others and myself. Embracing the fact that I am a sexual being and enjoying my time as a relatively attractive young woman, which doesn't always mean having intercourse.
Making a difference. Particularly for people in crisis. I don't find it depressing that I regularly see people experiencing the worst times of their lives because I am empowered to make things better for them, at least a little bit. Nothing is more rewarding than knowing that you've had a real positive impact on someone's life, even if your interaction with them was short-lived.
Learning. I feel wiser and more capable everyday. This goes along with teaching, something I have recently begun doing and have found to be more of a learning experience than anything.

Senior year to now

2008-10-29T20:00:00.002-06:00

I forgot to mention something important. Near the end of my junior year and right before I joined the SAR team my mom went to rehab for a month. My step-dad finally persuaded her to go under her own will. Within 30 minutes of her release, as my mom and step-dad walked in the door at home, my step-dad started complaining of severe chest pain. My mom drove him to the nearby hospital where it was confirmed he was having a heart attack. Soon, he was in cardiac arrest. My mom recounted hearing "code blue" being paged over the intercom and a flurry of doctors and nurses and techs rush into his room. They successfully resucitated him and he has returned almost completely to the state of health he was in prior to the heart attack.

In my senior year I continued my involvement in SAR and on the newspaper. I also started taking a "med prep" class which was pretty intensive... about half of my credit hours. It covered basics in health care like ethics, medical terminology, standard precautions, professional standards, sterile technique, etc. The teachers were two nurses, and unfortunately they sucked at running a class. The medical terminology and the sterile technique stuff was the only worthwhile part of the program for me.

I also took college anatomy and physiology. It was more difficult than I expected, but I loved the class. My professor was crazy: he was a single dad of 3, a neurosurgery resident, played in an orchestra, and taught at 2 different colleges. I don't think he slept, and he made the neurology unit really hard.

My relationship with Chris was on shaky ground. He found it difficult to deal with the fact that I was devoting so much time my own endeavors, and that one of those endeavors, SAR, involved me spending great amounts of time around men. I found it difficult to deal with his career as a music marketing rep and DJ - which required him to spend much of his time in bars and clubs all night. He felt like I was growing away from him and although at the time I denied it, it was true.

I started working at a drop-in nursery at a rec center about 1-2 times a week. The pay was awful, but the nursery was often empty so I just did homework.

I started my EMT-B class my second semester of senior year. It was every Saturday from 8 am - 5 pm for 6 months. I loved it. It was my one respite from the drudgery and inaneness of secondary education. I blazed through it too, having already passed my SAR team's emergency care class with flying colors. I fell in love with everyone in my class. They were truly great people and it makes me happy to know that they will be among the new crop of EMSers taking care of sick people.

I didn't attend any high school proms or homecoming dances. Simply put, I didn't see the allure in paying a decent sum to be in a dark room overcrowded with people I generally did not like dry-humping each other to obnoxious music. I was anti-social... but honestly only when it came to high school.

I was happy to see graduation come, but didn't romanticise it. I was still working hard in my EMT class and other endeavors well after my graduation, anyways. My mom didn't show up to my graduation. After I walked I checked my voicemail. She left me a message but it was so slurred I couldn't understand it. So I basically came to understand she was too high to come to my graduation. That pissed me off.

I broke up with Chris shortly after graduation. It was really hard to do, but I never thought about turning back. It just kind of happened. I felt like I had to experience the world more, date a few people, and live independently while I was young. Him and I are still struggling to keep this friendly relationship.

I passed my NREMT stuff with flying colors. I finally got my driver's licence in June, right before my SAR team's annual trainings. In my first month of having a driver's license I drove well over 500 miles, many of those miles were in the mountains. I hadn't been interested in driving until my senior year because I was happy walking everywhere or taking public transportation. I didn't see the need to spend all my money on gas. I had no real need for a car until that point.

Around this time I had a fling with a gorgeous firefighter who was the son of a high roller on the SAR team. I'll never get him. He came on to me really strong. He was the one who started it. I hadn't even really talked to him prior to his initiation of contact. We went on a date that ended pretty hot and heavy... and then another date that went similarily. However, I said no to sex at the time because of the politics that might erupt if the affair came to light (his dad was my superior at the time). A few weeks later when I felt that the situation was safe... no dice. "I don't know what I want out of a relationship right now," and this was his response to me saying that I wanted to keep things completely casual and avoid a serious relationship or commitment of any kind. Oh well. It still bothers me to this day for some stupid reason.

I also took my IV approval course in July with 2 friends. I completed the course, but didn't get enough sticks in my clinical rotation to get the approval. I could have scheduled another clinical, but got lazy. I have no real need for IV approval anyways.

My best friend A and I went on my first road trip ever to Cheyenne shortly after. I had been seeing someone stationed at Warren Air Force Base, so we stayed up there during Frontier Days. We managed to have a great time, despite the fact that the guy I was seeing was exhaustingly clingy and touchy-feely. We would be sitting on the couch and I would try to get up to go pee and he would be grabbing at me. That didn't last too long after we left Wyoming.

I started school as a pre-nursing major at a state university in the heart of downtown in August. Many of my friends from the SAR team attend school on the same campus, so I spend a lot of time with them. And as you may have noted, I'm completely enamored with one of them.

I snagged a student employment gig as a medical assistant at an ob gyn clinic operated by the university's hospital and med school. It's a perfect learning environment, and there's no nurses so I do a lot of nursing-ish work.

I go to school 2 days a week, work 2 days a week, and help teach my SAR team's emergency care class 2 days a week.

It's a lot easier to write about your life in a few years of retrospect. Writing all this stuff down has made me realize how young I am. I've only been alive a few years, really.

Sophomore to junior year

2008-10-20T22:23:00.008-06:00

"Yay! Spinal immobilization!"

Things kept truckin' right on from there.

Chris and I became a serious couple, of course, and I stopped cutting and taking pills. Admittedly, I still smoked pot occasionally, but not nearly to the degree I once had, and I was no longer dependent on it.

I started seeing a psychiatrist who threw out all previous diagnoses and diagnosed me with ADHD. I'm really sick of this game of adding and subtracting diagnoses but the Adderall I've been prescribed has been the only the only thing that has helped me, although I do despise the idea of taking an amphetamine on a daily basis.

I transferred high schools to the one where most of my friends attended. I took biology with the most amazing teacher ever, Ms. Moore. She called all things microscopic and living "wee beasties" and took us for nature walks on a regular basis. I love her to bits.

I had earned a 3.5 + GPA by the end of my sophomore year and won a few awards. It felt great.

Things at home were as turbulent as ever. My mom was taking prescription pills so often that her normal state was complete incapcitation. My new step-dad Dicky had moved from California but was in complete denial of my mom's addiction. My dad was struggling to make ends meet and we even ended up living off a food bank for quite a while.

Chris provided an oasis for me. He treated me like a Princess and he was my best friend.

Junior year was much of the same. Chris and I started having a few tensions in our relationship, but that's to be expected; in general things between us were amazing. I started taking college courses like English and Anatomy and Phys. I loved being away from the superfluous, ridiculous, overly dramatic world of high school and actually learning at a purposeful pace.

I wrote for the school paper and became somewhat notorious for my out-there ideas and occasionally controversial opinions. I wrote news stories about the rise of meth labs in suburbia, the horribly inconsiderate attitude of the general student population towards one another, and the misuse of the term "African American."

I became aware of a local search and rescue team that was completely run by high school students. I became extremely interested and even wrote a newspaper article about the team, allowing me to interview a member of the team, Ashley, who turned out to be freakishly similar to me in goals, interests and attitude. She is now one of my best friends.

With plenty of enthusiasm I joined the team and prepared myself for Basic Training, AKA search and rescue boot camp. Little did I know the ass-whooping that would ensue. After hours and hours and hours of carrying out heavy people on litters and hiking over rough terrain with no rest, I was on the brink of collapse. No one thought I would last through the day, nevermind the rest of the weekend or the second weekend of basic training. I called my dad hysterically crying asking him to come pick me up. Fortunately, I soon changed my mind.

I barely eeked through the first weekend, but did better on the second. I realized that SAR is essentially back-breaking physical labor and a lot of hiking, and started getting in better shape. I was pretty low on everyone's list after I struggled so much through basics, but I would have my time to shine. When the emergency care class, a course with a curriculum somewhere between First Responder and EMT-B level, rolled around, I shocked everyone. I flew through the class, only missing 1 point on the final. I arranged study sessions, wrote study guides and worked my ass off to ensure everyone else passed too. I am proud to say that the emergency care class I was in had the highest pass rate in the history of the course.

I stopped smoking pot completely once I joined the team. SAR became my full-time job, and my friendships in it became increasingly more important. Because of all of these factors, I started drifting away from Vanna and my old group of friends.

A second chance

2008-10-19T00:56:00.005-06:00

After my discharge from the mental hospital, things seemed to get even worse. The Lexapro made me feel empty. Completely empty. The habits continued.

Vanna opened up one night, about 2-3 months after my stay in the nuthouse. She told me about how I was destroying myself, that I was a complete slut and drug addict, and that I needed to stop feeling sorry for myself and just change what I was doing. It was harsh, really harsh, but the thing that killed me most about it was how true it was. I was only 16 and this was the reality of my life. It hit me like a brick.

I couldn't take it.

I took every pill in my house, which was a cocktail of cold medicines, benzos, anti-depressives, antibiotics, sleeping pills and NSAIDs. I felt like it wouldn't be enough because there was only a small amount of each available so I started searching for an instrument to slit my wrists with but couldn't find one because my dad had thrown out all of the sharp objects while I was hospitalized. I found a dull knife but it didn't really do the job. It did leave me bloodied though. I laid on the floor defeated and in misery from all of the pills. I kept trying to close my eyes, and they were closed because I could feel my closed eyelids with my fingers, but I couldn't stop seeing. It was like my eyelids were transparent. Imagine trying to fall asleep but being unable to close your eyes.

I crawled into my room and eventually got up the strength to hang a sloppy noose of shoelaces from the rod in my closet. As I slipped my neck into it and let myself collapse into it... I started blacking out and felt so relieved... but the noose slipped from the bar and I fell to the floor. I pawed the laces loose from my neck and finally fell asleep. My dad tried to take his medications in the morning but they were all gone. He found me in my closet bloody, sick and with a shoelace around my neck. I went back to the ER, and back to the same mental hospital yet again.

The EMT who rode with me to the nuthouse was unbelievably sweet. He gave me a teddy bear and didn't treat me like a dumb ass for what I had done. They actually let me keep the teddy bear with me while I was in the nuthouse.

One of my favorite nurses from my first stay admitted me. The look of disappointment and sorrow on his face when he saw me coming back in absolutely crushed me. My roommate this time around was a girl my age who had also tried to kill herself. We were very similar and became good friends. They had given her charcoal in the ER because she had ODed and I remember that she was pooping black for her entire stay.

On the second day I was sitting in the commons when a new patient came in. Instantly after seeing him, I thought to myself, "for all I know I could end up marrying that guy," I don't know why that thought came to mind. He was pretty cute though, and something about him intrigued me.

His name was Chris and he was 19. He threatened suicide after his long-time girlfriend cheated on him and dumped him. Him and I became friends quickly and I had a serious crush on him.

This time around I had a new psychiatrist. He threw out the borderline personality disorder and depression diagnoses, and instead diagnosed me with Bipolar Disorder and placed me on an anti-psychotic. I didn't believe the diagnosis but didn't really care.

One day in my stay I suddenly realized the only person who could fix me was myself. I stayed up all night and wrote out a list of everything I wanted to do, see and accomplish before I died. This was my revelation. I woke up the next morning a different person and have never been the same, in a good way, since.

Chris was scheduled for discharge that day also. It saddened me. Patients weren't allowed to exchange any contact information and were strictly forbidden from making any effort to make contact with each other after discharge.

I was sitting in my room when all of a sudden Chris came in. I was shocked because this was huge violation of the rules and a nurse could easily see down the halls at all times. He hugged me and slipped a piece of paper into my hand. It had a little love poem and his contact information. I almost fell over from excitement. I didn't think the feelings were reciprocal until then. I couldn't wait to get home.

I went home a day after he did. I called him immediately. We talked for hours and scheduled a date for the next day.

We did a lot of things on our first date, but the most memorable was when we sat on top of this tiny man-made waterfall in my favorite park and kissed. At that moment I fell in love, and as if reading my mind, he said "I think I love you."

Freshman year

2008-10-19T00:16:00.009-06:00

(PS: I've added a few pictures to some of the older posts in the series.)

Me at 15 years old.

My dad moved into a new apartment. I decided to go to a different high school than Vanna. I thought it would help me refocus my energy on my studies. It didn't.

I was smoking pot almost every day freshman year. My dad either turned a blind eye to it or joined me. I was constantly cutting myself and abusing benzos, especially Xanax. I also started drinking at parties.

One night while hanging out with Vanna and another friend, I took at least 7 mg of Xanax. The dose prescribed to my dad was 0.5, and the maximum daily dose for anyone is supposed to be 4 mg. I have very little memory of the night, and I woke up with a lip piercing, which I barely remembered giving myself with a safety pin. I kept the piercing for several months.

Unsuprisingly, I continued to do very poorly in school. I eventually decided that I would be lucky to get my EMT-B at a community college. I didn't have any aspirations beyond that because I didn't believe I could achieve any more than that.

I had flings with several random guys, many of them quite a bit older than me, and never while I was sober.

Vanna was starting to get concerned about me, but she was still right by side doing the same things.

I celebrated my 16th birthday by getting drunk with Vanna, her boyfriend, and another guy at his house. I had about 1/4 of a handle of vodka and completely blacked out, vomited on the guy's bed, and the 3 of us got kicked out onto the street in below zero temperatures. I don't remember any of that, but I do remember waking up in my apartment's stairwell. It's a miracle we made it there. Somehow I looked back at nights like this with some sort of wishful reminiscence.

My dad finally started getting concerned about my behavior. I was constantly intoxicated, and rarely came home on weekends. My grades were the worst they'd ever been. He's always been a person who expresses any and all of his emotions with anger, which only made the situation worse. It was constant anger at home.

When my dad found a large blood stain on my carpet and bloody x-acto blades in my room, he confronted me. It was really hard to hide the hundreds of cuts and scars on my legs when he started catching on. He cried and it broke my heart. I let him take me to the ER. The sweetest nurse cleaned up my wounds and affectionately expressed her hopes that I would stop. They did a psych eval and I of course tested positive for weed and benzos. They put me on a mental health hold and I spent a night in the ER and they shipped me to a nuthouse the next morning by ambulance.

I don't remember much about the nuthouse but I know it really pissed me off. There were a few nice nurses and techs but most of them were assholes. I don't blame them. We had to wear scrubs for the first few days until we "leveled up" by being good little boys and girls. We always had to walk in a single file line and we weren't allowed to touch each other. There were bars on all of the windows and they searched our rooms all the time. I saw a psychiatrist a few times while I was there. She was a fucking bitch. She told me I had borderline personality disorder, that I would eventually abandon every single person I would ever become attached to, and would up end up very very very alone in the world. Yeah, that helped. They made me fill out a 100 + page packet that hurt my hands and didn't accomplish anything, diagnosed me with depression and put me on Lexapro. I stayed for a week and they discharged me.

After I was discharged things felt even more messed up. I came back to school the week before finals, and the school had no mercy for me. They expected me to complete all of my missed work and take finals as normal. I dug my own grave with my poor grades, but they buried me. I earned a 1.73 GPA freshman year. I was trying to stop my bad habits but I started smoking pot, cutting, drinking, and taking pills soon after I got out.

Middle school

2008-10-16T20:51:00.014-06:00

Vanna and I in 8th grade at a school dance...

I was painfully awkward in middle school. I was chubby and unpopular, clumsily making the transition from reckless tomboy to calculating girl. Things were bad at home. My mom moved into a town home and started abusing prescription narcotics more and more (this was apparently a habit she had before I was born, but I didn't notice it until around this age). My dad had found a new apartment near Columbine High School. He went to sign the lease on April 20, 1999, but the road was completely shut down by police. He found out why later. We moved in a week or 2 later, and since he had just gained primary custody, I stayed mostly with him.

In 6th grade I wrote a persuasive paper on how nurses should get paid more. I interviewed my grandma's favorite nurse at the nursing home, took surveys of other students and everything. I have to admit, it was damn good. My first journalistic masterpiece.

Other than that, I started doing poorly in school. In elementary school I earned straight As (except for gym). My grades started nose-diving. I still excelled at tests, but had trouble completing homework and class busy work.

One day at home, I was on the computer and my dad was in the other room watching TV. All of a sudden I heard him make a very loud groan, as if he were in great pain. I ran into the room to see his face contorted and red... eyes staring at nothing... mouth foaming.... fists clenched. I sat by his side, yelled his name and shook him but he didn't respond. My first thought was heart attack. I quickly crossed that off, and by putting together pieces of stories I'd heard, including the ones my dad had told me about his sister having seizures as a child, I realized he had a seizure. By the time the paramedics arrived he'd fallen into a snoring, sleepy postictal state. I rode in the front seat of the ambulance, and my mom picked me up from the hospital a few hours later. The ER couldn't find a reason for his seizures, and even weeks later after several appointments with a neurologist, no cause could be found, and he was diagnosed with idiopathic epilepsy.

To this day, if my dad groans in a certain way, my heart will start racing and I'll run to find him. He's had several more seizures since the first, but they're few and far between.

In my 7th grade social studies class I sat next to a girl named Savanna. She was my polar opposite in many ways. She was tall and as skinny as a rail, blonde-haired and blue-eyed. Within a couple of weeks we had a weird relationship in which she shared her snacks with me during class and I let her use the brush and mirror I kept in my locker. Soon, we were best friends. I shortened her name to Vanna and the name has stuck to this day.

We had sleepovers often and spent a long lazy summer at the side of the public pool. She was extremely innocent and sheltered, so I ended up being very protective of her. She had several boyfriends, and when one of them cheated on her, I kicked his ass in front of all of his friends. Twice.

Eventually she started dating her neighbor Chris, who was 3 years older than her. They dated for nearly 2 years, and he treated me like a little sister.

My dad and I were on a long drive home from a dinner at a family friend's house late at night once when I had a horrible stomachache and nausea. Eventually, he said "I'm going to hell," and pulled out a joint. He told me I could smoke some if I wanted because it would help me feel better. I had recently started suspecting that he smoked, so I wasn't completely shocked. So I smoked pot for the first time. I just got really tired.

My mom started dating one of her high school sweethearts who was a park ranger living in California at the time. His name was Dicky, and I met him when he came to visit. I liked him. They got married soon after that. It shocked me since I had only met him once, but I didn't really care.

In 8th grade some of our friends started smoking pot, and Vanna and I followed suit. For a long time we didn't spend a dime on the habit, but got by on the generosity of our friends. She broke up with Chris, and then we started doing other bad things. She shoplifted a lot and pierced her own ears, tongue, and belly button. I smoked a lot of pot and got suspended 3 times in middle school total - once per year - for being rebellious to teachers. I started cutting myself and I didn't know why.

At a 4th of July festival we met a boy named Ranse. Vanna started dating him soon after, and he was really, really weird. I liked him enough, but he said the strangest things. One day we went on a double date to the mall with his cousin Jared. I was 14 and Jared was 17; it was the summer after my 8th grade year and I'd soon be starting high school. He was gorgeous. I thought he was way out of my league so when he started showing me attention I got so excited, even if he was weirder than Ranse. After a few hours of knowing him I could tell he was pretty aggressive. He bit my lip until it bled a little and was very grabby.

Later that same night the four of us got stoned and went to a local cemetary to walk around. Vanna and Ranse disappeared, so it was just Jared and I all alone. We started making out and I let him touch me down there... but when he started taking his pants off I felt like things were going way too far. I told him no but he persisted. I told him no one more time and had a little struggle with him, but gave up because I didn't want someone to call the cops who would find us with drugs trespassing on private property out past curfew. And so I lost my virginity in a graveyard. Vanna and I walked back to my house and I told her about it and cried but she didn't understand.

The summer became a blur of parties, boys, and bad behavior. Vanna started dating a guy named Steve, and eventually she lost her virginity to him in the stairwell of my apartment building. Steve had a best friend named Tyler, who worked in a restaurant less than a block away from my house. We all smoked a lot of pot together. Tyler, who was 20, had really good weed and not much else going for him. Either way, I started meeting him after he'd get off work. We'd hang out in his car, smoke pot and then have sex. In all honesty, it was an unspoken contract of trade: weed for sex. At this point I started hating myself, but ironically I made no effort to change my behavior.

I was still cutting myself constantly, mostly on my legs, and started raiding my dad's medicine cabinet for Xanax. I got addicted to that real fast.

Preschool to 5th grade.

2008-10-12T22:56:00.008-06:00

Me in my favorite Pocahontas costume terrorizing my cat Annabelle.

The only thing I remember about kindergarten was the time we had a substitute teacher and the fire alarm went off. She panicked and froze up so I started directing the class into a single file line until she regained her composure.

At home I ran wild along the canal and greenbelt near my house with my neighbor Patrick. We adventured on secret trails and built forts tucked away on the banks of the canal. One time we snuck into a barn and found hundreds of typewriters. There was basically nothing but typewriters in the barn. We stole a few for our fort.

I liked to dress myself and wore weird stuff. I went through a serious Pocahontas phase and wanted to be an Indian more than anything. I wore a Pocahontas costume constantly and wore it while running around a nearby pond, playing a wooden flute that tasted like smoke.

My parents started sending me to "Pony Day Camp" where I learned how to horseback ride. My favorite horse was Daisy. I always had trouble learning how to post while trotting. It made me angry that they wouldn't let me canter or gallup without first learning to post while trotting properly. I just wanted to go fast. I loved exploring the land on the ranch, which was nestled in the foothills, as much as I enjoyed horseback riding. One time a cow got loose and they had us go find her by sticking our fingers in cow pies and tracking the warm ones.

I read at a higher level than any of the kids in my grade. They had to seperate me and another boy from the rest of the class when it was time for reading practice. I was proud but also embarrassed.

My gym teacher was an asshole. He ridiculed me in front of all of the other students on a regular basis for my ineptitude. I think he may have been part of the reason I started hating sports.

I was unpopular because I was a weird ugly little tomboy that wore glasses. They also started pulling me out of regular class for "gifted and talented" classes, which I thought were fun. We played a lot of games.

One day, I think I was about 7-8 years old, my dad barbecued some hamburgers on the grill for my mom and I. Her and I were sitting on the bed on the second floor of our house as my dad finished up some grilling, when all of a sudden there was an explosive noise and through the windows the entire world outside appeared to be on fire. We screamed and ran down the stairs... I'll never forget seeing my dad, shirtless, screaming in pain, covered in burns, and dousing himself with the garden hose. All of the neighbors came running because they thought a car had exploded and were shocked to discover it was just the propane tank of the grill that had. This was how I was first introduced to firefighters and paramedics. He spent some time in the burn unit, his face, chest, arms and abdomen covered in second and third degree burns. It was at this time that I realized I enjoyed being in a hospital. He made an amazing recovery and now it's nearly impossible to tell that he had such horrific injuries.

For some strange reason I was obsessed with the idea of becoming a lawyer in elementary school. I even had these thick legal books for the home that I carried around. I knew a completely unhealthy amount of information about law for a child. I got tired of it by 4th grade.

My parents argued all of the time for as long as I had remembered. My dad's business started going down the tubes and things fell apart from there. They started getting divorced when I was in 2nd grade. It wouldn't be finalized until I was entering 6th grade. It was a brutal, nasty split.

My grandma had a stroke soon after my dad's burn fiasco. She was staying with us at the time, and I remember coming inside to see her sitting in a chair, and she was crying but her face looked funny. I asked her what was wrong but when she tried to speak it came out like gibberish. I told my dad that something was wrong with grandma and the paramedics came again. It turned out that she couldn't speak but she could write perfectly. I stayed with her for hours in the ER, and then in the ICU. She made a great recovery because she had been treated very early. A few days later she was almost 100%. The doctor in the ICU blew up a glove-balloon and my grandma, the doctor, a nurse, my dad and I played glove volleyball. I decided I wanted to go into the medical field.

I was the only girl in the math gifted and talented class. We played this fantasy stock market game and I won, mainly because the boys invested heavily in the company with the ticker symbol "NHL" because it was hockey playoff season, but I looked up what the ticker actually stood for (not the hockey league) and knew better. It really pissed them off. I was never particularly good at math after that year.

In 5th grade I got a really bad cold. Which slowly developed into a cold that gave me severe difficulty breathing. I ended up in the ER and was hospitalized for a week because I had bad pneumonia and bronchitis. I liked the hospital. They rolled this cart with video games into my room all the time. I was really, really, really good at the jet ski game by the end of the week.

Birth to preschool.

2008-10-12T13:39:00.008-06:00

(note: if you haven't noticed... I'm doing a life story series. I was inspired to do so by something I read and this is mostly for my own benefit, but you're more than welcome to enjoy the ride)

For a while my parents and I lived with my mom's sister and her 4-year-old daughter. My aunt's boyfriend and father of my cousin had suddenly left them.

I was generally a happy, complacent baby. My mom was terrified that I would get too cold and dressed me in so many unnecessary warm layers that I would cry. She would take me to visit Stacy sometimes.

Soon after my first birthday my aunt and cousin moved out, and we moved to a big new home. My dad had started his own home remodeling business and it was doing well. He spent a lot of time with me because my mom was still a flight attendant so she was gone on trips a lot and he was self-employed so he could set his own hours.

As soon as I was able to I was tearing my clothes off constantly. I loved being naked. Maybe it was revenge for my mom smothering me in warm clothes. I went to the emergency room twice before my second birthday. Once because I drank an oil candle, and again because I stuck a ton of packing peanuts up my nose and my parents couldn't get it all out.

I asked to be taught to read when I was about 3. My parents bought me Hooked On Phonics. I hated it. They scrapped that idea and taught me to read by themselves. I was reading ravenously by the time I was about 4. They told me I was adopted around this time and it was really no big deal to me. It didn't bother me at all.

They bought me a pet goldfish but I killed it accidentally when I kept putting my hand in the bowl and touching it. After successive fish-replacement-murders, they decided to get me a cat instead because it would be harder for me to manslaughter. We got a tabby kitten from some people with free kittens in a box outside a grocery store. I named her Annabelle and she became my close companion for well over 6 years. Whenever I cried she would come running and lick up my tears.

I loved being outside. I went to a preschool called Building Blocks where my tomboyish nature started showing. I hung out with the boys and caught garter snakes in the playground. I had my first boyfriend in preschool, his name was Brent and we planned on getting married. My best friend was Sonia. We were in Brownies together.

I had long, long hair but one day I gathered all of my dolls and toys in a room and gave them haircuts. Then I gave myself a haircut. From that point on my mom kept my hair boyishly short. I hated it. We went on a vacation to Disney World when I was 5 but I got the chicken pox and we came home early.

I actively participated in both Judaism and Christianity at this point. I liked Judaism more.

Conception to birth.

2008-10-12T13:05:00.005-06:00

My parents were really young. They met at their Catholic high school and fell in love. Stacy had tons of long, long curly brown hair and big sad eyes, and Andy, who was older, had jovial eyes that probably couldn't express sadness if they tried. They dated for quite a long time, and both of their pious families came to accept the relationship. The turmoil didn't start until Stacy got pregnant when she was 16 and Andy was 18.

Andy worked maintenance at an apartment complex and shared this crisis with his boss Mitch, who he had become close with. Mitch, a handyman, home remodeler and designer was almost 40 and had recently been married to a flight attendant named Lynn. Lynn had been rendered infertile by an experimental IUD. A connection clicked. Mitch and Andy started discussing adoption. Mitch took the idea home to Lynn, and Andy discussed it with Stacy. With the approval of their parents, the solution became viable.

A growing Stacy left the scornful eyes of the Catholic high school to attend a special high school for pregnant girls. She lost all of her friends, who either disapproved or couldn't seem to wrap their heads around the baby growing in her belly. Lynn became her close friend and confidant, talking hours away with her, taking her shopping, and offering a shoulder to cry on. Lynn understood, because Lynn had given a baby up for adoption herself when she was young.

The families became some awkward but caring conglomerate. When they found out I was a girl they started discussing names. Stacy wanted the name Ashley. Mitch and Lynn wanted the name Lauren. They compromised and named me Lauren, with my middle name Ashley. They decided that after the birth, the adoption would remain as open as it was during the pregnancy. Stacy and Andy were obviously both Catholic, but Lynn was Protestant, and Mitch was Jewish. To my biological parents request, Mitch and Lynn agreed to baptize me and encourage me to seek Catholicism (they never did).

I was born at night in a blinding snow storm in the presence of a huge group of people, family. They vacuumed me out so I had a misshapen cone head for a while. My dad, Mitch, was concerned that I would look like that permanently. The doctors assured him that my head would return to normal.

The legal adoption process started 2 days after I was born when my adoptive parents took me home.

Pissed.

2008-10-05T22:29:00.003-06:00

I'm really pissed.

It really pisses me off that I don't have any answers about my high blood pressure.

It really pisses me off that I have to miss school for doctor's appointments.

It really pisses me off that I have to walk around with electrodes and wires strapped to my chest so I can't wear certain shirts... and this stupid device makes an annoying beeping noise all the time.

It really pisses me off that despite being young, eating fairly well, being a healthy weight, and exercising regularly I might have primary hypertension. I don't smoke. I don't drink a lot of caffeine. I don't eat a lot of salt. I don't have any known family history of it. I know this makes me sound like a bitch but I thought most people with primary hypertension were either old, obese, or had crazy family history of it. Why me?

It really pisses me off that my systolic BP suddenly went up 30 points in less than 2 weeks, without having ever increased at all before, and my cardiologist doesn't seem to think that's a big deal.

It really pisses me off that every time I call the cardiac monitoring service to transmit the events my monitor spontaneously records, they won't tell me what the rhythm is.

Misadventures in cardiac event monitoring.

2008-10-03T20:58:00.004-06:00

I went to the cardiologist a few days ago. My blood pressure is still at about 140/80-90. He said the the funky things my GP saw on my 12-lead EKG were "normal variants." I had another 12-lead EKG taken in his office, without any abnormalities.

So he scheduled me for a stress echo (like your run-of-the-mill stress test, but I get my heart echo'd before and right after also) and set me up for a month of "cardiac event monitoring." Little did I know all the highly irritating, hilarious and fascinating things I was about to experience.

A cardiac event monitor is very similar to a Holter monitor. It's a constantly monitoring 2-lead EKG that records selectively. I have 2 leads on my chest that are connected by wires to this pager-looking/sized black device. It's constantly monitoring my heart, but only records when I press a button or when my HR goes over 150 or under 40. The 60 seconds prior to the trigger and the 30 seconds after are recorded and stored in the device as "events." The device can record up to 3 events, which are then transmitted VIA phone to some technicians at some company who send the short strips to my cardiologist. To do this, I call them from a land line, tell them about my symptoms during the event, and put the mouthpiece of the phone and press a button to send. The pager-ish device proceeds to make a scary fax machine screechy noise for several minutes and that's it. Then the events are cleared and the fun starts all over again. This article describes the whole cardiac event monitor thing in more detail.

I'm supposed to press the record button whenever I have palpitations, but in the 2 days that I've been wearing the damn thing I've yet had the need to do so. However, it's set itself off due to tachycardia about 6 times, despite the fact I haven't really done anything physically strenuous.

I put it on for the first time on Thursday morning, right before going to work. It managed to set itself off from tachycardia twice by the time I made it to the clinic, and unfortunately it makes this loud intermittent beep as long it has any events recorded on it. So I walk into the clinic with wires hanging out of the bottom of my scrub top mystically making electronic beeping noises every minute or so. To stop this beeping I had to borrow the attending's land line to call that number to transmit, so my boss had to endure about 5 minutes of me talking on her phone and 8 minutes of annoying screechy fax machine noises. Thank god my boss is a doctor, because I think most other bosses would have fired me at this point.

Today was even worse. There was a different attending on today, so I had to explain, again, why wires were dangling out of my top and why I kept beeping. This time, I had 3 events by the time I got to work. So I borrowed the attending's phone again to transmit, but this time the entire world must've been having palpitations because I was on hold forever. So long that I kept having to hang up to go take care of patients, come back, try again, wait on hold, and repeat. Over and over and over again. And every patient was looking around the exam room trying to figure out where that damn annoying beeping was coming from while I was trying to talk to them. Finally I got through to the tech to transmit and the beeping ceased.

Later in the day I was assisting the attending and a 4th year medical student with minor surgery.. basically being the scrub tech instrument passer. All of a sudden they desperately needed this tubing, and it wasn't in the room. So I dart out the door and I'm running around the clinic like a bat out of hell flinging open cabinets trying to find it. I find it, bring it back to them, but it's the wrong kind. I again run around the clinic like crazy trying to find that damn tubing. Unfortunately, we're out of the right kind. I return to the room in defeat to find them continuing the procedure Macgyver style. And I hear that damn beep. The patient looks confused as they finish her procedure to the lovely tune of...

BEEP!................................ BEEP!........................... BEEP!............................. BEEP!............................ BEEP!...............................

Later I discharge her from the clinic to the same glorious melody. I apologize, but decide not to explain. Don't want her thinking I'm terminally ill AND nuts.

And everything aligns against me.

2008-09-29T21:59:00.006-06:00

Isn't it lovely that during the exact time that I'm discovering I may have a heart condition... and the doctors are trying to pin down a diagnosis... I'm having the busiest week of my entire year?

3 Midterms, tons of papers due, random assignments, teaching classes, work... now compounded and severely complicated by the fact that I have to miss multiple classes for urgent doctor's appointments.

It's also hard to focus on school when you're concerned about your health.

Sometimes you get to swim with the current, and sometimes you have to swim against it. As long as you don't tire out and drown, it'll just make you stronger.

I'm a pretty damn good swimmer.

And the doc says...

2008-09-24T18:21:00.003-06:00

Went to the doc this morning. BP was still 140/80. From what he told me that only thing he heard upon auscultation was an innocent heart murmur I'd already known about. Here's the EKG:

Doc said there's nothing blaringly abnormal, but a few funky things that he's not completely comfortable with. He mentioned some similarities to Wolff-Parkinson-White because in his opinion the QRS complex looked barely stepped-off but he said he may have been imagining that (I think he was), and that I have a relatively short PR interval but not short enough to be a huge concern.

So I've been referred to a cardiologist who I'll be seeing next week.

What the hell?

2008-09-24T06:44:00.007-06:00

"140 over 78," the phlebotomist said, as if it were normal.

"What? Are you sure about that? I usually run about 110 over 70," I replied, obviously shocked.

"Probably just nerves," he brushed my concerns off and continued to set me up for the blood donation.

Nerves. I've donated blood and been stabbed by fresh IV students so many times that getting poked (especially by someone who has actually done it on a human before) is really no big deal to me at all. And if it was nerves... why was my heart rate normal? I shrugged it off and blamed it on his poor BP skills.

The next day while we were teaching the SAR probies how to take vitals I had my friend, an EMT, take my BP. I was in my element. I couldn't be more relaxed being at my second home around my second family working on something that I love... there was no possibility of "nerves" interfering with my vital signs here.

I watched the little arrow fall as he took my BP... "that was early..." I thought to myself when I felt my pulse return with a vengence. He made a strange face and said "Yeah... it's about 140/80."

"You're just fucking with me."

"No. I'm sorry. I swear it's 140/80."

"Shit. Shit shit shit shit. What the hell? What's wrong with me?"

I knew he was right... I could feel that it was high while he was taking it. The probationary members, not really understanding what this blood pressure business is all about yet, shifted in their seats uncomfortably and smiled nervously.

I'm a healthy 18-year-old, in better than average shape that's consistently had a BP of 110/70 for the past year - as recorded hundreds of time due to being in an EMT class and other medical-ish classes. Until now.

Then I started thinking (probably overthinking) about other stuff that's happened lately. The sporadic episodes of palpitations and sharp chest pain that I attributed to innocuous PVCs related to my screwed-up sleep schedule and stress. The innocent heart murmur.

I'm calling the doctor today.

Lovely Random Acts of Kindness

2008-09-20T02:04:00.002-06:00

Late at night in the parking lot of my apartment building after a long hard night of mini-golf (which turned out to be more of a full contact hockey game) and a movie with the boys, I gathered all my crap from my car. There was a lot of crap to be taken: my big ol' pack, my big ol' boots, my purse, my SAR uniform and a book. I found places on my arms and in my hands for everything and started for home in a half-asleep cold-medicine daze.

I dumped everything on my bedroom floor so I could open my snail mail. Check my email. Check the news. The usual. After about an hour I realized that I should probably hang up my uniform, which I had carelessly tossed on the floor when I got home. When I went to do so I made horrifying realization. My uniform shirt was not there. I looked all over the house, but it was not there.

Because I distinctly remembered draping it over my arm at the car I immediately went to go retrace my steps to the car. The whole time I was freaking out... it sounds so weird but I am attached to that shirt. Not only was it sorta expensive, but I've had it since I joined the team and it's been on my back through everything. Not to mention the little green notebook I always keep in my breast pocket, that I've also had since I joined SAR, that is falling apart and only has about 20 pages left, but has a list of every phone number I could ever possibly need inside.

I made it to my car without finding my shirt. There's a bar on the 1st floor of the building so there's always people walking around the parking lot. I began to think someone had just picked it up... which really freaks me out. Now I'm angry, worried, and concerned... imagining some drunken moron doing god-knows-what wearing my shirt with my star of life patch and my notebook and my agency's patch and my nameplate on it. I'm sure any person who wears such a uniform can understand why I was so worked up over this possibilty.

Defeated, I started heading back home when I noticed something draped over this sign in a kinda-obscure kinda-not place right up against my apartment building. And of course, it was my uniform shirt. Whoever placed it there chose a perfect location.... somewhere that people just passing by wouldn't really see... but a person going into the apartment complex and looking aroudn would. They also took care to hide the patches from view, making it look like just any other plain ol shirt.

I really wish I could find the person who did this for me and thank them. We need more of that kind of anonymous courtesy in the world today.

Organisms

2008-09-18T14:12:00.004-06:00

For me, the question has never been "why are we here?" As someone with agnostic and existential tendencies, the lack of an answer doesn't bother me in the slightest. I don't need someone to hand me a purpose in life. I really don't give a damn why, if for any reason, we exist.

I'm much more curious about why life is so driven to make more of itself and persist. Yes, this question is somewhat related to the generic "why are we here?", but this is more a question of biology rather than philosophy.

At the most fundamental level our genes are pushing us to stay alive and reproduce. Thanks to genes our cells divide, specialize, grow, function, die. Which eventually guides us to eat, drink, fight, fuck, sleep, repeat. There's general bio in 3 sentences for you.

Life, at it's core, is a pretty simple concept. What blows my mind is that every organism from bacteria to human has the drive to live and make more life.

First day at the OB GYN clinic...

2008-09-04T23:12:00.003-06:00

I don't think I'll have any desire to have sex again for about 10 years...

You know what though, it's good experience to have, there's a lot of openings in the OB GYN field. ;)

Any weird insecurities I've had about my own genitalia have now been erased.

The place is oozing with estrogen. It's quite a change of pace from my usual gang of SAR buddies, who are all men.

The area of the clinic that I work in exists solely to educate new OB GYN interns and medical students, so there are no nurses. Just medical assistants (my position), attendings, residents, and med students. This is great news for me because a. it's a teaching environment and b. I do a lot of "nursing" work - like intake, history taking, blood draws, Rhogam injections, instrument passing in procedures, discharge, etc.

I really like it though. Great patient care experience. The staff is awesome too.

How to Prevent Air Emboli, by a Crackhead.

2008-09-01T17:33:00.010-06:00

Man tries to amputate own arm at Denny's
Associated Press

"Police say a man tried to cut off his own arm at a restaurant in Modesto, Calif., because he thought he had injected air into a vein while shooting cocaine and feared he would die unless he took drastic action.

Authorities say 33-year-old Michael Lasiter rushed into the Denny's restaurant late Friday and started stabbing himself in one arm with a butter knife he grabbed from a table.

They say that when that knife didn't work Lasiter took a butcher knife from the kitchen and dug it into his arm.

Police Sgt. Brian Findlen says Lasiter told officers he thought he needed to amputate his arm to keep himself from dying from the cocaine injection." click here for the full story.

I couldn't help it...

2008-08-29T02:26:00.005-06:00

But really... kudos to my lovely, bunny-rescuing local fire dept. (sometimes they save people too).

Actually, I feel obligated to point out just how phenomenal these people are, and how honored I am to work with them on calls, trainings and the ride-alongs they've graciously allowed to me to come on.

If this call isn't one of the most amazing, most expertly-handled calls you've ever read about, seen or heard about, you're lying.

A lawn worker struck by a car, drug underneath it for a distance, and then pinned and trapped, left with an evisceration through his back along with other injuries.

Total scene time, with extrication: 5 minutes and 26 seconds.

Time from 911 call to comprehensive care at a level 1 trauma center: < 20 min.

Best part of it all: the patient lives.

I got it!

2008-08-27T13:44:00.003-06:00

I got the job at the OB GYN clinic!

I'm very excited. This job has more patient care than any other job I'd be able to get right now, and the clinic is a part of my university's schools of medicine and nursing.

I'll be admitting and discharging patients, taking vitals and bloods, setting up rooms, assisting hands-on with procedures and sterilizing equipment.

It's not an ambulance or the ER, but I think it's a pretty darn good start. Wish me luck.

Designer scrubs

2008-08-25T17:57:00.002-06:00

I found an even better job with more patient care at a OB GYN clinic associated with my school. I interviewed for it today, and hopefully I'll get it.

I got bored and started browsing online for scrubs, because I'll probably need 2 sets for this job. It's cracking me up though, because there's all these designer scrub companies like...

Baby Phat Scrubs by Kimora Lee Simmons - includes the "Leopard Chic" and "Bling" collections.

Scrubs, by a sexy fake doctor!

Going along with the Katherine Heigl collection is the Grey's Anatomy Scrub collection!

Man, I dig the cool colors and fits and stuff... but people need to realize that no matter how much you try to stylize the uniform, you're still wearing pajamas to work.

A job!

2008-08-21T00:25:00.002-06:00

Looks like I could be getting a job pushing patients around for radiology at a local hospital.

We all gotta start somewhere. :)

FRI

2008-08-19T23:40:00.006-06:00

I attended a very large Fire/Rescue/EMS conference recently. It reminded me of the commercialism in this business.

The ability to save lives is a commodity... it comes in different colors and sizes and prices. At the Zoll booth I performed compressions on a dummy for 2 minutes and won a Zoll t-shirt based on my efficiency. I saw the local fire dept's EMS chief wandering around, shopping for prams and monitors and ambulances and god-knows-what. A skinny lady with big boobs and a thick layer of makeup strutted around in a tight-fitting shirt and a fake pair of low-cut, form-fitting bunker pants... I have no idea what she was selling.

SCBAs, fire engines, mobile command posts, helmets, thermal imaging cameras, stair chairs, radios, spreaders, cutters, rams, forcible entry tools, turnout gear, burn buildings... the list of crap for sale is endless.

Fire, rescue, EMS... they're all industries and of course there's going to be entrepreneurs that capitalize on a need in any industry. But when is the purchasing just masturbatory? How many agencies spring for the really big pretty fire truck when the smaller version would be just fine? Why did my local police department just dump hundreds of thousands of dollars buying brand new cruisers with giant push bumpers and fancy paint jobs when the department has a "no-chase" policy (therefore no need for push bumpers at all) and the old cruisers were only a few years old and functioning just fine?

Holy crap

2008-08-09T23:34:00.002-06:00

I start college on Monday. It's so early and I'm still not sure if I'm ready.

Unfortunately I got lazy and registered too late to get into any really good classes, but I'm still taking all nursing program pre-reqs like psych, global political issues and "racial minorities in the US".

The pressure is on though. To get into the BSN program I cannot earn anything but As and Bs. Period. They do not consider applicants with GPAs below 3.0 but the program is so competitive that the bar is set much higher than that even. I'm extremely determined though so I'm confident that I'll take care of business, even if I have to spend every waking moment studying.

Wish me luck.

State Certified

2008-07-29T14:16:00.003-06:00

I finally got my state EMT-B certification in the mail today after nearly a month of turning in all my paperwork.

Watch out world, now I can legally practice.

I'm still applying for random jobs at hospitals like perioperative tech and "multi-skilled patient care technician".

And I'm an 8-hour clinical rotation away from having my IV approval.

School starts on August 11.

Life moves fast when you're ambitious.

TEMS (tactical emergency medical services)

2008-07-17T17:11:00.007-06:00

You know... getting all moulaged up and being dragged around by sexy gun-toting paramedics is fun and all... but looking like a strawberry and desperately trying to scrub stage blood off of your skin for the next 3 days is not.

Yeah that's me up there. Scenario: math teacher got caught sexually assaulting a student, was fired, and subsequently came back to shoot up the school and take revenge on the guidance counselor who blew the whistle. I had 3 GSWs to the face and neck and was DRTSTW (dead right there stayed that way).

D50

2008-07-15T20:46:00.003-06:00

As I knelt onto the wet flagstone behind the unresponsive, laid-out stranger's head, I grasped the angle of his jaw with my fingertips and jut it forward to try to relieve some of his comatose snoring. His pupils pointlessly fixated on the sky above my head and foam dribbled out of his mouth... his wife confirmed that he was diabetic and had been having trouble with his sugar lately.

The rest of the crew worked in that freaky lightning fast synchronized dance... the paramedic set up a line as the firefighter/EMT tested his sugar. The engineer handed the D50 to the medic and as soon as the EMT confirmed that the man's blood glucose level was ridiculously low, the medic was pushing the D50.

They had me hand over my jaw thrust and grab a manual BP and by the time I had the cuff on he was coming out of it as evidenced by his sudden confused glances. The medic, his wife and I reassured him but he quickly understood what was going on. He knew his name, the time, and that he had been feeling pretty low on sugar when he came out into the backyard, but didn't remember falling or seizing.

The medic checked out his head, neck and back. He encouraged the man to take a ride to the ER, but unsurprisingly he refused. He was pretty much totally fine, just a little loopy. The wife brought the man some cheese and bread and orange juice as we sat and talked with them for a while. It was almost like a pleasant visit, the dog came out and the guys from the crew played fetch with him. About 5-10 minutes after the man had recovered from his comatose state I rechecked the man's BGL, the medic called in the refusal on the biophone, and we left.

What an amazing thing to witness - it's an exceedingly rare occurrence that EMS can go above and beyond stabilizing someone long enough to get them to the hospital. To bring someone from a completely unresponsive and dangerous state back to normal... it makes me excited about expanding my scope of practice and gaining the experience to make those tools useful.

Sticks

2008-07-12T17:08:00.003-06:00

I met him yesterday, and now he's letting me push a needle into his vein for my first time.

There's something so intimate and bonding about the IV approval course. In my state EMT-Bs are allowed to start IVs, administer D50 IV, administer Narcan intranasally, take blood, and use glucometers after taking a 24-hour course with an 8-hour clinical rotation.

Our first live sticks are on each other. It's nerve-wracking. I'm standing over his arm with a 20 gauge staring at the juicy vein I selected. I insert the needle and start advancing the catheter over it, but I pull the needle back out too quick and blood starts gushing every where. I tamponade (apply pressure to) the vein as my fellow student turns a bit white in the face. Miraculously, I was able to save the stick and get a successful line in by starting a little fluid going and finishing the catheter.

Now my own arms have a multitude of little bruises and puncture wounds from being practiced on. It's a surprisingly easy skill to learn, but a difficult one to master.

"Experience is a hard teacher...

2008-07-09T00:40:00.003-06:00

...she gives the test first, the lesson afterwards." - Vernon Law

I feel sometimes like I'm moving too fast in this field. On Friday I start my IV approval course. Right now I'm applying for all these crazy jobs: critical care tech, emergency department tech, operating room tech... and sometimes it quite honestly terrifies me that in a month or so I could be treating patients for real. Not as a student. Not until the paramedics show up. For real.

Sometimes I wonder if I'm ready, but the truth of the matter is that in this field at some point you just have to jump in. You can attend lectures and classes and practice splinting and vitals and assessments on other students until the cows come home, but the only way you really get good at taking care of patients is by taking care of patients.

It's just one of the risks we have to accept coming into this line of work. People who are new to the restaurant business or retail or media industry will make embarrassing mistakes. Those mistakes may cost their employer some business or perhaps even destroy a little property. However there are only a handful of fields in which a simple mistake can cost another human being's life or limb. I do feel completely confident that I will not make such a devastating error, but the gravity of this line of work never really leaves the back of my mind.

I'm at such a breathtakingly exciting yet completely nerve-wracking point in my life. This is where the real learning begins.

You might be an ARP if...

2008-07-05T10:11:00.004-06:00

Just to refresh everyone's memory... my SAR team is the only team in the nation that is youth-based. We also do operational assistance for local law enforcement and fire agencies: rolling hose, changing air tanks, scene security, evidence searching, trainings, traffic direction, event medical... etc etc.

You might be an ARP if...

You've had blisters in places you never thought possible.
Sleep has become an option rather a necessity.
You are happy to be woken up at 3 am by the screeching beeps of a pager
Your boots age 10x faster than average.
You've spent your Christmas night in a van babysitting a burnt-down house.
You've played a terrorist/hostage/bank robber/rioter for the SWAT team, essentially playing paintball with them.
Lacking a window punch, you've gained access to an MVA victim using an avalanche shovel.
You've directed traffic before you could legally drive.
You've gone for two hour hikes at 3 am... sometimes to look for a missing person, sometimes just for fun.
It seems like every year your dividend at REI gets larger.
You consider yourself an energy bar/gel/powder connoisseur because you've tried just about every brand and flavor.
Your tan isn't really a tan... it's just a thick layer of dirt.
Free food motivates you do things you otherwise wouldn't.
When hanging out with a group of friends you are comforted by the fact that you are usually accompanied by some combination of SAR personnel, EMTs, swiftwater rescue techs, rock rescue techs, cops, firefighters, Hazmat techs, avalanche rescue techs, paramedics, doctors, nurses, etc...
Most people your age play video games and get drunk for fun. You save lives.
You know not to volunteer for a dog team or to carry the rock bags unless you want to work your ass off.
You could live out of your pack for months. You could live out of your car indefinitely, and indeed you've lived out of each for some amount of time on multiple occasions.
You know which members to avoid sleeping near because they snore, sleepwalk or talk in their sleep.
You've forgotten what home looks like.
You prefer to light your campfires with road flares.

This post is a part of Normal Sinus Rhythm, a collaborative writing project in which awesome EMS bloggers from all over the country share their experiences/misadventures/whatnot.

The real heroes.

2008-06-28T23:19:00.006-06:00

After a while, he got used to me dropping everything and leaving the restaurant/store/party/etc whenever my pager went off calling me to the last seen point of a missing person.

Although he has a weak stomach, he learned to deal with my gory stories, which I recited in vivid detail.

Once he held me and wiped away tears as I cried for nearly 2 hours after hearing the news that hunters had discovered the body of a man we had searched for without success, and that he was likely alive while I was searching.

He grew accustomed to my routine disappearances to the backcountry, which often lasted days with no contact.

He let me practice my assessments and vitals on him.

Although a music industry studies major with absolutely no interest in science or medicine, he pretended to be interested when I selfishly recounted my passionate interest in the pathophysiology of hypertrophic cardiomyopathy and commotio cordis.

He understood that I couldn't always make time for him while I was taking a 30+ credit hour course load, working a part-time job, and on call for SAR 24/7/365.

Even though he was the jealous type and my line of work often put me in close quarters with several men, he tried his best to grin and bear it.

He tried his best to respect the completely unique, incredibly close bonds I formed with others on the team, mostly with guys.

But most importantly, he believed in my dreams as much as I did, sometimes even more so.

It's hard to say exactly why this 3-year relationship came to an end. There's a lot of reasons. I'm sure that the stress my work placed on both of us played a part.

But here's to those folks who love an EMSer and put up with all of the pressure. Here's to those who try to make it work the best they can. Here's to those who have stayed up late night worrying about their loved one while they're out fighting fires or crime or trauma or terror. Here's to the husbands, wives, boyfriends, girlfriends, moms, dads, sisters, brothers, daughters, sons and friends who know that they will never really get "it", but respect "it" anyways.

Thank you.

This post is a part of Normal Sinus Rhythm, a collaborative writing project in which awesome EMS bloggers from all over the country share their experiences/misadventures/whatnot.

It's official....

2008-06-27T10:26:00.001-06:00

I'm a NREMT-B!

My Captain's Fall

2008-06-24T22:51:00.002-06:00

I follow their swift motions with a wide-eyed gaze, my trembling hand gripping the bloody portable suction unit.

As they package her on the backboard and place her into a litter my radio buzzes with talk of ALS and landing zones and sucking chest wounds.

"Ger her out of here, don't let her out of your sight and don't let her get on that litter," the Chief says as he hands me over to a new babysitter, The Other Lt.

I drop the suction on the ground near the crushed and bloody branches and shuffle past the probationary members who avoid my lost stare. The Other Lt. grabs my arm and guides me down the slope. We walk through the people who have already been set for relief - to rotate people off of the litter carry-out. I shiver and mutter "we should have worn helmets" to myself as we pass, but I do not cry.

A few people who know me well hug me and provide words of comfort that I cannot remember as I pass. I know we have made it to the road when I am blinded by arrays of flashing lights. With short, simple reassuring sentences I am guided into the passenger seat of the Deputy Chief's truck... I feel like a small child.

I am driven back to the mobile command post where a member of the BOD who is also a shrink takes me under her wing and tells me things like "she's in good hands now," "it wasn't your fault," "I'm glad you were there to help her," and "they're going to do everything they can." She wraps a sweater around me and Sgt. V brings me water.

They tell me that she's on the helicopter now, en route to the trauma center. A bonfire has been burning since before the incident and I am huddled around it as members trickle back from the carry-out. I finally start to cry, quietly.

The Chief updates the team on their Captain. Many of the members, even the new ones, are sobbing. He asks me about what happened.

"We were... scouting for scree... scree-evac and she fell." I mutter.

"How far?"

"I... I don't know... I just... 30 feet?"

"Were you wearing helmets?"

I fail to respond because everyone knows that we weren't. I start truly bawling and the new members look on with pity. The Chief gives a little speech about safety. He walks away for a little.

"We have another update on the Captain, but I think it's best that she gives it to you herself..."

The Captain, dirty and "bloody" but grinning from ear to ear comes out from behind a large rock. I run up and give her a high five. She never fell, I just carefully moulaged her and in the dark it's easy to fake bagging someone. The probationary members look bewildered. Some look angry. Some laugh.

For decades my SAR team has done this tradition. Call it cruel, but it has this tendency to bolster the team fast. I went through it last year... it makes you realize how quickly you begin to care for people working with you in this field.

Scrubbing

2008-06-18T02:44:00.003-06:00

She's at least 60... I'll say she's 67 or so. She's chubby and her skin is mottled with years gone by and her wrinkles seem like notches for all of the experiences she's had. Her eyes are simply jovial... curved and sparkling, while her mouth holds onto this constant little smirk. She has that starchy, curly white hair that most old women have, but little bits of it are singed.

She burned down her kitchen today, unfortunately. She left something on the stove and when she came back it was all ablaze. She lives alone, and she tried to fight the fire alone. A neighbor called 911, and the firefighters found her struggling to breath throwing buckets of sink water on the flames.

When they took her to the hospital, they managed her smoke inhalation pretty easily. By the time I met her, she was breathing with ease. Now the concern is her hands. Somehow they got burned pretty badly... and she is diabetic so wounds are more of a problem. I've been called into to scrub the burns.

My preceptor, an ER tech, helps me set up a little sterile field with gauze and a little sponge and a solution of sterile saline and johnson's baby shampoo in a little dish. I dip the sponge in the solution and prepare to scrub the first area... it's 2nd degree on her palm. I am so nervous about causing her pain. I imagine how bad it would hurt and wince. Finally I just start, gently at first, monitoring her facial expressions and voice... but she doesn't make any hint of pain. I realize that they've medicated the hell out her. Thank god. She has this lovely British accent and as I'm scrubbing away little flecks of black, burnt skin she tells me about her hometown.. Liverpool.

It takes over half an hour for me to scrub her burns. I'm meticulous, though. The whole time she is stoic and lively, chatting up a storm and staying cheery. I admire her for that. I bandage up her hands and tell her: "no more fire-fighting, okay?" before I leave.

Surgeon?

2008-06-17T00:02:00.003-06:00

Maybe I could be a trauma surgeon?

I've been damn steadfast about this nursing thing... maybe I decided too fast. I've been warned away from medical school from several friends who have been there, done that... but there is a certain appeal to cutting people open and actually fighting death rather than prolonging it as EMS does (which is of course a noble goal).

I'm the type that finds beauty in the biscuspid, awe in the alveoli, and joy in the jejunum. Anatomy is my God and physiology is my religion. At the cadaver lab, I was right up there... the first one to get my hands dirty... as others stood motionless in the back with a look of shock or left the lab dry-heaving. I'd probably make a good surgeon. I think on my feet and absolutely flourish under pressure. I am detail-oriented and catch things that others don't.

I like the idea of trauma surgery because they so often operate on cardiothoracic and abdominal trauma, which are my FAVORITES. Oh my God, it sounds so weird but I freaking love cardiothoracic injuries. They fascinate me. I think I have scared off more than a few people because I started excitedly discussing stuff like commotio cordis and tension pneumothorax like most women talk about the "Sex and the City" movie or chocolate or shoes. Just the mechanisms and physiological undoings are so intriguing.

Disadvantages... well I'm not so much into the whole medicine philosophy as the nursing philosophy, but from what I've seen trauma surgeons become much more involved in the long-term care of patients than surgeons of other specialties do. They also seem to be more involved in the health care team, working side-by-side with nurses and techs and the likes. But still. Also, most trauma surgeons do general surgery as well, which is like... meh to me. I'd probably enjoy it but yeah, I'm a trauma junkie. I guess I wouldn't mind doing Little Susy's urgent appendectomy at midnight, but you know...

Big advantage: putting in chest tubes. I know, I'm a nerd. I just want to stick a tube in between someone's ribs so they can breathe. Really bad. This is a such a big deal to me that guys from the SAR team call me "Chubs", short for "chubby for chest tubes".

My First Trauma

2008-06-16T10:43:00.005-06:00

I know this is long overdue... it happened about a month ago on an ambulance ride-along.

The day had been busy with fairly routine calls. Take Mr. Jones from hospital A to hospital B. Take Little Susy from the urgent care facility to the real hospital because she has appendicitis. Yada yada yada.

After all of that stuff, I was relaxing on their ridiculously comfy couch watching some stupid movie when we overheard on the radio the local fire department getting called out to a 2 car, 2 motorcycle MVA about 2 miles from the station we were at. The EMT told me to prepare to go on the call. The company I was riding with is private and does a lot of non-emergent transport, but they have a contract with the local fire department to essentially take all the 911 shit that they don't want or can't handle alone.

Within a few minutes, we're called out to the crash. I'm elated. This was the last hour of my last ride-along I had yet to see any MVAs or real trauma. On the short drive over I glove up and slip eye protection into my pocket. My heart is pounding. As we're pulling up I can't see anything because I'm in the captain's chair in the back. The paramedic hands me a traffic vest so large that at least 4 of me could fit into it.

We come to a stop, the back doors open to reveal sunshine and road, and I scurry out. The scene is the typical well-organized chaos... police and firefighters and cones and flashy lights abound, but they're all in order. There's 2 motorcycles laid out in the road... one of them is barely recognizable as a bike.

It's a fairly busy and large intersection but now it's almost completely shut down. Bystanders are gathering in the grass and on the sidewalk, talking loudly and bonding with strangers over their communal witnessing of someone else's tragedy. As the medic, EMT and I walk up they all fall silent and stare. I try to pull the humongous traffic vest back onto my shoulders, but it keeps trying to fall off of me.

My eyes finally locate our patient. The firefighters are all standing around him... one is holding c-spine. By his clothing it is clear to me that he was on a motorcycle, and I'm happy to see that there is a helmet lying next to him and that he has gnarly helmet hair. From a distance I can tell that he is not bleeding, grossly deformed or screaming in pain. Based on the mood and activity of the firefighters I can tell that he is probably not critical.

A firefighter gives us a rundown of what happened. 2 buddies were out riding motorcycles. A car pulled out in front of them and they each hit her. Biker #1 was not wearing a helmet, hit her first at full speed - about 45 MPH -, is in bad shape, and has already been transported by the fire department. Biker #2, our patient, was right behind Biker #1, was wearing a helmet, had time to react and slow down a bit. According to the firefighter he's pretty much okay... just has some crepitus over the clavicle with shoulder/clavicular pain.

The EMT calls me over to help with packaging as the medic and firefighter continue to chat. He hands me a c-collar as I look over the pt. He is middle-aged and looks great for his age... strong features, clean-cut, in good shape. He is exposed from the waist up and I can tell that he is shaking from a distance. A wave of... what it is... mercy? pity? sympathy? Well, whatever it is, it socks me in the stomach and resonates throughout my body. I cannot know exactly how he is feeling, but I do know that he has experienced something awful.

That image... of an injured, trembling half-naked man lying in the grass with firefighters and bystanders gathered around... will never leave me. It's amazing how quickly a moment of impact can steal someone's dignity. It's hard to explain, but that image captures so many reasons why I want to go into this field.

The EMT introduces me.

"This is Lucid. She's a student but she knows what she's doing. She's going to put this uncomfortable collar around your neck to remind you not to move it, okay?"

Moving only his eyes he glances over at me.

"Okay." He half-smiles at me, but I can tell he's in pain.

I size up the collar and place it on him. The firefighters roll him onto the board and strap him down. I secure his head down and they move him into the ambulance.

The hospital is only about a mile away. I ride in the back with the medic and talk to the patient, let's call him Jim, as the medic starts an IV. I ask a few questions about his pain and the accident and his history... I decide not to palpate his clavicle because he says it hurts and it's clearly deformed.

Out of the blue he says... "Rick is in pretty bad shape, isn't he?" It's more of a statement than a question. He knows. He watched his friend crash.

"I didn't get to see Rick. I know he's hurt, but I don't know how bad. He's at the same hospital we're going to, so we'll probably find out more when we get there," I tell him.

Jim registers my answer and stares silently at the ceiling, through his eyes I can see his mind tugging around thoughts. We pull into the ambulance bay and roll him out of the ambulance into a trauma room. The trauma room 2 doors down where I assume Rick is, is buzzing with activity and humming with noise.

The customary information swap amongst the medic and the doctor and the nurses and the registrar and the patient begins as I switch Jim to the hospital's oxygen and make sure he's comfortable. After the doctor does his own assessment, begins his orders and has Jim log-rolled off of the backboard, Jim finally receives some information after giving so much. The doctor tells him that it looks like he simply broke his collarbone so they're going to get x-rays of that and his spine just to make sure everything's okay. Jim doesn't seem to care much. He just asks about his friend.

"Jim, your friend has a pretty bad head injury. We're doing some tests to look at his brain right now and we're doing everything we can, but at this point we don't know what his condition is going to be. Do you have any questions?"

"No."

The doctor and nurses leave the room. I ask Jim if he wants anything.

"Yeah... my cellphone... it's in my pocket. Can you get it out for me and help me call someone?"

I slip the phone out of his pocket. He has me look for a man's name in the cell's phonebook so I scroll through all these people to find it... dial it... and hold the phone to his ear for him because it hurts too much to raise his arm up. They don't pick up so he leaves a message... who was it? His son? Brother? Then we call a woman... I think it was his sister... she picks up and starts heading for the hospital once he tells her what's going on. We call one last person who doesn't pick up. Based on the somber message he left, I think it was someone from Rick's family.

The EMT calls me out of the room, it's time to go. I wish Jim the best for his recovery and Rick's. It's really hard to find the right words. I squeeze his hand as I leave.

As the medic finishes up paperwork in the EMS lounge he tells me what he learned about Rick's condition from the fire medics who transported him and the nurses.

"It doesn't look good... he didn't know his name or anything and apparently he was very combative in the back of the bus. Now he's unresponsive. His pupils were normal on scene but now one of them is blown."

I don't know what happened with Rick or Jim. I'd like to imagine that they both recovered just fine and right now they're back on their bikes, this time both wearing helmets.

NREMT-B Practical

2008-06-15T11:39:00.002-06:00

Yay! I passed my NREMT practical yesterday on the first try for everything. Now I just have to pass the written/computer-based test.

I honestly thought I was going to fail the long spine board station... it was a disaster. It's a skill I'm definitely comfortable with (last week I taught it to 30 probationary members!) but I'm more accustomed to working with a particular type of board with spider straps. In the exam I had to use a particular type of board that I despise and seatbelt straps which I really, really despise. They get stuck under the board and malfunction and get in the way and get stuck up patients butts and are generally a pain in the ass (figuratively for me, literally for the pt).

So I get started on the long spine board exam with one of the more intimidating proctors watching my every move. CSMs go well. I start applying the c-collar but I'm struggling because my "patient" is wearing a massive hoodie and the hood is getting in the way of the collar at every turn. Finally I get it on and it's sized wrong. So I take it off and start over, again struggling with that damn hood. This time I get it right.

Finally he's collared and I'm ready to place him on the board. The proctor and I log roll him and I pull the board up to his back and we roll him back down. He's barely on the board. Okay, let's try it again. We roll him again and I try to get the board up against him but it's really stupidly-shaped so when we roll him on to the board, he's barely on it. At this point I'm sweating, humiliated, and getting into that nervous death-spin cycle, but I know that I just need to do it again until I get it right. So we log roll him one more time, and this time his body and the board cooperate and he is neatly centered on the board.

I immobilize his thorax, pelvis and legs with no trouble, and then I get to the head. I place the head blocks and start trying to tape his head down but the damn tape sticks to my gloves like crazy. Now I'm really frustrated. So I spend all this time fumbling with the tape as it rips my gloves and turns itself into a twisted mass of worthlessness.

Finally I figure it out and place the forehead strip, folding it to be nice to my "patient". As I start taping the chin down I look up and notice that the forehead strap has slipped down conveniently right over my "patient's" eyes. At this point, I want to cower out of the room and sit in a corner for a while, but I don't. I move the tape out of his eyes and apologize and finish the job. I leave the room confident that I had failed and really angry that everything seemed to go wrong and I couldn't seem to get anything right.

The other stations went smoothly but that experience in the long spine board station definitely dropped my confidence a little. I was shocked when I learned that I passed that station, although my instructor did comment that I had stepped over my "patient", which I don't remember doing at all but probably did.

At first I was pissed that all of the equipment "malfunctioned" and all of the circumstances seemed to be stacked against me, but then I realized, hey... that's EMS for you. It's rarely pretty and perfect and things are not always going to go the way they should. Equipment is going to break. Partners are going to be stupid. Patients are going to be difficult.

Anyone can backboard someone in a nice clean little room with plenty of light and a calm patient and all this perfect equipment and a bunch of hands, but EMS will ask you to backboard a screaming, bloody patient who is upside down surrounded by a crumpled vehicle in a ditch while it's raining at night after you have gone without sleep for 2 days and you really, really need to pee.

That stuff cannot be taught in a classroom and while it's intimidating it's also something I'm anticipating. It's a challenge that I want to match my resourcefulness and stubbornness against. I hope I can stand up to it.

Homicide files

2008-06-12T23:39:00.002-06:00

Today I did some undercover work with the investigations unit of the local sheriff's office (sounds much cooler than it is). Things didn't work out exactly as planned so we're going to try again in a couple of weeks.

We (we being my Captain and I) went back to their headquarters to eat afterwards and an investigator gave us a bit of a tour. He showed us where they keep all of their major case files... most of them homicides. He had to return to his desk to work on some stuff but he told us we could look through the files for a little if we wanted.

These files are amazing. They are gigantic binders, often 2-3 for each case, filled to the brim with crime scene photos, autopsy photos, dialogs, test results, comprehensive personal histories of suspects and victims, and much more. They really capture and tell the story of a murder from many different angles.

There was the elderly woman who lived in the ghetto, but was a grandmother figure to many. She had no children but had lived with and taken under her wing an autistic adult for 10 years. She was willing to help anyone who came to her needing it.

One day a neighborhood crackhead came to her and asked for $20. She refused, and the crackhead got angry and bludgeoned the poor innocent old woman to death with a hammer. The autistic adult, who was basically this woman's child, was found sitting next to the old woman's battered body.

Yes, they did track down the crackhead, who confessed and is now serving a life sentence, thank God. I can't comprehend senseless violence, really. Some violence I can understand, but I guess this is the type of act only a crackhead could wrap his head around.

There was also the strange case of the husband, wife and daughter who entered a suicide pact together one day and all took a bunch of pills. The daughter died first, and then the husband and wife entered a semi-coma. When the husband came to and realized his wife was still alive, he shot and killed her.

Such a strange concept. Suicide pacts are nothing new... but with your own wife and daughter? So sad.

I wouldn't mind being a cop if I could put creeps like this behind bars on a regular basis.

Ponderings about c-collars

2008-06-11T22:30:00.004-06:00

Excuse me, but does Laerdal StifNeck (a company that makes adjustable cervical collars) employ giraffes exclusively? According to them we are all a bunch of fat short freaks with no necks. I'm sure many of you EMS'ers have picked up on this and have had a chuckle or two over it, but I'll explain this for everyone else.

Laerdal StifNeck Select collars have 4 neck height settings, from tallest to shortest: Tall, Regular, Short and NoNeck (a size name they have trademarked). The ironic thing is, almost everyone is a short or a "NoNeck". Excuse me Laerdal, I have a fucking neck thank you very much. Is it me or is that kind of insulting? Those smug bastards at Laerdal are calling us all freaks.

I have probably collared at least 30-50 individuals with StifNeck collars in the past year, and only one was a regular and I have yet to meet a "tall". So here's my open letter to the folks at Laerdal StifNeck.

Dear Laerdal StifNeck,

This is not a "regular" neck length:

So until you start manufacturing cervical collars exclusively for the lovely Kayan people of Burma, please stop being a bunch of assholes and referring to the rest of us as no-necked turtle-freaks. Every time someone applies a cervical collar on me and adjusts the collar to your trademark size of "NoNeck", I think I die a little on the inside.

Please, revise the size categories of your cervical collars to make an inch of sense.

Love,

Lucid.

adventure time

2008-06-11T18:10:00.003-06:00

So a couple of guys from the team have welcomed me into a tradition for the past couple of weeks. I dubbed it adventure time.

The first time they taught me how to rappel at night in death fog.

The second time I was supposed to rappel - it was again the middle of the night- but 3 0f them went over the edge first only to discover that only one of their ropes hit bottom... and bottom was a gigantic crevasse. So I didn't get to rappel but we did have a good time and found an epic set of rocks.

Apparently next time we are going to create a completely gigantic slip and slide with several tarps and copious amounts of dish soap. I can't wait. (Location? I voted for the Sand Dunes)

On a side note, I always assumed that one day I would be an EMS educator. I figured that I would love to one day teach people all about emergency medical care. But today I gave the entire probationary class a crash course in topics such as medical direction, confidentiality, scope of practice, negligence, BSI, etc and skills such as c-spine immob., back boarding, bleeding control, basic shock treatment, and splinting.

It was hard. I got so freakin' bored of explaining the same simple concept over and over again to people who weren't paying attention. And I got sick of supervising their patient packaging and correcting all of them... I think I will have to shoot myself if I ever have to say "this strap needs to be tighter" ever again. Man I have much more respect for my EMS intstructors now.

Balancing act

2008-06-10T23:21:00.006-06:00

I am learning more and more that being an officer is a huge balancing act. On one hand, I need to build camaraderie, trust, and rapport with my underlings. On the other, I need to lay down the law and command respect. It's not an easy thing to do. They need to feel like they can come to me with everything from a great dirty joke to a very serious issue.

I had to lay down the law today on a probationary member. I may have scared him off a little bit, but sometimes I just have to take care of business. You see, this probie's uniform looked like utter shit. You would think that by now he would've learned how to tuck in a freaking shirt. Hell, before I joined the team I had never tucked in a shirt and I learned pretty fast how to do so all by myself just like a big girl. But no, this kid has his pants sagging down his ass and his shirt all muffin-topped spilling out over his belt.

I told him over the weekend... pull up your pants and tuck in your shirt. Others told him the same thing over the weekend. Today, before I snapped, at least 3 different people had told him politely on different occasions to fix his uniform, to no avail. So after I told him for the fourth time today and he rolled his eyes and ignored me as he walked out the door, I lost it.

"SMITH. Stop," I said in my I-mean-business-voice. He paused in the doorway and looked a little scared.

I pushed my own pants down to the delinquent-teenager-sag position and pulled my shirt out all funny so my uniform looked as crappy as his did, "This is not how you wear a uniform Smith." His fellow probie buddies watched on, wide-eyed.

I grabbed him by the waist band of his pants, pulled them up over his hips to the proper position, and tucked his shirt in bit by bit as I turned him in a circle. "This is how you wear a uniform. Understood?" I said firmly as I fixed my own uniform.

"Yes Lieutenant," he said before cowering all the way out the door.

You know what though? His uniform looked good the rest of the day. Maybe I sound anal about the whole thing, but I'm really concerned about professionalism. I sure as hell wouldn't want a bunch of punk-ass looking kids that look like they just rolled out of bed trying to save my life. It does make a difference, I don't care what anyone says.

We have 2 more days of intensive training for probationary members. We'll have to see if that probie will revert back to his sloppy uniform ways. I'll let you know.

Basic 1

2008-06-09T21:38:00.002-06:00

This weekend's Basic Training was excellent.

There are several standouts among the probationary members that totally blew me away with their enthusiasm, work ethic and endurance. There are others that clearly will not last much longer. But in general, I have to give this probationary class mad props for the way they encourage each other and pass on an infective positive attitude to each other. We asked them push their physical and mental limits VERY hard, and when it comes down to it, attitude matters almost as much as physical ability.

This training was also a triumph for me. Last year at Basic 1 I was sick. Out of shape. Tired. Unprepared. I totally sucked and even missed a few evolutions because I was so messed up. Nobody thought I would make it through the weekend, never mind through the second weekend of basic training. Nobody thought I'd be on the team for much longer.

This year I was ready... in better shape, prepared, healthy, and excited. I did much better and totally confirmed to myself that yes, I can do it. It's amazing what a difference a year makes.

Now I'm counting down the days til Basic 2!!

It's that time of year again: Basic Training

2008-06-05T15:21:00.005-06:00

Tomorrow the team and our large class of probationary members will embark on a journey they will never forget: basic training.

Basic training (AKA Basics) is essentially search and rescue boot camp. They are the most awful, painful, and difficult 2 weekends I will ever love and fondly remember.

After returning from Basics, everyone will be blowing black shit out of their noses for days. Muscles that we didn't even know existed will ache. Not only will our feet be blistered, but our palms will be too. We'll all be so dirty that when we shower, the water will turn opaque brown and we'll leave behind sediment on the floor. We will all have gained a second family and realized how far we can go when we push our limits. Most importantly, we will be a search and rescue team.

The first day of the first Basic weekend is pure hell. We wake up with the sun, eat a quick breakfast, and do a mock search. We find the person code 1 (alive, uninjured, no assistance needed) about 1.5-2 miles away and hike back. The next scenario is a search with a code 2 find (injured or ill, needs rescue/assistance) and so the probies get their first taste of a carry-out. This is a carry-out:

The victim is loaded into a stokes litter and carried by 6 people (ideally). People are rotated on and off the litter periodically but it is hard work. You're carrying significant weight with one hand while wearing a hot, uncomfortable uniform and a pack that weighs 15-40 pounds while hiking over rough terrain at altitude for miles. During Basics, we purposely make the carry-outs more difficult than normal by choosing long, difficult routes and not using the wheel (a wheel that can be attached under the litter to help support the weight) or scree-evac rope systems (a way of making carrying the litter on slopes easier).

We repeat this cycle of search...find...carry-out...brief rest...search....find...carry-out...brief rest... all day. That night the exhausted members lick their wounds and pass out in their tents early. They sleep like babies. Until we wake them up in the middle of the night to do 2 more carry-outs.

It is the most physically strenuous work most people on the team have ever done and will ever do. Last year, when I was a probationary member I thought I was pretty much going to die. You just can't anticipate how difficult it is going to be without going through it firsthand. This year will be better because I'm prepared.

It's a beautiful experience though. I love everyone on my team like family and we have a great time toughing it out together.

I can't waaaaaaaaaaaaait. I'll let you all know how this year goes.

NREMT-B exams, oh how I will destroy you.

2008-06-05T00:27:00.003-06:00

So this is what I have left to complete before I become a brand spanking new NREMT-B:

-mock practical
-real practical exam
-final NREMT written exam

I am so glad to be done. 6 months of class, every Sat., 8-5. Can you imagine the liberty of having my lovely Saturdays back? It will be glorious.

So I'm feeling pretty damn confident about the exams. I've been so immersed in EMS for the past year that I would be ashamed if I screwed up. I've heard that the written can be a bitch because the questions are funky, but I think I'll be fine. I'm a little worried that I'll go into this whole thing overly confident and fall on my ass but my gut is telling me otherwise.

An instructor told me that you're ready for the practicals when you can do all the skills while barely paying attention and complaining about something else. I think I'm at that mindless regurgitation phase:

"BSI-my-scene-safe?-it-appears-I-have-1-patient-high-MOI-it's-a-
rollover-I'll-get-someone-on-c-spine-and-consider-ALS...." and so forth.

Anyone who's taken a CNA, NREMT, etc exam knows the drill. It's pretty damn ridiculous.

mind vs. body

2008-05-30T13:25:00.012-06:00

My feet are planted firmly on the rock, hands gripping the rope. My friends are beaming some light down for me, but everything besides myself, the rope and the rock has been swallowed by midnight darkness and fog. There are no trees, ground, or people. Just me, the fog, and the rock face. It's like being wrapped in some kind of warm fuzzy nothingness, and it's a beautiful feeling.

"Whatever you do, don't take your right hand off that rope," my friend told me before I went over the edge for my first rappel.

My heart is racing, but I'm far from fearful. It's exhilarating to force your body to do things that it instinctively dreads. My mind trusts my harness and the rope and the BFR (big fucking rock) I am anchored to... it understands the physics and the systems of things. My body doesn't. There is no fighting that epi dump of instinctual fear when walking backwards off a cliff, and why would you want to? The contradiction provides that lovely rush of risk that is like no other feeling in the world.

I rappel down until I'm about 5-10 feet from the ground and it's still barely peeking through the murky shadows. I'd like to ascend a tad and return to dangle there in divine suspended animation for a bit longer, but I can't. It's someone else's turn to give it a go.

Let's Talk About Capillaries.

2008-05-28T23:48:00.007-06:00

I retain information best when I write about it. So I'm going to try to post some edubloggins, if you will, on a regular basis. I'm going to focus on topics in anatomy and physiology as they relate to EMS. Here goes episode 1.

Capillaries: your cells need gases, nutrients and hormones to survive... and these microscopic blood vessel wonders deliver. The average capillary has such a small internal diameter that red blood cells are just able to march through it in single file. They are the transition from arterial blood flow to venous blood flow.

Capillaries are not lone rangers, however. They work together in interweaving systems called capillary beds. These capillary beds are more complex than one might think. Mechanisms at play in the capillary beds contribute to many of the skin signs we see in hypovolemic shock... pallor, coolness, clamminess, blueness.

You may recall that in a hypovolemic state, the body will shunt blood away from the surface and into the core, where vital organs are located. When faced with limited resources (blood) the body says "screw you skin, we're giving this stuff to the organs that really count." But how does the body actually do this shunting stuff? Vasoconstriction is far from a complete answer. Much of this action goes down in the capillary beds themselves.

Okay, don't be intimidated by the crazy diagram I made in paint. We'll start left to right, which is the direction that blood flows. The capillary bed is fed by the terminal arteriole, a baby artery. Blood passes into the metarteriole, the intermediate between an arteriole and capillary. The metarteriole is continuous with the thoroughfare channel, the intermediate between a capillary and a venule. Blood flows from the thoroughfare channel into the postcapillary venule, which is a baby vein. This is obviously a direct route, so what about that crazy web of capillaries?

The capillaries in that web are known as true capillaries, and they branch off of the metarteriole. So those green things in my diagram, the precapilllary sphincters? Those are simply cuffs of smooth muscle that surround the root of every true capillary. When these sphincters are relaxed and open, blood flows freely into the true capillaries and can make exchanges with tissue. When these sphincters are contracted and closed, blood cannot flow into the true capillaries and is forced to take the direct route (terminal arteriole > metarteriole > thoroughfare channel > postcapillary venule) and bypass the surrounding tissues.

To give you a better picture, imagine that the above diagram has the precapillary sphincters open and all the color in the true capillaries represents blood flowing. Here's what the diagram would look like with the precapillary sphincters closed:

When the body is responding to a condition such as hypovolemic shock, it tries to compensate and keep the blood pressure up. In addition to shunting blood to vital organs, widespread vasocontriction will occur, keeping BP up and increasing venous return. The body can keep this act up for a remarkable amount of time and maintain a stable BP, which is why a decreased BP is an ominous sign in someone in shock. The body is failing to compensate for the loss of blood volume and organ damage and/or death is likely to occur due to immense hypoperfusion. Any questions?

Reference:
Marieb, E. N., & Hoehn, K. (2007). Human Anatomy and Physiology (7th ed.).
San Francisco: Pearson Benjamin Cummings

2008, so far, in life experiences.

2008-05-27T20:13:00.005-06:00

20 Things I've done this year that I'll probably never forget:

1. Learned how to drive.

2. Learned how to self arrest on a glacier.

3. Got promoted to Sgt., then Lt.

4. Became a legal adult.

5. Started my EMT class. (almost done!!)

6. Stuck a tube down someone's nose. Scrubbed a burnt hand. Cut away some clothes. Cleaned up a ton of blood, vomit, and poo.

7. Cut a vehicle into pieces using powerful hydraulic tools.

8. Celebrated New Years in Miami

9. Battled the DMV, causing a huge stink which eventually lead to them changing an unfair rule.

10. Landed a helicopter.

11. Held a human heart that was nearly the size of a basketball.

12. Graduated from High School.

13. Played paintball with the SWAT team in the interest of training.

14. Received the Danny Dietz Scholarship of Honor.

15. Treated my first patient.

16. Did a bust with the Sheriff's Office.

17. Did my first rappel in the middle of the night in death fog on wet rocks.

18. Published my last newspaper.

19. Finally started physical therapy for my jacked up knees.

20. Learned how to talk to patients.

It's been an amazing year so far. I've learned and experienced so much, and I feel so incredibly blessed. I hope I never lose this sense of wonder, anticipation and enthusiasm that I have for life right now, even though I probably will. It seems that the real world tends to beat that out of people. Oh well, I'll find my way.

Honor

2008-05-20T22:25:00.005-06:00

It's hard to describe how flattered and privileged I feel. I have just received the Danny Dietz Scholarship of Honor.

Here is an excerpt of an article about the amazing man this scholarship was created in honor of:

"The rescue helicopter had crashed. The Navy SEALS were wounded by Taliban gunmen, vastly overpowered and outmanned in the remote region of Afghanistan.

Danny P. Dietz kept fighting.

More than a year after the 25-year-old Navy SEAL from Littleton was killed, he has been awarded the nation's second-highest military honor, the Navy Cross.

The award - one of only 20 given for valor since fighting began in Afghanistan and Iraq, and second only to the Medal of Honor - will be presented to Dietz's widow and parents during a ceremony at the U.S. Navy Memorial in Washington, D.C. on Sept. 13. The medal will also be presented posthumously to the family of Dietz's teammate, Matthew Axelson, of Cupertino, Calif.

The pair were part of an elite team of four SEALs on a reconnaissance mission "tasked with finding a key Taliban leader in mountainous terrain near Asadabad, Afghanistan," according to a Navy news release.

On June 28, 2005, "They were spotted by anti-coalition sympathizers, who immediately reported their position to Taliban fighters. A fierce gunbattle ensued between the four SEALs and a much larger enemy force with superior tactical position," the Navy release said.

The SEALs radioed for help, and a responding Chinook helicopter was shot down by a rocket-propelled grenade, killing eight more SEALs and eight Army NightStalkers. It was the worst single combat loss for the SEALs since the Vietnam War.

According to the Navy, "Despite this terrible loss, the SEALS on the ground continued to fight. Although mortally wounded, Axelson and Dietz held their position and fought for the safety of their teammates despite a hail of gunfire. Their actions cost them their lives, but gave one of the other SEALs an opportunity to escape."

That SEAL, who has not been publicly identified, was sheltered by a friendly Afghan, then turned over to the U.S. military."
Jim Sheeler, Rocky Mountain News, 9/2/06

Tonight I was awarded the medal and a scholarship by Danny's family and a SEAL who was involved in the battle that took Danny's life. They are all truly remarkable people and I am extremely grateful that they chose me to receive their son's Scholarship of Honor.

Danny's father was a Hospital Corpsman and he spoke to me about the struggles and gratification of fighting to save the lives and limbs of others. He told me that things will get difficult... in school, in the hospital, or wherever my passion will take me, but to never give up. Keep fighting. Like Danny did.

The man who presented me the medal was critically injured in Afghanistan and reminded me of the sheer magnitude of the work I'm going in to. He would not be alive today if it were not for those doctors and nurses who fought endlessly to keep him going.

This award has inspired and touched me deeply. It gives me an even deeper sense of purpose and duty as I prepare to go off to college. Danny, his family, and the people he served with will always be on my mind and near my heart. I will strive to serve Danny's memory with passion, honor and determination.

Justice

2008-05-18T15:08:00.005-06:00

I can definitely see myself as the person who changes up careers. I honestly wouldn't be surprised if I ended up doing nursing, law enforcement, and firefighting over the span of my lifetime.

That law enforcement bit may shock some people, but I think I would really enjoy doing investigations. I enjoy digging for clues, imagining all of the possibilities, understanding people's motives and what makes them tick, and eventually putting all of the pieces together. I would love to spend some time busting up drug and gang operations. One of my secret dreams is to work undercover to bust meth operations. I hate meth. It's by far the most evil and destructive drug in America right now.

The thing that bothers me about law enforcement is that regardless of how much the criminal deserves it, your actions often result in the devastation of their life. I'm not saying that LEOs are evil or bad at all, in fact, I respect them highly because of their ability to cope with that fact. They see crazy, evil, disturbing things just as much as anyone who works in EMS, but they have the responsibility of inflicting harm. Yes, the ends justify the means and they are keeping everyone safe, saving lives, and making society better, but to reach that goal they have to make life worse for certain people.

The event that really made this clear for me was my participation with law enforcement in a bust. I can't divulge too much information, but I will tell you that I was trying to purchase items from businesses that they were not legally allowed to sell to me while an investigator observed. Out of the countless businesses that I visited that day, only one was busted. Was it some seedy, immoral crook with a rap sheet a mile long that did the illegal deed?

Of course not. It was a very pleasant and friendly old man who was just running the family business and unfortunately made a mistake. An illegal and costly mistake.

I felt like utter shit. It gave me endless respect for the men and women of law enforcement who deal with these nagging moral dilemmas on a daily basis. We all want justice, but how many of us could wield the force of it while looking into the eyes of another human being who has for one reason or another, found themselves on the wrong side of the law?

'Copters and cutters and spreaders, oh my!

2008-05-18T14:18:00.012-06:00

A couple of weeks ago my EMT class did our extrication/helicopter lab day. We started our morning by landing the back-up helicopter (AKA the ghetto bird) of my future employer, AirLife. This was after the lecture on "the tail rotor will slaughter you" and "powerlines will slaughter us" safety type stuff.

It's not the roomiest office, but it has killer views.

Here's a patient's POV. You can see why tall people, obese folks, Hare traction splints, and anything that needs to be done on the patient's left side can be a problem.

After helicopter-landing, it was time for car-cutting. I felt really silly, like a little girl playing dress-up, except with bunker gear and heavy hydraulic tools.

Now that my friend is stress relief.

Die post, die.

Classic pin-up, eh?

Sometimes I wish I could be a fire medic. It would be a nice variety... one call you're taking a chest-painer to the hospital, the next you're battling a structure fire, the next you're rescuing someone trapped in an elevator. However with my gender, smaller stature, knee issues, and respiratory problems (I apparently grew out of asthma) it would be a long shot. Besides, I appreciate the academic rigor and endless opportunities that nursing presents.

Lt. Lucid returns

2008-05-08T11:44:00.005-06:00

Hello everyone. First of all I am still alive. My home computer is dead, and I've just been unbelievably painfully busy with taking in the new class for my SAR team, overhauling all of our medical equipment and reorganizing our cabinets, helping with the rebirth of our bike team, finishing up my requirements for my EMT class, responding to calls, meeting newspaper deadlines, etc etc.

On Tue. I worked my ass off from 4 am - 9:30 pm, on 3 hours of sleep, with no break. There's been plenty of 17-18 hour days. It's hellish, but I love being so productive. I have the art of biting off the maximum that I can chew and nothing more down to a science.

Second of all... I've been promoted! Yay. You can call me Lieutenant now. I'm now in charge of training, operations, and two sergeants & their field teams, in addition to the tasks I already have.

I have three events on my list to recount for you once I get the chance - my extrication lab in which we cut up cars and landed a helicopter, my 2nd ambulance ride-along in which I got my first real taste of trauma, and the search I went on Tuesday, in which I hiked for miles looking for someone who would run away from his rescuers once found. Stay tuned.

I'll also be checking out your bloggins that I have missed so much as soon as I have the time!! :)

Police dogs

2008-04-17T01:39:00.005-06:00

K9 officers from the Sheriff's Dept. came to hang out with our SAR team today. Reason being that we often participate in evidence searches, and their dogs are sometimes used as "last resort" search dogs when the risk of a person remaining missing outweighs the risk of them being bitten

Example: once upon a time a woman attempted suicide by overdose and then wandered off into a rural area. was last seen going in and out of consciousness. extensive area searches on foot and by cruisers failed. she was eventually found by a police dog and was bitten, but she survived. To be fair, the dog didn't bite her until after the lady kicked him in the face.

They really are crazy critters. They truly love biting people. It's obvious. They did a demo for us and once they knew they were going to get to attack our Deputy Chief (yeah, he was suited) their demeanor totally shifted. He might as well have been the mother of all steaks combined with the coolest squeaky toy ever. Once the handler gave the cue, the dog took flight (like really... he basically flew) and sunk his teeth into the gigantic suit, his tail wagging all the while.

Many of the dogs play this game... they nose-nudge people in the crotch to try to get them to jump so they can bite them. They're freaking nuts. I love it.

But I don't have wrinkles!

2008-04-14T22:04:00.005-06:00

I work at a nursery (kids not trees). I was talking to this 7-year-old boy.

Me: "Guess how old I am."

Him, dead serious: "In your fifties."

Am-boo-lance

2008-04-14T10:06:00.003-06:00

So I had my first ambulance ride-along yesterday. It went well... too well.

I loved being on scene. I loved the challenge of building a rapport with patients and initiating the assessment/treatment of them in such a short amount of time. I loved the autonomy of the ambulance. I loved being in the patient's homes and catching a glimpse of their life. I loved walking into situations without really knowing what was wrong. I loved the look of relief on the face of the family members when we pulled up. I loved chatting with the crew.

Shepp you're right. Being 0ut in the field is addictive.

I had planned on working as an ER tech because it pays better and it would give me a good head start on my nursing aspirations. I don't know anymore. I think I'd like the field more.

Neonate-in-the-pants and intubation adventures

2008-04-12T17:29:00.005-06:00

I just have to share this story.

A paramedic was telling me about this "imminent delivery" he ran a while back. It took them a while to get there, and when they did it seemed like the delivery was not-so-imminent. The woman was relaxed and told them that she had one contraction several hours ago. No contractions since and her water hadn't broken. (Not sure why 911 was called).

So they started walking her out to the ambulance when she said she had another contraction. And then her water broke.

So they get her in the ambulance and then they hear a "waaaah". Both of the medics think the other is just screwing around. Nuh uh. That was real. But where's the baby? One of the medic feels for crowning over the clothes, but there's nothing.

The baby was in the leg of the woman's black stretchy pants. They cut him out and he was alright. :)

On another note, although I know I'm not supposed to do it, today I learned how to intubate (on a dummy). It was really fun. I don't know why. It's like a little treasure hunt for the cords. Just dig around a little until you find 'em. I've been told that it's usually nowhere near as easy or fun on a real person who's sick enough to warrant an ET tube. :(

PS: first ambulance ride-along tomorrow. Wish me luck.

Irrelevant ponderings and realizations

2008-04-11T14:07:00.009-06:00

English teachers read thousands of student's writings in their career. When was the last time you read something meaningful that your English teacher wrote?

There is probably a kid out there who has discovered the truth about Santa by looking him up on Wikipedia.

Do kids in the UK walk to left in their school halls?

I wish I could have like a discomfort-free, UTI risk-free foley inserted nightly. Because I really really hate being woken up by the urge to pee exactly 2 hours before I actually need to wake up.

In about 900 million years, the sun will be too hot to allow for survival of life as we know it on Earth. What are we going to do about that? Planet-hop?

Why on Earth would anyone in their right mind want to be a middle school teacher? Or a dentist (I understand the $$ factor, but really... beyond that... do people really have a fascination with other people's teeth?)

On many aeromedical services I've seen, the majority of the flight nurses are blonde. Examples:

It's kinda bizarre. (Crzegrl... are you a brunette in a sea of blonde flight nurses?)

In a couple of years I'm going to be applying for a flight nurse position and they're gonna be like...
"Oh yes, you're a great candidate... but about your hair... we've gotta do something about that..."

Because I want to be a nurse. That's why.

2008-04-10T16:37:00.004-06:00

I don't know how many times I've had to tackle the well-intentioned but highly-irritating question, "But you're so smart! Why don't you just go to medical school?" when someone learns of my nursing aspirations.

People just don't understand. I don't want to go to medical school because I want to be a nurse. I want to be a nurse for several different reasons... the holistic philosophy, the direct patient contact, executing treatment rather than choosing it. Maybe it's because I'm a little masochistic.

It's not because I want to go into health care but I'm not intelligent enough to be a doctor.

It's not because I'm female.

It's not because I'm worried about the cost.

It's not because I'm incapable of being in charge.

It's not because I'm afraid to take O-chem (although I'm not a big fan of o-chem, it's not a reason I want to be a nurse)

It's not because of the sleepless nightmare known as residency.

I don't want to be a doctor because I want to be a nurse. I know perfectly well that if I really wanted to, I could definitely tough it out through medical school and residency and as a doctor. I know that I'm smart enough.

Since when is someone "too smart" to be a nurse? I guess people outside of the field just don't realize that some of the brightest minds in health care belong to nurses. Nurses with Bachelor's degrees, Master's, even PhDs. Nurses who have written textbooks, performed medical research, educated thousands of students, changed policy, and sparked innovation. Nurse Practitioners who effectively fill roles once occupied solely by physicians. Nurse Anesthetists who are rivaling anesthesiologists.

So please, don't tell me that I'm too intelligent for nursing until you know what modern nursing is up to. Thanks for complimenting my smarts, but don't insult the field I'm passionately pursuing.

Danny Dietz scholarship

2008-04-04T11:11:00.006-06:00

Today I turned in my application for the Danny Dietz Scholarship of Honor.

Gunner's Mate 2nd Class Danny Dietz was a Navy SEAL that was killed in Afghanistan, along with Sonar Technician 2nd Class Matthew Axelson, as they were engaged in fierce combat while mortally wounded. Because of their courage one of their teammates was able to crawl away to safety. They were both posthumously awarded the Navy Cross.

He was an alum of my high school, and a scholarship was set up in his honor. I really hope I receive it. Everyone who knew him remembers him so fondly, and his bravery is inspiring. It definitely is a Scholarship of Honor.

I'll let you know how it goes.

Wide-eyed recruits

2008-04-02T23:46:00.003-06:00

Tonight was the first informational meeting for prospective members of my SAR team and their parents (we're the only search and rescue team in the nation manned by youth).

They were all so quiet and reserved. They didn't speak up much. One kid was so tiny. I was glad when another short kid showed up a little later, because I knew he would at least have a good partner on the litter.

I gave a powerpoint to the group, which was thankfully large. I felt good... I noticed that my public speaking skills have been improving, and the group (especially the parents) were receptive to my wisecracks.

It hit me afterwards that it was just a year ago that I was in the audience for this same exact meeting. I was too shy to really talk to anyone, but I couldn't wait to get started.

I knew that my time on the team absolutely changed my life and pushed me through personal growth freakishly fast but it really hit me tonight. I'm more confident than I was a year ago. I'm tougher than I was a year ago. I'm more knowledgeable than I was a year ago.

I'm glad that I'm a sergeant while the new class is coming through.... well I kinda hope to continue to be one for a while. I'm excited to take some probies under my wing. There's a good chance, however, that once the new class comes in I'll be promoted to lieutenant. Promotion is great and all, but I won't be as connected to the probies because I won't be their first link in the chain of command.

My First Meme

2008-04-01T23:33:00.005-06:00

From Derek:

Here goes:

The rules are:

1. The rules of the game get posted at the beginning.
2. Each player answers the questions about themselves.
3. At the end of the post, the player then tags 5 people and posts their names, then goes to their blogs and leaves them a comment, letting them know they’ve been tagged and asking them to read your blog.

What I was doing 10 years ago:
Learning my multiplication tables or something. Trying to make it through third grade. :)

Five things on my To Do List tomorrow: (not in any particular order)
1. Go to school
2. Work out
3. Give presentation to prospective members of my SAR team
4. Work on getting all of those donated sterile surgical gloves out of all of their excessive packaging. They're taking up too much room in the supply cabinet and we don't need our gloves to be sterile.
5. Plan/prepare for another recruiting presentation and a CE class on Thu.

Snacks I enjoy:
Lemons, lime, lemon pepper, pizza goldfish, parsley and salt water, vegetarian "chick'n" nuggets, mint choco chip ice cream, candy candy candy.

Things I would do if I were a billionaire:
Rent out a water park, have it filled with warm bubble-bath bubbles, play some awesome music and have a sweet private party.
Travel everywhere. Chile is on the top of my list.
Spread modern techniques and technologies of emergency medicine around the world, especially in Latin America and South America. Take back their knowledge of traditional healing and herbal medicines.
Buy my SAR team a helicopter with forward looking infrared and a submarine just for shits and giggles, among other things. Make a scholarship fund for future members.
Chef and maid.
Make Chris a killer studio.
Stop worrying about paying for my education and the cost of education for my future family.

Three of my bad habits:
1. Compulsive hair-touching
2. Messy room
3. Work-a-holic

Five places I have lived:
1. Denver, CO
2. Littleton, CO
3. Littleton, CO
4. Aurora, CO
5. Littleton, CO

Five jobs I’ve had: (I'm too young to have had this many jobs, so I'll list volunteer and school stuff too)
1. Babysat for one family - preschool twins and toddler - twice a week every week for 2 years.
2. Drop-in child care center / nursery at a rec center.
3. Search and Rescue sergeant, EMS officer, co-PIO (public information officer), Chair of Fundraising and Recruiting.
4. School newspaper news section editor, designer and reporter.
5. EMT-B student. Concurrent high school senior and college freshman: pre-nursing (BSN) major.

For this one I'll be tagging:

Mr. Shepp
Other people when I get around to it. :)

An ode to nitrous oxide

2008-04-01T17:17:00.004-06:00

I have a confession. I love nitrous oxide (laughing gas). I ask for it every time I go to the dentist and they have to do anything remotely invasive.

First I can feel the relaxation and numbness settling into my muscles.

Then that "adult soft rock" music on the radio starts to sound muddled, like I'm underwater.

When the assistant walks by, his footsteps sound like the rustling of a bird's wings.

And then I start to reflect on what I'm doing with my life. I wonder about what I need to be doing more and what I need to be doing less.

I need to study more. I need to exercise more. I need to eat less junk food. I need to eat more vegetables. I need to be friendlier.

It's strange, I do that every time I go under the gas.

One time they must've given me too much or something because I looked down at the mask and convinced myself that I was a duck. I wasn't truly hallucinating or anything, but I talked myself into believing that I was a duck and the face mask was my bill.

Bad crab cakes do not warrant a Hazmat response.

2008-03-30T21:27:00.004-06:00

We were running scenarios in my EMT class yesterday. I was playing patient: my "husband" and I had a nasty case of food poisoning from some bad crab cakes. We were sitting at a table when the guy who was running the scenario came in... let's call him Jimbo.

I fake-puked on his feet and apologized profusely.

My "husband" said "I gotta warn you man... I'm explosive outta both ends."

Jimbo put his hands up and immediately walked out of the door and told the instructor: "I'm calling Hazmat. This is CO."

The instructor, the other students and I all got that furrow in our brows.

Instructor: "Hold on a second. You think this is carbon monoxide poisoning?"

Jimbo: "Yes. There's two people sick with flu-like symptoms in the same place. The book says that's carbon monoxide poisoning and that you can't enter."

Me: "We were awake and talking... you could've asked us what was going on you know. Explosive vomiting and diarrhea aren't really signs of CO poisioning."

Jimbo: "Well the book and [main instructors name] says flu-like symptoms... yadayadayadayada... blah blah..." he continued to defend his diagnosis.

The room was silent for a second as the instructor tried to find what to say. She kinda ripped into him. Just a little bit.

They went back and forth for a while. Jimbo's the type of guy that gets ultra-defensive when he gets called on an error, regardless of how minor it is. He won't admit to being wrong without a fight, and when he does admit it he blames it on circumstance or someone else.

We restarted the scenario, but Jimbo was butt-hurt and tried to pass the scenario onto another student. The instructor insisted that Jimbo continue to lead. They went back and forth for a while before he finally agreed to continue.

He started back on the right path... asking questions and surveying the patients and scene. My "husband" excused himself to go to the bathroom to poop.

Jimbo to instructor: "Ok. So I'm going to want him to poop in a bucket so I can take it to the ER."

I couldn't take it. I burst out laughing.

Instructor, with a look of pure disgust: "Why? Why would you want a bucket of poop in your ambulance?"

Me: "Jimbo, can you imagine what the nurse would say if you handed her a bucket of shit? Can you imagine the look on her face?"

Again, a squabble arose, with Jimbo defiantly defending his shit-collecting and the instructor and I raising the points of only needing a tiny tiny bit for hemoccult tests, that the man has explosive diarrhea... he's probably going to give 'em a massive stool sample at the ER eventually, and that bringing in poop will give you the reputation in the ER as "that crazy guy who brought in a bucket of diarrhea."

Oooooh brother.

From zero to hectic in fifty seconds

2008-03-28T04:14:00.002-06:00

So that clinical... the spring-break-grave-trauma... it started off horribly slow.

Like... "no-ambulances-for-four-hours" slow.... like "Everyone-including-the-security-guards-remarks-on-how-strangely-slow-it-is" slow.

For the first 7 hours of my 8 hour shift, I mostly stood around the nurses station. I shot the breeze with a few patients, including an absolutely amazing WWII Marines vet who was at Iwo Jima, among many other battles.

Then magically in that last hour of my rotation, all hell broke loose.

First came a pt that hardcore intentionally ODed on EtOH and benzos. I dropped my first NPA in her, but had to pull it right back out because she became pretty combative. Her BP was insanely low... like 86 / 44 last I checked.

Then came a man whose wife awoke to him seizing... she called 911 and the man became extremely combative with the paramedics who brought him in. Luckily by the time he landed in the ED he was out of the "beat-your-ass" postictal phase and into the "sleepy-drunkish" postictal state.

Then came a boy slumped over in a wheelchair, rushed in by the triage nurse. He was about 15 and drunker then all hell. An acquaintance had driven him from some house party to the front doors of the ED. He's a John Doe, because he's completely unresponsive and the guy who brought him in didn't even know his first name.

Man, that poor kid is going to have a hell of a time when he wakes up. He kept slumping over and moving around.. banging his head on the side rails, he's got a foley, he probably aspirated some vomit, he's going to have the mother of all hangovers, and his parents are going to be mega-pissed. That's a bad spring break right there.

And then at exactly 3:30 AM, the time my rotation was supposed to be over, the first trauma team activation of the night came in. Drunk dude was leading cops on a chase when he crashed his pickup and was ejected. He was banged up but there were no obvious major injuries that I could see.

Poor guy, he was completely alert giving his information to the registrar, when they started placing a foley. I had to hold his legs down. Man, that would suck. I hope if I ever need a foley, I'm as out of it as that OD lady was. When they placed a foley in her she didn't even twitch. Mr. Police Chase, however, definitely felt it.

I bet he learned his lesson. The next time he gets shit-faced and runs from the cops, he'll wear his seatbelt.

Spring break grave at a trauma 1

2008-03-26T22:59:00.004-06:00

Tomorrow I work a graveyard shift clinical at a busy trauma 1: 7:30 p -3:30 a. Seems like a good shift to catch some MVAs, considering it's spring break and I'll be there while the bars are closing. I have yet to see serious trauma while on a clinical, so I'm pretty excited. Not that I want anyone to get hurt, I just want to be there when it inevitably happens.

I'll let you know how it goes. Don't expect too much, though. You know how fickle the Trauma Gods are. It may just be another shift of endless piles of old men with pneumonia.

The best pieces of advice I have received so far

2008-03-23T11:48:00.006-06:00

1. It is not your emergency.

2. Always look ahead of you, behind you, above you, around you and below you.

3. If its warm, wet, sticky and someone else's, don't touch it.

4. Never forget that you are first and foremost a provider of care.

5. Check your gear religiously and thoroughly.

6. Sleep, pee and eat at any given opportunity, because it may be hours before you have that opportunity again.

7. Don't recap needles, get in the firing path of an airbag, piss anyone off, or put water on burning magnesium.

8. Anyone can be combative. Even your sweet lil' grandma can rip through kerlix and beat your ass given the right conditions.

9. Your status as an officer is secondary to your status as a regular member.

10. People do not always go missing during normal business hours; in fact they usually go missing at 2 am.

11. Don't drink and drive. Don't drive tired. Don't use lights and sirens unless you absolutely have to. Everyone else on the road is a complete moron that will hit you given the chance.

12. Learn Spanish.

13. 5% of EMS is about saving lives. The other 95% is about frequent fliers, paperwork, drunk idiots, drugged-up idiots, sober idiots, toothaches, headaches, pneumonia, cleaning up poop/vomit/urine/etc, and anything else boring, disgusting, and/or ridiculous you can imagine.

14. Document everything.

15. Sick kids should always scare the shit out of you, no matter how "okay" they look at the moment.

16. Priorities, greatest to lowest: yourself, your partner/team, the patient, family, bystanders.

17. Always have at least one way out of any location.

18. You will have to save the lives of people who probably don't deserve to live.

19. Always prepare for the worst case scenario.

20. This is the hardest job you will ever love.

50 years and still searching... What a half century of SAR looks like.

2008-03-20T23:11:00.009-06:00

Our SAR team was founded in 1957... the second team in the state. Here's some then vs. now for you. Notice the addition of girls to the team... that happened in the early 90's. Now half of the Officer Staff is female, including the Captain and myself. Some of these pictures may be from as early as 1957.

By the way, notice those ugly white helmets? It seems that at one point they were required for like... everything. Going on a line search? Wear a helmet. Treating a victim? Wear a helmet. Securing the perimeter at a crime scene? Better wear your helmet!

On second thought, it may not be a bad idea for us to re-implement that rule, considering the completely freakish number of concussions a particular member has acquired in a short amount of time doing relatively non-dangerous activities.

Speaking of pediatrics...

2008-03-18T21:19:00.004-06:00

Here's my accomplishment of the year, and a reminder to CHECK YOUR GEAR:

I'm in charge of medical inventory for my search and rescue team. My first run-through of our 3 gigantic emergency care backpacks was pitiful. Broken 02 regulators, missing c-collars, and the worst find: the single BVM in one of the packs was completely broken and non-functional.

Imagine sitting beside an apneic patient on the side of a mountain 6 hours from civilization and desperately trying to assemble a broken BVM.

Anyways, I noticed that we were only carrying 1 pediatric c-collar and 1 pediatric non-rebreather in each pack, although we had plenty of infant and pediatric-sized equipment stored away. I also noticed that one of our packs would be impossible to bring back up to par... for adults.

Inspiration struck; let's turn the crappy e-care pack into the team's first pediatric pack. And so it was born: a pack filled with pediatric and infant c-collars, NRBs, BVMs, BP cuffs, etc, etc. Now I feel I can treat a kid with our supplies with confidence.

(By the way, that BVM looked totally fine, until I tried to assemble it. This just illustrates how important it is to check your equipment thoroughly instead of just giving it a glance-over)

To peds or not to peds?... that is the question.

2008-03-18T15:06:00.003-06:00

I love kids. Naturally, the thought of specializing in pediatric EMS/trauma has crossed my mind many, many times.

I wonder if I could deal with it, though. Could I really wake up every morning for work, knowing that the day will bring abused and neglected children, dead babies, and innocent kids in horrific pain? How could I ever tell anxious, desperate parents that their child is just not going to make it? How could I look into the empty eyes of a child whose short life has already been shattered by a traumatic brain injury?

I don't know. It sure as hell wouldn't be easy. But all of the reasons that make me unsure if I could handle the emotional gore also make me want to dive in and try to make a little difference.

Stupid answers

2008-03-14T16:34:00.002-06:00

I was using the workbook for my EMT class when I couldn't help but notice how stupid some of the potential answers for multiple choice questions are. Here are some gems, stated as a complete sentence, with the answer portion bolded. Comments in parentheses.

When a patient begins to vomit, it is essential that you have a blood pressure cuff ready to go at the patient's side.

To determine a patient's skin temperature, the EMT-B should listen carefully with a stethoscope.

During the assessment of an infant or child patient avoid eye contact at all times.
(that's how they consume your soul)

If a patient stands in a corner of the room with fists clenched and screaming obscenities, you should challenge the patient in an attempt to calm him.

When suctioning a newborn insert the syringe about 22 inches into the baby's mouth.
(You'll know you've done it correctly once you penetrate the skull and see it coming out the back of the head.)

A lovely day of SWAT training

2008-03-09T21:10:00.003-06:00

The Cap'n and I headed out to the boonies today to play in SWAT trainings. This was my second SWAT training experience, but last time we were working with the new guys and no TEMS (tactical EMS) medics. This time we were playing with the seasoned SWAT officers and three TEMS medics.

So this is how their trainings work for us... we show up at some strange location and basically play paintball with the SWAT team. It pretty much rocks. Today we were in a big field and I played the daughter of a crazy man screwing up the DNC by wielding a knife and parking in the middle of the road with his two kids in the back, the getaway driver for a pair of bank robbers, and a hooded hostage.

I was hoping to get shot by one of their special paintball/bullet things because on Tue. I'm playing patient for a paramedic class and I wanted them to freak out if I was a trauma pt. and they had to strip me down and see huge welts... I figured it would add to the realism. Unfortunately I was only shot once in the back by one of the bank robbers and I was wearing a bullet proof vest at the time so I didn't even feel it.

Oh my god.

2008-03-03T21:09:00.002-07:00

I was adopted at birth. My birth mother was 16, and my birth father was 18. My birth father worked with a man whose wife was rendered infertile by some investigative IUD. So an arrangement for an open adoption was made. I was adopted at birth, and my parents were always extremely honest about the adoption. There was never a point in my life that I did not know I was adopted, and I coped with it extremely well.

Fast forward to now. On Friday I was on the 6 pm news because the DMV is screwing me over. My entire birth family, including my birth mother, saw me. Her parents called my dad while I was at work. They were elated. They want to meet me. My birth mother wants to meet me.

Here's the kicker....

My birth mom is a nurse.

Can you believe it?

The Most Dangerous Thing I've Seen Someone Do.

2008-03-01T12:46:00.003-07:00

One time I was at a house party. We were in the backyard and the homeowner noticed that some of his trees' branches were resting on a power line, and he commented that he should cut the branches soon.

"No problem! I'll do it right now! I'm an arborist," replies random extremely stoned and wasted hippie.

So the wasted/stoned arborist gets a chainsaw, climbs the tree about 20- 30 ft., and starts cutting the branches.

Hmm... a very intoxicated man climbing a significant height and operating a chainsaw within close proximity to a power line.

He was fine.

My brain

2008-02-25T23:29:00.002-07:00

A lotta love and a little wide-eyed wonder? Guess so. Where's the sarcastic bits?

"Reborn babies" give me the hee-bee-jeebies.

2008-02-25T22:19:00.008-07:00

To each their own, I guess. The following pictures are not of newborns, dead or alive. They are of dolls. Freaky dolls that women spend hours upon hours creating from the templates of existing dolls. I don't know why I always end up finding stuff like this.

"Lucy hat ihren Körper mit der Nabelschnur behalten den ich nur komplett neu gewichtet habe Gefärbt habe ich sie wieder wie alle meine Babys mit hochwertiger und ungiftiger Künstlerölfarbe und feine Äderchen bekam sie auch gezeichnet. " (yeah... no idea what that means)

"With the smooth smelling lotion what they will bring along you can wash and restyle the hair. Her nose has been opened and underlaid carefully so that the filling cotton will not be seen. She has got humanlike (with capillary veins) green mouthblown German glasseyes from Lauscha."

"What a handy tool! I use this on the warm doll head to catch the edge of the eye after squeezing the face to allow this... It's smooth rounded edges are perfect for safetly catching the edge and releasing the eye so it can be easily removed with no scratches."

"Only a premium angora mohair that's dyed in a beautiful medium brown was used by micro-rooting Stacy's hair. To achieve such a realistic look, it took over 30 hours. With her hair sealed You'll be able to come and style her hair the way you want. "

Oh... so this is why I have nightmares.

My first clinical

2008-02-24T11:09:00.002-07:00

So last night I had my first clinical, helping out with triage in the ED. I was pretty anxious about it, not just about making mistakes. I was also concerned that by the end of my shift I would be like "screw this, I don't want to go into this field," and although I'm young, I've already completely dedicated about 3 full years to this goal and I would have no idea what I would want to get into besides EMS.

It didn't go that way at all. It totally reaffirmed my devotion to the field. I love talking to such a wide range of people with such a wide range of problems... the 1-year-old with pink eye, the bawling, drunk lady who got beat up in a bar fight... the cheery 92-year-old woman who slipped and fell... the 21-year-old developmentally disabled girl carrying her teddy bear and complaining of ear pain... the hefty middle-aged man with a staph infection and surgical complications. I absolutely loved it.

My second patient was a middle-aged man in excellent shape. He dropped a 400 lb. dough mixer and it gashed his shin on the way down before landing on his right foot. This man must have had an extreme tolerance to pain because he walked in (albeit slowly and with a limp) and sat down, completely calm and polite the entire time. This was especially amazing considering he had a recently diagnosed stress fracture in his left foot. Poor guy; I hope that the new injury wasn't too bad.

A couple of minutes later a young man was wheeled in, slumped over, shirtless and pale. He had crashed into a tree and for some reason he had been treated by paramedics on scene but his family drove him to the hospital. His family said his shoulder and humerus were broken, and indeed he still had an air splint on his upper arm and a barf bag on his lap.

His head was slumped over and he was shivering as I started to take his blood pressure. He was obviously in an extreme amount of pain, and he started heaving a little bit.

"Sir, are you okay?"

"Yyy...yeah... I'm just a little... nauseous."

At this point I had come to terms with the fact that I was going to be puked on. I had known it would happen sooner or later, and this was it.

Miraculously, he managed to avoid vomiting the entire time I took his vitals. No word on when or if he puked on someone else.

It was a good night. I had a great preceptor who was eager to teach and happy to hand me the reins. I wasn't hit, pissed on, yelled at or puked on. I obtained vitals with ease, and learned a lot.

I can't wait until I get to work in the back.

Triage, here I come.

2008-02-22T22:07:00.002-07:00

I've got a busy day tomorrow. EMT class from 8-5, and then my first clinical rotation from 6-10 at a busy trauma one. I'll be hanging out with the triage nurse, taking vitals and doing assessment.

It's crazy... I'm at the point in my education where I'm starting to live, eat and breathe emergency medicine. Things like pneumothorax and anaphylaxis and HIPAA play in my brain on some sort of sick carousel. I love it.

By the way... are you aware of the danger that hybrid cars pose to emergency personnel? Click here to learn more and find out how you can stay safe when dealing with an MVA involving a hybrid.

The age of majority

2008-02-20T01:17:00.003-07:00

So I'm 18 now. How do I feel?

Sexualized.
There's some disturbing, blatant sexualization that comes with being a remotely attractive 18 year old girl. It's the minimum socially acceptable age you have to be for men to openly objectify you. It's pretty nauseating, when you think about it.

Scared
HOLY SHIT I DO NOT WANT TO GET OLD. Death doesn't scare me, but circling the drain, slowly losing vitality of the mind and body does scare the shit out of me. It's scary to think that in a couple of years the downward slope will begin and there's no fighting it. I've only got a couple of years left of my mind and fitness gaining.

Excited
And although I feel I've come so far, I know the journey is really just beginning.