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The Handover – Passion edition

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Welcome to Volume 2, Number 1 of the Handover, a blog carnival by and for EMS.  I’m very proud to be hosting it here at Notes from Mosquito Hill this month.  I’ve been participating since Kal hosted the carnival last July, and I count myself lucky to be among such exalted company.

Prehospital medicine is a passionate business in many ways.  We often deal with people on the worst day of their lives, and emotions run high.  This makes for interesting stories.  Most of us don’t do it for the money, as we could often make a better salary in another field.  (Some of us even do it for free.)  We stay because of our own passion for the work.

Then there is that unique condition of the EMT or medic who blogs:  the passionate story.

So without further ado, I bring you The Handover: Passion Edition.

Ben the Insomniac leads off with a post which combines two of life’s great passionate subjects, war and children.

Archie cries. Renee can do nothing to comfort him, but tries anyway. She sings to him, her voice broken by her fears. She smiles at him, the glint in her eyes betraying the tears that she tries to hide. She has nothing to offer other than her warmth, her touch, her love.

This is The Whistle.

Squeezy writes of her own passion.

After 3 years, day in, day out, she can only hope she is offered the best job in the world: a job as a paramedic.

This is Girl in Green.

CKEMTP writes of what the job has given him.

Thank you EMS for allowing me to see the power and passion in people going through the worst times in their lives… and in some cases the best ones.

This is Thank You, EMS.

Michael Morse brings us a snapshot to chill the heart of any parent.

The kids were no longer smiling. I think they sensed my trepidation.

This is Tiny Package.

Greg Friese sends a tale of a whole gaggle of passionate patients.

. . .they had already walked/run more than two full marathons, bicycled more than 65 miles, swam more than ten miles of cold whitewater, and kayaked nearly 50 miles.

This is Passion in the Blazing Heat of the Utah Desert.

Peter Canning sends a series of snapshots of parents and their love.

“He’s had a hard day,” his mother says. I can see the sadness and tiredness in her eyes, but there is no anger there, no hint of a breaking point.

This is I’ll Be at Your Side.

Justin Schorr, aka The Happy Medic tells of his own passion for his job.

Why do folks think I have an answer for why I love my job?  I just do.

This is Why Do You Love Your Job?

Mark Glencourse, aka Medic999 sends along a post on dealing with the trauma we face.

I dont know whay this one has affected me so much. I know that it all goes down as experience, it will end up as another story shared with new colleagues, but it will also be another one stored away, but never forgotten.

This is Suicide.

EpiJunky submitted a beautiful example of the kind of passionate writing I love to see, and a wonderful example of the attachments we sometimes form with patients.

She managed to smile.  “Don’t be sad, I’ll be okay.”  I didn’t realize that I had tears running down my face.

This is A Fan of Her Life.  It’s a two-parter; be sure to read them both.

For my own submission, I handed the blog and the theme over to Mrs. Mack505.  To my delight (and relief?), she selected one of my top three candidates.

Her husband had seen to her every need, helping her to the bathroom and feeding her for as long as he could. Her degeneration had progressed to the point that he had to carry her upstairs to the toilet, yet he continued single-handedly.

This is Olive Oyl.

For those of you who may be new to Notes from Mosquito Hill, I would encourage you to dig deeply, or to try the EMS and CMTSU (Can’t Make This Stuff Up) tags.  I’ve been posting a lot of photos lately, but the writing is all still here.  It’s just spread out a bit.

Next month’s edition will be hosted by CKEMTP over at Life Under the Lights.  His working theme is ‘Respect,’ and he has a big idea to go with it.  I’ll let him tell you about it when he gets the post up.

Here’s hoping you enjoyed our spin on passion.  Thanks for reading.

Mack505, in quarters and off the air.

Call for submissions

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Notes from Mosquito Hill is proud to host this month’s edition of the Handover EMS Blog Carnival, but I need submisisons!  The deadline is Monday, February 22 at midnight.  I currently have two submissions and one “Eep, I forgot!”

One of the two submissions is from a new blog, so there’s definitely something to anticipate!

I know the EMS blogosphere has been very busy with the Chronicles of EMS lately, leaving us on the back burner.  I’ve been following it with interest, too. But let’s not forget some of the other things that make this community great.

In keeping with the season, this month’s theme is “Passion,” but with a slight twist. Of course there is the obvious meaning: please send me stories of situations where the patient’s passion, or your own, was the focus of the situation.

Here’s the twist:

For the open submisison section, I want to see your best passionate writing. Some of my favorite medical blogs are incredibly well-written and evocative. The subjects may sometimes be mundane, but the storytelling can be exquisite. It’s obivous that the writers are passionate about their subjects. For a few examples, check out Epi-Junky, Siren Voices, Trauma Queen, or my own ‘best-of’ tag.

Let’s see the the best you have to offer, regardless of the subject!

Questions, comments, and of course submissions can be sent via the contact link. Deadline February 22, 2010.

Mack505, out.

I’m not overweight, I’m overequipped (Project 365 – February 12)

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To continue another meme from a few other bloggers I read:

I’m not overweight, I’m overequipped. Behold, the contents of Mack505′s pockets.

DSC_5761.JPGRight front pocket – headphones, business card holder
Left front pocket – nail clipper, Chapstick, USB thumb drive, Albuterol inhaler, hand sanitizer, pocket knife (currently Schrade X-Timer, sometimes a Kershaw)
Left hip pocket – wallet

Right thigh pocket – documentation quick reference guide, pocket protocol guide, Post-It notepad, shears, credit card holder with EMTP ticket, CPR card, ACLS card, and fire department ID.
Left thigh pocket – Littman stethoscope

Belt – Dakota carabiner watch, pocket flashlight (currently a Coleman LED), glove pouch, key carabiner with 3502 elevator key and Gamewell fire box key, iPhone with Otterbox case and Nite-Ize holster (bonus points if you can identify the podcast!)

Shirt pocket – pen acquired from the UPS store

And of course the sunglasses.  Currently Smith ‘Sequel’s with the orange lenses installed.

For off-duty time, delete both thigh pockets, the flashlight, the pen, and the keys. Add a Motorola Minitor V fire department pager.  Now that it’s all out of my pockets, maybe I should go weigh it.

Edit: 5.2 pounds!

Now I’m awake. . .

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Gravel sprayed behind us in a ‘Dukes of Hazzard‘ cliché as we tore away from our post.

“Medic 9, we have it.” A reported neo-nate with difficulty breathing. We had been enjoying the warm summer night at the city line. If I had to be out of my bunk, this particular post wasn’t a bad spot to be.

Engine 68 was also rolling with us. Their quarters were closer to the scene, but they had been comfortably in bed. It was anyone’s guess who would arrive first.

Empty streets; the roar of the diesel; the WHOOSH of our passing at high speed. There is no need for sirens at this hour. We drive inside a disco-bubble, with the strobes randomly illuminating our world in red and white. You learn to look low, watch the headlight beams, and try not to look directly at passing signs as they flash.

We could see the engine approaching the block from the other direction, and they beat us to the turn by a split second. The captain and backstep firefighter jumped out almost before the rig came to a complete stop and were off at a sprint.

As I rounded the back of our ambulance, my world froze. The captain, who had been in the house less than 15 seconds, was returning at a jog. He held a baby in front of him, with his arms fully extended, and his face bore a look of shock. I uttered something profane to Earnest Partner, who threw the back doors open and climbed inside. I followed him, and we began to set up for resuscitation.

Our beautiful summer night suddenly looked very bleak.

Within a matter of seconds, the captain jumped into our ambulance and placed a three-week old girl on our stretcher. The infant took one look at me and began to cry.

(M505 exhales a long-held breath. Even years later the memory of the moment is intense.)

The world resumed its normal speed. It was soon evident that we were dealing with a common cold and a set of nervous first-time parents. A gentle ride to Local Children’s Hospital took care of everything.

Except our adrenaline. No point going back to bed.

Sausages & Beer

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In this life, humor is where you find it. When you spend enough time working closely with the same person, it can come at the strangest moments.

Long Lost Sister and I respond to the nondescript industrial building. A Basic Life Support ambulance has responded ahead of us for the worker fallen down a full flight of stairs.

It’s 5:00 A.M. We’re on the tail end of a long shift and feeling a bit punchy. The BLS crew meets us at the door with the patient neatly immobilized, packaged, and ready to travel. She lost consciousness, either before or after the fall. Now she’s confused, or maybe not. We can’t tell, as she speaks no English and we speak about 12 words of Spanish, combined.

LLS and I both stay with the patient, making one of the EMTs drive. We’re still not sure exactly what we are dealing with. Did she pass out for a medical reason and fall down the stairs, or did she fall down the stairs and sustain a head injury? No one knows.

LLS asks about the type of work she does, looking for clues. “It’s a meat packing plant,” I respond. “They make sausages.”

Something about that strikes LLS as funny. She begins to giggle and snort. “You work with sausages?!” she asks the patient, who doesn’t understand. It’s contagious, and now I’m trying to maintain professional decorum myself. I succeed, but barely.

The patient begins to strain and squirm against the straps immobilizing her. She could exacerbate her injury, and I strive to remember the espanol for ‘please don’t move.’ The best I can muster is ‘please sit down,’ which I don’t use for fear of causing more confusion. We settle for ‘shhh’ and a gentle touch.

As we turn into the hospital parking lot, LLS looks up at me, mumbles “Sausages!” and dissolves into another fit of schoolgirl giggling.

Preceptor/Partner and I have driven the highway between Local Community Hospital and Big City Trauma Center more times than we can count. We know every pothole and curve by heart. If it weren’t for the traffic, I think I could make the run with my eyes closed.

Midway between LCH and BCTC there is a large liquor store with a scrolling sign. It usually advertises the latest deal on wine, or perhaps rum.

Late one summer night, as we pass the store the sign briefly flashes **ICE COLD BEER**. It sounds good, but of course we’re on duty. I point it out to P/P in the back, but the sign moves on to other things before he can look out the window.

This happens repeatedly over the next few weeks. P/P, who would love an ice cold beer, never sees it. He begins to believe I’m pulling his leg.

Then it happens. We are returning from BCTC one evening, and P/P is on the phone with his wife as we round the corner. There it is! We both scream “ICE COLD BEER!” at the top of our lungs. We are left trying to explain the joke to his wife, and we have a good laugh to last the rest of the shift.

To this day, the phrases “You work with sausages?”, “ICE COLD BEER!”, or “You got some splainin’ to do!” if uttered in the proper tone of voice, will cause LLS, P/P, or Patrick respectively to dissolve in fits of laughter.

The Handover

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This month’s edition of the Handover EMS Blog Carnival is up at over at Medic999.

This month’s topic is ‘Your First Emergency.’ Thanks to a guest post, we here at NfMH have two posts included! (Thanks, Mark.)
Why not pop over to Medic999 and see what everyone else wrote about?
If you enjoy what you see here or elsewhere in the Handover, I encourage you to check out my Blogroll in the sidebar. I’ve been slowly adding lots of good stuff to it.

The Show Must Go On

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“We’ve got a fire on the stage!” I tore from the back of the Performing Arts office, sprinting for the Stage Right doors.

I grew up in a firehouse. I always knew someday I’d be not only a firefighter, but that special breed above all else, a ROWLEY firefighter. Episodes of ‘Emergency!’ piqued my interest and stealthily indoctrinated me with the value of EMS. Dad would leave at all hours of the day or night, answering box alarms sounded on the air horn in the center of town. He kept his turnout gear at the top of the back stairs, which he only used when going to fire calls. In later years we had an extension of the Red Base, a pre-911 fire department party-line emergency phone. I could listen in on the dispatchers as the emergencies happened! We could even sound the ‘fire whistle’ from our front hall, although I never succumbed to the temptation.

I used to attend drills on Sunday morning with Dad, learning all I could. I remember checking equipment; my specialty was the batteries in the flashlights. I have one vivid memory of sitting on top of the engine during a pump drill, guiding the deck gun and using it to blast the bark off dead trees.

I don’t exactly remember my first emergency call. I have one vague memory of sitting in the cab of Engine 7′s 1947 Howe on a flooding/service call. That truck was sold in 1980, so I was still pre-teen.

I remember my first call as a driver, and my first call as a Lieutenant.

On the medical side, I remember my first day on the ambulance as an EMT. We did dialysis runs all day long. First call as a newly-minted paramedic: an electrocution. I remember my first cardiac arrest, but that’s a subject for another post. I remember my first cardiac arrest SAVE, which should be yet another post. I remember my first fatal crash, and the first time I used the Jaws of Life.

First emergency, though, ummmmm. . .

First really big fire? Malden Mills, December 10, 1995. I doubt I’ll ever see another like that; it’s a story to tell the grandkids when I have some.

Very first emergency, uhhh. . .

As I rounded the corner, I could see my best friend approaching from Stage Left with a dry chemical extinguisher. He let loose on the small fire, barely missing me in his zeal. The charred remains of a smoke machine sat on the smoldering carpet on the stage riser.


While he unplugged the smoking hulk, I strode to center stage and waved for the sound man to turn up my microphone. I politely asked the milling crowd, waiting for intermission to end and the show to resume, to evacuate the auditorium. They didn’t hear a word, as our sound man had missed the cue.


Returning to the seat of the fire, we peeled back the carpet and checked for extension. Fortunately there was none.


I returned to the office to look up the phone number for the local fire company. This was pre-911 in our area, and it wasn’t a real emergency anyway. Just a little smoke, now.


When the first engine arrived, the Captain was irate we hadn’t pulled the box. We saw no need – the fire was out. What’s a little smoke?


The engine company inspected our work, evacuated the smoke, condemned our smoke machine, and stomped out. Dress rehearsal was over.


The date was March 16, 1989; second Thursday of the month and the night I was appointed to the Rowley Fire Department.

Impressions

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It’s been a weekend of firsts here at Notes from Mosquito Hill. My first submission to The Handover was published, and I’ve started to see my first readers and comments from outside my own personal circle. Today brings my first guest post.

I’d like you all to welcome my sister, Rescu82, to the Blogosphere. She says she’s not ready for her own blog, but she has a few stories for mine. 82 is a nurse in a major metropolitan trauma center. She lives out in the foothills and volunteers as a paramedic in Ancestral Hometown. She also works as a per-diem paramedic in Laketown, a neighboring tourist area. Recently she’s been dragged over to the Dark Side by the firefighters with whom she serves. Although her response areas are very rural, every summer we tourists bring the big city to them. What they lack in quantity, they surely make up in quality. I’d love to work there myself.

So without further ado:

Impressions: A Rookieʼs First Fire

I am doomed to wear sweaty, gross shorts.

I had just returned from a jog when one of the guys yelled across the station. “Neighboring Town was just toned for a fire in a garage!” I head for my gear anticipating the soon to drop Laketown tones. They drop before I reach my gear. “Respond mutual aid to Neighboring Town for a garage fire. Reported as person trapped in the building.” I barrel across the apparatus floor and jump up into Engine 9.

Looking around the truck I realize that I am with a young but good crew, all with more experience than me. As we cross the Causeway headed for Neighboring Town, we can see a cloud of thick black smoke roiling into the sky. When I see that, my stomach drops out from under me. “Oh my dear God….Iʼm about to be baptized!” Next, the adrenaline shakes hit…. followed by the paramedic instinct to take slow deep breaths and get the shakes under control. Fear is good, it makes you think. I remind myself panic is the enemy as I continue to gear up while we rumble down State Road toward the cloud of smoke.

As the truck pulls up to the scene all I can focus on are the flames shooting into the sky from the destroyed garage. It is gone, the cars are smoking hulks, and the flames are eating the house. Snapping out of it I try to get out of my seat and canʼt move. I try again and still canʼt move. “Great” I think, “what stupid thing have I done before I even got out of the truck?” I call one of my company members to help me. Grinning he reaches in and pulls the release for my SCBA. I had failed to pull it before I packed up. Determined not to make a bigger mistake, I hop out of the truck and grab my weapon of choice, a Halligan tool. My company and I report to Incident Command for our assignment.

“Attack line” is the answer we receive. Turning around and looking at the flaming house, the shakes threaten to return as I snap on my regulator. The mask sighs as I trigger the regulator with my breathing. I follow my company to the attack line. I focus on taking measured breaths. We take up our position and with a senior firefighter guiding our nozzle man off we go. “Wow look at the fire rolling out the front door,” is all I can think as we make entry into the house with a charged 2 1/2″ line. Doing my best to duck walk through the white hot ash at my feet, hang onto the Halligan, sound the floor, and drag the line, my next thoughts are “itʼs sort of pretty” and “Dang, I donʼt have enough hands for this!” Suddenly the hose goes limp in our hands and the fire which we have been successfully pushing back comes blasting at us like a blow torch, rolling over our heads. Rear over elbows the four of us bail out the front door.

“Holy Cow! What just happened?” The answer comes back to me, “water supply issue”. Regrouping on the front lawn with my company, I watch the fire blast out the front door again. The line fills with water and command gives us the go ahead to again make entry. We resume our positions on the line. Iʼm directly behind the nozzle man and I have a linebacker behind me. Again, we enter the house and push the fire back into the kitchen. This time we make it a good 10 feet into the house before the hose goes limp. Again we bail out the door, this time blasting through a Loo who is blocking our escape while watching our progress. He is not impressed; neither are we.

This time the question as to what happened isn’t phrased as politely as it was the first time. The Pump Operator is fired and replaced with an old timer who can get water out of a stone. The line is charged for a third time. We make entry for the third time.

Weʼre doing great, pushing the fire back into the kitchen and following it toward the back corner of the house. The back-up line makes entry behind us.

The senior firefighter at the head of the line with the nozzle man turns to check our progress. He yells something, grabs the nozzle man, and slams him into the floor following him down. I canʼt hear what he yells over the crackle of the flames and the muffle of his mask. “What the?” I think followed a split second later by “better follow him!” I dive to the floor. I am face down in the white hot ash. All I can think is, “My knees are hot, my knees are hot.” I am waiting to be hit by the ceiling. I am waiting for the floor to drop away. I am waiting.

It happens fast. A scalding steam bath. The back-up line opened their nozzle over our heads on the fire in front of us. One molecule of water expands to 1700 molecules of steam. I am baking in my own skin. My knees are roasting. I am face to face with the inside of a giant wood stove. I am a log in that wood stove. I am thankful for my hood protecting my ears and neck. Just as quickly as it happened, it is over. I am back on my feet duck walking again.

Command pulls us out. The roof is getting soft and we are switching to an exterior attack. My company exits the building. I walk to the rehab area and pop myself off my air. I peel off my turnout. Underneath, I am sopping wringing wet. The 80 degree air feels as cool on my skin as opening a freezer door does on your face. It feels good. I sit down and drink water.

In a while we take up and go home. Ancestral Hometown is covering back at the station. As we back into the bays, the guys from Ancestral Hometown rowdily congratulate me on catching my first real fire. I get high fives all around. The senior firefighter who was on the hose with me pulls me aside. He tells me that he was impressed that I didn’t panic under pressure and he will take me with him into a burning building anytime. High praise from that person. I smile and laugh. I know how hard my heart was beating while I was waiting.

I stow my gear, stop to admire my pink knees, and hop into the Jeep to go home. I put down the windows and crank the CD player blasting Avril Levine’s “Girlfriend”. I sing at the top of my lungs. I am riding my adrenaline rush. I am dirty. I stink. I am still insweaty gross shorts and I donʼt care.

I swear I never told her about the topic for the upcoming August Handover.

Sunrise and CISD

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The Martin boys were home from college, enjoying a night out on the town. Some time around midnight, the twin brothers decided they were too drunk to drive home. They did the right thing, like their parents taught them, and called their friend and neighbor ‘Joe’ for a ride. Unfortunately, Joe was also too drunk to drive and too drunk to know it.

The intersection had a stop sign. The street approaching it was a 25 MPH zone. The intersection sloped upward, creating a ski jump shape. Joe was a local boy and knew all of this. The accident investigation would reveal Joe’s car was going almost 60 MPH when it left the ground. Continue reading →