Sneakers

I wrote my last dispatch from Caritas Norwood Hospital. In order to become a paramedic you have to do 400 clincal hours. Right now, I'm in the ICU. An hour ago the overhead PA system called for a "Code Six" in the ER. A code six is a dead person, its a code. I took off from my little desk in the ICU just in time to perform CPR while we tried to establish more IVs in a 43 year old man who was covered from head to toe in his own blood.
Now, I have been a firefighter for two years, I work as an EMT, gore and blood is nothing new to me. It almost never bothers me and for the most part, today is no different. I feel bad that I could not save him for his and his family's sake. My professional job ends when I hand the patient over to the ED staff. For the past few months, though, I have been the ED staff. Out in the field everything is different, being in the hospital is a big change. In the field I could take comfort in the fact that I would be at the hospital soon. Once at the hospital, theres nowhere to go.
Today was one of those bizzare days, the ICU is not exactly busy, I mean we had some interesting stuff but I love working down in the Emergency Department. So when I heard that code come in I ran to help out.
The guy was bald, strapped to a bright orange back board and covered in blood that had, presumably, hemorhaged from varices in his canercous lungs. Paramedics were unable to entubate him in the field because of the copious amounts of blood pouring from his airway so they shoved a CombiTube (a dual lumen device that is inserted blindly to at least open an airway) down his throat and kept the suction going strong. A Norwood firefighter was doggedly pumping the patient's chest when a nurse told me to relieve him. I had already double gloved, a habit from the field, when I started compressions. A respitory technician as suctioning the man while another worked the bag valve mask. I fell into a rib-cracking rhytm and watch the monitor periodically to make sure my compressions are making the man's heart contract and thus pump blood.
I don't notice the blood spraying onto my shirt untill its too late, luckily none of it is in contact with my skin so I'm in the clear, not that this guy had anything contagious anyway. I work the rest of the code, alternating CPR with another medic intern. In addition to a certain number of hours, paramedic students have to perform a certain number of skills. So as I'm doing CPR I ask Kerri, a trully gifted ER nurse, if I can push the required drugs. She's one of my favorite nurses as we work really well together, like my old partner at the fire department we don't need to say "I'm doign this...." or "Watch it, I got an IV here." On some level we know what the other is doing. Its weird but at the same time reassuring. So Kerri lets me push a miligram of Epi and an AMP of BiCarb in the hopes to get this guy's heart pumping again.
In a code, certain drugs are pushed. You push a miligram of Epinepherine every three minutes, alternated with a drug called Atropine at the same dose and timeframe. You do this untill you push three megs of Atropine and then you keep going with the Epi until the doctor tells you to stop or you run out. After an extended period of time, relative when it comes to a code, usually about fifteen to twenty minutes, the human body will become acidic because it can't offload the CO2 that has built up. So you need to push Sodium BiCarb to try and fix the Ph, sort of like a pool guy.
Every two minutes you stop CPR just long enough to see if the little green line on the monitor starts wiggling on its own. If it doesn't you keep going and keep checking.
Unfournately, the man we had today did not make it. He died despite our best efforts and now I am sitting here drinking a black coffee, writting this article. Like I said before, death does not bother me, its an inevitable part of my profession, indeed just in medic training I have had six codes that ended in death. We got one back. Then theres the bodies I saw with the fire department, so its not new to me. But this guy, dressed in a Red Sox hoodie and brand new sneakers kind of fucked me up. Just something about seeing the new sneakers really bothered me.
When someone dies in the ER its standard procedure to strip them down to their underwear and put them in a johnie, to make them look more presentable to the family. As this guy was covered in blood we had to bathe him too. When I was taking his shoes off, I noticed they were brand new. All be it covered in blood but they were straight off the shelf and out of the box. Thats when I did something I should never have done. Without realizing what I was doing I imagined this guy alive, picking out those shoes. He must have seen them on the shelf and liked them, thought they were cool. Then he tried them on and they were comfy so he bought them.
Now they are wrapped in a bag marked patient belongings.
I do what I do because I want to help people and I couldn't help this guy. No one really could, but his family is still alive. Because his family is still alive I took a warm washclothe, warm because for some reason unbeknownst to me I thought it would be more comfortable for him, and I washed the blood from his face, his hands. I cleaned him up so his family wouldn't have to see what we had seen.
I'm not going to end up all depressed and distraught over the man's passing. I'm not cold about it either but I can accept it and move on with my life. I can do that because its part of my job, I can do it because I didn't know him, I can do it because we did all we could but mostly I can do it because I have to. Writting it down in this article makes me feel more human, I can share this experience with everyone else so its not just my own. Someone said that "A man's death is the death of us all." Don't ask me who, as I think we have established I am a firefighter not an English major. That might not even be the correct quote but its something like that. So with that in mind, I wrote this article. This article isn't for you the reader. Its not so that you can see what I do at the hospital. This article was typed with shaky hands and the fabricated memory of a man picking out shoes and the fun I imagined him having doing it.
As ghoulish as I can admit that sounds, I can't help it. Like I said earlier, I am not going to go into a deep depression, or even a mild one, over this episode in my career, but I am going to remember it. A man died today, I don't know him and you don't either but he was someone and his family loved him. S0mething as nromal and carefree as a pair of new sneakers drove that painfully home to me today. In writting this I have exorcised any of the thoughts and feelings that probably would have festered if I didn't get them out.

Stoned

A small deposit of calcium can build up in your kidneys. Most of the time its too small for you to notice and you just viod it along with your urine or in the best case the calcium never builds up. If it does build up and then refuses to pass you are blessed with what is known as a renal calculi, a kidney stone in laymans terms. Picture trying to pass a three milimeter razor blade while urinating and you get a glimpse at the last month of my life.
I was driving to paramedic school when I noticed a slight twinge of pain in my back, just to the left of my spine. Within five minutes I was pulled over to the side of the road, vomitting and shivering from pain in the freezing January mist. Me, being the hard ass (or is it hard head?) that I am, I drove to school and tried to stay for class. My instructor, a Boston EMS paramedic with centuries of experience told me either my buddies could take me to the emergecny room or Taunton's 911 AMR truck would do the honors. Grudgingly I agreed and after a battery of tests and several pwerful doses of dialutid, a narcotic analgesic I was released and sat for the rest of our cardiology lecture.
And so began the month from hell. Cardiology is when everything in paramedic comes together. All of the drugs we had learned about were starting to make sense because we were able to understand what they are doign and why the are doing it. Needless to say this is a very important section of medic, certainly not one an aspiring medic should miss. So one can understand why I was less than thrilled to hear that I would need to see a urologist and even more pissed off when said urologist told me he wanted to wait a month before doing anything with my stone.
A month of god awful pain passed before I decided to admit myself to Rhode Island Hospital and have the specialists go in and scoop out my little diamond.
As soon as I was discharged I had to take my paramedic mid term. I had to take a test based on an entire semester's worth of knowlege, while still under the effects of painkillers as my urinary tract was totally and painfully inflamed. Despite all that I managed to start IVs on dummies, entubate the dummies and recognize the squiggly lines of EKGs for emergency treatment. I scored a 97.5 on my mid term practical and a 90 on the written which to me was astounding.
I had been at about a level four out of ten pain consistently for a month, durring that time I developed an understanding of how prisoners of war can be tortured into insanity.
Now comes the recovery, I have started going back to the gym, my previous gym addiction ahd to be placed on hold as the pain was so bad. I am in the home stretch of paramedic with the end date of May 18 in sight and my clincal hours (400 total) are being whittled away with militaristic discpline to a 30 hour a week schedule composed of ten hour days.
Overall I miss being a firefighter very much, while I certainly enjoy the medical aspect of my job, I long to be sweating my ass off, crawling along the floor under a pall of heavy, oily smoke. To that end I have various applications in with multiple departments and I am trying to secure part time work at my ala matta Holden Fire Rescue in Holden, MA. Untill then I work as a paramedic intern and an EMT Intermediate for an ambulance. Soon has gone from the abstract future of college days to a tangible reality within sight.