EMS NEWS

Although I am almost certain I was not at fault, I still worry that the lady who rammed her Ford Escort into the side of my rig a few weeks ago is gonna try something crazy like a lawsuit or my boss is gonna call me in for a chat after I forget about the whole thing. I know it’s irrational, but I’m driving around in an advertisement for deep pockets. My other fear is that the old lady who fell down the stairs is going to sue because she had to wait a few extra minutes because we had to stop instead of continuing on the call. I wonder what an auto insurance quote for an ambulance runs, anyway?

So, if you’ve been in an ambulance crash before, what ultimately ended up happening?

After 5 years in this line of work I finally had an ambulance crash.  We were responding to a call lights/sirens on a busy road when we reached an intersection.  There were cars in both lanes so I swung left to the turning lane and then proceeded into the intersection slowly.  My partner yells out “WHOA” and I feel a crunch.  The lady in the RIGHT lane pulled out as we were turning and drove right into us.

…And that’s how you get out of a call.

Minor damage…just ripped our metal fender in two.  I think I should call and get a life insurance quote Hopefully nothing else comes of it.

I don’t get many crackheads at work.  I can only think of one within the last few months.  Crack isn’t really prominent in suburban white America (where I work.)  What IS prominent in suburban white America, is falling down, breaking a hip, drinking over the age of 80, and heroin.

We currently have one repeat overdoser.  This varies, sometimes we have 3 or 4, then they die, get locked up, or get kicked out of mommy’s house.  This particular kid is 23 and his parents only real concern is the amount of money the ambulance charges everytime we get called to pump him full of Narcan.  (They could have paid for a few stays at a drug treatment center from the number of times we’ve been there.)

We also had a doozy a few shifts ago.  A 50-ish caretaker of an old man decided to sneak a few of the old man’s Oxycontin and then no one could figure out why he couldn’t wake up.

I have successfully passed my fireman’s agility test.  My time wasn’t that great but I had never done one before so I didn’t want to pass out halfway through.  I was told that times only matter if there is a ‘tie’ between candidates. 

From what I could tell, I was the youngest candidate there at 28, so that give me an advantage, I think.  The test was based on the CPAT test.  It’s been 3 days and I’m still sore.

We had REAL stairs.  Sissies.

We see it all the time on the ambulance.  Drug seeking.  Drug seeking in and of itself isn’t such a bad thing.  You may really need a narcotic and you may really be in pain.  However, as this doctor says, nothing is worse than someone who is lying to get narcotics.  A drug-seeking act won’t fool very many health professionals.  We just aren’t that stupid, and you aren’t that smart. 

Advice from an ER doctor to drug seekers

Date: 2007-03-27, 9:56AM PDT
OK, I am not going to lecture you about the dangers of narcotic pain medicines. We both know how addictive they are: you because you know how it feels when you don’t have your vicodin, me because I’ve seen many many many people just like you. However, there are a few things I can tell you that would make us both much happier. By following a few simple rules our little clinical transaction can go more smoothly and we’ll both be happier because you get out of the ER quicker.
The first rule is be nice to the nurses. They are underpaid, overworked, and have a lot more influence over your stay in the ER than you think. When you are tempted to treat them like shit because they are not the ones who write the rx, remember: I might write for you to get a shot of 2mg of dilaudid, but your behavior toward the nurses determines what percent of that dilaudid is squirted onto the floor before you get your shot.
The second rule is pick a simple, non-dangerous, (non-verifiable) painful condition which doesn’t require me to do a four thousand dollar work-up in order to get you out of the ER. If you tell me that you headache started suddenly and is the ‘worst headache of your life’ you will either end up with a spinal tap or signing out against medical advice without an rx for pain medicine. The parts of the story that you think make you sound pitiful and worthy of extra narcotics make me worry that you have a bleeding aneurysm. And while I am 99% sure its not, I’m not willing to lay my license and my families future on the line for your ass. I also don’t want to miss the poor bastard who really has a bleed, so everyone with that history gets a needle in the back. Just stick to a history of your ‘typical pain that is totally the same as I usually get’ and we will both be much happier.
The third rule (related to #2) is never rate your pain a 10/10. 10/10 means the worst pain you could possibly imagine. I’ve seen people in a 10/10 pain and you sitting there playing tetris on your cell phone are not in 10/10 pain. 10/10 pain is an open fracture dangling in the wind, a 50% body surface deep partial thickness burn, or the pain of a real cerebral aneurysm. Even when I passed a kidney stone, the worst pain I had was probably a 7. And that was when I was projectile vomiting and crying for my mother. So stick with a nice 7 or even an 8. That means to me you are hurting by you might not be lying. (See below.)
The fourth rule is never ever ever lie to me about who you are or your history. If you come to the ER and give us a fake name so we can’t get your old records I will assume you are a worse douchetard than you really are. More importantly though it will really really piss me the fuck off. Pissing off the guy who writes the rx you want does not work to your advantage.
The fifth rule is don’t assume I am an idiot. I went to medical school. That is certainly no guarantee that I am a rocket scientist I know (hell, I went to school with a few people who were a couple of french fries short of a happy meal.) However, I also got an ER residency spot which means I was in the top quarter or so of my class. This means it is a fair guess I am a reasonably smart guy. So if I read your triage note and 1) you list allergies to every non-narcotic pain medicine ever made, 2) you have a history of migraines, fibromyalgia, and lumbar disk disease, and 3) your doctor is on vacation, only has clinic on alternate Tuesdays, or is dead, I am smart enough to read that as: you are scamming for some vicodin. That in and of itself won’t necessarily mean you don’t get any pain medicine. Hell, the fucktards who list and allergy to tylenol but who can take vicodin (which contains tylenol) are at least good for a few laughs at the nurses station. However, if you give that history everyone in the ER from me to the guy who mops the floor will know you are a lying douchetard who is scamming for vicodin. (See rule # 4 about lying.)
The sixth and final rule is wait your fucking turn. If the nurse triages you to the waiting room but brings patients who arrived after you back to be treated first, that is because this is an EMERGENCY room and they are sicker than you are. You getting a fix of vicodin is not more important than the 6 year old with a severe asthma attack. Telling the nurse at triage that now your migraine is giving you chest pain since you have been sitting a half hour in the waiting area to try to force her into taking you back sooner is a recipe for making all of us hate you. Even if you end up coming back immediately, I will make it my mission that night to torment you. You will not get the pain medicine you want under any circumstances. And I firmly believe that if you manipulate your way to the back and make a 19 year old young woman with an ectopic pregnancy that might kill her in a few hours wait even a moment longer to be seen, I should be able to piss in a glass and make you drink it before you leave the ER.
So if you keep these few simple rules in mind, our interaction will go much more smoothly. I don’t really give a shit if I give 20 vicodins to a drug-seeker. Before I was burnt out in the ER I was a hippy and I would honestly rather give that to ten of you guys than make one person in real pain (unrelated to withdrawal) suffer. However, if you insist on waving a flourescent orange flag that says ‘I am a drug seeker’ and pissing me and the nurses off with your behavior, I am less likely to give you that rx. You don’t want that. I don’t want that. So lets keep this simple, easy, and we’ll all be much happier.

Sincerely,
Your friendly neighborhood ER doctor

I was supposed to spend tonight with Corrin at the holiday party in Indy, but the weather had other plans.  Once I heard there was freezing rain I decided I better leave before it gets dark.  It was sleeting as soon as I left, but the roads were okay til I hit lafayette.  Then I started noticing people coming from the north with their hazards on, so I figured something bad must be going on.  Then I noticed I seemed to be floating on the road and promptly slowed down to about 30.

There was a green Lumina in front of me.  He made the mistake of tapping his brakes on a frozen bridge and slid into a ditch.  It was complete ice from there on in, and there were accidents all over I-65.  I got off the interstate and drove over to 41, which wasn’t much better, but at least there weren’t as many semi trucks. 

I snapped a few pictures, as safely as I could.

My poor car is completely covered in ice!

So, it took me almost 4 full hours to get home.  When I finally did get home, I almost fell over because the parking lot and sidewalk here are covered in ice, too.  I had to shuffle all the way inside.

This picture was taken a few weeks ago after a 90-something drove his car through his free-standing garage.  He was not injured, and it made for an interesting photo-op.  His foot slipped off the pedal and away he went.

Well, last night we were called to a nursing home and I recognized the name immediately, although I wasn’t sure from where.  The nurse giving us a report mentioned he had crashed his car through his garage a few weeks ago, and then broke his hip in a fall shortly thereafter. 

He was the second patient of the night who refused to talk to me.  I’m not sure what it was yesterday, but two patients in a row literally refused to talk to me.   They just shook their heads yes and no.  I was even being polite!

Anyhow, it’s not often that I deal with a person at home and then take them out of a nursing home a while later.  The only other time I can remember it happening was when an elderly couples’ house caught fire.  The husband fell at a nursing home several weeks later, and I only remember it because he fought with us (swinging and kicking) the whole trip.

You know, stereotypes exist for a reason.  We’ve all heard about the crazy lady with the 50 cats who lives alone.  Once you hit a certain amount of cats, you stop cleaning up after them and juts let them poop whereever they want. 

We were sent to a 911 call to evaluate an elderly female.  When we got there, a police officer said he is sent to the house all the time.  He said the lady is a shut-in.  He said the ammonia smell is overpowering and he thought maybe she went into a coma from that.  It was that bad. 

The smell really hits you when you walk into a house like that.  There were more litterboxes than I could count, as if she just put a new one down instead of cleaning an old one.  I didn’t see too many cats because I’m sure they hid as soon as we barged in, but you could tell they were there.  I’m just surprised they weren’t eating their owner.

The officer said the patient is normally alert and walks around the house.  When we found her, she was lying in her own filth.  Stewing, really.  It looked like she had to have been lying there for a few days.  The B.O. smell was worse than the pee and poo.  She wasn’t responsive, although her eyes were open. 

A quick check told us she was havng a stroke, so away we went.  Next stop for her:  nursing home.  What will happen to all the cats?

There was a crash last night involving a car and a light pole.  It wasn’t too bad, but the driver was drunk.  (Just like every Saturday night car crash.)  The cops told us the driver was 17 so we have to take him to the hospital by law.  (Minors can’t refuse medical treatment.)

I was in a foul mood already because we were very busy all night.  I think I called the kid a son of a bitch at least twice becausehe wasn’t following my directions and we were standing in the middle of a busy road.  Then he started crying.  Whatever happened to dignity? 

After a few minutes he mentioned something about just having a birthday.  Sure enough, he was 18, not 17.  That’s the difference between spending a night in juvenile detention and spending a weekend in county lockup, not to mention going on his adult record and costing him a few thousand dollars.  I mean, either way you’re going to lose your license, but at least you have a chance of it falling off your record if you are a minor.

Should have stayed 17 just a little bit longer, buddy.

This just happened.  You always hear about old people who’s foot slips off the brakes and they drive through a wall or kill a pedestrian.  Well, it actually happened to us.  90-something year old man drove right through his garage.  He wasn’t hurt, nor was anyone else.  It allowed me to take this wonderful picture!

It was a Ford Crown Victoria, of course.

I looked all over for a news article on this, but it must not have made the papers yet.  Last night in our quiet little town we responded to a call for a battery victim.  99% of the time this is either two drunks getting into a fight or a domestic fight.  The victim almost never wants to go to the hospital and just wants everyone to go away. 

This time was a bit different.  We show up, and the victim is a 69 year old woman.  She said that a black man in his mid 20s wearing a hoodie and carrying a club of some sort, broke into her garage, pushed her to the ground and hit her in the head with the club.  He then stole her purse and groceries.

The lady was covered in blood but everything else checked out okay.  She wasn’t hysterical or panicky either which REALLY surprised me.

This whole county is rapidly going to shit.  Most of the stuff I see doesn’t even make the papers, so the average person isn’t aware of it.  Let me just try and remember some of the things that have happened this year in my area:

Infant with 3rd degree burns to the buttocks, presumably due to abuse.

6 year old with massive head trauma after a 32 inch TV fell on his head.

Plane crash on Calumet Avenue, killing 2.

Gang-related murder. 

Catholic school closed for a day while the funeral for a gangbanger was held at the church.

17 year old suicide by hanging.

Man shot 9 times by his son.

Bank robbery leads to 2 destroyed police cars, 3 injured officers, and a garage fire.

Anyhow, that might seem normal for a larger town, but we are talking about 25,000 residents here.  I really can’t wait to get out of this area because I’m not raising kids in an environment like this.

I’m sick again.  That marks twice in 6 months which is very unusual for me.  I’m not sure how I caught this one.  Corrin is sick, but I just saw her 2 days ago so I don’t think it would have kicked in so soon.  The hospitals are completely full with elderly people with the flu, but I usually don’t have to worry about catching anything because I’m pretty careful with the hand washing and such.  I guess it’s just my number this year.

Last night I sprayed zinc spray into my throat, took Benadryl, Advil, 4,000mg of vitamin C, and 3 doses of Emergen-C, but I still woke up sick.  The charge nurse at the ER took pity on me and snuck me some Cetacaine, which is 20% benzocaine spray that they use to anesthetize vocal cords before an intubation.  It is super-strong, but wears off in 10 minutes or so.   I guess I have a whole bottle of it…

Anyhow, if my updates are scarce in the next few days it’s because I’m sleeping 20 hours a day. 

Corrie and I were watching a show today talking about the importance of long term care insurance.  Since I just turned 28, I felt strangely old.  Not old enough to consider buying nursing home insurance just yet, but maybe I do need a good life insurance quote just in case I kick the bucket. 

Taco Bell ran an ad years back where a russian satellite was supposed to land in a certain spot in the pacific ocean.  If it hit that spot exactly, everyone in America won a free taco.  (I’m just speaking from memory here so I may have messed that up.)

The strange part was that they actually took out an insurance policy to cover the amount of giving a free taco to every man, woman, and child in the U.S.  Where do you go for that kind of insurance?  GEICO?

I make funny faces when I drink.  Can you believe that somewhere in America, someone can call 911, and this is what they will get?

And as Corrin was nice enough to note, I wore my wedding ring all night, because I am a good boy.

I don’t have any life insurance right now.  I used to be covered by the Army, but that expired a couple of years ago.  Whenever I read a book or the newspaper you alwas hear about crazy wives murdering their husbandsfor the life insurance payout.  I think Corrin is just crazy enough to do it, too.  If you need life insurance no exam style because you have something to hide medically, then pray that your wife is sane.  That’s all I’m saying.