12.18.2008

Ignorance would be bliss.

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.

12.15.2008

Anomalies.

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.

12.08.2008

Fun with avalanche rescue.

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.

11.28.2008

Another pursuit

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.

11.24.2008

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

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.

11.22.2008

The things I treasure most.

  1. Adventure. Going new places, trying new things, challenging myself to step outside my comfort zone.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

10.29.2008

Senior year to now

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.

10.20.2008

Sophomore to junior year


"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.

10.19.2008

A second chance


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

(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.

10.16.2008

Middle school


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.

10.12.2008

Preschool to 5th grade.

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.


(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.

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.

10.05.2008

Pissed.

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.

10.03.2008

Misadventures in cardiac event monitoring.

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.

9.29.2008

And everything aligns against me.

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.

9.24.2008

And the doc says...

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?

"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.

9.20.2008

Lovely Random Acts of Kindness

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.

9.18.2008

Organisms

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.

9.04.2008

First day at the OB GYN clinic...

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.

9.01.2008

How to Prevent Air Emboli, by a Crackhead.

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.

8.29.2008

I couldn't help it...


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.

8.27.2008

I got it!

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.

8.25.2008

Designer scrubs

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.

8.21.2008

A job!

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

We all gotta start somewhere. :)

8.19.2008

FRI

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?

8.09.2008

Holy crap

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.

7.29.2008

State Certified

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.

7.17.2008

TEMS (tactical emergency medical services)



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).

7.15.2008

D50

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.

7.12.2008

Sticks

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.

7.09.2008

"Experience is a hard teacher...

...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.

7.05.2008

You might be an ARP if...

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...
  1. You've had blisters in places you never thought possible.
  2. Sleep has become an option rather a necessity.
  3. You are happy to be woken up at 3 am by the screeching beeps of a pager
  4. Your boots age 10x faster than average.
  5. You've spent your Christmas night in a van babysitting a burnt-down house.
  6. You've played a terrorist/hostage/bank robber/rioter for the SWAT team, essentially playing paintball with them.
  7. Lacking a window punch, you've gained access to an MVA victim using an avalanche shovel.
  8. You've directed traffic before you could legally drive.
  9. You've gone for two hour hikes at 3 am... sometimes to look for a missing person, sometimes just for fun.
  10. It seems like every year your dividend at REI gets larger.
  11. You consider yourself an energy bar/gel/powder connoisseur because you've tried just about every brand and flavor.
  12. Your tan isn't really a tan... it's just a thick layer of dirt.
  13. Free food motivates you do things you otherwise wouldn't.
  14. 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...
  15. Most people your age play video games and get drunk for fun. You save lives.
  16. You know not to volunteer for a dog team or to carry the rock bags unless you want to work your ass off.
  17. 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.
  18. You know which members to avoid sleeping near because they snore, sleepwalk or talk in their sleep.
  19. You've forgotten what home looks like.
  20. 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.

6.28.2008

The real heroes.

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.

6.27.2008

6.24.2008

My Captain's Fall

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.

6.18.2008

Scrubbing

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.

6.17.2008

Surgeon?

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".

6.16.2008

My First Trauma

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.

6.15.2008

NREMT-B Practical

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.