"Over my dead body"

EMS is not my only pursuit in life. I also design, write and edit for the school paper. Check out this editorial I wrote for the Feb issue.

A Buddhist funeral in Tibet often ends in sky-burial, the practice of cutting the body into pieces which are then placed on a mountaintop to be eaten by vultures.

Most of you will find this practice repulsive, even barbaric and disrespectful. I find it to be absolutely inspiring.

Today, death is something that most of the living keep a safe distance from. In America the corpses of our loved-ones are usually whisked away by strangers, bled out, pumped full of toxic chemicals for an unnatural freshness, sealed in a metal casket, and dropped into a concrete tomb.

Each burial adds more non-biodegradable materials and noxious chemicals to the cemetery and takes away from the land and resources available to living people and animals. The whole process will usually cost a family at least $6,000-$8,000.

Other bodies will be cremated in a fossil-fuel-driven incinerator, releasing dangerous pollutants such as carbon monoxide, sulfur dioxide and mercury vapor into the atmosphere. “Ashes to ashes, dust to dust” is usually not the case here, as most cremains will be placed in an urn, isolated from the ground.

I am disgusted by these practices. As a biologically-minded person, I am comforted by my affirmations that Earth is but a pebble covered with a film of life; a living, breathing sugar-coating whose livelihood depends on the continuous cycling and transfer of energy and matter.

Therefore, I actually find the idea of my body decomposing and being consumed by other living things to be quite soothing. (this bit was a huge pull quote. haha.) Perhaps a molecule of my bone will one day find itself in a blade of grass, or a bird’s feather.

I don’t want to be embalmed, placed in a concrete tomb cut off from the Earth, or wasted in a fire. This can be an extremely difficult task, considering anything besides the standard American funeral can be almost impossible to accommodate and even taboo.

In my ideal funeral, which at the time is impossible in Colorado, my body will be wrapped in a simple biodegradable shroud without being embalmed or made-up, and my grave site will be in the dirt, out in the wild. No formaldehyde, steel, or manicured lawns; just the simple outdoors. Perhaps a tree will be planted by my grave.

death by inhalation of poop-vomit

I can't get over this... hahaha. I was browsing around this awesome blog... when I came upon a link to a study on "Death From Clozapine-Induced Constipation". Clozapine is used to treat schizophrenia, and apparently a couple of people taking it have become so constipated they've vomited their own poop, inhaled it into their lungs and died due to pulmonary shit-dema.

I quote the study:

"The aforementioned fatality, described by Drew and
Herdson,3 occurred in a 49-year-old man with paranoid
schizophrenia who was treated with clozapine (500 mg/day)
for 2 years. He died unexpectedly in a psychiatric ward.
Postmortem examination revealed severe pulmonary
edema secondary to inhalation of feculent vomitus"

Wow what an awesome way to die!

the 5 medical terms that get stuck in my head the most

I have pseudo-OCD brought on by my medication (Adderall) so sometimes I get words stuck in my head. These words are always medical terms, and in any given day one will be playing in my brain over and over again like some sick, meaningless mantra. Here are the three words that seem to get stuck in my head the most often:

1. Sternocleidomastoid
I genuinely love this word. I don't know why, but it literally makes me smile. The good thing is that I will never ever forget where this muscle is. The bad thing is that I can't remember any other muscles.

2. Decubitus ulcer
This one's not too weird... until you realize it's just a fancy way of saying "bedsore"

3. Necrotizing Fasciitis
Synonymous with "bad fucking day" and also known as an infection of flesh-eating bacteria, necrotizing fasciitis is the only term that replays in my head that actually represents something bad-ass.

4. Oogenesis
The process of the creation of ova (eggs... female sex cells). I have to thank Ms. Moore, the best biology teacher in the world for this one, and for calling all things microscopic and living "wee beasties"

5. Atelectasis
Sounds like: an awesome metal band, a violent video game, an action movie with gaudy special effects, an edgy new company
Really is: a collapsed lung. Yawn.

An ode to textbook "patients" part 1

I just realized that someone could mistake these for pictures of real patients. I have no idea who these people are, I found these pictures in textbooks.


I see therapy in this child's future. Lots of therapy.

This is how the elderly get jiggy with it.


Heeeeey.... maaaacarena!!!!

I'm going to be one of those medical textbook photo people.

A while ago I pondered the origins and situations of the people in medical textbook photos. Now I know where some are harvested: the classes that utilize the textbooks.

The company that makes my EMT text are coming out with a new edition, and they badly need a photo update. All of the models in the current text scream early nineties like only scrunchies, stripes and sneakers can. So, in a couple of months they'll pay students from my class to model for various photos.

Obviously I want to do this. Something about the whole idea makes me giggle on the inside: imagining the hundreds of thousands of students who will look at how strange and bland I look. Eventually I'll look really dated.... to the point that most people couldn't imagine actually encountering me unless they happened to take a time machine back to their childhood.

I'm praying I get an especially bloody, embarrassing or awkward assignment. I'm not willing to take it as far as Mr.Closeup-Video-of-Rectal-Thermometer-Insertion (true story), but I'd love to be Miss Remove-The-Pencil-From-My-Cheek or Miss Bleeding-From-My-Scalp-With-Ridiculous-Head-Bandages.

EMT class

Tomorrow morning I start my EMT-B class. I'm a bit anxious - not because of the material (learned all of it in my SAR team's E-care class - except airways) but because of the whole circus sideshow type thing and clinicals. I'm only 17, and I stick out like a sore thumb in college courses.

Last semester I took anatomy and phys at night and I was one of two childless people in the class. At least 5 of my peers had children my age or older. So not only are there awkward stares and "How OLD are you?!" comments the first couple of days of class, but I usually end up somewhat alienated. I simply can't contribute to those bonding conversations about taxes, raising teenagers, lazy husbands, and shitty 9 to 5 jobs.

I'm also anxious about the clinicals and ambulance ride-a-longs, which start in March. The age thing plays a factor in that too, of course. Will the nurses and paramedics be more reluctant to let me play? Will the patients freak out?

It's hard to gain respect as a healthcare provider when you haven't even graduated high school.

big house fire

So I was in gym class today doing my bench press test, and as I'm locking out the barbell above my chest with my teacher spotting me, my pager goes off... "BEEP BEEP BEEEEEEP BEEP BEEP." Shit. This is only my third class with him and I hadn't yet had a chance to give the whole "I'm on call you might hear my obnoxious pager in the middle of class and I may have to leave abruptly" speech that all my teachers get.

"Hey! Why do you have your... cell phone... pager thing? Put it away!" he is totally bewildered, because cell phones are never a problem in gym classes, and how many teenagers carry a freakin' pager?

I explain the situation to him, and he calms down quite a bit while I see what's going on.

It's a big ass house fire, and the fire dept. wants as many of us as possible. (If you're a stranger reading this, it's important to note that my search and rescue team does a ton of assists to fire depts. and law enforcement that have nothing to do with SAR). So I get home, get in uniform, get my pack, get a ride and get over there with one other member, Parker.

It was certainly a big ass fire, still active when we arrived on scene. The news was all over the place and they had a ladder up over the house to spray down on it. You know a house fire is bad when you can stand in the front yard and see the backyard without a door or window. Good thing no one was hurt.

Our headquarters are nestled in a fire station about 15 miles away from the scene in a different district. When my lieutenant swung by there to pick up radios, he said the firefighters were standing outside looking at the smoke cloud. It was a very overcast day too.... gives you an idea of how bad the smoke was.

The thing that sucks about fires when it's this freakin' cold out is all the water... it freezes and the entire scene becomes an ice rink. You can't take five steps without slipping... it's probably more hazardous than the fire itself.

So why were we there? Well to roll hose, of course!

News story

on call + insomnia = bad

So I'm a horrible insomniac and have been since I was about 7 years old or something. Seems like an easy problem to fix, considering I'm already seeing a shrink and he could just throw some Lunesta my way. However, I can't take sleeping meds because I'm on call 24/7/365... and I don't think you would want me running through the forest at 3 am looking for your lost toddler in such somnolence.

In fact, my shrink seemed more concerned about this possibility than I did and he even stated that he would not prescribe me sleep meds as long as I'm on call.

I can understand why. I met my boyfriend in the hospital 2 and a half years ago. They put him on Ambien one night, and for some reason that little freak wouldn't go to bed. He just kept running up and down the damn halls with his arms out yelping about how he was a "magic carpet". (God I love him... freak)

Hallucinations are never a good thing on a search line, especially from the team leader.


Just another random inconvenience that you never realize at first.

It was funny... when I told him that I was on call 24/7/365 this look of deep empathy and nostalgia came over his face. He kept muttering to me (more to himself) "being on call is rough... yeah.... it's hard... being tied to a pager", and I could see his mind wandering off to memories of being awoken by a pager, called to care for patients during his residency a long, long time ago. Then he got this smirk of satisfaction, probably because he will never experience that jolting "BEEP BEEP BEEEEEEEP BEEP" ever gain.

I demand one.

hmmm....

Had a root canal today and was given Vicodin. Why does it always give me reoccurring hiccups? I've been given it a few times before for dental stuff, after bumping my sciatic nerve in a fall, after a car crash, etc... and every single freakin' time it gives me the hiccups. Anyone have an explanation?

On a side note... I actually had a good experience with an insurance company recently. In October my SAR team was en route to a call in a member's personal vehicle following another member's vehicle. Both cars were loaded with heavy packs and 5 bodies each, speed was about 30 MPH... some idiot ran into the street, first vehicle screeched to a stop, the brakes of the car I was riding shotgun in failed and kaboom. Airbags deployed, both cars were totaled, one member was taken to the hospital VIA ambulance because of c-spine concerns, and everyone else went to the ER just to be safe.

Everyone was fine except for one concussion and one broken clavicle (interestingly, that injury was caused by the energy of the seatbelt being focused onto a shoulder radio mic). I've had the knees of an old woman since I was 10 y/o and they hit the dash pretty good in the crash so there were some concerns, but the x-rays were normal except for the pre-existing disease and some additional swelling and contusions.

I just want to give a round of applause to USAA insurance. Everything was handled promptly and politely, everyone's medical bills were taken care of entirely and we each received some settlement cash (that desperately-needed $500 is going to my tuition). I really did not expect an insurance company to actually do the right thing.

PS: this accident could've been much worse, but everyone was wearing their seatbelts. I know for a fact that my head would've had a nice meeting with the windshield had I not been strapped in, and I would've had some sort of significant head injury. SO WEAR YOUR SEATBELT. ALWAYS.

PSS: the person we were on our way to search for was found safe while we were still on the scene of the crash.

the more I learn, the more I yell at my TV

I know, I know. I can't expect TV to portray medical scenarios without flaw. But still... you think they could pull their heads outta their asses for 2 seconds and at least do some research on whatever they're depicting. Hell, you could even google most of this stuff. Here's some of my favorite medical TV blunders.

CARDIAC ARREST ≠ HEART ATTACK
This one really pisses me off, because it happens constantly. It doesn't bother me so much when a fictitious show makes this error, but I usually see it on supposedly informational shows like the news. They're genuinely misguiding the public. Here's a good example. This little girl clearly did not die from a "massive heart attack". If she had arrhythmia, she obviously died from cardiac arrest. Although it's great that they televised this story, 9News is actually undermining the Brianna Badger's Foundation's mission, which is to educate the public about cardiac arrhythmias. The impact of this common mistake on public thought is evident because I know that many, many people think that cardiac arrest and heart attack are the same thing.
So let me clear this one up:
heart attack AKA myocardial infarction - The heart is still pumping. The blood supply to the heart muscle is interrupted, usually because one of the arteries servicing the heart has become blocked. (may later deteriorate into cardiac arrest)
cardiac arrest AKA clinical death - the heart stops pumping. In children, respiratory arrest or arrhythmia are the typical causes. In adults, a heart attack may eventually lead to cardiac arrest, but they are two distinct conditions.

TV MEDICS ARE RETARDED
My dad would not allow me to change channels from some overly dramatic episode of CSI... in which one of the characters was wandering lost in the desert after being trapped under a car and yada yada yada. Now I have no idea why CSI was doing search and rescue, but of course they found her collapsed, unresponsive and pulseless. Enter the most incompetent air medical team on Earth. They landed the chopper ridiculously close to the victim without a landing zone set up and threw a non-rebreather on her and stuck her with an IV before loading. That's the only treatment she had. They also allow her fuckbuddy partner guy to come along for the ride. While in the air, she randomly opens her eyes and smiles. (I'll get to this point in the next section)
What the fuck?!
I would rather be treated by drunk chimps. Any average joe who's taken your average CPR class knows that a pulseless person gets CPR. DUH. And why the hell would you put a non-rebreather on someone who's not breathing?! She needs a BVM and chest compressions you morons! And there is no way in hell you would have full crew, a patient, and a random dude on a chopper due to weight restrictions and HIPAA and not wanting some random dude getting in the way. Air ambulances have enough weight problems without allowing bystanders on the chopper; they often have to take a patient and leave a nurse on scene due to weight.

PEOPLE DON'T WAKE UP IMMEDIATELY AFTER CPR
So last night I was watching the Baywatch movie in Spanish with my boyfriend (don't ask) and some overly tan and muscular dude drowned and died, so some overly tan and muscular Baywatch dude starts giving him CPR. The fact that he was only giving 5 compressions is an entirely different story, but the thing that really made me yell at the TV was how the once-dead guy spontaneously stood up and kissed his girlfriend after about 3 minutes of CPR. WHAAAAAAT?
Ok, if you need CPR, you're pretty much dead. Sometimes, the hospital can make dead people come back to life with fancy defibrillators and medications and procedures. CPR is essentially a prehospital measure to keep your brain alive long enough to get you to the hospital with a chance to be genuinely resuscitated. If you're really damn lucky, your heart may start weakly beating again, but there is no way in hell you're going to wake up, stand up, kiss your girlfriend, dance around, and go swimming. Even if you get to a hospital, you're probably SOL. Even if the hospital does get your heart beating again, you're not going to fucking wake up, get off the table and hug the nurses.

10 things most people don't know about search & rescue

1. 99% of us are volunteers. We never get paid a dime.
   
2. It is extremely physically demanding work. You never really know how hard you can push your body until you join SAR. Hiking for hours over rough terrain carrying hundreds of pounds of equipment with blisters on your feet and hands... it's all a part of the day's work.
   
3. Sleep is optional.
   
4. A person's SAR team is their second family. They will often see the team more than their real family and together the team will deal with things that only the team will ever understand the significance of.
   
5. Despite technology, our best tools are still our eyes & ears, our boots, and our backpacks.
   
6. Few people will ever understand the pure joy of getting someone home safe when everyone else thought they were long dead.
   
7. Few people will ever understand the pure agony of failing to find a lost person.
8. We spend much more time training than we do responding to calls. IT NEVER ENDS.
   
9. We are tied to a pager and on-call 24/7/365. Yes, that includes Christmas and your own birthday.
   
10. Despite doing challenging work for no pay and little thanks, we LOVE what we do. It is unbelievably rewarding.
    

my one and only unsuccessful search

Lately, I've been thinking a lot about the only unsuccessful search I've ever been on. I don't think people realize how rarely SAR fails to find someone, and we usually find them alive and well in good time too.

Last year this guy went missing in the woods around his house. He was an older, retired military officer with severe Alzheimer's- he was non-communicative, didn't get around too well, but had received extensive survival training in the military. He had gone to check on his horses with his dogs. They found his ATV crashed - no sign of the man or his dogs.

The terrain was fairly rocky, out in the middle of nowhere with scattered ranches. It was late summer so the days were warm but in the mountains the nights easily get cold enough to cause hypothermia - especially in an older, unprepared, underdressed elderly person exposed for a long time. I was very concerned. I wanted to find him BAD. Previous searches had been for experienced, younger hikers with sufficient supplies.

Our team got called down to the search days after it had started. There were probably about 50 people searching on foot, and a helicopter with thermal detection in the sky. Our team of 4 completed 2 patterns. Nothing was found, no evidence of him... just nothing. I had to go home that night, but others from my team stayed and more went up the next couple of days.

Nothing.

I was so frustrated that weekend.. I kept thinking:
"We searched for you for hours... hundreds of us! Where did you go? How far could you have gone?"

People in SAR and EMS tend to keep hope up for too long or lose it too soon. We've seen people pull through and live through extraordinary odds, and have seen tiny little things kill big people. I knew he was probably dead after he was missing for well over a week, but this little inkling of hope based on his survival training marched on.

About a month after the search, the man's body was found by some hunters about 2 miles away from his house. His two dogs were alive and still by his side, which is pretty unbelievable and a story in itself.

The thing that killed me, though, was what the medical examiner released to the media. He said the man probably died from exposure, dehydration, hypothermia, etc the day after I was on the search. He was alive when we took the 3-hour drive down there, he was alive when I stocked my pack and laced my boots, he was alive when I called for his dogs and shouted his name while trudging through the woods. He wasn't in our pattern, but still... it's the type of thing that never leaves you.

He was alive.

crash rescue

This morning we had our aircraft crash rescue training. It went pretty well... there was good turn-out, the weather was nice and I'm being to see the strength and unity of the team making significant strides, which is always encouraging.

This was my second or third time leading a team... two members and I line-searched the side of the road. The other team was the find team - there were 4 pts: 1 black, 1 green and 2 yellows that became reds pretty quickly. I stayed behind with the less severe of the yellow/reds while the team carried out the most critical pt (in reality I sat with Ashley for over an hour of great, out-of-scenario, deep conversation in the mountain sun).

When they came back, Ashley was my pt. We got her out of there super fast. On-scene time was about 10 minutes (even with difficult packaging - she needed to be backboarded from a sitting position against a tree and had an open tib/fib and a high suspicion of c-spine injury) about 30 for transport in the thompson in snow for about mile.

I have to say, this training definitely boosted my confidence as a leader. I was basically thrown into the position of sergeant and although I was definitely ready for it, it was a little bit overwhelming at first. Now I've collected myself and I feel ready to tackle anything.

the "patients" in medical textbook photos

Have you ever really looked at those random, healthy people being poked, strapped down, bandaged, posed and exposed for the sake of education in medical textbooks and videos?

I wonder if people just do that for a living. Sounds like fun, actually. I wonder how much these people get paid.

And that guy in this nursing video I watched about taking vitals... I mean it definitely takes a special person to take a thermometer up the ass while the cameras roll knowing that hundreds of thousands of people (many of them young women) will one day sit in a classroom and watch close-up footage of your rectum being probed for at least 2-3 minutes.

A very, very special person indeed.

My insomnia is worsening, and I have to be sitting in my med prep classroom in 7 hours.

"Too Close to Home"

I just found this article on the JEMS website... it shocked me. I hadn't heard anything about this. LFR is the fire dept. that we work closely with... our headquarters is located in LFR station 12. Just bizarre. The article also goes on to discuss the problem of suicide in Colorado. The suicide rate in CO is high compared to the rest of the nation, and that rate is increasing. The article provides an interesting examination of the effects of suicide calls on emergency personnel. I'll post again when part 2 comes out.

"On Oct. 29, death came knocking on Station 13's front door, but luckily none of the crew was there to answer. An elderly male parked his car on the lawn -- right in front of the station's sign just feet away from the day room windows and front service door. He got out, removed a large hand gun from the vehicle and shot himself in the chest with the high-caliber weapon. He apparently survived the first wound to his chest and then shot himself in the head. The second shot left him unconscious and barely breathing in a large pool of blood on the sidewalk. Station 13's crew was out of the firehouse at the time of the shooting. A series of station tones rang out in their vehicles, and a familiar voice aired an ALS response, "Engine 13 and Medic 13 respond on a possible suicide in front of your station, standby for law enforcement."

"This patient was no stranger to the members of Littleton's Station 13. Just five months earlier, he had attempted suicide using carbon monoxide at his home. Station 13's crew found him in his garage with the car running. He was semi-unconscious, barely breathing and saying he wanted to kill himself. He had written a note, collected his personal papers and provided his insurance papers for whoever would find him. The crew transported him to a local hospital, where he spent time in intensive care and received mental health counseling for his depression. He was released, only to complete his suicide wishes months later on the sidewalk of Littleton's Fire Station 13.

What was his motivation to commit this act in front of a public building, where so many school children have come for station tours? Of all places, why here? Did he come to the firehouse looking for the crews who had defeated his earlier suicide attempt? Was this a planned homicide-suicide quickly modified when he discovered Station 13's crew missing? No one will ever know his motivation even though a suicide note was found in his car. He did not mention why he chose Station 13 for his final moments, only who he was and who should be called after his planned death."

Full article

what I know so far