Whoops...my patient died

Ok. Every person in the medical field has looked back on their career and thought of a patient that, if they didn't kill, they at least did not help. Not on purpose of course. Well this patient is a little different. I know now that there was no way to save him. But I digress.

Busy days are the worst. Nothing is as exciting as crawling into your lumpy bed and pulling your blanket/sleeping bag/sweater or whatever you have with you over your shoulders and closing your eyes. BEEP BEEP BEEP! Dammit! The stupid radio! "MVA in the middle of Frickin Nowhere!" I honest to goodness slept my way out to the call while my partner drove like a bat outta hell, lights and siren on. We pull up to the scene. A battered and bloody man is sitting on the bumper of the fire truck.
"Can you wake up my buddy so we can go home?" he asks me, his drunken slur unmistakable. I scramble down to where the action is. Four firefighters are piled inside a single cab truck around my patient who is barely breathing. Before I get to the truck, one firefighter is yelling to me, "I'm going with you to the hospital"!! I shrug. I don't give a crap who comes with me. Maybe no one will come with me depending on the patient. This particular firefighter annoys me anyways. When I fail to answer her and begin assessing my patient she taps her bloody fingers on my shoulder and repeats herself.

"Fine!" I answer just to get her to shut up. She drops the c-collar she was putting on the patient and runs to yell at her captain I said she could come with me. The patients head bobbles. Three of us gasp and grab his head. I yell for someone to put the c-collar on and ask the guy breathing for the patient if there is an airway adjunct in (something that keeps the airway open). A quick shake of his head tells me airway is priority. I set my EMT to get an IV and I attempt my first (and so far, last) NASCAR style intubation. I am lying on the hood of the pickup my head and shoulders through the broken windshield attempting to stick a tube down this guys throat. Needless to say, it fails.  We forget the airway and haul his but onto a backboard and trek him up the embankment to the ambulance. The one overeager firefighter is waiting in the back of the ambulance. I take one look at her and one look at the patient and ask for another firefighter too. We are at least twenty minutes to town so I tell my partner to go and I will do everything else enroute. Jumpy firefighter is helping the patient breath and competent firefighter is helping me set up medication and equipment to try to intubate again.

I push Jumpy out of my way and attempt another intubation. One breath in and the tube fills with blood. I pull the tube out and bloody vomit follows immediately. All over the patient. All over the ambulance. All over me. Now I am annoyed. I ask Jumpy to suction his airway while I get a new tube. The task seems to be too much for her so Competent jumps in and helps. I kneel in the pool of bloody vomit, cringing as I do so. I attempt an airway again with the same result. I am truly annoyed now. I have failed to get an airway, my #1 priority, and I am covered in nastiness. We are about 10 minutes from the hospital and I pick up the radio to let them know where we are. Just them Competent says, "Hey! look at the monitor. How long has he been dead?" In silence we all three stare at the flatline on the heart monitor. "Shit!"

We start CPR and medications to start the heart with no real gusto. We all know the facts. Trauma codes don't come back. We arrive at the hospital and the doctor calls him dead before we finish transferring him over. Now that we are in a big trauma room with bright lights and no rain I can clearly see a large split down the side of his head. Yeah, he never had a chance. Still, I never want to hear my firefighter say to me again "how long has he been dead?"

Disgusting People

Busy days mean eating what you can, when you can. I had just shoveled in a large meal from Taco Bell when we got a call for a sick person. My stomach rolled as we navigated the streets to a small cul-de-sac on the other end of town. A woman is standing outside smoking as we arrive. Dispatch was busy so we got no info. "Are you my patient?" I ask, hopeful this will be an easy call. She shakes her head no and starts explaining how its not her fault. What is not her fault? I don't really care so I walk past her pretending to listen and in the front door. The smell assaults me as I walk in. The house is dirty. Not 'I haven't folded my laundry' or its been a few days since I vacuumed' dirty but years of filth and neglect dirty. The cobwebs in the corners have dirt hanging off them. There is literally no more room on the kitchen counter for another empty container, dirty dish or half rotten food. It is a scene from the show Hoarders, only with a path wide enough for his electric wheelchair to go through.

Sadly this is not the first house I have seen in this condition. The wheelchair is emitting an odor I know well too. Gangrene. My stomach rolls again. The woman at the door now says it has been two weeks since he has taken his shoes off. Hesitantly my eyes roll down to his feet. Among the misshapen toenails and different colored flesh I see an open wound on the top of his foot that is oozing. I look around the room a little more carefully. Blood and pus have been smeared on surfaces, doors and the TV. Two weeks? The woman replies it may have been more like a month. My stomach is losing the battle. I retreat to outside because I "forgot something" in the ambulance, my partner hot on my heals. We take some deep breathes and grab bandages. I put them on loosely and from as far away as I can. We help him to our bed and vacate the house as soon as possible. I figure his health is generally poor judging from the house and the kitchen. I start an IV and breathe through my mouth. "So two weeks?"I ask the poor old man. "You haven't taken your shoes off that long?" He shakes his head. "So, uh, does that mean you haven't showered in that long too?" He smiles at me, a huge grin.Food particles and who knows what else are caked on his teeth at least halfway up his teeth.

My stomach lost its battle.

The most exciting job in the world.....

People meet me and ask what I do for a living. "A Paramedic?" they say. "Wow, that must be exciting!" Well, let me tell you about the most exciting job ever. I get to work and say hello to my fellow EMS workers. Hello is often answered with a detailed description of the day and how it sucks. I grab my keys to my ambulance, my box of narcotics that several patients will try to con me out of during the course of the day and my dreaded radio. We climb into the rig to find out what kind of poor condition it was left in by the crew before. Unless there is blood, vomit or a missing heart monitor I keep my mouth shut about anything that might be wrong. After all, tomorrow I will probably not leave it much better for them.
We head to post, usually some street corner where we can pilfer wi-fi and see a good assortment of crazy people. Some times we are there five minutes and sometimes it's two hours. One thing is for sure. My back hurts sitting in these damn ambulances but I am too scared of the psychos outside to get out and stretch.
90% of my calls involve people over the age of 75 and probably 80% of my calls do not need to go to the hospital. Three phrases that will instantly make me hate you are 1. If I go with you I will not have to sit in the lobby, 2. I have an appointment with my doctor tomorrow, and 3. This has been going on for several days (usually this one is at 2am on a weekend).
Fall victims are prevalent in the elderly. We go, help them up and leave. They use their handy lifeline buttons to get us to haul ass to their homes only to find they need to change their oxygen bottles, the battery in their wheelchair is dying, they want their blood pressure checked or they are unsure how many pills they can take.
Most car accidents are fender benders where a person is convinced they will get out of a ticket or get more money if they say they have neck pain. Not to mention the two or three patients a day who have been vomiting for an hour and want us to "make it stop!" You have the flu! Drink some water and go to bed you jack ass!
Then occasionally, not even every shift, it happens. A real call. A call that requires you to use your skills. A call where someone really needs you. You rush in.make command decisions and think, this is why I am here. Then the doctor yells at you for forgetting to bring one of the patients 17 medications or your boss yells at you for forgetting to get a copy of their insurance card. By the end of the day I am tired, grumpy and behind in charts. Some days I can barely remember all the calls if its been busy. I try to replace everything we used in the last twelve hours. A new fresh crew comes in as I am trying to finish up. I give them a detailed report of my day, even though they didn't ask so they know my shift sucked and go home, once more a disgruntled paramedic.