I Passed!!

Thank God that is over! I passed it all and am going to spend the next few weeks eating and sleeping. I may go for a walk or at least sit up occasionally, but we'll see. Woot!

Lift Test Tomorrow....

I will pass it or die trying.

Seriously.

I will haul that 190 lb beast up and down the stairs on the stair chair, up and down stairs on the stretcher, then throw it into the back of the ambulance triumphantly.

I will pass or die trying.

Examination Blues

Exam time is here, I am getting ridiculously stressed. I was never this nervous in university, although I got lower marks than I am getting now. This program just means so much more to me than uni did. Failing out is not an option, my standards are set incredibly high. The college also has high standards though, as anything less than 70% is considered a fail.

Tomorrow morning is the final fitness testing. Among other things, I will be running, doing push ups and doing chin-ups at 8:30 tomorrow morning. I'm not the greatest runner in the world, so this has me concerned. If it was purely strength based, I'd be ok. I thought Paramedics didn't run, so why subject us to the torture of a shuttle run??? Grr...

We also have lift tests, practical tests and theory tests. Lift testing is challenging, but I have done them all in practice. It was such an amazing high last week, I was able to carry 210 lbs up and down 2 flights of stairs, then lift 300lbs up and down one flight. I feel like a tank, I've never been stronger in my life.

Practical testing is stressful, but a good score is not unobtainable. Follow the check sheet during a simple scenario and pass easily.

Theory tests - I have 4 of them in 3 days. Written exams, all worth a substantial percentage of the final mark, all of them needing a minimum of 70% to pass. My goal is nothing less than 90%. Study, study, study!


I thank God for Ryan at this time, but must also apologize to him. He is the one who sees me at my most stressed, the one I call and cry to when I get overwhelmed. He is the one who sees me cranky and irritable, yet the one who still loves me.

I am sorry for being so cranky lately, dear, you mean the world to me and I shouldn't release my stresses on you. I appreciate your support immensely and love you with all my heart. XOXO

Different Worlds

How do I explain to my non-EMS family and friends what I see and how I am able to deal with it? How do I explain that I don't lose sleep over the teenage overdose patient without sounding cold and heartless? Can I ever explain my way of thinking?

Can I explain that if I did let these things bother me, I would never be able to do this job? Is it possible to show them that I care for my patients deeply and fully when with them, then largely forget them when I walk through the door? Will they ever understand that I simply can't work on the next patient if the previous one still has me by the heartstrings?

Sometimes I don't think they will ever get it, but I hate it when they assume I'm uncaring and heartless. I could not do this if I cared less than I do or had a smaller heart.

Shift 2: In Which Red Actually Does Stuff

1900: Arrival, sent to rural base 2

1925: En route code 4 to chest pain/SOB. Tearing down back country roads in the fog and rain with lights and sirens blaring is fun - not knowing where we are going makes it feel faster than reality. Assisted with 02, vitals, cardiac monitor and stretcher lifting. ACP partner did 12-lead ECG, gave nitro and put in an IV. I can't watch needle sticks on TV, but in real life I find it fascinating. Monitor shows 3rd degree heart block.

2100: City base 2

2115: Code 4 to SOB/severe headache. Pt. felt a headache come on 'like a sledgehammer' and then started to experience chest pain. No physical evidence of a stroke/TIA, although he has a past history. Monitor, nitro, 02, IV. Monitor shows Atrial Fibrillation with a very irregular beat and 2nd degree heart block. Very sweet, 'pleasantly confused' old European man who tells me the same stories multiple times, calls me beautiful and kisses my hand when we part.

2300: City base 2

2330: Code 4 abdo pain. Moronic drivers stop in the middle of the road and try to race us through a light. I learn many creative sentance-enhancers from my preceptor, who is driving. Code 3, CTAS 3 on the return, walked pt into the waiting room. Possibly cancer-related.

0040: Code 4 overdose. Teenager takes a bottle of Tylenol 3 leftover from a family member's surgery. Worried parents hover as we assess their drowsy and lethargic daughter. She vomits - straight up, and I find myself impressed by that as I step out of the way, hauling the 02 bag with me. She is much more alert now. My ACP preceptor calls me his partner as he steps out of the room to allow me to change her shirt, that makes me smile - internally. Assessing further in the truck, her BP is almost unpalpable and he starts 2 large-bore IVs to push fluid in. He considers Narcan but doesn't want to make her vomit more since she is in no immediate danger. BP has risen to almost normal levels upon arrival at the hospital. Once transferred to the hospital bed, her father asks me about her enlarged lips. I realize they have swollen up since we first saw her, and her eyes are starting to puff. Pointing this out to my preceptor, he informs the nurse of a possibly codeine allergy. After cleaning the stretcher thoroughly, we once again head off into the night.

200: Main city base

430: City base 2 - the guys get the recliners, I sleep in the back of the truck. Ahh, the life of a lowly student.

646: I wake up as the truck starts to move, we're headed back to the main base to clock out.

700: Another positive evaluation in my book and I'm off, sad that rideouts are over but thrilled about the experience.

Shift 1: The Great Base Tour

1800: Main city base

1830: Rural base 1

2010: City base 1

2030: Hospital to babysit a mental health patient due to offload delays and a lack of security/staff to handle another, violent, psych patient - there were already half a dozen in the waiting room

2130: Rural base 2

2:46: City base 2

3:14: Rural base 2

3:44: City base 2

3:53: City base 3 - last truck available in the region

4:04: City base 4

5:56: Main city base

6:00: Home

EMS: Earn Money Sleeping

I recently finished my 2 observational rideout shifts with an EMS service, and I gotta say, the Earn Money Sleeping quip certainly is true. Both shifts were at night, the first one we did nothing, the second was busy until 2:00, then quiet.

I am disappointed in the number of calls we did because I want to see more, I want to do more. I have classmates who have assisted with a childbirth, MVCs, even one who did CPR on a VSA that they eventually got back - fully conscious and talking with no permanent deficits. Ah well, I will get my chance. I made a good impression on both my preceptors and had a lot of fun.

I don't want to go back to studying now - I want to keep working on the trucks. I did realize how much more I need to learn though, so back to studying I must go.

Stresses

We've been talking a lot in school about critical incident and post traumatic stress, and it has me concerned. I hear about tortured children, innocent murder victims and horrific car accidents. I see images of this trauma; mangled limbs, bloodied faces and unrecognizable body parts. I wonder if I can handle it. I don't want to fill my mind with these images, I don't want to see things that will cause me to wake up in terror in the dark of the night. I don't want to cry for hours over the horrific scenes I will witness. I wonder if I am to sensitive for this job. I wonder if I can last without it destroying me.

I turn to my faith, immersing myself in uplifting music and reading the bible to cleanse my mind, attend church services to uplift my soul. I hike through the woods to relax and refocus, I stare into the rushing inferno of a waterfall and the sound soothes me. I take comfort in the strong, understanding arms of my Love, knowing that he will understand and go through the same things as a police officer. I revel in the company of my friends and we share stories, fears, hopes and dreams.

I really want to do this; my desire, my drive to be the one lifting those unfortunate souls back onto their feet is ever growing. I care so much about the patients that I have not yet seen. I study into the night to learn as much as I can to become a better medic for them. I want to do this, and I will do this. I know it will be difficult, I know there will be times when I will be knocked down. I also know that I will get back up, I will continue on, and I will leave the profession on my own terms.

Midterms Approach...

It's halfway through the first term, and midterms are looming in the not so distant future. So far, my life consists on school, dinner, study, bed, repeat. I don't know how anybody can possibly do this with children or families at home!

So far the intense studying seems to be paying off, as I am at the top of my class. Woo! Now I have to get back to studying so I can keep it that way. :D

Learning How to Think

I was a medical first responder for several years before becoming a paramedic student, and I know that experience has, is and will continue to serve me well as I advance in this career. At the same time, I've noticed some glaring differences between the two stages, the most obvious is the ability to think.

As an MFR, we treat because ultimately, we are told that is the way to do it. Some MFRs can explain why we do things, but a large majority can't really reason their way out of a cardboard box. As my prof says, this is the difference between a technician and a clinician. MFRs are taught the skills and they are able to carry them out, but a paramedic should be able to tell you exactly why they are doing things, what effect it has on the body, and all sorts of other details. I love this distinction, because I often felt that this was lacking in my volunteer work. There were times when I would question oxygen administration, splinting and even back boarding, to be met with a stone-faced, by-the-book response. Yes, I know that the book says we should consider spinal injuries if the patient falls, but when they land on their side from a relatively short height and have NO signs or symptoms indicating any injury of any sort, do we REALLY need to backboard them??

Anyways, I love how my teachers are stressing critical thinking, thorough assessments and a rock solid knowledge base. It makes me feel that I can at last break out of the trained monkey stage and get more clinical in my thinking and treatment.

Adjusting Well

I'm well into the first month and all I can say now is that I love it! I know where everything is, what is expected, and what I need to be doing. I have made amazing friends that are just as passionate about this as I am. It is the best academic experience I've ever had, I'm challenged mentally and physically and thrive on it.

I've realized that my background has prepared me well for this program, and although it is difficult and a lot of work, I can and will succeed. I've never been so excited about school before - it's incredible.

I'm learning a lot about the field of paramedicine, and realizing that the possibilities are endless and I want to do it all. Being a tactical medic with the police would be amazing, but so would a community medic in Northern Canada. I could end up teaching these courses, be a manager or supervisor, or thrive on the everyday calls out on the truck. I love the opportunities I'm discovering, I love the friends I've made, and I love my program. My professors are inspirational, hilarious and knowledgeable, I try to soak up every word in class. The fitness teacher is lovably sadistic, as my weeping muscles will readily attest to.

Thanks to my friends and family members who offered me encouragement and support in the last few weeks during the adjustment period, as well as medic7. Thanks for the uplifting comment! I'm tackling this program with all my energy, it's an experience of a lifetime leading to an incredible career.

Slightly Overwhelmed

Paramedic school has begun, and after having course outlines, objectives and expectations thrown at me relentlessly, I'm feeling rather overwhelmed. I just don't know where to start it seems, I feel like I'm behind before we've even begun.

The more I look over what we will be learning, the more I realize what I don't know. I think I am a good, solid MFR, but that doesn't translate to a thing in this strange realm. Everything is taken to another level, a million steps further, and my comfort zone has been blown out of the water. I have spent the last few days realizing that I don't know squat.

I think I'll feel a little more confident soon, or at least I hope so. I need to get all my textbooks, my uniform, my immunizations, all my stuff organized and ready to go. I'm still excited, but that feeling of excitement tends to get snuffed out in waves of panic and the fear of failure.

Learning to say no

A few months ago, John warned me that I needed to slow down and relax before starting the paramedic program in the fall. As I usually do when people tell me to slow down, I ignored him. I was finishing university, working a lot at my two jobs, volunteering even more and generally running around everywhere doing everything. Who had time to slow down, relax, see friends or even talk to family? Certainly not me!

My hectic lifestyle caught up with me in the form of bronchitis, swine flu, mono, or some combination of the three. After spending 2 months sick, I have decided I should indeed slow down. I need to learn how to say no, how to allow myself time for me. I need to reconnect with family and friends that have been pushed to the wayside in favour of work, school or volunteering. I need to start making time for church and church activities. I need to get back on my bike and rekindle my love of cycling. I need to take time to go for a hike with Ryan and just enjoy his wonderful company.

To start, I'm going camping in the absolute middle of the wilderness for 7 days with Ryan. It's going to be an amazing trip, and I'll come back so utterly refreshed! No technology, no noise, no crowds, no cars - I can't wait! I'm looking forward to life slowing down a bit...I just need to keep saying no to things I don't really need or want to do.

Starting in 7 weeks...

I am getting very excited to begin the paramedic program, now less than two months away. I have secured my little apartment near the college, have started to pack and am starting to get all the orientation information. It sounds like a busy first semester, I have 8 courses! In university, the max I ever had was 5, so that worries me a bit. Here is an overview of my courses and my thoughts on them, since I've been fighting bronchitis for the last 2 months and haven't done anything remotely exciting in the field.

Writing Skills
Not too worried about this one, I think I know how to read and write very well. I've read hundreds of journal articles and written reviews of them, done presentations in front of scads of people and have written massively long reports and essays. I think I should be ok in this course.

Phys. Ed
This concerns me the most of any course, actually. I've been sick for 2 months and hve done very little physical activity, my lung capacity is next to nothing and my muscles have all but atrophied. It will take some hard work, but I know I can build my strength and cardio back up and become a red-headed powerhouse again. ....I hope.

Assessment and Treatment Skills
I am looking forward to this, I love patient assessment, I love learning about the body and everything that can go wrong. I think my enthusiasm for this course should serve me well and it won't be too difficult.

Patient Care Lab
Hopefully my volunteer experiences in patient care will give me an edge here, but I know I have a lot to learn to enhance my skill set. There is a 190 lb lifting portion to this course that I will have to work on, but I can do it.

Medical Legal
This course studies all the regulations governing ambulances and paramedics in the province, especially concerning patient care and privacy. I wonder where this blog fits into that....?

Intro Psychology
I've taken several university psych courses, but I'm interested to see the slant towards paramedicine that will happen in this course. Shouldn't be difficult, given my background, but it will be fascinating.

Clinical
AWESOME!!! I can't wait for this, I want to be out in those trucks right now! Haha, I'm not eager at all...

Anatomy and Physiology
Cells, tissues, organs, microbiology and diseases, bring it ON! My favourite course in university was an amazing A&P course in 2nd year, the prof was amazing and I learned a lot. This course should be great, I'm looking forward to it as well.

Well, there is an overview of everything I'm doing in 7 weeks...not that I'm counting, or anything. ;) Basically, I'm a little worried about the physical portion, not too worried about the academic portion and awesomely excited about it all. Now I just need to spend 800 bucks on textbooks and hope my 8-year old computer doesn't fry. Gotta love school though!

Fresh Eyes

My feet are sore, my muscles are aching and I'm exhausted....but I wouldn't trade it for the world. The festival today was a lot of fun, I had great partners, great calls and great food, not to mention very cute cops. I've really moved into a teaching role lately, mentoring the new members like John did for me is very rewarding, although sometimes very hard work.

One new recruit is my particular favourite, a spirited and lively girl that we shall call Katie. She is all excited over benign calls, she loves to jump on the radio first - just so she can use it, and she is incredibly eager to learn, taking instruction and criticism very well. She reminds me of how I was a few years ago, she's a lot of fun. One of my favourite new members, although a seasoned responder, is Carlos. He is excellent with patient care, one of the best in the division, and always kind and sweet with a ready smile and quick joke. Working with the two of them is a dream.

After sending two patients out with ems, one super drunk/altered LOC and one drunk/seizure and were wandering around the beer area. Carlos, Frank and Katie went to check out Joe, who was drinking but saying he shouldn't be because of his heart meds. I was watching them work, flirting with talking to the cops, when I heard Carlos raise his voice, "Joe! Joe! Joe, open your eyes!" I glance over and see the man slump in his chair, his body beginning to jerk and convulse. Carlos grabs his top, Frank grabs his bottom and I remove the chair as we lower him to the ground.

I stand back and watch as they treat, hooking up oxygen, grabbing the suction, writing down vitals, all the necessary but extra stuff, and let my responders work. Carlos is excellent, Frank and Katie are learning fast and are very eager, Joe is in good hands. My new cop friends call ems for us and in no time at all, we bundle him off to the hospital to get checked out, told the same thing as last time, and booted back onto the street to get stupid drunk again.

Katie is so excited she can't stand still. She goes over the details of the call, what we did, how we did it, picking apart everything. She is ecstatic at how many "awesome" patients she had tonight (count: 3 - all in various stages of drunkenness), and how she is totally in love with this job. I watch her excitement and grin, feeling my own love for this coming back. It's easy to forget how much I loved it when I first began, sometimes it takes a fresh-eyed, eager young member to remind me.

Drowning in Paperwork

In 3 months I start the paramedic program, and I'm starting to get quite excited. There are a lot of very big, very fast changes going on right now, and I'm running around like a chicken with its head cut off trying to get it all done. In the span of a few months, I'm graduating university, buying a car, getting my own apartment, moving to a different city and starting the paramedic program.

As well, before I start the program I need to track down all my immunization records, possibly getting a few to get them up-to-date, get a police check, a TB test, a mask fit and collect proof of all my current certifications. Sometimes it seems like I'm drowning in paperwork to try to get everything done!

I am looking forward to September though, it's going to be a wonderful switch from university - which has been almost entirely theory based. I'm excited to start clinical placements and actually apply what I've learned. It's going to be hard work, but I can't wait to start it.

You killed Fluffy!

I was teaching a lesson on head injuries a while back, ending with scenarios, as usual. The scenario I came up with involved a person riding their bike, swerving to miss a cat named Fluffy, and hitting a tree. One of the members had brought her small son with her, who was sitting quietly in his corner and raptly watching Mommy treat the patient. She called me a few days later to tell me the following story...

Driving home down a country road with Kenny in the back seat, I noticed a small rabbit jump out of the ditch just in front of the car. "Oh no!" I thought, "It's Fluffy, and if I swerve I'll hit a tree and get a head injury!" With the scenario from training in my mind, I stoically held course, hitting the rabbit but staying on the road and away from the trees. Hoping Kenny hadn't seen anything, I kept driving as if nothing had happened.

Childish laughter from the backseat surprised me as Kenny spoke up, "Mommy, it was Fluffy! You killed Fluffy!!" He got a kick out of it, but I had to open my big mouth, "No, honey, Fluffy was a cat, that was a rabbit." So much for making it better, the laughter stopped and his eyes welled up in tears, "You killed the Easter Bunny! Mom, you killed the Easter Bunny!" Now he was bawling his little eyes out, "Good move", I thought, mentally kicking myself. "No, no, honey, that was way too small to be the Easter Bunny, he's much bigger!" This thought placated my crying son, and he turned off the waterworks, only to start giggling again. "Mommy killed Fluffy! You did, you killed Fluffy!" Apparently hitting a cat is funny, but killing the Easter Bunny is a horrific crime.

The Next Step

"Choose a job you love, and you will never have to work a day in your life." ~Confucius

I love volunteering; treating patients and being in uniform are two of the most enjoyed parts of my life. I love being on duty, seeing new things, meeting new people, facing challenges and always adapting to new situations. I would do this every day if I could, I can think of no other career I would prefer. This brings me to my next step, since I graduate university this spring.

I have been accepted to the Paramedic Program at one of the best colleges in the area, I will begin the 2-year process this September. I am ridiculously excited, I've been wanting to do this for a while. I know the job is not all fun and excitement, I've already been bled on, puked on, frozen in the winter, boiled in the summer, bored out of my mind and so exhausted I couldn't sleep when my shift was finally done. I just love it, I can't explain why or how, I just do.

My goal is to kick butt in the program, since everything that I don't learn will come back to bite me on the street. I know my degree will generally count for squat, I need to work my tail off to be good, nay, to excel as a paramedic on the street. Although I'm not giving up my volunteer position, this blog will inevitably begin to chronicle my progress through school and calls I get while on the road with my preceptors. I'm excited for the change!!

The call comes over the radio and Ryan and I respond to a fall in the front lobby of the hockey arena. An elderly woman has taken her walker down the escalator and ended up falling down the last few steps. I take the call and carefully start assessing her, the poor woman has a slight mental impairment, a host of medical problems and is frightened and shaking like a leaf.

I check her shoulders and neck, running my fingers along her collarbone to assess stability. I check both her arms, running my hands down the bones to feel for deformities or swelling, watching her face for grimaces or any other indication of pain. All I find is a tender bruise starting to swell up just above her elbow; pulses, mobility, sensation, grip strength and everything else is normal. I check everything, running through the full assessment just to be sure. As I release her from my care, I tell her all I found was the bruise on her arm, but to go to the doctor and get checked out later if anything continues to hurt. Completely confident in my assessment and treatment, I fill out my paperwork and contently return to our seats in the stands to watch the end of the game.

Two weeks later, she approaches me at another game, her arm encased in a very supportive sling. "You know my arm that you said was just bruised?" She says with a slightly accusatory tone, "It turns out I broke my collarbone. I went to the doctor and it hurt more than all of my surgeries put together." Slightly dumbfounded, I stammer out an apologetic response while trying not to second-guess my basic assessment skills. As we part, I turn to Ryan in shame, "I thought I nailed that call, I checked everything! She had no pain, no swelling, no deformity, no instability, no nothing!" I barely hear his consolatory response as I'm lost in my own embarrassed thoughts.

I know I wouldn't have run that call differently if I came across it again, but I still feel bad that I missed it. I thought my skills were oh-so-good, I was getting cocky, especially in front of the newer members. I guess we all need to be knocked back to earth occasionally, even if its by something as simple as a broken collarbone.

Discord

The performer revels in the adoration, the screams and cheers of thousands of fans. He hears them scream his name, sing every lyric of every song and raucously applaud everything he says or does. I hear the scream for help, the cry of a frightened fan with blood running down her face. I hear security shout for me as yet another person staggers out and collapses against a pole, or is carried out by anxious friends. I hear the same stories time and time again, from nearly every patient who walks through our doors.

He sees them jump up and down with excitement, he sees the wide smiles on their faces, the signs splashed with his name and his T-shirts on every body. He sees attractive young women winking at him and smiling suggestively as they bare much in their concert attire. I see the police hauling yet another obnoxious drunk out of the crowd, tossing him out before he creates yet another patient for me. I see the blood hit the floor, drying into deep red-purple stains, a surprisingly beautiful colour against the dingy tile. I see knees buckle as people collapse, their pale and sweaty faces showing fear through their weakness. I watch the crowd closely, picking out those who will soon join me, seeing potential patients in every corner. I see a scantily clad woman fighting to stay upright on huge heels as she stumbles around in a drunken haze, eventually failing miserably and hitting the floor in a pile of skin, makeup and beer.

He smells the smoke from the pyrotechnics mingling with the odour of alcohol and sweat from the massive crowd. I smell the fruity tropical drinks in the vomit my young patient is spewing everywhere, I smell the alcohol on the breath of every patient who stumbles in. I smell smoke and blood, beer and vomit. The inescapable odour permeates my uniform and my hair, searing itself into my very pores.

He feels the thunderous bass shaking the stage beneath his feet, he feels the touch of frantic hands against his feet, his legs, his hands. I feel the grip of a drunk young woman on my hand, her fingers locking through mine in a desperate attempt to regain stability. I feel the swelling grow in a broken nose, I feel my sweat on my forehead as I try to stem the ever-rising tide into the first aid post.

He sings of the glories of alcohol, I see none of it. The young women who came in attractively dressed now slump to the floor, skirts riding up and shirts hanging low, with no control over themselves. Men who come in quietly leave with an escort of blue, or stumble out in a cloud of profanity. I spend the entire evening treating what alcohol has done to these people, and can't help but realize the discord between my experience and the ones glorified in his songs.

Concerts

March seems to be concert month around here, which is a welcome break after the long, slow winter. There are several large ones approaching, and I find myself looking forward to the preparation, setup and organization of these events. I love being the control person, running the show from the pre-duty briefing until the debriefing at the end. I carefully set up my teams based on qualification and experience, sending them out to pre-arranged locations at the pre-arranged times. I rotate them often enough to keep them from getting bored, and shuffle them around to maintain coverage when calls start pouring in.

We prepare for the worst when setting up before every concert, our entire triage area is designed to manage mass numbers of casualties. We prepare a drunk section where they can vomit peacefully with limited mess, water is set up for the fainters and splints and backboards are laid out for the unfortunate souls who venture into the mosh pit. Our tent stands guard at the entrance, a post through which all must pass in order to maintain order and control. I brief the teams, giving them the layout of the show, times, attendance numbers, radio instructions and assignments. As much information as I have, I reveal. I want my responders to be fully informed, holding back information to preserve a sense of power and control drives me nuts, I always strive to be fully open.

Hopefully, this month will go smoothly and the concerts will prove yet again to be a learning experience for everyone involved. I do my part by making sure all the extra stuff is taken care of, freeing up the responders to respond to calls and treat patients to the best of their ability. Hopefully, having me at the helm and on the radio allows them to focus on their job and not worry about anything else. I love treating patients, but I'm loving the organization and dispatching side more than ever.

Politics and Patients

Standing on the balcony and watching the milling theatre crowd below, I am struck by a sudden realization. The politics don't matter, I can deal with the issues and squabbles that have plagued us recently, because I do this for good, unchanging reasons. I do it for the people below me, for the experience and joy of treating a patient, to help a person out in their moment of need. I can look every single person here in the eye and say, "I do this for YOU." I experience a new pride in the crest on my sleeve, a renewed joy at the rank on my shoulder, a feeling of fulfillment and joy in my job. I do this for the patients, they are what matter, nothing else, and I will stick with it.

Anger

I watch the concert from a safe distance with my earplugs in, but it is still deafeningly loud. There is more black than the average funeral, as weirdly pierced, spiked and tattooed teens wander aimlessly around, charging into the concert room when the main band comes on. Nosebleeds seem to be the order of the day, courtesy of the frenetic mosh pit and flailing arms. A slightly older guy comes storming out of the crowd, blood streaming down his face, his arms, his clothes, the floor. I sigh, glove up and grab a mess of paper towel. Here comes another one.

He storms over to the wall and kicks it, hard, then whips his sweater at the nearest garbage can. I shake my head at his display of temper and walk over when he appears to have calmed a bit. Handing him the stretch of paper towel, I touch his arm and beckon towards the first aid room. He storms into the room just ahead of me, then lets loose a curse and kicks my trash can, bending it in half and sending bloody gauze and other debris cascading over the entire floor. He then proceeds to brutalize the helpless wheelchair, cursing and yelling about the injustice of his nosebleed. "HEY!" I yell, angry that I will have to clean up after his mess, angry that he is disrupting MY safe place, MY treatment room. "WATCH IT!"

He turns with clenched fists and takes a few threatening steps towards me. Thoughts fly through my mind like lightening, "I'm about to get punched, Ryan is going to KILL him, this is going to hurt, WHY didn't I call in my partner or security???" At the same instant that he starts moving, I do as well. Stepping outside, I wave to the nearest security guard, who comes running. Still mad at the guy for being such an ass, I re-enter the room and lose it on him. "WHAT THE HELL DO YOU THINK YOU ARE DOING?" I shout at him, "SIT DOWN AND SHUT UP NOW, OR I WON'T TREAT YOU, I WILL THROW YOU OUT OF THIS ROOM AND HAVE YOU THROWN OUT OF THIS CONCERT! Now calm down, and sit your ass down, NOW!" He looks taken aback, and as the security guard enters, he finds a blood-covered man cowering on the cot. "Everything ok?" he asks. "Just fine," I answer, "He was just a little upset." He nods and steps out the door, leaving me with the patient who is now extremely contrite, apologizing for the mess, for his anger, even for his injury.

I help him stop the bleeding, clean the blood off his hands and face and send him on his not-so-merry way. The look on his face when I started yelling at him sticks with me, I can't help but laugh as I clean up the mess and remember his incredibly abrupt change in behaviour. I guess redheads have a bit of a temper after all. ;)