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. ;)

The Concert Hall

The singer is incredible, he has an absolutely amazing voice. I had been a distant fan for a while, I like his music, but not in a rabid, buy all his CDs the moment they come out way. After the first song though, the goosebumps covering my entire body just don't go away, and I'm on the edge of my seat, awash in the rapture of his gorgeous voice. All the stresses and cares of the world melt from my mind as he sings, Christmas carols, Worship songs, his own songs, he just keeps singing and singing.

A hand on my shoulder breaks me out of my spellbound reverie and I jump, startled back to this world. Jakob leans over me, "We've got a call down front," he stage-whispers, "do you want me to take care of it so you can watch the show?" I quickly shake my head no and follow him across the back of the theatre. As much as I was enjoying this man's voice, my purpose for being here is to treat patients, not to kick back and relax.

The usher leads us along the side of the theatre, passing rows and rows of people who drag their attention away from the stage to gaze curiously at us and whisper to each other. We stop stage left, 3 rows from the front, in perfect view of the stage and the entire theatre. I make my way down the aisle, which thankfully, happens to be one of the widest rows in the place, and stop where the head usher is crouched in front of an elderly woman, slumped over in her seat. She gives me a quick report as I sidle up beside her in the dim light.

"She was feeling faint, dizzy and nauseous, with severe pain in her right foot since this morning." I nod and crouch by the woman, running through the assessment questions to try and rule out major issues, like an MI or stroke. A few minutes later, I am relatively convinced that although it is nothing too serious at the moment, we need to get her out of the theatre seating where I can do a proper assessment. Since she says she is unable to walk, we bring a wheelchair as close as possible and lift her into it.

By now the entire auditorium is watching us, and the performer knows it. I am completely focused on my patient, aware of but not focused on anything around me when the music stops. "I don't mean to draw attention to it, but I see we're having some difficulty in the front here." I hear a melodic voice say, and I look up, straight into the singer's eyes - he's almost close enough to touch, staring down at us with loving concern. "Why don't we pray for this woman's healing, and thank God for her life...." He begins to pray for her, for her healing, and for us. In slight disbelief, I carry the wheelchair-bound woman up the stairs as the entire crowd joins him in prayer, then applauds.

We head for the stage door exit, as the woman has requested an ambulance, and she's just not 'right' enough to let her go home. I don't know what was happening with her, but judging from her 6 million index cards full of allergies, medications and conditions, I'd say it was beyond my ability to treat. Just before the paramedics arrive, the performer comes backstage to see the women, wishing her well, and nodding his thanks at us. Since I am a complete professional, I certainly did not grin like a fool for the rest of the evening....

Just because we can?

I had an 'asthma' patient not too long ago, who came over to me freaking out, gasping for breath, moaning, crying and clutching her chest, throat, face etc. I sat her down, stared her straight in the eye and told her directly to calm down. I coached her breathing for very few cycles before realizing that she was, for lack of a better expression, full of it. She would gasp and spit, choke and sputter, then look up at the scoreboard and cheer raucously for her trailing team. She would be close to death, then pick up her cell phone and start texting her friends. A colleague of mine walked over and asked, like I was completely inept, why this asthma patient was not on O2. Ummm....because she doesn't need it?

A few weeks later, I was running an event as control when one of my teams got a call for an injured cheerleader. She had been kicked in the head, rather hard, as she fell from the top of a formation. The trainer had walked her over to our post and sat her on the back step of our ambulance. She had a nasty headache, as well as nausea and dizziness. She did not have neck pain or tenderness, and from all accounts, had not actually fallen onto her head. I know I wasn't at the call and didn't assess her myself, so perhaps it is unfair to criticize the team's treatment. They put her in a KED (since she was sitting down), and were preparing to backboard her as EMS showed up. The paramedics checked her over, WALKED her to their stretcher, placing her on it sitting up comfortably, and left for the hospital.

A little girl turns her foot at a kid's event, my partner and I head over to check her out. She is sitting on the turf, no tears, no obvious look of pain on her face. She winces slightly when I touch the lateral edge of her foot, but there is no instability and only minimal swelling. Placing an ice pack on the injury does wonders to relieve the pain. My partner pulls me aside and asks if I'm planning on splinting it. I say no, and explain when he gives me an incredulous look. I am not putting a small child in a massive, uncomfortable knee-toe-splint for an injury that just doesn't seem to logically require immobilization. Sure enough, she is up and running around by the end of the event.

Over-treating patients seems to be a rampant disease among many of the people I work with. The "Just because we can" attitude drives me insane, and I strive to counter-act that whenever possible. On our training nights, this attitude is clearly visible among many of the responders. When we focus on patient assessment techniques, vital signs and theory, people are bored and disinterested, brushing it off as been there, done that. This is even the case among responders who are and always have been terrible at patient assessment, obtaining accurate vitals consistently, scene management and the like. As soon as we pull out the equipment, however, people get more interested. Backboards, the KED, crazy splinting stuff, people would rather do that than practice the oh-so boring, routine steps of assessment and treatment. There is also a great tendency to jump on the chance to 'practice' their skills on a real patient. I don't like that mindset, but sometimes I worry that I am under-treating in response to their over-treatment. I guess it has to be a fine balance, and always, always with the patient's welfare at the forefront.

Little Things

The beautiful little blond kid bounces over to me, then shyly asks for a bandaid as his father stands back and smiles. I kneel down to his level and ask him if a Spider-man one will do. His face lights up with a massive grin that is instantly mirrored on my own face.

She cries without ceasing, her massive shoulders shaking with sobs. She is filled with guilt over the pills she took, not enough to kill her, but enough to alter her mental status and have her seeing snakes. She is terrified, her mental status not much more than a child. I take off a glove and reach for her hand, letting her feel how much I care as I link my fingers through hers.

I stop short as I notice a bowl of small, wooden animals from Africa in the booth beside me. My grandparents bought a collection of them for us when we were kids, but I haven't seen them in years. I pick up a few of my old favourites and caress them softly, lost in memories of childhood. I turn to my ever-present partner Ryan and tell him we have to come back here later in the Fair. I forget all about them as we get swamped with calls, but he slinks back that evening and buys a bag of them. (I know I'm not supposed to know about them yet....but another partner let it slip.)

It's the little things in life that can make your day...I feel blessed to be able to give and receive so much love. Thank you, Lord, for this wonderful world.

The Midway.....

It's been a long weekend, and this has been such a loooooong day. Ryan and I are finishing up 17 hours on duty, two back-to-back shifts, and we're beginning to get a little loopy. I love working with him though; this cute new transfer and I get along very well.

We finish packing up our station for the night and head to his car, joined by Sarah, a bouncy brunette who is always a lot of fun to be around. The sugar rush brought on by massive amounts of fudge is fighting back the exhaustion we feel, leaving us giddy. We drive slowly out of the festival grounds, past the midway - which is still running! Ryan looks at Sarah. Sarah looks at Ryan. They both turn and look at me. "LET'S DO IT!!" we say in unison, grinning like maniacs. Pulling into a clump of trees and parking, we all jump out and lose our uniform shirts. We run across the road in black tank tops and our tac pants, attempting to hide from all the other members who are pulling out behind us. Stupid reflective striping!

The Tilt-a-Whirl is first up, spinning and laughing as the stress of the day flies off our shoulders and away into the starry night. The queasy feeling hits me as I step off the ride, odd, since I can usually handle these things just fine. I shake it off so I don't miss any of the fun, and we head for the spinning strawberries.

As soon as the carney releases the break, Ryan grabs the wheel in the centre and begins to spin. He spins and spins, faster and faster. Sarah and I are plastered to the walls; laughter and the force of the spin leave us unable to move. We hit Mach 10 and suddenly I feel like I'm about to die. I turn "glow in the dark white" as the spinning world begins to blur and fade away in front of my eyes. Ryan turns to look at me and immediately grabs the wheel with both hands, straining to stop the spinning motion. Just as the strawberry begins to slow, the actual ride begins and a whole different spin is presented. I hold onto the cool walls with both hands, trying to focus on something, anything solid and taking breaths as deep as I can muster. It's the ride that never ends, we just keep going around....and around....and around...and around...

After what seems to be an eternity, the ride stops and I am freed from my strawberry prison. Sarah helps me down the narrow metal steps; my legs just aren't working very well. Ryan grabs my other arm and they lead me back to his car in the bushes. "I just have to sit for a minute," I manage, trying not to sound as bad as I feel. It doesn't seem to work, as I collapse in the grass and they go into patient care mode. I'm feeling too nauseous to care at first, I'm just trying not to blow chunks over the most gorgeous guy I've ever met. Ryan rubs my back, telling me to "throw up, it'll make you feel better." as Sarah looks at me with a twinge of jealousy in her eyes. When Ryan gets up to grab a blanket from her car, she leans in closer, laughing, "You're faking it to get the attention, aren't you?!!" I attempt a smile, which turns into another groan, "I only wish I was, I've never felt so sick in my entire life!" She laughs again as he rejoins us on the damp grass, wrapping a soft pink blanket around my shoulders and continuing to rub my back. As sick as I feel, I simply can't appreciate his comforting touch.

After 45 minutes, I feel well enough for the car ride home, but just barely. They help me inside and I collapse on the couch with relief. I am on duty for the next several days as the festival continues, and am nauseous for all of them. Maxing out the daily recommended Gravol limit does little to help, and I live on white rice, crackers and ginger ale. The new running joke of the division is that Ryan makes me sick....which is ironic, since we start dating less than a week later.

Angry Patients Suck

A young girl runs up to our tent, panting and flushed. "I need help, my friend is hurt, come quick!" I stand and try to calm her down, "What happened, where is he?" "He dislocated his shoulder again, he's screaming, over on the grass at the other side, hurry!"

We hop on our stretcher-carrying super cool fashion statement of a golf cart and make our way through the festival crowds. I sit on the back with Ryan as NDP drives, the girl beside him giving him directions. We pull up to the group playing football on the field, our patient is obvious.

A young man is bent double on his knees, one arm hanging uselessly. He is alternately screaming in pain and dry heaving into the grass. His friends, a rough looking bunch, gather around yelling at us to hurry up. As I start talking to him, trying to assess him, he pleads with me to "just pop it back in, pop it back in!!" I explain I cannot do that, I am not trained to and I could just make it worse. At this, he begins to swear and curse at me, his friends joining in. "Pop it in, b****, just pop it in!" He begs for help, then screams at me to get away. I am on my knees in front of him, trying to reason with him, explaining what I can do, offering to call the ambulance for him. He doesn't listen, getting more and more angry. His friends join in, swearing at us, "F-ing ambulance drivers, what do you know?", "Just go, get away, you're useless!" I want to help this guy, but he and his friends are making it impossible.

Ryan touches my elbow, subtly drawing me away from the crowd. With his light touch, he makes me aware of the position I was in, and I smack myself for forgetting about scene safety.....again. NDP tries to get the patient to sign a refusal of treatment as he half crawls, half stumbles away, "I'm not signing nuthin', F-er!" His friends refuse to sign as witnesses until NDP mentions the calling the police to control the situation. They yank the PCR out of his hands and sign angrily, still swearing at us.

We get back on the golf cart and sigh. So much for trying to help people. I can handle frequent fliers, barf, blood, whiners and people of all ages without a problem, but angry swearing bothers me. I try not to let it and enjoy the beautiful day. As much as I wish I could have helped him, there was nothing else I could have done for the guy. I let it go and relax, enjoying the ride back to base.