The Tones Go Off

I missed many holidays because I was working.  Sometimes I really envy the people that have 9 to 5 jobs...they get up at 7 AM, get ready, drive to work while drinking a cup of coffee at a nice slow and even pace, and arrive at work. They can chat with the office crowd. I cannot say that I haven't ever had that type of work....I have had "normal" jobs in my younger day. 

In Emergency Medical Services, for a semi-rural department, things can get very hectic, scary and hairy, especially in the middle of the night.....well,  also in the daytime hours. The EMT s and Paramedics are allowed to respond from their homes at night, provided they can get to the scene or to the station to pick up the required apparatus within an allotted time frame. This is usually an ambulance and a fire engine.  There is also someone that may act as a first responder that goes directly to the scene....someone that has some gear in their possession. They carry oxygen, a med bag with basic items, such as bandaging materials and splints, and maybe a blood sugar machine. This person could be of higher training or of lesser training who can manage the ABC's.  That means airway, breathing and circulation, the very first steps of managing a patient. The first responder must also know CPR.  This person is also important because they radio transmit basic needed information regarding this patient or of the scene. The crews like to know if the scene is secured and is safe to enter.

Soooooo..... When I am on night duty, I am obligated to respond to any and all calls during that particular night. I carry a pager that alerts me by making a very loud beeping sound. The dispatcher sets off those loud beeps so the crews are alerted to a call. The tones go off!  That is the terminology for it when the beeper opens up and beeps by radio transmission.  Certain set tones are set for individual departments and these other tones preempt the beeping tones. The pertinent voice information follows from the dispatcher as to the nature of the call and the address of the scene, and any other important information we may need.  Again, is the scene safe?
Are the Deputies en route?

Usually I am asleep.... AND THEN,  the tones go off !  It blasts me out of bed, literally!!!  I jump out of bed immediately, heart pounding, and  not just because of getting a call. It is because I am literally so startled by the very loud sound it makes, even though I have heard it so very many times before. I begin to recover and I take a deep breath and jump into any needed clothing, gear, and footwear. I start thinking and analyzing what I hear from Dispatch. I grab my reflective coat, my keys and drive to the station as rapidly as I see fit by the information I already know.

I usually call on a portable radio that I am enroute to the station or scene, especially if there is any variation of what I was originally supposed to do. For example, I may go to the scene instead of picking up the ambulance.  This is usually for the reason that I could actually be passing the scene of an accident while  going to get the ambulance. In most cases, stopping would be the right thing to do. In cases where I have absolutely no equipment or radio that may be the absolute wrong thing as that could confuse the flow of the ways things are supposed to go.

Things do not always go as planned, personally or otherwise. For example, I have been caught in the shower too many times over the years when the tones go off. It is always at the worst point of the shower that this has happened. It is usually when your hair is full of shampoo. That means you are at the point of no return and you have to do a crappy job of rinsing. It also means that you can skip the towel....there is just no time... and force your clothes on a wet body. Putting on a sports bra on a wet body is one of the most difficult jobs I have ever  encountered...as I grit my teeth and jump around, and starting to sweat. Block that picture from your mind,
although very true to the situation.

 DAMMIT    BEEP BEEP BEEP BEEP  S#@T F$#K

And my hair! I have to rip a brush through it. If it is cold enough, I have had my hair freeze solid when wet.  Plus not a bit of makeup,  and a general unkempt look,no time for that... maybe even bad breath from sleeping.... that is usually the time when you are the star and expected to take total care of the patient.  Those times make it so very hard to be on your "A game".  We try to carry mints, but we forget to refill them every now and then. Hope they are unconscious or they soon will be.  Hah!

The movies and TV shows depict it as being such a glamorous job.
All the men and women never have anything visually out of place, not even one hair.  They always have crisp uniforms and look fresh. That is not at all how it is in real life. Sometimes we are stuck on a call for several hours,  such as a standby for a structure fire.  The ambulance crew may be out in the rig for several hours. We possibly can catch a nap in our bunker gear and hope the chief has called for port-o-potties when we are there for so many hours. If not, we are SOL. If we are really lucky, a truck arrives with coffee and Gatorade and awesome little pound cakes and other great snacks. We love that truck ! And we love the people who come out to set all that up for us.

WE never know what is to be encountered.  All that is known is what the dispatcher tells.  All the dispatcher knows is what they have been told by someone else on a phone.  Things can get misconstrued, or the patients can mislead. I am not saying that is the norm.                                  

CALL 911!!!!!   

WE have to be very vigilant as some stupid move or mistake on someone's part could fade all our lives as emergency personnel. Many of us have sustained injuries ourselves through falls, slipping on ice, pulling muscles, getting hit by vehicles, getting hit by people, getting burns, inhaling bad fumes, stuck with needles, and many more maladies that are encountered. I have personally been stuck with a few needles, fallen backward off the back of an ambulance and injured my tailbone. There are so many things that have happened. They are always unpredictable things.

Our patients that we encounter have endless amounts of ailments. I never thought there could be so many problems with people. We never know what will happen until we see for ourselves.  I have so many pictures in my head that haunt me until this very day.  Sometimes I replay these scenes in my head for years.

One day I made a mistake and said that I thought I had mostly seen "everything".   WRONG.  The very next call after I said this, a poor woman was sunbathing in the park and sleeping all nice and comfy. THEN, a BIG radio controlled helicopter stalled in air and fell right out of the sky. There was a remote control helicopter meet going on at that same park.  It silently fell out of the air on her and sliced her diagonally from right shoulder to left hip with a big gaping blade laceration. WHAT THE HELL! She was transported and had to have multiple sutures. I will never ever say again that I have seen it all!

I have come across hangings, rollover accidents involving children, 
teenagers ejected from vehicles and found to be dead, overdoses,
gunshots to the head and other body parts from suicide, pedestrians hit with brain matter on the road, motorcycle accidents that have hit head on with automobiles, and school bus accidents with children injured. I have seen limbs severed and found them in unusual spots away from the bodies.  I have seen a child scalped from a motor vehicle crash. I have seen a woman so strung out that she perceived herself to be having orgasms all the way to the hospital. (I want some of that which she took!) I have seen a child on the back of a motorcycle fly backwards over an estimated 150 feet and land with a severely broken pelvis so his legs appeared to be spread and twisted over his head from thigh with both feet over head.  So many more tales to tell. I haven't even touched on some of the more gruesome ones.

On the flip side, a call may come over the air for a woman bleeding.
Well... that could mean a number of things, but that is all the dispatcher had for us. The people hung up the phone! So off we go
having not a clue if she is about to deliver a baby, or has misused a chainsaw, or has a knife impaled in he chest.  We arrive on scene
and find her sitting in a chair. She stated she scratched a mole and it would not stop bleeding. I smiled and took care of her with a little pressure and a band-aid, but deep down I am thinking to my self...."wth... it is 3 AM and I am out of my warm bed on this cold night for your stupid bleeding mole.  I have to type in a seven page report besides!!! This sucks!!! "  But I politely take care of her, swearing under my breath, have her sign a release, and clear the scene....along with the engine, the chief in his car, and the paramedic response vehicle, and the ambulance that I responded in. She won't get a bill for this, because there was no transport.  BUT the taxpayers will be paying that bill!

Back to my warm bed and praying for the Pager God to let us all rest for a few more hours.

THE FIRST CALL

                    From the words of a Mortician

There is a job not many know

Many sorrows we can never show

That involves just so many things

Of what the twisted fates may bring.

There is a happy season to be born

And as loves in your life are left to mourn

Comes the season to wither and fatefully die

Where the beginning of the end indeed draws nigh.

I saw my friend Jim, walking just the other day

There was something he really wanted to say

He greeted me, smiled, and tugged my sleeve

But he just turned away so quickly to leave.

I wish I had insisted and chased him a stride

He could not say any,  he had too much pride.

His eyes did not sparkle and he looked just so pale.

I turn now at night and wonder just why did he fail.

In the late night hours the death call came in

A  faltering sad voice of  some next of kin

I knew what it was as I stood up to answer

Was it a homicide, accident, some form of cancer?

   It was Jim's own son calling who lived so  far away

               He said he had many troubles until  his dying day,                      Telling the story of his hanging and details of this case.

 Soon he will be interred into his final resting place.

When I heard of this news I felt a cold chill

I cursed the Reaper for yet another friend to kill

Picturing a broken sad man hanging from the rafter

Who will never again imbibe life, love or laughter.

The FIRST CALL is the start of what was to follow

The family must plan while in grief they shall wallow

An appointment to meet and most details taken

Making plans for a man that shall never reawaken.

I then met the Coroner at the scene of Jim's death

On a clean white sheet as we noted no breath

After the rope was cut and he was lowered to the floor

His body was stiffened for he went through Death's door.

Jim was taken to the morgue then I headed for home

I left his remains there on the prep table all alone.

Crawling back to my bed on this crisp autumn night

Why in God's name did Jim give up and end his plight?

I should have seen the signs in my depressed fading friend

Could have deterred him from the planning of  his life to end

I wished I had made some time to invite him for some tea

The only help that is left to offer is of my trade professionally.

I know I will do my absolute best as to how it all should be

I will even put a smile on his face for everyone to see

Everything to be perfect, his suit, his shoes, his casket

By his feet is a token from me, a note in a flower basket.

It is a very deep and personal note between just him and I

An apology to him and  a very sad and personal goodbye.

Hiding it there to go unnoticed by mourners who attend

I'll remain in good with our Maker so to see him in the end.

Good Bye My Dear Friend.

We lose our friends and family, too.

DESPERATE LIARS

I have certainly, in many ways set myself apart from others.
Oh, not in a bad way really....but, for example, I went to the last class of a 48 hour series to fit the new curriculum of "advanced paramedic".  All through those hours of sitting in class, as I occasionally glance around, I see many people in EMS.  Most are young strapping bucks, and there are a few doe and one with fawn soon to arrive.  And here I sit.... more than a bit older...  at least I still have a decent rack!    YEAH!!!  At least I am not a trophy!
WE all ride the "Bambilance", and most of us have dodged a few bullets, either figuratively or literally speaking.   YUP!!!  You can tell this is Wisconsin!

BUT REALLY......
People try to attack us at times, many assault us in different ways. These are usually the druggies and drunks. For the most part I have been very lucky. I have been slapped and scratched. I have been grabbed from under my breast while taking a blood pressure on a drunk man.   I have been spit on . I have been kicked. And someone tried to bite me.

Some people just do not want to go to the hospital, get violent and try to abandon ship. There are rules for this of course. Generally we do not take people that are fully competent and wish not to go, even if they need to go.  That is their decision.  BUT...
"implied consent" allows us to take unconscious persons or people that are not acting competent due to a head injury or obvious danger to themselves if we do not take them. Sometimes, that is when the "real fun" begins.

I have helped others chase patients like that.... we know the outcome will be very bad if we don't catch and transport. I probably jogged over fields and valleys for more than few in my day.

One person was captured by the deputies and another medic after leaving the scene of his own motorcycle accident. Now the accident was not too serious, but he bolted through several farm acres after 
he dumped his bike on a curve. He did not want to go with us AT ALL!!! Maybe he was hiding his use of illegal drugs. He argued so strongly with my squad officer and he was put in his place by my squad officer.  Some of the EMS officers think they are "all that and more".  Well, the guy was really pissed and the cops told him he had to go to the ER and was also under arrest.  He agreed not to fight or run and only to sit on the ambulance cot.
I said to him that he still had to be seat belted.  Well everything seemed cool and we went en route to the hospital 10-40.  (That means non-emergent with no lights and sirens.) We stopped at a stoplight and GUESS WHAT????  The male patient stood up RAPIDLY and took two giant leaps and jumped out of the back doors as we started to roll again. Our mouths just dropped! That S.O.B.!!!  He secretly unlatched the buckle! Another chase again...but the deputy was right behind and to the ground the patient went in a flash.  This time he was handcuffed to our cot and transported to the nearest facility.  I do not believe it was alcohol, maybe drugs, maybe a concussion?  He did not present in an obvious way in his diagnosis.  People will try to schmooze when they are hiding something or lying.

As in the words of TV Greg House M.D........ "Everybody Lies"

SOILED WHITE SHEETS

The right shoulder is painful today.  Years of wear and tear on it...... pushing, pulling, turning, rolling, assisting, catching, and all the other things I do and have done to patients and  "former" patients....
It has not been my intention to yank or wrestle or even FIGHT with some of them, but it has happened.

I didn't want it to fight for the most part... but, then again, I wished many times I could have really kicked their ass but good!!!
IF it were in some way  just legal!!!!

In that type of context in my writing I am putting it very lightly to you that some of these patients are living.

AND SOME ARE DEAD.

I have years of stories to tell you before my own life fades. I do not intend to make this something to scare you, or cause you unrest, although the thought is amusing to me.  All of what I am about to tell you are based on true happenings with only names or  places changed to secure the ethical practices I have been sworn to in my early careers as a Funeral Director/Embalmer or in EMS (Emergency Medical Services). 
 I also cannot guarantee any certain truth about lives of people involved.  I do guarantee the practices and procedures of technical aspects are truth... but that is also subjective as neither mortuary science or emergency medicine is an exact science.  The years in Emergency Medicine is the flip side of the record in which I had been partaking while, concurrently Undertaking. Sorry for the really bad pun.

For years I owned a small funeral home in an ethnic melting pot of the big city. I got married. I popped out three babies. I was a social flower that bloomed. I lived large and I even got large.We lived in an apartment above the funeral home. I raised my three delightful children there and went to work downstairs. I had a nice husband (at first of course..or I wouldn't have tied the knot.)  I got divorced 13 years later. (He became 'not so nice!!!)    That is why 13 is such a lucky number to me! Then I moved north...like about 65 miles north. I felt that was far enough for beasts not to roam.

I also worked in a hospital as an Emergency Medical Technician-Paramedic and in the field based out of a Fire and Rescue Department in a small town on the ambulance. That was the Northern Life that I choose for "fun" while going through an ugly divorce.

I guess people like myself are "adrenalin junkies". We do not run the other way when something happens. Our eyes open wide and our pupils dilate, our ears perk and we zone in to sounds as if we have bionic hearing.... then in a guttural "HUH????" comes out of out mouths.  We start to drool and run toward the scene.  Soon , as I have many times observed, the fire and rescue personnel become like buzzards, flocking over the sick or injured to get their "skills" in. They are starting IV's, immobilizing the patient on a backboard, calling in other departments for MUTUAL AID.  They are putting on oxygen and bandaging.  And all this is for a scraped elbow!  Now I really do love helping the new firemen, because they are so cute...but event then I say this is overkill....sorry for the pun again. They really did not need to send 8 emergency vehicles
to that scene.  Ahhhh wait......CHAOS ...  Chief Has Arrived On Scene....

Dead or Alive.  They are loaded on white sheets being soiled in crimson and taken away. SOMEWHERE.... is it bright lights and cold steel?  Or a cold dark room where they lie alone until their disposition is determined and next of kin are notified?   

Stay tuned for the next chapter.......