My Brain Has Issues
It's 1:30 in the morning, and I should be asleep. After the weekend I had, and the relatively low amount of catching up I managed today, not to mention the fact that I feel like mongrel dog-ass, should all combine to create an opportunity for sleep that doesn't end for at least 12 hours. Instead, I'm laying in my bed staring at the ceiling while my various insanities run through my head in an endless line.
The trouble is that I don't have someone that I verbalize all of those things with anymore. For a long time, my ex-girlfriend got to hear all of it. The various inadequacies I posess, problems relating to the people around me, all the little injustices of the world that everyone sees, but for some reason seem worse to me. Then she dumped me.
For a while after that I found substitutes, including one person who I believe may legitimately be the most wonderful person I've ever met. She messed with my head in other ways, but for pure caring and empathy she's going to be nearly impossible to top. Recently though, I'm just lacking that person that I can a.) trust, and b.) relate to well enough to talk these things through.
I'm a deep thinker, and for once, I don't mean that in a cocky way. I mean that I consider things, and I roll them around in my head, and it lets things get to me. I almost took off for Haiti in January. I was ready to go to the airport, drop all the money I had on a plane ticket, and take off. All that stopped me was the fact that if I did that, I'd be leaving behind people that were counting on me. If you really want something out of me, don't offer me money, adoration, undying love, or even power. Just make sure someone I care about, and feel responsibility for won't be taken care of.
One of the things that popped into my head while I was lying here in bed was the mother of a former patient. Her son was the first cardiac arrest I ever worked. He was 7 years old.
I was working in Cary, and it was sometime right around 7o'clock. Shift change happens at 7 at Cary, which means that the building was really full. I was a newly christened and blessed EMT, but I'd been riding as an Explorer (A sort of ridealong program for high school students. I basically functioned at the EMT level, just under supervision, and I didn't drive) for about a year. I was riding with a paramedic and an intermediate that day.
We hadn't even checked the trucks off when the tones went off. They actually dispatched it as a cardiac arrest, which is rare. Usually it goes out as an unconscious person, or a medical nature unknown unless it's at a nursing home. I was totally okay until they came back with more information and told us it was a 7 year old.
In EMS, we don't deal with kids a whole lot, and when we do one of two things is nearly always true. Either the kid is fine, or they're in a whole lot of trouble. Needless to say, this guy was in the latter category. Another paramedic who had worked the day before heard this on the radio, and jumped on the suburban we use for special events and responded to help.
We got onscene about 2 minutes after Rescue 4, and I'd already thrown all the equipment we'd need to work a code on the stretcher so we could get it in the house. A code requires an incredible amount of stuff, and is challenging, especially if you're new, but it's nothing like what they show on TV. There is no yelling, in fact it's eerily quiet. Sometimes I think it's out of that innate respect for the dead that all cultures seem to have. No one says "stat", no one tells the patient to "Breathe dammit!". When it's done right, and runs smoothly, it's a thing of beauty. When it isn't, it's a clusterfuck.
We made it inside, and watched Rescue 4 deliver a second shock with their AED. That told us pretty quickly that he was in fact clinically dead, but that he had a chance. We connected their pads to our monitor, and saw that the kid had actually converted into a half decent rhythm. I had taken over bagging the kid (breathing for him with a bag-valve mask) and reached down to his neck and felt a pulse.
This officially made it go time. There was no more messing around. We literally threw the kid on a backboard, put him on the stretcher, and hauled ass, trying all the while to get some information about the kid from his parents.
Once we were in the back of the truck (All 4 of us. Me, bagging the kid, one medic on the bench trying for an IV, the intermediate on the CPR seat on the other side looking for an IV too, and another medic getting ready to try to intubate him) and the firefighter put us on the road to the hospital, things just got so easy. It was surreal. We were asking one another to pass things back and forth like we were at the dinner table.
It ended up being impossible to get an IV on this kid, and for reasons I learned later, his anatomy made intubating him impossible too. Realistically, this was a BLS code and my skills as an EMT were pretty much the highest level of care this kid could receive. When we were about 2 minutes out from the hospital, his pulse dropped too far, and we started compressions. I heard one of his ribs break and considered puking, but thought better of it.
Inside the ER, we moved him over to their bed, and Jan gave her report. Through this process, I ended up next to the kid, and had to take over compressions for a bit while a nurse bagged him. I could feel his heart underneath his ribs, and his eyes we half open and staring at me. Weirded me out. Eventually I get the opportunity to hand off my duties, and I shuffle out of the room, and watch as they continue to work on him. They cut off his underwear for one reason or another, and the kid had shit his pants. I can actually remember sitting there and thinking to myself "Please don't let me shit myself when I die."
In the end, they tried a few rounds of drugs, but nothing was going to keep this kid's heart going. From the information we got, we knew he had some congenital defects, and other problems and his body had just given out. Even so, there are just no words to describe what it's like to watch a kid die in front of you. I watched his heart stop as I was putting new linens on the stretcher for the next person we'd put on it that day.
My mind was just racing as I cleaned the truck and got everything put back in order. I couldn't figure out how I was supposed to react to this. Something was really bothering me. This was my patient, and they're not supposed to die. I couldn't understand it.
I walked back inside the hospital, and as I turned a corner, the kid's mom came out of the room he was in, literally right in front of me. I looked at her, and suddenly, everything just broke. Tears started literally streaming down my face. This lady didn't even miss a beat. She walked straight up and wrapped me in a hug. Held the back of my head and everything. Classic mom move. I just sobbed against her. Totally embarassing, but the ER was relatively deserted that day, and thinking back, this probably didn't last all that long.
Finally she just kinda leaned her head up, and whispered "Thank you" in my ear, and we both went back to what we'd been on our way to do. I don't remember her son's name, and I never knew hers, but that lady may be the one reason I didn't really lose it later on. She made me realize that no matter what, there's only so much I can do, and in the end the decision of who makes it and who doesn't isn't up to me.
Every year at the annual Christmas party, they hand out sweatshirts to everyone that has a successful field resuscitation in the year before. By our criteria, a successful resusciation means getting someone to the hospital with pulse and a blood pressure, which we'd done with this kid. I've never been able to bring myself to wear that sweatshirt.
The trouble is that I don't have someone that I verbalize all of those things with anymore. For a long time, my ex-girlfriend got to hear all of it. The various inadequacies I posess, problems relating to the people around me, all the little injustices of the world that everyone sees, but for some reason seem worse to me. Then she dumped me.
For a while after that I found substitutes, including one person who I believe may legitimately be the most wonderful person I've ever met. She messed with my head in other ways, but for pure caring and empathy she's going to be nearly impossible to top. Recently though, I'm just lacking that person that I can a.) trust, and b.) relate to well enough to talk these things through.
I'm a deep thinker, and for once, I don't mean that in a cocky way. I mean that I consider things, and I roll them around in my head, and it lets things get to me. I almost took off for Haiti in January. I was ready to go to the airport, drop all the money I had on a plane ticket, and take off. All that stopped me was the fact that if I did that, I'd be leaving behind people that were counting on me. If you really want something out of me, don't offer me money, adoration, undying love, or even power. Just make sure someone I care about, and feel responsibility for won't be taken care of.
One of the things that popped into my head while I was lying here in bed was the mother of a former patient. Her son was the first cardiac arrest I ever worked. He was 7 years old.
I was working in Cary, and it was sometime right around 7o'clock. Shift change happens at 7 at Cary, which means that the building was really full. I was a newly christened and blessed EMT, but I'd been riding as an Explorer (A sort of ridealong program for high school students. I basically functioned at the EMT level, just under supervision, and I didn't drive) for about a year. I was riding with a paramedic and an intermediate that day.
We hadn't even checked the trucks off when the tones went off. They actually dispatched it as a cardiac arrest, which is rare. Usually it goes out as an unconscious person, or a medical nature unknown unless it's at a nursing home. I was totally okay until they came back with more information and told us it was a 7 year old.
In EMS, we don't deal with kids a whole lot, and when we do one of two things is nearly always true. Either the kid is fine, or they're in a whole lot of trouble. Needless to say, this guy was in the latter category. Another paramedic who had worked the day before heard this on the radio, and jumped on the suburban we use for special events and responded to help.
We got onscene about 2 minutes after Rescue 4, and I'd already thrown all the equipment we'd need to work a code on the stretcher so we could get it in the house. A code requires an incredible amount of stuff, and is challenging, especially if you're new, but it's nothing like what they show on TV. There is no yelling, in fact it's eerily quiet. Sometimes I think it's out of that innate respect for the dead that all cultures seem to have. No one says "stat", no one tells the patient to "Breathe dammit!". When it's done right, and runs smoothly, it's a thing of beauty. When it isn't, it's a clusterfuck.
We made it inside, and watched Rescue 4 deliver a second shock with their AED. That told us pretty quickly that he was in fact clinically dead, but that he had a chance. We connected their pads to our monitor, and saw that the kid had actually converted into a half decent rhythm. I had taken over bagging the kid (breathing for him with a bag-valve mask) and reached down to his neck and felt a pulse.
This officially made it go time. There was no more messing around. We literally threw the kid on a backboard, put him on the stretcher, and hauled ass, trying all the while to get some information about the kid from his parents.
Once we were in the back of the truck (All 4 of us. Me, bagging the kid, one medic on the bench trying for an IV, the intermediate on the CPR seat on the other side looking for an IV too, and another medic getting ready to try to intubate him) and the firefighter put us on the road to the hospital, things just got so easy. It was surreal. We were asking one another to pass things back and forth like we were at the dinner table.
It ended up being impossible to get an IV on this kid, and for reasons I learned later, his anatomy made intubating him impossible too. Realistically, this was a BLS code and my skills as an EMT were pretty much the highest level of care this kid could receive. When we were about 2 minutes out from the hospital, his pulse dropped too far, and we started compressions. I heard one of his ribs break and considered puking, but thought better of it.
Inside the ER, we moved him over to their bed, and Jan gave her report. Through this process, I ended up next to the kid, and had to take over compressions for a bit while a nurse bagged him. I could feel his heart underneath his ribs, and his eyes we half open and staring at me. Weirded me out. Eventually I get the opportunity to hand off my duties, and I shuffle out of the room, and watch as they continue to work on him. They cut off his underwear for one reason or another, and the kid had shit his pants. I can actually remember sitting there and thinking to myself "Please don't let me shit myself when I die."
In the end, they tried a few rounds of drugs, but nothing was going to keep this kid's heart going. From the information we got, we knew he had some congenital defects, and other problems and his body had just given out. Even so, there are just no words to describe what it's like to watch a kid die in front of you. I watched his heart stop as I was putting new linens on the stretcher for the next person we'd put on it that day.
My mind was just racing as I cleaned the truck and got everything put back in order. I couldn't figure out how I was supposed to react to this. Something was really bothering me. This was my patient, and they're not supposed to die. I couldn't understand it.
I walked back inside the hospital, and as I turned a corner, the kid's mom came out of the room he was in, literally right in front of me. I looked at her, and suddenly, everything just broke. Tears started literally streaming down my face. This lady didn't even miss a beat. She walked straight up and wrapped me in a hug. Held the back of my head and everything. Classic mom move. I just sobbed against her. Totally embarassing, but the ER was relatively deserted that day, and thinking back, this probably didn't last all that long.
Finally she just kinda leaned her head up, and whispered "Thank you" in my ear, and we both went back to what we'd been on our way to do. I don't remember her son's name, and I never knew hers, but that lady may be the one reason I didn't really lose it later on. She made me realize that no matter what, there's only so much I can do, and in the end the decision of who makes it and who doesn't isn't up to me.
Every year at the annual Christmas party, they hand out sweatshirts to everyone that has a successful field resuscitation in the year before. By our criteria, a successful resusciation means getting someone to the hospital with pulse and a blood pressure, which we'd done with this kid. I've never been able to bring myself to wear that sweatshirt.
posted by C at 1:32 AM
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