Independance Day, 2009

Happy 4th of July!


http://www.youtube.com/watch?v=km3e9dngf5Y

I think you will be glad you watched this.

Back to Class

It is an awful place, the end of the road. At 0130 we entered through the front door, past the regulars, empty vodka bottles and spent cigarette butts leading the way. Some slept on benches, covered with little more than rags. Others stayed awake, staring into space. We wheeled the stretcher past them on the way to the sixth floor. We had been called to remove an intoxicated man passed out in the corridor.

The elevator seemed smaller than it actually was, stained stainless steel walls, sticky floor, filthy buttons. I tried to hold my breath till floor six but had to exhale around the fourth and breath in the fetid air before the doors opened into the stench of the sixth floor.

A man lie unconscious on the floor further down the door lined corridor. Inside the tiny one room apartments sounds emanated, AC/DC from a portable radio, a man on the phone telling somebody about the unfit living conditions, somebody snoring, somebody vomiting.

I approached the patient, leaned over and shook him. Cockroaches scurried when he moved, there must have been fifty of them under his body doing god knows what.

"Hey, buddy, wake up," I said, shaking him again. The security guard who escorted us up shook his head and walked away.

"Come on," I said, "we'll help you up."

He opened his eyes and looked at me, did a quick assessment, then tried to stand. he was unsuccessful. We helped him kneel, then rolled him onto the stretcher, covered him with a sheet and wheeled him down the corridor, into the elevator, to the lobby and into the night.

On the way to the hospital, as I gathered the necessary information something hit me in the back of the head like a 2x4 swung by a giant.

He was battling cancer, taking chemo and sick as a dog.

He was my age, had a family once.

He was my friend, a long time ago. We went to school together in the seventies. He didn't recognize me. I didn't say anything as I wrote his name on the report. Once, we had similar dreams, similar hopes and similar ambitions.

His fell apart. Mine came true.

I've done seventeen runs in seventeen hours. An hour ago I thought I had it tough.

Descisions

The Supreme Court ruled in favor of a group of white firefighters who claimed racial discrimination after the City of New Haven attempted the discard the results of a promotional exam because not enough minority candidates scored well enough for promotion.


http://www.nytimes.com/2009/06/30/us/30scotus.html

For those of you who are not aware of the testing procedure for promotion in the fire service in the United States, it is an incredibly competitive process that requires hundreds of hours of preparation to finish at or near the top of all candidates. Those who score highest on the test are promoted. Everybody eligible to take the test is given the same time to prepare, the same list of source material and the same incentive; promotion.

I have mixed feelings about affirmative action.

http://rescuing-providence.blogspot.com/2009/05/affirmitive-action.html

Once a person is hired, all preferential treatment must stop. It is an insult to the minority candidate to give him or her an advantage. It is difficult enough for minorities, even those who did not need affirmative action to be hired. They live with the stigma that they were not as good as others who were passed over because their skin was a different color, or their sex was different. That all fades once a person has proven themselves in the station, on calls and on the fire ground.

It will reappear, in an even more vicious form if preferential treatment is given for reasons of promoting minorities. I am thankful the supreme court ruled correctly, though dismayed that it wasn't unanimous.

Answering the Call

This one is for all the folks answering the 911 calls.

http://www.time.com/time/specials/packages/article/0,28804,1903486_1903487,00.html?artId=?contType=?chn=

I don't know how they do it!

Three in, Three Out

So anyway, Providence is home to 180,000 official people. The real number is well over 200,000. Add to that, the 200,000 or so people who fill the city every workday, then come back to party.

Providence runs with six ALS vehicles and zero BLS vehicles. Six trucks handle 30,000 ALS calls per year and the number is growing. Can't seem to squeeze any more rescues out of the city without taking understaffed firefighters away from the trucks.

What to do?

Nothing. Run, boys, run.

And call for mutual aid.

1430 hrs, a minor fender bender on the south side. Three guys scurry around moving plastering equipment from the trunk of a barely damaged vehicle into the back of a pick-up. They see the rescue and stop, holding their backs.

I took two. Rescue 2 took another. A third rescue was called a minute later so the driver of the other car could get on the bandwagon.

Three rescues tied up for no reason other than fill the pockets of some lawyers and their prey.

Half of Providence's fleet gone in a blink.

Vacation begins in two hours.

Yay.

DOA

"You don't need all that, just bring a sheet."

The captain filled the doorway for a moment, then disappeared.

"Bring it," I said. Adam grabbed the monitor and 02, I carried the "blue bag."

Inside, a man lie dead on his couch. His body was filthy in life, in death it was blue and filthy. A dog whimpered from behind a closed door, weeks old food sat on a filthy stove, rotting in a filthy pan in a filthy kitchen. Bugs feasted.

I stood in the doorway which led outside, getting an occasional breath of fresh air, consoling a sobbing woman. I didn't ask if she was related, her grief was proof enough for me that she belonged here. A group of five others hovered around the dead man, the usual chatter, the usual questions, the usual tears.

"Lets go, move it outside," bellowed the captain. "Nothin here but a dead body and a lot of stink."

Adam told me later I had murder in my eyes.

For some inexplicable reason the people listened to the captain and started to leave.

"Get out of the way," he said to me. "I'm clearing this place out."

He's the fire captain. I'm the rescue lieutenant. We had been dispatched for an unresponsive male. I was in no mood for a pissing contest. I put the sheet over the deceased.

"You don't have to go anywhere," I said to the people as they left the dreadful place.

I can't wait for this shift to end.

Lessons

So, it is time for Grasshopper to try to snatch the pebble from my hand. (RIP David Carradine)

The "new guy" has been driving for three months now, in three more months the department will put him in charge of a Providence Rescue. Will he be ready? We shall see.

First test, 0715, fifteen minutes into our first shift, cardiac arrest, 55 year old male.

I failed this test, couldn't relinquish command. Just couldn't. It's one thing to train somebody, another thing altogether to put him into an impossible situation and possibly do more harm to his confidence than good. Our patient was deceased. His extremities were cold to the touch. My guess was he had been gone for at least an hour.

The man's son, who happened to also be a CNA, felt his wrist, stated he had a pulse, then looked to us. The man's wife appeared from a rear bedroom and became hysterical. Many moons ago I may have declared the man dead. Time teaches. The family needed to know everything had been done for their husband, father, son.

I had Adam get the ET tube while we did CPR and monitored the heart. Asystolic. My IV attempts were dismal failures, we arrived at the ER before administering any meds through the tube. The hospital is a teaching hospital, they took over care. He was pronounced dead fifteen minutes later.

The day progressed, I drove for the first time in a while and my partner handled the patients. He was doing fine until 1430 hrs when we were called to a Family Services Center for a suicidal fifteen year old. Ashly sat in the office with her grandmother, sullen, petulant and annoyed, everything I was when I was fifteen. She had numerous attempts in her history and suggested to a councillor today that she wanted to die.

Adam sat in the Captains seat while I took the young lady's vital signs. I learned something on this run; I am truly incapable of keeping my big trap shut and letting other people shine.

"You know, Ashley," I said, "I hated being thirteen, fourteen, fifteen, sixteen, seventeen...actually I was miserable until i turned forty, only then did I manage to find happiness."

She looked me in the eye, unimpressed.

"Twenty-five is actually pretty good," chimed in my student, "he's just so old he can't remember."

Well, the suddenly animated Ashley and my "student" had a nice little chuckle for themselves as I slinked to the drivers seat and left them in the back.

I looked in my hand as we left the scene.

The pebble was gone.

Honest Mike's

Here at HONEST MIKE'S we have a HUGE selection of SLIGHTLY USED rescues at prices so low we must be CRAZY!!!!

No, it's really just another tuesdat at RIH ER.

Dani's Anatomy

http://medicdani.blogspot.com/

I want to be twenty again. No I don't. Yes I do. On second thought, no I don't. Well, yes I do. Well, maybe...

Just read the thing!

Successful Demonstration