Finally

Read part 3 here.

The class ended last Wednesday; went out with a bang.  I was pretty worried about the final exam really.  I was basically all studied out and I didn’t really know how much I remembered of the material we had covered.  I didn’t know what to expect.  The three classes prior to the final, we had played a weird, not quite right, version of Jeopardy with questions that were based on but supposedly not directly off of the test.  (Some of them really were.)  I made note of some things that came up during that time that I wasn’t so confident on and I took the day of the final off work so I could prepare.  I spent the day reviewing the subject matter I had noted, which proved to be helpful because I’m sure I’d have missed more questions on the test if I hadn’t done so.

The final was 167 questions long, and about 2/3 of it were scenarios and not black and white questions I could’ve answered in my sleep.  It took some time to get through it all and I realized immediately on the 4th question that very careful and detailed reading of every word of the test questions was going to be necessary.  Question number four asked something about delivery of a baby being the expulsion of the fetus from what internal female sexual organ.  One of the answers was the cervix and another answer was the vagina.  I was stumped for a minute realizing that both were correct answers and being unsure of what was the “more true” answer he was looking for.  And then I re-read the question and this time “what internal female sexual organ” stood out.  I had completely missed the word internal the first time I read it.  After seeing that, the answer was clear and obvious.

One hundred sixty-seven questions carefully read and answered took a while to do, and still I was only the third person to finish the test.  It took me just under two hours.  I handed the paper to my teacher and started to walk away and he asked me, “Don’t you want to see how you did?”

I said, “Yeah, but I have to go the bathroom.  Grade it while I do that and I’ll be right back.”

When I walked back in a couple of minutes later he had a big grin on his face and he said, “I wouldn’t have expected anything less.  Ninety percent!”

“Exactly?” I asked somewhat surprised.

“Yeah!” he told me.  Now I’m no math whiz, but 90% of 167 questions tells me I missed 16.7 questions (how you miss .7 of a question I don’t know)  I’d say 16 or 17 questions out of 167 is pretty damn good!

“So, next semester,” I told him, “I’d like to come back and just sit in on the class.”

Just sit in?” he asked surprised.

“Well, I guess I can do more than that, if you like,” I answered.

“Good!” he said.  So I guess I’m doing more than just sitting in.  Does the fun ever end?

I know this probably comes as a surprise to anyone who read some of my earlier posts toward the beginning of the semester.  My teacher was a bit of an ass hole early on and I still don’t really agree with his attitude and some of his methods, but as the class progressed and as the student body dwindled (we started with 45 and 15 people took the final) his attitude and demeanor softened quite a bit.  I have no doubt that it was all by design (which is the part I don’t agree with) but I made it through to the end and I passed, possibly at the top of my class.

I probably said to more than one person early on that I would never come back to help out next semester, but I’m realizing now, that can only benefit me and if I refuse to do it, I’ll just be depriving myself of a learning opportunity, and a chance to get more experience.  I’d have to be stupid not to take advantage of that.

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Trauma

Read Part two here.

 

On Thursday, December 9, not that exact dates are important, I spent twelve hours working in the emergency room in the county hospital.  You may recall that I was a wee bit anxious about that.  We’ve all seen the televised drama of hospital emergency rooms and we all know that they are hustling, bustling masses of controlled chaos; blood everywhere, people maimed and disfigured, writhing in pain and crying out for help.  In short, barely contained hysteria.

Before this I had only ever been in an emergency room three times, two times accompanying the patient and once a hardly-even-qualifies-as-an-emergency recipient of mediocre at best care.  In each of those instances, things were so calm and serene in the working areas of the emergency room I felt sure the real traumas were brought to a different and isolated section of the hospital, protecting those of us with weak constitutions and weaker stomachs from the sights and sounds of such mayhem one could only imagine.

I was pretty worried about what I was going to encounter in this twelve hours working “in the county trauma center” as I was told over and over again, I would be doing.  The hospital in question is the County Hospital, the County Trauma Center, the County Teaching Hospital.  “You see everything there,” I was told more than a few times, and while I knew I needed to test myself and prepare myself for what I might encounter in a career as an EMT, I was still worried about what the day held in store.

When I arrived at 6:55 in the morning, the registration area was packed with people but it seemed to be the entry point for all who had business with the hospital.  There is no way I saw all those people pass through in my time on duty.  After a couple of missteps I found my way to the appropriate area where I was directed to one of the staff who would give me my assignment for the day.  The nurse I would be working with had not yet arrived and I was told to just hang out for a few minutes until she checked in.

I took the opportunity to get the lay of the land and understand, as best I was able, what was going on around me.  I was at Nurses Station 1, which amounted to a big open counter top ringed workspace with computers and chairs inside, and three computer terminals on the counter at one end.  Surrounding the Nurses Station were rooms and alcoves with hospital beds and various equipment inside.  On one wall was a white board which had each of the patient rooms and assigned staff scribed on it.

When Johnna, the nurse I worked with, arrived I found out we were assigned to three rooms, ten, eleven and twelve, and she set about showing me the ropes.  I followed Johnna around much of the time, observing her work, helping out where I could.  As an EMT, I am not capable or legally allowed to start an IV or administer any medications, but I was able to check and monitor vital signs and document them, I was able to provide comfort where possible both with my bedside manner and by providing pillows and blankets, food and beverages.  I watched as the over night nurse explained to Johnna what was going on with each of our patients at shift change and then we went about checking on and caring for each of our three patients.

I was surprised by how calm and serene everything was.  No crying or screaming in pain, no blood on the floors and walls, no severed limbs lying around or entrails dangling from eviscerated abdomens (abdomi?).  In fact, there were no trauma patients at all.  Well, that’s not true.  When you hear the word “trauma” you tend to think of violently injured patients in dramatic situations, or anyway I do.  The truth is, a trauma is any injury that is the result of outside forces, as opposed to a medical condition that becomes an emergency.  So knowing that, there were plenty of traumas, but nothing dramatic

I was also surprised to find how quickly it all became run of the mill.  No sooner had the patients left our care than I forgot their names.  The moment I walked out the door at the end of the day, I forgot most of the conditions we treated.  And the truth is, we didn’t treat all that many patients.  In fact, on two separate occasions the third of our three rooms, room 12, sat empty for more than an hour between patients.

When I arrived, the young woman in room ten had been there since 8:00 the night before, hooked up to monitors and with an IV in her arm.  She was complaining  of severe pain in her neck that worsened when she moved.  The nurse would give her an IV pain-killer and the pain would go away for a while and then it would come back again.  There were no obvious, outward signs of illness, but then there often aren’t.  Her vitals were unremarkable, she just periodically asked for more pain medication.  Being the cynic that I am, I considered, more than once, that she was just there for the drugs, but she didn’t look the type.  She was released without any definitive diagnosis and directed to follow-up with her Primary Care Provider (PCP).

The not young woman in room eleven was in early stages of Alzheimer’s Disease and lived in an assisted living facility with her husband who is apparently confined to a wheel chair and insists that she be the one to push him around.  She, apparently, fell while trying to help him in or out of his wheel chair and hit her head on the corner of the coffee table.  She was slow to respond, but we were told by the care facility that this was normal behavior for her (this is called “baseline”.)  I helped clean up her wounds and held her neck in place while the doctor rolled her onto her side to examine her back.  I observed while a technician conducted and Echocardiogram.  There was no benefit to my seeing this, but it’s not something one gets to see everyday (and it got me out of Johnna’s hair for about 15 minutes.)  A CT scan revealed that she had a subdural hematoma, which we learn in class is a serious problem worthy of priority transport to the hospital, (a subdural hematoma is what killed Natasha Richardson)  but no one seemed too concerned about it and she wasn’t showing any signs of being in serious jeopardy.  We monitored her condition while waiting for a room to open up and after a couple of hours of cooling her heals in the ER she was transferred to the ICU.

I was asked to assist one of the other nurses as he was about to clean a patient and change the bedding after he (the patient, not the nurse) had defecated on himself.  The patient had an open head wound and was in a cervical collar which needed to be supported while he was rolled from one side to the other for this procedure.  I was standing at the head of the bed, gloved hands holding his head and neck, ready to give the count to roll the patient when the Doctor walked in.  The nurse explained what we were doing and asked if the Doctor wanted us to wait till he stitched up the wound.  The Doctor wanted to examine the wound and see what needed to happen.  While I was standing there holding the man’s head, the doctor removed the bandage that was taped over the wound and started “digging around” in the wound to see what the situation was.  I was pleased to find that I was not bothered by this and had no inclination to pass out or vomit.  I didn’t voluntarily stand there and watch the whole procedure, (which frankly I don’t think makes me a wimp – like I told my teacher, “I’m not going to volunteer to look at things ‘for fun’.  I look at what I have to look at.”)  Also, I was in the way.  Twenty minutes later they called me back in and I held the patients C-spine while the nurse cleaned the patient and changed the bedding.    When we were finished and I let go of his head again, I had blood on the palm of my gloved hand.  My first time having someone elses blood on my hands…  Wait, that doesn’t sound right.

We had another patient, a 24-year-old, developmentally disabled woman accompanied by her mother.  She’d been seen the Saturday prior at another local hospital and diagnosed with Bronchitis, but she wasn’t getting any better.  Interesting the correlation between not taking the medication prescribed and not improving.  Anyway, this young woman had had her fill of needles and poking and prodding and she wouldn’t allow the nurse or myself to come near her.  She wouldn’t get fully on the gurney and every time Johnna walked in with an IV kit the young woman went into hysterics.  Johnna told the mother that we couldn’t treat her daughter until she was properly seated on the bed and that we had to put in the IV because the Doctor was going to require blood tests and there may be some medications to be administered.  She told the mother we’d come back when the daughter was properly seated on the bed.  For two hours we check back and the patient was sitting on the side of the gurney with her feet on the floor and every time we walked in she watched us warily to see what we might do.  Ultimately, it took four of us including the patients mother to forcibly hold her down and get the IV port into her arm.  She wasn’t happy, but once the port was in she was OK.

There were three “Level 2 traumas” that came in that day.  I assume “Level 2” means more dramatic as previously discussed.  The irony is not lost on me that two of those traumas came in while I was eating lunch in the Hospital cafeteria and the third came in while I was holding the C-spine of the head injured, soiled man.  I have no idea what those traumas were, what condition the patients were in, or what I might have seen had I been in the corridor at the time, but as luck would have it, I missed all three.

I observed a couple of EKGs, something else an EMT does not do.  I cleaned and prepped a handful of rooms, well, three rooms a handful of times.  The fact is, the experience is not the same as EMT work, at all, but it still exposed me to some of what I can expect.  While it was a long day, the first ten and a half hours seemed to go by fairly quickly for me.  It wasn’t until about 5:30 PM when there was a lull in activity and I stopped wandering around that the fatigue hit and my legs started to ache.  I would have given just about anything to sit down, but I didn’t want anyone to think I was being lazy and I was afraid if I sat down, I might never stand up again.  That last hour and a half dragged on and I was elated when 7:00 rolled around.  Elated that I got to go home, but even more so that I had made it through the day without incident and got a little more proof that I am cut out for this job.

~~~~~

Read Part 4 here.

Rode Along

Read part one here.

On November 10th, I did my ride-along with the Oakland Fire Department.  My ride-along was with Station 13 in Oakland’s Fruitvale district.  For those of you who are current with your national (or international) news stories, Fruitvale is where Oscar Grant was unfortunately shot and killed on New Year’s day, 2009.  It is a low-income area with a lot of un or under-employed individuals for whom 911 is the only source of health care readily available to them.

Interestingly, the big fear that I had going into it was that there would be some major trauma and I’d be unable to handle seeing it.  I viewed the ride-along as my opportunity to prove to myself once and for all whether or not it would be an issue.  So as you might imagine, I didn’t see a single trauma all day.  We had nothing but medical emergencies, which, in most cases, weren’t really even emergencies (if you define an emergency as a life-threatening event.)

The first call of the day was a possible seizure which, as it turned out, the Fire Lieutenant said, was probably not a seizure but something drug related.

There was another call for a woman who was in severe abdominal pain and was histerical when we arrived begging us not to let her die.  She had been eating regularly, but hadn’t had a bowel movement in several days.  Abdominal pain doesn’t seem surprising.  I found out later in the day that this patient was a “frequent flyer” who the fire crew knew.  They also knew her to be a chronic crack abuser and apparently, crack stops up the works, if you know what I mean.  Being incredibly uninformed about (and disinterested in) drugs, I did not know that.  I suppose I’m going to have to learn about such things, but to be honest, I’m not at all sure how to do that.

The most memorable patient of the day was complaining of “difficulty breathing”.  The patient wasn’t actually showing signs of having difficulty breathing but it’s not really surprising if he was, given that he weighed in excess of 600 pounds.  Treating and transporting him to the hospital was a bit of a fiasco, but mostly on the part of the ambulance company who didn’t have a bariatric ambulance readily available and when it did arrive the operators on it didn’t know how to work the equipment.  Fortunately, it wasn’t a true emergency because we would have been screwed.

One of my classmates did his ride along with Station 13.  It happened to be the day after the Mehsserle sentencing was handed down and there was some speculation about whether there would be more protesting that day which could have taken place in the area Station 13 serves.  No protesting took place but it seems likely that people were reluctant to go out, just in case.  Whether it was because of that or random chance, my classmate got one call the entire day.  It’s hard for me not to see this as a good thing as calls to 911 mean bad things are occuring, and while we were there to get the experience, someone has to be in distress in order for that to happen.

At any rate, when the first call came in about 90 minutes after I joined the Fire Fighters, the Paramedic on the crew told me in route, “So I’m just going to let you take it and we’ll follow your lead.”

I was stunned.  “On the first call?” I asked.  I had hoped to get to watch them do a couple calls before I jumped in, get a little bit acclamated first.

“This could be the only call you get.  You just never know,” he replied.  I couldn’t really argue with that logic.

Nothing we did in class could prepare me for the experience of working with the fire department on medical emergencies.  We had practiced Medical Assessment a few times in class, but it’s always done by yourself or with one other student.  It’s always done in a calm, safe environment, with a “patient” who isn’t really sick and who isn’t in distress.

With the fire department I was working with four experienced EMTs (one a Paramedic) who all knew what they were doing and were accustomed to getting right to work.    I found that I was not prepared for the situation.  Still being new to the whole thing, I had to think about what was happening, what I needed to be doing and what questions to ask.  The experienced Fire Fighters on the other hand would dive right in and knew just what to do and just what to say and just what to ask, as you would expect them to.  I found that more often than not, they had already done or said or asked everything that I could think of to do or say or ask.  So it would seem I knew the steps, I just didn’t have the confidence or the certainty of what to do.  When I wasn’t right on top of everything they stepped in to pick up the slack and when it was all said and done, it felt, however inaccurately, like I didn’t know what I was doing.

By the end of the day, I was pretty frustrated with myself for not performing better than I did.  Of course I wanted to be a natural and to wow the fire fighters with my impressive ability.  Instead I fell back on old patterns and shied away from the forefront due to my insecurity and lack of confidence in my knowledge and ability.

I asked the Fire Fighters for their honest opinion and by and large they were positive, but they agreed that I needed to assert myself more and be more confident.  Unfortunately, only so much of that can be put on.  The rest comes with time and practice.

I left the fire station about 5:45 in order to get to my class at six and I basically walked into the class just as we were starting.  Little did I know that Mr. Williams, my teacher planned on skills testing that night.  Dispite my fatigue and frustration with my performance and experience that day, I did all of my skills tests except for Medical Assessment and passed every one on the first try.  I was, in fact, the only person to pass every skill I attempted.

I guess that’s enough for today.  Tomorrow-ish I’ll tell you about my day in the county trauma center.

Read part 3 here.

Oh Where, Oh Where Has That Riggledo Gone?

Remember when I used to write a blog?  Remember when I said I was going to make a habit of writing more regularly?  Yeah, me either… apparently.

I spent the last 17 weeks in a strange, other-worldly, vortex in the space-time continuum, in which time flew by while seeming to drag on FOR. EVER.

Gracious!  When you say it like that, 17 weeks, it hardly seems like any time at all, and yet, it feels like a lifetime ago that I started my EMT Class.  Maybe it’s just by comparison to the roughly equivalent time I spent anticipating the class, never really fully grasping the magnitude of what I was about to subject myself to.  I knew it was going to require a lot of work.  I knew it was a significant commitment on my part; returning to school at all, let alone for such a significant undertaking, after so many years.

I enrolled in this class in May, but then there was nothing to do until class started.  I sat around thinking about the class and wondering what I was getting myself into.  When my textbook came and it was more than two inches thick, with over 1500 pages, I thought surely it must be more than one class worth of material.

I knew I was going to have to work hard, but I never imagined how hard.  I had no idea how all-consuming this class would turn out to be.  The first half of the semester was, admittedly, more work than the second half.  Most of the reading, introduction of new information, intensive testing and general trials and tribulations took place before the mid-term with the second half focusing more on learning the skills and learning to put the information into practice.

But the second half of the class also, included the more anxiety inducing tasks of spending 10 hours on a ride-along with the Oakland Fire Department and an additional 12 hours in the County Trauma Center.

Amid all that work and stress, I also had a real, paying job to do and I found myself unable to live up to my usual level of slacking off and screwing around on the computer on company time.  (I won’t lie.  I found that part disappointing.)  As a result, my time to read and write blog posts was significantly diminished and as a result, I have published only 20 blog posts in the last seventeen weeks, which frankly, is more than I thought I had.

The class is over, it ended last Wednesday, and now, finally, I have a minute to breath and tell a little more about it.

~~~~~

Well, anyway, I thought I could.  I wrote several more paragraphs after this but wasn’t able to finish the story in the time I had available to me so I’ve copied them into a draft and I’ll attempt to finish the story tomorrow.  I’ve got a lot more to say.

Read part two here.

Freaking Out

Tomorrow morning at O:dark o’clock (to those of you who aren’t complete morning whimps, that would be 7:00) I have to be AT the County Trauma Center to start my twelve hour day, doing I don’t even know what.  It’s a required component of my curriculum for the EMT Class and so naturally we waited until the very last two weeks of the semester to do this.

I haven’t thought too terribly much about it until now, but now it is upon me and I have to admit, I’m terrified.  When I don’t think about it then, of course, everything is fine, but when I do think about it, I feel sick to my stomach and light headed.  Thank God, I saved some of the Ativan my Psychiatrist gave me a while back to use until the Buspar kicked in.  I’ll defintely need that tomorrow morning.

I’ve never been to this hospital before, and while I found an address on-line and found it in my GPS in my car, I don’t know where the hospital is.  Normally, I’d have done a dry run by now, but I just haven’t had time and I won’t have time tonight unless I do it after class (which I might – although with as much as it’s ranined today, I’m not so sure it can be called a dry run.)

I’m flat broke right now, and it suddenly dawned on me last night that I didn’t know what the parking situation was or if there was a charge.  I called the hospital today and found out that there is a charge, but I spoke with a woman in the facilities department who told me she would validate my parking, if I come see her during her office hours.  That shouldn’t be a problem but if I don’t catch up with her, I’m kind of screwed.

No one has been able to tell me what to do when I get there.  Where am I going?  Who am I supposed to report to?  What should I come prepared for?  Whatever I’m doing, I just pray that it goes better than my Fire Department Ride Along did.

And yes, of course, I know, “it’ll all work out” and I’ll “do just fine” and all that other crap stuff people tell me when I freak out like this, but yeah…  Right now?  I’m freaking out.

Poor, Poor, Pitiful Me

I don’t really know where this is going to go.  I really shouldn’t even be writing right now, but I can’t seem to focus on anything else so maybe this will help clear my mind.

I’m feeling so lost right now.  So many things going through my mind and I don’t know how to sort it all out.  I genuinely hate feeling this way.

~~~~~

My class ends next week.  I have the final exam on Wednesday and I’m terribly afraid I’m going to fail.  I don’t really have a lot of time to study and I’m kind of all studied out.  Thursday I have a twelve-hour shift in the county trauma center as a part of the curriculum for my class and I have no idea what to expect from that.  I’m sure it’ll be fine, but I’m terribly anxious right now thinking about it.  I’m so ready for the whole thing to be over except I don’t really know what comes next and as long as I’m in class I don’t have to think about that.

I feel like everyone’s expectations, including my own, are too high and I’m not going to live up to them and that could be really embarrassing and hurtful, if I fall flat on my face.

~~~~~

Late one night last week, when no one was paying any attention (which is usually when I have – and post – my most pitiful, feeling-sorry-for-myself thoughts) I posted to Twitter, “I wish I could see what you see.”  I only got one response to that, which really was one more than I wanted, but that one response was about the inches of snow on the person’s back patio.  Definitely not what I meant.

I’ve made a lot of connections with people on the internet and those people all seem to like me.  The thing is, I genuinely do not understand why.  I just don’t see all the apparently good things they seem to see.  I certainly don’t see the “sexy” guy some of them talk about, when I look in the mirror.

But those people are all on the internet, they’re not physical beings in my life and with a couple of exceptions, they’re all far away.  Why is it that I can’t make connections with real people, one’s who don’t live in the box on my desk, or the slip of a screen in my hand?  Why is it that I can’t connect with people who live near me?

~~~~~

I had lunch with, Lori,  a friend from work, today and after the course of our conversation lead to how I spend holidays alone, she invited me to come to her family’s house in Modesto on Christmas Eve.  It was a very generous offer which I sincerely appreciated but which I also declined.  I told her that I feel like I’m intruding on other people’s family time that way and that Christmas is a particularly complicated day for me.  I don’t enjoy being alone, but I don’t enjoy feeling like I don’t belong either.

~~~~~

Being alone has sort of become a recurring issue for me lately.  I am really tired of being alone.  But there are so many reasons why I am and I couldn’t even begin to guess at how to change them.  It’s not just that I’m tired of being alone, but I’m tired of being… God, I can’t believe I’m going to say this, but I can’t think of another way to put it… I’m tired of being single.  I’m tired of not having anyone to share my day with and have conversation with and laugh with.  I’m tired of going to bed alone every single night and waking up alone every single morning.  I’m tired of coming home to an empty apartment and cooking dinner for one and cleaning up all by myself.  I’m tired of having no one else to clean up for and putting it off because of it.  I’m tired of feeling apathetic and lazy because I don’t have anyone to be accountable to or for.  I’m tired of feeling lonely and unworthy and unwanted…

And I’m tired of feeling sorry for myself.