To the Iraqis!

I am amazed at the bravery of the Iraqi people. Against all naysayers here in the U.S., and Europe, against all odds in the Arab world (talk about peer-pressure), facing the known threat of suicide bombers at polling booths, they came out to make their purple mark in casting their vote and letting the world know that they want freedom. The rest of the Arab world has to be peeing their pants that such a phenomenon is taking place. "Allah" forbid that a Western idea like democracy ever be considered an option. Iraqis have now twice proven that they are capable of exercising democracy. Sure it isn't perfect, but when has democracy ever been? And when is the last time we've had close to an 80% turnout for elections? The word "politician" has such a negative connotation here in the States. "Statesman" is never used to describe any of our representative officials these days, but how about these Iraqi politicians? They go out on the campaign trail with bodyguards knowing that someone is probably going to try and kill them, and many have certainly died trying to run for office. Can you imagine your state rep running for office and getting blown up by an IED while on the way to your house to ask for your vote? Those Iraqi politicians are brave men and women, and I cannot wait to see what kind of statesmen they will be. They are birthing a new nation, a huge burden, and it will certainly be tough, but the world hasn't seen this kind of resolve for freedom in a very long time. So tonight when you go out, lift up your suds for a toast to the Iraqis. Cheers!

Spinal Tap

Just got off my first ER shift, and all I can say is... Holy blood draws! I lost count of the IV's and blood draws I did. It was a fairly slow night in the ER so we were pretty much just helping out the Nurses with IV's, and doing physical assessments with the Docs. There was only one trauma patient tonight who came in with 3 GSW, (gun shot wounds), one in the lower back, one in the right bicep, and one right above the knee which went straight through his femur causing obvious deformity- his leg was at a right angle when he came in. I was hoping to get a chest tube, but it wasn't necessary as the lower back wound didn't penetrate the pleural cavity. The highlight of my evening came when one of my patients presented with a stiff neck. She had no fever so I figured it was probably simple musculoskeletal aches and pains, but the Doc wanted to be absolutely sure it wasn't meninigitis, so he called for a lumbar puncture in order to see her cerebral spinal fluid. Guess who got to perform the procedure- moi. I located the iliac crest, found my plumb line for L4 (lumber 4) and inserted this huge needle/catheter into this lady's lower spinal column, and retrieved some spinal fluid. Once it started dripping out of the catheter, I could tell it was normal, it looked like water. It was so cool! Doc Rob was impressed with my confidence and aggressiveness, as most interns trying that for the first time are pretty scared. As a matter of fact, the young intern assigned tonight was making fun of me b/c I was having trouble with some of my IV's, but had no problem with a lumbar puncture. She claims to still get quite nervous with those. Oh, I love medicine! So, there is my first day in the ER. More soon.

Quote of the Week

"There is no room in this country for hyphenated Americanism."

-Theodore Roosevelt

The End of the Ambulance Runs

24 hour shifts every other day... I am exhausted to say the least. It was snowing again this morning so I eagerly went out for a walk and then some coffee and a good book at Starbucks. Gingerbread latte- delicious. It gave me that nostalgic feeling of Christmas which I just haven't had time to enjoy yet. We have been ridiculously busy, and it has taken its toll, but it has come to an end at last. Now we'll go to the Virginia Commonwealth University hospital for clinical rotations, ER is first. The schedule will be 12 hour shifts Mon-Sat, half graveyard shift and the other half day shift. I am looking forward to a change of pace. The ambulance shifts were great, but there were a lot more BS calls than actual emergencies, which was disappointing. It amazes me how some folks will just totally waste taxpayer's money, and valuable resources on such petty nonsense. I won't go into it, as it frustrates me. Overall, it was a good training experience, I learned a lot from these awesome firemen/paramedics here in Richmond. Coming to a scene and being able to take charge was probably the most important aspect I learned. Crazy stuff happens out there, and it was great to be ready for anything, and respond to chaos. I love chaos. I'll depart after this weekend temporarily for Christmas leave and come back on the 4ht of the new year. Still not sure where I'll be for Christmas as most of my family no longer has a house, but I think my cousin may come through for us, we'll see. My dad is still cleaning up and just beginning to rebuild in Waveland, MS. Sorry it's been so long once again since I last posted, but sometimes work is just too overwhelming.

My First Ambulance Run

I walked into the Henrico County Firehouse, Engine No.5 at 0630 yesterday morning not really knowing what to expect. The only instructions I had been given was to make sure I kept track of any procedures or treatments that I do, and have the paramedic on duty sign off at the end of the shift which would be 24 hours later. I was also told that if I am lucky enough to get some shut eye that I would need a sleeping bag because Firehouses are notorious for keeping their sleeping quarters cold. I had packed up my backpack pretty full with a variety of articles- workout clothes, protein powder, my ipod, Anne Rice's new book "Christ the Lord: Out of Egypt, my Bible, some cash to pitch in for Firehouse chow, stethoscope, shears, some quick-reference emergency care handbooks, a headlamp, and of course my pocket knife. I was dressed in some ugly faded black cargo pants issued by the army for rotations, a black SOCM Medic T-Shirt, a XXL Navy blue Jacket with an EMT patch on it (also issued to me by the Army), and my hiking boots. If any of you know me, I am not a large-framed fellow so that Big and Tall jacket swallowed me whole, and I looked absolutely ridiculous, but orders are orders. As soon as I walked into the side door of the firehouse, my roomate Derrick, who had the shift the previous night, was walking out and immediately stopped me stared me dead in the eye with the most alarmed expression on his face after giving me a quick once over, and said, "Dancing Jake- you gotta get rid of that jacket, they are gonna give you shit all 24 hours man. Trust me, I am gonna burn mine when I get back!" I about pissed myself laughing at the dire look on his face, and he finally loosened up and followed with a roar of laughter realizing the hilarity of his urgent warning. Anyhow, it was just the stress relief I needed as I once again headed into the unknown. I immediately ran back to the van and pulled out my handy dandy North Face Denali jacket and switched it out, waved goodbye to my buddies who were waiting to either get dropped off at the next station or were coming off last night's shift, and then headed back inside.

I walked into the firehouse and on my left were the trucks, one EMS Advanced Life Support unit, and one Fire Engine. To my right was a small but sufficient workout area complete with a tread mill, weights, and a couple machines. I looked across the garage and there was a door marked "sleeping quarters" and a door with a window where I saw some fellas shooting the bull, and drinking some coffee. I approached the door and made my entrance. A tall, older fella standing arms folded and stern immediately turned, looked at me and said, "Well, who the hell are you?" I fired back, "I'm Jake 'Last Name'- who the hell are you- sir?" He was immediately disarmed I suppose, because his stone face wrinkled to a grin as he then approached to shake my hand with a huge chuckle and said, "Captain Lane, of Engine no. 5, you must be another one of those Special Ops guys huh? I'm your supervisior for the next 24 hours." And of course I replied, "That's right. It's good to meet you sir, I'm reporting for EMT duty so I'm all yours."

I was then introduced to the rest of the fellas who were both coming in for work and a few who hadn't left yet because they were sharing about their calls from last night. Apparently, it had been a pretty busy night last night because all they could talk about was that "multiple stabbing" they had. Derrick had apparently done an excellent job in treating and evaluating the patient under thier supervision so I had a big show to follow. It got me excited and I was a little jealous, but I knew I'd get my chance. The fellas ranged in age from mid-twenties to upper-forties and seemed like a pretty decent group of guys. They immediately thanked me for not shameing their Firehouse with one of those horrendous GI-issued EMT jackets that my buddy Derrick had worn yesterday. I told them that I would have never dreamed of getting caught in public with that thing. ;-)

After a couple hours with no calls we started to do some chores around the station, and the paramedic in charge of me, Brent, got me familiar with the truck and protocols. Brent showed me how all the equipment worked, the airway kits, the AED, the Adult kits and then the Pediatric kits, which he said we would probably never touch. How wrong he was today. Our very first call was a motor vehicle accident involving a school bus loaded with about 30 kids and a sedan with two passengers. We arrived on the scene within 5 minutes of the call, and it was crazy. Kids were just on the side of the road screaming and hollering, and teachers trying to calm them down as the accident happened about 200 yards from a local elementary school. We immediately got out of our truck and approached the scene and looked to see if anyone was in need of critical care. After being statisfied that everyone could move on their own we directed the students to go towards the school where we got them into a classroom to triage them. Two students were having trouble breathing and about five others said their neck and side hurt. We then directed the rest who were okay to another classroom, and began surveying each of the students with complaints. We packaged the kids who complained of neck pain with a C-collar and long spine board and then checked out the otehrs to see if there were possibly any signs internal injuries. The two who had trouble breathing seemed to be hyperventilating due to being scared, but their airway was in no way compromised. Anyhow, to make a long story short, we brought them to the hospital. Our truck had the bus driver and a twelve year old girl. Th bus driver couldn't move her arm, so we suspected a possible fracture, but she didn't seem in too much pain. The little girl was one of the hyperventilators. I was in charge of the little girl and basically just gave her some oxygen took a set of vitals and tried to calm her down. She eventually calmed down and was breathing normal at the hospital arrival. That's about it for my first run. We also made the local evening news and were filmed putting our patients into the truck. As for the rest of the day and early next morning we had three more calls. One 1o month old baby who was having a seizure, one 12 year old boy who was feeling really weak, and one 75 year old woman who had fallen. The baby ended up being fine and was not having a seizure, but the two very young teenage parents were scared as their baby was "vomiting white stuff". Her temperature and vitals were fine, and it seemes that all she really needed was to be burped after being fed her formula. The 12 year old was diabetic and had taken too much insulin thus causing him to become hypoglycemic. We simply took his blood sugar, and after determining it as low, gave him some oral glucose, and his mom fixed him a PBandJ sandwich which got him up to par in no time. The elderly lady was fine, but scared, and was just given some oxygen to calm her down. I'll be posting more as I get it. Hopefully, we'll get some more exciting stuff next time.