7.28.2004


I'm looking at some of the other blogs that I read and thinking, "Man, what's up? They haven't written in a while!" Then I realize I haven't written in over a week! EEP! Sorry, all!

I had duty last Friday night with a different crew than I had last Monday. A good bunch. I had 2 calls but nothing too exciting. One was a car accident in a parking lot where the patient did not want to go to the hospital. She was restrained in the low-speed collision and her only complaint was her knee where it hit the door. Ice pack and a promise to call 911 or go to ER if she felt pain anywhere else. Of course, I gave her a full examination, including neck palpation, checking for orientation and vitals. All normal.

The other call was the bass player of a band at a local bar stepped on a piece of glass and produced some rather dramatic bleeding. Fortunately for her there were a few nurses and EMTs at the bar who treated her foot pretty well. By the time we got there she had a really nice dressing made up of cocktail napkins and a table cloth. It was stable with no bleeding through. Her vitals were completely normal, she was alert and oriented and she was joking quite a bit. We loaded her and transported. Her son (about 9, I guess) came along for the ride and he LOVED it. I had him checking her pulse, listening to heart sounds and even pumping the BP cuff. I think he was the most tickled when I asked him to carry my jump bag on my way to the ambulance.

Ok, I'm headed to a summer camp for the day to help out and have fun with a bunch of kids with neural cancer. Herself and I went there last Sunday with a bunch of books and we had a big read-in. There's something really cool about 30 kids in a cabin on a rainy day with their noses stuck in books. Not a single peep, each one of them engrossed. Cool! Today, if the weather permits, I'm taking a gang of them canoeing, kayaking and maybe even swimming.

Woo Hoo!

--maddog

7.21.2004


It's just about time for me to think about heading home and, yes, the alarm goes off again. 33 y/o male c/o (complaining of) breathing difficulty and chest pains. This one is over in the next jurisdiction too.

I head for the ambulance and find that Zach, my neighbor's son, is my driver. Cool. This time out the door, I give my old ambulance number on the radio as I report us responding. Our radios have a transponder signal that are unique for each unit. I realize this and I imagine the dispatcher seeing one number on the CAD system and hearing another over the radio. I quickly repeat my transmission with the corrected unit number and I can hear the smirk in the voice of dispatch as they confirm.

It was bound to happen.

The station who's area this call is in has sent an engine and a Medic unit is on the way. I walk into the house to find a guy my age sitting on the stairs holding his chest and looking pained. Pretty clear signs. One of the EMTs from the engine has taken vitals already and they're all within norms. Skin is warm and dry, pulse is 94 and strong (little high) and respirations are about 24 and regular. The guy has no previous history of chest pain or trouble breathing and he's answering my questions perfectly without having to pause between words for breath. His color looks good too. Shit! This guy's no older than me! I resolve, at that moment, to boost my weekly running distance to 30 miles.

Pain is 5 on a scale of 1 to 10, does not move or radiate and locates mostly in the right side of his chest. Equal pupil action, clear lungs, all lobes, normal digestive noises and both eyes orient and track equally to voice. This last bit I picked up busting drunk and high boaters. I'll ask him a question on one side and then move over to the other side of the patient to check a BP cuff or something innocuous and then ask him another question to see how he tracks. Bouncy eyes or unequal movement will give me a clue there may be something going on in the brain pain and help guide my questions and examination.

The FF/EMT from the Engine looks at me, "Cancel the Medic unit?"

As much as I hate to (I believe in all ALS, all the time), I say "Sure." and she does so via her handheld radio. The hospital is about 3 minutes away and this guy is presenting no other signs or symptoms.

SIDE NOTE: How many of you out there are comfortable with BLS providers making a decision whether a patient need ALS care or not? email me or use the comments link at the bottom of the entry.

There are 2 teenagers home and nobody else. I ask the patient if he wants them to come. I tell him I can take one of them and his 15 year old daughter opts to come. The patient walks well and without assistance to the door and we put him on the stretcher for the 25 yards to the Ambulance.

We install the stretcher and I get the daughter to belt in. I see the daughter's anxiety rising and she starts unconsciously sucking her thumb. I start asking her about school and keep her talking as I retake dad's vitals and work on paperwork.

Transfer is smooth and courteous. The triage nurse is bigger and taller than me but he pauses to talk to the daughter for a second and then guides her to a waiting room while he orders a 12 lead and blood work. As I step out I hear him tell an orderly to get her a soda. I look back and the expression on his face mirrors how I'm feeling. Compassion. This is her dad. This is scary stuff for her.

I clear my paperwork as Zach sets up the stretcher and ambulance for the next run. I take a minute to go to the waiting room to talk to the daughter. She looks small and alone but she's got a brave face. I take a minute to tell her what's going on in her dad's room and to assure her they're not hurting him. I also tell her that it probably means a lot to her dad that she's there and to show her how to get a line out to call her brother.

She thanks me as I head out. I apologize to Zach for taking so long and tell him why. He says, "No problem. That's what you're good at."

Music to my ears.

--maddog

"lub-dub, lub-dub, lub-dub, hello?, lub-dub, lub-dub, lub-dub, Hello?, lub-dub, lub-...

First night at the new firehouse:

I arrive at 7pm in uniform with the patch from my old station still on my left sleeve. I am greeted by a group of people in a friendly way. "I'm the new guy." I say.

"You're the new ambulance officer?" they ask.

"Yep, sick, bleeding, ill or injured. Bring 'em on!" I say.

"Hell!" Says one, "I'm gonna buy you dinner!"

More of the same sorts of welcomes. Nice way to start! Deputy Chief (We'll call him Jake) arrives a few minutes later and we get right to business. He gives me the written test for ambulance officer and gives it to one of the firefighters too. This one is considerably different from the test I took at my old station. For starters, there's an actual written test, it has a LOT of patient care questions and seems to be focused on ensuring the person riding the ambulance is ready to treat patients and knows where to take them.

During all this I notice how clean and orderly the ENTIRE station is. Even the crew lounge is a clean and pleasant place to be. My neighbor's son (we'll call him Zach), who lives at the station, gives me a tour of the place.

After passing my Ambulance Officer test (1 question wrong, I blanked on the normal blood pressure for an infant), I was entered into the log as approved to ride on the Ambulance. I proceeded to set up my sewing machine, remove my old patch and put on a patch from the new station on my left sleeve. Other members began to offer me money to sew their patches and hem pants. I think I earned a lot of brownie points by offering to do them all for free. I'm going to have a busy duty night next time!

First call comes not too much later. In fact, I was in the lounge talking with one of the members about my transfer and how much I like medical and trauma calls when the bell rang for the ambulance.

76 y/o Male with loss of sensation in his left hand. Call goes out as a possible CVA (stroke). The address is a managed care facility next door to the hospital. It's a recovery facility for patients released from the hospital next door. It's not our jurisdiction but, the company that covers it has no ambulance due to mechanical problems or something.

That company has dispatched their brush truck with a pair of FF/EMTs who are there when we arrive. The patient is alert and oriented X3, Hx (History) of Congestive Heart Failure (CHF) being treated for pneumonia most recently and a medication list longer than my leg. He's a good sport and responds well to my questions. The other station's people are already getting vitals so, I get some history from the nurse and the patient. His face has no droop, he speaks with no trouble, and has no other complaints except the numbness. We load him up for the 100 yard drive to the Emergency room.

My ambulance doesn't have an SaO2 meter and the one the other company brought doesn't work. I take his pulse and respirations manually and notice something I've never seen before. He's got no pulse ever 4th beat! I check his other wrist and get the same thing! Wow! 3 good, strong, steady beats and then one's missing! I note it in my patient care form and we admit him to the ER.

On my way out, I run into a medic who's restocking his ambulance and I ask him about it. No other signs, Hx of CHF, what pulse is there is steady and strong, patient has no altered mental status and complains of no pain other than the numbness in the arm.

"Secondary blockage, sounds like" he says. and then proceeds to explain how sometimes the action potential or nerve impulse cannot perfuse properly through the heart muscle and it doesn't fully contract. It was really cool of him to explain this and I could tell he's "into" the science of the medicine. The really awesome part is that we covered the science of it in my Anatomy and Physiology class the very next day! w00t!

I had another patient that I'll write about later.

--maddog

7.19.2004

Firehouse transfer update:

I sent and email to my "New" chief last night to let him know I was interested in coming over. I got an email back from him THIS MORNING welcoming me aboard! He also said he'd have his deputy chief contact me about making arrangements to come on by.

Well, the deputy chief called me about an hour later. I'm going in tonight to get all set up and my duty night is now Fridays!

How efficient! I love it! Things already seem to be running better than they did at my last station.

Awesome! Maybe I'll even get some calls tonight!

--maddog

I reached Ms. K.. All is well. Perhaps I am too much of a worry-wart. I had told her of my fear and how much I care for her.

She had meant to say she might not make it next week for some bizarre and outlandish reason. She is clearly not suicidal in the least. She also said that my concern makes her feel "fuzzy."

*WHEW!*

I'm going to go get myself worked up over something else now.

--maddog

Am I worrying too much?

Every Sunday night, Herself and I gather with friends for Sunday Dinner. We usually watch a movie or good TV show afterwards. Lately, we've been watching the second season of "Six Feet Under".

On of my dearest friends, Ms. K, expressed a dislike for the series tonight even though we've seen a bunch of episodes already. As we were saying our goodnights and noting who would be coming next week, Ms K. says to me in an almost private way that she might not make it next week. I ask her why.

"I might have gone and done myself in."

I ask her what does she mean as my heart skips a couple beats

"You know, like the people in this show." she says, indicating the television with the closing credits to the show we just watched.

"Yes, but doing yourself in implies a certain amount of involvement on your part." I say

"Yes, well, you know.." she says and we all go our separate ways.

Now I'm all bunched up in knots. In high school, a classmate of mine had glibly remarked about killing himself one Friday afternoon. The following Monday we all found out that he ate his father's shotgun over the weekend. Am I making too much of this?

Ms. K. is an intelligent, confident and together person. I love her dearly. She is one of my closest and dearest friends. I might be overreacting but I'd HATE to be wrong. She's never made any other indications or given any signs of suicide. She's generally happy. She's also very private. I am fraught with worry.

I've left her a couple messages to call me but perhaps I should tell her my concern. It might be best for me to remind her how dear she is to me and how frightened I am for her. Again, I may be totally overreacting and I certainly hope I am.

I'm still sick to my stomach.

--maddog

7.18.2004


Firehouse transfer update: Progress!!

My "exit interview" with my chief went very well. He doesn't know me very well. We haven't had much chance to interact so, he went to the officers and told them I was asking to leave, and if they had anything to say about it. To my surprise, one of them said, "Damn! Maddog? He's always in uniform, always got his shit together and he knows his stuff. Why does HE have to leave?"

I'm delighted that I'm well thought of. I'm sure that if I had known it before I made my decision to leave, I would have thought differently about transferring. In any case, I'm happy with my decision and am looking forward to shifting over.

During the interview, Chief asked me why I was leaving. I decided that it was for the best to not tell him my gripes. He's recently made chief. He's had the position before and is well respected. I see that he's already making positive changes and I don't want to sound like a whiner on my way out.

If I were to stay, I would bring up the issues and stick around to help with the solution. As I am leaving, I don't want to burn bridges and I don't want to be a complainer without offering to help fix the problem. I told chief the basic truth. I want to move to my hometown station because I want to serve the community I live in. The station is closer and I'll be in my hometown. Simple enough.

Chief saw this as an excellent reason, told me he'd personally call the chief at my hometown station and give me an excellent recommendation and then he invited me to come back and ride any time. That was nice. I left there happy and eager to get moved in to my "new" station.

--maddog

Campus Law Dog

My friend, Lips, has put up his blog. It promises to be excellent. I've heard him tell of a typical day at work and it can only lead to an excellent read. His blog is in the blogroll on the right of the page. I'll call him by his blog name from now on, CampusLawDog, or CLD. If someone in the Coast Guard ran a lot of Search and Rescue (SAR) cases, we refer to them as a "SAR Dog." Likewise, if that person runs a lot of Law Enforcement boardings or is particularly good at getting busts, they are often referred to as a "Law Dog." I think the name is an appropriate mix or CLD's Coast Guard heritage and enthusiasm for making people miserable.

He wasn't too happy about the "Lips" nickname and he trotted out a few of mine from out time on the water together. You win, CLD. I'd just as soon leave it at that. Heh heh.

Firehouse transfer update:

My old firehouse called me in today to cover the ambulance. I did and had no calls :(. Our ladder truck was at a funeral and most of the station crew was there too. I contacted my Chief and I'm going to be meeting with him in about 15 minutes. YAY! Now I can start running calls at my hometown station.

Cya all later! And be sure to check out CampusLawDog's blog.

--maddog

7.16.2004

"Language is a virus..." and, apparently, so is blogging...

I have a really good friend who worked with me the last time I was on active duty in the USCG. He's a reservist like me. He's had a LOT of experience at sea, in the surf and in "the shit" as an active duty Bosun's Mate. He's competent, knowledgeable and I'd go to sea with him any time, any where.

His civilian job is a police officer at a major university. By consequence of the university's location, he's actually a local, fully empowered, municipal police officer who's jurisdiction happens to the the college campus. This saves him from having the horrible "renta-cop" status that many small campus police officers have.

Weekly, he calls me with stories about the crazy things he encounters in his job. I'm a college student and I can't even imagine the crazy stuff he tells me. He also reads my blog. He's one of the very, very few readers who knows who I am. Hell, he knows me better than most people. I owe him my life and, I'm sure, vice-versa.

He's kind of a skinny guy with a big head but, strangely, he has perfect kewpie-doll lips. Women spend a lot of money to get the kind of lips that appear on his sea-worn weather-beaten face. So, Of courese, I shall refer to him as "Lips" from here on.

He's decided to start blogging. I think it's an excellent idea. The only roadblock is that he can't come up with a good name for his blog. I've suggested, "Campus Cop, College Cop" and even "University Uber-cop" but I don't know what's taken out there. He still can't decide on a catchy one and has asked me to help.

"You're the artsy creative one, Maddog. You figure it out!" Lips says to me.

We bicker as if we've been married for 20 years. Yah, we do this all the time.

I appeal to you, my loyal readers (yeah, BOTH of you). Help me out with coming up for a name for my friend's blog. I'll link to his blog from mine and, I assure you, it promises to be great stuff. Lips is counting on you. Use the comments link below or email me with suggestions.

-maddog

7.15.2004

Backlash

Finals, Funerals, Moving and other madness have all conspired to wear me down. I haven't had a full night's sleep since Saturday (my cat is not too keen on his new digs and is sure to let everyone know at midnight, 2am and 4am) and now I have one of those hideous colds with wet coughs, drippy nose and general misery. I believe the British call it a "streaming cold." That's about right. My nose is a waterfall.

Bleah!

I'm hoping to accomplish 2 things next week that will make my blog more interesting:

1. Finalize my transfer to my home station and start pulling shifts there (gotta do this right).
2. Get a job at the private ambulance company and start working with Peaches.

The latter should be pretty interesting because of the people that work there. If you call the main number, the outgoing greeting says, "Thank you for calling XXXXXXXXX ambleeyance company..." I love it! That's a trademark of my state. The word ambulance is always pronounced "Ambleeyance" by the locals (imagine a lot of nasal tone in the pronunciation). There were times when I felt like getting on the radio after being called, "..Communications to Ambleeeyance XXX..." and saying "AMBYEUUULANCE!, Dammmit, ambUlance!!" but I just grind my teeth and laugh bravely.

..is that anything like "newculer vs. nuclear?"

Off to school with me!

--maddog

7.12.2004

One final down....2 more to go.

We've moved in with my parents while our "new" house gets remodeled. We've done this before. Now, I just have to pass my A&P Lab final and practical tomorrow.

As of last week, Peaches was ahead of me in the Lecture class by 1.2 points and I was ahead of him in the Lab by 2 points. We're running this contest through the end of the second session which starts tomorrow.

The lower score has to take the higher score to dinner and the lower score has to wear a dress.

Awesome!!

On to study!

--maddog

7.09.2004

I'm back!

I have returned from the funeral. Uncle John was waked in true Irish style. We drank and told stories until 5am. Ow!

Today I sell my house and buy another one. The "new" house is a wreck. Herself and I will be moving in with my parents until the "new" house is finished with the renovation. Tomorrow we move most of our stuff to storage and the dog, cat and ourselves to my folk's place.

Sunday, I'll be cramming because I take my finals on Monday and Tuesday and then start the 2nd summer session.

"WHEW!"

Somewhere in there I need to find time to get transferred to my "new" firestation. It seems my chief has agreed to facilitate the transfer and has notified the chief at my hometown station. Yay!

I noticed a lot of you reading (over 100 in the past week). Not much on comments or email, though. Everyone on vacation or am I just hella-boring? Hopefully, things will settle out a bit and I'll have more EMS-related entries. I have applied to a private ambulance company as a part time dispatcher and EMT. They have a very flexible schedule and the office is right near campus. I've pretty much got the job but I have to go through all the HR stuff.

I'm surrounded by boxes and bare floors. My dog has been permanently anxious. Perhaps she thinks we're going to move and leave her behind. Poor pup.

--maddog

7.06.2004

Memories of Uncle John.

Here is, quite possibly, the last picture taken of my Uncle John Monaghan, Jr before his death. This was the Monday after Father's day and he gave my father, brothers and I a personal tour of the USS Constitution, where he worked as a rigger and craftsman.




That's my oldest brother to the far left (back to camera), my Uncle John in the yellow hard hat, My father to the right of him and my middle brother on the far right looking up at the fighting top of the mainmast. What a day that was!

I head out for his funeral this afternoon. Uncle John was healthy, happy and loved. We all should be so lucky.

--maddog

7.02.2004

Maddog blackout again...

Herself and I are taking the dog and heading to the mountains for the weekend. No internet access there. We'll return Monday night, I'll take my Anatomy and Physiology test on Tuesday and then get on a plane for my Uncle John's funeral in New Hampshire. I'll return on Thursday, sell my house on Friday and move on Saturday. Monday sees me taking my delayed A & P finals and I start the second session on Tuesday.

There's so much going on I can't find time to write but there's so much going on I feel the need to do so even more strongly.

Thanks for the comments and emails of support. Keep 'em coming. I'm finding it more and more difficult to be the supportive solid one for my family. This is the first time my mother has lost a sibling. I have nightmares about my brothers dying so, I can only imagine her anguish. My extended family is extremely close and we'll be descending in a horde on New England next week. It will be wonderful to see all of them but for such a terrible reason.

"....steady on, Maddog. Steady on...."

--maddog

7.01.2004

...and so we commit their bodies to the deep... (Again, dammit!)

Uncle John loved his job. He loved his family too. He owns the cabin and boat where I went sailing with my father and brothers. He also gave us a tour of the USS Constitution, the ship where he worked as a rigger and craftsman.

Yesterday Uncle John fell 75 feet from the mainmast of the USS Constitution to his death. He was 55, healthy, happy and doing what he loved. I'll miss him horribly.

We had spent a weekend drinking too much, staying up all night, sailing all day and, as we were heading back home, he proudly showed off where he worked. He left his high paying job as a chemical engineer and took a huge pay cut to pursue his dream of working on square rigged ships. The last time I saw him, he was gearing up to go aloft and I could tell he was happy as all get out.

Fair winds and following seas, Uncle John.

--maddog