Saved - Or, What Its Really Like

Wednesday, June 14, 2006Saved (the TV Show) - or What it's REALLY Like to be a Medic? Current mood: energetic So, I've been asked a couple of questions in the theme of SAVED (the TV Show) and feel the best way to answer this would be through some form (knowing how I tend to express myself) of multi-part exploration of life to date. So, to everyone its going to be either - here it is for your reading pleasure, or here's your turn to scream in agony.What a REAL medic does in his/her day. I'll use first-hand experience. There are so many days to pick from so I guess I'll need to adjust a bit and go for the partner type first and then maybe go into things on an individual basis later on. But, we'll see.Let me describe my close friend Joe (we were partners for the better part of a year, with each describing the other as the best partner we've ever had.)My first day with Joe - We started at 5AM, so we met outside the shop at 4:45 or so. We were working a 24 (one day) together. Joe and I had known each other from lifeguarding at the beach. We seen each other in passing and had seen each other at a few parties here and there. That though was about 10 years before we were ever formally introduced, but we had a general understanding of each other.Some back story. Joe's a smart guy, really smart guy. He's a pain in the ass as well. His philosophy in life could be summed up to be, do as little work as possible while also getting paid as much as possible at the same time. Enviable in certain aspects, in others not-so-much. I guess we each have strong and soft points. I'm perfect, so I don't have any soft points (yeah, imagine that). He's a medic for say 10 years or so prior to this day. Me at the time of our first meeting, 18 years.Today is a day that we are put together because Joe's regular partner bangs in sick. We're staitioned out of a small sub-station in Amityville, NY. We punch our time cards at 5 on the dot, go up on the air (radio) and say we're in the process of doing our starting rig check. (This process involves going through the rig in detailed format to make sure we not only have every piece of equipment the State of NY mandates we have, but also the equipment we're supposed to carry prescribed by our medical director, and finally the equipment we, as medics carry with us for our personal edification.) The basic equipment is: O2, splints, backboards, stretcher, bandages, BVM, suction, light medical kit with tape and airways, sheets, linens, etc, etc. You get the picture. Then the advanced equipment, needles, IV solutions, 87 medications, narcotics/triplicates, intubation kits, etc etc. You again get the picture. Then its personal equipment. For me that meant carrying my own stocked and fully equiped supply bag. It contained everything I knew I'd need in a grab and go format soft sided case. It was used for emergencies and auto-accidents only. The remainder of the time I'd use the cheesy bags the company would supply.The check-out process would typically last about 25 minutes as I said. We'd then radio 'available' and receive our scheduled 'critical transports' for the day. The firm we worked for had been contracted by various hospitals and cardilogy teams to do all of their in-bound critical transports from ICU's/CCU's at smaller surrounding hospitals (which could mean up to 90 miles away) and bring them to the larger heart centers (Winthrop University Hospital and St.Francis Hospital - both on Long Island). Our first 'job' of the day would be scheduled for 6:15 pickup so we could have the patient into the various cath labs or surgery by 7:30.After having received our initial assignment, it was off to breakfast, which typically consisted of either a bagel place or a deli.That first morning Joe and I started at the same time and location along with another crew in another rig. We were assigned to the same hospital and therefore had the same in-bound pick-up times. The sending hospital was fairly local, so we had about 25 minutes to grab a bite and go. Joe and his 'friend' in the other rig decided we'd go to a local bagel place. We wore flight suit type uniforms. Pockets all over the place (legs, thighs, knees, chest, arms, etc.) Most of us kept an IV line and various needles, medications and IV pump tubing, Steth and personal BP cuff, scissors, hemostats, on our person all the times. On a good day we'd start out weighing about 28lbs more than when we arrived because of all the equipment we carried. These flight suits were the all the rage, grey with reflective maroon banding on them. (If I find a pic of me in one I'll post it). Underneath our uniforms we'd typically wear something season dependant. Typically though we'd have a pair of shorts and a tee shirt, or mock turtle neck on, and finally paratroopers boots.So, in we pull to the bagel place. 2 white ambulances with a maroon stripe down the side in a not-so-good section of town. In we walk and look at the counter. The three others (we were crews of 2) got behind me and let me order first. It wasn't an appealing place, but I'd seen worse, (I figured this place was tradition for them). The lone storeowner goes and puts my buttered bagel and OJ into a bag, I pay and turn around to find no partner, no ambulance, no other ambulance. Gone. WTF. I walked outside and looked up and down the blvd. Nothing. - So THIS is how things are going to be? I walked inside and called disptach and asked them to have my rig return to pick up the needed partner.20 minutes later here come 2 ambulances and they think its the funniest thing ever. Hahahaha. I climb in and Joe is beside himself laughing. Its now daylight, so I have my shades on and give him the 'beware' look over the rim of the glasses. We're off to the hospital.At the hospital I get out and say to Joe..."That's 1, you don't want anymore, believe me." To which Joe responds with a chortle and then a general laugh at my expense with the other crew. If he only knew.We grab the patient. Joe's playing medic on this one so he checks my every move. Lines set up right, he reminds me how to bleed an IV line (which I glance at him with a 'DUH' and then follow it with a dirty look. But fine I say to myself, he doesn't know me and there are a few weasles out there.) Joe is acting a little apprehensive (for all I knew though he could've been like this always) because the guy were transporting is getting 180 mgms of Tridal. ( That's liquid nitroglycerin, going striaght into his veins and vaso-dilating anything it comes in contact with. Mind you, the highest amount I'd ever seen given in all my years was 220 mgms. The stuff could stop a bull in its tracks. It managed considerable heart pain by opening the arteries bringing needed blood and oxygen to the heart muscle, the the muscle could get more O2, and therefore stop hurting) He doesn't want that amount of medication interupted even for a second. Fine, I'll deal with Joe later. We'll then play the 'what we know and don't know' game. (for info, we typically carried a 4 channel Imed pump as standard equipment, always mounted to the stretcher).The patient is a little apprehensive about what he's about to go through - turns out a CABG-5 - and starts getting a little chest pain. I'd already looked through the orders while Joe was flirting and find he's able to get as high as 190 mgms, so I up the med a bit and the pain clears. Joe sees me do this and asks what I'm doing. I tell him and he starts to ball me out for upping the meds without him there. I said, "you're getting report, I looked at the chart while you were flirting, then cleared it with his nurse, so get your facts before you speak." He returned an "oh" and gave me the look of 'sorry'. (I thought that one look was pretty cool because we all tend to be the type 'a' of type 'a's.') All the way through the hosp I'm doing my normal thing of talking up the patient and trying to figure a way, or subject matter, that would work to calm them down. Joe on the other hand is always reviewing the passing crowds. He was a flirter. It was always stop here for this or to speak with that nurse. I was fine with that, but I wasn't of the same midset. I was doing this because I LOVED emergency medicine. I got a kick out of it. I got my jollies from it. The sicker the patient the more interesting the call. I wanted to do every single job I could get my hands on. This was the biggest 'issue' Joe and I would have with each other. He'd rather sleep. Since I could NEVER sleep in a rig, down time was torture to me. But I did bring books with me and would be studying for some new medical test, class, or seminar, so I put the time to good use. (I also washed the ambulance which Joe would NEVER bring himself to do.)So, we were off. The drive to the other hospital was uneventfull. Bring the guy up to the OR, drop him off, give a couple of reports, strip the stretcher, get new linens, abscond with some padded chucks (you could never have enough of them), and we left.We go available. Another in-bound job from further out, Stony Brook to Winthrop. Joe grabbed some zz's while heading out to the other hosp. Get to the CCU, the guys fine, no lines to speak of, we grab and go. I'm speaking with the guy as Joe is driving. History, meds, report, report, report (I tended to write allot about each patient because of the ever growing litigious nature of society. I'd always be ordering more continuation forms.) My chicken scratch novel over, I sat and talked with the patient face to face (another rarity in the business. Most medics sit behind their patient in a jump seat and talk to the back of the patients head.) During this conversation Joe has this puzzled look on his face which I see when his eyes cast to the back of the ambulance through the rear-view. I scoot up to the pass-thru door in our van 'bus' and ask why the funky face. He says "you're talking too much." "What?" "You're talking to your patient. What's up with that?" "I always talk to my patients." "Weird," he says.Get to the hospital, transfer the patient over, give report, new linens, hi hi wave wave and we leave. Its now about noon and we're cleared for lunch. Joe gets on the radio and arranges to meet his friends (you remember, the two dorks we started with that morning) to meet at a diner in Farmingdale on 110. So, we go over there and sit in a booth and order lunch.Joe starts into this technical conversation with his friend about medical terminology. They're spouting this and that and laughing all the time. I chow down on my chef salad. I'm starting to get the feeling like they're carrying on with this inside discussion. Almost to the tune of, we're smarter than him and our antics will put him in his place. They then ask the stupid questions, going around the table, trying to stump me. They ask the trick questions on drug interactions, and then launch into a whole diatribe about how you should be able to use morphine more heavily in conjunction with pressors, turn to me and say, what do you think. I said, 'Sure, sounds good." They start to laugh like hienas....until I interject "that is of course until you consider the contraindications, let alone the admonition from our medical director, or for that matter prior clearance from the attending. Then its just a flat our STUPID idea in that setting. (score one dropped jaw for me). They needed to shake that one off.Then it became the very quick but intense battle of "I went to this college and worked under him," game. Around the table they went. Smirking, they get to me. Where'd you learn. I answered with "give me a time frame gentlemen and I'll list them all for you, but understand this, I've been at this a lllooonnnggg time." Then, intrigued, they compared cert numbers. "Lowest number doesn't have to pay his portion of the bill." I retort with "Thanks guys, lets do this again." Stunned, they say "prove it." Which I do.Then the looks change a bit. They want to querry me on science. Politics, current events. We sat there for an hour. By the end of this initiation, I'd been granted entry into their 'club' of sorts. Little did they know how much of a mistake that would be.Joe and I spent the remainder of the day handling emergency jobs in private homes, nursing homes, transports between hospitals, transports into the city. He was exhausted. By shifts end we'd done 22 jobs and we didn't sleep at all (other than for a few zz's while one drove).As we handed off our rig to the next 24 crew, Joe turned to me and said, ya'know, you're not that bad to work with." I returned the gesture but added "remember, you still have 1 strike. 2 more and the shit is going to fly hard and fast." He looked puzzled and then got this impish grin as if to say, "I'll work on that in 2 days when we're back together during our 12 hour tour." stay tuned, more on the real medics, Joe and a typical day.