My own Skywatch Friday....

Hey David, this one is for you.

Here Comes The Sun (February '08 Epijunky)

Yeah, school was canceled that day :)

Five Years and Two Words ago... Part III

I got my first denial from Cigna about a week after my consultation.

The staff at BTC had warned me about it. "Everyone gets denied the first time. Be prepared for it."

I wasn't. I had read and reread my health insurance policy. It stated that the procedure would be approved if my BMI was over 40, or over 35 with a comorbidity.

Mine was 43.8. AND I had hypertension, which counted as a comorbidity.

To their credit, Cigna spelled out exactly what it would take to get an approval. I was not above jumping through their hoops. I was determined.

**********

First things first. The Sleep Study.

The accommodations at the local hospital were actually quite nice. My room was set up like a hotel room. It was private, I had my own bathroom. There was even a lovely painting on the wall. My window overlooked the Doctor's parking lot and the local Walgreens.

My first bit of advice for someone going for a sleep study. Bring your own pillow. Seriously. Unless you like those crunchy plastic encased delights that the hospital supplies.

Then they hooked me up. Literally.
Every single one of those wires got attached to me. On my scalp, my face, my legs. It was great fun trying to get comfortable in bed. It was even more fun trying to fall asleep at 9pm when I'm used to going to bed much later. I would have sold my soul for an Ambien.

It was quite possibly the worst night of sleep I've ever had.

Have you ever tried to sleep with a nicotine patch on? I don't recommend it. If you're attempting to do this in the presence of someone with a video camera, I ABSOLUTELY discourage it. Pseudo Dad once told me he wished he a way to hook my brain up to the TV when I slept with one of those on.

When all was said and done I found out I had moderate Obstructive Sleep Apnea. I stopped breathing on average 60 times an hour.

I guess that explains why I'm tired all of the time.

I became the proud owner of my own CPAP. Complete with heated humidifier.

**********
Providing Cigna with proof of my past weight loss attempts was easy. I had close to eight months of Weight Watchers documentation. I had over 40 pages of charting from my medical records listing my weights. I had never been so glad that they had taken my weight at each appointment.

Proof of all of my attempts and failures. Proof of how weak I was. In black and white.

**********

Two hurdles down. Bring on the last one, the Shrink!

I would have to say that my favorite part of the "hoop jumping" would have to be the psych eval.

They gave me a 600 question "survey" to complete. It took me almost two hours to complete.

How many different ways can they ask if you believe that cupcakes are following you? (The answer is 42, by the way.)

Even more educational was the hour long talk that I had with the extremely handsome Psychiatrist.

"You're an emotional eater. Pretty soon you won't be able to use food as a crutch. How do you plan on dealing with stress once you've had the surgery?"

Shit. That's a good question.

"Epi... Many of my past Gastric Bypass patients have turned from one crutch to another. Sometimes alcohol, sometimes drugs, sometimes sex. Marriages have been destroyed by this. How are you going to cope with stress?"

I really don't have an answer for that.

"Well, that's something we're going to have to work on, isn't it?"

**********
Next up, the surgery and the aftermath.

And maybe a few pictures. Maybe.

A little bit of my soul...

I lost a little bit more of my soul today.

Today I took a wonderful gentlewoman to a Doctor's appointment.

To get her toenails clipped.

Hand to God.

Five Years and Two Words ago... Part II

So when I left you yesterday I was telling you how desperate I was.

I wish I could post a picture of myself at this point, but to be completely honest, I just can't bring myself to do it. It was bad, folks.

I'm a tall girl, I had that in my favor. But even at 6'1”, 330 lbs is... Well, it's big. I remember watching a football game and realizing that I outweighed a lot of them.

So I found myself in the offices at Bariatric Treatment Centers in Ypsilanti, Michigan (now called Barix, the name just hasn't stuck with me yet). I was going to meet my potential surgeon, Dr. P. I was nervous, and rightfully so. I was preparing to hear how someone was going to cut me open and rearrange my insides. The only thing that calmed me was realizing that I didn't fill the double-wide chairs that furnished the room.

I know how ridiculous and pitiful that sounds.

“Epi?” A nurse was hailing me from the receptionists desk.

I inhaled and stood from the double-wide wooden chair. It let out a sigh of relief when I got up

“Welcome, Epi... How are you doing today?” The Nurse was warm and inviting. She squeezed my arm as she led me into an exam room.

“I'm pretty much terrified.”

"There's nothing to be afraid of...Here, let's get a quick weight on you first...”

Oh for the love of Christ.

Nothing knocks the last shred of denial out of a potential patient quicker than facing what they hate the most. The dreaded scale. I kicked my shoes off and emptied my pockets out. I stepped on the scale and looked away.


“Three Thirty Two” The Nurse read cheerfully.

I wasn't feeling nearly as cheerful. I wanted to die. At that very moment.

How in the hell did I get to this point?

“How about we get your BP while we're at it? Hey, Epi, are you okay?”

Tears were stinging my eyes. I couldn't force myself to speak at that moment.

“Epi... I was where you are right now. I was there two years ago. I know how you feel.”

All I could do was nod my head. I'm not sure I've ever been as embarrassed as I was at that very point. I had put on close to 100 pounds in less than three years.

**********


Dr. P met with me and sang the praises of the Roux-en-Y procedure. They would cut me open, section my stomach, separating away the top so that it would be roughly 20cc's. They would staple shut the bottom portion, but not remove it. They would reroute my small intestine to meet the new “pouch”, thus bypassing where the majority of the calorie intake takes place.

I could expect to lose approximately 70% of my excess weight.

Now I've never been great at math, but that worked for me. I was sold.

“Not so fast... There are risks....”

Chronic Anemia.

Dumping Syndrome.

Staple Failure (basically a leak after surgery which is potentially fatal).

Hernias.

Nutritional Deficiencies.

Okay, so I could die during surgery. I could die right after surgery. I could end up screwed up royally through nutritional deficiencies (B-12, Iron, Calcium...). Here, I thought this was the “easy way out...”.

The potential to be a better parent, a better wife, and a happier person in general won out.

There was one thing that was clear. I wasn't going to be able to do this on my own. The cards were stacked against me. When you weighed what I did the chances of taking off the weight that I needed to take off, on my own without surgery, was less than 10%. It just wasn't going to happen.

“Okay... If we're going to move forward, there's a few things you're going to need to do,” Dr. P. told me. “You're going to need a Psychiatric evaluation. You're going to need to prove to your insurance company that you've made attempts to lose weight through non-surgical means for at least six months, and you're going to need a sleep study.”

“Fantastic, Doc. I'll get on that immediately.”

“Epi?”

“Yes, Doctor P?”

“Are you sure this is what you want to do? Why don't you go home and talk to your family about this? This is a life changing surgery you're about to have.”

"I understand Doc... I've talked to my family and they're completely supportive. My husband is a little nervous about the whole thing, but he's quickly coming around. I'm ready to get this show on the road..."

**********

Five Years and Two Words ago...

I was a different person in many ways. Five years ago my life changed. I was approved for Gastric Bypass Surgery.

Five years ago I was in the middle of what I considered a fight for my life. I was fat. I was depressed. And I was sick.

And I had no one to blame by myself.

My son was all of three years old and I could NOT chase him around. Even worse was the constant exhaustion. I had a hard time getting my big ass off the couch or out of bed to play with him. The easiest tasks wiped me out. Taking my son to the park. Cleaning the house. Living.

I blame no one but myself. Not genes, not some medication or disease process that was causing me to gain weight. It was all me. I was guilty of loving all things sweet and salty, in mass quantities.

Pint of Ben and Jerry's Wavy Gravy? Check
Bag of Doritos? Check.
2-liter(s) of Mountain Dew? Check Check.

It was a visit to my physician that clinched it for me. On the billing sheet I was handing in to the check out clerk were two scribbled words that changed my life.

Morbid Obesity.

Morbid Obesity? As in... I'm so fat it's going to kill me?

I mean... I knew I had been shopping at Lane Bryant more and more over the previous few years, but to say that I was going to die because of I was fat... Jesus. Are you kidding?

He wasn't kidding. My blood pressure was sky high. I was a borderline diabetic. I found out rather quickly that my snoring and constant exhaustion was due to sleep apnea. I was a heart attack waiting to happen.

If I was to be the Mother that I truly wanted to be, if I was going to be the Wife I had been and wanted to be again... I had to make some changes. I had to make them now.

I joined Weight Watchers one last time. I lost 32 pounds in a little over a month and got the 10% keychain. I thought that finally... FINALLY I was rocking this weight loss thing. I was doing it! Surely I don't need to spend that 15 bucks a week on meetings, right?

Yeah....

I quit the meetings and the weight came right back. Jesus, I had ZERO will power. There's nothing more depressing than realizing that you are weak.

That was the last straw. It was time to do something a little more drastic. A commercial for Bariatric Treatment Center came on the TV.

Gastric Bypass Surgery.

I had a long battle ahead of me. My insurance company wasn't exactly keen on the idea of approving something that was going to cost them over 90K when all was said and done.

Thinking back, I can't blame them. At the time I believed it was something I was entitled to. I jumped through their hoops. Every single one of them. At the time I believed this was my last chance at regaining some normalcy in my life. I was desperate.


**********

More tomorrow... It's been a VERY long day.

Blast from the Past.

Meet Epijunky. DECA Geek Extraordinaire. 1993.
(I'm in the back on the left)

Epi's trip to Bass Pro

I *heart* Bass Pro

Seriously. How could you NOT love a place that sells these:

Yes folks, those are bloomer bottoms for a baby. I've never wanted another baby girl so badly in my life.

And then there's this. The perfect accessory to anyone's... Uhm... I'm not sure where I'd put it, but I *MUST* have one.

The place is awesome. I loved the entranceway...

"Welcome Fishermen, Hunters and Other Liars" How can you not love that? It's perfect.


The kiddos instantly found something they loved. I could have some fun with one I have to admit. When I find that job that pays me a little more I'll see what I can do.

Hey, look! It's McHottie when he's having a bad day! Okay, so maybe he's not that bad.

Yours Truly attempting to shoot a squirrel. Or a goat. Or a Bear. I'm not sure what it was.

The Boy. Sure, his stance needs a little work, but he did pretty well regardless.

He looks like he's ready to storm Normandy or something... I think we each (Little Bit included) did at least ten rounds. It was free shooting at the range today :)

Okay, so in a totally girly sort of way, I LOVED this. I want to do a kids room with a ceiling like this. The boats even had anchors lodged in the endcaps the rods were on.

If I had a million dollars I probably could have blown it today. The boat show just about killed me. In the end I left with fudge and a shopping list for the next time. The kids had a great time, and as a Cabela's purist, I have to admit I was in heaven.


The Importance of Scene Safety

(Prologue: A few weeks ago someone emailed me and asked that I write about the time my partner saved my life. Here you go Gwendolyn :)

Here, for your reading pleasure...

How to Get Yourself Killed by Being Too Eager
(A lesson in "What NOT to do" by Epijunky)

The Scene: A rainy April night in Toledo, Ohio on the wrong side of the tracks.

The Players:
Epi - One brand new Basic EMT.
Quixtar Partner - One very experienced Intermediate EMT.
Father Time - One very old and crusty dispatcher.

Epi: (Sitting in a chair in dispatch) I'm tired. I really need to sleep.

Quixtar Partner: (Bright eyed, even at two in the morning)

He doesn't have two little ones waiting for him at home in four hours, he gets to go home and SLEEP! I hate him.

QP: Go to sleep... I'll come get you if anything happens.

Epi: But there's a commercial for OxyClean on... And that stuff is great at getting those minor blood stains out.

QP: Go to bed Epi, that's an order from an Officer.

Epi: You realize I have problems with authority, right? Particularly when they're ordering me to sleep. (Rubbing her eyes) We've done sixteen runs today. How are you still vertical?

Father Time: (mumbles something under his breath about youth being wasted on the young)

QP: I eat these. (QP pulls out an Energy Bar and hands it to me.)

The label doesn't say Amway right on it, not that I can see immediately anyway, but I'm fairly certain based on prior conversations that it's a Quixtar product.

Epi: (reading the nutritional facts) QP... The main ingredients are sugar, caffeine and crystal meth. That explains why you're still so damn perky.

Father Time: (Chokes on his coffee. Once he clears his airway and hacks up some aspirated coffee, he laughs until his face is purple.)

Cue the loud crash directly outside the windows in the dispatch office.

QP: (Jumps out of his skin) Good Lawd... What the... (He struggles to look out the window and see what's going on)

To his credit the windows are higher up on the wall than typical windows. And QP is barely tall enough to ride the bumper cars at Cedar Point.

Two cars have collided on the corner directly in front of the station. The scene is lit by one street light. To the North is an abandoned warehouse. To the South is our station. To the East and West are aluminum recycling yards. We're not in the roughest neighborhood in the city, but we're definitely in one of the more colorful ones.

Father Time: I'm going to call TPD, Ya'll gonna go check them out?

QP: (Looking at me) I know. I know. Let's go see what we see.

Epi: (Trying my hardest to not be excited over something like a car accident) Okie, lets go.

I grab the First In bag that is sitting next to the door and proceed to walk (not run, not skip, not do the cabbage patch kid dance) towards the scene. I make it about fifteen steps, or about a quarter of the distance there before I'm yanked violently backwards.

QP: (In a loud whisper) Epi. STOP!

QP is pulling on the strap to the First In bag. He's not just stopping me, he's pulling me backwards. It takes me a second or two to process what is going on and regain my balance. When I turn to look back at the scene I see why I'm being dragged back to the station at a sprint.

Male Driver has pulled a gun and has it pointed directly at Female Driver.

I feel my heart kick into overdrive. I let loose with a few very appropriate four letter words and haul ass back to the station. I'm convinced I'm about to be shot in the back.

Let me repeat that. I was absolutely POSITIVE I was about to be shot.

I can't even begin to describe what goes through your head when you're convinced you're going to be killed any second. All I can say is that they involved my children, my husband, and just about every person I care about. Faces flashed before my eyes.

When we reached the door to the station it was locked. QP fumbled with his nametag for what seemed like an eternity before he could swipe us in. We crash through the doorway and land on the linolium floor just inside.

Father Time leaned over in his chair and eyed us suspiciously.

QP: (Panting) Gun!

FT: You two okay??? (FT is calling TPD back to let them know what's transpired)

Epi: We're okay.

QP: (Still catching his breath. He looks me directly in the eye.) When, exactly, did you finish school?

Epi: Three months ago.

I know where he's going with this. I prepare for the verbal beating I'm about to receive.

QP: Do you remember when they talked about Scene Safety? Do ya REMEMBER THAT?

I nod. That's all I'm going to allow myself to do.

QP: Did you size up the scene before you ran out there?

Epi: (Stammering) I thought...

QP: (Slams the palm of his hand on the glass door) You DID NOT think. You charged out there Johnny and Roy style and didn't wait for me. You put us both at risk. We could have been shot. DO YOU REALIZE WE COULD HAVE BEEN SHOT??? Jesus CHRIST Epi!!!!

I've never seen QP angry before. But then again, I've never almost gotten him killed. I'm thirty years old. And for the first time on the job I feel like a stupid foolish child. I swallow hard and fight the urge to cry. I'm sitting on the floor next to QP staring at my knees shaking like a leaf.

If I could be so stupid as to ignore one of the most basic of things they teach you in school, I have no business working as an EMT. I want to jump to my feet grab my bag and run for my car. Instead I continue to sit next to QP.

Epi: (Whispering) QP, I'm so sorry.

QP: I could shake you, girl. You scared the hell out of me. (He wraps an arm around my shoulder.)

Epi: I don't think I have ever been so terrified in my entire life. QP... I'm so sorry.

QP: I almost shit myself when I saw that gun. Epi, promise me something.

Epi: You name it, Partner.

QP: I don't want you to EVER forget what just happened.

Epi: I promise.

**********

I had a dream last night about the car accident I wrote about a few months back. That in turn reminded me of when the above fiasco took place. The incidents are about three years apart, but I have to believe Someone up there is trying to tell me something.

I'm listening.

Today.

Today I managed to slice my hand open and simultaneously expose myself to grease, sweat, and countless diseases. Some are resistant to antibiotics, some not so much.

Today my Partner for the day offered to call in Lifeflight for the aforementioned cut while also telling me how Not hardcore I am.

Today I watched my partner for the day, and learned something about building a relationship with my patient. I was impressed.

Today we were called to the Home Office to talk to the EMS Director. My heart rate reached the level where adenosine would be appropriate.

Today I exhaled a very large sigh of relief when I learned it wasn't me that the EMS Director wanted to talk to. Sorry about being so giddy about that, Partner for the day.

Today I noticed that Partner for the day not only held doors for me, but also offered his hand when I it was my turn to climb out of the back of the squad.

Today I thanked him repeatedly. And he noticed.

Today I washed our squad with a weeks worth of dead bugs stuck to the front of it. And I sprayed myself in the face when I attempted to drench Partner for the Day. This supplied him with endless amusement.

Today I might have then lost my damn mind and turned the hose on him anyway for laughing.

Today Partner for the day decided to be patient.... before soaking me from head to toe with another hose.

Thank you, Partner for the Day.

I didn't save a life. I'm not even sure I made a difference in someone's life. But it was a good day regardless.

Today was a good day.

Forever a Tigger.

Randy Pausch died today.

I'm reserving comment for later on tonight.

Matty

Epi: "I'm in desperate need of material, Matt. I mean... I'm trolling myself to see if there's a draft somewhere I forgot about. I'm on empty."

Matty: Have you considered going to bed?

Epi: Not even for a second.

Matty: Alright. Talk about what you know, then.

Epi: You want me to talk about dirty diapers and disappointment?

Matty: LOL yet ANOTHER great book title. You really need to find a publisher.

Epi: You're a lot of help ya know. I'm totally sticking my tongue out at you.

Matty: Or how about a blog about how you straighten your curly hair every day? Or you could ponder the benefits of raisin colored lip balms versus pink? Pink! There you are, you could do an entire post on why you love pink.

Epi: I hate you.

Matty: No you don't. You love me.

Epi: No. Clearly you're out of your mind.

Matty: I love you. Come on, admit it, you might like me a little bit. Maybe just a little bit???

Epi: Leave me alone. I am busy and important.

Matty: Okay, so write about how you're busy and important!

Epi: LMAO You're on crack, Matt.

Matty: I knew you loved me!

Non Princess Emily, pt. II

Here's Part One...

The sun is out.

Not one of those days where it beats down on the truck all day and we go home with one-armed sunburns, thank God. Instead we're blessed with 80 degrees and a constant breeze. Nature's air conditioner.

"We need a frisbee, McHottie." He grunts, not even opening his eyes. He's using a book as a pillow.

I should try that. I can't get comfortable in the front of the truck. I've padded the voids with bath blankets... I've shifted positions countless times. I hate not having a station to go home to when we have down time. We're posted in a parking lot on the side of a book store. We're hiding.

"Unit 120, One-Two-Oh..."

I reach for the mic. "One Twenty, go."

"You have a One pm pick up from a private residence on Hudson, going to Ortho Clinic at Our Lady of the Spiral Fracture. Time out, 1230."

"One Twenty is clear and enroute." I set the mic down and look at McHottie with an insane grin on my face.

"What are you smiling about Epi?" He's rubbing his eyes as he shifts the truck into drive.

"We're going to get Emily."

**********

I LOVE Pediatric runs. I will take a ped patient over an adult patient any day of the week and twice on Sunday.

The truth is, they inspire me. They are some of the bravest patients out there.

Put an adult and a kid with the same ailment in identical ambulances.

The kid will clutch their SpongeBob Squarepants blanket and ask a ton of questions about the equipment.

The adult will whine about the temperature, demand a drink of water, ask you to carry their suitcases, inquire about getting a ride home, possibly swing at you, then bitch about the bumpy ride.

Like I said. I love the kiddies. And Emily is my favorite.

**********

McHottie pulls the truck up outside of Emily's house on Hudson Street.

Any time I get to go back to my old neighborhood I get a smile on my face. I have so many memories from my childhood that involve a five block radius. Learning to rollerskate at the Board of Education parking lot, Learning to ride my bike down the sidewalk (and simultaneously learning where all the cracks were that would put me horizontal), going to the carnival on Manhattan, playing hide and go seek with my friends... It's been almost 12 years since I lived on Hudson. Time has not been kind to the block, but the memories remain.

"One twenty's on the scene," I toss the mic down and reach for the gloves, those beautiful purple gloves, the gloves that keep me from breaking out into a rash. How I love those gloves.

There are a total of five steps leading to Emily's house. We navigate them carrying the empty cot with no problem. Dodging the small children and the toys on the front porch proves slightly more difficult, but manageable. They're ridiculously cute. And curious.

The little one wears pig tails and reminds me instantly of my little girl. “Are you here for Emily?”

I pause long enough to answer her. I wish I could stay and play with their Barbie dolls.

“Come on Epi, We're running a little late.” McHottie gently prods me with the cot.

“What, you don't want to stay and play with dolls? Don't lie now.”

He rolls his eyes at me. I'm getting used to his violent eye rolls. Apparently I have this effect on my partners.

The house is warm. There are fans set up everywhere. Emily is laying in her bed in the livingroom. SpongeBob is on. Emily LOVES SpongeBob.

“Well HEY there, Princess, how are you?” McHottie's face lights up at the sight of her. We really do love this kid.

“I know you!” She squeals in the cutest eight year old voice known to man. She's clearly psyched to see McHottie. “And YOU! I know you too!”

“Yep, remember? I'm McHottie and this is Epi... She's going to be in back with you today, is that okay?”

“Oh Yes. Yes Yes YES!”

“Emily, will you finally let me sign that cast?”

We make small talk with Emily and her Mother while we we untuck her sheets and move her over to our stretcher. She's impressed that I have seen the episode of SpongeBob that's on. SpongeBob has just gotten canned for his addiction to karate.

I lean down and whisper a secret in her ear. “Hey, Emily? I'm not really a grownup. I'm really nine years old. Don't tell anyone okay?” Her brown eyes are huge. She puts a finger over her lips and nods her head.

**********

"What's that? Is that what you use to listen to someone's heart? What's in there?" Emily is non-stop questions.

"That is what we call suction. When I turn it on it gets really loud and makes this slurping noise." I make the sound of slurping the last ounce of soda out of that McDonalds cup.

Emily starts giggling. The giggling turns into a belly laugh when I stick my tongue out at her.

"Epi?"

"Yes honey?"

"You have a lot of stuff back here, don't you?"

I've given up on filling out my Patient Care Report and shove it under the head of the stretcher. She's laying there in a full body cast with names scribbled across it. From what I can see it's the ENTIRE staff in Peds at Toledo Hospital. There are several coworker's names on it as well.

"Yes, we do. We use it to help people."

"You save a lot of lives, don't you." It's not a question, it's a statement. Emily's eyes focus on mine. She's in awe of me. I don't want to disappoint her, but I don't want to lie to her either.

"Emily, we work hard to help as many people as we can." It's the best I can do.

Her smile grows. "You guys are like superheroes, aren't you?" Again, a statement. Not a question.

My heart melts. "Baby, we do our best."

McHottie yells from the front of the truck. "Tell her we can't be superheroes because we don't have capes. Tell he she has to make us a few capes."

I relay the message and Emily laughs again.

"Epi?"

"Yes, Emily?"

"Will you sign my cast?"

"I'd be honored to." I remove a sharpie from my pocket and sign it.

To the bravest girl I know. We *heart* you. Epi

**********

We dropped Emily and her Mother off at the Ortho Clinic. They had a bed for her so we couldn't justify waiting for her. The boards were insane that day, and dispatch had two runs lined up for us after Emily's.

As we were getting ready to leave I found out that they were going to be removing Emily's cast that day. She was going to be free. I never did find out why she was in the cast, all I know is that she has Cerebral Palsy and that she was going to be spending eight weeks in that cast. Her Mother was very young and didn't understand a lot of the medical jargon being lobbed her way. The facility supplied us with even less information.

We keep hoping to get paged to a run from her house for some appointment, but that run hasn't come yet.

I'm both grateful and a little sad about it.

I miss her, you see. She's one of the reasons why I do the job I do.

I am SO blessed.

I'm exhausted.

I'm so tired that I can't see straight. My 32-year-old body is rebelling against me. My back has hurt for the last three weeks. The glands in my neck are swollen to the size of ping pong balls. My voice is gone. I'm sure I'm running a fever but I have no idea where the thermometer is. I'm simultaneously wracked by chills and the sensation of being entirely too warm. I've been fighting off the plague for the last two days.

I'm losing the fight.

Work is wearing me thin. There's more than a few posts there, but I just can't bring myself to do it right now.

I have two friends who I'm so worried about I'm having a hard time sleeping. When my cousin took my BP tonight it was 212/110. And since my gastric bypass I very rarely run higher than 110/74.

There is so much drama in my life now that I could write my own self help book five times over.

All of that being said, I am ridiculously blessed.

I am loved.

I am so loved.



I love you.

(Quick Edit: To the Anon commenter. I know who you are dipshit. Screw you you worthless piece of shit. I'll make Satan look like a girlscout.)

A Meme... Stolen from someone's archives.

WERE YOU NAMED AFTER ANYONE? God no. My middle name was issued to most of the girls in my neighborhood between the years of 1973-1976, however.

WHEN WAS THE LAST TIME YOU CRIED? Last night. But I'm going to blame it on being physically and emotionally fried.

DO YOU LIKE YOUR HANDWRITING? My penmanship is stellar. I owe that to my mother making me rewrite my homework just about every night between second and fourth grade. Thanks to Mom the EMS Captain where I'm employed can actually read someone's run reports.

WHAT IS YOUR FAVORITE LUNCH MEAT? Roast Beef, hands down.

DO YOU HAVE KIDS? Two. Boy and a girl, eight and three years old. For some reason I've been reading Parenting magazine lately... Maybe I wouldn't mind one more.

IF YOU WERE ANOTHER PERSON WOULD YOU BE FRIENDS WITH YOU? Yes. I am a dedicated friend. I'm honest, and I'll go to war for you if need be.

DO YOU USE SARCASM A LOT? *Blank stare* Surely you jest.

DO YOU STILL HAVE YOUR TONSILS? Tonsils are gone. So is my gall bladder and my appendix. And 3/4's of my stomach.

WOULD YOU BUNGEE JUMP? In a heartbeat. Sign me up.

WHAT IS YOUR FAVORITE CEREAL? Strawberry Yogurt Cheerios. They're like a desert.

DO YOU UNTIE YOUR SHOES WHEN YOU TAKE THEM OFF? Depends on what shoes I'm wearing. Work boots, yes. Tennis shoes, yes. Sandals, crocs and my chucks? No.

DO YOU THINK YOU ARE STRONG? I never thought I was until I started at my current employer. We had (up until recently) a contract at a nursing home where the minimum weight was 400 lbs. My arms definitely developed a bit after a few months of runs out to that facility. I would say that there's one woman where I work who is stronger than I am.

WHAT IS YOUR FAVORITE ICE CREAM? Oh GOD I miss ice cream. Since I had the Gastric Bypass I'm pretty much limited to a lick or two off my kids cones. The flavor doesn't matter so much anymore. Pre-Gastric Bypass I would have to say Peanut Butter and Chocolate from Baskin Robbins.

WHAT IS THE FIRST THING YOU NOTICE ABOUT PEOPLE? In a man, their eyes. Then their laugh. I love to laugh.

In a woman, hair. I'm not really sure why.

RED OR PINK?
Pink. Pink pink pink. My cell phone is pink (and the one before that was as well.) McHottie refers to my purse as "the pink amoeba".

WHAT IS THE LEAST FAVORITE THING ABOUT YOURSELF? The difficulty I have with leaving work at work. I hope to overcome that soon, I'm working hard on it.

WHO DO YOU MISS THE MOST? My Grandmother. She died ten years ago this year, and every time I pass the hospital room she was in when she passed I start to cry.

WHAT COLOR PANTS AND SHOES ARE YOU WEARING? I'm wearing pink red and white plaid flannel pj shorts and no socks or shoes. It's the middle of summer, ya know :)

WHAT WAS THE LAST THING YOU ATE? Crappy Thai food about nine hours ago.

WHAT ARE YOU LISTENING TO RIGHT NOW? Well, Deadliest Catch is on Discovery, and I can hear it, but I'm not really paying attention.

IF YOU WHERE A CRAYON, WHAT COLOR WOULD YOU BE? Pink. I'm girly like that :)

FAVORITE SMELLS? Fresh cut grass. Roses. Suntan lotion. The smell right before it rains. Lilacs.

WHO WAS THE LAST PERSON YOU TALKED TO ON THE PHONE? Matt. *waves*

FAVORITE SPORTS TO WATCH? College Football (GO BLUE!), followed by college basketball (GO DUKE!). That should make me popular :)

HAIR COLOR[S]? Reddish/blondish/brownish. Truthfully, I'm not sure what to label it as.

EYE COLOR? Brown, naturally.

DO YOU WEAR CONTACTS? I'm blind as a bat without them (to the tune of 20/400 vision uncorrected.) Tomorrow I think I'll be wearing my librarian glasses.

FAVORITE FOOD? Steak. Bloody. Maybe some mushrooms on top. Hey, I'm anemic. I need some iron :)

SCARY MOVIES OR HAPPY ENDINGS? Normally scary movies. Considering the fact that I have 30 Days of Night sitting on my desk for the last month, unwatched because I'm too afraid to watch it alone, I'm going to go with happy endings for this one.

LAST MOVIE YOU WATCHED? Anchorman. I LOVED it.

WHAT COLOR SHIRT ARE YOU WEARING? It's a black LifeFlight t-shirt. This shirt, 15 hours of CEU's and a nasty hangover are what I came home with from the last Partners For Life EMS conference. Which reminds me that I really need to sign up for my next Buddy Flight.

SUMMER OR WINTER? Summer for the weather, Winter for the holidays. I can't STAND the cold weather. My entire body hurts for almost four months a year and I'm constantly telling folks that I was born in the wrong climate. At the same time the months of November and December are my favorites. I love the holidays.

HUGS OR KISSES? That's a tough one. My kids give some of the best hugs EVER. My Partner gives great hugs when I'm having a rough day. At the same time there's something to be said for a hungry, firm, passionate kiss. A kiss that takes your breath away. A kiss that makes your knees shake.

FAVORITE DESSERT? My idea of a desert and the general publics are probably a little different. I can't have sugar like I used to. So for now it's the sugar free yogurt cones from that place in Swanton. And Grapenuts Granola. That's some good stuff :)

MOST LIKELY TO RESPOND? Shoot, I'm not tagging anyone, so I doubt anyone will respond.

WHAT BOOK ARE YOU READING NOW? Rescue 471 by Peter Canning.

WHAT IS ON YOUR MOUSE PAD? A free mousepad from the local computer shop where I bought the parts for my last several computers.

WHAT DID YOU WATCH ON T.V. LAST NIGHT? Intervention on A and E.

FAVORITE SOUND[S]? Either one of my kids laughing. There's something about hearing your kids laugh, really laugh...

ROLLING STONES OR BEATLES? If I had to pick I'd say Beatles, but I'm not a huge fan of either.

WHAT IS THE FARTHEST YOU HAVE BEEN FROM HOME? Seattle, Washington. Coincidentally the most beautiful place I've ever had the pleasure of visiting, twice.

DO YOU HAVE A SPECIAL TALENT? I'm pretty decent with a camera I guess.... I can play a mean version of "Dead Or Alive" by Bon Jovi on air guitar :)

WHERE WERE YOU BORN? THE Toledo Hospital in Toledo, Ohio. The happiest place on earth.

Eight.

Eight codes I've worked as of today.

Eight patients who haven't made it.

*sigh*

For Naomi.

(Slight edit: Apparently I posted the wrong draft. Some slight changes towards the end, my apologies)

This post is a contribution, although late, once again, to Normal Sinus Rhythm. A collaborative writing project by EMS bloggers all over the country. Please visit them if you get a chance!

"This might be the best taco I've ever had." Marine Corp Medic crams the remains of said taco down his gullet. I'm not even sure he chewed it. He inhaled it.

God he's hot.

I picked up a shift working with a Medic for 24 hours. It's a welcomed change from working at the Closet, and while I adore Pseudo Dad, the snoring is a bit much sometimes. Last shift I contemplated suffocating him with one of those plastic covered hospital pillows. If the lack of oxygen doesn't do him in, maybe one of the diseases on the pillow will.

A girl needs her sleep ya know.

"So, Marine Corp, tell me. What exactly is that contraption you have strapped to your belt?" It looks like the Galls catalog vomited on him. It looks like a pair of trauma sheers/seatbelt cutter/window punch/scalpel/maglight/corkscrew/vanity mirror/hunting rifle. It's deliciously wankerish, yet fantastic at the same time.

He hands it to me so I can play with it. "It's beautiful," I start, fighting back the giggles.

Marine Corp Medic is not amused with my ribbing. He mumbles something about it being lucky and issued to him by the Corp.

"No, no, I understand." I snort out loud before losing it completely. "If I ever need to open a bottle of wine and perform surgery in the dark I'll know who to call."

"Epi, give it back."

"Can't I just hold it awhile longer?"

"No, you can't. Give it." His hand is outstretched palm up. I stick my bottom lip out and give him the mammoth five pound Galls Special back.

Marine Corp Medic and I have just stopped at one of Toledo's best kept secrets. El Camino. The BEST Mexican food I've ever had. My Medic Partner approves.

We're sitting in the parking lot looking out as the traffic flies down Sylvania Ave. It's the first meal we've had so far after back to back to back 911 runs. It's already 4:30 in the afternoon.

My partner has finished his third and last taco around the same time I start my second. I offer him my last taco as there's no way I'll be able to finish it.

"Girl you need to learn to eat faster or you're going to waste away to nothing working this job."

"Fat chance of that happening." Just as I take a bite of my delicious bit of ground beef, chilies, cheese and sour cream I see something odd out of the corner of my eye. It flies past too quickly for me to process it.

"JESUS FUCKING CHRIST DID YOU SEE THAT?" Marine Corp Partner is yelling for me to call dispatch and he disappears before I can even realize what has happened. I scan the street in front of me trying to put together what happened.

There's a 1990-ish Oldsmobile on it's roof, not forty feet away from the truck.

I key up the Mic mouth full of taco. "Uhm, Unit 2 to dispatch."
"Unit 2, go ahead."

"We're at Sylvania and Douglas, We just witnessed a MVC, one car on it's roof, contact Toledo's Finest for us and send another unit"
"We're clear Unit 2. TC, Fire and police are being notified."

"EPI!!! AIRWAY BAG!" Marine Corp is yelling from the street. I look up to see where he is and that's when I notice the second car.

Oh... Shit.

I jump out of the truck with the portable radio and run to the back where the airway bag is. I pick up the heavy blue bag and the Narc bag next to it. I pull a backboard out and move as fast as I can towards the first car, the one on it's roof.

The snow is coming down. There's close to two inches on the ground already.

"Epi, do you know where the intubation kit is? Hand me the BVM."

I've never been so happy in my life that I did the rig check that morning.

I pull the BVM out and tear the plastic bag it's in. I put it together and hand it to MCP.

"Uhm, MCP, seven or 7.5? What blade do you want?" I pause long enough to see a 70 year old woman hanging upside down. Blood cakes her face. She's not breathing. Groceries are everywhere in the car. A head of lettuce, cans of baked beans, a loaf of bread and a gallon of milk are scattered everywhere. It hits me, we're going to have to get her out.

"Epi? Answer the damn radio before I throw it across the street."

"Unit 2, come in, Unit 2...."

"Oh... Uhm, Unit 2 here. We have one patient, two cars involved." I look up at the other car, the driver is talking on his cell phone excitedly and watching us work. "The driver of the second car looks okay, I would still send that second unit though."

"We're clear 2. Fire and police should be there shortly."

MCP is holding C-Spine. "Let's get her out, she's not trapped. I can't tube her at this angle and the car isn't stable."

I pull the board towards us and ask him where he wants me. He has me take C-spine while he retrieves that deliciously tacky tool off of his belt that I had been laughing at not five minutes prior. He cuts through her belt and supports her body as she starts to fall from the seat she's in.

In seconds she's on our backboard. MCP is tearing open a tube when I notice her chest rise.

"MCP?" I watch her take another breath, then another.

"MCP???" I repeat, tapping his arm.

"What?" He says attaching the syringe to the tube.

"She's breathing, MCP. Looks like 12 or 16... Color's improving."

MCP watches her chest for a second then looks at her face. "Well shit. Go Grandma." He cranks the O2 up to 15 liters and puts a NRB on her.

"Do you want me to go check the other driver?" I ask as I dust the snow off of me.

"What other driver?"

I motion towards the pimped out Neon with heavy front end damage across three lanes of traffic.

"Jesus I didn't even see that car. Go check the driver, if you need me, yell."

The driver is still yammering loudly on his cell phone, I can hear him from across the street.

"Sir?" I start as I approach him. A shiver runs through me. I'm soaked to the bone. "Sir, are you okay?"

"Eric, duuuude, you need to come get mee. Pleeeease dude." The smell of the alcohol coming off of his breath is so strong that I have to take a step back. "Whoa."

"Go take care of that stupid bitch. THAT STUPID BITCH THAT CUT ME OFF!!!" Douchebag patient screams into the phone. "Duuude. PLEASE." Douchebag patient is begging to whatever poor bastard he's trying to convince to come pick his sorry ass up. He keeps looking around nervously as cop cars are showing up.

MCP is standing by the first patients car watching everything unravel. I look back at him and he's starting to walk towards us. Another crew has arrived and are loading up the first patient.

"Sir, you need to hang up the phone." I stammer. Douchebag patient is dialing another number. Completely ignoring me.

Shit. He's not listening to me. Why am I so nervous. Why won't he listen to me? I'm going to look like a complete moron. Dude, put down the phone, just let me take a look at you and shut the fuck up. Please. I'm begging. Okay, time to pull up your big girl panties and take control of the situation.

"SIR." I yell this time. I use my Mommy-is-pissed tone-of-voice. "Hang up the fucking phone. NOW." I can feel my heart racing, but enough is God damned enough.

"I'm fine..." He continues to dial.

"You're bleeding from your forehead and you're drunk. Now hang up the damn phone before I call the cops over."

"Everything okay over here?" MCP walks up behind me.

Douchebag patient is 5'10" and a buck fifty soaking wet. I'm three inches taller and a bit heavier. Marine Corp is 6'5" and 250 pounds of muscle with a vein that bulges out of his forehead when he's pissed.

And He IS pissed. "He giving you a problem?"

Dipshit, er, I mean Douchebag patient's eyes are the size of half dollars. Marine Corp Partner is rather intimidating.

I look at Douchebag with renewed courage. "Just hang up the damn cell phone and let me take a look at you. Please. Unless you'd be more comfortable with my partner." The street lights are on, the snow is falling, I'm chilled to the bone. What I'm assuming is broken glass or asphalt has ripped a hole in my pants, melting snow is running down my leg into my socks.

Translation: I'm balls ass cold.

The Douche in the end submitted to a stellar BLS assessment by yours truly. He ended up boarded and collared but okay. Seven stitches to his forehead. And a pair of shiny handcuffs.

Patient #1 made a complete and full recovery. She went from a bloody blue upside down old lady to a very grateful patient who still sends me emails from time to time. Apparently she had been feeling ill most of the day. She didn't remember heading out to the grocery store in the snow. Turns out she had a massive MI. Per the local STEMI protocol she headed to the nearest ER with a Cath Lab. I met up with her two days later during a shift with Pseudo Dad. Her family was fantastic.

One more reason why I love my job.

I was a newer EMT then, I was easily intimidated. I'm proud to say I've grown a bit since then. I still like working with the guys, and I miss Marine Corp and Pseudo Dad, but I don't need them to feel secure as a female EMT. I don't feel like I have to be protected from a patient because I'm a woman.

It took a little old lady and a drunk asshole to begin to teach me that.

A quick conversation with my 3-year-old.

We're bouncing along in the truck heading towards the station where I left my change purse (and drivers license, and two credit cards, oh, yeah, and all of my cash). Little Bit is in the backseat strapped into her booster seat chattering to herself.

"Maaaaaamaaaaaaaaaaaaaaaaaa!!!!!"

"What is it Sis?

"Mom! Motorcycle!!!" She's bouncing up and down in her booster seat, pointing excitedly out her window. "MO-TOE-PSYCHO!!!!!"

I look to the left to see what type of motorcycle she's referring to. Everything is a motorcycle to She Who Rules right now. Helicopters, big trucks, bicycles, ambulances, and yes, even motorcycles. This particular motorcycle happens to he a LCEMS Lifesquad. It's a monster. (One of those McCoy's with the Chevy chassis. They give me a serious case of truck envy). It's approaching from the left, code three and hauling as--- hauling booty.


Epi: "Where do you think they're going Sis?"

She Who Rules: "Uhm, I don't know."

Epi: "Do you think they're going to the hospital?"

SWR: *blank stare*

Epi: Okay, clearly we need to work on your vocabulary. "Do you think they're going to get someone who is sick?"

SWR: "Nooooooo" *giggle*

Epi: "Do you think they're going to get someone with an owwie?"

SWR: *hysterical laughter* "Nooo Mommy. You silly"

Epi: "Well little Missy, where are they going so fast?"

SWR: "TO EAT!!!!!"

Epi: *Snort followed by belly laughs* "Sweety..." *trying to breath* "Sis, I think they're taking care of someone with an owwie."

SWR: "TO EEEEAT! TO EAT TO EAT!!!!!"

Epi: *wiping tears from my eyes* "Baby, you really think that they're going to get something to eat with all those lights and making so much noise?"

SWR: "Yes, they hungwee!"

Epi: "Okay, Sister, they probably are hungry. I'm sure they're going for cheeseburgers. Code Three, for cheeseburgers."

SWR: "CODE THWEEEE!!!!!" *More hysterical laughter*

Okay, so not to make light of Code Three driving or Toledo's Finest, but it was kind of cute.

Hey Epi... Where'd you get that scar?

I need to get a better shot of the scar, I know.
"Unit 152, Code Three for the County, One-Eight-Seven-Seven Collingwood, Cross of Springs Blvd. Code Three for the County, time out 1545."

"Unit 120, A direct call, 15789 Sterns. That's Sterns in Michigan, cross of Laskey. That's code three for a chest pain."

"Unit 262, Code Three for the County, Coral Gables Trailer Park, Lot 15. You'll be responding as the South West car, code three for the county."


"Unit 262 to Dispatch, can I get location on that run?"

"Unit 262 that's Burn and Moses, Burn and Moses. Across from Burning Bush Plaza."

"Two-Six-Two is clear on Burn and Moses, put us enroute."


**********
I take a long sip out of my bucket-sized styrofoam cup of coffee and continue reading the paper. We're posted at one of the 24-hour-stations, but we decide to sit out in the truck. It's almost 9pm. I'm quickly losing daylight so I fold the paper up and stuff it behind the drivers seat with my camera bag and the neon vests we've never used.

Join Quixtar Partner is furiously typing on his laptop. "Epi, it's not a scam, it's not a pyramid... You just have to put some time into it..."

"QP... It's Amway. Which is great. They have some great cleaning products. But I can't afford Amway for myself, I'd have a hard time selling it to my family and friends."

"You're right, they do have some amazing cleaning products but --"

The radio... sometimes I'm saved by the radio. "Unit 260, Two-six-zero."

We focus our attention on fighting for the mic. "QP...My.....truck.....give...me...Yes, Unit 260, go base."

"Unit 260, Code three for the county, 150th and Sunset, Sunset Mobile Home Park, lot A24, Code 3 for the county."

"260 is clear on Sunset, we're enroute" I grab the mapbook and hand it to Quixtar Partner. "I'm pretty sure I know where this is, can you look it up for me?" He nods and flips through the binder while I light the truck up and pull out of the parking lot.

**********

The trip there is blissfully uneventful. After the accident a crew had the week before, I'm a little shaky driving code three. The time of day and resulting lack of traffic help considerably. QP confirms the location of our run as we're pulling up to the same location. The large red firetruck gives it away.

Another of Toledo's finest greets us at the curb. "Hey Epi, how ya been girl?"

I pull my purple gloves on and reach for my sharpie. "I'm doing okay, hows your little guy?"

"He'll be in third grade this fall... Okay, so... Here's what we have," He pulls a small piece of paper from his front pocket. "38 yo female, with psych history, no one on scene can confirm what exactly that psych history is... Her daughter states she hasn't taken any meds today and that she's "just not acting right"... Her vitals are all normal, maybe a little tachy, but she's been running laps around the courtyard for the last half hour." He motions towards the small courtyard in the trailer park.

We see our patient, in her pink nightgown doing exactly what Toledo's Finest said she was doing. Running laps around the courtyard, up one side down the other. Most of the time she was jogging, occasionally breaking out into a sprint. There's a crowd of thirty or so residents, six of us EMS folks, and four police officers watching with rapt attention.

"How long has she been doing this?" QP asks staring at our patient.

"Oh... I don't know, ten minutes," A police officer answers.

Another officer leans towards me and whispers, "Too bad she's not built like my partner here, she would have fell out nine minutes ago." I lean back to get a better look at the partner he's referring to and find myself laughing out loud.

**********

"What's her name?" I ask.

QP looks at the paper the firemedic handed him. "Glenda... No, Glinda. Glinda."

"Like the Good Witch?" I ask. QP does not get the Oz reference. "It's okay, QP, I'll explain it later. So, do we have a plan?"

"Tackle and hog tie her?" One of Toledo's Finest offers.

"No one is tackling anyone, " I start. Eight guys simultaneously look at me like I have two heads. "Okay, no one is tackling or tazing anyone yet. There has to be a better way." I look out at Glinda, her pace is slowing. "Has she showed any signs of being violent?" I ask.

"No, nothing like that, She just need her meds," Her daughter says trying to be helpful. "Please don't hurt her..."

"Let's go talk to her," I say to QP and whoever else cares at that point.

"Like hell you will, I'll go talk to her." QP is feeling way too much testosterone at this point and it's pissing me off.

I look at him directly in the eyes. "My patient. Quit treating me like a delicate flower because I'm female. We can go together." QP is speachless. I start walking towards Glinda.

"Hey Glinda, how are you?" I'm walking next to her now. QP follows protectively a few steps behind. She's taking her pulse at the wrist, just like I've done a hundred times during a workout.

"I'm doing okay, are ya'll here to take me to the hospital?"

Wow, that was easy.

"Actually I am. Are you ready to go?" I can't help but be a little shocked at how normal she's acting. I guess I expected her to be bat shit crazy.

"Well, I need my purse, but other than that I'm ready."

"Glinda, I'll have your daughter grab your purse," I start, motioning to her daughter. Our crowd's collective jaws have dropped at how smoothly things are going. It's gotten very quiet at the scene. I help her climb into the back of the truck, sit her down on the cot and sit next to her on the bench seat. QP climbs in as well and starts on getting her blood pressure and other assorted vitals.

"Glinda, how are you feeling?"

"I'm okay, I guess. My head feels a little funny. And my neck hurts."

"Your neck hurts?"

"Well, yes, Ma'am... I fell down the stairs earlier..." She brings her right hand up and rubs the back of her neck.

QP is already reaching for the collar and towel rolls.

**********

"Alright, Glinda. We need to get this collar on you. When you fell you could have fractured your neck. I realize that you've been running a bit since you fell and that you probably feel fine, but I would feel better if we got you on a backboard and put this collar on you. Now my partner here is going to hold your head perfectly still, and any questions you answer for me I'd like you to answer without moving your head. Let us do all the work. Okay?"

Glinda nods her head.

"Hold still hon, Don't move your head at all, okay?"

QP holds c-spine while I put her collar on. If she shows up in the ER without a board and towel rolls the Doc will lose his mind. As a Basic I have no c-spine clearing protocols. Everyone with a fall and neck pain gets a board and a collar.

It was right about the time I was taping her down that I realized something might be wrong. My arm is caught on something.

My arm is caught on her mouth. I scream. "Jesus CHRIST she's biting me she's biting me!!!!"

QP lets go of c-spine and starts yelling at her as well. He finds a pressure point on her arm and presses down hard.

Glinda screams out. "Shiiit that HURT! Why did you do that???"

"Are you serious? You were BITING ME! You FUCKING BIT ME, GLINDA!" I'm so angry I find myself having a hard time not kicking her ass while she lay on that backboard. My heart is racing along, blood is running down my arm and pooling at my feet. I grab a hand towel and hold it to my fresh bite mark resort to taking several deep breaths in an effort to calm down.

(Eta - So that pretty much dispels all rumors that I'm a hand holder, right?)

We finish taping Glinda down and QP runs up to the front of the truck to drive us the short distance to the ED. My partner gives the radio report as I'm still cursing under my breath. Today I'm not so much feeling like a good Catholic Girl.

Glinda is whimpering. "Why he hurt me? I didn't do nothin' to no one..."

"Glinda, calm down. You bit me. You hurt me. You need to get some help at the ER. You need to take your meds when you're supposed to take them. You need to know that it's not...nice...to...bite...people." I'm fighting off the feelings of anger by telling myself over and over that she's sick.

It's not her fault, right?

**********

The rest of the run was uneventful. Several crews greeted us when we arrived at the ED, including Pseudo Dad, who was demanding that I go home for the night. I was a little shaken up. But honestly, she bit me, there was some blood and a few butterfly bandages involved. She didn't have any diseases that I had to be worried about.

She was just a little off.

I spent a few hours in the ER getting everything done. Paperwork, some ibuprofen, more paperwork, a visit from a Supervisor, and a few high fives on my first EMS scar.

As I was walking through the ER to find QP I caught a glimpse of Glinda. She was sitting up in bed laughing with her daughter. I started to get angry and considered popping my head into her room to say... Goodbye.

I kept walking.

Denial, pt. 2

We load Carlos onto the stretcher with terrific care. He barely weighs 120 pounds, McHottie could have picked him up and placed him there all on his own.

The ride to the hospital is close to an hour long. We pass three hospitals along the way there, and it frustrates me. Stretcher rides are not comfortable. He's jaundiced. His BP is in the tank, or heading that way, at 80/48. He hasn't dialized in five days. He's breathing at a rate of 12. The only words he mumbles during the transport are "frio" and "duele". I took two years of Spanish and they were more than a few years ago, but I remember the words cold and pain. I pile some bath blankets on him and try to get him as comfortable as possible.

**********

We walk into the registration area on the main floor of the hospital.

"Would you mind getting him registered?" I ask politely, handing McHottie Carlos's packet of paperwork. He heads off to the registration desk where there is just one person in line.

I turn my attention back to Carlos. "It looks like it should only be a minute, hopefully they'll get us back in a---" Without warning a group of concerned faces charge us. Everyone starts talking at once.

"Dad, how are you feeling?"
"Dad, was the ride okay?"
"Dad, did you eat today?"

We were swamped by seven of Carlos's grown children, and two grandchildren. Carlos barely sees them. He doesn't respond verbally. One by one the joy his kids had originally just to see him turns to disappointment and concern at his condition. His granddaughter starts to cry. I hold my ground and refuse to leave his side.

"He's doing okay," I assure them. A nurse is motioning to me to bring Carlos back to where the exam rooms are. McHottie reappears with a look of total shock on his face at the number of family members there. Very rarely do we have more than one person show up to see a Doctor with one of our patients. More often than not we are the only ones there for our patient. More often than not we are their family during visits like this. We are their advocates.

**********

There's no way there will be a room big enough for all of us.


The Nurse proves me wrong. The room she has for us comfortably holds the stretcher, all of Carlos's family and the medical staff.

McHottie and I lower the cot down so that the shorter family members (and the doctor), can have better access to Carlos. McHottie retreats to the waiting room while I hide in the corner out of the way. Our rules state that if the patient comes on a stretcher we can't move them to any bed that doesn't have rails. There's no such bed, so for the time being Carlos has to stay on the uncomfortable stretcher.

I'm glad that his family is there. I love the fact that they're fussing over him. Too often my patients are all but forgotten by their families once they go into a nursing home. My heart is breaking for him because of his health, but I'm grateful his family is there with him.

They talk about the last visit they had with this Oncologist about a month ago. The oldest daughter seems to be the designated expert of the family. She's a Nurse at another local nursing home. She's researched his cancer, the mortality rates, the treatments, and the best Doctors in the area. This is not one of the Doctors on her list, and she's very vocal about it.

"I just don't trust this Doctor. I want him seen up at Big City Hospital. They have inhouse dialysis. They have a Cancer Clinic. I want a second oppinion. I want someone who is an expert to see him." She's scared, her voice is cracking.

When the Nurse comes into the room to take Carlos's vitals the family beg her to get him some pain control. McHottie has already made her aware of his pain. The Nurse does a fantastic job of assessing Carlos and getting his vitals in spite of the family. She quickly retreats to find a syringe and a vial of Morphine.

I ask the family if they would have a problem with me sitting just outside the room so that they could have some privacy. They thank me. I let them know that I'll be just outside should they need me.

**********
I'm thumbing through a three year old issue of Ladies Home Journal. The office is woefully low on reading material. McHottie is watching Different Strokes.

"You know, this isn't nearly as funny as I remember it being," He says sipping on his hot chocolate.

I nod my head, deeply engrossed in a slow cooker recipe for pulled pork. It sounds and looks delicious.

The Doctor emerges from Carlos's room looking particularly grim.

"Hey, I'm going to go check on them and see if they need anything." Now McHottie nods, deeply engrossed in a pre-cracked out Dana Plato.

I knock on the closed door and poke my head in. "Do you need anything?" Three men leave the room and begin a hushed conversation outside the door.

"Ma'am, could you put his head down a little? I think that might make him more comfortable, " The Granddaughter asks politely.

"Absolutely."

The hushed conversation in the hallway is getting louder. I hear the words "Three weeks" very clearly. My heart sinks a little more. Carlos is staring at the ceiling with his hands folded on his chest. I look to the eldest daughter, whose eyes are red from crying. "Ma'am, are you okay?"

She shakes her head and breaks down. "They told us he had two years to live four weeks ago. Now they're saying two, maybe three weeks. I don't understand..."

Everyone in the room is crying, some sobbing loudly, some just wiping tears away. I don't have anything to say, it's not my place. I put my hand on the daughter's arm and let her know that I'll be outside, and that if the family or Carlos needs anything to find me. She thanks me yet again.

**********

"So it's just a few weeks then..." I finish telling McHottie what had happened in the room. Tears are working their way down my cheeks. "I feel horrible. I feel bad that we assumed right off the bat that he didn't need a stretcher. I feel bad that we didn't want this run. This is our job, right here..."

"Epi... There was no way for us to know. Think about him a week ago. He was walking around. He practically jumped onto our cot. He was talking and pissed off about having to go to dialysis. Cancer is a sick bitch." That's my McHottie, the voice of reason.

The men in the family have settled down and rejoined the women in the exam room. A random daughter close to my age pokes her head out and motions for me to come to the room. I stop at the door before coming in and ask her if he's okay.

"Dad's fine, but could we have another blanket?"

Of course you can.

When I return with the last of the bath blankets on our truck the family is yet again divided. Decisions are being made, voices are raised, people are still crying. I feel awkward witnessing this, as it's such a private matter, dealing with a dying parent. It's something I've been through with my Grandmother. It's gut wrenching. I let them know that I'll do whatever I can for them.

A voice pipes up from the back of the room, "Can you take him to Suburbia Hospital?" The voice belongs to the youngest son.

"He can't go to Suburbia, there's no inhouse dialysis there." Eldest daughter reasons. "And it's out of the way for everyone to visit. He needs to go to up north. Mayfly General." She looks at me hopefully. "Can you take him to Mayfly?"

"Let me check with dispatch on things. Typically it's not a problem."

**********

"Epi, take them wherever they want to go, Baby. Just let me know." Mom Dispatcher is working, and she does her best to take care of us and our patients. I'm grateful that the board is slow enough for us to be able to help the family out.

"McHottie, looks like we're taking him to Mayfly. They want dialysis."

"I don't understand that, why? Why put him through that?"

"I don't know. They're not ready to give up I guess." I understand what that feels like.

I walk back to the room and meet Eldest daughter at the door. "Ma'am, we're going to take you wherever you want to go. Do you have a Doctor who will take him on up at Mayfly?"

"What do you mean?" She's confused.

"Do you have a Doctor who is going to directly admit him? Otherwise he has to go through the ER... And there's no guarantee that they will admit him through the ER. They could just send him home from there."

Granddaughter approaches us and puts and arm around her Mother. "Mom? Is everything okay?"

Her Mother is falling apart in front of me. "I don't know what to do. I don't understand what you mean. I want him in that hospital. I want him to have dialysis."

She wants her Father to live.

"Ma'am... Have you asked him what he wants to do?"

"What who wants to do?" She asks wiping away tears.

"Your Father. Have you asked your Father what He wants?"

She closes her eyes and realizes that she has not. She hasn't asked, in fact, no one has.

*********

They teach us in school to be an advocate for our patients.

Human Nature leads us to care for the families by extension.

When the families wishes and the Patient's wishes collide... It's not something they teach you to deal with in school. Obviously my Patient's well being is my primary concern, but at times it's easy to want to do everything you can for that grieving family, and in turn temporarily forget who it is you're really there for.

**********
Carlos chose to go back to his Nursing Home.
Not a new one a hundred miles further away.
Not a Hospital with a state of the art cancer center.
Not one with in-house dialysis.

The family contacted Hospice that day.

It was with a bit of a heavy heart that I realized the following day that he wasn't going to continue with dialysis at all. I understand it, I would make the same decision. But knowing that I probably took him for his last trip outside into the world, into the sunshine...

It broke my heart a bit. For Carlos and his family.

Denial, pt. 1

"So, short of heading to the beach with a bucket of Corona's and a lime, this really isn't a bad place to have lunch, really. If you can actually call what you're eating lunch."

"Screw you, McHottie, don't mock my bag of Gardetto's. They are so tasty." And they're cheap. They're very cheap.

We're parked in a Metropark, overlooking a playground, an open field, and a heavily wooded area. If there's one thing I absolutely love about the city of Toledo it's the metroparks. You're never more than ten minutes away from a beautiful space, and they're completely free. We're in the one park I've never been to. And it's beautiful. And I have my camera.

Now, if the boards will only stay quiet...

We sit and listen to Jack Johnson on the Ipod and enjoy the beautiful weather. Neither of us really notice when the car pulled up. It was when the occupant got out that we first started paying attention.

"Epi? What's she doing?"

We both simultaneously tip our heads slightly to the right. Like maybe that will help us understand what it is we're witnessing.

"I'm not sure. Dancing? Maybe it's a really good song on the radio."

McHottie decides he must find out. He braves the 90 degree plus heat and rolls the window down and strains to hear what could be inspiring such a... joyful display.

"I don't hear anything."

I don't hear anything either, of course over the sound of the diesel engine and the a/c roaring at a temperature that could keep a side of beef frozen...

Now she's stomping her feet and tossing her hands in the air while she spins around slowly in circles.

"Wow." For the first time since I've met McHottie about six months back, he is absolutely speachless.

I continue to munch on lunch, but it's as if I'm watching a train wreck. I just can't look away. "She's... she's... she's absolutely fantastic."

"She's pink slip material," he laughs. "Hey... Epi..." He's pointing at a picnic table where a male couple are watching our subject with equal interest.

"I'd sell my soul for a video camera," I start. "No one is going to believe this. It's like... performance art." We've been watching her for a good five minutes straight. "It's like God knew exactly what I needed and for once gave it to me."

Our subject starts heading back towards her car and retreives what I can only describe as an article of jewelry formerly owned by Mr. T. A thick gold chain so large that we can clearly see it from across the parking lot. She puts the chain on and it hangs down to her belly button. Then she reaches back in the car and pulls out a green lawn chair.

McHottie is clearly deflated. "Damn, she's done."

"Base to Unit 120" Neither one of us want to pick up the mic, but like those student loan bill collectors, dispatch isn't going to forget we're here if we don't answer.

I key the mic up, "Unit 120... go"

"You have a 2pm pick up at BFE Nursing Home. Do you need directions?"

"Not necessary Ma'am, we're clear on BFE and en route." I check my pager to see if we know the patient we're picking up. "Hey, " I ask McHottie, who is still staring at our potential pink slip subject, "That dude we picked up last week from dialysis... the one who should have gone by 'lette... What was his name?"

"Carlos...Carlos... I don't remember his last name." McHottie picks up his pager and checks the run. "VILLEGAS! That's him. Screw that, he can go by wheelchair..." He picks up his cell phone and calls dispatch while our favorite subject ever shakes it like a Polaroid picture.

McHottie finds out from dispatch that there are no ambulette's available, so we can either take Mr. Villegas to an Oncology appointment, or we can take our pick of the two bariatric runs that are on the board. The call is ours. We choose Carlos. McHottie says the sun shines out of his ass... Today I believe him. Hey, my back hurts.

**********

We make our way out to BFE Nursing home and grumble all the way to our patient's room. Yes, sometimes even the most perky of the transfer EMT's can be cranky. I just wasn't on my A game today.

When we walk into Carlos's room I stop immediately. "Whoa. What happened?"

The Carlos "laying supine in bed" is not the Carlos we know from last week. Plain and simple he looks like shit. He's pale, he's staring at the ceiling, and he's not talking to us.

I approach his bed slowly. Is he breathing? Is he alive?

McHottie mumbles under his breath, "I guess this is why he's going by squad..."

"Carlos?" I put my hand on his arm. "Carlos? You ready to go?"

He turns his head slowly to face me... There's very little behind his blank stare. I'm absolutely without words. How can someone deteriorate so much in such a short period of time? It hasn't even been a week...

McHottie notices that his lunch tray has been untouched. "Carlos? Do you want to finish your lunch? You have time to eat if you would like." Carlos slowly nods. "OK Carlos, we're going to leave you to eat, we'll be back in a few minutes."

We regroup in the hallway. I speak first, "He looks really bad."

"Yeah, I know." McHottie lowers the cot down to a level closer to a park bench and we sit. And we wait for Carlos to eat. Okay, so we know he's probably not eating... we wait for a Nurse to make an appearance and hope that he's eating. Thirty seconds later our conscious gets the best of us and I get up and go track a Nurse down.

**********
His nurse is flipping through the drugs in the medcart when I find her. "He's really deteriorated in the last few days. Apparently it's a very aggresive cancer."

Oh Jesus.

Thanks AD...

I've been getting a shitload of traffic (and emails... and comments...) courtesy of AD pimping my blog.

Thank you, everyone. Everyone who commented and emailed me or found me through IM's... You've been almost entirely wonderfully supportive.

I initially wrote this because a friend told me it was a story that needed to be told (Yes, Matt, that's you). It was my first code. I've had a few more since then, thank God no one that I knew like Hilda, they've gone MUCH smoother.

It's still upsetting. They still make me nervous and shaky. But they've gone better. I'm able to focus and do what I'm supposed to do. I might cry afterwards, but at least I'm functioning during.

I want to thank AD for the mention. It means a lot coming from him, he's pretty much the reason I started writing again.

Thank you, AD.

Priceless.

Shamelessly stolen from Idaho Kat. Go check her out!

Procure yourself a Defense attorney: (Depending on the charge, anywhere from 5K to 500K or more!)

The pimped out suit you wear to court: $100.00 (Given the suit in the video I'd say that's fair)

Defending yourself at said case: Free.

Faking a frickin' MI and having the Judge call you on it: FUCKING PRICELESS. Pardon the language.

I promise the video is worth it.

Ouch.

Stopped at the Speedway to fill the truck today...


Ouch. Seriously.

Glad we have fuel cards.

The Ballad of Hilda and Oscar (Continued)

"They want to take him away... We haven't spent more than a few nights apart in 63 years..." Hilda's voice is trailing off. I feel a knot form in my throat.

A lot of my coworkers are not the hand holding type. They say that getting too attached to your patients is a bad thing. They say that getting too emotionally involved can end your career and reduce you to twice-weekly psychiatrist visits.

I can't help it. I'm a hand-holder.

When I see someone truly hurting, physically or emotionally, it's in my nature to want to help if I can. Even if it's just to hold their hand, stroke their hair, or listen. It's part of being human. I believe that most of my patients really just want someone to hear them.

I pull my purple gloves off and place my hand over hers. "So, have you talked to Oscar about this?" I give her a gentle squeeze.

"I tried... He just won't listen to a word of it." Hilda retrieves a tissue from her pocket. Her sweater reminds me of one my Grandma used to wear, with Christmas Trees and snow covered hills embroidered into it. The tissue has soaked up its fair share of tears today. I reach across the table and grab the box so she can have a fresh one.

"Thank You Dear."

"Ma'am, you're very welcome. What about your children, have they talked to him yet?"

Hilda shakes her head. "Jeff and Jeannie are coming up this weekend. They're living in Pennsylvania now." Hilda wipes her tears away, but more follow. One by one they fall down her pink cheeks.

Partner pokes his head around the corner, "Epi? Chair time is in twenty five minutes, we're going to be late."

I nod and turn back to Hilda, squeezing her hand one more time. "Ma'am, will you be okay? Is there a friend I can call for you? Or the Social Worker here?"

"I'll be okay. They're going to come today when he gets back from his treatment. I guess I should start packing his things. Do you think they'll allow him to have some personal items? Like our Wedding picture, or some flowers?"

My heart hurts for her. It's hard not to put myself in her position. "I'm sure it won't be a problem." I get to my feet. I don't want to leave her, but the clock is ticking and dispatch is already paging us for an update. I don't know what else to say to her, She's sitting at that table, She's confused and sad, and heartbroken.

All I want to do is give her a hug. "Ma'am, we have to get Oscar over to Regional, they get pretty upset with us when we're late."

"You go on ahead. And please, call me Hilda. None of this Ma'am silliness. You kids are like family to us. Don't forget your cookies now." Hilda smiles. I feel a little better.

As my Partner and I are rolling the stretcher out to our truck, Oscar pipes up. "What were you two gals talking about in there? Did you get my beef jerky? My Hildy, she can talk a wildcat's ear off."

I hold up the zip lock bag with the jerky in it. "It's right here, Oscar." I hand it to him and he clutches it possessively.

"You didn't eat any, did you?" He's accusing more than asking.

"Oscar, I promise, if there's any missing my Partner ate it." I laugh, looking back at Partner. He looks shocked that I joke with patients. "It's okay, Partner. Hey, where's the cookies?"

His look of disappointment says it all. "I forgot them. I guess the next crew will score a snack."

Oscar and my partner are loaded in the back of the truck. It's starting to snow. I have a feeling Oscar might be a little late.

**********
Oscar and Hilda settled into their South End home shortly after he had returned from the war. The same neighborhood that Hilda was raised in. They bought a house two doors down from where she was born.

She was soon pregnant.

Jeffrey was their first child, followed by Gwen and Rita, the twins, and the baby of the bunch, Frank. Hilda never failed to catch me up on their lives.

She never worked a day in her life outside of the home. She was a firm believer that her primary job was her children.

"You know, Oscar worked three jobs in the beginning. Thank the Lord he was able to get in over at the Jeep plant, or I don't know what would have happened. No one can be expected to keep up that pace. He was working so hard for us."

I nodded. "That must have been very hard on him."

Hilda's smile was fading, "It was. He just kept drinking until he got sick."

**********
"So, who else is left to go home?" Partner was getting antsy. He wasn't used to working on a day car. As a Paramedic, even a new one, he was used to something more exciting than constant transfer runs. I wanted to tell him that's what he gets for picking up a day car shift, but I bit my tongue.

"What day is it? Wednesday... That means Oscar, Jose, the Guy from Arbors, and the two at Maumee." I rub my temples, it's been a long day. "...And Unit 27 and 34 went out to the East side, so that just leaves Oscar and Jose."

The radio traffic picks up. "Unit 26... Two-Six... Head on over to Regional Dialysis, take a patient back to Lutheran Assisted Living, time out 1640."

I squeal like a little kid, "We're going to get Os-car... We're going to get Os-car!" I do a little dance from the passenger seat.

Partner already thinks I've lost my mind. "I've never seen someone so excited over a tote."

"Mr. Medic, you committed a cardinal sin. You left the damn cookies."

**********

We load Oscar up and begin the twenty minute trip back to his apartment. Partner takes patient care, and I can hear him doing a little bonding of his own in the back. Apparently Oscar and Partner share a love of all things Jeep related.

The snow has stopped and the sun, even though it's setting, finally makes an appearance.

We walk through the long hallways of the facility, turning here, dodging this drug car there, doing our best to not bump Oscar's elbows.

Finally we find their apartment. It couldn't be any farther from the entrance of the building. The only room further is a broom closet.

Hilda's neighbor opens their door before we can knock. I recognize her instantly. Her husband had been a patient of mine a few times at the last company I worked for.

"Well Hello Mrs.--"

Mrs. Eaton cuts me off abruptly. "Hilda is sick... Come take a look at her for me?"

We wheel Oscar into the living room. "Sure, we'll take a look at her." Partner says. "Let's get Oscar into his bed first," his tone bordering on impatient.

It's closing in on the end of the shift, and we're both exhausted. "We'll be right in there, go sit with her for a minute and we'll be right there." She follows his instructions.

We work on getting Oscar into his bed. Partner is rolling his eyes and fluffing a pillow when it happens.

"OH my God Hilda??? HILDA????" Mrs Eaton, the neighbor is screaming from the kitchen.

I will NEVER forget the sound of her voice. She was terrified. I was terrified.

Partner flew out of Oscar's room. I raised the rail on Oscar's bed and ran after him. My heart was pounding out of my chest.

On the floor of the kitchen crumpled like a rag doll was Hilda. She was grey. She was unconscious. She looked... dead.

"Jesus Christ." Partner was shaking her shoulders. "Ma'am? Are you okay? He instinctively checks her airway and for a pulse while I stare with my jaw on the floor.

"Epi, no pulse."

All I could do was stare at him. I was frozen. NO pulse? She's not the sick one. HE is the sick one. She's the one who makes cookies for us.

"EPI. COMPRESSIONS. NOW!!!" He yells at me. He's not requesting, He's ordering. He reaches for the portable radio and starts rambling to dispatch about having "Emergency Traffic".

I drop to my knees and place my hands together right in her nipple line. I pause for a second. I've never done compressions on a human before. I start pushing. I push hard. I hear and feel a crack. Every hair on my body stands on end. I pull my hands up.

Wait, that's supposed to happen.

I go back to doing compressions. I can't look at her face. Another crunch. This time I don't stop. I just count. I don't know why I'm counting.

Mrs. Eaton is sobbing. I can hear Oscar yelling from the bedroom. I keep pushing. The horrible crunching noise has stopped. I stare at the wall while I push. I truly believe if I can't see her face, if I don't look at her, if I don't see her as a person, I'll be okay.

Partner appears with the BVM. The nervousness I saw in him over the course of the shift has vanished from his face. He's focused. "Stop, Epi."

I pull my hands up. He delivers two breaths with the BVM. I start pushing again.

"Do you need to switch?" Partner asks me. I shake my head no.

"Who's coming?" I ask. I'm starting to sweat. My hair is sticking to my face. It occurs to me that I'm actually worried about which ALS crew is responding. It seemed odd to me somehow.

Partner gives her two more breaths. "Four is coming, and the Captain. You need to switch?"

I'm good for another couple minutes. My heart is pounding, I'm soaked in sweat. The muscles in my arms are raw. I just can't bring myself to stop. I look around Hilda's apartment and see the plate of christmas cookies on the kitchen table. I shake away memories of her reminding us to take the cookies.

After what seems like an hour but was in reality about six minutes, our assistance Unit Four comes running down the hallway. Favorite Medic and his partner the Pinup have the LP, Airway bag and drug bag. They start talking to Partner.

My arms are getting tired. I start to panic. I look up at Pinup, who is one of my favorite EMT's.

"Jesus, EPI... Let me take over." She all but pushes me aside. I sit back and she takes over. I feel defeated. I curse my recently healed broken humerus. For the first time I look at Hilda's face.

I look at Hilda. The adoring Wife of Oscar. The doting mother of four, Grandmother of 7, and Great Grandmother of 2. I watch as Favorite Medic rips Hilda's sweater and shirt off and cuts through her bra. I sit on the floor with my back against her cabinets and try to not think about Oscar and where he's going to end up. I don't realize it, but I'm crying.

**********

Later on that night Partner tells me that I was crying while I did compressions. He's the first person to tell me that I'm too nice to do this job. I get too emotionally invested in my Patients and their families. Maybe he's right.

I'd love to be able to tell you that Hilda made it. I'd love to tell you that she's alive and kicking, and taking care of Oscar, and still spoiling the EMS crews and showing off pictures of her Great Grandbabies. I'd love to tell you that she taught me how to knit.

But you know I can't.