Background...

For the last 19 months I have been working as an EMT-Intermediate for a high-volume, urban 911 ambulance service in Atlanta (for those of you who live in Atlanta, that gives you one option...we'll call it GEMS on this blog), and have had some of the most memorable adventures of my life.  Whether or not these experiences had positive or negative patient outcomes, many of them stand out rather prominently in my mind.  I should also note that for the past 13 months I have been in paramedic school, which is perhaps why even negative patient outcomes have been great for me.  I have learned so much, seen so much, and felt so much. 

Why today, of all days to start this blog?  Well, I just took my final exam for paramedic school, and rocked that shit, so, today is the day.  I am not quite a paramedic yet, but I will be as soon as I finish my national registry written and practical exams.  Regardless, the job has been so meaningful to me, I just thought I would share it with you all (whoever that is...friends, family, random EMS junkies who love reading this stuff).

Anyway, for my first post, I am going to paste a couple of emails that I sent to a group of my friends earlier on in the year, and then I will explain some other fun facts about my tenure at GEMS.

"I haven't really written too many emails about my life because there isn't much to write; I work while most people sleep, and I sleep while most people work.  My life has become mostly work and a lot of play during my time off.  Just about the only serious aspect of my life are the bills I have to pay.  But, with Emma's encouragement (or more accurately, her request) I am going to explain my gmail/facebook statuses into this email about my "life".

My job is a lot of fun.  I deal with a lot of crazy, pregnant and actually sick, sick and injured people.  I make a difference in their lives and get paid crap for it.  People don't really respect my job, but I love it anyway, because I respect it.  I see things that no one should ever have to see, from death to neglect to abuse.  Child abuse. Child neglect.  Sad, sad realities that, thankfully, we haven't had to experience, nor should we ever have to experience.  My job is dangerous.  I never know when I will leave my apartment for the last time.  I spend my nights walking into strangers' homes, rolling up on shootings, car wrecks.  I park on the side of the highway to work high-speed crashes with high-speed traffic flying by a mere 5 feet from me.  I park in the middle of the most dangerous neighborhoods of Atlanta.  I walk into the homes of thugs, criminals and ignorant people.  I walk into houses of old men and women who live in Atlanta, and the tiny homes, apartments and projects of people in--for all intents and purposes--the ghettos of Northwest, Southeast and Southwest Atlanta.  At any moment I could be attacked like some of my coworkers have been.  At any moment I could be gunned down by people who don't want us to help the people they've shot, stabbed, beaten.  I have to drive fast going to the rescue of the people in Atlanta, risking my life every day, driving down the poorly controlled roads.  My job is sad.  I have to go into the shelters of Atlanta that none of us knew existed.  I see the poorest of the poor.  The dirtiest of the dirty.  The smelliest of the smelly.  The dumbest of the dumb.  The sickest of the sick.  I see people at their worst.  People who are dying from AIDS and other infectious diseases.  I see homes that should be condemned.  I go into prisons and bandage criminals who have gotten the shit kicked out of them.  I have to speak calmly to people whose minds are controlled by hallucinations and delusions so they don't attack me, hit me, spit at me.  I have to fight back when speaking calmly doesn't work.  I have to deal with people who hate white people and people who hate black people and people who hate people.  People who hate.  I have to see children sick as hell.  Children who could die if we don't show up when we do.   Kids.  Little kids whose parents don't take care of them.  Little kids with burns and bruises all over their bodies.  Kids who have fourteen year old children as their mother.  Kids with kids as their mother and no father.  No grandmother.  Just their great grandmother and their mother who will neglect them in a matter of years, or months, or days.  If I see another pregnant 14 year old...I'll scream.  My job is gratifying.  I go into homes of people who need help.  People who might die without our help.  People who are too sick or injured to drive themselves to the hospital.  Some people who don't own cars.  Some people who don't really need to go to the hospital.  But some people who would have died had they not called 911.  People who have an oxygen saturation of 44% when it should be 95-100%.  People who have MASSIVE heart attacks, or strokes.  People who have low blood sugar.  People who have seizures.  People who have low blood sugar, then a seizure as a result, and then have a stroke.  People who have asthma attacks.  People whose lungs collapse.  People with major gastro-intestinal bleeding.  People with congestive heart failure who cannot breathe because their lungs are filled with blood/fluid that is backing up from their ineffective heart beats.  People whose heart rates are 250 beats per minute and people whose heart rates are 30 beats per minute (normal is 60-100).  People who need medication, or will die.  People whose lives we save.  People who can only say "thank you" by the time we deliver them to the hospital.  But sometimes people who will never be able to say thank you again.  Or I love you.  Or anything...ever again. People.  My job is traumatizing.  Calls for suicide attempts and suicides.  Depression.  Schizophrenia.  Murder.  Twenty year olds killing twenty year olds.  Eighteen year olds killing eighteen year olds.  Thirteen year olds shot by their drunk step father.  Drunk drivers driving on the wrong side of the road.  Oblivious drivers talking on their cell phones, crashing.  Motorcycles wiping out, injuring their rider.  Killing Mothers, Fathers and Children to someone.  Brothers and Sisters to someone else.  People losing their limbs and breaking their bones.  Blood flowing and guts hanging out.  Old people falling and breaking their hips.  Old people dying.  Young people dying.  A lot of death.  A lot of destruction.  My job is funny.  Some people call 911 for a broken nail, a stomach ache, a fever.  Some people call 911 for a stubbed toe or a bump on their ear.  Some people think 911 is the answer to their stupidity.  To getting a Q-tip stuck in their ear.  My job makes me happy.  Pregnant women sometimes run out of time, and have no other option but to call 911 and have the EMTs and Paramedics deliver her baby.  I get to do good for other people.  Make them smile.  Help them when they cry.  And save their lives.  I save lives.  We save lives.  We save lives on the frontlines of medicine...

After my job, I hang out with my friends, my coworkers.  We drink.  We party.  We sit at bars until they close and then go to someone's house to drink some more.  We drink A LOT.  But we share a common bond which is the reason we drink:  We work hard for people who need our help.  We work hard for people who abuse our service.  We work hard and see a lot of things that shouldn't exist in the world. 

People often ask me "Why didn't you just apply to medical school?", or "When will you be taking your MCATs?", or "Why would you want to work on an ambulance?", "Why waste your time?", "Why do this job when you could make much more money doing something else?".  But, I didn't "just" apply to medical school, or schedule my MCATs because I want to work on an ambulance.  I want to spend my time learning more about medicine from the front lines; medicine in the field, in an uncontrolled, dangerous, scary environment.  I don't do it for the money.  I won't ever do anything for the money.  I do it because my job is fun, dangerous, sad, gratifying, and funny and it makes me happy.  I love my job.  And when I'm ready, and feel that I've gained all I can gain from doing my job, I will schedule my MCATs and apply to medical school.  And become a doctor.  But until then, I will continue to love my job because once I'm a doctor, I'll always be a doctor...and doctors don't work on the chaotic streets."

 

"Nights like tonight are the reason I work so often!

Tonight I kinda delivered my first baby!!!

Buuuut...it wasn't as pretty as it was supposed to be.  Basically, we got called to the jail for a woman who was supposedly 36 weeks pregnant whose water broke.  We got there and the nurse in the medical ward told us that her water didn't break and that 'she just pissed and shit herself to be obnoxious'.  So, my partner and I were like okay, whatever.  Got her on our stretcher and into the back of the ambulance and transported her to the hospital.  The woman was not complaining of contractions...or anything except pain in her vagina.  I felt her stomach and it was hard, like a pregnant woman's stomach is, but not HARD like a pregnant woman's belly is while she's having contractions.  So again, my partner and I were like whatever.  While transporting, my partner began looking through her paperwork from the jail and saw that in half the paperwork, our patient was registered as a MALE named 'Kieth'...and the other half of the paperwork indicated that she was a female named 'KIETH'...needless to say, we were confused.  My partner and I decied that it would be best to check to see if she had a penis or a vagina, so we check...and found something ridiculous hanging out of our patient's vag.  Honestly, neither of us could tell what it was....so my initial guess was prolapsed uterus, my partner thought it might be a cyst of some sort.  While we were figuring out what we should do for either situation, our patient decided it was a good idea to pushe...and we realized that it was a butt and the upper part of a baby's legs.  For those who might not know...baby's are supposed to come out head first.  So, naturally, we were both like FUCK! We gotta roll...so we continued on to the hospital and tried contacting a million different people at the hospital to let them know we were on our way and only a few minutes away...but that's a whole different story.  Anyway, just as we arrived at L&D the baby came out all the way and resulted in my first pediatric resuscitation.  After the NICU team worked the baby, they finally got her back, but they said she would probably have severe brain damage.  That really upset my partner and I because we obviously would have been more proactive if the patient voiced that the baby started coming out...but hindsight is 20/20.  Regardless, at the end of shift my partner and I walked up to the NICU to find that the baby we delivered was still alive, and moving around, and showing no signs of brain damage.  In fact, she'll be taken off the ventillator tomorrow morning (which I guess, at this point, is this morning)."

Now, a brief continuation of the stuff you might see in the future.

During my year and a half as an EMT-I at GEMs, I have responded to over 1800 calls.  Of those, roughtly 29 have been for cardiac arrests (hence some people at work have called me "the grim reaper"), over 100 calls have been for severe respiratory distress/CHF exacerbation/COPD exacerbations, approximately 10-15 shootings, and countless calls for homeless people who just wanted a warm place to sleep for the night.  I figure, if I've had this much fun as an EMT...being a paramedic at GEMS will be a delight...and those experiences, I will definitely share.

While I don't plan on giving you a play-by-play on all the calls I have run thus far or the calls I will run in the future, I will definitely give you the highlights on some of the most dramatic situations.  In this post, you saw about my first (and only) delivery.  In the next few posts, I will start to write about some of the other crazy calls I've responded to.