She was rather pretty. And in pain. Scared.
The dispatch sent us to a "hemorrhage with abnormal breathing", which was nice and vague, and could be really anything. While responding, additional information came down that this patient was suffering from an incurable condition, and was vomiting.
Engine 51 and I were first due, and I was trying to be ready for whatever.
Let's see..... bleeder (source unknown) equals big band aid box, breathing trouble equals airway bag and 02, vomiting equals suction unit, and the general what-the-heck-are-we-getting-into vibe might equal an AED if a free hand remains.
Ready to go to war el solo, I walked in and found a young lady seated primly on a living room chair, coat on, purse at her feet.
Fire Department. Did you call?
Yes.
..... Where is the sick person?
It's me.
(Oh. No blood. No gasping for air. ........ OK.)
Bleeding? She claimed trace amounts of blood in her vomit (the nausea a response to her pain). Any left for me to evaluate the amount of blood loss? No, it was flushed down.
Trouble breathing? Only on deep breaths, because of the pain. Color normal, skin is cool and she is sweating a little bit.
The pain. She's tired and somewhat gaunt. She had been crying, and was getting close to more tears. She started telling me her story.
I was finishing my initial assessment and vitals, and not finding anything urgently wrong, as the rest of the cavalry arrived.
The medic asked her more questions, and I had time to look around. Pictures on the walls and bookshelves showed a much more vibrant version of our patient, perfect smile and cheekbones the envy of many models, fabulous blonde locks, clearly the life of any social gathering. Back then.
Long story shorter, she was in pain. Things were not going to get better. Her pain meds were not getting it done, and she did what everyone does when they don't know who else to call. 911 will make it all better.
Except this time, we can't. The medics explain that they can't really do anything more than what she's already got, but perhaps the hospital can.
Then, the tears again. She'd tried the hospital and run into some sort of roadblock with her insurance carrier, and she was afraid of going outside of their coverage because of the expense. We were her last hope for more relief, and we have nothing of substance to offer except an expensive ride to the ER for expensive interventions, which she hoped to avoid.
I am torn a little. She clearly knew the magic words to tell the dispatcher to get us in her living room when there was no emergency. We hate that. But all of her doors were closing, and we had nothing to offer, no way to save the day. We hate that.
The pain was real enough, as you could see in her face, but it was the fear that was taking over. And that led her to take advantage of us. We hate that, but we get it, too. Maybe I am rationalizing so as to not be angry.
There has to be more to the story. No caretaker? No family? No friends?
She signed a refusal, and cried softly.
If I ran 10-20 calls a day, I know I would blow this off and just be irritated before forgetting about it, but I don't, so I can't.
Wednesday, June 30, 2010
Sunday, June 27, 2010
The Gods of Logic are Crying
Even those who love destroying logic are slack-jawed.
I returned from my days off to find that the Kitchen Remodel is complete. It ended with the new floor and refreshed walls.
The Fridge? Back where it started.
Yes, you heard that correctly. Back where it started.
Why?
There's no power outlet on the wall where they wanted to put it.
Yes, you heard that correctly. There is no power outlet located where desired, in the very building which serves as the nerve center for the freaking power company.
Recap boiled down: Fridge too big. Remodel of kitchen ordered up to move cabinets to fit new fridge. Mid-remodel, budget is slashed, fridge will just be moved, but won't have access to water supply that justified its purchase. Late-mid-remodel, lack of power outlet is noted, fridge won't go to new home because we're out of money to install a freaking outlet.
Maybe we could eBay the table to raise those funds.
I will upgrade my observation of those who love defying logic. Nay, they are not merely slack-jawed. Yes, even the haters of logic are crying.
I returned from my days off to find that the Kitchen Remodel is complete. It ended with the new floor and refreshed walls.
The Fridge? Back where it started.
Yes, you heard that correctly. Back where it started.
Why?
There's no power outlet on the wall where they wanted to put it.
Yes, you heard that correctly. There is no power outlet located where desired, in the very building which serves as the nerve center for the freaking power company.
Recap boiled down: Fridge too big. Remodel of kitchen ordered up to move cabinets to fit new fridge. Mid-remodel, budget is slashed, fridge will just be moved, but won't have access to water supply that justified its purchase. Late-mid-remodel, lack of power outlet is noted, fridge won't go to new home because we're out of money to install a freaking outlet.
Maybe we could eBay the table to raise those funds.
I will upgrade my observation of those who love defying logic. Nay, they are not merely slack-jawed. Yes, even the haters of logic are crying.
Wednesday, June 23, 2010
Kitchen Problem, errr..... Remodel Update
It has begun. Earlier than anticipated.
Review:
Amazing Kitchen Developments!
I'll try to be brief. When planned, this remodel was intended to change up the cabinets and counters to fit the new fridge. So all of the furniture was removed, including the fridge. A new floor was laid down. A very expensive, durable, industrial no-skid floor, which is in direct conceptual conflict with the previous replacement of our very durable metal/formica table, with a fancy $700 black finished wooden table. Yeah. Vulnerable carpeting and indestructible table out, and in with indestructible flooring and a vulnerable table. Both expensive. Both unnecessary.
But what's this? Costs are too high? Just a few weeks ago this was not a problem, but things changed in a short time. It will be expensive to replace the cabinets, so let's just leave them where they are, and when we're done with the floor and walls we'll put the new fridge over on a different wall instead.
If you've followed the saga all along, you can probably see where we're going.
Along with a ton of other unnecessary changes, the fridge that was replaced without cause was an overall downgrade, and it doesn't fit where the old one went. Through the evolution of progress, a kitchen remodel was proposed and accepted so that a reconfiguration will allow the fridge to fit. In mid-renovation, the budget was adjusted, eliminating the cabinetry changes, Now the fridge is going where you can't hook up water to it (one of the given reasons this fridge was bought in the first place was to replace our water cooler vendor contract with a water-dispensing model).
When all is said and done, the cabinets will be unchanged. The fridge will be on another wall, and there will still be a corner void where it used to go. The water coolers will still be here. We'll have a new floor and redone walls, which were never needed to begin with. Hell, NONE of this was ever needed at all. I can't fathom the number of cases of hot chocolate this project could have funded.
Remind me why we did this again? Never mind, just clobber me with a baseball bat and put me out of my misery.
Review:
Amazing Kitchen Developments!
I'll try to be brief. When planned, this remodel was intended to change up the cabinets and counters to fit the new fridge. So all of the furniture was removed, including the fridge. A new floor was laid down. A very expensive, durable, industrial no-skid floor, which is in direct conceptual conflict with the previous replacement of our very durable metal/formica table, with a fancy $700 black finished wooden table. Yeah. Vulnerable carpeting and indestructible table out, and in with indestructible flooring and a vulnerable table. Both expensive. Both unnecessary.
But what's this? Costs are too high? Just a few weeks ago this was not a problem, but things changed in a short time. It will be expensive to replace the cabinets, so let's just leave them where they are, and when we're done with the floor and walls we'll put the new fridge over on a different wall instead.
If you've followed the saga all along, you can probably see where we're going.
Along with a ton of other unnecessary changes, the fridge that was replaced without cause was an overall downgrade, and it doesn't fit where the old one went. Through the evolution of progress, a kitchen remodel was proposed and accepted so that a reconfiguration will allow the fridge to fit. In mid-renovation, the budget was adjusted, eliminating the cabinetry changes, Now the fridge is going where you can't hook up water to it (one of the given reasons this fridge was bought in the first place was to replace our water cooler vendor contract with a water-dispensing model).
When all is said and done, the cabinets will be unchanged. The fridge will be on another wall, and there will still be a corner void where it used to go. The water coolers will still be here. We'll have a new floor and redone walls, which were never needed to begin with. Hell, NONE of this was ever needed at all. I can't fathom the number of cases of hot chocolate this project could have funded.
Remind me why we did this again? Never mind, just clobber me with a baseball bat and put me out of my misery.
Sunday, June 20, 2010
The Ladder 49 Effect
My wife literally paused the movie. It's not what you think, though.
The crew was on the roof of a burning multistory building, and a man was trapped at a window below, on the ledge, and looking ready to jump. The guys were rigging their rope equipment, methodically and expertly checking everything twice before sending a man over the edge.
My wife stopped the movie and said "I get it, now". This was years ago, but I remember it. She went on to describe how, when things get dicey at home, like one of the kids gets injured, or an appliance springs a leak and floods the basement, or we're just really late for something important, it always drove her crazy when I would sort of slow down instead of showing the appropriate amount of alarm.
Suddenly, it all made sense to her.
Actually, I hadn't realized that it was ever an issue, personally. That shows my ignorance.
She realized that, as a conditioned response to creating order from chaos, deliberate calm must be injected into the situation. This attribute is how firefighters, soldiers, police officers, medics, etc. stay in control, prioritize (triage), and start to take apart the problem in order to fix it. For me, it is essential both on the fireground as well as in the transmission grid control center.
Epiphany realized, the film was continued.
Fast forward years.
We were in the ER with the three-year-old son #4, experiencing some symptoms of an anaphylactic reaction that nearly took ten-year-old son #2 from us a year ago. Sure, I was concerned, but on the OK-UhOh-OhCrap scale, he was only slightly on the UhOh side of OK. The nurse came in to hook him up to some monitoring widgets and get his latest vitals, and I remarked that his color was great and his breathing was not labored.
Some discussion later, after the nurse departed, revealed that wife was a little offended. She perceived that I was belittling her concern for our son and getting chatty with the help.
We had a good long talk in the ER as son #4 slept (did I mention, it was 3AM?).
She now realizes that the Ladder 49 Effect was in play here. That detachment from any actual emergency is essential if I am going to be useful in helping fix it, especially if it involves my family. I am not going to do my children, wife, or anyone any good if I am freaking out.
She understands now, that when I detach and distance myself from an emotional response when six-year-old son #3 has blood streaming down his face from a playground injury, it's not that I don't care. It's how much I DO care. The apparent detachment is in exact opposite proportion to how concerned I am.
You've probably got that one captain on staff. You know, the one who is always calm. And when he gets really, really calm, everyone else on the crew and overhearing him on the radio starts to get a little lathered up, because when he actually puts the calm on in full force it is precisely because the OhCrap score is really, really high.
So, to those of you who detach by necessity because of how much you do care, just realize how it looks to your significant other. Wife gets it now, and can rationalize what looks like increasing detachment into how concerned I really am, but emotionally it will never work for her. When you're dealing with family, if you can remember it and if it doesn't interfere with mitigating the chaos, at least try to pretend to look concerned once in a while, for the sake of those who don't "get" how we roll.
The crew was on the roof of a burning multistory building, and a man was trapped at a window below, on the ledge, and looking ready to jump. The guys were rigging their rope equipment, methodically and expertly checking everything twice before sending a man over the edge.
My wife stopped the movie and said "I get it, now". This was years ago, but I remember it. She went on to describe how, when things get dicey at home, like one of the kids gets injured, or an appliance springs a leak and floods the basement, or we're just really late for something important, it always drove her crazy when I would sort of slow down instead of showing the appropriate amount of alarm.
Suddenly, it all made sense to her.
Actually, I hadn't realized that it was ever an issue, personally. That shows my ignorance.
She realized that, as a conditioned response to creating order from chaos, deliberate calm must be injected into the situation. This attribute is how firefighters, soldiers, police officers, medics, etc. stay in control, prioritize (triage), and start to take apart the problem in order to fix it. For me, it is essential both on the fireground as well as in the transmission grid control center.
Epiphany realized, the film was continued.
Fast forward years.
We were in the ER with the three-year-old son #4, experiencing some symptoms of an anaphylactic reaction that nearly took ten-year-old son #2 from us a year ago. Sure, I was concerned, but on the OK-UhOh-OhCrap scale, he was only slightly on the UhOh side of OK. The nurse came in to hook him up to some monitoring widgets and get his latest vitals, and I remarked that his color was great and his breathing was not labored.
Some discussion later, after the nurse departed, revealed that wife was a little offended. She perceived that I was belittling her concern for our son and getting chatty with the help.
We had a good long talk in the ER as son #4 slept (did I mention, it was 3AM?).
She now realizes that the Ladder 49 Effect was in play here. That detachment from any actual emergency is essential if I am going to be useful in helping fix it, especially if it involves my family. I am not going to do my children, wife, or anyone any good if I am freaking out.
She understands now, that when I detach and distance myself from an emotional response when six-year-old son #3 has blood streaming down his face from a playground injury, it's not that I don't care. It's how much I DO care. The apparent detachment is in exact opposite proportion to how concerned I am.
You've probably got that one captain on staff. You know, the one who is always calm. And when he gets really, really calm, everyone else on the crew and overhearing him on the radio starts to get a little lathered up, because when he actually puts the calm on in full force it is precisely because the OhCrap score is really, really high.
So, to those of you who detach by necessity because of how much you do care, just realize how it looks to your significant other. Wife gets it now, and can rationalize what looks like increasing detachment into how concerned I really am, but emotionally it will never work for her. When you're dealing with family, if you can remember it and if it doesn't interfere with mitigating the chaos, at least try to pretend to look concerned once in a while, for the sake of those who don't "get" how we roll.
Thursday, June 17, 2010
We Remember The 3 and The 9
This is a rough week in the fire service, as we remember two tragedies that combined to take twelve firefighters from our ranks.
June 17, 2001, City of New York, NY. The Father's Day Fire.
We remember...
Firefighter Jown Downing, Ladder 163
Firefighter Brian Fahey, Rescue 4
Firefighter Harry Ford, Rescue 4
- - -
June 18, 2007, City of Charleston, SC. The Charleston Sofa Super Store Fire.
We remember...
Captain Louis Mulkey, Engine 15
Captain Mike Benke, Engine 16
Firefighter Melven Champaign, Engine 16
Captain William "Billy" Hutchinson, Engine 19
Engineer Bradford "Brad" Baity, Engine 19
Firefighter James "Earl" Drayton, Engine 19
Engineer Mark Kelsey 40, Tower 5
Engineer Michael French, Tower 5
Firefighter Brandon Thompson, Tower 5
Take a moment today to remember, and be free giving out hugs to your family tonight.
June 17, 2001, City of New York, NY. The Father's Day Fire.
We remember...Firefighter Jown Downing, Ladder 163
Firefighter Brian Fahey, Rescue 4
Firefighter Harry Ford, Rescue 4
- - -
June 18, 2007, City of Charleston, SC. The Charleston Sofa Super Store Fire.
We remember...Captain Louis Mulkey, Engine 15
Captain Mike Benke, Engine 16
Firefighter Melven Champaign, Engine 16
Captain William "Billy" Hutchinson, Engine 19
Engineer Bradford "Brad" Baity, Engine 19
Firefighter James "Earl" Drayton, Engine 19
Engineer Mark Kelsey 40, Tower 5
Engineer Michael French, Tower 5
Firefighter Brandon Thompson, Tower 5
Take a moment today to remember, and be free giving out hugs to your family tonight.
Sunday, June 13, 2010
Not to be Outdone
I was inspired by the new mascot hired at Happy Medic Headquarters, but since I don't have the funds to hire Paul Combs to manage the talent search, I just had to go clean up the guy already working as my mascot.
He's done a fine job, I guess, but it was time to dress him a little better.
So here he is, showing a little more pride, and ready to get back to work.
He's done a fine job, I guess, but it was time to dress him a little better.
So here he is, showing a little more pride, and ready to get back to work.
Friday, June 11, 2010
Losing Sight of the Purpose
I cannot explain - maybe some of my readers can - the train of thought that prompts some of my brethren to place apparatus wheel chocks at an angle to the tire.
Wheel chocks are designed to take the brunt of a rolling tire square on, so as to evenly transfer the force against the lower far edge of the chock to the ground.
Placing the chock at an angle creates imbalanced transfer of forces, inviting lots of interesting new scenario outcomes. One interesting possible outcome is the violent launching of the wheel chock.
So, seriously, why do some guys do this? Maybe I should ask, I admit I have not done so. The only thing I can come up with is that it makes it easier to see from the mirror so you don't miss it and leave it behind and/or drive over it.
If you do your walk around and practice good apparatus operator habits, this should not be a problem. That said, I've driven over a few wheel chocks myself.
But, I digress.
I recently came across this wheel chock deployment on Engine 55.
When you reach the point of modifying your practices so far that you nullify the point of the practice in the first place... well, I don't know what to call your behavior, but wake up and pay attention to what you're doing, please. Seriously.
I took the proper steps to get this corrected here. If it's happening at your place, here's your chance to see what lies ahead and why you should nip it now.
That is all.
Wheel chocks are designed to take the brunt of a rolling tire square on, so as to evenly transfer the force against the lower far edge of the chock to the ground.
Placing the chock at an angle creates imbalanced transfer of forces, inviting lots of interesting new scenario outcomes. One interesting possible outcome is the violent launching of the wheel chock.
So, seriously, why do some guys do this? Maybe I should ask, I admit I have not done so. The only thing I can come up with is that it makes it easier to see from the mirror so you don't miss it and leave it behind and/or drive over it.
If you do your walk around and practice good apparatus operator habits, this should not be a problem. That said, I've driven over a few wheel chocks myself.
But, I digress.
I recently came across this wheel chock deployment on Engine 55.
When you reach the point of modifying your practices so far that you nullify the point of the practice in the first place... well, I don't know what to call your behavior, but wake up and pay attention to what you're doing, please. Seriously.I took the proper steps to get this corrected here. If it's happening at your place, here's your chance to see what lies ahead and why you should nip it now.
That is all.
Tuesday, June 8, 2010
Budget Cuts Fail
You think it's bad now?
It could always be worse. Even for this guy. Imagine cutting his bike to a unicycle, or taking it away altogether.
It could always be worse. Even for this guy. Imagine cutting his bike to a unicycle, or taking it away altogether.
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