The heat wave supposedly ended two days ago, but here I am sweltering in an ambulance sitting in the parking lot behind CVS. My phone says its 79 degrees, but there is no shade, no wind, the humidity is heavy and the AC isn’t worth shit.
I had to go to bed early last night to get up at 4:50 to make it in for my 5:30-17:30 shift. I packed a water bottle with ice, but the ice is all melted and there is just a couple inches of coconut water left in the bottom that I am sipping at. We are covering the world from area 13–no relation to area 51 in Roswell, New Mexico–but sometimes it feels just as strange. Covering the world means we are the only ambulance available, everyone else being on emergency calls or at the hospital. We have been dispatched four times today, three for man down unresponsive, two of those for possibly not breathing, and one of them for CPR in progress. Not a single patient at any of the three calls. The first one at least a bystander, said the man had been sleeping under the trees, got up and walked away. The second one, at a shelter, the fire department came out and said the guy was fine and didn’t want to go so they were cancelling us before we even went in The last one was supposedly CPR in a bodega, woman on the floor. We pulled in and three dudes looking completely unconcerned were sitting by the open bodega door, drinking from paper bags. They said nothing was going on in the store, maybe we should check around back, so we drove around back and found nothing. We called dispatch and they said try across the street from the store, but we went there, and looking with the fire department helping, we came up empty again.
The one call we did transport was a woman in pain all over, history of alcohol use disorder and a bad MVA that left her with back issues. She said it hurt whenever she moved or breathed, but she was fine when just being still, so we didn’t give her any more than comfort care.
I checked my bag thoroughly this morning. I don’t work enough that I can afford to just toss my gear in the rig and head out. I need to remember where eveything is. We got new radios this morning as well as new narc kits. The radios were nice, and easy to use with a key button you could press if you got on the wrong channel — it would put you right back on the company frequency. They gave me the choice of a shoulder strap or a belt clip. I took the belt clip. I found those less obstrusive. The narc kits were nice too, except where before we had two kits, now we only have one and it has less meds in it than each of the old kits. There is 300 mcgs of fentanyl, 20 mg of midazolam and 1000 mgs of Ketamine. No more moprphine or ativan. You use the kit, you are out of service until you can replace it at the pharmacy with a new one, but if we are at status zero and a call comes in, you still have to take call, full narcs are not. The idea is if you are out of fentanyl, you could still use ketamine. And if you are out of midazolam, you could also use ketamine. Not certain I like that choice, but they said it would be rare to have to do a call in those circumstances. We’ll see. I’ve used both kits in the past, but didn’t always return to the pharmacy after using the first kit, particularly if I used it earlier in the shift. I would wait till I brought a patient to the hospital where our exchange pharmacy is located.
Seems like every time I work there is something new going on. Last time, it was a new form of cardizem where the powdered cardizem is self contained in a bag of fluid and you just have to reach in pull the top off and mix it. Once the QA person demonstrated it to me, it looked easy enough, but I haven’t had to use it.
We’re a little more than halfway through the shift. A BLS unit just called for a medic for seizures, but they dispatched someone else. A GSW went out to and another medic got that one– kid shot twice, but not in fatal areas. I’ve been scrolling through my phone trying to answer some emails from my hospital coordinator job. I try to always respond within an hour if I can so I get frustrated on days I work the road that I fall behind. Some inquiries I can answer from my cell, but others have to wait till I get back to the office, calls like patient followups or people wanting opioid data.
Sitting in the ambulance, I read a ton of news stories on the phone. The world seems like it is going to hell. My daughter is going to college in two years and I worry what she will do for a living. Should she use her college years to get practical experience like nursing or business or should she study history and English and maybe go to law school? It’ll be up to her. I don’t think I would reccomend EMS to her. All day long I’ve been thinking about all the partners I’ve had over the years who are dead earlier than they should have been, and I think about how my back hurt earlier today when I rode that one call in and the bumps threw me up in the air, and I landed hard, and swore under my breath. My partner and I were talking about dead bodies and how it is always interesting to wonder about someone’s last hours as you stand there in their now quiet homes looking at them where they departed this earth, on a bed or a bathroom floor, or in a car in their garage with a needle in their arm. It made me think of the time I presumed an old partner of mine, seeing him lying half naked against a wall in a clutterd apartment with a parakeet flying around uncaged. I didn’t even know it was him until the cop said his name from the ID she’s found. I looked closer at his face then. It was him all right.
In between calls this morning, I went down to the pavillion by the pond in Pope Park and collected the new heroin bags. They were: Wolves, King of Death, One way, Pound Cake, Versace, Mad Hustle/Dope Soul, Cleveland Cavaliers and a couple others. I also collected several syringes to dispose of in the ambulance’s sharps box and found a couple empty naloxone nasal injectors. There was a guy sleeping on the pavillion’s cement floor against the brick wall, wrapped up in a dirty sleeping bag and some kind of arm chair cusion. He no doubt had seen better days. I turned my radio down so the radio traffic wouldn’t rouse him orr startle him from his sleep, and mistake me for a cop there to hassle him.
For lunch I went to the Kien Asian Market on Park Street, which is a small oriental grocery run by Vietnamese. They make bahn mi sandwiches in the back. I got a #2 and #4, toasted not spicy. It cost me $13.50 where not too long back it would 8. Like I always do, I ate the #2 grilled beef bahn mi and am saving the #4 pork skin one for when I get home.
This week I ordered two bar stools and a round bar table for our small back pation that abutts the woods. It took me two nights to assemble them, taking my time as I watched TV, They came out sturdy enough. It was a lot of putting screws in predrilled holes and then handcranking them in with a small tool they provided. When I sit in the bar stool, I am high enough that my six foot seven height still doesn’t reach the floor, through I can rest my feet on the foot rest. I would like to sit out and have a beer tonight when I get home, but won’t if it stays this humid. Maybe we’ll get a thunder storm to cool things down. That’d be nice.
Five hours to go in the shift. Were headed now to cover a suburban town as their ambulance just went out on a call.
***
We stopped at the office on the way to the suburban town as it was on the way and my partner needed to use the rest room. When we went in the building they were having a going away celebration for the operations manager, who is leaving to be a police officer. I got to shake his hand and say good bye. I precepted him many years ago when he was a new medic and thought he did a good job running the place. I’m happy for him and his new career. They had food out and there were a lot of people there. We were a little bent out of shape that they hadn’t rotated us in to partake, but it worked out we got there though we couldn’t stay long and I didn ‘t get anything to eat as I had just had my #2 bahn mi and I don’t eat cake.
No sooner did we get to the town, then they sent us back to the city. Nothing to eventful the rest of the day. I intercepted with a BLS crew for an unresponsive diabetic. His sugar was 32. I put in an IV and gave him 25 grams of D10 and he woke up gently and admitted he hadn’t eaten all day. After that we moved around a bit from one posting location to the next. Five o clock rolled around and the computer sent us in. We dumped the days trash, gassed up the rig and I replaced the D10. I turned in the radio, my gear and the narc keys. I’ll be back at work on Sunday for an 8 hour shift.
At home I ate the #4 pork skin bahn mi and sat out in my back patio and drank four beers and listened to some songs from Bruce Springsteen’s new Tracks 2 release. Normally my wife would sit out with me, but she was in the garage with a friend packing barrels to go to her family in Jamaica. She collects clothing and sneakers and adds in food goods and toiletries and sends them to Jamaica where her brother sells them on the street. The beers I’d bought at Tree House Brewery a couple weeks back. They were light lagers, only 3.5% alcohol in 12 ounce cans. You can drink a lot of them and not get too sleepy or hammered. My back yard needs sprucing up, and I need to clean the vinyl siding on the house. Sitting there drinking I thought we should have a 4th of July cookout this year for extended family and friends. It would motivate me to clean the yard, and I could cook some hamburgers (I have a special recipe where I chop up bacon in small pieces and mix it in with the hamburger meat along with special spices). I could also cook cod, shrimp and bacon-wrapped scallops. My wife could make ox-tail, curry goat and rice and peas. I could slow cook some ribs too. I like a good feast. I believe in “food is love.”
I came inside as it got dark and started to cool down. My wife and I watched an hour of TV and then I went to bed. I had to get up early to take my daughter to a college basketball recruit camp. When that’s over, I’m going to stop at Tree House again on the way home and buy some more of that 3.5% beer. I am content with life and looking forward to the 4th of July. I may even buy some fireworks.