One of My Favorites

Had one of my favorite things happen at a call recently.

It's a simple thing. A small town thing.

We got a call to an address where I had been before, but the patient description was not even remotely familiar, even though the location was.

We don't have a lot of rental property out here, but we do have some- and this was one, so I thought maybe the previous patient had moved or something, and that was why this wasn't ringing a bell.

But when I walked in, something happened that clarified everything.

The patient recognized me. 

Remembered that I had been there before, six months ago.

When the patient's FRIEND was staying there while recovering.

THAT was why nothing sounded familiar.

Same address; different patient.

At the call months ago, I assumed I'd never know how things turned out, because that patient doesn't actually live in my response area, so it was unlikely we'd meet again. It was a somewhat uncommon medical situation, so I had wondered, more than once, how things had gone.

The friend was happy to give me an update, and let me know the former patient was doing very well, indeed.

So nice to hear!

I was somewhat surprised to be remembered.

One Small Post

It has been forever since I've posted.

No excuse for that, other than life being life, and things being things.

As usual, after a long break in posting, it's a bit of a challenge to decide what topic is "good enough" to be THE post that starts up the blog again.

Also, as usual, my decision ends up being that it doesn't matter. This isn't about the big, important topics, it's about the daily, small things. The insights. The experiences. The learning process.

Since my last post, I've gotten to do something that is near and dear to my heart.

I've become a lab instructor, with a great crew of other lab instructors, and help teach EMT classes at the local community college.

Not only that, but one of the primary instructors has a different take on how best to teach the class, since the state changed the curriculum. We're running a class that is heavily lab-based, with much less powerpoint and much more hands-on. We're currently in our second run of this concept, and I have to say, I think we're heading in the right direction. Still some stuff to work out in order to make it the best it can be, but we've seen many advantages to this model, and on top of that, we're having a great time, as are the students.

The first semester I was doing this totally kicked my butt, in a GREAT way. To be able to present didactic material in the lab setting, while keeping the hands-on part engaging, not spending too much time talking OR skipping any of the critical information, requires the instructors to be on top of our games, and has been SUCH a great learning opportunity for all of us, not just the students.

Instead of the typical lab structure of setting up stations that the students then rotate through, we have "teams" of students, each assigned to one instructor for the whole lab, and then change which instructor they work with from lab to lab. This means much of the instruction is done in a small group setting, which has done wonders for encouraging students to ask questions, and to keep up with the reading, since they really are expected to participate and contribute to discussions (and they DO). This ALSO gives the instructors a lot of one-on-one time with every student in the class, and our post-class review highlights any student who is having trouble keeping up.

For me, this way of teaching is a "natural" fit, since it is so connected to the teaching I've been doing in the rest of my life for the past 15 years.

I think this is enough for coming back to this blog. Lots of other stuff to say, of course.

Updates on our "medical mystery." (Solved? Maybe.)

Lessons learned from calls.

Maybe an update on not being so alone out here anymore… or am I?

Or maybe… I'll end up not posting again for a couple of years. It could happen.

At any rate, if anyone out there cares, this is just a short post to show that I haven't quit, haven't disappeared, haven't become one of the many, many people who burn out.

I am, however, intensely jealous of everyone in Baltimore right now for EMSToday. I couldn't afford to go, in time or money. :::sigh:::

Grieving

Some calls stand out.

It might be because of the patient's condition, or it might be that things went particularly well- or not well. It might be the weather, or who was there, or where it was, or almost any other detail. There's no question, some stay with us longer than others.

If the reason that the thought lingers is that it was an emotionally traumatic event, there are a variety of ways that people deal with that. There's even a process in place, to bring help to anyone who is having a hard time.

I've been doing this for a few years now, and have seen more than a few things that most people never see. I've had calls go extremely well, up there near the "miracle" category. And I've had some that didn't go well, necessitating much thought and re-assessment and some researching and pre-planning for the next time.

I've had calls that might make most people stressed out not cause me to be so, and I've had some that weren't particularly "bad" stay on my mind for a long time.

I get attached.

This shouldn't come as a surprise to anyone who knows me. I get emotionally attached to inanimate objects, like my car, or my computer, or the house I lived in as a child, so attachments to actual people isn't much of a stretch. Even if I don't know them.

Through all of this, I've learned what helps me process things, what helps me cope, what helps me stay human, without staying sad.

I recently had a call where the patient didn't make it.
It wasn't a surprise, given the situation at the time.
I would really like to have been able to do something more helpful, but it was not to be.

I read the obituaries every day.
Partly to see if anyone I know died, partly to notice the ages of the deceased, but also, to see if any of "my" patients are in there. Sometimes, we get called to a patient and we don't find out directly what happened, but they never go home again.

It is in those obituaries that I sometimes begin my healing process. I read about their lives, their families. Sometimes the things they have done, or the dreams they had. I see how they were- and are- loved.

I "get to know them," just a little. Enough to say goodbye, and to mourn them as a person. Enough to be sad for their passing, and to remember them.

And then, I can move on.

Goodbye, my short-term friend. May your smiles be remembered, and lighten the hearts of your family and friends.

In the Middle Of It

So we're taking this class, and having a great time. Learning a lot. Working with some great people. And now, cardiology. What we've been waiting for.

Sounds great.

Except for one little detail...
We are also right in the middle of our very own Mystery-Diagnosis-worthy medical situation.

As in, I wouldn't be surprised if we actually DO end up on that show.

So far, we're on Dr.visit #7, and medication #9.
And no one really has a clue what is wrong.
Lots of theories.
Conflicting theories.
Most of which don't match the signs and symptoms.

Some tests are being ordered, and I'm bouncing back and forth between "Oooh, cool!" and "oh, crap!"
Hopefully they will shed some light on the situation, and we'll get things figured out and fixed and life will go on.

In the meantime, this is wreaking havoc with any ability to do clinical or ride time, and the future of staying in the class is somewhat doubtful.

As much as I find the entire subject fascinating, I've been telling people that what I'd really like is for no one in my family to ever have anything medically "interesting" happen to them.

When we get to the other side of this, I'll write it up as an exercise, and see what people think. Until then, good thoughts would be appreciated.

Where Has the Time Gone?

Haven't found the time to write here for a while. Again.

Life is busy.
That's not a complaint, but it does make it challenging to keep up with everything.

I'm taking a class that takes a lot of time, for the class itself, studying between classes, and now, substantial ride and clinical time.

These are good things. I'm learning a tremendous amount. Excellent instructors. Plus, I've been doing this long enough now, and doing enough additional learning, that many things are starting to come together well.  That's interesting, a little exciting, and very useful on scene.

We've had interesting calls.
We've had more small town, small agency, politics.

I'll work on sharing more of the good stuff here. Learning opportunities. Stuff I've been thinking about. At least SOMETHING, rather than nothing.

Appreciating all of the support from those of you out in the blogosphere, even while I've been mostly absent.

The Tough Women Club

It was nearly Christmas. We were just sitting down to watch the Grinch, and tradition in our family is that if you want to see the major Christmas specials- Rudolph, the Grinch, and Frosty- you have to catch them when they are shown. No taping allowed.

Not five minutes into the show, the pager went off.

I knew where the house had to be, being familiar with our response area. It was back behind trees, at the end of a long driveway, with no obvious numbers. WE knew where it was, but the ambulance likely would not.

Sure enough, they missed the house. Twice, at least. We could see and hear them go by, but since I'm not allowed to carry a radio, we had no way to contact them to give them directions.

Meanwhile, we were inside, with the patient, listening to her story.

She told us about her cardiac history. About her stroke history. About being diabetic. About her asthma. She talked about tiring more easily than she used to. And oh, by the way, she casually mentioned she also has cancer.  All of this relayed with no apparent distress, like discussing the weather, or a television show.  She was, as she described herself, "a stubborn old lady." Certainly tough enough to kick whatever this was that made her feel "a little off." We had a good laugh together, the three of us, the "tough women" club, before anyone else arrived on scene.

She reminded me of another patient we had seen, another tough old lady, who made me smile more than once over the years. I wondered if they knew each other, if, perhaps, they had been close friends, they seemed so alike. I could easily imagine the two of them as youngsters, turning heads and causing trouble. This little town seems to grow some tough women, women who live long and well. Women who are good workers, and even better friends. The kind of person you can count on, no matter what.

I just now saw her obituary. She died a few days ago. I'm absolutely certain she was tough to the very end, and probably had friends and family chuckling over some joke, or tall tale. If I had to guess, I'd bet she was comforting family and friends, rather than the other way around.

Godspeed, Alma. Keep everyone wherever you are in line, until the rest of the club gets there, okay?

Connection/Separation

There is a patient we have seen many times over the past few years.
I like her.

She has a rare chronic medical problem, one I had never heard of before meeting her, and am now almost an expert on. When she calls, I know what to expect, where her pain will be, and what I can do to help alleviate it. I love knowing those thing, knowing that I am able to offer her at least some relief before the ambulance even gets there.

It is an intimate thing.

When a person is in a lot of pain, they are rarely at their most sociable best. Anytime someone is very ill, they tend not to be fresh as a daisy and ready to entertain, to say the least.
That we are allowed into that world is an awesome privilege.
She and I have met enough times that she trusts me, at least enough to allow me to be there, to touch her, to comfort her. She knows I care, and I know that she is grateful.

Living in a small town, it is inevitable that we would have friends in common, and we do. We don't "run in the same circle," but we do see each other from time to time at events, or in passing.

It is always good to see her when she is feeling well, when she is out being happy, being a whole, comfortable person in the world. To look at her then, you'd never imagine that she has any medical problem at all. She is vivacious, smiling, confident.

But not once, in any of the times we have run into each other outside her home, has she said hello, or acknowledged me in any way. And not once have I gone up and spoken to her, either.
It is an unwritten agreement, of sorts.
Although there are times when we are as close as people can be, sharing sweat, tears and pain, the rest of the time, I do not belong in her life. I am forgotten. Unacknowledged.

It is not that I expect her to run up to me and thank me every time she sees me.
That would be horribly awkward, at best, and isn't at all necessary.

I just find it interesting that there can BE such separation of connection.

I like how I am able to be there when she is having difficulty, and not have that spill over into a semi-social relationship, just because we live near each other. That we are not "friends" does not lessen the intensity or value of the relationship we have. It may well enhance it by removing all social awkwardness, or any obligation to each other outside the narrow window of emergency situations.