Tuesday, January 30, 2007

Glimpses

Friday, noon: We crouch and kneel and stand, six of us, around a middle aged woman sitting on a chair in a department store. "I took a bunch of my anxiety pills," she says, sleepily, with pinpoint pupils. We struggle to start an IV, and eventually give her IM narcan. She perks up, and as we take her out to the ambulance she asks me, all of a sudden, "How long ago did you narcan me?" In the back of the ambulance she gets upset with my partner. Shouting, screaming, cursing, she admits to using heroin. She rips out the line we'd finally established, and tries to get off the gurney. A flexcuff keeps her down. As we take her into the hospital, she asks, "Why'd you have to f***ing narcan me, you a**holes? Why don't you just put a f***ing bullet in my brain? Just put a bullet in my brain!"

* * *

Friday, sunset: I sit in the cab of the ambulance, at a post that is close to huge bluffs overlooking the shipyards. It's unseasonably warm and smells like spring. I turn up the radio, roll down the window, pick up my book, and marvel that they're paying me for this.

* * *

Friday, night: She looks up at us sleepily. "I don't want to be here anymore," she says. As the firefighters try and get vitals, and the fire officer and some cops try and make sense of the pill bottles, I ask what she took. Something. Everything. We finally get a good list of the empty bottles: Atenolol. Xanax. Prozac. Nifedipine. Digoxin. We take her to the nearest hospital, code 1, no lights but a quick trip. They put her down, tube her, muttering urgently about the Digoxin in particular. I listen to a nurse talk on the phone as she draws blood. "We need ten vials of Digibind. ... What? You've only got five in the whole hospital? ... Well, get more! I don't care where from."

* * *

Saturday, evening: The three huge beers he had only compounded the pre-existing brain injury from a long-ago trauma. Somehow he set his hair and head on fire with a lighter. His wife, anxious, says he told her the lighter exploded. I look the offending implement over with the fire officer. "What do you think?" I ask him. He looks at the patient, looks at me. "Operator error," he says, sotto voce. We take him to the hospital with a burn center. On the way my partner pulls up his shirt to look for burns elsewhere, and he laughingly accuses her of getting fresh. His wife tells him to behave, and we all chuckle.

* * *

Saturday, after midnight: I agreed to work a double. Now we go code 1 to a club downtown. As we pull up we spot five or six cop cars, all lit up. "This must be us," I quip. Our patient is sitting on the curb, in handcuffs. Nasty cut above his eye. "I wasn't even involved!" he protests. We ask him which hospital he wants to go to. "None!" he says. "I want to go home!" We talk to the cops. I crouch next to him, touch his shoulder briefly. "Look," I say, trying to be kind and not condescending. "You've basically got two choices. Go in the ambulance, no handcuffs, a citation for the charges, and go to whatever hospital you want. They'll fix you up and send you home. Choice two, go in a cop car, still go to the hospital, and then go to jail." He eventually agrees, and falls asleep on the way up to the hospital.

3 comments:

penguinshrink said...

Did you already suspect opiates with the lady in the department store, or do y'all routinely give narcan for suspected benzo OD?

Susan Palwick said...

These are wonderful miniature stories. Thank you for posting them!

PDXEMT said...

Penguinshrink-

She was sleepy, pinpoint pupils, depressed respirations, location and circumstances suspicious for narcotics OD.

Generally whenever someone is altered with respiratory depression and we can't rule out narcotics, we'll try some narcan. Can't hurt, y'know?