Nausea

This is the third time we've transported her in three days. She can't stop throwing up. She goes to the hospital, comes home, feels awful for a while, and calls us again. I'm trying not to be grumpy, and failing. I was sleeping, comfortable finally, curled up just so that the pager and keys and trauma shears don't dig into my side and leg, waiting out the last few hours of a slow night.

* * * *

The fireman -- a friend of mine -- starts to give me report, but it's an hour before the end of my shift and the hospital is a thirty minute drive away. I brush him off and speak more harshly than I intend to her.

"Still puking? Yeah? Taking your meds? Okay, let's go. Come on, the stretcher is outside."

She's a former drug addict and has the scars -- all up and down her arms, and just as much in her demeanor. There's something in the attitude of many addicts that is a bit whiny and pathetic; it's like the drugs have robbed them of all their dignity and self-worth, and they can never really get it back.

Or, it could be that she's been hurling for a week.

* * * *

Paramedics don't love these calls. Even though we know we aren't actually there to save lives, we want to make a difference. We want to take care of breathing problems and heart attacks and gunshot wounds and car wrecks; not nausea and foot pain and difficulty urinating and all the minor, non-emergent complaints that we end up handling as the healthcare safety net.

We run the calls anyway, and we either get bitter or make our peace.

* * * *

I climb into the back of the ambulance, trying not to sigh audibly.

"Anything different?" I ask, and she shakes her head. Just not getting any better. Couldn't get an appointment to see my primary doc.

I hook her up to the monitor, get a blood pressure, glance at the EKG, all the usual business. When I go to attach the electrodes, I find one that I attached yesterday on her shoulder. Huh. I put the fresh electrode in my hand down and clip the wire on the old one. It works just fine.

The old scars on her arms are now mixed with a fresh crop of track marks from the past week. I know, I've put four or five of them there myself. She's not an easy stick, but the past couple nights I managed to get something, maybe get a bit of fluids in, give her some meds.

Last night I went all the way to the end of the nausea protocol and gave her the quarter-cc of inapsine, as she filled up three biohoop bags.

I rub my face with the back of my arm. I know there's no line to be found on her arms. Whatever. I put one in her leg, mid-calf, in a big vein that I spot without even a tourniquet, hoping the hospital won't raise their eyebrows too far. I dump half a liter of fluid and some zofran in it, and she doesn't puke for a bit.

Great. I pull up my chart from last night and copy her meds, allergies, history. I contemplate copying and pasting my narrative.

* * * *

"I don't want to go to the hospital, you know," she tells me as we unload her. "This is the last thing I want to be doing. I wish I was sleeping, not in the ambulance. I just feel so awful."

"I know," I say, patting her shoulder briefly as my partner punches in the code to open the door to the ER. "I know."