So I know already that I’m probably gonna catch some grief over this one. I can hear it already.
“Patient advocate are ya?” or “Best patient care possible, no matter what is it?”. I can hear the jabs coming already. Go ahead…I’m a big boy, I can take it.
Seems that these days everybody is up in arms over the whole “socialized medicine” thing and how it’s gonna kill grandma or people will be left dying in the streets waiting for some elective surgical procedure. Seriously people, get a grip. If we were not so caught up on ourselves being a nation of “I want it NOW!!”, we’d be storming the capitol steps demanding a European styled medicine system. If we were not so lawsuit happy and ready to take every doctors lake house and Porsche just because they won’t give us our next opiate fix, maybe we could tell the truth to the system abusers. Maybe then we could get down to the business of getting diseases cured and that other important stuff like fixing acute and emergent problems instead of waiting for a simple cold to turn into pneumonia that exacerbates your emphysema from smoking two packs of cigarettes a day for thirty years and now has you knocking on deaths door.
So…what brings this about? Glad you asked.
We get a call the other morning…at 0330, you know the ones. Nauseous and vomiting, needs transported to the ER. Usually not too big of a problem. I don’t mind so much going out and BLSing in a call like this, as aggravating as it may be, but with six to ten inches of snow on the ground and a sheet of ice on top of that for good measure; not too happy about this.
My partner and I (not my usual partner…whole ‘nother story) head out to an outlying subdivision a couple of miles outside the city limits. We turn off the main road which is treacherous enough as it is with ice and packed snow, onto the street where the sick person who is vomiting lives. Now the emergency is over, reds ‘n’ whites off and scene lights on so I can see house numbers.
We’re perusing the neighborhood when dispatch calls our truck on the radio. Now I know we haven’t passed the house because I’m watching house numbers you see. Surely to god this isn’t gonna be one of those calls where the patient just stopped breathing…it’s happened! Lucky us. They just wanted to let us know that the caller called back to let us know that the patient is “vomiting violently”. Violent vomiting you say? Right. Exercising the demons is probably more like it.
I start thinking about my course of action. As long as it’s not a poisoning or an overdose, she’s getting 12.5mg promethazine, maybe 25mg if she’s a good actor and a biobag minus the in-flight movie.
We pull up in front of the house and I immediately know why we are there. In front of their cutesy little house sits a snow-covered car surrounded by a yard and driveway covered with maybe six inches of snow…and not flake has been disturbed.
I back in while signing on scene. Grab my jumpbag and begin the trudge to the front door, all the while feeling a little bad for disrupting the pristine picture perfect scene worthy of a Thomas Kincade rendition.
I’m greeted at the front door by a rail-thin man clad only in his matching gray thermal long underwear. He begins to hurriedly tell me that his wife has been sick for the past three days and has been throwing up ALL night. “She’s thrown up so much there’s nothing left to throw up”, he tells me as he leads me to the hyperemetic patient. I guess where I’m at two plus two don’t equal four, because nothing left to throw up and violently vomiting isn’t working for me.
I reach the back bedroom(of course) after winding my way through, around and over the clutter strown about the house, to the sight of a 250lb plus lady sitting on the edge of the bed with a trash can between her knees.
“Hey, what seems to be the problem?”, I ask.
“I’ve got diverticulitis” she answers.
“How long has this been going on, the vomiting that is?” I asked trying to find my route of possible treatments.
“About three days” she says flatly. **Note for record…It only snowed YESTERDAY!!**
I look into the trash can between her legs and see that she has produced some content, not a lot and nothing particularly concerning with the appearance. So I continue on with checking vitals and my interview, feeling the situation out. Then I finally get to the question that we all love to ask, just hoping to make the patient realize what a turd they are for calling at this time of morning for this,
“So…How is what you’re experiencing now any different than it was twelve hours ago?”
“Nothing really, I just can’t stand being sick anymore”, she says like I’m an ass for even asking the question. Obviously she’s entitled to endure as long as possible and then call me when she tired of enduring…silly me, what was I thinking?
Well, obviously she wants us to get her to a place where she can be cared for better than she can care for herself at this time of morning and consents to transport…obviously. I even offered to help her get to the car; she doesn’t think she’ll make it and her husband can’t worry over her and drive too. My partner (seriously, another story) and I retreat to the truck to retrieve the stretcher all the while wondering how we will get it to her through the muck and mire inside. We quickly realize what a chore this is going to be as we attempt to roll it through the snow. HA!! Yeah, we don’t have the four wheel drive model. We end up having to basically carry it to the porch. We envision out loud doing this with her 250 lbs of violently vomiting diverticulitis ridden whiney butt on the stretcher. Why do I do this job again? O yeah, kids got to eat…I remember now.
I go back into the bedroom to assess her mobility. “Can you walk if I help you?” I ask offering her a chance to help herself in the search for definitive care.
“I had hip surgery three years ago, but I got this cane that I use…I think so” she says as she eases herself off the bed and onto the floor.
“Careful now, don’t be in too big a hurry” says the man in the gray thermal underwear. All this time he’s been standing in the background not saying a word. Every so often I’d cast a glance his way to see if he wanted to chime in. Nope. He just stood there and dutifully nodded to her recounting of the incidents leading to our presence.
The patient is now waddling her way through the clutter in much better fashion that I have managed this far. I guess some things do come from experience. She makes it to the front door of the house without so much as a grunt or a groan. I guess it’s worth mentioning that we’ve been on scene at least fifteen minutes by now and she hasn’t vomited once, violently or otherwise; not even a wretch.
She climbs onto the stretcher and we strap her in so “she doesn’t get there before we do”(c’mon, you say it too...don’t deny it) and cover her with a paper thin sheet and a slightly thicker blanket to protect her from the frigid night air. This will also add an extra layer of insulation if we happen to dump her butt in the snow while trying to plow our way to the truck.
We strain our backs one more time, taking a yet undetermined amount of time off of our usefulness to society allotment, and lift her to the loading position. We then begin the arduous task of plowing our way through six inches of snow back to the truck for this all important trip to the hospital. I’ll not put in print the words that formed in the deep dark recesses of my mind during this journey of about 50ft., nor will I admit to what I really wanted to do.
As we get the stretcher loaded into the truck and secured to the locking bar, I step back so as to allow ample room for my partner to enter the truck to exercise those well honed BLS skills that only a man of his caliber can. After all, he’s a supervisor; surly by now he realizes that she doesn’t need any life saving invasive interventions. He mounts the box in a fashion that leaves no room for interpritation about how he feels having to ride this one in. “Don’t like it…then medic up” I think inside while laughing under my breath.
I shut the doors and do a little ambu-pat as if I really expected the truck to pull off into the night with the siren wailing just like they do in the movies. As I turn to go towards the drivers side, the man in the gray thermal underwear, now wearing work boots that are untied, appears and asks, “Can I tell her somp’n right quick?”
“Sure thing”, I say as I open one door.
He pokes his head in the open side while leaning on the closed door and says to his not violently vomiting, diverticulitis ridden, whiney 250lb hefty wife, “Hon…I’ll be right on over, soon as I get dressed.”
The guy is lucky I didn’t use him to make snow angels!
~~And a special "Thanks" to my alcoholic friend for letting use his laptop so that I may continue my work while my PC recovers from a viral infection~~