Warning: don’t read this post at the table, especially if you’re of weak constitution.
Wait, what? We’re mostly all medics here, aren’t we? We wade through pools of blood, slipping over puke and poop, sweating profusely to our grossly disfigured patients with impaled rods through the eyes and Jell-O for bones.
How many of you flinched?
Everyone has their weak spot on a call. Mine are dentures that pop out unexpectedly and DOA’s that look zombie-esque. I have horrid irrational grossouts and fears. (If you haven’t read my post on Zombie Awareness you should do so now.) The point is, we all have them. Seasoned veteran and n00b alike, you’re going to see, smell, feel, and (for the unfortunate) get a taste of things you’ve never wanted to experience in your life on this job that we call EMS.
“What’s the point besides trying to gross up out, MsP?” you may ask. I’m getting there. But first: a story!
I was in Paramedic school and was being taught by the lovely “Sal.” He was a jolly man, always smiling, and an excellent teacher. You could ask him questions all day and it never bored him nor tested the limits of his endless knowledge of all things, medical and trivial alike. (He likes old cars and motorcycles, too!) One day, when we were about to go off onto our own with shiny gold patches blazing in the Louisiana sun, he sat us down.
“Ladies and Jellyspoons,” he said smirking through his thick white mustache, “old Sal wasn’t always this old and wise.”
I giggled because to me he was born with a white mop of hair and bright white mustache. He looked at me half joking and half sternly, like a dad would an unruly toddler.
“When I was a mere probie, I learned that it’s more than fine to tell your partner when you’ve had enough.”
In my mind I’m thinking: enough of what? Enough sodas, enough food, enough of the teasing, enough of the pranks?
“Old Sal is not infallible. I’m going to tell you a secret that you have to swear to never tell!” (I changed your name, Sal so it doesn’t count!) “There is nothing I hate more than poop. Give me anything else on any other call, but the moment someone drops a deuce, I’m done for. Not just the ‘run away’ kind of hatred, it’s the ‘by the way, I was finished with that sandwhich, enjoy it on your boot,’ kind. Well, little did I know that my partner hates vomit and that’s about all. You see where this is going, don’t you? We were called to an abdominal pain and as we learned of her complaints, I blanched as white as my mustache hairs. She had the fois, ladies and gents.” (For those not in the know- the fois is a Cajun French term for “the runs”. pronounced Fwah.) “So it’s my turn to ride this call, and I know that if she craps herself that I won’t be able to handle it cramped in the back of the rig with her. I wanted to prove to my partner that I wasn’t a weenie probie but a real man. I put on my best somber face and sat down in the captain’s chair. We did everything necessary on the call BLS and ALS wise, and yes, notice that I said BLS before ALS.” (How he loved his teachable moments!) “Well, as we’re pulling into the ambulance bay, I breathed a sigh of relief. She hadn’t so much as passed a ghost turd that whole transfer time. Before my partner could reach the door, though, it happened. I heard the telltale sign of the lower abdominal growl and I scrambled for the handle, but it was too late. Before I knew it, the worst smell imaginable hit me. It could have knocked out a hippo on speed. I tried to breathe through my mouth, but all I kept thinking was ‘It’s in my mouth, my breath is going to smell like this now, oh God, it’s in my mouth.’ That’s where I lost it, leaned over and puked all over the side of the stretcher. Like I said before, I did not know about my partner’s aversion for puke, nor had he witnessed the arrival of our wonderful lunch of seafood po-boy just 2 hours after it’s disappearance into my lower gut. He opened the door, saw the patient looking terrified and looked at me, still hunched over and saw the vomit making it’s way towards him. He looked at me, pale as a ghost, and just started violently throwing up all over the place. It was on the cot, on the paneling on the side of the cots, on the ground of the ambulance bay, probably in the patient’s sock which was still dripping with poop. You get my points. It was a horrible, horrible mess to say the least.”
At this point, I was laughing hard. I grew up with all boys, so bodily functions didn’t gross me out so much.
“Ah, young MsP, you will find your kryptonite,” Sal said smirking. “My point is, kids, it that I should have told my partner that I was ok with blood and guts and puke… but not poop. I should have told him about my limits as a medic. You’ll find yours with experience, or maybe you already know it. But the moment you do, don’t lie to yourself, your partner, or your patient about who can handle up on it in the end- because you’ll all suffer… and have a big mess to clean up afterwards.”
So, off we went with our little gold patches a few weeks later- onto our own rigs. Sal and the rest of my classmates all were employees of The Bourg, while I went off in a new direction: a little Mom and Pop service I call “The Red.” I saw trauma after trauma, was puked on, and had to clean endless amounts of poop from my stretcher… and still no kryptonite.
Then out of nowhere, it hit me. I was working a traumatic arrest and was in the back of the unit with an EMT and my EMT partner was driving. As we were rolling and my EMT was doing CPR, I took out my airway kit. As I stopped him and put my laryngoscope blade in, I was peering down and finding those little white landmarks we so love to see- the vocal cords. All of a sudden, dentures were in my field of view. What is it about them that grossed me out, I don’t know. Maybe it’s because this person’s (who wasn’t over 50) hygiene was bad enough to make them lose their teeth, maybe it was the pale light pink of the denture, the fact that you eat with them and can take them out at night, or the DISGUSTING rattling and sucking noise they had make when coming off that did me in, I’ll never know. (For those reading, I did NOT crank back on the teeth- this is not why they popped out. I now know that dentures aren’t stable when flat on your back, unconscious, after a traumatic accident and constant jostling of CPR.) I looked up at the EMT and blanched. He looked at me quizzically as I told him to resume CPR while I bagged. As I was bagging, I just started gagging. I never lost my dinner, but my partner in the front couldn’t stop laughing. “Of all the things,” he said, “it’s dentures. You can cartwheel through poop and be shoulder’s deep in a cow’s tooter delivering a calf and not flinch. But dentures?!”
I gained my composure, pulled the dentures out completely and sat them in a bag and intubated the patient successfully. (All of this took place in about less than a minute, for those worrying about my procedure taking too long. Plus, they were still being vented my a BVM… besides the point again.) From that call on- it was one of the first thing I asked on codes at the local nursing homes- Age, medical history, how long have they been down, do they have dentures? I get a raised eyebrow and usually I hear “yes.” I ask if they’ve taken them out. If there’s a “no” there, my partner knows to pop them out, start ventilating while I start a line, and once I’m up to airway- they aren’t there to bother me.
My point is- you have to work with your partner… work with your strengths and carry each other through the weaknesses. Everyone has a unique little quirk that they can’t stand to see, hear, feel, or smell… be accommodating, be understanding, try not to rag on them too much, and be honest with each other. If you feel like you can’t handle something, let them know in private- not in front of the patient by all means, kiddos. You all know this I’m sure… but I’m just pointing this out.
Let’s also keep in mind that our families may or may not understand our day jobs. Keep the gruesome that we’ve come so accustomed to away from the dinner table, away from the tiny little ears that buzz around us, away from granny’s knitting circle. If you have a cool story, leave the part about the geyser like shooting of arterial blood onto the ambulance ceiling out…. maybe just say “there was a lot of blood.” Luckily, my whole family is a group of cattle farmers and rough necks. I can vent where and when I want. For those without that support system- don’t forget… you have a huge family at work to talk about cool war stories with!
So- now I’m curious, blogosphere… what’s your kryptonite?
