Almost 16 years ago I had the most amazing day. I was doing three weeks of training in Manhattan, and I had one day off; a Sunday. I rented a car, drove 3 hours out of the city to the end of Long Island, Mantauk where I rented a sailboat and had 2 glorious hours on the water. The whole drive out had been rainy and overcast. When I arrived to Mantauk, the cloud cover broke, and I had those two hours of sunshine and fine wind.
Afterward, I drove to a local place, Mama Jojo's, where I had a whole lobster dinner with an iced cold Corona, and the best cheesy bread rolls I think I've ever had. As I ate my dinner at an outside table overlooking the harbor, a light breeze blew, and there was a nice sunset. But then, the clouds came back, the rain started, and I made the 3 hour trek back to Manhattan. It was the best day.
The next day, back at training, my instructor asked about my day off. After I had expounded on the glories of the day, he said to my surprise, "So it was a good day to die?"
I looked at him in disbelief. How could anyone want to die after having experienced such a wonderful time. Then he explained:
There was an American Indian chief who awoke one morning, stepped out of his teepee, and proclaimed that it was "a good day to die." His fellow tribesmen looked at him confused. The chief continued, "Look all around you. The prairie grass is high and green. The skies above are the brightest blue. The buffalo are grazing nearby, and a clear stream runs close by. It is a perfect day."
"Who would want to die on a gray sullen day? Today is a good day to die."
I was thinking about this as I arrived at Mercy Flight on what was a glorious morning. The thunderstorms that had been plaguing the area had dissipated into a bright blue sky with big fluffy white clouds. A fine breeze blew from the west. What could be more perfect?
Our first flight took us north to a community event where local schoolchildren were learning about community safety. Here's a pic as we approached:
You can see the school buses and one of the local firetrucks which I got permission to climb up on and ride up on the cherry picker to its full height of 102 feet.
Here's a pic of Mercy 7 which I took from the top. This was the helicopter we were flying today:
And here she is close up. It's a much bigger helicopter than the one I rode last week.
We spent about an hour at the community event and then flew back. During our shift, we were put on alert twice but did not fly out. Finally, around 5 p.m. we were called to pick up a transfer from near the New York/Pennsylvania border. It was a 25 minute flight, so the longest I had ever been on a helicopter.
My thoughts continued as we flew over the green hills and valleys to the south of Buffalo. Cows sat in the fields. Rivers flowed through canyons. The air was clear, and everything seemed right with the world. Of course, not everyone was having my day.
Our patient was a young man enjoying his beautiful day by riding his ATV with a group of friends along the local trails through the woods and a quarry. He fell off and was knocked unconscious. On his physical exam, I guessed he had a broken nose and most likely a skull fracture. He had scrapes and bruised all over his abdomen. Relatively speaking, he was doing ok, and we flew him the 20 minutes back to ECMC where the trauma team took over. It was their 3rd trauma from this ATV event, so they were very busy.
I guess I'll find out in the next couple of days how the patient did.
From there we flew back to base, and my shift for today ended. The first pic is the sunset I saw on my way home. What a glorious day. And, although for me it was a "good day to die" that would not be allowed for the patients under my care on this most beautiful day. I can thank God for that and everything today.
"Vivir con miedo es como vivir a medidas" - a life lived in fear is a life half-lived.
Just a couple of thoughts on my ride-a-longs with the local ambulance service:
If you see flashing lights behind you, move to the right.
If you hear a siren, put down the cell phone, look around you, and move to the right.
If a large moving vehicle with flashing lights and a siren suddenly appears in your rear window, turn down the radio, put down the cell phone, and move to the right.
Lights and sirens coming toward you on a street means... um... move to the right.
If you are driving and come to an intersection where everyone else is stopped, don't take it to mean that they are waiting for you... it's probably because everyone else saw the big moving vehicle with the lights and sirens coming down the street.
Emergency vehicles are like deer, if you see one there might be others, so take a few seconds to make sure a second one isn't following the first.
If you call 911, a lot of people are suddenly going to show up. If they're at your house, that means that can't be at someone else's, so don't call unless you've got a legitimate reason.
One final thought: yield to emergency vehicles, they might just be heading to save someone you love.
Tomorrow, another shift with Mercy Flight. Better weather on the horizon, so we'll see what the day brings.
I honestly think I must have had something to do with the olympics in a former life. Nothing will bring a tear to my eye as easily as watching the opening ceremonies and seeing the olympic cauldron be lit.
Growing up watching Nadia take the gold, I dreamed of finding my sport and competing in the olympics. At my age, my only hopes now are sailing and equestrian. Still, one of my more reachable goals is to attend an olympic opening ceremony. One day... maybe in two years in Vancouver?
As the next 17 days progress, I know I will be watching the competitions; still getting misty as the U.S. flags are raised and our national anthem plays. Do you plan on watching?
Ok, so I really haven't written because there hasn't been a lot going on. I am in the middle of my EMS/Toxicology rotation, and I have been going daily to the Poison Control Center of WNY for lectures and to follow up on the cases we have been asked to consult on, and then my afternoons are spent in a variety of different activities. Mostly, I am enjoying driving the SMART 1 vehicle around town, and I am starting to take calls with the fire department and ambulance service.
Last week Friday, I spent the evening with the crew from Rescue 1. There were two calls, both of which were canceled en route. However, there's still something to be said for pulling out of the fire house, lights and sirens, riding the big red truck. I enjoyed the time spent with the fireman, and I wish them continued safety.
I went out with one of the attendings and a fellow resident as medical back-up for Erie County Sheriff's SWAT team. They did a raid on a house, and we were there in case of injury. It was very interesting and exciting in a "Cops" style, up close and watching the action sort of way. No injuries, thank God, and I wish on them continued safety.
I spent a good part of the weekend preparing for a lecture on ventilators that I gave yesterday at our EM grand rounds (oh, yes, grand round Wednesdays are back!) It seems to have been well-received. So kudos for me.
Today I did a ride along with one of the paramedics from the local ambulance company. It was interesting because in the middle of one of our calls, I received a page from Poison Control about a case. As I rode in the back of the bouncing ambulance, I took information about this case. I was on my third phone call by the time we reached the VA to deliver our patient.
After I called back the consulting hospital, ECMC, with our recommendations, the paramedic, Tony, asked if I wanted to go to ECMC and see if the patient had been transferred. I said yes, and we arrived just as the patient was starting to be evaluated. It was nice because I was able to follow the case. We call that "continuity of care;" when the same provider follows a patient through their medical course of treatment. Of course, one of my colleagues took the case over, and I will follow up, along with Poison Control, in the morning, but it was interesting to see one of the patients I get called about in the E.D.
Tony and I spent a good deal of the shift going from call to call, and there's a lot of forms that need to be filled out for each run,so Tony spent most of his time typing on his portable computer. The cases were pretty run of the mill, but it's always good to see what the EMS guys are dealing with "pre-hospital."
Tomorrow it's back to PCC in the morning, but Saturday is my first Mercy Flight shift. I hope the weather clears, and we get to fly! And, yes, I plan to have my camera at the ready.
As for the veggie thing. I am at the end of my last week. How hard has it been? Just a little. I spend so much time out of my home, that I usually eat out. I am realizing just how difficult it is to eat vegetarian and healthy in this town. Choices are very limited. I did find a very tasty eggplant parmesan at a restaurant called Towne near downtown Buffalo. I judge Italian pastas on the sauce, and this one was just the right blend of tomatoes and spices. Yum.
Just a few more days of the pledge, however I am considering more my choices in foods.... I just made the pledge to eat only free range egg products and limit my intake of eggs in general. I think we'd all make a difference if we just considered where our foods are coming from. And, with the gas crunch, more restaurants and local markets are supporting local growers which don't have to be shipped as far. That's something we can all benefit from. (ok, ok, off the soapbox)
Ok, so the picture above is from one of my last patients at Children's. I think I talked about the 12 year old who stuck some things up his, um, weenis. Today the picture loaded, and I am using it as an example of some strange things that people do to get high. Now, there is a certain pain/pleasure described by patients who stick things in their urethras. There's actually a name for this which I couldn't find because I am too tired right now, but the link is to an interesting article on the subject. Strange Found Bladder Objects
I am bringing this up because I am currently on my first official rotation of my second year: EMS/Toxicology. I spend my mornings in the Poison Control Center of Western New York which is based out of Children's Hospital. We go over cases that came in the day before, and follow-up on cases that are currently active. Most of the cases involve overdoses and ingestions (such as kids swallowing bleach).
Every day I have to make a small presentation about this or that drug that we've been consulted on. I have talked about acid/bases and what happens when you come into contact with them. Tonight I finished research on my project for tomorrow which is on overdoses of muscle relaxants. What those crazy kids won't take to get high.
During the rest of the day, I am on 24 hour call for the Poison Control Center and for Erie County EMS. I get called if there is a question directed to the PCC from a hospital regarding treatment of a patient in their E.D., and I could potentially be called for any incident in the county requiring a physician to be on-scene. During the school year, we get called for mostly school bus accidents where there are a large number of patients that don't necessarily have to go to the hospital, but who all need medical clearance before being released. Every once in a while we get called for something more interesting: Swat Team Shooting
i also get to do ride-a-longs with local EMS including Mercy Flight, BFD Rescue 1, Rural Metro Ambulance, and possibly some other agencies. There are a couple of other "fun" projects, but I will elaborate on those toward the end of the month.
For now, I have to go to bed and get ready for my PCC rounds this morning. Oh, and if you see this vehicle around Erie County:
That'll be me behind the wheel!!
I promise to share interesting stories as they come.... until then, stay safe!
Oh, and on the veggie front. It's been almost 3 weeks. Today I tried the Super Veggie at Subway, and it was tasty. I was sooo tempted by some fish, but I promised to make it a meat-free month, so I kept my pledge. A week to go, but to be honest, it's actually getting easier to make the veggie choices, and I am learning to be very creative when going out to eat.
Ok, so I've been very busy over the last several days with this and that and being a vampire. Once I got used to the night schedule, I had three days in a row where I had to do daytime things, and tonight I go back to nights. Two days of a nights with a turn-around shift where I get off at 4 in the morning and go back to work at 1 p.m. But, it's my last weekend at Children's until January.
Some of the things that have happened:
We had the intern's welcome picnic at a park in Eden, very beautiful, and I was trying to share pics, but they're not uploading for some reason. Then I worked that night.
I had a very strange case of a young boy with a swollen, um, weenis. My attending was concerned he might have constipation causing a blockage of his ureters leading to infection, and we found... well, couldn't load that photo either, it showed a number of wires in his bladder. He finally admitted he had stuck them up there. He went to surgery that night.
Monday, another shift in the E.D. We actually cleaned the board, and I was lucky to get sent home somewhat early.
Tuesday I tried to clean and catch up on all the things I hadn't been awake during the day for.
Wednesday, my EM class went to U of B for some procedure training on cadavers. I got to help with the teaching, and we had a lot of fun catching up since we hadn't seen each other in a while. I kept myself awake most of the night to try to stay in vampire mode.
Yesterday I went to one of the local firehouses to run through procedures with their EMT's. One of my future jobs in EM will be medical director for the local EMS agencies, so this gave me some practice.
OK, have to be running, get dressed and off to work. We'll see what the evening brings.
On the veggie front: I resisted temptation at the picnic where they were grilling the best-smelling BBQ. Ribs that were falling off the bone. MMMM... I had the salt potatoes, salad, and mac and cheese. Ok, ok, I had a matchbook-sized piece of ribs, but I didn't enjoy it, well, yes I did. Other than that it's been soy in my coffee drinks and cheese sandwiches. Veggie burgers are the mainstay of my existence at the hospital, although they did have a veggie soup the other night. We went to a local Tex-Mex deli that was supposed to have fish tacos... I had the bean and cheese burrito. Can veggies eat fish? What do you think?
