From: st871622@pip.cc.brandeis.edu (not him again)
Subject: "Bar code"
Date: Mon, 25 Jul 1994 20:41:15 GMT

I don't know why I did it. Perhaps I felt an obligation to serve the
community. Perhaps it was the fact that I hadn't worked a shift at this
company for quite some time. Maybe it was the fact that a supervisor was
on the other end of the phone, offering to suck my dick if I worked. Well,
in the end, I think my negative cash flow was the big reason I worked a ...

DAY SHIFT!

Anywhere you go, whatever work you do, if you have a choice of what shift
to work, never, NEVER work a day shift. Sigh.

Anyway, I showed up in the morning, already on my third cigarette, glugging
a large cup of coffee that I'd hoped would replace several hours of sleep
I _didn't_ get the previous night. I was raring to go.

Nervously, I eyed the garage. Good. No management-types in sight. I walked
briskly towards the crew quarters, hoping the dispatcher wouldn't see me,
and try to force me onto a truck before my shift. I was halfway across the
garage floor, when the general manager emerged from behind a row of metal
lockers. Most of the ambulances were out; I was trapped - with nothing to
slink behind. His eyes fixed, then narrowed on me. I started to sweat.

"Tae, how GOOD of you to show up today. It's been ENTIRELY too long since
the last time I saw you."

"Why, Mr. Mansfield, good morning." I smiled weakly, "How's the family?"

"Lousy. The wife just smashed up a rental car. My daughter moved in with
a hippie." he growled. Damn. Then he noticed my uniform shirt. "That
doesn't look like the shirts we issued to you."

"Well, you see - I was called in on short notice, and I didn't have any
clean company shirts. Besides, this shirt is much more comfortable, it's
a blend of cotton and polyester - see?"

"No, that won't do," shaking his head, "we have a strict uniform code here,
you know that, Tae. Normally I'd have to send you home, but you're in luck.
I happen to have some spare company shirts right here." Pats the lockers.

He then pulls out a stiff, all-polyester shirt, and hands it to me.

"Here you go - oh, and don't forget to put on your tie ..."

Damn. Damn. Damn.

An hour later, I was in the ambulance, fighting morning traffic to get to
my 'satellite' location - a parking lot next to a donut shop. The other
paramedic unit had received a call, and we were going to 'sit on the line'
between the two cities - so that we could 'cover' both areas. Dispatchers
call this 'dynamic system status management.' I call it 'sitting in a
parking lot, for hours on end, on one of the hottest days of the summer, 
with no AC, and no bathroom in sight.' Damn.

My partner, Mellisa, had just passed her medic exam, and was chomping at 
the bit, waiting to do a call. Myself, I was looking forward to walking to
the donut shop, where I would buy the biggest cup of iced coffee I could,
drink the entire contents, then urinate into the empty cup. 'Sides, Mel
was beginning to get on my nerves. She was one of those 'morning' people,
and chattered on about how bright and sunny it was, and how she hoped to
do a call, and how she was getting married soon ...

I got out of the truck, and started to walk to the shop. It was either 
that, or I'd find the nearest large rock, and SMASH, SMASH, SMASH!

ObAside: My former roommate (also a paramedic), and I used to plot ways to
kidnap her. We'd convert the spare room in our apartment into a 'dungeon,'
walls painted flat black, that 'egg-crate' foam sound-proofing covering the
walls - so as not to disturb the neighbors. We'd nail the window shut, and
after placing her in the room, seal her off from the rest of the world. The
only thing we'd feed her was raw red meat laced with LSD. Occassionally,
we'd use a slide projector to show images of violent deaths and eyeballs on
the one white square of paint on the opposite wall. Ministry and Skinny
Puppy would blare from speakers mounted on the walls, behind metal grates.
Eventually, she'd go insane, and we'd be able to put her on a leash and
walk her around the neighborhood, while she drooled and made guttural 
noises. Every so often, we'd have to pull hard on the leash, as not to let
her get too close to the neighborhood children. 

Er - where was I? Oh yes.


I was about to place my coffee order, when I heard my unit number being 
called over the portable radio I carried. I heard Mellisa answer - we were
being dispatched to a 'man having a seizure.' Didn't get my coffee. Damn.

As we pulled up to the address, we could see the police and fire 
departments, huddled over a man, who was laying on the sidewalk, IFO (in
front of) a neighborhood bar. They seemed to be doing CPR on the man. Since
the man was not trying to push the burly firefighter off his chest, we had
a pretty good idea that he was indeed in cardiac arrest.

Since Mellisa was newly certified, and needed some experience, I told her
that she could intubate, while I would set-up the cardiac monitor, and
start the IV. 

A crowd had gathered, some of the people in the crowd were friends of the
man. Apparently, they had all gone drinking in that very same bar, and when
they emerged, the man complained of feeling dizzy, then collapsed. After
a few minutes of "Hey Fred, are you okay?" passed with no response, they
called the police.

While we worked over him, several of his friends were shouting drunken 
words of encouragement:

"C'mon *hic* Fred! I know you can make it!"

"Hey Fred, can you hear me? Wake up!"

I attached the monitor to his chest, while Mellisa positioned herself at
the patient's head. I did not envy her; several minutes of 'firefighter'
CPR had produced a stomach that was obviously distended with air. I turned
on the monitor. V-fib. Ventricular fibrillation. Shockable rhythm.

I charged the paddles, and when the whine of the monitor leveled out and
I heard a *beep* I yelled "Clear," then shocked the man. His arms jerked
upwards, then fell back. I stared at the monitor, waiting for it the EKG
tracing to re-center. Asystole. Flatline. One of the man's friends took the
electrically-induced arm spasm as a sign of returning life:

"Atta boy, Fred. He's coming back!" Murmur in the crowd ...

Once I had the IV established, I quickly 'pushed' several milligrams of
epinephrine (Adrenalin) and atropine into his vein in rapid succession.
I told the firefighter to continue compressions, to try and circulate the
drugs.

Meanwhile, Mellisa was having a hard time placing the tube. Several times
she said she could see the vocal cords, through which she'd try to pass the
tube. But every time she visualized the cords, then grabbed the tube to place
it, the vocal cords would disappear, frustrating her efforts.

After a few tries, she finally placed the tube.

"There - I think it's in." she said.

She spoke too soon, as vomitus and gastric contents started to pour out of
the tube - a sure sign that it'd been placed in the esophagus. The end of the
tube had been aiming straight up. A stream of vomitus, propelled by the man's
inflated stomach, shot into the air - only to land on his face, chest, and
Mellisa. She quickly turned the tube down towards the pavement, and a small
stream of pink, cloudy liquid began to creep slowly towards me. I moved 
aside. Too late. My pants leg cuff darkened with the vomitus it had absorbed.

The sun was directly above us. As I kneeled on the sidewalk, looking at the
monitor, I could see the heat waves distorting the air several inches above
the street. The smell of vomitus, which I believe had an odor of grain 
alcohol, in addition to the acrid smell of bile and pizza, began to make me
gag a little. Just then the monitor indicated that the patient had a 
shockable rhythm. I charged the padlles again - this time at a higher energy
setting, and shocked him again. His arms flew up again. The monitor stayed
flat. Again.

"'Scuse me - do you think he's gonna be awright?" asked a boozy voice just
inches from my ear. It was one of his friends. 

I don't know. Maybe it was because he startled me, or perhaps it was that
fact that I was wearing the equivalent of Saran Wrap, in terms of breath-
ability and heat retention, for a shirt, and I was getting heevy from 
kneeling in some guys regurg, but my response was less than polite:

"Get the fuck away from me."

A cop motioned for him to move away. Mellisa was able to place the tube. I
had just finished giving him another round of drugs. The monitor showed a
change in rhythm. I checked for a pulse. Surprisingly, there was one. The
patient's face began to change color, from a dark mottled blue, to a nice
shade of pink - almost red in fact. I wondered about this for moment, then
realised his color was partially due to his consumption of alcohol.

His pulse rate began to climb; so did his blood pressure. After rolling him
onto a long board, we loaded him into the ambulance. Off we went to the
hospital. He's in the ICU at this moment. Physiologically - he's doing pretty
good. Neurologically - it's anyone's guess whether Fred's still in there.

Oh well, at least we still get to bill his insurance.

- Tae

The moral of the story: NEVER work a day shift. 

---------------------------------------------------------------------
From: st871622@pip.cc.brandeis.edu (not him again)
Subject: RE: "Bar code"
Date: Fri, 29 Jul 1994 20:03:34 GMT


David.Cockburn@launchpad.unc.edu (David Cockburn) asks:

: Tae, I'm curious: why not? My MedicalMissus(tm) reckons the nights on
: duty are far worse, usually due to alcohol/drugs etc.  All the worst
: accidents seem to be then, too.

Well, David, I agree with your missus: night shift garners much more of
the drug-related trauma than day. But that is not the thing that bothers 
me about working nights. I'd rather work the evening or night shift. You're
dealing with a 'trauma junkie' of the highest dependancy. I can't describe
how much better I feel about my life when I'm standing over some poor fuck
who's noisily puking out his lower intestines. 

ObAside: I've been known to say to myself:"Better him than me." A line
	   shamelessly stolen from "Full Metal Jacket," while standing over
	   said fuck.

The reason I warned y'all not to work the day shift is that that's when
the highest ratio of managers-to-employees arises. That's when they notice
that your boots are scuffed or  not polished. Or your tie is loosened
in _only_ 96 degree temperatures. Or your billing paperwork isn't up to snuff
and the poor, high school educated, big-haired, gum-snappin', 'Vito'-dating,
oxygen-wasting office 'girl' just can't seem to make heads or tails of it.
So what the poor girl to do? Continue to sit in an air-conditioned office,
polish and sand her nails down to the consistency of ice-picks, and dream
of the day when she finally hits the 'Megabucks' lottery, so she can get the
boob job she's always wanted and finally dump 'Vito' and his Chevy Camaro,
for someone with more 'class' - like 'Luigi' - you know, the one the drives
the IROC.

Bitter? Me? Noooo. 

- Tae