Fear of the Unknown

Sometimes I have to wonder why I do what I do with all the adversity, disparity, carnage and sorrow that I see. I see it in the ED and I see it out in the public. There are just certain instances that make me stop and think about what I do and how easily that my patient could be me and then I’d be dealing with their circumstances.

 

There are also those patients that make me stop and think about my life and how I’ve done things, right and wrong. Have I been in their shoes? Can I truly be empathetic or sympathetic? More and more I find myself relating to the plight of my patients and their families as I get older. I find myself saying, “yep. Been there, done that” quite often.

 

This weekend was one of those weekends that made me do a lot of thinking.

 

Wonderful couple came in the other day as one of them was complaining of CVA-like symptoms. The patient had had one before with no lasting effects. Had been following all the doctors orders in regards to medication, diet, exercise, and lifestyle changes. Yet even though all these things had been done to the “T,” the symptoms popped back up out of the blue. The patient was surprised, frustrated, and very upset. Why, after all this effort, was this still happening? Why bother continuing on to do the “right thing” when this still happens?

 

At the time when they came in we were busy and I really didn’t have a lot of time to sit and talk but the look I was given told me it was best to sit and chat for a while, to try and relive some stress that was apparent and evident in the patient’s eyes and face. The same questions kept popping back up. The wrinkled brow and questioning eyes never left the patient’s face. The hands were constantly moving, needing something concrete to grasp to make some sense of what was happening. And the same routines were replayed verbally over and over trying to find something different that had been done out of the ordinary to explain this sudden recurrence of the CVA symptoms.

 

We talked about the signs, the symptoms, the medications, the routines, and anything else that had gone on in the past 6 months or so. Nothing had changed. Then the questions changed to, “why continue?” The patient knew why but still asked anyway. It was fairly obvious to me that the fear of the unknown was eating away at this patient’s mind and raising the stress level even higher. “I’m just a paramedic but I’ve seen this a lot. I’ve treated this often.” I offered various scenarios of what I’ve seen and how I’ve handled things, all the while making sure the patient understood that not everyone is alike; we all have the potential to react to things differently (health problems, medications, procedures,…). I mentioned about being proactive by continuing to do what the doctors had said. I reiterated like I do quite often that medicine is not an exact science; that’s why they call it a “practice.” We prescribe and do things based on evidence, experience, and knowledge knowing that not everyone will react to the same way or respond to the same treatments the same every time. Things change. People are unique. Situations vary from one minute detail to the next.

 

But what it all came down to was this patient’s fear of what lies ahead and not knowing. I said, “I could get killed in the next 90 minutes as I’m driving home from here. I just don’t know.” And with that simple statement after all this dialogue lasting almost 45 minutes, I noticed two raised eyebrows that said, “you know, he’s right.” We all have the fear of the unknown but we can’t let it consume our lives and what we do. We cannot run our lives based on what we don’t know. We cannot let the unknown issues dictate how we go through our daily lives. We prepare as best we can and take what each second, minute, hour throws at us and deal with it. We do the best we can. The unknown cannot consume us or we too will become consumed with worry and fear.

 

As I left that patient’s room for the last time I did so knowing that I had eased at least a small amount of the stress and fear that was hanging in the air. I heard a spouse say, “He’s right. We DON’T know what will happen in the next 10 minutes so we’d better get prepared.”

Making a Difference

When I was in high school I worked during the holidays and summers for my uncle. It was usually hard work that went hand-in-hand with some long hours, especially on shutdowns. The money was good for a high school kid and I enjoyed spending it. I learned a lot from him and the guys who worked for him. I also learned my work ethic from him, something that not many people seem to have these days.

His work ethic as a business owner and employee was one that never ceases to amaze me, even today. He's constantly on the go, always working, and he takes great pride in his work when it comes to details and the smallish things that a lot of people overlook. It's the extra couple minutes of cleaning, putting a nut on a bolt the right way, fixing the ding in the sheet metal that wasn't our fault; things like that he's always done to ensure customer satisfaction so that they come calling again if they needed our services.

Daily here at work I do a new contractor orientation. I may have 1 or 20 people come through this class and I see a wide variety of people from all walks of life that come to work here. One thing I always make a point about during that class is taking pride in the work that is performed here. Working at a children's hospital is a little different than anyplace else I've ever worked. I'm sure that some of it has to do with me having 3 kids but it's part of it. Many people have come through here telling me that their kids were treated here, someone in their family was here, or that they themselves were here. I always mention that we're building a hospital to take care of and treat the future generations and to not cut corners. It might save a little time and money to put "this paint" on versus "that paint" but would anyone want to come here knowing that corners had been cut to save money if they were bringing their own kids here? I want the best for my kids and I hope that everyone working here feels the same way.

It's all about taking pride in your work, craftsmanship, and the work ethic you exude every day. Hopefully some of it's infectious to those working around you. I want people to be proud of what they do and what they accomplish. I want people to be able to stand back and look at their handywork after they're done and smile saying, "I did that!" All the while knowing that eventually, at least here, that a sick child who's here for treatment will be able to be treated better, have some enjoyment, or be more comfortable just because someone took the extra couple minutes to do things the right way, put that little extra added touch, or made things look that much better in the patient care areas.

Daily I see hundreds of people walk through our doors knowing that they've come to one of the best places for care of their kids: all colors, shapes and sizes, and religious beliefs. They all come here for one reason; to get their child healed and back to leading a normal life. All of that could not be possible without the dedication of the staff, doctors and nurses, and the people who built and keep the facility running like it should.

Most jobs I've ever worked I hear people gripe and moan about this problem or that problem, all too often just to be heard. The problem is usually insignificant and meaningless in the realm of their job but it still gets heard. "It's not my fault. It's not my problem. Someone else left it that way."

Seriously?

Do something about it. Take a little pride in your work and of where you're working, regardless where it is. Too many people want a pat on the back for things that are so small and minute that it means nothing. They want credit for something that they didn't do. Make a difference. Take a stand. Maybe someone else will see you pick up that board that isn't yours as you put it in the trash and do the same, all in the name of making things look better and cleaner.

Recently I saw an article about legacies. I thought long and hard about that and wondered what I've done. I don't want to be remembered for what I've done, built, or how much money I made. I want to be remembered for the contribution I've made to my kids and to other people. Since I was 17 I've enjoyed helping others and trying to make things better for people. You need a couple bucks? Here you go. You feel crappy? Here, let me give you some medicine and try to make you feel better. You don't understand that? Here, let me try to explain that to you so that you do. I enjoy seeing other people getting the due credit they so richly deserve but never have because they're like me; they won't brag or boast about accomplishments just to get recognized. They don't want to be in the spotlight. I too don't deserve it so I don't push myself on others. If I get noticed for anything, I want it to be for what I've done, based on my merits and the pride I've taken in my work.

Be proud of what you do. Look at all the peoples' lives you can possibly touch by doing a better job at work. A smile and a kind word goes a long way. The extra minute you spend on that task making the results just that much better can be the difference between a simple smile or a huge toothy grin full of gratitude and wonderment. Be that person who makes a difference in someone else's life.

My favorite thing to do here where I work? Walking down the halls and hoping I see a patient I can wave at. I truly love it when a child smiles and waves back at me. It really does make my day :)

The House That Love Built

Being a part of the medical community has allowed me to see a lot of grief, tragedy, hurt, sorrow, and pain. But there’s also the healing and happiness part of it that isn’t always seen by everyone.

I’m a grown man with 3 kids, all of them still in elementary school. The one thing that’s probably gotten harder as they’ve grown older is me dealing with pediatric patients. I picture my kids as the ones in front of me. I treat the kids like my own. They hurt, so I hurt. They want comfort, hopefully I can do something to provide that to them regardless if their parent or guardian is there or not.

My “real job” is doing construction safety, basically OSHA compliance on a construction site. My current job is at the only Level 1 trauma facility in the state of Indiana for kids; Riley Hospital for Children at Indiana University Health. The drive is long every day and so are the hours, but being here, being a part of this fantastic place in a small insignificant way makes it all worthwhile. This is one of those places where miracles happen daily.

Recently I got a chance to tour the Ronald McDonald House located here within the facility. They only have 6 beds here for patients’ families but they offer a place to rest, relax, get away from the beeping pumps, monitor alarms, and noises associated with being in a patient’s room or unit. The House Director showed me the rooms and told me about what they do, who they see, and why they do what they do; they provide a respite, a place of healing and rest that families so desperately need as they’re here with their child receiving treatment or life-saving intervention.

The Director showed me the journals that were in every room that families who stayed there often read and then wrote in, in their own words, about their own personal story. How I would have loved to have read those stories but it would have ripped my heart out. I also respect everyone’s privacy and the need for peer support, such that I could not give them as I haven’t been in their shoes.

Today we had a site lunch and I asked the Director to come up and speak as many of the guys and gals here have heard of the Ronald McDonald House at Riley but don’t know much, if anything, about it. Daun Hughey and Joe Schulz, the Director of Development, came up to speak and brought this video for everyone to see. As the video played about the Ronald McDonald House both here at Riley and one just around the corner from here, I scanned the room of grown men and women, sitting quietly in chairs after eating lunch, to see their reactions. A couple looked away from the screen, another couple dozen dabbed at their eyes, more nodded their heads, but everyone and I mean everyone had their attention firmly on that video. Priceless, simply priceless. 

The people of our site are building this hospital for those kids and their families. They’ve heard of some of the things that happen here but now they got to see a side that few others do. They got to hear and see what some of the families have to go through, the hardships they’ve faced, and how they get through every single day while they stay here for days, weeks, and months with their sick child getting possibly the best medical care in the US. Riley is one of those places everyone hopes they never need but thank God every day that it is in case we do.

 

If you’re ever in Indianapolis and have the need to feel loved and welcomed, feel grateful for what you have, want to donate a little time, money, or supplies, I urge you to stop by the Ronald McDonald House here at Riley. Daun has a "wish list," as she calls it, that always needs things checked off of it. I’ll personally take you there, introduce you to the Director and some of the awesome families and volunteers who call the Ronald McDonald House at Riley their second home. You’ll see very quickly that it is truly, “the house that love built.”

Here's another link to the video http://www.youtube.com/watch?v=mGPgeZSSDDA
And here's one to the Ronald McDonald House www.rmh-indiana.org/

It's That Time of Year

It's nearing Christmas Day around here. Everywhere I go I see signs of Christmas. Trees, lights, signs, for-hire Santas walking down the sidewalks, pictures of kids oogling over their favorite toy ads, and all sorts of other visual reminders of the holiday season.

I look forward to Christmas for a couple reasons. It's to remember the birth of Christ but it also seems to bring families closer together. People give more. People tend to help out a little more. People seem to be just a little nicer than at other times during the year. Two of our kids still believe in Santa.

We watch the old Christmas cartoons I watched as a child. We make cookies on Christmas Eve and put out the reindeer food on the yard, the plate of cookies and milk by the fireplace before bedtime. It just makes things more fun.

And then there are some of the things that pop in my head at this time of year that make me sad, things I don't necessarily want to remember but I do, and they usually come up now. These are things that while sad make me very grateful for what I have around me each and every day.

I see people every day on a specific sidewalk just a couple blocks from where I work begging for money. They have no job. They have no home. They have practically nothing. I occasionally drive by a large shelter downtown and see the crowd milling about aimlessly outside waiting for the next meal, waiting for the next bed to open up so they can go lay down or just stay warm for the night.

How many people have lost a friend of family member throughout the year? They will be spending their first Christmas without that loved one, without that friend. There will be a profound emptiness in the time of families, togetherness, and love. I look at those who are working Christmas Day. I've done it countless times. I've been in foreign countries on Christmas Day and other holidays, spending it with people I work with; no family, no presents, no catching up on family gossip or eating my mom's killer apple pie.

I always think back to Christmas Day 1991 when I was working on an ambulance. Low man on the seniority list, just finished with Paramedic class. A cardiac arrest, a pediatric one, all of 6 months old just brought in to this world to experience her first Christmas. The jokes and happiness we had in the ER that morning cut short by this totally unexpected tragedy. We all worked and worked for seemingly hours doing everything we could to revive this frail little girl. Somehow, by the grace of God, we did. She was transported by helicopter to a children's hospital where she passed 3 days later. Heartbreaking, truly heartbreaking.

I cried that day. I cried because of what had happened, what I witnessed, what we all had done, and what we had achieved on that day, Christmas Day. I think of how that family lives with what happened on that day so many years ago and how their lives would and are forever changed by the events of one day, that day, Christmas Day.

But life goes on. We all do. Lest we forget those who are not here with us anymore. They will always be with us and there will always be the reminder of being with them, even if for just a short period of time. Those who have passed, those who are working, those who have nothing, and those who have everything.

There's still kindness in the world and I see it every day. There's still love in the world and I experience it every day. There will always be the hatred and cruelty that will mar what we see and blur our views, but that will go to the back of the line.

For everyone who is missing someone, for everyone who is not home with their family, for everyone who has nothing, and for everyone who has everything, be glad you have something, yourself. Merry Christmas and Happy Holidays to all.

I Love My Job!

Like most people in the EMS field, I didn't get in to this for the money. Granted, I was 17 when I began my involvement with ambulances and the love affair has grown steadily since then. I'm 40 now and I can honestly say that I love my job, I love what I do.

A lot of us quickly realized that the money just isn't easy to find in EMS so we have second and / or third jobs to help make ends meet. A lot go on to other careers but stay in healthcare. Some go on to do something completely outside of our world. But the dedicated bunch of EMTs, Paramedics, and others that remain in the EMS world, destined to be wanting more money but loving their jobs so much that they dare not leave are still here.

EMS used to be my only job. It was my first career. I loved it then, I love it now. I'd say I'm a "seasoned veteran" who's seen a lot but not everything. I've done my fair share. I've worked all around the world. I've gotten to do things most would only dream about. Yet here I am, still part of a volunteer department and loving it.

When I moved out of state I left my first EMS position behind, the place that opened up so many future doors for me. I came back after a couple years because I felt I owed it pretty much everything. I don't do it for the money, I do it for dedication and pride. I'm proud of who I am and what I've become. No, not all of my decisions have been good ones but I've learned from my mistakes. Helping others is at the forefront of what I like doing. That has transcended from the EMS world in to whatever else I do as well.

My "other life," or my real job (the one that pays the bills) is as a safety consultant on construction sites. I walked in to doing safety when I was working offshore on oil and gas drilling rigs around the world. Safety and EMS out there pretty much go hand in hand; you do something unsafe and get hurt, you go see the medic. So I fit in perfectly doing both. It's worked well for me and here I am.

It seems as though the last couple sites I've been on have somehow been tied to healthcare. I've worked at a facility that makes medicines, some of which I've either taken as a patient or given to some of my patients. Then I began a project building a new hospital. Now I'm at a site where we're building a new tower for a children's hospital. It's always been frustrating because I've started a lot of projects but have never gotten to see the end. Safety is usually one of the first positions to be removed from a site due to budget constraints. So as my sites have been completed I've only gotten to see the finished product if I've gone back on my own.



 But with the hospital project it's a little different, a little unique, and it makes me smile. I spent two years on that site, seeing it go from a hole in the ground to a nearly finished facility, one that will specialize in cardiac care. I've gotten to know the hierarchy of the hospital very well. I know the building like the back of my hand. I hold a vested interest in it because I will be taking my cardiac patients there. It'll be a true definitive care facility for those patients I pick up.

What's special is that I will be working there as an employee in the ED. I even asked the manager if i could work the first shift that the facility is open. She told me that I've "earned it," and that it was mine. I beamed with excitement after hearing that. Finally I get to see a facility I worked on, helped build, and will be a future customer of. Now I get to be there and see how everything we all toiled on for so long will work.

As I wait for that one to open up and to begin working there I've been moved to another location. This time it's a more special place. One of those places that makes me tear up when I see certain reminders or hear certain catch phrases about the place. I'm at a children's hospital, building a new tower for kids who so desperately need to be here. This is one of those places that nobody wishes was needed but everyone is thankful that it is, just because of the special things that happen here,the miracles that happen daily, the lives that are saved because of the awesome people and care that the sick kids around here can receive. This is one of only 250 childrens' hospitals in the US. That's not too many if you stop and think about it. Only 250 facilities to take care of our sick and injured children, nieces, nephews, and grandkids.

I did an informal "Hank Poll" the other day and approached 42 people working here out of roughly 175. Every single one of them either knows or is related to someone who has had a child or relative treated here. I'm one of them. This facility is part of a large network and my youngest has been here a couple dozen times. Close friends of mine have had their kids here. People I work with have been here or had their kids here. And everyone has come out better and healthier.

I walk around here daily just smiling knowing that I'm part of building a new tower that will help children, help them heal and get better, be a comfortable inviting place for parents to bring their sick kids to be treated and hopefully back home very shortly after. I see the stuffed animals on the banister in the lobby and smile. I can remember #3 saying, "daddy, I want one of those!" and pointing to one of the big lions. I see kids being pulled around in red wooden wagons instead of wheelchairs. I see kids smiling in the family areas with IV poles next to them as they color in books with their parents. I see adults sharing french fries from McDonald's with their kids in the lounge areas outside the lobby by the cafeteria. I see and hear kids playing together upstairs in the patient rooms with their siblings.

I've called this building, "the best place in the world." I'm proud to be a part of it. I honestly hope I never have to bring one of my kids here ever again. I would like to see a place like this never be needed by anyone, but I'm damn happy that it is here in case it is needed by anyone, including me, to help sick and injured kids from not just here but anywhere in the world.

Places like this with me a small part of it, make me honestly say, "I love my job."

Drives Me Nuts...

A toothache at 2am.

An earache at 430am.

Drunk drivers who hurt or kill other people when they're perfectly fine, other than the obvious fact that they're brains are switched "OFF."

Yep, ambulance runs. There's plenty more where that came from.

"Take me to _____ Hospital. I have my 'card' and you have to take me."

People who meet you outside their house with a packed suitcase in hand, ready to go.

"Can't get this damn splinter outta my hand."

"Oh, this ain't no big deal cher. I've had me 8 babies already. This one will be awright. Jes tired uh bein' damn pregunant like."

"Ain't gonna go there. They's some mean peoples there. Take me to ______ (60 miles away). They knows me theyuh (smiles with a toothless grin)."

A girl's first period with her mother right next to her. Would have thought the world was coming to an end.

Sore throat. Seriously? A damn sore throat???

Out of medication and there's plenty of free medicine at the hospitals.

"My momma's already theyuh and I wants to go see huh. Can y'all take me theyuh?"

"My hair hurts."

Big boogers that just can't be removed.

Bugs in ears.

People who get return trips to hospitals still wearing the gowns they came home with a month prior; and it looks like they haven't been washed or taken off that entire month.

Oxygenated patients who smoke, still smoke, or are presently smoking in my presence with oxygen on.

Patients who have to have a smoke before they go to the hospital. Sorry, I wait for no KOOL.

People who swear at me, not with me.

Assholes. Cocky.

Other healthcare providers who critique how I'm handling them or their family.

Healthcare providers who are on scene first and do the complete wrong thing for the patient's welfare.

Family members who just won't shut the hell up and let the patient speak for themself.

Police who don't help out when asked.

People who just won't help themselves. They don't care, don't give a shit, or whatever. If you don't, why should I?

Lastly (for now), people in EMS who don't have the passion, drive, compassion, to be there day after day helping others who truly need our skills and expertise. If you don't like it or want to be there, leave. You drag the rest of us down. 23 years in to my young EMS career and I still love it.

Hangin' It Up

I've always been told that healthcare providers are the worst patients. I agree. We know too much. We self treat. We self diagnose. We're never wrong. We're never sick. We know more than most doctors. I usually tell my patients, as I'm sticking them, that it's odd that I have to hurt them to make them feel better. I also tell patients that medicine is called a "practice" because it's just that; it's NOT an exact science.

I've wondered, more often recently than before, about the future. What will I do? Will I keep in the healthcare field? How long is too long? Am I burned out? Have I had enough? Do I still love it, have the passion for it, want to educate and impart my experiences to others?

Things now aren't what they used to be. Instead of people bossing me around and telling me what to do I'm kind of in that seat now. Our generation is taking over from another one and we're molding the next generation to take over from us. It's kind of neat to see people I grew up with running things, owning businesses, making money and having families and doing all the things we watched our parents do.

I am a picky person. I don't settle for second best. I know what I like and that's it. I don't accept change very easily unless I can see benefit and immediate results from it. I used to act first and think second but now I've changed that. I try to take my time and make informed decisions and calls before I pass judgment on someone or something. I try to not let biases get in my way.

I, like most, get fed up with the system. I get tired of hearing bullshit complaints from nurses, doctors, hospitals, or patients about something we did supposedly wrong. It takes my time and energy away from doing my job to investigate things and back my staff up. It's a pain. First off, are they not accountable? Why am I getting the call and not them? Well, I am in the head chair so it is kinda my job. But hearing bullshit complaints and dealing with petty issues that need to be resolved elsewhere grows old.

Another issue I have is taking care of kids. Pediatric patients have always been tough no matter the situation. Having kids of my own makes it even tougher. I picture any pediatric patient I have as being one of my own. Can i give them the same treatment, the same compassion and care that I would if they were my own? Sure I could but I wouldn't want one of my kids to need my skills and knowledge. I would never want to stick a needle in my child's arm or immobilize them after a wreck or put them in a splint because they fell and broke their leg. I'd hate that. It hurts even now to see my kids get so upset when they get booster shots. I can see and hear the terror in their eyes and cries yet it's for their own healthy well-being.

I know I can't always make things right. I can't always kiss the oowies and make them go away. A hug doesn't work all the time or a rub on the head, a scratch of the back. Those times hurt when I can't make the pain go away, for my kids or someone else's.

You know, I've never, in 23+ years had an adult call that's bothered me. From my first cardiac arrest to being puked on to my first evisceration. I've seen a lot but not everything. The only run that still, to this day, bothers me is a pediatric one. I don't remember the name but I can remember all the minute details of who, when, where, what happened, almost regurgitate it from beginning to end. Almost 21 years ago that happened and I can remember it so vividly.

I see people who have been doing this for years and they get burned out. They lose their drive for helping others. I haven't gotten to that point but dealing with all the bullshit is old. I get tired of the lack of respect, the not getting answers, the accountability or lack thereof people tend to have.

I've contemplated for the last year of slowly letting myself out of this realm. I don't think I'm ready. The younger generation is up and coming and eager to step in to our shoes and push us to the back of the class as they assume their positions in front. I'm almost ready to see it happen but I have a little more left. For now, I'm where I'm at. If you don't like it then I say, "tough shit." Come at me with respect and desire and I'll help you get whatever you want. Come at me with disdain and laziness and I'll boot your ass out the door. I've earned the respect of my peers and I expect it to be shown to me as I'll show it back with eagerness.