winter
Friday, November 13, 2009, 04:30 p.m.

Winter has set in, and I welcome its arrival. I feel less guilty now for staying around the house and lazing about. I try to get motivated to join the local YMCA and begin swimming in their pool, but alas, laziness prevails.

About three weeks ago, my childhood dog, Popcorn got hit by a car in one of his crazy escape attempts from my Mother's house. He suffered from a bad head injury with cerebral edema, and required admission to the local animal hospital. This place looked better than half of the hospitals in Brooklyn that I take my patients to.

The 14-year-old Maltese made a miraculous recovery, but will have some long-lasting effects from the injury. Mostly a head tilt, where he keeps on looking to his left side. Poor dog.

I had a patient yesterday who suffered from what we call "acute pulmonary edema". She was an obese 47 year old lady with a long medical history, complaining of trouble breathing. Her blood pressure was sky high and her lungs were filling with her own fluids, causing her to quickly drown as she sat in her sister's living room.

We gave her medications to lower her pressure in the house and quickly took her outside, where she stopped breathing and her heart had stopped beating. After intubation and about 5 minutes of CPR in the back of the ambulance, we brought her back to life. My partner for that day considers this call a huge success... I will always wonder if there was any way that we could have prevented her cardiac arrest.

vacation relief
Wednesday, October 21, 2009, 10:28 a.m.

Last month, my schedule changed and I have been taken off my normal unit to go onto "vacation relief". This is where I come to work with no idea of where I'm working, and whom with. I get placed on a truck in place of someone who is sick or on vacation, and work their shift for the day.

Vacation relief has its good sides though. The lieutenants don't really care whether you come in late or leave early. Some days are spent hanging out in the station rather than sitting in an ambulance. You get to work with different people and see their "interpretation" of medical care. If you work with someone you hate, then chances are that you will never work with that person again.

I hate it.

anniversary
Monday, October 12, 2009, 11:38 a.m.

Last year, my wife and I got married. I used to never say "I love you" in daily colloquy, fearing that the words would lose their meaning. Now, I bandy it about with other common phrases like "Lets eat soup" and "I'm hungover." The good thing is, "I love you" still has not lost its luster in my book.

cities
Tuesday, September 29, 2009, 10:08 a.m.

It's been a pretty busy September for the wife and me. We went to Seattle the first weekend to celebrate Ashley's marriage. We rode the monorail in the rain, rowed boats, spent time in coffee shops, ate amazing donuts and not so amazing Chinese food, and talked about how we weren't in Brooklyn anymore.

The second weekend, we hosted Genevieve's parents. We planned an itinerary that revolved around the best of NYC's Asian food, punctuated by the best of brownstone Brooklyn's WPB (white-people-brunch). Thai in Woodside, Korean BBQ in the Palisades, Sichuan in Flushing, and eggs in Fort Greene. An amazing weekend that requires some Lipitor to correct.

The third weekend, Genevieve and I spent one night in the city of our dreams, Philadelphia. Land of the 8-hour workday and $250,000 victorian homes. We stayed in the PSFS Building, visited the Franklin Institute, had the best Greek fish ever at Dmitri's, chugged lagers at McGlenchy's, and pondered the future.

barnegat
Saturday, August 29, 2009, 10:39 a.m.

I spent last week at Long Beach Island, staying Jeff's uncle's beach house at Barnegat Light. For most of the time, it was Jeff, Cara, Genevieve and me at the house. Drinking second-hand beer on the porch, eating fried seafood, and laying out on the sand.

"We should just move out here", Jeff says.

I respond, "I don't want to live here... there's no Chinese food!"

arrested
Saturday, August 15, 2009, 04:10 p.m.

She had just turned 80 years old. Sitting on an easy chair in a cluttered apartment, her skin became ashen and damp. Her daughter and granddaughter noticed that she was trembling and called us. She is confused.

"Here, squeeze my hands" my partner says, holding her hands in his. She complies weakly and begins to stare distantly. She tries to answer our questions, but with each response her voice gets quieter and quieter until she is just moving her lips and no sounds come out.

"We need BLS", my partner says. For serious calls, we ask for a second ambulance, with two EMTs to help us.

I try fruitlessly to get a radio transmission to Brooklyn Central dispatch inside the pre-war apartment building. I have to leave the living room and stick the radio out a window in the bedroom. By the time I return, my partner tells me, "I can't get a blood pressure. Let's lay her down."

We help her off the chair and lay her down. The heart rate in the monitor rapidly dwindles: 90..80...70..60.50.40..40..30..20. No carotid pulse. Shallow gasping for air.

After 40 minutes of CPR, intubation, and intravenous medications, she regains a pulse for two minutes. It quickly fades. We strap her to a board, take her down 4 flights, put her in the back of our bus, and drive over to the ER. The doctor there pronounced within five minutes of looking at her.

In my three years with the Fire Department, I have had two prehospital saves. Now I'm even. This is the second time I have seen a patient take their last agonal breath.

cross street location
Friday, August 7, 2009, 03:56 p.m.

I work as a paramedic in New York City's 911 system. Part of our job is sitting around in a parked ambulance on the street and waiting for assignments. Each ambulance in the city is posted to an assigned street corner, with crews having the discretion to park within a 3-block radius. Leaving your post can get you in trouble.

If the day is busy, with many assignments, like when I worked as an EMT, this rule is not such a big deal. Now that I'm a paramedic, the amount of calls per shift has gone way down. Days where we sit on a corner for 4-5 hours are common.

Sitting around for a long time sucks, frankly. Spending hours sitting in the front cab of a Ford truck is not the best for ones posture. Also, if you work in a densely populated neighborhood, there is nowhere to hide. I work in the neighborhood of Flatbush, where people are leery of emergency service workers. Most pedestrians who walk past our ambulance like to stare and sometimes scowl at us.

"Get out of my hood!" their faces say.

Sitting in a truck all day also damages my liberal psyche. I feel personal guilt every time I start my Volvo. I ride my bicycle to work most days to save gas and the environment. It all feel futile when compared to the countless hours I spend idling the diesel ambulance engine at work.

"Why don't you just park with the engine off?"

I turn the engine off if the outside temperature is somewhat reasonable, and if I'm in a newer ambulance. Sitting in an un-air conditioned vehicle on a hot day or an unheated truck on a cold day is frankly inhumane. Also, the older ambulances have a tendency to never start again if you turn off the engine and leave the radio on for longer than 30 minutes.

I agree, idling an engine all day is completely atrocious, and horrendously damaging to everybody's quality of life. Ironic, considering the city's massive initiative to reduce the amount of asthma-causing vehicle emissions, especially diesel exhaust. But, there is nothing we can do here, and our engine idles away.

bones!
Wednesday, August 5, 2009, 10:14 a.m.

The wife and I spent last weekend with her extended family in New Orleans. We committed all sorts of dietary mistakes, including oyster po-boys, pralines, biscuits 'n butter, and praline bacon. Everything we ate was either fried or slathered in butter. In between meals, we spent the time either drinking or walking around the parish and absorbing the swampy heat. The Fauborg neighborhood has faint calliope music that follows you as you walk along the Mississippi River.

We took a streetcar to the Garden District, and snuck into a closed above-ground cemetary. We were alone as we walked along the tombs as if they were tents in a silent flea market. So many of the inscriptions were broken -- smashed into thousands of illegible stone fragments. A few were cracked and on the verge of collapse. One crypt had the coffin area dug out, the dark space menacing those who passed.

"We should hide in the opening and scare passing tourists", I said.

Genevieve motioned her hand straight out and yelled, "Bones!!"

360 joules
Monday, July 27, 2009, 10:41 a.m.

Yesterday, I saved a life. I was working a mutual shift on my day off, and wound up going to a call for an unconscious man on the sidewalk in front of the McDonalds. A crowd had formed around this man when we pulled up. A bulky 50-something bald man. He was jogging when he collapsed says a bystander, made apparent by his jogging clothes, lack of ID, and small abrasion on his head.

He's in cardiac arrest. No pulse, no respirations. I instruct the firefighters on scene to start CPR. I take out my monitor, stick the pads on his chest, and check the rhythm.

It's V-Fib... a shockable rhythm! Charge to 360 Joules. Clear! Shock. The crowd gasps when the man's arms flail awkwardly into the air and fall directly down. We place him on our stretcher and throw him into the back of the ambulance. My partner immediately intubates. I look at his arm and see great veins, the IV was easy. We give the standing order IV meds and start rolling to the hospital accompanied by two firefighters. Shocking 2 more times en route.

We pull into the ambulance bay, and he's back in V-Fib. One more shock, some more CPR, and he regains a pulse. 30 minutes later, he starts breathing and blinking. This guy might make it. My partner, a 20-year naval veteran, says this is one of those rare career-defining jobs. I agree.

inaugural
Tuesday, July 7, 2009, 12:26 p.m.

Since the last post, I have gotten married and become a paramedic.

Today is one of my days off of work. I am working my way slowly down the list of errands, and am looking forward to seeing my wife for dinner in the evening.

I have already walked the six blocks to Time Warner to swap my broken cable box, and have already moved the car once for alternate side. I'm now waiting until 1pm to move the car back to the south side of the street, and then I get to drop off the dry cleaning, mail a wedding present for Ashley, and look for a place that sells swim goggles.

Yesterday I rode my bicycle down to Fort Tilden's beach on the Rockaways with my work partner, Alex, and his two friends. They told me about a free public pool in Red Hook, perfect for lap swimming. Starting to swim again is my new obsession.