Reflections of a Paramedic student
5am. I walk out of my apartment into the crisp air and am met with darkness. The roads are dimly lit, dimly for Queens anyway. I have my Ipod on, but I shut it off just to savor the absolute silence. It's rare for metropolitan NY to be this quiet but even with the major roads and the train near me, it never ceases to amaze me that there can still be this kind of silence. Stores aren't open, there are barely any cars on the road and certainly none in my little residential corner of the world. I start to walk towards civilization, the subway. As I reach the empty main road, I enter the also empty CVS to buy a drink or two for my day, the attendants look at me in awe. Why would anyone be in here at 515am?
The subway is occupied by myself and few others. It starts to fill in more once we get closer to Manhattan. As I reach the stop I need to take to change subways, I find myself thrown into a sea of people shuffling towards the same goal. I squeeze into the subway car, thankfully it's only a few stops. Walking out into the world again, the sky is beginning to lighten. Carts are brewing coffee outside and there is already a long line at Starbucks. I make it to my final destination, the ambulance I will be riding on today as a student. I introduce myself to the crew and we check the truck's equipment. I am working with two females today, a rarity, but all the same nice. In my mind, the noise of the day picks up. We get online and start heading towards out posting spot. We've only moved a few blocks before we get a call at a homeless shelter and psychiatric ward. It was my first time there, and I would like it to be my last. Our patient ended up blacking out outside and the people at the shelter thought he had a seizure. In reality, he had taken too much Methadone and had blacked out. His vitals and EKG were fine and he was alert as well. He refused to go to the ER, so we couldn't take him, much to the chagrin of the aides in the shelter, who didn't seem to want to deal with him. We leave the area, hoping not to have to come back.
The city is awake now, the honking of horns screeching of engines and yelling of curse words permeating the air. Men hocking "cashmere" scarfs and "gucchi" bags line the streets, and the carts were slowly changing from coffee to hot dogs. We grab some breakfast and make it to our post. Right across from us a building was being insulated and bricks were being put up to form the walls. I watch with interest as the workers create a beautiful mosaic with the bricks they are laying. The inside of the truck is insulated from their cat calls to the all female crew, so to me they work in silence.
Next call we get is for an unconscious female. The wail of the siren brings me out of the stupor I'm in from reading my book. I grab some gloves and the noise roars louder as we pull up to a school. Oh God, not a child...I think as we run in with all of our equipment, only to see a woman in her 50s on the floor, her shirt ripped open and the FDNY EMTs pressing on her chest hard and fast. "An arrest," C, one of the medics said. I run outside, the blood pumping in my ears as I grab the cold fluids from the cooler, 2 bags, and the cold med bag and run to the school, kicking the door open since my hands are full. M, the other medic shoves the intubation equipment into my hands and says, "it's all you." The noise in my head intensifies, I've never done this before, and I can barely make out the shaky "ok" that I said. She gasps my shoulder and says, "you can do it."
I position myself at the patient's head and wait for my chance. I check my equipment again and crinkle my noise at the smell of burning flesh as the medics shock her for the third time; a smell I hadn't experienced in years. M nods at me and tilts her head back, applying cricoid pressure to make the vocal cords pop out. The noise in my head is screaming, quiet... I stick the larygiscope into her mouth, sweeping the tongue aside. "Can you do it?" They whisper, be quiet. I start to see the cord, the light from my scope making them pronounced. "You'll fail, she's dead." Shut up..."You aren't cut out for this, you can't do it. No, shut up. I advance the tube into her mouth, turning it to curve into her cords. "Fail..." Shut the fuck up! Now or never, I shove the tube past the cords, inflate the bulb and attach the bag to it. My head is screaming as I slowly press the bag, M checking for sounds in the belly to indicate a failed tube. I hold my breath as I watch the chest rise and M gives me the thumbs up. The noise is cut out as I focus on breathing for this woman. We load her into the truck and I switch to doing compressions on her. The drugs are flowing into her veins from the IV, now it's all up to a bit of luck and our continuing work. I press down on her chest hard and fast all the way to the hospital, no change. In the ER, they get a pulse back for a minute, and then lose it again, finally calling the death official. I walk to the bathroom and meet with M and C, both of them telling me I did a great job, I didn't lose my cool, I acted like a real paramedic would. They knew I would succeed. I walk into the bathroom, numb. Sitting down, I shed a silent tear for the woman who died well before her time even with our best efforts. I then shed a few more tears from sheer fear, tears that were held back by adrenaline and the noise during the call.
I can do this, I will do this. I am capable, I am good, I am smart enough. The noises will always be there, the city, the people, the doubts, trying to close in on me. But my confidence, my passion, my drive, my desire to help will keep them away.
Success
The subway is occupied by myself and few others. It starts to fill in more once we get closer to Manhattan. As I reach the stop I need to take to change subways, I find myself thrown into a sea of people shuffling towards the same goal. I squeeze into the subway car, thankfully it's only a few stops. Walking out into the world again, the sky is beginning to lighten. Carts are brewing coffee outside and there is already a long line at Starbucks. I make it to my final destination, the ambulance I will be riding on today as a student. I introduce myself to the crew and we check the truck's equipment. I am working with two females today, a rarity, but all the same nice. In my mind, the noise of the day picks up. We get online and start heading towards out posting spot. We've only moved a few blocks before we get a call at a homeless shelter and psychiatric ward. It was my first time there, and I would like it to be my last. Our patient ended up blacking out outside and the people at the shelter thought he had a seizure. In reality, he had taken too much Methadone and had blacked out. His vitals and EKG were fine and he was alert as well. He refused to go to the ER, so we couldn't take him, much to the chagrin of the aides in the shelter, who didn't seem to want to deal with him. We leave the area, hoping not to have to come back.
The city is awake now, the honking of horns screeching of engines and yelling of curse words permeating the air. Men hocking "cashmere" scarfs and "gucchi" bags line the streets, and the carts were slowly changing from coffee to hot dogs. We grab some breakfast and make it to our post. Right across from us a building was being insulated and bricks were being put up to form the walls. I watch with interest as the workers create a beautiful mosaic with the bricks they are laying. The inside of the truck is insulated from their cat calls to the all female crew, so to me they work in silence.
Next call we get is for an unconscious female. The wail of the siren brings me out of the stupor I'm in from reading my book. I grab some gloves and the noise roars louder as we pull up to a school. Oh God, not a child...I think as we run in with all of our equipment, only to see a woman in her 50s on the floor, her shirt ripped open and the FDNY EMTs pressing on her chest hard and fast. "An arrest," C, one of the medics said. I run outside, the blood pumping in my ears as I grab the cold fluids from the cooler, 2 bags, and the cold med bag and run to the school, kicking the door open since my hands are full. M, the other medic shoves the intubation equipment into my hands and says, "it's all you." The noise in my head intensifies, I've never done this before, and I can barely make out the shaky "ok" that I said. She gasps my shoulder and says, "you can do it."
I position myself at the patient's head and wait for my chance. I check my equipment again and crinkle my noise at the smell of burning flesh as the medics shock her for the third time; a smell I hadn't experienced in years. M nods at me and tilts her head back, applying cricoid pressure to make the vocal cords pop out. The noise in my head is screaming, quiet... I stick the larygiscope into her mouth, sweeping the tongue aside. "Can you do it?" They whisper, be quiet. I start to see the cord, the light from my scope making them pronounced. "You'll fail, she's dead." Shut up..."You aren't cut out for this, you can't do it. No, shut up. I advance the tube into her mouth, turning it to curve into her cords. "Fail..." Shut the fuck up! Now or never, I shove the tube past the cords, inflate the bulb and attach the bag to it. My head is screaming as I slowly press the bag, M checking for sounds in the belly to indicate a failed tube. I hold my breath as I watch the chest rise and M gives me the thumbs up. The noise is cut out as I focus on breathing for this woman. We load her into the truck and I switch to doing compressions on her. The drugs are flowing into her veins from the IV, now it's all up to a bit of luck and our continuing work. I press down on her chest hard and fast all the way to the hospital, no change. In the ER, they get a pulse back for a minute, and then lose it again, finally calling the death official. I walk to the bathroom and meet with M and C, both of them telling me I did a great job, I didn't lose my cool, I acted like a real paramedic would. They knew I would succeed. I walk into the bathroom, numb. Sitting down, I shed a silent tear for the woman who died well before her time even with our best efforts. I then shed a few more tears from sheer fear, tears that were held back by adrenaline and the noise during the call.
I can do this, I will do this. I am capable, I am good, I am smart enough. The noises will always be there, the city, the people, the doubts, trying to close in on me. But my confidence, my passion, my drive, my desire to help will keep them away.
Success