Moving Along Nicely

A quick review of the last stretch of my third semester:

• Most gruesome test ever - Cardiac Box Test COMPLETE
  
• Fairly annoying but not too awful - Neurology COMPLETE
• Pretty mellow but annoying - Endocrinology COMPLETE
• Easy all things considered - Allergies and Anaphylaxis COMPLETE
• Tougher than I thought - Toxicology COMPLETE
  

I am at the phase where I can not only see, but feel the end of the tunnel. As discouraging and difficult as school is sometimes, I am still loving. Things are starting to make sense; the job is coming together. My shifts in the hospital are a little less gruelling because I can now see a patient and get a better picture of what is going on. That is a cool feeling.

We have only 8 more weeks of actual class time left. I am looking forward to starting the last clinical phase. Mostly just because I am getting tired of class work; I want to get out there and see some stuff. Eight weeks of class, 360 hours on an ambulance, then we're off to the National Registry Exam. I should be licensed in less than 9 months from now!

Things have been real slow here in Rural America. Hunting season is at hand, so we will probably see a few environmental emergencies and maybe a search and rescue or two. Who knows. Busy season is right around the corner though, and this ski season is looking to be awesome. We already have more snow than we have had in years. Of course, this is the first time I haven't bought a season pass in a long time...

Its All Down Hill From Here

I passed. Unbelievably so, but ture. I passed the cursed "Cardiac Box Test." It was by far and away the most miserable test I have ever taken, but it is now behind me. Let me summarize the misery for you:

• 285 multiple choice questions done one page at a time (you can't go back and change answers or look ahead, you must turn in the pages as you complete them).
• 67 EKG Strip Interpretations
• 86 questions pertaining to ACLS protocols
• 38 questions pertaining to EKG rhythm interpretation rules

As I was deep in the middle of the 6 hours it took to take the test, I was impressed with the amount of stuff that has been crammed into my head over the last year. I actually know some of this stuff; even more impressive is that I comprehend most of this stuff.

The post-test beer drinking was well deserved and appreciated by all of us. We had a great time and all surived with few scars. The stress relief was nice. About half way through the test all I could think about was how nice it will feel to be done with the test, and boy did it feel nice.

No good news on my poor friend. After surgery, he did get some better function in his hands. We are all holding out for his legs. It doesn't look good. He is in good spirits though, and his family is with him and supportive. I am sure that no matter what the outcome, things will work out for him. They will because they have to I guess.

A Shitty Day In Paradise

I just returned from a friend's wedding. It was beautiful. The ceremony was held at a secluded ranch far out in the middle of nowhere. The trees were all golden yellow and orange, it truly was a spectacular setting for the wonderful act of marriage. I had been tasked with cooking the meal, which was an ordeal worthy of it's own blog, but all turned out well.

The thing about weddings is that afterward, when all the tears are dried and anxiety has subsided, people tend to want to drink, and (with this particular group of friends) drink a lot. Sometime throughout the revelry, the idea was put forth that a good midnight swim in the pond would be a grand idea. I am famously known as a party pooper but this time kept my dissent and reservation to myself. By this time I was on the downward trend of revelling, and was beginning to think about going to bed. I had long quit drinking was enjoying the associated people watching that sober people find themselves doing when surrounded by partiers.

Off the boys went with a trail of whooping girls behind them. Camera in hand, my wife marched along as well to get the great action shots of our drunken and naked friends hitting the ice cold water. I ducked off to refil my water bottle and then headed down to the pond. I heard a few splashes and then I heard some screams. I stopped and thought to myself, "Aw, there just drunk and somebody is fooling around."

Just then my wife came running up the road, "Grab your bag! Allen is hurt, hurry!" On a whim I had decided to bring my back country jump kit. I knew there would be drinking, and I knew we were a long way from any kind of help, so I threw it in not thinking I would actually need it. I headed back, grabbed the bag, and ran towards the pond. I saw a guy staggering up the road and asked him what happened, "Oh, they're just fucking around. He's ok." I felt a little better.

As I approached the pond I noticed a naked guy laying beside the pond with about twenty or so partyers crouched around. I got closer and wedged my way up to Allen. He looked a little freaked out but fairly fine. I asked what happened and about twenty or so partyers began to tell me not just what happened, but that he was fine, he was just drunk, and that we just get him up and take to the camp fire to warm up.

I looked at Allen and asked him what happened. "I can't feel my legs."

"What happened? Do you remember?" I asked.

"I don't know, I can't feel my legs." I looked him in the eyes and saw that he was scared. The chatter around me was pissing me off and yelled out loud for everyone to shut the fuck up and be quiet.

"You in pain anywhere?" I asked. It hit me just as I asked. I was looking him in the eyes and I just knew. There are times when you just know. I have been on many trauma calls and medical calls and there have been times when I had no idea what was going on with a patient or why they called us. But as I looked at Allen, I knew we were in serious trouble here. I knew he was hurt.

"No, I am kinda cold. My hands tingle, I can't feel my legs."

I ordered a couple people to go fetch a folding table or a door or something to use as a backboard and I sent someone else to get a bunch of sleeping bags. I did a quick trauma assessment on him. Nothing remarkable, small laceration on the top of the head, no sensation or movement below the middle of his sternum. He was breathing fine, but his chest was "a little tight." He could move his arms, but he couldn't squeeze my hands. My stomach dropped as I realized that being drunk was no excuse for this. My heart sank when I realized that getting him to a hospital was going to be at least a three hour adventure. The nearest rendevous with EMS was ten miles on a really horrible two-track four wheel drive road. The nearest regional hospital was another 50 miles and it was unlikely that they even had a CT scanner.

I looked up and saw my best friend (the groom) standing there and I knew that his wedding was effectively ruined forever. No one would ever talk about their wedding without thinking about Allen and his broken back (or neck). He saw in my eyes that the situation was serious and he walked away. I could see him starting to freak out as he walked toward his new wife. The midnight swimming adventure was his idea.

I rounded up the three or four sober people I could find. We got him duct taped to a folding table, loaded in the back of a truck, called 911, and headed for the hiway. I gave him to a group of volunteer EMS people in a brand new ambulance after a gruelling 35 minute drive. They had a little attitude at first, but I think the tone in my voice let them know that not only did I know what I was doing, but that the situation was serious. He was flown to a trauma center over 500 miles away. I haven't heard what the outcome was. My gut says he will never walk again, my heart hopes for something else.

I haven't prayed in a very long time. I prayed for Allen today. I can't stop thinking about him, his wife and new baby, the look on my wife's face when she told me to hurry. It was a real life lesson (and career lesson) in what it feels like to be the loved one at an emergency instead of the rescuer. I got to be both; I don't like being the loved one.