Monday, June 25


It's nothing like an hour of running with my wife and dogs, good vegetarian food and  North Carolina Cabernet to relieve stress.

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Wednesday, June 20

A White Bowl

"I seem a small table with a white bowl and I was so afraid"

My grandmother told me. I new she was talking about a recent surgery she had to endure for oral cancer but I did not have a clue what she was referring to.

She began to cry as she explained, "I heard something that sounded like a horse trotting toward me and it kept getting louder and louder but I knew if I could just get my hands into the white bowl then I would be safe."

She continued to cry as my aunt explained that during her stay in the ICU granny's "heart went bad and all of the white coats came in."

Granny was very close to death that night and suddenly I realized she was explaining to me what she experienced during that time. How fragile is life and how enduring is death when our mind continues even when our bodies have given up.

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Wednesday, June 6


I enjoy reading the thoughts of other bloggers, especially others in the medical field. I have been reading one this morning, Surgeons Blog,that was especially good. He has written a series of post that detail a specific surgery that I especially enjoy. He also writes about death earlier in his blog that struck a note in my mind. Although my current training in medicine is limited to a very small set of actions and treatments that are provided in an emergency, I do have the unfortunate job of witnessing death often. The perspective of a physician seems to be in tune with how I attempt to rationalize death. (In the future after I have completed further medical training I hope to return to this is to see if I was right.) I do feel when my patient's die that I somehow failed them especially when a certain set of skills are "supposed" to make a difference when executed correctly and they do not. It is very difficult, nearly impossible, to not blame oneself in these instances. Unfortunately, the very high turnover or "burnout" rate that is seen in the prehospital health profession can be attributed to the guilt felt when a patient's outcome isn't satisfactory. I can't help but think that a physician must feel the same guilt because death is certainly universal.

As for me, each person that I come in contact with in life is unique whether it is a patient or their family member. In the unfortunate situations I sometimes find myself, I always attempt to explain to the patient and the family as clearly as possible what I believe is happening and the possibilities that can occur. Although I don't always have the luxury of time, as my profession hinges on crisis and not prevention. It would be much more difficult for me to get to know a person and watch them deteriorate slowly over a coarse of care that I had planned. Certainly that will be a tremendous change for me in the future. But for now, I must be content in the fact that life, as a great circle, must be completed by death and sometimes there is no cure or quick treatment. I can only become the best at the small set of skills that I am afforded and make sure that when the call comes I can perform as the patient deserves, flawlessly.

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Tuesday, June 5


I am not sure what to write this morning. A couple of interesting things have happened in my life over the past few days. Nothing spectacular just the same old same old really.

I had a complaint filled against me. That's generally an awesome thing to learn about. The other morning I had a whining rich teenager who was riding in a large SUV and crashed into a rock pole. It was a very minor accident and he was one of three people in the vehicle and the ONLY person complaining of neck pain. So, we took all of the necessary precautions; putting a C-collar on him and placing a long spine board to his back and taking him down from a standing position without moving his neck or back. It was just a taxi to the hospital after that.

This scenario happens all of the time. More likely than not when we arrive at the hospital the patient is sent to triage after their C-spine is cleared to wait there turn. But, at 0300 in the morning there obviously was nothing to do in the ed. When we arrived their were several nurses and doctors waiting in their main trauma room. We wheeled our patient in the room and placed him on their cot. I begin telling the story, or giving a report, and the doctor began speaking over me. At that point I gained a signature from one of the nurses and left the room. Yes, I could have stayed and gave a more detailed report after the doctor cut me off but I didn't. I felt that a brief explanation of the incident would suffice because it was very minor.

The next day as I am sitting at my second job when my phone rings. It's the assistant director of the ambulance service. He called me, on my day off, to explain that the doctor contacted him and was upset because I did not give an adequate report.

Looking back I try to take my ego out of the equation because it has no place in patient care. I probably should have stopped and explained over and over again that the accident was minor and the only complaint the patient had was neck pain. No obvious trauma was noted and he was mainly afraid that his mother was going to ground him forever. The neck pain was probably an attempt at sympathy on the patient's part anyway.

I just can't believe something so trivial went as far as it did. I also can't help to think that if this patient was a minority and not from an influential family that he would have been immediately dismissed and the staff would have cared less what I said or did prior to bringing him to the hospital.

What a crock of shit.

By the way the patient was discharged with no injuries.

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