Man With Swollen Arm That Wasn’t Actually Swollen: “Not a drop. I been sleeping all day.”

AD: “You’re slurring your words, unsteady on your feet, and your breath could knock over a moose. Plus, there’s a nearly empty half-pint of Taaka in your pocket. You wanna try that answer again?”

MWSA (insistently): “Man, I ain’t had a drop to drink all day. I got drunk off my ass yesterday, but I been sleeping it off all day today.”

AD: “And what day is today?”

MWAS: “Wednesday night!”

AD: “I’ve got bad news for you, Sir. It’s Tuesday afternoon, and you’re still drunk.”

You know, most people that drink heavily tend to lose big chunks of time when they’re drunk. It takes a special talent to gain 30 hours when you’re in the bag.

KatyBeth (hitching up her pants): “I can’t help it, it’s genetic.”

AD: “Genetic… how, exactly?”

KB: “Mom says I inherited the Grayson butt.”

AD: “There is no such thing as the Grayson butt.”

KB: “Uh huh. No butt, bad math skills and no rhythm. That’s my curse from your side of the family.”

AD: “Remind me to have a talk with your mother when I bring you home.”

By way of Mostly Cajun, I learned of Calibre, a freeware e-book reader and converter that is capable of converting other e-book formats into Kindle’s format.

So hit up Barnes and Noble, Sony or iTunes for a copy of the book, and then use Calibre to covert it for use on your Kindle.

And thank you for your contribution to the Double Wide Fund.

(Click on the book cover for the purchase link.)
 

For those of you unfamiliar with the history, the book was published by Emergency Publishers in fall of 2005. It was written in first person, present tense narrative, much like a journal. My wife left me unexpectedly in September of 2004, and in the next four months I needed some way of passing the nights on an ambulance between calls, without driving myself crazy over the demise of my marriage.

The book was it.

The blog started in December 2006, mainly to promote the book and to polish my writing style. About a year after my blog started, an editor from Kaplan Publishing, a dvision of Simon Schuster, happened across my blog, and offered me a publishing contract. When told that I already had a book in print, he asked if I could get out of my contract with Emergency Publishers, and allow Kaplan to publish the book under their own imprint.

Lou Jordan, my friend and publisher, gave me his blessing and terminated my contract, and I signed with Kaplan. Lou had accomplished his stated goal, which was to give me my start, and get me noticed by the big boys.

Kaplan cleaned the book up a bit, changed everything to past tense, and published it in hardcover as En Route: A Paramedic's Stories of Life, Death and Everything In Between. They included a story from the blog as an epilogue, which I think really wrapped up the book well.

But they also deleted a dozen or so chapters, because my editor at the time (since gone from Kaplan) felt that they were too controversial, and that their deletion would not hurt the book.

I disagreed, because I felt that a) the chapters on the chopping block weren't that controversial, and b) they contained most of the narrative thread that wove the rest of the chapters together. Without them, the book read like a collection of short stories.
 

I was overrruled, and the book was published without the deleted chapters. Since then, my concerns were validated because most of the criticism of the book centers on exactly what I and Kaplan's own proofreaders warned; it felt like pieces of the book were missing.

A year later, they released the book as a trade paperback under yet another title, A Paramedic's Story: Life Death and Everything In Between, causing some of my readers to buy it, mistakenly thinking it was a new book.

So if some of you out there have two copies of my book, I apologize. I just wrote the darned thing, someone else markets it. If you'd like to have your copies signed, drop me a line and I'll tell you how to send it to me for an autograph, provided you pay for the shipping.

I don't make any royalties from sales of the original book, but if you've already got a copy of En Route or A Paramedic's Story and wondered what was missing, this one will answer that question. 

And you can't beat the price.

The kid was in good spirits, smiling and laughing. The tooth seemed in good shape, too, despite it’s less-than-desirable storage receptacle of the mother’s lint-filled pocket.

So, I gently took the tooth from her, handling it by the crown only, and wrapped it in saline-soaked gauze while I called the local hospitals to get confirmation on what I already suspected.

None of the local hospitals have the capability of re-implanting a dislodged tooth, and none of the local dental clinics that take Medicaid answer their emergency numbers, or even have emergency numbers, for that matter.

So, I whipped out my smartphone for a consult to Dr. Google, to refresh my memory on just how long a dislodged tooth is viable for reimplantation.

I learned a couple of things:

1. Milk* is still the best preservative if you don’t have a Sav A Tooth kit. I had been taught that milk had fallen out of favor as a tooth preservative.

2. The fibroblasts on the root of the tooth that are the “glue” that make reimplantation possible start dying after 30 minutes.

Our little girl’s fibroblasts were already dead, buried, and the remaining fibroblasts in her socket were having a rollicking Irish wake.

Looks like our patient will be channeling her inner hockey player for a while, until a dentist can fit her with an artificial implant.

* I asked Siri, “Does the milk have to be Pasteurized?” and she answered, “No, just deep enough to cover the tooth should be sufficient.”**

** Not really. I’ll be here all week, folks. Try the veal, and be sure to tip your server.

Seems like my high school guidance counselor was right when she said that "fascist tool of the totalitarian state" was the perfect career choice for me. And all this time, I figured I was just a simple paramedic.

In response to Tamara's link to my Lines In The Sand post, a couple of people went into a bug-eyed, slobbering, incoherent rage took umbrage at my assertion that you don't have the right to refuse care if you have expressed, by word or deed, a desire to kill yourself.

Actually, that's pretty much the law in my state and a bunch of others, but let's take a moment to delve into how, by the convoluted reasoning of some, my following that law is the moral equivalent of herding Jews on the train to Auschwitz.

And yes, people actually said that.

Like TJIC, for example:

How does this differ from "OK, Jew, I understand that you want to leave this prison camp, and that would be OK by me, EXCEPT for the fact that I'd get written up and get three demerits if I let you, therefore I won't let you – your actions have consequences for other people, and you have to realize this!"

Wow. Just… wow.

I guess I shouldn't have taken my "I am TJIC" badge down off my blog, huh? While I appreciate that Travis might have a sore spot or three about having his rights trampled over words he said, that statement is a perfect example of why many don't take libertarianism seriously.

I mean, you get a bunch of individualists who are passionate about personal freedom and smaller government, people who are legitimately concerned about the encroachment of government on our personal freedoms, whose general approach to life is "You leave me along and I'll leave you alone," and invariably there is one in the bunch who says something so far out in friggin' left field that the rest of them want to sidle away, eyeing him nervously all the while.

And in so doing, alienate about 75% of the fence-sitters who might be sympathetic to their cause.

But hey, more power to you, Travis. You stay militant, brother!

If you really equate me transporting someone whose words or deeds demonstrate that they may not – at least in the eyes of the law – be in full possession of their mental faculties, with a Nazi trooper herding Jews onto a train to a concentration camp, then we really have nothing else to discuss.

Have a big libertarian "Go fuck yourself!" and have a nice day. 

A fellow with the handle of ILTim also opines:

"Who the fuck are you to decide that a person should be dragged against their will to gitmo/ fluffy bunny land/ wherever you please? That type of personal violence could and should be resisted in every way available and necessary including lethal force."
 

Well, here's the thing, Tim. If you were that willing to use lethal force, you damned sure should have used it on yourself before the cops and EMT's got called to the scene. If you're that slow, or you're running your mouth about it, you're going to the hospital. And if you try to resist by lethal force, I'm gonna go hide behind the engine block of my ambulance while the cops ventilate you thoroughly with .40 caliber holes.

And after my shift is over, we'll go hit the local jackbooted thug bar, I'll buy them all a beer for saving my life, and we'll do a few Nazi salutes and read selected passages of Mein Kampf together.

First of all, I don't get to decide. I just get to transport them to the place where someone with more training than me in psychiatric care decides. I didn't make that law, I'm just subject to it. I suppose I could just shrug my shoulders and say, "Your life, your choice," and walk away, but when I get sued – and I will get sued – the only way I'll get away with it is if I have a jury full of people like you and TJIC.

Except, guys like you would never make it onto that jury. You'd be outside the courthouse wearing a sandwich board, screaming "SHALL NOT BE INFRINGED!" for the television cameras, while everybody watching mentally relegates you to the same niche as the disheveled guy on the next street corner, wearing the sandwich board that says, "REPENT, THE END IS NIGH."

If that makes me a moral coward in your eyes, then so be it. Your opinion of me doesn't cost me much sleep. Grab yourself a picket sign and hang out in Moral Absoluteville with TJIC, while the rest of society does its best to ignore you. Me, I'll still be here, trying to convince people of the rightness of libertarian ideals, and likely making more headway because I'm not spouting off crazy shit like comparing EMT's to Nazi death camp guards.

The whole point of that post is that words have consequences. Travis discovered that very thing, and apparently hasn't learned anything from it. In a way, I find that admirable…

.. from afar.

I say "from afar," because while it's nice to hold people up as heroes, heads bloody but unbowed and all that, up close and in person they often turn out to be unreasonable assholes. In any case, I imagine Travis will lose as little sleep over my opinion of him as I will over his opinion of me. I just wish he realized that people with his attitude make far better symbols than effective advocates.
 

On the brighter side, there were some reasonable voices in the crowd. Roberta X:
 

All the enhanced 911 systems, medical alarm monitoring services and 24-hour sitters in the world will do you no good if the paramedics cannot find your house among the dozens of other cookie-cutter homes on your block.

Do yourself a favor and invest another $30 in your safety and peace of mind, by going down to Home Depot and buying some 3-inch reflective numbers for your house AND your curb, and installing one of these:

That's a GE 3-position emergency light switch. Installs just like a regular light switch, takes about five minutes, if you're really slow walking to the breaker box. Up is on, down is off, and middle blinks the light on and off repeatedly, drawing the medics to your door like resuscitating moths to a cardiac arrest flame.

Well, it does if you install it on your porch light. If you install it on an interior light, there's just no helping you.

And my partner last week may well have been the smoothest driver I've ever had. You could barely feel the road when he drove.

Of course, it's easy to be smooth when you drive at the approximate speed of tectonic shift. Dude didn't need a speedometer, he needed a calendar. I finally told him to just keep the lights and siren off, because when you're driving substantially below the speed limit and angry old folks are passing you on their Rascal scooters, flipping you off as they whiz past you in the breakdown lane, what's the point?

It wasn't just the driving, either. Dude moves at the blistering pace of a geriatric sloth with a Xanax habit. On one call, a wreck, I told him to follow behind me with the spine board and stretcher. I had assessed the patient, listened to her tell me she wasn't injured and didn't want an ambulance, written down her demographic information, had the refusal form signed and witnessed and was on my way back to the rig before he got the stretcher unloaded. He even looked disappointed slowly; it didn't so much flash across his face as it did a slow melt. I was back in the rig and massaging my temples before he got his frown fixed into place.

I never thought I could find something more mentally stressing than having a speed demon as a partner, but this came close. Halfway through the first shift, I had to quit stomping the imaginary accelerator on my side of the rig, lest he squeeze the steering wheel in half, he was that white-knuckled. I finally just wound up driving to all the calls myself. Seemed a more productive use of my time than expelling exaggerated sighs and pointedly looking at the speedomoeter, anyway.

I mean, I like to watch the seasons change, but not from the back of my ambulance between scene and Emergency Department.

Jeez…

So when you’re arguing, you know that there are certain buttons you just don’t push, certain subjects that you just don’t broach.

You Just Don’t Go There.

And when you cross those boundaries, you know there will be consequences, ranging from getting the cold shoulder for the next few days, to unwilling celibacy for the foreseeable future, to having her/him toss you out on your ass.

And when your argument spills over into physical violence, expect that one or both of you will go to jail when the cops get involved.

Likewise, there are some things you Just Don’t Get To Say.

If your spouse/lover/life partner/ babydaddy chose to get the police involved, or if a third party overheard your argument and called 911…

… well, suffice it to say we don’t grant Mulligans. You don’t get to take it back.

And chief among those things You Just Don’t Get To Say in an argument is, “I’m just going to kill myself.”

Almost as bad, but without the implied threat, is, “I wish I was dead.”

Make the threat more specific, like say, threatening a specific way to do harm to yourself, just adds the element of a defined plan to your suicide threat, and makes it all the more credible.

Say those things, and I can guarantee you one outcome: You. Will. Go. To. The. Hospital.

Your only choices are whether you go restrained or unrestrained. You don’t get to say no any more.

And yes, I am perfectly willing to believe that you said it in the heat of anger and didn’t really mean it.

I also believe that someone who seriously intends to kill him/herself would be willing to tell any lie necessary to get the cops and paramedics to leave so they can get on with mixing their hemlock smoothie.

You don’t get to be that person.

And no, I don’t really give a rat’s ass if you get a mental health record or if you have class/work/social engagements in the morning that you just can’t miss.

Neither am I going to lose sleep over the fact that a 48-hour stint in the psych ward ruins your chance at that law enforcement career you’ve been so zealously pursuing, or takes you out if the running for Man Of The Year at the local Rotary Club.

Pleading with me for lenience is only going to fall on deaf ears. The only leniency you get is the ability to choose the pleasantness of the ride.

You made the threat. I don’t get to decide whether it is credible, nor do I want that responsibility. Plead your case to the ED doc and the mental health tech if you want. Sometimes, if they believe your story, they’ll cut you loose.

But it’s my job to get you there for that conversation, and get you there I will.

Fighting with me is pointless. I will win that fight, every single time, and all your struggle only guarantees that you will spend the next 48-72 hours walking around in shoes without laces and talking to psychiatrists about things you’d rather not discuss with strangers.

So, consequences.

Don’t like ‘em, then don’t say those things. Don’t cross that line in the sand.

Hugs and Kisses,
Your friendly neighborhood Ambulance Driver

http://www.youtube.com/watch?v=eR7-AUmiNcA

Brought to you by KatyBeth, who is, like, the biggest Sarah Bareilles fan evar.