Our 'Special K' patient

Went to a call yesterday, 20 something male with the all to common "abdo pain" as the call header on the CAD. Pulled up outfront of a palatial estate with 3 luxury vehicles(sympathy deminishing) out front, he was waiting in ernest for his taxi it seemed. I got out and pointed to the ambulance side door, he walked in hunched over grabbing at this mid section. Once inside the theatrics began, writhing in pain, moans and groans, flailing arms and feet. "so much pain..so much pain!!" between heavy gasps for air. I managed to settle him down, get a set of vitals(blood pressure, heart rate, SpO2, resp rate and GCS) and put a name and DOB on my paper form that I had to hand to hand into admitting once we got to hospital.  We were only minutes from the hospital so I didn't get the full story.."so much pain" over and over was all I had to go on for a report to the triage nurse.
Anyways it turns out that this guy has a habit of putting straws in his urethra(where the pee comes from for those not anatomy savy) in order to produce a positive blood sample so that he can get pain medications. He is addicted to Ketamine which is used as a animal tranquilizer, and or anaesthesia. Why are people so fucked up to get themselves addicted to such drugs!
Ahh well, rode my mountain bike in the last 2 days to work, pissy weather, but nonetheless I feel validated that I'm getting a little exercise. Signed up for a 50km trail ultra in early March, it is one that I havn't done for 8 years so I'm looking forward to getting back to do it. I guess I should be running into work instead of riding..tomorrow.

Boxing Day

The 25th has passed, the over indulgence, presents, fake gift giving, lounging, catching up with family and all the other assorted tasks associated with Christmas. I live in a predominant Asian community (65% Asian) , I was at the malls just like everybody else, but I wonder if people even know what Christmas is about, the true meaning of Christ(mas)?
I am a Christian, and I celebrate for my saviour. The commercialism of Christmas has turned me off in recent years. I suggested to my wife that next year we forego the gifts and just go on a family holiday. Hmmmmm
Boxing Day today, went for a run...it was FREE!

Dtes

Driving down Powell St one shit ass dreary day, saw a cracked out street worker stumbling to get across the street.
Stop. Parked it. "Girl where you goin?, you gotta be careful"(as I hand in hand help her across the road) ....... Walking back to get in our rig I see this poetic stash of needles. Snap.
I love what I see and do, even on the dreary days.

Tuesday.

Relaxing at a coffee shop, note book in hand, a whole list of things to do...where to start?
Actually I think this is the issue a lot of us have, and then we do nothing because we feel overwhelmed. Getting started is always the first step, having that self discipline to just 'get on with it', to get your tired body out of that nice warm bed and go for a run, to go to that shitty job when you want to call in sick, to do those mundane chores when it seems so much easier to just avoid them 'until tomorrow'. We procrastinate, we avoid, we delay, we make up excuses, were just LAZY sometimes. And that's ok...sometimes, but not all the time. Being a self motivated, self disciplined person is not in all of us. Do the best that 'you' can do, don't put your standards so high that they are unattainable and thus you set yourself up for failure every time. Set goals, set several goals for one thing. Be realistic, be fair, and be motivated to get on with your day. Plan your day, plan your week, don't put it in stone but do know what you need to do and want to do. Get those dull, boring, mundane things out of the way, set time aside for family and friends, and most importantly, set time aside for yourself.
Look at that half filled glass of water as 'half full' not 'half empty'. With a week before Christmas and the events that just took place in US at the elementary school shooting, we should all be grateful for what we have.
Happy Tuesday!

Senseless

20 innocent angels dead at the hands of a monster with a weapon.
RIP

Not that I'm big on the social network scene or anything, but I'm sick to shit of hearing people's lame 'status updates'
..."saw a red car today"..."need to study"..."I have a headache"
Seriously!
Tonight is my first of my two night shifts, it's 3:26am as I write. We just finished taking in the suicidal 80 yr old who had been drinking solid for 1 week. He was smashing his head off the fireplace and tried jumping out the 2nd story window. Most of the shift has been uneventful , one minor car crash, a air evac transfer for a terminal cancer patient, a short of breath ol' girl.
It's a wet and dreary December night and I'm looking forward to 6:30am when our shift ends. Get home and crawl into bed and run my frigid popsicle sticks up against my wife's warm legs. A soft kiss and I'm out. Then one more night shift to go, after that I'm on holidays until the 27th. Got some running and other training planned in with the Christmas shopping. I enjoy Christmas time, although its a busy time it's a fun time, filled with lots of nostalgic moments.
Sadly it's been proven that more people commit suicide over the Christmas holidays than any other time during the year.
Come on 6:30!

Barn call

Yesterday we neared the end of our 12 hour shift, we received the below pictured call.
He went out to his barn with a shotgun, lowered the butt to the ground and put the barrel in his mouth.
Who knows what troubles he had in his life? Marital woes, money problems, deteriorating health problems, depression...
So many unanswered questions sometimes...
I need to go for a run tonight...

老婆 lǎopó

Lǎopó means wife in Chinese, it's informal, kinda like if you call her 'sweetie' or 'honey' or something. Meifeng is my 'lǎopó' and never have I met such and amazing person. I am truly blessed to have her in my life. Her story, her life, is one of hardships, trials and tribulations, and resiliency in the face insurmountable odds. Her life has been about kicking ass in a society and culture that treated her(and many millions of Chinese women)..like shit.

  Huang Meifeng was born on August 2nd 1975 in rural countryside china. Three brothers and a sister had preceeded her, so on the seniority list she was rock bottom. Her family was poor..like dirt poor, they were farmers like many around them in central Guangdong province.  They lived off the land and squeezed out a meager existence. Two other siblings had died prior to Meifeng coming into the world, the result of Chairman Mao's 'modernization of China' , a modernization that killed 70 million people.

  Her harsh life started early, when she was a month old she became very sick, frail from illness with no medicine her parents thought she too would die(when I asked meifeng how the two siblings died she said her mother simply told her '..no food'). One night her father put her outside in a tree(yes 'in' a tree) to die, her mother stirred all night and at 4am went to get little Meifeng, still fighting for life. Her neighbours would say to Meifengs parents "oh, your baby is still alive?"  her early childhood played out on a balance beam of life and death with sickness. She survived and grew, she received the clothes passed down from 3 brothers and her elder sister Li Zhen, by then rags really. Her hair was shaved off so as to keep cool on the hot summer days.. plus it was just way easier, no hair to wash, no cute elastics to buy, no waste of time with braids or ponytails, all the villagers called her 表叔仔(it's like 'little boy').  Food consumption was basic at best, rice and maybe some vegetables if she was lucky, porridge for breakfast, nothing for lunch and rice for dinner, all the good portions went to her brothers. Meat never found it's way into Meifengs bowl. She told me for many years they had meat only once a year, on Chinese New Year and it was pork, but not the meat of the pork, just the fat. Her sister Li Zhen was shipped off to a distant relative when she was eight simply because they could not feed her. At seven Meifeng's father tried to have her adopted by a family in Hong Kong but she said she cried and begged her mother for a week saying she would work the farm day and night, her father relented, but only because he needed her to work the farm. Fom ages 6-10 life was very tough for Meifeng, I asked her what was most difficult?  she just looked at me and cried......."hungry".  Her family had very little money(..and you need to understand that when I say 'very little money' that means..pennies!) they could barely afford to put her in school(which you had to pay for) they could not afford school books, she said she would beg the other children to share their books with her, but many were in the same boat as her. " I wanted to go to school, study hard, but very difficult". Work never stopped for Meifeng, the mountainous walk to school was 1hour..it was accompanied with back breaking load of wood she would carry to sell to the village men who would make buttons out of it. I asked "how long did you carry the wood to school", she replied.."every year". After school she would walk the hour dirt path home, down her bowl of rice and hurry out to the mountain hillside to cut wood. I asked "why hurry?" and she told me it got very dark out in the hillside and she would get very scared as she was by herself, she would cut three or four trees and tie them to her back and drag them home before it got pitch black, when she got home she would then cut it into the proper size to carry to school in the morning, then alas was homework and bed. Weekends were much the same she said, "sunrise to sunset..work.. but we sneak away to play with the cows or swim in the river" . For Meifeng there was never any candy, treats, birthday presents, shopping at the mall, nothing. In the summer she went barefoot, in the winter she was allowed to wear shoes and her parents made her very aware she was lucky to have these, they were 3 lace rubber and canvase moccasins that cost 1RMB(RMB=Renminbi or the Chinese Yuan, 1rmb=15 cents Canadian...so...you do the math!)  

 at 16 years of age she saw TV for the first time..this was 1991! She was also told that she wouldn't be going to school anymore, instead she would work the farm and sell vegetables to help support the family.  It was tough work, labourous and long hours..everyday. Six months later she did what 200 million other peasants did, she migrated to the big city in search of better money. She found a job in a factory where they told her she would only work 8 hours a day and have 2 days off a month. Instead she worked 14-16 hours a day with no days off, her pay..29rmb or about $175 a month. They took money off for food and uniform and she slept in the factory dormitory with hundreds of other girls. She told me she did this for almost 4 years, making an assortment of things from mens underwear to running shoes, by the 4th year she was making almost 400rmb a month..something her father did not even make in a year.

  To say Meifengs childhood was 'tough' is a grotesque understatement. It is a miracle that she is even alive today. She was deprived of all things we take for advantage here in the West. She went without food, she went without shelter(in May of 1982 they had typhoon flash floods that destroyed their home and crops, they lived in an outside shelter with five other families and existed of only potatoes everyday for many months), she lost her education, she was dressed in rags. But to her, when I talk to her, she feels lucky because many girls like her never went to school at all, never had parents, never lived. In the rural countryside typical Chinese parents never show affection to their children, there are never any hugs or kisses, or "have a good day at school". Meifengs parents never told her they loved her, but she knows she was 'loved', had they not she would not be my lǎopó.               

Calls you don't forget.

Throughout ones career you will go to calls that will stick with you. Something about the call will be imprinted upon you, whether its visual, a smell(and possibly taste), or auditory. Sometimes it's a lot of these things..very sensory driven. The circumstances of the call usually come into play as well. Tragic calls involving children are hard to forget, but no matter what it is...something about 'that' call gets imprinted into your brain . I have had many memorable calls throughout my career. Some good and some bad. This call happened a few weeks ago and it was a tragic call.
That day had been normal like so many others, I was 'attending', which means I was the Paramedic in charge of patient care and treatment. We had completed a few calls, coffee was running through the veins, the sun was out...a good day so far. We had just cleared the hospital when a call came through on our computerized information system located in the cab of our ambulance. 'Code 3' for the high fall. I scrolled through the information gathered about the call, address, reference coding, and short detailing notes.  It stated that somebody had fallen from the 17th floor of an upscale condo and the patient was on the pool deck located on the 3rd floor, a fall of 14 stories or about 140-150 feet.  As I read out the information to my partner we both looked at each other and said " he'll be code 4 for sure" a reference meaning the patient will be dead. Nobody survives a fall like that.
We arrived on scene just after Police and were quickly ushered into a locked off elevator with all our gear crammed in...full well expecting not to use any. As we came out onto the 3rd floor and through the outside doors to the open air pool deck a mother and young child walk by with horror on their face, testament to the carnage we were about to see. As we rounded the corner I saw the contorted naked body of what I figured was a 20 something male. Just above where he was folded around a wooden sitting bench was the metal railing fence upon which he landed on (see included picture which gives you some gravity of the mechanism of impact) from some 13 stories above. He was motionless and lying on his right side, his left leg was contorted up in line with his upper body, his right leg going down. I could see both arms had open fractures as I neared the the body, blood and tissue oozed from his abdominal cavity. His head was covered in disheveled mess of long black hair, I poked my fingers though his mane to find a carotid pulse. Up until then I had fully expected that he would be dead, to fall more than 140 feet and impale abdomen across a metal fence is to be expectant of certain death. 'da dump..da dump..da dump..' as I felt a steady pulse across my gloved fingers. I looked at my partner and with dumbfound calmness said " he's got a pulse". Just as I said this I saw him open his eyes and look forward, he let out a low powerless moan. I motioned for our clamshell device which is like a plastic backboard that comes apart in the middle to scoop up spinal caution patients.
Suddenly everything changed about this call, my mindset went from ' ah that sucks .. he died' to ' ah shit..let's get to work'. The Fire dept guys had just arrived and together with my partner we set about extracting his crumpled body from the wooden bench and getting him into a position that we could scoop him up with the clamshell. Based on mechanism I knew he could go into cardiac arrest at any moment and also it was highly likely that he would not survive to the operating table, which is what he needed...immediately.
Even though his left leg was going in the wrong direction it was making a pressure point on the eviscerated trauma going on in about his pelvis and lower abdomen. I knew that once this pressure point was removed and the leg brought down into its natural position that he would bleed out in a gushing mess, but really what options did I have, he needed to go and it had to be asap. Everything was ready, clamshell in place, we had him with a cervical neck collar on, oxygen high flow with BVM(bag valve mask) at the ready, the stretcher lined up for a quick departure to the elevator. I designated the pressure point to my partner as we brought his leg down and brought his body into a position where we could get him on the clamshell. Within seconds he was loaded and moving off to the elevator, blood was coming from his abdominal cavity at a steady rate even though we had trauma dressings and my partner had most of his hand sunk into his lower abdomen. I kept a steady watch on his carotid pulse seemingly expecting him to go into arrest at any moment. I had called for one of our Critical Care Paramedics to assist and give enhanced patient care while on route to Vancouver's major trauma receiving hospital. We 'notified' the hospital of our incoming trauma patient. He was intubated, large bore IV's running and his chest darted enroute.  Two minutes from arriving at the hospital emergency doors he went into cardiac arrest. We unloaded him from our vehicle and commenced continuous CPR,  I road the stretchers lower bar as we calmly moved into the ER trauma room, 'one and two and three..' I quietly said within my brain. A whole slew of emergency doctors and nurses let us transfer our patient over and we gave an accurate story about what we knew, what we had done, and what we observed.
We continued through about another 3 to 4 minutes of CPR while the the ER physician went through his mental checklist, monitor, abdo ultrasound. "Stop CPR!" the doctor called out " ...and thank you everybody" as he looked at us all, he then noted the time to the nurse who was scribing the notes.
And so it was done and we set about cleaning up an absurd amount of blood , feces, and other body fluids. The ambulance was a mess with shit everywhere. In silence for awhile my partner and I did our own thing, each of us reflecting on what had just happened. While we were cleaning up all our gear the Police who were on the call arrived, I asked if they had a name and date of birth so that I could note it on my paper work. As it turned out he was 20 years old that day, his birthday. His younger brother was in having a shower when he climbed over his 17th floor balcony and lept off. Why? we will likely never know.
The rest of the shift rolled on mercilessly, we took time though to go have another coffee and find humour in the tragic call we had just done. Making sense of it all is the best we can do, even if it doesn't make sense sometimes.
Tragic!

Life as a Paramedic - My Job

I am a Paramedic and I love my job!
In this day and age some of us consider ourselves lucky to have a job, few of us are able to have a job that we have passion for and that we enjoy doing. I fall under the lucky few(I think?) in that I'm paid to do a job that I really enjoy...most of the time anyways.
It has taken me 10 years of hard work and plugging away though to get where I am today.
Paramedics usually don't just become 'paramedics', it's a passionate path that most of us follow. It's many years of volunteer work, low crappy pay commuting to rural stations,  hundreds of hours in a classroom and countless more at home with your nose in a book or on the computer. It's clinical and practicum hours, clinical exams, practical exams, governing body licensing exams, employer exams.
For me, it just kind of clicked one day when someone said that I should become a Paramedic.  The years before this I wouldn't have even thought about doing this job, but at that moment in time it all made sense...yes...yes, I should be a Paramedic!
After I left the military I was kind of lost, not knowing what job path to go into, I was soul searching trying hard to find something I had desire for, a job I would enjoy, a job that could give me a challenge. I had a lot of empty holes in my life that needed to be filled from my years of being in the British special forces. Frustration in job direction was a brewing problem, and then there was that day that it clicked... Yes! I should be a Paramedic!
I took a lot of courses, I put in my time, and at times I struggled and questioned why I had chosen this path. But at the end of each day I knew this was what I wanted, it was the same thought process I had when I was in basic training many years before in England.
Today I am a full time Paramedic working in a major metro area, and in particular the community that I call home. I work four days on and four days off, two days and two nights of 12 hours each. I can run or ride my bike to work, and have a regular station to report to. Each and every day is different and when I put on my uniform before the start of my shift I always wonder what things I will see and do in my shift. It is sometimes boring, but mostly it's exciting and challenging, both physically and mentally. It is what I want to do, it is what I was supposed to do.
I am a Paramedic and I love my job.

Meat and potatoes

The 'meat and potatoes' run, not necessarily the most fun of runs but it's great for that base mileage. The picture enclosed is where I do my meat and potatoes run. It's flat, fairly uneventful, but it's trail. I do have to pound the pavement 1km to get to it but once I'm on it I can go for a fair distance( all connected its about 35km of trail).
I try to do my one hour-ish meat and potatoes run about 3 to 4 times a week, this mixed in with a long run as well. As its the off season I'm not really doing any tempo or speed work, I'll throw in a couple 'pick ups' near the end of the run to keep it interesting.
Also I do some riding throughout the week, both riding to work(16km round trip) on my mountain bike and spinning at home on my road bike. At home I also do my own little cardio and strength training exercises down in the garage.
Keeping the motivation to get out for those base mileage runs is difficult sometimes but we all know that once we get done one of these runs it sure feels great. Breath in that fresh air, warm up that muscle memory, get a little rain on the back of your neck. Run!