A night out in Worcester

So as part of my Emergency Medicine rotation, I have to do two ride-alongs with Worcester EMS. I had kind of a crazy and interesting night, which I feel like sharing parts of semi-publicly. We had quite a few calls tonight, which usually came in right as we were nearing a coffee shop (did the dispatcher know what we were doing and where we were going? perhaps). There were a couple non-interesting calls, so I'll leave those out. But even amid the mundane, the two paramedics I was with were quite a duo. They were hilarious and inappropriate, and just as I was on the brink of rolling my eyes at their adolescent humor, they quickly and smoothly sedated and intubated an old woman in respiratory distress. I mean, I had barely opened the bag with the equipment and I looked up and the tube was in her mouth (paramedic: "When you look in and see their teeth come out, you know you're golden"). Preceding her florid respiratory failure, she had just been having some difficulty breathing. Her rapid decline (this was the most serious gasping for breath I have ever witnessed) while we were on our way to the hospital forced me to poke my head up toward the driver and ask, in a polite and high-pitched voice, "um, excuse me? could you please pull over?" and as soon as we stopped she was intubated and we were on our way again. And the medics were nothing but patient with me as I fumbled with IV tubing and squirted saline on them (and on me) (Medical Students: Always Cool Under Pressure). Actually the scene wasn't as frantic as I would have imagined an emergency intubation on the side of the road to be. (End result: we brought her to the hospital, and I have no idea what eventually happened to her.) (Unsatisfying, I know.) What's also interesting about this lady is that she kept saying over and over she didn't want a breathing tube (known in medicalspeak as being DNI: Do Not Intubate), but then when she actually started gasping for breath and frothing at the mouth, she said she wanted the tube. This is not the first time I have seen this happen, where people swear up and down they want no "heroic" measures, then when it comes down to it, they want everything. I guess your feelings are different when you're thinking about what may potentially happen in the future and experiencing what is actually happening. I can't imagine the terror of knowing you're about to die, even if you're very old and very sick and have thought about it a lot. But this is a discussion for a whole other post.
Anyways, we had this other call which was to a "man down" in downtown Worcester. He ended up being a drunk guy with new and old cuts, scrapes, and bruises all over him, and large switchblade hanging out of his back pocket (which, upon noticing it, the paramedic and police officer quickly took). At first I was thinking, this guy's totally drunk, he was stumbling around and fell and hit his head, he's refusing to go to the hospital, why are we here? Then I got more of an idea of what was going on, and it turned out he was well-known to all parties on the scene, he's a sometimes-resident of the PIP shelter, he's pretty skinny and pathetic and gets jumped all the time, and had been beaten up today because he had $20 that someone else wanted. He carries the blade for protection. The officer told him he understood it was for protection, because there were some dangerous characters out there (I'm cleaning up his language in paraphrasing here), and then told him, after seeing a bottle of gatorade in his bag, to "pound that shit." I was kind of surprised (and then felt guilty that I was surprised) at how patient and respectful and just plain nice everyone was being to him. The man eventually decided to come to the hospital, and as we were getting out, the medic reminded him to please be polite and treat people with respect, and that's how he would get treated by the doctors and nurses. I'd like to think that's true, but I'm not sure the bleeding drunks sleeping in hall stretchers get treated the same as other patients. I know if there were a choice of two patients to go see, I probably wouldn't choose the drunk man in the hall. (I wish that wasn't true and I didn't think like that, but I'm being totally honest). But it was nice to see this man from a different angle; fine, he's an alcoholic (who am I to judge), but he's also just trying to survive (and has probably had a pretty bad life so far), and ends up bleeding on the sidewalk every couple of weeks because Worcester's Finest want to mug him for his $3.50 bottle of vodka. Life's a bitch for some people...so who am I to judge them and not treat them with respect??
[Side note: talking about this man brought up one of UMass' family physicians who works at the PIP shelter, Worcester's only (I think) wet shelter, and an all-around rough place. We quickly concluded that this particular doctor is a bald, male version of Mother Theresa, in that he is compassionate and respectful and patiently treats everyone, even if they walk out the door and start shooting heroin into their eyeballs; then they come back the next day and he treats them again. We are certain that he has an express, speed-of-light ticket to heaven. He's the kind of doctor that before medical school we all wanted to be like, treating everyone, being kind, being non-judgmental. Now most of us are just in awe that someone like that exists, and we mull over his saintliness as we elbow each other out of the way for the few open derm slots.]
And just when I thought I'd seen enough for one night, we got a "FDGB" (fall down go boom) call. We walked into the house, and it was (I'm not making this up) a family of deaf people. Most people that know me know that I love sign language and that learning it has been a hobby since college. It's not really a handy life skill (even though ASL is the third most common language in the country, after English and Spanish), and I don't think I've ever been called upon to actually use it. Needless to say, the paramedics were kind of stunned that I could communicate with this family and figure out what happened, and then talk to the patient on the way to the hospital. I ended up waiting there until the interpreter got there, leaving my ambulance to go out and take more calls, cause I felt bad leaving this poor person in a cervical collar strapped to a backboard staring at the ceiling and unable to communicate with anyone. I'd imagine that would be a pretty scary situation for a deaf person, only able to look up, not really able to move at all. At the end of the night I was pretty pleased that I hadn't totally forgotten all my ASL, though certainly it could use some work.
I feel like I packed a bunch of crazy experiences into one short shift. Thanks for reading this very long post (if you even did...and didn't skip right to the last sentence...I have a short attention span too, I know how it works). I don't think my next ride-along will be quite as adventure-packed, but we'll see... :)