I just wrapped up a 48 at the ALS IFT job. It was pretty quiet, with only a few calls to interrupt by busy schedule of napping interspersed with the Mythbusters marathon on Discovery.

I had a G1,P0, 32 weeks with contractions 4 minutes apart who needed to go to a hospital with a NICU. She was very nice and, as usual, demurred when I offered my name for the baby. She did not deliver in my truck, thank god. I don’t mind delivering a baby, it’s the cleaning up the mess that I don’t need.

I also transported a 24 year old guy who, rather unfortunately, weighed 475 pounds and was experiencing some “palpations”. I put him on the monitor and saw he was in sinus tach with trigeminal PVCs. Interesting. Some O2 and away we went. We’re not treating PVCs here unless there are symptomatic, so no Ami or Lido was warranted. Nice guy, just a shame to see such a young guy in such a spot.

We ate like kings over the last few days. The BLS B shift made a huge dinner and treated the duty medics to ham, smashed potatoes, stuffing, green bean casserole and pie with ice cream. In return, the ALS crews covered some BLS calls to give the crews a break so they could relax and eat dinner in peace. They seemed to really appreciate the fact that we jumped in to cover for them.

I start a 72 at the busy 911 service tomorrow morning. I’ve passed the protocol test and 12 lead/STEMI test that the county requires and after one more rotation with a senior medic, I should be good to go solo. I’m excited, but scared shitless. This service is busy as hell, very high speed and has a LOT of trauma and very sick people. For example, on my last shift, there were 2 GSWs, several major MVAs, a couple of codes and all manner of priority 1 sick folks. That was in 48 hours, in a city of 75,000. Crazy.

Anyway, I’m laying in bed with a cup of coffee and the dog curled up next to me, just relaxing. I hope everyone had a great Christmas and Santa brought you everything you wished for.

More in a day or two.

Last night, while laying in bed with a cup of tea and the dog curled up next to me, I had a thought. I suddenly realized that I should be thankful for the good things I have in my life and stop wallowing in self pity.

Enough.

I’ve been punishing myself for past mistakes for far to long. I’ve had enough of the self flagellation. Publicly whipping myself with nettles only makes me look foolish and doesn’t do anything except prolong the pain.

So, to that end, I’m done with the bitching, whining and complaining and this blog will return to what it was intended for. A vehicle for me to talk about my ongoing paramedic education, interesting calls, learning experiences and ways I think we can further the profession of paramedicine.

I’m at work at my second job now, the IFT ALS service, watching ESPN and thinking about lunch. No calls so far today, and I actually hope it stays quiet. I had a crazy 48 hour shift at the 911 ALS job, and a day without anything major sounds good. I’ll be working a 48 over Christmas at this job, so the medics with little kids and families can have Christmas with their loved ones. It’s the least I can do.

I had a couple of good calls on the 911 shift, including a status asthmaticus that I found tripoding and unable to speak who was not opening up following non stop at home albuterol nebs. It made me pucker a little, but I managed to get his sats up with a Duo neb, Solu-Medrol and Mag by the time I got to the ED. I had the tube kit open and ready to go, but he was doing better and able to talk when we got him in the treatment room, thank God.

I also am the refusal king. In one 48 hour shift I managed to use all of the refusal forms in the medic unit. ALL OF THEM. Crazy.

Anyway… I’m back on track. I’m feeling better and I’m getting back to focusing on the EMS calls.

I bury myself.

I work a zillion hours. I take every overtime or coverage shift I can. When I get a text from dispatch looking for a medic for an out of town trip, I’m on the phone in moments. “I’ll take that shift.”

I immerse myself.

When I’m with a patient in the back of the rig, they are my singular focus. We talk, we laugh, I monitor their vital signs. Sometimes I give them medicine to make them feel better and forget their pain.

I’m drowning.

When I’m not on a call, in the rig or at the station BSing with the other medics and EMTs, I’m overtaken with such a wave of sadness that it defies any description.

I’ve been a bad person. Bad. I destroyed the trust and kind heart of a woman who did nothing but love me through my own selfish and heartless actions. I am beyond any penance. I know that I am past the point of forgiveness and I am destined to forever be submerged in this well of pain as punishment for the things I’ve done.

I just hope that I can be a good, kind caring medic for my patients and help them through their pain, even as I struggle to cope with mine.

It’s a small consolation, but right now it’s all I’ve got.