EMS Ride Along

My current rotation requires us to do 1 ride along with the county Sheriff. The special thing about them is that they are Paramedic/ Sheriff so they are allowed to arrest you and if they need to shot you, they are obligated to try to save your life right after. Basically, they respond to all calls- medical or not.

I got to the Sheriff Department in Flint, Michigan [voted the most dangerous city in the US last year] and had no idea what to expect. I met with a group of Sheriff's and then was introduced to Mike, the Sheriff/ Medic I was going to ride with. A 6 foot 4 in handsome 27 year old white guy, looked promising... until I stealthy looked at his left hand to then find his wedding ring.

The shift was from 3pm to 11pm and I had a blast. We rode around the city patrolling and when we werent responding to calls, we were scoping out the local real estate.

"Well thats kinda a cool house" -me
"Want it? You can buy it for a $1"

That was the theme of the night. We also stopped at Starbucks where we got free coffee just for being in uniform and got dinner to go later in the night.

We would cruise around and he showed me the city and then we would get a call, turn on the lights and sirens [of the Ford SUV] and we would speed like crazy.  I never felt scared because he didnt go to crazy, and would always slow down to a near stop when approaching an intersection that had a red light. We did go about 120 on the freeway though. And damn it feels great to be driving 80 on a city street and have everyone move out of your way!

 One of the first calls was a young man having a heroin overdose. This is also how we ended the night. In between we had a baby with a seizure, a deaf lady with a bug bite, a man trying to cash a fraudulent check at a gas station, etc Probably the most entertaining was a call we got at about 10pm, "women in her 40s shot" we responded to the call and when we walked into the bar, we found a middle aged white lady sitting in a chair with her leg extended, looking pretty comfy. Yeah, she was shot...with a beebee gun.

I am very happy I had this opportunity to see life as a first responder. It almost bums me out I did not try being an EMT or paramedic for a while. Life in the ED will be just as exciting though I'm sure. Im looking forward to doing another one this month if I have time and also doing another ride along in New York on my next rotation.

Still no Spanish....

I worked with the same attending for the last 2 days and he is wonderful. Loves to teach, challenge me with question yet is so encouraging and nice. Yesterday my first patient was a 20 year old who was a slam dunk case of appendicitis. I was suspicious of it, did some tests, clinical exams, imaging and then sent her up to surgery. I'd like to think I saved her life but its not exactly a mystery when your right lower quadrant starts to hurt, even she knew it was probably her appendix. damn. What made it super sweet was her uncle asking my out on a date before she was taken up to the surgery floor. I politely declined.

 Today was all about seizures, had several cases. Then the day ended with a 17 year old who was playing with a machete [why you ask? because he is a 17 year old boy] and got his arm sliced open. Was a 10cm laceration on his bicep that went pretty deep, deep enough for me to stick a quarter of my finger into the hole [after i numbed it up of course]. I ended up doing a double layer closure- took 5 stitches on the inside to put together the muscle then 15 sutures to close up the skin. I think i did pretty good for being tired, sick and tired [we had a lecture at 6 this morning].

I was very tempted to draw eyes and make a smiley face....

My first day without a Spanish speaking patient, EVER

Day 1

Well, after a brief spur of the moment excursion to salt lake city, I made it to Grand Blanc Michigan. My connecting flight consisted of an Obama hating 80 year old who wouldn't stop talking to me and my final flight had a good friend flying with me so it was a nice suprise to see a familiar face. We landed got our rental car (ford escape AKA my mini white escalade) and drove through downtown Grand Blanc to find somewhere to eat before we parted ways. After the 30 second drive through downtown...we found a place. After eating, I drove to the place im staying and was very lucky to find a great condo with a 4 month old golden retriever puppy. Im staying with not 1 but 2 EM residents. A lil intimidating but both are wonderful...and there is beer in the fridge.

Monday wake up was 6:30 and got to the hospital by 7:30. I walk in the main entrance and there is a hotel-like lobby with 4 story ceilings, a big fountain and a Subway Sandwich restaurant in the background. Not too shabby. Couldn't help but feel a lil overwhelmed in a new hospital, new city, new car, and a complete lack of direction. After the orientation, meeting a few people, and having breakfast with my $50 a week cafeteria stipend, I felt a lot better.

Orientation and tours ended around 10:15 and at 11am I started my first shift. Every person I met was welcoming and helpful. The attendings were the least intimidating doctors I have ever met. Each one was excited about meeting a new student and offered to help with anything I needed. I saw a lot of patients and it worked out that I had 4 SOB patients, 3 ending up having PEs. I helped my new roomate/ resident on a central line and attempted to start an arterial line but neither of us could get it (HIV pt with small vessels and septic so his BP was low--would be hard for anyone I imagine). I ended the shift with a 14 year old girl who had a seizure after smoking the new drug called 'spice,' a man made THC like substance that doesn't test + on any urine drug screens and is technically legal and very dangerous. She was fine but sad to see people making money off this stuff, legally...

I'm excited about my month here and look forward to more experiences. I'm nervous, of course, but forget all about that when working. I hope I don't do anything stupid at work (or home!) and can't wait to see more of Michigan. Detroit is close and I plan and driving to a couple other cities to check out other residency programs.

It's freakin humid as hell though...

Step 2s outta da way

This week was filled with obstacles yet i managed to survive and am proud of myself for it.

I took the COMLEX II on Monday consisting of 8 blocks of 44 questions, with an hour to finish each block. They are kind enough to give us a 40 minute break in the middle. I finished with a upbeat attitude knowing I did my best.

I then spent Tuesday hiking on the beach in SD and swimming in the ocean. My first full day off with no books for MONTHS.

Then came USMLE Step II on Wednesday, another 8 blocks with an hour to do each, ranging from 40-46 questions in each block... This test was no freaking joke. I was sweating through each block finishing with 30 seconds to spare. I got worked. I walked out feeling like I did not study enough and spent the next 2 hours driving back to LA in a fog of 'what the fuck just happened'. Needless to say, I am a little concerned about my score.

Now, I sit in the Salt Lake City airport [with free wifi thank you baby jesus]. I am on my way to Grand Blanc, Michigan to spend a month at a level 1 trauma center emergency department with a highly ranked emergency program. I am staying with a resident. Trying to not be nervous, think i am more tired than anything else considering i didnt get to much sleep last night. oops.

Interview Invitation #2

Arrowhead Regional Medical Center.

AKA the county hospital of San Bernardino County. the BUSIEST emergency department in California [LA County is second...]. Over 130,000 visits a year.

 Pretty. damn. excited.

Quotable Quotes

Im gonna start by saying I really dont know if I like Dr Oz or not, but either way, i was watching the show NY med and he had a pretty good quote in there that made me think. He was talking about his mail and reflecting on a thank you note from a patient and said:

"the fact that she wanted to say thank you is all i needed to know, i think thats what drives most doctors to do what we do. and thats why it hurts doctors so much when they get sued, because they feel like they did all this work, and they really did think they were doing it for the right reasons, and yet someone disliked them so much they sued them" -Dr. Oz

Needles and Tubes

4 weeks with Dr. G are over and let's just say I am not ready to intubate by myself anytime soon. Good thing i have 3-4 years of residency to perfect the art. In brighter news, my last shift was today [he gave me Friday off] and it was an Obstetrics day. So we spent the morning in the OR doing C sections which are always great, we had 1 scheduled and then had 3 crash [emergency] sections. All turned out well. Babies crying all over the place. I did a bunch of stuff, started IVs, did a spinal, did an epidural. Epic way to end a rotation. It was a great month and I loved everyone I worked with. Will probably be returning to do another 2-4 weeks in October.

Next up, COMLEX and USMLE Step 2.