Truth Against the World

Wednesday, January 18, 2012

6 Year Burn Out

We were dispatched to an "unconscious" 911 call at one of the local Dialysis clinics. Dialysis, now there is a miserable existence to live. Show up to a clinic two to three times a week to sit in a chair for a couple of hours while a machine filters your blood for you. You have complete renal failure which is why you need this machine. In your arm is a large rope under the skin in the area of your bicep that looks like a snake has burrowed it's way into you. This is the stent they use to access the closed system that your blood traverses. Once dialysis starts the average lifespan is about 6 years or so. You have to really watch your diet and you're all the time having to get fluid pulled out of your body while you are dialysised because your kidneys don't work and that plays royal hell on all of your body systems. You quite literally become part machine and 9 times out of 10 you are also an insulin dependent diabetic. You have major health problems.

At any rate, we are dispatched to the dialysis clinic cause somebody passed the fuck out in the lobby en route to getting their oil changed, I mean blood filtered. We have to hurry up and get en route, not to save a life, but because we have to beat the local rescue squad that the corporation I work for is trying it's damndest to put out of business. This is a mostly volunteer rescue squad that has paid paramedics on the truck. People who live in the community volunteer their time to assist the rescue squads and the community. The corporation I work for wants them out of business for no good reason. In fact, it will just mean that Tenet will have to spend more money handling the 911 calls in the county. My director vehemently denies all of this, and he definitely denies that we are supposed to be "racing" to the calls. But if we don't beat the rescue squad our supervisor is on the phone with us asking why. This is what corporate sponsored nonsense likes to accomplish.

We get to the clinic and the staff has the patient, I mean customer, in a dialysis chair and they are attempting to gain I.V. access. The customer looks pretty bad off. He's conscious when we get there and breathing rapidly and a little deeper than I would like. It looks like Kusmal's respiration’s which is what happens when your blood sugar goes through the roof due to the fact that your pancreas doesn't produce insulin any longer. Your kidneys don't work either. You should be dead but people gotta profit from your miserable ass. That's the point of healthcare in America, profit. They get an I.V. established and the patient, I mean customer, goes into some activity that resembles a seizure, although not the classic grand mal. Maybe an absence seizure, but not quite that either. I don't know what the hell's going on with him, but I know we need to get him on the cot and into the truck. There's about four dialysis clinic staff members in this small room, along with the two rescue squad members that have just arrived, as well as my partner and I. It's crowded and the clinic members are freakin' out cause that's what they do during emergency situations. The customer's wife is freakin' out as well. She's hollering out loud about Jesus and "in Jesus's name pray," and it sounds like a god damn exorcism is going down.

We get the customer in the back of our truck and tell the rescue squad that we don't need them since the customer is conscious and seems to be doing better. He says he's not been feeling good today and he's recently had heart surgery. My partner puts him on the heart monitor and it looks good, but she decides to get a 12 lead just to be sure. I get a blood pressure and barely hear a systolic of 70 and no diastolic. Shit, that's not good. You need a systolic of 70 just to profuse the brain. Much lower than that and you'll go unconscious cause your brain ain't gettin' enough oxygen. The customer starts into his quasi lookin' seizure activity again. My partner's still trying to get the 12 lead going and I'm making for the door to get this rig en route to the hospital. That's when my partner pipes up "shit, start bagign'"

"What are you talking about?"

"He's barely breathing, look!" I look and sure enough he's breathing about six times a minute and agonally at that. I get an OPA (oral pharengeal airway...a device used to keep the tongue out of the way and keep the airway open) out and measure against the angle of his jaw to make sure it's the right size. I sink the OPA and he takes it like a champ, no gag reflex, shit. I start bagging (breathing for the patient with a device called a BVM for "bag valve mask." The action of using one in the field is referred to as "Bagging" in EMS jargon). The customers pulse now drops down to the low 20's,

"Fuck, he's crashing!" Says my partner. Sure enough, he's crashing cause now he's no longer breathing by himself. My partner goes to pace him with the monitor (which is where the monitor gives little shocks at a rate that is conducive to keepin' your ass alive. The idea is that the monitor gives the electrical signal to your heart to keep it beating). The customer's chest starts jumping slightly with each little shock and then the monitor starts going to shit. It stops pacing and we can't get a read at all.

"What the hell is wrong with the monitor?" Exclaims my partner a bit distraught.

"Hell if I know, check the limb leads."

"I've already checked them like three times!! What am I supposed to do now?"

"Hell if I know..." She fools with the monitor more, unplugging, turning on and off, nothing is working.

"What's the end tidal CO2 say?" I ask.

"Negative 50."

"That's not even fucking possible." End tidal CO2 is supposed to be between 35 and 45 and it's not possible to go below 0 which is your ass is completely dead, deader than that even.

"What are we supposed to do now?!!"

"I can't find a carotid." I say. He's got no pulse. "I guess we start pumpin' now."

"He's dead." My partner says. "He's gone isn't he?"

"Looks that way." Yep, died right there in front of us. He was talking and now he's dead. I feel absolutely nothing. Not the slightest bit of sadness. I suppose that makes me a good emt. I'm a professional who doesn't get personally involved. I'm a master of clinical attitude. We just watched this man die. We were supposed to be the ones who stopped his death from happening. We're supposed to open the back doors to the ambulance and drop kick the Reaper's ass out of the truck and take off. Unfortunately that's not what happened. I think to myself that maybe it's a good thing I just put in my two week notice. Seems like maybe I should be at least somewhat upset about the fact that I watched this man die right in front of me.

My partner calls our supervisor after the call to inform her that the lifepak (the heart monitor) is fucked up. She tells my partner to hook it up to me to make sure that it's reading fine. She does and it reads fine. Problem solved. Must have just been a glitch in the lifepak. That's a pretty fuckin' big ass glitch doncha think? It's a glitch that might have saved a man's life had it not glitched when we needed it. When the Grim Reaper comes for you, there's nothing anybody can do about it. I've gotten to know the Reaper's work pretty intimately over the last six years. 

 They say six years is when you burn out. I never believed it until it happened to me. I've been in it for six years and I felt my ability to continue evaporate like water on hot asphalt. Seems like I have some humanity to regain. Hopefully growing some vegetables and tending to my toddler will help me in that endeavor. I do have a feeling that I will be back. This is just a sabbatical. I've got to recoup for the next six year round that I'll more than likely have to endure. The tragedy of my situation is that I'm not burned out from the work of being an emt. I'm a damn good emt. I don't take any of this shit home with me. I'm burned out because of the corporate bull shit. After dealing with all of the dumb ass corporate induced shit I have nothing left for my customer's bull shit. I'd have plenty of tolerance for our customer's shit if my employer would just leave me the fuck alone and let me do my job, but apparently that is not possible in the corporate world. There's no room for profit in healthcare. Like everything else in America it's all fucked up. Something as simple as two emt's on a truck responding to people's emergency's can't even be left alone. It has to be micromanaged and bureaucratized to limit liabilities. I've put hundreds of people into full spinal (c-collar, head bead, back board) none of which needed to be spinalized because of the threat of lawsuits. Hundreds of patients and maybe 20 of them needed a spine board as an actual precaution. The amount of BS is gargantuan in scale. But I suppose that's everywhere isn't it? I just hope some Druid magic discloses some enchantment to me in the near future. It seems to be doing just that. I've simply grown exhausted by the American Hologram.


Justin said...

Just wanted to pop over and react to your archdruid comment. That's pretty cool re: farm.

Jeff Z said...

You're doing the right thing.

Your concern for your kids' future and health is well placed, but what your kid needs is you, not your money or insurance. If you're on fukitol and who knows what else, what kind of dad can you be? The saner choice is to drop out of the rat race. The gig is almost up for the society as a whole, so it's really a sort of pre-emptive action. You're just getting back to the land while it's still optional.

I hadn't heard of six-year burnout before- but I'm feeling it. I'm approaching six years at my shitty desk job and every day it becomes harder to drag my ass in. I think we are (my family and I that is) going to be in the city for the duration of whatever is coming, but I can feel my life energy sapping away as I sit in front of a computer doing something completely inconsequential and stare outside, thinking of all the more important things I could and should be doing.

Older people think our generation is lazy. I don't think so. They had a future, or at least had a reason to believe that they did. Not so much for us. Being debt-free and having some workable soil will mean a future for us. I see, and hear secondhand of a lot of people in their 20s and 30s now, working their asses off to have a sustainable future for themselves and their communities, and older people saying- to paraphrase- 'we've
seen all that before- it'll work out fine'.

Until it doesn't. And it looks like it won't this time. Glad you're getting your family into a good place. I like WHD's idea of 1000 acres with all the kindred spirits from 'off the grid in minneapolis' migrating out to it, but i think the reality of geography and family and inertia won't let it happen. Love the idea though.

Luciddreams said...

Hell yeah, I love WHD's idea about that as well. Hadn't read it till you pointed it out, but I've only been following him for six months or so? Maybe longer.

Well I can say that I'll have 14 acres, and I'll have more work than one man can do. I'm taking applications for my tribe. You just have to answer one question (that I am gleaning from WHD's book), and that question is "who do you serve?"

Peace brother, thanks for the encouragement and I'll send some energy your way to fight that cancer.