The calls that knock you down and teach you

The call came in like any other, "68 y.o. Male feeling ill". As we arrived on the truck, there was no hint of the chaos that was about to unleash itself in the house on a quite street. The Paramedic on the ambulance, is often known for his ability to be calm under pressure, this night he looked panicked as he met us at the door and said," we need to go right now!" the man was pale,cool and diaphoretic. When we attached him to the four lead, he had tombstone t-waves. It looked like he was having a heart attack in the bottom part of his heart. When we placed the 12-lead on him, the ectopy had cleared and he was in normal sinus tachycardia. We where puzzled. Then things got worse. He began to complain of not being able to breath. His lungs where demonstrating pulmonary edema. One of the other medics on scene began to reach for a nebulizer mask, when the patients pupils dilated shifted to the left and he vomitted. now we where thinking neurological cause. As we sped towards the stroke center, he began to drop his Herat rate from about 160bpm to 40bpm rapidly. I remember asking, "do we have a pulse?" No pulse. "Ok gentleman, here we go." As we pulled into the ER, we got a pulse back, then lost it. We worked him in the ER for another 20 minutes before we got a pulse back, just as the attending physician was about to call it. During that 20 minutes, the ER attending took a portable ultrasound, and discovered a 7cm dissecting aortic aneurysm. They patient maintained a pulse into the OR where he died on the table. Many lessons where learned, but I often am left to wonder if my seeing all of this knowledge was worth the death of a father on the eve of fathers day? I have faith that one day, be it today or 30 years from now, that what we saw last night will effect the life of a patient and their family.

Location:S 25th St,Bellevue,United States

Changes and Challenges

Frances and I, despite a fair amount of jet-lag found a great place at a fair price and began to determine what we need to bring with us in the fall. I have included picture below. I still cannot help but shout from the rooftops that I am going to be a doctor!!!!
I had a hard time returning to work and dealing with all the normal everyday crap knowing that I am moving on in less than three months. I began to think that nothing I had to experience in that time would teach me, and then the call came in for a GSW following a pursuit. I expected to find the normal small caliber injuries that I have often dealt with in my career in EMS. Instead, I found high powered armor piercing round injuries. It was unreal, I had never actually seen a real pericardial syntesis until that afternoon when the Helo crew performed one on this patient. It was one of the most devastating calls that I have been involved with to date, but it taught me once again that in the face of the worst, I can be calm, cool, and collected. Additionally, in the midst of chaos, I could teach and simplify the most complex of concepts. While it is difficult to see these traumatic things, I can move forward in the knowledge that given the worst, I will be fine. All that I need to overcome now is the academic challenges of the first two years.
Enough of the depressing. Frances and I found a one bedroom apartment with all the amenities to make it comfortable for a newly married couple. It has a great view, a nice bathroom, and a kitchen that many a chef would be jealous of. It even has a wine-cooler! Here is to the adventure this fall, and any still waiting for me at work. Enjoy the photos below: