Friday, end of the work week. Time for a nice dinner out, maybe some dancing or a show in their younger days. Now, they don't get out as much, the children are grown, the grandchildren filling their hearts with pride. Friday might not have been anything special any more. The usual routine, watching the news and the late show then off to bed. They lived in the in-law apartment, upstairs around the back, close to the love and support of family because they weren't getting any younger or healthier.
Today she had seen her doctor because she hadn't been feeling so well. Not that she'd been feeling great too many days lately, cancer will do that to you. He'd given her some new medication for atrial fibrillation, she was going to start tomorrow. Her chemotherapy was on schedule and everyone seemed hopeful for remission.
Her husband was sitting in his favorite recliner waiting for her to finish up in the bathroom when he hears her fall. She didn't even call out, just a thump as she hit the floor and the glimpse of her head in the hallway. He called downstairs for help and then called 911. The woman on the phone asks the usual list of questions and when she gets to "Is she breathing?", her daughter finds out the unfortunate answer is no. The dispatcher gives directions for mouth-to-mouth and that sinking feeling sets in. "Does she have a pulse?" "Please start CPR."
Her daughter gives an audible sigh of relief when the FF walks in and gently asks her to move out of the way. She won't be the one to have to do compressions, to hear her mother's ribs breaking, to wonder if she's doing them right, to wonder if she could possibly be responsible if her mother doesn't survive. Suddenly a scene of quiet desperation has changed to a scene of flurried activity. CPR in progress. Paddles on, monitor showing asystole. First try at an IV, no good. She gets moved to a backboard, strapped down and then she's gone, hustled down the stairs to the waiting ambulance.
Once she's inside, the family thinks the ambulance will be leaving now. But there's order to this chaos and things that are easier done before departure. IV established. ET tube placed and secured. Drugs given and a tiny glimpse of hope on the monitor screen. Finally, someone comes back out of the ambulance to tell them what is going on and the ambulance heads out in a hurry. More chaos as everyone decides who goes and who stays, which car to take, who is able to drive, and the million other decisions that have to be made before everyone can run out of the house.
The drive is the longest twenty-five minutes any of them can remember. By the time they reach the hospital, it is all over. The hospital staff doesn't let them back to the room right away. Nothing left to see or do, her room guarded over by security and a nursing staff which is trying to support them and prepare themselves for an incoming major trauma all at the same time. Dazed and confused, they stand at the room at a loss for words or actions. Loving companion for more than 40 years of marriage, kind mother, gone in the space of a missing heartbeat.
28 April 2007
26 April 2007
Appearances
I was eating dinner in a local fast food burger joint on Tuesday night and had ended up sitting next to a mother who was eating dinner with her little boy (probably around 4-5 years old). She was having the usual struggle of getting him to eat what she wanted him to eat in a reasonable amount of time. He immediately noticed me as a suitable distraction and spent some careful time evaluating the situation. His conclusion? "Mom, that girl is eating without her kid. Why doesn't her kid get to eat?" His mom tried to smooth things over with, "Maybe she doesn't have any kids. Eat your chicken strips." I tried not to laugh too much because he was clearly watching for my reaction.
Today I ran an 8 mile training run. During mile 6 I was feeling wiped out and just trying to get to the mailboxes at #15 for the next mile marker. I could see them just ahead and generally pay little to no attention to traffic on the other side of the street so I didn't notice the pickup heading my direction. I didn't notice until the 17-18 year old guy driving it felt the need to lean way out the window and whooo-whooo at me. I was too tired to laugh, but still a bit stunned because it has been quite a while since someone made lewd noises at me on the side of the road.
In both cases, K was entirely too amused when he heard about it later. So apparently I look like a mother who has left her child in the car away from fast food AND someone worth whooo-whoooing at.
Today I ran an 8 mile training run. During mile 6 I was feeling wiped out and just trying to get to the mailboxes at #15 for the next mile marker. I could see them just ahead and generally pay little to no attention to traffic on the other side of the street so I didn't notice the pickup heading my direction. I didn't notice until the 17-18 year old guy driving it felt the need to lean way out the window and whooo-whooo at me. I was too tired to laugh, but still a bit stunned because it has been quite a while since someone made lewd noises at me on the side of the road.
In both cases, K was entirely too amused when he heard about it later. So apparently I look like a mother who has left her child in the car away from fast food AND someone worth whooo-whoooing at.
18 April 2007
MD process
- 18Apr07: Wait listed by school from 1Mar interview
- 16Apr07: Wait listed by school from 29Mar interview
- 29Mar07: On-campus interview
- 23Mar07: Third school invitation for interview (apparently app was complete)
- 1Mar07: On-campus interview
- 28Feb07: Rejection without interview to second school, third school application never considered complete due to missing reference letters
- 5Feb07: Invitation for interview at one school received
- 18Jan07: Fielding questions from interested supporters, but no news from the schools themselves
- 25Dec06: Rejection without interview to first preference school
- 14Nov06: All reference letters returned to schools
- 30Oct06: Secondary applications returned to all schools
- 02Oct06: Secondary application information for remaining two schools received
- 28Sep06: AMCAS review completed
- 08Sep06: Secondary application information for second school received
- 06Sep06: Recommendation letters requested
- 30Aug06: Secondary application information for first school received
- 28Aug06: Transcripts received, application in line to be reviewed at AMCAS
- 21Aug06: Application submitted to AMCAS
- Apr06: MCAT taken
Name change
So, maybe I need a name change for my blog. I'm not transitioning anywhere in a hurry. Last decision came back today - wait listed again.
Last day with Ellie on 911 today, the slowest day in the history of ambulances - even when we only had 3 in the rotation instead of 4 for a couple of hours while a couple of overachieving crazies took a patient all the way to Big Big City hospital an hour away instead of to one of the locals and having a transfer truck move them there.
Anyway, I'm out for some yummy sympathy food and to think about buying appliances for the kitchen that are actually from this decade.
Last day with Ellie on 911 today, the slowest day in the history of ambulances - even when we only had 3 in the rotation instead of 4 for a couple of hours while a couple of overachieving crazies took a patient all the way to Big Big City hospital an hour away instead of to one of the locals and having a transfer truck move them there.
Anyway, I'm out for some yummy sympathy food and to think about buying appliances for the kitchen that are actually from this decade.
17 April 2007
Earmuffs
I worked an OT shift on the ambulance last night and I had NO idea that Monday nights were that busy. I got to finish a dinner I started at 2030 at 2330 and slept a little from 0200-0430. Many places here are flooded out, roads washed away, etc. but not in the city, in the city we have the usual suspects.
"BEEP-BEEP-BEEP Ambulance meet the PD for an assault in the alley behind [local scummy bar]."
I had just finished about 10 bites of dinner with K, just enough to make me realize how hungry I was and not enough to actually do anything about it. Calls had been coming in just fast enough that Code 10 (my partner for the night) and I had been next out pretty much all night. We'd finish one call, hop in the ambulance to leave the hospital, maybe get parked at the station and then head right back out. Calls at the local scummy bar are generally not fun. This is a place that opens at 0700 and has customers all day - a steady flow of people with nothing better to do and no better place to do it. Many of the patrons are homeless, alcoholic, psychiatric, in ill health or all of the above.
We missed the turn to the alley, but did get enough of a glimpse to see PD already on scene. Rolling to a stop out front, the flashing lights attract only a limited amount of attention. Folks around here see us come and go so often that we aren't even interesting. Code 10 hops out of the truck and heads towards PD without waiting for me to grab the first-in bag, leaving me hustling to catch up while trying to take a good enough look around to decide if we really should be heading down this dark alley, PD or not.
We find the patient sitting on the ground, hunched over his knees, none too happy about the situation. He's covered in blood and the area below his right eye has seen some better days. When PD shines the flashlight on the patient, I'm surprised at the size of the swelling and the lacerations given that the patient isn't complaining about any of the injuries to his head. He's understandably annoyed with having been assaulted, but he's not showing signs of internal head injury, he's cooperating with the police, stands up when offered a hand and walks to the ambulance where we actually have enough light to see what is going on. As we're walking back, Code 10 asks him about living in the south city our company covers (because he works mostly down there). "Nahw man, I live in this city." "But you told the police south city." "Yeah."
We get him on the stretcher, start in with vital signs, and trauma assessment. NH has a protocol for being able to NOT use a cervical collar and backboard on patients, but it involves the patient being "reliable" and drunk=unreliable. The patient reports 4 beers and despite Code 10 giving him a hard time about it, will not admit to any more. Mid-twenties male, around 5'10", 160-175 lbs, admitting to 4 beers in 4 hours, probably a little borderline on the reliability. Patient denies head, neck, back pain beyond the obvious injuries and is complaining about pain in his ribs where he was kicked. We decide not to do the board/collar, start an IV and get rolling to the ED.
En route, the patient continues to be upset about being assaulted and his associate (who's had way more than 4 beers) in the front seat isn't really helping by turning around and shouting "helpful" advice every couple of minutes. "Yeah man, let them help you." "Dude, don't fight with them, they're just trying to help." I'm not sure what convinced this fellow that his assistance was needed because I wasn't having any problems with the patient at all. No drunken belligerence, no theatrical threats to the life of his attacker, no macho bravado. A rather pleasant change from the usual assault victim who seems to be determined to convince us that this was entirely undeserved, totally shocking and calls for an immediate retaliation.
The patient was having 7/10 pain in his ribs, with a notable contusion and a small amount of crepitus on his right side. He has some diminished lung sounds in the bases of his lungs, but he's also not taking full deep breaths, so I don't think he's really passing air that deeply. The crepitus seems to me more like a broken bone than any air trapped under the skin, so that is a good sign for his lung function. He doesn't want any pain medication and keeps fidgeting to try and find a comfortable spot. I try to reassure him that there is NO comfortable place on a stretcher so that maybe he'll hold still long enough to get a little pain relief. He's groaning about the pain, but actually manages to keep his language decent, although once asking me if I would do earmuffs so he could scream and curse a bit. He laughs a little when I tell him he's not going to top anything I hear around the station, but decides maybe he doesn't need to curse after all.
Neither of us heard what happened to him. Code 10 was convinced he was going to be transferred to a bigger hospital for surgical repair of a broken bone under his eye. I was guessing short observation and discharge from the ED because I don't think it was broken and there isn't much they do for broken ribs if they aren't causing any problems. The doc had him collared and x-rayed for spinal injury after we arrived but didn't really give us a hard time about not having done it on scene. He was gone by the next time we were in that ED long enough to check and nobody in our company transferred him anywhere, so I hope he's home recovering and maybe finding some new associates.
"BEEP-BEEP-BEEP Ambulance meet the PD for an assault in the alley behind [local scummy bar]."
I had just finished about 10 bites of dinner with K, just enough to make me realize how hungry I was and not enough to actually do anything about it. Calls had been coming in just fast enough that Code 10 (my partner for the night) and I had been next out pretty much all night. We'd finish one call, hop in the ambulance to leave the hospital, maybe get parked at the station and then head right back out. Calls at the local scummy bar are generally not fun. This is a place that opens at 0700 and has customers all day - a steady flow of people with nothing better to do and no better place to do it. Many of the patrons are homeless, alcoholic, psychiatric, in ill health or all of the above.
We missed the turn to the alley, but did get enough of a glimpse to see PD already on scene. Rolling to a stop out front, the flashing lights attract only a limited amount of attention. Folks around here see us come and go so often that we aren't even interesting. Code 10 hops out of the truck and heads towards PD without waiting for me to grab the first-in bag, leaving me hustling to catch up while trying to take a good enough look around to decide if we really should be heading down this dark alley, PD or not.
We find the patient sitting on the ground, hunched over his knees, none too happy about the situation. He's covered in blood and the area below his right eye has seen some better days. When PD shines the flashlight on the patient, I'm surprised at the size of the swelling and the lacerations given that the patient isn't complaining about any of the injuries to his head. He's understandably annoyed with having been assaulted, but he's not showing signs of internal head injury, he's cooperating with the police, stands up when offered a hand and walks to the ambulance where we actually have enough light to see what is going on. As we're walking back, Code 10 asks him about living in the south city our company covers (because he works mostly down there). "Nahw man, I live in this city." "But you told the police south city." "Yeah."
We get him on the stretcher, start in with vital signs, and trauma assessment. NH has a protocol for being able to NOT use a cervical collar and backboard on patients, but it involves the patient being "reliable" and drunk=unreliable. The patient reports 4 beers and despite Code 10 giving him a hard time about it, will not admit to any more. Mid-twenties male, around 5'10", 160-175 lbs, admitting to 4 beers in 4 hours, probably a little borderline on the reliability. Patient denies head, neck, back pain beyond the obvious injuries and is complaining about pain in his ribs where he was kicked. We decide not to do the board/collar, start an IV and get rolling to the ED.
En route, the patient continues to be upset about being assaulted and his associate (who's had way more than 4 beers) in the front seat isn't really helping by turning around and shouting "helpful" advice every couple of minutes. "Yeah man, let them help you." "Dude, don't fight with them, they're just trying to help." I'm not sure what convinced this fellow that his assistance was needed because I wasn't having any problems with the patient at all. No drunken belligerence, no theatrical threats to the life of his attacker, no macho bravado. A rather pleasant change from the usual assault victim who seems to be determined to convince us that this was entirely undeserved, totally shocking and calls for an immediate retaliation.
The patient was having 7/10 pain in his ribs, with a notable contusion and a small amount of crepitus on his right side. He has some diminished lung sounds in the bases of his lungs, but he's also not taking full deep breaths, so I don't think he's really passing air that deeply. The crepitus seems to me more like a broken bone than any air trapped under the skin, so that is a good sign for his lung function. He doesn't want any pain medication and keeps fidgeting to try and find a comfortable spot. I try to reassure him that there is NO comfortable place on a stretcher so that maybe he'll hold still long enough to get a little pain relief. He's groaning about the pain, but actually manages to keep his language decent, although once asking me if I would do earmuffs so he could scream and curse a bit. He laughs a little when I tell him he's not going to top anything I hear around the station, but decides maybe he doesn't need to curse after all.
Neither of us heard what happened to him. Code 10 was convinced he was going to be transferred to a bigger hospital for surgical repair of a broken bone under his eye. I was guessing short observation and discharge from the ED because I don't think it was broken and there isn't much they do for broken ribs if they aren't causing any problems. The doc had him collared and x-rayed for spinal injury after we arrived but didn't really give us a hard time about not having done it on scene. He was gone by the next time we were in that ED long enough to check and nobody in our company transferred him anywhere, so I hope he's home recovering and maybe finding some new associates.
16 April 2007
Waiting
I haven't done much posting lately because I feel like I'm in a holding pattern. I'm waiting for the last two medical schools to crush my dreams or give me nightmare debt. I'm riding on the ambulance waiting to find out who my new partner is - I heard a rumor the other day that he's been sighted and the best anybody could tell me is that he looks like so-and-so, but with glasses. That information really didn't help my insecurity because appearance isn't the issue. I'm trying to figure out how to manufacture enough hours in the day for race training and there are only so many times I could write - "ran a lot today. tired now, body hurts." before even my family would quit reading.
Today there has been a small change. The school from the second interview made an admissions decision on my application. Wait list. Why am I not surprised? At least I'm getting better at waiting. Now the question is, do I succumb to the encouragement of the admissions office and be a pest, repeatedly declaring my undying love for their institution in the hopes that they will admit me? Is any medical school better than no medical school, or do I learn from my experiences there that this is not the right fit and let it go?
Today there has been a small change. The school from the second interview made an admissions decision on my application. Wait list. Why am I not surprised? At least I'm getting better at waiting. Now the question is, do I succumb to the encouragement of the admissions office and be a pest, repeatedly declaring my undying love for their institution in the hopes that they will admit me? Is any medical school better than no medical school, or do I learn from my experiences there that this is not the right fit and let it go?
10 April 2007
Quick updates
- I HATE working on my birthday. Working just takes all the fun out of the day, especially when K had to work too.
- My partner was working overtime yesterday and ended up on a call that made the front of the newspaper. She's lucky enough to be out of town the rest of the week though, so she'll probably slide on having to buy everyone lunch.
- K came to the ambulance co. station on Sunday to make Easter dinner for everyone on shift, and I ended up having a 4+ hour transfer which started right around the time he got to the station and pretty much missed the whole thing and the chance to hang out with him.
- I broke down and called the admissions office of one of the medical schools today and they tell me that a decision will be in the mail by the end of the week and here by sometime next week at the latest. This process requires a lot more patience than I possess.
02 April 2007
Interview #2
I had my second (and last this year) medical school interview last week. The general structure was something like the first interview, presentation by admissions staff, meeting with financial aid, lunch with students, tour of facilities, and finally a single one-on-one interview with someone with the potential to let me in to the school.
But there was one major difference. This is the school that never showed my application as complete. These are the admissions staff who NEVER answered emails and 2 voicemails, and in the course of half a dozen phone calls never once actually answered the phone. This is a place that tells you to show up at the admissions office, without actually giving you the address of the building or the room number; a place that charged me to park in a campus parking lot while I interviewed. So I was feeling a bit abused by their system.
During the admissions presentation, the woman made sure to point out that even though it was a getting to be a little late in the admissions cycle, we were not just interviewing for slots on the wait list, there really were still seats open in the class. Following this declaration, she promptly told us that if we got wait listed we should call regularly to check on our status and to indicate that we were still interested in the program because people who did call regularly could be admitted ahead of higher ranked individuals who did not call regularly. Oh, and be sure to check your status on the online applicant center as we update that frequently. WTF?!?! So my persistence and ability to annoy you counts for more than my application and interview?
I probably should've held my tongue, but I could not let these statements pass. I stated that this was not at all comforting as they do not answer the phone or return messages and their online applicant center never even showed my application was complete. She gave me that insincere "nice" smile and said she would love to have my feedback on the little postcard included in my packet today. Because apparently she was too busy ignoring me right that minute to actually hear what I was saying? Not really selling me on the school with those statements.
The students were fairly informative, as usual, but they were all first year students. They were not really in a position to answer some of the questions about things that happen during the second year, about how the selection process works for third year clerkships, about the relationships (or lack there of) between the classes, et cetera. The tour was a joke, we saw two lecture halls, a small group classroom, a bunch of hallways and an atrium in outpatient area of the hospital. Another applicant in my group asked to see the anatomy lab space, can't do it. I asked if we could see anything in the hospital, even the cafeteria, can't do it. When we returned to the waiting area the admissions lady wandered by to chat, so I asked her what it would take to get a tour of any inpatient area of the hospital. Her response, "Well, we really aren't satisfying you today, are we?" along with that annoying fake smile again. Final answer was that the hospital would not allow it, even as individual applicants instead of a large group. My experience as an EMT leads me to believe that it is extremely likely that I could've walked over there and into just about any adult inpatient area without being stopped or questioned, but I decided that if they wanted me to judge whether I was willing to attend their school based on hallways, then that was what I would do.
The actual interview itself went well. I enjoyed talking with the MD who interviewed me and thought I performed reasonably well. He apologized at asking his first question, but honestly, I think it is probably the most reasonable question anybody has asked me. "What the heck happened on your MCAT?" I don't remember posting my scores here, my subject area scores were fine, but my writing score (on a scale of J to T with J being the low end) was a K. In other words, beyond awful, translated to the lowest 3%. He said he'd never seen a score that low and didn't know they actually gave them. He wanted to know if I'd challenged the results of the exam because that seemed like it should have been a mistake. I think I was able to give him a reasonable explanation and after asking whether I'd written my personal statement essay myself (I did), stated that he wasn't concerned about my writing abilities because it was one of the better statements he'd read this year.
He had some other good questions about my work as an EMT, my experience teaching, and why I wanted to change careers at this point. When I was doing some practice interview questions with investigators I work with, one asked about my most difficult call as an EMT. I was able to come up with a recent call that fit that bill. The interviewer's actual question was slightly different though, he wanted to know about my worst call. I've never met an EMT that enjoys that question. Some people ask it because they are prepared to be grossed out about dismembered, decapitated, bloodied patients. But I define "worst" a little differently. To me, worst is a call I still remember the next week, a call where I wish I had the ability to give the patient something more. So I told him the truth and he was definitely surprised that my personal worst did not involve death or traumatic injury at all.
The interview was the end of the day. Although I've been on this campus before, I asked the admissions lady for a campus map because there wasn't one in the folder (which seemed strange). I got a non-answer answer about how the campus was changing so quickly right now that they didn't have a current map, but eventually got a non-current map out of her. I have no idea how my dissatisfaction with their system or their admissions staff is going to factor in to their decision-making, but I'm not willing to pretend I'm happy-go-lucky satisfied when I'm not. If it comes down to a choice between this school and nowhere, I'll probably go, but I'll have to think about it.
But there was one major difference. This is the school that never showed my application as complete. These are the admissions staff who NEVER answered emails and 2 voicemails, and in the course of half a dozen phone calls never once actually answered the phone. This is a place that tells you to show up at the admissions office, without actually giving you the address of the building or the room number; a place that charged me to park in a campus parking lot while I interviewed. So I was feeling a bit abused by their system.
During the admissions presentation, the woman made sure to point out that even though it was a getting to be a little late in the admissions cycle, we were not just interviewing for slots on the wait list, there really were still seats open in the class. Following this declaration, she promptly told us that if we got wait listed we should call regularly to check on our status and to indicate that we were still interested in the program because people who did call regularly could be admitted ahead of higher ranked individuals who did not call regularly. Oh, and be sure to check your status on the online applicant center as we update that frequently. WTF?!?! So my persistence and ability to annoy you counts for more than my application and interview?
I probably should've held my tongue, but I could not let these statements pass. I stated that this was not at all comforting as they do not answer the phone or return messages and their online applicant center never even showed my application was complete. She gave me that insincere "nice" smile and said she would love to have my feedback on the little postcard included in my packet today. Because apparently she was too busy ignoring me right that minute to actually hear what I was saying? Not really selling me on the school with those statements.
The students were fairly informative, as usual, but they were all first year students. They were not really in a position to answer some of the questions about things that happen during the second year, about how the selection process works for third year clerkships, about the relationships (or lack there of) between the classes, et cetera. The tour was a joke, we saw two lecture halls, a small group classroom, a bunch of hallways and an atrium in outpatient area of the hospital. Another applicant in my group asked to see the anatomy lab space, can't do it. I asked if we could see anything in the hospital, even the cafeteria, can't do it. When we returned to the waiting area the admissions lady wandered by to chat, so I asked her what it would take to get a tour of any inpatient area of the hospital. Her response, "Well, we really aren't satisfying you today, are we?" along with that annoying fake smile again. Final answer was that the hospital would not allow it, even as individual applicants instead of a large group. My experience as an EMT leads me to believe that it is extremely likely that I could've walked over there and into just about any adult inpatient area without being stopped or questioned, but I decided that if they wanted me to judge whether I was willing to attend their school based on hallways, then that was what I would do.
The actual interview itself went well. I enjoyed talking with the MD who interviewed me and thought I performed reasonably well. He apologized at asking his first question, but honestly, I think it is probably the most reasonable question anybody has asked me. "What the heck happened on your MCAT?" I don't remember posting my scores here, my subject area scores were fine, but my writing score (on a scale of J to T with J being the low end) was a K. In other words, beyond awful, translated to the lowest 3%. He said he'd never seen a score that low and didn't know they actually gave them. He wanted to know if I'd challenged the results of the exam because that seemed like it should have been a mistake. I think I was able to give him a reasonable explanation and after asking whether I'd written my personal statement essay myself (I did), stated that he wasn't concerned about my writing abilities because it was one of the better statements he'd read this year.
He had some other good questions about my work as an EMT, my experience teaching, and why I wanted to change careers at this point. When I was doing some practice interview questions with investigators I work with, one asked about my most difficult call as an EMT. I was able to come up with a recent call that fit that bill. The interviewer's actual question was slightly different though, he wanted to know about my worst call. I've never met an EMT that enjoys that question. Some people ask it because they are prepared to be grossed out about dismembered, decapitated, bloodied patients. But I define "worst" a little differently. To me, worst is a call I still remember the next week, a call where I wish I had the ability to give the patient something more. So I told him the truth and he was definitely surprised that my personal worst did not involve death or traumatic injury at all.
The interview was the end of the day. Although I've been on this campus before, I asked the admissions lady for a campus map because there wasn't one in the folder (which seemed strange). I got a non-answer answer about how the campus was changing so quickly right now that they didn't have a current map, but eventually got a non-current map out of her. I have no idea how my dissatisfaction with their system or their admissions staff is going to factor in to their decision-making, but I'm not willing to pretend I'm happy-go-lucky satisfied when I'm not. If it comes down to a choice between this school and nowhere, I'll probably go, but I'll have to think about it.