Progress

I can no longer hear the owls in the evening.

I haven't seen a single deer in over a week, not even a track.

The resident fox no longer yaps outside the window at night.

The air smells perpetually of pine resin and diesel smoke, heavens know there's enough arboreal blood to go around.

My backyard looks like the last bastion of a dying forest.

This is progress.

Insomnia Sucks

Let's ramble, shall we?

I hate my scale, I want to beat it into teeny tiny unrecognizable pieces.  Why?  Because I have been literally working my ass off and the damn thing never budges.  Seriously, it's making me quite mad.  Now please don't be rational with me about this.  I go to the gym four to five times a week, I know I'm shrinking, my clothes fit better, I'm getting in great shape.  I also know quite well that muscle weighs more than fat, but c'mon throw me a bone here!  I eat salads five to six days a week, I'm up to eyeballs in supplements and healthy meals, I avoid sugar like the plague.  So why why why will the scale not budge.  I have this 6 lb window, all I do is move up and down within that small range.  How can I go down two pants sizes and not lose more than six pounds?!?!?  h8 h8 h8

My birthday was last week, it was not the best I've ever had.  The absolute bright spot was the cake that our au pair made for me.  I cannot tell you the last time someone actually baked me a cake from scratch.  And it was an ohmygawd cake -- 2 full lbs of dark chocolate went into making it.  Dark chocolate cake, soaked in coffee and rum, ganache filling, homemade whipped cream decorations on top with hand-chopped dark chocolate decorations.  It was totally awesome and I don't think she realizes how much all her work meant to me. :)

Beyond that however, it was pretty much a wash.  I'm not exactly fair about it, I have these little internal expectations and when they don't get met I enjoy a self-indulgent sulk.  But since I don't share said expectations it's kind of a forgone conclusion that I will get disappointed.  Vicious cycle I tell ya.  It's not about the gifts, I honestly just like to be remembered on my birthday and allowed to feel just a little bit special.  So let's see -- no breakfast in bed, my husband didn't even say Happy Birthday until like ... noon (we were at the gym).  The present he bought me, which was a totally gorgeous bracelet, didn't come in time - so no gift.  He didn't even sign his card till like 3, when I had to get ready to go to work.  Yes, I worked on my birthday.  Then while we were having coffee and that awesome cake ... my dogs got in an awful fight with one of our cats.  She passed away a few days later from her injuries. :(  Oh and my mother didn't call.  But hey!  My dad sent me twenty bucks like three later!  I actually feel a little bad when folks asked me, "How are you?"  I don't want to answer honestly.  Like I said, it's just fodder for a totally self-indulgent and overblown sulk.  I pouted for a bit and moved on, there's always next year after all!

A local building company has purchased the four acres next to my house and has decided to put in a cul-de-sac and squeeze like 11 houses back there.  This is all happening RIGHT next door.  Backhoes and chainsaws going non-stop since last Monday.  Now the woods surrounding my house are filled with terrific trees, a lot of them are pine that stand 40+ feet tall.  As I heard them come down I was literally wincing, in tears.  I'm just numb to it now.  We had our own wildlife community here - deer, turkeys, foxes, raccoons, opossums, woodchucks, squirrels, rabbits, chipmunks, bats, even a bear.  That doesn't even count the hawks nests, and our owl.  Where will they go now?  They weren't bothering a soul, and it's just ripping the soul out of this tiny patch of quiet.  Even my 9 year old stepdaughter is demanding we move now, she can't stomach being around "people who would do this."  Don't get me wrong, I'm fully aware that at one point they probably had to do something very similar just to build the house I now live in ... it just feels very personal and very sad.  Not to mention that HELLO, we work NIGHTS!  Oy.

In other news, I used my evil overlord powers on Jen and forced her to indulge in even YET another yummy fragrance for her extensive repetoire.  And Laurell K Hamilton's next Merry Gentry book comes out in April, so I was forced to re-read the series up to that point -- so I can be prepared for the next way of soft core Sidhe porn.  It was a moral imperative.

My parents close on their Jersey house this coming Friday (finally).  They will adjourn to my late grandmother's house in VA, which they fixed up for themselves.  I'm pretty convinced that the next time I see them, will only be as a result of a calamity.  It's just got a sense of impending finality.

I suppose I can toss in a Satan story as well.  At some point in the last few days, my darling son must've seen some type of birth on television (I'm truly hoping it was Animal Planet).  Anyway, he's been taking his stuffed animals and cramming them into his pull-up -- until he's got this huge bulging pouch going on.  He'll even pat it and such.  Then he'll waddle around like that for a bit.  When he's had enough he squats down and makes horrid grunting noises, even saying "push" once in awhile.  Then he pulls one of the stuffed animals out of the bottom of his pull-up and begins petting it, saying "Good job!"  If he's really proud of his performance, he'll take a bow too.  Not quite sure where he got it from, but I'm dying to tell his first real girlfriend. ;)

Course, he also won't use the potty without wearing a ski mask -- I have yet to figure out that correlation.

My husband wants to collaborate on a non-fiction book with me, centered around our personal philosophies of emergency care.  Intriguing idea, but I have stage fright!

Alright there, I've rambled.  If anyone made it this far and would like me to post about a particular topic -- lay it on me.

When it rains, it pours.

Friday night I mention to my husband that my son's face looks weird, just an off-hand comment that maybe he's really tired or something.  Come Saturday morning I'm down here in my office.  He wakes up normal time, comes downstairs and immediately gets into a fight with his brother, status quo.  Well he ends up crying and comes running in here for Mommy and ... the right side of his face wasn't moving.  The left side was all scrunched up, crying like normal -- but the right side was a mask.

(Insert small nervous breakdown on Mommy's part.)

So I had an idea what this might be, but no freakin idea why.  There's a condition called Bell's Palsy, where one side of the face becomes paralyzed (in rare cases, the whole face).  It's actually inflammation of the 7th cranial nerve, which operates the facial muscles.  Usually tied to a virus like Mono, most people make a full recovery in about a month.  Most.  Start the phone calls.  I finally get the pediatrician on call who tells me to get him to the ER to make sure that's what's going on.

So I spend all Saturday afternoon at the hospital.  Bell's is rare in young children, so at first nobody was buying into it unless they saw it for themselves.  It can be a little frustrating, being on the receiving end of health care for a change.  Especially if they don't know you might have a clue of what you're talking about, or that you can understand what they're saying.  The doctor finally comes to see him and orders a CT scan.  I asked if they planned to sedate him, because that's a natural worry.  He says no, they'll try it without first.  I started laughing and he said, "Don't worry, I have one of my own."  I just looked at him and said, "Yes -- but do you call yours Satan?"

Needless to say a half hour and one toddler having a nervous breakdown later, we're back in the room.  The doctor comes back in and looks at me and I said, "Knock him out."  This process was reminiscent of Mutual of Omaha's Wild Kingdom.  "While I stay safe on the  high savannah, my partner Jim will go in and dart the very angry little rhino."  Eventually one stressed Mommy and three nurses later they got the shot in his leg.  As soon as he was out they literally ran him over to the CT scanner, because the sedative was short acting.  Then came the waiting.

So I sat in the rocking chair, watching my sleeping son and playing through every worst case scenario.  If it's not Bell's, the thought of what was paralyzing his face terrified me.  If it wasn't a lurking brain injury (he's got a huge nugget and bumps all the time), then in toddlers with wierd presentations it usually means one thing -- a mass.  I swear I was my own worst enemy.  My husband got to the hospital right before they came and said the CT was completely negative.  Note to self: buy more candles to burn in thanksgiving.

The only thing left is to figure out what might be causing this, and whether or not it will go away.  The most likely suspect is Lyme's Disease.  My research even says that Bell's is actually a common presentation in children who have it lurking in their system and we're loaded with it out here.  They drew a titre, but I have to wait a couple of days for the result.  That and a follow up with a pediatric neurologist, not always an easy specialist to find.  The ER doctor did consult with one on the phone, who said she'd see him on Thursday.  She was supposed to call me today to set it up.

Of course by this afternoon the phone hadn't rung.  So I decided to start calling, because of my insurance.  Wouldn't you know it, her group doesn't take my insurance.  And his doctor's on vacation till the 13th.  The office lady tells me now I have to call a hospital in Philly (2 hours away) and get one of them to see him.  They have an office about an hour away from me, but they're only at that one a couple of times a month.  So first I call the original neurologist's office, they were very nice but couldn't help much.  Then I call this other group.  I explain what's going on and that my son needs a consultation and follow-up.  "We're not taking new patients until December, we can see him then."  I reply, "But that doesn't help me, my son's face is paralyzed now."  No luck, "Sorry, no new patients till December." (click)

So in between bouts of crying, I'm on the phone with the pediatrician's office and the insurance company, while frantically combing the internet.  I finally find a group an hour away in the other direction, in NJ.  Of course nobody answers the phone.  She finally calls me back at 10 to 5 and I go through the whole story again, sniffling.  They agreed to see him tomorrow afternoon (hooray!).  Then it was the last minute call to the office before closing to get the damn visits approved.  Four hours after the saga begins I have an approved appointment for my son.  I hate healthcare.

It doesn't seem to be bothering him, though he touches his face now and again.  His right eye gets irritated and tears a bit, but that's because he's not blinking as often on that side.  At least it isn't drooping, because then he'd need a patch to protect his eye and gods only know how I'd manage that with him.  But every time he laughs or talks his face just twists up to the left and I want to burst into tears, my beautiful little boy's face. :(

I really don't know how much more I can take.  Though then again it's not like I have much of a choice.

Miscellaneous Monday

In the wake of Mother's Day, I do have to gush a little. James made me a coloring book picture of a teddy bear today while in daycare at the gym. It's just a page ripped out of a book, with blue and brown marker scribbled on it -- but it's almost in the lines ... sorta. And he looked so happy with it that I just about melted. It now proudly resides on the fridge, when he's not carrying it around in his grimy little hands.

On the subject of moms, did everyone at least call their mother yesterday? I did, dreading as usual my dose of yearly angst but pushing forward nonetheless. My mother sent me a card for Mother's Day with an apology letter in it for her phone call of a few weeks ago. Well, it was mostly an apology letter ... though apologizing for something you have no recall of is pretty weak. Besides, the majority of the letter was just more of the same theme we've been reliving for the last decade. How I couldn't possibly understand or realize what she goes through, how worried she is about my brother (they're a matched set of alcoholics) etc. Though I will admit she reached a new level of guilting me. Apparently now she doesn't feel like I love her because , get this -- I've never forgiven her for divorcing my biological father and changing her life. Well, that would be pretty textbook save for the fact that I was only nine months old. I have no recall of him nor interest, anxiety or psychological baggage as a result. Perhaps some mild curiousity at his half of the DNA. I realize I'm stubborn but that would be one hell of a grudge. Anyway, we got through it with pleasant conversation and no real changes of course. There's always next year.

Last week was my husband's birthday, and as part of our night out we went and saw Van Helsing. First off, it's a fun movie. It's campy and not for purists and we had a good time. And Kate Beckinsale in that outfit alone is worth the price of admission. The theater we go to generally doesn't get overly crowded. Just as the movie was starting, this black family shows up -- guy, his fairly pregnant SO, and two children. A boy who looked about 12 or so and a little girl who couldn't have been more than 5 or 6. They slide into the seats right in front of us. The guy reeked of some heinous aftershave or something and would keep throwing himself back in the seats when amused. But the most upsetting part was the little girl. As soon as the movie started she started to cry, she was sincerely frightened and they were just awful to her about it. Saying things like, "I warned you. You should've listened to me when I said it would be scary. I'm never taking you with me to the movies again. Hush and go to sleep." etc etc. Even when she was sobbing, "But I think its real Mommy!" They completely blew her off about it. And THEN, so they wouldn't "disturb" the rest of the folks in the row, they would climb over the seats to an empty row behind us to get in and out ... multiple times. At one point the little girl got stuck trying to climb them and started crying and the woman was saying, "Look girl, I'm 6 months pregnant and I can do it now just climb over." I was so upset by all this. Who lets their five year old decide for them if she'll see a rated R movie or not??? Here's a clue people, the word is "No". Say it once in awhile, you'll find it's good for your kids. And who ignores their child sobbing in fear? Oh I was so angry I just wanted to kick them all in the head and take the little girl to go see something Disney.

And my work-related advice of the day: If you have a relative who's a dialysis patient with no feet and a myriad of other health problems, please do not let them live in the attic. It's a complete bitch trying to get them out of it when they keel over.

Now if you all will excuse me, I have some Evil Overlord tasks to attend to.

On a lighter note

I don't talk about work much, I really don't.  I may vent after a shift or whatever, but in general I'm not one to go off on a bunch of war stories -- especially when I am around non-EMS people.  Now, put a bunch of EMS people together and the stories will propagate endlessly.  I've had a pretty long career and have certainly forgotten more than I will ever remember, but there are always a few things that withstand the test of time.  If anyone is sincerely interested in the darker side of humanity perhaps I will write about it here.  In the meantime I thought that instead of headless pedestrians I might share one of my favorite stories from early on in my career.

While the show M*A*S*H did an excellent job of demonstrating "gallows humor", it can be hard to understand where it comes from -- especially when you see it in action.  It is not meant to be disrespectful or insulting, it is merely our way of distancing ourselves and placing it in a framework we can function in.

We laugh.  Alot.


Quite a few years ago now, my first medic partner Andy and I were working a city unit on a chill February day.  (For those of you who know me, yes I actually did work days for a time, the horror of it all.)  We got called down to the eastern end of the city, by the river, for a drowning.  Now when we pull up there's a frenzy of activity as the Fire Department is working to fish some man out of the river.  As we're waiting for the victim to be brought up the bank to us, we notice something definitely out of the ordinary -- a handful of men wearing windbreakers with pulldown ID flaps that read "US Treasury Agent" aka the Secret Service. 

Since we're not in the know at this point, we start inventing reasons for being there.  Andy and I decide that if the Secret Service is involved, then the guy must be a KGB agent of course.


So let me cut to the actual story.  The victim was travelling by train, and on him he was carrying counterfeit money plates.  The agents had been trailing him.  When he caught on to it, he ran from the train station.  They chased him on foot down to the river.  He threw the plates into the murky water and then jumped in and swam out aways.  (Where he thought he would end up I have no idea, the other bank is in the city too.)

The police got involved during the foot pursuit and now together they congregate on the bank and wait for one of the boats to come.  Meanwhile our friend the "KGB agent" has swum to a buoy and was hanging on.  So they figured they'd let him cool his heels till they could scoop him up.

For forty minutes.

Did I mention it was February?

Anyway, in true hypothermic fashion he goes unconscious and ends up drowning before the FD can fish him out of the water.  Thus enters our heroes (ta da!) and that's where we were at.  Now for Andy and I, this is straightforward stuff.  We do CPR and all our little advanced procedures and try our best to begin warming the body up -- because you can't be officially dead until you're warm and dead.  We take him to the hospital with little more than some jokes about sleeping with the fishes.  Then it gets interesting.

Now, if you've ever seen CPR, it's pretty unmistakeable.  One would think that a clerk in an ER like ours would be quite used to it.  Apparently that's not the case.  As we're rolling by the registration area, everyone's working on him and there's water running everywhere.  The clerk stops me and says, "What's his chief complaint?"

(Insert dumb German Shepard look and a few blinks on my part.)

My response is, "Can't swim." 

We take him in the back and are now transferring him over to the ER stretcher, calling out a report and answering whatever questions they're throwing at us.  We have one doc there who is particularly obnoxious.  Allegedly a very good surgeon he's a blustery and caustic individual.  He's demanding to know the full story.  So ... we give it to him.

Doc: "What was he doing in the river?"
Me: "Drowning." (insert kick from partner)

Finally we fill him in on everything we know, sans the total truth part.

Doc:  "So what you're telling me is ... A KGB agent, being chased by the Secret Service, jumped into the Passaic River and drowned."

Andy & I: (nodding) "Yep, that's what we're telling you."

Doc:  "What in the hell was he doing there?!?!?"

Me: (in bad Russian accent) "Don't be ridiculous!  He vas looking for stupid moose & squirrel!"

(insert red-faced surgeon and partner dragging me rapidly out of the ER)

We laugh.  Alot.  Don't ever take it personally, we do it to everyone.

Masters of the Obvious

There are a few things inherent to my line of work, two of them are the ability to make rapid decisions and the power of observation.  Now it never ceases to amaze me when other personnel (for example the police) overlook something particularly pertinent.  This is not a bash on any of my uniformed brethren -- there's just as many faux pas among our own.  But without further ado, I bring three of my favorite exchanges that caused me to cock my head and give them the "dumb German Shepard look."  Be advised there is some gore involved.


Scenario 1 (from last night):  We get called to a motor vehicle accident on a major highway around 3:30 am.  It's late, not too much traffic.  We arrive to see a very badly damaged vehicle with at least five Pakistani nationals drunk, bleeding and flailing inside.  Yelling is a good thing in triage, it means you're awake and breathing.  Since there wasn't much to do until the Rescue unit cut apart the minivan, I decide to survey the scene a little further. 

So I'm strolling along the perimeter, humming, and come across two other police officers by the median.  We smile and exchange some pleasantries above the background clatter of the hydraulic tools.  During the course of the conversation I happen to ask, "So are there any other patients from any other vehicles while I'm out here?"  Now mind you, we've been here about ten minutes give or take, and I've been chatting with them for a couple.  They reply, "Just the guy in the van."  I say, "What guy?"  They point to a blue van I had walked past twice that I had not seen anyone in.  So I hotfoot it back over there to find "the guy in the van" -- face down on the floorboards between the front seats, taking his last few breaths.

After running back to the other guys and gathering some help, I say to them "Just when were you planning to tell us about him?"  They answer, "Oh we reached in and didn't feel a pulse so we just left him."  The gentleman died shortly after we dragged him out of the van -- did that delay make a difference?  Probably not at all, but still they could've mentioned it!  Yeesh.

Scenario 2 (a few months ago):  We get called for a pedestrian struck on a main thoroughfare late at night.  By the time we arrive there are plenty of other folks there, fire and police etc.  It's in front of a KFC.  The patient is laying on the sidewalk, as we position the vehicle our headlights are shining on him like a spotlight -- illuminating the man's main problem.  Where his head should be is a smear.  Literally.  No head ...just a big bloody smear with a bit of a debris radius involving skin, brain and skull fragments.  We're still about 20 feet away, but that's what we see, an intact body and this smear.

While we're admiring the unusual injury pattern on poor Icabod here and parking the vehicle, a detective walks up to the truck.  Just to be sure of what I'm seeing I ask, "Does that man have a head?"  Now the detective who's been here for awhile now looks right at the headless body and sincerely says, "I don't know."

Good thing he gets paid more than I to notice these things.

Scenario 3 (a few years ago):  I have the misfortune of being called to a 16 year old shot in the head.  Now if there's one thing you learn the hard way, it's that where I work -- shooting someone in the head does not kill them.  And even when it does, it's certainly not right away.  So in typical fashion, this young man with his egg severely scrambled has not gone into the light and is still breathing.  So we are working hard to do what we can for him, I will skip the gory particulars.  Anyway, while all this is going on the police keep mentioning about just being careful to preserve the scene as best we can.  "And don't touch the gun!"  Which causes me to notice the revolver on the floor next to my left knee.  So I look at it for a moment and look back at the officers.

me: "This is the gun?"
detective: "Yes, that's it, don't touch it."
me: "This gun right here?"
detective: "Yes."
me: "It has no trigger.  How did he get shot?"
detective: "No trigger?"
me: "No."
detective: "Oh."

Here's your sign. 

Postscript on scenario 3 -- The triggerless gun was actually the weapon involved.  His friend had found it in the trash and figured it was harmless because it was missing the mechanism.  Unfortunately he started pulling back on the hammer ... while standing behind his friend.

What's in a name, or a word?

He did it, my son the archdemon finally said "Mama"!

Yeah yeah, not quite so earthshattering I know -- save for the fact that he is over 2 and a half years old now and never says it, ever.

It's become quite the long standing joke around here, how his burgeoning vocabulary contains everything from "Jasmine" (one of the dogs) to "Ciao", but not "Mama". He even said "Bonjour" the other day. He can speak foreign languages, but not say "Mama."

I'm quite sure he does it deliberately, because he presses his lips together and grins when you ask him to say it. Even hint about Chris and it's a joyous "Dada!" But even hanging him upside down and feeding him to the dogs won't elicit a "Mama" out of him. (I know, I've tried.)

Until today, when Chris asked him to say it. He looked up, said "Mama" and immediately ran off to play in dirt.

The day is looking up.