First Days

First days rarely go well. I've heard a lot of horror stories of peoples first days on various jobs. So, here are the stories of the first day of my EMT hospital time,  my first day working on an ambulance, and my first day on shift with the fire department.

Hospital time:

Becoming an EMT or a paramedic requires you to do clinical time in an ER before being certified. It pretty much immediately follows the didactic portion of the class and serves as your first real encounter with patients and all that you've been learning about. Bear in mind, I had zero experience at this point.

On the first day of my EMT basic clinical rotation I walked through the doors of the ER about 15 minutes before my shift was due to start. One of the nurses was heading toward a drawn curtain when she spotted me in my student/intern uniform. She stopped and asked if I was reporting in. I said yes and she immediately sighed and said, "Great! Go help Doug in Bed 2." I looked around the ER and saw that Bed 2 was the one with the drawn curtain and that the nurse had returned to the nurse's station. Eager to help but a little unsure of protocol, I quietly stepped around the curtain and there was Doug. To be more precise, there was Doug, a large opaque plastic sheet in his hands, and the naked corpse of a thin 90 year old man. He told me to come over and roll the body towards me so he could get the sheet under him. Now, I'd never even seen a dead body before, let alone handled one, but I did as instructed. We completely wrapped him in the plastic and taped it shut. Surprisingly none of it really bothered me. The part I found strange and a bit irreverent was when it came time to secure the extra plastic. The plastic was longer than the body and if it were a tootsie roll you would just twist the ends and leave it at that. In the case of this man, not being a tootsie roll, the extra plastic at the end was folded back over his face and secured by taping it repeatedly around his neck. Being dead, it didn't matter, but it was a strange sensation putting plastic over someones head and taping it around their neck. It seemed a little serial killer-y.

Well, having gotten the 'first corpse' thing out of the way, I reported back to the nurse's station. I was given a few random assignments but nothing too eventful until a patient came in with a bleeding arterial dialysis shunt. This is the implanted port used to remove blood, filter it, and put it back into the body during dialysis treatments.

The patient was a large African-American woman and the blood was under quite a bit of pressure since it was from the arterial side. I was assigned to hold direct pressure on the site with some gauze pads. Every once in a while the doctor would come in to see if the bleeding had stopped. He would ask me to relieve some pressure and fold down a corner of the bandage so he could see. At this point the blood would squirt out about 2-3 feet and he would say, "Not yet. Keep pressure on it." and then leave again. This went on for quite awhile with me just sitting in a chair next to this woman with both my hands wrapped around her large forearm and squeezing the best I could. They finally had to put a blood pressure cuff on her arm as a tourniquet to slow the bleeding. It was my job to sit there and watch the time and monitor the cuff. The cuff had to stay on for ten minutes at a time. It was pumped up very high in order to achieve the tourniquet effect and it was obviously painful to the patient. I could feel her hand getting cooler and see the color change in her skin. At the two minute mark she started asking if it was time to take it off yet. I had to do the, "Not much longer. Hang in there." dance with her to make it through the time. We did that dance at least two more times. All in all, that incident lasted almost three hours and pretty much took up my entire first shift in the ER.

Ambulance:

I worked part time on a BLS ambulance for awhile while going to paramedic school. We did mostly inter-facility transports, that is, taking elderly people from nursing homes to their doctors appointments or to the hospital. This pretty much just entails transferring the patient from the bed to the gurney and taking vital signs. Rarely do we travel lights and sirens and we don't respond to 9-1-1 calls. It is usually pretty uneventful.

I showed up at the barn and met my partner for the day. He informed me that he was a huge Eagles fan and that is what we will be listening to in the ambulance and if I didn't like it then that was too bad. Okay, good start. We left the barn and headed immediately to the gas station to fill up. I was the new guy, so I pumped the gas. I had no idea how low the tank was or what it even held because I wasn't driving. It was obvious it was full however, when the pump burped and gasoline came sloshing back out of the tank and all over my thigh.

Strike one.

My partner then informed me that, "Oh yeah, that can happen. Sorry I should have mentioned that." He was sincere, he hadn't set me up, however I had no other pants and now I reeked of gasoline. My partner told me he had some pants I could use and we went back to get them. His waist was about four inches bigger than mine and I'm sure I looked ridiculous in his oversize pants but I didn't really have any other option.

With a change into the clown pants we headed off to our first call. When we arrived at the house we found out that this patient was on a ventilator. Being only EMTs and not paramedics or nurses, we are not allowed to transport patients on ventilators and we had to explain that to the family and then hang around and wait for the ALS ambulance to show up. It's very awkward standing around with nothing to do and not much to say. It wasn't our fault we were the wrong ambulance, but we were the ones there and the family wasn't thrilled about it.

Strike two.

We ran a couple of nursing home transfers and then got a call to respond to a house. Most of our calls were to hospitals or nursing homes and usually not to private residences. When we arrived we found that our patient had been changing his catheter and encountered a problem. (Here comes the pitch.)
This was causing him to bleed from the site and the bleeding was not stopping. (Anyone else, sensing a pattern here?) Once again, as the new guy, it was up to me to deal with the bleeding while my partner drove. (He can't hit, he can't hit, he can't hit. Sssawing batta'.) So, yes, I got to hold direct pressure on a patient's penis all the way to the hospital. At least this time I didn't have to break out the blood pressure cuff.

Swing and a miss. Strike three.


Fire Department:

On your first day on shift in the firehouse everything is a test and everyone is watching you. How well do you do your job? Do you step up and do the chores and all the work in the station without being asked? Are you entertaining and do you tell good stories? Do you seem lost or at home? You are under a microscope and walking on eggshells. There are many firehouse rules or etiquette that should be followed and hopefully someone has clued you in ahead of time and not steered you wrong. One of these rules is never show up empty handed. On the fireground it means you always have a tool of some kind with you so you can do some work. On your first day it means you bring ice cream. This is where I was steered wrong.

The last week of my academy, just before starting on shift a particularly particular captain advised me that I need to show up with ice cream on the first day (and probably every day after that for awhile). Okay, thanks, good to know. He then informed me that I should bring something particularly good like Butter Pecan and none of that "mint chip shit". Okay, thanks, good tip. I of course didn't take into account that I would not be working for this captain or his crew and that bit me in the ass. More on that later.

 

I did all the cleaning and the chores and all that I was supposed to so there was no fodder for the cannon there. The getting to know you period, or third degree grilling as it turned out, was another matter. I am vegetarian, a relatively rare thing in the fire service, at least in that small department twelve years ago. There were many questions about why I chose vegetarianism and a million what-about-this-situation hypotheticals. I knew I was in trouble when I stated, "Look we can go over this for hours and it isn't going to change anything" and the answer I received was, "Oh no, no, no. We have 20 years to go over this."

It was somewhere around this time that the Butter Pecan was discovered. I knew this because I heard from the kitchen behind me, "Who brought in this shit?". I fessed up and told the story of the captain who had led me astray. At this point, the lead investigator in the vegetarian 'grilling' went to the blackboard to educate me. He drew a large C on the board. "Now pay attention. This is C shift, okay? C is for Chocolate. C is for Carnivore. C is for Catch and DON'T release." He wrote these all on the board; there were more but I probably blocked them out at this point. It reminded me of Mr. Hand from Fast Times At Ridgemont High putting Spicoli's "I don't know" on the board for all future classes to see.

I was then grilled about my cooking ability and it was determined before I'd ever made anything for them that I couldn't cook but merely heated things up. Then they informed me that I would be cooking tonight. There were six of us altogether at this station and I had never cooked for that many people, and honestly I didn't really have much of a repertoire anyway. So, I decided to go safe and make build your own burritos. I got a lot of food because the other rule is it is better to have too much than too little. I had prepped all the ingredients, made the guac, and set everything out. I was at the stove finishing the meat when the crew took their seats at the table. I had laid out the tortillas on the table already. The next thing I knew one of the other firefighters was standing next to me at the stove heating up his tortilla over one of the gas burners. He had no shirt on.

 

I did a little double take, said nothing, and went back to cooking. This firefighter was a little hyperactive and I figured that he was probably changing and decided midstream to get his tortilla ready first so it didn't really phase me. The meat was finally ready and I turned from the stove to put it on the table and found the entire crew waiting patiently at the table, shirtless. Their shirts were hung neatly over the back of their chairs and they eyed me expressionlessly. As I said, everything is a test. What I had to figure out quickly was what was the answer? Was it, am I stupid enough to fall for this, or was I supposed to join in? I decided, as ridiculous as it was, that it was the latter. I set the food on the table, looked at each one of them, peeled off my shirt and set it over the back of my chair and sat down.

Everyone dug in and we ate that way for about five long, silent minutes until the lead investigator broke and said, "I can't take this anymore. I can not eat and stare at you flabby, pasty, bare-chested fuckers." Everyone started laughing and I was high-fived by my captain. I had gotten it right. The funniest part was that they actually believed that they could convince me that this was the normal firehouse way of having dinner so that the first time I worked at another station or with another crew I would whip my shirt off at the table and embarrass myself.

And for the record, everyone ate the ice cream.

Skills

Firemen are supposed to be jacks of all trades. We are called to handle not only emergency situations but, for some reason, any possible situation that people can't handle on their own. We go to water leaks, lock outs, stuck wheel chairs, open cans of paint on the sidewalk, chemicals in the storm drain, ducklings in the storm drain, cats stuck in fences or up power poles, downed power lines or phone lines, and so on and on and on. I've responded code three for a man who, it turns out, couldn't get his voice mail on his answering machine. We are expected to mitigate any situation we are called for. We can't always do it, but we certainly try. Most of us therefore become jacks of all trades and masters of none. We know just enough about a lot of different things to hopefully do something about it and not get ourselves killed.

That...or we just wing it and hope for the best.

The cool thing about this aspect of the job is the exposure you get to these skills and tricks and access to the knowledge that each of us brings to the job from our own unique pasts. For example, just the other day we were responding to a lockout at the local elementary school. When the dispatch came in, we didn't know if it was a lock out of a building or a car. My firefighter quickly grabbed his lock pick tools in case it was a building we needed to get into. In the rig he informed us he had his tools. I responded, "Lock pick set? You have a lock pick set?" He replied very matter of factly, "Yeah, just in case."

Cool.

The call turned out to be for a car and they had it open before we got there but as soon as we got back to the station the questions began. Turns out this fireman had worked for a locksmith for a couple of years and learned a lot of great tricks for getting into locks.

 

I'm used to the fact that we normally just break things, in the cleanest way possible of course, to get in where we need to go so this peaked my interest. He had several tools for picking locks and I immediately went grabbed our door lock prop. This is basically a 16" by 20" solid piece of wood with four different door knobs it, each with a different style of lock. He proceeded to teach me about locking mechanisms, most of which I knew from basic firefighting books, and then how to pick the locks with different style tools. It's not easy and it is not an exact science but after only a few minutes I had successfully picked my first deadbolt lock.

I love learning new skills and getting to do things that I would never have learned, seen, or done in any other occupation. Now I can add cat burglar to that list.

Hazards Of The Job (In 3 parts)

ONE:
The increased risk of cancer in my profession is very high. Years of breathing in diesel fumes from our fire engines, smoke from fires, chemical vapors and anything else you can imagine coupled with the myriad problems and decreased immune response caused by sleep deprivation creates a ripe environment for the big C. 

These are known risks and risks we accept but try to minimize with safer work practices and better safety equipment, etc.

My very first chief retired three months after hiring me. He got sick and was dead within 6 months after that. He never saw a healthy day in retirement.

Most recently in my department, a beloved senior fireman -still on the job in his 60s- passed away from lung cancer. He never smoked a day in his life.

But, it is not always the retired guy or the senior guy who gets sick...

TWO:
Obscenity. Atrocity. Injustice. I don't use these words much, but they seem appropriate in this situation.

In the 12 years I have worked in the fire service I have worked with a lot of really good people. But, in that time, there have only been a handful (five to ten?) that I really connected with, would do things with off duty, and truly call real friends. Now, one of them is sick. Really sick. He has been diagnosed with Stage 4 colon cancer and just started chemotherapy.

He is 31 years old.

He has always been one of the most selfless people I know. If you need a trade, a ride, help moving, whatever it is, he's there for you. It could be argued that as a young guy with no kids he is in a position to do that. But, it's not that simple, it goes beyond that. It just is who he is.

I worked with him in his probie academy and when he was a brand new fire-medic as a sort of field mentor. We have a ten year age difference but hit it off right away. It could also be argued that this is because I live in a state of suspended adolescence (as most firemen do). But it's not that simple. We share a similar twisted sense of humor and love of movies and other pop culture geekery. We 'get' each other's references and what they might mean in the broader/deeper context of the conversation. Back at that field mentor time, we worked with a captain ten years my senior (20 years his) and I pretty much considered my role on that crew to be translator, explaining to him what the captain means and wants, and explaining to the captain what he needed and expected. There was definitely some butting of heads between those two and I think my role in the whole thing really helped bond us. He later got switched to a different shift, but still at my station, so I saw him in the mornings and when one of us got to work overtime with the other.

He just passed the test to become an engineer (my position) which means (when he promotes) we wouldn't get to work together anymore until one of us promoted to captain. The engineers exam is a tough test and I was proud of him and glad he did so well, but also bummed that we wouldn't have the opportunity to work on the same crew anymore.

I don't have much first hand experience with major illness or death and, I shouldn't be, but I've been surprised at how much this has bothered me and how often I'm thinking of him. I suppose it could be argued that it is simply the fact that it is the first time I've had to face this sort of thing on a personal level or that he is so young and this is so wrong.

But, it's not that simple, it goes beyond that.

THREE:
It is now a year and a half later. My friend has gone through chemo, surgery to remove part of the colon, weight loss, and weakness. He has been off of work this entire time. He was young and strong going into this ordeal and I think that made a huge difference. He never laid down or quit. He approached this as a fight he not only could win but would win.

He responded well to the treatments and the surgery got the rest of the cancer. He got stronger. He went from barely being able to walk around his block to jogging up the highest peaks in town. Stage 4 remission brings with it a high likelihood that the cancer may come back some day. But for now he is free and clear. He beat odds that were roughly 96% against him.

Yesterday I signed up for overtime and was expecting to get the vacancy at our old station. When they called me for the overtime they told me I was going to a different station. I checked the roster to see why I didn't get to go to my old house and found that my friend (and newly promoted engineer) was working in that spot that day. I hadn't seen his name on the roster for a year and a half without the workers comp code next to it. It was pretty amazing to see.

I'll take my second choice station any day to see that.