Para-gods. Para-magi. We all want to be the best. “God couldn’t make it today so he sent me.” The saving of lives and near death experiences of multiple patients can set you up, or as quoted from a recent “House” episode. “They could build monuments to your ego.”
The initial call description invariably sends a rush of adrenaline to your system which gets you ready for the unexpected, the terrifying and the stressful. We bolt from the station in our trustworthy “Sopwith Camels” to fight back the specters of death and pain, and then it happens. The call that makes you shake your head, laugh yourself sick, or is so completely ridiculous it knocks you off of your little pedestal.
My all time favorite was for a patient who was having mental status changes. My evaluation revealed an 88 year old female, who was completely oriented and alert. Her vital signs were all with normal limits, and she was pleasant, though irritated at being bothered with all of the attention.
Her daughter was adamant she be seen at the hospital because she “just isn’t acting right”
I explained to her that I couldn’t find anything out of the ordinary with her mother, she was alert, completely oriented and in my opinion was perfectly fine with no obvious confusion or witnessed loss of consciousness.
“Well that’s just it! She is usually very confused but she has been acting normal all day. There is something wrong.”
You can just imagine the hospital staffs reaction to that report.
We were dispatched to a patient who was complaining of the inability to walk and lower limb weakness. When we arrived in the vicinity of the given address the patient was jumping up and down on the sidewalk waving his hands yelling “It’s me, I can’t move”
Dispatched to a call for severe abdominal pain, we were taken aback by the patient who met us on the sidewalk and clambered into the back of the ambulance before we had the door completely opened. She was talking a mile a minute, and said she needed pain meds and wanted to go to St Mary’s, her pain was 10 out of 10 and she needed Morphine ..Right…now!
At that point her brother comes to the back of the truck, looks at me and says “She is a drug addict; do not give her any pain medication.”
The patient jumps up off the stretcher, shoves past her brother and turns around pointing like the evil monkey and yells “I’m telling mom!” She proceeds to run toward the house swearing and yelling at him, manages to fall on her face twice before getting to the house, and then slams the door. Not satisfied with her initial spate of cursing she opens up the door and sends another barrage at her brother, while he ignores her and profusely apologizes for her behavior before assuring us she won’t call us again.
My partner and I held it together until big brother went back in the house, and then laughed ourselves sick until we were able to clear the scene without cackling on the radio.
Physiologic symptoms for seizures are finite and difficult to fake. The inmate we ran on 3 times kept adjusting his complaints according to our evaluations. We mentioned on the first call there was no bowel or bladder incontinence although the patient was witnessed thrashing around on the floor in an apparent attempt at a grand mal seizure. There was no post ictal reaction either. The police decided he was well enough to remain in his cell. Two hours later, we are called again for an unwitnessed seizure, pt found unresponsive on floor. This time he decided to wet his pants with water. They sent him to the hospital where we advised staff he had apparently had bladder incontinence, but there was no detectable odor of urine. The third time we were called to the jail for an alleged “seizure” he had actually pissed in his pants and all of his vital signs were better than mine! What he couldn’t fake were the dilated pupils elevated pulse and blood pressure, sweating and drooling that follow a grand mal seizure in the post ictal phase. I finally had to tell him. “Look buddy, you can piss yourself all you want, knock yourself out, but you can’t fake the rest of it. How about you try for a really bad headache or something?”
Overdoses aren’t usually very amusing, unless you consider the diabetic who decided to end it all by overdosing on PEZ. When we got on scene 8 packages later she was in tears and had only managed to raise her sugar to about 400, making her sick to her stomach and causing a massive headache. I can only imagine the petition that episode produced.
Sometimes it’s your partner who amazes you. Mine was sick with possible food poisoning for the majority of a shift recently. He spent several hours running into every bathroom we came across in between calls and at the station, refusing to go home. As he sprawled across the station couch and groaned about never eating a particular restaurants sub again, I had to admire his determination, until about midnight when we received a call for a patient with severe back pain.
I watched as he steadily got quieter and greener throughout the call, and before the end, my super stud partner was vomiting on a tree next to the ambulance to my horrified astonishment and the responding Firefighter/medics amusement. He managed to projectile vomit approximately 5 feet, earning him the nickname of Pukey for the duration of the shift.
A week later we ran on this same patient, and upon seeing my partner remarked on his fortitude for working when he was Ill. He reassured her that he was only doing his job. She wiped the modest smile from his face with her next remark.
“What is your name” she asked him “I’m going to carve it in that tree for you.”