Subaqua Sternal Rubs

I was weak. I had made it through 26-week Terms before, but during this, my 6th Term, (which is only 18 weeks long), I took a short sabbatical and went home for a week. It was right after passing (and getting a better than average score) on my second exams when everyone I know was either 1) going on vacation to another beach (not interested - gets kinda old after being in the Caribbean for 2 years), or 2) going on a scuba diving vacation to another island (which I can't as a result my little accident). So for about the same amount of money others were spending on a weekend away, I spent a whole week at home seeing family and friends (or at least the ones that were working either at the ambulance or hospital when I was.)

The trip started last Tuesday with a flight on LIAT (also known as Leave Island Any Time) from the E.T. Joshua Airport. True to the more popular explanation of its acronym (rather than Leeward Islands Air Transport), the Dash 8 turboprop had a bit of mechanical difficulties before take-off. Every time the pilot attempted to start the engines, the entire electrical system shut down. After the 10th attempt, we were finally off to Grantley Adams International in Barbados only slightly delayed. But hey, what can you really expect for a $22 fare?

In Barbados, I survived the grilling by the Immigrations Officer, and was able to convince her that I really didn't want to stay in her country and I really did need to get to the check-in counter for my BWIA flight to Miami. Since I had no luggage to check-in, I did make it, but not without a chiding from BWee staff that I needed to "run" to the gate. The BGI –> MIA flight was on a relatively empty B737, and was relatively comfortable. Not only did BWee provide pillows and blankets for everyone (that couldn't be used for take-off/landing for some reason), but they also provided a hot meal. (Did anyone ever think it would become a luxury to be served airline food?) The transfer to USAir in MIA went smoothly, save for me almost forgetting my jacket at the check-in counter. (Since all flights were booked as separate E-tickets on each carriers website, I had to check in separately for each segment. There wasn't enough time to get a unified paper ticket from one of the travel websites mailed down to me.) The USAir flights to Charlotte and then home were uneventful.

Upon arriving at my home airport, I hopped in a cab to guess where? Yup, the ambulance station. In my defense, 1) there was no one at home anyways for the next 3 hours, 2) I didn't know if my car at home was working or even present, and 3) I had promised an on-duty medic that I would stop by. After a couple of hours of not doing calls, I went home to surprise my parents with my visit. When they finally arrived 3 hours late due to airline delays, it did not dawn on them that I might be home when they saw an ambulance parked in the street in the vicinity of my house. Their first instinct was that they should go check on the neighbors and make sure that they were ok (which didn't please my sister, who had just come home from work, and thought that my parents first instinct should have been to make sure that she wasn't dead.) The parents were definitely surprised (sister not so much, as I had to enlist her help with some of the bookings). We talked for a bit, but then the parents had to go to sleep, seeing as they are old and all.

The next day, I picked up a shift working at the hospital ED with both my father and sister (for the latter, I should be getting a nice bonus for referring, which should cover most of the cost of this trip.) Nothing too interesting that I can remember, case-wise. I got stuck doing the sub-acute stuff (i.e. lacerations, extremity injuries) for the first few hours, and then I got moved to the main ED side where it was a little busier. A few old faces, a lot of new faces, and some people in new roles. Evidently I was moving too fast for some people, who hadn't yet adopted the "treat'em and street'em" mentality yet. Oh well, I get paid either way.

Over the next couple of days, I alternate between being on call at the ambulance, and spending time at home with the family (and eating some really nice home-cooked meals.) Pretty quiet call-wise, I even did a 12-hour "no-hitter." Otherwise, some pretty run-of-the-mill stuff. An Urgent-Care to ED transfer for "Rule Out Cardiac" Back Pain, where the 12-lead EKG showed no acute changes. Another Urgent-Care to ED transfer for a 3yo who swallowed a cashew, which was aspirated into the right mainstem bronchus, causing a bit of wheezing. Oh, and the call where we got to fill out two crew member injury reports (myself and one of the medics). The call goes out for a "1-Bravo Unknown Medication Reaction." Even though I am not up for a call, I tag along with the crew since the dispatch info sounds pretty BLS and if so, I could send the medic back to finish her homework. We pull up to find a 40-ish, 400lb-ish gentleman sitting in the bushes outside his house. The patient's wife reports that the patient is on high doses of narcotics (Fentanyl patch and Vicodin po) for chronic pain secondary to multiple orthopedic surgeries. He also has a rather large abdominal scar for multiple GI surgeries to relieve "obstructions." (Constipation secondary to narcotics, anyone?) Anyway, it appears as though the patient is highly dependent on the narcotics, and hasn't had any for 4 days since he didn't get his prescription refilled. So in order to combat the withdrawal, the pt's wife gives him the same dose of Vicodin that he is supposed to be spreading out over 24 hours in just 2 short hours. So is the patient in withdrawal or is he overdosed? Heck if I know. Either way, he has altered mental status (as evidenced by him attempting to eat oh-so-nutritious rocks), and he is combative. All I can say is thanks for the new stretchers which allowed us to lift the 400-lb pt with the touch of a button. After getting the pt. into the ambulance, it became clear that we would need to restrain the patient. That's where I got my injury - a small abrasion on the leg. The medic got hers on her hand trying to start an IV (though thankfully not a needlestick.) The rest of the ride and transfer went relatively uneventfully (except for the hospital claiming that we didn't call to notify them. Which we did, twice. So we just kept walking by the charge nurse desk without breaking stride and put the patient into a bed we thought most appropriate.)

The flight back to SVG was relatively uneventful, and the same 4-stopover convoluted flight-plan. Though on one of the USAir flights, I did have a rather childish 50-yo woman sitting behind me. When I leaned my seat back the generous 17-degrees to take a nap, she proceeded to kick the back of my seat until it was straight up again. Really, people, have you no manners? And what gets me, is that there was an open seat with no one sitting in front. If the whole 17-degrees of my right to recline bothers you that much, why not just do the civilized thing and move? Oh, and LIAT was late again due to mechanical problems, but I made it back ok.

Only 37 days until I am back in the US for good!

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