The lights came on in there usual rude fashion, flickering twice then becoming bright , the dispatcher broke my sleep with a monotone 'Medic 31, code 4 in progress, 1421main street, repeat, CPR in progress 1421 main street, time 0307 Firecom clear'�. I laid there for a few seconds to gather my senses, then in robotic function brought on by a busy day and only one hour of sleep so far, stepped into my pants, slipped on my Redwing fire boots and pulled the zipper that closes the front of them. I snatched my uniform shirt off the foot of my bed as I headed for the bathroom, peeing is important at 3am.
60 seconds later my partner and I were on the road letting the dispatcher know we were in route to the local nursing home where I was sure some newbie nurse would be pounding on a hunk of flesh that was suffering from TMB (too many birthdays).

Let me introduce myself, I'm Rob I work for Wood Falls fire dept in Washington as a Senior Firefighter/Paramedic, now before you start to think I'm just some burned out Medic who should be retired. I want you to know I love my job but after 20years of being a medic I have come to understand some realities. 0307 in one of the many local nursing homes when someone suffers a cardiac arrest it's usually because the patient is worn out and it's their time. Not all but most of these folks have very poor health and an extremely poor quality of life, which is the nice way of saying they're veggies in the garden.
If they could speak and tell you a clear thought, it would be take me to my favorite place give me a large bottle of wine and a large bottle of Valium, both at the same time.

Two minutes later my partner Rusty an EMT extraordinaire has tossed all of our gear onto the gurney and we are dragging it to the door, once inside the night ward clerk points down the hall and says 'room 203'�. The smell of urine hangs in the air and after all these years it still offends my sinuses. We step thru the doorway of room 203 to see one frazzled nurse and three CNA'S doing the chicken dance. The body is half hanging off the bed, one CNA is trying to do CPR with the body bouncing on the bed the other is trying to force air into the patient's lungs with an ambu bag. There is puke all over the floor and I'm not sure if it's from the patient or the CNA'S. The nurse and the other CNA are arguing over what I'm not sure.

Rusty has worked with me for 5 years and knows my routine, he pulls out the leads from the heart monitor and attaches them to the chest I step in between the nurse and the young CNA. I look at the nurse and tell her I need to know what happened and this patient's medical history , with that I turn and move to the head of the bed, while the nurse is telling me the history I slide a clean blanket onto the floor to cover the puke, no point in getting dirty. Rusty and I move the patient to the floor, I place a tube into her lungs to protect her lungs from the vomit and also to get air into them. The nurse tells me the patient is a 58y/o female two days post-op from a hip replacement, when she stopped by to check on her she had a seizure. She ran to the nurses station and called 911, when she returned the patient wasn't breathing was pulseless and blue. I looked at the heart monitor Asystole or flat line for those of you that watch tv. Now this patient was clearly not the normal nursing home pt. So I looked at her arm to start an IV , to my amazement there was a heplock already there, a heplock is a small access port that goes on the end of a iv catheter sort of an IV without the bag. I asked the nurse if the port was good she said 'oh yes it had just been started because the pt had an infection and needed some IV antibiotics'�. Well lucky for us no need to waste time looking for an IV site. I looked over to the drug bag and asked the cna next to it 'hey, can you throw me the yellow bag'� . I opened the bag and injected 10 cc's of Epi into the patient, Rusty had taken over managing the airway from the other cna while the nurse and the other cna alternated doing CPR. I ran thru some more Epi, some atropine, checked the patients blood sugar, 108 it was fine. I thought about pacing and maybe some bicarb but decided with no response to any of the drugs it was just time to call it. We had been at it now for 20 minuets. I confirmed that the heart truly was Asystole on the monitor by changing the settings and listened for heart sounds, none. At 0331 I declared the pt dead. While the staff placed the body back on the bed and covered her with a sheet I notified dispatch to call the Coroner. Rusty began collecting our gear while I rifled thru the chart to get patient info and any other history I might have missed. This patient was surprisingly healthy no previous problems no daily meds just the fall with the hip fracture, sometimes it just your time.

Speaking of time, Rusty was dragging his feet and I wanted some quality bed time I looked over and saw the reason why. The young CNA was helping Rusty put our kits back together and was asking him questions about becoming a Paramedic. The fact that she had on tight white pants with a white lace thong poking over the top when she bent over had not escaped his eyes as she was performing CPR. Now I don't mind a little flirting just not when it's getting in the way of my sleep time. I went over and introduced my self, 'Hi I'm Rob thanks for your help tonight'�, she smiled and said Christin with a C. I'm curious about being a paramedic, I turned to Rusty and said are we ready to go yet, he grinned and said almost. Knowing he hadn't done shit yet. I turned back to Christin, well come by the station some time we will give you a tour and answer your questions, I handed her my card turned and glared at Rusty who smiled but now had our stuff ready to go. Thanks again for all the help Rusty said as we walked out the door. I figured 10 minutes for charting while Rusty made sure all the drugs were replaced I could be in bed by 0400.

On the two minute drive back to the station Rusty babbled about the young CNA and what great attributes she had, Rusty is 10 years younger than me, while I don't mind eye candy, this girl couldn't legally drink! However, Rusty's response was 'I don't want to take her drinking'�. We arrived back at the station I headed for the radio room to write my report, Rusty headed for the supply room, 15 minutes later I had dumped my uniform next to the bed and was dreaming of warm sandy beaches in the Tropics.

I woke at 0730, shift change had happened 30 minutes prior. I strolled to my locker grabbed my shorts and a tee shirt and headed for the showers. Five minuets later I was driving my 20 year old classic El Camino pickup truck, which the guys at work had dubbed the cruck It's not a car and it's not a truck it's a cruck. I pulled up in front of Starbucks, now I don't know why they don't have a sign on the front of their stores like cigarettes. They're addicting, I haven't smoked in 20 years but I didn't spend anywhere near on cigarettes what I spend on Starbucks each month. Well at least I was trying to be healthy, Vanessa the very cute barista made me my usual, double tall, non fat, raspberry, latte. Then bagged my low fat blueberry muffin to go. Hell it's easy for her I get the same thing every day. 'How was your shift Rob?'�'� I blinked,'�what'� how was your shift'� she asked again, 'sorry Vanessa, we were out late last night got a couple hours sleep but that's it'�. I paid my bill, left the store and hopped in my cruck.
At least it was summer my favorite time of year, I popped the cruck in gear and headed for my home on Whidbey Island one and a half hours later I pulled into the Freeland Marina parking lot. Five years ago I had come across a 60' ketch that had seen it's best days racing in the BOC, which is an around the world yacht race. The boat had a lot of miles on her and was tired, I had spent the last five years rebuilding her to a pristine state, not to mention every dime I made. Some time in the distant future, when I had replenished my savings account, found a first mate, cook, bottle washer, wife all rolled into one I would pull the plug and sail the oceans in Blew by you, the name of my boat.

I grabbed my backpack walked down the dock to the boat. John the harbormaster lived aboard Maestra his 50' trawler in the marina. I waved at him as I passed by on my way to my boat. A nap was the order for the day as this was my first shift of the rotation. I work what's called a modified Detroit schedule, which means I work 24 hours on followed by 24 hours off, then 24 on, then off 24 on 24 then I have four days off. I do this three times a month, which means on average I work 9 days a month. It sounds better than it is, as the day after a shift I'm pretty much wiped out and need to rest up for the next shift, by the end of the third shift I need my four days off. Four hours later I woke glanced at the clock it was 1530 time for a shower and to take care of a few projects. 20 minutes later I was showered, almost completely awake and contemplating another latte. My cell phone rang, Hola this is Rob, hi Rob it's Bryan, Bryan was one of the shift Captains at work. What's up? Noel at the Coroners office wants you to give her a call, Ok anything else, no that's it bye, thanks Bryan. I punched the end button decided to skip the latte and opened a bottle of Red Truck Cabernet it was now after 1600 my unofficial time of when I could drink, unless I needed to change it for the occasional bloody mary in the morning. I uncorked the wine and poured some in a glass but thought I should let it breathe for a while, then called the coroners office. I got right thru to Noel on her private number, I had taken Noel out several times, one particular time thinking I was real suave we took the boat out and anchored in behind Gedney Island, the basic plan was to feed her lot's of good wine, cook her a gourmet meal and then jump her delightful 5'11' triathlon toned body. The reality was she became sea sick right after dinner threw up on the table while trying to get to the head, she then spent the next seven hours wishing she was dead. When morning came I took us back to the marina she apologized jumped in her car and left, my chances of finding out if those legs go all the way up and make an ass out of themselves are looking slim. 'Hi Rob how are you?'� 'Good, Noel how's life your way?'� 'fine. Hey, you guys ran a code last night at main street nursing home'�, 'yea I remember it, what about it?'� 'Did you see anything unusual about it ?'� 'No, other than the lady wasn't very old, she was already Asystole when we got there, well, hearing the nurses story it sure seemed she went quick, she had a seizure went into respiratory failure then cardiac arrest probably in a 20 minute period'�, 'Yea, that's the history I got, did you find anything when you did the autopsy?'� 'No, it just seemed weird, I can't put my finger on it, oh well, if you think of anything call me but I'm closing the case and releasing the body for burial'. 'Ok Noel, hey, maybe we could go for a picnic some time?'� 'Yea, as long as it's on land and not on that steel torture trap you live on'�. 'Careful Noel, she'll hear you'�. 'Sure Rob, bye.'�

I settled down on the couch with my wine, dialed in the Ipod, Diana Krall's steamy voice accompanied by her very talented fingers on the piano played thru the speakers, after fantasizing about playing Popsicle Toes with her and then wondering about Besame Mucho with her I headed outside to light the BBQ for dinner. Moving back inside to the galley I got out some mixed greens to which I added some crumbled blue cheese, chopped walnuts, pea pods, sliced fresh crimini mushrooms and fresh whole pear tomatoes. I had prepared a nice raspberry vinaigrette the day before, it was now chilling in the fridge. I had a nice new york strip that I rolled in some garlic seasoning, pepper medley and some seasoning salt. The BBQ was nice and hot as I seared the first side of the steak for four minutes I seared the other side and four more minutes later it was on my plate. I drizzled the raspberry vinaigrette over the salad and refilled my wine glass. Diana was now into the classics, Ira & George Gershwin and was on the second verse of They Can't Take That Away From Me. The steak was done to perfection, the salad nice crisp slightly tart with the vinaigrette, the whole thing was nicely washed down with the Red Truck Cabernet. After doing the dishes and relaxing with a few tunes from Gabriela Anders whose version of The Girl from Ipanema was my favorite. I thought about the box of Cuban Cohibas cigars sitting in my humidor that one of my cop friends had bought back from Canada. While on a joint training mission with Victoria PD he had purchased the box for me and dropped them in the trunk of his patrol car, at the border he smiled and they waved him thru. I had a bottle of Gran Mariner that would go well with a cigar. However, the healthy side of me won out and I went for a walk. After a 45 minute walk I returned to the boat and headed to bed.

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