Free Essay from Pulse
Mar 21, 2022 9:01 am
Saturday morning when I went to have a peek at Pulse: A Paramedic's Walk Along the Lines of Life and Death on Amazon, I noticed a one-star rating (the horror!). No review to go with it, so I don't know if the rating was a mistake or someone really hated it, or if there was an issue with the download/upload and they were "reviewing" Amazon via me. (And I would like to say that if it was you who left the star, you have every right to do so; reviewers leave reviews and they get to leave whatever reviews they please; they end.)
At any rate, that little one-star troubled me. And so I thought I'd do something a little unconventional. Because I personally don't think Pulse is a one-star read. And I don't think you'll think so either. Because of that, I decided to send a follow up email with one of the essays from the book. For free. Just for you.
Trigger Warning!: This book is about my husband's work as a paramedic. Because of that, it does contain troubling stories about injury, death, suicide, abuse, and other heavy topics. If you don't like to read about those things, it is probably not for you. We tried to handle those topics as compassionately as possible, but they are quite raw and real and we don't hide that in the essays.
Today I'm going to include an essay that has a happy ending (and a little humor), but also involves a diabetic who was crashing. If that's not your cup of tea, I understand.
"Mud Pit: Naked Diabetics and Other Wrestles I’ve Had"
We’re not cops. We don’t carry guns or Tasers or handcuffs. I didn’t come into this job expecting hand-to-hand combat. I expected old people, crying children, blood and guts, and even death. But I never expected to hold another human being down against his or her will. Because I never understood how significantly a will could be altered.
Over the years, I’ve held down addicts and drunks, head wounds and psych patients, people fighting restraints in a helicopter that could go down if they win, people struggling to pull out the very tubes that are giving them breath. Equal parts intimate and irritating, hilarious and heart-breaking, desperate and dumb.
***
The dispatch code comes in: “Diabetic problem.”
On a good day that means that we walk in, give the patient orange juice, and they’re fine within ten minutes.
On an okay day, they can’t swallow, but we give a quick IV with sugar water, which brings their sugar up in seconds; then they can eat.
On a bad day, we hold them down and start the IV. Not fun, but fast.
And on a really bad day, we walk into a dark room to find a woman on the bed—altered, combative, and stark stinking naked. I don’t remember sheets.
None of which is necessarily her fault. When the body’s sugars drop to a certain level, the brain suffers; it can’t function normally. And it doesn’t.
“Hey,” I say. “What’s going on?”
No response.
Okay, okay. Out comes the glucometer. “We just need to see your finger.” A quick prick to test her. She pulls her arm back like a stubborn child resisting a shot. But she’s not a child and she’s not really resisting. She’s in a different place. Her movements and actions could be those of someone dreaming, of someone haunted, of someone feral. Confused, disoriented, erratic, raw. It seems unfair to compare her behavior to an animal because in it is something so ragged and desperate, so deeply human. Just not the type of human ideal for sticking with needles. But stick her we must.
By this point, her sugar has dropped to a dangerous level. If it keeps dropping, she’ll eventually lose consciousness. And once that happens (even before that happens) the threat of death is real and close. It’s not our job in this moment to be judicious, compassionate, thoughtful, kind, patient, therapeutic, or even respectful (though I would argue that at the end of the day, saving someone who doesn’t want to die is all of those things). Our one job is to get her sugar up to a level where she can think, eat, live.
Which makes our mission statement simple: Save patient.
The implementation is a little bit harder.
I get the prick, test her sugar, but now she’s even less cooperative. Writhing, kicking, grunting. Our next job is usually to put a tourniquet around her arm, so we can clean her arm and insert a needle. Normally, we’ll tape it there and run a dose of D50 (essentially sugar water). However, she is currently swinging her arms around, rolling on the bed, twisting, thrashing. I make a grab for her; she jerks away. My partner scrambles toward her on the doughy mattress; she lurches and hits.
Have you ever tried to wrestle a toddler who didn’t want a shot? Imagine doing that with a 180-pound woman who’s nude, reckless, and . . . slimy. It might not seem like the nicest word, but it feels like the most accurate one. When the blood sugar drops to a certain level, the body produces an excess amount of adrenaline. This causes the obvious problems of fighting and attempted flighting. It also causes a whole lot of sweat. We struggle to get a hold of her arm; this woman is slick.
She’s in her bed, whipping her slippery body around. I crawl on and grab her arm, twist the tourniquet around it. But IVs can be difficult to stick even when a patient is calmly sitting on a table and not trying to punch you in the face. At this point there’s no way I can get out a needle and have things end well. We have to get her under control. You know, so we can give her the medicine that will help her get under control. (And that, Alanis Morissette, is what we call ironic.)
My partner—a huge guy—grabs at her other limbs, swatting and slipping until, eventually, he drapes his full 260 pounds across her legs and torso. A biblical-level struggle for a moment of stillness. I swab the arm, insert the needle (yup, I got it). Normally, I would tape the IV and let the medicine do its thing, but she’s flowing with sweat. No tape on earth is going to hold. Not to mention the fact that she’s pulling and squirming, trying to fight free; and I still want to get through this experience without getting elbowed in the nose, kicked in the crotch, or stabbed with my own IV. So instead of tape, I pin her hand under my knee, leaning against her arm and shoulder, gripping her tightly while I hold the IV in with my free hand. She wriggles and pushes, whimpering and moaning. Until she doesn’t. Regains herself. Sits up as my partner and I stagger away, sweaty and smelly now ourselves.
Naked and fluid-soaked on the bed, she is reborn. Plus forty years of embarrassment. Because newborns couldn’t care less about being in their birthday suits on a bed with two medical who-knows-whos standing in the room.
We hand her a blanket.
Our job done, my own memory clouds. I don’t remember what happens next. I can’t remember if there are family members there to help, if she gets dressed, if she thanks us or apologizes.
I know we don’t leave until she eats. The D50 doesn’t last forever, and we don’t want to be back in an hour.
Maybe a mother or son or husband brings her something. Maybe she rummages through the refrigerator herself. Eventually she’ll hold an apple or cheese stick or sandwich to her mouth—alert, alive.
We walk out the door.
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