Never cease to be amazed

The ER must be one of the most amazing places to work. You see some folks during what might be the worst moments of their life, or maybe the most embarrassing moment. It's amazing to observe how differently various people react to their own emergency. Some folks make a big deal out of something that seems minor, while a few rooms away might be a person who has a very serious condition, or an injury that looks like it must really hurt, but that person hardly lets out a wimper, or tries to downplay the pain or severity of it all. One old gent was cracking jokes left and right today while we were treating him. Really funny ones too, but now I cant remember them. Bummer! Then he started quoting Bible verses too, with the references. Good ol' boy. Feeble as he was, the old bugger was so much more full of life in his old age than some folks who come in with all kinds of depression issues and whatever else. I think every shift I see at least one or more patients with a completely different condition than what I've seen before. Anything. Weird rashes, unexplained seizures, trauma of all kinds, swelling where it's not supposed to swell, shrinking where it's not supposed to shrink, crooked where it's not supposed to be crooked, oozing or spewing where it's not supposed to ooze or spew, stinking in ways it shouldn't stink, and so on. You name it, we got it. I don't think you can ever possibly say that you've seen it all because we get so many different things that you never would have guessed would happen. People get stung, bit, burnt, stepped on, smacked into, pinned in, infected, dislocated, neglected, drunk, high, and who knows whatever else, and then they come to us by all means of car, truck, camper, cops, taxi, bus, ambulance, helicopter, covered wagon, or slingshot from afar. OK, just kidding about the last two. Something I saw in EMS is that if it isn't a major trauma, or something dramatic that required a lot of aggressive interventions, then it was dubbed a "boring medical call." Although it's great to be able to do that kind of intervention, I'm seeing more and more that figuring out what is really going on inside of a patient with a medical problem, not a trauma, is just as intriguing. Well that is easy for me to say, because I'm not the doctor or nurse doing all of that figuring out right now, but I'm learning a lot. I guess that's the difference between working in an ambulance where equipment, space, resources, and time, in some cases, to help you figure it out are more limited. I guess that's the difference of definitive care. Not to underestimate the capabilities of EMS - I still insist that EMT's and Paramedics do things that many nurses would tuck their tails and run the other way if they had to deal with - however, EMS still eventually transfers their patients to someone else to deal with it. This is where the rubber meets the road, where the buck stops, where the figgerin' out gets figgr'd. That's one of the things that we often wonder in EMS, but don't usually get to find out - what ever became of so-and-so patient? What were they diagnosed with, and how were they treated. It's good to be able to see both sides of the picture, both pre-hospital and in-hospital. Sometimes I wish I could follow a few cases the whole way from their onset of a medical or traumatic event through the follow up visits they do with their own physicians after being discharged from the hospital. Not a likely thing to happen. Oh well....