ON EFFING UP
One time, when I was a brand new medic my partner and I gave the wrong medicine to a patient. It saved her life anyway but both meds in question were narcotics, the most regulated drugs ever, so we ended up getting dragged downtown to explain ourselves.
The lady was succumbing to a bout of Acute Pulmonary Edema- a situation I've talked about a few times on this blog that involves the failing heart backing up fluid into the lungs, essentially drowning a person inside themselves. You can have it just a little bit- your lungs sound like a straw sucking out the last bits of soda around wet ice cubes- but it can also flash flood and pinkish fluid will gush up your airway and asphyxiate you. Plus, if you're old, even having a mild amount of fluid can cause so much respiratory distress that the body will quickly exhaust itself with the effort of each breath and give up. This lady was a few minutes away from crashing. The fluid was at the top of her chest and would come pouring out her mouth any moment. Her eyes weren't focused, her body was doing that spiraling down the toilet bowl swirl that I tell my students to watch out for.
My partner and I had spent the day having a friendly debate about Morphine, cuz that's what bored medics do. We use Morphine in that situation to help open the veins up and lower the blood pressure, which is usually through the roof in APEs. It also has the added benefit of sedation, which allows you to intubate, which is what this lady needed because she was about to stop breathing completely and a tube down her throat'd be the only thing that'd keep her alive. When my partner called up the Online Medical Control people to get permission to use narcotics, he asked for Valium and they gave it to him. Valium is a sedative used specifically for the purpose of knocking someone out so you can tube 'em. But Morphine musta still been on his mind, cuz that's what he handed me and that's what I gave the patient, although neither of us realized the mistake until after everything calmed down.
The thing about knocking someone out to tube them is that then you HAVTA tube them, cuz you kill their respiratory drive too and that's already low. And the thing about tubing a living person is you can see the weird little inner mouth that the vocal cords form and watch them open with every troubled breath the patient takes. And you wanna open up that airway, see the cords and then sit there poised with the tube ready to stick down there at just the right moment. It's like some creepy Indiana Jones/William Burroughs insanity, but we love that mess as I'm sure you've realized by now.
Anyway, I opened her mouth, took out her dentures, got all up in her airway with the tube ready, holding her tongue out of the way with a metal blade, and watched the cords open, close...open...close...open and I pushed the tube through and secured it in place. It was in, confirmed, solid, %100 and we triumphantly zoomed off to the hospital all happy happy that we'd saved another life.
Until we realized we'd given the wrong sedative.
Anyway, like i said, we ended up downtown at EMS headquarters to explain what we'd done. My partner was the senior medic and he did most of the talking. He said- Look, we did mess up and give the wrong med, it was a very hectic scene, the lady was crashing and we were under pressure and we messed up. That's it.
There's always one EMS lieutenant they bring to be a total dick and then a doctor who's mad coool (that was the only time I've been but everyone tells the same story)- the Lieutenant basically was like "Well, you're job is to deal with stressful situations and not mess up. So that's no excuse at all."
And, much as I hate hate hate to agree with a lieutenant, the dude had a point. First of all, we deal with all kindsa situations and an old lady dying in front of us was really not the peak of insanity. She was on the bus, so it was a controlled atmosphere. Plenty of times it'll be the same thing but there'll be children crying for us to make mommy breath again, fire men crapping themsevles, angry husbands cursing us out, threatening our lives, crazy frothing dogs, cocaroaches, mice scurrying around, gettin in our equipment, endlessly cluttered apartments with no room to move in, let alone spread out and work up a cardiac arrest. PLUS, dirty needles, electrical volts, freakazoid partners, white supremacy and patriarchy...anyway, you get the point. We deal with stressful situations. It's what we signed up for. It's what we joke and carry on about at the bar after work. It's part of what we love and hate about the job. And we all will and have made mistakes, it's also a part of the job, we're not super humans, but to ask for an out because the situation was hectic is to ask to be told: That's your job. Do it.
I say all that because EVERY time, every DAMN time, a cop effs up and shoots an unarmed man of color, you get the mayor, the police chief and a hundred different union reps and apologists screaming and crying about the line of duty and you don't understand what it's like to possibly have a gun pointed at you. (or a wallet). And it's true, I don't. Nor do I want to. That's why I chose the job I chose. But for someone who chose to be a cop, they've taken on the responsibility of living in the cross hairs and having the power of death at the whim of their trigger finger. That you were in a stressful situation doesn't get you a pass; it's not the go ahead to go buck wild. Especially because it's probably those same stressful situations that you go bragging about at the bar, that you roll your eyes and shrug off about at parties when someone asks you about the craziest mess you've had to deal with.... For both PD and EMS it's those challenging moments of the job that makes us love it, which means we don't get to run back and hide underneath them when things don't go our way.
End rant.