I am awakened by the chirping of my phone. It is dispatch on the phone. We have a patient. I get dressed, hastily brush my teeth, and head for the door.

We get to the airport and I am enchanted by the night sky. The dark outline of the aircraft is illuminated by moonlight. Its wings remind of an eagle in flight. I’m about to get a ride on the eagle.

We ascend to 15000 feet. The night is clear and I watch the world outside and I am enthralled by its beauty. The moon looms brightly in the horizon casting eerie shadows on long thin tendrils of clouds. The stars twinkle brightly tonight. I continue to watch captivated by the beauty of it all.

As we go in for the approach to the runway, we cut through the clouds.. The moon radiates an ethereal rainbow around it as it shows translucently through the clouds.. I wish I could capture this moment to share it.

The moon continues to play hide and seek in the clouds as we descend. I take a deep breath and sigh. How could I be so blessed?

The twinkle of lights from Wailkiki, the beautiful coastline of Honolulu meets us as we land. I thank God for another safe landing and for giving me another night at work to be very grateful for.

Wow! We’re actually in the air to go and pick up a patient!!!!

The skies were eerily beautiful the way the half moon threw light on top of the clouds and gave them a shadowy Halloween orange glow. The weather was clear and the humming of the engines is almost hypnotic in their steady whirring. Peaceful . . . tranquil . . . soul-soothing . . . Yes, I love my job! This is one of the many reasons why.

Breaking my nostalgia, I hear a somewhat staticky voice ask me something . . . somewhere . . . Oh, it’s not in my head. It’s my partner on the comm system and he’s . . . oh yeah . . . the patient . . .

It’s a young girl who is 29-weeks pregnant and is being transferred to a facility with physicians who can deal with her issues. Wait!!!! A what? A pregnant person? A girl? I mean, of course, a girl, but . . . uh, great! An obstetrics call! Ugh! My least favorite. Not my expertise. Uhm! Oh-kay! At this point, we know nothing. We know she’s 29-weeks pregnant and she is ‘sick’ enough to be transferred by air, apparently.

Oh great!!!!

Then my partner says, ‘well, if she delivers in the air, I can deal with a 24-weeker. You can take the mom.’

What? What????? Did he honestly say that???? He has lost his mind!!!

My response, of course, was (with great emphasis bordering on hysterics, I might add), ‘We need to get orders to stop any contractions and ask for sedation. We have to be very specific about the tocolytic (drug that stops contractions) and we make sure that we can get orders for pain control and, most importantly, some sedation should the patient need it because sometimes they do become quite anxious during flight and we don’t need a hysterical patient on board.’

I delivered that in one breath, of course, using my calm and collected voice befitting a crew chief, but refrained with difficulty to say, “damn it!” at the end of my speech. Hey, I was training my partner, ok?

Anyway, I got my heart rate almost to chest pain level and my blood pressure up to stroke parameters for nothing. Reminds me of a quote by Mark Twain: “I am an old man and have known a great many troubles, but most of them never happened.” Sometimes our fears get ahead of us, but I guess you gotta prepare for the worst and hope for the best. Yeah, yeah! The patient never had contractions and was being transferred for “evaluation.” Well, then.

You know, I shouldn’t complain. I wanted a patient and I got one. So there!

As we approached San Francisco International Airport, the lights of the city, on the Golden Gate bridge, on all the bridges, the bay . . . it was all worth it.

Yeah . . . I think I’ll do this again. I must have done something right in my life to be rewarded with a job like this.

Is it possible to be so bored that you’re so bored of being bored? I’ve exhausted doing every activity, task, project, assignment, and reading I could possibly do without going into a nervous breakdown to prevent utter boredom; yet, it is still hanging on to me like some nagging, annoying PMS cramp that not even overdosing on Ibuprofen is going to relieve. I am so bored that the fly that is persistently buzzing around our bananas captivated my attention (okay, for two seconds). I am so bored that interest has lost its interest.

At this point, I’d like to go into a drooling stupor just to forget that I am bored. I am quietly calculating how much narcotics it would take to get me into this placid, indifferent, mindless state without my brain and lungs disconnecting.

So, what do you think is required for us to do today? Watch a video! Awesome! At some point, I was wondering why I had a puddle of wetness on my flightsuit until I realized my tongue was hanging out and I was at risk of becoming dehydrated from the fluid loss I was experiencing via my taste buds. Had anyone walked in during the riveting learning video, they would have thought I had gone blind from the glaze in my eyes as I mindlessly stared at the TV screen.

Where are all the stupid people? I could always rely on them. They give me job security. They are failing me today. Is it possible that the world became so healthy, safe, and smart that there are absolutely no patients out there to require our services? Surely not!!!

Somebody nudge me or slap me or pull my hair. Let me know I am part of the physical world.

I think my brain has turned to melted butter.

Duhhhh!!!

Apparently, today, I’m a chicken!!!

The amazing thing to this story is he is a foster child. The cynic side of those who are in healthcare will suggest that fostering him brings with it some financial benefits. After all, his healthcare benefits are provided for and his expenses can’t be that much. No need for school clothes, shoes, not even food per se. I suppose that could be true, except his foster parents are filing for adoption. They want to keep him. Wow, right?

Even the harshest critic would doubt his initial opinion after seeing how his legal guardian interacted with him. “Dad,” as we referred to him, was very attentive to him. When the child whimpered or looked the slightest bit troubled, ‘dad’ was touching him, soothing him. When we got to the bedside initially, ‘dad’ was tenderly cleaning him and carefully dressed him warmly for the transport. He asked questions and ensured the child’s comfort. He talked to him with such tenderness and obvious love that even the hardest cynic’s heart will melt.

Meeting people like ‘dad’ strengthens my belief in the goodness of the world and the beneficence of the human spirit. I believe in the goodness of the human heart. ‘Dad’ was living proof. That call left me smiling and thankful that I am alive in this world and all is well.

He was crushed by a heavy loader equipment into a wall of landscape blocks. The driver of the loader was high on meth. That guy WAS fired. Was he charged criminally for anything? I don’t know. Meanwhile, this patient’s life is changed and will probably not be able to work for a while and that may or may not be financially disastrous to him.

Why DO bad things happen to good people? How does a hard-working, very nice, happy man have probably a year of productive life taken away from him by someone else’s stupidity? Life is not fair. It really isn’t sometimes.

Last night, he was out late again, partying with friends. He was intoxicated, high on cocaine, marijuana, and oxycontin. It’s just another night out of seven years since he started using drugs. Except that it wasn’t just another night. Last night, he remembered getting in the shower, woke up lying on the tub unable to move his legs and felt numb from the mid-chest down to his toes. His arms worked, but the sensation in them was dulled. His left hand barely able to grasp mine. I see the panic in his eyes, his anxiety escalating.

I wondered what my life would be like if I followed the same path he’s walking. I wondered what his life would be like if he never discovered drugs. As I held his hand giving him as much reassurance and comfort I could give him in the time I had to care for him, I wondered if he would ever walk again. I imagined that he must have a beautiful smile and an engaging laugh and I wondered if anyone will be fortunate enough to see those in the coming days.

I watched his eyelids flutter, his long eyelashes dancing as they met and my heart felt heavy wondering about his life barely lived, his potential unattained, the possibility of a life spent in wheelchairs or in long-term care dependent on others to live. I relinquished care to the ICU nurse and bade him good luck. He held onto my hand and thanked me. I left his room and as the elevator doors closed and the lifting mechanisms started their steady whirring, I stood silent and wondered. . .

Report starts at 0800, then daily equipment checks. Yeah, that’s not too hard . . . once you learn the equipment. Because, there’s the cardiac monitor – all three of them. Two, at least, are the same. All three have all these buttons and features and lights that blink at you, then they alarm if you don’t do anything within a specified amount of time. It can be very intimidating.

I pressed the Print button accidentally on the MRL and almost used up all the paper. Oh, yeah. That’s one more thing. One has to remember all the terms and names of the equipment. Like the MRL. What the heck does that stand for? I don’t know. It’s the cardiac monitor/defibrillator we use. Okay. Then, there’s the Propaq. It’s a heart monitor but NOT a defibrillator, so therefore, if we have to use that for any reason, we have to remember to take the Zoll with us. See what I mean? Lots to remember.

Then, there’s the LTV. That is our ventilator. Talk about buttons. And dials. More lights. More alarms. It has this really annoying beep. I’ve heard it in my sleep when I’m having a nightmare. OH MY GOSH!!!! <sigh> . Of course, you have to know stuff like Volume settings, or Pressure settings, PEEP, PIP, VTe, SIMV, TV, FiO2, etc. I am not talking about just knowing what they stand for. I mean, like, what they mean and when to use them and if it’s appropriate to change the settings and, aaaahhh! Yeah, then you have to learn to push the stupid buttons. Then you have to figure out how to configure the tubing and plug the ends to the right holes, then you have the connectors for monitoring stuff like EtCO2. Oh, yeah, there’s a little dial on one side, too, that you have to learn which way to turn. See? More stuff to know.

And then the Minimed. What the heck is a minimimed? Why can’t we simply call it an IV pump? Every nurse knows what that is. Anyway, that is the most annoying piece of equipment ever. That damn Air in Line alarm!!! One night, we accidentally used one of our IV pumps as a basketball. Oops. I wanted to feel bad, but maybe it was the best thing for it. I’m just kidding. Those stupid minimeds! I hate them but, at the same time, I love having an IV pump for all my infusions. <sigh again> Oh well. . .

So, there’s learning all the equipment, then there’s learning aviation-related things, too. You know, I always say this because it’s true. My knowledge of aviation is I know the difference between a helicopter and an airplane; and I mean, by what they look like. Anything else after that, I have no idea. Have you ever looked at the control panel of an airplane? The entire pilot cabin area is full of dials, and gauges, and levers, and buttons, and arrows pointing . . . directions . . . Then there’s the foot pedals. You use them to turn left or right or brake. How confusing is that? If I had to go from flying an airplane to driving my car, I’d get confused and try to turn with my feet while in my car. That’s great! Instant rejection from every car insurance. And the steering wheel (oops, yoke) . . . it goes right or left or up or down . . . yeah, that’s not confusing. . .

Oh, yeah. The levers, too. I have enough trouble remembering B, R, D on my car’s steering wheel. Sometimes, I screw those up, too.

I finally learned to not walk into a propeller. Not that I have, but I probably would have. Thank goodness for the pilots. They’re really good at steering me in the right direction – like away from the propellers. Yeah, those spinny things.

Then there’s the clinical stuff to learn, and protocols, policies, etc. My brain is exhausted. I might have killed all my brain cells.

How totally weird is that?

During the course of a patient run, we introduce ourselves to so many people – ambulance crews, other nurses, doctors, patients, patient families. The list grows. So, I worked with Ruth again the other day. When Ruth and I are working, our usual introduction run: “Hi, I’m Ruthie and this is my partner Ruth.” We get the usual, ‘oh, how cool!’ smiles.

We went to a small little town in the northern tip of California a couple of days ago. While loading our gear onto the ambulance gurney, the EMTs introduced themselves and, what do you know. One of them is Ruthie. Going up to the patient’s room, we introduce ourselves and, imagine, the amusement on everyone’s faces. Then the unit manager came in to say hi and her name is Ruth. So, now, in the tiny little room, there were two Ruths and two Ruthies. How totally weird is that?

Our patient, who was pregnant, suddenly felt obligated to name her baby Ruth.

Sheesh! Just when I was feeling so unique to the world . . .

A quiet airport?

We were in a tiny airport one morning. On our way in, I noticed that there were houses along the sides of the runway. The pilot and I sort of joked about the values of real estate these days. On our way out, I noticed a sign on the side of the runway. It said: Please fly quietly. Fly quietly? I looked at the pilot and asked if that was possible. He said, ‘Sure. Would you like to go outside and push the aircraft? Point taken. Well, what’s up with the sign then?

Calling the kettle black

We went to pick up a 2-year old this morning (like at 1 am, when I had just fallen asleep). I was told that someone wanted to ride along with us down to the receiving hospital. I thought it would be mom. As I approach the door to the patient’s room, someone comes out and I cheerfully asked if she was mom and if she was the one who will be riding in the airplane with us. Whoever this person was, she venomously said, ‘No. Mom’s at home passed out drunk.’ Whoa! Oh-kay! As I go in the room, I am met by another person and, undaunted, I ask her if she was the one who will be riding in the aircraft with the patient. When she said, yes, I asked how she was related. I found out she’s grandma. So, I got that settled.

I found out that my angry greeter was the aunt. I mulled over that because her tone suggested she did not approve of the patient’s mother and it was certainly full of judgment and resentment. It was perplexing to me because the mixed toxic fumes of alcohol and cigarettes on her breath and skin made me nauseous. It made me wonder why she was so angry. Maybe she was having a bad hair day. I know I was. The stupid headsets we have to wear really craps out one’s hair style.

Pilot joke

I was at the bookstore one day and, while I was browsing, some guy comes over and tries to make small talk. (Okay, he was trying to make a move). It wasn’t working out for him, so for his final run, he tells me he’s a pilot and he’d like to take me flying one day. Yeah, ok. Thaaat’s nice. I work with pilots so it’s not like I’ve never seen one. I went out with a guy who piloted his own airplane. So, what makes you special???

Anyway, not to be a b*tch or anything, I said a polite ‘No, thanks’ and continued looking at the book I was holding: “The bullsh*t men say to get you on a date” (Okay, I made that one up, but, well, there should be a book like that. Maybe I’ll write one.)

So, here’s the joke: How do you know there’s a pilot in the room? Answer: No worries. He’ll tell you.

Okay, one of the nurses and I laughed at it, but at the risk of hurting the feelings of our pilots at work. We didn’t want to do that, so we just giggled to ourselves. I like all our pilots. They’re so calm and laid back. And they’re fun to work with. The thing I admire about them is that they are on such even keel in any situation. I love even-tempered, positive people.

I was on a flight with a couple of neonatal nurses. One was a nurse practitioner. She was a total grumpous. Our pilot that day was one you want to work with when you’re feeling blue. He can cheer up Eeyore. That takes some talent. It was a beautiful day. The weather was perfect. The view all around was majestic. Our pilot comments on how very pretty the day was and what a wonderful day it was to fly. The nurse practitioner comes back with, “Yeah, it would be even better if we can see through these dirty windows.” I turned and told her to turn the little knob on the inside window. The windows are tinted. When you turn them one way, they go dark. You turn them the other way and it clears up. It’s actually pretty cool. It’s like a built-in visor for your windshield.

She turns the knob, looks out, and says, “Oh. It’s still not clear enough.” Wow! Speak about glass half-empty people, huh? Maybe she has PMS. Maybe.

When we got to the airport, the EMTs who picked us up were grumpy and defensive. What is up with that???? It took a little bit longer to be at the bedside with the baby. The EMTs came in the room and told us they were leaving for ‘a little bit.’ I asked where they were going, only because I noticed it was lunch time and I thought they probably wanted to go and eat lunch. Since we still had a couple of procedures we had to do, I asked where they were going only to find out if they were going to lunch so I can tell them not to rush. Instead, when I asked, the girl EMT said and not too nicely, “We’re just going to the cafeteria. We’re not far.” Wow! Why so defensive? Go have lunch already. Maybe it will help your disposition.

As an aside: sometimes, it’s just a question. Don’t be so freaking defensive. Maybe someone asked you a question for your benefit, not to question YOU per se. Get a grip.

Anyway, between the nurse practitioner and the EMTs, the day was becoming bleak and dreary. For them, though. For me? Whatever. I had many more hours to go before my shift was over so I couldn’t let those negative people ruin my day. They have bigger issues. I had Hawaiian barbecue dinner to look forward to. Yummy!

Stay away from grumpy and negative people. They are toxic and contagious.

You know, that is one way to conserve oxygen. How thoughtful of the guy who designed that. I mean, that’s keeping it very simple, right? No breathing equals dead person. Dead person equals no oxygen needs. Yeah, makes sense to me.

For some reason, that is not comforting to me.