The Man - Check it out!

Three calls today. A man who dropped a steel beam on his foot and smashed it. A minor MVA with neck pain, and a school child who had an hour long episode of lethargy, not unlike a postictal state, except there was no witnessed seizure. We gave the first guy morphine, we boarded the second, and just provided supportive care to the boy, who returned to alertness with us.

Our White Cloud nurse rode with us today so I was glad to see she got three calls.

***

The steel beam guy was sitting on the cement floor when we entered the warehouse and he looked to be trying to hold back tears. I took his boot off and looked at his foot, and, at first, it didn't look too bad to me, then he said, "My toe don't go that way." His big toe was a little bit askew and when I took off the other boot and compared, it was obvious. One big toe was pointing at twelve o clock, the other at almost three. It also looked flatter by about a third. It hurt when I touched it.

We got him in the back, and I asked him how bad his pain was and if he had any allergies. I like to be aggressive with pain control. He said he was okay. I offered the morphine again, and he said, "What's it going to do? Put me out?"

"It's just going to take the edge off," I said.

"I don't want any needles," he said. "I'll be all right."

So I let my partner tech the call. My partner later told me as soon as I stepped out of the back, the man said, "This pain is baad!"

Fortunately, on our way to the hospital we passed the ambulance quarters where I saw the White Cloud, our nothing ever happens when she works paramedic student. I waved to her to hop on, which she did. I started back toward the hospital and not a minute later I saw a car barrelling up behind me, trying to pass, then driving along side me like we were neck and neck at Daytona. I glanced angrily at the driver and saw in the passenger seat my 8:00 partner. So I pulled over -- there were no other cars on the street, and I had her get behind the wheel, while I went in back, and the tech in back got in her car and was driven back to the base so he could go to his other job.

So now in the back with the medic student, I had an opportunity to press the guy again on his pain, and the both of us were able to get him to agree to get a little relief, so we gave him 3 of morphine. I was planning to give him more, but he felt a little flushing with it, and so refused anymore. By the time we got to the hospital, the pain was getting even worse.

It turns out he broke his foot.

The point of writing all this is so many patients try to be stoic at first. And while I am much more aggressive with pain management than I used to be, I need to be more so. There is no need for people to suffer trying to be macho.

When he said to my partner that his toe really hurt when I got out of the back, my partner said to him. "Dude, you just told him, it didn't hurt!"

He could tell my partner about the pain, but not me because I was the authority figure -- the Man.

But the Man needs to do his job and sell drugs to his patients that they need.

"Hey Check it! Check it! I got Blue Star, man, Blue Star. Ths stuff is premo, premo, man. Code Three rating, man. I got the best, right here, man, right here! Check it! Check it out!"