ASD.. Don't know what it is... Just ask me, I'm an expert!

I know a lot of autistic adults.. in fact, you might call me an expert on them....

Since moving to a more rural setting some time ago, I have noticed the prevalence of Autistic Spectrum Disorder amongst my 'peers'...  Obviously these folk haven't been formally diagnosed... but with my extensive experience I can spot 'em at 50 paces.

ASD is typically characterised by a number of 'issues',
1/ social interaction
2/communication
3/restricted, repetitive or stereotyped behaviour interests and activities

The majority of people I have worked beside 'in the country' have fallen into this definition.

I have been asked to move an ambulance eight (8) times, only to end up back where I parked it in the first place, and when I had the audacity to roll my eyes and ask, 'Where would you like it?' (I had several dark, anatomical places in mind!) the person barking the orders adopted a sarcastic tone and said, "What do you think?"

What do I think?  What do I think?  I think where I had it parked in the first place was best.  It was easy to get the stretcher in and out, it was safe, and it was 10 feet away... that's what I think! But instead, knowing I was dealing with yet ANOTHER undiagnosed ASD sufferer, I just replied, "Whatever's easiest for you, buddy!"... I even had the patients husband come up to me and tell me to 'just do what he says as 'some men are ALWAYS right!'... Embarrassing?  A bit... but I am getting used to it.

Another colleague felt he had to tell me to 'slow down' on the freeway.. it was a straight bit of road, daylight, dry and I was doing 120kms... He was male and I am not... Clearly 3/ Stereotyped behaviour.

Lately I have been working with the 'Barker'.  I am not to interact with the patients at all... I am to 'Get the Bed'.  'Get the bag'.  or 'Get ready to go'.  This suits me fine, except when I am supposed to be attending to the patient and writing up the paper work!  

Things are just done differently when isollated.  Drugs go out of date, people forget their manners and common place checks are ignored.  A Station Officer once told me not to replace a half empty oxygen cylinder, "Patients need VENTILATION NOT OXYGENATION", he had said. ( WTF???????)

I worked with a couple of 'instructors'.  Both were amongst the most uncommunicative people I have ever met.  I asked for clarification on a couple of clinical issues, and was told to 'look it up'.  Another, I asked where the shoe polish was, and he took it as an opportunity to put me down in front of a couple of other peers.  It made me feel small.  Obviously, he was compensating for something!

What goes around comes around.  Do you ever find yourself wondering what sort of childhoods people had?  If my instincts are correct, they are a motley bunch with bad histories....

Thats the kind of person this job attracts.  The moody, objectionable, sometimes helpful and loyal types.  It is a fine job.  And it takes ALL types to get it done right, most of the time.   

  

The 'EMERGENCY' services...

I got pulled over for speeding the other day...  Most days, if travelling in uniform, the copper normally smiles and gives you a warning.  But yesterday, I was not in uniform.  I WAS travelling home from a long shift, and I had my mind on getting there quickly... I must have subliminally sent that message to my accelerator foot.. and then there was a black car right up my tukus.. and then I saw the lights flashing... 

I pulled over on the verge of the highway.. nose in to protect the officer from passing traffic.  He informed me of my alleged speed.  I squirmed.  I always feel guilty when talking to our states finest... Even though I am a boring, obedient citizen.  I tried to think up an excuse.  I hesitated over my work I.D, hoping he'd notice I was an ambo and let me off.  No, this time I was gonna cop a fine.  And then he walked to the front of my car, and I couldn't see him for a moment.  In that instant a brief flash of relief as I pictured an unconscious, uniformed man in front of my car... one I could reverse away from and skip the fine... One I could administer life saving techniques on, and skip a fine... One I could... and then he stood up. Damn!

'Your tyres are bald, unsafe.  I have to issue you with a defect notice', he gloated.  
'Asshole', I thought.  My poor car had travelled many, many kilometres in the name of duty, and had hit several roos, magpies and a wombat.  I have been saving for a new car for a while, so when my partner offered to repair the front light with cable ties and 100mile tape, why would I object???  I was starting to regret my 'thriftiness'.. 

'Please, please, please don't make me get a road worthy,' I prayed to a God I don't believe in.  

'Just 2 tyres this time', the wonderful officer said.  I coulda kissed him.

Today I went to get the new, secondhand tyres. (Did I mention how thrifty I am?)  The small town tyre joint couldn't fit 2 tyres til next week.  I was horrified.  I had hoped I could get the defect notice taken off my car before the weekend road trip I had planned.  I gave my best smile, and 'come to bed' eyes (usually reserved for my hubby on Saturday nights)... but this tyre fitter was made of stone! 

'Not til Tuesday' he said.  

"No worries- just don't expect me to drop everything for you if you need ME, one day when I am working!" I thought...  I am like an elephant that way... never forget!  To his face I just smiled and thanked him anyway.

I coasted around to the other tyre place in Smalltown.  The dusty old manager there was more than happy to help me out.  He found two secondhandies, and sent me to Vicroads to make the appointment for the inspection.  Appointment made, tyres replaced, defect removed.

Life is GOOD! (And I WILL NEVER, EVER TAKE morning tea to Smalltown copshop EVER again!  

You must see some terrible things...

I fell into being a paramedic... I had been a back-packer for 4 years, and came home with nothing.  I didn't even have enough money to buy a coffee at the airport while I waited for my Dad to meet me.  It was hard moving back in with my Dad and his wife, after going where I wanted, wherever the wind blew...  I had changed while I travelled around the world, I'd had experiences, met people, seen things.  I came back an adult, different... it was hard to find my place here. 

I worked a couple of different jobs, went out with friends, met a guy, married.  Followed him and his job interstate.  But I couldn't settle.  I was lonely.  We got a dog and it helped.  But when my hubby was away, I felt sad, depressed.  I had no sense of belonging, self worth.  I wanted to connect, be a part of something.  I wanted to matter to someone. I gave up on my marriage and left it behind.. (with a fabulous bright yellow casserole dish which I have never seen since!)

I started again. Not alone now, with a dog.  I answered a few ads for jobs in the Saturday papers, (thats how things were done back then!) and as fate would have it, I went for two aptitude tests on the same day. The morning test was for a large international company that planned on opening a casino, right in the centre of town.  I had grand visions of 'high rollers' and croupiers and had a applied on the off chance of getting a gig.  One of my friends had started 'stripping' to pay her rent, and another worked in the 'typing pool' as she called it.  (She was a 'tranny' and the 'pool' was a brothel.. but it was the 90's!)  I had no talents in either of these 'crafts' and had to turn my attentions to more mainstream jobs.

The second test, the same afternoon, was for the ambulance service.  There were hundreds, and hundreds of people there.  I later heard that 3000 people sat that test, that year!  I didn't feel nervous sitting the test.  Most of the questions were the same as the morning, so it was easy for me to whip right through it.  I answered every question with 8 minutes to spare.  I felt good about it when I left, but I had no idea what my future was going to be.

It took about 2 weeks before I received the letter to say that I didn't get a high enough score to become a croupier in the fabulous, stupendous, most dazzling casino in the southern hemisphere.  I wasn't heart broken.  I had an ignorant optomism back then about life and windows and fate.  I waited to hear from the ambulance service.  I got a job at a high profile tourist place, even got to be a 'manager' when she went away.  I also got 'head hunted' by a local sporting shop, who I had enjoyed hanging out with in my spare time.  They offered me more work and training... how could I say no????  

So after 3 months of working and playing I finally got a letter saying, 'Congratulations- you are going to be one of newest paramedics!' It was hard to believe.  I sat the test for 2 jobs on the same day, but I didn't get a high enough score to be a card shuffler.  Instead I was to become a PARAMEDIC!!!!  I knew from that day, that I would retire in this job!     

The strength of 3 men

I have been in this job a long time.  When I first got here, I was only one of a handful of women.

It was difficult being female in a 'man's' domain... Yeah, yeah, I hear you fellers out there sighing and rushing to reach for the mouse so you don't have to hear about how inequitable things were... but before you go, know this.  The ambo role is becoming a womans domain.. the tides are turning, and now there are 1.5 females joining to every male.  The uni courses are 3:2 in favour of women.  Paramedics is the new 'Nursing'.

I got responded to back up a crew.. they were 50 kms away, and doing CPR according to the radio update.  I heard the patient had been driving to hospital and arrested.. the first crew on scene were treating.. it didn't sound good.  A full resus, in a car, in the middle of the night, on the road, 50kms from hospital.  Occassionally I get a bad feeling on the way to a job.  This was one of those days.

I pulled up to find the rear doors of the ambulance open, the flouro blazing as a diminutive female paramedic pumped up and down on this mountain of a man's chest.  From the drivers seat, it did not look good.  I alighted my vehicle in awe of the ambos who'd managed to get this enormous man from the drivers seat of his car, to the stretcher, and loaded into the ambo.  They were doing their best, breathing for him, and pumping his heart for him...  but he wasn't responding.  He had IV access, but no response to 5 doses of heart starting adrenalin.  If this had have been a hollywood movie, he would have been sitting up, smiling and shaking our hands by now... but this wasn't... and he wasn't... and then I noticed his wife.

She was tiny, scared looking, like one of this timid native marsupials.  She was pale in the light of the van, and shaking.  She tried talking, her mouth moving, but the words didn't come out.  She was frightened.  In shock.  I glanced again at the crew working on the patient and decided to turn my attention to this woman, this bird.  Are you related to him? I asked.  I tried to be gentle, almost whisper the question... but at these times it is paramount to consider the patients rights to privacy, and respect the law. 

 'Yes, he's my husband, Jim' she said.  I looked back at the ambulance, I read the crews faces and decided to break the news to this woman.  'It's not looking good for Jim', I said.  As soon as I said it, I regretted it, and this woman, this wife collapsed into my arms.  It is a hard job sometimes.  It's hard to be professional, cold.  It's hard to break the news... and it's hard to pass on the info that we have no hand in dealing. 

Jim and his wife were holidaying.  Their first break away together, without the kids, in 20 years.  They were learning to love each other again and were just starting to relax into their 6 week holiday.  Jim had been feeling so good, that he had decided he didn't need his medication anymore.  His life saving medication and as a result  he died that day.  

I often see things that make me race home at the end of the shift and grab my kids and hug them so tight, they complain.  This was one of those days.  

So this is Christmas..

 Being fairly young in the job had it's advantages... The older men tended to 'look out' for me.  I don't deny there was a 'men's club' mentality, but on the whole, the male paramedics I worked with were all reasonably good blokes. There was this unwritten law that I just did whatever they told me too... and I was okay with that.  

So when I was told to bag up a chisel and get some ice for the stumpy bit of skin that later turned out to be a penis, I didn't give it a second thought!

It turns out that most men are quite precious about their 'dangly bits'.. unless it's Christmas Eve and the voice in your head tells you that Jesus wants you to cut off your penis with a chisel.  

I thought it was an interesting job.  I had never seen a chisel before!

He Died Like Elvis

He Died Like Elvis.

We got a call to one of those high density public housing buildings... I am always nervous in these joints.  The lifts are too narrow to fit the stretchers in, and the bulk of these patients are either mental health patients or badly managed chronically ill.  They tend to have an apathy for life that is hard to understand... I find they are unwilling to fight for anything.. let's just say, they are the 'passive people' of society. 

The last time I had been to this place, I had attended a young lady who kept a pony in the living area of the flat.  It was really, a full size pony... and there was pony poo everywhere... but I digress...

Today the call was for an unconscious man of unknown age.  For the first time in a long time, we had someone from the 'office' to accompany us to the patient.  This almost never happens, and it seemed odd at the time.  As we made our way up in the lift, the staff member shifted from one foot to the other... uncomfortable, uneager.  I told him he didn't have to come in with us if it made him uncomfortable, but he stoicly opened the locked door of the flat and entered before us.  

We looked around, looking for the patient. The flat was tidy, bare and dust danced lazily in the sunlight coming through the sealed windows.  We were directed to the tiny bathroom of the flat, and there, half sitting, half leaning on the wall was a dead man.  He died in the same way Elvis had.  On the toilet.  Pants down.  But this man had been there a while.  His feet and ankles were swollen and purple.  His head, touching the cold wall, had turned black, and his glassy, glassy eyes, half open were no longer shiny marbles, but flyblown and unseeing.  It made me sad to think that he had died this way, and no-one had known for days, maybe weeks.

I turned to the staff member, suddenly realising his discomfort.  He had known in the lift, but couldn't say... and you know what?  I was okay with that.

As we left, without touching anything, within minutes of arriving, I noticed something sitting on the bookshelf near the window.  I walked closer to it and realised it was a small birdcage.  It wasn't until I was right beside it that I could see the green budgie, stiff, legs in the air in a final salute...  I thought about that budgie for ages... it bothered me.  I imagined the little feller chirping for food for days before his body finally gave up.. just as his human Dad's had.  But do you know what I thought about more??? 

 What if the pony owner had died without anyone knowing? 

A NEW DAY IN A NEW PLACE..

So I drive into the place... it's deserted, in a deserted town... not the middle of nowhere.. but I can see it from here...  What will today hold? 

One of the things I love about being a baggy arsed ambo... is the variety of work I do.  Day in, day out.. each day is different.  An adventure.  Today I am in the 50's... this place is MADMEN territory.  Even before I open the door to the old brick joint, I can feel the asbestos busting to break free.  I am not disappointed when the wave of stale cigarette smoke hits me... it is the perfect accompaniment to the cliche of this joint.  There is an old 'OFFICE' sign above the door..  what was this place before it became an ambo station???  A motel???  I shudder to think of the travellers that once called the house 'home'. 

Before I can find the truck, the drugs, the radios.. the phone rings.  A voice barks at me, "Why haven't you logged on yet?  I've got a job waiting for you... Get the drugs and get out of there".  

'Good morning to you too', I think... I start to explain that the drugs are MIA and the truck is unchecked... but the voice of todays 'God'... booms, 'Just get out there!!!'.

I set my personal GPS to the address of the patient, log on and find the truck.  Pretty soon I am on my way to the 'real' middle-of-nowhere... backing a couple of underpaid and overworked community officers.  I push 140kms/hour, trying to beat the estimated travel time of 57mins according to my battery operated companion... I hesitate for just a second at the 'Dry road Only' sign... and pull up, brakes smoking with just 3mins to spare.  

My patient is old... not old by a teenagers standards.. old by an 'ambo's' standards.  He has the features of a person not long for this town and that smell.... but I digress.  He is well enough to wiggle a line into, pop up some fluid, and keep him alive until our arrival at a large regional hospital.  

I always chuckle to myself when I roll a patient into an emergency department and the staff say, 'We weren't expecting you'.  I never really know what they are expecting me to say to that... 'Really, well we'll go somewhere else then?'  or 'Didn't my staff let your staff know we were on the way? or "I'm sorry, but I DID see an EMERGENCY sign out the front didn't I???  Or is this just one of those non-treating hospitals???'  

Patient unloaded, urine voided, paperwork printed, and on my way again.

I finally get to check the truck and it's ancient contents.  No SPO2 monitor for these folk... They do things the 'old fashioned way'... if it's gasping/blue/ACS, put oxygen on it, otherwise... leave it til it IS gasping/blue/ACS.  Only 5 different drugs out of date in need of replacing (the worst being the 14 months past due date aspirin- but that's not an important one anyway).. I empty the heaving bins, replace some gloves and take my community officer back to her branch.

Finally back at 'Motel 6' I get to restock properly.. have some brekky and chill til the next 'BIG ONE'..