A Dominican Ambulance Story

Disclaimer--I have changed the name/patient info in this post to keep it Hippa-compatible.  It is based on a true story though. 

Let me preface this past by saying that I have tendency to be what people in EMS call a "black-cloud." This means that when I am on shift, I tend to get a lot of calls and/or fairly serious calls. Of course, this held true when I was working my last shift of the semester.  While I was studying in the morning, I had a nagging inkling that I should charge my phone but of course I didn't. (This came back to haunt me around midnight.) After a quite first 5 hours of my shift the phone rings and my adventure starts.

At 4pm the phone rings and I have a panicked person saying they someone was hurt from playing sports.  So I call security and have them head over to the health clinic to pick me up and then we go off to pick up that patient.  We successfully get back to the clinic and start to examine the patient.  Soon I realize they have a dislocation.  The supervisor and the doctor come to the clinic and we rest the dislocation but soon realize that there might be a possible fracture.  Which means a road trip to Roseau, the capital,  in a Dominican ambulance. We had to to go to Roseau because the hospital there has the only working X-ray machine. Since I was the low-man on the totem pole, I was chosen to go with the patient.  (Thankfully the doctor gave me motion sickness medicine. Of curse the medicine didn't kick until we were 10 minutes away from the hospital).

Ambulance Journey: I walk outside the clinic and see an ambulance which looks a lot like the ones from the 1970s.  The ceiling was so low that my head touched when I was sitting on the bench in the back. ( By the way, the bench was made out of plywood held onto the side of the vehicle by a hinges.)  We got loaded up and headed on down the road.  Going lights and sirens confirmed the fact that I do not like the roads here.  At one point, I was worried that I was going to throw up on my patient because I was so carsick.  I was practically green because I was so nauseous. My poor patient was in tons of pain from all the potholes, so we made quite the team.  My favorite part of the drive was when we got stuck on a one-lane bridge because of parade (all I could see out the windows was a car covered in balloons, tons of people, and of course the odd smattering of goats).

Hospital: Whew. After an hour ride, we arrived at the hospital's Casualty Unit (aka the ER).  I consider it a successful journey because I didn't throw up on the patient and my patient didn't pass out from pain.

7pm--We are able to go to our "room."  Normal ERs have individuals rooms for the patients, this hospital had one small room sectioned off into 5ft squares by curtains.

7:45pm--We go to Xray waiting area.  I realize my phone battery is basically dead.

8pm--X rays finally get taken.  We are told to go stand in the hallway and wait for the doctor to see us.

8:15--A guy comes in covered in stab wounds with his head wrapped in a bloody sheet.  (I am beginning to realize we are going to have a long night ahead of us). We are still standing in the hallway.  One of the other patients standing there with us almost faints because of the stabbing victim.  I call the doctor back at Ross to let them know we are going to be a while.

8:45--Still standing in the hallway.  We hearing screaming from outside.  From the level of screaming, I figured this person was going to have something seriously wrong with them. Nope, it turns out they just wanted to be seen faster.  Of course it worked.  I turn my phone off to conserve battery but now the Ross Doctor can't contact us.

9:00--Still waiting and standing.  I don't know how my poor patient is surviving this ordeal. The pain must have been awful.

9:30--Go in to see the doctor.  The doctor said "well, its broken." (Now the patient and I had already looked at the X-ray. We knew it was broken.  A clear, obvious fracture straight through the bone.)  And then she asked the dreaded words..."Are those the only X-rays you had taken? You were supposed to get two others."

9:40--So we had back to X-ray.  The X-ray techs were changing shifts so we wait.  While waiting, I had a crazy guy mumbling to himself on one side of me and on the other side was a super sketchy police officer who kept hitting on me. At least there were chairs in the X-ray waiting area.

10--Get the X-rays done.  My patient is given more pain meds.

10:30--See the doctor.  She says that the patient has to come back on Monday for more x-rays and to see the head of causality unit. We ask if the orthopedic doctor will be there.  She said he might be there. If not, the patient will have to come back in 2 weeks to see the orthopedic doctor.  In the meantime, the patient was told to wear the improvised sling that I had put on earlier in the evening (it was made out of a triangle piece of fabric and an ace wrap).

11:00--Talk to the nurses about heading home and their response was "well, you have to wait for the other patient from  Portsmouth to be seen. Then the ambulance is going to take the two of you back with that patient and with his nurse".  I ask the nurses if there is any water or vending machines. (I hadn't eaten since 10am and neither my patient nor I had anything to drink.)  We were told there weren't any vending machines but they gave us a glass of tap water for us to share. We were then told to stand and wait for the other patient to be done.

11:45--Still waiting and standing. Creepy police officer comes back and gives me his number. He then goes on and on about how I can stay at his apartment whenever I come back to Roseau.  He wanted my number (There was absolutely NO way that was going to happen.) I told him that if he needed to reach me he could call security on campus.  Needless to say he wasn't too happy with that option.

Midnight--Crazy frustrated by this point in time.  I go to ask the nurses if there is a taxi to take us back.  They said our only option was the ambulance and told me to go back and wait in the hall.  They then closed to the door on us so we were stuck standing in this empty hallway.  I find an old gurney for my patient to sit on.

12:30am--Turn my phone on to try to make one last attempt to get us home ASAP--I call campus security to see if they have any idea how to get us back.  They said they couldn't come because they only had one patrol car running that night.  So we wait some more.  Remember, this whole time I am standing.  The nurses still refused to acknowledge our presence.

1:30--We FINALLY start the trip head back to campus but the ambulance situation is less then ideal.  The patient from the knife fight is in the stretcher, my patient and I are squished on the plywood bench (The nurse got the comfy front seat).  At least the drive back was relatively quick (I think I dozed off a couple times between hitting speed bumps.)

Back on campus: We get back to campus around 2:30 and I send my patient home with security   Of course, when my first patient left, I have a new one come in.  Thankfully that call was done within an hour and I could finally go home.  I got back to my apartment around 4am and blissfully fell asleep.

Moral of the story:  Always charge your phone and never ever say the q-word while on shift. Also, never turn down the chance for an adventure.  While the experience was fairly awful while we were going through it, I now have a great story to tell people and there isn't anything I like more than an entertaining story. 

Scrappy the Wonder Dog!

After his antics today, Scrappy has earned his own blog post!  When I first arrived on the island in August and was showing Amelia and Carter around campus, we had a local dog become attached to us. He would follow us around.  I didn't think much of the whole thing besides that the dog really liked being petted.

As the semester has progressed, I noticed that the dog was EVERYWHERE on campus.  Always prancing around like he was on a very important mission and always going up to groups of people. Almost like he was checking up on the students to make sure they were ok.  One time even even made it up the huge hill to De Champs (the local restaurant/hotel/bar that a lot of students hang out at).  He sat down with a group of students while they had dinner.  It was then that I learned the dog's name....Scrappy. It turns out he has many nicknames as well. One of my personal favorites is Scrappy-doodle.

Scrappy is the perfect name for this dog. When I looked up "scrappy" in the dictionary, I found at that there are two parts to the definition. The first part is that scrappy applies to something that "consists of disorganized, untidy or incomplete parts" and the second part described scrappy as "determined, augmentative  and pugnacious." The first part fits because the dog is clearly a mutt (hence the disorganized parts). The second part  (determined) fits because he is always on a mission and he sometimes gets mad when you stop petting him.

Scrappy has been known to come into study rooms with students.  He will sit with them for the whole time they are studying and never leaves until they pack up their stuff.  Today, he reached a new level.  He decided to come to class with the first semester students.

Scrappy going to class. Note how excited he is--the tongue is out and tail is mid-wave. 

Imagine this scene, a classroom filled with students who are there for a mandatory lecture.  All of a sudden a dog comes trotting in, down the main aisle. Of course he looks extremely proud to be inside (I personally think he likes the air conditioning and loves being in large crowds of people).  When people try to usher him to the back of the room, he starts running through the rows.  Once people stop trying to catch him, he walks back to the main aisle and just stands there wagging his tail.  Finally someone catches him and brings him outside.  A couple of minutes go by and voila! There's scrappy again! He managed to get back inside.  This probably happened two or three times until finally Scrappy got the message that he needed to stay outside.

That all happened today. Scrappy the wonder dog decided he wanted to take a class and decided that since all the action was inside, he needed to be inside as well. After all, it is his job to make sure everyone is alright.

Dominican Advertising

Advertising in Dominica is unlike anything I have ever seen before.  There aren't any normal billboards, only the occasional hand-painted ads on the sides of local bars.  There also seems to be minimal printed ads because I don't think there is a printed newspaper (or I have yet to see one). What they love to do is drive around with a pickup truck that has a huge megaphone strapped on top and yell out the advertisements.

I have heard it a couple of times advertising the local market and various Lime (the phone company) deals.  Today it has reached a new level.  Apparently the little bar right next to my apartment decided it needed more business, so they got the megaphone truck guy to help them out.  He has been yelling out garbled slogans about cheap beer and how everyone should come on down.  For a while he kept doing laps around the short block that I live on.  Definitely not conducive to a Saturday of studying but at least it exposes me to different advertising methods!

Here is a video of what it was like, just click on the link (except the guy was talking in English not Chinese and the truck is a really old, beaten down pick-up). megaphone truck video  I tried to get an actual picture  but that didn't work out. Once they saw me trying to take a picture, they started calling out to me by the megaphone.

Med Student Hypochondriac Instance #1

I have this slight coffee addiction that sometimes means I am only living off of coffee.  Not such a good idea but generally I get away with it.  Today was a different story though! 

We are currently on the cardiovascular module and are learning about heart murmurs, abnormal heart sounds and other cardiovascular pathologies.  One of the things we had to do for our block grade was learn how to take a blood pressure and pulse.  Both of which I absolutely rocked, special thanks to my 4 years of EMS service.  What wasn't so great about the experience, was being used as an example of a tachycardia (that means my resting heart rate was above 100. It was only 110 but still not a good thing!).  

I had been feeling kinda out of it all day so I knew something was up. Of course since I was having heart palpitations and a fast heart rate, I jump to worst-case scenario mode and think that I have one of the obscure cardiac anomalies. I was almost to the point of going to the health clinic, which means I really was not feeling well. And then I realized.....I had not drunk any water for the past two-ish days!!! Due to my lovely studying and lack of sleep, I have only been drinking coffee! Which is unbelievably stupid, especially when you live in a place where the average temperature is 85 degrees.  I had gotten myself so dehydrated that it was affecting my heart.  

So after chugging 3 liters of water, I am back to normal.  No more heart palpitations, no more fast heart rate and no more thinking I have a rare congenital heart defect!  Major sigh of relief.  My new study plan is to drink a bottle of water for each lecture I am going through.  That should keep me decently hydrated. 

Lesson Learned:  Coffee does not equal water! Also that med students will all become hypochondriacs at some point during the med school process.  

My Birthday in Dominica

Hey everyone! Sorry that it has been so long since my last post.  I have had a crazy, very intense past couple of weeks and am just finding some free time now to post. 

I figured I would write about how my birthday went in Dominica.  Overall, it was pretty awesome even though the actual day was kind of rough (I had a 4 hour gross anatomy dissection as well as 4 hours of lecture).  On the Saturday after my birthday, I went out to brunch with some of my friends here.  It was nice to have real food and to actually socialize with people.  And it was special because my parents surprised me with a cake! I had told them how sad I was that I didn't have a cake for my birthday and how sad I was the I didn't have people from home to celebrate with.  They spoke with the restaurant and had them bake me a cake--so even 3000 miles away from home, it felt like my parents were there with me.  It made the homesickness not as bad!

My cake and the super intense "candle",

The knife to cut the cake.
Only in med school would the knife be a plastic saw.

Came home to this note on my fridge from my maid.  

I also got my first package and mail.  One of my EMS friends sent me the amazing hazelnut coffee from CTB because she knew I had run out and that I am absolutely obsessed with it.  My parents, siblings (Amelia and Carter) and aunt each sent me cards, which I am now using as wall decorations in my bedroom.