divide

After nearly three hundred clinical hours in the local hospital, I finally had my first two shifts riding along with the Paramedics at the city Fire Department. They were not particularly busy nights, but the handful of patients we had left me feeling both assured that learning paramedicine is exactly where I want to be and overwhelmed by how far I have to go. In class, I'm keeping up with the material and doing well on tests. In the hospital, my patient assessment skills are solid and I'm learning to develop differential diagnoses before looking at the charts or talking to nurses. With over thirty IVs under my belt, I'm feeling better about wielding needles around unwary veins. But ultimately bedrooms, kitchens, sidewalks and street corners are where I'm going to be assessing patients, and the back of an ambulance will be my clinic. And after 48 hours responding to "Fairbanks Fire Department, Ambulance Request, D - Delta response to ...," I am acutely aware of the vast divide between these two settings, and how much better my knowledge and skills need to be before I can use them efficently and effectivly for both routine and emergent patients out in the world.

Today, I was back in the hospital assessing ICU patients and tearing through back hallways to the lobby with the rapid response nurse, racing the respiratory therapist to a page. But my heart was not in it.

My paternal grandmother, who has been spiralling rapidly into advanced dementia, fell and broke her hip in the middle of the night. She was in surgery for most of yesterday, and due to the nature of the break and her general state of frailty probably won't walk again. Although she is stable and has no idea who her children are or where she is or why, I want to be with her. Today in a hospital three thousand miles from the hospital my grandmother is in, every patient I moved, every occluded IV I flushed, every blood pressure I took, I was hyper-aware that I was doing these things for strangers, and not for her. Their families were there in the hallway talking to the nurse, in the room reading quietly by their resting loved one. And I was there, bringing warm blankets to other people's grandmothers and grandfathers and not my own.

Ever since I left home for college, I have chosen to live far from my family. And I have been content with this decision, and I still am. But right now, that distance stings and that contentment has sharp edges on every side.