It's difficult to predict what will make you uncomfortable. Everyone has their own triggers. Hurt or abused kids are an obvious source of discomfort. Thermal injuries (burns), too. I know a guy who hates to see hangings. Suicides, in general don't bother him, not even self-inflicted gunshot wounds, but "swingers" creep him out.
Personally, I almost lost it on that aid call that evening. The patient lived with his family just around the corner from the fire station. We'd never been there before, but the whole family suffered from a hereditary disorder of the nervous system. No one there was younger than 50 and as they aged, the disease slowly robbed them of coordination and dignity. Our patient was progressing in his illness to the point where he had great difficulty swallowing. We were informed that he had been eating a pork chop and a piece was apparently lodged in his airway.
Preparing dinner is a sport in the firehouse. In my department, we take turns cooking, and we have some very accomplished chefs. We buy all our own food, and someone working overtime contributes more to the fund. Several OT's might contribute more than $100. We eat pretty well. Because disaster could strike at any time, we eat pretty fast, too.
He was still breathing, and stood in the center of the room swaying. Long strings of saliva dangled and spun from his lip. He was gagging and heaving with every breath. He considered us through watering eyes. Wretched sounds came from throat. I took a set of vitals: BP, pulse, respirations, level of consciousness, all unremarkable.
There are two primary requirements for our firehouse cooking: Lots and cheap. If it tastes good, that's alright too. But if you make a stinker dinner, you will hear about it forever. I'll briefly mention "hot dog spaghetti", as an example. If I remember, it wasn't cheap either. You know who you are; sorry, pal.
When a person is choking on something, the basic protocol is wait for things to get either better or worse. The patient clears their airway, or they pass out from oxygen deprivation. If they pass out, they're at risk of cardiac failure, and that means CPR. The chest compressions during CPR might dislodge the blockage, and things get better quickly. But if they can still breathe, it becomes a waiting game.
We have one large station that houses 12 firefighters: four crews and our battalion chief. The meals prepared there can be epic. Find a good price on meat at Safeway, for instance, and the combined buying power of the large station can make for an elaborate meal. It also helps to have a lot of manpower in the kitchen when we're drilling and running calls all day.
Three firefighters, captain, driver, pipeman, stood in the room. Our patient continued to sway back and forth. Rain pissed sideways against the windows, but the house was a stronghold of sauna-like heat against the winter murk. Did I mentions the gagging sounds? The copious drool?
My captain, NJ, disappeared into an adjoining room. Our driver turned to look away from the patient. I was alone with a gagging, wretching man and my overstuffed stomach. I tried to forget about all the salad, bread, steak, potatoes, and ice cream that was churning in my gullet. Perspiration beaded on my scalp, running into my eye.
Ever experience a sympathy puke? Like when you see someone hurl and suddenly you join the party? Six times my pharyngoesophageal sphincter, the flapper at the top of my stomach, spasmed. Six times I fought the rising gorge, acid burning my throat, the taste of vomit in my mouth. Torture. I looked for an exit, weighing liability issues of patient abandonment in my head.
With one last agonizing heave my patient hurked up the chunk of pork chop. It landed on the carpet with a wet plop. "Sorry," he said. "Sorry about that."
"Don't be sorry," I said. "I'm glad it's finally out. I'm really glad you're better."
"Anyone in the mood for popcorn?"
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