Part 18: On Pins and Needles

The job at the dry cleaners was okay, but not really fulfilling.  I was anxious to get back in the saddle. Now that I had been accepted to the Emergency Health Services program at UMBC, it sunk in that I would remain in Baltimore for a while.

Working at the dry cleaners had been a godsend, providing me a routine to acclimate to my new Baltimore home. The shop was around the corner from the Murray’s home, the family in Woodlawn from whom I rented a second-floor bedroom. I couldn’t have asked for a better boss than Louie, the dry cleaner owner; a man of even temperament and good humor who backdated records so I was eligible for in-state tuition at UMBC, saving me thousands of dollars.

But I wasn’t in Baltimore to retrieve shirts from a hanging conveyor belt.

Until I got my EMT certification straightened out, I couldn’t work on an ambulance in Maryland. I considered my options. Requirements were very low or nonexistent for many allied health jobs. Back in Tennessee, for example, there were no certification or training requirements to work as an x-ray technician. If you could get a doctor to show you how to work the x-ray machine, you could be an x-ray tech. The standards have probably tightened up since then.

Prior to 18 months before my arrival in Baltimore, there were no educational requirements to take the licensed practical nurse certification exam. I could have challenged it and taken the exam cold—and probably passed—and would at least have an LPN that would get me a job in a nursing home.

If I have one outstanding talent, perhaps even going so far as to immodestly call it a gift, it is the ability to hit a vein with a needle.

It’s one of those things that you don’t know you can do better than others until you do it, like sitting cross-legged. Some people can do it with ease, and some can’t. It doesn’t mean that one person is smarter or better than another. It’s a fluke of physical dexterity, like being able to balance a broom on your nose.

I have an uncanny ability to sense the three-dimensional space beneath the skin and thread a hollow needle into a blood vessel sometimes not much larger than a strand of spaghetti.

And not on young people in the prime of health with nicely anchored veins bulging all over the forearms, but with patients in shock with no palpable veins. I could find vessels at the threshold of detection, using my fingertips like sonar to discern the subtle bounce of vein from other subcutaneous tissues. And then guide the bevel of the hypodermic needle down a flight path to a spot where I visualize the vein to be—and there it is.

I was good with very elderly patients with delicate veins that roll around beneath the skin, and squirming children petrified at the sight of needles. I didn’t have to probe around, and most often hit the vein with the first stick. I knew every trick in the book to make veins distend, how to anchor rolling veins, how to do a stick absolutely painlessly.

The skills involved in starting an intravenous line are very similar to drawing blood. During my off-hours at the West Memphis Fire Department, I worked part-time at Crittenden Memorial Hospital drawing blood and running EKGs.

I had a reputation for being a very good phlebotomist—quick, reliable and painless. Patients requested me. During codes, when a patient crashed in the emergency department or up on one of the units, they would often bend the rules slightly and have me to draw blood with an IV catheter to avoid risking a second stick.

Like the line from The Guns of Will Sonnett, “no brag, just fact”; I’m better with a needle and syringe than anybody I know.

Maryland didn’t allow any yahoo with ten fingers to operate an x-ray machine, but certification wasn’t required to work as a phlebotomist. I got a job drawing blood at a clinical lab in the medical office building on Pine Heights Avenue adjacent to St. Agnes Hospital.

I thanked Louie for the opportunity he had given me, and instilling within me the lifelong lesson that there are two kinds of lint; dark lint that shows up on light clothing, and light lint that shows up on dark clothing.