Overdoses

Marielle and The Upstairs Overdose.

So, TINS ©, TIWFDASL ©. This one time, Marielle and I were working Medic 7. Now, at this point, I’d been working the road a spell, and had, approximately, 2/3 of a clue. So, we caught a run for an overdose, and off we went.

It was my day to drive, and Marielle’s day to medic, so we arrived at the scene, notified dispatch, and beat upon the door, announcing ourselves. “Fire Department!” One of the occupants thundered down the stairs, and announced back up the stairs: “The ‘Mergency Mutha Fuckas is here!” Our host bade us follow. We followed.

Near the top of the stairs lay a gentleman, who appeared nearly completely disinterested in the goings on around him. Everybody else there appeared, themselves, disinterested in the named patient, but there were no threatening nonverbals, so, whatever, another day in Da City.

Our new friend was breathing, sort of. For bonus points, he did, indeed, posses a pulse, and was perfusing nearly all of his organs, as reflected in the presence and regularity of his radial (wrist) pulse. I was entirely happy to place this gentleman upon a stretcher, trot downstairs, and meander off to the hospital of my partner’s choice, but, NNOOOOO!, she felt the burning need to awaken him right there. She applied the BVM, and commenced to resuscitatin’.

Now, among my (small) fund of clue, was the insight that these citizens, who had expressly called the 911 EMERGENCY phone number, and requested an EMERGENCY ambulance, might, somehow, have determined that they were confronted with an EMERGENCY, and likely would be skeptical that said EMERGENCY could be resolved, satisfactorily, in their living room. Indeed, clinically, it occurred to me that, should Mr. Sleepy awaken, that his wakefulness likely had a half life shorter, in clinically significant terms, than the half life of his narcotic of choice. In either event, if did not seem that “customer satisfaction”, clinically satisfactory outcomes, or abbreviating our dwell time here, well within the potential hornets’ nest, would be promoted by awakening this soul, in the living room, and discussing with him his unhappiness at his pharmacologically induced bliss, being interrupted. Then, of course, there was the back injury eliciting potential of maneuvering an irate, dystaxic, nearly overdosed adult male down the stairs, without dropping him. I suggested as much.

Uh, Marielle? Wouldn’t this be simpler, in the truck?”

She looked up at me. “Stretcher Ape, I’ve brought half a dozen of them back this way!”

Unspoken was the Paul Harvey Moment. As in, what was The Rest Of The Story? Like, once you had, indeed, awakened this soul, and then had to implement a follow on plan of care. Would this newly reanimated patient, breathing spontaneously, feel motivated to deliver a soliloquy on your mother’s poor life choices and unusual tastes in romantic partner(s)? Or, perhaps, seek to kinetically provide dissuasion of repeating this Dreamus Interruptus upon himself, or another similarly situated child of God? Or, once the recently dreaming person was woke, might the companions now take an interest in his life circumstances, and feel that, notwithstanding his protestations to the contrary, you HAD to “snatch him on up, and carry him on down to the hossipal!”? Tangential to that, just how do you negotiate with 4-8 angry inebriates? (Please provide a syllabus of your tutorial in the comments!)

I realize that this was not a Teachable Moment for her, nor for me, and handed her the handie talkie, and loped down the stairs in hopes of moving him before he became too animated and restless.

Sigh.

Of course, he WAS animated, and WAS restless. On the way down the stairs, it was a near thing whether he would roll of the stretcher, one, the other, or both of us would tweak our back(s), or some combination of the above.

Well, that day The Patron Saint Of Emergency Motherfuckers smiled upon us, and Mr Formerly Somnolent was safely tucked away on our stretcher, in the ambulance, and he was delivered to TSBTCIDC. After a brief prayer at the Altar of The Ghawd Narcan, he dashed out of the department, before Marielle had completed her trip sheet.

And THAT, boys and girls, is why I am blessed to be doing Ghawd’s Work, fighting Disease and Saving Lives.

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Life in Da City!

Athos, Porthos, and the Discarded Prescription

Once upon a time, in a reality far, far away, I was working a couple of schedules at Medic17. This was a house with a three medic crew, and we were just outside of the downtown area of Da City. Remember, this was on the order of 35-40 years ago, and the all night, wide selection of dining experiences thing was years, or decades, in the future.

So, after about midnight, your meal choices were the brown bag you brought in to work, White Castle, which was several medic districts away on the far west side, or Shanghai Palace. The late night Chinese restaurant was, itself, a considerable distance out of our first response district.

So, TINS ©, there I was, cruising Da City late one night with Athos driving, Porthos medic-ing, and me riding in the patient compartment. We went to the only drugstore open all night in Da City, Larned Drugs. Athos needed some cigarettes, and Porthos and I wanted a Coke.

We parked on the sidewalk, for, after all, were we not Da Fire Department (it said so on the door of the truck!), and entered to make our purchases. Concluding same, we exited, and stood outside, enjoying the summer night breeze. Along came some soul, who exited Larned Drugs muttering and swearing, announcing insights into the pharmacist, his lack of education, and the unusually close relationship he and his mother shared. He crumbled something up, tossed it upon the sidewalk, and stalked up the street.

Athos retrieved the something, and uncrumpled it to reveal a prescription sheet from DBTHIDC. Strolling over, beneath a streetlight, he read it to us, showing off somebody’s (the recently walked-away complainer?) penmanship, wherein the prescription directed the pharmacist to dispense “Mofeen, one pound.”

Life in Da City! · Pre Planning Your Scene

Nursing Student Ride Along

Doug and I, at “Lucky” Medic 13, had one schedule with Cletus as our third partner. Cletus appeared reasonably intelligent, but had the unhappy superpower, of rubbing folks the wrong way. On many occasions, he would be medic-ing, enter the scene, announce us with “Hello. How can we help you?”, and get a growled response of, “The Hell you mean by that? You can’t talk to (me)(him)(her) like that!” And, of course, in Medic 13’s area, negotiation was a lost art. A night that we didn’t get into some sort of fight with a chucklehead or two, was a night we were not at work. This, even in Cletus’ absence.

 

So, Back in The Day, some of the local RN programs would offer their students the opportunity to ride along with Da Big City EMS, as part of their emergency nursing rotation. Typically, these were women, and they were commonly young, bright-eyed-and-bushy-tailed, cute, smart, and agog at the gritty realities of Da Street. We would occasionally get one of these women as our ride along. Considering the aforementioned “Fight Club” nature of our area, we took pains to give them The Talk (EMS Version).

 

This consisted in admonishing the student to NEVER get separated from Doug and me. We showed them the radio in the cab of the truck, and directed them, “If one of us says, ‘Let’s go get the stretcher’, that means ALL OF US go get the stretcher, and then unass the scene. If you get to the truck before us, in that situation, you pick this microphone up, right here. You push the red button, hold it down, and you say, ‘Medic 13! Medic in trouble!’, and keep repeating it, without releasing this red button, until the cops show up. Then show the nice police officers where you saw us last. Got it?”

 

That typically produced wide eyed head nodding. Some of the quicker students would ask, “Why would you both leave?” We would explain that we were reluctant to engage our students in fisticuffs, with folks who did not know who the Marquis of Queensbury was, let alone know his rules for boxing. We would do a pocket dump, showing pocket knives, Kel-Lites (heavy duty, police-style flashlights, useful for illumination, or as a bludgeon), belt knives, neck knives, and explaining the utility of each. More wide eyes.

 

So, this one student was in quarters, getting The Talk, when Cletus arrived. He was off duty that day, yet for reasons not clear to Doug or me, felt the need to hang out at the firehouse. Must not have had cable, I guess. Now, Cletus and I are honkeys, Doug very African Heritaged. Our student, who was a cute as a bug’s knee, was, herself, of the African Persuasion. Cletus sat there, until Doug and I had concluded The Talk, and then I went up front to call my girlfriend on the house pay phone (You may have heard of them. Way, way back, before the I-Phone 3, there were these telephones, connected with wires to the Phone Company. After you deposited money, you could dial a number, and get connected to whoever you wanted, sort of like a cell phone, except with other people’s germs all over them.)

 

So TINS © , there I was, chatting away with my girlfriend, and I saw Cletus and Our Student exit the firehouse, and turn left, towards J’s Lounge. Now, in Da City, the firehouses are not generally in the “high rent” district. Rather, they were scattered around the city, and that tended to place them in what might be charitably described as firefighting target rich environments. Similarly for EMS houses, except substitute “pathology target rich environment”. So, next door to our firehouse was J’s Lounge, whose historic claim to fame was the distinction of being the site of several shootings, conveniently located next door to the medic unit’s quarters. Since, at that time, Da City was running around 130,000 EMS calls a year, with something like 16 ambulances, well, we were seldom home, and so the citizens expected the firefighters to be the first responders. Ghawd, did they LURV that! About as much as they’d enjoy a fully involved structure fire with the nearest 6 hydrants being out of service.

 

So, since our house was located in a neighborhood in the center of Da City, and the majority of Da City’s residents were themselves of the African Heritage Group, well, that left Cletus (honky), strolling into J’s Lounge, with a clientele representative of that corner of Da City, in the company of an attractive young woman, herself a stranger in these here pars, and, for bonus points on Cletus’ part, Black.

 

Now, at this point in Da City’s history, relations between the races were, well, tense. A lot of the Black folks were conscious of White political leaders, and decisions that had been taken by these White politicians that were not advantageous to minority folks. A certain percentage of the White population leapt to the conclusion that, inasmuch as minority criminals were featured in news reports of, well, crime, that therefore, all minority folks were criminals. Neither set of citizens stopped to consider the possibility that some White folks were assholes, some Black folks were jackwagons, and a lot of the rest of either group simply wanted to be left the hell alone, to work, pay their bills, raise their children, and generally get about their days.

 

So it was into this oven that Cletus and Our Student strolled. Once I identified what the frack it appeared that Cletus was doing, I abruptly hung up on my girlfriend, and sprinted to our quarters. Doug looked up from his textbook, and, as I grabbed the handie-talkie from the charger and motioned him to follow me RFN*, asked what was up, I told him, “Cletus just took Our Student into J’s!”, and he bolted from his seat.

 

We had just about made it to the front of the firehouse, when Cletus and Our Student returned, Cletus with a big idiotic grin on his face. Doug and I called dispatch on the HT (“Medic 13, back in quarters, off the air.”), and dragged Cletus back to our quarters. Once there, Doug bade him sit, and began a profusely illustrated, highly evocative, richly turned narrative, filled with esoteric turns of phrase describing deviant familial relations, marital practices, and love of our fellow beast, with the recurrent theme of “What The Fuck Did You Think You Were Doing?”

 

Long around the second or third stanza, Cletus lost his grin, and turned to me for support. Doug tagged me, and climbed out of the ring. I wasn’t quite as polite as Doug had been.

“So, Cletus, you know you’re white, right?”

He got smart. Well, OK, smart assed. “Well, d’uh! Of course I know I’m white!”

“And, perhaps you had noticed, most of this city is Black, right?”

Again, the smart ass. “Well, D’uh!”

“Just like this nice, and naïve, young woman, right here?”

“Yep, I noticed.”

“Have you noticed that folks in this town, particularly the folks we deal with all the time, are kinda tense about that whole Black/White thing?”

“Uh-huh.”

“So, Young Einstein: what do you suppose is the conclusion that our neighbors over there, most recently in our mind for that shooting last month, will jump to when a young white boy, strolls into their bar, escorting a attractive young Black woman? You are aware, are you not, that a primary commercial enterprise hereabouts is, er, um, the ‘escort’ business, right? What, are they recruiting illegal immigrants from Hondouristan to work these streets? Or do these women kinda look like our other neighbors? Hmmm?”

 

He responded with a blank look. I did not let that stop me. Doug nodded, and waved me forward. “So, here’s what happened: my white, and civilian clothed partner, walked into a black bar, in a predominantly black city, in an area whose major commercial enterprise is the sex trade, with a very attractive black woman, who is a stranger hereabouts. He laughs about this, while his partners were anticipating yet another shooting in that bar, only this time featuring their partner. Do you see, yet, how and why we anticipated this going horribly wrong?”

 

Our Nursing Student contributed, right about this point in the lecture series on Appearances Mean Things, “I think I need to go home, now. Thanks, guys for the lessons!”. And, with that, she scurried out of the door, into her car, and puttered away.

 

Cletus started looking uneasy, and suddenly remembered something pressing that he had to do, right now, at home. And, away he went.

 

Doug looked at me, and shook his head. “You sure know how to pick ’em!”

 

 

*RFN=Right Fucking Now

 

guns · Life in Da City!

Why am I a suspicious soul?

 

Why am I a suspicious soul?

 

Because of runs like the following.

 

TINS ©, TIWFDASL © , and Medic 13 (our unit) caught a shooting. (Yeah, I know. Shocking! Shocking! Folks getting shot in Da Big City!) So as per the usual plan, we Weedle-Deedled our way to the scene, and pulled up after the police had retired the combatants to neutral corners. (Remember that assumption. It figures prominently in the rest of this story.)

So, our friends at DBCPD (Da Big City police Department) pointed out the shoot-ee, who did not appear to have a care in the world. Well, not THIS world. In fact, he appeared disturbingly unaware of the excitement unfolding around him, and so we assessed him quickly. Awake? Nope. Breathing? Nope. Carotid pulse? Nope. Trifecta of cardiac arrest. The Bonus Points of chest wounds meant that our friend was a trauma code, and trauma codes are widely renowned for having malign outcomes. In short, pretty much Dude be Daid. (for our non-street speaking readers, “daid”=DEAD.)

 

Around this time in Da City, another crew had left a dead fellow on the scene. They had figured that the GSW that had pretty thoroughly emptied his cranium had removed him from the living column of life’s census. However, once they had gone in service, one remaining neuron in this person’s hind brain had met up with another lonely neuron therein, and, in saying “Hello!”, had elicited one, last, agonal breath. The cops on the scene had freaked out (“He’s alive!”), called for another unit, and this medic crew, reading the writing on the wall which said, “This way to departmental charges and unemployment”, took another path, which included transporting this patient so the hospital could pronounce him. The first crew was suspended without pay for something like 6 weeks.

 

For this, and other reasons, there was no way we were going to leave this soul on the scene. Onto the cot, into the truck, and prep for liftoff! As I was connecting the oxygen to the BVM, and generally settling in for a lengthy episode of solo CPR in a moving vehicle (nearly as much fun as it sounds like it is, you ought to know), the rear door opened, and a female face appeared therein. She asked, “Can I ride with you?”

“Who are you?” I inquired.

“Oh, that’s my fiance!”

Let’s pause a moment. After several years on Da Streets of Da City, I concluded that there was not a solitary female older than 17 in the corporate limits of the City of Da City, who was not betrothed. This particular run was NOT after those several years, and so the following may be unsurprising, in retrospect.

Well, I invited said Fiance to enter the vehicle, and secure her safety belt. Doug set off to the The Best Trauma Center In Da City (TBTCIDC). He gave radio report, and I CPR’d my little heart out. Ms. Fiance inquired after my patient’s condition and prospects: “Is he gonna be alright?”

I gave her the long answer. “Well, ya know, when we do CPR-this is CPR- on somebody, they are very, very sick. In fact they are critically ill. Critically ill means that there is a very real chance that they will not survive. Now, I’m doing everything I can to help him, but people who are this sick, well, a lot of ’em die. We’ll just have to see how he turns out.”

She digested this for a moment. “I’m sorry I shot him.”

Huh? I mean, What The Fuck? Huh? Gotta admit, I was so startled, I stopped CPR, looking at her for a minute. After several breaths (mine, not his), I collected myself again and resumed CPR. Ya know, CPR, by yourself, in the back of a moving ambulance, coding to TBTCIDC, is kind of challenging. It becomes particularly so if you are trying to keep your eyes on the just-self-admitted-shooter of your trauma code. Yeah, him. Right there, under your hands. And, well, she is all of 24 inches away. Yeah, that sort of distracting.

I had just about deluded myself into thinking that I was getting back into my resuscitative groove, and had turned my gaze from Ms. Shooter/Fiance, when she decided it was time to expand her fund of knowledge. “Is this gun big enough to kill him with?”

Holy Fenestrated Fertilizer! What the absolute fuck could possibly happen to make this run any worse?

I froze, keeping my eyes on my shootee. “Er, Ma’am? Would you please put that back wherever you got it from?”

A moment later, “Ok, I put it away.”

“Thank you! Please keep your hands on your lap!” NOW, I kept my gaze upon the shooter/Fiance. Of course, THAT meant I wasn’t doing compressions, or ventilating my patient, but, in truth, I was kinda paralyzed. So, when we pulled to a stop, and Doug launched from the driver’s seat, to extract the smoothly running resuscitation that was his smooth, professional, skilled partner, well, that is NOT what he beheld. Rather, it looked like a sort of diorama, perhaps entitled, “Medic Gets A revelation In The Back of the Ambulance”. In any event, it was a still life, not a moving picture. He tried to form his question, along the lines of “Why aren’t you doing CPR?”, but I propelled myself past him, and dragged him away, stuttering profusely. My part of the dialogue sounded like “G…G…G..G…GUH…GUH…GUH…GUN!”, and it took him a moment to process it. Meanwhile the ER crew had extracted our patient, and were running him into resuscitation.

Doug and I grabbed one of the BTCIDC cops, and Doug, by now obviously the brains of the operation, told said cop our tale. “She’s got a gun, she shot our patient, and here she is!”

We found somewhere else to be.