Life in Da City!

Dead man on the roof

We typically ran a three medic house, at Medic Seven, just so one of us could take a road trip in the event that somebody or other called in sick, was injured, or other wise was absent for one reason or another. I got the detail, and wound up working Medic One with (let’s call him) Roger Whitaker.

It was his house, and I therefore was the medic that day. It was mid summer in Da City, one of those days with blue skies, sunshine, and temps running high 70’s to low 80’s. Simply a great day to be alive, in your twenties, and working outdoors. We cruised along, between runs, windows open, talking about inconsequential things, and listening for our next run. And, it happened.

We were sent out on a “unconscious man”, at an address down the street from the engine company where we commonly gassed up. At one point, like 30 or more years ago, this had been a prosperous, upper middle class neighborhood. Just off Main Street, the buses (I suppose, at that time, it was trolleys, but the same effect obtains) ran to downtown and back, and north to, let us call it, Middleville, where another of the industrial empires had several of their factories. The managers and suchlike, living in this neighborhood at that time, could take public transport to and from their jobs, and the families, with domestic help, could keep the home fires burning.

Once Da City changed, and the prosperous moved to Da Burbs, well, all those 4, 5 and 6 bedroom homes became multiple apartment buildings. One of them was our destination.

We pulled up in front, called on the scene, and walked to the door. One of the residents met us there, and led us up the staircase, into one of the apartments, around a corner into the kitchen, out of the kitchen window, and onto the tarred roof of the grand porch the building boasted.

This had evolved into some sort of patio for the residents, and there were three men there, two of whom were drinking something from a brown paper bag in the sunny July afternoon, and the other lay, as if asleep, semi prone. Alumni of the old-school Red cross Advanced First Aid And Emergency Care course (yes, I AM THAT old!) might recognize this posture as “the coma position”, as it facilitated drainage of oral secretions from someone who could not manage them on their own. Like, someone in a coma, fer instance.

Roger approached the upright, actively drinking folks, in order to elicit some information regarding our presumably somnolent subject. I approached him, and, kneeling, channeled my inner “CPR Manikin”. I did not quite bellow, “Annie! Annie! Are you all right?”, but I did attempt to shake our friend, to rouse him for conversation.

It quickly became evident that no amount of shaking, nor shouting, nor any other sort of human intervention would cause this gentleman to join in our conversation, without a Ouija board. When I lifted his off arm, as a lever to roll him preparatory to sitting him up, well, he rolled as a unit, as if he was a man shaped board. Students of emergency care might recognize this as “rigor mortis”, and it occurs variably, on the order of 6-14 hours after death.

Our patient had been laying on that hot roof for a long time.

Roger asked one of the bystanders, “When was the last time any of you all talked to him?”

One looked at the other, squinted up into the sky, and answered, “I guess it was before noon when he sort of moaned, laid down, and sort of rolled over. He hasn’t moved since.” Since this was late afternoon, well, this was not going to be a successful resuscitation.

I looked at Roger, he looked at me, and we shook our heads. He retrieved the handie talkie, and called dispatch for TBCPD, and a medical examiner’s crew, and holstered the radio. The second fellow, agitated now, asked, “Is he….? Is he….? Is he….?”

Roger interrupted, “Man, he daid!”

This gentleman walked to the parapet of the porch, threw one leg over same, and made as if to leap. Roger peered over said parapet, admiring all the broken concrete piled against the foundation, and said, “Friend, if you don’t mind, kinda jump a ways out there, into the yard, why doncha? My knees are aching, and I just know I’ll wrench something if I have to pull your broken body off all those rocks!”

The guy stopped, frozen, and stared at Roger for a moment. He lifted his leg back over the parapet, re entered the building through the kitchen window, and was last seen walking down the middle of the street, gesticulating and cursing, heading westbound.

Life in Da City! · Pre Planning Your Scene

Stairway To The Bathroom

 

So, once upon an EMS, I was working a medic unit in the center of the city. We caught a run to the near west side, and so, off we went. It was late on a lovely July afternoon. I remember the leaves shading the yard of the house we were called to. We walked up the steps, up the porch that ran along the side of the house, and knocked upon the door.

An excited gentleman answered our knock, and directed us into the home. There, a turn into the bathroom revealed our patient. He had, or so we were told, stumbled while descending the stairs, had fallen down those selfsame stairs, and, since the stairs terminated in the bathroom in which we were standing, when he came to a stop, he did so abruptly, having struck his head upon the bathtub. He seized, and our correspondents thought that this was a bad thing. Their opinions were not changed by the fact that our new friend had not awakened at all since the fall and seizure.

My partner at this point, who we can think of as Heinrich Hobson, was a veteran of the streets, and schooled in the ways of Da City. So, of course, once he left for the ambulance to retrieve the cot, backboard, and suchlike so we could transport our patient, well, THAT is when the excitement began.

So there were two ambulatory men, and one huge woman, on our scene, in addition to our unconscious patient. This woman was carrying an enormous purse, and began to exchange (heated) words with one of the gentlemen. The shouting escalated, and Mrs Large Purse decided that it was time for Show and Tell, and therefore Showed us all her nickel plated semi automatic pistol, all while Telling us how, in her words, “Alright, m0th3rf4ck3r, now you gonna DIE!”

It was not immediately clear which “m0th3rf4ck3r” was “gonna die”, or whether this was a particular prediction, or applied to all of us in the room. Since I kinda stood out, being (a) in uniform, and (b) the only paleface present, I felt as if I were a lightning rod awaiting that thunderstorm, and wondered, to myself, if there was not someplace I ought to be. Like, anyplace but that house.

I began to sidle my happy little way out of the room, and onto the porch. Once on the porch, the voices in my head held a debate regarding the proper way to unass the fatal funnel that the porch presented. One chorus encouraged, nay, DEMANDED, that I “RUN!”. The other viewpoint was that, in running, I would both attract (more) attention, and likely would elicit the predator-prey response in the nice lady with the pistol. I was not altogether certain that I really would enjoy the starring role of “Prey” in this production, and so, while the voices in my head held their debate, and then broke out for focus group discussions, I longstepped my way down the porch, and into the street.

Heinrich was collecting the straps, board, sheets, blanket and whatnot useful in comfortably transporting our patient, and I walked right up to him, and in the scholarly, educated, calm, thoughtful manner of speech for which I have become justly famous, brought him up to date on events within the domicile. What I said was, and I quote directly, “G! G! Guh! Guh! Biigggg! Biggg, guh!” Several choruses of that gibberish followed, until The Nice Lady With The Gun appeared on the porch, and I finally orchestrated a semi coherent thought. “We go now!?”

Of course, calm as could be, Heinrich grasped the handie-talkie, and began to bring Dispatch up to speed.

Dispatch, Medic 8. We need police here, my partner reports that there is a woman with a gun inside on our scene.”

Dispatch did not require a lot of time to process this. “Medic 8, have you cleared the scene?”

Negative, our patient is still inside.”

Dispatch’s opinion of that plan? “Medic 8, clear the scene! Immediately!  Police are on the way!  Repeat, CLEAR THE SCENE!” 

At this point I was in the passenger seat, listening to all the wisdom Our Friends At Dispatch were sharing with Heinrich, and wordlessly testifying to their TRUTH! Heinrich debated the ethics of unassing the scene wherein our patient lay, vs returning to save lives another day (the latter course of action I enthusiastically supported), with dispatch, articulating the position that we could not leave our patient.

I had my own thoughts on that matter, mostly along the lines of WHY THE F4CK WERE WE NOT IN THE NEXT PRECINCT BY NOW?! While this conversation continued, and I slunk down in my seat, thinking invisible thoughts, one of the gentlemen from the scene, he of the “Alright, m0th3rf4ck3r, now you gonna DIE!” insight, came to MY side of the truck, grasped the sill of the door, and asked, “You all ain’t gonna leave me here, are you?”

I started to roll up the window as fast as I could (no, I do not know why), and told him, “Mister, if you do not pull your fingers back right quick, I ain’t gonna leave ALL of you here!”

So, as it happens, if you really feel a burning need to know just how many officers DBCPD has on duty, and with access to a car, at any given time, I recommend that you find a seat across the street from a scene wherein an EMS crew has just called “Medic in Trouble!” Let me tell you, it made me feel all warm and fuzzy inside, as car after car squealed to a stop, and officer after officer piled out ready to kick ass and take names. Fortunately, by this time, Ms. Gottagun had strolled down the street and into another house altogether, and the officers declared the scene secure. Our friend of the tub-strike (remember him?) got bundled onto a spine board, and trucked off the TLHTTIC.

No medics were harmed in the telling of this tale. For some of them, however, their foundation garments will never be quite the same shade of not-brown.

Life in Da City!

Doberman Overdose

 

So, I was working Medic Seven with Doug. We caught a run for an overdose, and proceeded to the call. Calling dispatch to announce our arrival on the scene, we stepped into the autumn evening.

So, there was (and, likely, still is) a considerable, amorphous, body of knowledge, that might be termed “street smarts”. For example, there is what we called “Decker’s Law”, which opined that, should you be on a block, and you were sure your call was at one house on that block, but, of course, there were no house numbers, you should knock upon the door of the house that appeared most likely to be a heap of rubble by the time you went back in service. Your patient awaited therein. Or, Ciaramataro’s corrolary: the house with the steel window and door bars was your scene. Or Ivan’s Axiom: the house with the “ghetto gates” had nothing within it worth stealing. And, those folks likely knew who was doing all the B & E’s in the neighborhood, because they were likely the ones performing them.

Other insights were more what might be called stagecraft. As in, do not have your back to residents of the scene. Or, know two (or more) exits from every scene. Or, do not stand directly in front of the door. Or, and relevant to this tale, plant your boot in front of an outward opening door, because you just might not really want whatever is inside, to abruptly come outside to play. With you. Or your partner.

So, TINS©, TIWFDASL©, with Doug on one side of the door, and myself on the other. Doug was on the handle side of the screen door, and I was on the hinge side. I knocked, and announced our presence in the immortal words of yore: “Fire Department!”

The occupant came to the door, and we heard his dogs enthusiastically greeting us before the door opened. Doug, thoughtfully placing his boot before the door, allowed said occupant to uselessly push against the door as the dogs leapt, barked, and slathered their greetings. This gentleman was exhorting us, “C’mon, c’mon, c’mon! He could be dying in here!”

We suggested, “Sir, if you will secure your dogs, we will be right in!”

He responded, “C’mon, c’mon, c’mon! Dude’s dying in here, and you all be fucking around!”

Again, Doug suggested, “Sir, you have to put your dogs up, or we aren’t coming inside! We aren’t going to get bitten by your dogs!”

Our Host again responded, “I ain’t putting my dogs up! Y’all get in here! He could be dying!”

I looked at Doug, and he looked at me. “You need to hear anything more?” Doug asked me.

“Nope, heard everything I need to hear.” Doug nodded, and said, “Let’s go!”

We got. Once in the truck, and around the corner, we went a couple of additional blocks, and called dispatch. “When you get another call to this location, send police. The resident has a couple of big dobermans, they are aggressive, and he refuses to secure them.”

I finished the run sheet, and prepped the next one. Dispatch did not disappoint.

“Medic Seven, you still near you last run?”

“Affirmative.”

“Respond to that scene, run number (number), address (address). Scout car has been dispatched. “

“Medic Seven on scene, around the corner, waiting for scout.”

The police car soon pulled up, we regaled them with the above story, and off we went. This time, the offices stood at the door, their boots were on the door, and we stood back to admire things.

The same gentleman opened the door, the same dogs danced and growled, and the same dialog. “C’mon, c’mon, c’mon! He could be dying!”

One officer said, “Sir, secure your dogs.”

Our Host had considered his response. “I ain’t locking up my dogs!”

The officer asked him, “Did you just tell me somebody inside there is dying?”

“Yep, and you all are fucking around on this porch!”

The holster snaps were released. “Sir, we’re coming inside in 3 seconds. Those dogs will be secured, one way or the other. You need to lock them up, right now!”

Our Host began to protest, as the other officer placed his hand on the grip of his sidearm, and began to count. “Three! Two! ….”

Somehow, it appeared, the dogs levitated, and disappeared with a “whoosh!”. Seconds later the gentleman announced, “They’re locked up, in the bathroom!”

The officers unholstered their pistols, and led us into the house. One officer, locating the closed door, presumably the bathroom, behind which the barking continued, ensured that it was latched, and waved us past. We moved on, and found an inert soul, unbreathing and pulseless. We started CPR, transported him to TSBTCIDC, and they pronounced him.

Yeah, some runs you remember, even after the better part of forty years.

Life in Da City!

Another use for a leg abscess

 

So, I spent some time pulling calls in and around “Da Corridor”. One schedule, early in my time on da street, I was working days at Medic Eight, and found that we had what might be described as “frequent fliers”. One such soul was a young woman who evidently worked what might be termed “The Entertainment Industry”. The first time I met her, I was amazed at the abscess on her right thigh, which appeared to be as big around as my fist, and a couple of inches deep. For all the hugeness of the wound, it appeared remarkably clean. No redness, no pus, simply pink moist tissue in the wound depths. It looked like a pink crater in her leg.

A convenience sample, with no rigor to the study whatsoever, suggested that IV drug use was really, really common among these folks.

We transported her for whatever the malady-du-jour was, and went back in service. I was surprised when the same woman was in my ambulance several weeks later, crater still there, still appearing uninfected, for some other illness. I asked her, “What have you been doing for that wound? How come it isn’t healing?” She rattled off some answer, and I let it go. Report to nurse, patient on cart, inservice, and away!

Yet again, the same woman several weeks later yet, another not-persistent-leg-ulcer-related nature of call. Yet again, same ulcer, same tremendous size, same did-not-look-infected appearance. I asked her, again, what was up with the persistence of the wound.

Her answer was astonishing. “Well, when I go to do my do (administer my heroin), I can just sprinkle it in my sore, here, wrap it up in saran wrap, and I get my fix. It’s about as good a rush as shooting up, and no needles!”

Life Lesson: Ostensibly poor life choices do not necessarily map directly onto “stupid”.

Life in Da City!

Baby Huey And The Guy in the Gutter

 

Welcome back. Now TINS©, TIWFDASL ©, and we came across a figure in the gutter. Ok, we weren’t FDASL*, really. In fact, we were cruising. Now, “cruising” was verboten. It reeked of spending Da City’s hard earned fuel to lollygag about, on da streets of Da City. No, Da City, in it’s wisdom, would much rather we lollygag in quarters. But, THAT is a tale for another time.

So, this one time, we were “Touring Our District”. (There, doesn’t that sound so much better?) Indeed, our sole mission was to improve our understanding of the streets of our primary response district, in order to hasten responses, and avoid potential delays in lifesaving care!

Yeah, That’s it! That’s the ticket! We were “touring the district”! Absolutely!

So, in the course of familiarizing ourselves with the streets of Medic 8’s district (conveniently enough, we were working at Medic 8, myself, Baby Huey, and Cletus, Da Genius), we happened across a figure in, TINS ©, da gutter of Turnbuckle Avenue. Curious as to how this might have happened, we stopped, and advised dispatch of this interruption to our night.

So the night in question was raining, and therefore, unsurprisingly, our new friend was wet, muddy, and, simply to make everything just nice, intoxicated as hell. We bundled him up, in our nice, warm, and dry truck, and proceeded to The Little hospital That Thought It Could (TLHTTIC). En route, I attempted to elicit any sort of helpful information, such as allergies, medications, medical history, name, address, phone number we could call for somebody to pick his soggy self up from TLHTTIC, but he wasn’t in much of a mood for conversation. (remember THAT thought.)

I tried chafing his wrists, I tried tapping his cheeks, I tried the tried and tested “Annie! Annie! Are you all right?”, but he was not having any of it. I contented myself with vitals, and idly admiring our ceiling, en route to TLHTTIC.

Once we arrived, the ED staff informed us that they had no vacant stretchers, and we would have to wait. Cletus Da Genius set off in search of a vacant stretcher. So, there I was, Baby Huey, Mr Soggy Intoxicated, and me, with Mr. Intoxicated on an ambulance cart fully elevated.

Now, potential energy is a funny thing. Different heights allow for different durations within which gravity (“It’s not just a good idea! It’s the LAW!”) can act upon a body in flight. Given the formula v=AT, well, a falling body from, let’s say, 3 ½ feet in the air, can achieve enough velocity that, suddenly stopping on a concrete floor covered with tile,  fracture something will fracture. Hips are popular in the falling populace, and among orthopedic surgeons who have children in expensive colleges, as well. So our new friend was at “The Orthopedic Height”.

With this in mind, our new friend decides to awaken. Whatever my other failings, I am not a fan of added injuries to folks who are, however briefly, my patients. So, I attempted to stop Mr. Intoxicated from launching himself over the side of the cart, and into a consult with orthopedic surgery.

At this point in my life, I was a union steward in our union. I was also an RN, having finished school and passed the boards a couple of years before. I’m not the smartest SOB, but I generally can recognize really, really dumb stuff, and avoid it.

So, OF COURSE, NOW Baby Huey bestirs himself from his coma, to provide me with an extemporaneous lecture on the medico-legal niceties and particulars of patient restraint. I had some familiarity with said niceties, and, as I tried to explain to my newly legal-beagle partner, if my choices were to “illegally”restrain this guy, or watch him fracture his hip, I wanted to be explaining my actions taken to protect the patient from harm. Baby Huey was unmoved, repeating, “Da man wants to go, you got to let him go!”

Several things passed through my mind. Foremost, I hated-truly LOATHED-rolling around in close contact with unwashed, smelly, halitosis ridden children of God. Secondly, I wondered where TLHTTIC got all those nurse-statues, because they sure as hell weren’t moving. Thirdly, where was Cletus Da Genius?

A couple of minutes of wrestling later Cletus arrived with a stretcher. Cletus, in contrast to Huey (in his newfound persona of Legal Authority on All Matters Relating to False Imprisonment and Illegal Restraint), did take direction, serenaded by Huey’s Moot Court exposition. Cletus and I managed to pivot our new friend, writhing as he now was, onto TLHTTIC’s cart, lower it to the laceration height, and secure all siderails up. As I turned to escape this clown show, I noticed said friend start to inch-worm himself to the head end of the cart, and there, I predicted, tumble headfirst onto the cement floor. Didn’t seem all that good of a plan to me, so I watched him. The nurse-statues remained immobile, and so, once I figured his center of gravity was approaching the tipping point, I slid next to him, reached beneath his arms, and controlled his descent to the floor. I then turned and moved smartly to the door. I figured that, by the time he found someplace to fall to, from the floor, I would be happily somewhere else.

Huey had apparently concluded his summation, and decided that he needed to follow me out to the truck. I was really over him and his stupid, pretentious, pompous nonsensical bullshit, but, since he was about 4 inches taller than me, and 80 pounds more obese, I didn’t figure that any conversation he and I would have, would end well for me. I tossed the cart into the back of the truck, and hit the bathroom, figuring he’d leave me in peace to do my business.

I figured wrong.

Huey had, it seemed, figured out, all by himself, that I was irritated. With this insight, he decided that this was a good time to become confrontational. Well, I did not really have to go to the bathroom all that badly, and, besides, I wanted witnesses if I had to knife him in self defense. I exited the bathroom, and went to the counter of the nurse’s station, to finish the run sheet. With how wonderful this run had been, I was gonna be writing the Great American Novel, with footnotes, illustrations, bibliography, and annotated commentary by both Johnny Gage as well as Roy DeSoto. (Foreword by Dr. Eugene Nagel).

Huey, not the smartest representative of Australopithecus, decided that he needed to know if I wanted a supervisor. Indeed, ignoring him was unhelpful, and he got louder, and closer to my personal space (and approaching the “Let’s find out what you have hiding in your peritoneum” range), bellowing, “Do you want a supervisor, Mr. StretcherApe? Well, do you?”

I paused, putting the pen on the counter, and reflected. I asked the nurse-statue posed behind the counter if I could please, borrow her phone for a moment? She said yes. I placed it upon the counter, smiled my best “The voices told me I really don’t need to take my medication every single day” smile, and sweetly invited him, “Great idea! Would you please call dispatch, and ask that they invite the shift captain to meet the on duty union steward, right stat like**, at TLHTTIC? Right about now would work just fine for me! Oh, thank you so very, very much!”

I turned back to my documentation, only to have a nurse-statue develop the powers of speech, finally.

You know, I need your name and unit number for my incident report!”

I responded, “Of course you do. And, I’ll need the names of every staff member on duty, now, for my incident report.”

She did a double take. “What are you going to be writing an incident report about?”

Well, besides the obvious, there is the matter of your personnel admiring my patient’s efforts to fracture his hip, without moving to stop him. That’s pretty remarkable, right there!”

You cannot write us up in an incident report!”

I’ll be sure to mention that. In my incident report.”

I had thought that the demons of pre hospital care could not possibly bedevil me any more. It was a nightmare shift, with nightmare “partners”, and my life truly sucked stool. Doug was off at another house, working start of the week days, and therefore soaking up sunshine and living the good life, while I was on nights, in EMS hell with Cletus and Baby Huey. Once again, I thought wrong.

So, a couple of weeks later I went up to headquarters to pick up my paycheck. Captain Raconteur was the administrative captain this schedule, and when I signed for my check, he asked, as if it was just another casual conversation, “So, you beaten up any patients lately?”

What the fuck? “Uh, pardon me, Captain?”

I asked if you had beaten up any patients lately?”

Uh, well, you know, I haven’t beaten anybody up at all, any time, anywhere. So, what prompts this question?”

Well, your partner wrote a letter reporting that you had beaten a patient, and that he was so distraught that he could not keep what he had seen to himself.”

Doug? Doug wrote a letter?”

Oh, hell no! It was Baby Huey. He wrote a letter about you beating some poor schmuck.”

Are you kidding? Were you gonna give me a chance to respond?”

Do you want to respond?”

Hell, Yes!”

Ok, let me dig it out of the file I placed it in.” So saying, Captain Raconteur poured his trash can onto the floor, and started to pick through the papers therein.

Did you really shitcan a letter reporting that I had struck a patient?”

Hell, yeah! Everybody knows Baby Huey is an idiot. You, well, you’re an RN, the union steward, and never had a single charge against you. Hell, I know you, and how you operate. If, in fact, you had smacked some fool, you would submit a lengthy letter, with names, addresses, phone numbers, and shoe sizes of a dozen honest citizens who will all testify that not only did this fool need smacking, if they had been the ones doing the smacking, they would have smacked him harder, and longer than you did. You did not submit any such letter, so therefore, Baby Huey is full of shit.” Captain Raconteur looked into the distance. “If I could buy Baby Huey for what he is in fact worth, and find somebody to buy him for what he thinks he is worth, I could retire tomorrow!”

I later crossed paths with Doug, and told him the tale. He stopped me. “Baby Huey has been running his mouth, about how he got you in trouble. Nobody, yet, has asked him how it’s clever to monumentally piss off your shift steward. We have a pool going, on when he’ll go up on charges, and see your smiling face, sitting there to represent him!”

*FDASL: Fighting Disease and Saving Lives

** “Right stat like” = “stat”, which means immediately. In medicalese, this means that there is nothing else you really need to be doing, other than this thing, and you must NOT be distracted from doing it until it is fully done.

And, to review: TINS=This is no Shit

TIWFDASL=There I was, Fighting Disease and Saving Lives

Life in Da City!

Let’s Be Friends

So, in the late Seventies/early Eighties, there was This Thing, called “Punk Rock”. At that time, the aficionados of this genre of music favored spiky hair, boots, torn jeans, and what might be charitably be characterized as “a bad attitude”. Surprisingly, venues favorable to hosting this sort of entertainment, did not tend to run to the country club zip codes, rather, the neighborhoods seemed to be more of the druggies-in-the-alley-and-hookers-on-the-corner sort. That meant (ta-Daah!), Downtown Da City!

So one night, there we were, TINS ©, TIWFDASL ©, and I was working my schedule at Medic 17. For some reason, Da City had just gotten new ambulances, replacing the second generation of 100,000 mile relics from the Dark Ages. Medic 17 had been blessed with a new ride. Athos had just waxed the floor of the patient compartment, and Porthos and I had checked equipment, washed the exterior, and generally spiffed up our home for the next 12 hours. A couple of hours into the shift, half a dozen runs, nightfall, life was good.

So, having casually followed the news, more to laugh at just how many ways they could mis-report the runs that I myself had personally been on the scene for, I was aware that there was some sort of punk concert that evening. The details were hazy, but the location part of the story became clear as we caught a run to The Michigan Theatre, for an assault.

DBCPD at that time had a special detail colloquially called The Big Four, with three (huge!) plain-clothed officers, and one uniformed officer. This unit was special called to scenes where general jakiness suggested the need for reinforcements.

The Big Four was there, on the scene, as we arrived. The uniformed officer pointed out one sullen lad, who appeared to have been on the receiving end of one enthusiastically applied, Mark 1, Mod 0, butt whooping. The officer explained that Our New Friend had exited the show, along with his three friends,and had evidently determined that it would Be A Good Thing should they expectorate upon passing residents.

 

It appeared that these fine young specimens of enthusiastic youth had finally encountered The Wrong Resident upon whom to expectorate, for he had pasted Spitee Number One most vigorously. We invited the young gentleman to enter our ambulance, to assess him and offer him care.

Our New Friend sat upon the cot, and Porthos returned to the driver’s seat, while Athos and I saw to our patient. Athos began the litany of questions our trip sheet demanded, and sought the “History of Present Illness”. (ie, “what happened to you tonight?”). For some reason, he was not providing an abundance of details, and finally spat a collection of bloody glutenous mess onto the floor of the rig.

 

Athos handed him a wad of gauze, and invited him to “Wipe that up, eh?”. Mr. Spit appeared not to take it in the spirit in which it was intended, and drew back his right arm, balling the fist.

 

I was NOT about to watch this asshole punch my partner, and so, with my right hand, I released and unlimbered my heavy flash light, tensing up to hit a line drive with his left eyeball.

 

Then, inspiration struck. I really did not want to smack this joker (notwithstanding the fact that half-a-dozen police officers would in all likelihood establish in their notes that Mr. Spit had possessed these very same injuries prior to our arrival). Dunno where it came from, but I launched into some street theater.

 

I ducked beneath his right arm, placed my left hand on his right shoulder, and began to babble. “Noooo! Don’t be like that! We’re friendly little guys! Let’s be friends!”, followed by an idiot grin.

 

He looked at me, as if he had only now realized that I was crazy as hell, and had not recently taken my meds. I glanced at Athos, and he looked at me, similarly surprised, but looking a bit disappointed that he was gonna be deprived of the opportunity to thump a fool. I looked back at Mr. Spit, idiot grin still pasted large across my face, and waited for him to make a move that appeared to be a punch.

 

One of the officers became curious, long around this point in the performance, about what our hold up was, and poked his head into the rig. Seeing Mr. Spit with a balled up and drawn back fist, and me and my bat-sized flashlight coiled up for the right field fence, he determined that Our New Friend was not all that needful of medical attention, so much as a little continuing education on Proper Deportment When In The Ambulance. He grasped Mr. Spit’s collar, and, WHOOSH!, he was gone.

 

The next I saw of him, Our Friend was sprawled across the hood of a patrol car, and a Very Large Officer was whispering into his ear. While laying atop him. Didn’t look too comfortable.

 

The uniformed officer poked his head into our module, and we exchanged car designators, and he waved goodbye. “We have everything under control here. Your friend just refused care.”

 

Another night of saving lives, in Da City!

Life in Da City!

Moving Targets

So, some background. I have spent some time in urban EMS, as perhaps you had determined from both the title of the blog, as well as my tales of rollicking good times. I have noticed a few things.

Thing The First: Typically, EMS service populations are not drawn preferentially from what might be termed “life’s winners”. Indeed, for some reason, the log books skew towards the underachievers, the disenfranchised, the unsuccessful, and those who, generally, actively choose the stonier path upon which to direct their lives. Thus, the Donna Reed Quotient is kinda low. Clean cut? Not so common. Well spoken? Again, um, no. Conversations revealing polish, education, and familiarity with The Classic Works of English Literature? Nope. Preventive, or any other sort of, maintenance in evidence? Uncommonly. Not of the dwelling, not of the vehicles in the yard on blocks, not of the furniture, not of the persons of the folks you meet.

There are, of course, exceptions to this observation. Among the impoverished portion of the community, there are folks who are clean, polite, energetic, hardworking, and who try to make that which they do have, last, and their households and persons reflect this effort. Their children can be seen, when you are on the scene, quietly, out of the way, watching you perform your EMS magic, when they are not completing their homework, or accomplishing chores about the home. But, these folks are outliers.

Thing The Second: There is a well nigh unitary correlation between what might be considered Dumb Life Choices (drug use, intoxication on a regular basis, failing to pursue an education, to name a few high profile such choices), and poor hygiene and poor housekeeping. Again, there are contrary examples, and I see within them a spark of potential for redirection of self into paths perhaps more life enhancing, but (1) they are exceptions, and (2) folks have to make these transitions themselves, because they value these changes, and will not do so because I am so freaking perfect, and think that they should. Because, for one, I’m not.

Thing The Third: There is a similarly high correlation between squalid domestic settings, and infestation with vermin. Deer hunters know (And, after all, I live in rural Michigan, and deer hunting is One Of The Eight Sacraments) that, if you want to attract deer (or any other game species), you provide those things that they seek, and they will come. Food source, shelter from wind, water, protected lanes of travel between these things? Set up your blind, the deer will come a’calling.

Similarly, if you want roaches, provide them with water (check your pipes), food (which we spell g-a-r-b-a-g-e), shelter (cracks in your cabinets, walls, or the openings for electric outlets).

As you can infer from the foregoing, dilapidated housing, with inattentive folks (because stoned/drunk/other), and a failure of the concept “take out the trash! Wash your dishes every several days! Remove/reduce the clutter everywhere that provides shelter for vermin!”, well, you get, at the least, bugs.

As attractive as that sounded to me, and as fun as it looked as well when in these houses, well, I was reluctant to form my own “Wild Kingdom” to enjoy in my very own home. I developed the habit of shifting my weight from one foot to the other, regularly, in hopes of at least providing a moving target for the insect life present in the biome. Kind of a common tic among my colleagues, at that time.

So, TINS ©, TIWFDASLIDC ©, and in the course of doing so, my partner, Doug, and I transported a soul to TSBTCIDC. Of course, this soul originated from, let us say, a domicile that would NOT win a Good Housekeeping Award, although Merck might be interested in seeking new antibiotics there. We arrived at TSBTCIDC, and I was giving report to Mallory. I was winding my tale up, about to deliver the epilogue, when she interrupted me.

Do you have to go to the bathroom?”

(Me, shifting weight from left foot to right foot, rhythmically and repetitively) “uh, no. Why?”

(Her, looking skeptical) “Because you’re doing the potty dance.”

I looked at my feet. Looked at her. Looked at my feet. Looked at her. “Nope, I just got into the habit of doing this, so as to make it harder for the roaches to hitch a ride home.”

Just so you know, that is not a particularly successful pick up line. For some reason, the women do NOT find that insight alluring.

Who knew?

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 off 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.

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 parts, 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