Overheard in the back of Rescue 1, during a clean-up.

"Piss isn't too bad."

"Puke is the worst."

"Nah, shit's worse than puke, any day."

"Blood is easy, it doesn't stink."

"That's why piss isn't bad, easy clean-up."

"Old piss is pretty bad."

"New shit is worse than old shit."

"It's still runny."

"Speaking of runny, snot's pretty bad."

"Yeah but you hardly ever wear it. "

"Yeah, puke wins that one."

"But shit's still the worst."

"Yup. Piss is my favorite. Definitely."

"I guess."

Overheard in the front of Rescue 1. Very late at night.

"I wonder why we never get sick."

"Because we already are sick. There's only so much sickness to go around."

"Yeah, but we're surrounded with sick people all the time. We touch them, breathe their air and all that, you would think we would get sick more often."

"You think too much."

"And why do we carry people with back pain down three flights of stairs when our backs are worse that theirs?"

"Because we can."

"So can they."

"The difference is, they know WE can."

"But we know THEY can."

"You think too much."

"I guess."

Overheard in the cab of Rescue 1 enroute to "man down."

We're Cavemen, you know.

(from officer's seat, fiddling with the radio) How so?

The station is like our cave. It's dark, dreary and ugly.

A man-cave.

Right. Instead of wall paintings we have a big screen TV. Every now and then an emergency happens, we pile on our skins and forage into the wilderness to protect the women.

Some of us are women.

Right, there have always been strong women.

Right. Remember Raquel Welch from 1,000,000 years BC?

Who?

(looks incredulously over at his man-boy driver) Never mind.

Anyway, when we get hungry we leave the cave to hunt for meat.

The supermarket isn't exactly hunting.

It is when you're looking for a deal.

I guess.

Then, we gather around the fire and eat.

 You do look like a bunch of Neanderthals at the table.

Exactly. Cavemen.

Right. (Mike keys the mike as Ryan stops the rescue in front of the "emergency.") Rescue 1 on scene.

The cavemen load up their weapons and forage into the wilderness, looking for their victim.

Overheard on the Street:

Police officer: "Hey, were you guys there that day when that girl flashed us?"

Firefighter 1: "Which girl?"

Firefighter2: "What day?"

Firefighter 3: "There have been so many, we forget."

The police officer walks back to his cruiser, shaking his head.

Police Officer: "I think I took the wrong test."

Overheard in the Cab of Rescue 1 after clearing Hasbro Children's Hospital:

"She was hot."

"She's fifteen you pervert."

"Not her you idiot, her mother."

"Her mother is old enough to be your daughter."

"That means I'm old enough to be her mothers father."

"Right."

"She's still hot."

"And you're still old."

"Right."

"Rescue 1 in service."

Overheard in Rescue 1 after a visit to the Coffee Exchange where the crew was completely ignored by the college girls behind the counter.

Lt:  "I don't get it. They don't give us the time of day. It wouldn't kill them to be nice to us. Jeez, girls aren't like they used to be. Why can't they even crack a smile?"

Ryan:  "Because I'm fat and you're fifty."

Lt:  "Oh, that. carry on then."

Overheard at the ER

The ER was a madhouse, drunken street people, drunken college kids, drunken housewifes, drunken fools. Minor injuries, a few legitamite trauma's, some sick old folks and a bunch of people vomiting. The wait was hours. In the middle of it all was a twenty something year old inmate from the ACI and two correctional officers. The prisoner had a minor injury to his throat from an altercation and had been waiting for a long time. As I walked past them I overheard the inmate ask his guards, "can I go back to my cell? Anywhere is better than here."

I ran into a guy I know while picking up some Thai take-out.

"How you doin?" he asked.

"Okay," I answered.

"Still a fireman?"

"Almost done," I said.

"Must be nice," said one of the six people at his table. I didn't say a word.

"Wish I could retire," said another.

"What are you, forty-five?" asked a third.

Just what I needed, a bunch of middle-aged people, business owners, office workers, construction people- whatever – in my grill. In my head a litany of responses were born, and quickly died.

"I wish I had worked in a nice air conditioned  office for twenty-two years."

"Must have been nice having holidays with your family."

"Ever have a ceiling fall on your head. One that's on fire?"

"Ever been stabbed by a dirty needle?"

"Ever been shot at?"

"Ever held a dead baby?"

"Ever…"  blah blah blah, it wasn't worth the effort.

Truth be  told, if I could do it all over, I wouldn't change a thing.

I paid the bill and left, for some strange reason feeling lighter than I did when I entered the place.

He’s screaming, she’s screaming, everybody is screaming, blood here, blood there, blood everywhere, nobody put the dogs out, they’re screaming too, the cops are screaming, Christ – even the houseplants are screaming.

Just because everybody is acting like monkeys doesn’t mean I have to jump into the barrel, and screaming “calm down” is akin to jumping in head first.

Standing in the middle of chaos, I crossed my arms, stood strait and asked just quiet enough that nobody could hear, “who is bleeding.”

It took a minute, and a few more quietly asked “who is bleeding’s,” but eventually things quieted down enough for me to find the bleeder, and remove him from the nuthouse.

If you want to capture somebody’s attention, whisper.

Congratulations to Warwick, RI  Firefighter John Halloran for being voted the nations sexiest vegan-next-door. According to the news story, John cooks vegan meals at the firehouse for his fellow firefighters. Having been a firehouse cook for decades, and having experienced the "constructive critisism" when the meal was anything but "hot and alot,"  from my own fellow firefighters, I can only imagine the thick skin this sexy vegan must have!

http://news.providencejournal.com/breaking-news/2013/05/warwick-firefighter-wins-national-sexiest-vegan-next-door-contest-ready-nee.html

Enjoy the trip to Maui, John, well done!

"Rescue 1 and Engine 10, respond to 1035 Broad Street for a man down."

"Why are they sending an Engine company?" asked my partner, a new guy who knew everything. "It's just another drunk."

"You'll figure it out."

I heard the slight urgency in the dispatcher's tone and knew that she sensed something in the caller's voice other than the usual intoxicated person call.

I scanned the horizon, looking for the patient. The scene through my windshield resembled a set from The Walking Dead; semi and fully intoxicated persons wandered about aimlessly, homeless for the most part, restless, hungry and unsteady. One of the regulars, "Junior," waved us over.

"He's over here," he said, unsteadily leading us around the corner where a man in his 40s sat on a curb, leaning on a building, clutching his chest.

"What happened?" I asked.  Junior spoke to the guy in Spanish then translated to me.

"He's been working on the new barber shop over there," he said, pointing at some new construction across the street. "Felt his chest thump, then lots of pain. He can't catch his breath. He thinks he's going to die."

The crew from Engine 10 arrived on scene, two firefighters retrieved the stretcher from my rescue, and my old partner, Renato, joined us next to the patient.

"Mornin' gang, looks like a possible MI; Renato, grab a 12-lead while we get him ready to roll."

Renato hooked him up to the EKG machine while my partner assessed vitals and readied the 02. Just as the results were printed, a non-rebreather went over the man's face, the stretcher appeared, Junior helped us load the man onto it and we were back in the truck.

"220/130, rate of 110," said my partner.

"Stemi," I said, looking up from the EKG. The crew got to work as I sent the image to the ER. An IV was established while nitro and aspirin was administered. One of the firefighters got in front to drive, Renato stayed in back with the new guy and me.

"Let's roll."

Junior closed the doors for us, a big smile on his face, his work done for the day. He even gave the obligatory ambulance door double thump as we left the scene, leaving an imprint of his big paw prints clearly outlined over the road grime that had accumulated.

Seven minutes from our time on scene to the door of the ER, two IVs had been established, a 12-lead was in a cardiologist's hands, a STEMI team began assembling, meds were on board, oxygen flowing, vitals re-assessed and the most important part – a stable patient whose life will continue was conscious and smiling on our stretcher.

He was in the cath lab less than an hour after the onset of symptoms.

The dispatcher heard something in the voice of the caller and sent the proper resources, our relationship with the homeless alcoholics led to one of them being willing and able to offer some needed assistance, a crew of ALS trained firefighters on scene, and an ER staffed, trained and ready to handle cardiac emergencies all combined to give a guy working on a barber shop the chance to finish what he started.

Dispatch. The Homeless. The Ambulance. The Firefighters. The ER.  When we work together, great things happen.

http://www.ems1.com/fire-ems/articles/1443561-When-we-work-together-great-things-happen/

http://www.ems1.com/ems-week-2013

We had a nice team save, here's how it went down…

http://www.ems1.com/fire-ems/articles/1443561-When-we-work-together-great-things-happen/

Memo to the knucklehead on the rice burner who nearly drove into my car head on because he was too busy flipping off and yelling at the driver of another car who, due to the motorcycle drivers inexperience nearly hit the aforementioned biker while changing lanes because apparently Mr. Big Bad Biker has never heard of blind spots:

     1. You share the road with automobiles

     2. Automobiles are bigger than motorcycles

     3. People in those big automobiles sometimes cannot see you, so PAY ATTENTION, Dumbass!

And furthermore, memo to the pretty, nearly naked hottie on the back of Mr. Big Bad Biker's rice burner:

     1. Get off the back of the bike and learn how to ride, then you will never be at the mercy of a moron who thinks his motorcycle is a toy and has no regard for his or anybody elses safety.

     2. Put on some clothes for Christmas sake, I'd hate to see all that skin smeared all over the highway!

Motorcycles are Everywhere. The days of the big bad biker are over. There are lots of Mama's boys driving bikes that are too powerful them out there. And, there are also a lot of weekend warriors on their $25,000 Harley Davidsons who should have bought a convertible.

Yeah, I know, I sound like a jerk. It's not all the carnage I've seen over the years that makes me so; rather, it's the guy my age who I take to the ER regularly for treatment for his seizures. He cracked up his bike ten years ago and has lived with the elderly in a nursing home ever since. The only helmet he ever wore is the one on his head now, the one that keeps him from cracking his melon again when he seizes.

Born to be wild? You tell me.

There, I said it. However, being a former motorcycle owner (1978 Honda CB 900) and sometime rider, and friends with people killed and maimed while on motorcycles and doing nothing to deserve their fate other than be clobbered by a car driven by a drunken driver, person not paying attention or just bad luck it remains to be said that we all need to put down our phones and beers and whatever else and pay attention while driving. Not everybody is a knucklehead, and even knuckleheads deserve a safe roadway, as long as they themselves follow the rules of the road.

It was odd how just as the victim plunged into unconsciousness some miles away, unknown to me then, I sat at my desk contemplating mankind's fascination with mind altering substances. My penchant for opiates and laudanum notwithstanding, it never fails to fascinate me how we as a species are willing to dance on the threshold of death's doorway, bloodstream filled with substances that dull our senses, distort time and deaden emotion. Perhaps this last is why we take such chances with our lives, for this can be a trying existence.

"Rescue 1 and Engine 12, respond to 323 Joseph Street for a man unconscious."

I ditched my melancholy immediately and hit the pole, opening the overhead doors to Baker Street and waited for my erstwhile partner, Dr. Watson. Some ten seconds later he appeared, opening the door to the Ford F-450 and climbed aboard.

"Dr.  Watson, well, met," I said as we roared out of The Yard and sped toward our victim. "Another game is afoot!"

"You look rested, Holmes, the break did you good."

"Never enough my good friend, rest is an elusive fish I can never seem to fully grasp."

"Engine 12 to Fire Alarm, we have a thirty year old male, unconscious, no trauma."

"Receive that Rescue 1?"

"Rescue 1, received."

"Odd. An overdose in that neighborhood is unusual," said Watson as we sped toward the victims home.

"Unusual, yes, but not unprecedented. Recall if you will the grandmother whose bottle of pain pills mysteriously vanished an hour before her bout of unconsciousness."

"One never knows the depths of despair a person will try to wrench themselves from with pharmaceuticals."

"Indeed." I keyed the mic as we rolled to a stop in front of a gracious colonial, well kept lawn leading to a brightly lit doorway where a frantic young woman waved.

"Rescue 1 on scene."

"At 2344."

Watson retrieved the necessary equipment for extrication from a rear compartment, I slung the med bag over my shoulder and hurriedly walked the walk toward the unconscious male.

"When was he last seen awake?" I asked the young woman at the door.

"About eleven thirty. We were playing cards with some friends, he seemed tired, then he just fell asleep. We can't wake him up, Hurry!"

In the kitchen a couple stood off to the side as the firefighters from Engine 12 assessed and treated the young, unconscious male.

"Glucose 128, BP 96/50, respirations at 6. Looks like an overdose but I don't see and tracks or evidence."

"Look more closely, " I said. The unconscious man's friends stated that he did not take drugs, and never did. Nonetheless I had Dr. Watson draw up a vial of narcan and immediately administer 2 mg through the IV the firefighters had established.

"What are you doing! He needs to get to a hospital!" the nervous wife shouted, and her friends agreed as the patient's color faded and he stopped breathing. We bagged him then, forcing life-sustaining oxygen into his lungs, keeping his 02 levels above 90.

"I'm afraid your friend has overdosed," I said to the concerned group.

"Impossible! Preposterous! You fools!" they responded. "How dare you accuse this fine, upstanding young man of using illicit drugs!

"Elementary," I responded as the patient began breathing of his own accord. "There is a walker in the corner, near the door. It has not been used recently, but not long ago enough for cobwebs to form. The obituary on the refrigerator, dated last week indicates that this young man lost somebody close, and the dead man's date of birth puts him at an age to be the father of this very young man!" I pointed to the victim who was now shaking cobwebs of a different sort from his drug addled mind. "In addition, there is a faint odor of a medicinal nature that lingers here, I have surmised that you cared for the person who died, right up until his dying moment."

She looked at me then, pain in her eyes, but relief as well as her mate regained consciousness. "My father in law died here last week. He was a wonderful man, he died of cancer."

"I am very sorry for your loss, I said. "Was he medicated?"

"Morphine. Sublingual. We put a dropper under his toung every four hours."

The young man who just returned from the other side looked sheepishly at the floor, then reached into his pocket and handed me an empty vial. I clasped my fingers around it, nodded my head knowingly in what I hoped was a gesture of understanding and not accusation and put it into my pocket. Dr. Watson and the firefighters cleaned up and returned our gear to our apparatuses, which gave me a moment alone with the young group.

"Sadness propels us to do things we would otherwise never consider. You will not be the first, nor the last to indulge in a dead persons medication. Some don't have the courtesy to wait until the person needing the narcotics dies, and help themselves to it while their loved one suffers in silence. May I suggest you find somebody to talk to, clergy, a therapist or even a friend. There were almost two deaths in this home this week, had we arrived a few moments later the outcome would not be a lecture, but a body bag."

We talked for some time, finally coming to the conclusion that this was a terrible mistake, a grief stricken young man dulling his senses with his father's medication. He had put a drop under his tongue every hour for the last five, sometimes more than one drop. It nearly cost him his life.

"Stay close to him, take care of him tonight, and get help tomorrow," I said as I departed, never fully comfortable in these scenarios, but confidant enough that the best course of action is family help rather than an emergency room full of drunken college kids, gunshot victims, blood soaked stabbing recipients and the like.

As Watson and I drove back to Baker Street, evidence of the fragility of our existence and frailty of our sanity weighed heavily on us.

"What madness allows a man to take his dead father's medication," asked Watson as the midnight hour came and went. As the hands of the clock pass twelve, an eerie calm descends on the city, lasting sometimes an hour, sometimes a minute, but it is discernable, and I am always grateful for the reprive.

"The same madness that allows a fifty-nine year old father to be taken before his time, my good friend. The madness of existence."

We rode in silence then, I filled my pipe with a sweet Turkish blend, and stared down, into the bowl as I puffed, mesmerized by the glowing tobacco and comforted by the familiar aroma as smoke swirled wistfully through the cabin.

http://www.fireengineering.com/articles/fire_life/articles/2013/april/fire-based-ems.html

…

This week’s (I wrote this a while ago) examples of how it could be:

• A diabetic, unconscious in Mount Pleasant. All Providence rescues out; Engine 15 arrives three minutes after initial call. Rescue 1 clears Rhode Island hospital, ETA 11 minutes. We arrive, patient is alert and conscious, BG 145 from a 22, IV established, D-50 administered, wondering what all the fuss is about.
• Overdose in the West End. Rescue 1 is fifth due, ETA eight minutes. Engine 8 arrives on scene in two. 2.0 mg narcan adm. IM, the patient who was seconds from death prior to their arrival now alert and conscious, denying drug use.
• Seizure in Washington Park. Seventeen-year-old kid, first seizure. Family going berserk. Firefighter from E-13 speaks fluent Spanish, calms the scene; two firefighters lift the 200-pound kid from his bed, postictal at the time, secure him to stair chair while the patient gets combative, figure a way to get him out of the bedroom and down the stairs while the rescue officer gets pertinent information from family. Once in rescue, IV established, meds administered, vitals assessed, and a report radioed to the ER. Impossible to do with two hands; six worked just fine, thank you.
• Two intoxicated males, on the street in South Providence. On arrival, Rescue 1 is attacked by intoxicated males. Police called. Engine company dispatched. Two minutes later, Engine 10 arrives on scene, order is restored, the intoxicated males subdued and restrained in the back of the rescue with assistance from firefighters. Police arrive on scene as we depart, engine company following.
• Chest pain in the North End, Rescue 1 ETA 12 minutes. Engine 2 on scene in three. Nitro, aspirin, and oxygen delivered in four, vitals and an IV to boot. Rescue 1 arrives on scene, the engine crew carries the elderly gent down two flights of stairs and into the rescue. I do the paperwork and say thanks.
• MVA on Rt. 95. Engine 11 arrives on scene five minutes prior to Rescue 1 and seven minutes prior to police. We arrive, the lights and presence of the engine providing some safety from passing motorists, bleeding from vehicle occupant controlled, c-traction applied, leaking fluids contained, and patient history assessed and documented. The firefighters retrieve the spine board from the rescue's compartment, extricate the patient, and deliver her to the rescue, then stay on scene until we depart…

"She isn't a bad person trying to be good, she's a sick person who needs to get well."

http://www.emsworld.com/article/10929600/stories-from-the-streets-compassionate-care