She walked out of her house holding her belly. She was pretty, but looked tired. I was surprised to see her walking. I’ve noticed a lot of people who call 911 in the middle of the afternoon because of abdominal pain are either drug seekers, hypochondriacs or worse. I can’t count the number of times I’ve been called to peoples houses for similar complaints to find the sick person lying in bed, unable to move and acting as if they were the only person on the planet that was ever sick. I’m not saying they are not sick, but to call the fire department because of a belly-ache is absurd. They wait for us to pick them up, put them on the stretcher and carry them out to the rescue. I learned fast. People have to be pretty sick for me to lug them down two or three flights of stairs. The first thing I often ask now is not “where does it hurt?” rather it’s “where are your shoes?” This woman was different. I would have carried her even if she insisted on walking. We helped her into the truck and got her on the stretcher. She spoke limited English so I let Renato do the talking. The color drained from his face as he translated. “She says her stomach started swelling last night at around 3:00. The pain has been getting worse. She had chemo four weeks ago but the cancer spread to her liver. It started in her ovaries but keeps spreading. It’s stage four now. She’s in a lot of pain.” I wrote the information onto the state run report. The fact that struck me most was her age. Thirty-seven. She lay on the stretcher, closed her eyes and rested during transport. A few tears were shed along the way, I don’t know if they were tears of pain or hopelessness.

She could barely stand; he wasn’t much better. They were down on the sidewalk at 390 Douglas Avenue. Somebody called us from their cell phone. A small cut over her right eye had stopped bleeding but the dried blood remained on her face. The guys from Engine 12 helped them into the rescue. She started complaining immediately, he nodded out. This was my first call in eight days. Vacation is nice but ends too quickly. “Wake up!” He jumped and opened his eyes. “What happened?” I asked. She answered. “Nothing happened. We don’t have to go with you so let us out.” You’ll fall if I let you out.” “No I won’t. If I do my husband will pick me up.” I looked at her “husband,” out cold on the bench seat. “Wake up!” They had all the signs of heroin addicts. She had just gotten out of detox at Roger Williams Hospital. He picked her up. From the looks of things detox lasted until the first package store or dealer. “How many bags?” I asked him, his pinpoint pupils giving up his secret. “I didn’t do heroin, I’m on eighty of methadone. I could do ten bags and it would feel like an asprin,” he said with pride. “I could do twenty, no problem,” she chimed in. They told me they just wanted to go home. Their address was a few blocks away. Rhode Island Hospital was packed, Miriam diverting and Roger Williams a nuthouse. “If I take you home, stay home,” I insisted. They relaxed and held hands during the ride. He told me he had to catch a bus at six the next morning. “Where are you going?” I asked. “Work.” Instead of bringing them to the hospital for babysitting I took them home and watched them as they stumbled in.

Thanks to Uncle Brian, Air Force Veteran, for sending this to me. I’m here, fat and happy after a nice Thanksgiving Holiday. Our brothers, friends, fathers and mothers are there, surrounded by bloodshed hatred and lonliness. Thank you all. You have my utmost respect and gratitude. Be safe and come home.

The embers glowed softly, and in their dim light, I gazed round the room and I cherished the sight. My wife was asleep, her head on my chest, My daughter beside me, angelic in rest. Outside the snow fell, a blanket of white, Transforming the yard to a winter delight. The sparkling lights in the tree I believe, Completed the magic that was Christmas Eve. My eyelids were heavy, my breathing was deep, Secure and surrounded by love I would sleep. In perfect contentment, or so it would seem, So I slumbered, perhaps I started to dream. The sound wasn’t loud, and it wasn’t too near, But I opened my eyes when it tickled my ear. Perhaps just a cough, I didn’t quite know, Then the sure sound of footsteps outside in the snow. My soul gave a tremble, I struggled to hear, And I crept to the door just to see who was near. Standing out in the cold and the dark of the night, A lone figure stood, his face weary and tight. A soldier, I puzzled, some twenty years old, Perhaps a Marine, huddled here in the cold. Alone in the dark, he looked up and smiled, Standing watch over me, and my wife and my child. “What are you doing?” I asked without fear, “Come in this moment, it’s freezing out here! Put down your pack, brush the snow from your sleeve, You should be at home on a cold Christmas Eve!” For barely a moment I saw his eyes shift, Away from the cold and the snow blown in drifts. To the window that danced with a warm fire’s light Then he sighed and he said “Its really all right, I’m out here by choice. I’m here every night.” “It’s my duty to stand at the front of the line, That separates you from the darkest of times. No one had to ask or beg or implore me, I’m proud to stand here like my fathers before me. My Gramps died at ‘Pearl on a day in December,” Then he sighed, “That’s a Christmas ‘Gram always remembers.” My dad stood his watch in the jungles of ‘Nam’, And now it is my turn and so, here I am. I’ve not seen my own son in more than a while, But my wife sends me pictures, he’s sure got her smile. Then he bent and he carefully pulled from his bag, The red, white, and blue… an American flag. I can live through the cold and the being alone, Away from my family, my house and my home. I can stand at my post through the rain and the sleet, I can sleep in a foxhole with little to eat. I can carry the weight of killing another, Or lay down my life with my sister and brother.. Who stand at the front against any and all, To ensure for all time that this flag will not fall.” “So go back inside,” he said, “harbor no fright, Your family is waiting and I’ll be all right.” “But isn’t there something I can do, at the least, “Give you money,” I asked, “or prepare you a feast? It seems all too little for all that you’ve done, For being away from your wife and your son.” Then his eye welled a tear that held no regret, “Just tell us you love us, and never forget. To fight for our rights back at home while we’re gone, To stand your own watch, no matter how long. For when we come home, either standing or dead, To know you remember we fought and we bled. Is payment enough, and with that we will trust, That we mattered to you as you mattered to us.” PLEASE, would you do me the kind favor of sending this to as many people as you can? Christmas will be coming soon and some credit is due to our U.S service men and women for our being able to celebrate these festivities. Let’s try in this small way to pay a tiny bit of what we owe. Make people stop and think of our heroes, living and dead, who sacrificed themselves for us. LCDR Jeff Giles, SC, USN 30th Naval Construction Regiment OIC, Logistics Cell One Al Taqqadum, Iraq

I knew he wouldn’t make it much longer. I can’t believe he lived for as long as he did. I can’t say I’ll miss him, or that I’m sad now that he’s gone. I am a little concerned that I don’t feel anything at all. I sometimes wonder if this job takes more than it gives.

There was a pedestrian struck on the corner of Cranston and Bridgham. We were at RI Hospital finishing up at the triage desk. I keyed the mike.
“Rescue 1 to fire alarm, in service from Rhode Island, we’ll handle Cranston Street.”
“Roger 1, you’ve got it.”
Renato hit the lights and sirens and sped out of the ambulance bay. We both knew a lot of kids hung around that corner. A minute into our response Engine 3 gave their report over the radio. “Engine 3 to fire alarm, advise Rescue 1 we have a seventeen year old male, conscious and alert with minor injuries.”
“Rescue 1, received.”
Renato slowed to a reasonable speed as we approached the scene. A young Hispanic guy sat on a curb holding his knee, squeezing it, trying to get more blood from the tiny scrape. A crowd had gathered, surrounding us. I asked the guy if he was hurt. Three people from the crowd answered for him.
“He needs a doctor!”
“Take him to the hospital!”
“What are you waiting for!”
I looked at the knee and asked him what happened.
“I was riding my bike and the car ran into me.”
“Did you run into the car or did the car run into you?”
The guy who was driving the car stood off to the side with the police. There was no damage to the bike, the car and the slightest damage to the knee. The crowd continued their banter. Renato talked to them in Spanish; that quieted things for a while. Again I asked the patient, “Are you hurt?” Again the crowd started.
“He’s hurt!”
“Get him to the hospital!”
“Hurry up!”
I had to walk away. I was talking to myself, something about lawyers, Jerry Springer, Democrats, Republicans and morons when Joe, the officer of Engine 3 pulled me to the side. He shook his head, took a deep breath and said repeat after me;
“In with Jesus,” he exhaled sharply and said, “out with the devil,” then walked back to the crowd. I’m not a religious man and I don’t know about Joe but he brought me back to where I needed to be. I walked through the crowd, back to the patient and said, “get in the truck.”

4:12 am. It’s late. Or early depending on how you see things. Right now I’m seeing things as pretty dreary. I was at RI hospital delivering my ninth intoxicated male of the night to the ER when a lifeflight landed in the helipad. A female, around sixty was in critical condition, her husband, also critical being transported by land arriving soon. The trauma team worked on the woman as I left to pick up a twenty-two year old who vomited. The girl was a real bitch, wouldn’t look at me and barely answered my questions. When I got back to the ER the woman was dead, her husband in the next room will survive but will probably be paralyzed. They were out celebrating his birthday. Something happened, the car rolled, they were ejected. The usually hardened people who work in the ER were stunned. They went on, caring for the endless flood of patients marching through their door. The unfairness and cruelty of life amazes me.

I’ve been here for thirty-four hours and have four to go. No sleep, thirty-two runs so far. I can’t wait for this to end, go home and kiss my wife then fall asleep and hope the depression I feel is gone when I wake.

“RESCUE 6 AND ENGINE 7, RESPOND TO 10 MEMORIAL BOULEVARD AT THE G-TECH CONSTRUCTION SITE FOR A MAN WITH CHEST PAIN, FIRST FLOOR GARAGE.”

We left the Atwells Avenue fire station at 2:04 pm. John McGovern was driving, we were both working overtime. At 2:07 Engine 7 gave a report over the radio. “Engine 7 to Rescue 6, fifty-two year old male, no history with severe chest, diaphoretic at this time.” “Rescue 6, received.”

2:11. We turned onto Memorial Boulevard, what should have been a bustling thoroughfare was a parking lot. In the distance a flurry of activity in front of the G-Tech building caught my eye. Construction workers, truck drivers and detail cops were directing the traffic frantically, clearing a path. Drivers of the cars and trucks blocking our way had no choice but to get out of the way. Fast. We flew through the path, inches between us and the stopped vehicles.

2:13. We stopped in front of the building. I saw the victim about seventy-five feet inside the garage, oxygen mask on his face, sitting, clutching his chest, two firefighters, Tim and Greg helping him. Lt. Paul Picozzi met us at the rescue and helped with the stretcher. The guy was soaked with sweat and gasping for air. We had him on the stretcher and into the truck in two minutes.

2:15. We ran an EKG and attempted an IV. Greg gave him as aspirin, John got the man’s blood pressure and heart rate. The truck was moving at 2:16. His EKG showed some ST elevation, indicating a probable inferior wall infarct. Another IV attempt failed en route. BP 158/100 with a pulse of 100. Greg slipped a Nitro tab under the patients tongue. “Let it melt, it should help.”

2:20. We wheeled “Roger” into the ER. Donna was working triage. One look at the patient and she was on the Voicera announcing a medical team was needed in Trauma Room 3. I gave her my report as we rolled down trauma alley toward Trauma 3. Ashley and Leeanne, two Trauma Rn’s waited.

2:22. Roger was on a Trauma stretcher, Ashley and LeeAnn starting IV’s while I helped Donna with another, more advanced EKG. Sara, the Trauma Doctor in charge assessed the situation, read the EKG when it was done ordered a Heparin Bolus, Plavix through the IV, a Nitro drip and a chest x-ray.

2:37. Seventeen minutes after arriving at the ER, 33 minutes after dispatch, Roger was in the Cath Lab with four IV’s running and the proper meds on board.

Roger was lucky. His heart muscle began dying the minute his chest pain began. The construction workers and truck drivers who cleared the way, the cops who kept the road clear, the nurses, doctors and firefighters worked perfectly together. A heart attack is basically the death of the heart muscle. Medical people have a saying, “Time is muscle.” Roger will probably make a full recovery. I hope everybody involved in Roger’s care understands how vital their role was.

As we drove away from the ER toward another run both John and I agreed. This is the best job in the world.