SNOW DAY!

He’s not sick, not stupid and not homeless. When he is tired, or cold or hungry he’ll call 911 and say his legs hurt, or he is bleeding rectally, or he has abdominal pain. We take him to the ER, they treat him and he is shown the door. He walks to the nearest pay phone and with discharge papers in one hand and the phone in the other he calls 911 for a ride to a different hospital. At restaurants he eats a full course dinner, clutches his chest and yells for somebody to call 911. Of course, somebody does, we show up and take him to the hospital. The restaurant eats the tab, the servers go without a gratuity, the “patient” wins again. He is a heavy man, fifty years old and diabolical. Time and time again we give him the lecture; somebody could die while he abuses the system, a kid could be choking, heart attacks, accidents, he could care less. He is getting his. I have never seen anybody with such absolute disregard for his fellow man. Our system of government is the most successful civilization has ever seen. The Constitution is a brilliant document giving us all the rights afforded within, most importantly the right to pursue our own happiness. People like “Norman, if allowed,will crush our pursuit of happiness. The legal system which is based on the Constitution has been corrupted to the point it is no longer recognizable to the people who wrote it. “Norman” and thousands like him are allowed to exist and make a mockery of our law by the very people who are trained to uphold the laws but have chosen to corrupt them instead. If I were to leave “Norman” at the pay phone, or if the police were to arrest him at the restaurants where he is having his alleged chest pain, or if we or the hospitals refused to treat him and in the unlikely event he actually had a real emergency, there would be a trainload of lawyers waiting to fill their pockets. The fact that people like “Norman” are allowed to thrive among us makes me wonder if we can ever get ourselves back on track. I certainly hope so. Until then, I’ll take “Norman” the two blocks back to the hospital when he calls. Or maybe not.

All she had was a wheelchair, a couch, a bed and a picture of Elvis. The place was clean, when you don’t have anything it’s easy to keep up. From her bed she told us about her pain. Four days now, getting worse every day. Diabetes for twenty of her fifty-three years had taken it’s toll. What little I recall of my grandmother’s mother is an old lady in a wheelchair with no legs. She lost them to the “Sugar” was all I was told.

We brought her to the truck, got her comfortable and headed toward Rhode Island Hospital. It was a long transport for us, about twelve minutes. I settled into the Captains chair and started the report while “Louise” sobbed in the stretcher. It was a busy night, the radio blared in the back, “Rescue 2 and Engine 14 to Manton Ave. for difficulty breathing,” “Rescue 5 and Engine 7 to Benifit Street for a man who has fallen.” “Rescue 4 to 100 Broad Street in the Lobby for an intoxicated male.” “Engine 4 with an East Providence Rescue to Blackstone Blvd. for chest pains,” and on and on. I turned the volume all the way down. From the cab came a familiar sound. “A little Elvis for your listening pleasure,” Jeff yelled back as we rolled down the highway. “Don’t be cruel,” “Hound dog” then “Teddy Bear.” Louise sat up in the stretcher, stopped sobbing and actually smiled. It was the best ride of the night. Sometimes Jeff’s music is the perfect medicine.

He sat on the cold street holding his foot in his hands. It was still attatched to his leg but just barely. I winced every time he tried to put it back where it belonged. With help from Engine 8 we loaded him into the rescue. I left the boot on but cut off the pants leg, exposing the bloody sock and compound fracture. Jorge was conscious, he looked more upset than anything. We held him still, started an IV and transported him to Rhode Island Hospital. No pain medication, Rescue 6 does without morphine.

Jorge had no ID, no home and now no livlihood. His immigration status is most likely illegal. How quickly things change. He was fortunate his injury didn’t happen in Guatelmala, his leg would probably be gone. It will be months, if ever, before he walks again. His injury will cost the system tens of thousands of dollars. He came here for the work, probably sending most of his earnings home. He and his family have some hard times ahead.

“He looks pretty big,” said Don Touro as we approached the crowd.
“He’ll be alright, I’ve had him before.”
Jonathan stood with a Providence cop and the guys from Engine 10 holding his bruised and bloodied hand.
“What happened?”
“He was mad and punched the walls at his group home,” Lt. Deedy from Engine 10 told me. “It doesn’t look too bad.”

As Don Touro bandaged the damaged hand Jonathan told me what happened.
“The people at the group home keep telling me I won’t be nothin when I get out of here. I’m going to be eighteen next month and on my own. They said I’m not ready but Carcieri is lettin all the eighteen year olds loose.”

In an effort to trim the Rhode Island State budget, Governor Carcieri has proposed drastic cuts to social programs. Among them is a provision releasing patients under the care of the Department for Children, Youths and Families, (DCYF)at age eighteen as opposed to the current cut off age of twenty-one. When I read about it in the paper and heard it on the news it sounded like a great idea. Decisions affecting other people are easy to make from the comfort of home.

“Why were you punching the walls?” I asked Jonathan as we rode toward Hasbro Children’s Hospital. “I just get mad and lose it,” he said. “I told the counsellor that said I was never going to make it I was going to kill her. Then I punched the window but it wouldn’t break so I went outside and threw rocks at it but I kept missing. I ran a few streets away and started punching a brick wall. Then the cops came, then you came and here we are.”

He is a big seventeen year old kid with a lot of problems. He has been in group homes since he was four and heavily medicated. This wasn’t the first time I took him to the hospital because of his outbursts. I don’t know if the group home is the answer, but I do know that if they set him loose next month he will be in real trouble.

He appeared a lot more dazed than he should have. The damage to his Camry was minor. The pick-up he hit had only a scratch and a broken tail light. The guys from Engine 10 saw something wasn’t right. “He might have had a stroke,” said Bruce as we tried to get him to tell us what happened. “I can’t move my left arm,” he said, speech slurred. I didn’t think he was intoxicated. We rolled the stretcher to the drivers door and lifted him onto it. The frozen rain and sleet that had been falling for most of the day and previous night made the footing treacherous and soaked us and the patient, a sixty-one year old guy from Cranston as we worked.

In back the situation came clear. Brad, my partner for the day a was working overtime. He started an IV while I got the patients vitals. B/P 212/140, pulse 74, pulsox 96% with a glucose level of 110. He had a facial droop on his left side along with left sided weakness. Probable CVA. We hooked him up with hi-flow oxygen, applied a cervical collar and ran an ecg then started toward Rhode Island Hospital. I was able to get some answers as we sped toward the ER. He was shovelling snow when he felt left sided weakness. He waited for half an hour for the feeling to go away. When it got worse, he got into his car and started to drive himself to the hospital. Sometimes the people who need us most “don’t want to bother us.” “Why didn’t you call 911?” I asked him. “I figured you guys were busy with real emergencies,” he said.

At the hospital the doctors confirmed our findings. He was a candidate for an aggressive but risky treatment for stroke patients. The treatment has something to do with thinning the blood. When it works loss of function is minimal. He was having a major stroke and tried to drive himself to the hospital. My guess is he will decide to take the chance.

Ice Rescue Drill, Roger Williams Park

Drew and Seth from Engine 11 cut a hole in the ice. One went into the freezing water, the other one rescued him. They switched places and did it again. Division 1, Battallion 2, Special Hazards, Ladder 5, Engine 13, Engine 10 and Rescue 1 took part in the drill orginized by Lt. Grantham of Engine 11. His guys did a great job.

As the night wore on his lungs filled with fluid. Finally, his wife called 911. When we arrived he was struggling for air, diaphoretic and nearly unconscious. His vitals showed his Pulsox at 83%, B/P 220/148, respiration’s around 40 with a heartrate of 140. At a fit seventy five years old Daniel looked like he could have been most of the guys grandfather, or in some of our cases, father. With help from Engine 12 we carried him to the rescue. Renato started an IV, Issac set up the 02 with an Albuterol treatment, I slipped a nitro tab under his tongue. I could see fear in Daniels eyes as he labored for every breath. He had a history of Congestive Heart Failure. His wife gave me his medication list on the way out the door. I saw aspirin and Lasix on the list. I filled a syringe with double his daily dose of Lasix and pushed it through the IV line. For me, one of the most gratifying moments of the job is seeing the effects of our work evident on the face of the people we help. Within minutes the Albuterol started to help clear his lungs, blood flow was increased by the nitro, the Lasix helped pass fluid from his lungs and the Oxygen helped considerably. I reassessed his vital signs; Pulsox, 96%, B/P 168/110, respiration’s 24 with a pulse of 110. Not bad. The best vital sign was the look of relief that showed on his rugged face. We transported him to Our lady of Fatima hospital. He was able to say thank you and shake our hands as we left. I thought to myself as we rode back to the station as the sun was rising how fortunate I am to have the best job in the world.

The Rescue Gods are toying with me. A twenty-one year old called with contractions two minutes apart. We were three minutes away from the hospital. Water broke, patient screamed, I broke out the catchers mitt. We arrived at Women and Infants at 0008 hrs. A baby boy was born at 0009 hrs. This one never made it upstairs. She barely made it off my stretcher. My record is still intact, barely. I have tempted fate, it’s only a matter of time now. I may have to make a sacrifice to appease the gods. Maybe I’ll let the next one push and get it over with.

A man dies in a heroic attempt at saving his daughters life. Time and time again he tries, stopping only when he has nothing left to give. His teenage daughter clings to life, 3rd degree burns over sixty percent of her body, scarred for life, however long that may be. A mother and son face an uncertain future, heartache, loss and economic disaster. Firefighters battle the early morning blaze, fearless warriors protecting the lives and property of the citizens of Providence. Outside the inferno, two firefighters wait, detailed to Rescue 6 for the night. One from a Ladder Truck, the other from an Engine Company. They watch knowing they should be inside with their brothers doing what they do best, fighting fire. The pulseless, burned body of the teenage girl is brought to them from the charred ruin. With minimal rescue experience in an unfamiliar setting, they do their job better than anybody has the right to expect. This incident, and countless others get a small mention for a day on the local news, an article in the local section of the paper until something more lurid comes along.

Everywhere I look I see images of Anna Nicole Smith. Her tragic end is on the front page in the newspapers nationwide, lead story on network stations, twenty-four hours on CNN, MSNBC and FOX. The media panders to a society that lives with heroes and superstars right in their midst. Our soldies die fighting a war that has lost it’s luster with the media. Without “in depth coverage,” “paparazzi” or fanfare we walk side by side with greatness, regular citizens as important and newsworthy as the “stars.” Some of us make our living where our mettle is put to the test daily. Others go about their business until tragedy strikes, then find within themselves the courage and conviction to make a difference. Then there are those who are fascinated by the glamorous images projected in front of them as they live their lives in front of their TV screen, waiting for somebody to save them.

Somebody was waiting at home. Midnight, twelve-thirty. One. They must have been frantic. A phone call shattering the silence, one nobody should have to hear. “There has been an accident.”

A truck hauling scrap metal was travelling south on Rt. 95. 95 splits into rt. 195 from the left hand lanes, confusing even for people familiar with the roadway as you roll through Providence. The trucker from Gettysburg, PA. was in the wrong lane. When he realized his mistake and tried to veer right back onto 95 his load shifted, the truck tipped onto it’s side, crushing the car in the next lane. A woman was driving home. She never made it.

The scene was chaos as firefighters tried desperately to clear the sharp metal from the overturned truck. A hole was cut into the roof to expedite things. As I walked the injured truck driver past the horrific sight he stopped and looked, visibly shaken by the sight. The rear tire was all we could see of the car crushed beneath the truck. At that point we didn’t know how many were in the car. It could have been full of kids.

When enough debris was cleared, Zack Kenyon, Lt. from Rescue 4 crawled through and assessed the situation. One victim, female, fifties, pulse less, deformities, deceased. Renato and I transported the trucker to Rhode Island Hospital. He had been driving trucks without incident for thirty years. He wanted to call his wife back home but his cell phone was lost in the debris.

When I got back to the station I called Cheryl. She yelled at me for calling so late. The sound of her voice was bittersweet.

I wonder why he was outside on an eight degree night, dressed in jeans and a short sleeve t-shirt with only a down vest to protect him from the elements. The wind chill was well below zero. If he had a destination in mind he never made it. Somebody saw a crumpled heap lying on the sidewalk and called 911. He was conscious, barely. No ID in any of his pockets and he couldn’t tell us his name. We found him at five a.m. Another hour and he would have been dead. He’ll probably lose the fingers on his right hand from frostbite, the left ones have a chance. Cocaine and barbituates were found in his blood. This has been a mild winter for most of us but a cruel one for the guy we found frozen to the sidewalk.

The city is lively tonight, the usual suspects drunk and helpless providing a steady stream of 911 calls. Toby Keith is playing to a sold out Dunk. The Granny Drop has been in full swing since this morning; Super Bowl Sunday and all, no room for sick old people at home. Diabetics, seizures, MVA’s and all that go with it have filled the area hospitals. I don’t know if we need more hospitals or less sick people. I do know that the people we have need to find a better way to take care of themselves. I often wonder what would happen if a true large scale emergency happened. We survived the Station Fire thanks to the heroic deeds of the people who worked that horrific night. That was one incident involving four hundred people and it nearly crippled the system. I hope to never find out how we could treat thousands.