I’m sure Catherine would have preferred to have her dad to escort her to Bay View’s Father-Daughter dance but she had to put up with me instead. I know I’m a better dancer than her dad but she would never say so. Thanks, Catherine for inviting me, and thanks to Bob and Mary for raising such a delightful young lady. Stay low, brother, you have too much to lose.

I was questioning my job and the entire EMS system Sunday night following a busy weekend. Seventy or eighty percent of our runs were alcohol and or drug related responses. The ER’s were bursting at the seams, the aroma inside reminiscent of the barrooms I used to frequent. Alcohol, vomit and medication mixed together puts an unforgettable stamp on a persons memories.

At 1800 hours we got a call for a woman in her eighties with difficulty breathing. Engine 3 got there first and gave the initial report.

“Eighty year old female, shortness of breath, heart rate 15 to 30.”

When we entered the room I couldn’t believe the woman in the bed’s vitals were as bad as reported. She smiled at me and looked completely at peace. Maybe she knew something we didn’t and wasn’t afraid. We put her on high flow oxygen, started an IV and ran a 12 lead ecg. Heart rate 22, possible bundle branch block. She remained calm all the way to the trauma room. Dr. Sullivan looked over our data and began the appropriate treatment. He told me his assessment and reasons why the patient was in the state she was in. I nodded, pretended I understood what he was saying, rubbed my chin with my thumb and index finger and said, “Of course, I agree. Thank you doctor.”

At 1900 hrs. we got a call for a man unconscious on the third floor of his home. Before we arrived, Engine 10 gave us their report.

“Thirty-five year old male, possible OD.”

Renato got the stair chair, I carried the blue bag up the stairs. The patient was in bed, diaphoretic but otherwise stable, good vitals. Renato spoke to the family and translated.

“He drank a lot.”

He must have drank more than alot. We deal with drunks all day and night, this guy was out cold, no response to verbal or painful stimuli. We carried him to the truck, worked him up and got him to the ER. Into trauma 2. Dr. Sullivan took over. I again agreed with his findings.

At 2000 hrs a guy called from his front porch. He was a dialysis patient having trouble breathing. Engine 10 got there first.

“Fifty year old male, extreme respiratory distress.”

We stepped it up and found the patient doubled over on his front porch. His BP was 258/160, pulsox 82%. Not good. The patient was frantic, panicking. I knew Dr. Sullivan would understand. We got a driver from the 10′s, kept the patient as calm as possible during the two minute ride to the ER. This guy needed all the help he could get. My decision to “scoop and run” was what I thought would be best for the patient. We gave him a nitro, no help there and rolled. Dr. Sullivan gave him more nitro when we got there, a respiratory team was called, two IV’s started, albuterol treatments, bi-pap and more than we could have done for him. Sometimes less is more on rescue. We could have helped him breathe, but the anxiety level probably would have negated our efforts. He wanted to be in a hospital, one was two minutes away. I think we did the right thing. Dr. Sullivan seemed to agree.

2100 hrs. Person unconscious, diabetic, third floor. We found a thirty year old guy in bed, covered in sweat and vomit, pinpoint pupils, glucose level of 20. The protocols look so easy in their nice white pages, all orderly and everything. Trying to follow them on a patient covered in vomit in an unsafe, unsanitary environment is another story. We cleaned him up the best we could, tied him onto the stair chair and got him into the rescue, no easy task. IV, 02, ecg, glucose test, vitals, 2mg narcan, an amp of D-50, 100 mg of thiamine and Sleeping Beauty turned into the Incredible Hulk. We held him down as best we could, security met us at the door to the ER. Dr Sullivan looked at me and Renato when all was said and done and the patient sedated and stabilized and told us to get some rest.

Where are the homeless drunks who walk into and out of the truck looking for a place to sleep when we need them?

Waiting on Broad Street. Be careful what you wish for. Three more runs after midnight.

She was eighty pounds soaking wet. Quiet at first, then she opened up. She had a fever of 104 with a persistent headache. The bruises on her legs couldn’t be explained. The eating disorder clinic that she was going to up until last week didn’t work, she lost weight during the program. We talked about her problems. She just doesn’t like to eat, she said.

I have learned a lot about eating disorders and the underlying causes that bring them on.

“The only thing you have total control over is your body and what you put into it. Sometimes that can be very comforting, but it tends to get out of control,” I said as we rode toward Rhode Island Hospital. Her mouth and nose were covered with a surgical mask, her eyes grew bigger as she listened to me. I looked at her without judgement. She knew I knew.

“I lied to them at the clinic,” she confessed.

“You have to tell the truth to somebody,” I said.

“I did. I have a new counsellor who seems to understand. I told her everything.”

“You are going to feel a lot better when you can eat again,” I told her, knowing not to say she would look a lot better too.

“That’s what they tell me.”

The health center at the college called us because they were afraid she might have meningitis. More than one health care professional told her that she is too skinny and needs to eat more. Telling somebody with an eating disorder that they are too skinny is like telling a bodybuilder he is too muscular. She needs expert help to get her back on track. I hope she finds it before she whithers away.

We’ve been to the house before, ten, maybe twenty times. For thirty-eight years they lived here, bought the house when I was in the first grade. A lot of living happened here. He’s in a nursing home now, the diabetes eventually taking it’s toll on his fragile body. He started to fall, then forget to take his medication. His visiting nurses from the VA, he was an Army Veteran of the Korean war, stopped coming after their patient was admitted , leaving her to fend for herself. Their middle aged son lived on the top floor of the three decker, he claims to be taking care of his mom, I think the opposite is true.

Lt. Ed Dwyer from Engine 8 gave his report as we turned onto Potters Ave.
“Elderly lady, down on the floor for an unknown time, multiple open sores on her back, needs evaluation.”

Immediately my mind flashed back to prior visits here. Her husband seemed to be the one in need of medical attention. She sat on an old, filthy chair near the front door, smiling as we worked, never saying much as we carried the man in her life past her, out the door and to the VA for treatment. I would often ask her how she was, mostly just being polite. She would smile, say, “Fine” and watch us leave. Her son was always “too tired” to help or come with us as we transported his decorated war veteran dad to the hospital.

The guys from Engine 8 waited on the front porch while Lt. Dwyer gave us more information. I listened, but was still shocked when I saw our patient lying on her stomach in front of the filthy chair. Her urine covered night dress was pushed over her waist, exposing her backside and the dozens of infected sores she had been sitting on for how long, I don’t know. Day, maybe week old feces covered her feet. I took a towel from the top of her chair and as Renato prepared to wrap her in some sheets tried to wipe it off. It had dried to the bottom of her feet. She screamed in pain as I wiped, skin falling off along with the mess. Renato looked at me, shook his head and nudged me out of the way. The firefighters from Engine 8 treated her with respect and kindness as they rolled her onto her side, covered her in sheets and placed her onto a long backboard with a cervical collar. She screamed the entire time. “I’m not leaving!” We kidnapped her from her own home, took her away from her son and her surroundings. I’m glad we did. She stopped screaming once we got her into the rescue, knowing her battle for independence was lost. The guys went back to the engine, a little dejected, I could tell from their somber demeanor. It can be difficult doing the right thing. We transported her to Rhode Island Hospital. I’m not sure what will become of her home, or the life she was used to.

Thanks to Pat Blackman, aka “Gramma Muggle” and her “Little Muggles” from Chester Barrows and Stone Hill Elementary Schools. The boxes of cards, letters and love arrived in Iraq just in time to lift the spirits of one soldier there when he needed it most. Grandma Muggle has been a huge supporter of the Providence Firefighters over the years and has extended her family to include the 1207th Transportation Company, stationed at Talil Air Force Base, Iraq. People like Pat and her family make my job, and the job of everybody “Over There” worth doing.

We got a call for a ten year old boy with “pain in his genitals.” What parent would call a rescue and subject their child to the humiliation of explaining his plight to more people than necessary I wondered. We arrived at the house, a drab, three story in a neglected neighborhood. I knocked on the door, a guy about thirty years old answered. A kitten tried to escape, the guy swatted it back in with the shirt he was holding. The boy stood to the side, looking miserable. His mother told him to tell us what was wrong. The little guy looked down at the grimy carpet and shyly told us that his privates hurt. He noticed when he was showereing. Renato, with two boys of his own back home tried to lessen his anxiety. “Maybe you got soap where it doesn’t belong,” he offered. “I don’t use soap,” the kid replied, miserable. “One day I was late for work,” I said as we walked outside. “I got out of the shower and was ironing my shirt naked and ironed my youknowhat by mistake.” It may have been the first time he laughed all day. I think we made a friend for life.

“Ladder 2 to fire alarm, advise Rescue 6 we have a fifty year old male, semi-conscious, possible CHF, with a language barrier.”
“Rescue 6 received.”
I was working overtime, the day after St. Patricks Day. We were up all night babysitting. New day, new problems. Ryan pulled the rescue behind Ladder 2. He got the stair chair from the rear compartment and I made my way up the snow covered steps into the first floor of the three decker. Any thoughts of communicating with the patient and his family with my Sesame Street Spanish were forgotten as soon as I got near the door. Incense, probably Jasmine wafted through the doorway into the crisp morning air, a sure sign of an Oriental family inside. Captain Varone met me at the door and gave me a brief rundown:
“He was okay at five this morning, then his wife found him like this. From what I can tell he has no prior medical conditions, They are looking for his medications now.” Our patient was on his back on the living room floor. His family, ten folks at least, crowded around, not knowing quite what to do, trusting us with their loved one’s life. It is a responsibility that used to overwhelm me, now I am honored by their trust. Carl Richards, a firefighter from Ladder 2 with extensive rescue experience was on his knees next to the man getting vital signs.
“It sounds like CHF,” he said while listening through the stethoscope as the patient struggled to breathe. “110/58, pulse 90.”
Ryan got the chair set up and we got ready to roll. We had him in the truck in about a minute, his family watching helplessly as we wheeled him out the door. Garrett Murphy drove the rescue, Jeff Andrews and the Captain followed in the Tower Ladder. Ryan established an IV, Carl ran an ECG and I contacted Rhode Island Hospital, telling them to get a medical team ready, eta three minutes. A Cambodian girl who spoke English arrived just before we left and rode in the front, supplying information as we worked. The man on the stretcher stopped breathing about a minute into the transport, Ryan had the bag-valve mask ready and started to assist ventilation’s. I slipped a nitro tab under his tongue and pushed 80 mg of Lasix, hoping to help him breathe. As we pulled into the ER he began to breath on his own and opened his eyes.

The medical team was ready in Trauma Room 1. I gave them what I knew. “Fifty-three year old male, last seen conscious by family at five this morning, found semi-conscious, diaphoretic in respiratory distress by his wife twenty minutes ago. Pulsox 82% on room air, blood pressure 110/58, pulse around 90. respiration’s fluctuating from zero to sixteen. Iv established left forearm, twenty gauge catheter, one nitro and 80 of Lasix administered. Last bp 90/50 pulsox 96% with 10 liters 02 by mask.”
The medical team took over, I finished my report, Ryan took care of the truck and Ladder 2 went back to the station.

I found out later that the patient suffered from a combination of CHF and pneumonia and his kidneys had shut down. His glucose level was 48, probably hadn’t eaten in days. Cambodian people are extremely reticent about seeking western medical care. The ER staff tried for hours to stabilize our patient. His heart stopped at around three-thirty. Jess, who had taken over his care saved him. CPR, Epi, Atropine, assisted ventilation’s got him back again. The last I heard he was in intensive care, clinging to life with his family holding vigil.

Five o’clock, quitting time! Thirty-four hour shift went by without a hitch. I was half a mile away from the station when I got the hook.

“Rescue 1, respond to Chalkstone Avenue for a woman with a swollen hand.”

“Rescue 1, responding.”

A late season Snow storm was raging, traffic snarled all over the state. Renato was working overtime on Engine 15, near where this call originated. Whoever he was to relieve just lost two hours as we wouldn’t be back for a while. We tried to get onto the highway but a gasoline tanker was stuck on the onramp. Somehow we maneuvered around it. I don’t know how Renato did it, I closed my eyes during the whole thing. We crawled to our destination, a house in the Mount Pleasant section of the city, two blokcs away from Roger Williams Medical Center. Fifteen minutes into our response fire alarm contacted us to check on our progress.

“Delayed response, we’re on Atwells, ETA ten minutes.”

They dispatched an Engine Company to babysit while we crawled along, passing accidents and other mayhem. Our patient waited.

Eventually we arrived. The patient, a forty-four year old Spanish speaking lady had been shoveling snow when pain appeared on a finger on her left hand. It started to swell. She called 911. The swelling was gone when we got there, but she wanted, no, insisted on being seen at the hospital. Not the hospital at the top of her street, Miriam Hospital, miles away. Five-thirty, Friday rush hour, raging snow storm. She had three firefighters from Engine 15, two EMT/Firefighters from rescue 1 to cater to her, yet she still was not satisfied. Her family was going to meet her at Miriam, that was where she needed to go.

“Your family should have stopped here and picked you up before meeting you at Miriam.”

She didn’t, and probably never will understand the waste of resourses and absurdity of the entire situation. We got through it, took her to Roger Williams and got back to the station at around six-thirty. I got home past seven, Renato got to Engine 15 to relieve John about the same time.

Another day on rescue.

Beautiful day, sixty degrees. Looks like spring is here. I fired up the Yamaha V Star Bob is letting me use until he gets back from Iraq. It runs a little better than the 82 Honda CB900C I’ve been riding.

Last July, when the busload of soldiers from the 1207th were leaving Camp Fogarty I took the old Honda to join in the farewell ceremonies. I noticed about fifty bikes lined up in front of and behind the buses. I asked one of the guys what was going on, he told me about his organization, The Patriot Guard, and invited me to join the procession. It was my first time in an actual motorcycle gang. I revved the engine and joined the other bikers at the back of the buses, pulling the old 900 right into the thick of things. When the ceremonies were over and all the goodbyes, hugs and kisses exhausted the 1207th boarded the buses amid cheers from the crowd of family, friends and well-wishers. And of course the roar of fifty bikes, ready to roll. I sat among them, the roar deafening, the vibration of the bikes all around me. Finally, it was time to go. I released the clutch, gave the throttle some gas and…nothing. The other bikes stormed around me as I sat, trying to get her started. I saw the buses leave, the bikes in front and behind. When things quieted down I realized my bike had never started in the first place. The battery was dead. I needed a hill to get it push started that morning but thought the battery would have charged during the fifteen mile ride to Fogarty. No such luck. My gang left me in the dust. As the crowd left I sat by myself until Mary and Catherine came to my rescue. They were amused by my plight, I was happy to take their minds off the departure of their husband and father. I was the least of their worries, but at least they got a chuckle on such a sad day. When all was clear I pushed the bike to a small decline where I mercifully was able to get it going. I never found my gang, they finished at the airport. I rode by as everybody was leaving.

Vacation is over, back at it tommorrow. I’m sure I’ll have some stories to tell.

I knew I was the minority before walking into the restaurant. It’s something I have gotten used to. Good food smells the same to everybody. I had no idea what they were selling but I couldn’t wait to take a bite. A group of men sat in a booth speaking a language that has become familiar, yet hard for me to understand. They looked in my direction then returned to their conversation.
The restaurant is set up cafeteria style; all the offerings displayed in steam tables or refrigerated cases. I placed my order with the girl behind the counter, certain it would be delicious. It was. When I paid I thanked the girl in her language. Her smile transformed her face from pretty to beautiful. She returned the thanks and still smiled as I left. The guys watched me leave.
Years ago I began working in this area. I have seen many changes. At first I felt like an outsider, it was obvious that I didn’t belong here. I was treated differently from the people who lived in the neighborhood. They seemed to tolerate my presence, but patiently waited for me to go.
Whether these thoughts were real or imagined I will never know. I do know that I no longer feel that way. We have both changed, the neighborhood more diverse, myself accepting the way of the people who live and work here. Time has marched on and we have learned from and accepted our differences.
Riding through the neighborhood I marveled at the businesses that have replaced the abandoned buildings. Restaurants and grocery stores, beauty parlors, barbershops, nightclubs, deli’s, and boutiques are some examples of what the main street has to offer. Some mornings I see sidewalks being swept by proud business owners. In the afternoons shoppers fill the streets and stores. There are sidewalk vendors, food carts and kids running everywhere. On weekend nights the dance clubs are full of people partying. They come from all over. The hard working people out for a night of fun outnumber those looking for fights and trouble
When I first came to this area, it was a dangerous place. The people on the street were to be avoided. Crime was prevalent, despair evident in the look of the people who lived here. Unfortunately, that element still exists. The difference is they are now the minority. People are free to go about their business with less trepidation. Danger lurks, but the cowards that prey on the ambitious have been forced into hiding. The good people outnumber the bad.
Progress is measured in many different ways. For years the City of Providence has been touted as the “Renaissance” city. Downtown enjoys an almost magical transformation. The streets are clean, business is booming and economic development is evident throughout the area. All one has to do is look at the place and see it is on the verge of greatness. Guarded optimism abounds in the most jaded pessimist.
Hard work, faith and perseverance have turned some of the city’s most notorious neighborhoods into safe, lively destinations. Broadway, Westminster Street and the West End all are reaping the rewards of deserved good press. People made this transformation possible, not politics. Honest, hard working people have a way of finding the louts and getting rid of them. It takes time, but somehow, good prevails.
Downtown and the neighborhoods are on the way toward reaching their potential. This neighborhood is on a similar path; the essential ingredients are in place. I have gotten to know and respect many of the people here. Unfortunately, deadbeats abound. Some people will go to great lengths to avoid work. Government policies and generous social programs make it possible for struggling people to start climbing the social and economic ladder. These policies, designed and implemented to help struggling people get a foothold have become corrupt. A culture exists which exploits the generosity of this country. I often encounter the attitude “what can you do for me?” There are those that have to be carried by the rest of us. They appear to be beating the system, but by not participating in the work that makes this country great they are beating themselves. It is my hope that the progress made by the people making this neighborhood work is contagious. Every person has a stake in our future. Together, we can make it great.
I enjoy thinking about the past and future. I spend a lot of time driving through the different neighborhoods in this city. I look at the buildings and people, thinking of what was and what is to become. My great grandparents came to this country from Sweden and Ireland. They settled in the area, some worked as carpenters and helped build a lot of the homes that line these streets. They raised their families through tough times, but never lost their hope or drive. Their hard work set the foundation for future generations. I will always be inspired by and thankful for their sacrifice.
As I travel through Federal Hill, I reflect on another group of immigrant workers who came to this area with little more than a desire to prosper in their adopted land. Their language was foreign, their foods different. They were probably leery of the people who invaded their “turf.” As years and generations passed, their place in the American culture solidified, became mainstream. Now, people from all over frequent the “Hill.” Some of the words spoken by these immigrants in their native language have become a part of America’s vernacular. People of all nationalities have a nostalgic feeling when they hear these words. It took some time, but their neighborhood “melted” into the “pot.”
As I drive down Broad Street and look to the future I envision much the same.

Hector is back in charge of Rescue 2. He doesn’t look any different but I’m sure his time in Iraq has changed him in ways we will never see. Those closest to him may notice the subtle changes, the rest of us are happy just to have him home. As the War on Terror grinds on and public opinion turns sour our soldiers continue to fight, continue to die. Nine more yesterday.

Every person serving our country in Iraq and Afghanistan has something in common. The people they leave behind jump at the opportunity to let anyone and everyone know that their brother, son, daughter, mother, friend, uncle, neighbor or even the guy at work they normally mumble a good morning to is there, in harms way. It makes us feel special, as though just knowing somebody “over there” puts us on a higher level.

My brother Bob is still in Iraq. He’s about half way through his deployment. Whenever the war is mentioned, I stand a little taller and tell anybody who will listen, “My Brother is there!” Thanks Bob. Thanks Hector. Thanks to everybody “Over There.”

For days she sat on her couch in her filthy apartment, struggling to breathe. At three in the morning she called. Trouble breathing. Her O2 tank and mask lay at her feet. “Why are’nt you using your oxygen?” “I can’t breathe.” “That is what the oxygen is for.” “Help me.” “Help yourself,” I said and put her oxygen mask back on. Twenty prescription bottles sat on her coffee table next to a remote control. Oxygen tubing was tangled everywhere, I’m amazed she never strangled herself. Andy and I carried all three hundred pounds of her down three flights of narrow stairs into the freezing night air. Getting out of the house and leaving her cigarettes behind did her a world of good.

She handed me a licence and registration. I gave it a quick look before getting her and her friend into the truck. Their car had moderate damage to the rear end, whoever hit them hit them hard from the look of things. I looked at the pile of debris scattered on the street, searching for some clue as to the identity of the owner of the hit and run vehicle but there was nothing but broken glass and plastic. Sometimes, if we are lucky, the licence plate falls off. Not this time. Renato had things well in hand when I returned to the truck. Our two victims were in cervical collars and lying on backboards. “Did you get the licence plate number?” I asked. “No, but you shouldn’t need it,” said the passenger, an eighteen year old girl from Smithfield. “Why not?” I asked. The driver, another eighteen year old girl from Smithfield looked up from the stretcher. “You have her licence and registration in your hand.” The girls had been out dancing at one of the downtown clubs. They looked like they belonged in a music video rather than on a backboard in a Providence Rescue. They were in good spirits, all things considered. Their injuries were minor, their car probably fixable. A police officer came to the side door. “The driver of the hit and run gave them this before she left the scene,” I said, handing the licence and registration of the suspect over to him. He looked at me, the girls, and the evidence in his hand. It’s a tough job, but somebody has to do it.

He was hauling lobster pots up from the bottom of the ocean, eighty miles off Nantucket when he lost three of his fingers. His shipmates packed the severed digits in ice, wrapped them in plastic and gave them to him. He put them into the top pocket of his coat. The Captain radioed for help. The Coast Guard sent a Rescue helicopter. The fishermen waited on the freezing ocean for help to arrive.

We got the patient out of the helicopter and into the rescue without much fuss. He was a tough looking Spanish speaking guy, his left hand wrapped with gauze and duct tape. The crew of the fishing vessel did a great job with what they had. The flight nurse came with us to give the report to the staff at the ER. He was a young, good looking guy, dressed in his orange jumpsuit. With his rescue gear he looked pretty impressive. When we arrived at the ER, Teresa, the Lieutenant in charge of Rescue 5 opened the rear doors and told him she liked his outfit. The flight nurse was very impressed with her, as any guy in his right mind would be. We got the patient through the triage desk and into the treatment area.

We took the Coast Guard guy back to the chopper. They took off toward their base, we were heading back to our station when I saw the fisherman’s life vest on the floor of the rescue. There was some expensive looking gear on it, I went back to the ER to return it to him. He was sitting on a stretcher in Fast Track, waiting. He looked me in the eye, held my gaze for what seemed a long time and said, “Thank you Senor.” He looked at his disfigured hand and closed his eyes.

This was my last run of a thirty-four hour shift. No sleep, non-stop calls. Instead of feeling exhausted, I was exhilarated. A man can come to this country, find honest work, live without fear and pursue whatever dreams he has. When tragedy strikes there are people who will scramble to a helicopter, find him in the middle of the ocean, fly him to a hospital, put him in a rescue where a beautiful Rescue Lieutenant opens the door for him, be treated with care, kindness and respect and be given the best medical treatment in the world. No questions asked, no thanks necessary, just a country full of people willing and trained to help. It makes me proud to be an American citizen.