For two days he endured the pain. Every time he tried to pee he was reminded that everything wasn’t “ok.” Finally, he called his son and daughter to his apartment on the second floor and told them the truth. They tried to help him down the stairs into their car but he couldn’t make it. Time had ravaged his once powerful body, that and a debilitating stroke he had while at the hardware store on Valentines day. Now he sat in bed, unable to pee or much of anything for that matter.

He lost his wife two years ago, then his daughter last year. Old age took the love of his life, breast cancer one of ten products of that love, the other, Eight girls and two boys were born during their marraige, one that spanned six decades. The pictures that covered the apartment showed a beautiful life together.

His youngest daughter who rode in the back of the rescue and told me their story thought her dad was dying of a broken heart. Since he lost his wife and daughter all he did was cry. Now, he thought he had prostate cancer. In a way, he was relieved; some men prefer to bear the pain of their family rather than see them suffer. Maybe he felt vindicated now that he felt his loved ones pain, forgiven for failing them.

We do what we do so often it is easy to fall into a routine. People call 911, we respond, triage, treat, transport. The calls differ but after years begin to resemble one another until your shift becomes just another day at work. It is imperative we remember that there are human beings on the other end of the 911 call. What to us is another job, to the folks making the call a potentially life changing event is unfolding.

An elderly lady in an assisted living facility is found unresponsive on her kitchen floor. 911 is called, we respond. One look is all I need, I know this is serious. The guys from Engine 11, who just last week helped deliver a beautiful baby boy are ready to do their thing. No words are necessary, we’ve been through this before. Cervical collar, backboard, oxygen, ECG, IV, contact Rhode Island Hospital en route with the information, “Eighty-four year old female, unconscious, bp 184/148, normal sinus rhythm, glucose 220, pulse 84, respiration’s 28, eta four minutes. I pushed the off button and put it back in it’s cradle. Only then did I see the name on the report. My sister Melanie’s mother in law. I think my heart hit the floor of the rescue. I looked at my patients face. Peaceful and serene, though her body was experiencing life threatening damage. The guys from Engine 11 and Mark from Rescue 1 B group, (Renato had a crisis of his own, our prayers are with his family) did their thing, switched oxygen bottles, monitored the vitals and got ready to transfer our patient from the rescue to the hospital. I watched from the captains chair and thought of the times I was in Hannah’s company. I smiled when I remembered her unfaltering faith in God. Whatever the outcome, she is in good hands.

I called Mel from the trauma room and told her the bad news. Good luck Bob, Mel and the Frasier family. Our thoughts are with you during this difficult time

0330. A man called from a pay phone stating he had trouble breathing. Arrived on scene @ 0336. Pt. stated he “smoked too many cigarrettes and now couldn’t breathe.” What to do?

A beautiful five year old shouldn’t be unconscious at nine in the morning. She managed to get up and dressed for school but not much more. She said she was tired and went back to bed. Her mom checked on her some time later and couldn’t get her up. When we got there the child was limp. We did everything we could think of, checked her glucose level, blood pressure, co level, ECG, put her on oxygen and tried to start an IV. She didn’t flinch when we put the needle in her arm.

I called Hasbro to tell them what to expect. They hear my voice so often telling them I’ve got a child with a fever, cough, bellyache etc. that my report took them by surprise. “Five year old female, unconscious, minimal response to painful stimuli, vitals stable but otherwise unresponsive.” We put the mom in back with her daughter, she was strong but shaken. I asked about seizures, medications, chemicals, anything I could think of as we transported. Nothing unusual about her history, she was fine last night.

The baby went directly to the Trauma Room at Hasbro. There a team of doctors, nurses, respitory people, students and EMT’s started another IV, kept the 02 flowing and pretty much brainstormed, trying to figure out what was going on. They took another glucose test, this time the result was 24, hypoglycemic. They administered dextrose through the IV and presto, a glorious five year-old appeared, replacing the lifeless figure on the stretcher. She has a lot of tests to endure but hopefully we had a happy ending.

These people are my friends, I thought to myself as the man lying on the stretcher spit, struggled and shouted, “get the niggers off of me!” I stood to the side and watched as a couple of security guards applied the four-point straps that would immobilize him. “Niggers,” over and over he said it. I’m sure that in the course of his normal day he would never consider saying it out loud. In his drug crazed, drunken state however the words flowed freely from his mouth.

The fact that he was an idiot did nothing to lessen my unease. I considered making light of the situation later when I talked to the guards, doctors and nurses who bore the brunt of his racist remarks but decided not to. There was nothing light about what happened.

We work together in one of the most stressful atmospheres there is. Mutual respect has been earned by the teamwork evident on a daily basis at the ER. The people here are not white, black, hispanic, gay or anything other than the folks I work with and trust with my life. Unfortunately, a moron comes here and reminds us we live in a world where racial divisions still exist.

Tuesday, a day like every other day… I know I’m whining but it feels good.

0738: MVA, Pt. didn’t know if she was hurt, needed ride to ER “to be checked”

0820: Difficulty Breathing. 80 y/o @ home, no distress, daughter wanted her to be transported to hospital for “some tests.” I had the nerve to ask her ,”what tests” and was told by the daughter to “mind my business, the doctors know.”

0915: Person fallen. Arrived on scene and was told the patient had left. Had the nerve to ask if they called the fire department back to tell them. Blank stare instead of an answer.

1022: Possible CVA Found a 95 y/o female sitting on toilet alert and conscious. Tried to explain Vaso/Vagal situation to family, realized I was confusing myself and transported the 95 y/o lady to a hospital of her choice passing three perfectly fine hospitals on the way.

1130: SVT Called to a doctor’s office for a pregnant female with SVT. Found a pregnant female with Sinus Tach. Transported her 100 yards to Rhode Island Hospital ER.

1245: A person called 911 for knee pain from a car accident yesterday. A rescue was sent

1315: A twenty year old female called for a sore throat. A rescue was sent.

1350: An intoxicated male requests detox from a pay phone. A rescue was sent

1410: Responded to Broad Street for an intoxicated male. Transported to RIH ER.

1445: Intoxicated male sitting on sidewalk called 911 for a ride to detox from his cell phone. A rescue was sent.

1530: Intoxicated male at the bus station needs detox…..

This is what our 911 system has become. It is a disgrace. I’ll be here another fifteen hours. I’ll let you know if I respond to any emergencies. Don’t count on it.

The call was for a possible stroke at a methadone clinic. There was almost a stroke allright, but the person having it was me. We pulled the rescue to the side door of the place, we’ve been there numerous times and know the drill. Our patient was reported to have vomited and was feeling nauseas after eating a powdered donut.
“What about the possible stroke?” I asked. The staff, nurses, psychologists and a bunch of other educated people looked at me like I was from another planet.
“He’s feeling weak,” said one of them, “and not acting normally. It could be a stroke,” he said.
“It could be whooping cough,” I said. We walked to the rescue. The guy was lethargic and had slurred speech. At least six two and two twenty.
“Are you going to vomit again,” I asked.
“Again?” he replied.
“Didn’t you just vomit?”
“That was two days ago.”
“Why are you going to the hospital?” I asked as Joe, my partner for the day started to pull out of the parking lot.
“I’m not going anywhere!” my patient shouted, jumped from his seat and opened the side door of the rescue. I grabbed his belt, yanked him back in and planked him back on the seat.
“Stop the truck!! Let me out! You A**holes!” He tried to get up again.
“Step on it Joe,” I said. Joe stepped on the gas, the patient lost his balance and fell back onto the seat. He continued shouting, I looked at him and told him it would be in his best interests to stop acting like a baby. He stood up again and went for the door. We wrestled a little but a heroin addict on methadone and powdered donuts is no match for a disgruntled rescue officer.

Security met us at Rhode Island Hospital and escorted our patient in. I got a coffee and waited for the next one.

“Rescue 6, Engine 15, respond to Erastus Street for a violent male who may need medical attention, stage for the police.”

We left the Atwells Avenue station and headed toward Erastus. Engine 15 arrived first and staged a safe distance away. Two police cruisers were parked in front of a two-story wood framed house, one of the officers was looking up at the roof area, the other ran inside.

“Rescue 6, Engine 15, the police say the scene is secure.”

I guess “secure” means different things to different people. Lt. Fontaine from the 15′s led the way up the stairs into a dreary apartment. A television lay smashed on the living room floor, a cool breeze flowed through a broken window.

“What’s going on here?” I asked anyone who would listen. A girl of about twenty-five answered,

“My brother just found out he has AIDS. He’s been crazy, he won’t talk to us or let us help him.

I looked into the bedroom. Two police officers had a little man between them. They escorted him out of the destroyed room toward us. I didn’t see any blood on him but you never know.

“He doesn’t speak English,” his sister told us as we walked him down the stairs toward the rescue. At the bottom of the stairs my patient ripped something up and threw it to the ground before getting into the truck. John Hannon, my partner for the day went in behind him. I stopped to pick up the torn pages of his passport.

He was from Guatemala, a legal immigrant according to the document I scanned as I stepped into the truck. Thirty years old, in the country since 2005. His work boots were spattered with different color paint, his work pants worn at the knees. He sat on the bench seat and stared strait ahead. I showed him the passport I had picked up off of the street. He said “thank you,” shook his head from side to side then looked at the floor.

“It may not be as bad as you think,” I offered. “They have medications now that help.” He didn’t understand me. I will never understand what he was feeling as I walked him into the ER, surrounded by security.

When Seconds Count….

When disaster strikes, illnesses arise or accidents happen in the City of Providence help is only a 911 call away. Or is it? Far too often when a rescue is needed there is nobody to send. Providence’s six Advance Life Support Rescues simply cannot handle the volume of calls generated by the people living in and visiting Providence. Responding to an emergency in a timely fashion is critical. Tragically, here in the Renaissance City, when seconds count, help is often minutes away. Surrounding cities and towns fill the gaps in coverage with mutual aid agreements, but due to a lack of reciprocation that safety net is eroding.
Each of Providence’s six advanced life support rescues handle nearly five thousand emergency calls a year, far above the national average. Cranston, East Providence, Johnston and Pawtucket routinely send their rescue crews into Providence when needed. Providence, the biggest city in Rhode Island and second largest in New England does not have the resources to repay the favor. Smithfield, Lincoln, Cumberland, Warwick, Central Falls; all send rescues to Providence. Are the taxpayers of those communities paying to subsidize Providence’s irresponsibility? What are these communities getting in return? Not much.
A progressive fire department, properly funded has a responsibility to the public it protects. Emergency Medical Services are the most used aspect of the fire service. Many departments report upwards of eighty percent of their calls are emergency medical responses. The cities and towns surrounding Providence have properly staffed their departments to handle the need:

Warwick, population 87,233* 4 Rescues

Cranston, population 81,617* 4 Rescues

East Providence, population 49, 515* 3 Rescues

Providence, population 176,862* 5 Rescues

*(2005 Census)

In 2006 Providence added a sixth rescue to help address the mutual aid problem. The truck operates on a temporary basis and has no assigned personnel, using overtime to fill the seats. While the number of mutual aid calls into Providence from surrounding communities did decrease slightly, it did nothing to improve working conditions, morale or number of calls responded to by the firefighters assigned to the rescue division. Most days the city’s six rescues run non-stop. Experience in the field is invaluable. You just can’t teach a person lessons learned in the street. All of the knowledge and experience doesn’t do much good if the person in possession of such life saving skills no longer serves on the rescue.
The stress of the job has taken its toll on the Providence Fire Department’s Rescue Division. Qualified Rescue Officers have given up their rank, handed in their bars and left the division, leaving the positions vacant. In their place, inexperienced firefighters have volunteered as acting officers on the rescue trucks. While they have performed better than anybody has the right to expect, the loss of leadership is palpable. Morale is at an all time low, firefighters who would rather be fighting fires, some with decades of firefighting experience are sent to the rescue division to act as rescue technicians. Some crews have an acting officer with five years experience in charge of a rescue with a technician who has twenty years on the job. The calls are non-stop, the crews deal with the situation the best they can.
Twelve people manning six rescues in a city of 180,000 is woefully inadequate by anybody’s standards. The dozen medics on call manage to provide Emergency Medical Services to the people of Providence in an efficient, professional manner when they are available. Their lack of availability is the issue.

* Thanks to Detroit EMS for the phrase, When Seconds Count, We Are Minutes Away.

“What’s your name,” I asked him as we helped him down the stairs. He lost his concentration and nearly fell as the next performer sauntered past us. Thankfully, one of us was fully focused on the job at hand and caught him before he went down. We slowly made our way down from the upper level of the club, taking in the sights when we made it to the first level. Our patient seemed unconcerned with the vomit that covered the front of his velour warm-up suit and sneakers. He had a glazed, dreamy look on his face. I asked the bouncer what happened.
“He was getting a lap dance, everything was fine, then he stopped moving and threw up on the dancer.”
“At least she won’t have to wash her clothes,” I mentioned as we walked under the “All Nude Room”" sign at the bottom of the stairs.
“He’s been drinking Heineken’s and Lemon Drops.” the bouncer stated as we walked into the brisk afternoon air. The fresh air did all of us some good, the perfumed atmosphere of the club ruined by the lemon scented vomit on my patient. One of the dancers who had finished her shift walked past us. She did her best to attract some attention but without the soft lighting and music the magic was gone, she became just another average looking woman trying to make a living.
“Buddy, what’s your name,” I asked again once we had him in the truck and on the stretcher. He stared at the fluorescent lights on the roof of the rig, closed his eyes, smiled and said,
“Jasmine.”

My patient was twenty-one years old, five months pregnant and on her way to her doctors office. She made it to the doctors office, just not the one she had planned on. No waiting either, her condition landed her in Trauma Room 2 at Rhode Island Hospital. The air bags may have saved more than one life this day.

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Only someone who has worked in EMS can understand these statements…

1. Don’t tell me you have abdominal pain as you eat Doritos in your living room as I assess you.

2. If you go to the ER by ambulance, the first thing I will ask you is how you are getting home. No, we don’t have people on staff to drive you home, and don’t tell me you don’t want to “bother” one of your family members at this hour. You had no problem bothering 911 for the back pain you’ve had for 3 months.

3. You don’t get to pick your own IV site. This will irritate me and I will probably miss your IV on purpose and start your site in the place I wanted to initially to prove a point

4. “Butterfly” is not an IV size, this word signals me to put in at least an 18ga or larger bore needle.

5. Nausea is not a reason to call an ambulance. If you are not in severe pain, or shitting your pants in front of me, your ass goes directly to the waiting room.

6. How can you have the worst migraine of your life, but be able to yell at me about how long it took me to get here after you just put down a magazine you were reading?

7. Don’t ever say things like, “I usually get 4 mg of Dilaudid”. Requesting your med and dosage will prompt me to squirt out half of the med before I inject, then I lie about the dose.

8. If you are allergic to Tylenol, Toradol, and Motrin, I have already assumed you are a drug seeker.

9. I don’t care if you are neighbors with the GI specialist. Unless he drove you to the ER himself, you can’t be that friendly.

11. Just because, “My doctor told me to call!”, this does not mean you get right back to a treatment room. This tells me you are a pain in the ass, and he’s pawning you off.

12. The louder you moan/whine, the bigger size IV needle you get.

13. Nasal Airways and Laryngoscope Blades cure pseudo-seizures. They also cure intoxicated persons.

14. If you are on more than 2 medicines at home, bring a list. Don’t say, “You know, the little white pill”. I am not a pharmacist.

16. Don’t bitch about missing breakfast when I’m on the ninth hour of my shift and haven’t peed yet.

17. What gives you the right to complain about your sore throat for a week while I have diarrhea from the antibiotics I’ve been taking for pneumonia?

18. Broken toes are not an emergency. We’ll make you feel stupid by putting a little piece of tape down there and kicking you out.

19. I am currently inventing a trapdoor system in the back of the rig to be triggered when you say the word “toothache”.

20. Cover you mouth when you cough/belch. This is just common courtesy. When you neglect to do this, I am tempted to bust ass and then close the door.

21. If you tell me you have fibromyalgia or chronic fatigue syndrome, know that I’m rolling my eyes and thinking you’re a loser.

22. If you list Haldol, Geodon, Xanax, and Trazodone as allergies, don’t tell me you have no psych history.

23. Never call in with chest pain because you were too embarrassed to say “penile sores” or “foul smelling discharge”. This will piss me off that I ran code to get to you and I’ll make your ride horrific.

24. Although you’ve been to the ER four times this week, you cannot list the ER doc as your family physician.

25. Do not talk to me, or talk on your cell, while I’m trying to listen to your lungs.

26. Don’t tell me you have no money for medicine while you have a carton of smokes in your purse, next to your cell phone, and each of your seven children are playing their own PSP’s.

Thanks, KristenEMT from GhettoMedic

He said she didn’t give him his medications, she said she did. After twenty-seven years of marriage, it had come to this. For the last seven years she was his caretaker. He was confined to his bed for the most part, three heart attacks and a stroke rendering him disabled. It looked like she was running out of steam, the burden thrust upon her taking it’s toll. Their house was a mess, laundry, dirty dishes, paperwork and pill bottles were strewn about haphazardly, clutter filled the room where he spent the majority of his life. A small TV sat at the end of his bed, his portal to the world. I wonder what he watched as the days dragged on, his room more of a cell than a place to get ready for and rest from a fulfilling life.

He was hysterical, sitting up in his bed, struggling to breathe through the hole in his throat. The stoma remained clear but I was concerned his movements would somehow clog his airway. She had a glazed look about her, at first I thought she had been drinking, her speech was clear but slow, her pupils dilated.
“He needs to go to the hospital,” she explained in a dreamy voice. “He says I didn’t give him his nighttime medication, but I gave them an hour ago.”
I looked on one of the dressers and saw a dozen pill bottles, some empty, others tipped on their side, duplicate prescriptions, half eaten candy bars and trash filling every inch of the space.
“Do you have a list of his medications?” I asked. She handed me a crumbled piece of paper she picked up from the floor. Lasix, Cardizem, Lisinipril, Lipitor, the list was lengthy. Two names jumped off the page, Oxycontin and Vicodin. There were no bottles on the dresser that matched.
“What about these?” I asked her.
“I had to hide them. He takes thirty if I let him.”
“Where are they?”
“I have them.” She opened a bedroom door. A giant Rottweiler layed on the bed looking at me. She entered the room, I stayed outside as she read the names from the bottles from behind the door. She pronounced the names like she had never heard of them.
I had seen enough. We got the man ready, put him in the stair chair and brought him out of his prison. He was crying quietly, saying he loved her and didn’t want to leave his home. I left his wife alone with her husbands prescriptions.

On behalf of all of us at Rescuing Providence, I would like to wish all of you a safe, happy, glorious Opening Day!

A lot happens it the course of a day. It started at 0700, a little kid, two years old was left in his fathers car while his dad went in search of some crack cocaine. Two hours the little guy sat alone in the car until somebody called to report the situation. In a house not far away a party was going on, smoke from the marijuana covering the toddlers who lived in the house where the party went non-stop. The police were called by a concerned neighbor, they called us to have the kids taken away. We brought them to Hasbro children’s hospital where they will wait for Foster Parents to pick them up. In a field not far away a woman, maybe prostitute, maybe not was being gang-raped. We were called to help an unconscious woman lying in a field. She was in her thirties, tight jeans, no shoes, ripped colorful gauze shirt. Her hair was full of dirt and leaves. She screamed “Get them off me!” all the way to the hospital. Twice she loosened the seat belts and tried to flee from the rescue as we sped through Providence. Twice I caught her just in time, the last half mile of the transport she spent on the floor at my feet, sobbing uncontrollably.
At the Providence Place Mall a guy in his forties was getting drunk with his friends for the day until somebody snapped. Mall security called us for a man outside one of the restaurants, covered in blood. Thirty stitches should put him back together. In the west End a man was stabbed in the side, he’ll probably live, we have no idea what happened. A motorcyclist lost his life on Rt. 95 when he slammed his bike into the back of stopped traffic. Homeless people gathered at 1035 Broad Street needed to be taken to the ER three different times to sleep it off. An old lady fell, broke her hip and was taken from her home in a stretcher, maybe the last time she will ever go through her doors. Dozens more, the call volume non-stop. The calls non-stop. The tone just went off, I’ll be going now.