Twelve steps to the top of the stairs, a landing there, above it a scuttle hatch. The hatch was open, a stool lie on the linoleum floor, violently tipped onto its side, resting now, about five feet from the body. His eyes were open, lifeless. Whatever things had crossed his vision over the thirty five years he spent here erased now, gone. Do those images live on, in a different form? Is the tape erased, emptied, destroyed? Does somebody else take over, and put their own images onto the reel, or are they just dissolved, vanishing into thin air, like the dust that the man at the top of the stairs will become?

Skin cold to the touch, no pulse, but I knew that, flat line.  An extension cord tossed to the side, as if it were a live snake ready to strike. Its still form haunting, just some copper and plastic, inanimate until a desperate man whose wife had taken their kids and left wrapped it around his neck and climbed the stool that has born the weight of him, his wife and probably his children so many times before. The stool held his weight until it was time, and he shifted his weight, tipping it over, then hung at the top of his stairs, and died.

His brother found him and cut the cord off and cast it aside. The mark remained around his neck. It will stay there forever, or at least until he turns to dust. And takes his memories with him.

A faint voice, barely audible called for help. That voice was the one I wanted to answer, more than the other, closer cries for help. The bus was filled with people of all ages, babies with fevers, kids with broken bones, cuts and insect bites, intoxicated teenagers, vomiting on the floor, pregnant women, one giving birth, one crying, another asking over and over for a ride to the hospital to “get this thing out of me.” Middle aged men clutched their chests, diaphoretic, gasping for breath, silently pleading for help that I couldn’t give. Elderly people, some with sure signs of broken hips lie scattered about, how long they lie there writhing in pain I didn’t know, the smell of human waste surrounding them like the fog that began to envelop the bus as it sped toward nowhere.

That voice, softer now continued to cry for help. I tried to get through the never ending line of patients, each one clinging to me, not letting go once I approached, having to tear myself away as I tried to escape, and find the person whose cries mattered most.

I knew it was my wife, and nothing I could do could get me to her. Other people and their incessant needs blocked me from getting to her.  I treated one and two would appear, their injuries and illness trifling compared to what I knew was the only one that truly mattered to me, the one I couldn’t reach.

Mercifully, the tones went off in the station, light filling the darkness. I didn’t move for a few moments, gathering my thoughts, and listened as the dispatcher droned on. Something about a twenty four year old female, pregnant with her fifth child, at the housing project experiencing chest pain.

The waking nightmare was preferable to the sleeping one. I put on my shoes.

It’s 9:30. she’s been drinking Monster Energy Drinks all day. She feels her heart skip a beat. Then another, then speed up, then slow down. She’s seventeen. Her mother calls 911. Her vital signs are perfect, EKG normal. I give them the option to stay home, let time heal the palpitations, let the caffeine or whatever it is they put in those things work its way out of her system. I suggest perhaps a visit to the family doctor is in order. Maybe she should stop drinking the energy drinks. Maybe they should take her to the hospital themselves instead of following in the family car. It’s only a mile away.

Maybe if the State of Rhode Island wasn’t paying the bill they would have listened. Instead, they insisted on the “ambulance” taking her to the ER, where the taxpayers pick up the tab for that bill as well. Some smart people decided that it’s a bad idea to charge “poor” people even a minuscule co-pay for emergency  services, the conventional wisdom being that if people have to pay, they might not seek medical care in case of an emergency.

Maybe some smart people are smarter than the other smart people, and know how to manipulate the system. Maybe people who were having an actual emergency wouldn’t be worried about a small co-pay.

I can hardly wait for everybody to get everything for nothing.

Eventually life on the streets  loses its allure and the cold, stark reality of loneliness, sickness and a wasted life takes hold. The magic elixir, alcohol, loses its ability to transform the landscape from dreary and lifeless, full of unsavory characters to a vibrant place to hang out, socialise with like minded individuals and think, for as long as the euphoria that comes from the bottle lasts, that life is good.

Life isn’t good for Kevin. His time is running out. He can still bring a laugh to the people who care for him with his trivia questions, but seldom does. He needs to be prodded into asking, “Whose the guy, that played the captain, on Sea Hunt?”

When I first met him I thought his questions were hilarious. Now, the same three or four questions bore me. They bore him. The only people not bored are the folks who have yet to meet him, and see him after he sobers up, and watch the shell of a person crumble from a disease that has taken over.

At one time I thought he might beat it. When they clean him up and give him a shave, haircut and new clothes he could fit in with just about any social setting. But the hair grows back, the clothes get stained with piss and grime, the stink clings to him, making his presence unbearable. What kills me is he knows it. Somewhere deep in his subconscious he knows he lost his chance, and its just a matter of time till he slips away, forgotten by everybody who once laughed at his drunken wit.

“I don’t feel so good,” he said the last time I picked him off Eddy street. Then he cried. And couldn’t stop until we brought him into the ER. Somebody asked him, “Whose the guy…”

“It’s C-C-C-Conan O’Brien!” said Kevin, without any of his usual exuberance.

He left that in the 1/2 pint bottle of vodka that joined all the others in the gutter.

http://rescuingprovidence.com/wordpress/?p=20

I just noticed Rescuing Providence has had 300,000 unique hits since I started this in 2007. I must admit, 300,000 is pretty cool, but to be perfectly honest I’m honored that even one person took the time to visit. Writing is a lonely job, a good job for people like myself, prone to isolation. Because I know that somebody, even one person, is reading these posts I feel more part of the world and connected to the people in it.

So, thanks for stopping by. You know who you are.

Leave a comment if you like, even just a hello.

0415 hrs.

The tone sounds in the station, the blow lights fill the space with harsh fluorescent light.

“Rescue 1, respond to 160 Broad Street, at Crossroads for a female with tooth pain.”

1. Denial

“Tooth pain? Surely they jest. This must be a mistake. I’ll just lay here, pull the blanket over my eyes, wait for the lights to go out and it will go away.”

“That’s rescue 1, respond to 160 Broad Street for a twenty-two year old female complaining of tooth pain”

2. Anger

The grumpy Rescue Officer sits at the edge of the bunk, finds his shoes, throws his shirt over his head and shuffles toward the pole.

“Tooth pain! This is bullshit! You have got to be kidding me! Call a cab! Get a bus! Get over it! Tooth pain, she’s going to have tooth pain when get there allright, no…she won’t have any teeth when I get there! Tooth pain. 911 for tooth pain…”

3. Resentment

As our heroes roll toward their fate they commisurate.

“Can you believe this bullshit! This is horseshit! Toothache! We’re the only truck in the city doing anything. Must be nice to work in a normal city with normal people who don’t call at four in the morning for a toothache! Why do they even send us? What’s the matter with those dopes at fire alarm? Toothache. Unbelievable!”

4. Acceptance

Rescue 1 arrives on scene to find a twenty-two year old girl standing alone outsid of the homeless shelter, holding her chin with both hands, crying. She looks miserable.

“Did you call for a rescue? You did? What’s the matter? Toothache. Come on, we’ll take you to the hospital.”

They help her into the side door of the rescue, make her comfortable, get some vitals and transport.

5. Closure.

At the hospital they bring their patient to the waiting room, say a few polite hello’s and get back into the truck and drive toward home.

“Rescue 1 in service.”

*** “Ahhh, life in the firehouse! Captain Schmoe captures it perfectly. Drop by and give him a visit, but make sure you do it after midnight and make a lot of noise.  Thanks Capt. great post!

http://report-on-conditions.blogspot.com/2010/04/five-stages-of-not-having-to-cope-with.html

Thanks to one of the commenters , HOWDY for this, perfect!!

http://www.youtube.com/watch?v=Usm9SpnHYJQ

The crazy pills somebody slipped into my coffee this morning are in full swing. How else could I describe this?

Called to the local high school for a female having difficulty breathing. Arrive on scene to find the female lying in the nurses office, on the couch hyperventilating. I learned that she is a Geometry teacher who had an argument then suffered an anxiety attack. Apparently, the principal and the teacher were discussing a language problem. The kids an this district are a mix of Black, Hispanic and White. Some of the kids couldn’t understand what the teacher was trying to teach.

“Well then,” I said under my breath, “How are we supposed to teach kids who can’t speak English?”

We put the teacher on the stretcher and wheeled her to the rescue. She had calmed down by this time but had difficulty answering simple questions.

Overdose? Stroke? Change of Mental Status?

0-3. She didn’t speak English. The Geometry teacher didn’t speak English. THE GEOMETRY TEACHER DIDN’T SPEAK ENGLISH!

I think the world has gone mad.

No, not the world, The United States of America has gone mad.

I think I’m having an anxiety attack. Somebody better call 911.

Gooch

Don’t be a chooch, click on Gooch! (above)

This was filmed in Rhode Island and is full of familiar characters.

I thought it was time to lighten things up around here, I hope you like the video.

A guy and his wife bought the place seven years ago, taking a chance. The place is stunning. Six months ago her eighty-four year old mom came from Brooklyn to live with them. Tonight, she fell down the back stairs, twelve of them, struck her head and injured her hip. Somehow they managed to get her back upstairs, but decided to call us for an evaluation.

She is blind, classy and proper, the epitome of grace, She sat on the edge of the bed, grimacing when she moved. She felt the edge of the stair chair, secured herself and moved over. We wrapped her up and carried her down a different set of stairs and into the truck. I couldn’t help mentioning the beautiful home, and the couple didn’t mind giving a little history.

“We couldn’t resist the place,” said the man. “We have some good neighbors. The people across the street and over on the corner have done a nice job restoring their places. And the kids are very polite if you treat them well.”

We carried the patient over antique rugs, through rooms full of valuable antiques, past a marble fireplace and through a stained glass doorway, onto a field-stone porch, lighted with ornate fixtures, down a path that led through a well maintained flower garden bordered by intricate stonework, through a wrought iron gate and into the rescue.

Her daughter came with us and looked out the back windows of the rescue, hazy from hours of grime picked up from travelling the streets that surrounded their home. As their place slowly faded from view she looked away, into the face of her mom. A minute later, I looked out the same rear windows and saw Broad Street, where an hour ago my patient was full of bullets, and an hour from now my patient would have a crushed skull and compound leg fractures.

I closed my eyes and rested them for a few moments, knowing these patients were okay.

“Broad Street was angry last night my friends, like an old man in a deli sending back a bowl of cold soup.”

1500 block 2100 hrs.

We started our little foray into madness with a man who went to the barber shop to get a little taken off the top and sides. He was shot three times. At least his haircut was finished. Once in the neck, one in the back and one in the tricep. He was conscious, worried that his mom would be mad. The other barber shop patrons, who were in the shop when the gunfire erupted told me they didn’t see a thing.

1000 block 2358 hrs.

An eighteen year old girl was punched, her being one of five or so young girls who were struck by the same guy, fell to the ground and struck her head. She was hysterical, fought us all the way to the hospital. Another rescue was called for a man down a block away from us. The alleged puncher, beaten and stabbed by an angry mob.

900 Block 0100 hrs.

Two women, both from Massachusetts crossed broad Street at the same time a guy being chased flew toward them. He didn’t stop. The ladies were run down, thrown, legs broken and skulls crushed on the unforgiving pavement. My patient’s leg made an L shape below the knee and the side of her head felt like broken glass. They intubated shortly after I turned her over to the trauma team.

“Somewhere on Broad” 0200 hrs.

A car flies into the ER, two guys fall out, both stabbed multiple times. One of the guys was in the OR with his chest cracked a short time later, the other critical.

160 Broad, 0400 hrs.

A twenty two year old female calls from Crossroads, complaining of a toothache. It was a relief. She walked into the rescue, we took her to the hospital.

What’s next? I can hardly wait, twenty-six hours till I call it a day.

Wrapped in a blanket, sweating, staring blankly into space is how I first saw him. A different version of him stood close by, watching everything I did. I felt the boy in the blanket’s forehead, the older boy stiffened and inched closer.

“He’s burning up.”

“103 degrees,”  said his mom, who scurried about the apartment throwing personal things into a big bag. The older boy must have decided I wasn’t a major  threat, sat next to his brother and stood guard.

“Is he developmentally disabled?” I asked, impressing myself with my delicate wording of the handicapped kid’s condition.

“Developmentally delayed,” said Mom, arching her eyebrow at my obvious lack of understanding.

Mom picked up her five year old and marched down the stairs toward the rescue, the seven year old followed me and Brian. Another boy, much older stayed home.

Inside the rescue, after the vital signs had been taken, the names and dates of birth, medications, allergies and past medical condition recorded we settled in for the ride. The seven year old took a second from doting on his brother, looked me in the eye and said,

“Emergency. E-m-e-r-g-e-n-c-y.”

“Not bad,” I said. His mother smiled.

“System. S-y-s-t-e-m.”

Mom shook her head and rolled her eyes, I was impressed.

“Medtronic. M-e-d-t-r-o-n-i-c.”

I looked over my shoulder and and saw Medtronic Emergency Systems written on the back wall, behind the monitor.

“Robert” laughed like  he had never laughed before, delighted that he had tricked me. Mom smiled knowingly, and “Steven” lay in the stretcher, unaware.

I pulled one out of my hat.

“Spell Vacuum.” No chance I figured. That word got every kid in my sixth grade spelling bee, no way a first grader would get it.

Robert smiled, looked at the floor of the rescue, concentrated then said,

“V-a-c-u-u-m.”

“Wow.”

Robert forgot our game, and focused on his brother. His proud mom told me he was gifted. She has him signed up for some program for gifted children at John Hopkins University in Maryland. He’s going to be a doctor.

And fix his brother.

http://queenofthedogs.blogspot.com/

Peedee from Queen of the Dogs awarded me the “You’re Going Places Baby” award a week ago, what with all the flooding and ensuing insanity I haven’t had a chance to say thanks. So…THANKS Peedee! The rules are, I have to tell five things about myself, then pass the award on to some deserving bloggers. So without furthur ado…

* I never graduated from high school. (They sent my diploma via US Mail, didn’t want me at the ceremony)

* Black Sabbath was and is my all-time favorite. One night Ozzy Osbourne and I crossed paths. Many hours, Stoli’s and other things  later Ozzy went on his way and I’ve got some great stories to tell!

* My extremely addictive personality has made me good friends with Bill W., almost nine years of sobriety, one day at a time.

* I’m not a paramedic, not even close. I’m an EMT cardiac level, a skill level unique to RI. We’re like half paramedic’s but one and a half basics.

*My daughters are actually my step daughters, who I met when they were four and seven. Twenty five years later and I don’t think it makes a difference.

I usually steer away from these kind of things but Peedee is a great person with a soldier for a daughter and some of the best pictures in the blogosphere. Thanks for dragging me out of my shell, Peedee.
On to my award recipients, in no particular order:

If you have visited some of my links you will find a few non fire or ems themed blogs. I love what I do, but I also love to get away, and these people help me do just that without ever leaving my desk.

Jean at Pondering http://beauvoirglass.blogspot.com/ is one of my favorites. Her thought provoking honest posts are compelling, to say the least. She is a survivor, and deserves this and much more. Stop by and check out her Pondering…store, lots of great stuff!

Susie Hemingway at A Power Within  http://susiehemingway.blogspot.com/ is in the fight of her life, and writes some of the most inspiring words I’ve ever read, Great stuff, well deserving of  any awards.

Jen started a blog recently called “You Called 911 for What?” that is getting a lot of attention. Give it a look and see why.

http://youcalled911forwhat.blogspot.com/

Enjoy them and the rules are: As Ann T. http://auntiehathaway.blogspot.com/ put them…
Tell 5 things about yourself (big or small) and keep the chain, link to me and then to your future awardees. That way people can backtrack their way across the blogosphere

Congratulations, folks, don’t forget to pass the award on!

Everybody on my blogroll and a bunch of others that I visit could easily be included here, but these are my favorites for today. I hope you stop by.

One more thing: The day Peedee sent me the award I had just finished watching Casablanca for the first time. Now that’s Karma!

Overheard in the cab of Rescue 1

Ryan: (driving to a call) We’re Cavemen, you know.

Mike: (officer’s seat, fiddling with the radio) How so?

Ryan:  The station is like our cave. It’s dark, dreary and ugly.

Mike:  A man-cave.

Ryan:  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.

Mike:  Some of us are women.

Ryan:  Right, there have always been strong women.

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

Ryan:  Who?

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

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

Mike: The supermarket isn’t exactly hunting.

Ryan: It is when you’re looking for a deal.

Mike: I guess.

Ryan: Then, we gather around the fire and eat.

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

Ryan: Exactly. Cavemen.

Mike: 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.

The body was covered. I stood with Brian ten or so feet away from it, watching cars speed past. It was 0330 or thereabouts, my guess is most of the people who gawked saw only a blur, then went about their business. Some may have been sober enough to see the sneaker that lie thirty feet further up Route 95, maybe noticed the wet splotches on the pavement but could never imagine the wreck that lie beneath the sheets.

A coppery smell lingers long after a traumatic death. It covers the air, fills your nostrils and stays for a day or so, then slowly recedes along with the vivid images embedded in your memory. The sharpness subsides but the experience stays forever.

The Captain set flares around the fatality, keeping the errant motorist at bay, hopefully. The body was alone, unprotected from further harm until the little red glows dotted the interstate. In an hour the flares would be gone, the body taken away, the cops and firemen ready for whatever happens next, or not. Cars would fly over the space where a young man lost his live hours ago, maybe feeling a chill when the sped over the site, maybe not. A family somewhere would soon wake to find life will never be the same, an empty space joining them where a life should have been.

Brian and I walked to the front of the rescue after a while, just to move, and breath. Ten feet in front of us were two lumps of what looked like shaved steak. Bloody blobs of human flesh. We looked at the parts, both of us refusing to believe it could be part of the victim. We discussed possible explanations, ruled out all possibilities then finally accepted we stood in front of something that had been part of a living, breathing human being a few minutes ago. There is comfort in denial, but fleeting.

We covered the parts with a towel, careful to avoid them as we pulled away from the scene. More calls waited, there was nothing we could do.

http://newsblog.projo.com/2010/04/2-men-killed-in-separate-pedes.html

Stephanie went down while lifting the stretcher. Her back. I swear I felt some of her pain simply by being next to her. The man on the stretcher had just been dragged from his basement bedroom and had a slim chance of survival. Zack saw me approach, pushing the empty stretcher from Rescue 1 toward the front of the fire building.

“I need you.”

I gave my new partner, Brian some quick instructions and took over for Stephanie, who somehow manged to drive Rescue 4 to Rhode Island Hospital before she too needed medical help.

The man was badly burned, not breathing and asystolic. Hector, from Engine 11 came with us as we left the scene. We did some CPR, started an IV, pushed some epi and hoped to see some movement in the flat line. Nothing. I prepared the ET equipment, tilted the man’s head back, inserted the blade and looked in.

Black. Inhalation burns. I thought I could see the vocal cords. The tube slid home. I pulled out the stylet and attached the bag-valve  to the end of the tube and squeezed the bag, saw the chest rise and the tube fill with condensation.

“Tube’s in.”

We continued CPR, got ready for some more Epi, but by then the truck had stopped, perfectly placed with all the others in the rescue bay. Steph stayed put, couldn’t move from the drivers seat. The guys from Rescue 2, who were at the ER with another patient went to get her as we brought the burn victim in. The trauma team took over, I helped put Stephanie onto a stretcher and walked outside. Hector followed, and brought me back to the fire.

By then things were under control. The victim’s mother was still there, asking if her son got out of the house. Teresa, from Rescue 5 had to tell her that he was out and had been taken to the hospital. The mother’s relief wouldn’t last long.

http://www.projo.com/ri/providence/content/pfire2_04-03-10_LSI047U_v3.3a56f7b.html

I didn’t see the swollen knuckles and crooked fingers. I didn’t even notice. All I saw in front of me was a job. A two-hundred and fifty pound job. My focus wasn’t where it should have been, on the patient, rather I worried how to get her down two flights of stairs, another set of concrete steps and into the rescue without causing more damage to myself.

She’s forty years old, diabetic and feeling weak. She’s also complaining of blurred vision. I’ve been at work, running non-stop for sixteen hours at this point, with eighteen to go. I spent the previous night picking furniture out of a foot of water, placing it on pallets or inverted plastic storage bins and worrying about my heating system as the flood waters rose. I’ve got a wife at home who can’t get downstairs to check the status, I’m running on adrenaline and blind faith, hoping I have something to salvage when I get home.

“I’ll help you down the stairs.”

She was a trooper. She stood, steadied herself and started walking.

“I can’t see,” she said, clutching my arm as we made our way to the top of the stairs.

“I’ve got you.”

We slowly descended, step by step. She was unsteady, I took hold of her hand. It was then I felt the fingers. Old man’s hands, completely out of place on a young woman. The stretcher waited at the bottom of the steps. She got in, we loaded her into the rescue.

She was tired from the exertion. I was certain her blood glucose would be low; it was 130, perfectly normal. Her pulse was rapid and thready, blood pressure 80/38. I still can’t believe I walked her down the stairs. I also can’t believe she made it.

Somehow I managed to pull things together, hopefully making up for my poor choices at the start of the call. We started an IV, ran some fluid, administered oxygen and did an EKG and got her to the hospital. Her Rheumatoid Arthritis had been acting up, she’d been vomiting for twenty-four hours and hadn’t been able to take her medications. If anybody needed a rescue, it was her. The drunks, misfits and whiners beat me this time, took away my compassion and common sense. Every now and then somebody calls 911 who actually needs us.

Time to re-group, get my mind back where it belongs.

Glad I got that off my chest, thanks for stopping by.