“It’s bad,” said Gerry. “We’re going to need the chair.”

When Gerry says it’s bad, it’s bad. Still, I wasn’t prepared for what waited in room 303.

The door was open. Three firefighters stood outside, then followed me in. They had already assessed the patient, then stepped out to wait for the rescue. It was impossible to stay inside the three room apartment for more than a few minutes. Week old food left on the kitchen counter now a feast for beetles, fleas and flies that zig-zagged around the fetid airspace, savoring the ripe aroma. A trail of feces led from the bathroom into the bedroom, or the other way around, it really didn’t matter.

My shoes stuck to the floor, a dingy cream linoleum, lifting in the corners, giving the cockroaches a place to hide, crunching when I tried to push the tile back in place with my foot. Do cockroaches bleed? If they do a puddle of roach blood congealed under the floor. Maybe it will work as glue, I thought.

Cigarette butts, piss, vodka bottles, shit covered sheets, piss covered clothing and in the middle of it a wasted, emaciated man. Eighty pounds. Eyes bulging, Mouth cracker dry, blood oozing from infected gums, two teeth covered in years of filth, skin so dry it flaked from his body, more bugs feasting on the human waste.

My stomach rolled, bile rose in my throat and I fought the look of horror off of my face as I approached the bed.

“We’re taking you to the hospital, sir.”

“Good. I’m thirsty.”

Once things got rolling it was quick work. Nobody wanted to linger, though the reek would attach itself to our skin and clothes. That we could wash away. The things we inhaled would stay for hours, maybe days.

“He goes to the VA,” said a guy my age, standing outside, waiting for us to extricate his father.  Nicely dressed, new shoes, clean white shirt, pressed and starched. Expensive watch, good haircut.

He must have read the expression on my face, the one I thought I had hidden under my mask.

“He won’t let us in,” he said, ashamed.  “We try. He’s stubborn. I’ve been trying for weeks to help him, he won’t let us. We’ve tried everything. I have four ladies waiting to clean the place as soon as we can. i tried to get elderly services involved. He won’t meet with hospice, won’t answer the phone.”

“What is wrong with him?”

“Stomach cancer.”

Nearly twenty years ago, I fought a battle of wills with a stubborn man with cancer. He wanted to die in peace. His way. He had a little boat, called it “The High Life.” Fourteen feet, Mercury Outboard, painted, taken care of. Six months into his fight with cancer, one he knew he would ultimately lose he asked me to let him take his boat, a full tank of gas and a case of Miller Lite and let him go. He couldn’t do it alone, he needed an accomplice.

I thought about his request for days, ultimately rejecting his wishes. His last six months were a nightmare. Watching your father wither and waste from a two-hundred pound god into an eighty pound shell is simply awful. If I could do it over, I would fill the tank, stock the cooler, drive him to the dock, shake his hand, kiss the top of his hairless head and wish him godspeed.

I hope I can find somebody to do the same for me, should the need arise.

“I understand,” I said to the son, and I meant it. The urge to judge and condemn the dying man’s son died with my memories of my similar fight. The young and healthy can, and sometimes do force their will on their parents. In this case, the family should have intervened. Had they known the extent of the misery inside their fathers place, they probably would have. Overpowering in the physical is easy. Winning the war of wills with a parent not so much.

We took his dad to the VA. He is a WWII veteran. We talked about the war during the ten minute ride. I told him about my father, his service during the Korean War. I thought about how the living impose their needs on the dying, and how the dying most always give in.

http://www.wpri.com/dpp/news/firefighter-delivers-baby-saves-life-providence

There aren’t many people who last more than a few years as a Rescue Officer in Providence. The Captain of Rescue 1 is one of them. You can’t put a price on experience, no more than you could put a price on this infant.

People get eaten alive on these trucks. Vinny survives somehow, manages to let it all go and keep on doing the job, day after day, year after year. His style may get him in some hot water now and then, but I know one mom who wouldn’t want him any other way.

“Mr Watson, the game is afoot!”

Watson wheeled the vehicle expertly into the fueling station lot, next to the detectives and fire brigade. I stepped out of the rescue and into the foggy night, instantly assessing the scene.

“It appears a scuffle has taken place!”

“Brilliant, Holmes,” said the Lieutenant of Engine 11.

The dim moonlight helped the bright fluorescent glow from the petrol pumps  illuminate the crime scene. There, a homely woman stood next to the constables, broken pump in one hand, blood streaming down her face, smearing her heavily laden mascara.

“Miss, what misfortune have you had the unfortunate experience of experiencing this evening?” I asked, observing her torn dress, scrapes on her arms, and a misshapen left hand. I discreetly compared the left to the right hand, making a mental note of the large size of those hands, and the obvious deformity of the left compared to the right.

“Four men attacked me and stole my car,” explained the homely woman in a deep voice.

“Mr. Watson! Prepare the rescue, we have a victim of a heinous crime!”

I probed for further details.

“How did you come upon these ruffians?” I asked.

“I was pumping gas, they came out of nowhere and started punching me.”

“It doesn’t add up!” I exclaimed. “This is a street notorious for prostitution! Surely the men of today would be kind to a woman lost in this place of ill repute!”

“Holmes! Look here!” said Mr. Watson, discreetly pointing to the bulge between the victims legs.

“Great Scott man! They’ve wounded her in the most delicate of places! Prepare to cut her clothes and do a thorough primary assessment!”

“Please don’t, at least until we get to the hospital,” said the victim of this abhorrent crime.

“She’s had enough trauma this evening Mr. Watson. Make her comfortable and leave this wicked place!”

We transported the victim to the emergency room, where she was immediately placed in a private trauma room and attended to by the emergency doctors.

“What is this world coming to Mr. Watson,” I asked my partner while packing my pipe with tobacco.

Some mysteries are better left unsolved.

http://theemtspot.com/

If I could market complaining I would be a millionaire.

I have arguably the greatest job in the world. Do I appreciate it?

Sort of, I guess.

Sort of. Sort of? Sort of!

What the hell is the matter with me?

Take a look at The EMT Spots latest contribution to the profession, and if you still feel like complaining, perhaps it’s time for a change!

http://theemtspot.com/2010/06/26/ten-reasons-i-work-in-ems/

Thanks, Steve

http://999medic.com/

We walk a little taller now, take more pride in our appearance, our skills, ourselves. A great guy in a funny green car touched the blogging world with his passion for EMS, friendship, family and everything this life has to offer. I’ve questioned my own commitment to my profession because of him, and decided that as long as people like Medic999  exist, and are part of the brotherhood of EMS providers, then I want to remain part of it.

Mark decided to end his blog for reasons important to him. The Chronicles of EMS continues.

http://chroniclesofems.com/

“Rescue 1, Respond with Engine 12 to 167 Smith Street for a person choking.”

“Rescue 1, Responding.”

“Excellent,” I said to John, my partner for the day. He looked me out of the corner of his eye, pressed the button for the lights and flipped the switch that turned on the sirens.

“It’s perfect,” he agreed.

High Noon. A person choking on the other side of the city. Engine 12 would beat us there by seven minutes. They would have either saved the victim, the victim would have saved herself, or it would be too late to do anything.

“We might actually be able to eat lunch before dinner time,” I said to John.

“Great. I’m starving.”

“Rescue 1 and Engine 12, we now have a report that that person is having a seizure.”

Choking and a seizure. Considering Providence is the pseudo-seizure capitol of the world, this news, though troubling was no cause for real alarm. The rescue can only go so fast, and Engine 12 should be on scene any second.

“Quick scoop, some vitals, glucose check…we’ll be done in fifteen minutes.”

“Nobody will miss us if we disappear to the cafeteria.”

“I love it when a plan comes together!”

“Engine 12 to Rescue 1,  bring a board and collar.”

“Rescue 1, received.”

We were one minute out.

“Board and collar. She must have fallen. Probably nothing. Half an hour, we’ll be done.”

“I think I’ll get the Brick Oven Pizza. It’s Wendsday, right?”

“Right.”

“Engine 12 to Rescue 1, step it up, pt. is unconscious with a head injury.”

“Rescue 1, received, on scene.”

Sometimes lunch just has to wait. Six runs later, we had some leftover Chinese. It was 5:30 when things slowed down long enough to grab a bite.

(The patient suffered a 1″ laceration to the back of her head following some seizure activity which caused her to fall backwards in her chair and hit her head on the floor. Providence is also the Real Seizure Capitol of the World)

They sit on or lay on their rolling beds, watching the parade. Some ignore it and sleep, others complain about their pain, nausea, itchiness, visions or the million other things that have brought them to the ER for treatment. We bring them in, one crew after another; our patients either carried like royalty on stretchers, or rolled in on wheel chairs. Others walk, or stumble  and are added to the cramped area, so close they share the same air, breathe the same germs and bask each other’s aroma.

The intoxicated homeless man may not invade the personal space of the little old lady with a urinary tract infection, but he doesn’t need to, his presence is known by everybody within twenty feet of him. Respectable people flinch, wrinkle their noses and inch away from the person fate has brought so close. It’s one thing to put a buck in the can of a person holding a “Will Work for Food” sign, quite another to be placed next to him while waiting to be seen. The ER is a great equalizer.

The people who actually need to be here, about five percent, are in the urgent areas, or, if they REALLY need to be here are in the trauma rooms, clothes cut off, tubes sticking out, and in everywhere, doctors and nurses working against time to save their lives. The rest wait.

Thankfully, the ones who need it most get it fast. Nobody at risk of death or permanent disability waits at all. They are having an emergency, and have come to the right place. They don’t have time to complain, they are too busy having their lives saved.

I listen as I pass through the waiting areas; angry people, complaining about the incompetence, the lack of compassion from the staff.

“This place is a joke!”

Actually, this place is full of dedicated professionals. Doctors who have devoted twelve years following their high school graduation getting educated, gathering experience, putting their lives on hold to learn everything there is to know about the human body and how best to treat, and hopefully heal what went wrong. Nurses, patiently taking care of too many patients, keeping the hoards of people demanding their attention at bay while somehow keeping track of every aspect of their patient’s care. Nurse Practioners and Physicians Assistants, x-ray technicians, CNA’s, secretaries, security guards, housekeeping staff, groundskeepers…all working together making sure the patients who come in are treated properly. It’s no joke. It’s a hospital. And a damned good one.

“If they DID SOMETHING we wouldn’t have to wait!”

What, exactly do you suggest “they” do? Turn away the people who actually don’t need to be here? Sorry, can’t do it. There are laws against such reckless behavior. Of course, there are no laws against abusing a system that is on the brink of collapse.

“Can you believe I’ve been waiting for four hours!”

At this pace you might just get better without a doctor telling you your stomach virus will pass, the sniffles will go away, you need to see a dentist about your toothache and a band-aid will stop the bleeding.

The fact that two-hundred people have shown up for routine medical care at a facility that is designed to care for one-hundred eludes them. They sit, and wait, and complain some more. I deliver another patient into the mix, get my report signed and head back into the city to get another one.

Every now and then somebody who actually needs a 911 response comes in, the rest wait. And listen to each other complain. They have plenty of time to do that.

I have been tagged. Yes, ladies and gentlemen, TOTWTYTR http://tooldtowork.blogspot.com/ graced me with a request to participate in this fun little diversion from the regular routine.http://lookingforlissa.wordpress.com/2010/06/15/bathroom-meme/ Considering the regular routine routinely lands me in the very place that this MIME originates, how could I resist.

I, Like TOTWTYTR do not usually participate in these things, but what the heck, it won’t kill me.

Here goes:

“From the desk of Mrs. Morse; There will be no clutter in or about the house. This includes random magazines, proposals, half written articles, songs or books left in the bathroom. The following approved reading list is acceptable, but subject to periodic review and substitution:”

The Loading Dock. This is a fun little collection of stories put together by Eric Liddy, a firefighter/EMT from Detroit EMS. The contributors participate in a great forum at Ghetto Medic http://www.ghettomedic.com/

A Large Print Word Search Puzzle Book. What can I say, sometimes I need to clear my mind.

Being Perfect by Anna Quindlin. Great life lessons.

A Short Guide to a Happy Life by Anna Quindlin. More good stuff.

Daily Meditations for men who Work Too Much by Anonymous. Inspirational quotes and a little essay giving insight to the words.

That’s it. Pretty dull, I know, but the temptation to fill the list with a fictional lineup including Playboy, Guns and Ammo, Soldier of Fortune and Muscle Magazine only lasted for a minute or so, when I realized nobody who knew me  would buy it.

In the spirit of the blogosphere, I need to tag five people.

http://whatanurse.blogspot.com/

http://callitasiseefit.blogspot.com/

http://happymedic.com/

http://manchmedic.blogspot.com/

http://ambulanceamateur.wordpress.com/

Have fun, gang. I fully understand if you choose to…er, pass.

Another epiphany…less overtime~more life!

I’ve been either working eighty hour weeks or recovering from the injuries caused in part by eighty hour weeks for so long I’ve forgotten how to live. Too bad my back is shot, there’s a lot of stuff I would have liked to do now that I’ve figured out that work is the root of all evil. Quick ten hour shift today, childsplay really, a finish line I can actually look forward to rather than some obscure point thirty hours in the future that I’m trying to reach, one run at a time.

I turned down the overtime shift for tonight. Just so happens the annual Gay Pride Parade starts at dusk. Always a fun night. Glad I’ll be home. 

South Providence, or The Southside, as the people who live and work there call it is often viewed, mostly by the people who haven’t set foot there in a generation, as the worst neighborhood in Rhode Island.Once a week or so somebody gets shot, there’s a lot of dealing going on and not a lot of white people. I suppose I’m not supposed to notice things like that, but a big white guy from the suburbs doesn’t have a choice but to notice. I get a good glimpse into how it feels to be a minority here.

I don’t live there. A few generations ago my family did. Or some of them anyway, I’m not quite sure, I’ve only climbed a few branches into my family tree. The people who live there now probably won’t be there generations from now, or at least their children won’t. It’s a place full of beautiful homes and streets worn down by time and changing values. The people who make the money, and used to live here have abandoned the inner city for the suburbs, and rural areas, leaving a lot of empty homes.

Rent is relatively inexpensive, low income families fill the once gracious homes. Twenty years ago, when I started working in Providence I was shocked by the living conditions disguised by the exterior of these places. Vinyl siding hides decades of exterior neglect, but you can’t cover lack of pride of ownership on the inside. Entering the triple deckers was an experience I’ll not soon forget, especially if they were on fire.

“Don’t touch the walls,” senior guys told me prior to entering a smoke filled place one night. The fire was in a back bedroom. The front rooms appeared to be alive. The cockroaches, smoked out of the walls had to leave their nests. I was more afraid of the living walls than I was the fire.

You would think things only got worse as time went on. The opposite is true. There are still a lot of dumps in the neighborhood, but more times than not the places we are called to are well kept, clean and updated. Last week we had an overdose in a basement. I expected the worse but was wrong. The guy who lived on the first floor owned the place and had just finished the basement for his son. It was a great job, wood stairs, tile floors, fresh paint. His son wasn’t doing so well, but that is another story.

A different house on a different street had the same look to it. I guess optimism is the best word to describe it. A little old lady was having dizzy spells and difficulty breathing. The family stood around, watching us work. One of the old lady’s daughters interpreted for us. Some little kids were running around. Every time one of them said something in Spanish, the father, in broken English told the to “speak English,” which the kids did.

The Southside may have it’s problems, but a neighborhood is ultimately comprised of people, and the people who live here are making the best of the place. I see it more and more, and it gives me real hope that the future is not as bleak as some stories would lead you to believe.

http://www.providenceri.com/Neighborhoods/lsprov.html

What if…

Gone now. Everything mankind had built, the technology, architecture, art…everything. The Apocalypse happened fast, cities fell, oceans rose, fire burned. People, used to an easy life, one of convenience had no idea how to survive in a hostile world. Sure, there were some, people who planned, built stockpiles of food, water, fuel and medicine. They lasted a little longer than most, but ultimately they too succumbed to the harsh reality of the new world order. Mobs roamed the streets looking for food, warmth, substanance. Most failed, starving to death cold, hungry and alone.

Through the ashes of or destruction a group of people rose, mankind’s hope for redemption. This was a different breed of people, used to surviving on nothing, seeking shelter in doorways, under bridges, in dumpsters. They lived for days with only food scavenged from seemingly nothing. They were immune to most diseases, having lived in filth for years, and actually thrived where better men failed.

The Providence Clan, led by the dashing, fearless Kevin M. fared better than most. This former Urban Outdoorsman ruled Providence ruthlessly. Sitting upon his throne of empty vodka bottles, stripped chicken wings at his feet, licking his greasy fingers he held court on the first day of each month. What once was “check day” now was the day of reckoning.

Former Lt. Morse, once proud Rescue Lt., now emaciated, starving and destitute stood before Kevin M., hoping for kindness, expecting none. Kevin tossed the pathetic Lt. Morse what remained of a chicken wing. As Morse scrambled for the scrap, Kevin M. spoke:

“Let me ask you a question…Who’se the guy…that played the Captain…on Sea Hunt?”

“Jeff Bridges?”

“You are not correct!” said Kevin M. with a wicked grin.

“Take him to D-Pod!”

The once proud Lt. Morse was never heard from again.

She sat in the front seat of the van, crying, being consoled by her friend. A co-worker stood outside the van, her car parked behind us. Two other concerned friends or co-workers stood by, their cars running close by. The work day was over. They wanted to get home. But not before their friend was properly taken care of.

Our six rescues were tied up, intoxicated persons taking half, other non-emergencies occupying the other three. Four rescues from surrounding communities were in Providence, more calls coming in by the minute. Minor car accidents, an overdose, a person feeling “tingly,” a child with an insect bite, a person who had been released from the ER that morning but was still vomiting…

“What’s going on?” I asked.

“She needs to go to the hospital,” said one of the friends. “She’s crying.”

“Is she hurt?”

“She was on the ground, unconscious.”

“Unconscious?”

She looked at me like I was an idiot.

“Yes. Unconscious.”

I’ve seen a few unconscious people over the years. i actually know how an unconscious person looks, before during and after their period of “unconsciousness.”

“She hasn’t been eating and has a lot of emotional problems,” said another, checking his watch.

I looked over the roof of the van at Rhode Island Hospital, 500 feet away. I reached in, felt a strong pulse, breathing normal.

“Come on,” I said, gently pulling the crying lady toward the door. “We’ll take you to the hospital, get some help.”

“She goes to St. Farthest,” said the lady closest.

“I’ll gladly take her to Rhode Island Hospital for an evaluation,” I said.

“She goes to St. Farthest!” Indignant, dirty looks all around as this lowly public servant obviously refused to do his job.

“Ill gladly take her to Rhode Island Hospital for an evaluation.”

“Just do your job,” one of the ladies glared at me.

“Mam, would you like to go to the hospital to get checked out?” I asked, nicely. She didn’t answer. Her support group was in full swing.

“Just take her to St. Farthest!”

The group started to dwindle. perhaps they were aware that perhaps they might be asked to actually help, rather than call 911 and have their problem dissapear.

Finally, the lady in charge stated that “I’ll just take her home!”

Finally. A person who actually decided to “do her job,” and be a decent person, a responsible person, a good friend and a contributing citizen.

She glared at me as I walked away, and continued to stare as I left, following the train of cars leaving the emergency.

Beautiful brown eyes. Heavy lids, struggling to stay open, too terrified to close. Bags under those big brown eyes and heavy lids, ugly, puffy, black and blue bags. The kind of eyes that haven’t rested in days, weeks, or years. Old eyes. Eyes that have seen too much. Wary eyes. Accusing, contemptuous. Hateful.

She clung to the woman  taking care of her, afraid to let go. Glared at me when I got close, flinched when I got closer, cried when we touched.

“Her mother was in the next room when he penetrated her.”

Penetrated her.

This child will never trust a man. Will never know the unconditional love of a father, an uncle, a friend. Will never understand that there are good men in the world, men who will hold her, protect her, love her. She will never fully trust her boyfriend, her husband, her son. Men will forever be bringers of pain and humiliation, degradation and broken trust.

I watched the mist flow from the nebulizer I had just put together, anything to avoid those eyes. They bore into my soul, making me feel dirty, ashamed to be a man. That another man could do this to a four year old is incomprehensible to me, but I felt dirty nonetheless.

Not only did this molester steal this beautiful child’s innocence, he took mine as well, filling me with the desire to take a knife, hold it in my hand, feel the weight, run my thumb down the blade to make sure it’s good and sharp, and plunge it into his heart.

Penetrated.

http://www.2dogs2000miles.org/

I had the pleasure of meeting Luke a few days ago. I love a man with a mission! And I miss my dogs. Every day.

http://rescuingprovidence.com/wordpress/?p=413

Good luck Luke! Please take a minute to visit his site if you can, and support his cause any way you can. I’d appreciate it, and so would the dogs.

They put her in the grass, twenty feet  from the road where a minute ago a slow moving car had run her leg over. She had been playing, enjoying the day with about twenty relatives, grill fired up, cold drinks around, an inflatable bouncy tent in one of the backyards.

I’ve responded to this area hundreds of times. Most of the time it’s for assaults, stabbings and shootings. Last year, two houses from where the little girl lie a police officer witnessed a robbery suspect shoot himself in the head during a torrential downpour. I declared him dead after looking for and finding no pulse, and witnessing the top of his head blown off,a mix of blood and rain water forming a river, running down the patio, into the grass.

http://rescuingprovidence.com/wordpress/?p=380

The little girl’s father had to be moved away from his daughter so we could do our work. He reluctantly let his baby go and watched a bunch of strangers tend to his little girl, who screamed in fear and pain while we splinted her lower left leg, crushed, bleeding and swollen.

“It’s okay Daddy,” she said as we lifted her onto our stretcher and rolled through the grass, into the street and into the rescue.

A crowd had formed. This time there were no hostilities. It’s a little different when the victim is an innocent seven year old, and the injury an unfortunate accident rather than an act of aggression, or revenge. They stood by respectfully watching as we did our thing, stabalized the patient calmed her fears and tried to ease her pain.

We tried to start an IV, and succeeded, but the little girl accidentally pulled it out.

There are differing philosophies regarding family members in the treatment area during an emergency. My own belief is to let the family in, have them close by to offer comfort, especially when children are involved. The little girl’s mother entered through the side door and sat on the bench seat, watching as we got ready to go. The leg had been packaged, only some gauze was visible under the blanket that covered her.

“What is her name?” I asked the mom.

“She doesn’t speak English,” from the little girl, calm as could be.

“Well then, what is your name?”

“Magneline.”

“Madeline?”

“No. Magneline. m-a-g-n-e-l-i-n-e.

Talk about grace under pressure!

She told me her date of birth, her correct address and anything else I asked her. And she told me she was worried about her father.

“Where is he? Is he okay?”

We got rolling, Hasbro Children’s Hospital less than a mile away. Her father followed.

Once inside the hospital, the nurses took over. In the small treatment room, with the girl’s mother still close by they undid our packaging. When the mom saw the injuries, she broke down.

“Don’t cry, mama,” said Magneline, soothing her mom, letting her know it would be okay.

Then they administered Morphine, and little Magneline rested.

Toothbrush?

check

Towel?

check

Book?

check

Back-up Uniform?

check

Lunabelle?

check

I’m ready to go. Saturday night in Providence. Luna is doing a ride-along.

Anybody who has read and tolerated this blog for any length of time knows I’m overdue for my yearly no more blog nonsense. Subsequently, anybody who has stayed with me also knows that any talk of ending the blog is just that, talk.

That being said, truth be told I have been considering letting Rescuing Providence rest. It’s kind of like Seinfeld or Friends, good when it was fresh, but the end came long after it should have. As much as I want to avoid a similar fate, I simply enjoy telling these stories too much, and the subsequent commentary makes it all worthwhile.

Which brings me to the point of all of this. A week or so ago I posted something about the Station Fire. The mother of one of the victims, unable to sleep, consumed with grief must have been cruising the internet looking for some connection with her departed daughter. She landed here. My post alleviated some of her grief, for a short time, anyway, and she left a comment telling me so. Things like that keep the magic of the internet alive. For such an impersonal device to have such an effect on people through nothing more than technology that the vast majority of us will never understand is truly a gift that should never be taken for granted.

Thank you, Annmarie.

http://chroniclesofems.com/2010/05/28/mmmmm-this-looks-interesting/

I do love a mystery! I may have to bring Sherlock Holmes out of retirement. First clue, follow the link.