If I didn’t work in Providence, I never would have known…

-Bullets make little holes going in and big ones going out…

-The “poor” really are poor…

-How to say, “you look hot!” in Spanish…

-How to say, “You don’t look so hot,” in Spanish…

-Money isn’t everything…

-Big screen TV’s are important when it’s all you have…

-College kids and alcohol don’t mix well…

-Especially their first year…

-The people who live here look out for each other…

-Except for the ones whe need to be watched…

-The toughest guys ain’t so tough when they’re tits up on a stretcher, bleeding and full of holes…

-You don’t have to be white to be racist…

-You don’t have to be racist if you are white…

-Immigrants work their asses off…

-A lot of them drink their asses off too…

-Politicians lie…

-Patients lie…

-Politicians make the worst patients…

-The general population has no idea how close to collapse the EMS system is…

-The general population doesn’t care how close the EMS system is to collapse…

-Until they need it…

-Some people are just evil…

-Most people are not.

Feel free to make any additions in the comments section, and city of town will do, (they’re all pretty much the same, after all)

I’m dog tired and look it. I can feel the bags under my eyes dragging my face to the pavement. People pass, I barely look at them, just enough to avoid contact. I’m isolated, lost in my thoughts, just trying to make it home.

A pizza I ordered waits for me at Pizza Pier. I can see the storefront in the distance, a few hundred feet away. I walk past the Sushi restaurant that shares the same block, peek in the window as I pass and notice a beautiful young girl sitting at one of the tables that line the outside windows. It’s just a glance, a fraction of a second, but I feel a little better.

I’m waiting for my pizza. Marlin, the guy behind the counter is busy with somebody else. I wait, and slouch a little, the hours having finally caught up with me. Thirty-four hours since my last encounter with unconsciousness. It’s different being a civilian in Providence, the uniform gone, the radio on somebody else’s belt and the crushing weight of being on duty lifted, for now.

“Michael.”

I turn and there is the beautiful young girl standing next to me. I’m filled with such ridiculous happiness I can’t believe how good I feel.

“You look tired,” she says, and gives me a hug.

“Just a little.”

We talk a little, hope to get together this weekend. I want to join her and her friend but I just don’t have the gas, and it would be a little tacky to bring a pizza into a Sushi place, I think.  I pay for the pizza and we walk out together. We say goodbye, and she leaves me, to join her friend back at the table by the window. I look in again as I walk past, smile and wave to them.

I don’t feel so alone when I get back to my car, turn the key and head away from the city toward home. I’m not as tired, either. I feel good. Great actually, and savor every second of happiness that an unexpected encounter with my daughter has given to me.

I had just left the naked men and all-male exotic review, and the perpendicular bologna and provolone sub was etched deeply into my mind when I was given a choice.

Respond to Charles Street for a woman sitting on the porch with a boil on her buttocks, or

Respond to 847 Broad Street for a woman lying on the ground eating dirt.

Considering that over that last day I had seen enough of other peoples body parts to last a while, I chose the lady eating dirt.

Bad choice.

I’ve got a few days off, see you in a while, as always, thanks for reading.

The nurse at triage gave me the news.

“His CO level is 84!”

“84, well, that explains it, no wonder he’s blue.”

We had found him at one of the gay bathhouses in the city, huddled in a corner, naked as the day he was born. He was confused and uncooperative, soaked with sweat and, well, blue. Men in towels and nothing more, and some without towels hovered around me as Brian got the stretcher from the rescue. Loud music from the strip club next door made it hard to hear or be heard. The blue man tried and failed to run away. I had nothing to grab but slippery skin, fortunately he decided to sit on the sticky floor.

I crouched down to do a better assessment, the view from that level was a sight to behold as the men got closer to the action.

“Step back and give us some air!” they did, a little, not nearly enough. Finally, the stretcher appeared. The usual struggle ensued and I had to call for help. When back-up arrived we loaded him onto the stretcher and wheeled him out. His BP was good, 124/80 or something like that, heart rate in the nineties, The pulsox was the kicker, 84%. He fought the 02 mask, and put up such a struggle I never did get an IV, but the hospital was close and we got him there quickly.

Once I learned about the elevated CO level I got on the horn and called for support at the club with a CO detector and possible evacuation. Meanwhile, the ER staff was busy trying to figure out just what was wrong with the blue man. One of the doctors, after hearing where the man was prior to his blueness put two and two together and figured things out. I was surprised it hadn’t occurred to me, once things came clear.

http://emedicine.medscape.com/article/815613-overview

The patient had been inhaling Rush, or Video head cleaner, poppers as they are known in the clubs, must have overdone it and that was that. I’m sure had I recognized the man’s condition prior to requesting two fire companies respond to the bathhouse there would have been a lot less excitement at the place. I’m also sure I’m not the most popular guy at the firehouse right now.

The guy recovered, but I bet it will be a while before his blood returns to normal. His skin was blue and his blood was black.

Picture if you will, a four-hundred pound elderly lady, standing in the center of the ambulance bay, directly in front of the rescue you are in, and inside that rescue is a man and his wife. The man had just left his doctor’s office in a taxi-cab and was broadsided in an intersection by an unsuspecting player in the drama that is about to unfold.

The four-hundred pound lady holds the security team at bay, spitting and swinging and refusing to move. When the security forces approach, she drops her black stretch pants, faces, (or asses) directly at the rescue you inhabit, bends over , grabs a healthy handfull of ass cheek with each hand and roughly pulls them apart.

Inside the black hole is something that can only be described as a twelve-inch bologna and mayonnaise sub, on Pumpernickel and dripping with melted provolone, standing perpendicular between the four-hundred pound woman’s buttocks cheeks.

The man on the
stretcher, who just had a brain tumor removed asks his wife what the hold up is.

She replies,

“We have just entered, The Twilight Zone.”

Two beautiful children stood on a streetcorner in South Providence, confused, overwhelmed and afraid. Dozens of people surrounded the girls, police officers, firefighters and concerned citizens. A car has bumped into the two, knocking one of them to the ground.

The kids were petrified. I crouched down to the five year old’s level and reached out my hand. She looked me in the eye, hesitated for a moment then took hold, squeezing so tightly I thought she might never let go. Her sister, nine years old stood guard, then softened. With my free hand I took one of hers and led them through the crowd, away from the busy intersection and into the rescue.

The Spanish speaking people were frustrated, the kids didn’t understand them. The police were baffled, and so was I. I gave the nine year old my phone, she smiled and dialed. The person on the other end was no help, she spoke in a different language altogether. I gave the five year old my pad and pen, she wrote an address down. It was just around the corner.

The little girl had a small scrape on her arm, the older one was fine. One of the bystanders told me that a car slammed into them and ran the little one over. The driver of the car said the kids actually bumped into his car and one of them fell over.

I had four different languages going at once.

We took the kids home. As soon as they opened their door, they ran up three flights of stairs and into their apartment. There, three more children lived with their mother, who was breastfeeding an infant. None spoke English. I managed to be understood by the oldest child, a boy of about fourteen.

They spoke Swahili. Honestly. Try to find a Swahili interpreter in Providence. Not so easy.

Somehow we sorted things out, the kids were all smiles and the mom appreciative. She gave the girls a thorough going over, decided they were fine and that was that.

Refusals? What good is a refusal when the person signing the form has no idea what they are signing?

Between me and the police we did the best report we could muster and said goodby.

Sometimes we have to wing it.

Learn the Language. Your life could depend on it!

There are about two-hundred residents at the hi-rise, most speak Spanish primarily. A few are fluent in English, more than a few make no attempt to learn the language of the place they now call home. Over the years I’ve accumulated enough of their language to get by. Simple things, “what is your name, date of birth, where is the pain, a lot or a little, what medications, are you allergic to any medications and where do you live pretty much gets me by.

The universal body language helps fill in the gaps. Have you vomited, are you pregnant, what’s wrong with you and stop talking are fairly easy messages to convey. It really isn’t that difficult, you just have to try.

There are always a few in every crowd that put zero effort into anything. It makes it easier when your can get by without learning to speak English. When all of your neighbors, the clerks at the stores you frequent, customer service departments of every merchant, utility company and government officials offer their services in your language complacency sets in.

If a patient gives me even the tiniest attempt at speaking English I’m willing to put every ounce of effort into getting their story right, and treating them accordingly. It is a lot more simple when they are unconscious, the language of dying is pretty much the same wherever you come from, and our interventions know no language barrier.

I walked into a fifty year old lady’s apartment. She sat on a couch in no apparent distress. I said hello. She looked disinterested.

“What is your name?”

“No English,” she replied, looking around for the Spanish interpreter.

“What is your name?” I asked again.

“No espanol?” she replied, annoyed, shaking her head in disbelief.

“No English?” I replied, shaking my head in disbelief.

She rattled off some long litany in Spanish, I returned the gesture in English. Her vital signs were normal. I shrugged my shoulders.

“El hospital,” she said, and looked at the stretcher, getting ready to get on. I shook my head no.

“What is your name?” I asked again. She reluctantly answered.

“Esther.”

It doesn’t kill somebody to at least learn the basics. If I can do it, so can they.

We all live here. We need to communicate. It’s not my life that could be in jeopardy if the correct message is not conveyed due to lack of effort to learn something.

We took Esther to the hospital. Using my Sesame Street Spanish and her limited English I learned that she vomited last night and was looking for some medicine to help her. She handed me the State issued medical card that says in English and Spanish:

Emergency Room Co-Pay  $0

Prescriptions Co-Pay   $0

Doctors Office Visits    $0

I still cannot figure out how somebody who can’t understand when somebody asks their name manages to get free healthcare, housing assistance and a check from the English speaking government.

Perhaps it’s better pretending I don’t understand.

Monday Morning, quiet now, waiting for the bottom to fall out.

Yup. Fell out.

“How are you feeling?”

“A little dizzy.”

The school nurse chimed in. “His heart rate is 160.”

I took his pulse, steady at 100.

“He’s mellowing out.”

“That’s not funny.”

“It is, kind of.”

Jeramiah took six bags of his mother’s marijuana to school with him. One of the other kids dared him to eat it. He made it through half of a one gram bag before a teacher saw the show. He’s eleven years old.

He told me there are a lot more bags where these came from.

Anybody who has read my ramblings for any amount of time may have noticed I am a little unstable and actually quite mad.

Zen question of the day:

Am I this way because of EMS, or am I in EMS because I am this way?

I watch her struggle, hiding my impatience as she closes the door behind her. She’s angry. I’m tired, it’s been a long day. She had looked forward to the me getting home from the city, hoping for a nice night, some conversation, maybe more. One look at my face was all it took. My expression reflected on hers, I saw the disappointment from the driveway. I’m done, and she knows it. The person who needs me most has to wait.

The once graceful form that flew through life without a thought has deteriorated, one leg is burdened by a brace, the other in constant pain from doing the work of two.

To the outside world it’s just an inconvenience, a limp, some fatigue, but, “she looks so good!” Inside she affords herself the luxury of showing some pain. Never all, but some.

People offer encouragement, never fully understanding. “It could be worse… everybody has some cross to bear… at least you have Michael… you’re lucky to live in a nice home…”

I spend my days carrying people down three flights of filthy stairs that she would crawl down, sweeping the dust from the steps as she went, because they refuse to walk, their belly hurts, or they are too emotional, or their family says they can’t.

If they only knew.

Sleep now, maybe more later. Tomorrow is another day.

“…She drew her wheelchair to the edge of the shore
And to her legs she smiled you wont hurt me no more…”   ~JIMI HENDRIX from Castles Made of Sand

Sometimes I think the world has gone mad, and I’m the only sane one left. Then I take a journey down my blogroll and find some comfort, some kindred souls and some inspiration.

Social media, blogging and cellphones are tools which can be used to educate and enlighten, entertain and teach. Used properly our world becomes a little less lonely, our message better understood. When used to send images of fatalities or messages from disgruntled employees and attacks against the very patients we are sent to help, all the good is thrown away, and nothing but an ugly impression is left.

I’ve found some winners during my travels through the web of media and information, and some I choose to ignore. Everybody who shares space on this blog is somebody I wouldn’t think twice about going into a bad situation with. I choose to stick with the winners

Thanks to all for leaving a great lasting impression.

a few of my recent favorites:

http://tooldtowork.com/2010/10/streets-and-trips/

http://insomniacmedic.blogspot.com/2010/09/real-world.html

http://www.ems1.com/ems-advocacy/articles/894089-Welcome-to-EMS/

http://sirenvoices.blogspot.com/2010/09/then-and-now.html

“Any idiot can face a crisis~it’s this day-to-day living that wears you out. “ ~ANTON CHEKHOV

A lot happens when “nothing is happening.” The mundane calls creep in, threatening to kill me with their, well, mundane-ness. Since when did an ear infection become an emergency? Or a low grade fever. Or a minor laceration. The very definition of an emergency has been corrupted by a government that somehow managed to make itself liable for not responding to every call for help for whatever reason.

But respond we shall. We “check” people involved in minor car accidents. We “check” blood pressures. We bring people to the ER to have stitches removed because they have figured out that if they claim the stitches are causing them pain, they’ll get a free rescue ride. We transport people in their thirties who are vomiting. People in their forties with sore throats. People in their fifties who “feel faint.” Here at Rescue 1 in Providence, most calls come from within a three mile radius of one of the busiest and best emergency rooms anywhere. And every street is within easy walking distance to a bus route.

Through it all, we persevere. The system is not our making. We get paid. We do the job, hoping that as advocates for our industry, slowly but surely things will improve. My contribution is this blog. By exposing some of the frivolity, even to a few people, maybe we can get this ship righted. Until then, I just keep on trucking.

I found the greatest piece of medical equipment last night. A frequent flier called for a ride to the ER, claiming she “might” have a seizure. She is seen at the ER three or more times every week for similar problems. We took vitals and settled her in, she’s developmentally disabled but able to live on her own, but barely. Along the way she informed me she had a severe headache, major chest pain, terrible back pain and her extremities hurt. Plus she was dizzy and weak, and might be hearing voices.

We brought her in, and I explained to the triage nurse the patient’s condition. The nurse looked skeptical, I had no IV, no 02, no ekg, ASA or nitro, not even a blood glucose. During transport from our stretcher to theirs, the patient’s thin nightgown rose up, exposing her legs. She sat on the hospital stretcher looking worried. I walked the fifty of so feet to the blanket toaster, unfolded one and covered her up, from her toes right under her chin. The patient grinned, closed her eyes and relaxed.

Just before I left, the triage nurse stopped me and said, “nice job.”

In it’s own way, the blanket averted a crisis, and I went about the rest of the shift, which proved to be just as mundane as the prior one.

Now and then God sends a patient my way to test my resolve.  Sabrina Moronica (not really but close) is twenty-one, has three children already and a swollen lip. At 0430 she rubbed some old Cipro on her lip to reduce the swelling, thinking it might be a cold sore and the antibiotic would help. When it didn’t, she swallowed another pill, forgetting that she is six months pregnant. Then she called 911 so we could give her an ultrasound so she could go back to bed, thinking the pill might hurt her baby.

We told her they took our ultrasound machine away and took her the 1/2 mile to the ER.

“I’m not hurting you, the handcuffs are.”

“Then take them off!”

“You keep swinging at us.”

She had already taken one of us out with a kick to the groin. Three police officers and four firefighters assisted in the take-down. She had been harassing people at a grocery store, then running in traffic prior to our arrival. Spitting, screaming and at one point lying in the middle of the road, refusing to move.

“Get that shit off my face!” she screamed, the sound muffled and distorted through the towel I had wrapped around her mouth.

“You’re biting.”

She struggled some more but was unable to escape. Tied with sheets onto our stretcher, held down by a few people but still full of hate and anger. She tried to spit but the towel stopped any forward progress the saliva and phlegm may have accumulated. It smeared around her mouth. I moved the towel a little and wiped her face, then replaced it before she could spit again.

“Why are you being nice to her?” one of the firefighters asked. “She took a chunk out of your arm!”

“It’s just my sweatshirt.”

Thankfully fall had taken over. With the chill comes a uniform switch. Short sleeve shirts are gone for the winter. Last week it would have been a chunk of flesh rather than some cotton from the sleeve of my sweatshirt.

“She kicked Tom in the nuts!” he said, struggling to keep her legs from delivering the same to him.

“She didn’t kick Tom, or bite me,” I said. She’s attacking things she thinks are a threat. It’s nothing personal.

Things calmed down for a while, until we got her to the ER and a whole new army presented themselves to her.

She attacked. We held her down until she was sedated.

I cleaned the saliva off my arm. The skin wasn’t broken.

“And now, for something completely different…”

“A man is choking in a Chinese Restaurant. Mr. Watson, the game is afoot!”

En route to the eating establishment thoughts of murder refused to be put to rest.

“Watson, perhaps the report of a man choking is a thinly veiled diversion masquerading a much more devious plot.”

“I’m not so sure, Holmes, this case appears cut and dry.”

“Elementary, my dear Watson! Precisely what the murderer would expect!”

We approached the scene of the potential crime, as every scene has the potential for wrongdoing. One simply need look under the rug, so to speak. A simple clue such as a steamed dumpling where a fried one should be has far reaching implications.

The proprietor met us at the door and directed us to a table in the rear, where the victim sat, surrounded by the very clues that would close this case.

1. The steamed dumplings.

2. A puddle of pink vomit, neatly (perhaps TOO neatly) plopped on the table.

3. A lump in the middle of the vomit.

“Sir. Are you quite alright?” I asked the victim. He coughed, and shook his head no. I removed a stethoscope from my bag and placed it front and back, and listened.

Perfect air exchange. Something didn’t add up. I smoothed my mustache with thumb and forefinger and took note of our surroundings.

“Are you in any pain?” I asked as Mr. Watson interrogated the suspects.

The man shook his head yes, and pointed to the center of his chest.

“Aha! Mr. Watson, prepare the EKG machine. The plot thickens!”

“Does the pain go this way or that,” I asked, pantomiming a crisscross pattern across my own breast.

Our victim pointed to his left shoulder.

“Can you speak man!” I shouted and shook him, peering deeply into his eyes. A small stream of drool appeared from the corner of his mouth, which appeared to droop to one side.

“Grasp my hands! Now squeeze and smile. Pull. Push. Tell me the day of the week!”

He did all I asked, I could ask no more. He coughed heartily then, and dislodged a chunk of what I could only guess was the murder weapon upon my cloak. Deciding the evidence was nasty, I shook it off, onto the floor.

Watson disentangled the web of wires connected to the machine, and placed tiny electrodes in strategic points of the man’s torso.

“We’re preparing a lie detector test to find out exactly what brought about this man’s unfortunate experience,” I scowled at the people who had gathered to witness the investigation. They spoke to one another in code, the words similar to a language I once heard on a trip to the Orient. Their fabricated looks of concern did nothing to sway my opinion. There was a murderer loose, and it was up to Mr. Watson and myself to find him.

“It’s perfectly normal, Mr. Holmes!” said Watson.

I perused the information from the sheet Watson handed to me, carefully shielding the information from the prying eyes of the nest of suspects. It was as he said, a normal Sinus Rhythm.

“I’m not so sure, Watson. Prepare the stretcher. We’ll remove this man from the scene and bring him to The Yard for further questioning.”

All eyes were upon us as we exited the scene.

“Have no worries, good people,” I exclaimed prior to the door shutting, observing them, noting every move and facial expression. I must say, these people were brilliant, no sign of anything but feigned concern showed on their stoic faces. “Our man will live to tell the tale of his misfortune this night!”

We loaded the victim into the rescue vehicle and left them there, talking in their strange language, undoubtedly concocting an elaborate web explaining the condition of the man who did nothing more than frequent their establishment and choke on a dumpling.

With the victim safely in the hands of the capable people of the hospital, I was able to reflect. I packed my pipe with pungent tobacco, lit the match that would ignite it and puffed. A plume of smoke filled the cab.

“Perhaps I was quick to judge, Mr. Watson. But, one can never be too careful, and we must always leave no stone unturned. Our people depend on us.”

“Elementary, Mr. Holmes. Elementary.”

We drove back in silence, content that the case of the steaming dumpling had been solved satisfactorily.

Her parents heard choking from behind the closed door. They tried to open it but something held it closed. The stepfather put his weight into it but it barely budged. Some commotion behind the door, then deadly quiet. He kicked the door in. His stepdaughter, two months pregnant and seventeen years old had tied one end of a stocking around her neck, stretched the other end over the corner of the door then tied the other end to the doorknob. Then she let her body weight go. The force of the door being kicked pushed her in, and freed the stocking from the top of the door. She was lying on the ground when we arrived, crying. Never have I heard such mournful, desperate sounds. Her body shook, the depths of despair so intense she appeared to be having a seizure. Red marks on her neck, choking, eyes filled with tears, despondent and alone, in a room full of strangers. And her parents, who stood by, shocked and afraid as we carried their daughter and future grandchild down the stairs and into the rescue.

She’s on the couch, crying. In front of her dozens of pill bottles and a few full ashtrays sit on top of an old coffee table. She’s fifty years old, but her left knee is only two weeks.

“I wish they never did this to me!” she cries. “They told me I’d feel better, but I feel worse!”

“Where are the Oxycontin?” I ask, foraging through the sea of prescription medications, some empty, a lot of duplicates, no narcotics.

“”They don’t work,” she said.

“Then where are they?”

“If I had them you wouldn’t get them,” she said.

We put her on the stretcher and wheeled her outside. A private ambulance drove past.

“Oh, that’s for me,” she said.

“For you?”

“Yeah, I have a doctors appointment at the hospital at 10:30.”

“It’s ten o’clock now, why didn’t you wait?”

“The pain is too bad.”

“How long has it hurt?”

“Three weeks.”

I have to dig pretty deep sometimes just to get through each second. Elderly people are going without food to pay for medications. Working people pay thousands every month for health insurance. This lady has a dual diagnosis, depression and substance abuse. She gets housing, healthcare and food, plus free education if she chooses to pursue that avenue and every break you could think of. Her medication bill alone costs the state thousands every month. Yet her doctors continue to prescribe narcotics to go along with the ant-abuse. And, she has a new knee that she didn’t even want.

“Why didn’t you cancel the ambulance when you called us?”

“I know those guys, figured they could use a break.”

“You know them?”

“Yeah, they send an ambulance for anything medical I have to go to.”

“Anything?”

“That’s right, doctors appointments, methadone clinic, counseling, you name it. And they wonder why the state is going broke,” she laughed.

I couldn’t even force a smile.

“They blew the horns…And the walls came down…They stood there laughing…They’re not laughing anymore…”

The Call, 1985ish

If you ever find yourself floating in a sea of discontentment, disillusioned about your job, what has become of it and looking toward the end of your career hardly able to wait for the day to come when you can leave it all behind, do what I did yesterday.

For twelve hours I watched one candidate after another perform the State of Rhode Island’s Physical Ability Test for Firefighter Candidates. The RI Association of Fire Chiefs developed and implements the process. Chief’s of Departments from all over Rhode Island volunteered their weekends to assist with the testing procedure, and observe. Providence, Warwick, Pawtucket, Cumberland, East Greenwich and a few other chiefs worked the course yesterday, replacing charged hoselines, putting ladders back in place, assisting candidates with their weighted vests and offering encouragement.

It was good to see the brass dressed in weekend clothes humping hose and talking to the potential recruits, who probably had no idea the guy dressed in jeans and a sweatshirt getting them a cup of water was somebody far more important than they appeared.

Over a hundred people took part in the testing process yesterday, more today and still more next weekend. Some excelled. Some failed. Every one of them gave 100% for a chance at a job that those of us on the inside sometimes take for granted.

Great job everybody! (except for the Rescue Guys who held up the entire process for twenty minutes because they just had to drive across the city to get the “1/2 off Firefighter Discount” at a local sandwich shop.)

“Rescue 1 and Engine 10, respond to 1 Hospital Street for a pregnant female in distress.”

A pregnant female in distress could mean a lot of things. The call is dispatched as an Advanced Life Support run, an Engine company and a rescue.

The doctor’s office we were called to is connected by a long tunnel to the emergency room. A walk of perhaps 200 yards. Being called to a hospital to take a patient to the hospital is a common occurrence, sadly. A lady dressed in scrubs looked up from a report when we arrived.

“Christ, how many are they going to send!”

Not off to a great start.

We wheeled the stretcher past the waiting room and reception area, toward the treatment rooms in the back. The lady in scrubs followed.

“Would the entire fire department show up for a real emergency?” she asked, no attempt to disguise the contempt in her voice. We kept wheeling.

Going downhill.

Sitting on the doctor’s examination table was a thirty year old woman, thirty weeks into her third pregnancy in no obvious distress.

“Hello,” I said.  She smiled nervously. Four firefighters from Engine 10 filled the small space.

“They sent the Army,” said the person who met us at the door, chuckling. “This is how they spend your tax dollars in Providence.”

I fired off a warning glance to scrub lady, who completely ignored me.

“How are you feeling,” I asked the patient. Before she could answer the representative from the doctor’s office chimed in.

“She’s going to the ER.”

“Why,” I asked.

“Because they’re waiting for her.”

hippopotamus one, hippopotamus two, hippopotamus three….

“Really.”

One of the firefighters recited her vital signs, all normal. I have to give them credit for acting like professionals. Sadly, this is business as usual. People who should know better than to abuse the 911 system are concerned only with their bottom line and liability. “Turfing the Gomers” is a term I first heard in the book House of God, all about a first year intern in a New York City hospital and his disillusionment with the health care system. It was written in the late seventies, I think. Things have gone downhill since then.

What is your name?” I asked the patient. No Gomer here, just a patient.

“Maria Hernandez,” replied the lady in scrubs.

“I’m talking to the patient,” I said.

hippopotamus four, hippopotamus five, hippopotamus six…

“How are you feeling?” I asked the patient. She was a nice lady, embarrassed by all the attention. She wanted to go home.

“She may be dehydrated, the doctor wants her seen at the emergency room.”

The scrub lady was starting to get to me.

hippopotamus seven, hippopotamus eight, hippopotamus nine…

Hippo Ten waited. I hoped he stayed in his pen.

“I feel okay, just a little weak,” said Maria.

“You guys are all set,” I said to the man in charge of the Engine Company. They gathered their equipment and left. Me and Brian put Maria on our stretcher and got rolling. I stayed behind for a minute.

“What is your name?” I asked Scrub Lady, holding my pen to the report she had handed me a moment ago.

“Why?” she asked, a little curious.

“Because I’m filing a report to the Department of Health explaining this office’s continuing disregard for the sanctity of the 911 system, insurance fraud,  and your squandering of taxpayer dollars for reporting  a false 911 call. It’s a criminal offense.”

I turned and walked away. Hippo Ten went back to bed, we walked the patient to the ER.

The staff at the office are well aware that this debacle will cost the patient, or the patient’s insurance company about four hundred dollars. It is easier to call 911 than to wait for transport, or a private ambulance company, or, heaven forbid, put the patient in a wheelchair and bring her themselves.

My report will get squashed somewhere, and I’ll never hear another word. But, the look on Scrub Lady’s face was priceless.

I started Rescuing Providence, the blog about four years ago. It’s a great place for me to leave it all on the table, so to speak. Little did I know that by leaving it all on the table, a lot of people would find it, and see it for more than just a bunch of crumbs left by a burned out medic.

This place has taken a few different turns, different looks and different perspectives over the years. I am graced with people from all over the country, and world who visit and leave a comment now and then. The comments give me the energy to keep writing, sometimes they are the only thing that keeps me going.

I’ve been keeping count. 500,000 hits sometime this morning.

Thank you.

Autumn is by far my favorite time of year. So, without further ado…

See you next weekend!

Lying on the kitchen floor, tears running down her face but not making a sound is our patient. Seven or eight people look on, some younger than our seventeen year old, some older. They peer out of nearly closed bedroom doors, or stand off to the side and listen.

“What happened?” I ask a man, who looked around thirty years old. Her brother.

“She’s been gone for two weeks. We were worried. She came home tonight. We argued. I threw her to the floor. She smashed her head.”

On the wall above us was the family portrait. A quick glance was all it took, I recognized the boss, a fiftyish year old lady, who in the picture sat serenely in the middle of  her clan of perhaps twenty, dressed in silk, perfectly posed. Here, now, she was still composed, but dressed in silk pajamas and concerned. The others continued to silently observe. The patient’s tears continued to flow.

I knelt beside her and felt the back of her head. A bump a little smaller than a baseball had formed there. I did a primary, she winced when I touched her right shoulder, but only there. One of the girls, who looked a few years older than the patient looked on, and seemed angry.

We boarded and collared the seventeen year old, and carried her down the stairs and into the truck. The boss and the sister came with us, leaving the rest of the family behind.

Once alone with the women, I asked again what had happened. They looked at me, as if I didn’t understand.

“We told you what happened,” said the sister.

“You look mad,” I said.

“She’s been gone for two weeks.”

“She was assaulted.”

“She was gone for two weeks.”

I looked toward the mom.

“Is she safe at home?”

“She’s my baby.”

“She was assaulted.”

“She was gone for two weeks.”

Mom sat back and put the serene face back on.  Sister continued to look mad. The “baby” continued to cry.

I should have called the cops and reported the assault on a minor.  I would have, if I thought it would help. The man who “threw her to the floor and smashed her head”  was genuinely concerned, but not remorseful. The mom was upset. The sister was angry, but not at her brother, rather at her sister who had run away. If the police got involved, and charges were filed things will only get worse for the girl, and her family. I don’t understand Asian culture, but people are the same. This girl has love and concern at home, and people who care for her welfare, and the honor of their family

Justice was served.

I think.

I hope.

What if…they started the dishwasher that started the fire at midnight rather than eight at night?

What if…the first in Engine company was tied up on a rescue call?

What if…the flames extended to the living quarters, and the smoke filled the house?

What if… all six of Providence’s ALS units were busy elsewhere?

What if… the seven babies were born into loving families rather than to drug addicts?

What if…there were no funds to operate a foster home for premature, drug addicted infants?

What if…nobody cared enough about these infants to work at a group home for minimum wage?

What if…we transported seven dead and dying babies to the hospital rather than seven living, breathing two week old little miracles who have half a chance because, though fate has thus far been cruel, chance was on their side last night.

Seven infants. Seven. Lucky seven? I hope so.

http://newsblog.projo.com/2010/10/two-fires-extinguished-over-ni.html