Them. Those people. Those anonymous, crooked, lazy, scamming evil immigrants who are ruining our country.

Them. Those people.

Immigrants. Documented, undocumented, legal or not, they are here. I’m usually first in line bitching and moaning about the illegal ones, how they are taking our jobs, and ruining our health care system, abusing our welfare programs and taking, taking, taking. I’ve probably said, more that once to put them on the boat and send them back to wherever they came from.

It is easy when “Those People” are anonymous masses demonized by our frustration with a stagnant economy. We have to blame somebody for our misery, may as well be “Them.” If not them, then who? Us? Absolutely not! “We” are working, and paying the bills for “Them” to suck the life out of this once great country!

Of course, most of us don’t bother to vote. Or run for office. Or understand how our government works. Or bother to notice that the people cutting our lawns, and cleaning our houses, and cooking our food and washing our dishes at our favorite restaurants, and caring for our children at the daycare center or for the truly fortunate, in our homes as nanny’s have to live somewhere.

A lot of them live in Providence.

And, they’re working on it. One house at a time. The cheap vinyl siding is gone, clapboard that had been covered since the seventies and the intricate trim that makes each house unique is no longer hidden. It is a time consuming, labor intensive project. The result of all the effort is evident on a lot of the houses around here, as families take back the neighborhoods. Mom and dad live on the first, Mami and Papi on the second and maybe a cousin or other relative on the third, to help with the mortgage. Kind of like when my grandparents lived in these places. The little ones have no idea if they are here legally or not, only that there is love at home, food on the table and a warm place at night, and the streets may not be safe, but what lies behind the door is.

It’s tough to be a hard ass when you work and live with “Them.”

“Hector” cut off his finger while using a table saw. Somebody called 911. Rescue 1 and Engine 10 responded. Hector was more afraid of us and our uniforms than he was of the missing finger and blood spraying from the stump. Wherever he came from was worse that here, finger intact or not, and he did not want to go back.

Renato, my Spanish speaking partner from a few years ago calmed him down, and wrapped his finger and put him on the stretcher. I asked, through Renato, discreetly as possible what his immigration status was. Renato’s parents came here from Ecuador, legally, but he knows from living in the city just how difficult things are for those who are not.

Hector is undocumented and working on a house that is not his, under the table, for somebody else.

Decision time, even though ultimately it really isn’t my decision to make. Do I notify the police, classify this as an industrial accident, get INS and OSHA involved and pretty much insure that Hector be deported, or, do I simply consider this an accident at home, and let the wheels turn however they may.

“It is an equal failing to trust everybody, and to trust nobody.” - Eighteenth Century English Proverb

Sargent Schultz from the old TV show possessed me as I wrote the report.

“I know nothing!”

Before we left the scene, the owner of the house arrived. A guy in his thirties, very concerned about Hector. I did a size-up and couldn’t decide if he was exploiting an illegal immigrant or giving somebody a break. I had Renato tell him the situation and watched his reaction. He didn’t care, was only worried about the finger. A minute later, a car sped toward us. A woman and teenage girl jumped out, and knocked on the rear door of the rescue. It was the guys wife and daughter. They immediately went to Hector, and cried, and hugged and carried on for a while. The women came with us to the ER, alternately holding his good hand and talking to him. Hector remained worried, but seemed comforted. He lives in the tiny third floor apartment in a house a few streets over, above his boss, his wife and daughter. The bosses parents live on the first.

Renato explained things to them, they understood, I think.

Just when I think I understand a kid cuts his finger off and I have to re-evaluate my belief system.

Sometimes less is more. We forget how it feels to be on the other end of the proverbial stethoscope. Heddwch lets us know.

http://thewelshviking.wordpress.com/2010/11/17/too-scared/

Thanks, Heddwch, great post!

A car taps a public transport bus. Three of the passengers see dollar signs. The rest get off and get the next one. I’m last on scene, and get the big one.

He’s homeless, lying backward on a spineboard with a cervical collar around his neck, looking up. I’m employed, sitting in a captain’s chair, facing backward and looking down on him. This is just another run for me, one of thousands. It’s his second time in a rescue. The first time, he fell when a stairway in a seaside mansion that he and his company were restoring collapsed. They had loosened the risers so they could get behind the steps, and remove a hundred years of paint that had accumulated. Time moved on, days then weeks, eventually the loose stairs let go, with him on the top step. Sixteen feet to the concrete basement, a few spikes in the leg didn’t slow the decent, but they did take his Achilles tendon.

Disability followed, then drug addiction. Then his wife was diagnosed with breast cancer. Then he took care of her, though their money was gone. He sold the Harley. Then the truck. Then what was left of the business. She never knew the depth he had sunk to, and she died thinking he would be okay.

He’s not okay. He lives in a homeless shelter, and hopes that this accident will be the break he needs. A couple grand for pain and suffering, maybe a Percocet of two for his troubles, and a fresh start. His calf muscle had atrophied, he showed me what was left before the truck stopped at the hospital. It was ugly. Medicaid wouldn’t cover a cadaver graft, it isn’t a life threatening condition.

It may not be life threatening, but it certainly is life altering.

A fall from the top step.

I had stopped looking down at him by the time we reached the hospital. I never should been looking down  to begin with.

I had no idea they were giving them away. I haven’t even thought about one since last December.  The Voice of God came from the heavens at exactly 3 O’clock and said, “You need a Peppermint White Chocolate Mocha!”

We left Rhode Island Hospital in search of the nearest Starbucks. It was only a mile away. Seven runs since seven, no end in sight. Only one thing could have made me happier than a Peppermint White Chocolate Mocha. And that would be a FREE Peppermint White Chocolate Mocha!

Thanks, Starbucks, you saved the day!

“Whoever calls 911, for whatever reason will get an ALS response.”

These words, taken from one of our “rescue meetings” after an hour or so of complaints from the people who actually take the runny noses to the hospital while the heart attacks wait  haunt me whenever I find myself being abused by one of the countless freeloaders that abuse our 911 system. They call because they can. And nobody, at least in Providence has the balls to stop them.

We’ve got six ALS units doing thirty-thousand runs annually. Most of our calls could be handled by a cab, or bus, or two feet. The ones that need us usually have to wait for the ones that don’t. Somehow, we hold it together, with a lot of help from mutual aid companies from surrounding communities.

Providence is broke, by most accounts. There will be no additional resources anytime soon. The number of 911 calls keeps climbing, and we keep sending people to answer the calls. But we are running out of people to send. The rescue division in Providence is a revolving door. New people come in, sure they can handle the call volume, do okay for six months or a year, and then, without realizing it, turn from idealistic competent EMT’s into cynical go along to get along ambulance drivers. I’ve seen it happen too many times.

Every person with ten or more years on the rescue is either completely nuts, divorced, miserable or a combination of the three. I worry about myself, some days I can’t even be in the same room with me, especially when I’m alone. The company is simply not that good. Boring, jaded, opinionated and plain old ugly. And tired.

But alas, a new day has begun, with new challenges ahead. I think I’ll hang around for another week, see what happens. I’ve got a Captain’s Test two days after Christmas, maybe I’ll study and see where that goes. Or, maybe I’ll call 911 for myself and throw in the towel. I don’t know, maybe I’m just tired.

We don’t need more rescues. We need fewer phones.

Thanks for reading.

You would think that people in the emergency response business would know a thing or two about doing their business in an emergency situation, and having the tools at their disposal to do a proper clean-up.

When a situation arises, and The Barbarian is at the Gate, so to speak, there can be no hesitation, no second guessing; we need to know that every resource is at our fingertips, ready to be unrolled in an instant should the tones go off and our emergency be interrupted by somebody else. Leaving a job half finished is messy business, extra paperwork is usually imperative to a successful completion of the operation.

If we can’t rely on each other for “scene safety” then we have lost all hope. A full roll isn’t a lot to ask. Or at least a back-up. Even the most dashing emergency responder looks a lot less so when dashing like a duck to the next stall.

Jeez, a little courtesy goes a long way!

On Veterans Day a 54 year old man walked into our Fire Station, showed the firefighters some minor lacerations on his wrists and asked to be taken to the VA because he was suicidal. I returned from a different call, put the heavily intoxicated man in the truck and got moving. Along the way he told me about the people he had killed, “in Nam,” and how he had nightmares, and couldn’t move on with his life. He had been drinking heavily since the war, and was homeless, and blamed the government. In his opinion, “The VA sucks,” but he had nowhere else to go. I make it a habit to shake the hand of every veteran who enters Rescue 1, for whatever reason, and thank them for their service. On this day I didn’t. On Veterans Day, of all days. It bugged me all week.

I didn’t need the simple math to know he was full of it, just listening to him was enough. A kid from Rhode Island had arrived home from Afghanistan in a casket that morning. I thought of him, dying in a combat zone, his family fully deserving of the benefits my government is in the position to bestow on his widow and two kids. He earned it, and then some. He has my gratitude, and the gratitude of all Americans who care.

The guy in my truck gets the same benefits, but thinks “they suck.” If I’ve learned anything in my forty-eight years, it’s this simple logic; you get what you put in, and people get what they deserve.  If you think the VA sucks, then it is you, who would have been sixteen when the war ended that actually sucks, Mr. Homeless Veteran.

A week later, an eighty year old guy sat in front of his TV, watching the Jets game. His wife walked in, and noticed the left side of his face was drooping. When she asked about it he couldn’t speak. Then he tried to stand, but fell. She called 911. When we got there, he had regained some of his strength, and the droop was mostly gone, and he could communicate. After explaining CVA and TIA to him, he reluctantly agreed to go to the hospital, but insisted on “The VA.”

“Why the VA?” I asked.

“Because they are excellent,” he said.

We couldn’t take him there, Rhode Island Hospital is far better equipped to handle a stroke, especially one with symptoms displayed so recently. He was okay with that once I explained things. Marines have a way of coping with adversity. I tried to get him to tell me a little about his experiences in Korea, but all he said was he lost a lot of good men, and good friends there.

You get what you put in. I shook his hand and thanked him for his service.

Sincere thank you to all of our Veterans.

Good luck, Mr. Korean War Veteran, and Rest in Peace, Sgt. Paranzino

http://www.projo.com/news/content/MIDDLETOWN_SOLDIER_KILLED_11-08-10_LFKQQ4D_v14.39698fe.html

The bagpipes, the dress blues, the stories of friendship, of sacrifice, of bravery, camaraderie and accomplishment; these are the things that drew me to the fire service. The bucket brigade,  Jakes and Pikemen, then Laddermen and Hose Jockeys, horses in the barn  pulling the steamers, dalmatians, bells and whistles, airhorns, sirens, flashing lights and everything that ties us to the past and brings us into the future have a solid place in my heart, and always will.

I am a fireman. My kids know it, and their children will know it, and with any luck, their kids will too. My helmet will probably hang on a hook in a garage not yet built, gathering dust until a child finds it, and puts it on his head, and begins the journey that I have taken. I wish him well.

Tradition.

For the last nine plus years I’ve worked in the Providence Fire Department’s EMS division. It isn’t often now that I have the opportunity to don the turnout gear, and put the helmet on my head. I miss it. But I have no regrets.

EMS traditions are not as glamorous, or colorful, or respected by most. They never will be. Funny thing is, I’m more proud of the nine years spent on a rescue than I am the ten I spent on engine and ladder companies. There is something about the personal nature of this job that attracted me to it. And, a few traditions that mean more to me than anything else.

Professionalism. Compassion. Competence. Excellence.

Every time, without fail, that a family member or friend needed an EMS response, those responders were excellent. Not good, not adequate, but exceptional. My father, who in the final stages of cancer would hallucinate and become unmanageable at home was treated by EMT’s from the Warwick Fire Department not like a nuisance, or a silly old man, but like a Korean War Veteran, and engineer, and son and father who needed help in his last hours. My mother, the victim of a massive stroke while visiting family in North Carolina. By all accounts the EMT’s who responded acted the same way, and managed the scene with grace and dignity. The EMT’s from the air ambulance that flew her home, with me on board exuded such expertise I never worried about a thing. They helped my parents, and in doing so helped everybody whose lives they had touched.

I often hear about people who were involved in a car accident, or had an allergic reaction, or whose grandmother was choking at the restaurant, or the million different reasons we are called. One thing remains the same, by all accounts. The EMT’s were simply awesome.

Tradition.

Big boots to fill. I’m proud to fill them.

My wish is that some day, when the kids find my old helmet hanging in the garage, one of them sees the old jacket, the one with the Providence Fire Department patch on one sleeve, and the EMT patch on the other, and I hope he puts it on.

And I hope he never looks back.

These homes weren’t meant for this. The people who live in them were not put here to exist in such misery. The foundation for a graceful existence lies hidden beneath years of grime and neglect. Some of these places date back to the 1700′s, a few older still. When the turn of the century and the wealth from the industrial revolution spurred another building boom, triple deckers as we call them sprouted everywhere. These homes weren’t quickly built shacks, they are works of art, if you care to look beneath the surface.

It is hard for me to ignore their loss of dignity as I dodge the pool of blood that starts in the entryway, splattered on ceramic tile carefully laid by some anonymous craftsman some hundred years ago. The blood leads up three flights of oak stairs, lined with intricately carved railings worn bare by hundreds of hands. Those railings, at one time not that long ago were polished and cleaned, and helped support people as they made their way home from work, or school, or a trip to the market. Now they support drunks and heroin addicts as they stumble toward their rooms.

Holes in the plaster that lead me toward the apartment where two women were stabbed will never be repaired. Antique light fixtures in the dark hallway sit empty, their bulbs either stolen or burned out and not replaced. The blood trail grows, the stabbings happened up here, in the third floor apartment, whoever ran away, wounded, must have controlled their bleeding as they ran toward the front door.

She sits on a dirty couch in an empty room. Her lip is bleeding. The other victim is  gone, in another rescue that sits outside. She was stabbed in the arm while fending off her attacker, the sixth stabbing in the city tonight.  Apparently, he too was injured, and is on the run. His blood trail hopefully will lead to his capture.

In a bedroom ten feet from the victim a young child sleeps face down on a bare mattress. An empty crib sits in the corner. A big screen TV takes up half the wall in the other room in the tiny apartment. Its presence in the place is absurd.  It signifies a total vacuum of hope. When a person who has nothing decides that a two-thousand dollar TV is more important than basic furnishings, they have given up . They must have learned, or been taught that it is hopeless to dream about things that saving money may provide; a home, a family, kids education and the peace that a life well lived brings. Living in the moment, instant gratification and all that isn’t very satisfying, and chaos takes over.

And people end up stabbed by their lesbian lover’s son in a crummy crack house that once knew true love and hope.

Her door is jammed, the impact pushing the metal into itself, sealing the passenger compartment. Her car is demolished. Shattered glass covers her, blood pours from her eyes. I look quickly to see if the pupils are responsive. They are. The drivers door is only stuck a little, I pry it open and reach in. She’s dazed, asks the same question over and over, forgetting the answer as soon as I tell her. Blood soaks the back of her head, I check for a trail to see if that is the source of her bloody eyes and find it is not, her eyes are bleeding.

Brian brings a backboard, we move it past the drivers seat and under her. I lean over and in, slicing my gloves on the glass that covers the passenger compartment. I find out later my blood and hers have mixed, my fingers are sliced open. I protect her head and neck by applying a cervical collar, then gently lean her into the board and lie her down. She tells me her head hurts. I’m not surprised. We pull her out of the wreckage and push her through the debris filled highway. Six or seven cars are involved, three more rescues are on the way. My patient appears to be the worst, the others are out of their cars, one leans against a jersey Barrier, his bloody head in his hands. Teresa is on scene and attends to him. We put our patient in the rescue and close the chaos out.

She’s conscious, but barely. Her limbs show no deformity and her vital signs are stable. An IV goes in, then another. Just a drip, I’m worried about the head injury. She says it hurts, bad. I loosen the collar and put my hand behind her head. It’s as soft as a pillow. But not as nice. The edge of her skull stops, and disappears into a mass of broken bone and brain matter. I hadn’t expected that, missed it the first time, while wedged into the car.

We bonded then, this stranger and me, instantly  connected  more intimately than anybody who hasn’t held a crushed skull in their hands could imagine.  Energy runs through all of us, and at times between us, our life force passed on in times of crisis, whether we want it to or not. I check her eyes again and secure the collar.

Then we roll. The non-re-breather covers most of her face, but not her eyes.  They don’t look as bright. As we approach the ER, she closes them.

http://www.blufftonfd.com/butts.shtml

Good morning everyone,

If you haven’t heard by now, Matt and Elizabeth McDowell are expecting a little girl by the name of Juliann McDowell. With the joy of Juliann’s arrival coming soon (Dec 28), there will be some major expenses due to the heart defect that they have already found in the multiple ultrasounds. Baby Juliann will require numerous open-heart surgeries, just after birth, in order to correct this heart defect. I have listed a link about the nature of the defect HERE.

In an effort to help McDowell (Jeebs) and Elizabeth, we are doing a 50/50 raffle to offset the major expenses coming their way. We will draw the winner of the Raffle on November 20.

I need your help to get this raffle information out… I attached the sheet with the raffle information so you can forward onto friends and family, even people you don’t know… It’s time for us to help one of our own brothers!

THANK YOU… In advance

Please don’t hesitate to call or email me with any questions!!!

Richard Dollahan
Captain Shift 3 Engine 325
Bluffton Township Fire District
357 Fording Island Rd.
Bluffton, S.C. 29909
work (843)757-2800
cell (843)247-4606
captain.dollahan@blufftonfd.com

He’s Not Heavy!
He’s My Brother!

One day it smells like pickles, the next it smells like ass, at times dirty feet…I’m tired of sharing, I want my own truck.

Clean the rescue ya mutts!

You could have twenty minutes or twenty years on the job, it makes no difference. When a call comes your way,  a true emergency, time stands still and nothing else matters except for what is happening at that very moment. The multitasking, the worries about past mistakes and future plans end and it’s just you, your crew and the patient. There isn’t a more perfect moment than the one you are in; each second passes, leading you into the next, and then the next, and with each second comes a chance that your patient will have a future, and not just a past. The IV’s go in, the medications get  pushed, compressions and ventilation’s done, defibrilation, the bouncy ride in the back of the rig, everybody focused on the same goal and doing their best.  It’s a magical environment, with the magic going mostly unnoticed by us, because we are too busy to acknowledge it.

Sometimes, the magic even works.

Ten minutes or an hour or more passes, but it feels like just an instant. There isn’t a better feeling than what you experience during that moment in time, when all of your training and experience comes together, all of your worries are gone, your hopes are put aside and you simply perform. It brings us to our most primitive state, where survival is our only concern. Our basic instincts take over, and we turn from a complex individual with hopes and dreams and problems and distractions into the culmination of all we have learned, and we are able to channel that energy, and hyper-focus on the job that lies in front of us.

These are the moments at work that I live for, when I feel most alive. When the monotony is pushed aside, the boredom and fatigue forgotten, and the opportunity  to save a life is upon me.

Even when the magic doesn’t work.

He sits and waits, patiently. He’s learned to be patient, living alone does that to a person. Years of activity, looking for a moments peace a distant memory, now there is nothing but quiet. He hears the truck arrive from his eighth floor window which he has left open, the night noise his only company in these lonely hours between sunset and sunrise. The elevator makes the usual hisses and groans as it climbs toward him, containing the only human contact he’ll have all day. He waits, then, a knock on the door.

“Did you call?” I ask the old man sitting at his kitchen table in no apparent distress.

“I did,” he responds, straightening in his chair. We leave the stretcher in the hallway and enter his home. It is a modest place, 60′s era furniture filling the cramped space, books and magazines spread around haphazardly it seems, but I suspect the old man could find a particular LIFE magazine from 1972 if I ask him. Pictures of a little girl fill most of the front of his refrigerator, and a different girl from a different generation takes up the rest. He sees me looking.

“My daughter and granddaughter,” he says. I nod.

“Why did you call 911?”

“I had a stone blasted last week, the pain is  too much.”

“Do you want to go to the hospital”

“What for?” he asks in an Eastern European accent, and shrugs his shoulders.

“They can help you.”

“Perhaps you can help me?” he asks, hopefully.

“Maybe we can.”

We spend fifteen minutes with him, going over his medications. He took some old Vicodin for the pain and is worried that if he takes the new one’s he’ll overdose. I play along, knowing he just needs some human contact, somebody to talk to. A swimsuit calendar hangs on a kitchen wall, November is particularly beautiful.

“Nice calendar,” Brian says, smiling. The old man grins, smiles wistfully and says, “pretty soon, they are gone too.”

We wish him well and close the door behind us.

She’s ten years old, on the bus and her face starts to twitch. Then her legs start shaking. She’s afraid, petrified, really, and wants to cry out but finds she cannot, her voice is gone. It lasts long enough for the other kids to notice, and the driver to stop the bus and call 911.

She’s a little kid growing up on one of the toughest streets in the city, and now this. Something similar happened a few weeks ago, at a birthday party. Her sister saw that episode, and was afraid, thought her big sister was dying. Their mom took her to the ER where they did a Ct Scan that was inconclusive, then follow-up testing, an EEG and some blood work, but no results yet. They are waiting for their next doctors appointment to get some answers, hopefully.

The episode has passed, Shyla  appears normal again. She tells me she likes math. She’s in a charter school, one only the best students get into. She sits now, on the bench seat in the rescue, next to her little sister and brother, with her mom in the Captains seat and the baby nestled in a car seat that I’ve secured to the stretcher. The bus was close to home when this all happened. The other kids are fascinated with the “ambalance.” The bus has left, taking with it a bunch of worried kids.

Shyla is lost in her thoughts, the worry evidant on her pretty face, that is the mirror image of her sisters, and a more youthful version of her moms. The mom holds up pretty well, but she too is worried, and it shows. She works at one of the area hospitals, in the neurology department, and sees daily the effects of neurological disorders. Perhaps it’s just a seizure, but why? There is no history of such, no fever, nothing to indicate that.

I keep an eye on Shyla. The other kids  enjoy the ride as we bounce toward the hospital. For them this is quite an adventure.  For mom and Shyla there is no adventure, just the realization that something may be seriously wrong.

They’re hopeful, and so am I that this is nothing, just a weird thing that will go away. But I get a sense that it isn’t the case, and I think Shyla does too. Ten year old kids shouldn’t wear the same expression as their mothers on the way to the hospital. Her quiet, subdued demeanor stands out as her siblings carry on.

I thought of them all the way home, and into the night. Somebody else will take their place, probably by tomorrow, but for now, I’ll close my eyes, and offer them closest thing I know to a prayer.

She’s dressed in black, a leather jacket and thigh high boots. And her hair is perfect. It’s five thirty in the morning, she’s dressed to kill. I too am dressed in black. Well, blue actually, but it looks like black in the early morning darkness. She steps into the rescue, all smiles and sits on the bench seat. Her sister, also wearing thigh high boots sits next to her. Their mom waves from the front porch as I close the door.

They laugh and goof around a little while we get the patient’s vitals. She’s eighteen and expecting her second child in three days. She’s feeling cramps. She thought 911 was a great way to get to the hospital for a check-up.

I was so tired I couldn’t argue. It was my twenty-third call in twenty-four hours, with only one emergency.

Just in time for the Christmas shopping rush, a little prompt to buy Rescuing Providence for everybody on your gift list!

He’s a good guy until his sugar level tanks, then he turns from Dr. David Brenner into the Incredible Hulk. Normally we treat him at his workplace and let him sign off, but today he needs to go. Not that today is any different from the other times we have been called to the welding company where he works, but the frequency of the calls makes it apparent that he needs to be evaluated.

He’s sitting on a chair in the warehouse, guys working around him. I have four firefighters from Engine 13 with us. Me and Brian could handle him, but with resources at our disposal it would be ridiculous to do so. Two people subduing an aggressive patient would need to use excessive force, and somebody would probably get hurt. With four or five people, the patient is completely overwhelmed, nobody needs to get carried away and everything goes smoothly.

We pluck him from his seat and put him onto the stretcher. I tell his boss that we plan on kidnapping him while he is out of it, taking the option of a lucid refusal away from him. I’ll give the D-50 en route. The boss is happy, I’m happy, the guys from Engine 13 are happy, and “John” is nearly unconscious but still full of fight.

The plan works perfectly. I’ve got Ryan and Brian in back with me, another firefighter driving and the other two following in the engine. The IV goes in, the medication follows, and John comes around, just in time to see the ER as we back into the bay.

“Where am I?” he asks.

“The ER, your blood glucose was 27, you had to go.”

“I need to stay at work, I need that job,” he tells me, trying to get off the stretcher.

“You need to get your glucose level under control. John, this is the third time this month. Your brain can’t take much more.”

“I guess.” He sits back in the stretcher and we wheel him in.

A fire department based EMS system is the most effective way to deliver quality patient care to the community. When the people assigned to those fire companies are trained and motivated, which they are in Providence, nothing beats it.