I kind of like staying up all night. When we were kids, seeing if we could make it to sunrise was a challenge, one that we seldom achieved. We would pitch a tent in the back yard, “Fort Apache” we called it, had a flag pole and everything, and goof around with some flashlights, take daring walks through suburbia after midnight, tell ghost stories and eat candy till we puked. Victory was ours when the sun crested the horizon, and we would collapse into our sleeping bags and sleep until noon in the humid, canvas enclosure. When we stole a milk box from a neighbor’s front steps, buried it and turned it into an indoor bathroom, Fort Apache was overrun by the enemy, and flattened. My dad had his limits I guess.

As a teenager, staying up until sunrise was usually done with some chemical enhancement (hey, cut it out, it was the seventies!) Friendships formed in the teen years were more solid, and more important than any other time in my life. I didn’t know it then, but those guys were the best friends I ever had, or ever would. I see some of the old gang now and then, and we have a laugh and tell a story or two, and then get back to the lives we forged. I doubt if any of those lives even closely resembles what we thought they would be. That is not necessarily a bad thing.

In my twenties I stayed up all night with ease, and had some great company during my all-nighters. (thank you Mrs. Morse) I wish I had half the energy now that I did then, everything was more intense if I remember correctly, the conversations more alive, learning about each other the only thing that mattered. Staying in a long term relationship has its bonuses. Remembering how it was during those all night sessions, moonlight illuminating our space, the birds starting their song an hour before sunrise, just me, and her and nothing else is how I spend a lot of my daydreaming time. It is time well spent.

For the last twenty years my all night episodes have been work related. I stay up all night all the time now. It’s actually nice to see the world at all hours, not everybody gets the opportunity so see the city at four in the morning, when the streets are quiet, the houses dark, the noise gone and the people gone with it. It’s just us, and the patients. I can imagine the place as it was twenty, thirty, even a hundred years ago. The landscape stays the same, the people are what is different.

I’m different, that much is certain, but I still like to stay up all night. Fort Apache may be gone, but the kid who camped there is not. Being awake when everybody else is sound asleep brings me that little edge of excitement that makes life worth living, makes me feel alive.

http://www.youtube.com/watch?v=2gkwVf4cHqM

http://www.youtube.com/watch?v=2gkwVf4cHqM

Her house is here, and the emergency room is right there, 150 feet away. She suffers from bi-polar disorder, has run out of, or decided not to take her medication, and is a possible danger to herself, and maybe others. Her social worker made his scheduled visit, decided that it was not safe to leave her at home, and insisted she get to the hospital. He called 911.

She is with her daughter and the social worker when we arrive. She is manic, speaking a mile a minute and obviously in need of medical intervention. She is cooperative, her daughter glad that help has arrived and the social worker ready to move on to the next one.

“She goes to St Farthest,” he says, once the patient is safely in our truck and out of his hair.

“Today she goes to that hospital, the one across the street.”

“I ain’t going there!”

“She ain’t going there!”

“I ain’t going THERE!”

“I ain’t staying here!”

Well isn’t this terrific. I have a volatile psych patient in the rescue, her social worker pulled a fast one, her daughter fully expects us to transport her mom to a hospital in another city, the patient expects the same, our six rescues are on calls, with four additional companies in on mutual aid.

Now what?

Is it prudent to take the truck out of service for an additional forty-five minutes to transport the patient across the city? Is it wise to extend the stay inside the confines of an advanced life support vehicle of an unstable person in need of psychiatric care? Will the patient’s condition deteriorate if she is brought against her will to a facility that she does not want to be in? Am I simply being a jerk because I don’t feel like transporting across town, or am I really concerned with doing what is best for the patient?

“We’re taking her across the street.”

“Screw you!”

“Screw me?”

“Yeah, screw you!”

“What did I do?”

“You won’t take her to the hospital! You won’t do your job!”

“Yes I am.”

“No you’re not!”

“Yes I am.”

“No. You’re not!”

“I think I am.”

“You’re not.”

“Let’s go.”

I am doing my job, aren’t I? It all used to be so simple.

Well here we have it. Another day. Yesterday is gone, tomorrow not yet here. Things weren’t perfect yesterday, and tomorrow, well, who knows? But today. Today has some serious potential!

If I regret yesterday, and fear tomorrow, this day will come and go with myself mired in second guesses, useless analysis and unrealistic hopes for the future. I think I’ll forget about the past, and not think about the future, and take this day one breath at a time.

I might even get something done that way.

The Verizon guy was at my house yesterday. One of the first things I asked him was if he knew my father. Of course he wouldn’t, my father was gone before this guy would have started working, but old habits die hard. There was a time when I could ask anybody who worked for “the phone company” if they knew my dad, and the answer would not only be yes, but some story about him would follow, always a good one, he was just that kind of guy.

“Name sounds familiar,” was how he answered. I’ve used the same answer hundreds of times when somebody finds out I’m a firefighter. I don’t want the person asking if I know their father, or brother or cousin or neighbor that I’ve never heard of the person. Our time here is so short, and the chance to make our mark fleeting. I do recall most of the names of the people I’m asked about, and some I remember particularly well, but there are always those who did their time, stayed under the radar and left without much fanfare. Those people are actually the strength of the fire service. Quiet, hard working firefighters, doing their thing, not looking for glory or headlines.

Another answer I’ve used, if the person in question is long retired or deceased is “I’ve seen the name in the journals but I never met him.” Sometimes I’ll say that I hear the name from time to time. It makes the person asking a little happier to know that their friend or family member made a lasting impression.

It may be my inflated ego, or just human nature, but when I go I want to be remembered for a little while at least. The best way to do that, I figure, is to keep showing up, continue doing the job and try not to be remembered for the wrong reasons.

My father passed away in 1991. He had worked for Ma Bell, now Verizon for forty years before retiring. I bet his name really does sound familiar at Verizon, he started as a janitor after the war and retired an engineer. They don’t make them like that anymore.

He’s been gone twenty years. I’ve been a firefighter twenty years. Weird, isn’t it.

Thanks for reading.

I hereby proclaim:

Any and all school-age children who need a ride to school may meet at the designated fields, spaced three miles apart.

Getting to the designated fields shall be the responsibility of the child or parent. All fields shall be strategically placed so no child need walk more than two miles to designated pick-up-drop off area.

School busses will no longer be permitted to stop on main or secondary roads every block so that the little darlings need not walk more than 100 feet to their homes.

People along the walking routes shall occasionally look out their windows or doors to make sure the children remain orderly and safe.

Any and all old vans with strange man inside passing out candy will be immediately reported to the Kings Men.

Anybody who misses the bus is on their own.

That is all.

She had a syncopal episode * during a bowel movement, fell forward, struck her head on her tub, rolled onto the floor, while still in the process of voiding her bowels and bladder, vomited when she hit the bathroom floor and stayed there for hours after regaining consciousness. Eventually, her son, who had been calling for hours and didn’t get an answer showed up, found his mom lying on the bathroom floor, covered in bodily fluids and moaning from the pain.

His mother wouldn’t let him touch her. It’s strange how those closest to us are prohibited from areas where strangers are welcome. The anonymity makes the loss of dignity easier to handle I suppose. He called 911, and stayed on the other side of the bathroom door and waited for help to arrive.

Engine Co. 15 arrived within three minutes and immediately assessed her level of consciousness and obtained the initial set of vital signs which they relayed to us, who were at least ten minutes out. The call came in at rush hour, (and shift change, of course.) We were the last available Providence rescue and the incident the furthest point in the city from our quarters. Some day, I hope that the people who design and implement EMS services locally, statewide and nationally can put aside their differences, their labor struggles, union issues and egos and come up with a better way to get help to the patients. Less than a mile away, in a different town, an ambulance crew stood by, completely oblivious to the situation down the road from them. The patient had to wait. It took us fifteen minutes.

Our guys did a great job, entered the bathroom, made the patient as comfortable as possible, did their best to clean up the mess and calmed the son, who was frantic.

The job itself was pretty strait forward, once we got past the smell and mess. A woman with a significant medical history, including but not limited to diabetes, hypertension and congestive heart failure, who also takes a large amount of prescription medication fainted while on the toilet, struck her head while falling from a seated position, unknown loss of consciousness from the head trauma due to the syncopal episode, possible CVA or TIA due to her hypertensive condition. (BP 180/110, HR120, spo2 92% ORA, BG-88)

A quick trauma assessment was unremarkable, the board and collar were applied, we cleaned her up as best we could, covered her with sheets and blankets, got her to the rescue, reassessed vitals, ran an EKG, started an IV, got her on some oxygen and off to the hospital we went.

What to the family appeared an impossible situation with no good outcome was easily mitigated, except for the delay in resources, by the Providence Fire Department. Nobody made faces, or commented about the urine, vomit of feces that we encountered.

If you guys are reading this, or anybody that has been in a similar situation, thank you. Being surrounded by professionals during less than ideal conditions makes us all look good. And, most importantly, makes the patients feel good, or at least better than they did.

http://www.medterms.com/script/main/art.asp?articlekey=9312

Defecation syncope: The temporary loss of consciousness (syncope) upon defecating (having a bowel movement). Syncope is the temporary loss of consciousness or, in plain English, fainting. The situations that trigger this reaction are diverse and include having blood drawn, straining while urinating (micturition syncope) or defecating, coughing or swallowing. The reaction also can be due to the emotional stress of fear or pain.

Under these conditions, people often become pale and feel nauseated, sweaty, and weak just before they lose consciousness.

Situational syncope is caused by a reflex of the involuntary nervous system called the vasovagal reaction. The vasovagal reaction leads the heart to slow down (bradycardia) and, at the same time, it leads the nerves to the blood vessels in the legs to permit those vessels to dilate (widen). The result is that the heart puts out less blood, the blood pressure drops, and what blood is circulating tends to go into the legs rather than to the head. The brain is then deprived of oxygen, and the fainting episode occurs.

The vasovagal reaction is also called a vasovagal attack. And situational syncope is also called vasovagal syncope, vasodepressor syncope, and Gower syndrome after Sir William Richard Gower (1845-1915), a famous English neurologist whose name is also associated with a sign, a solution, another syndrome, and a tract in the central nervous system.

The Lifepack 12 isn’t going to help you. The med bag won’t do much good. The Protocols are useless, unless you put them in a metal binder. The radio helps, but only if you use it as a brick.

EMS in its most primitive state is simple. Man (or woman) vs. Man (or woman). I’ve written extensively on this subject *, but when all the talk is through, and all the scenarios, and lectures played out, and you are looking into the eyes of madness all the education and equipment doesn’t add up to much.

Instinct takes over. Fight or flight. Sometimes, you have to fight.

My partner comes back this week. A month and a half healing from the last patient that attacked. It all happened so fast. I’ve been over it a million times in my head and thought of a million different ways I could and perhaps should have handled the situation.

Bottom line is this: People are unpredictable.

Stay safe out there.

*

http://rescuingprovidence.com/2011/01/24/the-war-is-raging/

http://www.projo.com/opinion/contributors/content/CT_morse9_03-09-08_GE95HGD_v24.39c45bb.html

http://rescuingprovidence.com/2011/02/18/protocol-update/

The obituary pages are full of people who died when they least expected to. Day after day their faces and life stories appear, followed by those horrible words, “died unexpectedly at home.”

The primary purpose of any Fire Department is to protect the lives of the citizens. Protecting property is high on the list as well. When a choice presents itself; save the million dollar building or get the person out and let the building burn to the ground, without fail the person comes first. Buildings can be rebuilt, people die and stay dead forever. The fewer people who “die unexpectedly at home,” the happier we are.

A person at home who feels dizzy, and vomits, then starts to mumble is in a lot of trouble. Stroke is the number three cause of death in the United States, with cancer and heart disease leading the way. We are taught and reminded that when symptoms of stroke occur to call 911. It is great advice. So why, when an engine or ladder company arrives on scene for an elderly person complaining of “dizziness” do so many consider this a waste of tax dollars, or a scheme by the fire department to pad their numbers?

We call ourselves firefighters. I suppose a campaign could be started to change the name, and subsequent image the name conveys to “emergency responders,” or something like that, but why bother? “Putting out the fire” alludes to a lot of different things, and as long as the “fire” goes out, it matters not what the people who put it out call themselves.

Firehouses are not full of firefighters standing idle, waiting for a reason to drop what they are doing, quickly put on their gear and board the truck, get out of the building in thirty seconds and arrive at your house, carrying an oxygen cylinder, medical bags full of advanced life support equipment and medications and a defibrillator so they can pad their numbers. They do it because the bell tipped, and a life threatening emergency could very well be on the other side of the door.

There are many reasons people call 911. Call all day if you need to, and we will come, ready and equipped to handle any emergency. But if you can, try to remember that it was you who called us, and we are doing our job by responding with the proper resources to prevent you from dying unexpectedly at home. We hope that you never have to call 911, for any reason. We would much rather be prepared and ready to respond to an emergency than actually responding to one, not because we don’t want to work, rather, because when we “work” somebody is suffering.

When I’m responding in the rescue to a call for an elderly person “feeling dizzy,” and an engine  or ladder company is first on scene, minutes before me, I would much rather hear the report of a person “alert and oriented, vital signs stable needing an evaluation,” than that of a person “semi-conscious, confused, hypertensive with left side paralysis.”

Even if the alert and conscious person is questioning why their tax dollars are being wasted by  firefighters who are trying to look busy and pad their run numbers.

Thanks to D.M. from the UK for the link!

(my mother, Ann Morse suffered massive stroke when she was 56 years old, and spent the last nine years of her life in a nursing home, never walked or spoke clearly again.)

In This Corner, we have the trauma team, gowns on, gloved up, eye shields in place, respiratory standing by, three RN’s a few ER Techs, doctors, residents and interns waiting in the wings. They’re waiting, thinking, going over protocols, medications and procedures, checking and rechecking the IV set-ups, intubation equipment, the organ bank has been notified.

The EMT’s arrive, patient clinging on to life, two IV’s established, an 8.o endotrachial tube in place and secured, equal lung sounds with good chest rise, clothes cut off for the most part, traction splint in place, three sets of vitals and a fairly cohesive report ready. They roll into the room, and prepare to move the boarded and collared patient from their stretcher to the Trauma stretcher, all neat with sheets and absorbent pads in place, security standing by due to the patients combative nature, most likely due to the probable head bleed from his meeting with the windshield.

The guy in charge of the EMT’s starts to give his fairly cohesive report, formulated in his head while enroute to the ER, while performing the endotrachial intubation, managing an airway, monitoring vital signs, directing IV placement, holding the combative patient down while his clothes are cut off in the back of an ambulance with no suspension over roads that have survived the winter of 2011 with a patchwork of asphalt and sand filling the holes.

The doctor in charge of the trauma team shouts, “Quiet.” The EMT in charge stops speaking. The doctor in charge says, “start with the ABC’s.” The guy in charge of the EMT’s speaks again, starts to recite the information he has gathered from the scene, including the pulsox, the blood pressure, the airway status and the heart rate and rhythm. The doctor stares him down, says “quiet,” and breaks out her stethoscope. The EMT again begins to give his report, the doctor again stares him down and tells him to, “relax.”

Relax?

Is there a more condescending thing to say to somebody who has just spent the last half hour in the field, battling the elements, the broken glass and twisted metal, the hysterical family, the combative patient and a multitude of other equally unrelaxing things?

Relax.

I’ll relax when the report is given, the patient is in your care and the paperwork is signed. Until then, I’ve got a lot on my mind keeping me from “relaxing.”

“Baxter Street Command to Rescue 1.”

“Rescue 1, go ahead.”

“I need a count.”

“One adult, five children in Rescue 1, six adults and five more kids outside.”

The kids outside were teenagers, too cool to hang out with the firemen. Hmmph. Their loss. We were in one of the toughest neighborhoods in Providence, or anywhere.

They sat in the back of Rescue 1, five girls, ages five to eleven. Three sisters, a cousin and a neighbor. The boss was with us, a woman of about thirty-five, keeping the girls in line. They listened to her, for the most part, but as the incident dragged on, and the shyness disappeared things got more interesting. I often wonder if people here notice how white my skin is, or if they just accept me into their neighborhood and don’t give it a second thought. I think the adults are more aware of racial differences, and if the kids are, they certainly don’t show it.

“If you could do it again, what is the one thing you would take with you?” I asked.

“My puppy!”

“You don’t have a puppy.”

“My jeans.”

“You got them on, girl.”

“FOOD!”

“I told you to eat before all this!”

“My phone.”

“You have your phone.”

“The refrigerator!”

“We have a winner! I said. The girls went on, asking questions, touching things, touching each other, giggling, squirming and asking more questions.”

“How come we had to leave.”

“Because your street has a gas leak.”

“How’s a street leak gas?”

“Umm…”

“When can we go back?”

“When the gas stops leaking.”

“When’s that going to be?”

“When they fix it.”

“What’s that?”

“A defibrillator.”

“What’s it do.”

“Starts your heart in case it stops.”

The Canteen Truck arrived on scene. http://www.providencecanteen.com/

“I’ll be right back.” Just in the nick of time, the questions were getting pretty darn tough.

The folks at the Canteen gave me a box of assorted cookies and crackers, and made six cups of hot chocolate for the refugees. I was about to become an instant Superhero.

“Anybody spills the hot chocolate is going out in the street.”

The kids went bananas. You would have thought I brought them the Willie Wonka Chocolate Factory. I sat back in the Captain’s chair, and watched the party. They laughed, and carried on, and shared the cookies with each other, some crackers here, some Oreo’s there, a little peanut butter for you, some cheese for the little one.

If I could take one thing with me after twenty years of mayhem, it would be that very moment.

“Rescue 1, respond to Route 195 West to assist companies on scene.”

“Rescue 1, received.”

We had just cleared Rhode Island Hospital. I heard from the radio transmissions there was at least one dead, multiple injuries and two people trapped. Things had begun to quiet down after a long, wild night. It was approaching 3:30, the time where things go one way or the other, either peace descends on the city or madness. Tonight, madness.

A half mile pile-up of cars proved to be no trouble for Mike, who expertly navigated through the mess, arriving on scene three minutes after dispatch. The Special Hazards had arrived just before us, and were getting  the extrication equipment ready. Tony,the EMS Sector at this incident directed us to one of the four cars that had sustained heavy damage.

“Mike, there’s two in there, they need 02, IV’s and whatever else you can think of.”

It’s nice not being in charge sometimes. I had a focus. We grabbed the necessary equipment from the truck and made our way through broken glass, car parts and other debris toward one of the wrecks, dodging the firefighters with the cutters and spreaders and hydraulic lines as we did so.

We were on top of a bridge that spanned the Providence River. Cold wind swept through the accident scene, spreading dust and sand, covering our uniforms, stinging the exposed skin. A man and a woman were in the front seats, along with half of the engine that had been pushed into the passenger compartment following a head-on collision at about 70 MPH. The other car must have been doing seventy as well. I noticed that car, about fifty feet from the one we were in, a tangled wreck. I couldn’t tell which vehicle had been travelling the wrong way, and at that point didn’t care, I had too much on my mind to judge anything. Two other vehicles that had been involved were damaged, but nothing catastrophic. The occupants were accounted for, and already on their way to the hospital.

The passenger door was stuck, the drivers side completely demolished. The drivers legs were crushed and trapped under the dash. The passenger had a little wiggle room. I got into the back seat, the broken glass shredding my thin uniform pants and ripping my gloves as well. Both patients were conscious, and in a lot of pain, deformities galore, bleeding, but no brain matter or organs laying around. So far so good.

We covered the patients with blankets as the guys from the Hazards started the extrication process, started IV’s, got non-rebreathers on both, assessed and reassessed vitals, administered some morphine to the driver and managed to safely extricate the passenger, get her boarded and collared, packaged and put on a stretcher for another rescue to transport. The driver was wedged in. It took half an hour to cut him out.

Mike stayed with him during the process freeing me up. I walked around the scene, talked with Tony and asked if he needed anything else. He glanced at one of the other cars, which sat against the guard rail, completely destroyed.

“Who confirmed the fatality?” I asked.

Questions that would be asked later needed concise answers. During a mass casualty, things like time of death, mechanism of injury, and the rest take a backseat to treating the living. The other car was there, and there was a dead person in it, and I did not want to go anywhere near it.

“Is it a male?”

“Couldn’t tell.”

I definitely didn’t want to get any closer.

“We think it’s a girl.”

It was fifty feet away. It was a long walk. It wasn’t a girl.

I don’t know why, but that made it a little easier. Not much, but a little.

A lady I know has had a tough month. Her son was struck by a car while walking in a snowstorm, broke several ribs, collapsed a lung and hit his head so hard he was knocked unconscious and ended up with a severe concussion. He was brought to the nearest hospital, stabilized and transported to the area’s Level 1 Trauma Center.

I had no idea any of this happened until the other day, when our paths crossed. She couldn’t wait to tell me about the ordeal-not the accident or the negative repercussions that followed, rather the incredible care her son received from the paramedics from LifePACT, and the emergency room staff at Rhode Island Hospital.

I am not a paramedic, and had nothing to do with the care that her son received, but she, without thinking twice, included me in the retelling of her story, telling me about the transport, the Trauma Room, and the ICU later.

“You people were fantastic.”

You people. You People.

I like the way that sounds, especially when “you people” happen to be the people I work with every day.

It gives me something to think about when I’m on a run. I don’t want to let “you people” down.

We’re all connected. When one of us looks good, we all look good. Of course when one of us looks bad…

“More! This is ridiculous!”

“Excuse me?”

“Why don’t you bring the army next time, she just needs a ride to the hospital for chrissakes.”

“Excuse me?”

“She’s upstairs with the rest of you.”

“Excuse me?”

We had been dispatched for an elderly female with difficulty breathing. I’ve been around for a while, and seen difficulty breathing in  a number of forms. The sniffles, chronic emphysema, a cold, congestive heart failure, anaphalixic shock, airway obstructions, and death to name a few. We assume the worst when somebody calls 911 looking for help. Often, the worst is what we find. Better to have too much help than not enough, especially when somebody has only minutes to live without intervention. We can, and often do save people from an early demise. It isn’t easy, and it takes a skilled team working together to move a patient, perform CPR, start IV’s, administer drugs, drive the apparatus, and control an airway.

“This is ridiculous. No wonder my taxes are so high!”

“Did you call 911?”

“Yeah, she needs a ride to the hospital.”

“And what did you tell them.”

“That she needs a ride to the hospital.”

“Did you tell them why she needs a ride to the hospital?”

“I told them she was having trouble breathing.”

“And if she stopped breathing, what good would two of us do, when one is doing compressions and the other bagging her? We could stay there all day.”

“You could call for more help.”

I closed my eyes and started counting backwards from 100. When I reached 85 or so I could open them again.

The lady was walking down the stairs now, escorted by three firefighters who had arrived on scene within two minutes, ALS equipment ready, defibrillators, medications, airway-everything needed to run a full code except for transport capabilities.

“All these handsome men!” she said, delighted by the attention.

Her son scowled as she walked past him, out the door and into the rescue. She’s sixty, has had bronchitis for a few days and wants antibiotics. He doctor told her to call 911 for a ride to the emergency room, he didn’t have any appointments until later in the week.

Blue Cross just raised their rates by 1 1/2 %. The Mayor of Providence says he cannot afford to keep the city running without concessions from the unions.

How about a little cooperation from the medical community and the citizens?

Might be a good a place as any to start cutting costs.

http://www.projo.com/ri/warwick/content/RI_MP_DEPLOYMENT__03-08-11_V7MSPA6_v11.1cb4126.html#slcgm_comments_anchor

“The men and women, who in civilian life work as electricians, managers, school teachers, police officers and firemen, won’t be guarding prisoners, but will oversee detainee operations for all Afghanistan, especially at the prison facility at the Bagram Air Base, with an eye toward turning the facility over to Afghan control.”

They call The Korean War “The Forgotten War,” but our generation has  forgotten our little war already. 2,354 soldiers have lost their lives fighting in Afghanistan, another 4757 in Iraq. Thousands more have been wounded, and more emotional wounds will surface as time progresses. I have encountered the “fifty yard stare” numerous times, the last time I saw it it didn’t last long, the soldier attacked us, my partner is still recovering, his cast came off yesterday.

My brother, Bob, as I call him, or “First Sgt. Morse,” as his soldiers address him when he is around, or “The Voice of God,” as they call him when he is not, will be joining the 43rd Military Police Brigade for a one year deployment. His family will be here, like they were the last time when he spent a year in Iraq, taking care of business, graduating from college, finishing their school year in Bayview, getting summer jobs, pursuing careers, going to cookouts, Forth of July parties, movies, Red Sox games and everything else the rest of us will be doing, only he won’t be here, again. And neither will the rest of the soldiers we send overseas whose job it is to make sure that we can enjoy these things, and have the opportunity to continue to do so.

The plane leaves tomorrow.

Stay safe, brother. Again.

And thank you.

http://ambulancedriverfiles.com/2011/03/blogger-save/

If this doesn’t give you chills, and you are an EMT-Paramedic-Firefighter-CPR Layperson, you’re in the wrong line of work.

Well Done, People!

http://www.susiehemingway.com/2011/03/08/the-tree-and-the-hawk/

Funny things, these blogs. They have a way of getting to you in ways you would never have imagined.

Thanks, Susie.

http://www2.turnto10.com/news/2011/mar/07/6/two-killed-early-morning-fire-ar-415977/

Thoughts and prayers for the victims of this morning’s fire.

We did all we could.

Anybody who has read my ramblings for any length of time may have noticed the up and down nature of this journal. Truth is, the ratio of misery to inspiration is greatly exaggerated here, with misery beating inspiration by a 20-1 margin.   It’s those moments of inspiration that make the misery bearable, though sometimes just barely. People grow tired of a disgruntled employee blog rather quickly, so I try to focus on the positive.

I know what you’re thinking: “If this is positive, I’d hate to see him negative!”

My family bears the brunt of my negativity. They hear the real stories, and see the real me. What I write is an edited version of the truth. I honestly don’t start out trying to water things down, but if I were to write (and sometimes I actually do) what is really running through my demented mind, I might get locked up.

On any given day in Providence, each of our six rescues responds to fifteen to twenty-four calls. There are stretches hundreds of calls where our services are absolutely unnecessary, people who live a stones throw away from an ER calling to get in faster, to beat the system, to use a resource simply because it is there. After ten or twenty calls for twenty year olds with belly aches and kids with fevers, the morale sinks mighty low.

When I see one of my colleagues on the rescue on the down side of things, frustrated, annoyed and plain old sick of doing this, I try to remind them of the tidal nature of things, sometimes the tide is low, sometimes high, and it’s up to us to ride the waves and find some middle ground in the swells. Sometimes it is them telling me to weather the storm, calmer seas are coming.

Yet there is always something to hang on to, some little piece of the puzzle that will get you through the day. The old lady’s pictures of her family on the mantle, the twenty year old’s kitten chasing your shoe laces as you walk her to the truck, the baby with the fever just being a baby with a fever.

Then there is the friends and acquaintances you make wherever you go. The hospital staff, the people at the coffee shop, the guys at the station and repair shop-everywhere you go there is something, or somebody there to lift your spirits and get you through the next few hours.

Though it sometimes seems so, we are not alone. Isolating is the worst possible method of getting through a shift. When we withdraw, as I often do, we are basically having a meeting with an idiot. There is a lot of empty space between our ears, and there is a cement fairy working hard to fill our heads with useless concrete. There is so much more to see, and be part of when we open ourselves up to a little help now and then.

The people around you are there for you, and you are there for them.  It all works out when you let it out. Or in.

That is all

I finished a twenty-four hour shift yesterday, slept a little, woke up, had a minute and thought I’d write a short post about something that happened during the twenty-four. I like to write something after every shift, I think someday when I’m older and even more frail I might get a kick out of it.

It’s a good thing I write this stuff down. I must have gone on fifteen calls at least during the twenty-four. I can’t remember one. Zip, zilch, nada.

Now that I’ve bored you with my nothing, back to our regularly scheduled monotony.

The City of Providence is collapsing. Draconian measures are needed to fix it, or even keep the city from going bankrupt. Every teacher currently employed by the city has been “fired.” Four Fire Department administrators have been eliminated. Who knows what is going on at the Police Department. “The Unions” are being told they are expected to open their contracts to reap more savings for the city. Nobody is safe.

I’ve watched for twenty years politicians raid our pension fund to fix budget problems, while filling city hall with cronies in no show jobs. I’ve watched them drive their city vehicles to and from work, and wherever else they wanted to go. I’ve watched Brown University and Johnson and Wales buy up every piece of property they could get their greedy little hands on, thus eliminating millions of dollars from the tax roles, while taking the source of their wealth-the students- in city owned and operated rescues to local emergency rooms because they are too drunk to stand. I see the “non-profits” fill their upper offices with people making hundreds of thousands a year in pay and benefits, and doing nothing to combat the enormous weight their ineffective policies regarding repeat emergency room abusers and fraud places on the healthcare system. I’m tired of watching, and taking the blame for other people’s transgressions. If all I can do is write things that on a good day a hundred people will read, then at least I’ll have done something.

People that have been elected to run the city into the ground blame “the unions,” the “unfunded pension liability,” and “unsustainable healthcare costs.” Not one of them has the courage to put the blame where it belongs, on themselves. The city council blames the mayor, who just happens to be a United States Congressman.  The congressman blames the previous administration, the previous administration, in the form of local celebrity Buddy Cianci sits behind a microphone at his day job at WPRO and blames anybody that will increase his ratings.

The blame rests squarely on Talk Show Host Buddy Cianci, Congressman David Cicillini and former mayor and real estate tycoon Joseph Paolino.

The Congressman, The Celebrity and the Businessman. And they all just happen to be attorneys. Great leadership, counellors. May you get your day in court, and be escorted out in chains.

His wife died at forty-five, breast cancer, then his father died, then a week ago he was crushed between some pallets while at work. He’s having a really bad year. I had taken his wife to the hospital a few times over the last year, she was terminal, but full of life. They shared a nice home, simple, classy people.

“It’s not the length of your life that matters, it’s the width.”

While at rehab a few days after the workplace accident his breathing became more difficult, then the chest pains started. We got him into the truck, ran the necessary tests, IV’s and things, made sure he was stable and got ready to go.

“What about my car?” he asked.

“You’ll have to get it later,” I said, looking out the rear windows at his Chrysler, a gang of kids standing nearby, waiting. The rims were especially nice.

“I’ll call my daughter,” he said, nervously.

We weren’t in the best neighborhood. I’d give the rims a life expectancy of six minutes after sundown, which was ten minutes away. I wouldn’t want my daughter anywhere near this place. The ER was less than two miles from our spot, I figured what the hell.

“Give me your keys.”

“Thanks, man.”

We’re Jolly Blue Giants when riding through the inner city in the Big Red Truck. In an ’05 Chrysler, alone, driving through the hood it’s a little different. The streets seemed smaller, the people more menacing. Kids I wouldn’t even notice when inside the rescue suddenly stood out as the sun set, every move appearing threatening. I had my radio, and uniform, but still, Casper in the Hood stands out. My radio snapped on.

“Engine 13 and Rescue 4, respond to 232 Ocean Street for a shooting, stage for police.”

Ocean Street. I was on Taylor. Ocean was two blocks away. Some people were running my way. I was a carjacking waiting to happen. I tried to lock the doors but couldn’t figure out how. The “gunmen” got close. I leaned to my right, ghetto style, putting my left hand lazily on the wheel , cranked up the tunes which my patient had tuned to the local hip-hop station and tried to fit in. The gunmen approached. Somehow, the hoodlums had transformed into a couple of ten year olds walking down the street. Lucky for them, Casper was ready for action.

I heard sirens in the distance, some cruisers passed me, the officers sizing me up as they passed. It was a white knuckle ride the rest of the way to the hospital, but I persevered, and parked the patient’s car and made it out of the parking garage and onto the ambulance bay just as my rescue backed in.

The patient looked relieved when he saw me open the rear doors.

“How’d it go?”

“Brakes were a little squeaky, but other than that, no worries. You’re in 8-C” I said, handing over the keys.

She never heard the dog coming as she rummaged through the trash, looking for something-anything of value. She’s been at it for years, one of those characters that makes the inner city so colorful. She doesn’t bother anybody, and everybody knows her, but nobody knows her name, or where she rests at night, or if she has family close by. She’s a ghost, maybe, one that simply appears, finds some things to keep her going, then slips back from where she came.

The dog didn’t believe in ghosts.  He  got hold of her leg, and twisted and shook, and took a big chunk of her calf with him, and spit it out on the ground next to where she lay. For such a little lady she sure held a lot of blood. The German Shepard was simply doing what dogs do, defending his turf. He gave the lady a warning bark, which she ignored, not because she wanted to, rather because she is deaf, and mute, which is something I didn’t know until yesterday, when I had her as a patient, and she couldn’t tell me anything about herself, or her injuries.

The Cambodian interpreter at the hospital fared no better. She used sign language, but not the universal kind that is understood by most people who understand that way of communicating. Did you know that there is only one way to do sign language? It never occurred to me, I just figured that there was Spanish, Russian, Chinese and every other language represented by the hand movements. All I know is that when I peeked into her room an hour or so after I had brought her in, she recognized me, and smiled, and pointed to me, then the door, and nodded her head up and down. I think she wanted me to take her back to where I found her.

The things I don’t know never fail to amaze me.

The bus was full, people on their way to work, or school. Most faces were grim and stared forward as I made my way down the aisle, looking for a seat. It was a Monday, people lost in their own worlds, automatons on auto-pilot, going through the necessary routine we call life.

One person looked at me, and smiled, and said a big Hello! He  went out of his way to make room on his seat, and motioned for me to sit. He talked all the way to our destination, and laughed, and was so full of life I couldn’t help but be inspired by, and effected by his charisma. His stop came first, and he grabbed his bags, and gave me a hug, and wished me well. He said goodbye to the people who ignored him as he walked out of the bus, and my life.

Some of those people returned his gesture with a self conscious smile, or a nod, but most ignored him. He didn’t notice, just continued to live, and love, and enjoy every moment. He made me wonder which of us was handicapped. I still wonder.

Children like him are wasting away in orphanages all over Eastern Europe. These little miracles have more to offer humanity than we will ever know. By helping them, we help us all. I was forever changed by a kind little man with Down’s, on a bus on his way to work, who made me stop and think about what I was missing. That was thirty years ago, and his memory lives with me every moment of every day, especially when I need to be reminded to live in the moment, and embrace things and people I would otherwise miss.

I couldn’t begin to tell the story as well as people who are blessed with a person with Down’s Syndrome in their lives, so I won’t try.

Please visit these links, and send a little donation their way if you can.

http://www.warwickonline.com/view/full_story_news/11580850/article-Catholic-school-community-rescues-orphan-with-Down-syndrome?instance=secondary_stories_left_column

http://ourdailysmiles.blogspot.com/

Thank you.