Everybody thinks it's great to be busy. High volume areas are in demand, Paramedics and EMT's brag about the number of runs they do.

*Newsflash*

It sucks. Patient care crashes. Morale crashes. The ambulance crashes. I don't care who you are, and how many calls you do, and how many lives you save, and how great you are and caring and knowledgeable, you can only take so much before YOU crash. Or I crash.

Closing in on 2500 runs and it isn't even June.

Rescue 1 is overdue for a crash. And the mayor wants a 10 percent reduction in fire department spending.

Calls have increased every one of the twenty years I've been here. Every one of the twenty years I've been here I've been told the city is broke, make due, give back.

I'm tired of making due. Something has got to give.

Give back, we're told by the taxpayers. Do more for less. Give, Give, Give.

I've given enough. Maybe it's time the taxpayers give a little, and put some pressure on their neighbors, and their elected leaders and figure out a way to get their fellow citizens to be a little more self sufficient, and quit using the 911 system just because it is there.

Nightmares, sleepy arms, scrapes, fevers, sniffles-and when we arrive and walk past their cars they look at us incredulously when we ask if they are serious, and demand we do our job.

If I did my job I'd beat the shit out of them for contributing to the downfall of our society. And then hold them accountable for squandering resources for their own selfish needs.

But that job is secondary to the job I do for the city. So I put them in the ALS rig, and they bitch and moan and demand to be carried in on the stretcher so they can "get right in," and I keep my big mouth shut, and swallow the rage, and do it again and again and again until something truly horrendous happens, and I'm called, but have nothing left with which to put the pieces back together properly, and I do a half-assed job and rush them to the ER where equally burned out people do their best to pick up my slack.

It's 0700. Shift change. Fresh faces at triage, tired ones still pushing stretchers in. Different patients, similar stories. The shift that just left fought the weekend battle with us, was as punch drunk as we were, beaten down by the incessant barrage of patients, some drunk, some mentally ill, some bleeding, some dying. Some had no reason at all for being there, just lost souls looking for attention.

I've got an old lady on the stretcher. Five minutes ago she sat in a pile of excretement of her own making, on the floor in her bathroom, looking dazed, drooling. Her family left her there, waited for us to enter the hot zone and offer assistance. They were not certain of her date of birth, or medical condition, but did come up with a hand written medication list.

The meds gave some indication of her condition, heart, diabetes, high blood pressure. The family gave us nothing. With little to go on, and some good tools to help put things together, we ruled out MI, Hypoglycemia or stroke. TIA? Maybe. Dehydrated? Maybe. Vasal/Vagal? Maybe. Seizure? Probably.

Back at triage. My friends from the night shift are gone, dragging their tired selves home, or wherever. My new friends are in, fresh and ready to work. They too will be beaten down before long, like last night's crew, but at the moment expect a cohesive report. Instead, they get this:

"Duh, I tink she had a seizure."

What can I say, I expected people on the same wavelength.

Bright eyed meets bleary eyed in a battle at triage, may the best man win!

I lost.

Sorry, Carol.

My story was incomplete at best, but made perfect sense to me. And anybody else who had spent the night babysitting the minions of Providence.

I reached in and helped her out. She had fallen into the bushes, and the other residents were laughing at her, calling her Vanessa the Drunk, Vanessa the Whore, Vanessa the Pig. She isn't a drunk, whore or a pig, she's a sixty-three year old lady who drinks too much, and gets sloppy, and used to sell herself on Broad Street back in the seventies.

It's tough to live down a reputation, tougher still when you don't leave the neighborhood where that reputation was formed, and solidified by your actions. Everybody knows you when you fail, and everybody gets to feel a little better about themselves because even if they too failed, they didn't fail as hard as Vanessa. I've known her for years, taken her to the hospital dozens of times. She's a sad lady who lights up when she drinks, the falls back into depression when the glow fades.

The overcoat she wore concealed an eight inch butcher knife. When I stood her up she stabbed at me, and very nearly landed it in the middle of my chest, and would have if i didn't jump back it time, and nearly fall into the bushes myself.

"Put it down Vanessa!" I yelled, but she would have none of it, and went at me again. I managed to separate her from the knife without stabbing myself, or her.

"What are you, crazy!" I yelled once we were in the back of the truck and away from the crowd. "You could have killed me!"

"I was trying to kill myself," she cried, and continued to cry all the way to the hospital.

I deal with murderers, child molesters, rapists, robbers and maniacs on a daily basis and the one that nearly killed me is an old lady who couldn't even hurt herself. Complacency kills, every minute of every shift could be the last. I need to keep that in mind as the hours and situations add up.

Three flights of trash filled stairs, cat urine overwhelming, barricaded door, filthy floor, empty fridge, a kitchen void of food, five hungry kids, girls with no shirts, babies with no diapers, hospital sheets instead of blankets, empty wall sockets, nothing to fill the plugs, no TV,no radio, no blow dryers or cell phone chargers, no dressers, small piles of clothes, some in stacks, some drying on the porch that overlooks a litter filled street.

No beds, bare mattresses, things crawling under my feet, no room inside the walls, no fear of light, desperate for crumbs that are not there, the bugs become playthings for kids who have no toys, pets if they can catch them, and put them under a plastic cup, bare lightbulbs swinging from extension cords as I pass, and find a mother breastfeeding her baby, who is sick.

Yet somehow, they smile at me, and speak to me in their African Language that very few here will understand, and touch me as I pass, and pick the baby from the mother's arms, and take her to a place that to these people must appear magical.

Remember to toast those that have preserved our freedom today. The Greatest Generation, the generations that preceded them and just as important, our generation.

There is a war going on, If one American soldier dies fighting that war, to that soldier and those close to him, that war becomes just as deadly as any in our history. Remember the families that anxiously await their loved ones return, remember the families that will wait forever.

I’m proud to be an American, proud of my country, our military and everybody who works toward making this the greatest civilization in history.

Celebrate Memorial Day. Travel. Have a cookout. Go to the beach. Enjoy your lives, spend time with friends and family, drink, laugh and relax. Feel the thunder and beauty of fireworks here at home.

It is an insult to those who have fought and died preserving our freedom to waste it. Enjoy, we’ve earned it.

Just remember to keep a place in your heart for those who are not here to enjoy it with us. And the generations of missing soldiers who preceded us.

It's three in the morning, and she is alone in bed, not the bed she shared with her husband for sixty-one years, no, not that bed; never again that bed for her, Now she rests in the hospital bed in the front room, the one that used to be the living room. A few weeks ago, her husband woke up in the bed in their bedroom, but couldn't speak. He couldn't move his left side either.

He was strong, his right side anyway, and emanated a look of frightened authority as we lifted him from that bed and put him onto the stair chair and carried him out of his home. The stroke happened sometime during the night, the damage too severe, comfort measures only at the hospital. He had a good run, eighty-nine years, but never expected to go down so suddenly.

He died a few days later, and his wife left his bedside, and went home. But it wasn't home, not really. Memories can only do so much for a grieving spouse. The familiar footfalls, the routine, the smells and sounds that come from a living, breathing mate can never be replaced by a memory.

So we come back to where she lives, the place she used to call home, and this time take her away. The anxiety of living there, alone became too much. She would stay awake all night, in the hospital bed in the front room, and listen for the familiar sounds that were no more.

Home is where her husband is. It won't be long before she joins him.

It's well past midnight, on a dark, quiet street on the outskirts of Providence. The house we were called to was dark. Not no lights on dark, truly dark, as if any light that may once have lived here were swallowed by a void. Ink black windows offered no reflection, or glimmer of life. I keyed the mike;

"Rescue 1 to Fire Alarm, do you have a callback, nobody is answering the door."

"Stand by, Rescue 1."

I stood at the top of the steps and listened for the ring. Nothing. Nothingness. More darkness, so black that even the ringing of a phone was swallowed.

"Fire alarm to Rescue 1."

"Rescue 1, go ahead."

"An answering machine picked up."

"Roger."

As I backed down the steps, the heavy wooden door with the antique peep hole opened inward. The hinges groaned from the weight of it. More blackness on the other side waited. There was nobody there.

"This place is haunted," I said to my partner, Black Cloud Mike, "You go first."

We entered the dark place, "Helloing" all the way. I heard a groan, then a whine, then say four beady red eyes in the darkness. A candle illuminated a room off the hallway, and a forty year old lady lay on a couch, covered with Adam's Family covers. The living room was full of old things, the candle's light illuminated the space, casting an eerie glow.

"What's the matter?" I asked the couch woman.

"I feel dizzy."

"I think you're house is haunted,"I said.

"Me too," she replied. "I've been here for three years and have never felt right."

We did some vital signs, everything was normal, or as normal as can be in a haunted house. Her two dogs, an old lady named Shoe, and a Boston Terrier Pug mix named Bug crowded us while we worked, desperate for attention from somebody beside the ghosts.

She decided she would be okay. We decided we had spent enough time in the house. As we left, "Bug" slipped past us and ran into the street.

It took us nearly an hour to catch him. He was a slippery little critter.

"Don't make me go back in there, the place is haunted," Bug pleaded. I brought him home anyway. Somebody had to protect  Shoe and the lady.

Considering food is life, and without it we will surely die, and because the citizenry of Providence is accustomed to fire department  personell being at their beck and call, I hereby announce that the expansion of the fire department emergency response scope of responsibilities will include, but not be limited to food shopping trips.

To activate the service, a hungry citizen will call 911, and explain to the operator their emergency. The proper response will be dispatched depending on the severity of the hunger, and be triaged accordingly. If a citizen has eaten within a two hour time span, the fire department response will be considered non-life threatening, and an ambulance only will respond. If the citizen has gone two-five hours without eating, an Advanced Life Support team will be dispatched, the first arriving unit will be supplied with snacks, the contents of which must be approved by the newly formed "Mayor's Blue Ribbon Commission on Emergency Nutritional Directives."

In the event of a six hour fast a full first alarm compliment, consisting of three engine companies, two ladder companies, a heavy rescue unit , battalion chief and ambulance will be deployed. Additional resourses will be put on alert.

The Honorable Congressman David Cicillini has procured Federal funding for the "Emergency Feeding Program," and is spearheading the Cradle to Grave initiative.

Remember, nobody need go hungry when they can call 911 for everything!

Just Breathe

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

Life is hard. Living is hard. I don't know a soul who doesn't struggle with it at one time or another. I used to wonder how some people got away with everything, and lived their days with ease, and got the girl they wanted, and the job they wanted, and always managed to drive nice cars, and go on lavish vacations while I managed to fuck things up more times than not, and drive jalopies, and get whatever jobs were available, and never have enough money to put gas in my car, never mind go on a trip.

Life has a way of working out, though. I've come to realize that it is perfect. Every bit of pain, and frustration, and sorrow has it's place, if even simply as a balance to the joy, wonder and triumph that makes its way through the maze of difficulty. If everything I have survived, the untimely death of my parents, my wife's debilitating disease, my own alcoholism, the tragic end of Zimba and Lakota, homes lost, and relationships destroyed to name a few have led me to this moment, where I am alive, and well, and able to sit here, and breathe, and think, and plan for the future while appreciating the past, but still be firmly planted in the moment, then those things were a necessary ingredient in life's recipie.

Somebody told me the world was going to end today. If it does, I suppose it was supposed to.

http://www.facebook.com/#!/video/video.php?v=116016768409055&oid=101308636577729&comments

I never get tired of watching this, produced in 1990. I started with the Providence Fire Department in 1991, remember it like it was yesterday. There's been a lot of days since yesterday it seems!

It's a dangerous journey, full of potential disaster. The hospital on the hill is my last choice, used only in emergency situations. This was an emergent emergency, still time to utilize my resourses. We left the hospital behind.

"To the station, James, and step on it."

As calls came in, and we rolled toward home the severity of the situation increased. I silently cursed myself for being so selective, but years on the run makes a man crazy sometimes. There are only  select few places that meet my criteria.

A rescue sent here, a rescue sent there, a rescue making a b-line to salvation. All around me the city exploded, inside me explosions of a different sort escaped, poisoning the atmosphere of the cramped cab. My partner rolled his window down and stepped on the gas.

In the distance, hope arose. As we crept closer I relaxed a little. Big mistake. As the overhead door closed behind me I duck walked up the stairs toward salvation. Three choices, door number 1, door number 2, or door number 3. Who cares, the middle one would do. And just in time.

But there is no happy ending here. Oh, no, not today. For today, the nine firefighters assigned to this station must have been too busy to replace the roll. What sort of man would do such a thing to a brother? This wretched place, these wretched people, not an honorable one in the bunch.

The mighty Rescue Lieutenant, almost Captain was reduced to a squatting villager foraging for scraps of paper when the bell tipped.

As luck would have it, we were sent to a home in the southside for an elderly woman suffering from constipation.

http://rescuingprovidence.com/2010/12/22/this-time/

She came here from a nice city in Russia, a place two days train ride from Moscow, a place so pristine mineral water flowed in little rivers through the town, clean enough to kneel down, cup your hands and drink. Her daughter had moved to America years ago, gotten married and had a family of her own, one with five children. That marriage didn't last, much like her own, divorce ended that, so she decided to move here to help her daughter. The city in Russia may have been beautiful, but life there was not. Her husband was a criminal, spent more time in jail than out.

"He used to drink, and shoot his guns in the house," the daughter told me. "Our walls were full of bullet holes. I was afraid. Afraid he would kill me."

Maybe her marriage was one of desperation, a way to escape. I don't know. Whatever the reason, her life here is no less desperate. Her mother, "a beautiful woman, strong and capable," had only been here for a year when the stroke came. She's confined to a hospital bed now, in one of the rooms that used to be for a couple of the kids. She's paralized, and has no health care insurance.

"Today is a good day," her daughter told me once the crisis had passed. We were called for heart palpitations but that turned out to be muscle spasms, a result of the stroke. "I get child support check, and I can now afford her medicine."

"What about the kids?"

"We'll be okay."

Five kids, now a full time patient with no insurance. Her plate went from full to overflowing, but she managed a smile and said she would be okay. She lived the first part of her life with a drunken lunatic, now the middle will be spent as a mother to her children and her mother.

But she will be okay. I mentioned some social service agencies, but she had already been down  that road, and did not qualify for anything but food stamps.

The kids were starting to rise as we finished up, the sun had yet to rise, but would soon, and another day will begin. And she will be okay.

This time.

http://www.emsnewbie.com/vegasbaby/

The only thing I like better than being on the rescue is writing about it! Here's a great chance for you folks new at this to give it a try. If you are a newbie and decide to enter and found the contest here, leave a comment, and if your entry wins 1st, 2nd or 3rd prize I'll throw in a signed copy of Rescuing Providence.

Remember, no comment, no proof!

So leave a comment and say hello already!

The Topic

EMS and the Social Media Revolution: How has blogging, Twitter, Facebook and podcasting affected your EMS experience, and how do you see it shaping you in the future? As an EMT student or newbie, has social media changed the way you study or learn, or the way you approach your profession? Has social media been a positive influence, or a negative one?

Sponsor: EMSWorld

Give us your thoughts -  they may win you a trip to EMS World Expo in Las Vegas!

The Rules

1. Contest limited to newbies. Submission limited to EMT students or less than 2 years experience, verified by either their instructor or copy of card/certificate with original date of certification.

2. 400-600 words, double spaced, 1 inch margins, 12 pt font, MS Word or PDF format.

Lodging provided by Cielo Azul Publishing

3. Submissions accepted from May 1 through midnight on June 1, submitted on the EMS Newbie website. (Submission page available starting May 1).

4. No names in your submissions. Do give the paper a title and put that in the actual document and the submission form.

Submit Your Essay

You can submit your essay here at the contest submission page.

The Prizes

1st Place: All expenses trip to EMS World Expo in Las Vegas. A 3-day conference registration and three show events (provided by EMS World), and a shift shadowing Dr Bryan Bledsoe at University Medical Center ED. Airfare supplied by Emergency Training Associates, and lodging supplied by Cielo Azul Publishing. The winner also gets a 1-year subscription to EMS World magazine, and appear on one of our live webcasts from the conference.

2nd Place: 1-year subscription to EMS World and fully stocked first responder BLS trauma bag.
A customized Confessions of an EMS Newbie case for your iPhone, or other smartphone.
A signed copy of En Route: A Paramedic’s Stories of Life, Death, and Everything in Between by Kelly Grayson.

Airfare Provided by Emergency Training Associates

3rd Place: 1-year subscription to EMS World and fully stocked first responder BLS trauma bag.

A signed copy of En Route: A Paramedic’s Stories of Life, Death, and Everything in Between by Kelly Grayson.

Stay tuned to the podcast and this page for additional information and new prizes.

0710 hrs. Ten minutes in, patient # 1, forty eight year old female struck by tractor-trailer while exiting Rt. 95. As an added bonus, pt's vehicle struck again by different tractor- trailer minutes after original accident. Board and collar applied, transported to ER with minor injuries…

0835 hrs. While doing housework discovered dozens of Saugy Hotdogs in refrigerator. Three #10 cans of B&M Baked Beans nearby. Six people on shift. Captain Healey must have gone shopping…

0850 hrs. 20 y/o male possibly on drugs, mother called 911 for an evaluation. Respond to find 20 y/o male sitting outside, mother inside with police, son has been stealing money from mom, she wants to throw him out, he told her he is addicted to crack but he told us he really isn't, but needs to go to ER so he can stay. Transported for psych eval.

0930 hrs. Firehouse bathroom cleaned and restocked. The Captain of the house, the nefarious Captain Healey mandated that the station bathroom's cleanliness is the responsibility of the rescue officer. Keeps us humble, I suppose. Rescue 1 is the last rescue in service, won't be here for long.

1123 hrs. Dispatched for nature unknown on Cactus Street. An elderly couple meets us at the door. Neither looks particularly sick, or particularly well for that matter. We walk to the rescue to find both are requesting transport to the ER for evaluations following a month of malaise. Neither speaks English, however, the entire alphabet was used in the spelling of their names, which takes a long time to get out of them. Utilizing my Sesame Street Spanish for EMT's and the latest gadgetry provided I learn that the male is hyperglycemic. The female is hypertensive and aching all over. We transport both a mile to the ER. They were actually quite nice.

1220 hrs. Unusually slow morning. Hmmm… Had time to read this editorial and subsequent commentary, and offer my two cents, not a good idea but I sometimes can't help myself. I get a little tired of the "union hack, greedy pig" thing and sometimes fire back, which does little more than give them justification to keep on attacking. But it felt good for a little while.

http://www.projo.com/opinion/editorials/content/ED_prov13_05-13-11_01O13L6_v68.371d5ee.html

"We live in a world that provides ambulances to people disabled because of drug addiction and alcoholism, take them to the methadone clinic in that ambulance, give them their "dose" take them back to their state subsidized housing, where they shop for food with their state EBT card and spend their government checks however they choose, after contributing nothing to society, financially or otherwise, yet the comments here attack people who have put twenty-thirty-forty years of their earnings into a pension fund and expect that that pension be viable.

Punish the workers, reward the slackers and keep your heads in the sand. Bunch of morons."

That'll show em! Show 'em that I'm a moron too for participating in a comments section of any newspaper.

1337 hrs. Intoxicated male on Elmwood Avenue. Our old friend Will-I-Am sleeping on the sidewalk. He's fifty, homeless and beyond rehab. Twice he has bee run over by a city bus, numerous times drunk himself into an intubated state in a trauma room. Not too bad today, hasn't pissed or shit himself yet. Only the fiftieth time this year for old will, but summer has just begun.

It's old home day at the ER, six homeless alcoholics have taken over the triage area, four brought in by Providence rescues, two from other towns. They all know one another. I hate bringing them in in the afternoon, they will be released at around eight tonite and we'll bring them back in around eleven.

1553 hrs. Engine 13 and rescue 1 respond to local University for a female having a seizure. Arrive two minutes later to find "seizing" student in nurse's office, alert and oriented and refusing treatment from school nurse who called 911 to obtain a refusal. Patient assessed, nurse addressed, rescue 1 back in service.

1631 hrs. Respond to a group home for a male unresponsive. Find Fred. I've known him for twenty years, first as a homeless heroin addict who could not or would not take care of himself, most recently as a disabled former addict living in a group home, sober for ten years, drug free most of that time. He wasn't exactly productive, but he stopped being a drain on society, at least less of a drain anyway. He died peacefully in his recliner sometime last night, I declared him dead at 1635 hrs.

1715 hrs. I'm at Rescue 4, Washington Street, Downtown. As I left Rescue 1, a call came in for an unresponsive female at the Steere House. http://www.usatoday.com/news/offbeat/2007-07-26-foreboding-feline_N.htm I won't get to see Oscar but I have a one body per hour limit. It's in the contract.

1839 hrs. Seventy year old female unresponsive in theater bathroom. Carried stretcher upstairs empty, downstairs full, pt. received two IV's 12 lead ekg, oxygen, narcan, glucose test and a quick ride to the ER before she regained consciousness. Her BG was normal, but an insulin syringe was found next to her in the bathroom. Narcan? Hmm. she's seventy now, would have been twenty fifty years ago, that would be 1961, thirty in 1971, anything is possible, the sixties were a strange time!

1950 hrs. Fifty year old female delusional, suicidal and psychotic. Not taking meds. Spanish speaking. She held it together all the way to the ER where she will get a psych evaluation and hopefully some help. I found out later what she was saying on the way to the hospital. She kept pointing out the rear windows and repeating herself. "Get me the knife!" I need to learn more Spanish.

2110 hrs.  Intoxicated female in cemetery. I haven't seen her in a few years, looks like she is having a relapse, becoming a regular, again.

2230 hrs. 16 Year old female, riding on friends shoulders falls backward striking her head on sidewalk, unknown loc, possibly intoxicated. Board and collar applied, iv established, vomit control initiated and transported to trauma center. A fall from approx. seven feet onto concrete has potential to be quite serious.

2350 hrs. 39 year old male beaten senseless by three "sissyboys" who punched and broke bottles over his head. Judging from his intoxicated belligerent demeanor in the rescue the end result was no surprise.

0122 hrs. Hand injury downtown. Police officer broke his finger during apprehension operations

0215 hrs. Twenty five year old lost an eye when somebody threw a bottle at him during a fight. Maybe it's me, but I don't see much fun at the clubs these days, a lot of posing, drama and drunk people. "It's all fun and games until somebody loses an eye." Someone did, a twenty-five year old kid out with friends, scarred for life. I used to think it would be cool to have a battle wound to show what a tough guy I am, something jagged and ugly, something to give me character and an air of danger. Thankfully it never happened, because that kind of thinking only comes from somebody who isn't scarred, and doesn't have to look at it every day. Those who live with the evidence of a twist of fate, or a bad decision can never go back to their former selves.

I got back to the station around four, opened my eyes and it was seven. A miracle, every rescue in the city was out, it's like a dome of tranquility descended over Rescue Four's district for a few hours. I'm back at Rescue 1, the aforementioned nefarious Captain Healey has some power tools out and is waiting on the apparatus floor for me to rehab an old cabinet;sanding, puttying and painting. He's going to have a long wait.

More runs to follow if I haven't bored you to death yet.

0800 hrs. My relief came late from Rescue 5, during my travel time back to Rescue 1 from Rescue 4 (i know, I can't keep up) and subsequent de-con, a seizure victim, who we met yesterday at the local college, a student with lacerated hand, also from the local tax exempt college, and an elderly lady who fell called 911 for assistance. The other Rescue crews came into my district. Rescue 1 is overdue…

0930 hrs. Saturday in the firehouse means two things. 1. Scrub out. 2. Hot dogs and beans. Part 1., Scrub-out. All apparatus moved outside, apparatus floor swept, hosed down, scrubbed with brushes and Spick&Span, rinsed with the booster line from Engine 13 and squeegee'd until dry. Part 2. Franks and Beans.

Ingredients:

Three dozen Saugy hot dogs

1 Onion

1 pound of bacon

1 gallon vegetable oil

2 pounds salted butter

Three # 10 cans of B&M Baked beans

Three dozen Snowflake rolls

Boil two gallons of water. While water is boiling pour gallon of oul into large pot, heat to nearly on fire. Add onion. Top with bacon until pan overflows with boiling fat and oil. Fill with baked beans. Drop Saugy hot dogs into boiling water. Using ladle, skim bacon grease, vegetable oil and a pound of butter and drop it into hot dog pan. Cook until hot dogs split. Slather another pound of butter onto Snowflake rolls and eat them while hot dogs cook. Serve hot and wait for the heart attack.

1052 hrs. A suicidal female is allegedly locked in her house, heavilly secured. Arrive on scene with Providence Police and an engine company. All eyes on me. The friend says she is definately inside, not answering the door, told her she is suicidal and has a history of prescription pill abuse and slicing her wrists. Landlord contacted, he is five minutes away. The police officer is trying to talk the lady out of her hysteria, I decide to force the door. I've seen one too many swinging bodies in closets to worry about lawsuits for unlawful entry. One of the guys lifts the hinges from an interior door, we enter and find the apartment vacant. minimal damage was done to the door.  I honestly don't know what the law says about this situation, but my internal law is at peace.

1257 hrs. Call for a woman feeling depressed. Arrive on scene to find a large man sitting on front steps of a run down house in a run down neighborhood. A lady stands behind him, tentative.

"It's for her," says Jabba the Hut, throwing his thumb behind his right ear as the flubber from his arm jiggles under his dirty t-shirt.

She walks zombie-like past him, toward us.

"You got something to say to me girl?" says the monster, angry, piercing eyes nearly hidden by the rolls of fat on his face.

"I'm sorry," she says, and continues her slow, trance-like walk toward the rescue.

"You better be."

A staring match between me and the tormentor ends quickly. No need escalating things.

"What was that all about?" I ask my patient once we get into the safety of the rescue.

"He's mad because I'm leaving him alone. I clean for him, make him breakfast and take care of him, he says he can't walk, but he manages to get to the breakfast table just fine!"

A tear begins to form, filling her eye, first one, then the other. As it takes shape and spills down her cheek rage builds inside of me. Yesterday I sat with a man I've known for twenty years as his lifeless body sat still on the chair he died on, gravity pulling his useless blood toward the surface of the chair and watched it mottle there and felt nothing. Last night I wrapped a bandage around a young man's head, covering the socket where once a bright blue eye looked out at the world around him and now was a dark, empty  pool of blood and felt nothing but the need to act. Today, a seemingly simple tear pulled me apart, and brought a primative urge to protect this woman, and get her away from her situation, and show her that a woman needs not be treated like an object, but did nothing. There was nothing I could do, but lend a sympathetic ear and bring her to the ER for a psych eval. She's been hearing voices.

"You're suffering with schitzophrenia," I told her. "You need somebody who understands, and can help you, not expect you to take care of him."

She sat and cried, and listened to the voices in her head.

You never know which call will get you.

1430 hrs. Sixty-two year old male with difficulty breathing. Upon arrival find patient in obvious distress, Spanish speaking, AYE AYE AYE the only words I can understand. EKG shows rapid a-fib. Some 02 and IV enroute during the two minute transport, pt delivered to treatment room, given Versed and cardioverted at 50 joules with a sucessful outcome.

1525 hrs. Eighteen year old male with abdominal pain.  I have no idea but I took him to the ER anyway. 120/70, hr 65 spo2 100% no vomiting, just a little pain in the middle of his tummy.

1637 hrs. This party might just end mercifully! I might do this every weekend, good luck came with my little Blog Log, this was the quietest thirty-four I've had in years. I've got about an hour to go, fingers crossed. prayers to the rescue gods and saline solution thrown over my shoulder! Let's go home…

1638 hrs. So I taunted the rescue gods and lost. I kind of did it on purpose just to see if I could get away with it. I didn't. Intoxicated male deep in the Providence Forest. He's a good guy, polite, cooperative and down on his luck I don't see that luck changing any time soon, but I've also seen a few miracles during this strange trip I call a career in EMS. Relief is in, I'm out!

Thanks for reading.

Last week, no murders. This week, three murders. A seventeen year old girl was one of the shooting victims, then a twenty-five year old guy stabbed to death on Mawney Street. Now this. I've seen a trend over the years, things happen in waves.  Summer is coming, fueds reigniting, people are broke, should be interesting.

Stay safe.

http://newsblog.projo.com/2011/05/one-person-killed-three-others.html

2230 hrs.

The "Big I Am" here; listen up.

I've been here before, seen this act a thousand times, don't buy it, nope, not for a minute. Yeah she had open heart surgery in March, yeah she says she has chest pain now, yada, yada, yada. Put the IV kit away, keep her on oxygen if it keeps her happy, run a rhythm strip and lets go.

What do you mean you think she needs nitro and aspirin? I'm telling you I've been here three times since the surgery, three times for nothin", nada, nothin. Did it all, IV, twelve lead, 02, nitro, aspirin the whole she'bang, nothin.

What's her pressure? See, 130/92, what did I tell you? Pulsox? Look-a-dat, 99%, who'd a guessed.

Let's go, real patients waiting, red and white taxi at your service, unbelievable.

Twenty Minutes Later:

The "Not so Big I Am" here, anybody listening?

How was I supposed to know she was having a STEMI? I did the EKG the last three times, nothing I tell ya! Yeah the IV would have helped, and a nice twelve lead preceding my grand enterance probably would have gotten the cardiac team moving, and saved some heart muscle, I know that, I gave her oxygen didn't I?

Aw c'mon, you guys know me! You know I always do things right! Every now and then I miss one, give me a break, will ya! Christ, it ain't like this is life and death, right!

Right?

Where's everybody going?

Progress Report

http://www.emsworld.com/web/online/Reading-Room/QandA-with-Lt-Michael-Morse/55$16835

People still find my book, Rescuing Providence interesting enough to talk about. Marie Nordberg from EMS World called me a few weeks ago and we talked about the book and the writing of it for a while, the above link is the result of that. Thank you, Marie, and EMS World for keeping things fresh!

http://www.facebook.com/sunkisst.tans#!/jemsfans

JEMS has been showcasing my blog posts on their fanpage for a while now, which I still find unbelievable. I never imagined I would be part of that world.

Dr. Francis Sullivan with the Brown University Medical School has been a great customer, buying nearly 100 books over the last few years and giving them to the new interns at Rhode Island Hospital. It's kind of cool knowing the interns have the book, and the now residents got a copy years ago, and had a unique chance to learn about us through my writing. Some of those doctors read this blog, and even though I am aware of that I still manage to keep things honest here.

I'm basically a firefighter who thought he could do a good job on the rescue. I am not a paramedic, but I do take this vocation seriously, and keep up with things, and always do my best for the patients. Some of my methods may raise some eyebrows at times, but this blog is what it is, and regardless of who is paying attention it is important to me to keep it honest. I could easily fall into the trap of writing what I think people want to read, but I would rather forget that people are reading, and simply tell the stories as they happen.

Maybe why that is why you folks keep coming back for more.

Many thanks for the continued interest. Incidentally, this is my 1000th post, and at the same time I noticed 5000 comments to those posts. And, since last year when I came to Fire/EMS blogs, well over 100,000 people have stopped by.

And that, my friends, makes me very happy.

That, and seeing this picture from last week and noticing the little guy next to me stealing my pose!

Thank you.

I've often wondered why I don't get sick. I carry sick people down their stairs, breathing their exhaled germs while huffing and puffing with their weight, put them into my rescue, wipe vomit from their faces and get splattered with their blood. On more occasions I care to remember all of the universal precautions available were not enough to keep from sharing things better left unshared.

"Next time you encounter someone with a nasty cold, take a good look. Psychologists at the University of British Colombia report that simply seeing ill people may boost the immune system. People exposed to photos of sneezes or lesions showed an increase in levels of a chemical messanger that is normally released after contact with microbes."

~Discover Magazine, December 2010

Considering the number of sick people I've seen I'm going to be well for a while. I wonder if seeing people with bullets in them will help if I ever get in a gunfight. With any luck I won't be testing that particular theory any time soon.

The soda was sweet, ice cold and perfect. It burned my throat as I guzzled the contents of the little eight ounce can but I couldn't stop drinking. The belch that followed was even more satisfying than the drink itself.

"I haven't had a real Coke in years," I said to Brian, who tossed his orange in the air as the elevator descended.

"Some things you just can't refuse," he replied as we got out of the elevator and walked past The Housecoat Brigade, smiling to the ladies, most dressed in colorful housecoats and full of the latest gossip.

"Ladies," I said, and gave them a courteous nod as they parted, and let us through the gauntlet, dying to find out why we had escorted two of their favorite subjects of whispers home. That will be a mystery, as far as I'm concerned, and the mother and daughter we just left will keep their day's adventure a secret, and bring it to their graves I'm sure.

They were delighted with me and Brian, and us with them. What had begun for all four of us as a miserable end to a difficult day had turned into one of those magical little moments in the city that make all of the long days and nights away from home worthwhile.

The mother and daughter had been shopping together, taking the bus to buy some brooms and  milk. They each had a broom and a quart in their bags as they sat on one of the sideways seats on a city bus when a loud thud interrupted the quiet hum of the diesel and natural gas hybrid motor, and pieces of broken glass flew toward them. It wasn't a lot of glass, but enough to scare the wits out them. Traveling through the West End of Providence on a city bus is a daunting task for anybody, a ninety and seventy year old especially so. They were frail of body but strong of will, and had been living in Providence for decades, and would be damned if the ever changing dynamic of the city would keep them inside.

We were called to transport the two to the ER for an evaluation, another turf job, this time by the police and bus company. Their loss. The ladies didn't want to go, and "waste four hours like the last time," so after an evaluation and phone consultation with their doctor, who they both had appointments with on Tuesday, we decided to take them home. It isn't every day a Providence Fire Department vehicle delivers people to a hi-rise rather than take them away, so it was a bit of a novelty for all involved.

They lived in separate apartments but we escorted them the the mom's place where they would rest. They loved the attention, and we felt good helping people in a different way for a change. I saw some coloring books on the kitchen table as the mom rummaged through her refrigerator looking for something to feed us.

"Do your grandchildren visit?" I asked, pointing to the crayons.

"We like to color, " the daughter explained. Keeps us from going nuts!"

Brian saved his orange for later. When he did eat it, he said it was especially delicious.

As for me, it was nice to have a mother to take care of again, even if only for a little while. But it was even better having one take care of me.

To be part of the EMS machine, or not to be. That is the question.*

Case in point; Two college aged females are in the rest room of a local college. One is vomiting, the other helping. One is intoxicated, the other appears not to be. College security happens upon the females and initiates the 911 system. A rescue is sent for "an intoxicated female."

Upon arrival, after searching the campus for five minutes due to erroneous information concerning the location, two security officers inform the EMS crew that both females are intoxicated and must be transported to the ER for evaluation. The EMS crew thanks the security officers, and escorts the females to the rescue, which is on a city street, away from the campus. Security insists that EMS transport to the ER. The coherent female informs the crew that she has contacted a friend and he is on the way to take them home.

Utilizing their considerable training and common sense, the EMS crew contacts the friend via cell phone, confirms that he is indeed on his way to the location, and decides to transfer care to a responsible party.

The friend gets lost . Meanwhile a two-alarm fire breaks out a mile from the incident, rescues are needed. The EMS crew meets the responsible party a few blocks away, confirms the ability and desire to take care of the situation and releases the patient. There are now two responsible adults looking after the mildly intoxicated female while the EMS crew responds to the fire.

Make sense?

Hell no!

Bring the intoxicated female to the ER where she will be ignored by the extremely busy staff until she passes the breathalyzer, then release her to her friends after charging her insurance company $400.00 for the ambulance service and another thousand to the hospital.

The nanny state works, for some anyway. As our health care costs escalate, and people are forced to do without or sacrifice other necessities to keep it the machine keeps chugging along.

As for us on the streets who might be able to make a difference?

Not a chance.

Well, maybe a little one.

I've got some typing to do. It seems college security doesn't like it when we don't do as they command.

* Hypothetical question as always