She called us because she was in severe pain. I didn't ask why she didn't have somebody drive her to the hospital when I found her lying in the front seat, didn't even think about it. Her husband and kids were standing next to the car, you could tell they were concerned. We wheeled our stretcher over to the car, transferred her to it and got her into the truck and did our things.

I am not a saint by any means. The words, "only sick people get the stretcher" have been uttered by me hundreds of times to various people who not only are looking for a free ride across town, but also want to take a nap on the way. I have no trouble walking a patient with no injuries and perfectly normal vital signs through the triage area and into the waiting room. I am not past standing somebody in the corner, but I just hadn't thought of that one.

She is my patient until the receiving facility signs my report. We sometimes transfer the patient to the hospital stretcher, or wheelchair, or seat in the waiting room, or this latest, stand them in the corner, then give the report. Depending on circumstances we leave the patient on our stretcher while giving the report, then transfer them to the appropriate spot, in the appropriate chair, bed or gurney.

I'm still thinking about the lady from my last post,   http://rescuingprovidence.com/2011/07/05/slammed/ A thousand appropriate responses have come to mind now that the incident is over. I should have completely ignored the person on the phone who told me to take the patient to the waiting room. I should have immediately found a stretcher for her and put her on it. If I failed to do those things, I at least should have told Young Nurse Ratchet to go away and found somebody with half a brain and an ounce of compassion, and have them do an assessment before telling her to get off the stretcher and stand if she couldn't sit.

But, not wanting to make waves, and always wanting to be "the good guy," I went along to get along. Problem is, I wasn't the "good guy," to the only one that mattered, the patient. To her, I was one of the douchebags, even though we had done everything right up until our last act, the one she will remember.

From this day forward, the patient in my care will be treated appropriately by everybody while in my care, and until I am out of sight.

That's right, everybody look at the bad guy!

The fire service has been very good to me. I've put a lot into it, taken every opportunity to advance, gotten the certifications and commensurate pay raises. Overtime is abundant. That was a bonus I never saw coming, when I was hired in 1991 there was zero overtime, and that lasted for years. As the years progressed the city didn't keep up with hiring and overtime was used to fill vacancies on our minimum manning roster. Some see that as a union money grab, but those same some would complain if we ran the department with volunteers.

Nonetheless, I've always had a job on the side. When I say always, I mean always. When I was old enough and would babysit, I got a paper route. When I stopped babysitting I did the paper route and cut lawns. Then cutting lawns and a job at the closest restaurant washing dishes. Then washing dishes at one place and bussing tables at another. That went from bussing tables to cooking at a third place, which metamorphosed into a cooks job while waiting tables, then tending bar by night and working construction by day. The construction thing led to some clean-ups, which led to my cleaning company by night and tending bar on weekends.

Eventually I was hired as a firefighter in Providence, and I tended bar on weekends and cleaned offices at night to subsidies the six months of minimum wage I earned while in the academy. Once on the job I dumped the bartending gig and kept the cleaning business, which I did up until a few years ago. I've been doing the rescue and operating a tanning salon for the last few years, getting ready for my next transition, business owner and writer.

That's the plan, run the business with my wife and turn out bestsellers! Should be a hoot. I've been writing for free for so long now I haven't figured out how to get paid for it, but I'm hoping something comes up. My second book is millimeters from publication-more on that soon- and my OP/EDS have been keeping my name from being completely forgotten.

This latest,

http://www.projo.com/opinion/contributors/content/CT_tan2_07-02-11_O1OU40V_v10.3fcba.html

shouldn't have had anything to do with what I'm doing here, but of course some knuckleheads just hate it when a firefighter has a second job. They think we are all union automatons who have no right running a business. Well, what I do in my free time is none of their business!

Some of us work second jobs to make ends meet. Some do it because they know no other way. Some are happy to do the demanding hours at the station and leave it at that. Whatever works is what I say, and kudos to everybody who finds contentment with what they do.

This economy is brutal. Finding work is hard enough, running a business next to impossible, but I'm doing okay, and regardless of what the naysayers have to say, will continue to do so.

She was laying in the front seat of a car when we arrived, said he abdominal pain was 10/10, had a history of ovarian cysts and the pain happened suddenly, while she was walking to the car. She had spent the day cooking fish during a fundraiser, a fish fry, that raised a lot of money for a friend with cancer.

She was about my age, nice lady, obviously in pain, elevated blood pressure, increased heart rate, and she just looked like it hurt. She asked to be transported to a particular hospital, one on the other side of the city, because she knew what a nuthouse the closest one was on a Saturday Night. She was right, the closest was out of control at that moment, five rescues as a time bringing patients into the overcrowded ER, elderly folks from nursing homes, people who fell, the usual intoxicated people, diabetics, heart attacks, shootings, stabbings and every conceivable malady imaginable. I had been there seven or eight times already, the staff must be sick of me by now, figured a trip across town wouldn't be a bad idea.

We put her on the stretcher, lifted her into the truck, gave a little 02, reassessed vitals and got moving. Her family was great, appreciated our concern and professionalism. It was a good ride, no troubles, she told me about her medical history, medications and allergies, the usual things.

I called the hospital enroute to give a report.

"Bring her to the triage desk."

Should have known. Things went downhill from there. The place had plenty of stretchers, but for some unknown reason the triage nurse, twenty-five years old, a little more than a year at the ER decided that this was not a "legitimate" patient, and said,

"Put her in a wheelchair, I'll get to her when I can."

I had established a little bond with the patient by now, saw no reason not to put her on a stretcher, but it's their hospital, so I tried to accommodate.

"I can't sit down, hurts too much," the patient said.

"She can't sit."

"Can she stand?"

"Excuse me?"

"Can she stand?"

Me and Brian exchanged dumbfounded looks.

"Either sit on the wheelchair or you'll have to stand," Nurse Young Ratchett said to the patient.

"This is a terrible idea," I said.

"We're slammed." she said.

I looked around, They wouldn't know slammed if it bit them on the ass. The "other hospital was bursting at the seams, and the staff there was professional, courteous and competent, and even kind to every shooting victim, homeless drunk and psych patient we brought them.

"I should have gone to the other hospital," my patient said.

We lowered the stretcher and she tried to sit in the wheelchair while everybody looked busy. She couldn't do it. I found he a stretcher, put a sheet on it and wheeled it over. The triage nurse had recruited a team of cynics by now, I was the bad guy.

In twenty years I had never seen anything like it. I stood by my, now their patient's stretcher and apologized for the awful display. She was fuming.

Crazy place when the "good" hospital is not nearly as good as the one in the ghetto.

I'm in a pretty un-patriotic place right now, and I hate being here. I've got a brother in Afghanistan continuing the tradition of standing up for the citizens of this piece of land we call America, sitting in a god-forsaken mountain on a rock, no hamburgers and beer for him, the only fireworks the occasional mortar lobbed his way, or gunfire in the distance. It seems like nobody thinks twice about our people there. Now I know how my father felt when he talked of "The Forgotten War."

Here, people buy pretty packages of fireworks from roadside stands, get drunk and play with matches, leaving street littered with burned paper and fuses. It's not even a day off anymore, considering half of the country isn't working, and half of those don't even want to.

Health care costs have turned this place into The Socialist States of America, even without President O'bama's new plan. Half of the costs associated with our health care spending are absolutely worthless, the ailments, scrapes and bruises aches and pains the citizens who seek emergency care, and medication paid for by Medicare would go away in time, or are so insignificant are treated like a minor inconvenience to anybody with half a brain.

Government spending on everything but the basics is so out of control the basics are now unaffordable. Small business's can't compete with big corporations, colleges are full of kids having a four year party, knowing full well that when the party is over, it's over, there are no jobs paying enough to keep it going. It's back to mom and dads, and hopefully they will keep everything going until the whole thing collapses and we can start all over.

Have a nice day. And Happy Forth of July.

http://newsblog.projo.com/2011/07/providence-shootings-investiga.html

We found him laying under a box truck. I crawled under, dragged him onto a longboard and with help from Brian and the guys from Engine 13 dragged him out. Once illumination entered the picture, supplied from a streetlamp directly overhead I saw the lower half of his right leg soaked with blood, and more spilling from the top of his sneaker. A quick assessment didn't show any more holes, we lifted him onto the stretcher and put him into the truck. Rhode Island Hospital was less than half a mile away, we had two IV's, an EKG, some oxygen and him stripped down in the minute it took us to get there. The guys did a great job, it wasn't our first shooting, and won't be our last. Things go on automatic now, new guys fall into place after three or four, and the cycle continues. As long as they keep shooting each other, we'll keep plugging the holes.

"What happened?" I asked as the crew did their thing.

"I'm supposed to be going to a party!"

"That's nice, but how did you get shot?"

"I don't know, jus' walkin. Hey! Them IV's hurt more than the bullets!"

"Who shot you?"

"Don' know, I'm supposed to be goin to a party!"

Turns out there were three holes, I only saw two, en entry and exit in the right leg, and another in the left. One bullet, three holes. The slug ended up on the floor of Rescue 1, couldn't have gone too deep into the left leg, probably punctured the skin a little and fell into his pants.

The Trauma Team did their thing, he ended up in surgery -no pedal pulse- about fifteen minutes after we brought him in. The police tried to get some information from him, but the party story stuck.

An hour later, Rescue 1 responded to a shooting, a block away from the first.

Must have been some party.

"You are way to cute to be in a knife fight!"

She brushed a lock of hair away from an eye, sat a little more straight, gave me a beautiful smile and said, "you think so?"

"I know so."

She really was adorable. Nineteen years old, looked fifteen, t-shirt tied way up her waist, jeans painted on, barefoot and bleeding from a stab wound to her upper arm. If I could, I'd give her a day with my daughters and a fashion make-over and she would be much more than adorable, she would be beautiful. Probably wouldn't be getting into knife fights either.

A lady who looked to be twenty years old stuck her head into the rescue, behind her, a mob of fifteen or twenty people argued, shouted, swore and carried on like a bunch of fools.

"Who, are you?" I asked.

"That's my mom," said Antoinette. Can she come with us?"

"Of course." Antoinette shyly smiled and looked at her feet as her mother entered the truck, one hand waving and pointing, the other plastered to her ear, holding a cell phone.

"Yolanda, that you?" she said into the phone while sitting down next to the daughter she never looked at.

"You bitch daughter jus stabbed my girl…the shit she did!…My girl didn't have no knife, Yolanda!" She took the phone from her ear and finally looked at Antoinette.

"You have a knife?"

"No mama, we wuz jus walkin, me an everbody else, goin the Latisha's to get some clothes and this van pulled up an those people jumped out and one of them turned me around and Tiffany stabbed me!"

"You hear dat, Yolanda, she didn't do nuthin! Yolanda? Yolanda? Bitch hung up."

When we arrived at the ER Antoinette insisted on walking out of the rescue and into the hospital. I took her good arm and helped down the step. She didn't need to, but she held on to me until we were inside, then smiled and said thank you.

Her mother was back on the phone. The police arrived. Antoinette was alone again, with the mask firmly in place. But she did smile with her eyes when I said goodbye and walked away.

Rescue 1 Log  2 Jul 11

Night Tour

1607       76 Baker                      Seizure

1755       68 Searle                     Vomiting

1905       550 Broad                   Intoxicated

2032        500 Broad                  Miscairage

2127        1 Finance Way           Fall/Syncope

2212        76 Benedict                Abdominal Pain

2344        787 Broad                   MVA

0040        21 Peace                     Stabbing

0133         68 Althea                    Overdose

0221         Oxford at Eddy           Shooting

0313         12 Ashmont               Shooting

0405         Broad at Laura          Motorcycle Accident

0620         1 Cadillac                   Medical Alarm

Put a fork in me, I'm done….

"How is he?"

"He's in the hospital."

"Get out of here, how long?"

"Four days, be out Saturday."

"I'll go visit him."

"Okay."

I visited him. I've only met him once, he's a friends eight year old son.

"Hi Nick,"

He never looked up from the hand held video game he was playing.

"Hi."

"How are you feeling?"

"Okay."

"I'm your mom's friend, Michael."

"Okay." Still didn't look up.

"Do you need anything?"

"I'm good."

"Winning the game?"

"Yeah."

"Okay, I guess I'll go."

"Okay."

So I left. He never looked up. I got back to the rescue, and we headed back to the station.

"How is he?" Brian asked.

"Okay, I guess. He never looked up from his video game."

"Kids are obsessed with those things. They never get outside and play like we used to."

"I guess."

"What happened to him, anyway?"

"He was riding his scooter, holding a butterfly net with one hand, trying to catch a butterfly that flew into a tree. I guess he got jumbled up and crashed the scooter and fell onto the handlebar. He's got a lacerated liver."

"Should have stayed inside."

"I guess."

***URGENT***

ATTENTION ALL PROVIDENCE RESIDENTS AND VISITORS

An epidemic has descended upon the Capitol City. If you are a grown man, between the ages of forty-five and fifty-five you are particularly at risk. All others use caution as well, symptoms have appeared in persons both male and female, between the ages of seventeen and ninety-six. There has been an influx of unconsciousness associated with Government issued public assistance monies. Symptoms include, but are not limited to:

-slurred speech

-unsteady gait

-strong aroma of ETOH on person

-obnoxious behavior prior to unconsciousness

The epidemic appears to target the indigent population. Areas surrounding homeless shelters appear to be the hardest hit.

The latest information from the CDC shows a direct correlation between affected parties and the electronic transfer of taxpayer money to their accounts. Symptoms can take ten minutes to several hours to manifest into unconsciousness. It is suspected that once funds are extracted from area banks, either the currency or the subsequent purchase of substances are the cause of this emergency.

All area hospitals are at peak capacity. Emergency services are on high alert. Please stay indoors and avoid public places until this emergency passes, likely around the fifth of the month.

Thank you for your cooperation

The seven year-old let go of the stroller for a second, that's all, and it started to roll. Twin ten month old infants were in it, it gathered speed on the steep hill and headed for the street. Cars sped by, oblivious to the events taking place a few feet away. A neighbor screamed, the twins mother turned around and saw her babies rolling away, and her son running after them. At the bottom of the driveway, the stroller tipped over, spilling the little ones onto the street. 

We arrived a minute later and found a baby boy and a baby girl, their faces bloody and heads bruised, crying, their mother crying and their brother, crying. The stroller lay on its side, the wheels still turning.

I like it when they cry.  I don't like quiet, still babies and a screaming mother. You never forget that sound, never forget the people who were not so fortunate.

They cried all the way to the hospital. It was the nicest sound I'd heard all day.

The twins were active, fidgeting about, climbing all over their mother and terrified. I know protocol called for immobilization. Proper transport techniques called for another rescue, a papoose for each, separating the family and causing a lot of grief. My assessment indicated immobilization would be inneffective. The protocols are black and white. My brain works in vivid color. I put them in their car seats and secured them to the stretcher.

Sometimes it's better to be improper.

When I was a kid, television was a little different than it is today. At the beginning of a show right after the credits rolled, "In Color" would appear in big letters. Our TV was black and white. It used to drive me nuts that I couldn't get the color to work, I thought the TV was defective. I'd watch a show "In Color" on our black and white thinking some day I would fix this gross injustice.

Yeah, that explains it.