Our Mission: Liberate the Power Ranger from Marcus, the leader of a nefarious gang of three year-olds with a penchant for beheading the Rangers and stuffing them up their noses.

Objective: Release the head of the Power Ranger from the cave and reattach to his body.

Obstacles: Nasal mucus, boogers, an uncooperative mastermind, an adult male and female servant watching our every move.

Weapons: Our minds, and a pair of stainless steel nostril pluckers

First attempt: Failed. Using Intel gathered from Agent Brian's memory bank, we had the male adult servant place his mouth over the tyrant's mouth, pinch the non-occluded nostril and blow. Two attempts ineffective, but snot did fly.

Summary: Total nostril occlusion necessary for successful liberation.

Second Attempt: Success. The tyrant's servants immobilized him temporarily, and using the stainless steel nostril pluckers the Power Ranger's head was liberated from the cave. CPR performed on unconscious Power Ranger, head re-attached, last report in critical but stable condition.

Conclusion: The outlaw confined to his room for unspecified period, Power Rangers retreated to secure location in a box on top of the refrigerator.

Over and Out.

Tonight, I wake without the tones. It is a bitter awakening, opening my eyes and knowing quite certainly that I am dead. The hunger is constant, the daily need to feed the only reason to continue this existence. That, and I kind of like it, once I make my daily peace with my being. A vampire can only tolerate a few moments of self loathing a day, before nature takes over, and our egos dominate. 

My hole is just that, a hole, at the end of a narrow passageway, some half mile long, one of scores that web through the underground of The Outpost. I do not think of those who used these catacombs before me, I am all that matters, the others dust, or apparitions in somebody else's nightmare.

I'm cold. I'm always cold, except for the moments of ecstasy when fresh blood enters my withering veins. It matters little whose blood, or the age of the victim when it comes to sustaining what I refer to as life, but now and then a vampire needs a little change of landscape, if you will. Tonight, I hunger for Scotch, a single malt preferably, but a nice blend will do. Considering I no longer drink, I need to find an inebriated person who has tipped a few too many.

Crawling from the dirt, shaking myself off and moving into the corridor where I can stand things come into focus. I find my way through the maze, and come upon the main artery. A wrought iron gate waits at the far end, I make my way toward it. Angus joins me, shaking dust from his uniform.

"Tonight, we prowl, my young friend! The waterfront awaits!"

"You truly shouldn't drink," says Angus. "It makes you crazy."

"I like being crazy. It keeps me young!"

As we approach, the gate opens, it's hinges creaking, squeaking and crying. We step through into a box car elevator, and Angus grasps the ropes that are attached to pulleys, and raises us fifty feet to the sleeping quarters.

My room is empty, as it should be. The day shift has cleaned my uniform, it hangs in my closet, freshly pressed and smelling faintly of starch. Excellent job, I must tell Tim. The shower room is just outside the door, I strip yesterdays' clothes from my dead body and deposit them into a hamper, where they will sit until tomorrow.

Showers are fabulous things, and I love the feeling of scalding water as it runs through my hair and down my body. Soap isn't too bad either, I lather up, and prepare for tonight's festivities. It does not take long.

"Rescue 1, respond to Route 66 for a motor vehicle accident, possible tipover."

The apparatus floor is deserted. Engine 13 sits quietly next to the Ford, which flickers, fades and rematerializes into the Cadillac. Angus joins me, taking the driver's seat as always, the overhead doors rise and the night is ours.

Highway 66 runs east, twisting  through our little town, many turns and hills, treacherous to navigate, but quite fun as well. Angus takes the road as if it were alive, and in need of taming. The Caddy roars, tires squeal, skid, fishtail and straiten. I roll down the windows, and let the Federal siren mix with the Stones, Sympathy for the Devil as we speed through the misty mountain toward our victims.

"There, up ahead," says Angus, and slows us down. We approach the scene slowly, creeping forward until we stop just behind a disabled Tahoe, with a U-Haul trailer attached. The trailer appears damaged, a man in his forties is crouched next to it, inspecting the rear axle. A teenaged girl looks bored, and stands on the side of the road, twirling her long, blonde hair. She perks up when Angus approaches, and looks away when I draw near. Angus approaches the girl, I approach the man.

"Good evening, sir, what seems to be the trouble this fine night."

"Looks like a broken axle. I called Triple A, they should be along soon."

"We had a report of a motor vehicle accident on this very road," i say, masking my disappointment. There will be no meal here, lest I take some unnecessary risks. The hunger must wait to be abated, but the lake is closer now, i can smell the festivities, miles away.

"My apologies," says the man. "Some cell phone ranger slowed to a crawl when he saw us on the side of the road, he must have called 911,"

"His mistake. What brings you to Essex?" I ask, noticing the New York plates on the Tahoe and the IAFF sticker adhered to the rear window.

"Starting over. Leaving the city, getting back to my roots."

"Are you a firefighter, sir?"

"FDNY, twenty-eight years. Called it quits last week. I might be interested in joining your ranks if you'll have me."

Great. Just when things were going so well.

"You would have to meet with Sid."

"Sid?"

"Yes, Sid. He's the Chief of the Department now, going on six years."

"What happened to Charlie?"

"Old Charlie? He's around, gone senile. Tells crazy stories, stuck in the old days. I'd stay away from him if I were you."

I looked for Angus, and found where I expected, as close to the girl as he could get. The Triple A van appeared on the horizon, and quickly closed the gap between us and him. We bade the newcomers farewell, and retreated to the Cadillac.

"To the Lake, Angus, and forget about the girl, she's a baby."

"I was a baby when I died, then, Malcolm."

"Forever enshrined in a twenty year old body. It must be torture, all that testosterone clouding four hundred years of undead living."

"Four-hundred and twenty-three to be exact."

"Ah, to be young again, but enough of that, it's time to feed!"

We left them, unscathed by their first encounter with The Outpost. I knew then and there it would not be their last.

Kittens lapped the blood from the filthy kitchen floor. A one and a half-year-old cried in a sixteen year old's arms. The badass boyfriend stood by, glaring at her, at us and at the kittens. We had taken him last week for some ridiculous pain med seeking journey through the healthcare system. The patient stood on the other side of the kitchen, blood pouring from one of her fingers. One of the guys from Engine 14 had attempted to wrap the finger, she shook it off, started screaming and wouldn't move. Wasn't the first time for her, either, more like the fortieth.

She is just one of the mentally ill people who use the 911 system and emergency rooms like their personal nursemaids. I don't really blame them, they are highly medicated shells of their potential selves, now turned into barely functioning inhabitants of the inner city, their meager government payouts barely enough to keep them in cigarettes, booze and illegal drugs.

Somehow I managed to get her to walk through the bloody mess, through the gauntlet and into the driveway. She raised her arm above her head, started to cry and tried to take her granddaughter from her daughter's arms. I got closer, took her good arm and tried to walk her away. Blood had pooled on her hand and down her arm now, and she shook it at me, covering me in droplets of her blood.

"Scared of a little blood!" she laughed hysterically.

Well, yes, I am actually.

The police arrived and offered to use the tazer.

I wiped the blood away and grabbed her, and said let's go. Miraculously she did.

In the rescue she remained calm, and cried, and admitted to taking every pill she could find. We rewrapped the wound, she ripped off the dressings and shook her hand again, this time getting the blood all over the rescue, myself and Mike, my partner for the day.

"That's it."

I got up, grabbed her arm and planted her face down on the stretcher. We were getting ready to tie her down when she gave in, promised to "behave," and apologized over and over.

I don't know, maybe I was tired, maybe the whole scene just depressed me, but for whatever reason I let it go, wiped the blood off-again, and let he be. She sat on the stretcher for the entire ride to the ER, apologizing some more, trying to explain herself and her anger issues, cried, shouted, banged her hand on the stretcher but kept the new bandages in place.

She's sick, I suppose, and needs help. She lives in a crummy apartment, has a crummy boyfriend, a crummy life and blood drinking cats.

But her granddaughter is beautiful. For now.

I need to re-assess my value system concerning glove use. For years, the first thing I did before any and all patient contact was glove up. I just didn't feel safe or protected without them. Time and runs add up, after decades and thousands of calls my religions adherence to PPE policy went out the window, and I started my current philosophy concerning them. Selective gloving.

Bad idea.

*Trauma scenes-always

*When I can smell the patient before I see him- always

*Nursing homes-always

*MVA's-sometimes

*Medical Transports-sometimes

*Soft tissue injuries with no bleeding-sometimes

*Cute little old ladies-hardly ever

*Headaches,assaches, sniffles-never, but that is because I do not have to have patient contact, my partner does.

My partner is the reason for this post. I am responsible for his or her well being. I've been around the block once or twice, and should know better. Simply because I have witnessed seasoned trauma nurses, doctors and others skip the gloves during patient assessment is no reason for me to do so.

It is exactly those incidents where people I respected, and whose experience is far greater than my own would choose to forgo the gloves that started my less than stringent use of them. I think I am a good judge of who to glove up for, but the only good answer to any question regarding the use of them is to use them-every time. Period.

I have found that what started small, not wearing gloves every once in a while has blossomed into a wearing them once in a while routine, and that is simply unacceptable, mostly because I have noticed people around me with far less experience than I are wearing them less.

And while I'm being uncharacteristically humble, thanks, C-Bob.

Just to prove I'm an idiot I decided to obsess about my blood pressure. First, I checked it in the rescue in the middle of a twenty-four hour shift. 148/90. Then, I did it at the hospital. 144/92. Then I did it again, and again and again, switching from the rescue to the hospital, always with the same results, 140's over 90's.

Being the OCD type, I took this little obsession home with me, and when at the local CVS or Walmart stick my arm into the Accu-Check machine. 120/80. And again, 118/76. And again, 128/80. We have a centuries old BP cuff and stethoscope on the top shelf of our linen closet, pilfered from one of the kid's Ken and Barbie play doctor sets, and utilizing my lovely assistant, Cheryl, would hold blood pressure clinics in my kitchen. 120's over seventies every time.

Very interesting.

I had a doctor's appointment, and lo and behold, back to 142/92. The doctor suggested medication, I decided to walk faster and eat less. A few weeks later, same deal, at work 140's over 90's, at home 120's over 80's.

This was puzzling. Hmmmm, I said to myself, and slept on it for a few weeks.

We had a mutual aid call to one of the suburbs surrounding Providence. Never one to let an opportunity pass, I stuck my arm in the rescues machine, and viola! 120/80.

With a new hypothesis firmly entrenched in my noggin, I visited a CVS in Providence. 148/96. My doctor's office is also in Providence.

Through sound scientific expirimentation and using a dummy (yours truly) as a test subject I have reached the conclusion that Providence, in and of itself causes an increase in ones stress levels.

Therefore, in conclusion, I have surmised that walking faster, eating less and avoiding work is the only rational answer.

Step 1-check

Step 2-check

Step 3-damn, I need the check!

The crash happens right across the street from the ER. A little old lady is bleeding from a small laceration on her head, but that is the least of her worries. A few hospital employees, well trained and well meaning are giving the patient emergency care prior to our arrival. One holds pressure on the woman's head, her vice-like grip possibly causing brain damage, the other provides c-spine immobilization, and quite a job of it, I must admit.

They appear annoyed at my presence, and directions, unwilling to give up the scene. The damage to the little old lady's car is minimal, she is not complaining of anything other than her head being pushed in and the neck being stretched. I ask if she has any issues with osteoporosis or arthritis. She does, scoliosis and severe RA.

The new emergency responders reluctantly make room for me as I get in the back seat and put a pedi-collar around my patients neck, thank the others for their help and get ready for the stretcher.

"Are you going to use a KED?" one asks.

"A what?" I reply.

"You need a board," says the other.

"A what?" I reply.

I run my hand down the lady's back, feel the curve, don't feel any deformities, she doesn't wince or retract, and with help from my partner lift her out of the car and onto my stretcher. Then I give her a pillow.

The first responders are incredulous, and a little pissed as well. They shake their heads, and tsk tsk, and ask where my gloves are, and cross their arms and glare as we wheel away.

The patient is simply glad to be away from them-well meaning as they were- and in the safety of Rescue 1.

for more, pleas visit

http://ambulancedriverfiles.com/2011/09/25/spinal-immobilization-you-make-the-call/

A thirty-five year old guy sits in the lobby of a waterfront hotel, one shoe missing and bleeding from a cut on his head. Three police officers are with him, asking questions. I put a bandage on the wound and hand him an ice bag. The police ask the usual questions; how many assailants, can you describe them, what direction did they go after the robbery and assault. The man answers the best he can, doesn't want to go to the hospital. but his forehead needs stitches, and his head pain in increasing.

"I just paid three hundred dollars for some orthopedic implants for my shoes," he says, before we get going. One of the police officers who had been scouring the waterfront for clues hands him an IPad.

"I didn't find your cell phone, shoe or wallet, but this was under the bench you were sitting on. Is is yours?"

The guy thankfully takes the device, turns it on and looks relieved. We get him into the rescue, do the vitals and all, then drive 100 feet to the scene of the mugging and light it up with the side scene lights. Me and Brian join the cops as we search the area for his shoe, and hopefully his cell phone, and just maybe the wallet-minus the cash. After ten minutes we give up, hopefully with daylight the stuff will appear.

On the way to the ER the guy tells me he's from Georgia, visiting Providence for a builders convention downtown, staying until Thursday. Now, he has no cash, no ID, no credit cards, no phone and no way to get onto the Southwest Airlines return flight. He's truly stranded in Providence.

"Thank you guys," he says as we roll down the bumpy roadway toward the hospital. "You have been a lot of help, I really appreciate it."

Millions of dollars spent on advertising the city, hundreds of millions on a beautiful convention center, a sparkling new hotel lobby with a water view and some cops and EMT's bending over backwards to help a visitor from out of town erased by two thugs with bats wearing hoodies , and now a hundred bucks in their pocket.

Great work, fellas.

"He's dangerous."

"Robert?"

"Yes, Robert is dangerous, we all are. But Sid."

"Sid is not well."

"Have you known him long?"

"Centuries."

The night grew short, only an hour before the sun rose, and my waking hours ended. I long for the days when a sunrise would not be the end of me, a finite life preferable to this-dying every day at sunrise. The road flew beneath us as the Cadillac purred, racing toward home. Angus drove expertly, if nothing else, eternal life offers a man plenty of time to learn to drive properly.

"He's going to be a problem."

"He already is."

Sid the Vampire showed up in Vermont thirteen months ago, taking over the struggling volunteer Fire Department of Essex. The members that hung on did so out of fear, the ones that opposed the takeover slowly disappeared. Some, fascinated and entranced by the charismatic new, self appointed Chief served him and his minions, keeping the Outpost safe for the nest of us who found refuge in the deep underground lair that lay hidden under the apparatus floor.

"I don't mind drinking the blood of our victims," said Angus. "And now and then if one dies that should have lived, well, that is unfortunate, but preferable to the slaughter that preceded our New Order."

"Things have become less bloody," I agreed. "But I must admit, Sid has brought some fun back into being a vampire. And, the seemingly inexhaustible piles of money he spends on the department haven't hurt the townspeople."

"He kills the townspeople!"

"Not all of them."

"Malcolm, you are truly mad. Sid will be our undoing. He is too reckless, too engrossed in his own grandiosity to see the big picture. You would be wise to oppose him, before it is too late."

"I do not wish to lead, my young friend, just eat."

The overhead doors at The Outpost opened, and the ambulance was swallowed into the dark, cavernous inside of the station. The Vampyros were still out, feeding on the victims of the latest fire, no doubt, concealing their ancient bodies among the smoke and ashes, working along side the mortal firefighters, but unseen by them as they danced through the smoke and flames, feeding.

Tim and Billy waited, ready to take control of the rescue. The form of the old ambulance shifted when Angus and I left and the gray traces of dawn tinged the eastern sky, and handed over control for the day shift, transforming into the Ford F-450 the townspeople had purchased with their fire taxes. They captured a glimpse of the Cadillac from time to time, but it was the last thing they ever saw, before eternal darkness.

Soft, muffled sobs,

private sounds of desperation,

for how long I don't know,

I was asleep.

Pain there,

pain and sorrow,

kept hidden,

allowed escape in solitude

lest the rest worry.

My eyes stay closed,

my body still,

my mind blazing

and hot

ready to explode,

and free the river of tears to join hers,

but I'm afraid.

Afraid they will never stop.

Under covers and still; we're equal,

our thoughts follow similar paths,

I'm by her side,

not twenty feet ahead,

impatient, waiting.

Always waiting.

our breathing synchronised,

our hopes and dreams similar,

but oh so different.

I dream of the day we walk together,

through the sand,

toward the sea,

soft, gentle breeze

taking some of the sting

from the sun's blistering rays

as the salt air draws us closer

to the ocean,

the sand burning our feet,

hopping,

running perhaps,

toward the soothing water,

where waves crash on our legs,

the earth moves under our soles,

taking our dissapointment with the grains that tickle our toes

out to the ocean

where it dissapears,

drowned in a sea of similar troubles,

and cleansed,

and brought back,

each wave

taking a piece of the disease with it,

and dumping it

where it sinks to the bottom,

and dies.

She just wants to walk again,

throw her cane into the ocean,

somebody to share her tears,

and hold her,

and not pretend they are asleep.

Ten years fighting a war that has lost the interest of the American people does not diminish the sacrifice, hardship and isolation those who have chosen to fight that war endure. Our soldiers are still there, still in harms way, and still doing the job they were sent to do. Eighty-six US troops had amputations in 2009, 187 in 2010, and 147 so far this year.

"Military doctors told a Pentagon news conference that while the severity of injuries was going up, the rates of those killed in action was going down.  They attributed the improved survival rate to improved care both immediately on the battlefield-such as applying tourniquets-and in their later care."  AP

My brother leaves today, his fifteen day leave spent with his family, catching up on things, taking care of business and trying to relax. His months in Bagram, Afghanistan have felt like years, and he will be there until February, when his year long deployment is through. The Taliban is still active there, and probably will be long after we leave. There are rocket attacks, roadside bombs, handmade land mines and other explosives to contend with, a population that truly doesn't understand why we are even there, but are more than willing to take everything we are giving them, including our lives and limbs.

One of the firefighters stationed at Camp Sabalu-Harrison, a prison camp in the middle of nowhere, but close enough to Kabul to have plenty of combatants running around lobbing bombs gave him a t-shirt to bring home for me. I'll be wearing it under my uniform shirt till it wears out, in brotherhood and appreciation.

Life goes on here at home for us, days and weeks flying by, but for those fighting our war, time crawls and seems to stand still. For some, standing still and crawling will continue long after our war is over, but  theirs goes on long after they have come home.

February will come, and my brother will come home, God willing, and he and all of our soldiers will get back to their lives, some staying in the military, some retiring, some continuing their national Guard duties. All of them have my deepest respect, and sincere thanks.

Stay safe, get the job done, and come home.

She pulled the safety pin out of her arm and handed it to me. Blood poured out of the hole, running from inside her elbow to her wrist. I handed her a few 4×4's.

"Thank you. You're going to get blood on your sweatshirt." It was a New York Yankees sweatshirt, but still.

She took the gauze pads from my hand and placed them on top of the hole in her arm as I threw the pin into the sharps container. Her other wrist showed old wounds. She is a cutter. Now she is self piercing as well.

We had left the group home minutes before, after the police had escorted her out following some behavioral issues. She was on fire then, full of anger, still hot from whatever had happened inside. It wasn't my first time with her.

"You look sad, Shantee, not mad." She stared into space, stone face in place, not blinking, not showing anything, she thought, but the mask was getting tired, her facial muscles giving in to the true feelings she tried desperately to cover with her self-mutilation. "What happened?"

Nothing.

"Is it everybody there, or just the lady working tonight?" It was always the same attendant whenever I was called to take her away.

"I don't like any of them."

"Have you tried to leave?"

"I have nowhere to go."

"Another group home maybe."

"Nope."

"You need a plan."

"I have a plan."

"And what is that?"

"I plan to die."

The way she said it stunned me, no emotion, no drama, just the facts. I've seen more than my share of hanging bodies and overdoses to not take her at her word.

"That is a terrible plan."

Nothing.

"I wouldn't want to be eighteen again for all the money in the world. A lot of people feel the same way. It sucks. And those kids you see on TV, and school, all cool and everything, without a care in the world, going through life without a care, two parents, maybe a car and a boyfriend? It's bullshit. It's a lie. Everybody hurts, they are just better at hiding it. There is always sadness, it's in all of us. You just got a little more. But there's another side, and you can find it, and you will, just don't give up."

The truck was backing in to the ER now, my time was nearly through.

"I'll tell you one more thing," I said as we walked out. "At least you're honest. That's a lot more than most of us have, so busy trying to look happy and all that bullshit. Stay honest, and don't let anybody lie to you, and I hope you will be okay."

Nothing. She followed me in, and sat in "the chair" and stared into space, lost again, wherever she goes.

Two hours later I brought another patient in. Shantee was still sitting in the same spot. She didn't expect to see me, and when she did, the most genuine smile I have seen in a long, long time brightened her face. She kept it for a few seconds, met my eyes, then looked away. It was completely spontaneous, and totally honest.

And it made all the bullshit go away, and made me realize why I'm here. I just may have saved a life tonight, and it didn't take any meds, or defibrillators, or rapid interventions, just good old emotion and honesty.

A picture says a thousand words. Click on the image to get the whole view.

Near catastrophy on Rt. 95 this morning. Thankfully there was no passenger to stop the errant tire that was flying down Rt. 95 after falling off of a truck. The driver is fine, and was reportedly at the closest 7-11 buying lottery tickets as of this writing.

Smoke still rose from the building as the firefighters chased sparks and opened walls and ceilings. The siding had melted or burned, the roof had a nice neat giant hole in it compliments of Ladder Co. 6. It was a tricky fire, a front to back duplex, took a while to bring under control, but ultimately was extinguished.

The sign on the pole magically appeared sometime during the fire. Opportunity knocks, or creating an opportunity, I don't know. Whichever, it was another great stop by the PFD.

http://newsblog.projo.com/2011/09/fire-displaces-five-residents.html

The baby wouldn't stop crying. It was three in the morning and he usually sleeps all night. The baby's mother, a baby herself called 911. He lived in a crummy third floor apartment, dirty clothes, dirty mattresses on the floor, broken chairs and not much else.  At least six skinny kids were running around when we arrived, and three generations of mothers, under forty. Some kittens lay in an empty litterbox outside their door, dying, one of them already gone.

"The bitch don't feed 'em, out runnin' around all night," said one of the mothers when I asked, the one in the middle it appeared.

The kids that were not sick didn't take their eyes off of us as we did a quick assessment of the infant and carried him outside. One of the mothers came with us, the one in the middle, and the other two went back to bed, leaving the kids and kittens to fend for themselves.

                    P_{rovidence EMS}

                     No Guarantees

American's have grown soft. Our nation once prided itself on rugged individualism. Now, people pride themselves on how much they can get for nothing. My little corner of society, Emergency Medical Services is not immune to the deteriorating condition on our people's pride, courage and steadfastness.

I have decided to act. Over the last ten years I have formulated a plan, and last night succeeded in overthrowing the EMS Czar from his throne at City Hall. I am now the Supreme Being, and what I say goes.

In addition to being brilliant, handsome and charismatic, I am also quite humble, therefore, I have organized a group of select people, the Providence  EMS Committee of Excellence.

We are committed to turning our once great land around, using EMS as a model, and bringing it back to what it should be, a land of opportunity, not a land of guaranteed comfort.

*Lawsuits will not be tolerated

Our Mission Statement: No Guarantees

We will gladly answer all calls for help from any person in our jurisdiction who needs it. We reserve the right to decide who needs it. If you think you need it, but we decide you do not, and you die, we are sorry. There are no guarantees in this life, but we do promise to do our best.

Effective immediately, citizens will be required to answer these questions to our satisfaction before Level 1 resources are committed to their cause:

Level 1

-is your life in immediate danger

-will our services prolong or improve your life

Unconscious persons also fit this category unless unconsciousness irrefutably caused by excessive alcohol consumption.

If the answer to these questions is yes, we shall respond.

There will be no charge for these responses, and immediate dispatch of appropriate personnel and equipment will be implemented.

All other calls will be handled by our Level 2, 3, and 4 response teams, and will wait until we can get to them, in the order of importance.

Level 2,

Abdominal pain, headaches, persons who "think" they had a seizure, weakness and dizziness and all the rest.

Patient will be responsible for the cost of these services. We have prepared a graph outlining the most recent charges associated with these medical calls.

Level 3,

Intoxicated, unconscious or not. This may or may not be transport to holding cell by Providence Police.

Patient will be charged for the cost of these services, and an additional fine, which increases at the rate of twenty percent per incident. When a person reaches $1000.00 he or she will be incarcerated until fees are worked off or paid by responsible party.

Level 4,

Rides to Emergency Rooms for STD, UTI, minor cuts and bruises, etc.

Cash on Delivery at current taxicab rates

Please be aware that we can and often will say no.

This program is a work in progress, improvements will be implemented as soon as the committee thinks and approves of them. Suggestions welcome.

"Why did you call?"

"My pancreatitis is acting up."

"Didn't I take you to the hospital for the same thing last week?"

"Yeah, and they didn't do nothin'"

"What did you expect them to do?"
 

She looked at me as if I were mad. Shelia, and people like her crowd our emergency rooms with their demands. Her pancreatitis is a direct result of her chronic alcohol consumption, which she refuses to stop, or slow down despite numerous doctor's recommendations and orders that she do so.

"They're the doctors, they should know how to fix me."

They're the doctors indeed, and they do know how to fix a lot of things. Doctors orders need to be followed if there is to be progress in a person's recovery. Ignoring those orders, then complaining you weren't fixed isn't going to solve much. If I had a nickel for every time I had somebody in the rescue who complained that the free medical care they were getting was worthless-I'd have a lot of nickels. People don't fill prescriptions, even though for most of the people who frequently call 911 they are free, don't lose weight, don't quit smoking and keep on drinking, and expect a doctor to miraculously make them feel better.

"And I ain't going to St. Closest, they don't do nothin."

"If you ain't going to St. Closest, why did you call 911."

Another blank stare. "Why don't you take me to St. Farthest, you ain't doin nothin'."

"Either get out or quit complaining, it's up to you."

She chose to stay, and get her pain meds at St. Closest. Then go home and wash them down with some vodka, and throw the doctor's orders away.

"Angus! Make haste, I feel the victim is one of my brethren!"

Five hundred horsepower roared through the Cadillac, I felt the engine's power course through my being, entwined; modern science and ancient magic. The two could easily be confused by the uninitiated, try and explain the workings of an eight cylinder engine to a fifteenth century farmer without magic being considered.

The hour grew late, the later it became, the earlier it got. One such as I must be ever watchful of the fleeting hours of darkness.

The roadway was clear, the evening quiet as we roared toward the motorcycle accident. A bend in the road, some taillights, a few bystanders and we were upon it. The highway patrol had yet to arrive on scene. The smoking ruins of what once was a Classic Panhead lie in a ditch that lined the road, its rider some fifty feet away. People stood close, one brave soul knelt next to the body.

"I think he's gone, he's not bleeding, and I can't feel a pulse."

"Thank you sir, we'll take it from here," I said to the gentleman who had stopped to render assistance. Angus had retrieved the stretcher from the rear compartment and rolled it next to the victim. I touched his face, his eyes immediately opened, and a fanged smile crossed his lips.

"Robert."

"Malcolm."

"You look well, all things considered."

"The moose took the worst of it," he smiled.

"He must have lumbered off to the woods to lick his wounds. You must be careful, these roads are treacherous."

"The most treacherous thing on these roads tonight is a vampire on the way to a fire! Get me out of here, I need to get to the Outpost, the boys await!"

We lifted our patient onto the stretcher and rolled him past the growing spectators. Once in the privacy of the ambulance, Robert dusted himself off.

"The tones went off twenty minutes ago, a vacation home in Essex burns, there may be blood left in the victims."

Angus had the vehicle rolling through the hills toward The Outpost. The stars at this time of the moonless night reached out to us as we traveled the lonely road, giving the appearance of space travel. I once drank the blood of a boy on acid, and the trails were similar. I enjoyed the flashback as we sped through the night.

Nestled amongst the hills was our destination, a timeless structure, made of stone, with two overhead doors newly added. The Outpost had been in this spot for centuries, taking many forms since it's first incantation as an alter for the animal sacrifices done by the natives to appease their gods. The latest incantation, Outpost 42 had been in existence for little over five decades, but time moves slowly here, and things are not as they seem.

"Thank you, Malcolm, Angus, see you at the big one!" Robert exclaimed. The overhead doors crept open, and the old engine roared to life. The Vampyros had awakened! The engine flew out of the station door, flames trailing, leaving a smokey trail that slowly vanished into the atmosphere. They would be first in, they always were, and be gone before real help arrived. Malcolm's crash just made things interesting, and the Vampyro's loved a challenge.

We're on the ramp at Rhode Island Hospital waiting for the next one. A still box comes in on Manton Avenue. Engine 14 is first due, the 15's, Engine 8, I think, Ladders 6 and 2, Rescue 2 and Special Hazards.

A minute passes. The radio clacks on. This is what I remember hearing as I contemplated dinging the fire. There were already one rescue on the way, and another would be called for the second alarm, probably not us, but  like to be close by at fires.

"Engine 14 to Fire Alarm, Code Red."

"Engine 15 has the water."

Some time passes, not much.

"Engine 14 to Fire Alarm, fire on side 4, first to third, six unit residential, unknown occupancy."

"Engine 15 to Fire Alarm, I need a ladderman with a saw on side 3."

"Ladder 2 Received.

A few minutes go by.

"Manton Command to Fire Alarm, heavy fire on Sector Three and the loft, and an exposure problem on side 2, give me a second alarm."

A few more seconds go by.

"Engine 14, charge my line."

"Ladder 6 on the roof."

"Water on the way."

"Engine 14 to Fire Alarm, we're on the third making progress."

"Engine 15, charge my line."

Forty minutes later the fire is called under control.

If not for an aggressive interior attack and experienced firefighters we would have lost the block, maybe more.

When I heard the chief on the radio saying heavy fire on the third and loft with exposures, then a minute later heard Peter on the third floor with his crew making progress, with the Fifteens ready for water right behind them, I was filled with pride, and said out loud to Brian, "those guys are good." And they are good, every one of the people I work with.

Thanks to all of you for making being a firefighter in Providence mean something.

Great Job, people!

http://bigdogfirephotos.smugmug.com/2011-Fire-Incidents/2nd-Alarm-Providence-RI-288/19006467_6HzF8s#1476783099_PK44Gk6-A-LB

In the quiet moments between calls the pieces begin to fall into place. The giant file cabinet that is my brain opens, and the smells, sights and sounds find their proper spot. Emotions need to go as well; can't be carrying those around for the rest of my life, there will be plenty more dragged out of me and filed away, just as these most recent must be.

I do not have a recycling bin available, everything must stay. But some files run deeper than others, and are more difficult to access. Some are missing, and hopefully will never be found. Others need to be in front of the rest, the good ones, and there are plenty of those.

As the years add up and the files grow, it becomes more difficult to put things away. Worse, the old files spill over, and start to interfere with the new ones, and things carry a much heavier load than they should.

Too bad I can't simply buy more memory, and have it installed. It would be nice to speed things up, feel young again and work without the old memories slowing me down.

I think my head is going to explode.

Instead of designing a power point presentation for the Trauma Care Conference, I’m writing Vampire stories; (no I’m not, just transcribing something I found)watching YouTube videos; (at least I finally learned how to play Spanish Romance on Acoustic Guitar) and writing blog posts.

You want trauma? I got your trauma, right here!

But anyway, have no fear, the old noggin is an empty, scary place, but my super-sized ego will never permit the other half of my brain to get in front of two-hundred and fifty people unprepared. I’ve got a little more than two weeks to get this done, but I’d be lying if I said it wasn’t weighing heavy on the old Lieutenant almost Captain.

All kidding aside, I’ve found that the best way to stay sharp is take a walk outside of your comfort zone every now and then. These walks are what found my family, got me onto a fire department, made me a rescue lieutenant, wrote me a book, got me to start, then twenty-five years later quit drinking, and a few other things I’d best not mention here until I safely retire and they can’t fire me.

Told you I had a super-sized ego. Thank god for Cheryl, she keeps me grounded, and if it were not for her, I wouldn’t even get out of bed.

And that is the truth.

A car taps another car on Broad Street. No visible damage. Four "victims" from car one c/o neck and back pain, three victims from car two join the parade when they see the mass casualty response. Seven rescues, major traffic tie ups, ER overflow and wasted time.

A jeep rolls on the highway, major damage, glass and car parts everywhere. Driver stands next to vehicle, refuses treatment or transport, no injuries.

Who is kidding who?

She is twenty-three and waiting on the sidewalk, beautiful girl, long dark hair down to her waist, pretty eyes and a giant smile. We look at each other, trying to figure out if we know one another, and if so, how.

"She's in here," she says after a moment, and leads us inside. The house on Daboll Street has seen better days, the paint is peeling, railing loose, some cracks in the foundation, but clean and comfortable. We walk up a narrow, freshly swept stairway to the third floor where "Mami" sits in a kitchen chair looking at us as we approach. "She had dialyses this morning but doesn't feel good, she's dizzy and has been throwing up."

Mami looks terrible. She's sixty-five, and tired. Kidney failure is simply awful, the Dialysis Centers a difficult place to spend three hours a day, three days a week getting dialysized. The young girl has all of her grandmother's medications ready, and gives a concise history in perfect English. We get the chair ready, lift Mami into it and lift her up and carry her down. It's been a long shift and the stairs seem endless. I'm walking backwards, one step at a time, the walls holding me upright as we descend. I'm thankful for the cleanliness, some walls in the places we go are alive with bugs and other things.

We start some oxygen and attempt an IV, test her blood glucose and run an EKG while the granddaughter watches. She is fascinated by the way we work, and asks a lot of questions. A light goes off in my head.

"Yolanda."

"It is you!"

"Your hair grew."

"It's been a long time."

She grins, I grin, everybody grins, even Mami, but she has no idea why.

In 1993 I spent six weeks reading Dr. Seuss books to an ESL (English as a Second Language) kindergarten class in one of the toughest schools in the city. It was a program designed to get police and firefighters into the city schools to be role models.  was supposed to follow a set course, starting with The Cat in the Hat, Green Eggs and Ham and some others. I never understood those books when I was little. I still don't.

I loved those kids, the teachers not so much. It was pandemonium after the first week, once we got comfortable. I wanted to make a good impression so I wore my dress blues to class, and I think I scared them at first, until they got over the fancy suit and realized they had a marshmallow on their hands. I would read a page or two of the good doctor, figured if I thought the stories were stupid, the kids who barely spoke English must hate them too, then let the hour descend into chaos as we told stories and drew pictures and goofed around.

I was not invited back, but made some great little friends. I would see the kids, about fifteen of them from time to time over the next few years while on calls to their schools or homes, or even on the streets. Every now and then I'd be doing something on a rescue run and some little creep would appear out of nowhere and give me a hug. Of all of the things I've done while on the job, that experience proved to be the most rewarding. Eventually the kids got older, and I stopped seeing them, and time progressed and they grew up and moved, or disappeared. I hadn't seen one of them in years.

"I still don't like Dr. Seuss," Yolanda says as we get out of the rescue and wheel her grandmother in.

"Me neither."

"The Grinch is pretty cool though."

"I love The Grinch!"

She's too old to hug now, too much time has passed, but that smile of hers will stay with me forever.

I was walking through the Vermont countryside when I happened upon a deserted fire station. A door hung loose from its hinges, so I stepped inside. Something wasn't right, the air was fetid, cold and dead. An antique fire engine sat idle on the dilapidated apparatus floor, decades old turnout gear sitting at the ready next to it, rotting where the long dead firefighters must have left them. I pushed through the cobwebs and found a lantern, struck a match and lit it. The sun was setting, noises from below filled the cavernous space, and the need to get back into the waning sunshine overwhelming. As I hastily made my way back outside I stumbled upon a centuries old desk, and on that desk was a tattered wooden box, and inside that box page upon page of written words. Here are the first of those, as I transcribe them:

Vampyros

by Scott Bon Halen

The tones bring me to life, bright light illuminating my space, blinding, painful, but not as deadly as the sun. My shift began at sunset, I've had many years to gather willing substitutes for the daylight hours. The city waits, vibrant, alive, pulsing with energy. Some poor soul called 911 at feeding time, and I shall respond.

Angus waits on the apparatus floor, the motor of the Cadillac Ambulance purring. A step on the gas and we are in motion, flying through the deserted mountain streets toward the southern part of The City of Hendrix, the wind cries as we speed toward the nightclub district.

"Have you eaten?" I ask my charge. He nods his head, and we say no more.

A young girl has drank too much at the dance club, her friends have deserted her, she lies against the wall of the club where she had her last drink, vomit staining her dress that is little more than a cleverly designed handkerchief. A police officer stands nearby, and walks away as we approach, slapping his nightstick repeatedly into his palm. A steady rhythm from inside the club fills the cool night air as we descend upon her, trancelike, rhythmatic and electrifying.

"Pretty little thing."

"She has no identification," says Angus as we lift her onto the stretcher and into the rig.

"Too bad for her."

Angus leaves me as we drive toward the hospital. I fish a twenty-two guage catheter from the compartment, tie a tourniquet around her arm, tap her hand gently, disinfect the spot I've found with an alcohol swap and sink the needle home. Blood fills the reservoir, beautiful, young blood, a crimson delight. I attach the tubing to the end of the needle and watch as her essence fills the plastic, rushing toward the open end. I close my lips around it, shut my eyes, and drink.

It is intoxicating. Her blood alcohol must be in the high two-hundreds. The mix drives me mad, the compulsion to drain her completely nearly overwhelming, but I know when to stop, and do so, as her blood pressure nearly bottoms out. I take the tubing from my mouth, toss it aside, and attach the IV fluid to the end of the needle and start the flow.

The hospital is busy, we bring her in and place her among the living dead who inhabit these halls, some old and diseased, some with holes from bullets and knives, others simply intoxicated, and low on blood.

I see my old friend Richard across the hall and give him a knowing nod, his flushed face mirroring my own, his hunger also satisfied for the moment, his victim covered with a sheet in one of the trauma rooms.

"Did he have a chance," i ask him as comes close.

"Yes, but I was starved."

"Be careful," I tell him, but he knows. We and the others have fed from our patients for centuries.

"There's a call on the highway for a motorcycle accident," says Angus. "Shall we?"

"We shall," I respond. "Dessert is served."

to be continued…

We are happy to announce our conference opening speaker…

Lt. Michael Morse of the Providence Fire Department, author of “Rescuing Providence”

Trauma Care Conference 2011

Life Changes in an Instant

Thursday, October 6, 2011
7:30 a.m. – 3:30 p.m.
Crowne Plaza Grand Ballroom Warwick, RI

Credits:

(Nurses/Allied Health)  5.5 Contact hours

(EMT Basic/Intermediate/Paramedic)  Approved for (5) Continuing Education Hours

Register Today!!  This conference sells out each year!

     Conference brochure and registration form available at:

     http://www.rhodeislandhospital.org/rih/services/Surgery/Trauma/conference.htm

I have graciously accepted an invitation to be the opening speaker at this year's Trauma Care Conference. My staff is busily preparing my opening remarks and should have a draft ready for my perusal in a few weeks. (I have forty-five minutes to fill) Prayers needed, this is not my forte', but I couldn't resist the opportunity to scare myself to death.

Hope to see you there!

Life changes in an instant. For first responders, a tone or radio transmission is the beginning, then action, then reflection, and usually satisfaction, regardless of the outcome. We know that whatever happened on the other end of the tones happened before we were aware, and would have happened with or without us. We do our job, and put our training to use, and test our resolve, and put the pieces back together to the best of our ability. Whether that is good enough in the end is irrelevant, we can only do so much.

We are the first link in a chain of events. When the people we are called to help leave our care, they begin a journey of rehabilitation that will lead them through many doors, and many people. Some are good, some adequate, and some great. But all of us are only as strong as the weakest link in the patients recovery, and if the first link is tarnished and ready to break the entire chain of recovery is weakened, and all of the great things that lead to a patients successful rehabilitation may be compromised.

Though our time with a patient is probably the shortest of all the people they will encounter during their experience, it is the most important. First impressions are lasting, and there are a lot of people behind us that depend on that first impression being a positive and competent doorway into their part of the patient's care.