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

So I'm thinking, (something I do from time to time) and it occurred to me how easily the problem of transporting psych patients, combative patients and intoxicated patients could be solved. If we trained a police officer as an EMT, or an EMT as a police officer, and teamed them up as the Psychological Crisis Team, or something like that, and had them respond to calls for help from the aforementioned patients a lot of problems would be solved.

The cops are not that good at dealing with emotionally unstable people, The medics really should not be put in the position of restraining people, or fighting them, or doing the ridiculous things we do to get patients from point A to Point B with the least amount of damage to the personnel or patients.

They have police paramedics, but that is something entirely different from what I propose. I'm not talking about paramedics standing by at drug busts and hostage situations, rather the meat and potatoes calls that we risk ourselves on all the time. The ones that get no headlines, but are far more risky than the prolific "dangerous" calls.

Can we train cops to be medics, or medics to be cops? Are there people willing to do it?

I think it is worth a try, anything is better than being in the back of the rig, unarmed, undermanned and overwhelmed with a volatile patient whose demeanor has changed from docile to hostile right before your eyes.

Mediccops. I think it has a nice ring to it.

I've given up on pushing Narcan through an IV. Don't even try anymore. IM works just as well and there is no mess to clean up when the patient rips the tubing from their arm and runs from the rescue. Speaking of which, I've exchanged tactics there as well. Once, I would wrestle the patient, or plead with them to stay put, the Narcan has a short half life blah, blah, blah. Now, with the simple stroke of a pen and a simple, "STOP! PLEASE DON"T GO," boldly stated from the safety of my Captain' seat my efforts to restrain the patient are documented and I can get back to work without breaking a sweat.

My friend slipped and fell, hurting her wrist. I talked her into going to the ER, knowing that she didn't have much, didn't make much and needed treatment.

"They will take care of you, trust me, I see it all the time," I told her.

"I can't afford it," she said.

"Listen, every day I bring people to the Emergency Room for free health care. They go every day, day after day. Drunk mostly, but sometimes they are sick, too. They get x-rays casts and medication when they fall. I brink kids with fevers to Hasbro, adults with sore backs to Rhode Island Hospital so they can get free Vicodin, illegal immigrants for ass aches because they can't be reported, believe me when I tell you, they will help you. They will fix you up, they have to, it's a law."

She listened, and drove herself to the ER. If anybody deserved a break, it was her, and not the break in her wrist, as the x-rays showed- a real break, one that would keep her head above water, and allow her to pay the mortgage on the house she bought twenty years ago in Oakland Beach, the down payment and subsequent mortgage paid from her labor, not handouts. She works, cleans houses, babysits, bartends, whatever it takes. She's never grossed more that twenty thousand in any year, but still pays property tax, and now tax on her 1990 Jeep.

"How did you make out?" I asked next time I saw her.

"I broke it," she said.

"Why isn't it in a cast?"

"I don't have insurance."

"Neither does anybody else," I answered, a little perplexed.

"I've got a house. And an ER bill for $540.00. And a referral to an orthopedist that I can't afford."

"Did you talk with social services?"

"They found out I own a house and sent me on my way. There was a line waiting."

"I'm sorry, I thought they would help."

"I should have known better."

"Me too."

I gave her my Ibuprofen 800's. She is going to need them more than me.

She lives in the basement of her brother's house, in a makeshift room separated from storage by some hanging sheets. There's a small bed in her corner, and a dresser, a dirty mirror stands against a wall, clothes piled high.

"I live like an animal, wit the bugs and the dirt," she explains. "Look at dis place, the dust is on everyting, I cannot breathe."

She takes a puff from her inhaler to emphasize her claims, then coughs.

"But you can't beat your nieces."

"They don listen, having boys over da house, it is not Christian."

"But it's your brother's house."

"He doin the right ting, but he can't always be here, he has to work."

This wasn't our first visit here. A good man tried to help his sister who had been living in and out of homeless shelters in New York City. She is non-compliant with her medications, bi-polar and delusional. She preaches, once on a curbside in Brooklyn, now in a basement in Providence. Nobody listened to her there, now nobody is listening here.

Three teenaged girls stood off to the side as we walked their "auntie" past them and three or four police officers who had been called to keep the peace.

"God be watchin you sinners!"

"Bye, Auntie," said the youngest as the others looked into their IPhones. One of the girls had a swollen face, all three had been crying.

She preached all the way to the hospital. I wasn't listening either.

0330 hrs.

"Rescue 1, respond to 123 Manhold Street for a twenty year old male with a toothache."

"Rescue 1, Responding."

"Here's what we're going to do. When we get there, we kill him."

"They'll catch us."

"No they won't, and here's why. When we arrive on scene, we'll wait five minutes, then go over the radio and tell them we have a DOA."

"Won't work, they'll do an autopsy."

"Here's the brilliant part, we have the perfect alibi, we were enroute when the murder occurred."

"Maybe, it's just dumb enough, we might get away with it."

"It's genious is it's simplicity."

"Who kills him, me or you?"

"You, I'll be the lookout."

"I never killed anybody."

"Neither have I."

"Damn."

"Rescue 1, transporting one to Rhode Island at 0335."

I’ve had a little time to put together some of my favorite blog posts for something I’m working on and found an amazing thing. I’m losing it. Slowly but surely the passion has died as the years progress. It is obvious to me, maybe not so much for the casual observer, but I know what I see, and what I feel, and what I write represents only a small fraction of that, and a steady decline in compassion and empathy is blatantly obvious in my posts. I still manage to throw a good one out now and then, but the frequency with which a situation moves me to think and write about is far less than it once was.

Writing is only a small part of my concerns. If what I think and feel is reflected in what I write, then how I act in the streets is similarly affected. I know I drag myself through most days now, and barely pay attention on many calls. I don’t remember anything about my patients more often than I like to admit, not even their faces. I’m not at all pleased with this, and can only think of one good solution. Maybe it’s time to let the next generation take the reigns.

If you are considering writing a blog or a book, or anything at all my advice is to do it now, rather than later. Life moves on, the moment we are in is all that really matters, what we feel and think at the moment worthy of remembering. Rescuing Providence is in its twilight, and will probably phase out sooner rather than later. I’m happy I mustered the energy and creative force to pull this thing together, it’s been five good years, and a lot of good stories have been told, and I’ve kept myself amused during some pretty dark times, and for that I am thankful.

I didn't break rhythm, but was tempted to interrupt my cadence long enough to flick the linguini at the end of my fork his way. Instead, into the pie hole it went, and I kept digging. Its not like we have all day between calls to eat.

scoop- lift-open-close-chew-chew-chew-swallow-scoop- lift-open-close-chew-chew-chew-swallow-scoop-lift-open-close-chew-chew-chew-swallow-scoop-lift-open-close-chew-chew-chew-swallow….drink…scoop- lift-open-close-chew-chew-chew-swallow-scoop- lift-open-close-chew-chew-chew-swallow-scoop-lift-open-close-chew-chew-chew-swallow-scoop-lift-open-close-chew-chew-chew-swallow….drink…

If one more Ladderman, annoying cousin or wife tells me to slow down and enjoy my food, I may be forced to break stride and attack. You enjoy your food by chewing every bite 100 times, I'll enjoy mine by chewing 100 bites once. Now where was I?

*studies have shown that eating fast frees up time to excercise more, thus burning more calories. In addition, the rapid pace of fast eating increases metabolism thus burning fat while eating, creating a perfect storm of consumrtion and elimination.

At the height of the storm, a seven year old boy started shaking. Then his foot went into involuntary spasms and his eyes rolled back into his head. His mother was alone with the boy, and waited a few moments before calling 911. She was frantic when we arrived, waiting on the front door step, waving us in. I've been in the habit of opening the door to the rescue before it stops completely and getting out as soon as it does when people look frazzled. That little act of action calms them down considerably. Knowing that the responders are actually responding alleviates their fears to some degree.

Brian followed me into the home and up the stairs where the little guy waited. His foot was still convulsing, but his eyes were back to normal. Beautiful eyes they were, big, wide open brown eyes that looked right through me.

"What is his name?"

"Daniel."

"DANIEL!" I said, feeling his forehead for fever. I've noticed that when you do that a little bond occurs between you and the patient, must be a time honored instinctual parental thing.

"101 degrees."

"How do you know?" asked Brian.

"My hand is a finely tuned temperature detector."

At one time, when I had two little ones I went ten for ten, temps ranging from 99 to 104. Right on the money. I'm a little out of practice now, but still know 101, that one is easy.

"He can't speak," said his mom as I lifted him off of the couch and brought him down the stairs to the rescue.

"Because of the seizure?" I asked.

"No, he has a birth defect, can't walk either."

He looked like a perfectly normal little boy having a seizure. Come to find out, he has never talked, never crawled, never walked, and probably never would.

It was a quick ride to the ER. Daniel lay on the stretcher, his foot still twitching, but otherwise stable. His beautiful eyes moved a little, he looked at his mother.

"He has your eyes," I said, and she smiled back at me.