The woman shrieked instead. I opened my eyes and beheld her once lascivious face now two halves, and a firefighters axe neatly positioned between those two halves. At the handle was none other than the FDNY firefighter whose truck had broken down last night.

"Fancy meeting you here," I said, and grinned, and allowed myself the luxury of feeling. I felt alive once again, deadly alive, and took the shattered table leg from her grasp, and just as her healing powers began to repair her face drove the stake through her heart. She had the audacity to look surprised, and not a little pissed, and formed her mouth into the beginning of a scream that never emanated from her disintegrating vocal chords, and she faded from our view, her shock evident on her, well-faces, then was no more than a pile of ash on the old  chief's kitchen floor…

http://rescuingprovidence.com/vampyros-whatever-you-do-dont-call-911/

"Vampyros" is the story of a volunteer fire company in the mountains of Vermont whose ranks have been infiltrated by a group of Vampires. They impersonate firefighters and respond to emergencies in the Town of Essex, reigning misery upon the townspeople.

Malcolm and Angus, two Vampire paramedics with more good than bad in their blood team up with a retired FDNY firefighter to rid the town of the scourge of the bloodthirsty Vampyros.

The story will be novel length, this is the first of what undoubtedly will be four or five drafts, I thought it would be fun for people who read this blog to get a feel for how something is written, one grueling chapter at a time, then revised when all of the mistakes become evident as the story progresses.

Fell free to edit, make suggestions, or simply ignore the whole thing, it's a work in progress!

As gray traces of dawn tinge the Eastern sky, the two travelers, men of Providence, enter the dark forbidden lands of the inner city. Even now the intensity of the minions power can be felt, saddening the heart, and weakening the mind. Their calls will begin soon, sapping their strength and testing their resolve.

Their journey begins, the beacon of hope exists a mere five minute journey from their location, and before the sun breaks the horizon, they just may find their salvation. It is the Holy Grail that awaits them, a magic elixir in a Styrofoam cup, the giver of life, saver of souls and the key to their future, or at least their next hour or two.

There, on the horizon is their destiny, they can see it in the distance, a mere one hundred yards away. They approach, giddy now with anticipation, the aroma of roasting beans fills the air around them, satisfied villagers sit at little tables, steaming cups in their hands and contented smiles on their faces. They have what our weary travelers seek, it is within their grasp, alive in their minds, almost there…

"RESCUE 1 A STILL ALARM."

An ethical dilemma faces our travelers as they wait for the rest of the transmission, praying to the coffee gods that this is some mistake, and a different rescue from a different land will be sent in their place. Even so, decisions must be made-to risk the lives and limbs of the people we are sworn to protect for a selfish fulfillment and creature comfort contained in a cup, (actually, a Cafe'  Tobe from The Coffee Exchange, also known as Rocket Fuel in a cup, a fresh brewed Dark Roast and a double shot of Espresso,) or respond to duty, and man up, and put our needs aside for the good of mankind.

"RESCUE 1 RESPOND TO BROAD AND ELMWOOD FOR A CHILD STRUCK BY A BUS."

Brian hits the lights and sirens and we leave the coffee shop in the dust. Who needs caffeine with adrenaline coursing through your veins.

People who live in squalor act accordingly. It's no coincidence that the 300 Block of Broad Street is infested with people who panhandle, shoot heroin, drink until they drop and create an atmosphere of decay by their very presence.

We tolerate it. The fact that we do so condones the behavior of the people who congregate there. Providence Rescue 4, Providence Rescue 1 and Providence Rescue 6 bear the brunt of the illusion of clean-up, gathering drunken men and women who have passed out on the sidewalk dozens of times a day-every day. Overdoses in the area's business's restrooms are an everyday occurrence as well. People piss on the street, throw their empty vodka bottles wherever they wish, drop Styrofoam food containers next to trash barrels and appear to the untrained eye to be litter themselves.

We let it go. We take them to the hospital for detox, or observation until the heroin leaves their system and they re-congregate right where we found them, the 300 Block of Broad Street. The police look the other way as we scrape them off the street and get them out of the public eye. I can't blame the patrolmen, they follow orders. I'm not quite sure what those orders are, but they cannot possibly be to allow members of our society to blatantly break the law then be treated with kid gloves by the medical professionals.

Make no mistake, these people are breaking the law, and their ability to do so undermines everything that holds our society together. Tolerating discord and lawlessness from a certain segment of civilization while the rest are expected to uphold the laws of the land is a recipe for disaster. The total absence of respect toward the citizens who fund and allow the lawlessness to continue unabated is exactly what we deserve for allowing it to begin with.

Real progress needs to begin, and begin now, before it is too late. Central High School and Classical High School are located right around the corner from the display of daily debauchery. The kids spend all day learning about science, mathematics, civics and history, then are led into the real world when the bell tips, and they return to their real lives. They trip over drunken bums, share bus stops with addicts, dodge rescues sent to "treat and transport" the same intoxicated people that were transported in front of them on their way to school, and sift through the littered streets toward their way home.

The lessons with the most lasting impressions are not the ones taught in the safety of their classrooms. When it is considered okay to live on the streets, and act like an animal with no repercussions, eventually the desire for respectability erodes, and ambition declines, and an if you can't beat them, join them mentality sets in.

We can beat them. We have to beat them, because it is not just themselves that are being destroyed, the very fabric of the city is at risk. Start small. Arrest the intoxicated people, if not where they dropped, then pick them up at the emergency room when they have sobered up, and have them spend the night in jail, then the next day at court being arraigned. Fine people for littering. Do it every time, when they do not pay their fines, issue a bench warrant and arrest them. Do not let the junkies off the hook. Maintaining a narcotic nuisance is a joke to them, but keep at it, keep arresting them, the heck with the upper level dealers, get the ones we can see off the streets, and the "upper level" dealers will soon have nobody to deal with.

Litter. Drunks. Junkies. Graffiti. Clean that up and things will begin to improve, I guarantee it.

VII

Dusk approached, I felt it in my aching bones and depleted veins. I often wonder had I been turned in my twenties if my eternal aches and pains would be less disturbing. I've asked Angus, but what does he know, he hasn't been forty-nine for centuries, never felt the same creaks and groans as he lifts himself from his grave each day.

Sid needs a talking to. This, I do not look forward to. I question my wisdom bringing him to Essex every night, wondering just what I had been thinking. He's a strange being, is Sid, and not to be taken lightly. He is sixth generation, and thus holds power over me, not invincible by any means, but he certainly holds an advantage…

http://rescuingprovidence.com/vampyros-whatever-you-do-dont-call-911/

I was at Wal-Mart the other day with Cheryl, picking up our usual stuff, cleaning supplies, vitamins and some light bulbs when I wandered down the Halloween aisle. I'm drawn to that stuff, always have been, though I haven't really gotten in on the adult Halloween Party bandwagon, it's more of a trip down memory lane for me now. In the middle of the Freddy Krugers, Pirates of the Caribbean, Angry Birds and Sexy Kittens was an adorable little Monkey Suit.

I'm four or five, ready to go. My first real costume is on, and has been for hours. It's a monkey suit, complete with a nice long tail. We got it from Sears, and I can still smell the newness of it, the faint plastic, the elastic that got caught in my hair as I put the mask over my face, the "soft" at the end of the tail. It was a great costume, and a great holiday at my house.

Mom and dad were lots of fun then, we bought a record called "Spooky Creepy Sounds from the Haunted House," or something like that, and my dad would run an extension cord out of a window and hide the record player in the bushes and let it go on repeat during the trick or treat hours.

A light post sat quietly at the end of our driveway three-hundred and sixty-four days a year, but on October 31st a scarecrow would lay at the foot of the post. Unsuspecting kids would start for our door, enticed by the creepy sounds coming from the bushes, go to the door, get a spider dropped on them from one of the upstairs windows (cleverly set up with a retractable line) and if they survived and made it to the door, they would be greeted by a ghastly apparition, my mother, sometimes with a stocking over her face and a hooded, leopard velour cape over her head.

Some kids actually managed to get some candy, and it was never the cheezy little bars, we went all out, giving some really good treats, full sized Reeses Peanut Butter Cups or Butterfingers, sometimes we would put a few together and wrap them in a baggie, but it was always worth the trip. Of course, once the trick or treaters bounded down our front steps with their bounty, the "scarecrow" at the lantern would come to life and scare the bejeses out of them. My father could always lie still for hours, and he put that skill to good use come Halloween.

As we got older it was more fun to stay home and enjoy the night rather than run around the neighborhood acting like a bunch of fools, egging cars, waxing windows and terrorizing the little kids. We did plenty of terrorizing right at home, thank you very much. Dad let us be the scarecrow now and then, and we would fight for the honor. As time went on, people were on to us, but they would still make the trip, parents making sure the new ones got a taste of some real Halloween fun.

It was silly, goofy in a great way, a bit inappropriate at times and completely insane and out of character, but it helped connect us as a family, and now, all these years later when I see a little monkey suit at Wal Mart I'm right back in the jungle with the people who matter most, and who live forever because they were not afraid to let loose now and then, and show their kids how to have a little fun. Remember, times were different then, parents were authority figures, not to be questioned, and not at all concerned about their kid's feelings or self esteem. They raised us they way they saw fit, and goddammit nobody would tell them otherwise.

Yesterday, I wrote about my mother's unfortunate experiences toward the end of her life. She had a rough time of it, that much is certain, but after her stay at Butler Hospital, and once properly diagnosed with Bi-Polar disorder and put on proper medication was making remarkable progress, putting her life back together, enjoying her family and gaining some independence. The last time I saw her standing she was boarding a plane at Green State Airport heading to North Carolina to spend a week with my sister Susan and her family. It was quite an adventure for her, and I'll never forget the way she looked as she walked down the boarding ramp, the airliner waiting and a new life ahead of her.

She had a massive stroke a few days after she arrived, and never walked, or talked again, and died in a nursing home eight years later.

Every year I break out the Leopard Print cape, and feel the softness of it, and pull it over my head and scare the kids who dare come to my door on Halloween. It's in the cedar closet in my basement, where it waits all year long.

Memories cannot wait, they must be created every day, because we just never know what the future has in store. Life goes on, we go away, but the impressions we make last forever.

We tricked her, plain and simple. Told her she was going to Butler Hospital for a Stop Smoking Clinic. It wasn't easy, and took lots of planning, and patience.

Things had been spiraling out of control for nearly a year, her grasp on reality slowly slipping away. Men came into her life, the kind that prey on lonely widows, the ones with a line of bullshit a mile long, and not a penny in their pockets. The last one was sent packing after it was discovered that he had been planning on buying a condo in Florida, with her money and his name on the documents, of course, to save on taxes.

Sometimes family has to step in, and confront a domineering mother whose mind is leaving, and show up unannounced, and drag somebody out of his parent's bed, somebody in their underwear and tell him if he is in the house at eight o'clock the next morning that will be his last day on this earth. Sometimes life ain't easy. It's hard explaining to the rest of the family who was just happy that their problem was happy for now, and out of their hair, and not making midnight calls to their homes, worried that there were men in her closets, and people outside, and an army in the basement.

There were times when it went the other way, when visions of grandiosity had to be tempered, and somebody had to be the bad guy, and return the brand new Mustang to the dealer, and take the depreciation even though the salesman sold a car at sticker price to a mentally ill fifty year old woman. Champagne had spilled on the upholstery, and cigarette burns ruined the rugs, and the convert able top was damaged. She bought the car one day, and went on a wild ride through South Providence, drinking and smoking, stopping to talk to people, and having a ball.

On the phone, she talked a hundred words a minute, and explained how she was heading to Sears in the morning, and buying every white shirt and pair of shorts they had, and dressing all of the inner city kids in them, and giving them money, and setting them loose to clean up the neighborhood, and paint the old buildings, and then airlift the refugees from Africa and place them in the newly refurbished neighborhood, and walk through her town and be treated like a queen.

Her house fell apart. The doors on the kitchen cupboards were left open at all times, so nobody could hide there. There was no food, she did not eat. She even stopped drinking toward the end, and you would think that would help, but things got worse as the Bi-polar disorder grew unhindered by the calming effects of the self-medication.

Her husband had died a year ago, and with him went her best friend, confidant, and enabler. He knew his wife was mad, but concealed it brilliantly from the world, kept her hidden in a world of comfort, and alcohol. Her kids knew she was a little strange, and had been for a few years, but she was okay now and then, and the two of them, husband and wife seemed happy.

The ride to Butler was ugly. Crying one minute, attacking the next, it's a miracle she made it. She marched into the reception area, and went directly to a secure room where the emergency physiatrist was summoned. She got up to leave. Security arrived and restrained her. Then they took her away.

Then, me and my brother and sisters relaxed for the first time since our father died.

Somebody asked me last week why I let people walk all over me, especially the lady a few posts ago who sprayed her blood all over me during a particularly bad call.

Learning about mental illness helps. Seeing it in others is an eye opener. Living through it is a whole different story.

I just see things different, I guess.

Alright all you Thumbalina's, yeah, you know who you are, listen up! There's a new game in town, and it's called "Angry Lieutenant."

The object of the game is to make the Lieutenant happy.  A happy Lieutenant is a fun Lieutenant, and when the Lieutenant has fun, everybody has fun, except the Captain, but he doesn't matter, he's busy watching Dragnet re-runs on Nickelodeon anyway.

It's Call to Duty time, and that means put away the little playthings and pick up a street book, or heaven forbid, a Protocol book and spend 1/10th of the time you have wasted killing zombies learning where you are going and what to do when you get there and we just might be on the same page.

Playing Scrabble with your little clan of cell phone bandits is a kick, I'm sure, but imagine how much fun you might have playing a few hands of Hi-lo Jack at the table in the Dayroom with the people you work with. Trust me, it's a hoot.

There might even be a ping pong table gathering dust in a corner, or in the dingy old basement, and a pile of paddles laying around somewhere and if you look hard enough, I bet a ping pong ball might have survived and is sitting, waiting to be put back into play. if not, surely there is a beer pong castaway floating around one of your places, bring it in and start a game, and get out of your heads and into the world of the living.

Get in the game, people, there's a world outside of your devices, one worth experiencing.

That is all.

I scramble around, working like a fool., thousands of EMS calls a year, every year for twenty years, trying to make a difference, thinking I have, hoping it isn't all for nothing. Knowing that in a hundred years everybody here will be gone, and all new people will inhabit this earth keeps things in perspective sometimes, but for the most part the overpowering urge to do something that matters dominates.

That I am a Rescue Lieutenant on one of the busiest ALS vehicles in the country counts for something-I think. At least I tell myself so. Some days things all come together, like there is some cosmic plan where everything makes sense. Other days, not so much.

Dim lighting illuminates the living room turned bedroom, a commode sits by the window, recently cleaned, the smell of Lysol mixes with the smell of dying, the familiar aroma that stays with us as we journey through the years. The couch is pushed to the side for now, but it will be back in position where the hospital bed now sits, tomorrow, maybe, definitely by weeks end. She's tired, sick and ready, waiting to go, but life is funny, those that wish and pray for it to end must wait while others never get a chance to know the peace and satisfaction that comes from a life well lived. The family is prepared, and the vigil is underway, I'd be surprised if there isn't a schedule somewhere, making sure she won't die alone.

A light rain falls in the inner city freshening the decay that coats the gutters and bringing with it a much needed rinse. The rain mixes with oil that has accumulated on the roadways since the last rainfall, four weeks ago, the combination turning the street into a late summer skating rink. The kids in the car don't know enough to be careful, they haven't lived long enough to experience a rain slick road on a lazy afternoon. The fact that the cops are on their tail and they have a grand in the glove box and a bag of rocks under the seat throws caution out the window as the driver hits the gas, skids through an intersection, sideswipes an innocent person's car then slides into a little tree, it's trunk barely five inches in diameter, but enough to encroach the passenger compartment, and kill the teenage girl who wanted so badly to sit in the front seat. She never had a chance, never thought it would end before it got started, never grew up, or old, or learned that it could all change in an instant.

She's in the bathroom of her rented third floor apartment, bleeding, a lump in the toilet floats, the pain in her abdomen seems miniscule now that her heart is broken. It's her third miscairage, her husband is at work, and has no idea, she's alone, truly alone now that their child is gone. She fishes it out of the bowl, and wraps it in a facecloth, and calls 911 and sits on the bathroom floor and cries. We arrive, and have no idea the turmoil going on inside her, or what she carries in her facecloth, only that she is bleeding, and needs us. She sits on the stretcher as we ride in silence toward the Emergency Room, wondering if she will ever have a family, and if the immortality that creation brings will visit her, or will her legacy die withe her, and her empty womb.

Another girl screams as we wheel her into Woman and Infants, she's crowning, the baby's head pokes out just as we transfer her from our to their stretcher, seconds later another baby is born in Providence, the nurses take over, I wipe my brow and thank the rescue gods we made it in time as the umbilical cord is cut and the new mother turns her head and tells the nurse to get that thing away from her. She will be smoking crack within the hour now that she got rid of the curse in her belly, not that the curse stopped her from smoking before, she was high as a kite when we picked her up from a condemned building littered with addicts and their paraphernalia.

He's building a fence, been digging for a few hours, his chest hurts, he ignores it, keeps on digging. A neighbor finds him unconscious next to a pile of dirt and calls us. The neighbor knows CPR and starts, and we continue, and do our thing, and get a pulse, and in the hospital they continue and get him breathing on his own. We consider it a victory and get back to work, where another guy is sitting watching TV, feels chest pressure, takes a nitro and calls us. He has two stents, and a history of open heart surgery, and he's a diabetic, and he eats bags of chips and drinks bottle after bottle of coke and weights almost four-hundred.

He goes to the cath lab. Then home, and back to his chair, and his chips. The man digging holes for his fence posts goes to ICU where he stays for a while, then dies, never regaining consciousness. He was fifty-one.

We deliver babies, pull people from wrecked cars, administer the right drugs at the right time and truly make a difference; most of the time. It's funny how we tend to dwell on the other times, when all we can do is wonder.

It's a crazy world we live in, but at least everybody will be different a hundred years from now.

http://www.youtube.com/watch?v=c94HGKW__OI

From day one to year twenty I never fail to be impressed with the incredible job our firefighters do every day. The fires tell only part of the story. The rescue runs when we save a life, or make a difference barely scratch the surface of what lies underneath.

We are not born with the knowledge and skill, not to mention the determination and resolve to fight these fires and respond to the medical emergencies. The apparatus does not take care of itself. People do not come and take care of our stations. Our equipment is not sent out for maintainance. Our pride cannot be bought, or given. It is earned, every day, day after day and year after year, passed down from salty old veterans to fresh young firefighters who in turn become those salty veterans taking the next generation under their wing.

I'm proud and grateful to be part of this group, and till the end of my days will hold my head high, and stand tall, and tell people when they ask what I did with my life that I am a Providence Firefighter.

But on a lighter note, I did manage to keep a strait face when I told the lady with the sore neck that I once got a Viagra pill stuck in my throat and had a stiff neck for four hours.

This has got to end.

A lady in her early twenties, who has full health care covered by the taxpayers of Rhode Island because she had a baby last year and is a single head of household, unmarried and living in government assisted housing because she cannot work and take care of her baby slept funny last night, woke with a stiff neck, called 911 and got a free ride to the emergency room, and a complete workup including but not limited to x-rays, medication, follow up physical therapy and a cab voucher home. She lives less than a mile from the hospital that she shouldn't even be in, and her baby daddy appeared out of nowhere and followed us to the hospital in his 2011 Nissan.

Meanwhile, in a home not far from here two parents get up at sunrise, get dressed, take some ibuprofen they bought at the local pharmacy, bundle their kids up and drop them off at daycare, punch in, put in eight or twelve hours, pick up the kids, fix dinner and go to bed exhausted and wake up the next day with a stiff neck from carrying a head full of worry around, wondering if their kids get sick if the co-pays will break their meager savings, and if the ten year old car they share breaks down how will they fix it?

The American Dream or the American Nightmare.

Battle lines are being drawn. People are angry. People are tired. Faceless Corporations and corrupt Wall Street investors whose fortunes grow while the people in the trenches suffer continue to profit, people who have given up or never really tried muddle  through and abuse government programs designed to help the down and out, not provide a lifestyle choice, and the ones carrying the cannon into battle every day are starting to shrug off the weight of responsibility that they can no longer bear.

The Tea Party. Occupy Wall Street. Conservative. Liberal. Haves. Have Nots. Have a Littles. Have Enoughs.

If we continue on this path, the spark of rebellion that we are witnessing will grow, and things will spiral out of control faster than anybody can believe.

It is difficult being a front row spectator as the debacle is played out before my eyes.

I wish I had some answers. Working with my head down, taking care of my own and making my little place on this earth a pleasant, productive harmonious enclave may not be enough in the years to come.

Little things like not calling 911 for a stiff neck, or better yet, having the ability to say no, and fine people who do so would be a start, and maybe the rest of us wouldn't feel cheated by the government we created, and allowed to spiral out of control.

Rounds 1, 2 &3

"In this corner, weighing in at a svelte 200 pounds, wearing the crisp blue trunks the challenger, Eddie "The EMT" Everyman! Entering the ring for his first professional bout with no record.

And in the opposite corner, weighing in at a combined weight of 6 hundred million tons wearing the baggage of generations of failed government programs the champion, John "Q" Public! He is undefeated with a record of 1000-0, with 500 knockouts and 500 decisions to quit.

"DING"

The fight is underway, the kid is holding his own, these two look evenly matched, a jab, an uppercut, the kid is stunned but fights on, HOLY COW he counters with a tremendous flurry and the fight continues…

Rounds 4, 5 & 6

This is a battle for the ages, both opponents giving all they have, the challenger looks a little worse for wear, may be slowing down a little while the champion gains strength, "Q" lands a series of terrible  body blows, "EMT" staggers but remains on his feet, he musters a counteroffensive and finishes the round strong.

Rounds 7, 8 & 9

It seems the champion is luring his opponent into his corner, getting ready to deliver the final blows, but the challenger is up to the challenge, he takes a defensive position, "Q" seems to be gaining strength as the fight goes on, "EMT" is against the ropes, the round ends with a ferocious flurry, some of those punches must have landed!

Rounds 10, 11 & 12

Somebody has to stop this fight! "EMT" is giving it his all but "Q" is getting stronger, more relentless, adding punches to his already formidable arsenal. "EMT" is down! Stay on the mat, for the love of God, Man…

1.2.3.4.5.6…he may try to stand…7.8. he's on his feet! The crowd goes wild!

Rounds 13, 14 & 15

This is tough to watch ladies and gentlemen, the challenger is beaten, bloody and bedraggled. His trunks are torn, his body bruised, face a swollen mess, but he fights on, the blows are relentless, he can't defend himself but he is too stubborn to quit. The public keeps on swinging at the defenseless EMT who staggers around the ring, looking for the answers, but he is exhausted.

EMT remains standing, and continues to fight,  the public keeps punching. The challenger looks to his corner,but nobody is there, nobody to throw in the towel, so he stands in the middle of the ring as the public punches away, and the referee looks the other way. The crowd is no longer cheering, they have lost interest, and wait for the next fighter to enter the ring. The fight ends, the public is victorious, the EMT returns to his corner, leans against the ropes, rests his head on the turnbuckle and is eventually led from the ring by his wife, who refused to watch the fight, but is the only one left to pick up the pieces.

Thirty-eight hours, thirty-eight calls. Shootings, stabbings, assaults, drunks, morons, nice people, cardiac arrest, MVA's kids fallen, babies crying…

I should have been a boxer.

Open at your own risk:

badsituations

In a counselors office at a state run facility specializing in juvenile psychiatric issues a mother and daughter sat in their therapist office in an attempt to hash out their differences. The girl was sixteen, her mother thirty-six. Things got heated during the session, words as weapons, hostility, some yelling, anxiety and stress. The mother was so upset she passed out, and could not be roused.

The counselor asked the receptionist to call 911, she did, and we responded.

Having seen it all, and quite familiar with these kind of "anxiety attacks," I walked nonchalantly through the doors of the place I have been to dozens of times for similar reasons. The receptionist directed us to an office toward the rear of the building, and we made our way down the corridor. I entered the small office;the therapist, who had also seen it all gave me a quick rundown. The daughter sat in her chair on one side of the room, her mom the other.

"Half way through our session things got a little crazy," the therapist said. "There was some emotional outbursts, some shouting, and Elizabeth had an anxiety attack."

I approached Elizabeth, tried to rouse her but couldn't.

"Does she have a history of seizures?" I asked.

"No, no medical history but she does take zanex for her nerves," said the lady behind the desk as the girl in the chair looked bored and the lady in the other chair remained unresponsive.

I lifted her eyelids-nothing. I noticed she wasn't breathing, then found no pulse.

"Derek, get the stretcher and the monitor."

"Rescue 1 to fire alarm, send a company to this address, Code 99."

She was in  Pulse less Ventrical Fibrillation. The therapist and daughter looked on as I got her to the floor and started CPR. She remained in V-fib the entire time, three shocks, EPI and Atropine ineffective.

Her daughter rode with us as we raced to the ER.

The woman never came back. Thirty-six years old.

I hope her daughter recovers.

I felt responsible to some degree. Should we have driven faster? Should we have brought the stretcher, and all of the equipment instead of just the bag like I used to do on every call until thousands of similar calls with borderline patients wore me down? Should I call it quits, and let somebody unjaded by decades of non-emergent calls take over?

It's been a while since that call, and dozens more emotional patients since that time. I'm always ready now, but at what cost?

I'll never really know.

The Beginning:

http://rescuingprovidence.com/vampyros-whatever-you-do-dont-call-911/

Part VI

"Malcolm. Malcolm! MALCOLM! Wake up!"

My quest for a dance must have ended badly, I sat in the Caddy, alone, my head pounding. Peanut M&M's littered the front of my uniform, chewed and spit out, melting on my shirt, not in my hands. When I drink I like little more than those little pebbles of delight, and can never get enough. Too bad whenever I try to swallow them they make it only as far as my throat, and spill from my mouth. In my lucid state I don't even try to enjoy them, but after a few drops of alcohol laced blood, I like to push the limits.

"I hear you you fiend, why are you torturing me?"

"We've got trouble. Big trouble."

"Run out of college cuties to seduce?"

"No, not that. Sid."

"What has he gotten himself into now?

Our time grew short, the joyous cacophony from the tree's inhabitants had overtaken the cricket's racket, their bird song one of my favorite things. In life I would spend every morning relishing the rising sun with Chickadees, Titmice, Robins and Jays keeping me company. Now, they sing my lullaby. Their chatter as the dawn progresses toward sunrise fills my aching heart with remembered joy, and profound sadness. Dying every morning takes some time to get used to.

"Do you recall the fire in town last night?"

"Vaguely."

"I spent most of the night while you were flying around the mountain with the Russians. They fed me, and told me the latest news.Three died in the flames. A forth is missing. A girl, barely eighteen. Her body was not recovered from the ashes, a massive manhunt is underway."

"Wouldn't that be a girl hunt?" I asked.

"A human hunt, it makes no difference. The girl is Charlie's granddaughter."

"The Chief?"

"Himself."

"Shit. Beautiful girl. I remember her from the time before Sid, when Charlie would take her to the Outpost, and she would sit in the Engine for hours, daydreaming, waiting for her chance to fill her daddy's boots."

"I'm afraid Sid has taken her, and plans on turning her."

"He wouldn't dare!"

"He killed Nancy."

"She would have been a lousy Vampire anyway. Junkies are never satisfied, all they want is more. More blood, more opiates, more of everything."

"Fucking Sid."

"He is vicious."

The lingering aftereffects of Tony's scotch fueled blood clouded my thinking, but not enough for me to not worry about the ramifications of Sid's latest foray into the obscene. His much publicized last act of stupidity at the Chelsea Hotel, where he stabbed a loyal follower to death in a drug and alcohol fueled rage was nearly his undoing. The girl, Nancy had been seduced by the bloodthirsty vampire Sid, and dreamed of the day when Sid would make her one of us. She never had a chance, just a plaything while Sid acted out his latest whim, big bad Rock Star. After the murder, and before he could be incarcerated, he developed an elaborate ruse to shed his celebrity, and injected a fan with an uncanny resemblance to him with enough heroin to kill a horse, and spent the next two decades in hiding, roaming the Middle East acting like a terrorist. His charismatic influence and hypnotic powers gathered him quite a following, and the trail of bloodshed led the authorities to his cave. He escaped exposure that time by sending another devoted fan into a crowded market, strapped with explosives, screaming Allah Akbar and blowing "himself" to bits.

"Time is short, Angus. Take us home. We need to rest, and think, and put an end to this before it gets out of hand. Drive, and tell me about the Russians, I need to live my life vicariously through you."

Angus managed to develop a relationship with seven Russian girls who spend their summers as housekeepers at the Echo Lake hotel. As part of their employment package the girls are given room and board, two to a cabin with one cabin holding three. They know of our nature, and are willing to offer themselves both as food and companionship to my young partner, and have occasionally shared their blood with me. Blood, and no more. Svetlana, the most beautiful of the seven, and most fluent in English told me one night, as I attempted every trick of seduction garnered from centuries of such encounters that she was into "older" men, not "old" men.

I suppose my forty-nine years of life before being turned is a consolation, but still, a vampire has his pride, and not a small dose of vanity.

"They will leave soon, the summer's end draws near," said Angus.

"That it does, my young friend. And if Sid is up to what we think, our time in Essex could end as well."

Engine 13 was sitting quietly in the bay when we returned to The Outpost, and an eerie silence filled the apparatus floor as we backed the rig into its spot, where it would wait for Billy and Tim to come in at sunrise. The ambulance was staffed twenty four hours a day, the fire engine manned by volunteers who would answer a page when an emergency presented itself, drop what they were doing and converge upon the station. At night, nobody answered the page, knowing full well that the volunteers of darkness beat them to the truck every time. The people of Essex, happy to have what they thought was a dedicated group of firefighters with a dynamic leader who provided them with vehicles and equipment, paid for, they were told, by a trust fund bequeathed to Sid, seldom visited at night. Tim and Billy functioned well as ambassadors for us, and kept the wolves at bay.

Sid may be a loose cannon, but he is a master at covering his tracks-until boredom sets in. Then, all hell breaks loose.

"This could be the beginning of the end, Angus. If Sid has the Chief's granddaughter hidden here, against her will, it is only a matter of time until we are discovered."

"I'm tired of running, Malcolm. This is the perfect place for us. Plenty to eat, a safe place to rest, and we do look splendid in these uniforms. Whatever posessed you to summon Sid here?"

"I wanted a new truck. I have no intentions of starting over, Angus. I shall confront Sid at sunset tomorrow, and put this fire out before it has a chance to consume us all."

The night gave way to morning as we descended underground. I crawled into my hole, exhausted by drink, flying and worry.

They are in their fifties and living together as man and wife. Different last names, similar complaints. When one goes, the other usually decides to come along. They bring their suitcase full of meds, and tell me their problems.

She is obese, and homeless, and lives on a folding chair that she folds up and hides between a couple of buildings nearby. Four hundred pounds, asthma, diabetes, heart problems and kidney failure. She's almost fifty. We pick her up, and take her in.

He's fifty as well, lives in a deserted lot on one of the side streets. There used to be a building there, but it burned down decades ago. He drinks, and pisses, and drinks and pisses and drinks and passes out. Somebody calls us, and we take him in.

He's a retired merchant marine, lives in one of the hi-rises, suffers from COPD and panics easily. He calls when the anxiety level gets too high, and we respond, and take care of him.

She had the baby at twenty-nine weeks. He's a year now, but still has occasional seizures. When his fever rises, we come and take care of him, Tylenol suppository and sometimes a transport.

He's twenty eight, suffers from asthma, has no medical insurance and calls 911 when he can't breathe. We give him a breathing treatment, he feels better and signs off.

Her blood glucose drops to the twenties, and she becomes combative, and her husband can't handle her so he calls us. Sometimes sugared OJ, sometimes D-50, but we get her right again, and she's nice as pie, and we go back in service.

Wherever they call home, we respond, give them the help they need or take them to it. We know their names, histories, birthdays and family and friends. Sometimes, the calls are a bit much, but more often than not, a familiar face, and comfortable routine is just what the doctor ordered.

I was asked to be the opening speaker at this year's Rhode Island Hospital Trauma Conference. I started my lecture, with this:

“It’s bad, I say to my partner as she wheels the stretcher close. With help from the members of Engine 12, who have been called to assist, we immobilize our patient and then load him into the truck and head for the trauma room at Rhode Island Hospital, the area’s only Level 1 trauma center. John fights for life all the way. His broken bones are hinged in multiple places; as he moves his shoulders and hips, the limbs go in opposite directions. The hat he wears, a light brown wool cap with earflaps that can be tied, finally falls from his head onto the blood splattered floor of the rescue. I remember hats like that from my own childhood, when mothers and grandmothers would bundle their kids up before sending them into the cold. The hats have regained their popularity with older kids. It’s funny how things come and go, I think. I pick up the hat and place it on his chest, the only part of his body that doesn’t appear outwardly broken. Inside, his vital organs are a scrambled mess. He somehow gathers the strength to grasp my wrist as I try to keep him from moving.

~from Rescuing Providence

I must admit, It did quiet the room down. Nothing quite like dead silence and two-hundred and fifty eyes upon you. The theme of this year's conference was "Life Changes in an Instant." My big next line, shamelessly stolen from Happy Medic from one of his excellent advice for Paramedics posts was going to be, "We are forever part of their life changing moment."

Instead, what came out was, "We change forever their instant moment." I did rebound at the end, and finished with the right quote. Thanks, HM!

http://thehappymedic.com/

All in all I think my first public speaking experience went well.

And lunch was excellent!

October 5, 2011                                                                                                        

Dear Doctor,

Please consider the position you put the people who answer 911 calls before telling your patients with potential life threatening problems to call 911 for transport to your facility. I am aware that the emergency room affiliated with the hospital where you practice is the best place for your patient-for you.

A person with chest pain who was seen at your office, and whose blood work is abnormal, or who you sent home only to later find abnormalities with their EKG may need to see you, and you are most likely the best person to treat them, considering you are their doctor, and know their health problems better than anybody.

However, when we respond to their home, and are informed that they had chest pain earlier in the day, and their potassium level is dangerously high, or their EKG is abnormal, and their doctor told them to call 911 for transport to their facility, which bypasses two emergency rooms with similar capabilities, problems arise.

You put us in the unenviable position of telling your patient that protocol dictates that we transport them to the nearest appropriate facility, and that facility just happens to be closer. Your patient is possibly suffering from a heart condition, that if worsens during transport leaves me and my service wide open for scrutiny at best, disciplinary action possible, and the detriment to your patient at worst.

Your patient is my patient as soon as I arrive on scene. I am responsible for his or her well being, and ensuring they get the proper medical care. If that means getting them to a facility other than your own, that is what I must do.

Please know that your request puts undue stress on the patient, who feels that he or she is being abused by the "ambulance drivers," and puts us in a rather bad and uncomfortable position.

Thank you in advance for understanding our predicament, and using 911 only in emergencies.

Sincerely,

The "Ambulance Drivers"

In Rhode Island, fire departments provide EMS services to each of the thirty-nine cities and towns. Every city or town has their own district, and provides adequate resources to answer the emergent calls. You cannot predict how many calls come in at any given time, often mutual aid from neighboring communities is needed to handle the overflow.

Most places provide adequate resources to ensure to the best of their ability a timely response to emergencies is sent. It is the most basic of government functions, and tax dollars well spent.

The mutual aid agreements between cities and towns works great, especially for the citizens of Providence. All day, every day rescues from surrounding communities are sent into the Capitol City. Seldom do Providence rescues return the favor. Tension between the departments grows daily, as the surrounding departments crews feel abused by the current system, and voice their frustration at the face of the problem-us.

It would be impossible for Providence's six ALS rescues to respond to every call that comes in, yet that is exactly what is expected of us. Mutual aid has been sent here fifteen times already today, while Providence crews were busy transporting people who vomited once, have diarrhea, are intoxicated, have swollen penises or think they might be pregnant.

A rescue from three towns over responded to a corner I had just passed for a stabbing a little while ago. The person in my truck, a twenty-eight year old man was complaining of a migraine, and had run out of medication prescribed for them. The guy that was stabbed survived, a roommate he found on Craigslist poked him in the neck with a kitchen knife. At least our calls have the potential to be colorful now and then.

This situation eats away at the morale of the personnel assigned to the rescues, the job simply cannot be done, we are overwhelmed. Add to that the animosity directed our way by the out of town rescues whose indignation is well earned and you have a recipe for some very long days, and unpleasant exchanges between people who need to work together for this system to work.

Providence has a choice. Put more rescues in service, or drastically cut the services we provide. I do not see either of those things happening any time soon.

T minus 48 hours.

Two days from now I'll be in front of 250 people talking about Trauma and how "Life Changes in an Instant."

I'm taking applications for the position of guest speaker.

Requirements are impersonating me and speaking for forty-five minutes without sounding like a moron.

All applications considered.

I had figured if all else fails I'll just read some stories. These stories on the blog would work, I thought. Big mistake. Reading them out loud just doesn't sound right, I don't know why. One of the firefighters who reads this thing once mentioned that I do not talk the way I write, and it's a good thing because if I did I would sound really weird.

I don't want to sound really weird in front of 250 of my colleagues. Probably should have thought of that a couple of weeks ago, instead of now, with a thirty-four hour shift ahead of me.

Alas, fear not, the old Rescue Lieutenant will come through in the end, the worst thing that can happen is I'll be a dud, and I'm fairly certain that I will not be the first dud to speak at a conference.

"It's no big deal," she said, "just a little pain in the middle of my chest."

"How much pain, scale of 1-10?"

"Nine."

"That can be a big deal."

"I didn't want to bother you boys."

"Trust me, you are no bother. If you wait to call for two days again, then I'll be bothered."

We did some preliminary vital signs and an EKG. BP 152-130, Sinus tach with left ventricular hypertrophy, SP02 97%, BG 337.

The deal was getting bigger.

"What kind of medical problems have you had in the past?"

"Oh, just the usual, high blood pressure, diabetes, and oh, I had a heart problem last year, something to do with my aorta."

Great. Now we have a bona-fide BIG DEAL.

"Be gentle," I said to Brian.

"Don't be silly, I can walk," she said.

"I'd rather you didn't."

I found out that last year she had an aortic dissection, which is basically a tear in the aortic wall that increases blood pressure and is often fatal.

http://www.mayoclinic.com/health/aortic-dissection/DS00605

We got her into the stretcher and out of her home. Then we got her into the hospital, and right to the front of the line.

"Thank you, boys, for making such a big fuss."

I often wonder why it is that the people who need us the most call us the least.

In the middle of transcribing the next part of this epic adventure, I was called away from my computer. I had planned on finishing this early this week, but apparently the story had other plans. I have no idea how it happened, but here it is:

Nestled among pines, maples and giant oaks, Echo lake draws an eclectic crowd of summer tourists and residents. They come for the cool nights, warm days and relaxing ambiance. And to drink their asses off. Million dollar homes line the shore, modest cabins fill the lots behind the mansions, most empty by fall's end, and inhabited by a few hearty hunters, snowmobilers and skiers for the bitter winter months. The though of the oncoming winter makes me shudder, not because of the cold, rather the drought. It's slim pickings from November thru March, a self respecting Vampire need to travel to feed, lest he run out of food, or be run out by his food supply. Once the herd thins, people grow suspicious, and good ole Malcolm cannot afford prying eyes, I'm having way too much fun in the town of Essex, County Hendrix, State of Vermont.

"Go to our spot, Angus, and we'll listen."

Angus steers the Caddy onto Abbey Road, which runs parallel to the lake's shoreline. We travel through Echo Falls, a dainty little village near the Southern tip of the lake which is home to antique shops, a few restaurants, most notably Alice's, a fine bait and tackle store for those who cannot simply will the fish out of the water and must use primitive rod and reel, a bakery and the all important Beer Store. They sell other things at the Beer Store, and it actually has a name, but nobody knows it, not even the owners, who simply refer to it as The Beer Store.

We find our spot, pull in, turn off the motor, roll down the windows and listen. A loon cries, his lonely call answered by a chorus of crickets, some croaking frogs and a few muffled human voices. We tune out nature and tune in mankind. Angus's frequency is tuned differently from mine, as are all vampires, we hear different things, and voices. I cannot hear what he hears, nor he I.

I close my eyes, open my mind, think of a single malt scotch and listen. It does not take long. West, one and a third miles as the crow flies. A man slurs his words, a woman cries. She is in pain, I feel her misery, and it seeps into my subconscious. He is full of drunken grandiosity. I focus, and hear them.

"I bought you this fucking house so I could get laid more than once a year! What the fuck is the matter with you,!

"You bring your little girlfriends here."

"Ah, bullshit, that's over, what the fuck, can't a guy get a fucking break!"

"Please, Tony you're drunk, just go away."

"I don't think so. Come here, whether you want it or not, I deserve a piece of ass!"

I felt her desperation, her nausea as he approached. I saw her eyes close in my mind, felt the revulsion when he touched her, her surrender, both of spirit and will filled my consciousness and made me weep for those who had no escape.

"Angus, happy hunting, I need a drink." With that, I opened the Cadillac's giant side window, and flew away, West. In seconds I'm in their bedroom, seconds later Tony is on his knees, begging forgiveness and not knowing why. He has no idea that his blood was drained to the point of unconsciousness, and he is now too weak to defend himself. All he remembers is a feeling of helplessness that lasted only a second, but rocked his foundation to the core. Having your blood drained while a supernatural being fills your subconscious with images from  centuries of torture for acts of aggression, rape and dominance has a way of humbling a man, and I get great delight at the sight of a once powerful asshole who's world has been shattered without ever knowing why.

Sometimes the change is lasting, sometimes not. Sometimes I tune to their frequency, and know I've tasted them and shared their thought, dreams and nightmares, and I've filled them with a few of my own. Sometimes they understand the chance that has been given them. Sometimes not. Those are the feasts I truly enjoy, when my bloodthirsty nature is allowed to run amok among lesser humans, and tear their flesh from their bones, and rip out their eyes while they still can feel, and know they will see no more, and rip off their testicles and stuff them into their mouth, and let them choke on their own skin.

However, tonight, my veins are full of Glenlevit! A single malt, just as I had suspected. Thank you, Tony, I hope we do not meet again. Well, that is not entirely true, hehe! God I love alcohol. This is the greatest thing man has ever thought of. Flying is a little tricky, ouch, who put that branch there, but so much fun! I want to dance. I need to dance! Who will dance with me? Anybody? Anybody at all? Surely somebody will dance…

Snotty little prick, thought he knew it all from the look of him. His commentary didn't help either.

"Got enough help, Jesus is the army outside?"

"They send an engine company for a report of a person unconscious."

"Why, I'm at a doctor's office."

"It takes a lot of people to resuscitate a person, we had no idea just how unconscious you were. You would be amazed at the number of times an "unconscious" person is in cardiac arrest."

"I was only unconscious for a second, this is ridiculous."

"I'll say."

"What's that supposed to mean."

"You're at a doctors office, thirty feet from the ER. You faint at the sight of a needle and we get a call for a man unconscious and you have an attitude."

"I'm not one of six city workers standing around with my thumb up my ass."

"You're going to have a boot up your ass in a minute."

I should just write one report and change the names and dates, save me a lot of time.