The Real World?

A world exists, parallel to our own. It is a small place, occasionally visited by people from this side. Everybody who lives there is dependent on those visits, as they are unable to care for themselves. For most, the entire life cycle begins and ends here, their time among the living brief. They are at our mercy, helpless little people who will never leave, never go to school, join a team or win a game. They won’t fall in love and get married or have a family of their own. They will never run, walk or even learn to crawl. Some can’t breath without our help.

Children with severe disabilities live here. It is the most heartbreaking place I have ever been. The most amazing people make their living caring for them. I have no idea how they do it day after day. They become emotionally attached to every one of their patients, treating them as their own. These kids feel love every day. Twenty four hours a day the floor is fully staffed, the need endless. Our society has evolved from survival of the fittest to where it is today, helping those unfit to survive. Are we right prolonging the lives of people who will never make it on their own? Each patient costs society millions of dollars, the end result is always the same, they die.

At three a.m. Monday morning I was invited to their world. One of the inhabitants, an eleven year old kid named Daniel was in respiratory distress. Me and Renato rode the elevator to the seventh floor in silence, both knowing what waited on the other side of the doors. The elevator doors opened, the hissing and clicks of the respirators keeping us company as we pushed the stretcher toward our patient in the room at the end of the hall. His crib was surrounded by nurses. The respiratory therapist gave me the story. His 02 levels had been dropping all night, all of her interventions were ineffective. He needed to be transported to Hasbro Children’s Hospital.

Daniel didn’t move as the therapist removed his breathing tube from the respirator and started to bag him through a stoma in his trachea. He hadn’t moved on his own in eleven years. One of the nurses removed the teddy bear he had clutched to his chest. He didn’t flinch. We picked him off the bed and put him on our stretcher. I noticed the pictures above his crib, birthdays, family, cards. It wouldn’t be long now, different pictures on the cork board, different family, different birthday.

Daniel smiled as we moved him. The nurses stroked his forehead, said they would miss him. He was aware we were moving though he had no idea why. Back in the elevator I quickly pushed the close door button, then the ground floor, leaving his world on the seventh floor.


Different day…


“Engine 3 to Rescue 1, code 99.”

“Rescue 1, received.”

Three years old. Pedi code. Two minutes out. Racking my brain, dosages, kilos to pounds, airway, rhythms, joules, access.

The baby lived on the seventh floor of a nursing home, “The Cabbage Patch,” I’ve heard it referred to, and I myself have called it that. Saying it isn’t disrespectful, or mean, or callous, it’s just one of the many ways we cope with the things we see. I don’t think the name is funny, and neither does anybody else, ironic maybe, or even appropriate, it doesn’t matter.

Most people have no idea places like this exist, or if they do know, they keep that knowledge tucked away somewhere. Children with severe birth defects live and die here, cared for by people trained to provide the best care possible when the family cannot.

Joshua lived on a ventilator. Three years had passed since he entered this existence, and for three years artificial means kept him alive. He grew, and ate, and smiled, and felt. His parents came every day and took him home on the weekends. His room was full of toys, and notes and cards.

Now it was full of firefighters, EMT’s nurses, a respiratory therapist, and others trying to help, and one of us did compressions on his little chest, and another bagged him, and I looked into his eyes to see, and I saw, 4mm, fixed and unresponsive. I honestly thought he would look back at me, and smile, and say, “what’s all the fuss?”

He didn’t. We loaded him up, and brought him to Hasbro Children’s Hospital where I gave my report, and the nurse signed the papers, and we left as his parents rushed in. He’s gone, now, at rest.

It was the last call of a long tour, one that I am glad is over. The good calls, the monotonous calls, violence, excitement and heartbreak all meld into one big package that I put away as soon as I leave the station, and return to the real world.


  • Frederick Mikkelsen says:

    Our youngest daughter cooked at the place on Plain & Borden when its patients were the children you mentioned. Mixed emotions – loss and relief – tough call

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