I sat in the Captains seat, palms and fingers cradling my head, willing my heart rate to slow down. Once I got control of that, I figured the dizziness would stop. The patient on the stretcher droned on about wanting an IV, wanting a blanket, wanting something, I don't know, I wasn't able to hear her.

We had arrived at her residence at the same moment that my radio started the transmissions that will last in my head long after I leave the EMS division of The Providence Fire Department.

"Expedite that rescue, CPR in progress…"

"Any rescue to clear…"

"Rescue 5, are you available?…"

"Negative, on scene with a patient…"

"Rescue 3, are you available?…"

"Negative, transporting to Rhode island Hospital…"

"Ladder 3 to Fire Alarm, CPR in progress, Providence Police officer involved…"

"Roger Ladder 3, we have mutual aid responding…"

"Rescue 6, your status?…"

"Transporting to Fatima…"

"Any Rescue to clear…"

The transmissions continued. My head kept spinning. My patient kept right on complaining. When we arrived at her house, her daughter had stuck her head out of the second floor window and told us "she can't walk." As soon as I entered their apartment, the patient stood up, and said "get me out of here!" and headed for the door. Her son, who looked to be about thirty years old yelled after her, "Where's my medications!" and the window yeller looked on, then said, "she needs to go to a nursing home, she hasn't changed her clothes in a week!"

and the radio went on…

"Ladder 1 with a Cranston Rescue, respond to Crossroads for an assault in the lobby…"

"Engine 3, respond to 99 Kennedy Plaza with an East Providence rescue for an intoxicated male…"

"Engine 13, respond with a Cranston Rescue to Roger Williams Park for an intoxicated male…"

and the voices in my head started…

and the lady on the stretcher kept on complaining.

and my head kept on spinning.

and it hasn't stopped.

I've been banging my head against a wall for years. Nobody listens, nobody cares. A good cop dies while our six rescues continue to be used as taxi's for the homeless and street sweepers for the city. Just remember, if you ever need us, when seconds count, we'll be minutes away, or not available at all.

Providence Journal, 2007

When Seconds Count….

When disaster strikes, illnesses arise or accidents happen in the City of Providence help is only a 911 call away.  Or is it?  Far too often when a rescue is needed there is nobody to send.  Providence’s six Advance Life Support Rescues simply cannot handle the volume of calls generated by the people living in and visiting Providence.    Responding to an emergency in a timely fashion is critical.   Tragically, here in the Renaissance City, when seconds count, help is often minutes away.  Surrounding cities and towns fill the gaps in coverage with mutual aid agreements, but due to a lack of reciprocation that safety net is eroding.

Each of Providence’s six advanced life support rescues handle nearly five thousand emergency calls a year, far above the national average.  Cranston, East Providence, Johnston and Pawtucket routinely send their rescue crews into Providence when needed.  Providence, the biggest city in Rhode Island and second largest in New England does not have the resources to repay the favor.  Smithfield, Lincoln, Cumberland, Warwick, Central Falls; all send rescues to Providence.  Are the taxpayers of those communities paying to subsidize Providence’s irresponsibility?  What are these communities getting in return?  Not much.

A progressive fire department, properly funded has a responsibility to the public it protects.  Emergency Medical Services are the most used aspect of the fire service.  Many departments report upwards of eighty percent of their calls are emergency medical responses.   The cities and towns surrounding Providence have properly staffed their departments to handle the need:

• Warwick,                    population  87,233*                      4 Rescues

• Cranston,                   population  81,617*                      4 Rescues

• East Providence,      population  49, 515*                     3 Rescues

• Providence,                population 176,862*                    5 Rescues

*(2005 Census)

In 2006 Providence added a sixth rescue to help address the mutual aid problem.  The truck operates on a temporary basis and has no assigned personnel, using overtime to fill the seats.   While the number of mutual aid calls into Providence from surrounding communities did decrease slightly, it did nothing to improve working conditions, morale or number of calls responded to by the firefighters assigned to the rescue division.  Most days the city’s six rescues run non-stop.  Experience in the field is invaluable.  You just can’t teach a person lessons learned in the street.  All of the knowledge and experience doesn’t do much good if the person in possession of such life saving skills no longer serves on the rescue.

The stress of the job has taken its toll on the Providence Fire Department’s Rescue Division.  Qualified Rescue Officers have given up their rank, handed in their bars and left the division, leaving the positions vacant.  In their place, inexperienced firefighters have volunteered as acting officers on the rescue trucks.  While they have performed better than anybody has the right to expect, the loss of leadership is palpable.  Morale is at an all time low, firefighters who would rather be fighting fires, some with decades of firefighting experience are sent to the rescue division to act as rescue technicians.  Some crews have an acting officer with five years experience in charge of a rescue with a technician who has twenty years on the job.  The calls are non-stop, the crews deal with the situation the best they can.

Twelve people manning six rescues in a city of 180,000 is woefully inadequate by anybody’s standards.  The dozen medics on call manage to provide Emergency Medical Services to the people of Providence in an efficient, professional manner when they are available.  Their lack of availability is the issue.

Michael Morse is a Lieutenant with the Providence Fire Department, and author of Rescuing Providence

The following is my response to a post at Anchor Rising http://www.anchorrising.com/barnacles/cat_social_services.html pertaining to disability being the "new" welfare.

You have two choices, continue the entitlements, or buy lots of guns and ammo. There are hoards of people who do not vote, do not work, do not care and do not intend to do without. They won't work for what they think they are entitled to, they will take what is yours if you do not continue to give it to them willingly. The government knows this, and is simply keeping the peace for as long as they can.

Things are ugly in the real world. The misrepresentation of real society by the media and government will not go on forever. Soon, very soon I believe, the clothes will come off, and the naked truth will be exposed. Then, all of this Liberal vs. Conservative nonsense will be shown for what it is, a bunch of entitlement minded fools pecking away at their keyboards while little by little the world around them went to pieces.

The masses won't care which side of the debate you were on, they will murder, steal and rape both sides indiscriminately.

*disclaimer, I just spent seventy-eight hours in Providence, watched a good cop die waiting for a Johnston rescue because Providence's six were tied up with the usual assortment of drunks, helpless and homeless people, listened to a stabbing victim ramble on about getting those punks, fought with a junkie who decided I was his problem, scraped half a dozen drunks off the sidewalk and brought them to an overloaded ER where people from "the outside" watched the parade of morons with horror. I'm a bit jaded at the moment.

Eyelids flutter as the needle pricks the skin, no reaction after that, daughter and son sit close, expectantly, waiting for their mom to come around.

She was okay an hour ago, they tell me, talking, walking, a little depressed, but alive. She had fractured her pelvis in August, and had been in rehab ever since.

She's still alive, just not responding. I reassure them. Her vital signs are excellent, her blood glucose level right where it belongs, and her heart is as strong as mine.

But why won't she wake up, they ask, looking at me for an answer. I have none. I'm racking my brain, looking at the EKG, rechecking the blood pressure, pressing her nail bed firmly with my pen, but nothing happens.

I think she might hear us, I think she knows what is going on, I think she's just tired, I say, and run the line.

I'm at a loss. She's eighty-nine, by all accounts thriving, ate this morning, went to physical therapy, took her medications and was getting ready for lunch.

Instead of lunch, she went to bed, and stayed there, not moving, not responding, not getting ready at all.

I kept an eye on things, the ER was close by, and her pulse was strong and steady, but her son and daughter were not.

I hate it when somebody dies, and somebody else asks how old, and the answer is up there, and they nod, knowingly, as if that makes the pain less to bear. I hate hearing how she had a good life, and it was her time, and how she'll be happier.

The people watching their mom dying don't see things that way, not at that moment anyway, they see the woman who made them sandwiches, and washed behind their ears, and laughed with them on Christmas morning, and scolded them when they were fresh. They see the woman who loved them. Loved them for eighty-nine years.

I transferred care to the people in the ER, and they listened as I told my story, and made mental notes of my findings, and saw for themselves that she wasn't responding, and looked at my numbers, and thought for a moment, then administered 2 MG of narcan through the IV that I had established.

I wish I had thought of that.

Mom was back a few minutes later, and daughter and son get to spend some more time with their mom.

I rounded the corner and saw him lying in the grass in the backyard of a recently renovated home in the West End. From fifty feet away he looked okay, forty not so much, thirty I began to worry, twenty and I knew something was terribly wrong, the last ten feet just happened. His name is Eduardo, and he had just finished work on the house, It was a good job, he told me, in between grimaces.

We had been called for a man down, and that is exactly what we found. his skin was cool and clammy, when he opened his eyes they looked haunted, and he said he had the worst headache ever, then vomited on my shoes. We lifted him onto the stretcher, and he cried "no!" and tried to steady himself. I hoped that he was suffering from vertigo, but knew I was kidding myself.

He took time this morning getting ready, his shirt was new, shoes matched his socks, his dress pants now covered with dirt. A wedding ring matched his watch, both meticulously maintained.

The people who found him told me what they knew, he was doing an inspection, everything was fine, then he said he felt dizzy, then he sat on the ground, and leaned to the side and vomited.

We started an IV, administered oxygen, took his vitals and got rolling. At 220/110, with a "9 out of 10" headache, and a perfect sinus rhythm I thought CVA. I did a neurological exam enroute, everything was normal. But he never opened his eyes. I told him not to worry, that I thought he was having what we call a TIA, or mini stroke, even though I was pretty sure it was a full blown CVA.

Little white lies don't count when protecting a person I decided, and I wanted him to know that something bad was happening, but certainly nothing catastrophic. He was terrified, but seemed to appreciate my honesty. He nodded his head, and relaxed-a little.

At the ER I got a little testy at triage, I hate it when people just don't see what I do, and don't sense the urgency. It's not their fault, they hadn't spent the last fifteen minutes with the man, talking to him, touching him, reassuring him, telling him that everything would be okay. They didn't have much invested, and at that moment, I forgot that. I suppose I was a little nonchalant when I arrived on the scene as well.

Once things got rolling they rolled quickly. The attending ordered some meds and an immediate cat scan. I waited, hoping he was a candidate for tPA. When he came back from Catscan, everything had changed. He could no longer asnwer questions, and his breathing had become erratic. Respitory was called and they inserted a breathing tube.

http://wiki.medpedia.com/Clinical:Guidelines_for_the_Early_Management_of_Adults_With_Ischemic_Stroke#Brain_Imaging

There would be no TPA, his brain scan showed a major bleed. They took him to surgery ten minutes later, hoping to relieve the pressure in his head.

He probably won't make it through the night, and if he does, he will wish he hadn't. A few hours ago he was getting dressed, getting ready for another day.

Kind of like we all do.

Police and Fire work side by side, days turn into weeks, and years, the calls keep coming, and routine sets in. Maybe we take each other for granted. Then, one of them is gone.

I've known Max for fifteen years, but never really knew him, he was just there. Now he's gone.

Officer Dorley was killed in the line of duty this morning. Thoughts and prayers for Max, his family and friends, all members of the Providence Police department and everybody who knew him.

http://www2.turnto10.com/news/2012/apr/19/35/cruiser-involved-serious-crash-ar-1005913/?referer=http://www.facebook.com/l.php?u=http%3A%2F%2Fturnto10.com%2Far%2F1005913%2F&h=nAQG6kANR&shorturl=http://bit.ly/HVlSql

He sat in a recliner, remote control in one hand and his cell phone in the other.

"What's the matter?"

"I'm schizophrenic and can't walk."

"How did you get to the third floor?"

"I walked."

"Well, one of you is going to have to walk back down the stairs."

"Okay."

Then he got up, and walked to the rescue.

The cable guy was finishing up, having spent a few hours in my house. It's tough not to figure things out about a person when you are on the inside. I spend a few minutes in a person's home and could write a book about them. I'd have to make a lot of it up, but you get the idea.

"You're the guy that writes those books."

"Yeah, I am."

"How's that going for you."

"Okay."

"My father was a firefighter."

"That's great."

"Only he never talked about the job."

"Really."

"Really."

I could tell that this was a man who didn't talk much. I never know what to expect when somebody finds out "I'm the guy who writes those books."  Not everybody is a big fan. There is a culture of secrecy on the job.

What happens at work, stays at work.

I tried that. It wasn't working. After a few years of sobriety I started writing. I haven't stopped. I haven't had a drink either. I traded one obsession for another; one was killing me, the other helps me live.

"What's he doing now?"

"Nothing. Had a heart attack, been dead ten years now."

"I'm sorry."

"Don't be. He was fifty-three. Should have talked about it."

"Attention Engines 10, 11,3, Ladders 5 and 1, Special Hazards and Division 1, a still box."

I kept my ears tuned to the Captain's radio while I chopped some onions, waiting to hear from the 10's. It didn't take long.

"Engine 10 to fire alarm, heavy smoke condition."

I chopped a little faster. At the time, Engine 2 and Ladder 7 were the staging companies in Providence. I was on Engine 2, and knew that if there was a building fire we would be called. We caught a lot of fire in the early nineties that way, as soon as we heard a still box come over the loudspeaker the crews would head for the trucks. If it sounded good we would be ready to roll when the first in company called "CODE RED!"

"Roger Engine 10, we have a report of smoke coming from the factory on Oxford Street."

"Roger that, Engine 10 on scene, Code Red, bang a second alarm."

I put the knife down and set the onions aside and headed for the pole. The rest of the crew was waiting on the ramp, looking south, over the Hi-rises that give Providence it's distinctive look, and beyond. A giant plume of smoke rose from South Providence, and below that, the glow of fire. We geared up and started for the trucks, the radio in the background sending additional companies to Oxford.

"Attention Engines 8, 11, 13, Ladders 2 and 6, Rescue 1 and Car 2, a second alarm."

Captain Crowley came down the stairs. He walked between  Engine 2 and Ladder 7 and onto the ramp, looking south. I remember being frustrated. If he would get on the damn truck we might beat the second alarm companies to the fire. His radio came on.

"Division 1 on scene, establishing Oxford command. General Alarm situation, send the companies in five minute intervals."

"Roger Division 1."

When it became obvious that the Captain had no intention of getting into the truck with the rest of us, we got out and joined him on the ramp. The glow had grown, black smoke rising, resembling a sunset, only in the wrong place. It was six o'clock on a warm summer's night, the real sunset was two hours away.

His radio came on again,

"Attention Engines 14, 6, 15, Ladders 4 and 8, Rescue 2, Respond to 178 Oxford Street, general alarm fire."

"Hey Cap, why are we waiting?" I asked, a little annoyed.

"Did they teach you anything in the Division of training?" was all he said.

They taught me a lot at the DOT. They taught me how to put out fires! This was bullshit. I had nearly a year on the job, I was ready!

Five minutes later, his radio again. "Attention Engines 2, 5 12, Ladders 3 and 7, Respond to a general Alarm fire, 178 Oxford."

Finally. Fifteen seconds later we were out the door, a minute later on the highway and seven minutes after that we approached the scene. I had heard the saying "we run into buildings when people are running out," but nothing prepared me for the sight of dozens of people running toward us, then past us with all of their belongings on their backs. From my vantage point behind the driver all I could see was fire through the windshield.

An abandoned mill was fully involved. The building covered two city blocks, and was five stories high. A clock tower rose another fifty feet above that. I stepped out of the cab into the intense radiant heat, and got to work. We set up the deck gun, taking it off the mount on Engine 2 and hauling it some 500 feet closer to the fire building. The operation took about fifteen minutes, we had to supply our own water.

Under the streets of Providence is an elaborate grid of water lines. Different hydrants are connected to different lines. We passed two perfectly good hydrants, in my expert opinion and tied into one 800 feet away. When we finally did charge the deck gun there was more than enough water to provide a steady stream nearly 150 feet into the seat of the fire. We moved the stream as needed, protecting exposures and cooling hot spots.

While we did our job, unglamorous as it was, the rest of the city's fire houses methodically emptied out and converged on the fire scene. Two exposures, both triple deckers on Side 1 of the fire building were engulfed in flames, Engine 12 and Ladder 3 put them out. I didn't get a chance to see that job, but it must have been incredible , the houses were still standing when the smoke had cleared.

Eventually, we got control of the fire. We cleaned up, and just under three hours after we were sent, we were right back where we started, I was chopping onions, and the Captain watching TV in the day room close by.

Over dinner he explained what went on behind the scenes. Chief Wentworth recognized the severity of the incident and called a general alarm. Rather than having all of our trucks converge on scene, we went when we were called, and while we were being sent into the fire, mutual aid companies were being called to man our stations. Captain Crowley waited on the ramp patiently, overcoming his instinct to follow the fire, and respond immediately.

Discipline, training, great chief officers and excellent fire company officers turned a potentially catastrophic Mill Fire in a heavily populated city neighborhood into a controlled training exercise for about ninety firefighters. There were no casualties, a few minor injuries and the shell of a once thriving factory still standing when the last companies left, about eight hours after the fire had started.

A couple of kids lit some boxes on fire inside the place, the oil soaked floors got going, and it was a powder keg after that.

Learning about water supply, the incident command system and hydraulics while in the academy was dry, to say the least. I never imagined that I would see the importance of what I learned in real time, with real fire, real victims and the very real possibility of losing a big part of the city to one of natures most destructive forces.

In the next five years, I responded to three more Mill fires, The Lincoln Lace Factory, the American Tourister blaze, and a machine company on Sprague Street.

It was different, fighting those fires, knowing that we had a plan, and experienced people to carry that plan out. Best part was, time had progressed, and I had become one of the experienced ones.

Last Saturday night every police cruiser in Providence was called to Level II, a nightclub downtown. A melee was in progress, ending with the stabbings of seven people, and multiple other injuries.

The press focused on the fact that EVERY cruiser in Providence was needed to quell the riot. Less newsworthy was the fact that EVERY ALS unit in Providence also responded.

There were no cops to patrol the city for a little while late Saturday night. Every day, day after day, week after week and year after year EVERY ALS unit in Providence is tied up on medical calls.

Dog bites man is certainly not newsworthy. Man biting dog might get you a headline. Providence EMS Run Ragged is simply business as usual.

Cops describe chaos at Level II

5 stabbed during Easter morning melee

Updated: Thursday, 12 Apr 2012, 12:53 PM EDT
Published : Thursday, 12 Apr 2012, 12:41 PM EDT

• By Evan Viola

PROVIDENCE, R.I. (WPRI) – Chaos. That is how police described the scene when they arrived to Level II nightclub in Providence early Easter morning.

Five people were stabbed inside the Richmond Street club, and 200 more were gathered outside in the parking lot ready to fight.

During a Wednesday hearing before the Providence Board of Licenses, police urged the members to shut down Level II for good.

"Chaos," said Officer DeMarco of the Providence Police Department. "There were fights all over the place and a lot of blood on the floor."

Eyewitness News has learned that dispatchers ordered every officer in the city to the nightclub district, forcing Cranston Police and State Police to cover all other calls.

"In 23 years, I've only heard four calls for every car in the city to respond," said Officer Gregory Daniels.

The four veteran officers who testified told board members they feared for their lives.

An attorney for the club's owner says he's not commenting until the board reaches a decision.

A hearing will continue on Thursday, the club remains temporarily closed.

Nothing to see here, folks, move along.

And a child is born,

another life,

another story begins.

This one arrives on a stretcher,

rolling through the doorway

at Woman and Infants Hospital.

It couldn't wait,

couldn't stand another minute

inside the womb,

of the woman who pushed it away

I said, It's a girl.

She said

get that thing away from me.

Sad, but no surprise,

We found her at the pay phone,

High on crack

Looking for somebody to blow

To keep the party going.

The baby came early,

Maybe she knew

She couldn't take another hit.

They cut the umbilical cord,

And separated promise

from desperation.

Mother and daughter,  both addicted

One by choice

The other just because.

I used to take my ability to hyper-focus for granted, thinking it was something everybody could do if they were in my shoes. It isn't a skill learned, nothing I had to study for, it just is. I read something about how sports stars do similar things, when the game is on the line, the roar of the crowd goes silent, the opponents slow down, the net, or puck or ball or hoop gets bigger, or smaller, whichever makes it easier to accomplish what needs to be done to win.

Cops have the same ability, when a gun is drawn and they have to kill or be killed. Some have actually reported that they see their bullets hit their mark, and shoot again as the world goes silent around them, then returns when the danger passes.

I don't have any games to win, or people to shoot, but I do have a life to save every now and then, and the silence that surrounds me when chaos is in the air, and my old man blurry vision suddenly becomes crystal clear is nothing short of a miracle. Studies have been done focusing on people who perform well under stress. It has been documented that the heart beats faster during moments of duress, the optimal rate between 120 and 140 beats per minute. Anything over that and the person in the situation becomes ineffectual. Under 120 indicates the person is in denial.

I'm not denying that I'm often ineffectual. There are a million things I do poorly. "I never shot nobody-don't even carry a gun" (AC/DC lyric that just popped in my head) and the only sport I was any good at is hockey, and even then I was never a first line player, more of a goon, to be honest. But in the back of the ambulance, when the game is on the line, and proverbial guns are blazing there is noplace I'm more at home, with my heart thumping away at about 120.

*this post was inspired by a passage from the book BLINK, by Malcolm Gladwell

The following is an excerpt from the book, Responding. My new truck, Rescue 5 is quartered just below Benefit Street.

0934 hrs (9:34 a.m.)

“Rescue 3 and Engine 7; respond to 268 Benefit Street for an elderly male who has fallen down the stairs.”

     We put down the paddles; I went for the Rescue, Wayne for the couch.

     We leave the station and turn left toward Benefit Street. When Providence was an industrial powerhouse, factory workers and their families inhabited the homes that line the historic street.  Textile mills and factories were abundant nearby, most of which have since been destroyed by fire.  Some of the mills have been converted to living space or offices but nobody is making much of anything these days in Providence, the manufacturing base has been shipped overseas.  The Providence Preservation Society saw the value of the old homes that had been subdivided and turned into tenements long before developers and real estate professionals did and insisted the homes be preserved.  Rather than let the area be redeveloped or demolished, the buildings were restored.  We now have the finest cohesive collection of restored 18^th and early 19^th century architecture in the United States right at our doorstep.  The “Mile of History” is one of the most prolific, vibrant parts of the city.  Reproduction gas street lamps illuminate the area at night; you can imagine yourself walking in the footsteps of Edgar Allen Poe who spent his later years in Providence courting a reputable widow, Sarah Whitman, at the Providence Athenaeum, the fourth oldest private library in the country.

     The guys from Engine 9 are inside the historic home; their truck parked about thirty feet past the doorway leaving room for the rescue. We pull the stretcher from the back of the rig; place a long spine board on top and walk in, passing a cast iron boot scraper that has been there for centuries.

      An elderly couple sits on a couch in the front room.  Bob Cataldo from the 9’s gives me the story.

     “He was trying to help his wife up the stairs with the laundry basket, she was raising it up to the balcony, he leaned too far and fell over the balcony and right on top of her.”

       “No way,” I say, shocked that the people are not more seriously hurt.  I walk over to the stairs, a balcony with a three foot railing is at the head of the stairway which has a landing about ten feet down, then another seven or eight steps.

     “Way,” says Bob.

     ”Are you folks okay?” I ask the gray haired couple sitting next to each other on the couch.  The man is crooked, rubbing his lower back, his wife sits straight, but has a laceration and bump on her forehead.

     “I’m fine, I’m worried about her,” the man says.

      “I’m okay, I’m worried about him,” she replies.

     “I’m worried about both of you.  I can’t believe you two walked away after that fall.  You must be pretty tough.”

     “Sixty years of marriage will do that,” they say at the same time, and then smile at each other.

     “We’re going to get you to the hospital, just bear with us, I want to get you immobilized on a backboard for the ride.”

     “I know how that goes,” says the man, “just a few months ago we were in a car accident on Academy Avenue, I went through it then.  It’s a good thing I did, the doctors at Miriam Hospital said the EMT’s saved me from being paralyzed, I had a broken neck.”

      “I thought you two looked familiar,” I said, “that was me!  A hit and run driver sideswiped you and ran you into a utility pole.  If I remember correctly, you were worried about your wife.”

     “He’s the one that ended up in the hospital for a week,” she said, reaching over to hold her husband’s hand. “There was nothing wrong with me.”

     With help from the engine company we “package” our patients for the ride to the hospital.  I still can’t believe these two elderly people had two traumatic incidents in the last month and managed to tell the tale.  From the look of things, no serious harm was done by the fall, which is truly amazing.  First, a fall of ten feet can be serious at any age, being eighty increases the chance of broken bones or worse.  Second, having a two-hundred pound man fall on you from ten feet has its share of complications.

     We ride down Benefit Street toward the hospital, my patients, together for better and worse, under my care again.

http://www.amazon.com/Responding-EMS-It-Happens-Now/dp/1887321144/ref=sr_1_1?s=books&ie=UTF8&qid=1334338757&sr=1-1

"Captured the vampire killers, Malcolm? You are one of the vampire killers," said Bo, whose size and charisma made him the defacto leader of this gruesome ensemble. We were completely outnumbered. Sid caught on fast when it came to firefighter operations. Killing a bug with a sledgehammer is our modus operandi on most jobs, if we have the resources that is. Lately, Sids resources have been dwindling. I think he's pissed. Too bad, I say.

"Bo, why are you involved in all of this. You have a good life, playing the blues till midnight, drinking the blood of your groupies till three, fighting a fire when the tone goes off, why follow that demon Sid? You may kill us, but eventually, the wheels will fall off of his department, and he will be gone, just like always."

"You don't know diddly, Malcolm. I don't give two shits about Sid. He's the boss for now, I, unlike you, respect the chain of command. It's been so for centuries, and it works. It is what separates us from existence and the void. Without some hierarchy, the whole shebang would implode, and Vampires would be no more. Then we'd be singin the blues fo sure!

"Is that a bad thing, Bo?" I asked, solemnly while making eye contact with Angus, who had been busy sizing up our foes while I distracted the leader. Nine against one. Four of the vampires weren't worth half a shit, so that left five. I could handle two, Angus two, that left one for Bob. I wondered if he were up to the challenge.

A gentle hum turned into a roar, and the headlights from a hundred Harleys illuminated our motley crue. Angus and I stood between Crissy , Bob and Charlie facing Bo and his nameless pack of drones, some of whom were barely vampires, having foolishly drank the blood of a vampire who simply wanted to have a little fun. Making a true vampire takes a little more than simple blood play. Kids, can't teach them anything. All of us looked toward the approaching lights, whose collective force appeared as one giant beam heading toward us.

A fanged smile crossed my face when I saw who rode the lead Harley. She rode the thing like a man, legs kicked out, shoulders back, a snarl that would make Billy Idol jealous and reeking of attitude. I do love Courtney. She stopped the bike in the middle of the crowd, gave the kickstand a rebellious whack, walked over to me, put her tongue into my mouth and grabbed both my cheeks hard enough to make it feel good.

"Ass is getting soft, Malcolm. These fuckheads giving you trouble?" she said, tossing  her head and swinging her blonde mane toward Bo's gang, once I stopped nibbling her tongue.

"Not much. Sid sent them to kill us."

"Fucking Sid," she said, put her thumb and index finger into that delectable mouth and gave a shrill whistle. Her gang, some Vampire, some outlaw, some thrill seekers and all almost as crazy as Courtney got off their bikes and surrounded us. Ever the opportunist, I slinked behind the bikers, shaking hands, bumping chests, high fiving, whatever greeting was appropriate to whatever biker. My gang followed me into the throng, careful not to get too close. All but Angus who fit right in with the misfits.

The slaughter was quick. There wasn't much left when the bikers were through. Bo managed to survive, and Courtney walked over to us, her arm around the bear of a man like they were high school sweethearts.

"Who do you love, Malcolm?" she asked me, grinning, her mouth covered with the blood of the undead.

"Always you. Stay for a while, I've got an itch named Sid to scratch."

"I'd love to, but you know how I love the Kangamangus Highway in the fall."

She grabbed my crotch, almost gently and licked my lips. I tasted the second hand blood of her victims. Then she was gone, the tail lights of the Harleys fading along with their roar. Then there was only us. And Bo.

"That is one crazy bitch, good thing she likes the blues!"

"What am I to do with you Bo? I've always liked you, I've never had any trouble with any of the poor soulless that Sid continues to sick on us. I don't like killing our kind, but I will survive. When it comes to them or me, I'll take me."

"I've got a show at Busters on the Lake at eleven," said Bo.

"Then let the show go on!"

Bo shuffled back to the abandoned fire engine, started it up and drove away.

"That was one fucked up calvary," said Bob, as we drew closer to one another. Our alliance grew stronger with every adventure we shared, I felt the bond grow with every minute we spent together. I'd like to attribute this phenomenon to my magnetism and charisma, but simple human survival instinct, freshly born in Crissy, Bob and Charlie and ancient between Angus and me mix together, and chemistry created by whatever forces make this universe we call home tick bonds us, and makes us more alike than any of us would like to admit.

Well, maybe not Angus and Crissy, who for now have bridged their differences, and share an intimacy only I can detect. Good thing for Angus, Old Bob the firefighter may be human still, but the power of a father scorned is nothing to take lightly.

I wrongly used the tragic LODD of two firefighters as fuel for a post about the current climate concerning public sector unions, especially firefighters unions. For that, I apologise. I've never retracted a post here at Rescuing Providence, and have no intention to do so now. I did delete the commentarry from that post out of respect for the deceased and their families. If anybody has any furthur commentarry concerning contractual issues and disability pensions or anything else that is bothering you, feel free to comment here.

0330 hrs. A little break in the action, just in time. My head hits the pillow and I'm gone, sweet blackness, no dreams, no tossing, no turning just me and unconsciousness. I call it death sleep. I've never actually been dead, but days like this lead me to believe it might be preferable to consciousness.

My body has melted into the bunk, the mattress that was bought after the Blizzard of '78 feels like a priceless feather bed, not the plastic coated, springy thing that it is. It is amazing what thirty hours of constant awareness does to a person's needs. I could sleep on anything now, and as the minutes add up, the body begins to recuperate.

Blinding light wakes me. I'm not certain how long I've been out, but it must have been a while. I'm refreshed, and ready to roll. The tones are far better than the bells that would rattle my bones all those years ago.

The digital clock on the dash reads 4:23. Little birdies start their chorus early this time of year, and their song escorts us out of the building and into the pre-dawn solitude. Nobody is on the road, not a soul. A few lights burn low in the houses we pass, a stray dog, some rats and a gentle breeze pushing the previous day's litter away from the curb are our only companions.

It's Gayle who called. She lives on a folding chair next to an abandoned building. Sometimes her niece lets her stay with her, usually at the beginning of the month, when the disability check makes its monthly appearance. Once that is gone-according to Gayle, spent by her niece and her friends on men, booze and cigarettes-she's out, back to her chair.

She sits there most of the day, and into the night, occasionally shuffling into a store for a bite to eat, or to get warm for a minute, but she is a large woman, and homely, and wears the aroma of street living. The proprietors of the shops quickly dispose of her, giving her something to keep her quiet, because if they don't, she will make such a fuss the police will be needed.

The cops don't know what to do with her, so they call us. She's a hard woman, mean as a snake and bigoted beyond belief, calling me White Boy Cracker, and my Asian partner the Walking Won Ton. She is not fond of the Hispanic population either, and continually ridicules her fellow African Americans, calling them Uncle Toms, or worse.

She likes me. I have no idea why. Other than the white boy stuff, that she says out of habit more than vitriol, she's polite, and cooperative. But she's also 400 pounds, and her home is broken, the tiny legs finally giving up, and collapsing under her weight.

We lift her onto our stretcher, my own tiny legs nearly collapsing, and she starts to cry. Bearing witness to the surrender of a person so used to hardship is nearly impossible to watch. She's obese, ugly, mean and alone. None of the area hospitals give her more than the bare necessities, and rightly so, she has burned all of her bridges in the city, and is truly alone.

Rhode Island Hospital waives their restraining order for tonight, but additional security is needed to keep an eye on her while she is treated for phantom chest pain.

At 0500 I'm back in my bunk, the plastic mattress feels like a fine feather bed once more. I close my eyes, and blackness takes over.

"What did he stab you with?"

"What does that matter?"

"It matters a lot."

"He stabbed me, just stop the bleeding."

"Did you see the knife?"

"What is this! I told you it don't matter."

"Actually, it does matter. In a minute, tops, your left lung is going to collapse, your chest cavity is filling with blood as we speak, your blood pressure is dropping, and you are about to lose consciousness."

"No shit?"

"No shit."

"It's just a little cut."

"Ever see a little cut from an ice pick?"

"Have you?"

"Only in the movies. It's not the size on the surface, it's the depth that gets you."

"Then I'm screwed."

"Why?"

"He stabbed me with a big screwdriver."

"Don't worry, we've got fluids going in, oxygen on and the best trauma team in New England waiting a minute away."

"I think you better hurry up."

He turned white, then was gone.

A tiny quarter inch slice under his left shoulder blade was the only mark on him. Stabbing victims crash fast.

Woody, my partner on Rescue 1 in 2001 told me, "It's not what you see on the outside, it's what lies within that matters.

My sincere condolences, thoughts and prayers to Lt. Robert Neary & Firefighter Daniel Sweeney, Ladder 10, Philadelphia Fire Department who were killed in the line of duty this morning, and to their families and all members of the Philadelphia Fire Department.

Apologies too, if this offends any of the survivors.

We hear it all the time, and say similar things as well. Things like, "it comes with the territory," "we knew it when we swore the oath," "stay safe, brother."

It's a risk, this job, this oath we swear, this life. People in the fire service are much like everybody else, we are willing to do what it takes to make a living, and maybe a little more.  Our job gives us a better chance of death and injury than most others. But it is what we signed on for, what we do, and what we accept as our job.

We also accept better than average pay and benefits, and a good retirement package. It's part of the deal. what we signed on for, and what we expect. It comes with the territory.

I've been fortunate, as have most firefighters. We are alive, most relatively unscathed. It isn't luck that makes it so, without proper training and equipment, and experienced teachers and competent leadership more lives would be lost.

We have done the job. We continue to do the job. We die doing the job, far too often. Every one of us knows the risk, and accepts it as part of the bargain.

It's too bad that every day the bargain is attacked by our employers. Using the poor economy as justification to reneg on deals made in better times is acceptable now. The American people are weary from years of recession, and battered every day with messages promoting the idea that public sector unions are the reason for their rising taxes and declining services. They listen to the media and their elected leaders, whose fiscal ineptitude landed most places in the dire circumstances they find themselves in. The public now expects and demands we make cuts, and give up benefits, and give back manpower to struggling municipalities.

While their end of the deal is written with invisible ink, our end of the bargain is signed in blood. We know what we signed up for, and every one of us will continue to show up and honor our commitment, and in doing so, will honor the memory of the fallen.

Things get noisy sometimes, it's hard to block out the world, and ignore the sirens and shouts, the blaring music and everything else that contributes to the ruckus.  I've found that those are the easy things to block out-it's the racket going on in my head that gets in the way more often than the roar of the world.

Now, when I hear the cacophony getting geared up I have to make a conscious decision to silence the distractions, forget about the Littman stethoscope, pull the cotton out of my ears and put it in my mouth for a minute and listen.

Listening is a much overlooked skill. Most people are terrible listeners. Most EMT's are terrible listeners. We know what is wrong with people better than they do, after all, and we have all these fancy gadgets to prove us right. Who cares what the patients say, what do they know?

They know everything. Everything we need to know about their condition can be learned by simply listening. Almost everything, anyway.

Give it a try sometime, you will be amazed at what you hear.

3:14. I have no idea why, but most nights, after sleeping for a few hours I wake up, and the clock displays those numbers. I dreamt of falling bodies last night after drifting off, probably around 4:14. I think my subconscious mind has stored things I've seen; put them into a vast file cabinet somewhere that opens at times when whatever force propels me feels I can handle it.

Last night, in the hours between four and six was time to clean out the falling body file.

He paced on the top floor of the parking garage for hours, finally resting on the ledge. Then he lie down, on his back, and looked toward the sky. Eventually he rolled onto his side, and looked at the ground. Finally he rolled over, and crashed five stories to the ground.

He took the elevator to the top floor, opened the door to the roof with the key that was entrusted to him as head of maintenance for the building. He paced, and hesitated, and took a few dry runs. Finally, he let it go, and ran full speed ahead to the edge, and flew off the side.

The crowd, impatient and bored after spending nearly an hour stuck in the traffic jam that he had caused egged him on as he moved closer to the edge of the bridge. The tower ladder approached from the opposite side, firefighters ready to wrestle him off the ledge. The closer they got the more the crowd cheered. Finally, he let go, crashing to the highway some forty feet below him.

She stood on the off ramp, lonely, depressed and exhausted from walking. She had walked for hours, thinking about things, her father, who was dying, the mother she wished she didn't know. A truck driver saw her go over, and called us. It's a strange thing, approaching the scene, seeing a crumbled heap in the roadway, under a bridge which you drove under a few minutes ago, when nothing but pavement filled the space.

They snuck out a window, a dangerous operation to begin with, more so now that ice had formed. His friend made it, he did not. He slipped, and fell eighty feet onto the cement below. He lived for a little while, we did what we could, but the feeling of falling accompanied me all the way to the ER.

He's old, and inside the mall. Third level, nothing but a railing keeping him on the ground. The place is full of shoppers. He doesn't see the,. and rolls over the railing and crashes to the ground. Some little kids scream.

She's sitting on an escalator railing, having fun, acting goofy. Her fiance is next to her. She loses her balance, tips over the edge, hits her head on a steel beam twenty feet later, then falls another twenty feet. He's looking at me, staring, seeing too much, expecting too much.

He sits on the window ledge at the homeless shelter, fifth floor, looking at the crowd below him. They don't know he's there-until he splatters in the middle of them.

Tomorrow we celebrate the resurrection of Jesus. I'm barely Christian, but can't help wonder why last night, of all nights I dreamt of people whose lives ended on my watch. I vaguely remember learning about the ascension, when Jesus rose to heaven. The older I get, and the more I see, the more comfort I'm finding in what I used to think of as kid's stories.

Might be time to re-open the faith file.

It's late, the hour, and the life of the man whose dying breaths fill the room. Those agonal respirations prompted one of the family to call 911, although they had been coached, and prepared for this moment for months. Their dad, husband, brother and grandpa lie dying in the living room of the house he built, and raised his family in.

Most were there now, the phone calls going out a few hours ago, that chain of communication families dealing with terminal illness know all too well.

"It's soon."

So the gathering of loved ones parts as we arrive, making way for our bag full of meds, the defibrillator, the stair chair, prepared to do what we must.

"Does he have any final wishes?" I ask, hoping somebody understands and comes up with the DNR. My partner puts an oxygen mask over the man's face, a few people protest, most just watch.

"The Hospice people have the paperwork."

His respirations are slowing now, his eighty pound frame shaking, thankfully unconscious as the morphine pump grinds along.

I hear the sirens of the engine company in the distance, more strangers about to invade this intimate gathering-this final farewell. It's a moment that will stay with the survivors forever, and give them comfort in the difficult days ahead. Knowing their loved one died with dignity, in the home he built, surrounded by family.

"I need a Do Not Resuscitate order signed by him or a doctor," I say to the person who appears to be in charge. He nods, understanding my request and the position I am in.

Two respirations a minute now. The guy is fumbling for the paperwork as his dad is about to leave this earth forever. The engine company arrives on scene, chaos about to enter and ruin the hoped for serenity of a man's final moments with his family.

"It's okay," I tell the man, and step outside, closing the door behind me.

Overheard in a house in a country not far from here…

"Son, what are you doing?"

"Learning to speak English."

"Why?"

"Because I am taking my family and starting a new life in America."

"Great idea, but why are you bothering to learn English?"

"So that I can teach my children before we go."

"Don't waste your time, the American people pay to to teach your children English."

"But I don't want them to fall behind in school."

"They have English as a second language classes in the schools."

"That will cost too much!"

"It won't cost you anything, the American people pay for it."

"But what if we get sick, we need to find a doctor, and work out a way to pay."

"No need. Hospitals are everywhere, and the healthcare is free!"

"Free?"

"FREE."

"Free for everybody?"

"Of course not. It's free for people who don't have anything. So whatever you do, don't buy a home, or get established! Make what you can, live a simple life and hide the money. Send it to me for safe keeping."

"But what of everything else? If we don't speak the language of America, we surely will be lost."

"The American people pay taxes so that the government can employ thousands of interpreters in every state. All government documents are available in every language known."

"How can the American people afford all of this?"

"They can't! Here's the best part, they're taking retirement benefits from their old people, saying that the benefits are unsustainable! They're cutting health care plans and making them either unaffordable or worthless."

"They do that to their own people while continuing to pay for educating ours? And giving us free healthcare? And spending billions a year to do everything in different languages?"

"Yes, my friend, they do."

"Sounds like a nice place to visit, but I wouldn't want to become a citizen!"

"You have that right my friend, now go relax, and plan your journey, and go to America and make as much money as you can, then come back home and live like a king while the American people struggle.

"It doesn't seem fair."

"It's not fair, it's the way it is."

o

http://rescuingprovidence.com/random-photos/

I took a few minutes cleaning up the site, thought this Random Photo thing came out okay. Every one of the pictures is in a post somewhere in this blog, these and hundreds more that I forgot to save. Rolling through old pictures brings out so many emotions, so many memories and so many good things that I had to make myself stop.

Well, that's not really true, I have every intention of going into my basement and breaking out the really old photographs. There's something special about a photo album that you can hold in your hands. I can feel the people whose spirit was captured by the lens when I can pick up their image, and inhale whatever it is that gives those glossy squares of life their distinct aroma.

I think I could close my eyes and know exactly what image I held, just by using my sense of smell. Digital images are great and all, but we tend to edit out the bad ones, and those often are the most memorable.

I'll be in the basement if you need me….

They're in their late seventies, been together for forty plus years. One morning, he tells her he doesn't "feel right." A few hours go by, he gets worse, then gets so dizzy he falls. She calls 911, and when she finally gets to the fire department dispatcher tells him that she needs help. He asked the nature, and she says, "my husband isn't feeling well."

That could have been that, the dispatcher could have sent a rescue to the address to handle the situation. But that's not what happened. Not at all.

The person who answered the phone has answered thousands of similar ones. He heard something and instantly knew there was more to the story. He pressed. She told him he felt dizzy, and had fallen.

The dispatcher sent the troops. Upon arrival, Engine Company 11 found a man in cardiac arrest. With Rescue 1 four minutes out, the crew confirmed pulselessness and defibrillated twice before getting a rhythm back, then a pulse. An IV was established before the rescue arrived, 02 flowing and the man breathing on his own.

He regained consciousness two days later, and his wife was right there with him when he did.

The man hand delivered a letter of thanks to the station on the first anniversary of his second chance. He's loving life like never before, he says, appreciating the chance he was given. In his words, "by you."

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"I have a plan," I said to our group of misfits.

"It had better be a good one," said Charlie. "Things don't look so good."

"It is. Hear this. Bob, you and I will follow our little friends Tim and Billy back to the outpost, and they will lead us to Sid. Charlie, you and Angus take Crissy to the Russians and wait there for us to return."

"That's your plan?" said Bob.

"KISS," I said.

"Kiss my ass," said Bob.

"Keep it simple, stupid," I said. "It's great advice."

"I'm not crossing Sid," said Tim.

"By not crossing Sid, you choose to cross me."

"Either way, I'm dead."

"We all die eventually," I grinned. "Well, not all of us," I said, flashing a fang.

"Who are the Russians?" asked Crissy.

This should be good.

"Some friends who help us now and then," explained Angus. "They live by Echo Lake, and Malcolm is right, theirs is the perfect place to regroup. It is far enough from the Outpost that Sid will not be able to read us, or find us, and the lodgings are vacant, The Russians have departed, just this morning, their work here done for the season." Angus shot me a smug grin, and I couldn't help but chuckle. Things just work out for him.

"I don't like the idea of splitting up," said Bob. "But I don't think we have a choice. The only problem is, I don't trust these two," he pointed a finger at Tim and Billy, who were hunkered next to their overturned ambulance.

"It won't work anyway, we don't know where Sid's lair is. He never lets us beyond the gate," said Billy, his face contorted with pain.

"Fucking Sid," I said. "We have to find him, and soon. Charlie's granddaughter is running out of time. Any ideas?" I asked our little group of vampires and vampire hunters.

"We could burn the Outpost to the ground, with all of you in it," said Charlie.

"You would lose your granddaughter," I replied as Angus shot him a look that would turn Satan himself into an icicle.

"We let these two take me to Sid," said Crissy. "KISS," she smiled, and she actually blew me one.  I'm starting to like her.

"Too dangerous," said Angus.

"Too obvious," said Tim.

"Too bad it's never going to happen," said Bob.

"Too bad we don't have a better choice," said Charlie.

It is safe neither here, or there," I said. "Safety left the building the moment Angus and I disposed of the Vampires at Charlie's house. Make no mistake, the chase is on, and we are the chased, rather than the chaser. It will be so until we flush Sid from his grave. Then, and only then, he is vulnerable. Vampires on the run grow more frantic as each hour of darkness passes. keeping him away from his web of safety for as long as possible is a good strategy. Using Crissy as bait may be our only hope."

"I've got a better idea," said Bob. You take me back to Charlie's, I get in my Tahoe, Crissy gets in the shotgun seat, we hit the gas and you all can watch our taillights disappear."

"Who do you think you are, Joe Robert's? There ain't no driving across the border, there ain't no outrunning the highway patrolman, there's nowhere to hide now, it's either kill or be killed. Vampires have not survived for centuries because they let people go. They let people go to their graves, and nowhere but. Here's a news flash people. We are fucked. Completely, utterly and desperately fucked."

""Don't hold back, Malcolm," said Angus. The group had gathered in front of me now, standing on the dark, deserted roadway between Bob's campground and the Outpost. The Russians place by Echo Lake was a half an hour distant, Code 3. Nine o'clock, eight hours till dawn, Creatures of the night had the advantage, Angus and I could run, and hide, and live the life of gypsies again until we found a new place, and established ourselves. That would surely be the end of Crissy, Bob and Charlie. Tim and Billy might squeak by, but that is doubtful. All eyes were upon me.

"I said I do not wish to lead, only eat," I said, looked up at the night sky as stars flickered and dimmed, then reappeared. Flashing lights broke the darkness from the north, ahead of us, and the south, behind. Then, familiar shapes  formed on the road.and when the stars stayed bright, the forms that had obscured their image materialized from the sky, and we were surrounded by bloodthirsty killers.

Four of the fiends disembarked from the pumper in front of us, dressed for battle, their turnout gear covered with soot and dripping with blood. The vampires behind us, two of them, rode in a tanker but wore the same gear, with the same tell tale markings of a recent slaughter. The monsters from the sky resembled roadies from the Monsters of Rock tour in 1985, only their lifeless bearing came from being undead rather than heroin.

"Stay still," I whispered to my gang. If anybody moves, we're all dead.

"I've captured the vampire killers!" I said triumphantly. "Help me bring them to Sid!"

'