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“Rescue 1, Respond to 1835 Broad Street for an intoxicated male at the payphone.”
Duty calls. Duty waits. I refastened my belt loosely and hit the pole.
“Rescue 1, responding.”
We rolled out of the station and into the city. Some folks would have taken care of business first; others may have gone out of service until the job was done. Not me. Nope, a call for help needs to be answered. I cleared my mind and focused on the emergency. Not my emergency. That would have to wait.
It wasn’t long before the cause of my discomfort was on my stretcher and I sat behind him, squirming. Now and then my pressure relief valve opened, biding me time and some unintended revenge as the intoxicated homeless man wrinkled his bulbous nose and slurred, “What stinks?”
As we rolled our patient through the ER doors I realized I had reached the crossroads. A pivotal decision waited. The staff rest room was occupied, the public one simply out of the question.
“We have to get back to the station,” I said to my partner, Mark. “I’ve got to go.”
A good partner knows instinctively when things are critical.
“Let’s roll.”
It’s a three mile trip from the Emergency Room to the Fire Station. ETA six minutes. I could probably make it. Everything was going great, light traffic, perfect weather conditions, no road construction in sight. I could see the Promised Land in the distance, a little more than a minute away. I relaxed, briefly.
“A train!” said Mark, hitting the brakes as my intestines churned.
“You have got to be kidding.”
“It’s the Harbor Chemical Train, slowest moving locomotive on the Eastern Seaboard!”
“Oh. My. God.”
I was now diaphoretic and rapidly cramping. Respirations increased as my heart raced. The railway gates closed, blocking our approach. Lights flashed, the shuffling monster crept toward the intersection. Just when I thought all was lost, a slight reprieve. Mark rolled the window down. ]
“Turn around, we’ll backtrack to the one way, circle around the bookstore, go back up the one way down and double back over the railroad tracks.”
“Done.”
He flicked on the warning lights and turned around. We approached the one-way, ready to make our move when a Battalion Chief appeared in the distance, heading our way.
“BOGEY AT 12 O’CLOCK!” said Mark, turning off the emergency lights. I curled my toes, smiled and waved politely to the chief as we passed his vehicle. We were now headed in the exact opposite direction of the Promised Land. Suddenly, inspiration.
“Stop at the Burger Place!”
“You must be desperate.”
“I am.” I flashed back to my last visit to this particular facility; an overdose in one of the stalls. Hygiene was not a priority. Thirty seconds later the pain in my abdomen subsided.
“I think I can make it, keep going.”
“Are you sure?”
“I can do this. I can.”
We left the burger joint in the dust. The station was around the next bend, salvation moments away. I saw it in the distance, a beacon, a ray of light, the most beautiful thing I had ever seen. We roared onto the ramp, I rolled under the slowly opening overhead door and duck walked to the rest room, just in the nick of time. The radio came to life.
“Rescue 1, are you available?” I smiled and keyed the mike.
“Roger that, what have you got?”
The rationale behind this post is based on my belief that Emergency Medical Services are provided by the government and paid for by tax dollars. I am well aware that my belief is outdated and no longer relevant, and EMS is now a business, but that does not mean I have to like it!
May 19, 2013
From POTUS
"NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 19 through May 25, 2013, as Emergency Medical Services Week. I encourage all Americans to observe this occasion by sharing their support with their local EMS providers and taking steps to improve their personal safety and preparedness."
hmm, says cynical me
May 20, 2013
From RCOPFD
"Now, therefore, I Michael Morse, Rescue Captain of the Providence, RI Fire Department, by virtue of the authority vested in me by, well- me, do hereby proclaim May 19 through May 25, 2013 as Emergency Medical Services Week. I encourage all Americans to observe this occasion by asking themselves if they want to continue having competent, trained medical help available and mobile and ready to respond to their emergencies. If so, please share your support with your local EMS providers by asking for emergency help only if there is actually an emergency happening. If not, allow the nation's EMT's and Paramedics to continue their march toward visiting nurse status."
And its not just the citizenry destroying our emergency medical response capabilities. A strong push from EMS Royalty to water down EMS into Mobile Community Health providers is underway. I have nothing against Mobile Community Health providers at all, but we have doctors and nurses for that.
EMS is transforming right before my eyes. What was an emergency response system for medical emergencies and trauma is becoming a big part of the economic machine. We are churning out EMT's and Paramedics quicker than we can provide jobs.
What to do?
-Keep the money train rolling by "transforming" EMS.
-Find ways to stay relevant.
-Create opportunity.
-Provide jobs
I'm not buying it. We are what we are, and that is emergency responders. I want nothing to do with blood pressure clinics, elderly screening or visits to the neighborhood day care.
Overheard in the back of Rescue 1, during a clean-up.
"Piss isn't too bad."
"Puke is the worst."
"Nah, shit's worse than puke, any day."
"Blood is easy, it doesn't stink."
"That's why piss isn't bad, easy clean-up."
"Old piss is pretty bad."
"New shit is worse than old shit."
"It's still runny."
"Speaking of runny, snot's pretty bad."
"Yeah but you hardly ever wear it. "
"Yeah, puke wins that one."
"But shit's still the worst."
"Yup. Piss is my favorite. Definitely."
"I guess."
Overheard in the front of Rescue 1. Very late at night.
"I wonder why we never get sick."
"Because we already are sick. There's only so much sickness to go around."
"Yeah, but we're surrounded with sick people all the time. We touch them, breathe their air and all that, you would think we would get sick more often."
"You think too much."
"And why do we carry people with back pain down three flights of stairs when our backs are worse that theirs?"
"Because we can."
"So can they."
"The difference is, they know WE can."
"But we know THEY can."
"You think too much."
"I guess."
Overheard in the cab of Rescue 1 enroute to "man down."
We're Cavemen, you know.
(from officer's seat, fiddling with the radio) How so?
The station is like our cave. It's dark, dreary and ugly.
A man-cave.
Right. Instead of wall paintings we have a big screen TV. Every now and then an emergency happens, we pile on our skins and forage into the wilderness to protect the women.
Some of us are women.
Right, there have always been strong women.
Right. Remember Raquel Welch from 1,000,000 years BC?
Who?
(looks incredulously over at his man-boy driver) Never mind.
Anyway, when we get hungry we leave the cave to hunt for meat.
The supermarket isn't exactly hunting.
It is when you're looking for a deal.
I guess.
Then, we gather around the fire and eat.
You do look like a bunch of Neanderthals at the table.
Exactly. Cavemen.
Right. (Mike keys the mike as Ryan stops the rescue in front of the "emergency.") Rescue 1 on scene.
The cavemen load up their weapons and forage into the wilderness, looking for their victim.
Overheard on the Street:
Police officer: "Hey, were you guys there that day when that girl flashed us?"
Firefighter 1: "Which girl?"
Firefighter2: "What day?"
Firefighter 3: "There have been so many, we forget."
The police officer walks back to his cruiser, shaking his head.
Police Officer: "I think I took the wrong test."
Overheard in the Cab of Rescue 1 after clearing Hasbro Children's Hospital:
"She was hot."
"She's fifteen you pervert."
"Not her you idiot, her mother."
"Her mother is old enough to be your daughter."
"That means I'm old enough to be her mothers father."
"Right."
"She's still hot."
"And you're still old."
"Right."
"Rescue 1 in service."
Overheard in Rescue 1 after a visit to the Coffee Exchange where the crew was completely ignored by the college girls behind the counter.
Lt: "I don't get it. They don't give us the time of day. It wouldn't kill them to be nice to us. Jeez, girls aren't like they used to be. Why can't they even crack a smile?"
Ryan: "Because I'm fat and you're fifty."
Lt: "Oh, that. carry on then."
Overheard at the ER
The ER was a madhouse, drunken street people, drunken college kids, drunken housewifes, drunken fools. Minor injuries, a few legitamite trauma's, some sick old folks and a bunch of people vomiting. The wait was hours. In the middle of it all was a twenty something year old inmate from the ACI and two correctional officers. The prisoner had a minor injury to his throat from an altercation and had been waiting for a long time. As I walked past them I overheard the inmate ask his guards, "can I go back to my cell? Anywhere is better than here."
I ran into a guy I know while picking up some Thai take-out.
"How you doin?" he asked.
"Okay," I answered.
"Still a fireman?"
"Almost done," I said.
"Must be nice," said one of the six people at his table. I didn't say a word.
"Wish I could retire," said another.
"What are you, forty-five?" asked a third.
Just what I needed, a bunch of middle-aged people, business owners, office workers, construction people- whatever – in my grill. In my head a litany of responses were born, and quickly died.
"I wish I had worked in a nice air conditioned office for twenty-two years."
"Must have been nice having holidays with your family."
"Ever have a ceiling fall on your head. One that's on fire?"
"Ever been stabbed by a dirty needle?"
"Ever been shot at?"
"Ever held a dead baby?"
"Ever…" blah blah blah, it wasn't worth the effort.
Truth be told, if I could do it all over, I wouldn't change a thing.
I paid the bill and left, for some strange reason feeling lighter than I did when I entered the place.
He’s screaming, she’s screaming, everybody is screaming, blood here, blood there, blood everywhere, nobody put the dogs out, they’re screaming too, the cops are screaming, Christ – even the houseplants are screaming.
Just because everybody is acting like monkeys doesn’t mean I have to jump into the barrel, and screaming “calm down” is akin to jumping in head first.
Standing in the middle of chaos, I crossed my arms, stood strait and asked just quiet enough that nobody could hear, “who is bleeding.”
It took a minute, and a few more quietly asked “who is bleeding’s,” but eventually things quieted down enough for me to find the bleeder, and remove him from the nuthouse.
If you want to capture somebody’s attention, whisper.
Congratulations to Warwick, RI Firefighter John Halloran for being voted the nations sexiest vegan-next-door. According to the news story, John cooks vegan meals at the firehouse for his fellow firefighters. Having been a firehouse cook for decades, and having experienced the "constructive critisism" when the meal was anything but "hot and alot," from my own fellow firefighters, I can only imagine the thick skin this sexy vegan must have!
Enjoy the trip to Maui, John, well done!
"Rescue 1 and Engine 10, respond to 1035 Broad Street for a man down."
"Why are they sending an Engine company?" asked my partner, a new guy who knew everything. "It's just another drunk."
"You'll figure it out."
I heard the slight urgency in the dispatcher's tone and knew that she sensed something in the caller's voice other than the usual intoxicated person call.
I scanned the horizon, looking for the patient. The scene through my windshield resembled a set from The Walking Dead; semi and fully intoxicated persons wandered about aimlessly, homeless for the most part, restless, hungry and unsteady. One of the regulars, "Junior," waved us over.
"He's over here," he said, unsteadily leading us around the corner where a man in his 40s sat on a curb, leaning on a building, clutching his chest.
"What happened?" I asked. Junior spoke to the guy in Spanish then translated to me.
"He's been working on the new barber shop over there," he said, pointing at some new construction across the street. "Felt his chest thump, then lots of pain. He can't catch his breath. He thinks he's going to die."
The crew from Engine 10 arrived on scene, two firefighters retrieved the stretcher from my rescue, and my old partner, Renato, joined us next to the patient.
"Mornin' gang, looks like a possible MI; Renato, grab a 12-lead while we get him ready to roll."
Renato hooked him up to the EKG machine while my partner assessed vitals and readied the 02. Just as the results were printed, a non-rebreather went over the man's face, the stretcher appeared, Junior helped us load the man onto it and we were back in the truck.
"220/130, rate of 110," said my partner.
"Stemi," I said, looking up from the EKG. The crew got to work as I sent the image to the ER. An IV was established while nitro and aspirin was administered. One of the firefighters got in front to drive, Renato stayed in back with the new guy and me.
"Let's roll."
Junior closed the doors for us, a big smile on his face, his work done for the day. He even gave the obligatory ambulance door double thump as we left the scene, leaving an imprint of his big paw prints clearly outlined over the road grime that had accumulated.
Seven minutes from our time on scene to the door of the ER, two IVs had been established, a 12-lead was in a cardiologist's hands, a STEMI team began assembling, meds were on board, oxygen flowing, vitals re-assessed and the most important part – a stable patient whose life will continue was conscious and smiling on our stretcher.
He was in the cath lab less than an hour after the onset of symptoms.
The dispatcher heard something in the voice of the caller and sent the proper resources, our relationship with the homeless alcoholics led to one of them being willing and able to offer some needed assistance, a crew of ALS trained firefighters on scene, and an ER staffed, trained and ready to handle cardiac emergencies all combined to give a guy working on a barber shop the chance to finish what he started.
Dispatch. The Homeless. The Ambulance. The Firefighters. The ER. When we work together, great things happen.
http://www.ems1.com/fire-ems/articles/1443561-When-we-work-together-great-things-happen/
What was your best team save?
Here's how to enter:
1. Submit a short story (300-500 words) about the moment your team pulled together to save a life or solve a problem.
2. Check back during EMS Week (May 19th through 25th) to see if your entry was selected by EMS1 editors as a finalist.
3. Vote for your favorite entry – or your own if you're a finalist. We'll announce the winners on May 25!
http://www.ems1.com/ems-week-2013
We had a nice team save, here's how it went down…
http://www.ems1.com/fire-ems/articles/1443561-When-we-work-together-great-things-happen/
Memo to the knucklehead on the rice burner who nearly drove into my car head on because he was too busy flipping off and yelling at the driver of another car who, due to the motorcycle drivers inexperience nearly hit the aforementioned biker while changing lanes because apparently Mr. Big Bad Biker has never heard of blind spots:
1. You share the road with automobiles
2. Automobiles are bigger than motorcycles
3. People in those big automobiles sometimes cannot see you, so PAY ATTENTION, Dumbass!
And furthermore, memo to the pretty, nearly naked hottie on the back of Mr. Big Bad Biker's rice burner:
1. Get off the back of the bike and learn how to ride, then you will never be at the mercy of a moron who thinks his motorcycle is a toy and has no regard for his or anybody elses safety.
2. Put on some clothes for Christmas sake, I'd hate to see all that skin smeared all over the highway!
Motorcycles are Everywhere. The days of the big bad biker are over. There are lots of Mama's boys driving bikes that are too powerful them out there. And, there are also a lot of weekend warriors on their $25,000 Harley Davidsons who should have bought a convertible.
Yeah, I know, I sound like a jerk. It's not all the carnage I've seen over the years that makes me so; rather, it's the guy my age who I take to the ER regularly for treatment for his seizures. He cracked up his bike ten years ago and has lived with the elderly in a nursing home ever since. The only helmet he ever wore is the one on his head now, the one that keeps him from cracking his melon again when he seizes.
Born to be wild? You tell me.
There, I said it. However, being a former motorcycle owner (1978 Honda CB 900) and sometime rider, and friends with people killed and maimed while on motorcycles and doing nothing to deserve their fate other than be clobbered by a car driven by a drunken driver, person not paying attention or just bad luck it remains to be said that we all need to put down our phones and beers and whatever else and pay attention while driving. Not everybody is a knucklehead, and even knuckleheads deserve a safe roadway, as long as they themselves follow the rules of the road.
It was odd how just as the victim plunged into unconsciousness some miles away, unknown to me then, I sat at my desk contemplating mankind's fascination with mind altering substances. My penchant for opiates and laudanum notwithstanding, it never fails to fascinate me how we as a species are willing to dance on the threshold of death's doorway, bloodstream filled with substances that dull our senses, distort time and deaden emotion. Perhaps this last is why we take such chances with our lives, for this can be a trying existence.
"Rescue 1 and Engine 12, respond to 323 Joseph Street for a man unconscious."
I ditched my melancholy immediately and hit the pole, opening the overhead doors to Baker Street and waited for my erstwhile partner, Dr. Watson. Some ten seconds later he appeared, opening the door to the Ford F-450 and climbed aboard.
"Dr. Watson, well, met," I said as we roared out of The Yard and sped toward our victim. "Another game is afoot!"
"You look rested, Holmes, the break did you good."
"Never enough my good friend, rest is an elusive fish I can never seem to fully grasp."
"Engine 12 to Fire Alarm, we have a thirty year old male, unconscious, no trauma."
"Receive that Rescue 1?"
"Rescue 1, received."
"Odd. An overdose in that neighborhood is unusual," said Watson as we sped toward the victims home.
"Unusual, yes, but not unprecedented. Recall if you will the grandmother whose bottle of pain pills mysteriously vanished an hour before her bout of unconsciousness."
"One never knows the depths of despair a person will try to wrench themselves from with pharmaceuticals."
"Indeed." I keyed the mic as we rolled to a stop in front of a gracious colonial, well kept lawn leading to a brightly lit doorway where a frantic young woman waved.
"Rescue 1 on scene."
"At 2344."
Watson retrieved the necessary equipment for extrication from a rear compartment, I slung the med bag over my shoulder and hurriedly walked the walk toward the unconscious male.
"When was he last seen awake?" I asked the young woman at the door.
"About eleven thirty. We were playing cards with some friends, he seemed tired, then he just fell asleep. We can't wake him up, Hurry!"
In the kitchen a couple stood off to the side as the firefighters from Engine 12 assessed and treated the young, unconscious male.
"Glucose 128, BP 96/50, respirations at 6. Looks like an overdose but I don't see and tracks or evidence."
"Look more closely, " I said. The unconscious man's friends stated that he did not take drugs, and never did. Nonetheless I had Dr. Watson draw up a vial of narcan and immediately administer 2 mg through the IV the firefighters had established.
"What are you doing! He needs to get to a hospital!" the nervous wife shouted, and her friends agreed as the patient's color faded and he stopped breathing. We bagged him then, forcing life-sustaining oxygen into his lungs, keeping his 02 levels above 90.
"I'm afraid your friend has overdosed," I said to the concerned group.
"Impossible! Preposterous! You fools!" they responded. "How dare you accuse this fine, upstanding young man of using illicit drugs!
"Elementary," I responded as the patient began breathing of his own accord. "There is a walker in the corner, near the door. It has not been used recently, but not long ago enough for cobwebs to form. The obituary on the refrigerator, dated last week indicates that this young man lost somebody close, and the dead man's date of birth puts him at an age to be the father of this very young man!" I pointed to the victim who was now shaking cobwebs of a different sort from his drug addled mind. "In addition, there is a faint odor of a medicinal nature that lingers here, I have surmised that you cared for the person who died, right up until his dying moment."
She looked at me then, pain in her eyes, but relief as well as her mate regained consciousness. "My father in law died here last week. He was a wonderful man, he died of cancer."
"I am very sorry for your loss, I said. "Was he medicated?"
"Morphine. Sublingual. We put a dropper under his toung every four hours."
The young man who just returned from the other side looked sheepishly at the floor, then reached into his pocket and handed me an empty vial. I clasped my fingers around it, nodded my head knowingly in what I hoped was a gesture of understanding and not accusation and put it into my pocket. Dr. Watson and the firefighters cleaned up and returned our gear to our apparatuses, which gave me a moment alone with the young group.
"Sadness propels us to do things we would otherwise never consider. You will not be the first, nor the last to indulge in a dead persons medication. Some don't have the courtesy to wait until the person needing the narcotics dies, and help themselves to it while their loved one suffers in silence. May I suggest you find somebody to talk to, clergy, a therapist or even a friend. There were almost two deaths in this home this week, had we arrived a few moments later the outcome would not be a lecture, but a body bag."
We talked for some time, finally coming to the conclusion that this was a terrible mistake, a grief stricken young man dulling his senses with his father's medication. He had put a drop under his tongue every hour for the last five, sometimes more than one drop. It nearly cost him his life.
"Stay close to him, take care of him tonight, and get help tomorrow," I said as I departed, never fully comfortable in these scenarios, but confidant enough that the best course of action is family help rather than an emergency room full of drunken college kids, gunshot victims, blood soaked stabbing recipients and the like.
As Watson and I drove back to Baker Street, evidence of the fragility of our existence and frailty of our sanity weighed heavily on us.
"What madness allows a man to take his dead father's medication," asked Watson as the midnight hour came and went. As the hands of the clock pass twelve, an eerie calm descends on the city, lasting sometimes an hour, sometimes a minute, but it is discernable, and I am always grateful for the reprive.
"The same madness that allows a fifty-nine year old father to be taken before his time, my good friend. The madness of existence."
We rode in silence then, I filled my pipe with a sweet Turkish blend, and stared down, into the bowl as I puffed, mesmerized by the glowing tobacco and comforted by the familiar aroma as smoke swirled wistfully through the cabin.
http://www.fireengineering.com/articles/fire_life/articles/2013/april/fire-based-ems.html
…
This week’s (I wrote this a while ago) examples of how it could be:
- A diabetic, unconscious in Mount Pleasant. All Providence rescues out; Engine 15 arrives three minutes after initial call. Rescue 1 clears Rhode Island hospital, ETA 11 minutes. We arrive, patient is alert and conscious, BG 145 from a 22, IV established, D-50 administered, wondering what all the fuss is about.
- Overdose in the West End. Rescue 1 is fifth due, ETA eight minutes. Engine 8 arrives on scene in two. 2.0 mg narcan adm. IM, the patient who was seconds from death prior to their arrival now alert and conscious, denying drug use.
- Seizure in Washington Park. Seventeen-year-old kid, first seizure. Family going berserk. Firefighter from E-13 speaks fluent Spanish, calms the scene; two firefighters lift the 200-pound kid from his bed, postictal at the time, secure him to stair chair while the patient gets combative, figure a way to get him out of the bedroom and down the stairs while the rescue officer gets pertinent information from family. Once in rescue, IV established, meds administered, vitals assessed, and a report radioed to the ER. Impossible to do with two hands; six worked just fine, thank you.
- Two intoxicated males, on the street in South Providence. On arrival, Rescue 1 is attacked by intoxicated males. Police called. Engine company dispatched. Two minutes later, Engine 10 arrives on scene, order is restored, the intoxicated males subdued and restrained in the back of the rescue with assistance from firefighters. Police arrive on scene as we depart, engine company following.
- Chest pain in the North End, Rescue 1 ETA 12 minutes. Engine 2 on scene in three. Nitro, aspirin, and oxygen delivered in four, vitals and an IV to boot. Rescue 1 arrives on scene, the engine crew carries the elderly gent down two flights of stairs and into the rescue. I do the paperwork and say thanks.
- MVA on Rt. 95. Engine 11 arrives on scene five minutes prior to Rescue 1 and seven minutes prior to police. We arrive, the lights and presence of the engine providing some safety from passing motorists, bleeding from vehicle occupant controlled, c-traction applied, leaking fluids contained, and patient history assessed and documented. The firefighters retrieve the spine board from the rescue's compartment, extricate the patient, and deliver her to the rescue, then stay on scene until we depart…
"She isn't a bad person trying to be good, she's a sick person who needs to get well."
http://www.emsworld.com/article/10929600/stories-from-the-streets-compassionate-care
"Do you worry that you let too much of yourself out," asked Greg http://everydayemstips.com/ as we finished out Western Omeletes. Breakfast was good, we went to a little place on Jefferson Boulevard, The Athens Diner, right next to what once was a bustling factory where the world got its plugs, switches and drapery hardware. That's gone now, and the factory workers are now doing something else, retired, mostly, the kids that would have worked there had to find another way to make a living.
"I used to, but when I decided to pursue the writing thing I learned that to be any good you have to be fearless."
Greg understood. That is the beauty of meeting and connecting with other writers, people who do so with no fear of ridicule from our peers. There are lots of people who enjoy what we write, and we, ourselves get an enormous boost from being able to articulate our thoughts. There is always the worry that we overdid things a little, put too much out there for the masses to disseminate. But to be any good, its just something that needs to be done.
Stereotypes are grounded in reality, and people from Wisconsin really are nice. Not only nice, but a bit fearless as well. Greg had just finished the Boston Marathon, and I could see the lingering dismay in his eyes as we ate. What was to be a great trip, a successful end to sixteen weeks of training and a meeting of friends who hitherto had only known each other through our writing turned into a terrorist attack.
I'm sure this was a trip to remember for Greg, and I'm glad we managed to fit a peaceful breakfast into his itinerary. It was something I had looked forward to for weeks, and I thought the bombings had ruined that as well, but a guy from Wisconsin and another from Rhode Island managed to move on, and talk about our lives, our families and the people who share our passion for spreading the word of what firefighters, EMT's and paramedics do, and get to know each other a little better, and create a friendship rooted in the words we write.
A couple of bombs and the ensuing manhunt didn't ruin that, and for that I am grateful.
A couple of douchebags killed and maimed a lot of people a few days ago, killed a cop last night and critically injured another. The one who isn't dead is holed up somewhere, no doubt planning to go out in a blaze of glory. The good guys have him surrounded, http://video.foxnews.com/v/1155606982001/ Stay safe, Boston, I'm praying that there is only one more death before this nightmare ends.
Prayers for West, Texas, where if not for the criminals in Boston the nations attention would be focused.
It doesn't matter how they were killed, whether they were innocent bystanders, firefighters, workers, cops or criminals, a lot of people are dead. If there truly is a day of reckoning, and judgment to be passed, whoever or whatever does the judging is in for a busy week. The gates of hell are wide open, but more important than that, the path toward infinite peace is clear.
We survive the mundane, seemingly endless calls for emergency medical services, put on our game faces, treat the chronic alcoholics, the diabetics, the dialysis patients the elderly who are looking for little more than a sympathetic ear and somebody to talk to. We do the everyday grind, some days making a difference, some days not.
Some days, days like yesterday, when Boston turned from a celebratory affirmation of life and those living it to the fullest into a mass casualty scene the people who responded did so in such a way as to make all of us sit a little higher in our seats, walk a little taller and know that without fail our brothers and sisters will and do go the extra mile, and make the rest of us proud to wear the uniform- whatever that uniform may be.
Any firefighter or paramedic or EMT worth his or her salt in some deep place within them wishes they were there, in the thick of things, doing what we know how to do with the professionalism, courage and dignity shown to the world yesterday by those who were there, and did what any of us would have done had the unfortunate events happened to us.
It is both humbling and exhilarating to belong to this group of individuals, who as a whole represent the best of what mankind is capable of becoming. I sit here in the safety of my home, think about the job done yesterday, and tip my hat to the responders, pray for the victims, and thank whatever forces led me to this calling. Again and again I'm reminded of what a special group of people I am fortunate enough to call my own.
Explosions were heard at the finish of The Boston Marathon a short time ago, people bloodied by the blasts were seen being helped to the medical tents that were set up for fatigued runners.
Greg, from Everyday EMS Tips and countless other EMS related endeavors is running the race, probably finishing about now. I'm planning on meeting him for breakfast tommorrow morning. My guess is he's in the thick of things, helping people.
Godspeed, Greg and all, stay safe, god willing I'll see you tomorrow.
Three dead, dozens injured. Sad day in Boston.
California Casualty publishes a quarterly newsletter called Flashpoint, it is a great resource and a good read for firefighters and everybody interested in Fire/EMS. (That's everybody, isn't it?) They asked if I would like to contribute a story, I did, and here it is. The rest of the newsletter is excellent, follow the link, you will be glad you did.
Everything she owned was in that house-everything she had ever owned. Nearly eighty years is a lot of time to acquire things, magazines stacked from floor to ceiling, boxes stacked on boxes, filled with things she owned. Furniture covered every inch of the three-bedroom place, mostly old, but a few new pieces scattered here and there. Most people consider their space in square feet, Mildred counted hers in cubic feet, and every inch needed to be filled.
The overflow spilled out of the entry door into the vestibule, where more “things” were stacked. From there, a path of stuff led to the driveway, where two mini-vans sat, idle for years, crammed with more things. One of the vans had a three cubic foot space where a driver might be able sit, if she crammed herself in, but visibility would be impossible, except perhaps for straight ahead. I don’t thing there has been much forward sight here, every inch of the premises reeked of life already lived.
She held on to the doorframe, digging her fingers into the greasy wood, refusing to leave. “I can’t leave my babies,” she said, frantic, panic setting into her eyes, eyes that had seen a lot, and had let go of little. Cats prowled through the clutter, seemingly everywhere, then nowhere, and then everywhere again. The stench making our eyes water and stomachs churn, bile rising in our throats as we tried to pry Mildred away from everything she had. Had ever had. There would be dead cats under her things, of that I was certain. The live ones didn’t have long to go either, and would be collected by Animal Control, quarantined, evaluated and most likely euthanised. Then, Mildred’s things would be put into dumpsters by workers dressed in white de-con suits, with artificial respirators to keep the diseased air out of their lungs, the very air that I breathed into mine every second that we lingered in the doorway.
I knew she was ill, and living in absolute squalor and disease, yet I simply could not drag her away from her world, the only one she understood, and take her to the hospital where she would be stripped, and showered, and given clean clothes, and put in a sterile room where air flow and empty space would suffocate her. Intelligence burned brightly in her vivid blue eyes, eyes as clear as my own, and I knew she was far from legally incompetent. She could not, and never would understand how these strangers entered her world and dragged her away, never to see it or her “babies” again.
“Mildred, we have to go. Your neighbors complained about all of the stuff and the cats. We have a court order that says we have to take you to the hospital for an evaluation before you can come back. It will only take a few hours.” She looked me in the eye, and I saw defeat and resignation in hers. “Promise I’ll be home again?” she begged, the loosened her grasp, letting go of the doorframe. I gained her trust only to betray her. It was the only way to get her to leave without physically dragging her, kicking and screaming away from her home.
The crowd grew, and the spectacle grew along with it, so I did my best to restore a sense of normalcy, and made promises that I knew were empty, and took her hand and led her away, past the nosy neighbors, some of whom shook their heads and tsk tsk’d as we marched past them. There were no goodbyes, no see you when you get back, no get well soons, just a little old lady holding a stranger’s hand and walking to an ambulance and into a new, frightening life.
A person needs space to grow, using past experiences as a guide while forging ahead. The weight of decades of living must be shed as the years progress lest the weight of our accumulations make moving forward impossible. We need to let go in order to flourish, make room for new things and experiences, and learn to give up what once held importance, but with time became nothing more than a burden. There is a lot to be said about starting fresh, and getting a new start. Every day is a new beginning, memories that we cherish, lessons we have learned, mistakes made and overcome all take their place in the forging of what that beginning will become. Mildred was lost in the accumulation of what was, never letting go, and never moving forward.
We rode to the Emergency Room quietly, her on the stretcher, lost in a world of her own thoughts, me behind her, writing my report, and trying to be objective with my words. I have faith in most of the people I work with, and the folks at Elderly Affairs do a remarkable job with the limited resources at their disposal, but I couldn’t lose the sinking feeling that Mildred would be lost in the shuffle, and the people who took her “case” would miss the connection to the woman who tried desperately to hold on to the only thing she knew. Perhaps it is better that they did not see the squalor, be immersed in the odors, see the poor little kitty cats as they scurried through the debris. Maybe they would see this as a fresh case, an opportunity to show a woman who needed their help how to let go, and start anew. I certainly hope so.
I heard on the news that there were over forty cats in her home, which had been condemned and scheduled for demolition. Some of them were suitable for adoption. I spent my days off cleaning my basement. It was time to let go of some things, and make room for something new.
We walk in, bringing nothing that will do anybody any harm, just tools to help the sick and injured. In the homes we enter are sick people, physically and mentally. Who those people are is a mystery until we establish contact, and do an assessment, until then we have only our faith in humanity to rely on, and we go in expecting a person who needs us to be waiting.
A person waiting to take us hostage needs us as well.
The jack-off in Georgia did a lot of harm yesterday before being shot to death by a SWAT team member. I don't know the firefighters who were taken hostage, don't know any firefighter who was taken hostage for that matter, but I do know hundreds of them that will be going into strangers homes today with nothing more than their faith in their fellow man in their pockets. No guns, no means of protection other than the general rules of a civilized society.
The perception of a civilized society took another shot yesterday. How many shots can society take before it crumbles? How many students will be shot, or stabbed, how many firefighter gunned down in the street or taken hostage in a patients home before the good guys give up, and let the assholes have it all.
Sometimes I wonder if we are better off without comprehensive news coverage. I live a long way from Georgia, but felt like I was in there with those guys yesterday. The kids who got stabbed in Texas are half a country away, but their images were in my living room most of the day. And those little angels from Newtown? They will be forever enshrined in my heart.
I suppose its better to know that evil exists, and thousands of miles distance doesn't mean a thing when the whole of humanity is threatened.
I'll keep on walking in, and continue to have faith in our fellow man, because once that is gone, I've got nothin to work for.
By the way, this is a picture of my cousin Rik with Roy from Emergency, a very rare and valuable shot! Everybody sees Johnny Gage, but Roy? According to my cousin who lives close to him, Kevin Tighe is a great guy living his life and enjoying every minute. So, in case you were wondering, the shorter of the two is not me!
…For now, EMS is my life. It is more suited to my personality anyway. Thinking back to my childhood and the dreams I had, it was the obvious choice. The popular television show Emergency was my favorite show back in the seventies. Johnny Gage and Roy Desoto were my first role models. As early as I can remember, I wanted to do this kind of work. When we played war games as kids I always wanted to be the medic. My vision of wartime heroism never involved killing the enemy, rather I dreamed of running through the rice paddies in Cambodia, bullets whizzing past my head, close enough to smell gunpowder, mortar rounds exploding all around me with dead guys everywhere. Disregarding my own safety I would go to the aid of my fallen comrades, taking bullets along the way, spitting out shrapnel and pushing morphine into the wounded soldiers. Once I killed their pain, I would carry the fallen on my back, using the fireman’s carry, back to the jungle and the safety of my unit. “Thanks Doc,” was all that I needed to hear.
“Rescue 3 on the scene.” I said into the mike…
Paladin Press, 2007
Two kids from different ends of Warwick, RI used to watch TV shows when they had time, me, I was drawn to Emergency and the like, sirens, disasters, IV's, and rescues, the other guy, my cousin Rik did the science fiction thing, space travel, time warps, odd creatures and Star Trek. I liked the sci-fi stuff, and Rik 
liked the rescue stuff, but our ultimate preference were pre-determined.
Funny how life works, here I am, half a century in with Rik close behind, and those lazy Saturday afternoons spent in the basement with an old black and white, most likely with our respective brothers; mine Bobby and his Mike, are long gone. But they are never far away. Our adult lives have been shadowed by those early dreams and fantasies, and somehow, some way we managed to hold on to our childhood into adulthood, and have lived and prospered never having to let go of that that makes us who we are.
Two men now live on different ends of the country, me in Rhode Island, Rik in Washington State. I am just about to cross the finish line on a very satisfying twenty-three years with the Providence Fire Department, half of those years spent writing about my experiences with lights, sirens and rescues, and Rik creates art that is world renowned, beautiful and timeless.
Now, we share most our time with our respective wives, mine Cheryl and his Shelley, and they understand us, and know that even when we are with them, a part of us will never leave the basements of our youth, and our brothers, no matter how far we go.
Jill, from Badger Transfer Solutions, LLC contacted me through LinkedIn, not to sell anything, rather to simply touch base and say hello, and let me know about her company. I did a little look-see, found the products to be of value and figured I'd help spread her message, and hopefully get a sale of two for them. Here's a post from the way back machine where we certainly could have used one of their units!
From the book Responding:, Emergency Publishing, 2011
I didn't know how else to ask so I just said it.
"How much does she weigh?"
"Your stretcher won't break, they did it before," said her daughter. My stretcher is rated for five-hundred pounds. My patient topped that, I'm sure.
"I don't want to hurt her if the stretcher collapses," I said. My patient remained motionless on the king size bed, filling most of the mattress space. She was wheezing with rapid respirations. A crew of ten firefighters had assembled around the bed, a crowd had gathered outside, waiting to see the show. We had to get her to the hospital. I stacked three hospital sheets, rolled them and put them next to the patient. Her daughter climbed onto the bed and rolled her mom onto her side. The smell nearly knocked me over when the flesh was exposed, maybe for the first time in weeks. Her head and skeletal system moved to the side, the flesh stayed put for the most part. I helped stuff the gathered sheets under her until most of her girth was on top. We had to get her through the bedroom door into a hallway, through the outside doorway, down six cement steps, through a crowd, onto the stretcher and into the rescue. Three firefighters got on each side of her, one at the head and one at the feet.
"On three," I said and we were moving. Once we got going it was hard to stop. At the bottom of the steps the stretcher waited. People gawked. The stretcher groaned but handled the weight.
"Nothing to see here!" said the daughter angrily to the crowd who stood their ground as we worked. We got her into the truck and closed the doors. The crowd dispersed, the spectacle over for now. Renato and John Hannon stayed in back with me as we made our way to Rhode Island Hospital, steadying the stretcher because we couldn't lock it into place; it wouldn't fit. I called the hospital to get a large bed ready.
"I've got a sixty-year old female, approx. 500 pounds enroute, we'll need a hospital bed, ETA three minutes," I said over the phone.
My patient turned her head and said, "I'm seventy-one," her pleasure that I thought she was ten years younger evident on her smiling face.
We could have used a Badger! 
New article at EMS 1 is here, thanks for reading, if you do,
…We wheeled the stretcher past the waiting room and reception area, toward the treatment rooms in the back. The lady in scrubs followed.
"Would the entire fire department show up for a real emergency?" she asked, no attempt to disguise the contempt in her voice. We kept wheeling…. keep reading here:
He wrote the note on Easter Sunday.
"No more pills, no more pain."
And then he shot his wife of forty-nine years, and then he shot himself.
They were seventy three and seventy, a loving couple beset with health problems, he a bad back and she the beginning stages of Alzheimers disease. They couldn't go on, lingering in the abyss of an uncertain future, waiting for things to get worse, because they knew, and we all know but kid ourselves we don't that at seventy things are not going to get much better.
Life is what happens to people when they are busy making plans for the future, but the future comes quick, and all the planning, and waiting, and hoping for better days disappears and the life we have formed suddenly appears when our days are numbered, and the reaper draws close, and that life may not be as sweet as we had hoped, and the days may be full of boredom, sadness and pain rather than the envisioned laughter, contentment and joy.
What madness possesses people as end of their time on earth draws close? How do some manage to carry on in the face of certain decline, sickness, loss of function and increasing pain? Is it fear and an inability to take action, or is it something more?
Are we afraid to die, or is our grasp on the life we are given so cherished that most of us cling to every second, and bear the pain, disappointment and fear that builds to a deafening crescendo as our lives careen down the hill toward the valley and the inevitable crash, or are the few who take action and bring an abrupt end to the suffering the ones who are afraid; has the life they have forged been such a disappointment that ending it is preferable to carrying on?
Are we certain of an afterlife? Will those who quicken their wait be deprived of it, if it exists at all? If we are 100% certain that a blissful existence awaits us, why not pull the trigger, and get on with it? Roll the dice, see what happens, because what happens has got to be better than this, it just has to. Even nothingness is better than this.
But, what if nothingness would be heaven compared to the afterlife for somebody who ended their present one, no matter the conditions that precipitated their demise?
Have we been sentenced to do time in an uncertain existence, bearing pain and suffering while others float through their lives with nary a blemish?
What madness is this?
I hate it when people kill themselves. I hate it even more when they take somebody with them, no matter the reason. It shakes my foundation, and I do not like a shaky foundation. Without a strong foundation, belief system, and productive achievement throughput our lives and an unrelenting nurturing of relationships there won't be much to live for when the going gets rough, as it most certainly will.
1 April 2013
Effective immediately:
General Order 2013-4-1
To: All Companies;
Due to the influx of social media, and with it the expectations of a new generation and their demand for instant gratification, the following changes in our policies concerning media relations are hereby ordered:
– All companies shall assign, or be assigned; if manpower warrants one (1) member whose sole responsibility at emergency scenes shall be the Tweeter.
-The assigned member will be trained in social media as deemed prudent by the Commissioner of Public Safety, and may or may not be able to perform the functions of emergency responder
-The Twit is hereby granted unlimited access to any and all emergency scenes, including but not limited to Mass Casualty, Haz-Mat and flu-like symptoms.
-All efforts will be made to ensure the Tweeter, (or Twit) be allowed to perform this vital assignment. Persons in need of immediate life preserving interventions will be kept a safe distance from the Twit so as not to interfere with his communication abilities.
– Be advised – facts are of secondary importance when communicating messages to the public. A steady stream of clever or self aggrandizing messages is preferable.
Implementation of these procedures is of vital importance. All training not related to The Twit is hereby suspended until further notice. All components of the Incident Command System shall be adhered to.
By order of:
EMS Administrator
City Hall
