Rescuing Providence

Two miles from my home five people died in a fire. Horrible. You just never know.

http://newsblog.projo.com/#558615

May the victims rest in peace and the responders find the peace they need.

We forced a storm door and entered the home through the rear door.

“Fire Department!”

A low moan came from somewhere and the search was on. The guys from Engine 10 went one way, Ryan and me the other. Something that never changes, be it a fire, inspection or rescue run, companies stick together. We found him first, lying at the bottom of the stairs.

“What are you doing down there?” I asked the man, a gray haired fellow with ashen skin.

“I went to get a drink and my legs gave out. Damndest thing.”

His place was full of things that helped define him. American flags. Books and newspapers. A US Navy cap perched on a hook near the front door. A Viet Nam Veterans tribute. Walking sticks. Canes. A walker, folded, sitting in a corner gathering dust.

“We’re going to get you up and take you to the hospital, you don’t look so hot.”

“I was afraid this day was coming. Make sure you lock the place up.”

We checked for trauma, put him on 02, sat him in a stair chair and carried him outside, into the cold.

“Do you want me to turn out the lights?”

He looked at me like my father would have. I smiled and flicked the switch.

Darkness.

Just as his possessions gave me an indication of who he was, his vital signs helped me know how he was feeling. His answers didn’t add up to the way he looked. His signs sealed it. 110/70. Not bad for an old guy who just got taken out of his house in a rescue. EKG was irregular, normal sinus with some runs of a-fib. The kicker was the pulsox. 72%.

“We’re going to give you some more oxygen and start an IV.”

“Good idea,” he said. “I’m having some chest pain too.”

“Why didn’t you say so?”

“You didn’t ask.”

“Scale of 1-10.”

“Eight.”

“Get out of here.”

“Seven.”

“That’s better. One nitro coming up.”

“My lungs are shot,” he said. “Spent a lot of time in the boiler room of an Oiler in the Pacific. Asbestos. The Japs and submarines couldn’t get me but the damn asbestos did.”

“Took it eighty years.”

“It’s been a heck of a ride.”

We got him to the hospital and gave my report. He went strait to critical care where a medical team went to work. Victoria, one of the ER tech’s was ready.

“I’m going to help you get out of your clothes,” she said.

He sat there and smiled, surrendering to whatever fate his body had in store.

“Been a while since you heard that,” I said to him before heading out. His grin was one of the things that makes this job so special.

“Are you a Lieutenant?” He asked, spotting my bars.

“I am.”

He gave a crisp salute and held it until I returned the gesture.

I’m glad I shined my bars yesterday.

Victoria pulled his shirt over his head.

Fleas flutter around the sleeping man, landing on his face, his hands. Biting, then flying off.

“Rubin!” I say, crouching down. He’s sixty, looks seventy, wrinkled, tired and just about done.

Sixty. That’s longer than most of his kind last. Street people don’t have longevity. Tonight, Rubin is inside, lying on a flea infested air mattress at Crossroads, one of the states largest homeless shelters. It’s his home, where he lays his head at the end of his long days spent wandering the streets of Providence. They let him stay here, tucked away in the corner of the “day room,” along with anywhere from ten to 100 other homeless folks. At six or seven they are shown the door, left to their own devices. For some, that means looking for work. For most, it means looking for a high. Booze, heroin, crack, pills; whatever works. Rubin depends on vodka in little half pints.

“I’m sleeping,” says Rubin, “leave me alone.”

“They’re kicking you out.”

“Why?”

“Because you are intoxicated.”

He’s nearly always intoxicated.  I watch as he closes his eyes and falls back asleep, the fleas return to his face. I brush them off, he swipes at my hand, slowly, thinking I’m a giant flea. He misses, I pull a sleeping bag over his face and leave him where he lies.

The girl at the desk apologises for calling us, but she’s not going to be responsible for him if he gets sick. Or seizes. Or dies. I tell her to call us back if he wakes up and walk back to the truck.

It’s all in the shoes. They’re two years old now, worn in, or out, just right. And they need to go.

One more polish will get them through another tour, but I’m going to have to get some new ones.

Funny how old and tired my uniform looks now. Last time I wore it I didn’t give it a second thought, just something to wear to work. It’s nice being able to wear the same thing every day, no bad decisions made at the crack of dawn to regret for the rest of the day. Same colors, same routine. Nice.

I wonder when I stopped caring about the uniform. My Lieutenants bars are covered with oil from my fingertips. Just a little buff with a Kleenex will do. There, little thing but so important. I guess a little steam from the iron will put a little life back into this old shirt, going to have to put in for some new ones. Hope they arrive before the end of winter.

Dark socks. I had to wear white socks out of necessity a few times, ruined my day. Every time I sat down there they were, little white beacons at the bottom of my legs bringing attention to my giant feet, and my tired old shoes.

Not tomorrow, shiny shoes and black socks. And a freshly pressed uniform that’s going to last this time.

See you at 0700 hrs.,  bright and shiny.

Every now and then I read a post from one of the many excellent blogs I follow that literally knocks my socks off.

http://sirenvoices.blogspot.com/2010/01/resurrectionist.html

Has anyone seen my socks?

Tom Cobb wrote Crazy Heart years ago. Now it’s a movie getting some great reviews. Jeff Bridges recently won a Golden Globe for his portrayal of the main character and there is a good chance he’ll win an Oscar.

I met Tom through my Uncle Brian. The two have been friends and colleagues for years. Tom’s book, Shavetail and Rescuing Providence were published around the same time. One day, Tom, Uncle Brian and myself were having a coffee when Tom mentioned that selling books is a lot like pushing water uphill. I still use that expression when somebody asks me how sales of Rescuing Providence are going. Judging from the short time we spent together, my guess is Tom isn’t overly impressed with all the hoopla.

As for me, this is the best thing to happen to somebody I know in a very long time! And I’m quite impressed.

I can’t wait to see the movie.

watch?v=VEaULZL7Nf0

http://www.thomascobb.net/index.htm

The Handover comes to Gomerville!

http://gomerville.com/2010/01/11/the-handover/

The official edition won’t be published until the end of the month, for now, here is my submission.

An EMS Portrait

Two kids, no more than eighteen sat on a sidewalk in Providence’s freezing November. Litter blew down the street, propelled by a chilling breeze that took the last memories of Indian summer away. Winter pushed through, nothing stopping her chilling embrace now.

The kids, a boy and his pregnant girlfriend had been walking when she felt severe abdominal pain. A pay phone was close, lucky for them; he used it to call 911. Engine 2 responded, along with Rescue 1 from the other side of the city. I was new to the job then, every call brought with it anticipation and excitement. I started the engine and waited for the crew to climb on board, Wayne and Arthur in back, Captain Costa in the officer’s seat. We turned left, toward the call. Less than two minutes later we found them, huddled together on the curb.

We talked to them, found out what was wrong, put them in the back of the engine where the doghouse radiated some heat through the diamond plate and let them rest. They looked exhausted, lonely and afraid. While doing vital signs I got to know them a little, as much as a five minute meeting affords. They were good kids, from an environment far different from the suburbs where I grew up. Her signs were good, she felt the eight month old fetus move and told me she wasn’t due for another month. They relaxed, we waited for the rescue. I was content that the little I did helped the situation, as the stress she felt dissipated, so did her pain. EMS at base level. I was satisfied.

Rescue 1 approached. An officer I’d never seen and his driver slowly pulled next to Engine 2, and even more slowly got out and slammed their doors.

“Where the fuck is she?” I heard one of them say. I opened the door to the engine, the other one stood there, arms crossed, shaking his head.

“Another fucking taxpayer. Let’s go.” He walked back to the rescue. The kids looked at each other, worry and anger filled their faces. I started to make excuses for the rescue guy’s behavior, then stopped.

“Assholes come from all walks of life,” I said to the two as they left my care and entered the fetid environment of Rescue 1. “Good luck.” I shook the boy’s hand and gave the girl a little squeeze on her shoulder.

“New guy,” said the “officer” of the rescue. They drove off, eager to dump their cargo and get back to whatever it was that was so important.

Back at the barn the guys vented a little about the morons on rescue, and then moved on. I never forgot. Years later, with that and hundreds of similar incidents in mind I took a Rescue Lieutenants test, finished second and started the second part of my career. I haven’t looked back. I still feel the anticipation and excitement when called, and still treat people with respect and dignity.

“Rescue 3 and Engine 11, Respond to 673 Carter Street for a woman not breathing.”

“Looks like the doctor’s going to have to wait,” I said to Ryan as I keyed the mike.

Rescue 1, clear of the detail, responding to Carter.”

“Roger Rescue 1, at 0945.”

First day back after three days off, third call in a little over two hours. That’s just the way it goes. An emergency medicine resident from Rhode Island Hospital was scheduled to ride along with Rescue 1 for the shift, we had been trying to connect all morning.

“Engine 11 to Fire Alarm, code 99.”

“Received, Engine 11, Rescue 1?”

“Message received.”

It was Ryan’s second week on the rescue after six months in the acadamy and another six at Atwells Ave, training with Engine 14 and Ladder 6. This would be his first code.

“Rescue 1, on scene.”

“Engine 11 to fire alarm, send a ladder company for assistance.”

Ryan and I exchanged glances. A ladder company at a code 99 meant only one thing.

A large woman was preparing to get on a handicap equipped bus when she went into cardiac arrest. She only made it to her doorway. She fell from her wheelchair blocking entrance to her home. Her daughter and the driver of the bus stood by, waiting for help. She had been down for about five minutes before we arrived. I checked for a pulse, knowing there would be none. She wasn’t breathing. Her daughter screamed, the bus driver waited.

“Start CPR.” I said, as I knelt at the doorway. One of the guys from Engine 11 jumped over my back, and over the four-hundred pound patient and into the hallway. He started compressions after Ryan had assembled the bag-valve device and began bagging. I tried to reposition the patient as her daughter tired of screaming and began to sob. Somebody handed me the monitor, I applied the pads in position.

“Stop CPR.”

The sporadic fluctuations in the ekg stopped, and a flat line appeared. In a dull monotone the machine told us what we already knew.

“No shock advised, continue CPR.”

The officer of Engine 11 brought a backboard from the rescue and we attempted to maneuver it under the patient. A lift here, a tug there, some pulling and pushing and we finally were successful. We strapped her down. Ladder 5 arrived. The Army, Navy, Air Force and Marines could have shown up but the same situation remained, a big lady was stuck in a doorway. We had her on a board, of which there are only two ends, and no room in between. I was at the head.

“On three. One, Two, Three.”

We got her up. I backed out of the doorway, three people on either side helped carry her to the Rescue while two others continued CPR. Air flow was terrible, but the best we could do. Three IV attempts in the doorway failed. The bigger the patient the more difficult to treat, I’ve learned.

I wish I could say the adrenaline masked the pain in my back, but after nearly twenty years, adrenaline is in short supply. Every bump in the road toward Rhode Island Hospital felt like the Grand Canyon.

I gave Ryan my seat, feeling bad that his first intubation attempt was doomed to failure, but wanting to give him the experience in a difficult situation. If he was nervous, it didn’t show, he tried, and tried some more but ultimately failed. Somebody got an IV, Renato I think, as we pulled into the hospital lot. I hobbled out of the truck, the crew did their thing, I gave the report to the medical team that had assembled and stood back and watched. Eventually I had to sit.

I left the trauma room ten minutes later. The patient was breathing on her own, heart beating steadily.

“Are you alright?” asked Kim, the RN in charge of triage.

“I think not,” I said and began the long road to recovery.

The MRI showed five crushed discs in my lumbar spine. They are gone, and are not coming back. The back specialist that treated me, on orthopedic surgeon, reportedly the best there is advised my doctor to not release me to full duty. Ever. My doctor agreed. They neglected to consult the real expert before ending my career.

Me.

A month after the “final” diagnosis I returned to the specialist, Arthur, my Physical Therapist’s report in hand. “Full flexibility without pain, improved strength, overall  prognosis good…”

I feel great, all things considered. I’m forty-seven, been lifting heavy things and people for a long time.

“I’m the one who’s going to die when it’s time for me to die . So let me live my life, the way I want to.”  Jimi Hendrix, If Six was Nine

Never quit, because you never know when the heart will stop beating. Or begin again.

I’ll be back to full duty in two weeks.

http://susiehemingway.blogspot.com/2010/01/silence-falls-by-susie-hemingway.html

I’ll heal. I’ll walk, maybe swagger. I’ll lift and carry, perhaps without the gusto I once had, but I’ll pull my weight. My bones will creak and  muscles will ache, but I’ll go on.  So will Cheryl.  One step at a time.

Another battle begins February 4th.  I’ll be Lieutenant Morse again. But I’ll always be Mrs. Morse’s husband.

http://firecritic.com/contests/blog-of-the-year-09/

Rescuing Providence Blog of the Year? As Kevin Millar said, (or Manny or Schilling or Papi, I can’t remember) in 2004, “Why not us?”

Thanks Firecritic and whoever nominated Rescuing Providence.

Vote early and vote often!