by Studs Terkel
I can remember several times when there was an elderly lady who needed assistance. There would be some young guys hanging outside, maybe gangbangers. I really didn’t check their credentials. I’d say, “Here, help me. You grab one leg, I’ll grab the other”—they did. And another time one of them came in. He’d been stabbed. He told me he fell on a pair of scissors. That’s physically impossible. He was like twenty years old. He said, “I’m going to kill the guy that did it.” I said, “Now, now. First of all, I don’t have any money for daisies and you’re going to be pushing up daisies. You go shoot that guy and you’re going to be in jail or you’re going to be killed. So chill out, take some deep breaths and the ambulance will be here in two minutes. And then I want you to come back and talk to me after you’ve been treated. We’re going to talk about this.” Like anger diffusion. I’ll tell you one thing, they respected me.
I did have another incident. These fellas were selling hot stuff, stolen merchandise. I said, “Gentlemen, we cannot shop indoors.” They were inside the hallway. We had a children’s clinic, an adult clinic. We had a preschool. There was a gymnasium. Two blocks from the projects. My staff were African-American and Hispanic. And they were naturally afraid because they lived in the area, and we had no security guards. The doctors were only there so many hours a day. So it was always up to me.
I said, “Gentlemen, you must exit the building—we’ll see you after work.” So thirty minutes later, I get a call: “Claire, what time do you get off work? We’re going to kick your ass after work and Friday at four-thirty we’re going to kill you . . .” So my mind went into overdrive. I could hear there were two of them on the phone. I said, “Gentlemen, what did you have for breakfast? I think you had Jell-O and your brains sound like scrambled eggs. By the way, didn’t your mother ever teach you how to eat a wholesome breakfast—you know, oatmeal, raisins, juice, milk?” I said, “Now, I am very busy. I have a teenage pregnancy clinic and perhaps your girlfriend or cousin or sister is here. So, I’m going to give you two instructions. Number one, do not ever enter the building unless you have an appointment and you better be ill. Number two, I’m going to inform you that I’m saying good day, and I am now saying good day.” Bang. [Laughs] Nothing ever happened. [Uproarious laughter] You’ve got to out-psych the psychos and think fast on your feet.
This gentleman comes in, five feet tall. Everything he’s wearing is black and white: his hat, his shirt, his pants, his belt buckle, his boots are all black and white. Now every patient that I have ever seen has always faced the scale when you weigh them. This guy faced me. Then he said, “Oh, excuse me—I gotta take something off.” He takes like an eight-inch knife off the inside of his boot and lays it down. I said, “Let me weigh you, and by the way, don’t ever bring that into this building again. That is totally inappropriate. I don’t want seniors fainting looking at that kind of stuff. What do you do, make furniture?” So then I do his history. “Have you ever thought of harming yourself?” “No.” “Have you ever thought of harming somebody else?” “Yes, I’ve thought about killing my father.” I said, “Well, let’s see the doctor and you’ll come back out and we’ll talk again and readdress that subject. I definitely feel you need psychiatric counseling.” So he goes in to see the doctor, and the doctor is African-American, six foot five. This guy’s about a hundred and forty but short. I said, “Doctor, please do not leave the premises until the young man has left.” Actually, he had to have an injection of penicillin. After the injection the guy gets dizzy, which was a con—he wanted to see if he could rip us off. I told the doctor, “I’ll make you some coffee, toast, juice, but you can’t go anywhere until he leaves the building because we have no security guards.” He stayed put.
And the next night, the same doctor was there. Two guys come in the building who apparently had been using drugs. I got their names, addresses, and phone numbers. I say, “I’m going to draw your blood,” and they suddenly split. The next thing we know, the doctor’s car keys are missing—he drove a big old Cadillac. They’d been in his coat, which he’d hung up. This is like frontier nursing. So I’m on the phone looking out the window. It’s about eight-thirty and it’s getting dusky.
About a week before this, two bodies have been found in an abandoned freezer across the street. So I’m dialing 911 and I look out and here they come again. And I’m on the phone. “Deputy, get over here on the triple triple double! They’re coming back in this cotton-picking building and we have no defenses.” Somehow, somebody must have alerted the guys that we were wise, because they came to the front door and then ran around the building. A squad car shows up, they put me in the backseat and say, “OK, give us the addresses.” And then they flash this big police light on the address ’cause it’s dark now. I said, “I’m going to lay down on the floor.” Because you know, if you’re ticked off and you see the police coming at you and you might have a rap sheet, there could be crossfire. Fortunately it was not the shoot-out at the OK Corral and we were able to regain the keys. I told the guys, “It is not necessary for you to return.” Please realize the majority of our patients were just simple folks, sweet, churchgoing, wouldn’t take a doily, very kind, concerned about their children going to school. Ninety-nine percent were angels—then you just have a few devils.
I had a few other situations. I visited the elderly. South of Taylor Street, that was all black. I volunteer to see this lady who was ninety with a pacemaker. The program I volunteered for loaned me a Fractured Fender car, a piece of junk. I see three guys, young punks, and I say, “Perhaps your grandmother’s the lady I’m going to visit. Where is 209?” I want to make sure they know I’m not an insurance salesman or a policewoman. So I go see her. I come out, there’s eighteen guys. I say, “What a great day for a baseball game! I just covered the Cubs versus the Sox crosstown game as a sports reporter, but I’m also a nurse.” So we talked a little bit. I’m walking down the sidewalk by myself, and all of a sudden a five-foot metal rod is dropped off the top of the building right in front of me. God saved me. So what I did, I put my hand on my hip and tapped my heel. I stood my ground. I realized they could have outrun me, eighteen against one, and the guy could have shot me from the top of the building. So I just stood there. I actually wasn’t afraid. Again, I was ticked off, angry: “How dare you?! Listen, buddies, you’re slowing me down!”
No one came near me. I just stood there for a few minutes. No one said anything, no one did anything. I know they thought I had a gun and might have been, I don’t know, a white Pam Grier. [Laughs] Anyway, so I walk over the grass and get in the car and I drove the heck over the grass. I breathe a sigh of relief, “Oh gosh, get me out of here.”
Then I go to a Hispanic neighborhood. INSANE UNKNOWNS is spray-painted everywhere—that was the name of a gang group. I promised to visit a post-op gallbladder, Hispanic lady. But in order to enter her house, you had to go down an alley and up the back stairwell. So I go to the corner and here’s a bunch of winos. I happened to have anticancer literature in Spanish. I tell them, “Buddy, guard me, hand this out, make sure everyone around knows I’m a nurse, and don’t let anyone rearrange a piece of my hair. And when I come back I’ll give you a candy bar and an apple.” And they did it. People, even if they’re half-stewed, generally like to feel useful.
One of the most depressing things is to be in a clinic and see everyone with their head down, with no hope, with their life over at eighteen, fifteen, seventeen.
I think I’ve visited just about every kind of neighborhood in Chicago, and I find that if you acknowledge people, you know, if you look at them as just human, they always come through.
Ed Reardon
I’M A CHICAGO BOY, born and raised on the North Side. I spent about fifteen years on the job as a paramedic in Chicago, working the streets all over the city. Ostensibly, you’re the eyes and the ears of a doctor. When a doctor can’t be on the scene, they’ll send guys like us. I like to call us gutter medics because we work in the gutter—we work wherever we find
a patient. Sometimes it takes you to some pretty strange places, strange situations.
The police don’t have paramedics. Chicago’s paramedics are strictly underneath the fire department auspices. We work twenty-four hours. We start at eight in the morning, we get off at eight in the morning. You take two days off, and then every fourth day you’d get a day off. That gave you essentially five days off in a row, so you had time to decompress. During a twenty-four-hour period, when I first started out, we could easily do twenty-five runs, be a minimum of one run an hour. No sooner would you put a patient down than you’d be picking up another one. You’d be going like that all day for twenty-four hours. So when you got off work in the morning, there really wasn’t much left of you.
You spent your first day walking around in a daze. The day after that, you’d just be recuperating, and then you’d go back to work. That was the way it was for the first ten years I spent on the job. They would call us when they didn’t know who else to call. They’d call us for domestic disputes. They’d call us when the police would have a problem that they didn’t quite know how to handle. As paramedics, we would straddle the police and the fire departments—we had one foot in each one of their yards. We’d respond with the firemen to a fire in case somebody got hurt. We’d respond with the police department. In a domestic dispute, you’ve got a guy beating up his wife, you’d walk in on that. If you had a guy standing out on a ledge, they’d call us for that. They’d call us when they didn’t know what else to do. If they had somebody crazy, if somebody said there’s a bad smell in the hallway, they’d call us. They call 911. The police would arrive on the scene and they would request the paramedics, just in case it was a medical problem. Sometimes people would call 911 and instead of asking for the police they’d ask for paramedics. Quite often we would go and there would be no police there at all, and it would be a police problem, something that we couldn’t even handle. Sometimes it would be a social-service problem: abandoned children or someone who wasn’t able to take care of themselves. Sometimes, dealing with life and death . . . [Sighs] . . . trauma, medical emergencies, heart attacks, diabetic comas . . . [Sighs] . . . murders, stabbings, gunshots, car accidents. In a twenty-four-hour period you did it all.
There was a set protocol that we would follow. Sometimes life isn’t black and white, it’s all nothing but shades of gray. By law, we cannot pronounce someone dead. It takes a physician to pronounce someone dead. If you have a skeleton there, you know the guy’s dead. Profound postmortem lividity—that’s where the blood is all settled into the lower regions of the body and there’s no resuscitating this guy. Decapitation: the head’s cut off. Profound rigor mortis, where he’s as stiff as a board and you’re not going to budge him. It doesn’t take a medical genius to spot someone who’s dead. But by law we’re obliged to at least make an effort. Sometimes you have to make calls that are really going to put you on the line. For instance, we were called into a home and the guy was dying of cancer. He was in his bed, he had his family around him, and you could see that the disease had completely ravaged him. He was unconscious but he was gasping for air, he was breathing his last breaths. I called the hospital and I said, “Listen, here’s what we got. The family doesn’t want him resuscitated. There’s no point. What should we do here?” They don’t know what to tell us. They don’t want to stick their necks out. They don’t want to say, “OK, do not resuscitate.”
This was before there was such a thing as living wills. I know that if we don’t make some kind of a decision, this guy, his last moments are going to be very undignified. We’re going to go through a whole resuscitation. That means doing CPR, cardiopulmonary resuscitation, on him, putting a tube down his throat. In a situation like this it would be debasing him. He’s not quite a vegetable, but he’s not going to be viable. As we’re sitting there, he literally breathes his last breath. He utters out a shout and he stops breathing. I look around and I mean, I see, it’s a Catholic family, we’re a block away from the church that I grew up in, St. Andrew’s Church. From my Catholic upbringing, I went to them and I said I’d already called a priest and he was on his way. I said, “Why don’t we gather around and say a prayer to St. Joseph?”—the patron saint of a happy death. St. Joseph is the patron saint of just about everything, actually, but a happy death is the one thrown in there. The family went with that, they thought it was a great idea. We kept them calmed down. We took the guy, we put him in the ambulance, and we took him to the hospital to be pronounced. Now, I’m wondering when I get there, am I going to run into some doctor or some nurse who’s going to call me on this? As it turned out, the doctor understood our position, the priest was there. It was fine with the family. He was dead and he was going to stay dead.
Every situation is different. Not far away from here over at St. Joseph’s Hospital, an old couple lived up in the high-rise just overlooking St. Joseph’s. You could look out their window, see the back door of the hospital. This guy was a pretty vigorous-looking octogenarian. He’d lived a very good life. On his walls you could see pictures of his family, you know, little things that you acquire that you bring along with you to remind you of where you’d been and who you are. We got in just as he was breathing, literally on the floor, breathing his last breath. We got on him right away, defibrillated him, put the paddles on him, shocked him—it’s an electric shot to the heart. Woke him up! Literally woke him up. His heart had stopped, there was no blood pressure, he wasn’t breathing. So now he’s talking to us and he’s not in the best of moods either. “What’s going on? What are you doing?” We said, “Relax, relax, we’re going to take you down to the hospital.” “Why? What happened?” So he’s giving orders, right?
We’re getting him on the stretcher and we’ve got him all bundled up and ready to go outside, get him in the ambulance. We’ve got an IV started on him so we can get some drugs in him if we need to. And we get to the elevator. There’s me, my partner, the man’s wife, and two coppers. We’re going down in the elevator, and he looks at his wife, calls her by name, he says, “I want you to know, it’s really been great. Thanks an awful lot”—bam, dead. That was it: he breathed his last breath and no matter what we did to him, we couldn’t get him back. We worked on him in the ambulance, we worked on him in the emergency room, but that was it. This man had gone. You wonder about it. He looked at his wife very purposefully, very adamant. Did he know? Did he see it? Did he have any inkling that this is what was going on? Five minutes before that, he was in charge, giving us orders, telling us, no, I’m not going to the hospital.
You try not to be affected by it. It’s a reality you’re facing, numerous times a day, it’s part of your job, it’s what you do. The body or the mind is a great layer of defensive mechanisms. You don’t do it consciously—I think that you develop a thick skin as time goes on. You don’t identify with that victim. He’s not from your lifestyle, he’s not from your class, he’s not from your race. That would never happen to a member of my family, no matter how much they look like him because we wouldn’t do something like that. You know what I’m talking about? There’s a denial, a way of putting distance between yourself and the victim. You use every trick in the book. Because if you don’t, you’re going to wind up carrying some burdens that you just can’t afford to carry. They’re gonna get way too heavy. And I know a few guys, they couldn’t handle it anymore. But there’s a toll that you pay for building up that callus on your emotions. It doesn’t come cheap. I’ve been off the job for ten years and I think that I’m probably free of it—I think I’m finally free of that thick-skinnedness that I had before.
You hear the humor that goes on in the back of a rig, the gallows humor. It’s all very defensive. You’ll see the same thing in cops, you’ll see the same thing in firemen, you’ll see the same thing in emergency room nurses, physicians. One of the things that was in our favor as paramedics was that we were hit-and-run guys—we got in and we got out, we didn’t stay with a patient. For instance, I never had to be around someone w
ho was dying on a long-term basis, like a hospice worker or a personal physician does. We would come in, we’d handle that patient, we’d be with them for a short period of time. Maybe the most intimate moments of his life we would be there for, but then we release him to other medics and we’re gone, we’re out of his life completely—that’s in our favor. Other healthcare workers don’t have that luxury. As paramedics we ride in on our horses, we’re heroes, we drag them out, we get them to the emergency room, we drop them off. We say we never drop off a dead patient, which isn’t true, but as long as we can try our magic on him, he’s still alive. It’s just a reality.
You can’t afford to leave yourself, any part of yourself, with any one of these victims. Grief is grief. Denial is denial. I don’t think anything used to make me more angry than suicides. The worst suicide that I ever saw wasn’t gory or anything like that. It was really contained. It was a nineteen-year-old kid who took a shotgun, put it in his mouth, and pulled the trigger. For some reason, it didn’t make a mess like you would expect it to. He sat in a very contained position against the wall. And it was the attitude that we found him in, the body, bare feet. He looked like a child, he looked like a kid. He left a suicide note on the counter. That was my big mistake—reading it. You separate yourself from things and you develop a thick skin. You try not to identify with the people that you have to deal with. Well, this kid left a note to his father and his brother about how he was tired of being treated as if he were retarded because he was very hard of hearing. He couldn’t talk right and he couldn’t hear. And that’s what drove this kid to suicide. My big mistake was instead of looking at him and walking out of the room and forgetting about it, I bothered to read the note. And that’s why it stuck in my head, it stuck in my mind.
