“Something’s coming up,” the firefighter says. I see pink sputum coming up the tube. I panic, thinking I’m in the stomach. I pull the tube and try again. I can’t see the cords, but I’m going to get this sucker. I’ve got to get it. Com’on. Now wait, there they are. I pass the tube again. I know I’m in.
“I’ve got the line,” Glenn says. “You want epi and atropine.”
“Yes,” I say.
I attach the ambu-bag and listen for lung sounds. Positive in the right and left sides under the armpits. They are wet. He has edema in his lungs. That’s what the stuff was the first time. Nothing in the epigastrium. I start taping the tube down to secure it.
“Let’s head in,” I say.
We arrive at the hospital moments later. They work the patient five minutes, then call it. It turns out he is in end-stage cardiomyopathy. His heart just gave out.
It is the first code I have done as a cut-loose paramedic. The first code Glenn and I have done together. Glenn shakes my hand. I pat him on the back.
“You got the tube,” he says.
“You got the line,” I say. “We got it done.”
I know I should show more compassion for the departed, but I have a job to do and I need to do it well. That night, I just keep seeing the tube pass the cords. I got the tube. I got the tube. I got the tube. I think someday I’ll get the tube and save the patient, too. Someday.
Front Page
Four-seven-two is called for a shooting at a bank on Homestead Avenue. We’re in the area, so we ask our dispatcher if they want us to slide over that way.
“Absolutely not,” the dispatcher says. “They’ve got a situation over there. I don’t want any other cars in the area. Four-seven-two, be careful, guys.”
Two minutes later, HPD dispatches us—451—as a second car for a heart problem at the scene.
We arrive a moment before 472. We’re here first, so I want the shooting. There are ten police cars at the curb. As I get out, a woman comes from the crowd, leading another woman and says, “This woman is pregnant and a diabetic. She’s not feeling well. Can you look at her?”
“Not right now,” I say, grabbing the oxygen bag from the side door.
A man is sitting by the curb; a police officer is holding an oxygen mask to his face.
“He’s having chest pain,” the officer says.
“Where’s the guy who’s shot?” I ask.
“Nobody got shot.”
“Okay.” I sound a little disappointed. I look at the man sitting on the curb. He is wearing a windbreaker and a Boston Red Sox shirt. On the ground a few feet away from him is a stack of one-hundred-dollar bills bound together.
“How are you?” I ask.
“My chest hurts.”
“Is he in custody?” I ask the cop. My eyes go back to the money.
“No, he was the hostage.”
“Okay.” I kneel by him and feel a pulse. His pain is in his chest on both sides. I learn he was Maced when the robbers dropped the money bag and it exploded. My eye catches another stack of one-hundred-dollar bills behind the man.
“They catch the bad guys?” I ask the cop.
“Yeah, it’s all under control.”
The man is breathing fine. He is not diaphoretic or pale.
Glenn and I help him onto our stretcher. As we are wheeling him to the ambulance, I notice he is holding his head. “Your head hurt?” I ask.
“Yeah, the guy whopped me with his gun.”
“Were you knocked out?”
“Yeah for a little while.”
“We’re going to have to c-spine him,” I tell Glenn.
“Wait till we get him inside. The cameras are on us now.”
“You have any tingling in your hands or feet?” I ask.
The man says no.
We get him to the ambulance and lift him in.
Once inside, we roll him on his side and slip a longboard under him. I apply a cervical collar. Because he received a blow to the head, we have to guard against a possible injury to his cervical spine.
“We need him for an ID,” a cop says, standing by the open door.
Before I can tell the man not to sit up, he is up. “That’s him,” he says, looking at the young man in handcuffs, who has a stack of bills protruding from his jacket pocket. “That’s the dirty bastard who clubbed me.”
“Thank you, sir,” the cop says, leading the man away.
We get the man back down on the board and secure him with belts, head rolls, and tape. I get a blood pressure, put him on the heart monitor, and give him oxygen via a nasal cannula. His pressure is high, but his rhythm looks good. I suspect his pain is related more to getting Maced and excited than to a cardiac problem, but I go ahead and put in an IV and draw bloods. I need to treat for both potential heart and cervical injury.
“We need him for another ID,” the cop says.
“He can’t sit up,” I say.
“What if we bring him around to the other window?”
“He can’t turn his head.”
“Screw it,” the cop says.
The man says the pain in his chest is gone, but his head hurts much worse now.
Glenn is outside looking at the pregnant diabetic woman, who is fine.
“What a day,” the guy says. “You have my jacket? Is my check still in there?”
I find the check.
“I didn’t even get to cash my check,” he says.
I talk to my friend Michelle that night. “I got sent to a shooting, but it turned out to be nothing again. Just a guy whopped on the head having some chest pain from the Mace.” I tell her the story.
“You’ll get your share of shootings, believe me.” She worked in the city for five years before shipping out to the suburbs.
“It’s just that I want to have done a good one so I won’t be frightened at the prospect of the unknown.”
“You’ll get one.”
That night on the eleven o’clock news, I watch the story about the holdup and see the police putting the two suspects in squad cars. I see the shot of Glenn and me wheeling the man on the stretcher and lifting him into the ambulance. I see the shots of the stacks of money lying scattered on the ground. I pat my pocket. Empty.
In the morning I pick up the paper. There we are in color on the front page, wheeling the guy to the ambulance while he holds his head. In the photo spread they identify the arresting officers, the bank robbers, and the victim by name. They don’t use our names, just list us as ambulance personnel. While I am sort of thrilled to be on the front page, all I can think of is the photo being shown to every EMT class in the state that day, with the teacher asking what’s wrong with this picture? The article says nothing about the man’s chest pain, only that he got whopped on the head and knocked out. And there we are wheeling him along without having his spine immobilized. I think, why couldn’t they have a photo of us wheeling him to the ER, c-spined, IV in place, bloods drawn.
I wait for someone to say something about his c-spine, but no one does. Michelle says I am overreacting. It’s just that I want to be respected and thought of as a good paramedic.
Circles
It is a beautiful day, temperature around seventy-two, the sky clear blue. We’re playing basketball in Sigourney Park, up ten to two against another crew—Darren Barsalou and Matt Rynaski. My height has led to our dominance, as I have swatted balls left and right and easily tossed rebounds back through the iron rim. Then just as Darren drives by me, faking me out of my size thirteen boots, and Matt taps the rebound in for a basket, the radio calls their number—a transfer from Saint Francis going back to a nursing home in South Windsor. They shake their heads and start away slowly.
“We’ll get you next time,” Darren says.
“Have fun, boys,” Glenn says.
I am wearing the HPD radio on my belt. Just then I hear it crackle, and in a dramatic gesture, bring it up to my ear. I feel a call coming. “Hartford EMS to …” the radio crackles.
�
�Four-five-one,” I say hopefully.
“Four-five-one. Respond on a one to a shooting on Main.”
Glenn and I shout, and we break into a run for the ambulance.
“Four-five-one responding,” I say.
We pass our disgusted opponents. “See ya, boys,” Glenn says.
I strap in tightly. We race east, swinging the corner hard onto Main Street heading north. Ahead we see five or six squad cars. When we arrive we see several cops on different corners all looking about. We can’t see any patient.
“Four-five-one’s out and looking,” Glenn says into the radio.
A cop says he thinks the guy might have left in a private car.
I ask a tall girl sitting on a rock in an abandoned lot what happened. “They stabbed him and took off. Then he got in a car and his friends drove him to the hospital.”
The cops aren’t having any luck finding anyone, so we get back in the ambulance and clear ourselves on the radio.
“Four-five-one, you take the motor-vehicle accident at Wooster and Pavilion, you’re right on it.”
We look quickly at the map. Glenn hits on the lights. We lurch forward. We take our first right. Wooster is the next right. We come around the corner and see Pavilion is the next right. Before we know it, we are right back where we were.
The cops and the girl on the rock are all looking at us.
“Did you see a car accident?” I ask.
The girl shakes her head.
“Somebody get hit by a car?” a cop asks.
“No, they stabbed him,” the girl says. “He’s probably already at the hospital by now.”
“Busy neighborhood,” the cop says.
Intercept
Most of the suburban and rural communities outside Hartford have their own volunteer ambulance services who respond to all 911 calls within the town’s borders. If the volunteers decide the patient needs a paramedic, they can either call the Life-Star helicopter, which they do in cases of severe trauma, or call for a paramedic intercept. They package the patient and start toward Hartford, while the paramedic unit starts out toward them. They communicate via the C-Med radio and agree on an intercept point, where they both pull over. The paramedic jumps out with his equipment, gets on board their ambulance, and they continue toward the hospital.
Simsbury Ambulance calls for an intercept for a man having chest pain. We meet on Route 185 on top of Talcott Mountain. I get in the back. The man is pale, diaphoretic, having pain at the level of four on a one-to-ten scale, with ten being the worst pain he has ever felt. The oxygen has made him feel better. His pressure is okay and he has a normal sinus rhythm on the monitor. My plan is to give him some baby aspirin, which will thin his blood and help prevent further formation of any clots in his heart that can keep oxygen from the heart muscle, put in a line of saline, and start giving nitro to see if that takes the pain away. The nitro will dilate his vessels, again opening up more oxygen to the heart, decreasing the heart’s workload. The problem is, he is allergic to baby aspirin, and I can’t give him the nitro until I get the line and I can’t get the line. My first shot blows. He has flabby arms and nothing is visible. I try again for one in the hand but get nothing. I sit back and wipe the sweat from my brow. If I give him nitro without a line in place, his blood pressure could bottom out, and I’d have no way to pump it back up with fluids. I look at the Simsbury EMT and shrug. Sorry. We continue on to the hospital. So much for the paramedic saving the day. I feel like a complete waste.
Wrestlemania
It’s Sunday morning. I’ve switched shifts with Scott Hanson—his Sunday for my Wednesday so he can go to South Carolina. I’m working with Sean Brown. It’s quiet. We’ve just done one call—a seizure at a nursing home. We’re covering the downtown area, parked in a lot just off the street where they hold the farmers’ markets during the week. I’m reading the sports section. Wrestlemania is in town. I have already told Sean about all my favorite wrestlers of past and present—George “The Animal” Steele, Professor Toro Tanaka from Hiroshima, Japan, and King Kong Bundy, who once committed the ultimate act of villainy by body slamming a midget in Wrestlemania IV at the Pontiac Silver Dome before eighty thousand screaming fans and a worldwide Pay-Per-View audience.
I am telling Sean about the time I saw El Olympico, a masked wrestler and the master of the flying dropkick, get knocked unconscious and carried from the ring on a stretcher. When I left the arena, I saw a man in a business suit carrying a briefcase exit from a side door and get into a Cadillac. It was El Olympico—still wearing his mask.
“Four-seven-two. Respond to the Civic Center. Man fell off the scaffolding on a one.”
“This could be a good one,” Sean says.
Within two minutes we are driving down the service entrance of the Civic Center. An automatic door opens for us, and we are waved through. We park, grab the stretcher, backboard, collar, and oxygen bag. We wheel the stretcher into the arena, where work is proceeding at a feverish pace for the night’s big event. A lighting trestle has fallen into the ring. One half is attached to a structure twenty feet up, the other half lies like a grounded seesaw in the ring, where several people hover over a downed man. I toss my oxygen bag into the ring and crawl in under the bottom rope. The floor is firm but soft and springy almost like a trampoline. I imagine flying off the top rope to flatten a helpless opponent before a capacity crowd. I kneel by the man, who is alert but in obvious pain. “What happened?” I ask.
A bystander tells me the trestle broke and he rode it down to the ring, landing hard with his legs around the beam. He did not strike his head.
“What hurts?” I ask
“My pelvic area.”
I press against his hips. “Does this hurt?”
I press against his abdomen. “Does this hurt?”
“No, no, man, it’s my pelvic area.”
I inspect. He is in great pain for understandable reasons, falling twenty feet with legs straddled around a metal trestle and coming to a fairly sudden stop despite the soft, springy surface. His pulse is good, and I see no signs of hemorrhage.
We put him on a backboard and carry him to the side of the ring. I hand my end of the backboard to a stagehand, then bound spryly out of the ring. They pass the boarded patient to me through the ropes, and I get him set on the stretcher. En route to the hospital, I bang in an IV line with a sixteen gauge needle in the massive vein on his left forearm and attach a bag of saline, ready to run if his pressure, which is good right now, starts to crash. He is crying, “Oh, Lord.”
At the hospital, they triage us to the trauma room, given the mechanism of injury. The patient has also begun complaining of tingling in his right thigh. I hear one of the doctors giving a report over the phone to another doctor. “He has right thigh pain,” she says.
“Excuse me,” I say. “His main complaint is pain in the pelvic region.”
She looks at me blankly.
“His balls are killing him,” I say.
“Testicular pain,” she says.
“Right.”
She speaks back into the phone. “He has great testicular pain,” she says.
I walk into the EMT room to do my paperwork. I see Sean and say, “Yes, we were there! In the ring at Wrestlemania!”
It’s Tuesday. Glenn and I are sitting outside Saint Francis. “Did I tell you I was in the ring at Wrestlemania on Sunday?”
“Several times,” he says.
“The place was packed,” I say. “Thirty thousand screaming fans. I leap spryly into the ring. Over the top rope, of course. The popular champion is lying there holding his nuts. What do I—the ambulance driver from hell—do?”
“You climb the corner post.”
“I climb the corner post. I leap into the air and slam down on him. The place goes wild! I lift him up and, wrapping my arms and legs around him, pound him into the ground with the pile driver. The crowd is appalled at the villainy. I bounce off the ropes and catch him in the face with the flying dropkick. I lift
him up, twirl him around, and body slam him. Then it’s one, two, three pin! And the World Wrestling Federation has a new world champion! I lift the golden championship belt high to the boos of the multitudes.”
“You could lose your cert for that.”
“But I’d be somebody. I’d be famous.”
Glenn grabs a portable radio. “I’m going to take a leak,” he says.
“The villainy, the villainy,” I say, hearing the beautiful boos of the Pay-Per-View audience as far away as Jakarta and Bora Bora.
A Little Touchy
We’re parked in front of Saint Francis when the Hartford dispatcher gives a call for an unresponsive person on Vine Street to a basic unit.
“This is getting ridiculous,” Glenn says.
The dispatching system is screwed up. Paramedic units are sent to cold and flu calls and the basic units that lack advanced life support equipment and training get the difficulty breathing and unresponsive calls. We’re getting nothing good. Where’s the glory? I ask. All I’m getting is BS.
“Four-five-one.” We’re called on the company radio. I am sure the company will reassign us the call.
“Four-five-one. We have a transfer coming out of Saint Francis. Bring your monitor and oxygen, going to the Cancer Center.”
We look at each other and shake our heads. It is our third transfer of the day. The only 911 call we’ve done has been for a drunk.
Upstairs in the intensive care unit (ICU), the nurse, a young heavyset girl with thick glasses, says, “We’d about given up on you.”
We say nothing.
Paramedic Page 10
