Paramedic

by Peter Canning

  “Go get some ice packs,” I whispered.

  She hit me again.

  One of the cops, a new member of the force, came back. He was a good guy to have on calls because he knew his medicine and wasn’t afraid to get his hands dirty. He nudged Colleen. “Boo,” he whispered suddenly.

  She hit him.

  He knew just what was up. We all looked at each other.

  “He’s dead,” I said. “He is dead.”

  They nodded as if we were in conspiracy. Together we walked back to the living room and nodded to the other officer and the woman.

  The family doctor had been called. While EMTs can presume death, only a physician can pronounce it. He was expected in half an hour. I was already late for my day job, but I decided to stay around until he came. Although I knew the man was dead, I did not want to spend the day at work imagining the physician arriving, going into the room as the woman again told her story about how peacefully her husband had died, and pressing his stethoscope to the man’s heart only to hear a beat. “My God! He’s still alive,” the man would declare in a voice the whole county could hear. I imagined the dead man rising and doing a jig on the wooden floor, then whirling his stunned wife around with a little do-si-do.

  The officer coughed. I saw Colleen jump and look toward the bedroom. The cop smiled at her. She glared.

  The man was dead, but we were going to wait until it was official. The older cop left, the younger one stayed with us.

  The woman told us stories and showed us pictures of all the fifty-nine foster children they had raised on their farm, how healthy and strong her husband had been up until the last few years when he’d become an invalid, and how it pained her to see him confined to his bed. “He had a good life,” she said.

  “It sounds like the two of you had good lives,” I said.

  “We did,” she said, “we did.”

  The doctor was late, but I didn’t mind. More time for the body to get cold.

  Nursing Homes

  I hate going to nursing homes. The places depress me. There is the procession of bodies in wheelchairs lining the corridors as you pass. Some are happily simpleminded. Others have in their eyes the horror of souls trapped in bodies, living in hell on earth. Always there are a few with their walkers, moving an inch a minute. We need to maneuver around them or else help them to the side. I try not to breathe in the smell of age and death, the combination of feces and baby powder that wafts in the air.

  Our company has contracts with most of the nursing homes in the area. If they need an ambulance for a routine transfer to a hospital, a basic ambulance is sent. If the call is for a heart or breathing problem or other serious medical emergency, a paramedic unit responds. Most of the emergency calls are for sepsis, stroke, or difficulty breathing. The bottom line on most of them is that the person is old and his systems are slowly failing and he is going to die soon no matter what you do.

  We get called for an allergic reaction and find a man unresponsive with a rash on his face and legs. Yesterday the nursing-home staff thought he had pneumonia, so they put him on IV antibiotics, which they have just discontinued. But I am not worried about the rash. The man is septic with a temperature of 103. He has recently spit up blood, and I hear the distinct gurgling sound of aspiration in his upper lungs. They have a tiny twenty-two needle in his wrist and have him on oxygen by cannula at two liters per minute. There are multiple Band-Aids on his arms from where they have tried to stick him. At least they have tried to care for him. Often, we are called for unresponsive patients and have to hunt through the halls trying to find a nurse who can give us any information. Some of them say just to have the hospital call them directly, or they seal up the medical papers and get pissy when we open them up. Excuse me, they say, that’s confidential. I say, this is now my patient, and I not only need to know this, but I am responsible for the patient, who is going to die unless we get him some fluids, oxygen, and medications, and get him to the hospital as close to five hours ago as possible, the time when it appears his condition first became acute.

  I put the man on an oxygen nonrebreather at fifteen liters per minute, and en route to the hospital, I put a large bore needle in an arm vein, run some fluid, and give fifty milligrams of Benadryl, which clears up the rash. I suction blood from his airway.

  We get called to a nursing home for a person with no blood pressure. Fortunately, instead of just saying Room 206 and pointing us down the hall, the nurse accompanies us to the room and says the patient is the one in the bed by the door. As I go around to the side of the bed to evaluate the patient and help lift him across to our stretcher, I notice the old man on the other bed is awfully gray and still. Our patient looks crappier as he struggles to get his breath. I get a pressure of 70, a pulse of 112. His lungs are full of fluid.

  “What a morning this has been,” the nurse says to me. “He can’t breathe, and this one over here died a half an hour ago.”

  I look over at the other man. He is a corpse.

  The woman is in third-degree heart block, but for the most part she is asymptomatic. Her pulse is just thirty-four. The nurses can’t tell me much about her other than that she is bedridden and her normal state is one of confusion. They don’t think she’s had any heart problems in the past. I need to get an IV so I can give her atropine if her pressure starts to plummet. Glenn tries for a line in her right arm, while I put her on oxygen. She fights the cannula, but I whisper gently that she needs it, and it will be good for her. She relents. Glenn gets the line, but it blows when he tries to draw bloods from it. I put a tourniquet on her left arm and go quickly for a thin hand vein. I get a flash that tells me I’m in, but she jerks her hand and the catheter flies out. “Jesus Christ!” I say angrily.

  “I know what you’re doing,” she says. “You’re bad men.”

  I hold a cotton two by four on her hand, which by now has a golf-ball-sized hematoma on it. I am angry at losing the line and a little frustrated at myself for yelling. “I’m sorry, ma’am,” I say. “I didn’t mean to yell.” I should have prepared her for the stick, but for a moment, I’d stopped thinking about her as a person, just as an old object I had to deal with.

  Glenn drives, and I manage to get a line en route. At the hospital, when we transfer her to the bed, she reaches for my throat and tries to strangle me. I ease her hands away. When the nurse comes in, I tell her that even though she doesn’t look it, she can be combative. The nurse looks at me sternly. I think it shows in my face that I yelled at the poor woman.

  Sometimes when I’m transporting an elderly male, I look down at him on the stretcher and imagine myself there in another forty years looking up into the eyes of a faceless EMT. Neither of us speaks.

  Most of my family has ended up in nursing homes. My mother died from multiple sclerosis in one. Though they took good care of her, I didn’t like visiting. My father, even though he was divorced from her, visited almost every day. His visits let the staff know she was cared about and kept them attentive to her. Many of my great-aunts and -uncles died in nursing homes. Both my grandfathers, too sick to care for themselves, were put in nursing homes, and both died within two weeks, broken men. My great-grandmother on my mother’s side went into a nursing home at death’s door and lived there for fourteen years, loving it. She was the queen of the place, proudly showing off her bracelet with the lockets bearing the names of her nine great-grandchildren. She died at ninety-four after being man-handled by an attendant who was supposed to be gentle with frail old patients when bathing them.

  When I was at the health department I went with an investigator to follow up on complaints against a certain home in Hartford. The department had a deserved reputation as ball busters for any violation, which I came to believe was a good thing. Old people need someone looking out for them. After reviewing records and interviewing random patients, we met with the president of the home, who got upset with us. “Old people get bruised,” he said. “I get bruised. I don’t need some muckety-muck”—he
looked right at me; I had been introduced as the commissioner’s executive assistant—“telling me how to run my business.” I stared at him then gave him a mysterious smile. I was thinking what his reaction would be if I were to suddenly shout, “You murdered my great-grandmother, you bastard!” as I leapt up and choked him, knocking him clean over backward until three big orderlies pulled me off. He looked at me twice, grumbled, but said nothing more, and just nodded sullenly when the investigator said he’d be receiving a written report in the mail.

  The Age of Love

  Austin Jones is a fifty-one-year-old man with lung cancer, on oxygen and a morphine drip to help him cope with the pain. We’re taking him from the Veterans Administration (VA) hospital in Newington to New Britain General for radiation treatments. This is the second day we’ve drawn him. Not that he’s a bad guy, but we’d rather be in the city doing 911 calls than running a transfer.

  He’s doing worse today. They had to give him an IM injection of four milligrams of morphine before we left. The student nurse stuck him three times before she could get the needle to work. He says he’s feeling better, but he is very diaphoretic, and I have to break open a cotton four by four to wipe his brow. Yesterday when we were coming into New Britain, he saw a Ferris wheel out of the back window and asked if there was a carnival in town. I said it looked like there was a traveling show setting up in the supermarket parking lot. He said he wanted to take his grandson to one. His grandson was the one who kept him going, he said. The truth is, I don’t think he’ll make it out of the hospital before what is eating up his insides does him in.

  Austin Jones. He told us he wasn’t from Texas. He is an Alabama native, named after an uncle who drove a truck and got killed in Texas before he was born. He got the name Austin to remember the man by.

  Now, over the radio, we hear a car dispatched to a shooting on Weston Street.

  I hear Glenn swear in the driver’s seat.

  A second car is dispatched.

  “We’ve got a one hundred,” a voice crackles. A one hundred is a full cardiac arrest. “We need a medic.”

  “Isn’t eight-six-six on scene?”

  “Eight-six-six, we’re down the street. We’re working another one hundred, and we have two other patients.”

  “You hear that?” Glenn calls back to me.

  “Yeah,” I say.

  “The city’s going wild,” I say to Austin. “It sounds like they’ve got four people shot.”

  “Where?” he asks.

  “I think Weston Street.”

  “Oh.”

  I know he lives on Edgewood Street. I dab more sweat off his face. “How are you feeling?”

  “I’ll get by.”

  I listen to the radio. Two ambulances head to the hospital, one to Hartford, one to Saint Francis, both priority one.

  “Where were you in the service?” I ask.

  “Germany.”

  “Yeah, how was that?”

  “Nice,” he says. “Nice.”

  “How were the German women?”

  He grins. “German women, Belgian women, Danish women, Swedish women. They were all fine. Treat you like a man there. It was like one giant shopping trip. Like nothing I’d ever seen before or since. Copenhagen, Denmark. That was the place we’d go.” He pauses at the memory and smiles. “It was the age of love.”

  “How long were you there?”

  “Eighteen months, nearly two years.”

  “That’s great.”

  “I would have stayed longer if that shit hadn’t broken out.”

  “Vietnam?”

  He nods and looks hard into my eyes like I don’t want to know about it. “Rough. Rough,” he says.

  “You were in the field?”

  He nods then looks down at his chest. I watch his lips move. He mutters.

  I look away.

  A moment later, I feel his hand on my arm. “My anger is not toward you,” he says.

  “I understand.”

  “It was just a lot of shit. I left friends there and I got friends who are sick now like me.” He shakes his head.

  A few minutes go by. It’s quiet. I hear the ambulances sign off at the hospitals.

  “I hope he’s okay,” he says.

  “Your grandson?”

  He nods. The sweat beads on his skin. “Kids, they shouldn’t grow up with this.”

  I towel his face and brow with a fresh four by four.

  “Goddamn,” he says under his breath.

  The EMT Sports Pages

  I read the obituaries every day looking for names I recognize.

  Oscar Levin, seventy-six. We were called to his apartment a few weeks ago. He was lying on the floor against the wall with a lampshade near his head and a tall lamp fallen across his legs. His glasses were askew on his face. He was sweating and his hands were shaking. He didn’t want to go to the hospital. He said nothing was wrong. He denied that he had fallen. He got so nervous, he urinated on himself. It took us forty minutes to talk him into going, then we had to carry him down the narrow stairs strapped to a safety chair. The obituary said he was a member of the Temple Israel Church and had been a cabdriver for fifty years before retiring.

  Elston “Moonman” Lewis, thirty-nine. We were called to intercept with a basic ambulance. The patient was in late-stage cancer, suffering decreasing consciousness. He had a pressure of 70. His face was neon yellow. He was thin, emaciated, hardly weighed more than eighty pounds. When we put him in the back of the ambulance, his feet stuck off the end of the stretcher. Neither Glenn nor I could get an IV in him. The paper said he was captain of an area high-school basketball team in 1974.

  Gilda Dempsey, fifty-six. We found her facedown in the bathroom in a pool of vomit, with her pants around her knees. She’d pitched forward from the toilet. Her teeth were clenched and her pupils pinpoint. Her lungs were thick from aspiration. She’d been an administrator of a local college, and the mother of four, grandmother of six.

  Austin Jones, fifty-one. Father of six, grandfather often. Friend of many. Veteran.

  Call it depressing, but you like to know what happens to the people you meet and maybe a little bit more about who they were.

  Worry

  It’s Tuesday morning, the start of my three-day shift. I awake at 5:29 A.M. I arise and turn off my alarm before it rings. I have slept fitfully throughout the night, gazing at the clock at 2:38, 3:20, 4:46, 5:07. I go into the bathroom and feel a retch in my throat. I hold my hands against the bathroom counter as I cough. I spit into the basin. The feeling gets worse and I have to kneel before the toilet. I retch but nothing comes up. I wipe the drool from my lips and stand weakly. My eyes are watery.

  I shower, shave, and dress in my navy blue uniform with the patch of the American flag on my right sleeve. I drink a little cranberry juice and eat a banana. The retch comes back over me and I am again on all fours. This time I throw up the red juice and the white ooze of banana. Again, I wipe my lips and eyes.

  Driving to work in the darkness, I both dread and welcome the day. Let me make it through till midmorning, when I can eat something to gain strength. If I am to be tested today, let me do well. Let me not fail.

  The traffic is light. I maintain an even pace in the slow lane. I wonder what will happen to me. Will I marry and father children? How will I support myself? How will I ever support them? Will my wife get cancer? Will my children be injured? Can I hold up to life? What will happen to me when I get old?

  I drive on and wait for the darkness to lift.

  CHILDREN

  Message

  When I was riding in Waterbury during my paramedic class, we went to a call for a “hurt leg” and walked up the splintered wooden steps of a roach-infested apartment building to find on the third floor a fifteen-year-old mother crying because her five-month-old had skinned her knee. The paramedic had to show the mother how to clean the wound and put on a bandage and assure her it wasn’t life threatening. As we walked out of the apartment building amid a thr
ong of kids, a girl maybe ten years old, tall with long black hair and deep black eyes—a child of stunning beauty—looked right at me and pleaded to me like I might be some kind of savior. “I hate it here,” she said.

  I took her words back with me, east on I-84 then north on I-91 to my townhouse in East Windsor and then back south to Hartford, up the steps on the capitol and up to the second floor, through the doors of the governor’s office. I waited with her words by the secretary’s desk, while the governor talked on the phone to his own son early in the morning before the boy went off to school and before the office was filled with staff and visitors and meetings and bill signings. When he was off the phone, I stuck my head in the door and, on his acknowledgment, proceeded into the great room where the governor sat behind his wide desk with his hardbound copies of A Connecticut Yankee in King Arthur’s Court and the U.S. Constitution. We chatted for a little bit, and when he asked me about my paramedic course I told him about the little girl and what she had said, and about all the horrors of the inner city I was seeing and how tough it was for kids. He nodded and looked concerned and seemed to take it all in.

  I am sure that girl had no idea where her words had been carried. She probably did not even know there was such a person as a governor, but I like to think that she believed somewhere there was a person who was fair and wise and could send hope her way.

  When I first started working for Weicker it was in 1976, shortly after his rise to national prominence in the wake of the Senate Watergate hearings, where he played the role of the young Diogenes, the Republican searching for truth even if it meant turning on his president. His campaign slogan was “Nobody’s man but yours.” He was reelected by a landslide, but the truth was, he hadn’t accumulated much of a record as a senator. In 1978, he and his wife had a child with Down’s syndrome. In the ensuing year both on the floor and in his office, Weicker was erratic, directionless, and subject to fits of rage. One day on the Senate floor, he called Senator Heinz of Pennsylvania an idiot in violation of all protocol. The account of the exchange as recorded by the Congressional Record after staff editing is interesting to read. There are remarks leading up to a confrontation that isn’t there and apologies for something that can’t be found. At the same time his wife told me how Weicker would lie in bed at night, holding the baby on his stomach for hours at a time as if they were the only two people in the world.