“The three of them.”
The three are the store’s owners. They shake their heads and laugh. “He was moving fine till you came. He was trying to get away.”
“They were hitting me with shovels, man,” he says. “Feel my head.”
I look around but don’t see any shovels. I feel his head. He has a small hematoma on it. There are some welts on his back.
“You let me go, I show you were they hit me.”
The sweat is pouring off both of us now. I tell Arthur we need to C-spine him.
“I don’t care what you do to me. You get me to the hospital. I could be dying. I think I got internal bleeding.”
I come back with the stretcher and long board to find the cop releasing the man from his bonds. Then she handcuffs him.
“He can’t be cuffed,” I say. “We have to put him on the board.”
“I can’t undo him,” she says.
“Why not?”
“I don’t have the key.”
“You don’t have the key?” I say.
“I didn’t think I was going to be arresting anyone today,” she says.
“You didn’t? Well, where is the key?”
“At the station house.”
Arthur and I look at each other. We are both sweating profusely. We look at the guy, who is dripping water.
“I’m dying here, man,” the guy says. “You all just letting me die. I know I got internal bleeding.”
The cop radios her base and learns that an officer stationed at the hospital up the street has a key.
“Let’s just put him on the stretcher,” I say.
We finally get him out to the ambulance and he jabbers the whole way.
I take his vital signs, which are fine. The guy won’t give me his name. I sit there toweling the sweat off my forehead while Arthur drives the few blocks to the hospital.
“How you doing?” I say to our patient.
“I can’t breathe,” he says. He starts puffing and panting.
“How long were you knocked out for?”
“Two, three minutes. That’s at a minimum.”
“No kidding.”
“I think I got internal bleeding,” he says.
“Did he say he had eternal bleeding?” Arthur asks when I get back in the ambulance.
“He said internal.”
“It sounded like eternal. I think you’re just giving him more credit than he’s due. Like the lady who took motowns and peanut butter balls.”
We both laugh. It is funny the things that either people misstate or you mishear. Motrin and phenobarbital become motowns and peanut butter balls. Alzheimer’s disease becomes old-timer’s disease. A cyst becomes a sister. The best one I ever heard was from another medic—a patient told him his uncle had died of a massive fart. The doctor had probably said he died of a massive infarction of the heart, and the poor guy misunderstood and believed the uncle had died from a giant fart blowing up inside him.
“Maybe he did say eternal,” I say.
“He did. I tell you, he did,” Arthur says. “I got eternal bleeding.”
* * *
We clear the hospital and get sent right off for a leg fracture on Garden Street. It is a rundown house. Four men sit on third-hand couches watching a tiny black-and-white TV. On the wall someone has drawn a large picture of a Rastafarian smoking a giant spliff. LORD OF LORDS, KINGS OF KINGS is written next to it. They are all drinking beer. The man whose leg hurts is in his fifties; the others in their thirties. We look at the ankle; it looks barely swollen. He says it’s been bothering him for about two months now, mon.
“Make sure dey get X rays,” one of the men says. “He get him some crutches so he get himself around.”
“They’ll X-ray it, but I don’t know if they’ll give him crutches. It don’t look broken to me,” Arthur says.
“They give me crutches when I just twist my ankle,” one man says. “Ask for them. They got ’em dere.”
We take him to Mount Sinai and leave him in the waiting room.
As soon as we get back in our ambulance, the Hartford police dispatcher calls us. “Four-seven-one respond to Maple Street for a firefighter injured—high fall. On a one.”
We both swear. We’re deep north and the address on Maple is deep south. And it’s rush hour.
We go flying across town against the traffic. I am thinking this is the big one. The guy fell off a building and I’m going to have to tube him. The firefighters are going to be all over us to help their buddy. We’re going to have to be quick. Get him tubed, get him C-spined, and get out of there.
These are the calls that if you do great, you’re a hero; you fuck up, every firefighter in the state will be on your case.
When we arrive, three ladder trucks are in the road. The air is heavy with smoke. I grab the green bag and head into the scene while Arthur pulls the stretcher and readies the C-spine gear.
I walk through the trucks and see several groups of firefighters with soot-blackened faces. No one is hailing me. I look around to see who’s in charge. “Where’s the guy who fell?” I ask. They look at me blankly. Finally one says, “There’s your man over there.”
He points to a group of five firefighters, all in full turnout gear. They are all standing. I look around as if I’m missing something. “Where?” I say.
“Right there. That man.”
A young guy steps forward. “I fell on my shoulder,” he says.
“How far?”
“Length of my body.”
“Did you hit your head?”
“Just my shoulder.”
I stand there and say nothing for a moment, then: “Okay, the ambulance is this way.”
“I’ll come get you later,” one firefighter says to him.
“Yeah, okay.”
Arthur is just coming into the crowd now, pushing the stretcher with the long boards on it, along with head rolls, belts, and a C-collar, and he is shocked to see me walking back.
“This is him,” I say. “Fell about five feet on his shoulder. Didn’t hit his head.”
I throw the green bag in the side door and go around to the driver’s seat. Arthur slowly puts the board away, then has the man get in on the bench. He splints his shoulder. From what I hear, it sounds like his shoulder popped out of the joint, then popped back in. He has some elbow pain, too, but nothing seems broken. I imagine some firefighter calling 911 and making up a big bad story to get his buddy an ambulance quicker. I tell the dispatcher we’re on an easy three to Hartford. I know all the other ambulances were sitting waiting to see how quick we’d leave the scene and on what priority. A one would have been the big bad one; a two would have been significant enough to ask about later—probably a head injury, some signs of shock—a three, nothing; an easy three—bullshit.
When we get to the hospital, the guy doesn’t want to be wheeled in a chair, which is what we usually offer for an injury or a drunk when we haven’t used the stretcher. But he’s a tough guy, and he walks in, arm splinted, carrying his helmet and coat in the other hand. I don’t even bother to go in. Arthur gives the report.
We clear and they send us on a priority two to an unknown all the way down Franklin Avenue. It turns out to be a six-year-old who fell, and one of her front baby teeth is sticking out at a ninety-degree angle to the other. Her mother is all upset that the tooth needs to be fixed.
We are speechless. “Why did you call us?” I say. “I mean, what do you want us to do?”
“Fix it,” she says.
“It’s a baby tooth. It’s going to fall out on its own.”
“But she can’t eat with it like this.”
I kneel down and look at it. I am thinking about just grabbing it and yanking it out. I touch it and wobble it a little. The girl starts to cry and hides her head in her mom’s waist. She looks at me like I am a villain.
“There’s nothing we can do, and they’re not going to be able to do anything at the hospital. Does she have a dentist? Take her to the d
entist. This isn’t an emergency. I mean, we’ll be happy to drive you to the hospital, but really we wouldn’t be anything but a taxi service.”
She says nothing.
“You could tie a piece of string around it, and the other end to a door, and then yank the door open,” I say.
She looks at me like she doesn’t understand what I am saying and hugs her daughter tighter to her.
Arthur and I look at each other and shake our heads.
“What kind of insurance do you have?” I ask.
“State,” she says.
“Do you have an HMO?”
She shakes her head no.
“In the future,” I say, “you will have to contact the gatekeeper at your HMO, and they will say no way will they pay for a loose tooth to be transported in an ambulance, and it will cost you personally two hundred dollars if you go.”
She looks at me with fear.
“But right now,” I say, “the state will pay for it. Two hundred dollars. It’s up to you. They won’t be able to do anything for her. You’re just going to sit in the waiting room, but if you want to go we’ll take you.”
She looks at her daughter, who is looking up at her, and then she looks at us.
“What’ll it be?”
She looks back at her daughter. She gives her a hug. “We’ll go,” she says.
I shake my head, then say, “Well, let’s get going.”
Hartford Hospital is busy. They have a major trauma going in room one. The triage nurse looks at us like we are kidding her when we give the report. She looks at the girl’s tooth and then looks at the mother. She sends them to the waiting room. “If we keep them out there long enough, maybe it will fall out on its own,” she says.
Our last 911 call is for a man with a swollen hand. He meets us at the curb. I look at his hand, then ask him which hospital he wants to go to. Saint Francis. “Okay. Get in.” I get his name, birth date, address, and state card number as we drive.
As we’re walking in to Saint Francis, I see the guy with “eternal bleeding” being walked to a squad car, hands cuffed behind him, headed for a night behind bars. “I’m going to sue, I’m going to sue,” he is shouting at the officer. “I could be dying!”
“Yeah, yeah, yeah,” the officer says, as he opens the back door for him. “Watch your head.”
In the ER I see the guy from the nursing home still on the stretcher, but this time a doctor is examining him. “You may have had a seizure,” the doctor, a moonlighter who has just come on duty, says. He is reading the nursing home report. “That’s why the convalescent home sent you here. Do you remember that?”
The man has a sour look on his face. “I want something to eat,” he says.
Kids
Arthur and I compete to see who can get the biggest smiles from kids. He, the grandfather, usually wins out, particularly with the babies. This despite my monkey imitations, which are widely acclaimed and always draw a positive response from the simian inmates when I visit the Central Park Zoo. “It’s not that they like you better,” I say. “It’s just that you’ve had more practice. Like since George Washington was president and pterodactyls flew in the sky.”
“Jealousy will get you nowhere,” he says, lifting the baby up over his head, smiling and saying, “You’re an adorable little muffin, yes, you are.” And they giggle and smile and laugh.
“Please,” I say. I hold my hands out to take the baby.
“Stand back,” he says, “you might scare her.”
We often introduce ourselves to kids as Fred and Barney or Mufasa and Riffiki. If they speak Spanish I will call Arthur un perro viejo, an old dog. “Feo, tonto, gordo,” I’ll say. Ugly, dumb, fat. And they will laugh, holding their hands to their mouths to try to keep it in.
“What’s that?” Arthur will say.
“I told them you were very handsome, strong, and bright.”
“Why do I get the feeling you just insulted me?”
“Muy tonto,” I’ll say. Very dumb.
And they’ll laugh again.
Arthur is a good sport about it.
Sometimes we introduce ourselves as father and son. “He’s my dad,” I’ll say.
“That’s right, son,” Arthur will say.
We will be standing by a fish tank. “In Norway, where we come from,” Arthur will say, “we eat fish alive.”
“No,” the kids will say, laughing.
“Swallow them whole.”
“Don’t they squirm?”
“That’s the best part,” Arthur will say, “but they don’t squirm for long.”
A pediatrician from the Connecticut Children’s Medical Center (CCMC) rides with us one day. Arthur says it must be hard working with kids who are so sick. The doctor says it can be hard, but the thing with kids is they often get better, and when they are sick, it is rarely their fault. Adults, on the other hand, are usually sick because of their own lifestyle choices—heavy eating, lack of exercise, smoking, alcohol, violence. And in the end, adults all die.
Neither of us likes doing calls where the kid is either seriously ill or seems to be seriously hurt. “What a shame,” Arthur says when we finish a long-distance transfer for a kid with leukemia. “Nice kid. Nice family.”
Kids are hard, hard emotionally and hard medically. They are not little adults. They are a completely different category. It’s much harder to tell how sick they are. Sometimes they are much frailer; other times their resilience will surprise you.
A three-year-old girl, left unattended by her mother, falls thirty feet out of an open window and lands on cement. A bystander picks her up and says she is not breathing. The first EMTs on scene, Faith Creer and Cindy Hudson, call for a medic. The girl is unconscious, they say, and only breathing sporadically. Arthur and I arrive and break through the crowd. While we C-spine the child on a half board, I get out an ambu-bag and assist respirations. She stops breathing and is out of it completely, but after a few breaths of the ambu-bag, she opens her eyes, breathes, then conks back out. On the radio, I call Hartford Hospital, requesting the trauma room. We’re two minutes out. I am bagging the unresponsive girl as we come through the door. The room is full of adults in medical gowns, expecting the worst. “Fell thirty feet, landed on cement, breathing very erratic.” As I say this the little girl opens her eyes and looks around.
“You sure it was thirty feet onto cement?” the doctor says. Other than an abrasion on her forehead, she doesn’t have a scratch on her body.
“Yes, and her breathing was very erratic, like periods of apnea,” I say.
They are goo-gooing and gaa-gaaing her now. She is wide awake. The doctor is looking at me like I am some excited rookie who misread the scene. They do a complete workup, and all they find is a hematoma on her liver. On the news that night, they interview local residents, who describe the fall and how she wasn’t breathing when they picked her up. They also say this wasn’t the first time she’d been left alone.
Two days later we are up in Windsor when we get a call to a day care center where a two-year-old fell two feet and hit her head. She has a little bump but is otherwise fine and peacefully reading a book. They have called her mother, who is on her way there. She wants her daughter seen at CCMC. I tell Art to get a backboard and C-collar equipment. While I am writing down the information the day care teacher is giving me about the girl, I look over at her. Suddenly her eyes do a little roll, her head falls to the side, and she conks out. I grab her hand and give her a little pinch. Nothing. No reaction. I open her eyes, and they do not react at all. I look out the window. Art is kneeling down by the ambulance, trying to get a kitten to come to him. He is going, “Here, kitty, kitty, kitty. Here, kitty, kitty, kitty.” I bang on the window. He pays no attention. I bang again. Hard. He glances up at me. Let’s go, I mouth.
The girl is completely out of it. We C-spine her quickly, put an oxygen mask on, and are wheeling her out just as the mother comes in. “This is all precautionary,” I say. We get her in the back of the
ambulance and I tell Arthur to go on a two, lights and sirens. The call has me puzzled. The girl didn’t fall two feet. She was fine and then boom, she was out of it. I do a terrible thing then. When someone is faking, I hold their hand over their head and drop it. If they are faking, the hand conveniently misses their face. If they are not, it smacks them. I usually only do it when I think they might be faking. I hold her hand over her head and release it. It smacks her hard right in the nose. She doesn’t stir. I put a tourniquet on her arm and stick her with a 22 IV She doesn’t flinch. I radio Children’s. Unresponsive two-year-old. Fell two feet. Was fine, then boom. Out cold. Just as we come into the city, Arthur hits a bump. The car goes airborne and hits the road hard. The girl opens her eyes. “Mommy,” she says.
Her mother turns around in the seat. “Katie.”
“Mommy,” Katie says.
Moments later when we wheel her into the hospital, she is smiling and talking like a normal two-year-old. “Look,” I say to the doctor, “I know what she looks like now, and I’m telling you kids confuse the hell of out me, but she was out cold. Completely. I know she’s fine now. I’m just telling you, her eyes rolled back and she went out.”
The doctor nods and smiles. They keep her for observation for four hours and send her home with a clean bill of health.
A couple of months later, we are transporting a four-year-old boy who banged his head on a table and, according to the mother, is sleepy and isn’t acting like himself. He doesn’t seem quite right to me either. Again, we go lights and sirens. Just to be safe. At Children’s, the nurse is also bothered, as the child keeps closing his eyes and doesn’t respond to pinches. “Let’s get a doctor in here,” she calls to another nurse. The doctor comes in, looks at the kid, then pinches his belly—hard. The kid lets out a bloodcurdling scream. The nurses look at the doctor like he’s a villain; they’re also upset he has belittled their diagnosis. “Hey, you just have to use a little force,” he says. “Can’t CAT scan everyone.”
The kid stays awake for the rest of his visit, screaming every time the doctor walks by the door to his room.
“I’ll let you try that next time we have a kid with a possible head injury,” I say to Arthur. “Just give him a vicious pinch in the belly.”
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