“Maybe we should ask if they’ve had any reports of explosions,” Art says.
We can’t find a motor vehicle accident anywhere.
“It’s by the Oldsmobile place,” the dispatcher comes back. “They called it in.”
“Oh great, a fender-bender in the parking lot,” Art says. We spin around and head to the dealership but can’t see anything. A salesman comes out and points down the road. “Down that way,” he says. “One of our cars was involved.” At the same time, over the radio, the dispatcher says, “We’re getting calls from the highway, there’s a car on its side just off the road.”
We race down the road. Ahead we see a vehicle on its side against the fence, people lying in the road.
“We’ve got it,” Art says. “We’ve got bodies all over the place.”
I get out and quickly note that no one appears badly hurt, but it is a strange sight. People are lying in the road like participants in a casualty drill, all except one man—wearing baggy pants and a snowjacket even though the temperature is in the sixties—who sits against the fence, shouting into his cellular phone. Nearby a brand-new 4-Runner, its windows all smashed out, is on its side against a fence. “Pick me up and get your fuckin’ ass out here,” the man on the phone says, waving his hands about like a rap singer. There are three other similarly dressed people lying on the ground. Two of them are also on cellular phones.
In the middle of the road is a skinny man in a white shirt and tie, wearing glasses. “I’m a little bit shook up,” he says, with a rapid Pakistani accent, “but I think I’m okay. They told me not to move so I been lying here still as I can be.”
“Well, what happened?”
“I told dem to slow down, but dey went faster instead. Then de car went ober and ober. I thought it was the end for this berson. Oh, I’m going to lose my job.”
I go back to the ambulance to radio that we have four minor injuries and will need a second ambulance. The cavalry is already on the way. Daniel Tauber is coming in a fly car and another ambulance has been coming priority one. Slow it down, I say.
A Bronco pulls up. The man who has been standing against the fence says something to a man on the ground, then gets in the car, which peels out. A police car is coming down the road, followed by a TV news van, an ambulance, and the fly car.
I take two of the younger men in my ambulance, while the other car takes the salesman and the third guy.
“I can’t believe this, man,” one guy says to the other.
“I ain’t going to pay for that, am I?” the driver says, as we head to the hospital. “That ought to be on their license … right?”
“They probably have insurance,” I say.
“Damn right. That car handles for shit.”
We’re still laughing about the call when we clear the hospital. On the radio a basic crew is shouting for a medic. They have a cardiac arrest. We are about to volunteer to back them up when the dispatcher Laura Howe calls Rebecca’s number—her car is closer.
“Her first code on her own,” I say.
“She’ll do fine,” Arthur says.
Car 875 calls us to assist them at an elderly housing unit. There we find a five-hundred-pound, sixty-year-old female wearing only a cotton robe, sitting on the floor by her bed. She looks like Jabba the Hut’s big sister. She had been trying to get off her bed and onto her mobile cart when she fell. She is unable to get up by herself and is too heavy for Faith Creer and Cindy Hudson to lift. Arthur and I each grab her under her shoulders and try to stand her up, but we don’t move her an inch. We stop because we are worried we will pull her shoulders out of joint. After numerous attempts, I finally squat down and put my arms around her chest. While our rider grabs her legs and Art a shoulder, I squeeze my arms tight. My arms disappear into her rolls of fat. As I drive my legs up and Art and the rider strain, we move her up against the bed. Art and I go flying on top of her, then she starts to slip back and I catch her with my leg. She slides down on my leg, but I hold it tight to keep her from hitting the floor. She reeks of BO and other smells. My leg feels damp. I can barely see it; folds of fat and both legs hide it. We push up, Art and the rider each holding a leg and my arms in a bear hug around her. We get her completely on the bed. Her house is disgusting and she has no business living there alone, but she doesn’t want to leave, and we can’t take her against her will. We leave the crew of 875 to get the refusal. We clear, but I ask to return to base to do laundry. I have been pissed on, puked on, bled on, and spit on. I have wiped shit off old ladies’ bottoms on numerous occasions, but when I look down at my pant leg now and see it covered with slime and gray pubic hairs and feel its dampness, I am nauseated.
At the base, I put my pants in the washer and pour in two cups full of soap. When I take my pants out, they are foamy white. I wash the soap out in the shower, ring them out, and toss them in the dryer. An hour later, my pants are hot and dry, but I feel only slightly better.
As we walk to the car, Rebecca and her partner pull in. They need to resupply after their code.
“Rebecca, my pride and joy,” I say. “How’d it go? Did you get the tube?”
“I got the tube,” she says, “and the save.”
“All right! A save!”
“I did you proud,” she says.
“No doubt.”
I want to stay and hear all the details, but we have to get back on the road—the city is hopping with emergencies.
It is one of the busiest days I’ve worked. We keep banging out the calls. I keep Arthur on the go. I’m whipping out run forms in a matter of minutes, clearing the hospital lickety-split, because they are short of cars. “Let me just go to the bathroom before you clear,” Art says.
“But you went this morning,” I say.
We do an old woman who fell and broke her wrist. “You’re such nice young men,” the woman says to Arthur.
“He’s not,” Arthur tells her. “He is my nemesis. An evil man.”
It is the only call I let him tech because he is slow with the paperwork. We are going to Hartford Hospital and I know I will have time to run across the street to the Children’s Hospital cafeteria to grab one of the cheap lunch specials, get it eaten, and be back in the rig before he’s done, which proves to be the case. “Maybe we’ll get a chance to eat before the next call,” he says.
“Eat, who needs to eat?” I say. “Suck it in. There are people out there in distress.”
He shakes his head and growls. I grab the mike, clear us, and we are immediately sent to Park Street for a maternity. The address is barely three blocks from the hospital. In most maternities we do in the city, the woman meets us at the curb, walks to the ambulance, and hops in back; we drive her to the hospital, we wheel her upstairs, and she gets off, hops onto the table, and delivers within the hour. I make a comment—What, they can’t walk two blocks? Art agrees.
The woman is coming down the stairs, wobbling. We get her on the stretcher, and she tells us she is twenty-three weeks pregnant. She was just at the hospital and they sent her home. “The baby is coming,” she says. “I got to go to the bathroom. Oh, this pain. Don’t let my baby die. All the others, they always die. This always happens. Oh, the pain is killing me. I am Caesarean,” she says.
Once we are in the ambulance, I check her to see if the baby is crowning. No sign yet, but the woman is screaming. I tell Arthur, just go. I really want to deliver a baby, but at twenty-three weeks, the baby cannot survive. I remember the one I did deliver, twenty-six weeks, and I never want to go through that again.
“It’s coming, it’s coming,” she says. “I can’t take the pain. Don’t let this happen.”
We’re out at Hartford a minute later. We take her right upstairs to labor and delivery, where her screams take a moment to get the staff’s attention.
“She was here earlier, twenty-three weeks pregnant. History of three miscarriages. Says she has to go to the bathroom.”
Their look that says, What, back again? changes quickly. We
wheel her into a delivery room and seven or eight doctors and nurses, quickly gowning up, enter the room. “She’s about to deliver,” a woman says who has briefly examined her.
“She’s going to lose the baby,” I say to Arthur.
“What a shame.”
I don’t even have time to write up the paperwork. They are screaming for cars, so I just clear. They send us out to I-84 East, near the Capitol Avenue exit to assist another car with an MVA. We fight through traffic with Arthur slamming the air horn and traffic turning right in front of us, or stopping dead, and generally causing Arthur to shout and slam the air horn more.
When we arrive on scene, I see that Daniel Tauber, the chief paramedic, and Pat O’Brien, one of the supervisors, are the crew. Daniel comes over; he is really angry. “There is not a scratch on the car,” he says, “and this woman wants her and her three kids to be checked out. They all have to be boarded and collared.”
On the radio we hear there is a child struck by a car over on Nelson. No cars are available for several minutes. One finally clears Hartford and must race completely across town to respond, while two units are stuck up here on the highway for bullshit. Daniel takes the mother and the youngest child, while Art and I take the other two girls, ages eleven and five.
At the hospital, I see Daniel has done a mummy job on the woman. He has tape across her eyebrows, three belts on, tape around her velvet dress, tape around her suede shoes. She is incapable of any movement except breathing. She could be turned upside down on the board and not move a inch. One of my little girls has already escaped from my C-spine job, and someone has given her a lollipop. She is sitting on her board, telling her sister that the hospital looks just like it does on TV.
As soon as we clear, we get called for chest pain. I find a fifty-year-old man, alert but lying on the floor. He is pale, ashen, diaphoretic. I give him two baby aspirin to chew. I can’t feel a pulse or a BP. His wife and daughter stand in the kitchen doorway, scared. I throw him on a nonrebreather and tell Arthur to get the stretcher. The monitor shows him in a sinus bradycardia at 20. I put in an IV right there, slam in a milligram of atropine. “Are we going to the hospital?” he asks.
“This may help,” I say.
The rate comes up to 60. When we get him in the ambulance, I hear a blood pressure of 100. I run the fluid wide open because his lungs are clear. He still has chest pain, but his breathing is a little better. I give him a nitro under the tongue and call the hospital. I tell them what I have and ask for orders for morphine if I can get his blood pressure up with the fluid. They grant it. I give him another nitro and four milligrams of morphine as Arthur races through traffic. I put in another IV line. His pressure is up to 120. He says he’s feeling better, though he still has some pain. I give him another nitro. When we hit the ER, they have a room ready with a crew of doctors who descend on him. The ECG confirms the infarct. They put him on heparin, a nitro and morphine drip, and within ten minutes have him upstairs for a catherization to clear out his blocked arteries. I see his wife and child in the waiting room; I bring them in so the doctors can explain what is going on. His wife squeezes my hand and says, “Thank you.”
While I am writing up my paperwork, I call dispatch for times. They ask if we can do a call on Willard—there is an unconscious party there and they’re out of cars. Willard is just down the street. “Sure,” I say.
“Arthur,” I shout as I come out of the security room. I see him in the supply closet off the hall. “We’ve got a call. Did you get a board in?”
“Yes, another call?”
“Hi-ho Silver,” I say. We get in the rig. “Unconscious on Willard. They were out of cars.”
“Am I surprised?”
A man meets us at the curb.
“What’s up?”
“It’s my brother. He was on the couch, then all of a sudden, he had trouble breathing.”
“How old is he?”
“Thirty-seven.”
“What kind of history does he have?” Code for Does he do drugs?
“He’s got heart problems.”
We get in the elevator. To fit the stretcher in, we have to lift the back to the sitting position. “Is he still breathing?” Arthur asks.
“Yeah, he’s breathing.”
“Sometimes they don’t tell us, so I like to ask.”
We get off at the third floor. The door opens and we are face-to-face with a dresser, a few rolled carpets, and a gilded mirror.
“Excuse us,” I say to the young woman who is obviously moving out. I help her move the mirror and carpets. “Please keep this elevator free for a little. We’re going to be needing it.”
“Okay,” she says, but as soon as we are by, she starts loading the furniture in.
We go down the hall a few doors and follow the man in. We leave the stretcher in the hall. I go in first carrying the monitor. Art has the bag. We go down a narrow hallway and turn into the bedroom. On the far side of the bed, a man lies on a couch. I walk over and look at him.
He is a tall young man. I look at him closely. It is one of those moments that seem to take several minutes, but in reality only lasts a split second, as my eyes tell my mind, my mind thinks on it and processes it, and then I say aloud, “Arthur, he is not breathing.”
We pick him up and carry him over to the other side of the bed, where we will set him down on the floor. We need a hard surface to make the CPR compressions effective. “Did he do any heroin today?” I ask.
“No, well, maybe some this morning,” his brother says.
We set him down and Art cuts his shirt off, while I put him on the monitor. He is in v-fib. “I have to shock him,” I say. I set the dial for 200 joules.
I shock him. His body flinches. I look at the monitor. He is in an idio-ventricular rhythm. I get the airway kit out while Arthur gets on the radio. “Four-seven-one, we have a working one hundred,” he says.
Dispatch comes back saying they are sending a crew. I know that means Daniel and Pat because they are just up the street. I stick the stylet into a number-eight tube, attach the ten cc syringe to the end, and then go in for the tube. I see the cords, easily pass the tube.
I listen for breath sounds, equal and positive, negative over the stomach. “I’m in.”
I glance at the monitor. He is back in v-fib. I shock him again. This time at 300 joules. His body flinches. Again, we get a rhythm. I feel for pulses. Nothing. Arthur starts compressions again. I recruit the cop who has arrived to handle the ambu-bag. I get some drugs out of my bag, and squirt some epi and atropine down the tube.
We hear the door open, and Daniel and Pat come in with their med kit and a backboard.
“What do we have, gentlemen?” Daniel says.
“Thirty-seven-year-old heroin user. History of heart problems. He was having trouble breathing, his brother says. We found him not breathing. In v-fib, shocked twice. I’ve just given some epi and atropine down the tube.”
“I’ll get a line,” he says, stepping over me.
We work him hard. I give Narcan in case it was a heroin overdose. More epi, atropine, and lidocaine. Daniel gets two lines going, running full fluid. We shock him nine times, occasionally getting a rhythm, but never a pulse. It is very hot in the apartment and we are all dripping sweat. Finally, he’s gone flatline.
“Let’s get him out of here,” I say. We secure him to the board, tuck his hands in his pants to keep them from flailing. He is a tall man; his feet stick off the end of the board. Arthur and I pick him up, perform several maneuvers to get out of the tight room and finally into the hall, where the stretcher is set up. We resume compressions and bagging in the hall as we roll down to the elevator. The lady moving in has gone with her furniture, but the elevator is not there. We hit the button and wait.
“He’s not going to fit in there,” Arthur says.
“We can lean the stretcher.”
“It’s going to be tight.”
We push the stretcher in and try to turn it, but the end
won’t clear the door. I try to lift the back, but it won’t give. I have to loosen the straps on the man, then pull hard. We push the stretcher, but the door still won’t close. Daniel and I both lift. The stretcher is only on two wheels now, and the man is leaning at a thirty-degree angle. The door starts to close, but it catches his feet. Daniel pulls them in, and I push the elevator door, which scrapes against the foot of the stretcher. Finally, the door closes.
We push the first-floor button, but the elevator goes up.
At the third floor, the door opens. A kid, chewing gum and sitting on a bicycle, looks at us blankly. “You’re going to have to wait,” Daniel says. The man starts slipping out the door, and we both grab the board and try to pull him up. The door starts to close, but hits the stretcher and opens again. We push hard against it, and pull up on the stretcher at the same time till it closes.
The elevator descends and opens back on the second floor. This time we hold the man to prevent him from slipping out. As soon as the door closes, we start CPR again.
Out in the ambulance, we fire more drugs into him, getting a rhythm, but no pulses. By the time we are out at Saint Francis, he is asystole. In the cardiac room, the doctor takes our report, and because the patient is such a young man, continues the effort. They get a rhythm back briefly but again, no pulses. He pronounces him dead.
He thanks us and says we did a good job. And we did. Even though the patient didn’t make it, he got great care—our best effort.
Our next call is a priority one chest pain two blocks from the hospital, but the patient turns out to be a fifty-year-old woman with a cold. I feel myself start to say to her, Why did you call us and not just make an appointment with your doctor? but I don’t. I can see that she feels awful and doesn’t know any better. Because it hurt in her chest when she breathed she thought it might be a heart attack, even though it’s the same pain she’s been feeling for weeks and she’s been coughing up yellow phlegm. She lives here all alone, and maybe seeing someone at the ER will give her some comfort. Maybe I can give her some comfort. I don’t argue with her, lecture her, tell her to walk the two blocks, or try to bully her into signing a refusal. I put her on the stretcher, talk nicely to her, and move us along our way so we’ll be free for the next call.
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