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by Michael Morse, contributing writer
He sat on the cold street holding his foot in his hands. It was still attached to his leg, but barely. I winced every time he tried to put it back where it belonged. With help from the crew of Engine 8 we loaded him into the rescue. I left the boot on but cut off the pant leg, exposing the bloody sock and compound fracture.
Jorge was conscious; he looked more upset than anything. We held him still, started an IV, and transported him to Rhode Island Hospital. No pain medication—Rescue 6 does without morphine.
Jorge had no ID, no home, and now no livelihood. His immigration status is most likely illegal. How quickly things change. He was fortunate his injury didn’t happen in Guatemala—his leg would probably be gone. It will be months, if ever, before he walks again. His injury will cost the system tens of thousands of dollars. He came here for the work, probably sending most of his earnings home. He and his family have some hard times ahead.
All she had was a wheelchair, a couch, a bed, and a picture of Elvis. The place was clean; when you don’t have anything it’s easy to keep up. From her bed she told us about her pain.
“Four days now, getting worse every day.”
Living with diabetes for twenty of her fifty-three years had taken its toll. What little I recall of my grandmother’s mother is an old lady in a wheelchair with no legs. She lost them to the “sugar” was all I was told.
We brought her to the truck, got her comfortable, and headed toward Rhode Island Hospital. It was a long transport for us, about twelve minutes. I settled into the captain’s chair and started the report while “Louise” sobbed in the stretcher. It was a busy night, the radio blared in the back.
“Rescue 2 and Engine 14 to Manton Avenue for difficulty breathing.”
“Rescue 5 and Engine 7 to Benefit Street for a man who has fallen.”
“Rescue 4 to 100 Broad Street in the lobby for an intoxicated male.”
“Engine 4 with an East Providence Rescue to Blackstone Boulevard for chest pains.”
And on and on.
I turned the volume all the way down. From the cab came a familiar sound.
“A little Elvis for your listening pleasure,” Jeff yelled back as we rolled down the highway. “Don’t Be Cruel,” “Hound Dog,” then “Teddy Bear.” Louise sat up in the stretcher, stopped sobbing, and actually smiled. It was the best ride of the night. Sometimes Jeff’s music is the perfect medicine.
He’s not sick, not stupid, and not homeless. When he is tired, or cold, or hungry, he’ll call 911 and say his legs hurt, or he is bleeding rectally, or he has abdominal pain. We take him to the ER, they treat him, and he is shown the door. He walks to the nearest pay phone, and with discharge papers in one hand and the phone in the other he calls 911 for a ride to a different hospital.
At restaurants he eats a full-course dinner, clutches his chest, and yells for somebody to call 911. Of course, somebody does, we show up and take him to the hospital. The restaurant eats the tab, the servers go without a gratuity, the “patient” wins again.
He is a heavy man, fifty years old and diabolical. Time and time again we give him the lecture. Somebody could die while he abuses the system, a kid could be choking, heart attacks, accidents, and he could care less. He is getting his. I have never seen anybody with such absolute disregard for his fellow man.
Our system of government is the most successful civilization has ever seen. The Constitution is a brilliant document giving us all the rights afforded within, most importantly the right to pursue our own happiness. People like Norman, if allowed, will crush our pursuit of happiness. The legal system that is based on the Constitution has been corrupted to the point where it would no longer be recognizable to the people who wrote it.
Norman and thousands like him are allowed to exist and make a mockery of our laws by the very people who are educated and trained to uphold the laws but have chosen to corrupt them instead.
If I were to leave Norman at the pay phone, or if the police were to arrest him at the restaurants where he is having his alleged chest pain, or if we or the hospitals refused to treat him and in the unlikely event he actually had a real emergency, there would be a trainload of them waiting to fill their pockets. The fact that people like Norman are allowed to thrive among us makes me wonder if we can ever get ourselves back on track. I certainly hope so. Until then, I’ll take Norman the two blocks back to the hospital when he calls.
Or maybe not.
He was hauling lobster pots up from the bottom of the ocean, eighty miles off Nantucket, when he lost three of his fingers. His shipmates packed the severed digits in ice, wrapped them in plastic, and gave them to him. He put them into the top pocket of his coat. The captain radioed for help. The Coast Guard sent a rescue helicopter. The fishermen waited on the freezing ocean for help to arrive.
We got the patient out of the helicopter and into the rescue without much fuss. He was a tough-looking Spanish-speaking guy, his left hand wrapped with gauze and duct tape. The crew of the fishing vessel did a great job with what they had. The flight nurse came with us to give the report to the staff at the ER. He was a young, good-looking guy, dressed in his orange jumpsuit. With his rescue gear he looked pretty impressive. When we arrived at the ER, Teresa, the lieutenant in charge of Rescue 5, opened the rear doors and told him she liked his outfit. The flight nurse was very impressed with her, as any guy in his right mind would be. We got the patient through the triage desk and into the treatment area.
We took the Coast Guard guy back to the chopper. They took off toward their base, we were heading back to our station when I saw the fisherman’s life vest on the floor of the rescue. There was some expensive-looking gear on it, so I went back to the ER to return it to him. He was sitting on a stretcher in fast track, waiting. He looked me in the eye, held my gaze for what seemed a long time, and said, “Thank you, señor.” He looked at his disfigured hand and closed his eyes.
This was my last run of a thirty-four-hour shift. No sleep, nonstop calls. Instead of feeling exhausted, I was exhilarated. A man can come to this country, find honest work, live without fear and pursue whatever dreams he has. When tragedy strikes there are people who will scramble to a helicopter, find him in the middle of the ocean, fly him to a hospital, put him in a rescue where a beautiful lieutenant opens the door for him, be treated with care, kindness, and respect, and be given the best medical treatment in the world. No questions asked, no thanks necessary, just a country full of people willing and trained to help. It makes me proud to be an American citizen.
She handed me a license and registration. I gave it a quick look before getting her and her friend into the truck. Their car had moderate damage to the rear end; whoever hit them hit them hard from the look of things. I looked at the pile of debris scattered on the street, searching for some clue as to the identity of the owner of the hit-and-run vehicle but there was nothing but broken glass and plastic. Sometimes, if we are lucky, the license plate falls off. Not this time.
Renato had things well in hand when I returned to the truck. Our two victims were in cervical collars and lying on backboards.
“Did you get the license plate number?” I asked.
“No, but you shouldn’t need it,” said the passenger, an eighteen-year-old girl from Smithfield.
“Why not?” I asked. The driver, another eighteen-year-old girl from Smithfield, looked up from the stretcher.
“You have her license and registration in your hand.”
The girls had been out dancing at one of the downtown clubs. They looked like they belonged in a music video rather than on a backboard in a Providence rescue. They were in good spirits, all things considered. Their injuries were minor, their car probably fixable. A police officer came to the side door.
“The driver of the hit and run gave them this before she left the scene,” I said, handing the license and registration of the suspect over to him. He looked at me, the girls, and the evidence in his hand.
It’s a tough job, but somebody has to do it.
For days she sat on her couch in her filthy apartment, struggling to breathe. At three in the morning she called.
Trouble breathing. Her O2 tank and mask lay at her feet.
“Why aren’t you using your oxygen?”
“I can’t breathe.”
“That is what the oxygen is for.”
“Help yourself,” I said and put her oxygen mask back on. Twenty prescription bottles sat on her coffee table next to a remote control. Oxygen tubing was tangled everywhere; I’m amazed she never strangled herself. Andy and I carried all three hundred pounds of her down three flights of narrow stairs into the freezing night air. Getting out of the house and leaving her cigarettes behind did her a world of good.
Hector is back in charge of Rescue 2. He doesn’t look any different but I’m sure his time in Iraq has changed him in ways we will never see. Those closest to him may notice the subtle changes, the rest of us are happy just to have him home. As the War on Terror grinds on and public opinion turns sour, our soldiers continue to fight, continue to die.
Nine more yesterday.
Every person serving our country in Iraq and Afghanistan has something in common. The people they leave behind jump at the opportunity to let anyone and everyone know that their brother, son, daughter, mother, friend, uncle, neighbor, or even the guy at work they normally mumble a good morning to is there, in harms way. It makes us feel special, as though just knowing somebody “over there” puts us on a higher level.
My brother, Bob, is still in Iraq. He’s about halfway through his deployment. Whenever the war is mentioned, I stand a little taller and tell anybody who will listen, “My brother is there!”
Thanks, Bob. Thanks, Hector. Thanks to everybody “over there.”
Melting (EMS 1 essay winner, EMS Week, 2009)
I knew I was the minority before walking into the restaurant. It’s something I have gotten used to. Good food smells the same to everybody. I had no idea what they were selling but I couldn’t wait to take a bite. A group of men sat in a booth speaking a language that has become familiar, yet hard for me to understand. They looked in my direction, then returned to their conversation.
The restaurant is set up cafeteria style, all the offerings displayed on steam tables or in refrigerated cases. I placed my order with the girl behind the counter, certain it would be delicious. It was. When I paid I thanked the girl in her language. Her smile transformed her face from pretty to beautiful. She returned the thanks and still smiled as I left. The guys watched me leave.
Years ago I began working in this area. I have seen many changes. At first I felt like an outsider; it was obvious that I didn’t belong here. I was treated differently from the people who lived in the neighborhood. They seemed to tolerate my presence, but patiently waited for me to go.
Whether these thoughts were real or imagined I will never know. I do know that I no longer feel that way. We have both changed, the neighborhood more diverse, myself accepting the way of the people who live and work here. Time has marched on and we have learned from and accepted our differences.
Riding through the neighborhood I marveled at the businesses that have replaced the abandoned buildings. Restaurants and grocery stores, beauty parlors, barbershops, nightclubs, delis, and boutiques are some examples of what the main street has to offer. Some mornings I see sidewalks being swept by proud business owners. In the afternoons shoppers fill the streets and stores. There are sidewalk vendors, food carts, and kids running everywhere. On weekend nights the dance clubs are full of people partying. They come from all over. The hardworking people out for a night of fun outnumber those looking for fights and trouble.
When I first came to this area, it was a dangerous place. The people on the street were to be avoided. Crime was prevalent, despair evident in the look of the people who lived here. Unfortunately, that element still exists. The difference is they are now the minority. People are free to go about their business with less trepidation. Danger lurks, but the cowards that prey on the ambitious have been forced into hiding. The good people outnumber the bad.
Progress is measured in many different ways. For years the city of Providence has been touted as the “Renaissance” city. Downtown enjoys an almost magical transformation. The streets are clean, business is booming, and economic development is evident throughout the area. All one has to do is look at the place and see it is on the verge of greatness. Guarded optimism abounds in the most jaded pessimist.
Hard work, faith, and perseverance have turned some of the city’s most notorious neighborhoods into safe, lively destinations. Broadway, Westminster Street, and the West End all are reaping the rewards of deserved good press. People made this transformation possible, not politics. Honest, hardworking people have a way of finding the louts and getting rid of them. It takes time, but somehow, good prevails.
Downtown and the neighborhoods are on the way toward reaching their potential. This neighborhood is on a similar path; the essential ingredients are in place. I have gotten to know and respect many of the people here. Unfortunately, deadbeats abound. Some people will go to great lengths to avoid work. Government policies and generous social programs make it possible for struggling people to start climbing the social and economic ladder. These policies, designed and implemented to help struggling people get a foothold, have become corrupt. A culture exists which exploits the generosity of this country. I often encounter the attitude, “What can you do for me?” There are those that have to be carried by the rest of us. They appear to be beating the system, but by not participating in the work that makes this country great they are beating themselves. It is my hope that the progress made by the people making this neighborhood work is contagious. Every person has a stake in our future. Together, we can make it great.
I enjoy thinking about the past and future. I spend a lot of time driving through the different neighborhoods in this city. I look at the buildings and people, thinking of what was and what is to become. My great-grandparents came to this country from Sweden and Ireland. They settled in the area, and some worked as carpenters and helped build a lot of the homes that line these streets. They raised their families through tough times, but never lost their hope or drive. Their hard work set the foundation for future generations. I will always be inspired by and thankful for their sacrifice.
As I travel through Federal Hill, I reflect on another group of immigrant workers who came to this area with little more than a desire to prosper in their adopted land. Their language was foreign, their foods different. They were probably leery of the people who invaded their “turf.” As years and generations passed, their place in the American culture solidified, became mainstream. Now, people from all over frequent the “Hill.” Some of the words spoken by these immigrants in their native language have become a part of America’s vernacular. People of all nationalities have a nostalgic feeling when they hear these words. It took some time, but their neighborhood “melted” into the “pot.”
As I drive down Broad Street and look to the future I envision much the same.
Beautiful day, sixty degrees. Looks like spring is here. I fired up the Yamaha V Star Bob is letting me use until he gets back from Iraq. It runs a little better than the ’82 Honda CB900C I’ve been riding.
Last July, when the busload of soldiers from the 1207th was leaving Camp Fogarty, I took the old Honda to join in the farewell ceremonies. I noticed about fifty bikes lined up in front of and behind the buses. I asked one of the guys what was going on. He told me about his organization, the Patriot Guard, and invited me to join the procession. It was my first time in an actual motorcycle gang. I revved the engine and joined the other bikers at the back of the buses, pulling the old 900 right into the thick of things.
When the ceremonies were over and all the good-byes, hugs, and kisses exhausted, the 1207th boarded the buses amid cheers from the crowd of family, friends, and well-wishers. And of course the roar of fifty bikes, ready to roll. I sat among them, the roar deafening, the vibration of the bikes all around me. Finally, it was time to go. I released the clutch, gave the throttle some gas, and . . . nothing.
The other bikes stormed around me as I sat, trying to get her started. I saw the buses leave, the bikes in front and behind. When things quieted down I realized my bike had never started in the first place. The battery was dead. I needed a hill to get it push started that morning but thought the battery would have charged during the fifteen-mile ride to Fogarty. No such luck. My gang left me in the dust.
As the crowd left I sat by myself until Mary and Catherine came to my rescue. They were amused by my plight, and I was happy to take their minds off the departure of their husband and father. I was the least of their worries, but at least they got a chuckle on such a sad day. When all was clear I pushed the bike to a small decline where I mercifully was able to get it going. I never found my gang; they finished at the airport. I rode by as everybody was leaving.
Battling the Elements
“Rescue 1, respond to Chalkstone Avenue for a woman with a swollen hand.”
“Rescue 1, responding.”
A late season snowstorm was raging, traffic snarled all over the state. Renato was working overtime on Engine 15, near where this call originated. Whoever he was to relieve just lost two hours because we wouldn’t be back for a while. We tried to get onto the highway but a gasoline tanker was stuck on the ramp. Somehow we maneuvered around it. I don’t know how Renato did it; I closed my eyes during the whole thing. We crawled to our destination, a house in the Mount Pleasant section of the city, two blocks away from Roger Williams Medical Center. Fifteen minutes into our response, fire alarm contacted us to check on our progress.
“Delayed response, we’re on Atwells, ETA ten minutes.”
They dispatched an engine company to babysit while we crawled along, passing accidents and other mayhem. Our patient waited.
Eventually we arrived. The patient, a forty-four-year-old Spanish-speaking lady, had been shoveling snow when pain appeared on a finger on her left hand. It started to swell. She called 911. The swelling was gone when we got there, but she wanted—check that— insisted on being seen at the hospital. Not the hospital at the top of her street; she wanted Miriam Hospital, miles away.
Five thirty, Friday rush hour, raging snowstorm.
She had three firefighters from Engine 15 and two EMT/firefighters from Rescue 1 to cater to her, yet she still was not satisfied. Her family was going to meet her at Miriam; that was where she needed to go.
“Your family should have stopped here and picked you up before meeting you at Miriam,” I said.
She didn’t, and probably never will understand.
“Ladder 2 to fire alarm, advise Rescue 6 we have a fifty-year-old male, semiconscious, possible CHF, with a language barrier.”
“Rescue 6 received.”
Ryan pulled the rescue behind Ladder 2. He got the stair chair from the rear compartment and I made my way up the snow-covered steps into the first floor of the three-decker. Any thoughts of communicating with the patient and his family with my Sesame Street Spanish were forgotten as soon as I got near the door. Incense, probably jasmine, wafted through the doorway into the crisp morning air, a sure sign of an Asian family inside. Captain Varone met me at the door and gave me a brief rundown.
“He was okay at five this morning, then his wife found him like this. From what I can tell he has no prior medical conditions. They’re looking for his medications now.”
Our patient was on his back on the living room floor. His family, ten folks at least, crowded around, not knowing quite what to do, trusting us with their loved one’s life. It is a responsibility that used to overwhelm me, but now I am honored by their trust. Carl, a firefighter from Ladder 2 with extensive rescue experience, was on his knees next to the man getting vital signs.
“It sounds like CHF,” he said while listening through the stethoscope as the patient struggled to breathe. “110/58, pulse 90.”
Ryan got the chair set up and we got ready to roll. We had him in the truck in about a minute, his family watching helplessly as we wheeled him out the door. Garrett drove the rescue, Jeff and the captain followed in the tower ladder. Ryan established an IV, Carl ran an EKG, and I contacted Rhode Island Hospital, telling them to get a medical team ready, ETA three minutes. A Cambodian girl who spoke English arrived just before we left and rode in the front, supplying information as we worked.
The man on the stretcher stopped breathing about a minute into the transport. Ryan had the bag-valve mask ready and started to assist ventilations. I slipped a nitro tab under his tongue and pushed 80 mg of Lasix, hoping to help him breathe. As we pulled into the ER he began to breathe on his own and opened his eyes. The medical team was ready in Trauma Room 1. I gave them what I knew.
“Fifty-three-year-old male, last seen conscious by family at five this morning, found semiconscious, diaphoretic in respiratory distress by his wife twenty minutes ago. Pulsox 82 percent on room air, blood pressure 110/58, pulse around 90, respirations fluctuating from 0 to 16. IV established left forearm, 20-gauge catheter, one nitro and 80 of Lasix administered. Last BP 90/50, pulsox 96 percent with 10 liters O2 by mask.”
The medical team took over, I finished my report, Ryan took care of the truck, and Ladder 2 went back to the station.
I found out later that the patient suffered from a combination of CHF and pneumonia and his kidneys had shut down. His glucose level was 48, probably hadn’t eaten in days. Cambodian people are extremely reticent about seeking Western medical care. The ER staff tried for hours to stabilize our patient. His heart stopped at around three thirty. Jess, who had taken over his care, saved him. CPR, epi, atropine, and assisted ventilations got him back again. The last I heard he was in intensive care, clinging to life with his family holding vigil.
We got a call for a ten-year-old boy with “pain in his genitals.” What parent would call a rescue and subject their child to the humiliation of explaining his plight to more people than necessary, I wondered. We arrived at the house, a drab, three-story in a neglected neighborhood. I knocked on the door, a guy about thirty years old answered. A kitten tried to escape; the guy swatted it back in with the shirt he was holding.
The boy stood to the side, looking miserable. His mother told him to tell us what was wrong. The little guy looked down at the grimy carpet and shyly told us that his privates hurt. He noticed when he was showering. Renato, with two boys of his own back home, tried to lessen his anxiety.
“Maybe you got soap where it doesn’t belong,” he offered.
“I don’t use soap,” the kid replied, uncomfortable.
“One day I was late for work,” I said as we walked outside. “I got out of the shower and was ironing my shirt naked and ironed my you-know-what by mistake.”
It may have been the first time he laughed all day. I think we made a friend for life.
A world exists, parallel to our own. It is a small place, occasionally visited by people from this side. Everybody who lives there is dependent on those visits, as they are unable to care for themselves. For most, the entire life cycle begins and ends here, their time among the living brief. They are at our mercy, helpless little people who will never leave, never go to school, join a team, or win a game. They won’t fall in love and get married or have a family of their own. They will never run, walk, or even learn to crawl. Some can’t breathe without our help.
Children with severe disabilities live here. It is the most heartbreaking place I have ever been. The most amazing people make their living caring for them. I have no idea how they do it day after day. They become emotionally attached to every one of their patients, treating them as their own. These kids feel love every day. Twenty-four hours a day the floor is fully staffed, the need endless. Our society has evolved from survival of the fittest to where it is today, helping those unfit to survive. Are we right to prolong the lives of people who will never make it on their own? Each patient costs society millions of dollars, and the end result is always the same: they die.
At 3:00 a.m. Monday morning, I was invited to their world. One of the inhabitants, an eleven-year-old kid named Daniel, was in respiratory distress. Renato and I rode the elevator to the seventh floor in silence, both knowing what waited on the other side of the doors. The elevator doors opened, the hissing and clicks of the respirators keeping us company as we pushed the stretcher toward our patient in the room at the end of the hall. His crib was surrounded by nurses. The respiratory therapist gave me the story. His O2 levels had been dropping all night; all of her interventions were ineffective. He needed to be transported to Hasbro Children’s Hospital.
Daniel didn’t move as the therapist removed his breathing tube from the respirator and started to bag him through a stoma in his trachea. He hadn’t moved on his own in eleven years. One of the nurses removed the teddy bear he had clutched to his chest. He didn’t flinch. We picked him off the bed and put him on our stretcher. I noticed the pictures above his crib—birthdays, family, cards. It wouldn’t be long now—different pictures on the corkboard, different family, different birthday cards, different patient.
Daniel smiled as we moved him. The nurses stroked his forehead, said they would miss him. He was aware we were moving, though he had no idea why. Back in the elevator I quickly pushed the close door button, then the ground floor, leaving his world on the seventh floor.
Thanks to Pat Blackman, a.k.a. “Gramma Muggle,” and her “Little Muggles” from Chester Barrows and Stone Hill Elementary Schools. The boxes of cards, letters, and love arrived in Iraq just in time to lift the spirits of one soldier there when he needed it most. Gramma Muggle has been a huge supporter of the Providence firefighters over the years and has extended her family to include the 1207th Transportation Company, stationed at Tallil Air Base, Iraq. People like Pat and her family make my job, and the job of everybody “over there,” worth doing.
We’ve been to the house before, ten, maybe twenty times. For thirty-eight years they lived here, bought the house when I was in the first grade. A lot of living happened here. He’s in a nursing home now, the diabetes eventually taking its toll on his fragile body. He started falling, then began forgetting to take his medication. He was a US Army veteran of the Korean War.
The visiting nurses from the VA stopped coming after their patient was admitted, leaving her to fend for herself. Their middle-aged son lived on the top floor of the three-decker. He claims to be taking care of his mom, though I think the opposite is true. The lieutenant from Engine 8 gave his report as we turned onto Potters Avenue.
“Elderly lady, down on the floor for an unknown time, multiple open sores on her back, needs evaluation.”
Immediately my mind flashed back to prior visits here. Her husband seemed to be the one in need of medical attention. She sat on an old, filthy chair near the front door, smiling as we worked, never saying much as we carried the man in her life past her, out the door and to the VA for treatment. I would often ask her how she was, mostly just being polite. She would smile, say “Fine,” and watch us leave. Her son was always “too tired” to help or come with us as we transported his decorated war veteran dad to the hospital.
The guys from Engine 8 waited on the front porch while Lieutenant Dwyer gave us more information. I listened, but was still shocked when I saw our patient lying on her stomach in front of the filthy chair. Her urine-covered nightdress was pushed over her waist, exposing her backside and the dozens of infected sores she had been sitting on for how long, I don’t know. Day, maybe week-old feces covered her feet. I took a towel from the top of her chair and, as Renato prepared to wrap her in some sheets, tried to wipe it off.
It had dried to the bottom of her feet. She screamed in pain as I wiped, skin falling off along with the mess. Renato looked at me, shook his head, and nudged me out of the way. The firefighters from Engine 8 treated her with respect and kindness as they rolled her onto her side, covered her in sheets, and placed her onto a long backboard with a cervical collar. She screamed the entire time.
“I’m not leaving!”
We kidnapped her from her own home, took her away from her son and her surroundings. I’m glad we did. She stopped screaming once we got her into the rescue, knowing her battle for independence was lost. The guys went back to the engine, a little dejected, I could tell from their somber demeanor. It can be difficult doing the right thing. We transported her to Rhode Island Hospital. I’m not sure what will become of her home, or the life she was used to.
She was eighty pounds soaking wet. Quiet at first, then she opened up. She had a fever of 104 with a persistent headache. The bruises on her legs couldn’t be explained. The eating disorder clinic that she was going to up until last week didn’t work; she lost weight during the program. We talked about her problems. She just doesn’t like to eat, she said.
I have learned a lot about eating disorders and the underlying causes that bring them on.
“The only thing you have total control over is your body and what you put into it. Sometimes that can be very comforting, but it tends to get out of control,” I said as we rode toward Rhode Island Hospital. Her mouth and nose were covered with a surgical mask; her eyes grew bigger as she listened to me. I looked at her without judgment. She knew I knew.
“I lied to them at the clinic,” she confessed.
“You have to tell the truth to somebody,” I said.
“I did. I have a new counselor who seems to understand. I told her everything.”
“You are going to feel a lot better when you can eat again,” I told her, knowing not to say she would look a lot better too.
“That’s what they tell me.”
The health center at the college called us because they were afraid she might have meningitis. More than one health care professional told her that she is too skinny and needs to eat more. Telling somebody with an eating disorder that they are too skinny is like telling a bodybuilder he is too muscular. She needs expert help to get her back on track. I hope she finds it before she withers away.
Why We’re Here
At 1800 hours we got a call for a woman in her eighties with difficulty breathing. Engine 3 got there first and gave the initial report.
“Eighty-year-old female, shortness of breath, heart rate 15 to 30.”
When we entered the room I couldn’t believe the woman in the bed’s vitals were as bad as reported. She smiled at me and looked completely at peace. Maybe she knew something we didn’t and wasn’t afraid. We put her on high-flow oxygen, started an IV, and ran a 12 lead EKG. Heart rate 22, possible bundle branch block. She remained calm all the way to the trauma room.
Dr. Sullivan looked over our data and began the appropriate treatment. He told me his assessment and reasons why the patient was in the state she was in. I nodded, pretended I understood what he was saying, rubbed my chin with my thumb and index finger and said, “Of course, I agree. Thank you, Doctor.”
At 1900 hours we got a call for a man unconscious on the third floor of his home. Before we arrived, Engine 10 gave us their report.
“Thirty-five-year-old male, possible OD.”
Renato got the stair chair, I carried the blue bag up the stairs. The patient was in bed, diaphoretic but otherwise stable, good vitals. Renato spoke to the family and translated.
“He drank a lot.”
He must have drank more than a lot. We deal with drunks all day and night; this guy was out cold, no response to verbal or painful stimuli. We carried him to the truck, worked him up and got him to the ER and into Trauma Room 2 where Dr. Sullivan took over. I again agreed with his findings.
At 2000 hours a guy called from his front porch. He was a dialysis patient having trouble breathing. Engine 10 got there first.
“Fifty-year-old male, extreme respiratory distress.”
We stepped it up and found the patient doubled over on his front porch. His BP was 258/160, pulsox 82 percent. Not good. The patient was frantic, panicking. I knew Dr. Sullivan would understand. We got a driver from the 10s, kept the patient as calm as possible during the two-minute ride to the ER. This guy needed all the help he could get. My decision to “scoop and run” was what I thought would be best for the patient. We gave him a nitro and put him on O2—no help there—and rolled. Dr. Sullivan gave him more nitro when we got there, a respiratory team was called, two IVs started, albuterol treatments, BiPAP, and more than we could have done for him. Sometimes less is more on rescue. We could have helped him breathe, but the anxiety level probably would have negated our efforts. He wanted to be in a hospital, one was two minutes away. I think we did the right thing. Dr. Sullivan seemed to agree.
2100 hours. Person unconscious, diabetic, third floor. We found a thirty-year-old guy in bed, covered in sweat and vomit, pinpoint pupils, glucose level of 20. The protocols look so easy on their nice white pages, all orderly and everything. Trying to follow them on a patient covered in vomit in an unsafe, unsanitary environment is another story. We cleaned him up the best we could, tied him onto the stair chair, and got him into the rescue, no easy task. IV, O2, EKG, glucose test, vitals, 2 mg Narcan, an amp of D-50, 100 mg of thiamine and Sleeping Beauty turned into the Incredible Hulk. We held him down as best we could; security met us at the door to the ER. Dr. Sullivan looked at me and Renato when all was said and done and the patient sedated and stabilized and told us to get some rest.
I’m sure Catherine would have preferred to have her dad escort her to Bay View’s father-daughter dance but she had to put up with me instead. I know I’m a better dancer than her dad but she would never say so. Thanks, Catherine, for inviting me, and thanks to Bob and Mary for raising such a delightful young lady. Stay low, Brother, you have too much to lose.
Michael Morse, email@example.com, a monthly contributor is a retired Captain with the Providence Fire Department
Michael Morse spent 23 years as a firefighter/EMT with the Providence Fire Department before retiring in 2013 as Captain, Rescue Co. 5. He is an author of several books, most offering fellow firefighter/EMTs and the general population alike a poignant glimpse into one person’s journey through life, work and hope for the future. He is a Warwick resident.
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