But almost as soon as I hear this gasp, I know what has happened. When we lifted him, some air was forced through his vomit-clogged throat, and for just a second it sounded like he was alive, fighting to breathe.
Is it evil of me to be relieved this boy is truly dead, because I am afraid of making a mistake. If that’s true, I don’t think I should be doing this much longer. Maybe it’s already too late.
Don’t Blink
Things are really slow today, thank God. And I don’t mean I’m thankful because I’m lazy. When we’re slow, it means fewer people out there are dying or getting hurt, and that’s a good thing. But life goes on, and we’ll soon be busy again, and there’s nothing we can do about it.
Jose and I are on the way to a possible DOA in a private home in Woodside. No information other than that.
We arrive on the scene, peaceful and pleasant and leafy on this Sunday morning. Our DOA is in the garage behind a private home. There are a couple of neighbors here with the cops.
The garage door is open. There’s an elderly, very thin white male—has to be in his mid- to late eighties at least—sitting on the garage floor between some old chairs and what looks like a wood lathe on a stand. He’s wearing a T-shirt and boxer shorts. No telling how long he’s been here, but he looks pretty fresh. I would think he’s been here overnight. Probably went out into the garage to do what—we’ll never know what.
The neighbors are telling us they hadn’t seen the guy for a few days and went to check on him and found him here. I like hearing things like this, people checking on their neighbors. It doesn’t happen enough.
We’re going to remove him to the Queens General morgue, since we have no calls backed up and nobody thinks the circumstances are suspicious—nobody, meaning the police. Nobody else’s opinion counts. We don’t have to wait here for the crime-scene guys to give this site the once-over, so we’re good to go.
But I’m looking at this man, and something is making me want to check him out one more time. He’s white as a sheet, his eyes are partially open, and he’s really stiff. But there’s the faintest patch of pink on his throat, just below his Adam’s apple. Like a faded rose tattoo. It shouldn’t be there. Not if he’s dead. It should be as white as the rest of his body.
I try for a pulse. Jose comes over. What, he says. Looking for a pulse, I say. Clearly none at the wrist. None at the neck, either. I rub my finger across his eyes. This is something Eddie taught me and something we never do if family is present, because it looks atrocious.
Eddie says when you’re really not sure if somebody’s dead you should try drawing a finger across an eyeball and waiting a bit to see if any tears form. Usually the eyes of a corpse will be leathery, with a dull luster. But according to Eddie, if there’s still life, tears will form, which is supposedly an autonomic reflex. I’ve never heard this from anybody else, and I’m not sure if it’s grounded in any kind of known medical science, but I give it a try. Nothing.
So. Can’t get a pulse anywhere. Dry eyes. No obvious respiration. Stiff. But there’s that faded rose. And no livor, which would be expected in his lower body. He’s pale all over. I point the pink patch out to Jose.
We’re both really in close, staring at the man’s throat, and one of the cops comes over to see what’s up. Then I see what I couldn’t feel. The edge of the pink patch is moving—pulsating—so slightly and so slowly that I have to blink and refocus to make sure I’m seeing it. I whisper to Jose. See that. He sees it. I turn to the cop.
This guy is still alive. We have to take him in.
I have to qualify that. He is the least alive of anybody I have ever seen. Who knows how long he’s been here in this garage. Probably the few days that his neighbors haven’t seen him. He could have had a stroke or something two or three days ago and just degenerated from that point until today.
Now I’m as annoyed with the neighbors as I was proud of them when we first got here.
If they hadn’t seen him around for a while, why didn’t they go looking sooner. After one day instead of three. I understand it takes a bit of time before you realize you haven’t seen somebody lately. But a guy this old—a friend—they should have dropped in on him daily. We might have been able to save him. Now I don’t think we can.
At first, the cops don’t believe me, but then they get agitated. Not angry but busy. We’ve all been caught by surprise. Jose and I run and get the stretcher. The cops have already lifted him up, and they just plop him on top of the stretcher, and into the ambulance he goes. And we’re off to EGH.
We’re not making this a rush call, but we’re not taking our time, either. Lights but no siren. Jose can drive very quickly when he wants to, but he’s so smooth you never think he’s speeding—which we’re actually not supposed to do, no matter what. It always surprises everyone when I tell them that we’re not supposed to violate any traffic laws, even though we’re an ambulance. But we do it every day. You just have to be careful.
In the back, I’m sitting on the bench looking at this man. There is absolutely no sign of life except for the rose patch on his throat and the faint pulse on the rose’s edge, which seems to be getting fainter. I’m wondering if I’m actually going to see him die.
I’m trying to think if I’ve ever seen someone die before; seen the exact moment when a life ends. I don’t believe I have. You read all kinds of accounts of what happens at the moment of death. People talk about rising up and looking down on themselves. White lights. Visions. But these people haven’t died; if they had, they wouldn’t come back to talk about it. When you’re dead, you’re dead.
But that isn’t what I’m talking about, what people think they see when they die.
I’m talking about seeing the moment of another person’s death. I’ve seen machines indicate the moment—oscilloscopes showing flatlines—but the people showed no physical signs of departing. A machine is a step removed from the reality. It’s a phone call instead of a face-to-face conversation.
I’m looking for something that will visibly mark this man’s passing on. I want a sign. Anything, really. A wisp of ascending vapor. The corporeal phlogiston of his burned-out soul passing up to heaven. Something mystical and beyond rational explanation.
I’ll have to settle for the disappearance of the rose on his throat.
It’s not that I’m a voyeur. I just want to be present, to be a witness to his passing. This man has no one but me to do this for him. I’ve always hated the thought of dying alone. All of us deserve to have someone with us at the end, and I will be there for him.
I guess we’re about halfway to Elmhurst General. I’m staring so intently at the man’s throat that my vision is starting to blur. Moving my eyes from side to side helps a little. This is like trying to see the sun go down. It moves so slowly that the movement is undetectable, but you know it’s going. If you look away for even a split second, it’s over.
My eyes are burning and I take them off the rose for half a second.
When I look back, it’s gone.
Somebody Else’s Shoes
People can get violently angry when they’re grief-stricken. If you’re in their way, you can get hurt.
I think this may be truer in New York than other places in the United States. We New Yorkers tend to be closer to our ethnic roots. You know that joke about what WASP brothers do after not having seen each other for thirty years (exchange business cards).
New Yorkers are not like that.
Of course, I don’t want to make generalizations. I’m just going by my family, which yells a lot, and my experiences on the ambulance, where we cover the whole melting pot, including plenty of cultures in which the physical expression of emotions is the norm. But wherever they’re from, whatever their cultural heritage, people in New York are well known to express themselves readily and freely.
Things can get biblical. I’ve seen people cutting themselves, beating their heads against walls, ripping their clothing, scratching their faces, and pulling out thei
r hair.
I’ve also seen people cutting others who happen to be around, or pounding them, scratching them, grabbing them, and screaming in their faces.
There’s an old expression that people usually attribute to the Romans but I understand goes all the way back to ancient Greece: when someone brings you bad news, you kill the messenger. Or shoot the messenger, as the modern version goes. In our family, if I ever went to my father to report bad news, I was the one on the receiving end of his wrath. The point is, especially in an emotionally charged situation and especially in New York: when you have bad news to deliver, you’d be wise to deliver it out of arm’s reach.
I myself have been pummeled on the body, grabbed, punched in the face, and had my arm twisted almost to the breaking point. Also kicked, nearly stabbed, scratched with fingernails, bitten, and spit on. What did I do, other than deliver the bad news. I was hapless enough to be too close to the recipient(s). Sometimes, you can’t get away.
Jose and I have a call in Kew Gardens. It’s a rush; possible DOA. It’s a baby. I know Jose is as sick with dread as I am. We’re not alone in that. Losing a child is as bad as life gets. For everybody.
It’s a very nice building. The cops have left word with the doorman to tell us where to go. Judging from the look on his face, he knows what we’re here for.
This happens a lot on calls. Instant group telepathy, or so it seems. It makes me think of a school of fish, instantly changing directions and moving as one.
People on the scene know the whole story and the backstory and everything in between. You want to know what happened, just ask a bystander.
Oh good Christ. It’s a sweet young family. Mom and Dad and two kids in the living room. A beautiful Life magazine feature-story family. The mom and dad can’t be beyond their late thirties. The kids look to be eight and ten or so. So they probably have an idea what’s going on—almost but not for sure. Yet.
I don’t want to be here. I really do not want to be here, God, please. Well, who would.
One of the cops ushers me down a hall to the baby’s room. It’s a large apartment, and apparently each child has his or her own room, including the baby. As discreetly as he can, Jose is blocking the door to the room as I go in to examine the infant, who is lying very still in his crib. I say his crib: there are blue blankets and cowboys on the wall. I can hear Jose making small talk behind me. He’s telling the mother that we’re going to check the baby out, and it’s better if she waits there for a minute, Thank you so much, dear—and Dad could you please keep Brother and Sister in the living room for now.
I’m looking at the baby. The cops are looking at the baby and then back at me as if they expect me to say something other than what I’m going to say, which is that the infant is dead. He’s been dead for a while, and he’s blue. I guess this is what they call a crib death. No one seems to agree on what that is and, of course, if they can’t agree on what it is, they can’t offer any suggestions on how to prevent it. More covers/fewer covers. Put them on their backs/put them on their tummies. It just seems to happen, even to healthy babies, without any warning at all.
The baby is ice cold. It’s about 8:00 a.m., and I’d say he’s been gone for at least a couple of hours, but it could be less. Babies give up their warmth so fast.
I am doing my best to prolong this moment, looking down at the infant, pretending to still be trying to find a pulse or something. Anything. Anything to keep from having to turn around and face the family.
I feel like I’m paralyzed. I know the mom is looking at me. I can feel her eyes on my back. I know what she’s thinking. She wants me to spin around dramatically and run out to the ambulance with the baby and see us tear off to the hospital with lights blazing and siren wailing. We’re going to save your baby.
This is what she wants, but she can’t have it.
I have to turn around and face her. Jesus, Jose, why did you let her get right up behind me like this. Her face is only inches from mine. I know she knows. I know she knows what I’m going to say. Why is she going to make me say it.
She could just ask, Is he, and I could just say, Yes. Or even just nod. Lady, please don’t do this to me. Please don’t.
She says nothing. I have to say it. I can’t think of five words harder to get out of my mouth: I’m so sorry, he’s gone. That’s what we say. Gone. Sounds so much better than dead and not as strange as passed. I’m trying not to move my head from side to side, so the kids don’t see. They’re looking in from down the hall. Dad is just standing there, numb.
I’m bracing myself for the worst. She’s so close to me. Is she going to start pounding my face or my chest. Or scratching. She’s on the small side. How much damage could she do. They both look pretty genteel, Mom and Dad. Maybe nothing will happen. Does she know how bad I feel about her baby’s death. If she did, would it matter. She’s raising her hands. Here it comes.
It’s nothing. She’s not crying or screaming at me or making a hysterical demonstration. Nothing but calm on her face.
She puts both hands flat on my chest, as gently as if I myself were her baby. I can hardly feel them, the pressure is so light, but I know they’re there.
She pauses for a moment, leans in very close, looks right through my eyes, and barely whispers: What am I supposed to tell the other children. Tell me what.
Until this moment, I was only wishing one thing: that I could disappear into thin air. Vanish like magic. I was wishing I could be in anybody else’s shoes, anybody’s anywhere, but mine.
Until now.
Erosion
It’s pointless to make up a best of (meaning worst of) list of the calls I’ve been on. It’s pointless because I know it will constantly be changing as time goes on. There’s always something to top the list, looming just over the horizon. And beyond that, something even worse. And on it goes.
Much better to group worsts by category. Horrifying injuries. Decomposing bodies. The death or abuse of a child. The lives people lead.
Maybe it seems like that last category shouldn’t be up there with the others. It’s not really something that generates an adrenaline rush or keeps me up nights. It’s more insidious and in a way more disturbing than the others.
After all, accidents and other terrible things happen by chance, at the spur of the moment. It’s the slow-simmering degeneration of people’s lives that really baffles me. It leaves me wondering how they let themselves get that way and how they never noticed or never cared. Or both.
There are people walking around every day with jobs, driver’s licenses, children, and voter-registration cards who are barely conscious they’re alive. It’s stunning to think they can function in the real world, but they can and do. In many ways, they’re almost feral. I imagine they exist the way the cavemen lived. Maybe not as nice as that.
It’s hard to say why this is. I’m sure a good number of them are not that intelligent, which isn’t their fault. God bless them.
The ones I’m talking about almost certainly went to accredited schools where they would have been exposed at some point to topics like what to eat, how to clean themselves, and where babies come from. Would have been exposed to these things. But maybe they just never sank in.
These are people who seem to have little or no idea of how the human body functions. Who have no concern whatever with hygiene, proper nutrition, or how to take care of themselves, their families, or their living space.
You have to exclude the elderly from this group, even though they represent a lot of the sad cases you run into, where things have slid downhill, past the point of no return.
People get old. They get weak. They stop caring or become unable to care. They can’t smell or see things the way they used to. They can’t take out the garbage or care for their pets. They don’t take their meds or can’t get out to buy them. They can’t bathe. They get injured and they get infections. It takes a lot of attention to maintain order in old age. I don’t think most of us are capable of maintaining this attent
ion all the way to the end, and if we don’t have someone looking over our shoulder to help, things can get very bad indeed.
But I’m not talking about the elderly or those who are impaired in some way and can’t help themselves.
I’m talking about the man in the back of 434 as we’re rolling up Woodhaven Boulevard, who has forced me to stick both my hands out of the window as far as I can, because they stink so bad that I’m just that close to heaving. And I may yet.
This man’s legs are covered with maggots from his groin to his feet.
What isn’t covered with maggots is a suppurating mass of pus from wet gangrene. I’ve seen it before but never like this. Never so extensive or life threatening. From what I’ve heard about wet gangrene, this could definitely prove fatal for him. At the very least, he’ll probably lose both legs immediately, and then it will be touch-and-go to see if they can keep the tissue death from spreading up through the rest of his body.
And I’ve smelled gangrene before, too, but never, ever, so repulsively foul. Short of a corpse in the full flower of putrefaction, he has got to be one of the worst stinkers ever. Yes, I know I said I wouldn’t make worst lists, but this case calls for an exception.
We got the call as a difficulty in breathing, a DIB. I can’t figure out why it came across like that unless whoever called had a mordant sense of irony and decided nobody could breathe with that kind of stench in the apartment. I guess his roommate called, because he was the only other person present when we entered the place. The cops, bless their souls, were keeping a prudent distance down the hall, knowing that we were the ones who’d have to go inside and handle—actually touch with our bare hands—this half-rotted human cut of meat. They only give us gloves for maternities.
Eddie and I could hardly keep from gagging. Trying to hold our breath was useless because nobody can hold it that long. Of course, there were the maggots. Thousands of them. And the room was full of their mommy and daddy flies, and other flies hoping to become mommies and daddies, looking for a clear place to land in the pus so they could start their future fly families.
Bad Call Page 12