We get him up on the stair chair and strap him in. He is dead-weight. All of us are dripping sweat. We have to carry him down three floors, which turns out to be seven flights of narrow stairs. I take the foot of the stair chair and Glenn takes the head. The cop stands behind me holding my belt to keep me from tumbling backward. The guy’s feet are hitting my knees. Both Glenn and I are irritable. The small of my back feels like it’s going to explode. I look at the guy we are carrying with revulsion. I have done countless overdoses and drunks and though I have never said it to a patient of mine, I want to say, “Scumbag.” I think I should have given him more Narcan. I gave him enough to put his breathing back to normal and put him on the verge of nausea. I could have slammed a heavy dose right into his veins without even bothering to do an IV, “hot-wiring” him, bringing him from deep heroin bliss to puking nausea. If he got violent, the cop could have smacked him with his billy club. I think I should have at least given him enough so he could stand, however wobbly, and we could have dragged him along, step by step, so we wouldn’t be carrying him in this heat, with our backs threatening to explode, and the two of us yelling at each other to go slow, or speed up, or lift better. I look at him and think, Scumbag.
I have thought that maybe I’ll become a PA or even a doctor. That would be great. Dr. Canning. Nice sound. Dr. Canning will see you now. Dr. Canning, stat! Oh, thank you, Dr. Canning. How can I ever repay you? I have no money. We’re poor, but I can bring you fresh milk every day from our one old cow. We’re going to name our baby Dr. Canning, Dr. Canning.
But I think I really don’t like sick people. Nothing against them personally, but I don’t like vomit, I don’t like the smells of infection, sickness, and age. I hate the sound of suctioning, I hate the terror I see in the eyes of people who are losing their health. I am realizing that I am a soldier who doesn’t like war. I look at all these doctors. In one sense I think that they are great—they are all incredibly bright—but do I want to spend my life inside a hospital, my complexion eternally pale? Do I want to spend six years of my life studying? I’ll be forty-four before I am done. I don’t think so.
Maybe I’ll go to law school and become a tax lawyer. Make a load of money, but tax lawyers have to work long hours, too.
I am having a crisis here.
The call is for a baby with a fever in Bellevue Square. The mother is diapering a baby on her lap. Another baby is lying on the couch. Three small children wander about half-dressed. A man in a baseball cap stands by the wall. There are two cribs in the living room.
“Which one is sick?” I ask.
“Him,” she says, pointing to the baby lying on the couch. “He got a fever that won’t go away. I give him Tylenol twice, but he’s still hot. He just not right.”
I pick the baby up. He is warm. His eyes look right up into mine. He is fifteen months old.
“He hasn’t been breathing right today. I gave him two of my asthma treatments, but he still not breathing right.”
“Your medication?”
She nods, not picking up my tone implying that maybe it was not the best idea to be giving a baby an adult’s medication.
“All right,” I say, disgusted with her. “Let’s go then. Which hospital?”
“Saint Francis, but I’m not going. He going to go.” She points to the smiling man in the baseball cap. “He the baby’s uncle.”
“Do you have the medical card?”
“No, I can’t find it. They have all the information at the hospital.”
“Okay, fine.”
I carry the baby out. The uncle follows us.
In the back of the ambulance, I take the baby’s vital signs and complete my assessment. His lungs are congested and he is hot. His pulse and respiratory rate are up, but not dangerously so.
“What’s the baby’s name?” I say to the uncle, who sits next to me on the bench.
“I think it’s Leonard.”
“What do you mean, you think it’s Leonard?”
“Leonard, yeah, it’s Leonard.” He nods.
“What’s the last name?”
He shakes his head.
“You don’t know the last name? This is your nephew.”
“Garcia,” he says. “No, wait a minute. Gonzales.”
“Which one is it?”
He shrugs and holds his hands up.
“I don’t suppose you know the baby’s birthday?”
He shakes his head again and smiles, as if to say he is sorry.
I look at my chart and all the empty lines I am supposed to fill in. Baby’s medication, allergies, family doctor, birth date, name.
At the hospital, I deposit Leonard on the triage desk next to the computer. “This is Leonard,” I tell the nurse. “He is about fifteen months old and has a fever. His mom gave him Tylenol twice and also decided to try two of her Ventolin treatments on him. Unfortunately, that’s about all I know. His mom is at home at this number and she should be able to tell you his name and birth date. The uncle here doesn’t know. Sorry.”
The nurse calls and gets the information. We get a wheelchair and sit the uncle in it, so he can hold Leonard. We leave them, uncle and nephew, in the waiting room.
I am worried that I am prematurely burning out, that all my grand statements about being a paramedic are going to dissolve in my growing distaste for the people I meet, my aching back, my declining savings, and my fear of dying alone and unknown and unloved.
We respond to a motor vehicle accident on Broad Street. The police are already on the scene. A quick survey shows a minor accident. A woman in a fur coat paces outside her Saab. There is a scratch on the bumper. A few feet away sits a Dodge, with a small dent in the driver’s-side front. There is no starring of the windshield, no damage to the steering column or car interior.
There are three passengers in the car. I open the driver’s door. The driver is slouched in his seat, holding his head and moaning.
“You all right?”
“My back is killing me. I got shot there last week. My head hurts, too.”
“How about your neck?” I feel his pulse. It is steady and regular.
“It hurts bad. I need her insurance card. Did the cop get that?”
“I’m sure he did. Did you have your seat belt on?”
“Yeah, yeah, but I took it off.”
“Did you get knocked out?”
“For a little bit,” he says.
I look across at the woman sitting in the bucket seat next to him. She has one hand on her head, the other rubbing her knee. “How about you?”
“I hit the glass with my head and my knee hurts.”
“Wearing your seat belt?”
She nods.
The man in the backseat has his eyes covered with his hand. He, too, is slouched down.
I ask, “How long were you unconscious for?”
He thinks for a moment, and then says, “I just woke up. I just woke up now.”
“Right,” I say, not quite containing my sarcasm.
We have to call for a second ambulance. All three get cervical collars to keep them from moving their necks. They are placed on hard wooden spinal-immobilization boards. Three straps secure them to the board at the knee, waist, and chest. Rolled towels are placed to the sides of their heads. A strip of heavy cloth tape secures their heads and neck rolls to the board.
“Goddamn, how long am I going to have to be on this thing?” the driver asks.
“Until they determine your neck isn’t broken,” I say as I roll the tape across his eyebrows.
En route to the hospital, his beeper keeps going off.
“Popular man,” I say.
“Goddamn,” he says, reaching to shut it off for the third time.
The dispatcher tells me to call one of the supervisors in operations. I do so and she asks me about a call I did the week before—an elderly woman in diabetic ketoacidosis. She lived alone in a dark apartment in a Hartford high-rise for the elderly. Her son had found her confused and calle
d us. She was dehydrated, breathing deeply to try to blow off the deadly acid building in her system. She had peed all over her thin slip and her bed. I got a line, ran in some fluid, and checked her blood sugar, which was too high to measure. I read in the paper that she had died a day later. The supervisor wants to know if I know anything about her wallet that had one hundred and twenty dollars in it. She says the police are inquiring. I say I don’t have it, and the son was there the whole time. The cops should check with him.
* * *
I don’t even want to do any more calls. I am tired and frustrated and in a bad mood. In a few days I will snap out of it. I will remember that I love this job. I will start doing challenging calls again. I’ll give nitro, Lasix, and morphine to a man in congestive heart failure (CHF), and it’ll chase the suffocating fluid out of his lungs, and he’ll be able to breathe, and relax and live for a while longer. And I’ll be on scene just six minutes at a bad car wreck—I’ll get my lines, make the patch, and get the patient into the trauma room. And I will gently convince an elderly woman suffering from gangrene to leave her north end home which she loves for the medical treatment she desperately needs. And I will goof with some kids in Stowe Village, who gathering around me will gawk at my great height and say, “How tall is you? You seven feet? No, you eight feet tall? You a giant!” And feeling like Gulliver among the Lilliputians, I will puff out my chest and compare myself to the idol of all little basketball heroes, the mammoth Shaquille O’Neal. “Who’s bigger, me or Shaq?” I will challenge. And we will all laugh as they say, “Shaq way bigger than you. Nobody bigger than Shaq!”
But today, as I sit in the ambulance cramped and hot, I think of all the wrong turns I have made. I could have married my college sweetheart and we’d have a family and I’d be a mild-mannered insurance salesman living in a house with a picket fence and taking my kids to Red Sox games. I could have stayed with the political game, bought an eight-hundred-dollar suit and become a lobbyist, making big bucks by selling influence. But no, I wanted to see the world. I didn’t ever want to be old and sitting there in my chair, feeling cheated that I hadn’t at least tried to seek my fortune. My childhood companions were Paul Bunyan, Huckleberry Finn, Boone Caudill, and Ishmael. They are not the stuff of insurance sales and influence peddling. I wanted—I still want—to be a hero. Working for Weicker was great—I felt like I was doing some good—but it was he who was the real greatness, not me.
I want to find my own greatness. I believe that this work, this city, this life is my battleground.
When Weicker calls, if he calls, I will say, “Thank you anyway, but this is my place now. I am a paramedic.”
City Scenes
The job of a paramedic is a passport anywhere in the city. In a day, you can travel the breadth of ghetto to corporate tower, from life’s beginnings to life’s end.
We’re called for chest pain at a downtown office building. A security guard meets us at the front door and escorts us to an elevator he has waiting. The fire department is already on the scene. On top of the stretcher we have piled our longboard, oxygen bag, heart monitor, drug box, and suction unit. We watch the numbers light up as the elevator rises toward the top: 8, 9, 10, 11, 12, 13, 14 …
When we get out of the elevator, a fireman says he’s stable. An attractive young blond woman in a red business dress leads us down the hall and through two walnut doors to a large office. A man in his late forties is on the couch with his feet up on the coffee table. His tie is loose. He is pale and ashen and on a 100 percent nonrebreather oxygen mask.
“Describe the pain,” I say.
He says he feels a little bit of discomfort in his chest like a pressure or a muscle pull. His hands are shaking. His pulse is 102. His blood pressure is 180/100. He says he called his doctor and took one of his pills, but when he didn’t feel any better he had his secretary call 911. On the monitor he has a sinus rhythm with occasional premature ventricular contractions. The man is having a heart attack.
As we help him onto our stretcher, I look out the full window. I can see all of Hartford. The office buildings, the capitol dome, I-84, abandoned factories, and urban neighborhoods. I feel like I am on top of the world.
“Pete,” my partner says.
“Huh?”
He looks at the buckle he is holding. I grab the other half and buckle it together. We get the man comfortable and secure the monitor and oxygen tank.
“You scared me,” the woman in the red dress says to the man. She hands him his jacket. “I thought I’d be looking for a new boss.”
“Thanks,” he says. “And call my wife.”
“Anything else I can do for you?”
“You’ve done enough.”
“You look real comfortable. I’d like to hop on for the ride.”
The firefighters laugh.
Color returns briefly to the man’s face.
“Not right now,” he says.
In the outer office, a group of women and men stand and wave as they watch us wheel him by.
“Get back to work,” he says. “I’ll be fine.”
In the ambulance, I start an IV and give him a nitro, which will drop his pressure and increase blood flow to his coronary arteries. I give him two baby aspirin to thin his blood and help dissolve any clots he may have in the arteries.
“You’re under a lot of stress?” I ask.
“Stress, yes,” he says. “I manage money. It’s been very stressful, particularly lately.” His hands are shaking.
My partner drives through the city streets toward the hospital.
“I just bought a new house,” the man says. “I’ve got two kids ready for college.” He shakes his head.
“You still feeling that discomfort?” I ask.
He nods. His brow is sweating.
I recheck his vital signs. I give him another nitro. “Hang in there,” I say.
The emergency parking lot is filled. We park by the entrance and wheel him in. There is a logjam at the triage desk. Three crews are ahead of us. A man and a woman from a motor-vehicle accident are strapped to backboards. A homeless woman I have treated for asthma before is in a wheelchair, getting a breathing treatment.
The nurse sees us. She looks from the patient’s face to mine.
“Chest pain,” I say.
“Cardiac room,” she says.
We push our stretcher past the others.
“My heart’s beating like it’s gonna explode.” A fourteen-year-old has been smoking marijuana. He is holding his chest and writhing with anxiety.
“How much did you smoke?” Glenn asks him.
“Just a little.”
“Uh-huh,” Glenn says.
We’re on the front porch of a two-family duplex. The boy’s mother is not home, only his seventeen-year-old brother, who is in the house talking on a cellular phone after his beeper went off.
The boy’s pulse is 140. His pressure is normal. He’s not sweating. His skin temperature is normal. His pupils are dilated but are equal and react to light.
He wants to go to the hospital, but since his condition is not serious, we can’t take him without parental permission.
“My mouth is dry. I can’t get no spit.”
“Smoking’ll do that to you,” Glenn says.
“I need to go to the hospital,” he says.
“Pretend like you have to go to the bathroom,” I say. “Bear down hard. That’ll slow your heart down.” Bearing down will stimulate his vagus nerve, which will depress the electrical stimuli in the heart.
He shakes his head like I am crazy.
A policeman arrives and gives us permission to transport.
As a formality, I put him on oxygen by a nasal cannula and get out our cardiac monitor. I turn the monitor on and apply the patches to the ends of the three electrode wires. The boy is staring in horror at the monitor, which is showing a flat line.
“Is that bad? Is that bad?” he asks.
We stare at the flat line together. “Yes, it is, but
…”
“I don’t want to die,” he says. “Oh, please God, I don’t want to die.”
“There is just one thing you should know.”
“Don’t let me die.”
“It’s not attached to you yet.”
He looks at the electrodes I am still holding in my hand. He is still too scared to be relieved.
I apply the electrodes to his chest. The monitor shows a sinus tachycardia rhythm at 135.
“Is that bad? Is that bad?” he says.
“It’s a little high, but …”
He is squirming in his seat. “Don’t let me die. I don’t want to die.”
“Pretend like you’re going to the bathroom.”
He follows my instructions this time. The rate drops to 120.
“There,” I say. “That’s better.”
“Is that good? Is that good?”
“It’s better. You’ll live.”
“It’s—it’s going up. It’s going up.”
The monitor is at 125, 128, 130, 133, 135.
I turn it so he can’t see it anymore.
“Is that bad? Is that bad? Am I going to die?”
I am tempted to jump about making madman devil faces and screeching guttural noises. Instead, I just say, “Kid, you’ll be fine.”
A visiting nurse meets us at the apartment door. “She’s eighty-nine years old and is a little difficult. She’s been increasingly weak over the last several days. Her doctor wants to see her in the emergency room.”
The apartment is beautiful. The living room is stylishly decorated with beautiful paintings, woodcraft, and abundant plants.
We enter the bedroom. The woman is lying on her bed with a pillow under her head. A woman in her fifties sits on the side of the bed holding her hand. On the wall is a painting by Gauguin—one of his works from the South Seas, a lush picture of greens, blues, and yellows.
“How are you today?” I ask, approaching her side.
“What a silly question,” she says. She has a very proper accent like a movie star from the 1930s. “If I were well, you wouldn’t be here, now would you?”
I smile weakly as I feel her pulse. “We’re going to take you to Saint Francis Hospital so your doctor can evaluate you,” I say.
Paramedic Page 24