Paramedic

by Peter Canning

  I grew up in white suburbia. The only black kids at my grammar school were a boy and a girl bused in from Hartford. The boy hogged the basketball and was always driving out-of-control and taking wild shots. The girl beat up all the toughest boys. I went away to a prep school in New Hampshire that had a fair-sized minority population, but most all hung out together. I was in the dumb math class, and besides two potheads, the only kid in the class dumber than me was a black kid from North Carolina. He got a full scholarship to Princeton, while I ended up getting turned down cold at Harvard and Princeton and only wait-listed at Amherst, where the director of admissions was my father’s old prep-school roommate. I remember being really pissed off at this kid until one night I heard him on the phone talking to his mother. His father had recently died and she wanted him to come back and work on the farm, and he was trying to explain to her what it meant to be getting a scholarship to a college like Princeton.

  My kid brother is seven years younger than I am. While I am the “black sheep,” the difficult child, he is the favorite son. After I followed the family tradition of going to prep school but failed in my attempts to get into Harvard, he was kept at home at the public school, where he starred as an athlete and student leader, all the while helping to care for my mother, who was losing her battle with multiple sclerosis. When he graduated from Harvard he decided he wanted to teach and ended up in Brooklyn in a tough, predominantly black neighborhood high school. Although he finally burned out from it and is now a first-year law student thinking about becoming a corporate lawyer to make a load of money, I still respect him. He also goes out with a black woman.

  My dad is a good man, even though he wishes I had not traveled the paths I have. He used to tell me black jokes when I was growing up, and I shared some I heard with him. Still, he is remarkably cool with the idea of his sons being with black women. His mother once told me she couldn’t believe they put different races together as roommates at colleges. My mother’s father, a timid inventor whose ideas were always being ripped off by others, thought blacks were of a different species. Times and people do change.

  When I first started going out with Michelle, I remember standing in the line at the grocery store thinking I am standing here with a black woman. People are looking at me, thinking, hey, there is a white guy standing with a black girl. When I am with Michelle, I don’t think about race anymore. She is just Michelle. I think if we were to get married and have a kid, I would hate for my kid to be treated badly, to be scorned because of his race. I read an article about interracial marriages and how one couple taught their children that they represented the best of both cultures. I think about teaching my son about Jackie Robinson. What a great story for a kid to learn. I think if things don’t work out with Michelle and me, and I have a kid with a white woman, I will still teach him about Jackie Robinson, and how one day when he was being viciously heckled by the fans and the opposing ball club, the Dodger shortstop, a white southerner named Pee Wee Reese, walked over to him and put his arm around him, and silenced the crowd. I think about teaching him about Hank Williams, the country balladeer, and Muddy Waters, the delta blues man, and how their music together formed rock ‘n’ roll. I drive the streets of Hartford. I smile at the little black kids, thinking my kid might look like that someday. I see the junkies and angry black males with surly faces, and I think I don’t want my kid to look like that.

  I’m Open

  We are sent for a leg injury on a basketball court in the north end. We arrive to find the man is a drunk known to us. He was trying to play and just fell down. There is nothing wrong with his leg. Glenn puts on his gloves and starts talking to the guy. I stand back and spot a little kid with a basketball. I guess he is about seven years old. Kids in the city are tight with their basketballs. I have yet to have one pass a ball to me. This, I sense, is my opportunity. I point to the man on the ground. “Did you do this?” I say.

  He shakes his head, like I am about to yell at him.

  “I heard that he went up to dunk, and you soared up there and stuffed him. Blocked his shot. In his face.”

  He breaks into a smile at the thought but shakes his head.

  “You must be some jumper to have gotten up that high, little guy like you.”

  “I didn’t do it,” he says, laughing.

  I point to another kid across the court. “He told me this guy went up for the dunk, and you soared up there and stuffed him. Rejected.”

  “No,” he says.

  “You hung in the air like a helicopter, he told me. You stuffed him. And look at him now.”

  “It wasn’t me,” he says.

  “I heard different.”

  “How tall are you?” he asks.

  “Seven feet—no, eight feet,” I say.

  “You tall.”

  “Yeah, but I won’t go against you. You’ll stuff me. Set me down like this poor guy.”

  He laughs again.

  I go for it. “Pass me the ball.” I clap my hands together. “I’m open.”

  He smiles and shakes his head.

  “I won’t bolt with it. I promise.”

  He won’t give it up.

  Glenn has the guy up now and we start back to the ambulance.

  “I would have passed it back,” I say.

  He keeps hold of the ball.

  “Don’t you be hurting anyone else,” I say.

  “I won’t,” he says.

  Paramedics

  Four-five-three pulls into the hospital with a priority-one patient from an MVA in West Hartford. Their portable oxygen has run empty, so I grab mine from 451 and connect their patient up to it as Tom Harper and Kelly Tierney take her out of the back. She is in her early thirties, pale as a ghost, her chest and one arm crushed. She has defecated on the board. She is taching out at 140 on the monitor. Tom says her pressure is down to 60 from 110 at the scene. He has a bag of ringers running wide open through the fourteen gauge in her good arm. We wheel her into the trauma room. I can tell Tom is disturbed by the way he looks at the doctor and two nurses who enter the empty room with us. He gives a crisp report describing the injuries and mechanism—a head-on crash, destroyed steering column, fifteen-minute extrication.

  When we leave the room, Tom lets his anger fly. “I asked for a full trauma response—that’s my right as a medic, they can’t refuse that,” he says, as we watch the trauma team only now come running down the corridor and into the room.

  As paramedics we have been given the right to call for the trauma team if our patients meet certain criteria. The hospital chose not to activate until they saw the patient themselves. The woman is critical. They put in a chest tube and ready her for the operating room. Tom is still angry. He stalks back to the ambulance, which is a mess of blood, torn medical wrappers, and gear.

  I sit in the EMT room with his partner Kelly Tierney. He describes the scene of the accident. The engine was under the car, the windshield shattered. While the girl was talking, she had no idea what happened or where she was. As soon as they got her out, they boogied for the hospital.

  When Tom returns from outside I say, “Tom Harper, it’s good to know you’re out there, doing what you do.”

  “Too bad I’m not better at it,” he says tersely. He grabs an equipment replacement sheet, then stalks back out.

  “They should have had the full trauma team there,” Kelly says.

  It is their second call of the day—the first they thought was going to be a code, but it turned out to be a presumption, a dead body on Laurel at the high-rise. I tell him I’ve been doing a lot of ALS calls, but they are all routine—put them on a monitor, give them oxygen, an IV, maybe a few drugs, but nothing life and death. He says it had been that way for them for the last month. This was their first bad one in a while.

  Glenn and I do a chest pain, which we take to the hospital across town. In the EMT room there, as I start my report, Sandy Balboni and Bill Buhener are doing their paperwork from their patient, a Room 1 trauma from the same acc
ident as Tom and Kelly’s. They say the man has a flail chest and massive internal injuries. They don’t think he’ll make it. I tell them about how Tom’s patient looked. They say both cars were destroyed. I ask if they had the full trauma team waiting for them. They said they did—they even met them in the parking lot, with a fresh oxygen tank.

  Sandy’s radio goes off. There is a call in West Hartford, where she is one of the medics, for a person “submerged.” The call goes to Meg Domina in Medic Two. They also send a transport ambulance.

  We wonder what “submerged” means—probably a drowning—and comment how busy West Hartford has been these past few days. There were fourteen calls in twelve hours yesterday, including a cardiac arrest Glenn and I worked with Bob Gionfriddo, one of the other West Hartford medics.

  Glenn and I do a seizure on Main Street. A security guard found the man collapsed in the elevator. He has alcohol on his breath but has a known history of seizures. He is combative and takes a swing at me. I use my broken Spanish to try to calm him down. He says his pecho—his chest—hurts. While Glenn holds him down, I put in a line and draw bloods. I get him on the monitor and give him some baby aspirin and a nitro as a rule out for chest pain. At the hospital, they want to put him in a room without a monitor. I tell them while I think it was probably a seizure, he did complain of chest pain. They clear Room 5 for us, and start a cardiac workup.

  We are back on-line in the ambulance when we hear an EMT on the radio tell the office they are still on scene in West Hartford. A man working in a trench was buried up to his waist in dirt, and as his coworkers tried to get him out with a backhoe, a water main broke and filled the trench, submerging the man. Meg Domina is in the trench with him now, up to her waist in water.

  We shake our heads. I can’t imagine being on the scene of that call. As much as I want to be challenged, that sounds like a nightmare—something I want no part of.

  When we return from a maternity call, we hear on the air that the scene is now closed. The man has been declared dead. The crews won’t be through for a while. They are bringing in the CISD (Critical Incident Stress Debriefing) team for everyone.

  Another West Hartford call goes out for a man unconscious. We say pretty soon there will be no people left in West Hartford.

  “Four-five-one. Signal seventeen in West Hartford,” the radio calls. “Cardiac arrest.”

  We shake our heads. Dispatch sends for another ambulance to back us up. When we pull in front of the address—a nursing home—I grab the monitor, blue bag, and biotech from the side while Glenn pulls out the stretcher, longboard, and straps. Inside they are holding an elevator for us. As the elevator goes up slowly, we glove up. Glenn attaches the defib pads to the monitor. I pull out the airway kit, slide a stylet into a seven point five tube, and pull out an ambu-bag and attach it to the portable oxygen. We’re ready to go.

  The door opens and a nurse points us down the hallway to the right. We dodge elderly patients in wheelchairs and walkers.

  Another nurse points us into the last room on the hallway, right across from the nurses’ station. “In there,” she says.

  We turn the corner into the room.

  A man is lying on the bed with a nasal cannula on. He is breathing. We look at each other, then at the nurse. Just then a cop arrives.

  “Is there a problem?” the nurse says.

  “No,” I say. “It’s just that we thought that this was a cardiac arrest.”

  “Well, it almost is. His pressure is eighty and dropping. It’s circulatory collapse. He has a history of congestive heart failure, heart bypasses, and COPD.” That’s chronic obstructive pulmonary disease. She is an older woman, who is visibly disturbed.

  “It’s okay,” I say. “We just thought he wasn’t breathing and his heart had stopped.”

  “I just wanted to get him help. I’m sorry for the confusion.”

  “No problem at all.”

  Glenn calls the office and tells them to cancel the other ambulance, while I assess the patient. His pressure is 110/60. He is a little cyanotic, so I up his oxygen, which improves his color. We go to Saint Francis on an easy two.

  We go nonstop all day—a burned foot, another maternity, a report of a man down in an alley who we could not find, more chest pain, asthma. I don’t mind. It is the last day of my shift, and I will be able to sleep late the next day. I like being busy.

  We get called to the high-rise on Laurel for a difficulty breathing. In the driveway are a police car and a hearse. “It’s from the presumption four-five-three did earlier,” Glenn says.

  “What apartment are you going to?” the office manager, a pretty young woman, asks.

  We give the number.

  “Oh, he’s a regular,” she says.

  A security guard says, “It’s probably just another of his anxiety attacks. We had a guy die here earlier. That’s probably got him upset.”

  I nod that I understand.

  “Which isn’t to say it might not be something serious,” he says.

  “We’ll check it out,” I say.

  Upstairs on the fifth floor, we see an open apartment door. As we come down the hall, we see a man walk past. When we enter he is sitting in his wheelchair.

  I ask what the problem is, and he says he is having a little trouble breathing. He says he has congestive heart failure, diabetes, and had a heart attack ten years ago. His color is good. His pulse is steady and regular. His pressure is also fine. I listen to his lungs. They are clear.

  “Clear,” he says. “The visiting nurse told me this morning she heard some crackles, and I was worried. She said if I felt like I was having a hard time breathing, I should call for an ambulance.”

  “Well, they sound clear to me, but we are happy to take you to the hospital if you’d like. Only you can tell us how you really feel.”

  “I just get worried,” he says. “I’m here all alone and I haven’t been healthy.”

  “It’s okay, we don’t mind coming. You can call anytime.”

  I get him to sign a refusal.

  “I feel embarrassed now,” he says.

  “Don’t be.”

  “Okay, thanks. Good-bye, fellahs.”

  “Take care, sir.”

  At six we are sent to Windsor for a fire standby. We end up transporting one firefighter with smoke inhalation and heat exhaustion. We are unloading him when Mike Lambert, the newest paramedic to be cut loose, comes up to us. He looks a little frazzled, a little lost.

  “You guys been busy today?” he asks.

  “Yeah, real busy. We’ve been running all over the place. Nothing spectacular, but just a lot of calls.”

  “I’ve only done one.”

  “One?”

  “Yeah, I was out at that call in West Hartford. They just finished up with it. The guy in the trench.”

  “You were at that?”

  “Yeah,” he says. “We couldn’t get to him at first. He was underwater. Then we worked him. We tubed him, gave him IVs, drugs, fluid. Nothing worked.”

  “Wow.”

  “Traumatic asphyxiation.” He shakes his head at the thought. “He was crushed by all the mud and he drowned. It took four hours to get him out of the pit.”

  “Man, sounds rough.”

  “We did all we could.” He holds his arms out. “There was nothing more we could do.”

  I want to say something to Mike, like good try or you did your best, but the thought of the horror leaves no space for words. We push into the ER with our patient, leaving Mike outside, alone.

  After “ER” that night, the local news comes on, and I watch the coverage of the accident. They say until they got the water main fixed and the water pumped out, only the man’s outstretched hands were above the surface. They don’t show the man, only the rescue workers in the pit. For a time, the water is up to their hips. I can see Meg Domina and Mike. The newscasters talk about how the rescuers risked their lives, going down in there to try to save him. They talk of the helplessness people felt. M
eg, who is six months pregnant, has a look of battle shock in her deep blue eyes as she works side by side with Mike in the pit.

  Boots

  We’re sitting in the EMT room at Hartford Hospital, and Glenn is giving me crap about how I need to shine my boots, when Rick Ortyl comes in. Rick is in his early forties and has been in EMS for twenty-five years. He works full-time as a medic for Professional and part-time as the assistant EMS coordinator for Saint Francis–Mount Sinai under Debbie Haliscak. He shakes his head. “How much longer are you going to be doing this?” he says to me. “I think I’m about ready to hang it up.”

  “So you’re just going to teach your classes and have all the young girls go ‘Oh, Mr. Ortyl, you’re so wonderful.’ ”

  “Yeah, that’s the life and, of course, I’ll come out and ride with you guys, and bust your butts every now and then.”

  “I’m going to keep doing it for a while longer—at least until I’m good at it,” I say, “but the truth is I have been in a funk for the last couple weeks that’s making me have my doubts.” I tell him how that week a doctor wouldn’t give me any medical history on his patient who was having a minor allergic reaction to a drug. Just take her to the hospital, he’d said. That had depressed me.

  He shakes his head. “There’s no respect from some people. I’m ready to pack it in, but then again, I may do a good call, then get all fired up about it, and be ready to keep going.”

  “Yeah, I know what you mean.”

  We clear the hospital just as two MVAs go out over HPD. We’re sent as the second car to an accident on Franklin, and Rick is sent on a one to the call off Maple that comes in as “patients trapped in car, fire department on the way.” There are only minor injuries at our call. A patient with neck pain and a refusal. The basic unit on scene first will take the patient in. I look around for the car that hit the Jeep but don’t see it. Glenn is back in the ambulance, clearing us from the call, while I help the basic crew get the refusal. I see Glenn gesturing to me to get in the ambulance. I leave the refusal with the other crew and return. “What’s up?”