It is a baby.
I walk out. The firefighters are all standing there. “Is it going to be all right?”
“Hey, sorry we yelled at you. It’s just that you’re always there before us.”
“No, that’s all right. You guys did great. You had the baby right there for us. It was down too long, but if it had a chance, you would have done your part great.”
“Sorry, we were just upset.” I see some teary eyes. These big men in their turnout gear who brave fire and danger every day. I understand what they are feeling. They were there for the terrible part. The mother running out, holding her baby. My baby! My baby! My baby’s not breathing! Then the waiting. Waiting for us to come. Where the hell are they? No motion in the baby. No life. Just the mother screaming. Their fingers going up and down on the baby’s chest. Using their giant adult ambu-bag to try to get air into its lungs, only able to give tiny squeezes. No motion at all. Nothing they can do.
There are two company supervisors at the hospital now to see how everyone is doing. This is the fourth baby code our company has done in a week. “Fine,” I say tersely. “The baby was dead.”
I hear Pam say, “No, I’m not all right. Twice in a week.”
In the call she had earlier with her regular partner, Shawn Kinkade, the baby was found with its head between the bars of its crib, not breathing, but freshly down. Shawn tubed it en route to the hospital and got a round of drugs down the tube. The staff at Mount Sinai worked on the baby for over an hour, but they couldn’t bring it back.
When you have a bad call, what you want most of all is a second chance, to get back out there and win this time.
Pam walks around, shaking her head. I can see her arms and hands, opening up, tensing, closing, opening again.
I go out to the car and get a run form. I go back inside. The baby has been called—pronounced dead. A woman doctor is asking everyone how they are. The firefighters are still standing around. They look pale, distraught.
I sit in the alcove to write my report. I look at the blank spaces. Name. I don’t know it. Sex. I sit there stunned. I don’t even know if it was a boy or a girl.
“I know we’re all tough guys,” Bill Terri-Savage, a supervisor, says to me, “but we’re going to set up a CISD debriefing for anyone who wants it.” CISD is critical incident stress debriefing, where everyone sits around and tells how they feel about the bad call they just went through.
“Fine,” I say, looking straight ahead. “I’m okay.”
“Just if you need it.”
I nod.
I get up, get the name from a nurse, and write it down on my pad. It is a girl, four and a half months old. The mother is in the room, holding the baby in her arms, cradling her, rocking her. I go back and sit down in the alcove. I write my report:
4½-month-old female found not breathing by mom. Unknown down time. On our arrival HFD and HPD on scene. CPR in progress. Baby pulseless, apneic, cyanotic. CPR continued, compressions and ventilations. Transported priority one to CCMC. Asystole on monitor. Intubation attempted. No cords visualized. CPR continued. On arrival Pt still pulseless, apneic. Turned over to CCMC staff with full report.
I call for our times. Dispatch and Respond: 8:09. Arrival: 8:12. Transport: 8:14. Destination: 8:17.
The dispatcher asks how we all are. “The baby was dead,” I say. “It looked like a CPR mannequin.”
There is still a crowd in the ER. Arthur is standing by the nurses’ desk, looking in at the mother holding her baby. He’s got four kids of his own, all grown now and out of the house.
I think I want to be anywhere but here. “Let’s go,” I say to Arthur. “Let’s get out of here. Let’s go do some calls.”
In the car, he sits behind the wheel for a moment before starting up the engine. “It’s a shame,” he says.
He’s been on the job in this city seven years. He’s been at EMS in one form or another—firefighter or EMT—for more than twenty-five. This is my third year in Hartford, eighth in EMS. We’ve been partners for almost a year, doing more than a thousand calls together. Shootings, heart attacks, strokes, diabetic shocks, assaults, burns, car accidents, drug overdoses, cut fingers, colds and flu, drunks. Most you forget about as soon as they are over. Others you carry with you.
A couple hours later, we’re sitting outside Saint Francis. It’s been quiet. We still haven’t done another call. “Four-seven-one,” the dispatcher asks us. “Are you interested in attending the CISD?”
Arthur looks at me.
“No,” I say quickly. “I’m all right.”
He says nothing.
“The baby was dead,” I say. “There was nothing we could do. Unless you want to go. I’ll leave it up to you.”
He is a strong man. I kid him about all the ibuprofen he takes, but the two of us have carried huge patients up and down stairs by ourselves. We pride ourselves on never having to ask for a lift assist. But now for the first time I notice the gray in his mustache, the lines etched in his face. He looks as old as I’ve ever seen him.
“No, thank you,” Arthur says back to the radio, his voice tired. “We’re doing okay.”
He puts the mike down, then takes off his glasses and pretends to rub a spot in them.
“I just want to do some calls,” I say, determined. “I like to do calls.”
I catch a small glisten in his eyes as he puts the glasses back on.
“I know you do,” he says.
STORY OF A LIFE
I never want to lose my focus on the patient, on the person.
Respect
I never miss work and I am never late. I try to do my job well but the truth is there are some days I don’t want to be here, days when I hate my job. When I find myself not caring. When I get testy, tired, snapping at patients—something that happens far more often than it should. I know that burnout is an occupational hazard. Burnout from too much stress. Burnout from lack of respect. Burnout from frustration. Burnout from finding out that what you love is not always what you want it to be. I see it in others, even in medics I respect, medics I revere. I guard against it in myself. I try to squash it down when it rears its head.
I want to be good, not just in the big bad ones, but every day, day in, day out. I want to treat everyone with respect. With care. Patient to patient. Heart attack to broken ankle. Migraine headache to massive stroke. My job is my church. Though I often fall short, every day I try to seek grace.
I want to allay my patients’ fears, make them feel less alone. The fifty-three-year-old man who passed out on the treadmill and still feels a little shaky. The seventy-five-year-old stroke victim who can only squeeze my hand with her right hand, and though she tries, cannot speak. The twenty-five-year-old with asthma, who now on her second Ventolin breathing treatment, is finally starting to calm down. The eighty-three-year-old woman who has a fever and has been vomiting all night. I introduce myself. “My name is Peter. I’m a paramedic. How are you doing?” I try to listen to their stories, hear their complaints, their troubles. I tell them what I am doing for them. What they can expect. I lay my hands on them. My words are soft. I try to look them in the eyes. When we get to the hospital and get them in their room, I introduce them to the nurse. I pass over care. I always try to touch their shoulder and say, “They’ll take good care of you here.”
I want to feel that what I do matters to someone, even if only for a moment.
Life on Mars
We get called for an unresponsive diabetic on Brookfield Street. We’re coming from Saint Francis, so it’s taking us awhile. The dispatcher radios back asking for our ETA—the man is still unresponsive, she says.
“Put us out,” I say, as Arthur pulls to a stop in front of the house.
The address is across the street from the Charter Oak Rice Heights Housing complex, World War II public housing. Once a model of its kind, it is now drug-ridden, litter-strewn, and targeted for demolition.
Two women in their sixties meet us at the door. “He’s a di
abetic,” she says. “I can’t get him up. My sister and I just got back from a trip to Massachusetts. I don’t know how long he’s been like this. He doesn’t take care of himself.”
The man is slumped in a chair in front of the TV, newspapers scattered on the floor, an empty ice cream carton and several bottles of beer on the table next to him. His skin has a blue hue. He is cold and very diaphoretic. His tongue is partially blocking his airway, producing a snoring sound when he breathes.
“When did you last see him?” I ask as I reposition his head so he can breathe easier.
“Two days ago,” she says, “when we left on our trip. I knew I shouldn’t have left him. He just doesn’t care anymore.”
I strap a tourniquet on his arm. It is a pretty good bet that he is hypoglycemic, meaning his blood sugar level is too low to sustain normal brain activity. Untreated, it can cause coma, then death. My worry is that he’s been out so long he has already irreparably damaged his brain. I get the IV and hand Arthur the needle to do a chemstrip check, while he hands me the IV line.
He puts a drop of blood on the strip and a minute later wipes it off. “I’m not getting a reading,” he says. “Too low to measure.”
I already have the dextrose out. As I push the drug in, the man slowly starts to move, then opens his eyes, and looks around like Rip van Winkle. “Ah, Christ,” he says.
“How are you?” I ask.
“George, I can’t leave you alone,” his wife says. “I called and you didn’t answer. We had to come back.”
“Maybe you should have left me,” he says.
“What time do you remember last being up?” I ask.
“I don’t know. I was watching TV, having a beer.”
“He won’t take care of himself,” she says. “He thinks nothing about eating a quart of ice cream. He’s going to kill himself.”
The man grunts and shakes his head. “You came home too early,” he says.
“I don’t know what I’m going to do.”
“We need to take you to the hospital,” I say.
“Can’t you just leave me here?”
“No, what I gave you won’t last. You should get checked out, and they’ll get you something to eat there.” I am also thinking maybe they need to give him some counseling. “Maybe they can alter your medications.”
He nods. He knows the routine.
We get him on the stretcher and out to the ambulance. Across the street, they have a fence up over a portion of the complex. A bulldozer is knocking down a two-story building. In a dwelling not yet targeted, a group of people sit out drinking beers while kids play in the dirt. They watch us take the man out on the stretcher and lift him into the back of the ambulance.
“So when do you think you were last alert?”
He shrugs. “I don’t know. They should have just left me alone.”
“You a baseball fan?”
“Detroit Tigers,” he says, some life coming back in his voice.
“What place were they in when you last checked?”
He snorts. “Last,” he says.
“Well, good news,” I say. “They won the pennant. Al Kaline came out of retirement to lead them. The World Series starts today.”
He laughs. “Get out of here,” he says.
“Did you hear about California?”
“No.”
“It fell into the sea.”
“No, get out of here.”
“I’m just trying to find out how long you’ve been sleeping. Hey, did you hear, they discovered life on Mars?”
“Yeah, I know, I saw that on TV,” he says, “and it’s a load of bull.”
I laugh. “Who would have thought,” I say. At least he was alert then.
“Life on Mars,” he says. “I should live so long.” He shakes his head.
“What was it—just some bacteria they found?”
“Bacteria,” he says. “Life is people—Martians, spacemen—not germs, for God’s sake.”
“I hear you,” I say.
We’re stopped in the middle of the road, just down the street from his house, as a dump truck swings around and tries to back into the demolition site, its backup alarm beeping.
“There goes the neighborhood, huh?” I say.
“Forty years I’ve lived here,” he says. “I worked for an insurance company. I had the money to move anytime. My wife wanted me to move years ago when it first started going downhill, but I like living here. It’s my house. I raised my family here. That counts for something.”
“I’m sure it does.”
He shakes his head. “Call me stubborn,” he says. “I like drinking beer, eating ice cream. How else am I supposed to live?”
“I don’t know.”
“They came back too early,” he says.
Lord Randal
“There he is on the corner,” I say from two blocks off.
“It’s Randal,” Arthur says. “Joan and I picked him up yesterday.”
Randal Martinez is a regular. I’ve picked him up myself seven or eight times. Hardly a day goes by that we don’t see him in the tube station at Hartford or in the crisis unit at Saint Francis. He’s a strongly built man in his late forties. He drinks till he can’t stand up, then he sits down on the sidewalk and waits for someone to come get him. He’s never so out of it that we have to use ammonia inhalants to wake him up or transport him comatose.
We park, get out, and stand over him, putting on our latex gloves as we greet him.
“Hey, hey, let me ask you,” he says. “I think I killed somebody.”
“You killed somebody!” I say in a loud voice.
“Shh, shh, shh,” he says, smiling.
“You sure you want to be telling us that?” Art says.
“I stabbed her,” he says.
“You stabbed her!” I shout.
“Shh, shh, shh,” he says.
“Okay, okay,” I say in a whisper. “You stabbed her?”
“No, I shot her,” he says.
“You shot her!” I shout.
He holds his finger up to his mouth.
“Okay, okay,” I say in a whisper. “You shot her. Where’s the dead body?”
He starts laughing and motions me to be quiet. “No, no, no, she OD’d.”
“OD’d?”
“No, no, no, I’m just kidding. I was just wondering what you guys would do if I really did.”
“We’d take care of you. We’d raise her from the dead. We wouldn’t let you take a murder rap.”
“You’re my friends.”
“What hospital do you want to go to?”
“ADRC.”
“You’re sure you’re not on the banned list?”
“Give it a try?”
“He needs his Tegretol levels checked,” Arthur says. “It’s what they said yesterday.”
“Howabout we take you to Saint Francis?”
He nods and offers us his hands to help lift him. We get him to his feet. He is slightly unsteady. With each of us holding an arm, we walk him toward the ambulance.
“Jeez, Randal,” Arthur says, “you must cost us one hundred thousand dollars a year easily.”
“Hey, hey, don’t say that about me.”
“You don’t have to pay it. The taxpayers have to foot the bill.”
Randal drops his arms down and makes fists.
“Easy, easy,” I say.
“I don’t like him talking about me like that. I’m a veteran.”
“I didn’t mean it personally,” Arthur says.
“I fought for this country. Eighteen-year-old Puerto Rican. I seen my best friend killed. Don’t talk to me. I cost you?”
“I’m sorry,” Arthur says.
Randal spits on the floor. “Fuck you for saying that.”
Arthur laughs and hold his hands up. “I didn’t mean anything.” He bows. “I am not worthy. I am not worthy.”
“Come on, Randal,” I say.
He is too unsteady and unpredictable to step up into t
he back of the ambulance, so I pull the stretcher out, and we get him on it.
“Did you fight in the war?” he asks Arthur.
“No,” Arthur says. “I didn’t get drafted.”
“How ’bout you?” Randal says to me.
“He wasn’t old enough,” Arthur says. “He’s just a baby.”
We get him in the back. Randal is still angry at Arthur. I tell Arthur to just head to Saint Francis.
“How old are you?” Randal asks me.
“Forty,” I say. “I was fourteen when the war ended.”
“Good, you’re lucky. How could he say that about me? Costing him money. It cost me. Hey, what’s your name? I forget.”
“Peter,” I say.
“Peter, Peter, pumpkin eater …”
I join him. “Had a wife and couldn’t keep her, / put her in a pumpkin shell / and there he kept her very well.”
He laughs. “I like rhymes and poetry.”
“You like poetry? I’ve got a poem for you.” I have been listening to a tape of great poetry. This poem caught my fancy and I have been memorizing it. I put on a thick Irish brogue and lean toward him. “ ‘Oh where ha’e you been, Lord Randall, my son? / O where ha’e you been, my handsome young man?’ ”
“Randal. That’s my name.”
I hold my finger to my lips. “ ‘I ha’e been to the wild wood: mother, make my bed soon, / For I’m weary wi’ hunting, and I fain would lie down.’ ”
His eyes are fixed on me. I press on. “ ‘Where got you your dinner, Lord Randall my son? / Where got you your dinner, my handsome young man?’ / ‘I dined wi’ my true love: mother, make my bed soon, / For I’m weary wi’ hunting and I fain would lie down.’ ”
I hear Arthur laughing in the front. I have Randal’s rapt attention. “What got ye to your dinner, Lord Randall my son? / What got ye to your dinner, my handsome young man?” / ‘I got eels boiled in bro’: mother, make my bed soon, / For I’m weary wi’ hunting and I fain would lie down.’ / ‘What became of your bloodhounds, Lord Randall my son? / What became of your bloodhounds, my handsome young man?’ ”
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