The career archive of a NYC paramedic

Month: July 2020

Social Media Hostage

I became a lieutenant around the time when a lot of young adults were abandoning their MySpace accounts and moving onto bigger platforms like Facebook and Twitter. Although it was recognized that most of us carried a phone we weren’t supposed to use them and of course, never on a call. Social media, on it’s own, also posed some new challenges to the department and a “Social Media Policy” was eventually created. It was during this time that I received a barricaded EDP job where the patient was locked in his grandmother’s apartment and holding his sister hostage.

The grandmother lived in public housing and had, at one time, allowed her 16 year old grandson to live with her for a while. Her son, she said, had “lost control and patience with ‘David'”. The grandmother thought she could help mediate the situation by having him stay with her since she had always had a good relationship with him. But unfortunately, not long after he moved in, he started doing things she didn’t approve of, including some criminal activity and drugs. Despite grandma’s best efforts he would not stop and she feared being evicted from her apartment should her grandson be arrested. She called her son and he had arrived that day to bring David back to their home in another state. After locking himself in the apartment (and locking his grandmother out) David’s sister, Mary, tried to get him to come out but instead became locked in the apartment with David. That’s when the family called the police.

Most of the time, these barricaded-type jobs involve waiting long periods of time for the police to get into an apartment. Before breaking down the door a lengthy negotiation often takes place either on the phone or through the door and while this is going on a long line of police officers stands by in the hallway. I and my crew also wait in the hallway, often at the opposite end. It seemed like an extremely long negotiation. The police were very much hoping David would open the door himself. So was I. It was summer, extremely hot, and there was no air-conditioning in the hallway. Everyone was restless.

My crew had spoken to the family and gotten much of the information for the call report already. All they needed was David, and possibly Mary. It was unclear at the time if David would be regarded as a mentally ill patient and a determination would be made based on things David said to the officer along with information the family provided about his history (and he had no history previously). All we could do was wait and see how things played out.

I made periodic trips to the other end of the hall for updates and on one trip back to our end of the hall, I saw that the female half of my female/male crew was using her phone excitedly. It looked unprofessional and I went to say something to her.

“But Lieu,” she said, “I found David online.”

“Our David?” I asked, pointing down the hall.

“Yes!” she said. “He’s livestreaming right now, acting like this whole things is a media event. He’s bragging that PD is buying them milkshakes and basically saying how he’s getting over on everyone.” I watched on her phone how our patient and his sister were interacting with their audience. Many of his friends were just downstairs filming things on their end and posting to David’s account. Both David and Mary seemed very comfortable being on camera and did not seem to be too concerned about the actions going on on the other side of the door.

I borrowed her phone and went over to my PD contact person. He was instantly mesmerized by the videos. He took the phone and moved up further in the procession to the negotiator. I watched the shocked and surprised expressions on everyone. They brought the phone back to my crew and asked them how to interact with David on this platform. The police were able to pretend to be followers asking him vague questions about their motives and were able to discern that there were no weapons. They continued to distract him while the Emergency Service officer got to work breaking down the door. This was also livestreamed on their end, as was David’s arrest a short time later.

We did not take David to the hospital as he was not considered to be an “EDP”. We did take his sister, Mary. She claimed to be deeply traumatized, despite her performance in the videos.

The police were extremely grateful for our assistance and the way it was handled through social media. I tried to put my crew in for some recognition from my department for their forward thinking problem solving but was discouraged by many officers up the chain of command. They noted that the use of the phone itself was problematic and felt that rather than getting a commendation we would all face some kind of discipline given they department’s distaste for social media. On the PD side, I speculate that the officers received congratulations and honors for the out-of-the-box techniques used on this particular call.

How to Speed Up the Triage Line

Throughout my entire career from EMT to paramedic to lieutenant I have been lucky to meet and work with many, many others who’ve adapted to the unusual and often troubling situations we are often thrown into by trying to find some entertainment value where you can. It’s liberating sometimes to stop and look around at all the mayhem, when it appears, and find something redeeming in it. Sometimes this adaptation evolves to help with problems other than PTSD.

Emergency rooms very typically get backed up and it is not unusual to wait behind numerous other units as one triage nurse evaluates the patients, puts them in the system and figures out where to place them. Triaging seems to be the least desirable position in the ER, if facial expressions are any indication, and on one particular night things were made worse by a dispute among the nursing staff as to who, in fact, was assigned the position that evening. As a result no one was being triaged and the nurses were going to great lengths to pretend that there wasn’t a long line of patients waiting to be seen. Tension was clearly visible between the staff, even from my distant vantage point.

Our patient was behind so many other patients that our stretcher was in the lobby area and not even in the actual emergency room. We paramedics and EMTs made the usual short conversations expecting things to be resolved soon but after some time it became clear nothing was moving forward. One of the EMTs who was waiting gave me a wink and said he would take care of it.

“Nancy,” he said, “go up to triage and put your radio on the desk. Make sure that radio is up to the highest volume.”

I nodded with a wink and a smile. He’s using the ol’ Annoy Them With The Radio technique, I thought. Th objective is to make a nuisance of yourself so they get rid of you. I’ve used this tactic with some success in the past. But Mr. Kevin had tweaked this strategy into a whole other dimension.

Our radios came with a command frequency which enabled two users to talk back and forth to each other over the regular frequency without interrupting it. Only people within a short radius would hear. When I reached the desk and put my radio down I noticed others had done the same. Kevin’s message would be broadcast in surround sound.

“Brooklyn Central,” said a disguised Kevin voice addressing the ‘dispatcher’, “Central this is Conditions 53 [he was posing as a lieutenant], I’m at the scene of the school bus accident…the bus that hit the building….at this time we have 12 patients…we are getting ready to transport and I’ll need a notification. Please let hospital A [the hospital we were in] know they are getting 10 adults…3 females and 8 males to Hospital A, all trauma. And let Hospital B know they are getting two, we don’t want Hospital A to get too overloaded…so 10 to Hospital A, 2 to Hospital B…thank you!” He changed his voice again to pretend to be the dispatcher acknowledging the transmission.

All three of the nurses within listening range became immediately outraged. “Is that right?!” they asked. We all shrugged.

“Are we getting 10 patients?! TEN! And the other hospital gets TWO? Who is this lieutenant? How do they expect us to handle ten patients all at once? Where are we supposed to put all of them?…”

One of the registration people was assigned the task of reaching the dispatcher to redirect some of the patients from the bus accident elsewhere and also to complain about the lobsided hospital designations for all 12 patients. The poor registrar could find no one who knew what she was talking about and therefore could not relay to the nurses that the issue was handled.

Suddenly everyone started moving. Beds were moved, spaces were cleared and the trauma room was prepped. It became an instant priority to deal with the patients that were waiting. We were triaged fairly quickly after that. It was done angrily, but it got done.

As Mr. Kevin casually strolled out with his stretcher he looked at me with a smile and remarked “Look how nicely everything works when everyone works together.”

The Purple Hippo Shooting

One day my partner and I were called to a wrist injury in the projects on the Upper West Side of Manhattan. The way the buildings were situated to the street made parking close to the address very difficult. Many housing projects have roadways that can get you closer but this one either didn’t or it was blocked in some way (not uncommon) so we had to walk a bit of a distance to get to the actual address.

The call was something of a low priority that we assumed didn’t even warrant the stair chair but we brought it with us. We always bring a specific set of equipment with us regardless of call type because things can often be much different on the scene as opposed to the way it was described to the 911 dispatcher. As EMTs that set meant a tech bag, an oxygen bag, a semi-automatic defibrillator, and a carrying device, which 99% of the time is a stair chair.

Once at the apartment, we found that the 911 dispatcher had been 100% correct-it was a wrist injury. An approximately 35-year-old woman had fallen two weeks prior and her wrist was wrapped in an ace bandage. She had gone to the hospital twice during that two-week period where each time x-rays had been taken and exams conducted and her injury had been determined to be a sprain. She had been prescribed pain killers and given instructions on limiting motion to her wrist along with a date to return for a follow-up.

The woman believed that both determinations were wrong, that her wrist must be fractured because she still could not move her wrist without pain. We pointed out that her instruction sheet indicated her wrist would be painful for possibly a month, even with a sprain but she was positive her wrist was far more badly damaged than they had made it out to be and was requesting a third hospital evaluation at a different facility. This would also be her third ambulance trip for the same injury. I don’t understand it but I don’t mind. It was an easy call, or so I thought.

Despite the fact that she ambulated around her apartment very easily while getting her papers together, changing her clothes, and searching for her ID, when it came to getting to the ambulance she said she would be unable to do so without assistance. She was too weak to even walk down the hall, she said, and she required the stair chair which we thought we wouldn’t need. Thankfully, the elevator was working (not always guaranteed) so there was no actual lifting but she was rather heavy and pushing the chair was a slow endeavor as we had parked so far and most of the roadways were not smoothly paved.

As we were slowly making our arduous journey to the ambulance, shots suddenly rang out, many of them.

It was a sound we were familiar with and immediately understood the danger. My partner was able to maneuver the chair behind a large playground object. The bullets were coming from multiple directions but it seemed the whimsical animal we decided to hide behind was a good shield. It was a large purple hippo.

In happier circumstances, I’m sure children enjoyed climbing the concrete hippopotamus. The patient, also familiar with what was going on, hastily unstrapped herself from our chair and took off running. My partner cheerfully announced “10-96!” to me (our radio code for ‘left the scene’) from where he was, which made me laugh despite the circumstances.

When the gunfire died down we quickly made our way to our ambulance and while we were putting away our equipment I was tapped on the shoulder by a young man about 16 or 17 years old. “I’m hit,” he said casually and lifted up his shirt to show me a small wound to his abdomen. The side door to the ambulance was open and he got in.

My partner had been on the radio asking for PD and additional ambulances in case there were injuries. He hadn’t seen the man who approached me. As he made his way around the vehicle he saw the teenager sitting in our truck and asked him what he was doing. I had gone around to the other side of the vehicle to obtain a backboard, which was our protocol at the time. Another slightly comical moment ensued of my partner and I completely missing each other walking around the vehicle to get to different compartments to get various equipment.

Once reunited, we worked very quickly to treat the patient and prepare for our trip to the trauma center. There is a ‘golden hour’ that we use as a rule, getting the trauma patient to a surgeon in as little time as possible. We closed up our doors with an officer and the patient’s friend accompanying us. It would turn out during the ride that the accompanying friend had actually shot the patient in the confusion with targets and the many people involved in this incident. It was a surreal time where none of these circumstances were treated as unusual and my partner didn’t blink an eye when we arrived at the hospital with one patient and one, now, prisoner who was completely cooperative and contrite. There was no animosity between the two with the shooter letting his friend know “if you need blood, man, I got you. I’m O, the universal donor. Good luck.”

Everything went very smoothly and our man survived. In the confusion there had been no second call number given to shooting since it occurred at the same address. Three people were associated with it: our shooting victim, a different shooting victim and the wrist injury. Later on when our ambulance call reports were looked at by the police or the DA there was some confusion regarding which victim went to which hospital since it turned out that both shooting victims had the same first name. They had contacted us for statements about the incident and to clear up which patient was ours.

“And what’s up with this lady with the wrist fracture?” We were asked. “Will she be pressing charges?”

Administrative Terrorism

When I came on the job as an inexperienced, naive EMT I had little idea how things worked in the real world. I was lucky to be partnered with a person who was already a legend throughout the service. He wasn’t only good at being an EMT, he knew how the job worked, how the city operated and he had a diverse skill set that was often invaluable. He taught me many, many things but one of the most satisfying was something he liked to call “administrative terrorism”.

It was unfortunate, but I came to find out that some of our supervisors lacked many of the important verbal communication skills needed to motivate poorly-paid civil service subordinates. The reward structure that traditional jobs rely on to motivate their employees (bonuses, raises, and other benefits) doesn’t exist for us and rather than get creative many chose the route of bullying and berating; negative reinforcement at its worst. Administrative terrorism was born as a creative way to handle uncreative supervisors, turning a negative situation into something entertaining. It also broke up the day if you were bored. I was privileged to learn from the master.

One of our lieutenants that used all the tactics in the negative reinforcement playbook was someone I’ll call Lt. Pat. Lt. Pat was obviously taunted as a child and used his new position of authority to make up for the wrongs inflicted upon him in the past. He was wildly incompetent and somewhat comical for us, even without the encouragement our karmic acts of rebellion brought out. Lt Pat desperately sought the approval of those higher up which made him an easy target for my partner whose many talents included being able to imitate the chief in charge’s voice over the telephone.

One day, chosen completely at random my partner asked me to hang around the front of the office and report back to him later what occurred. I didn’t know it at the time but my partner had surreptitiously unplugged the fax machine a little while earlier. Mr. Pat was at the desk and due to hearing difficulty he kept the phone volume up to a level where I, and anyone within a 2 mile radius, could hear. The phone rang, Lt Pat answered in his authoritative manner.

“Hello. Lt. Pat? It’s Chief McAllen,” I could hear my partner say in his best Chief McAllen voice. ” I’ll be sending over a report through the fax machine. I’ll need you to answer a few questions at the end of it and fax it right back”.

“No problem, Chief,” Lt Pat answered confidently. “I’ll take care of it right away.” He continued with whatever he had been doing at his desk for a little while until another call came through.

“Pat?” my partner said. “I’m waiting on that report.”

“I’m sorry, Chief but nothing’s come over.” He answered.

“Ok. I’ll send it again.”

More time went by. Nothing came over the machine, of course. Another phone call was made.

“Pat. I don’t know if I stressed this enough to you but this is somewhat urgent. I need your answered questionnaire pronto.”

“I’m sorry Chief, but still, nothing has come over the fax machine. Perhaps you better send it again.” Lt. Pat sounded contrite.

“Ok Pat”, he said. “But make sure this thing gets done. Drop anything else and send it over right away.”

At this point Lt. Pat stopped everything he was doing and watched the machine. As someone who liked to limit the movement of his considerable girth he chose to not to get up and check out the machine directly, but he stared at it. He also looked at the clock somewhat nervously but of course, no paper, no sound came from the fax machine.

“Lt. Pat,” came the next call. “I sent this report out to 5 supervisors and I have 4 questionnaires sitting on my desk right now. Guess which one I’m missing?” He sounded exactly the right level of angry you could expect from Chief McAllen. “I’ve sent this time over about 5 times. Are you telling me you haven’t received even ONE?”

“But I haven’t!” said Lt. Pat. He sounded like a little schoolboy at this point. A nervous little schoolboy.

“Pat,” the chief voice replied. “You checked the machine, didn’t you? Nothing’s jammed? Receiver not off the hook?”

Lt. Pat finally made it over to the machine, phone in hand. The unplugged cord was situated in a very obvious way on the side of the table it was on which did not face the lieutenant desk. Lt Pat picked up the cord and dejectedly reported that he had found the problem.

“Was it turned off?” He said, in a rather condescending tone.

“It wasn’t plugged in…” At least he was honest. I have learned on this job that honesty is not the virtue that it is elsewhere. They pretend that it’s important but it’s rarely rewarded.

An exasperated ‘Chief McAllen’ hung up. As Lt. Pat scrambled to plug in the machine my partner strolled in with a piece of paper.

“Hey there, Lt Pat,” he said cheerfully. “Would it be OK if I fax”ed this dental form in to the union office? I’m having a root canal–” he was immediately cut off.

“NO!” Lt. Pat screamed. “NO! STAY AWAY FROM THE FAX MACHINE! I’m waiting for something! No one goes near the machine! No one!”

My partner flashed me a smirky grin with his back to Lt. Pat.

“Wait until he calls back the division to speak to the chief again.” He told me later. “No one will have any idea what he’s talking about. Whatever statistical anomaly they’re focused on right now will be put on the back burner for at least a week.”

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