streetstoriesems

The career archive of a NYC paramedic

Month: February 2021

MAST On the East River

February 9, 2021 /

My partner, Quinn, and I were cruising down the FDR Drive towards another EMS station in lower Manhattan. Our lieutenant had sent us on an errand as soon as our shift started. We were to retrieve and deliver a large box of Very Important, Desperately Needed, Get Them Here ASAP supplies and equipment.

The FDR highway circles the outer edge of the borough on the east side. It was a cold January day and we could see some chunks of ice being tossed about in the choppy waves flowing next to us. We got off at our exit but continued along the underpass near the waters edge. Not far after getting off, we noticed some commotion up ahead. Two sanitation trucks were parked askew along with a few random cars. A small group of people had gathered at the low wall at the side of the river. They were all fixated on something in the water. My partner gave me a big grin and I knew that our box of Super Important ASAP Supplies was going to wait a little while.

Quinn parked our vehicle properly and we got out to see what the fuss was all about. We joined the group and looked in the direction where they were all focused. We were horrified to see a medium sized terrier struggling to stay afloat in the cold water below.

“What happened?” my partner asked. The group explained that, minutes ago, they had witnessed the dog jump onto the wall and lose his balance, sliding over to the other side, which had a 20 foot drop towards the icy river. They were trying to find a way to get him out. Someone had obtained a rope but it was thin, lightweight and blowing around in the wind. As each wave crashed against the wall near the dog, the group, including my partner and I, gasped and grew more panicked.

Suddenly, one of the men jumped into the water to get him.

My partner rushed over to our ambulance, which was close by. He opened one of the outer compartments which held the equipment we rarely accessed. He dug out the bag containing our MAST pants, short for Military Anti-Shock Trousers, and went to work pumping them up.

MAST pants- medical equipment and flotation device

MAST pants are a medical device once thought to assist trauma patients by shunting blood from the lower extremities to the vital core organs in the torso. They were actual pants made with rubber bladders which were inflated via a foot pump. They have since fallen out of favor, but at the time they were considered a vital piece of equipment, required on all ambulances.

Without a human or a mannequin in them, the MAST pants required a lot more air than we had ever needed in our practice drills. The two of us alternated, stomping on the pump attached to hoses that attached to the pants. It only took a few minutes to get them puffed up completely but it felt like an eternity.

Once filled, we brought our life-saving medical device to the wall where the rope was attached and they were thrown into the East river to be used as a flotation device for our brave swimmer and the unfortunate dog. As the man draped himself and the dog over our makeshift life preserver, he seemed relieved that some kind of plan had been enacted to get them out of the water. Or perhaps his look of relief was in response to the siren heard in the distance.

FDNY had been called and arrived on the scene quickly. The firemen were able to reach down to grab the dog who was quickly handed to me. I began trying to warm the small animal with some sheets and blankets I had ready. Their plan to rescue the man involved sending a ladder over the wall for him to grab. This plan would be quickly modified because the man wasn’t able to hold on to the ladder.

As the firemen lowered their ladder down the other side of the wall, my partner and I noticed something purple drift away towards the middle of the river. While the others were distracted by what was admittedly a spectacular water rescue, Quinn and I watched with trepidation as our state-required medical device bobbed along the chop of the current. We were going to have some elaborate explaining to do.

Without being able to do anything about it at the moment, I rushed to the dog to the ambulance where I tried to warm him up near the heat vents. Shortly thereafter he was joined by his rescuer, who was brought into our vehicle in a large stokes basket, which ironically resembled a small boat, carried by the firemen.

stokes basket

One of the firemen took the dog and I got to work cutting off the man’s wet clothing. Even my hands were becoming red and losing grip strength from handling the cold pieces of cloth, I couldn’t imagine what that man was feeling. He was so hypothermic he had stopped shivering. The man’s lungs were clear, though, and I was grateful he hadn’t aspirated any of the river water.

The heat coming out of our vents seemed pathetically lukewarm. The fireman and I tried desperately to warm our patients en route to the ER. We used every available sheet and blanket and also utilized bandaging, looking for anything that was dry. Thankfully the hospital was nearby and we rushed our man into the ER where quite a few of the people working there expressed disbelief that someone would risk their life to rescue an animal.

“I know if the situation were reversed he would have tried to help me,” he told the naysayers through chattering teeth.

Sadly, the little dog did not survive.

My partner gave me a few minutes to cry my eyes out in the back of the ambulance before he brought up the important issue at hand: “We need to acquire another set of MAST pants.”

It was quite a dilemma. Even before their capabilities were debunked, MAST were rarely used. They weren’t something that we were going to easily find laying around in the discarded EMS equipment areas of the ER. At the stations, they were kept locked up because, we were told, they were very expensive. Given that we could be held financially liable for the improvised flotation device making its way down the East River, this was going to be our top priority, even though we still had to pick up that Super Important Box of Very Necessary Things at the other EMS station.

We returned to the station that had been our original destination and tried various, unscrupulous, ways to gain access to their well-fortified, spare equipment locker where gilded medical treasures were kept. Our covert acquisition op was a disastrous failure. We tried a similar distraction technique back at our own station which also crashed and burned. It appeared we were ill-suited for a life of thievery and deception.

We spent the rest of the day brainstorming ways we might redistribute the city’s MAST pant supply in our direction. Many creative ideas were explored but none ended up being feasible. Eventually we resorted to volunteering ourselves for every trauma job in our vicinity so we might pretend we used them in a situation where they were warranted. As long as we had paperwork that reflected a MAST application we would be in the clear.

Unfortunately, there was no trauma to be had that day. Anything that came over as remotely shock-inducing ended up being unfounded or severely downgraded. The day was getting shorter and we needed to resolve this by the end of our tour. We decided to pick up an auto accident in the hope that this could be our golden ticket toward a set of MAST pants. Manhattan is well known for its gridlock traffic so collisions in the borough weren’t likely to produce the kind of injuries our anti-shock device was designed for but we were getting desperate. It looked like we were going to have to fudge some paperwork.

It made me feel very guilty to do so, I had never lied on my call reports before, but I felt much worse about the idea of forking over a majority of my paycheck for a piece of equipment that was well on its way towards obsolescence.

I produced two call reports for the same, barely injured, patient. The correct one would be handed into the hospital, and the well-elaborated one would end up in our lieutenant’s “Review” box. It was tough keeping a straight face when we told our boss what we needed from the Fort Knox of EMS supplies but he gave us what we needed.

As we made our way back to our truck, with a great sigh of relief and a new set of MAST pants, we were assigned another call. A multi-service operation was underway and we were going to be a part of it. Another man was in the East River and all the emergency services were converging on him.

We were assigned to a pier in the area where PD and FD harbor boats were patrolling the water. Numerous sightings had been called in for a man drowning. According to the chatter on our radio, some of the units thought they knew where he was. They were looking for someone struggling near the base of one of the bridges. Then, soon after, we heard they had gotten closer but the man appeared to be long gone, as in dead and decomposing. This was not an uncommon call type for us, actually. It was sounding like our last job of the day was destined to send us on a trip to the morgue.

One of the boats finally did reach the ‘man’ and declared it unfounded over the radio. They did, however, tell us to standby. When the FDNY fireboat pulled up near us, one of the firemen held up their long hook. Attached to its end was an inflated pair of MAST pants that had been mistaken for the bloated body of a drowned man.

“Those look like the MAST pants we use!” my partner cheerfully yelled over to them with an incredulous inflection. “How do you think that happened?”

Young Thespians in Jail

February 6, 2021 /

A huge building had gone up near our area. It took up a whole city block but it was unremarkable and there were no signs advertising what it was used for. We weren’t all that curious and just continued to drive past it with occasional passing interest. For many years we were able to blissfully ignore it. But then, one day, our good fortune changed and we became very familiar with this large building, as we started going there all the time.

We found out that the building was a juvenile corrections facility, housing children age 16 and under who had committed the worst crimes and required a high level of security. They had an infirmary and a medical staff that had been getting by without calling for an ambulance for so long that their new about-face was somewhat perplexing.

Our first call there was for a 16-year-old boy having seizures. He had obviously never witnessed anyone having an actual seizure, either in person or on TV, or he could have provided us with a more believable performance. There are different kinds of seizures and some of them present differently, but our patient hadn’t mastered any of them and seemed to be making things up as he went along. With his floppy arm movements and erratic blinking, I had a hard time believing that the professional medical staff in the infirmary had bought into this pageantry. Perhaps they believed he was in need of hospitalization because the kid didn’t have a seizure history and may have been worried the seizures were a manifestation of a hidden brain tumor.

We gave the young man an IV, which was easy to do since he temporarily halted his flowing, dance-like arm motions so we could get it without accidentally sticking him elsewhere. My partner and I had spoken at length about how painful that would be, while we were preparing our IV set up. I guess he had been lucid long enough pick up on that bit of information. After we secured our IV, the patient resumed his feeble attempts at seizing, but would again, temporarily, stop each time we pushed medications through the IV.

We have had many people fake seizures for us, for various reasons. Sometimes it’s to be dramatic, for others it’s an attempt at getting some Valium. We didn’t know the motivations for our current patient, but if he wanted Valium he’d have to do a better job at convincing us.

We could still give him “the cocktail”, however, as we called it, for our “Altered Mental Status” protocol. At the time we carried Thiamine (vitamin B1) which was part of the cocktail triad, along with Dextrose (sugar) and Naloxone/Narcan (the drug that reverses the effects of opioids). It makes me sad that new paramedics will not have the ability to witness the placebo effect of the Thiamine wonder drug, since it has been taken out of our protocols currently. Thiamine was considered so benign that the board, who decide our protocols, found it to be an unnecessary expense. They had obviously never witnessed its miraculous efficacy.

If the kid envisioned a future on the stage, he could have learned something from us that day. Having had so many opportunities to practice our own acting skills, I’d like to think we did our routine convincingly. We used the standard script developed for these occasions. It’s one that all paramedics seem to have subconsciously downloaded into our psyches, possibly acquired subliminally when learning our protocols.

We start out with Dextrose and then deliver the Narcan, each time announcing to each other, with solemnity, that we hope the drugs work because the patient appears so seriously ill. We then kick up our level of resolve by moving to the standard, somber discussion about Thiamine.

“I guess we will have to give the Thiamine,” I announced with extreme concern.

“I know. I can’t believe the other drugs haven’t worked yet. We have no choice,” remarked my partner.

“But remember the last kid we gave it to? He’s a vegetable now, on permanent life support. I’m worried about its safety for teenagers. I don’t think they tested this enough on younger patients.”

“Yeah, but it’s still in protocol, at least until they settle the lawsuit. I’m not getting in trouble. Hand me the vial.”

“I don’t know, I really want no part of this,” I said with emphasis.

“It’s OK,” said my partner, nobly. “I’ll take complete responsibility.”

Miraculously, our 16-year-old made an instantaneous recovery in a matter of seconds. He sat up as if sleepy, wondering what was going on. What was happening? Did he have a seizure or something?

The dopey medical staff was also impressed, which had me seriously doubting the framed credentials hanging on the wall. We took him to the hospital to get “checked out”. We gave the ER staff a brief description of the psychedelic dancing he wanted to have interpreted as a seizure and they said they looked forward to the presentation.

A very short time after we dropped off the male, we were called back for a female. The juvenile center was certainly making up for lost time after all those years of handling the residents by themselves. Our second patient was 15-years-old and she was trying for the Academy Award in the Asthma category.

She had done a good job of convincing the inept staff that something asthma-like was going on. I wondered if they had ever dealt with a real asthma patient. The staff was in a panic, knocking things over and bumping into each other, trying to fill her nebulizer device. We, on the other hand, were extremely familiar with asthma and all of its manifestations. It made up a major percentage of our call volume. We gave her performance a decided thumbs down.

All of her ‘wheezing’ was caused by a concerted effort on her part to constrict her throat muscles. Her lungs were absolutely clear. Because she had to un-constrict her throat muscles to talk to us, her ‘asthma’ was temporarily abated when she answered our questions. I discreetly pointed out to one of the nurses how miraculous her recovery was. The nurse seemed to feel it was their quick action with the nebulizer that was responsible, despite a floor wet with spilled asthma medication. My faith in those accreditations on the wall continued to wane.

We took the asthma-girl to the same hospital as the seizure-boy because it was the closest. As per the policy of the detention facility, each trip to the hospital meant that two corrections officers were needed to accompany the patient. At the hospital, the two pairs of officers met up. They resented that their day had been interrupted by extraneous visits to the hospital, as it left them short-staffed at the facility. They too suspected the youngsters were faking their illnesses and they were furious.

About two days later the ‘asthma girl’ had another attack, despite a handful of new medications prescribed by the hospital. We had only gone to our newly-noticed juvenile facility three times at that point, but it was already growing tiresome.

When we wheeled her into the pediatric emergency room, lo and behold, the seizure boy was there again also! He had suffered another episode. It was a spectacular coincidence.

I noted the time on my watch and saw that the pair’s latest medical attacks had occurred at the same time of day as their previous episodes. Their amateurish performances were on a schedule.

I took one of the disgruntled correction officers aside and inquired about the relationship between the two and was shocked to discover that not only were they boyfriend and girlfriend, they had landed in the facility for committing the same crime together. I could have never predicted it.

The corrections officer had much dirt to spill for us. It turned out that the lovers were not just terrible actors, but terrible human beings as well. He, and later the other officers, told us that the young couple had attempted to kill the girl’s grandmother when she became an impediment to the young lover’s plans. She had not approved of her granddaughter’s dating choice and grounded her one weekend. The next day they put drain cleaner in her coffee. Despite the unusual smell and taste, the grandmother had ingested enough to cause severe burns to her esophagus and was in critical condition at a hospital. The pair had left the drain cleaner and the coffee cup containing the drain cleaner on the same counter, making it easy for the police to put two and two together. Their fingerprints were all over the bottle and the coffee cup and neither of them had called 911 when the grandmother began choking and writhing in pain. A neighbor happened to be walking past the apartment and heard the fall and the elderly woman’s attempts at screaming. The acting debut of the young criminal lovers, which consisted of pretending to be upset and shocked that grandma had drunk something so toxic, was not well received by the police or the neighbor.

Ever since their arrest, the two had been housed in separate areas of the same facility and there were never opportunities to come in contact with each other. It seemed that the only place the couple could be reunited was at the hospital, even if only for a short time. As a result, their “illnesses” became more and more chronic, wearing out the patience of the EMS community, and also the hospital staff. Many people we knew had taken at least one of them to the hospital at some point, and all of them, thankfully, mocked their poor interpretations of an asthma attack and a seizure.

Having witnessed the damage drain cleaners can do when ingested, I had zero empathy for the plight of the star-crossed lovers and their efforts to be together. Nor did any of the other EMTs and paramedics, who were getting a little tired of having to participate in their charade of a medical emergency. It was curious that those two were the only patients we were ever called for. How long would we all have to wait until they were sentenced and incarcerated elsewhere? We agreed that this thing needed to be nipped in the bud if we wanted to resume our ignorance of the large building on Pitkin Avenue.

We collectively decided that other hospitals should share in the poor acting abilities of the young would-be murderers. We were sure the corrections officers would be willing to assist us in the endeavor.

The next time we went there, it was for the female, who protested when we gave the name of our intended hospital destination. “Her doctors” were waiting for her at another hospital. Surprisingly, it was the same hospital her boyfriend had been transported to just an hour before. The corrections officers jumped right in and explained that their policy had been revamped to keep inmates separated outside the facility as well as inside.

During discussions of the new policy, our patient’s ‘asthma attack’ miraculously subsided and she decided that she no longer wanted to go. We had to take her anyway since she was not old enough to make the decision on her own and the facility required transportation. Since her reason for going had been thwarted she protested wildly over her desire to stay. But the concerned nurses at the infirmary noted how her disease had been progressing so badly as of late and they would not be comfortable with her staying there. The young actress was a victim of her own success.

Now that she was going against her will, she whined and complained about the waste of time it was for us to take her. Why was she going if she was OK now? She glared with hatred at me and the corrections officers when it was clear we weren’t going to turn the ambulance around, despite her best arguments.

After a short interval of quiet contemplation, she suddenly told us, and this was shocking, that she *didn’t* really* have* asthma! The whole thing had been a sham! Just to see her boyfriend! She had put one over on us, but good.

I couldn’t believe we had been tricked. I tried my best to convey how stupid we felt, that as medical professionals, we had not been able to tell. She smugly nodded, proud of the way she had manipulated us into believing her. She let us know that she was going to use the exact same skills to convince the jury that she shouldn’t go to prison. She admitted the case didn’t look good but she was sure no one would want to send a young girl to prison for killing someone with so little time left on the planet anyway. She was confident the acting skills she had honed on us could make a jury feel sorry for her, and probably her boyfriend too. After all, look at how many professionals had bought into her performance. She smiled a self-satisfied smile of superiority that I hoped would serve her well in prison when she got convicted.

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