The career archive of a NYC paramedic

Month: March 2021

Bleeding Hearts

Almost immediately after receiving our job for an “unconscious in front of a deli”, another call went out to a different unit, alleging that a person with “severe abdominal pain” was on the same corner. Two more ambulances and a fire truck were dispatched to a “Cardiac Arrest” at an address with cross streets strongly implying that they too were headed towards the same intersection.

The EMS equivalent of the Cavalry converged upon that one corner, which had a large deli at its crossroads. A disheveled man was sitting outside on an overturned milk crate. He had a dirty beard and the clear flask of a well-known brand of vodka dangled, somewhat, out of his jacket pocket. Though he glanced at us when we arrived, he made no effort to flag us down. The man was very much awake and seemed to be comfortable. We all assumed he was probably the intended target of all these 911 calls; people often call for strangers who have no idea that someone thought they were in need of emergency care. But we made a good effort to check around and inside the store to make sure there wasn’t someone else, someone with a true emergency, in need of medical personnel.

The man became angry with our efforts to locate patients who might have matched the medical complaints we had been summoned for (seizing, unconscious, and/or in cardiac arrest) and finally announced that he had called 911, not just once, but several times, for himself. He berated our unprofessional-ism for not recognizing that his non-distressed demeanor and lack of effort in announcing himself obviously meant that he was the person in cardiac arrest/having a seizure/experiencing severe abdominal pains.

“I hadda call THREE times! Three! It took you guys almost FIVE minutes. What if this was an emergency?”

“So you’re admitting this isn’t an emergency needing an ambulance?” we asked.

He backtracked a little. “Well, it most certainly IS an emergency. But not the dying kind.”

We let the other crews, who were getting off duty shortly, know that we could probably handle this medical enigma on our own. They thanked us and wished us luck.

The man walked over to our ambulance carrying a large plastic shopping bag that he was very protective of. A diverse bouquet of pungent body odors wafted towards me as stepped into our vehicle.

“Your entire agency should be dissolved by the city. Waste ‘a money. They just need taxis. Free taxis for everyone. No one needs these big trucks.”

We pointed out how our service is designed for medical emergencies and that we are supposed to handle life-threatening conditions.

“For what? They can go to the hospital if they have a medical condition.”

It was no use explaining.

Once inside, the man immediately demanded that we take him to a hospital that was not the close one nearby. He was geared up for an argument but he got none. The hospital he wanted wasn’t unreasonable, although it meant I’d have to try to block the smell a little longer.

“Them nurses there are NASTY!” he told me, as he shook his head. “Ugly too. But that’s the hospital it’s gotta be.” He looked sad but determined, as if he had resigned himself to a task for which he’d be martyred for.

He refused to answer my routine questions about his name and birthday. He was ready for another argument, explaining how I wasn’t entitled to any of his personal information. He went on a long diatribe about privacy issues but I had already put “unknown/refused” on my paperwork. When I asked to take his vital signs he also refused, telling me he’d “sign the paper”, meaning he understood how this all worked. He flipped my paperwork over to the correct section and signed the name he told me I wasn’t entitled to know.

When I asked him about his reasons for going to the hospital he seemed comfortable revealing some of his medical history. He told me he had high blood pressure but he wasn’t taking his medicine because it made him “less of a man”. He said he was “healthy as a horse, and hung like one too”. A big wink, in my direction, accompanied that information.

I also received a very long list of every injury that had ever befallen him. He had TMJ from being slapped by his ‘ex’, he lost a tooth by biting into a biscuit from a large fast-food chain he was currently under litigation with, and he fell down some stairs when he was drunk, which injured his hip. He ended his story by telling me that his last MRI showed he had bulging discs.

I just wanted something halfway relevant to give to the triage nurse. “Am I telling the ER that you have back pain?” I asked.

“No, Moron, I’m telling you I ALWAYS have back pain,” he shook his head again. The torture I forced him to endure…

He called me several other names and titles that illustrated his frustration with our procedures. I was a “bureaucrat” for requesting an exam and interviews instead of just taking him to the hospital where he “needed to be right away”. I was also a “lazy union drone”, an “idiot”, and my favorite, “a feminazi” because I was doing a “man’s job”. He told me I had foolishly “bought into that whole women’s rights nightmare” because I was a “man-hater”.

He went on to complain about my partner as well, for not refusing to work with a woman (“it takes the masculinity away from all of us”). He told us how much he hated the entire 911 system, the city itself, the shelter system, and he went on and on about our previous mayor, who he believed was still “running the show”. He hated “bleeding hearts” and the socialists who were destroying our city. He also complained about the city services he wanted but did not exist, like free taxis. He complained about the amount of money he received from his federal Supplementary Security Income, telling us a monthly total that was more than my partner and I took home with our regular salaries.

“You can’t live on that in this city!” he screamed.

I know man, I know…

One person, in particular, he decided to vent his frustrations about, was the woman who had purchased food for him from the deli. She was another “MORON” for not understanding that he’d been asking for money for food, not actual food.

“Maybe I wanna make my own choices,” he said. Then he referred to her with a really bad slur for a female. “She was like ‘I don’t want my money being used for alcohol. My religion is against alcohol. I don’t want to support any bad health habits…’ blah blah blah. Fucking bleeding heart…Those people are the ones destroying everything.”

As he was berating the woman who bought him the contents of his bag, he took everything out of it to rearrange the items. She had given him a large bottle of water, a big can of iced tea, an assortment of baked goods, a package of socks, a package of t-shirts, tissues, a small bottle of pain relievers, a few bagged snack items, cold cuts, and two large Styrofoam containers of food. She certainly was an evil monster.

“This asshole didn’t even have my food heated,” he told me with all seriousness. “You know, they let you reheat the food from the food counter in there. She must have known, there’s a sign right there on the sneeze-guard. I would have gone in to heat it myself but I’m banned from the store. I spit in a few of their food trays once. I didn’t like their choices and I had a right to express myself when they didn’t take my concerns seriously. Bunch-a bleeding hearts…” It seemed to be his favorite insult.

“Cold food. Can you believe it?”

As someone who ate between calls and on the run, sadly, I was all too familiar with room temperature sustenance.

We had just reached the ER when he was finished fixing the bag up the way he wanted it, with the food containers near the top. He promptly undid his seat-belt, slid over to the back doors, and expertly opened the back lock. Then he made his way over to the hospital entrance without waiting for either my partner or myself. Now that he had reached his intended destination, he no longer needed to have anything to do with us.

He punched the ‘secret’ code into the panel that opened the electronic doors and proceeded to walk past the triage area. A security guard followed him, telling him he needed to wait for the nurse.

“I don’t need a nurse,” he told him. “I know where I’m going.”

The security guard didn’t seem to know what to make of that but decided to just let him continue rather than pursue him any further. Our patient walked right over to a small, closet-sized room that the nurses used as a kind of lounge. It contained a locked bathroom, two chairs, and there was a microwave on a counter.

He opened the door to the microwave, put in the first of his two containers, and pressed the button for “potato”. The man had concluded his ultimate errand.

The entire ER came to a standstill as every nurse in the vicinity noted what was happening. Each face expressed disbelief and anger. They looked around at each other to see who was going to act first. Oh boy, were they outraged!

The nurse who was supposed to triage me marched right over to the small room with resolute determination. She was fuming. “Sir, this room is off-limits to patients.”

“I’m not a patient,” he told her matter-of-factly. “I’m just here to heat my food.”

“Sir! This is a restricted area. You need to leave! You can’t just come in and start heating your potato.”

“It’s not just for potatoes. I’ve got pork that needs to be heated to a specific temperature or I might get sick. There’s also some mac and cheese, some green beans… ‘Potato’ is the most efficient setting on a microwave. You don’t even know how to use this thing, do you?”

“This microwave does not belong to you. You can’t use it. You don’t belong in here.”

“Sure I can. My taxes paid for this microwave.”

“Sir, you don’t understand. You need to leave and get back over to triage,” she said as she pointed to the triage desk. You could tell that her patience had reached its limits.

“No, you don’t understand. This is the whole reason I came here, to use the microwave. I’m not sick. And if I were, I sure as hell wouldn’t come here.” He looked around the ER. “This place SUCKS!” He seemed surprised at everyone’s reaction as if he’d said something perfectly reasonable and they were all getting angry for nothing.

“Security! Security!” the nurse started yelling.

At the same time, another disheveled looking man, who was on a stretcher in the hall took a moment to defend the hospital. “Ahhhh, it’s not so bad…”

A different patient decided to tell our guy, “you don’t even pay taxes.”

“Yes I do,” he answered. “I pay taxes every single day on alcohol. Do you know how much the liquor tax is in this state? It’s robbery. I coulda bought 10 microwaves by now with all the cash I’ve given to this bleeding heart state.” Bleeding heart was, by far, his favorite term.

The security guard, now forced to contend with the disruption he might have intercepted earlier, simply parroted what the nurse was already saying. “Sir, you have to leave…”

“Hold your pie-hole,” said our patient as he dipped his dirty finger into different sections of his Styrofoam container. “I’ll be out of your hair in just three more minutes. Your appliance needs servicing, by the way. For 1000 watts, ‘potato’ should have done the trick by now.”

The bald officer decided to get to the root of the problem. Looking around, he asked, “Who brought this man here?”

I raised my hand.

“What’s wrong with him?” he asked me.

“I don’t know,” I replied honestly. “He refused to provide any information.”

“What? Are you all stupid?” announced the guy I had brought in. “I CAME HERE TO USE THE MICROWAVE.” He yelled each word slowly as if reprimanding a room full of misbehaving children who did not understand. Then, his mood switched over suddenly to humor us. “Now that I’m here, maybe I’ll lay down on one of these stretchers when I’m done. Probably have the ‘itis in a few minutes…” He laughed, seemingly oblivious to the unchanged demeanor of the crowd.

The nurse, who despite her constantly annoyed expressions was one of my favorites, became more of my hero when she decided to take control after giving a disgusted look to the security guard. She shoved past the foul-smelling man and took his food out of the microwave.

“The Jo-velle Deli on Louisiana and DeKalb. Excellent buffet. Smells great, right?” Our guy gave high marks to the establishment that banned him.

The nurse took the food and started marching with it, towards the electronic doors. Our man followed her, although he seemed to be confused about what was going on. When she got outside, the Styrofoam container was semi-tossed onto a broken stretcher in the ambulance receiving bay and she wordlessly went back inside.

After she signed our paper, which was accompanied by a “look”, we went back outside to find our man eating the food that terrible woman had purchased for him. He looked up at us and smiled, pointing to his meal.

As we got in our truck, he yelled at us to wait for him. He would be needing to microwave his other Styrofoam container soon and there was only one other hospital we could take him to now that he was banned from using the microwave at this one.

Fighting Demons

It was easy to see that the building had once housed a storage business. It was square and utilitarian and it said “Horizon Storage” on one of the walls. The only thing that let you know that it now served as a house of worship was a big wooden sign over the lettering of the previous owner. “Vision of the Awakened Triumph Church” it proclaimed. “The Rev. A. Thompson, PhD, Pastor”.

We walked into a large room where a congregation wearing their Sunday best had their attention fixated on several men, surrounding another man, who was wearing a burgundy suit. They were in a circle around him, each with an arm touching him, and they appeared to be praying. When the congregation saw us their serious faces of concern turned into smiling faces of relief. “Hallelujah, and welcome!” they greeted us. I was instantly smitten by their friendliness and hospitality.

We went over to the man they were praying over and the other men moved away. The man dressed in burgundy instructed the others to continue with the service. “It’s important,” he told them.

Although we were in the back of the room, it was difficult to hear the patient and we suggested going out to the ambulance. But the man insisted that he didn’t want to go to the hospital. He did not even want to be checked out in it. He said it was important that he stay. So we did the best we could to evaluate him where we were.

Brother Henry was a little disheveled. He had some dust on a sleeve and a few bruises on his hands. While he was telling us about a few more injuries, a nearby woman yelled at him to “Tell them how you went out! They don’t care about a couple of bruises. Tell them how you ended up on the floor unconscious!” She told us that was why we were called. “We wouldn’t have called if it were just a few bruises,” she told us, as if no one would call for such a frivolous reason. How I wished…

Brother Henry looked a little embarrassed but he shook his head and said with his voice rising, “I may have fallen down but I was never knocked out!”

We asked him if he was dizzy now or before the incident and he said no. Another woman said he had “problems with sugar” but Brother Henry assured us that he did not have diabetes. All of this, coupled with our initial difficulty hearing, steered us towards a medical path for the origins of what happened. We hooked him up to our monitor and evaluated his vital signs several times while continuing to ask questions. At one point the entire congregation broke out into song and it was modified to be about us, being the instruments of the Lord. They also prayed for us several times. It was incredibly nice and wonderful.

We could find nothing of concern with our exam but we still recommended Brother Henry seek additional evaluation at the hospital because he may have passed out. Brother Henry interrupted, “Passed out? I never passed out.” We explained that we didn’t know what had caused the incident and he shook his head and said very emphatically “Sure I do! I told you when you got here. I was fighting a demon.”

This took us both aback somewhat as we tried to figure out what metaphorical context he was referring to. Was he an addict? What other ‘demons’ are there? It turned out, however, that he meant a literal demon, the kind that involved being a mythical beast intent on evil. And everyone in the congregation agreed.

Brother Henry explained that he had given a particularly powerful invocation which had conjured up an entity that he described as half man, half beast. Everyone in the room nodded in solemn agreement. A small puff of smoke had appeared, through which the demon had entered, laughing. He said his head was large and somewhat resembled a buffalo. “With wide horns!” said one lady. “That’s how he was gored!”

Brother Henry lifted up his shirt to reveal a red circular bruise. There were fresh scratch marks on the floor, which, we were told, were made by the cloven hooves of their common enemy. Henry showed us his damaged pant leg where underneath was a long red scratch and more bruising. He said the demon had kicked him. His description had the demon towering over all of them at around 7 feet. Others volunteered that he had long fingernails painted red and glowing yellow teeth. Not one of the 30-40 people in the room disputed this description or version of events.

“Where is the demon now?” we asked.

The demon had disappeared, they said, when it saw that he was no match for a powerful man of God. Brother Henry was a strong elder, they explained, and he was backed up by people of unshakeable faith. Vision of the Awakened Triumph: 1, Demon: 0.

My partner and I just looked at each other for a minute. The paperwork was going to be tricky.

I quickly opened my call report paper and flipped it to the side where the RMA (refusal of medical attention) section was and Brother Henry readily signed in the appropriate areas. The Rev. A Thompson, PhD, witnessed it himself. It was either have him sign the RMA or haul all 40 of them to the psych ward for evaluation.

As we left, the friendly people of the church all wished us well and said they would pray for us. We could use it.

“What just happened in there?” my partner asked. I shook my head. I thought about the bruises and the rips in his clothing, the seriousness of everyone in the congregation. What could have caused all those injuries? What had they all witnessed? Some sort of mass delusion? Maybe there was a reasonable explanation that they interpreted as a demon? Who could say? We weren’t there. I just hoped our paperwork wouldn’t be flagged by the reviewers at the Office of Medical Affairs.

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