Category: hhc nyc ems

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 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.

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?”

I got involved in EMS because my mom moved to Florida. Needing a job to support my sudden non-rent-free lifestyle, I answered an ad in the newspaper (how employment was often procured pre-internet). It offered free training with the promise of future employment in a desperate bid to get a huge influx of naive do-gooders to join the ranks of the city’s ambulance service, which at that time was run by NYC’s Health and Hospitals Corporation. I quickly took the bait. Having been a fan of the “Emergency” television series back when TVs only had 5 channels, I welcomed this opportunity to be like Johnny and Roy, intrepid pioneers in a new medical field. I looked forward to an exciting job “saving people” until I could get my life together and do something else.

I passed my 3rd grade level reading and math entrance exam, took a physical and joined the training academy shortly thereafter. Our education started with CPR. When I received my coveted provider card it was with the mindset that my newfound skills were the catalyst towards changing dismal outcomes for the better. To say I was excited was an understatement.

After my EMT graduation I was off to “the city”. (For those of us who live in the outer boroughs, that means Manhattan). For the benefit of us newbies they held a “roll call”, where the lieutenant addresses everyone at the shift and gives out the unit assignments. On the following days things went back to normal and we just showed up, got our keys and left. But on day one the lieutenant apologized to me saying he had no choice but to put me with the only person available. The EMT I was supposed to have been paired up with had called in sick and this man with the vacuous eyes and ill-fitting uniform was the only one they could put me with. “Any problems,” the lieutenant told me, “you call me up right away. Keep your eye on this guy. And don’t be afraid to snitch. I’m expecting a phone call.” Great.

I discovered I had been paired up with “a skell”. This is someone who is lazy and takes unnecessary shortcuts. (There was also a term “skell” for the patients which had a slightly different definition). The naive, idealistic me was nervous and scared. I had no idea what to expect from a terrible partner. This wasn’t what had been sold to me at the EMS Academy. I expected equally enthusiastic coworkers. We were ‘saving lives’. How could you not be 100% into this? Instead I wondered if I would I be fired on my first day. Why would they do this to me? But also, how bad could it be?

Our first call was assigned, a cardiac arrest. I was going to use my CPR card! I was going to ‘save a life’! Right out of the box. It was exactly how my new position had been described to me. I was going to a high priority call to help someone in need.

My partner, however, hadn’t had his coffee yet.

Prior to firing up the lights and sirens he stopped at a local deli and in the most nonchalant tone ever asked me if I wanted a cup of coffee. I was astounded. “No!” I said. “We have a job! We are going to an arrest! Seconds count! We need to go! Now!”

“Well I’m getting a cup of coffee.” he stated. After was seemed like hours he emerged, cup in hand, and off we went, finally. “I like to drive holding my cup,” he said, “that way no one thinks we’re using the siren to get coffee. I can show them I already have it.” He laughed and took a sip, with enough practiced skill that it didn’t spill despite the bumps and swerves of our emergency response.

My initial consternation with my partners lackadaisical attitude was cut short when we arrived at our destination and my idealism took an even bigger hit. Our call had taken us to Chinatown and into a rundown building where our patient was on the fourth floor of a walk-up. It was a dingy and depressing looking apartment with bunkbeds and cots in every room. There was nothing on the walls and the windows were covered with sheets duct-taped to the frame. The centerpiece of the kitchen was a dirty bathtub, which I would come to find out later was not uncommon for many apartments on the lower East side. The paramedics were already there, having not made a pitstop en route for caffeinated beverages. They were working on an older woman who was laying on the floor of this relatively small apartment inhabited by at least 20 other people. A young boy stood nearby with a look of panic and sadness and it caused me to become slightly unfocused. My partner directed me over to the BVM where I would be providing artificial ventilations. His cavalier attitude had been completely transformed as he spoke to me both professionally and with patience. He seemed empathetic towards the emotional reactions I was, apparently, doing a poor job of hiding. The little boy was crying. For me this was just one of many cardiac arrests to come, for him this was his whole life. Everything he had and the direction of his life were all on the line here. To make matters worse things did not seem to be improving for this woman. Cardiac arrest is a very, very difficult thing to reverse.

The paramedics who were administering the drugs and watching to monitor were also kind and seemed to have a great deal of respect for my partners skills and experience as they bantered back and forth. The whole scene in my memory seems very surreal looking back. So much was going on and yet it seemed to be moving in slow motion. There many people standing around, watching, making my first foray into real CPR a bit unnerving. Also, as this was my first cardiac arrest, my first call altogether, I was unfamiliar with how casually emergency medical providers do their jobs while holding mundane conversations in the midst of someone else’s tragedy. It was something that I would soon take part in myself. No one was dismissing the seriousness of situation or being unsympathetic towards the family, (or as it turned out, living companions who barely knew each other). It was just normal to make conversation at work. It was just that our workplace was someone’s home and our job involved a dying woman.

As I squeezed the BVM to push air into this woman’s lungs I couldn’t help but be fixated on the young boy watching intently with hope and tears. He didn’t speak English. No one in the apartment did. A translator was found in the building somewhere and even her ability was limited. After putting a few snipets of information together it was discovered that the woman was the only relative the young boy had in this country and it was questionable if there were any family left in China. No one else in the apartment knew the woman. It was a mutually beneficial living situation for everyone there to share space and meals but people came and went frequently and most of the residents barely spent more than a few hours at time at the apartment, usually just coming to sleep in between different employment situations. My thoughts were with child and wondering what would become of him should the woman not survive, a circumstance that grew more likely with each passing minute and eventually actualized. Would any of the others there take him under their wing? Would he get sent back to China? Did he want to go back to China? I would never find out but I think about it often, actually. We were both thrown into an unpleasant reality that day, made to realize that everything can change and not always for the better.