Category: paramedic (Page 2 of 3)

When you graduate from paramedic school, the protocols that were in place for your initial certifying exam will be the ones you remember forever. So much depended on knowing those procedures and the orders in them, the drugs, the dosages, they all stay ingrained in your memory. You might develop dementia 50 years from now and forget addresses and birthdays but you’ll still remember every sedation drug and dosage from your graduation date, at least I will.

But the world of medicine is an ever changing landscape of innovation. New drugs come on the market replacing old ones, philosophies change regarding telemetry contact, and every once in a while considerations are given towards changing methodologies that are problematic. Thankfully the ones involving patients who are actively seizing were included in that. Giving medications though an IV to people who are violently flailing their arms about has always been near impossible but it was the only available way we were able to manage it. We old people like to pat ourselves on the back for dealing with these situations professionally, without all the fancy changes that have made things easier but the truth is, we cursed the protocol committee MD’s that seemed to encourage our high rate of getting stuck with random needles. Another issue was that the main drug of choice is a narcotic and all narcotics required physician pre-approval for administration back when I carried a drug pouch. This was causing delays during life-threatening events, so today they can be given as a standing order and the physician contact, still required, can be handled after the call.

At one point the regional MD’s approved an additional drug option for active seizures, one that could be administered through a needle to the shoulder. It didn’t require physician approval prior to giving it, either. The new drug was called Versed (Midazolam) and it came out with great fanfare. It could be used in other protocols but its much touted usage was for actively seizing individuals that you couldn’t obtain IV access on. When our Advanced Life Support Coordinator came to the stations to stock our narcotic lockers and drug pouches, he went through the new protocol changes with us and notification bulletins were xeroxed and hung up on walls everywhere. For some reason, no one made a notation in the little mini protocol books we all carried. Most of us probably trusted our awful memories that were locked onto the rules at our graduation dates.

Eventually more new changes came out. Other procedures and operational notifications got tacked up to the walls, covering up the old things tacked up on the walls. Given the constant influx of notifications over the fax machine the Versed notice was probably six pages deep when my partner and I were sent to that awful housing project.

It was a newly designed complex built by architects that hated paramedics and the handicapped. Stairs are no friend to either and they were all over the place. First you had to go down a set of steps to get to a courtyard and then after a walking a bit you went up another set of stairs to get to a lobby area. Then you had to go either left or right down an open air pathway and if you were lucky you just went up another set of stairs to get to the first row of apartments. Since we were never lucky, there was another long open pathway, like a balcony, to get to anther set of stairs and up to the second row of apartments. We did this carrying our 80 pounds of bulky equipment. We were worn out before we even rung the doorbell.

The door was opened by a teenager who told us his aunt had a seizure. He then left the apartment, leaving the door open, which we assumed meant he would be back. We went in to find the aunt, a large woman with an elaborate hair-do involving bobby-pinned curls, laying on a couch. She was awake but disoriented, which is common after a seizure. Usually the patient will come around without any intervention. We knew we would need assistance getting her out so we requested help and started evaluating her. We had just taken out the blood pressure cuff when we heard gunfire, very clearly thanks to the open door. The police must have been nearby because it wasn’t long before several of them started running past the opening. Two officers briefly stopped in to ask if we had seen anything but continued down the pathway when we said we hadn’t.

Then our patient started seizing. We automatically tried to get an IV line because that was our usual procedure and habits are sometimes hard to break. We heard more gunfire in a different direction but we were completely distracted by our inability to get a line on a flailing armed woman with poor vasculature. It probably would have been safer to finally close the door but we were pre-occupied. Finally one of us remembered our new wonder drug. We have Versed now! We can just give an injection! Problem solved. We took a vial out of the case.

“Do you remember how much to give?” my partner asked.

“No,” I said, embarrassed. “Do you?”

“No.”

This was great. The answer to our problem was here but we had no idea how much to give, rendering it useless. There had recently been somewhat of a scandal about Versed dosing. Someone in the Bronx had given the intramuscular injection dose through an IV. Other details were hazy of course, as is all information that just comes through, passed down from from person to person. The IV dose was smaller, no doubt. But how much smaller? Did anyone remember the milligram amounts? No, of course not.

Thankfully, we lived an age of technological advancement. We could use our brick-like newfangled “cell phones” to get more information. Sadly, there was no internet access. Texting was still being done through telephone numerical keys with digits appearing on a tiny grey screen. The best we could hope for was to call someone that might know. I had lots of paramedic coworkers listed in my directory. My partner had more. Someone would surely have the answer.

We continued with the IV while phone calls were made. Many calls went unanswered and the ones that did had no answer for us. At least 12 state certified paramedics had been reached and none of them knew for certain or had access to a location where they could shuffle through the bulletins on the wall to look it up. Two milligrams was the most popular guess. Some said 5 mg, others said 1 mg. Only one person emphatically told us it was 10 mg, the correct answer, but he was someone neither I nor the person he was working with, who had been my phone contact, trusted to know the actual dosage, given his unorthodox interpretations of other protocols and procedures. “Are you guys at that fire?” they asked us, during our telephone poll. Why would they ask us if we were at a fire? No, silly we are on a status elepticus, obviously.

Thankfully we were finally able to get an IV and called telemetry to get permission to give the other drug. But we now had to figure out how to get out of there. We had no assistance yet. Our patient was really heavy and had the possibility of seizing again making carrying her down all those stairs incredibly dangerous. We asked for assistance again. Then we heard the fire call come over asking for additional units at the same time that we glanced at our open door and saw large flames and smoke coming from another complex nearby. It was like we were in an apocalyptic vortex of 911.

Everyone was obviously being dispatched to all the other ‘exciting’ things going on nearby. After waiting a considerable time for help that wasn’t coming we decided to try this on our own. She was really beyond the weight limit I felt comfortable carrying but I thought I could probably do it. If it was too much we would stop on the next landing and wait there. As we walked over to the stairs we saw some of the cops dealing with the shooting. Normally helpful, they quickly disappeared, fake talking into their radios. We also ran into some firemen who were checking out the complex for a possible second fire, which was really just a bad address for their real fire, given the similarities between the two complexes. But they too disappeared. We were on our own.

We went down the stairs very slowly, hugging the side of one wall for support. Then we went back for our equipment and walked over to the next set of stairs. When we reached those stairs we saw the teen who had opened the door. “What happened to her?” he asked, as by now most of her bobby pins had become undone and her hair was an unruly mop of curls.

He briefly tried to communicate with his aunt. We asked if he would help us out by carrying some of our stuff. He shrugged as if it were no big deal and enlisted the help of a friend who was standing with him. They picked up the drug bag and the monitor. Then they quickly put them down.

“This shit is mad heavy! I ain’t breaking my back down those stairs.” Despite more gunfire in one direction and an active fire in the other, the two boys took off running. Getting overcome by smoke and possibly getting shot were better alternatives to carrying our heavy equipment. It was a sentiment I fully understood and sympathized with.

It took us about a half hour to get to our vehicle, going through the maze of stairwells, rolling our patient over uneven pavement. And at one point we had to stop and give more medicine when the patient started seizing again. Thankfully, we had made our way down most of the steps when it started. When we got to our ambulance we were surrounded by police cars, but no officers. Down the street fire trucks blocked their way out and they had gone to clear the path. It would be another short wait before we could be on our way. Our patient had chosen a very inconvenient time to start seizing.

As long as I live, I will never forgot the dosage of Versed, unless of course, they change the dosing. Memorizing something by associating them to specific events is one of the most effective ways to retain information. Recalling how much Versed to give and everything else associated with sedation and the status ep protocol brings back very vivid memories of feeling all alone during an urban mountain trek, gunfire, smoke, flames and flying bobby pins.

Update: A recent protocol change has been implemented to take place two months after this story was written. It will have the dose changed completely to 5 mg.

It was a warm Saturday in July and crowds of revelers were everywhere in the newly gentrified streets of Bushwick. Both the older dance clubs and the newer bars had crowds of young people congregating around them. Not a single seat was empty in the outdoor seating areas of the new trendy bistros that had opened up. Friends walking and talking greeted each other with loud, celebratory platitudes as if reconnecting after long periods of time apart. Traffic was at a crawl as their passengers took it all in on the way to their destinations.

We had no where to go and my partner was enjoying the plentiful eye candy of scantily dressed women as we drove around. I was focused on women who had put obvious time and effort into the way they looked walking hand in hand with men who were wearing the same stained t-shirt and jeans that they had probably rolled out of bed in. My partner and I would point out people that matched our interest despite knowing the other was only truly looking at our own particular fixation. There was much to watch and see, while we made our way down the long blocks of eateries and bars, appreciating the lives of people who didn’t have to work on weekends, or at 1 am.

We eventually found our way onto a long avenue of popular social activity. We trailed behind a souped up car whose two male occupants had decided to provide commentary to every woman walking nearby.

“Yo, Mami! Let me put a baby in you!”

We figured out early on that offers of semen denoted rare approval while most of their loud yelling was reserved for those they were unwilling to reproduce with in their current state. The unasked for critques were exclusively devoted to women. The men wearing stained T-shirts and sporting unruly beards would have to seek unbiased assessment elsewhere.

“Is that a bird’s nest? Your hair looks like a bird’s nest. I’m telling you that I don’t like your hair.”

“It’s a shame all of that thickness is around your belly and not your ass where you need it.”

“That face is mad ugly but it’s ok, girl, I can’t still bang you from behind and I won’t have to look at it.”

With all this charm and personality it was hard to imagine these two men were single and their car wasn’t being swarmed with multitudes of attractive women begging for their attention.

Eventually they took advantage of our tailgating ambulance by incorporating it into the statements directed at unsatisfactory women.

“Even the medics can’t fix what trauma happened to your face.”

“Maybe the ambulance can fix what that ugly stick did. I doubt it, though.

We felt it was important to follow them proactively since we felt it likely that one of them was going to get punched in the face eventually. I at least hoped that one of them would get punched in the face. It might even be helpful from a medical perspective if we were nearby for that..

Much of the crowd were speechless, regarding the comments with shocked looks of outrage. Some of the recipients of the harsh critiquing made hand gestures or shouted back expletives, which made the motorists howl with laughter. Here and there, individuals smirked or outright laughed. The two men in the car seemed to take great enjoyment from their audience.

There was a steady stream of yelling until another woman caught their attention. She was by herself with a serious expression on her face and seemed to be determined to reach her destination. The men became laser focused on this one woman who failed to inspire any sexual desirability in either of them. The loudmouth in the passenger seat decided to let her know why.

“Holy cow, girl! That outfit may have been cool 30 pounds ago but now you gotta put that back in the closet until the Slim Fast kicks in!”

She didn’t even glance in his direction and just kept walking.

“Hey girl, I like my women thick but you really pushing the envelope!” Shockingly, she didn’t seem to be too interested in being one of his women and just kept going in the same purposeful way of walking that she always had.

They continued yelling stupid things at her. Everyone was looking in her direction and waiting to see what she did. But she did nothing, just kept walking. Some other women were also walking nearby but the two men decided to devote their efforts on the one who ignored them.

She made it to a corner where a food cart had been set up. She stopped there and appeared to order something. The car in front of us paused at the green light there and used the opportunity to harass the woman further for getting something to eat.

“Man, you just can’t help yourself, right? No man wants you so you eat, and then no man wants you because you eat so much. That’s your problem.”

They laughed and laughed ignoring the honking of horns and the toot of our siren.

She received her order very quickly and emerged from behind the food cart with a huge oversized plastic plate piled high with food. She also had a large paper cup with a cover loosely placed on top. In the beam of the streetlight I could see the steam coming off whatever was on that plate.

The passenger in the car made some snarky comment about the super-sized order and how her clothes wouldn’t be able to handle any extra expansion.

What followed was a spectacle worthy of media broadcast on the level of the moon landing. I think I join every other person in the vicinity who was witness to it in remembering all the details about that time and date, what we were wearing, our exact location, and who we were with.

It happened relatively quickly. Walking purposefully over to wide open window of the passenger side, the woman threw the plate and everything on it, directly onto the vocal man in the passenger seat. Up until the moment the food was airborne the man had maintained a stream of demeaning commentary. Perhaps he was distracted, thinking of more insults to hurl before he could figure out what was happening. But instead, she had turned the tables on hurling things. She also thrust the contents of the large cup at the driver, tossing the empty container onto the hood of the car, where leftover contents oozed and began to solidify, thanks to the heat of the engine. Then she simply turned and walked away. The woman’s face never once deviated from the purposeful, serious expression she had started out with. My hero of the day disappeared into the crowd of awestruck pedestrians, vanishing forever.

It had been done with such purpose, as if evening the score with misogynists had been her intention all along. It was unlikely given the randomness of those two men out at that particular time but I’d like to believe the universe had a plan that day. My heart beamed in admiration for this wonderful, anonymous woman who had bested these crude and nasty men.

I cheered something out my window that I hoped the woman would hear and I started clapping. I was joined in my applause by a few other women on the block but mostly everyone else just stood around stunned, but also smiling. I was so proud of this courageous woman who had returned the unfavorable feedback the men had been dishing out. It was a beautiful moment of well-deserved vengeance.

Very soon public attention was redirected at the men covered in hot ethnic street foot. Fingers were pointed and loud laughter could be heard from far distances.

The passenger door of the car opened and I watched as food rolled down the man’s chest and lap and onto the street as he got out and stood up. The tossed components still emanated with fresh-from-the-grill steam.

The driver was even more infuriated. He got out much quicker, looking at his chest and flicking off whatever had adhered to his white linen shirt as if it were poison. He removed the cup from his car and tried to wipe away the congealing food before thinking better of doing so with his finger.

The passenger looked directly at me and yelled “Did you see that? You saw what happened right? Look at me!” He called the woman a rude expletive, considered by many to be gasp-worthy, and rather than try to find and confront the woman who had made him the object of ridicule and mirth, he marched over to me.

The astonished man presented me with his right arm which was covered in a thick, brownish red sauce with little pieces of rice and lettuce still stuck here and there. The combination smell of the food and a very powerful men’s cologne wafted into the cab of our vehicle and made me a little nauseous, but also a little hungry.

“Look! Look! I’m burned!” he told me.

His arm was slightly red but it was difficult to tell underneath the generous helping of an unknown culinary specialty. The brown/red sauce was on his face and chest. His shirt, formerly, mostly white and made of linen, was covered in spackled colors of Asian food. There were long noodles stuck along the low V created by the few buttons on his club-wear that were closed. His particularly long chest hairs made an ideal trap for the smaller sized ingredients to adhere to. I wondered what kind of dish had both rice and noodles. It also contained a generous helping of an unusually smelly chili-type soupy sauce. The noodles alone quickly had me craving carbs and I made a mental note that I would have some before the shift was finished. But for now I had an irate man demanding something be done for the injury underneath his spilled entrée.

We went to the back of our ambulance where I doused the man with some of our water. After his face and arms were wiped down there didn’t appear to be any significant injury but the man insisted that he had been scarred. He searched his skin for evidence that his flesh was not peeling away.

His friend came by and remarked that he thought the food that was flung at him had been chili, but it smelled different. He was angry that the car he kept impeccably clean was now covered in unknown food from what he presumed was an unsanitary, unregulated cart. He began musing about how soon he could get his vehicle detailed and wondered if the smell could ever be fully eradicated.

His friend was outraged. “I’m burned and all you think of is that car. I could be scarred for life. Disfigured, even.”

“That’s really awful,” I sympathized. “You know how scars affect your attractiveness. Big, big turn off for women. Almost nothing worse. What will all the ladies say behind your back?”

The man considered my sarcasm with a serious aura of disappointment, and possibly nervousness. He continued to mutter curse words about the devil-woman who was now the bane of his existence. Despite his protestations the man did not seem to have any kind of burn. But he insisted on being taken to a burn center for evaluation. We didn’t mind because the hospital he requested was surrounded by many still-open take-out places where we could find some Asian noodles of our own.

So we headed to the burn center where the mostly female staff there had many amusing things to say about his imperceptible burn and about their shared loved for Asian cuisine.

Earlier that day, George had been at his lawyer’s office finalizing his divorce from the “shrew who sucked the youth out of me”.

He had gotten married later in life, after what he remembers as a pretty successful bachelorhood. His family and friends, particularly the female family and friends he noted, had hounded him for most of his life to settle down. When he got older, he admitted that getting married sounded like the right thing to do. But George was a free spirit, and matrimony had too many restrictions. The dissolution of his unhappy marriage had been a long time coming.

He decided to spend his first night of legal freedom by spending some of the money had hidden in a safe deposit box he acquired shortly after he was married.

He felt that his wife was far too vigilant about his spending, so when he had a little extra, he would hide it. Subconsciously, knowing that divorce was in the cards, he’d built up a small freedom fund.

Now that he was single again, single for good, he planned a long evening of good food, hard drinking, and some gambling-all things his wife had hated.

He also used a website his card-playing buddies had told him about to find a temporary lady friend.

At some point in the early hours of the next day he woke up to paramedics and the hotel manager looking down at him at his residency hotel. He was naked on the floor and handcuffed to a pipe attached to the baseboard heater. There were random specks of glitter on his oiled body and he smelled of alcohol and urine.

There was also a slight scent of seared flesh.

His shoulder and part of his upper arm had been leaning against the heater for so long that he had developed second-degree burns. The shoulder was also severely deformed by an obvious dislocation.

His ‘date’ had called 911 for someone having multiple seizures at the hotel. She had described him as an elderly 70 to 75-year-old man, although George was only 56.

She also robbed him, apparently, taking George’s watch, jewelry, and cash, even his lotto tickets. The hotel manager recalled seeing a “working girl” leave more than an hour before. He offered to go to his office to get a handcuff key that they kept for situations like this one.

“It happens more often than you can imagine,” he told us quietly with wide eyes and eyebrows raised. The manager also approved of our latex gloves, saying that housekeeping services were sporadic and not very consistent.

“It was a night to remember!” George told us triumphantly, when asked about what happened. The diamond in his gold front tooth sparkled as he gave us his big wide smile.

Unfortunately, though, he didn’t remember many of the details. But despite being handcuffed to a heater, robbed, burned, and experiencing what looked like a painful dislocation, George was in good spirits. He conceded that he probably did have a seizure since he was incontinent and his seizures usually coincided with nights of heavy drinking.

His blood pressure was also very high, and he told us he did suffer from hypertension. When asked what he took for it, he simply said “blood pressure pills.” He didn’t know what kind because his wife had always picked up his prescriptions from the pharmacy and when she did, she arranged them into multi-day containers with the days of the week listed on the sections.

He hadn’t taken any of his medications since he moved out, more than four months ago. He also didn’t know anything else about his medical history besides the seizures and high blood pressure.

“My wife was the one who kept dragging me to doctors and made me take take all those pills,” he said distastefully, as if it were yet another terrible thing his divorce lawyer had liberated him from.

I wondered how the ex wife was celebrating as I looked around the dismal room George was living in. The manager had told us the hotel had an assortment of leasing arrangements. “Some stay an hour, some stay a day, and other stay longer,” he told us.

Although George had a dresser, it looked like he hadn’t unpacked, as he appeared to be living out of two suitcases that were open and set up on stands. The queen-sized bed mattress was covered in a yellow, stained, zipped-up covering.

It was bare except for a disheveled sheet and two pillows. The walls were covered in a dark wood-like paneling and the floor was covered in a stained, green low pile carpet. George had a small refrigerator and a hot plate. On a small shelf he had a bottle of ketchup, a bottle of hot sauce, two boxes of Capt’n Crunch, and a loaf of white bread, the kind I thought they had stopped making after I left grammar school. On the nightstand he had a few bottles of liquor with various levels of liquid in them, several dirty glasses with cigarettes extinguished in them, and a dirty fork.

George seemed genuinely content, despite the current situation. Not once did he complain about the pain to his arm or shoulder or the IV we gave him in case he had another seizure. He expressed some intermittent discomfort when we splinted his shoulder and when we went over bumps on the way to the hospital but he assured us “it’s not your fault.” He was even sympathetic towards the woman who robbed him. “At least she called you guys,” he said. ” Who knows how long I would have been laying on that floor for if she hadn’t?”

We chose a burn center to go to because it was also a trauma hospital but it was a little bit of a longer ride. Along the way George told me about his happy outlook for the future and how he’d never get married again. I implored him to follow up this hospital visit by going to all the doctors his wife had previously dragged him to. I tried to appeal to his motivations by suggesting that he didn’t want to give his ex the satisfaction of seeing him in a wheelchair if he had a stroke. He considered it a salient point and I was hopeful. I also suggested that he get tested for STDs and he gave me a sly wink and a smile.

At the hospital the nurse asked George how he had damaged his arm. With a big smile that showed off the diamond on his front tooth he said, “By living the freestyle life of a single man!”

I learned how poor the range of our radios was the first time I got stuck in an elevator. We were only trapped for about 10 minutes or so but in those 10 minutes, I learned I had a crippling case of claustrophobia. Being trapped made that tiny little room feel like a coffin. The only scenarios I could imagine involved never getting out, as if we had gotten stuck because of an apocalyptic event that had also wiped out any possibility of rescue. But you don’t even need an apocalyptic event to be frantic. One woman in China died because she had gotten stuck in an elevator and no one had looked for her.

Not long after, I watched an old French movie called Elevator to the Gallows which has a malfunctioning elevator as a central theme. After these two experiences I decided to do some research on elevator mechanics, vowing to always carry the tools with me that could get me out of a broken elevator.

To my horror, I discovered that there is nothing I could bring that would be of any help. Not even that occasional hatch in the ceiling that they are so fond of showing in movies and television could be an option as it can’t be accessed from the inside (now you know too). You are completely at the mercy of your rescuers. This was terrifying to a newly self-diagnosed claustrophobe in a city of tall buildings.

Now that I’m a lieutenant, unless there’s a pressing need for me to hurry, I’m taking the stairs whenever possible. My crews know when I enter a lobby and they’re waiting for the lift that I’ll meet them upstairs. Many believe it has to do with the Fitbit on my wrist and my obsessive need to get my steps in, but the real reason is irrational fear, mostly. Especially now, since technology has greatly improved the capabilities of our radios and cellphones so that the conditions that led to most of my fears have been alleviated, although some still do exist.

Not long after I watched the French movie, I was on a call in a tall building. I had gone back downstairs to get some things from the ambulance. The patient was probably going to RMA [refuse medical assistance] and we wanted another EKG. We had needed inconsequential things, like more electrodes and another PCR (pre-hospital care report, which in those days was paper). There was nothing important involved that could have been used as a tool or a weapon. I was in the elevator by myself pushing the ‘close’ button when a man got in as the doors were closing.

He gave me a dirty look and said, “I saw you hit the close button on me.”

“I didn’t see you,” I said.

“I don’t believe you.” When he got in, despite all the available room, he chose a spot right next to me. I moved away.

He then started looking at me in a way that made me very uncomfortable. As he stared at me through his thick glasses I noticed he had a large red stain on his grey shirt that was hard not to look at questionably. He stared at me as if he had tasted something awful and was considering spitting it out. I looked ahead and hoped it wasn’t the blood from a previous victim on that shirt.

We shared an awkward silence until the elevator jumped slightly and then refused to move. Panic immediately set in. My new elevator companion gave me another look of disgust, as if I were to blame.

I tried very hard to pretend I wasn’t imagining that this loser was going to be the last person I would see before dying of starvation when no one came to get us.

I tried hitting the button for the floor we were on, but nothing happened. I hit a few other buttons on the wall (not all together, another tip I had learned). None of them did anything. The emergency button did, however, produce a short-lived alarm.

There’s supposed to be a phone in the elevator panel somewhere that you can use to summon help, but this one didn’t seem to have one. The man, I suppose it’s human nature, also tried hitting some of the buttons. When he tried the emergency button this time there was no alarm.

He gave out a big “oh that’s great” and looked at me as if my attempt had broken it. I tried calling someone, anyone, on my radio but there was no success. He stepped sideways to get closer to me. I stepped forward to get away.

He got directly in front of me, seriously invading my personal space. I could smell his awful breath. “I’ve got asthma,” said the man.

“Congratulations,” I replied, backing off.

“No really,” he said. “Right now. Look.”

He proceeded to hyperventilate. He was a little taller than me and overweight. He had brownish-blond hair in a strange kind of wave pattern all over his head. His thick glasses had wire frames and the little nose pieces were dirty enough for me to see, thanks to his incessant need to stand close.

“You’re hyperventilating,” I told him.

“No I’m not,” he said in a perfectly non-breathless sentence. “No, it’s asthma. Do something. Give me some of that stuff.” He gave me a look that said he meant business.

“I don’t have my bag,” I said, pointing out the obvious. “It’s upstairs.” He immediately stopped hyperventilating. The uncomfortable creepy vibe he gave off was setting off alarm bells with my already heightened fear instincts. I didn’t want him to think I was afraid and holding it together was maddening given how the stuck elevator situation was more than enough stress for me without having to worry about who I was trapped with.

He then moved slightly closer to me. I jumped away. “What the hell!” I yelled. “Stop it. You stay over there, and I’m going to stay over here.”

I took my radio and tried again. I switched channels and also tried using the point to point feature. I used every frequency. Nothing worked. I had a cell phone but the range in those days was also questionable in such a small space and I had no signal. But signals varied depending on carriers and I could see a phone sticking out of my neighbor’s pocket.

“Try your phone,” I asked.

“I don’t have one,” he snipped at me, using a very different voice. “You’re some real privileged bitch if you think everyone has a phone. Fuck you.” I was mortified.

“What’s that in your pocket?” I asked.

“My phone.”

I felt that I was starting to hyperventilate myself so I tried to concentrate on a fixed point on the wall. I tried to reassure myself that my partner upstairs wouldn’t leave me here, that he had probably already called the firemen who could arrive quickly and break open the door. People must be waiting in the lobby who would also call, I reasoned. Help must be on the way, right?

I just needed to keep my eye on the crazy person I had no way of getting away from. The realization that there was no possible way of escape was really setting in. I told myself that I was pretty strong. I could take him, I thought to myself. I knew the idea was a bit inaccurate. For some reason, crazy people, when they’re fighting you, possess an unfathomable amount of strength that has nothing to do with their size or conditioning. I had had a lot of experience in these matters.

I remembered a 16 year old girl on my first EMT rotation, who weighed possibly 95 pounds at most, who put three police officers and one of the EMTs I was riding with in the hospital with serious injuries.

I had all kinds of conversations with myself in my head.

This guy was taller than me. What would I do if he tried something? I had a rolled up piece of paper and some electrodes. Oh wait, I also had my pen, my beloved gel pen in my pocket. Could I use it as a stabbing instrument if he attacked me? It would probably break. It was plastic, cheap disposable plastic. Everything is made to break and be disposable, what a sign of our times. I wondered what he was capable of. What about that stain? Yes, what about the stain…Had he just returned from killing someone? No, you’re just imagining that. It’s more likely a food stain. A very large food stain. Because he’s a big doofus and he always spills things, probably. He gets stains on himself because he stands too close to people with food and it ends up on him when he invades their personal space. He invades everyone’s personal space, not just mine. Right?

Suddenly the man started screaming. He screamed the way a person does when they’re on a roller coaster or running from an ax murderer. But his screaming had a distinct feminine tone to it. It seemed like he was putting a weird effort into these dramatics. Was he mocking me? What kind of psychological games was this guy playing?

Then, he suddenly stopped and in the most casual way he turned to me, as if he had just thought of a great idea and said, “If I pick you up, you can get out through the hatch! All you’d have to do is climb the wires to the next floor and get help!” He stepped over to me a little.

“It’s not going to work,” I told him as I stepped away. “I watched this French movie once, about an elevator and…”

“You just don’t want to.” He cut short my movie synopsis and lead in about the futility of self rescue in an elevator.

“Well, yeah, that too. But still, it wouldn’t work. Plus there’s no hatch.” The idea of this guy picking me up made me cringe. He had better not try.

He looked up. “There has to be a hatch. Every elevator has a hatch to escape from.”

“No,” I told him. “Only in the movies.”

He looked at me in disgust again. Good. Stay away, creep. I checked my watch. Seven minutes had elapsed. Seven stupid minutes. My God, how long would I be trapped? I tried my radio. Nothing. Ugh. There has to be some way to get through. The creepy guy took out his phone.

“Oh,” I said snarkily. “Look at that. A phone. What a privileged life you lead.”

He ignored me as he punched some buttons. “Yeah,” he said loudly. “I’m stuck in an elevator with this mean, nasty paramedic girl. Yes, she’s a bad person. A real bad person. She won’t climb the wires to get us out of here. Real selfish. She doesn’t care. A real meany. Meany, meany, meany.” It was obvious to me he hadn’t talked to anyone. Not anyone human, anyway.

“Who’d you call? Your kindergarten teacher?”

He glared at me. “I was right though.”

“You are.” Hopefully he thought I was dangerous too. “Usually, I am very nice.” I let him know.

“Yeah, right. And I’m normal.” He really said that. At least we were both on the same page with that.

We stood awkwardly around for a few minutes when our stupid dance started again, where he invaded my personal space and I got it back.

“I think you should climb the wires and get help. It’s obvious no one is coming to save us.”

“Hold on, there. It’s only been a few minutes. And I don’t know how to explain this to you but there is no hatch. Look up. Where do you see a hatch?”

“There’s got to be a hatch. I’m sure the ceiling is like a panel that is covering it. Come on, I’d do it myself but I don’t think you can lift me. There has to be a hatch. There has to be a way out. What if there was a nuclear attack and all the rescuers were dead. How the hell would we get out?”

Yup. I had the same idea.

And then, as if our similar thought patterns had meshed and created an electrical field large enough to revive the elevator, we felt a few more bumps and it started moving again!

A massive sigh of relief fell over us as the doors opened to my floor. The man got out too, despite having pressed a button for a floor higher. I felt that he too would become a stair-walking enthusiast.

As he opened to the door to the fire exit he asked me, “What’s the name of that movie?”

“Elevator to the Gallows,” I told him.

“Thanks,” he said. “And I’m sorry. I’ve got claustrophobia.”

“No problem. So do I.”

“So that’s why you were so nasty. I understand.”

“Thanks,” I told him. “Sorry.”

I got back to the apartment where our job was, with my stupid, useless electrodes and my stupid, useless PCR. I walked through the door feeling a little drained, a little relieved. I wondered if my partner would be there. I figured he’d be in the lobby waiting for the firemen. I guess we could cancel them now. But he was there, nonchalantly sitting with the patient.

“What took you so long?” my partner asked. A few more minutes and I was going to go downstairs and get the stuff myself.”

Please note, the movie, Elevator to the Gallows provides no meaningful solutions for escaping a stuck elevator, at all. But it’s an interesting movie on it’s own.

Here are some links about being trapped in an elevator:

https://abcnews.go.com/GMA/man-trapped-elevator-41-hours/story?id=4693690

https://www.huffpost.com/entry/woman-dies-in-elevator-china_n_56dd2134e4b0ffe6f8e9d56c

https://www.nydailynews.com/life-style/stuck-elevator-article-1.2696361