The career archive of a NYC paramedic

Tag: EMS

The Long Distance Girlfriend Experience

The ads on late-night television imply that for about $5 a minute you can speak with an eager nymphomaniac clad in sexy lingerie and writhing about on the satin sheets of her king-size bed. “They’re definitely over 18!” many of the adverts proclaim. The callers probably assume the woman they’re sharing sexual secrets with is doing so from the private comfort of her own home. How romantic (or hardcore) would it be to hold an intimate conversation in a cubicle next to 30 other cubicles?

The phone sex industry exploded in the 1980s with the emergence of 1-900 phone lines. 1-900 phone numbers charged exorbitantly higher rates than regular phone numbers, usually by the minute, and seemed tailor-made for carnal interplay, or psychic readings. Despite the best efforts of puritan government agencies and the later development of technology that delivered porn to your phone, sex chat lines continue to endure to this day. There is a lucrative appeal, apparently, to engage in naughty talk with an anonymous stranger. It provides an outlet for men to engage in a soft-porn fantasy: the long-distance girlfriend experience.

One day I was shipped out to work with someone in downtown Brooklyn and I ended up having one of those “nymphomaniacs” as a patient. It was where my innocent eyes were opened to the elicit world of landline love.

We were sent to an office building in the business district. When the doors opened up on the 6th floor, it looked much like the typical office settings I assume most people work in, though there were some notable differences. The cubicles were larger than any of the cubicles I’d seen elsewhere and the dividers seemed to be covered in a thick soundproofing material. Large billboards near the ceiling, holding messages about bonuses and incentives, had images of shiny, red-painted lips talking into phone receivers held by hands that had shiny, red-painted fingernails.

None of the employees resembled the woman in the pictures hanging overhead. No one wore lip gloss and any manicures were subdued. The uniform of the day appeared to be sweatpants and unmatched leisurewear. There wasn’t a teddy to be found, though there were plenty of hiking boots and flannel shirts. Aside from the relaxed dress code, another thing that let us know we weren’t in the standard American workplace included the two large and very intimidating security guards at the entrance.

A friendly woman greeted us immediately and told us she’d take us to the patient. The woman wore a lanyard around her neck attached to two pieces of official-looking ID proclaiming her name to be “Bambi”, quotation marks included. A quick glance at the other lanyard IDs revealed that a name ending in “i” was likely a prerequisite for employment. We were surrounded by a number of Rikki’s, Tammi’s, Freddi’s, and Toni’s.

As we walked down the path towards the patient we listened in on snippets of raunchy phone interactions. The women vocally expressing their enthusiasm for deviant sex acts did so while filing their non-red nails, thumbing through magazines, and various other multi-tasks. One woman’s attention was intensely directed towards a birdhouse she was building out of popsicle sticks, while at the same time feigning believable interest in bondage. Her face lit up when we admired her handiwork as we walked by.

The whole time we were walking, we were followed by a young man, dressed in a suit and tie, holding something. When we reached our patient, whose lanyard gave her name as “Candi”, quotation marks included, the man propped a prosthetic leg against the wall of the cubicle. He gave a polite nod and left.

“My leg!” shouted “Candi” with delight. “Thank you so much!” She was a fairly large, middle-aged woman with a haircut that resembled a crew cut. It looked as if a tremendous effort was being expended to breathe.

“Bambi” told us that when “Candi” started complaining of difficulty breathing they moved her into a bigger cubicle that had a window, which they opened so she could get some air. “Bambi” proudly told us that “Candi” was their most consistent Gold Star employee and hoped we’d give her Gold Star treatment. Going by the billboards near the ceiling, it meant that she was receiving the highest bonuses.

My partner asked what we were both thinking, “What gets someone a ‘Gold Star’?”

“Call me and you’ll find out,” “Candi” said through labored breaths but with a wink and a sly smile.

“Candi” was sweaty and very pale. Our visual medical impression told us something serious was going on. We got to work quickly putting her on oxygen and assessing her vital signs. When we asked her about her medical history she dumped the contents of her large handbag onto the desk. She dug around through the pile that included her wallet, some keys, a lighter, a pack of cigarettes, a few candy wrappers, and a very large rubbery dildo, to hand us her medication bottles. They indicated she had hypertension, diabetes, high cholesterol, and a thyroid condition. She also told us she had renal failure and was under the care of a cardiologist. For someone who was only 45, she had an extensive medical history.

She opened up her flannel work-shirt so we could put on the little pasties for our monitor and we listened to her lungs, which were clear. When I mentioned this to our patient, whose other ID said her name was Mary Robles, she gave a somewhat resigned expression. “Then it’s my heart,” she said.

She pantomimed the cardiac monitor paddles from the days of old, imitating the recoil of being shocked by a jolt of electricity, as her thumbs pressed imaginary buttons. She’d obviously been through this before, apparently with machinery using 1970s technology. When I told her we used sticky pads now, not the old-school paddles, she nodded sadly, knowing as we all did, that the pads did not hold the same dramatic effect.

Our modern cardiac monitor indicated that her heart was beating erratically and very fast. At the time we didn’t carry any drugs that would fix it. As Mary/”Candi” understood, a dramatic jolt of electricity was the only thing we could do. But we did have some drugs that would help our patient with the pain of the procedure. We just had to call our MD to get approval.

“Bambi” waved over to the phone on the desk and told me I could use it to make the call. She went over to help “Candi” put her stuff back into her purse without telling me about the numerous assortment of buttons on the phone. It was hard to stifle a laugh as we watched her try to wrestle that dildo back into the overflowing purse. My partner turned his head as he attempted the easier job of starting an IV. Making the phone call turned out to be far more challenging.

For the youngsters who have never used a landline I’ve provided this video:

I had some difficulty figuring out how to get an outside line with their phone. I couldn’t find a button that produced a dial tone so I started randomly hitting each one. It seemed that each button I tried gave me access to the phone calls being made from the cubicles around me. Each call I inadvertently eavesdropped on was long past any foreplay discussion and some involved heavy moaning. It was rather eye-opening conversation and when “Bambi” noticed my reactions as I quickly hit other buttons, she stepped in to assist me.

Laughing, she explained that we were in a “Quality Control Cubicle” and a regular assignment at this office was listening in on phone calls. “If the customers only knew…” she said.

With her assistance I was able to get in touch with our telemetry doctor who gave us permission to use Valium to sedate Ms. Robles. He and I both expressed some concern over the procedure we were going to do, given the overall precarious health of the patient, but the MD admitted there was no other option. The patient, herself, wasn’t the least bit worried, however.

“Bring it on, I’m ready!” she said, loud enough for the MD to hear.

“Looks like everything will be fine,” he told me.

Cardioversion is a heart-stopping experience, quite literally for the patient, but also for paramedic caregivers as well. After you sedate the patient and charge up the machine, there’s usually a bit of apprehension before hitting the button that will deliver a few joules of electricity through the benign-looking pads we use now, instead of the familiar paddles seen on screens large and small. Interrupting the abnormal electrical activity going on in someone’s heart carries the risk of stopping it permanently. It has never happened for me yet, at least in someone who was sitting and talking to me, but there’s a first time for everything.

In the case of Mary Robles, sending those 100 joules of electricity to her heart did nothing but cause her to utter a loud, prolonged, moaning-type of yell, which fit in quite well with her current surroundings. I’m sure the soundproofing material of those cubicle walls did nothing to block the sound to her fellow moaners nearby. Except Mary/”Candi” wasn’t faking it, this time.

Her heart went right back to the very fast, erratic, and inefficient way it had been beating before. This meant we would be pushing that button again, this time with a slightly higher dose of electricity.

Our patient was unfazed. “Fire away!” she said after we shot her up with another round of Valium.

We were far more nervous than Ms. Robles when we pushed the button a second time. Once again, we delivered the jolt which brought forth another yelling type of moan. It was also followed with a relieved kind of “Whew!”

We all carefully watched the monitor with anticipation. Thankfully the jumbled electrical patterns organized themselves into a regular rhythm. Our patient knew what this meant even before we told her and she raised her arms and yelled a triumphant, “YES!”

She told us she felt much better and her vital signs reflected it as well. As she grabbed her prosthetic leg she told me that losing her leg made her better at her job. I gave a confused look and she just smiled. I still wonder what that meant.

As we headed to the hospital, she told me that many of the employees there were customers of hers. I asked her how she knew but she just gave me another wink and a smile.

Free Onion Rings

A large, unconscious man had wedged himself in the corner stall of the woman’s bathroom of a White Castles restaurant. He was barely breathing and a needle was still in his arm. He wasn’t rousable and we wanted to fix his respiratory effort sooner rather than later. The hope also was, that if we get could wake him up with Narcan, he would be in a better position to unwedge himself, or at least assist in the process. Narcan (naloxone) could reverse the effects of the heroin he had just shot himself up with. As the smaller partner, my larger partner had rationalized, it would be better if I was the one to try and maneuver the way in to provide the transformative drug.

In those days there was no aerosolized, nasal naloxone, as there is now, and the only way to administer it was through an IV or with an intramuscular injection. I went in, syringe in hand, to try and access his shoulder. I wrestled with his clothes to clear a path for my needle and did my best to create a sterile field. It was a cramped space and I was trying very hard not to touch anything I didn’t have to. I was ready to hit him with the naloxone when I was suddenly distracted by a commotion behind me. A woman had shoved her way into the bathroom and my partner was arguing with her.

“But I gotta GO!” she yelled angrily.

“You’re gonna have to wait. We’re busy in here.” he answered.

“Well, can’t she move over?” she pointed towards me. My legs were extended into the connecting stall, impeding her intended use.

“Are you kidding me?!” my partner yelled exasperatingly.

“Am I being asked to move?” I asked. “Because I’m not going to. Look, he should be out of here shortly, just give us a few minutes.”

“I don’t HAVE a few minutes! I got to GO!” she yelled. “That man isn’t even supposed to be in here. This is the ladies room. Why is this my problem?”

I went back to lining up my bullseye and my partner continued arguing with the woman. Eventually the manager stepped in and was able to lure the woman a few feet away, but only for a few minutes, with the promise of free onion rings. She stayed nearby however and watched what we were doing, the whole time bouncing around as if her bladder were to imminently explode.

We were able to get our patient awake and breathing. When he started to come around he became the object of the woman’s derision. The onion ring promise only applied to us, my partner and I. If she was going to leave the patient alone more items from the dollar menu would have to be thrown into her take out order.

“Didn’t you see the SIGN?” she yelled at him. “Ladies room? See the girl in the picture, she’s wearing a big wide dress.”

Our patient didn’t know what to say. He’d just been whipped back to reality against his will, a reality he’d tried to escape not so long ago.

“The men’s room is right next door,” she continued. “Was it too far of a walk?”

The man looked at me for assistance. I had none to offer in this situation.

“You junkies, always gotta use the ladies room,” she continued. I had to admit she had a point. I don’t remember giving naloxone to anyone passed out in the men’s room, though I probably did. There were so many fast food restaurants and so much naloxone being administered there, who could remember them all?

“There’s never a line in the men’s room,” she said to me, and again she was right. Whether at the airport, a concert, a rest stop, or a fast food restaurant there is always a line, while the men in our lives just waltz right in to their area and emerge while we’re still waiting. It a source of frustration for me too. I’ve never parlayed this into free food but I was going to see if there was a way sometime.

“Why they gotta use OUR room? They got like 20 urinals and 10 stalls and all we get is like, TWO. Anywhere you go, men get all these toilets and all these urinals and we get TWO. There’s something going on. The people who design these bathrooms hate women.”

We were getting into conspiracy-theory territory here. I encouraged our patient to get up and start moving.

I had to internally give some kudos to this woman. There was a good possibility, based on experience, that our patient would have directed some of his irritation at having his high eliminated on us. Her wrath at being inconvenienced had redirected his attitude around and he was very cooperative with us, even agreeing to go to the ER. Perhaps he was just trying to escape this woman. Hopefully he made a mental note to use the mens room next time he wanted to get high in a burger establishment. It’s unlikely he’d get an argument there.

“You know I’m right!” she continued yelling as we made our way out.

Overdoses in fast food restaurants are a dime a dozen but many other call types find their way into franchise eating establishments. Fried food lends itself to medical emergencies but usually the cause and effect isn’t so immediate.

Not very long after that we were called to a seizure in a different hamburger franchise. He had collapsed in front of the cashier and the fact that he was still seizing when we got there was very concerning. It was a true emergency.

But one hungry couple couldn’t wait for us to pack up and leave and went over to the register to order a meal. The woman behind the register was dumbfounded.

“I ain’t waiting on those long lines while you’re open,” the woman said. The cashier indicated that she wasn’t “open”. “Then what are you doing now? You ain’t EMS.” There was a certain logic to it, but we were EMS and she was most certainly in our way.

“We’re working here, you need to get out of our way,” my partner had a great tone that he used. It was a mixture of condescension and exasperation.

“I don’t think you understand how hungry I am. I got to eat. Now, or else you’ll be taking me when I pass out!” Apparently his tone wasn’t going to be enough in this situation. Maybe because of her persistence we really could understand how hungry she was. But we really didn’t care.

Our patient having the seizure was difficult to manage. With his constant movements picking him up to put on our stretcher was an arduous endeavor. We had quickly started an IV and were attempting to get medicine to stop the seizure. In those days it involved calling a doctor on the phone (these days there are standing orders for giving it).

I suggested she or her boyfriend, who had retreated, could help by holding one end of the stretcher to keep it from moving. “I don’t work for you,” she said. But then she reconsidered. “If I help them will you give me a free onion rings?” she asked the cashier. When the cashier agreed she also asked for two shakes and large fries. Her request was granted. It was almost enough to make you cry in laughter, if you weren’t already exhausted from trying to lift a heavy person having a grand mal seizure. The woman got on one side of the stretcher and held it. She congratulated herself for keeping our stretcher from rolling away and got her prize. “You should hire me!” she said.

Yes, because you’ve been so helpful.

As we rolled our stretcher away I could hear her arguing with the staff again. She said that her entire order should be free, because of the great assistance she had provided. She thought the chain restaurant would reward her with everything she wanted. She had risked her health, for heaven’s sake. They should be bending over backwards to make her feel special. Her picture should be on the wall and she didn’t even work there. For heavens sake, she had just saved the life of a man in their restaurant and they couldn’t give her a free meal?

And Somewhere Along the Way, She Was Shot

This is one of those “worst” jobs.

Trying to find the address the dispatcher sent us to had us searching a desolate, poorly illuminated street. Most of the industrial buildings appeared to have been abandoned but the presence of new gates and security cameras indicated some of them probably were not. It was difficult to locate a number on most of these buildings even using our fancy vehicular spotlight. We asked the dispatcher to verify the address and try the callback for a better location. Our “Unconscious” in bed person didn’t seem to live here, no one did. The area had at least ten more years to go before the first loft apartments would start gentrifying the neighborhood.

Finally a man appeared, seemingly out of nowhere. He was thin, about 50ish, and his stubble was mostly grey. He had become very annoyed by the 911 people calling back over and over again to ask about a location that he felt should have been obvious to find. We told him we would follow him.

He led us down a short alley to the padlocked side entrance of one of the buildings that was, actually, abandoned. There was no way we would have found this patient without a guide. The entire area seemed eerily bleak and unusually quiet. Yet despite our unease, we still followed the strange man for some reason.

The man showed us a large hole in the wall that had once been a window and pointed to where the patient was. We shined our two flashlights into the darkness. A large figure lay on what could hardly be considered a “bed”. It had possibly once been a mattress but now it had completely become one with whatever the floor was.

“Is this the only way in?” we asked. The man nodded. We looked at each other with a smile as we shined our flashlights around the entire space contained behind the ‘window’. Many rodents scattered. The area was filled with garbage, so much garbage. There were extra piles of garbage on top of the floor which was covered in garbage. We had more than a few safety concerns. We looked at the ceiling to see if it would hold for the duration of time we would possibly be in there for. It’s not like we know anything about building construction but I thought it would hold. There weren’t any other people around, except for the inconvenienced man and the individual on the other side of the room.

My partner nodded over to the person on the ‘mattress’. “What’s going on with that one over there?” he asked.

“I can’t wake her up!” he said. The man went on to explain that he had found the woman, who he was familiar with and called “Flo”, on what he called his bed. He wasn’t really sure what her real name was. They had had “relations” and then afterwards they shared some drugs and took a nap. Now he wanted her to leave. This was his hangout and she was only a visitor, in his telling of it. He tried rousing her but she never responded.

One after another, we athletically hopped up to sit on the open window ledge. We swung our legs around to the other side of the opening and shined our lights below us before hopping down. Every step we took was done carefully as we made our way over to the woman. The floor was littered with drug paraphernalia and the air smelled of death and every kind of rot imaginable.

The woman was completely naked. She was initially on her side and when we turned her over we discovered that she was pregnant. My partner and I exchanged the first of many knowing glances toward each other, glances that we could easily interpret despite the darkness of this filthy area.

Her pupils were pinpoint and her breathing was slow and irregular. “How much did she have?” I asked her companion.

The man had no idea. It turned out that when he said they had ‘shared’ drugs what he really meant was that he had shared her drugs with himself. Whatever she had taken, she had taken it before he found her. It became clear he had had “relations” with the woman while she was in this unconscious state. I was even more disgusted.

We asked him where her clothes were and he said he didn’t know. He had found her like that and taken it as an invitation. He had found a needle in her foot and without knowing what was in it, used what was left on himself. There was nothing unusual about any of this, in his world. He had no idea how long ago that was because, as he told us, he doesn’t wear a watch. He was just a free spirit.

We hit the woman with some naloxone (Narcan) and gave her oxygen in the hope it would reverse whatever chemicals she had shot into her foot. But even though her breathing got a little better it did nothing to change her unconscious status. We started ventilating her with our BVM (bag-valve-mask) and called for EMT back up to assist us.

“I’m not really into working her up in this hell hole,” my partner said to me. The man became somewhat confused and visibly insulted. What hell hole? This spacious warehouse loft that smells of death? Why, in a decade or so hipsters will be paying thousands of dollars for this place that he now lives in for free.

But we opened the drug bag to see what we could accomplish until the BLS got there to help us get her out. We needed multiple little pads of alcohol to swab her arms clean while searching for a vein to stick, which was a monumental endeavor since most of them had been destroyed from years of injecting chemicals into them with unsterilized needles. I’m going to pat ourselves on the back for the success in getting this difficult IV in the darkness, illuminated only by shaky flashlights that don’t have the LED capability they have now, in modern times.

My low lumens flashlight is the EMS version of I walked 5 miles to school in the snow.

While running the flashlight up and down her limbs in search of a usable vein we noted an injury to her upper left shoulder. It looked like a bullet hole. The man knew nothing about it and was as surprised as we were.

We heard the sirens of our back up and we sent the man out to show them how to find us. In the meantime we gave “Flo” more naloxone, to no avail. This certainly wasn’t just an overdose. Whatever she had taken had also been injected into the arm of our guide and it didn’t seem to be affecting him as profoundly, although she certainly could have taken significantly more.

As our EMTs made their way through the ‘window’ we yelled across the abandoned room for them to be careful, as if they couldn’t see for themselves the danger inside. I loved them for having brought a hospital sheet with them, as so many don’t. It would be a tremendous help in moving her since she had no clothes to grab on to. The crew moved right to the top of my most favorite EMT list when they noted our nice clean IV with admiration.

“Where’s her rapist?” I asked.

“Oh, I don’t know. He pointed to where you guys were and he took off and left,” one of them told us. He looked at the patient. “Wait, is she pregnant?”

“Yes, and it looks like she’s been shot as well,” said my partner. This was like one of the ‘mega-codes’ we train on at the academy, except they usually just stick to either trauma OR medical, not both at the same time.

As we balanced ourselves on top of piles of garbage we managed to get our patient onto a carrying device so we could get her out. We then slowly made our way over to the hole in the wall, stepping over crack pipes and needles, every kind of trash, and the long dead corpses of rodents who did not survive. We luckily made it without falling. We then carefully passed our patient through the hole in the wall onto an awaiting stretcher.

I was never so grateful to make it to the clean, controlled environment of our ambulance. We could finally make a better assessment of our patient. But taking a good look at our patient made me incredibly sad. This woman’s body told the story of a hard and rough life. What kind of messed up circumstances had this woman lived under, what stories could she tell? She was a tall woman who looked to be in her forties, although that was purely a guess. She had scars everywhere. There were track marks where I never thought there would be track marks. She was missing most of her teeth and her nails were either really long or gone altogether.

Her gunshot wound had a clear entrance and exit wound but did not seem to be causing any significant bleeding. We would probably be going to a trauma center even though the gunshot was the least of her issues at the moment. Her vital signs remained fairly stable. Since we didn’t know the onset of the symptoms, of what appeared to be a stroke, going to a ‘stroke center’ would not have been useful. There is a definite timeline that stroke procedures require and we had no way of knowing when everything started.

We intubated her and hooked her up to our monitor. She seemed to be slightly responsive to painful stimuli, which was a good step in the right direction.

“Umm, guys,” said one of the EMT’s tugging at my shirt. “I think the baby might be coming.” He was noting what appeared to be water breakage on a particular area of the sheet covering her.

I’m sure we all looked similarly terrified. An OB kit was pulled from the cabinet and more sheets were utilized, just in case.

What kind of notification would we be giving?

We tried to give the basics to prepare the trauma center without being too long winded. If we told the whole story we would be at the hospital by the time we were finished. We tried to downplay the gunshot but that’s all you have to hear for it to make it to the top of the interest hierarchy. We were also requesting that an incubator be standing by.

It was mayhem inside the hospital. Thanks to our notification dozens of trauma related people were standing by along with others not sure why they had been summoned for a gunshot notification. I guess when you hear that a patient has a gunshot wound all the other information gets drowned out. You could tell they were gearing up to get mad about something. And nobody listens to the whole synopsis.

There were so many people throwing out questions at us from all directions. We tried very hard to tell our patient’s story in one cohesive storyline but it kept getting interrupted by questions we had no answers to. Didn’t you give naloxone? Why isn’t she breathing on her own? How many months along was she? How long ago did the gunshot happen? Where are the police? What kind of medical history does she have? What did she take? Did you give the naloxone? Why did you take off all her clothes? Does she take any medications? What’s that smell? Is this her first pregnancy? Did the father come along? Is there any weakness on a particular side? Did she say anything? What kind of gun was it? She’s obviously on something, why didn’t you give naloxone?…

This seemed to be a hospital far too comfortable with having everything taken care of beforehand. Had they never gotten a patient before that didn’t arrive with a complete medical history? They continued with their demands for answers we didn’t have and they never stopped bringing up naloxone, as if we hadn’t already given her our entire protocols worth. I was starting to get annoyed at all of them in their nice clean environment. They didn’t have to step over crackpipes and rotting fast food to get to their patient. They didn’t have to contort their body into a small width of space between the captains chair and the back of the stretcher in order to insert a tube down the patient’s throat. They didn’t have to hold their breath for minutes at a time to deal with the overwhelming stench of different things dying and decaying at different rates around them . I doubt they could have gotten an IV the way we had. Was anyone even noting the stroke that we had given as the first priority of our notification?

The EMTs and I were feeling a little overwhelmed when my partner used his charm and wit to put some perspective into the hoard of questioners and complainers.

“Look,” he yelled, surrounded by the angry faces of a crowd demanding answers. “She was found in a garbage dump. The only person with her told us that he fucked her and then stole her needle and ran off somewhere. That’s all the information we were given, now it’s all the information you have. And somewhere along the way the woman was shot.”

We brought another trauma patient to that hospital a few hours later. It was somewhat insulting and also somewhat useful that no one seemed to remember us at all. It was a different nurse doing triage and she apologized for a delay in finding us a stretcher. “You’re not going to believe this but some EMS crew brought in this lady who having a stroke, and she was shot too. AND she had a baby in the ER! Can you believe it? They delivered a baby in the ER!”

“That IS crazy!” I replied.

“They were going out of their minds around here when I came in. And the OB floor took their time sending down an obstetrician so an ER doctor had to do it. They were lucky it wasn’t a C-section.”

I found out that is extremely rare for comatose women to give birth unassisted but our patient had, for the most part. No one had to tell her to push and no one had to do an epidural. She delivered a small, underweight baby girl who had a long road ahead of medical treatments.

The incompetent EMS people who brought her in had not provided any of the necessary information, such as the number of pregnancies she had previously, when her due date was, where she was getting her prenatal care, none of it.

“I guess you had to ask the patient herself, then,” I surmised.

“How could we do that?” she looked at me like I was crazy. “The woman was unconscious. She couldn’t tell us anything.”

A Foul Mouthed Nun

Before I went to a Catholic high school I knew very little about nuns except for the stereotypical things: they wear habits, they pray all day, and they like to beat up little kids who don’t do their homework. I had many Catholic friends growing up and I never heard any of them dispute these accepted norms. My dad was a former Catholic who had left his religion for various ideological reasons but still felt they would provide an excellent education which is how I ended up at an all-girls high school taught by many nuns, most of whom didn’t wear habits and didn’t beat us up for not doing homework (the stern look worked much better anyway). But yet it wasn’t until I had a nun as a patient that I learned there were also nuns into weight-lifting and some of them even cursed like sailors.

Sister Theresa Agnes had been visiting NYC with another sister from a parish upstate where they were both stationed, if that’s the correct term. The two women looked as if they could be actual sisters, with similar features and mannerisms. They had been running around all morning going to the more obscure city landmarks that most tourists don’t see. They were particularly interested in the borough of Brooklyn.

We found her in an old church in, what was then, a ‘bad’ neighborhood in Brooklyn. We had driven past this beautiful structure many times and it had often seemed almost abandoned. It was not illuminated at night like many of the other churches and we had never seen much activity, but, of course, we worked at night. Some of the windows had been broken, the openings protected with makeshift coverings that remained in place for years. But it was still a magnificent building that looked as if it were transported from another, much older, country. When we went inside it confirmed my long-held belief that beautiful architecture cannot be fully appreciated from only the outside.

Our patient was found in a large room with a high ceiling and several huge paintings which seemed very old. It had carved wood walls and furniture. The room smelled pleasantly of wood cleaner and old incense. Sister Theresa and the other nun were holding hands with two priests and they were all praying. When we walked in Sister Theresa perked up noticeably. “Look,” she told them. “They sent us two women! Girl power!”

We were told that Sister Theresa Agnes had passed out not once, but twice. The first time she briefly passed out it was blamed on the heat of the day and a change in schedule and scenery. She remained slightly dizzy and became easily short of breath. The second time she was out slightly longer and it had occurred after walking up a short flight of stairs.

The 58-year-old seemed tired and she looked pale from across the room. She asked one of the priests if she could have some more water and he took a glass that had been near her and went to fill it. Like my high school teachers, neither of the nuns was wearing habits and they both had on running shoes. We talked about how the women had spent their day and asked how long Sister Theresa had been experiencing dizziness and fatigue. Upon much consideration and reflection, she admitted it had probably been going on for a few weeks.

“That would explain how you were able to beat me at tennis,” said the other nun. “She’s very competitive when it comes to sport,” she told us.

“Well I’m glad I’ll have a legitimate excuse now,” said our smiling patient.

When we seemed to have a difficult time counting her pulse, Sister Theresa noted that her heart rate was usually slow because she was a runner.

“Runner, yeah, sure,” said the other sister, rolling her eyes. “She’s a triathlete. She does marathons. She’s a cyclist, swimmer, rock climber, and she lifts weights.”

“It brings me closer to God and I feel better when I’m active,” she told us.

But her heart rate was really slow. It was remarkable that she was sitting up and having this conversation with us. We put her on our monitor and found her to be experiencing a third-degree heart block. It’s an electrical arrhythmia usually cured with a pacemaker. It was probably only because of her excellent physical conditioning that she had been able to tolerate so little oxygen circulating in her system for so long. A third-degree heart block is considered to be extremely rare in healthy, physically active individuals making our patient an interesting anomaly. (We found out later that she had once contracted Lyme disease from her many sojourns outdoors and it had put her at risk).

We gave her an IV and tried our first line of treatment which we knew would probably not work. The drug we gave her, Atropine, works at a higher area of the heart than the area causing her electrical disruption. What she ended up needing was trans-cutaneous pacing (TCP).

TCP works much like an internal pacemaker by sending electrical currents that override the heart’s faulty pathways. It’s done through pads on the patient’s chest. To tolerate the constant influx of small electrical jolts we called our telemetry physician in order to give her narcotics. We would be giving her Valium, which works as an amnesiac. It wouldn’t exactly stop the pain but would make her forget it was happening.

We had everything set up and warned our patient of what was going to be happening. She assured us it would be OK. We started up our pacing and she suddenly started cursing like some sort of sailor. A polite sort of sailor.

“FANGDAMMER!” she yelled. This unique word hadn’t yet been added to the lexicon of expletives uttered to me by the public. It was quickly followed by “Poo On A Stick!”, “Crappity!”, “Schinittycrapes”, and “Dookerzonks” (I apologize if I’ve utilized incorrect spelling here. I’m going phonetically because my internet dictionary has been of limited use.) She denied being in pain but she continued to spew words like “Craditoollies” and “Snogerites”. It was an interesting phenomenon brought on by the sedation drug.

Rather than be outraged by all this foul language coming from a bonafide representative of a religious order, I wrote many of them down for future use. I figured that these were secret code curse words, backed up by the wrath of God. My enemies had no idea what they had coming to them.

The unorthodox street talk continued as we moved her to the ambulance. One of the priests helped us with our bags and seemed embarrassed by the constant flow of profanity coming from his colleague. We assured him that we had heard it all before, even though we hadn’t, actually. We have to maintain a professional demeanor so we told him that we understood it was just the Valium talking.

When we got to the hospital she thanked us and apologized for her “rancid potty-mouth”. She also said she had been blessed by our care, which was one of the nicest things anyone has ever said to us. She was quickly evaluated and it appeared she would be getting her own pacemaker that day. She looked forward to getting back on her feet again soon so she could continue to explore our big city. We said goodbye and thanked her for the new words we would be spewing back at terrible drivers with lesser vocabularies. We had all been blessed that day.

Here is a link if you’d like to learn more about third-degree heart block: https://my.clevelandclinic.org/health/diseases/17056-heart-block

The Sign In Sheet

One of my favorite partners was a notorious serial dater. I loved working with him for many reasons but his dating life really added some entertaining spice to our day. His social life left little time for sleep or recreation and I was fascinated with how he juggled his long list of romantic entanglements. Most of his relationships tended to overlap and sometimes the various women involved would find out that their romance had not been exclusive. “I never said it was,” he’d tell me, confused as to why women would get so angry when they found out about the others. As EMS people, with unusual scheduling issues, these conflicts, of course, found their way to the workplace, since that is where his pool of date-able women often originated.

The furious aftermath of their short term alliances led to many angry women showing up at the station after work and during. Some left nasty letters on the ambulance and several would develop stalker behavior. He was always very unbothered by all this. Their problem was never going to become his, he told me. He had such a pleasant, cavalier attitude to everything. One of his ex’s threw a very thick milkshake at the ambulance windshield that used up all our washer fluid to remove. “She always had a very good arm,” he’d tell me.

Seeing how women were drawn to him was incredibly interesting as well. Women would come on to him while we would be treating their husbands family members. He told me about taking one woman out who had been the daughter in law of a previous patient. “The mother in law babysat her kids that night so she could cheat on her son!” he told me, almost as shocked by this as I was.

There was an ER doctor that he was seeing who was very comfortable with having a casual relationship. She seemed like a fun, nice woman and she also had a difficult schedule as well so my partner’s no drama personality suited her. But she also wanted a baby. She was getting older and the biological yearnings for a child were constantly warning her that her time was running out. She offered him a no-strings-attached deal to father the child she desperately wanted and was happy to raise alone. My partner said he would love to ‘help her out’. There were many shifts that were cut short as he left work early to provide his biological material. “She’s ovulating right now. I better hurry,” he’d tell me with all seriousness.

He had neglected to tell her, as he neglected to tell many of the woman he was dating, that he’d had a vasectomy years before, after the birth of his daughter. “Don’t you feel guilty?” I asked. “You’re robbing her of possibly her last chance to have a child of her own.”

“I’m doing this woman a favor,” he told me. “Kids are a lot of work. She has no idea what she’s in for.”

Sometime later she moved on to in-vitro fertilization, believing that all the issues to conceive were on her side, given that he had fathered a daughter.

Many of the women he dated would come to him with worries that they were ‘late’ and he would light up, telling them “that’s WONDERFUL! Maybe it will be a boy, and my daughter can have a brother! But I’m pretty sure you’re just late,” he would tell them, confidently.

There were some people who used the word misogynistic to describe him and his nefarious ways with women but I never thought so. In fact I felt he was very much the opposite. Most of his friendships were with women and he never said anything negative about the ones he dated. In fact he adored them, all of them, at the same time. His positive attitudes towards women could be found everywhere. A group of us were complaining about a much despised captain and conversation had spiraled downwards to making fun of the way her uniform would never fit in any flattering way, causing her to be compared to a misshapen garden gnome. My partner’s contribution to the discussion was to point out that she had lovely eyelashes, the kind any woman would die for. He said it with complete sincerity. He could always find something positive about anyone’s appearance and could offer styling tips to improve further.

But for a time his dating life caused us some issues at work, at least I felt they did. One of his ex’s, who was a nurse at a hospital we went to every day, was extremely hostile towards him, and I by association. I felt a bit uncomfortable talking to her because her personality around us was very curt and short and sometimes rude. But my partner took it in stride, refusing to acknowledge any difficulty and treating her with either saccharine friendliness or as if she were a complete stranger.

One day she was working in the non-urgent area where she was doing triage. We had brought our patient in, sat him in the waiting area, and put his name one the list. Wanting nothing to do with us she made every effort to make us wait as long as possible. Normally the triage nurse would listen to our presentation, sign for us so we could leave, and the patient would be registered by the time she called on him when it was his turn. But she would only talk to us when our patient was called in the order he was on the sign in sheet. She made sure that all the other people on the list ahead of him would be fully taken care of first, with detailed interviews, several sets of vital signs, writing on the forms very slowly, ripping them up and starting anew when she made a mistake. She seemed to think she was punishing us by preventing us from going out and getting another call. When she finally did get to our patient, the slow, lengthy triage process moved forward with lightning speed and without even looking up, she quickly signed her name in anger, almost ripping the form. I doubt she even heard one word of my synopsis.

None of this bothered my partner. But when our next non-urgent patient wanted to go to the same hospital and seeing my oh-here-we-go-again reaction he told me not to worry, things would be different.

At the hospital my partner took my paper and went over to the small triage room. He gave her a big smile through the small cut through as he took the sign in clipboard. Knowing that the last name on the list was our patient she would, as last time, go through every name before it slowly, calling everyone before ours, even those who had been called earlier and had not answered. My partner wrote several names on the list, using different handwriting, and ended with our patient. He quietly replaced the clipboard, handed me our call report, and remarked that even though we might wait a long time with this patient, he doubted we would with any future patients that day. He gave me a smile and went off to flirt with the girls at registration.

When his ex-girlfriend-triage-nurse came out she gave me an unappreciative glance and took the list. With her stalwart look of efficiency she stood before the waiting room with the clipboard and called out for Peter File. I could see the frustration in her face as Peter File failed to come forward. “Peter File!” she called loudly. “You’re next!”

When Peter File didn’t answer, she asked for Clea Torres. “Hello? I’m looking for a Clea Torres!” she shouted. Did she really not hear herself yelling out these juvenile fake names?

Apparently not, because she continued down the list asking for Hugh Jassol. She was getting a bit desperate because there was only one name left on the list before our patient. Hugh Jassol was called many, many times. The entire waiting room looked around smiling, wondering if there had really been parents so mean as to name their child in a way that would subject him to much bullying, no doubt.

The only name left now was Jack MeHoff. Jack MeHoff had to show or she’d be forced to deal with me after a normally short waiting period. How would her ex learn that he shouldn’t have ended things with her if his partner wasn’t mildly inconvenienced?

“Jack MeHoff!” she yelled. “Jack MeHoff?” She was pleading for there to be a real Jack MeHoff to come forward. Everyone in the room except her seemed to realize she was calling out a crude masturbatory term. You could hear the desperation in her voice. She even went so far as to ask several of the men in the waiting room. “Jack MeHoff?” she asked one man sitting in the back.

“Certainly not!” he indignantly told her.

The Two Roslyns

I met the first Roslyn a year or two after I started working in Manhattan. The first time we went to her apartment she had accidentally broken a crystal vase and had cut both of her hands significantly. One wound on her wrist was bleeding badly enough that she thought she may have severed an artery and she was very distraught about it. Despite being upset, she was polite and mostly friendly. There was a lot of blood in her modern living room which had sweeping views of the East River. As I started the paperwork I leaned on her grand piano and glanced at the framed photos on display. They illustrated an enviable life. There were photos on safari in Africa, skiing photos in what looked like Switzerland and several happy pictures of friends and family. In one photo it appeared that a young Roslyn had gotten some kind of award riding horses. There was also a wedding photo with a handsome man. The man was not present and when it was time to go to the hospital she was asked if they could notify her husband.

“Oh no,” she replied, somewhat bitterly.

We took her to the hospital and while we were waiting to be triaged another crew of EMTs, who were leaving, saw her and said hello, using her name. She said hello back in the embarrassed kind of way a person does when they think they’ve been mistaken for someone else and are just trying to be polite.

“Do you know her?” I asked later.

“Yeah, sure,” they said. “She’s a regular.”

Really? Most of our ‘regulars’ are either homeless or have chronic medical conditions requiring frequent hospitalizations. Our homeless regulars are, almost without exception, people with substance abuse issues. She didn’t seem to fit either of those categories. What could make Roslyn a regular?

“You’ll see,” they said. “She calls all the time.”

She calls all the time? For what? Is she accident-prone?

I had forgotten about it until the next time we were summoned to her apartment, which was not too long after. This time her apartment was messy. It wasn’t ransacked but it looked more like someone hadn’t picked up after themselves in a long time. The wedding picture was gone and some other things looks slightly different but I couldn’t tell exactly what.

Roslyn was intoxicated and rambling about having things stolen from her apartment. Her statements didn’t go together and went off on tangents that had to do with her job or her family, both of whom she hated at that moment. A long time was spent deciphering everything she said but eventually it was determined that the missing items were taken by her now ex-husband thanks to a “misogynistic, two-bit, loser judge” who had sided with him in the divorce. It wasn’t clear what she had called for since she didn’t want to go to the hospital and there was nothing actually ‘stolen’. The police abandoned their report but stayed on to assist us in taking her to the hospital as she was in no position to make an informed decision to refuse. She was furious about going to the hospital. We were accused of working for her ex. Our previously friendly and polite lady had turned into a cursing, spitting lunatic.

Each trip to Roslyn’s home for the next year or so also involved alcohol to some degree of another. There were stints in rehab, relapses, and long periods when she was sober, when she’d call 911 for relatively minor things every now and then. On these types of calls, I think she thought of us more as company and tried to serve us food and played the piano for us. She told us about her stressful job that she liked, despite a boss who had gotten promoted over her. She complained about her ex, who she felt had made out too well in the divorce. She gossiped about her neighbors. And once, when I admired a painting in her hallway, she mentioned she had painted it, saying that her first dream was to be an artist and that someday she was going to try again. Getting to know her during these sober periods made it all the more heartbreaking as we watched her decline years later.

Eventually we were called to her home when she had relapsed and discovered she had acquired four new roommates-other alcoholics who were clearly taking advantage of her. At some point she had lost the job she loved when the same man who had been promoted over her fired her. She told us of her struggle to find another job even though, she said, she didn’t need one. It was just something she wanted to do because she was good at what she did. I suggested that she could now pursue being an artist and she berated me. There was a huge personality difference between sober Roslyn and drunk Roslyn.

She may have misjudged how expensive Manhattan living is or perhaps her roommates had drank her savings away, we could only speculate, but sometime later we ran into Roslyn at a different hospital, on the west side, where we found out she was living somewhere else. She had lost her modern apartment with the East River views and was temporarily staying with a friend until she got back on her feet. She was genuinely optimistic and I desperately hoped she would be able to improve her situation soon.

Every once in a while we would see her again in different places. If we were driving around and spotted her we’d get her some food or give her a blanket. She was very well known by most of the EMTs who worked in midtown and we’d hear updates from each other after periods of not seeing her. Sometimes when we did see her, she acted like we were long lost friends. Other times when we picked her up she didn’t recognize us. And many times she was extremely mean and abusive. Knowing her backstory led me to be more sympathetic towards the many other alcoholics we dealt with on the job, who were similarly frustrated and angry at anyone whose existence validated their fear that they didn’t have control over their day to day life.

I would eventually leave Manhattan to go to paramedic school and after that I worked in Brooklyn. I never saw Roslyn again. At the time I left, Roslyn had used up all of the favors her friends owed her and was now exclusively living on the street. It had taken only the short time that I knew her that she had gone from having what seemed to be a fabulous life of the rich and privileged to becoming one of the many overlooked and forgotten people living in the street begging for change. It is my great hope that she eventually did turn things around.

There was another Roslyn I remember from my days in Manhattan, also. The second Roslyn’s trajectory went in a decidedly opposite direction. She also became a semi-regular during the time I knew the first one. This Roslyn had only called 911 for herself once, after her leg was injured by a bicyclist as she sat on a curb begging for money. Roslyn Two became familiar to us because many other people called 911 on her behalf.

A very large percentage of calls to 911 for people living on the street are made by a sympathetic or concerned person who sees something that bothers them without often knowing the whole situation. Calls come in for ‘unconscious’ people who are sleeping or ‘not breathing’ when they definitely are. Despite the large number of these calls leading to interactions with people who take their annoyance out on you for being woken up or interrupted I still found it a redeeming quality of humanity that so many people were concerned enough for strangers to have someone check up on them.

People called for Roslyn because they thought she was abused. Our second Roslyn had a discoloration on her face that could be construed as a black eye if you only looked at it quickly. She seemed to have parlayed this birthmark to her financial advantage.

The first time I met her we were responding to a 911 call for a woman who was beaten up and left in a garbage bag. The location given was in an area of high tourist traffic near Rockefeller Center. When we arrived we saw a small woman wearing a black garbage bag as a dress. There were cut outs for her arms and she had shorts on underneath. She also had a cup that she used to solicit donations. When she saw us coming she ran up to us and asked “Did someone call for me again?”

When we said yes she said that she felt that someone who had given her money may have called. She apologized for inconveniencing us and assured us she was OK and did not need an ambulance. The garbage bag, she said, served to garner her more sympathy and had gotten her more ‘tips’ which is how she referred to the money she made panhandling. We made the call an unfounded but came back again later when yet another call came in fitting Roslyn’s description.

When we returned, she apologized again and reaffirmed that she did not want to go to the hospital or anywhere else. The man I was working with was very curious about her panhandling lifestyle and Roslyn was happy to talk with us about it. She said she could “take a break” but even while ‘off the clock’ and talking to us several people went out of their way to put money in her cup anyway. The ‘tips’ she was getting were not in coins, but in bills of $10 and $20. She told us this kind of donation was typical and that the summer months were very lucrative for her. During the Christmas season, however, she made much more, enough to pay her rent for the entire year.

We met her several times after that. Each time she let us know she as OK and each time she offered to buy us coffee for our trouble.

We learned much more about her enterprise when the bicyclist ran over her leg and she went to the hospital. She didn’t want to go initially but we convinced her by suggesting a cast and crutches could be helpful to her career. Her face lit up and she immediately hopped in our truck. As we wrapped up her leg she told us more about herself.

For a while she had lived in subsidized housing getting every government benefit available. She was very proud of the fact she no longer was, and that her kids went to private school. She said she had someone who helped her manage her income and that she had a diverse portfolio that included a 401K heavily invested in municipal bonds. She had worked it out that she only had to ‘work’ for 10 more years and at that time she would be moving to Florida to retire. She would be 38. Asked if she would continue to panhandle in Florida she said wouldn’t and was looking forward to picking up some hobbies like ceramics and painting.

A few months later I ran into the second Roslyn off-duty. I was out with some friends ‘in the city’ and as we were walking along a sidewalk she was there, sitting in front of a closed storefront with her outstretched cup. She looked very sad, almost in pain, as we approached she asked for some assistance. She didn’t recognize me without my uniform and with my hair down.

“Hey, it’s me!” I said. “EMS.”

Her whole demeanor changed. “Hey there, Nancy. Good to see you!”

“How is business going?” I asked.

“Pretty good,” she said. Then she winked and said “But it could always be a little better!” She stretched out her cup.

“I should be asking YOU for money”

She laughed and admitted that was probably true. I introduced her to my friends and made a little joke about how in a few years we’d run into her in Florida, sipping fruity cocktails with little umbrellas in them

“I’ll be in Florida all right,” she said. “But no fruity cocktails. I don’t drink. Ever. Drinking killed my father and I’ve never touched it. I’ve seen what it can do.”

I thought of the other Roslyn and agreed with her about the devastating effects it can have.

The Beeper

Back in the olden days, when access to a web-less internet was obtained through a company called CompuServe, the hottest status symbol of the day was a high tech device called a “pager”. People of importance would never think to leave their homes without the elite electronic device clipped to their waistband. In the egalitarian age of the early tech boom, having a pager didn’t symbolize importance by being wealthy. Having a pager meant that you were important because you were someone people needed to get in touch with. Doctors, deal-makers, and your pot supplier, anyone who kept the supply chain moving. My partner also had a ‘beeper’ because he was a union delegate. As someone who tended to shun excessive social interaction it was nice to vicariously experience the marvels of the modern age through him.

Despite newer technology some beeper stores are still thriving. (photo taken in 2020)

He had his newly upgraded alpha-numeric pager when we were called to a building on the Upper West Side that is renowned for its famous architecture. One of my favorite things about this job is the access it gives us to see the inside of amazing homes and places that most people only hear about or see on screen. Many of the pre-war building in Manhattan have subtle intricacies that are never given enough prestige when presented as part of a background to a movie or news story. Being inside these beautiful old places gives you an historic feeling of old New York and I like to try to imagine what the world looked like to people who lived there decades before.

The call was for an EDP or ’emotionally disturbed person’ who, the caller felt, was not taking care of herself. (When you’re wealthy the term for this is ‘eccentric’). The woman was obviously well off to be able to afford an apartment in this exclusive building that had famous artists and celebrities living it. We took the elevator up with several people dressed in expensive clothing as we wondered if, perhaps, our patient was someone we might have heard of in some way. We knocked on the door and it was opened by a little white-haired woman with the biggest, sweetest smile. She looked at us with awe, as if we were the celebrities and were here to fulfill a spectacular wish.

“What do you freakshow motherfuckers want with me now?” she said. She went on to elaborate that any requests for sexual favors were not going to be met. Her big smile never left her face. She was wearing a stained, purple printed house-dress that was over a set of thermal long-johns. She had uncoordinated socks on her feet and her long nails were dirty. Behind her, we could see what seemed to be a huge, mostly empty, apartment with bare walls and bedsheets haphazardly duct-taped to most of the windows.

“Do you know who called 911?” my partner asked.

Somewhere in the apartment a Jamaican accented voice yelled out “I called for her. I’ll be right there. Let these people in, Miss Jensen.”

Miss Jensen silently opened the door wider and moved to the side. She never took her eyes off us and for a while she fixated on me.

“You better get yourself to a good dermatologist, your face is disgusting,” she told me. “I’m just being nice, seriously, I don’t know if anyone can help you. You really need one of them, plastic doctors. And you should get yourself some cocaine. That would take care of those rolls. You’re a big cake and cookie eater, aren’t you?” She gave me some more advice that she felt might assist me in getting my reproductive organs noticed by the male population.

“Why, you’re just a lovely beam of sunshine, aren’t you?” I remarked.

“You don’t have to thank me,” she said calmly. “Just get the fuck outta my house.”

“Now, now, Miss Jensen,” said the lady with the accent. A tall, slim, well dressed woman emerged from a room taking off a pair of latex gloves. She reminded me of Iman, the fashion model. “Forgive her, sometimes she’s real mean,” she whispered to us.

“I ain’t mean. I’m honest.” said old lady Jensen. She turned around picked up a plate. “Cookie?” she offered.

The woman with the Jamaican accent gave us a wide eyed serious look and shook her head, as if warning us they were loaded with poison.

Miss Jensen, seeing her plate of cookies rejected, casually threw them in the garbage, along with the plate. She then wandered off into another room. The apartment had a peculiar foul smell, like rotting food, but when the woman went away the odor seemed to travel with her.

“Thank you for coming. I’m Tanya,” said the other woman. “I work for Miss. Jensen’s family.”

“Are you her home attendant or a visiting nurse?” said my partner with a tone indicating that he didn’t believe she was. She wasn’t dressed like a home attendant or visiting nurse.

“No,” said Tanya. “I… I just sort of bring Miss Jensen the things that she needs. You see, her family doesn’t really deal with her anymore. But Miss Jensen isn’t in control of her finances. They gave her a number to call, it’s a service, she is supposed to tell them what she needs, then they page me on this device and I go out and buy it for her.” She showed us her pager that looked just like my partner’s newly upgraded beeper. “But she doesn’t know what she’s doing. She calls the poor people at the service and talks to them about nonsense. So I come here from time to time and fill up her refrigerator and ask her if she wants me to bring her anything.”

Miss Jensen emerged from one of the many rooms of her apartment and went up to my partner just to inform him that he should expect to die alone. Then she turned around and went back. The apartment was mostly empty. There was nothing on the walls and only a few scattered chairs for furniture. There was a path, however, that had been created with two rows of Lladro figurines leading to another room. There was no TV, no books and I wondered what Miss Jensen did all day.

Tanya continued, “I think I am the only one who comes here. I was originally told she had more people, a nurse, a housekeeper, but I think if she did once have them that they no longer come here. Miss Jensen needs help, much more than I can give her. But when I talk to the family they say she is fine. She is not fine. She hasn’t taken any medicine in a long time from what I can see. She’s not taking care of herself and I can’t do it for her. I’m not qualified and they don’t pay me for that. I do all kinds of other things around here because I feel sorry, but I’m not giving her a bath or combing her hair. She sometimes scratches with those long nails of hers. You can’t tell her anything. She won’t listen.”

“Do you know what she’s supposed to take?”‘ I asked.

I heard Miss Jensen yell from wherever she was, “COCAINE! I use cocaine, that’s why I can get a man and you can’t, girly!” She cackled like the evil villain in a Disney movie.

Tanya looked at me, slightly embarrassed and slightly smiling. “She’s supposed to take psychiatric drugs. I do not know what kind”

I went over to find Miss Jensen to see if she would let me take some vital signs. She was actually very pleasant to me and allowed it, rolling up the sleeves of her dirty clothing and revealing a dry, frail arm. Her vitals were pretty good. I asked her if she would go to the hospital with us.

“I’d love to get out of this place for an afternoon,” she told me. “Let me change my dress.” She walked over to a large closet and when she opened it, it appeared that many of the contents of a normal home were stored inside. There were unopened appliances, a large television, boxes of clothing, dishes, and random objects. They were all piled in, seemingly arranged in an intricate balancing act. I feared that when she dug out an identical purple house-dress from a box everything would come tumbling out of alignment but thankfully they didn’t.

Her new going-outside house-dress was also stained and unwashed. She turned her back out of modesty as she took off the old dress and put the new one on over her long johns. Tanya came into the room and asked Miss Jensen if she might want to take a shower or bath before leaving. “It’s my only chance,” she looked at me, pleading. I was very much in favor of the idea.

“What for?” Miss Jensen scowled. “I’m quite lovely just the way I am.” Then she gave us all a big smile. As she walked around her barren apartment she stopped near one room, pointed and said with another big smile “That’s where the… accident happened.”

Tanya looked at me seriously and whispered, “Her family thinks she killed her husband. A big wall unit fell down on top of him. That’s why they want nothing to do with her. I don’t think she was ever strong enough to crush him like that. But I think she wants everyone thinking she could. Then again, she is very resourceful.” She also added, “I don’t think it was a happy marriage.”

Maybe we were in the home of a noteworthy individual. If Google had existed I would have checked her out. Scanning through miles of microfiche at the local library didn’t hold the same instant gratification.

Tanya said she had to go, she had some errands, but promised to meet Miss Jensen in the hospital. Miss Jensen was ready to go shortly after. She seemed to be happy to go outside and said she hoped she’d see the same MD she saw the last time Tanya made her go.

When got into the elevator to go down there were four other people already inside. As the doors closed, their faces indicated that they had gotten a whiff of the malodorous cloud that surrounded our patient. We slowly went down another few floors before stopping to let another person in. I could see the people in the back considering whether to get out or not but they didn’t decide quickly enough and were stuck with us for the duration. The person who got in clearly regretted it. Suddenly my partners beeper started beeping loudly.

“What’s that?” Miss Jensen asked angrily, looking around.

Without missing a beat, my quick witted partner whipped out his pager and checked the message. He looked at Miss Jensen and said, “Why, it’s my smell-o-meter. According to this, you are exceeding acceptable clean air standards by 65%. It might be time to do something about that.” I burst out laughing. The others in the elevator didn’t seem to know what to do. They looked scared but also seemed to smile a little.

Miss Jensen considered this, for the first time thinking about taking advice instead of giving it. She demonstratively sniffed the air, and herself. “You might be right,” she said quietly. “It might be time.”

The Polygamist

Along with smoking and poor diet there are other factors that can endanger one’s health and longevity. Although not cardiac in nature, one man’s poor lifestyle choices led him to call 911 for chest pain on several occasions. His heart problems began when he complicated his life by sharing a 700 square foot apartment with the three girlfriends he was juggling. “I’m a man who loves too much,” he would say. “I can’t help it. No one woman could handle all that I have to give. My heart is just too big.”

“He’s having a heart attack,” said one of the girlfriends as we arrived. She said it with no great urgency, just matter-of-fact, and directed us behind her. We entered an apartment whose decorating scheme centered around large storage container boxes doubling as furniture. In addition to the containers being used as tables and stools, one held a small toddler who would be pushed around the apartment by 5 or 6 other small children while we were there, all happily oblivious to the events going around them. The place was already chaotic and we hadn’t even met all the wives yet.

We found our 42 year old male sitting in a chair flanked by the other two women in his life. They were each holding an arm and stroking his hair. He was hyperventilating and clutching his considerable belly. A plethora of prescription bottles were found on a bright red plastic storage container that doubled as an end table.

“Please,” he said looking back and forth to each woman with a pained expression on his face. “Please get me a cold wet rag for my forehead.” The two ladies looked at each other for a few moments before one of them reluctantly got up. She must have known doing so would cause her to lose her spot. When she got up the woman who had answered the door took over the left arm position which clearly annoyed the woman getting the wet rag.

As we cleared some space for our equipment a chubby little arm attached to a curious little girl stretched out with a lollypop for me. As I declined, I told our patient, Miguel, how cute I thought his daughter was and how we shared a proclivity for sweets.

“Oh she’s not his.” said one of the girlfriends. “Only three of these are his, two with me and one with her,” pointing to the other older girlfriend.

“And another on the way,” said the youngest one, proudly patting her belly.

As we extended our congratulations we noticed the other two women looked at each other and rolled their eyes in displeasure. The younger woman saw this and smiled even more. There was definitely and underlying dynamic going on here.

“I got other children too,” said Miguel. “They just don’t live with me.”

This man had quite an extensive love life, obviously. What kind of charm did he hold? He definitely wouldn’t be considered attractive in the conventional sense. He was overweight and missing a front tooth in a set of broken yellow teeth. Hygiene didn’t seem to be an priority, including the food clinging to an oddly shaped handlebar moustache. How did this man have three women fighting over him?

And what of these women? What was in this for them? Were things that grim in the dating world? I felt that they could probably do better. They were more than moderately attractive with pretty faces. It seemed that Miguel had a ‘type’ in that all three of the ‘wives’ looked as if they could be sisters, or at least related.They were on the tall side, taller than Miguel, heavy-set and had long curly hair. Two of the women were probably in their late 30’s. The younger one was in her early 20’s.

As I attached our cardiac monitor to Miguel and took some vital signs my partner approached one of the older women and asked if they could assist by providing some basic information. The other older woman shoved her out of the way and said “Ask me. I’ve been with him 11 years. I know him better!”

The first one then shoved her way back over and said “Well I’ve been with him NINE years! So you should ask me!” Perhaps she was just bad at math or maybe the seniority rules worked differently over here. The two argued briefly over who should be giving out his information, each insisting that they were more knowledgeable, based on their many years clutching his arm and providing wet rags. Another tangent they went off on centered on how slow the other was in obtaining the damp rags and not holding the arm supportively enough. My partner looked over at me with the same pained expression Miguel had when we walked though the door. The younger one walked over with an ID or Medicaid card and attempted to hand it to my partner. One of the other ladies took it out of her hands and threw it on the ground.

“Stay out of this!” she told the newest wife. She shrugged and walked away, resuming her seat on a futon.

“Good luck,” she told my partner.

“I get heart attacks all the time.” Miguel said to me. He handed me his latest discharge paper from the local hospital. It was dated only a few days earlier.

“ACUTE ANXIETY” was the diagnosis. The paper showed he was prescribed another anti-anxiety drug with instructions to “reduce stress.”

“It feels the same now as it did then?” I asked. He nodded. “What was going on when this came on?”

“They was fighting.” he said casually.

“Ahhh…” I said.

“Oh that’s nothing,” he said. “They always fighting. Every day. This is nothing new.” Then he took off the oxygen mask we had given him and said very loudly towards the women, “But I love all my wives EQUALLY!”

The woman kind rolled their eyes a little but the nine year veteran looked at the younger one and said “That’s right! We are all EQUAL”

The youngest just patted her belly and nodded with a sly expression that made me think that she had a slight advantage over the other two.

I went through the medications that were next to the lamp on the storage container table and noted they were all for anxiety and acid reflux.

“Oh yeah,” Miguel said. “I get a lot of anxiety. And acid from anxiety. I had it a long time. I get disability for it.

“So you don’t work.” said my partner, not as a question but as a statement. “And you’re home all day. Here. With the wives. And they’re home all day too. With you. And each other. And you’re all just together. Here.”

Miguel nodded. The wife with 11 years pointed out that she and the 9 year wife don’t work either. “We are here all the time to take care of him,” she said. “He’s a very sick man. He needs help. That’s our job. But she works. She’s out working a lot of the time.” she said pointing to the youngest with contempt.

“Hell yeah!” said the youngest wife. “And be here with you all day? How do you think we pay for this place? And your QVC habit?”

The tension had just gone up a few notches. “Take me to the other room,” said the 11 year wife to the 9 year wife, “before I get arrested for slapping down a pregnant woman.”

“You do like the QVC.” the nine year wife told her as she walked away.

With the exam wrapped up all signs pointed to another anxiety attack, with some possible GI issues as well.

“So I don’t have to go?” asked Miguel.

“Oh no,” yelled my partner from the other side of the room. “There’s no way we are leaving you here.”

Miguel’s symptoms seemed to decrease considerably when we left the apartment. I found it strange that none of the women offered to accompany him but I learned later that a previous crew had made this a rule and it seemed to work out better for all involved to not have anyone go instead of having a huge fight over who would stay with the children and who would go to the hospital.

We returned to the same apartment a few months later on Valentines Day. The three wives had gotten into a brawl over the gifts Miguel had chosen for them. As another testament to his high desirability he had made sure it was the thought that counted, rather than the price of the gifts. The three women had each gotten some kind of NYC tourist trinket, the kind sold by street vendors. A clock highlighting the Statue of Liberty lay broken on the floor. Miguel’s love for NYC, or perhaps just NYC souvenir items, was an unsaid point of consternation, I felt. There was also a difference of opinion on the amount paid for each item with the consensus being that the little replica NYC taxicab cost more than the clock and the “I Love NY” t-shirt, which was 2 sizes too small for any of them. An argument ensued regarding the t-shirt with the recipient implying it was meant for one of the others as a hint that she was getting too large. It seemed lost on her that all three of them would have been considered too large by that reasoning. It was the same woman who had been confused about whether 9 or 11 was a longer duration of time.

Despite some scratches and disheveled hair none of the women wanted to go the hospital. Miguel did though. He practically ran to the ambulance. We suggested that his toxic home life may be to blame for his numerous hospitalizations and he acknowledged that it did. But he simply said “There’s nothing I can do about it. I am a lover. I cannot choose who I am.”

The Kazoo

One of the worst parts of being a supervisor is being forced to answer an incessantly ringing phone. If you are a prank phone call enthusiast this fact allows for many opportunities to unite with your coworkers in a creative team-building activity that helps with morale. As someone who took part in so many of these exercises to improve station spirit, I knew one day when I took the promotion to lieutenant that I would eventually have to be at the receiving end at some point. So I accepted my inevitable pranking with professionalism.

At first I was disappointed in the lack of effort, then at the poorly thought out themes. I allowed for the fact the younger generations were more familiar with texting than calling but the fact that they still tried every once in a while should have caused them to come up with a better game plan. But eventually a formidable pranker rose to the fore.

The first round of calls involved someone trying to sell all of us chained to our desks a blender popular on the infomercial circuit. He called repeatedly causing most of my coworkers massive headaches as they were required to pick up the phone shortly after slamming down the receiver moments before. But I enjoyed engaging with him, acting immensely interested in buying a blender and asking for an extended sales pitch. My pranker was able to think spontaneously and keep up with my demands. My partner watched me during one phone call and started screaming at me to hang up. “It’s a scam!” she screamed. “A scam!” I completely ignored her as I prepared to give up my phony credit card number.

It was a nice change but just a step above amateur. But then one of my crews got the fantastic idea to hand their phones over to drunk patients after calling me. It led to some fun conversations. They eventually figured out the best person to give their phones to was a homeless man named Jorge.

Jorge used to ask me philosophical questions and answer me with completely unrelated topics.

“Hello, lieutenant.” he used to say. “Why do we need one million different kinds of wine? Do you think if someone was blindfolded they could really tell the difference? I call bullshit on that. Do you like vodka better? I do. Vodka makers don’t play the same kind of stupid games.”

“There’s like a million different brands of vodka.” I’d say.

“My doctor says I don’t get enough fiber.”

“Maybe they should put fiber in vodka. Vitamins too. Fortify it.”

“It’s been a long time since I had a smoke. I sure miss it.”

My crews would give me updates on Jorge from time to time since I never seemed to run into him on the nights I was on the road. I learned when he had broken a leg, when birthdays occurred, how many of the homeless women he was interested in and his luck with dating them. He was definitely one of the better regulars. One of my crews liked him so much they gifted him a kazoo.

For many nights thereafter I was serenaded on the phone by kazoo. Though I missed our intellectual discussions, I enjoyed the musical performances more. He really put his heart into them. My crews told me how much he loved learning to play new songs and give performances to anyone who would listen. Unfortunately one night, during a long drunken binge, he lost his kazoo. Or perhaps it was stolen by someone who did not appreciate his instrumental abilities. Either way, it made Jorge extremely sad.

When I found out about the missing kazoo I decided that it had to be replaced. Not only was I missing out on new Jorge material, I was sure the other lieutenants who worked the desk lamented the loss of our local talent. When I finally found one I carried it around with me and asked my crews to help me find Jorge so I could give it to him personally when I was on the road.

My crews called me the next night I was out and I met up with them. I got to meet my instrumentalist in person. He seemed like a friendly, happy man and I could see why so many homeless women found him to be a catch. Presented with my gift, he cried tears of happiness.

“The nurses,” he told me, “will be so relieved I can play again. The other patients in the hospital too. You helped so many to enjoy my songs again.”

I was grateful to share the gift of music with others.

After testing it out he took out his government-issued cell phone. It was a huge chunk of a phone, the kind most of us thought was a technological upgrade from the flip phone back when cell phones were just novelties. I watched him as he turned it on and went to his directory. I looked at his “recent calls” log and I saw the list:

911

911

911

(my station)

911

I discovered that he had called me on his own, not just when someone gave him their phone. It warmed my heart how my crews had set up perpetual calls for me. They were true professionals and I felt the torch had been successfully passed.

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