The career archive of a NYC paramedic

Tag: EMS jobs

Pork Chops au Revoir

Eugene was a urinator. Without fail, whenever we picked up our homeless regular from the underpass of the West Side Highway, he was sure to use our ambulance as his own personal toilet. It was no accident, no failure of bladder control due to illness. We had taken him to numerous ERs, where whatever condition he might have had, could have been treated. But Eugene admitted that he had nothing medical that precluded him from marking his territory like a feral cat. Eugene was proud of his urinary control and told us he made sure to pee on every societal institution he came in contact with. On top of being a urinator, he was also a cantankerous and angry man. He used abusive language, particularly to me as a woman who, he felt, should have no issue cleaning things, as it was something women were just supposed to do. Regardless of how much we begged him to relieve himself elsewhere, he was sure to reserve a portion of his liquid waste for the door or the step-well or some other corner of the tiny space we called our workplace. He was very matter-of-fact about it and told us we should be grateful it was just urine.

Our ambulance is our home for eight hours, five days a week and we needed to have some control over our environment given that our other places of work-the street, peoples homes, offices, everywhere else really, were unpredictable. We liked our familiar truck, with its arbitrary intercom system and it’s non functioning, first generation computer terminal, which was promised to be on-line in the near future. We had a gas vehicle, which would eventually be phased out for the diesel workhorses that held up better to 24 hour constant use, and we enjoyed the occasional backfire which could be mistaken for gunshots. We were a little protective of our vehicle, which technically belonged to the city though we treated it as if it were our own.

I guess you could say that thanks to Eugene, our ambulance was the cleanest in the fleet. Following a Eugene transport, we would spend an exorbitant amount of time hosing down and flooding the patient compartment with every cleaning solution we had on hand. Then, for good measure, we would use our own personal cleaning products for a secondary wipe down. It’s citrus scent made us forget the ammonia produced by Eugene’s overworked kidneys.

We had just finished an extensive clean up of our ambulance from a trauma job when we received the familiar address that let us know Eugene was looking to go to the hospital again. I was working with Quinn, who resolved that something needed to change in our relationship with the passive-aggressive urinator. When we pulled up he immediately began negotiating.

Eugene seemed almost apologetic but it was out of his hands, he told us. When he needed to go, he was going to go. It was almost a Pavlovian response, he tried to explain. He was just used to peeing in ambulances and he didn’t really want to stop. He suggested that, perhaps, he could switch it off with a substantial donation of cash. We checked our pockets but our monetary reserves were a little low for the bribe he was asking for. It looked like we were going to be spending more time soaping up the back with disinfectants.

As Eugene searched through his scattered belongings for his Medicaid card, he told us he wanted to go a particular hospital on the Upper East Side. Despite his lack of electricity, he had managed to become familiar with a new radio advertising campaign for one of the big hospital chains and he felt that it resonated with him. “We go the extra mile for our patients!” they proclaimed. He liked that. The closer hospitals that he usually went to barely went the required mileage, in his opinion. On the East side there was a hospital that was not only standing by for possible customers, this one was asking, no begging, for him personally to come in and be treated by their welcoming staff.

Quinn made a deal to take him there, without the requisite argument about going to the closest 911 receiving, if he could hold his urine in. Eugene reluctantly agreed.

He got in and laid himself down on the stretcher. He wasn’t going to sit on the bench seat for this ride to update his hypertension meds; he wanted the gold star treatment. Quinn was remarkably accommodating. He smiled and even got him a pillow. Pillows were rare commodities in pre-1995 EMS. We were already going the extra mile and we weren’t even a part of that healthcare system.

As I sat in the back with Eugene, I started writing my paperwork for the extended ride to the other side of town. It was probably just an extra six or seven minutes or so but going across Central Park was like leaving your own territory. Things were quiet initially, when I suddenly heard a squelch from the novelty intercom on the wall. I had always felt the intercom was a needless addition to this generation of vehicles. Our truck had big, wide open square between the patient compartment and the cab. You could always hear each other without even raising your voice. But I knew my partner had been itching for an opportunity to use it and here he had found it.

Quinn was a master voice impersonator. Over the intercom he sounded like an elderly woman. “Hello, hello?” he said in his female voice. “Is there a Mr. Eugene on board?”

Hearing his name, Eugene reacted. “What?” he asked. “Is someone talking to me?”

“Yes,” said my partner. “My name is Mary and I work in the kitchen of the Extra Mile Hospital. Have you heard our new slogan?”

“Yes,” said Eugene proudly. “You go the extra mile! That’s why I’m going there. I heard good things about this place.”

“Why thank you, yes!” said ‘Mary’. “We certainly do go the extra mile. Which is why we set up this service to take your meal order while you’re on the way to us, so its hot and ready when you get here.”

“Meal order?” said Eugene. “Is it lunchtime already?”

“Well, almost,” my partner answered in character. “You see, we believe that good nutrition is the hallmark of excellent care. We think that you’ll heal better with nice hot meal in your stomach. That’s part of our new philosophy of going the extra mile.”

“Why ain’t that something?” smiled Eugene. “Other hospitals should do the same thing! How come they’re all not doing it? All the other places are really stingy with the bologna sandwiches. They should be listening to you!”

“Yes, that’s true. Everyone should. But they don’t. But you’re not just getting some cold, dry sandwich. We’d like to set you up with a real hot meal. You’ve got to make a selection and we will present it to you at the ER.”

What the hell was my partner up to? It was genius, I had to admit. I was dying inside at how he had come up with this idea on a whim and here he was, going through the motions, finally making use of that intercom. It was difficult to stifle my laughter but I did as Quinn, as Mary, presented Eugene with several culinary choices. They sounded like descriptions off a high priced menu with random French phrases thrown in that Quinn had been learning in preparation for an upcoming vacation to the City of Light. Eugene could choose from Filet of Sole de Parlez-vous (filet are you speaking), Ah-la-Vache Prime Rib (literally, oh my cow), and Pork Chop au Revoir. Eugene chose the Good-Bye Pork Chops.

“That’s wonderful, sir,” she told him. “It comes with a side of green beans and mashed potatoes. There is a nice red wine reduction added to the gravy and a hint of garlic to the potatoes.”

“That sounds fantastic!” said Eugene. He had such a big smile on his face. I almost felt sorry for this man who had caused me so much disgust and scrubbing related back pain. I was pretty sure he wasn’t going to be getting any kind of meal at his hospital of choice, not even a stale sandwich wrapped in plastic. As someone who’s eating plans have often been interrupted by a dispatchers voice over the radio, I had some empathy for his upcoming plight.

“Ok sir,” Mary told him. “I’ll put that order in. Just remember the order is number E-as-in-Eugene, two, three, four. You got that? E234.”

“I got it!” said an extremely satisfied Eugene. Then he looked at me and said, “See? THAT’S why I wanted to go there.”

All I could do was nod in agreement. This was certainly quite a hospital he thought we were headed to.

We made it to the big hospital on the wealthy side of town and Quinn opened the back doors. As I hopped out, Quinn asked Eugene how he was doing. “I heard you could order lunch here,” he said to him.

“Yes! And I did!” Eugene told him.

Feeding people seemed to be a successful strategy that hospitals should probably look into actually doing. Eugene was already a different person, a pleasant person. He’d probably be an ideal patient for everyone involved, after a nice, hot meal. It seemed to be a small price to pay for a better working environment.

“You’ve got an order number for your meal, don’t you?” my partner asked.

“Yes I do,” said Eugene. “E234. When do I get my food?”

“Good, right after you’re registered, just tell them your number,” said my partner. His tone now turned a shade more serious. A concerned look was on his face. “But I’m going to tell you something. Don’t forget your order number.”

Eugene was all ears.

“The food they cook up here is outstanding. It’s made by chefs with Michelin stars to their name. In fact, it’s so good the staff likes to help themselves to the food. They might even tell you that you’re not entitled to a meal just so they can enjoy it themselves! But you’ve got an order number, right? Don’t you forget it.”

“I won’t!” replied Eugene with all seriousness. “Thank you.”

I was feeling really bad for Eugene until we transferred him over to the hospital stretcher and I noticed he had pee’d on our stretcher, violating the initial agreement.

“I had to. I’m sure you don’t mind. I little extra elbow grease never did any harm to no one. Make sure you clean it real good,” he told me with a big smile when I saw what he had done.

“Enjoy your pork chops,” I told him with a tinge of sarcasm.

“Oh I will,” he told me. “While you’re cleaning up that stretcher.”

Maybe I shouldn’t have taken that much enjoyment in it but I did, especially when we returned with another patient. After leaving the ‘Extra Mile’ Hospital, we had gotten hit with another job very close by and brought the patient back to the same place. We found our previous patient, Eugene, tied to the stretcher he was on. He was screaming mad, yelling at every employee who walked by.

“Look at you! I know you can’t pass by a plate of beautiful pork chops without helping yourself! I know it! You don’t look like someone who could stop themselves from eating even a free bologna sandwich that didn’t belong to you!”

The nurse triaging our present patient gave us a nasty look. “Thanks for bringing that one in,” she told us. “He’s been nothing but abusive and threatening violence on everyone here. Thinks he’s getting fed, a voice named Mary told him, he says. If he keeps this up he’s going to psych.”

“I WANT MY GRAVY WITH THE RED WINE!” we could hear him in the back ground. Everyone could hear him.

“Sorry,” I apologized. “He wanted to come here. He saw your ad.”

The nurse shook her head, “They could have saved us a lot of problems by not sending out advertising. How much did all those billboards and radio ads cost? We’re short-staffed enough without asking for more people to come here.”

I understood her complaint and empathized with her and the rest of the ER that now had to deal with Eugene. She signed my paper and as I was leaving she let me know that Eugene had soiled his stretcher not just once, but two times since we had left. The man certainly had a powerful urinary system.

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?

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 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 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.”

© 2025 streetstoriesems

Theme by Anders NorenUp ↑