Tag: ems stories

September 13, 2001

September 8, 2021 / Nancy Gwillym

On September 13, 2001, I was sitting in my union’s office with several coworkers, from different Brooklyn stations, awaiting transportation to Ground Zero. We were collectively living in a strange kind of haze after the biggest terrorist attack on our nation, and our city. We had been told to report to our union office if we wanted to assist in the rescue and recovery mission but no one there that day knew what to do with us at the moment. There was a row of telephones on a long table and one of them began to ring. I was the closest, so I picked it up.

“Howdy!” said the friendliest voice I had heard in many days. “We’re from a local in western Montana and we just need for one of you to give us the go-ahead to put our truck into drive.”

Was this a wrong number? Who were they trying to get? What were all these phones for anyway?

“Excuse me?” I asked. “I’m sorry, I’m just waiting here and picked up the phone. Who were you looking for?”

“Well, howdy again, ma’am,” he said. He slowed his speech a little and his enthusiasm went down slightly, but only slightly. “Your brothers and sisters in western Montana have loaded up an 18-wheeler, don’t ask us how we got it, we ain’t telling. We’ve got supplies and a few extra humans to help out our friends in NYC. Now, we’ve got this behemoth pointed east. Joe here, assures us he knows how to drive it. I’m not asking for the paperwork. All we are looking for is the go-ahead to move this thing forward.”

He had put a huge smile on my face but I just automatically started crying. I was actually bawling if we are being honest. I’ll admit I was quite a bit sleep-deprived, which makes it fairly easy to turn on the tear spigot but that, I’m sure, only played a partial role. I was mostly filled with an overwhelming sense of love and gratitude towards this stranger on the other side of the country who had assembled supplies, volunteers, and even a very large truck under auspicious circumstances, apparently, just to help out people he had never met. I’m not sure what he thought when he heard me crying.

“Don’t worry, darling,” he told me quietly. “Love always wins. It might take a while before the light gets shined upon it, but evil always takes a backseat to good.”

I thanked him profusely for that, and for the mission he had set up. I told him I was in no position to authorize anything, and that maybe he should call back later. But he didn’t care. He felt that my answer indicated that his truck needed to hurry up and get to New York. They were just going to head east until they found us. He wanted us to know that help was on its way.

I will never forget that phone call.

***************

When the two airplanes struck each of the buildings of the World Trade Center I was working my other job at a cardiac monitoring service on Long Island. (Most of us work an additional job to support the job we are addicted to.) When news came that something huge was going on in downtown Manhattan, my boss rigged a television up and we all watched it together. Everyone there knew what I did at my other job and they all just looked at me quietly.

My then-boyfriend/future husband was working EMS and on the clock while all this was going on. I had some trouble getting in touch with him but our lieutenant (we worked at the same station at the time), told me he was ‘probably’ safe.

I was able to get a hold of my partner, who lived close to the cardiac monitoring place, and he came and picked me up in his car. We drove to the city together.

Most of the roads towards the city had police roadblocks and we had to keep flashing our ID cards for much of the ride. We had ideas of picking up our equipment and heading to Manhattan, even though we were scheduled to work our unit that evening but first, went to our station to see what was being done from there.

Everything was up in the air. I don’t know what kind of planning was going on for that evening or the days ahead because it seemed that anyone in charge was in lower Manhattan and inaccessible. We weren’t sure what to do, no one was.

For the time being, our lieutenant told us, we were to stand down. A city bus was on its way to take us to Manhattan. They were working out the scheduling and the logistics.

Eventually, the bus arrived and we got on it. And then it was canceled. No more people would be going to Manhattan, the lieutenant told us. Too many units were there and not enough were covering the regular 911 needs of the city.

So on the evening of September 11, 2001, my partner and I worked our usual truck.

It was a strange time to be doing your regular job. The entire city was in shock, as were we. I remember most things as if they happened in slow motion. Reports floated their way to the station of the names of people we might know, people who were missing. The call volume was higher than average but quite a few of them were calls of anxiety. Many people were hearing things, seeing things that turned out to be unfounded. We took some drunks to the hospital, many of whom didn’t even know that a major disaster had taken place a few miles away.

I wondered about my sister, an air traffic controller, who must have worked her tail off to land all those planes. It’s a stressful job to begin with, but on that day everything that was flying had to land, immediately or as soon as possible. You can find real-time air traffic images online to see just how daunting a situation that was.

We did our regular job again the next day too. Everyone was still feeling the effects of this major devastating event, even more so since more was known about it. So many people were missing, coworkers were missing. Several people I knew had already been confirmed dead.

It’s difficult to do your job when you’re an emotional tinderbox. There are drug dosages to be calculated and protocols to remember. You’ve got to pay attention when you’re driving. All the while you had to hold it together for everyone else, despite more and more information pouring in, more names of the missing, more buildings.

There were countless stories about people jumping off those buildings to avoid burning to death inside. You could only try to imagine the kind of desperation that takes. At the time, it was thought that hundreds could be trapped in the rubble. To think about those poor people, desperately waiting for help, was heartbreaking.

Our unit had developed a friendly relationship with Squad 252, which was in our area. We even had the code to the door, which surprised the firefighters that had been sent there to cover the firehouse. We went over to see how they were doing but the looks on the faces of the men there told us everything.

And yet I was still picking up drunks and people were still calling for colds that their antibiotics hadn’t cured in three days. Normally those calls don’t bother me. I often find them entertaining and they are a nice balance to the ‘real’ calls that involve suffering. But at that time there was nothing redeeming about calls like that, and there were so many of them, during the aftermath of a terrorist attack. Didn’t they even watch the news?

Back then, I like many others, had no landline. I was living with a friend and the only phone line in the house was dedicated to dial-up internet. My then, high-tech brick of a phone had no service for more than a day after the attack and when it finally did come back it had a very limited range. I desperately wanted to get in touch with my family. I was able to call my mother in Florida after a few days but my dad in Hawaii would have to wait much longer. It was like we were back in the days before the industrial revolution. Most people were having difficulty with phone service and yet others were still able to call for an ambulance because their foot had a rash.

I cannot describe how maddening this all was to me. When you deal with the onslaught of pain and suffering fairly regularly one of the biggest coping mechanisms is knowing that you tried and that you were able to help. Sometimes your efforts fail but the simple knowledge that you did everything you could makes all the difference in the world.

There is also something to be said, something important, about keeping busy. But nothing we were doing was satisfying. Nothing seemed like ‘helping’. It seemed like everyone wanted you to forget what was going on and just do what you used to do as if nothing had changed forever.

So, on my first day off I wanted to head to lower Manhattan and dig. But you couldn’t just drive over with your shovel and helmet. There must have been some organized efforts I could join, I thought. Or I would be one of the medical volunteers somewhere, I hoped. Anything. I would do anything.

But on the days previously, when I had been working, information about how to go about doing so was spotty and constantly changing. Initially, we had been signing up for extra ambulance shifts that would be dedicated to lower Manhattan but they had been canceled. I had tried to go over after and before my regular shift. (And I still had to pick up my car and the stuff I had left at my other job in order to try and accomplish these things).

The best lead I had was to go to the union office as I had heard they were bringing groups of EMTs and paramedics to work ad hoc posts that had been set up. I had spent less than five hours at home in three days and I couldn’t wait to go to Ground Zero because I was desperate to assist in some way, anything, to feel useful because driving people to the ER for anxiety wasn’t doing it.

A little ragtag group had assembled at the union office that day. I clearly had not been the only one who had heard this was the place to go. But the two people in charge at the office didn’t know what to tell us either. Their information was also constantly changing.

My then-boyfriend/future husband had gone to a different location where EMTs were being picked up to work at medical outposts that were being created. Paramedics were excluded, we were told, because paying us was too expensive (ridiculous, given the sparse difference in our salaries). It seemed they didn’t care that they had ‘volunteers’ who were willing to do things for ‘free’. This just added to the outrage, that in the middle of a nationwide tragedy, the same silly nickel-and-dime rules were applying. There was just so much to be angry about.

But then the phone rang, and I spoke to my new friend from western Montana.

I told the small group about the call and it empowered us to get up and go together. The union gave us a placard and we got into someone’s vehicle and made our way downtown, shovels in hand.

Along the way the roads were lined with hundreds of well-wishers holding signs of encouragement, handing out water and snacks at traffic stops, and cheering us on. My hope for humanity was returning again.

Lower Manhattan was surreal. It had been two days after the attack and the air was still thick with a big white fog of particulates. It was really overwhelming and surprisingly quiet.

Maybe it’s just my slow-motion way of remembering it, but sounds seemed dull, the way your neighborhood feels when it’s covered in a blanket of snow.

We parked in an area where other vehicles had been assembled, ones that had been recently used, as opposed to the ones covered in white dust and debris. As we walked towards what was left of the Trade Center we would often see a random person, almost everyone was wearing some kind of uniform, and they would give you a somber nod that you would return in kind.

I was struck by the lack of “stuff” in the debris. It seemed to be mostly building material, steel, and rubble. Two major office buildings had come down and there was a surprising lack of office equipment, crushed or in pieces. There was also no glass. I assumed it was a large part of what was making up the white fog.

The air had a strange, acrid smell to it. After only a block or two, our uniforms were already covered in dust. At the first makeshift station we passed, we were handed an N95 mask, the kind I used to drywall my living room. At some point, later on in the day, I was warned by someone in a state uniform that my N95 mask was wholly inadequate and that I needed to get something better.

“Where?” I had asked.

“Oh, we don’t have any. Nobody does. But what you’re wearing, it’s not enough,” he told me. He’s the only one who said anything about it on any of the days I was there.

Everything’s good, here’s your mask, you probably don’t need it, air quality is fine…

We walked around seeing different people in different places. It was comforting to see familiar faces of friends you hadn’t been able to get in touch with. For this reason alone, I was glad to be there.

We spent a good while walking around, taking in the new landscape. I snapped a few photos with my disposable film camera. It was numbing to see what was still standing and what had been crushed.

At some point, I volunteered at a medical station that had no medical people at it. Someone there begged me and one of my group to stand by until they found a dedicated crew. It was in the lobby of a partially destroyed building. About an hour later, there was a sudden call to evacuate due to the instability of that building. My friend and I took off and went to look for someplace else we could be useful.

Much of the day consisted of stopping by, assisting, and then leaving when different orders came or new groups arrived. The amount of work ahead was, of course, insurmountable and it didn’t feel as if we had accomplished anything of significance but it felt much better than pretending nothing was wrong and following the same routine we had been doing.

The one thing that does stand out among all the sadness and shock was the massive number of people who came to help. They too, I believe, felt that doing something was an important way to get past the helplessness one feels when something terrible has happened.

So many individuals were donating their time, services, and resources. Massage tents had been set up, catering of all kinds was going on, tables were set up with all sorts of donated articles- t-shirts, gloves, flashlights, socks, helmets, climbing gear, and so many other things, it overwhelms me to remember.

And there were also the crowds, lining the roads leading to lower Manhattan. Access was blocked for most people and yet they found a way to participate and help. Their encouragement and positivity were a wonderful window of light in the dark room of our collective mental anguish.

I went to the site a few more times over the next several months. Over time, things became more organized. There were specific areas you could work, and eventually, Ground Zero became coordinated into a routine with procedures to follow and ways for things to be cataloged. The outpouring of love and appreciation from the public continued for a long time as well.

I never found out who the caller was on that day in the union office. I hope that he knows how uplifting his voice and his message were and how it meant far more than all the supplies they had managed to assemble in that short period of time. He was 100% correct about evil taking a backseat to good and he was definitely part of the ‘good’.

My First Baby Delivery

April 4, 2021 / Nancy Gwillym

I was sitting in my doctor’s waiting area perusing through piles of long-expired magazines. It was 40 minutes past my appointment time and there were others who had waited longer. The staff told us that the doctor was running late, she had an emergency delivery at the hospital. We were offered to reschedule but I preferred to get my visit over with, as did most of the others, apparently.

Eventually, the door opened and my doctor hurried in. As she took the scarf off her head, she apologized to the staff and everyone sitting.

“Thank you for waiting,” she said. “It was a difficult delivery but there’s another beautiful baby boy out there today!” Everyone clapped and the extended appointment times were quickly forgiven.

Not long after, my name was called. I put down the April 1999 edition of Mother and Baby and headed into one of the exam rooms. When she came in and saw it was me she exclaimed, “Oh! Now here is someone who will appreciate my hectic morning!” (and I did). “It was a problematic pregnancy, the numbers were off, there were issues at the hospital but it came off OK and now mother and baby are doing well.” She seemed so relieved.

“That must be the greatest experience,” I told her. “Presenting a happy mom with her healthy baby…”

She knew I was a paramedic and we had often shared interesting medical conversations interspersed with the usual chit-chat as she scraped my cervix. She was my favorite doctor by far. I had met her own kids at the office and she frequently gave me what she called “Standard Jewish Grandmother Advice” about love, baking, and getting older, even though she was not much older than I was.

“You’ve never delivered a baby?” she asked me, surprised. “You need to intercept all of those cab drivers who are doing it. They’re all over the news.”

“I’ve delivered babies,” I told her. “But I’ve never had a happy, normal delivery.”

She looked concerned, as is everyone I tell this to, especially my new coworkers who have yet to have a baby delivery under their belt. Her look turned to horror when I elaborated on the handful of delivery experiences I had. I am grateful there aren’t that many.

Often, it’s not so much the delivery but the circumstances around it. I am incredibly happy that I have not encountered any serious issues during the process itself. The mothers really do all the work, usually. You just guide the little one out, suction, flick the feet, place 2 clamps on the umbilical cord, and cut in between. Easy, right?

Not exactly, it is a bit nerve-wracking for me, for some reason. It would probably be good to do all this in a controlled environment but that has never been my experience. It’s always occurred in inconvenient and less-than-ideal areas where you’re groping about for all the little things that get scattered when you rip open an OB kit nervously.

None have ever been delivered in the back of my ambulance, which would have been a more controlled setting. But I’ve seen ambulances where a baby had been born and the aftermath made it appear as if a serial killer had brutally tortured several people with a knife so it probably isn’t as controlled as I would like to imagine it is.

The circumstances that made my delivery experiences PTSD invoking had more to do with speculation about the series of events that would happen after. All of my baby births have involved underweight, drug-addicted little infants who were quickly handed off to the social service agencies of our city. It’s difficult to process the feelings of hopelessness you experience when you assist in the arrival of someone who immediately needs help from our overburdened bureaucracies, in addition to the Neonatal Intensive Care Unit.

The first baby I assisted in delivering was to a homeless woman in a small park flanked by tall office buildings. The park was not very big and she was right in the middle, sitting on some newspapers on the floor next to a bench.

She was naked from the waist down with her legs spread wide. She had not gotten prenatal care and wasn’t sure how far along she was. When we got there, the baby was just about to rear his tiny head. She couldn’t be moved.

As the baby was coming out, I looked up to see hundreds of people looking down at us from the floor-to-ceiling windows of the buildings surrounding us. We used a sheet to create something of a tent but they probably knew by now what was going on. It was a harrowing experience for a first-time OB call and I was far more nervous than the mom.

When the baby was born, he was really tiny. The mother smiled when we gave him to her and she rubbed his small face with her finger. She seemed a bit distant and not at all happily overwhelmed as I expected her to be.

I look back and wonder if she were trying not to get too attached to a baby that would probably be taken away and put into foster care. I had assumed she was exhausted from giving birth without an epidural.

She had told us she had given birth once before. “Another boy,” she had said, somewhat wistfully.

She told us he was in foster care, explaining that in NYC babies weren’t allowed to live on the street with homeless mothers. She expected to be given a placement in a family shelter now that she had this child. She hoped that when that happened, she could try to get her first child back. It hadn’t occurred to me at the time that she probably could have gotten into a family shelter with the first child, with that policy, and yet her child was still presently in foster care.

Not long after arriving at the hospital, the baby was quickly whisked away into an incubator. We found out that he was only 5 pounds and would probably be going through some alcohol withdrawals.

People at the hospital berated us for not keeping the baby warm enough, despite using our last sheet and blasting the heat in the ambulance in the summer. This was the same hospital that was stingy with their one-for-one policy with bedsheets. We now have swaddle blankets for infants that do a better job of conserving body heat, but at the time we were at the mercy of the hospitals for sheets and blankets which were used for so many things, including blocking the view of unwanted onlookers and keeping newborns warm.

When we returned again a few days later with a different patient we were told that the mother had snuck out of the hospital, leaving her baby. She had given us all a fake name.

Once again we were treated harshly for “not checking her ID” as if we had technology that can detect fake Medicaid cards. They had fallen for the same ID but it was easier to lash out at us, I suppose.

I asked (someone else) about the baby and they said he was still in the pediatric ICU and would be placed in foster care. We were able to see him for a brief time. Surrounded by other tiny babies he looked rather healthy and very cute and also very vulnerable. I couldn’t imagine someone running out on this little one. His first experiences in this cold, harsh world had already been cold and harsh.

I was initially filled with anger towards the mother. But I understand that she was an addict and addiction-thinking is governed by instincts that become redirected toward everything substance-related. Perhaps, I reasoned, she had left him for unselfish reasons, knowing that she couldn’t give him what he needed.

It filled me with tremendous sadness, thinking about that poor little baby starting out so alone. What would life be like for him? Would he ever see his mother again? Would he meet his brother? Would he get adopted by a nice family?

Whenever I think about this call it becomes a long list of negative thoughts: of the lonely baby, the mother so substance-addicted that she chose a life on the street with her drug of choice over this little boy, the hospital with their petty need to take things out on us that we had no control over, and those office workers with their horrified faces. I imagined the story the gawkers would tell their friends later and how the story would be told.

I also wondered about all the blood that had been left in the park. We didn’t have any kind of resources to clean it up and I remembered the police officers, who had been on the scene with us, leaving at the same time. An average person walking their dog through the little area would probably assume someone had been murdered.

I never saw the mother again. It’s a little strange for EMS people to not run into the same homeless people in the area. They become our regulars and we develop a rapport with them. We even get to know the ones we don’t transport on a regular basis, waving to them as we drive around the neighborhood. Maybe she had found some other place to go or had gone into treatment, prompted by the birth of a baby she had left at the hospital.

When my story, and my exam, was finished my MD said little. I felt terrible for taking away the high of her successful morning and tried to steer the conversation toward other things. Afterward, I went over to the office staff to give them my copayment and take the usual card they hand out, which reminds you to make another appointment at a specific date. This time, I was also handed a prescription. No medications had been discussed and I was a little surprised. But it wasn’t for medication. It had the address of a bakery nearby. She had written on it, with a smiley face, “Get yourself some cheesecake. (a small one). Doctors orders”

Young Thespians in Jail

February 6, 2021 / Nancy Gwillym

A huge building had gone up near our area. It took up a whole city block but it was unremarkable and there were no signs advertising what it was used for. We weren’t all that curious and just continued to drive past it with occasional passing interest. For many years we were able to blissfully ignore it. But then, one day, our good fortune changed and we became very familiar with this large building, as we started going there all the time.

We found out that the building was a juvenile corrections facility, housing children age 16 and under who had committed the worst crimes and required a high level of security. They had an infirmary and a medical staff that had been getting by without calling for an ambulance for so long that their new about-face was somewhat perplexing.

Our first call there was for a 16-year-old boy having seizures. He had obviously never witnessed anyone having an actual seizure, either in person or on TV, or he could have provided us with a more believable performance. There are different kinds of seizures and some of them present differently, but our patient hadn’t mastered any of them and seemed to be making things up as he went along. With his floppy arm movements and erratic blinking, I had a hard time believing that the professional medical staff in the infirmary had bought into this pageantry. Perhaps they believed he was in need of hospitalization because the kid didn’t have a seizure history and may have been worried the seizures were a manifestation of a hidden brain tumor.

We gave the young man an IV, which was easy to do since he temporarily halted his flowing, dance-like arm motions so we could get it without accidentally sticking him elsewhere. My partner and I had spoken at length about how painful that would be, while we were preparing our IV set up. I guess he had been lucid long enough pick up on that bit of information. After we secured our IV, the patient resumed his feeble attempts at seizing, but would again, temporarily, stop each time we pushed medications through the IV.

We have had many people fake seizures for us, for various reasons. Sometimes it’s to be dramatic, for others it’s an attempt at getting some Valium. We didn’t know the motivations for our current patient, but if he wanted Valium he’d have to do a better job at convincing us.

We could still give him “the cocktail”, however, as we called it, for our “Altered Mental Status” protocol. At the time we carried Thiamine (vitamin B1) which was part of the cocktail triad, along with Dextrose (sugar) and Naloxone/Narcan (the drug that reverses the effects of opioids). It makes me sad that new paramedics will not have the ability to witness the placebo effect of the Thiamine wonder drug, since it has been taken out of our protocols currently. Thiamine was considered so benign that the board, who decide our protocols, found it to be an unnecessary expense. They had obviously never witnessed its miraculous efficacy.

If the kid envisioned a future on the stage, he could have learned something from us that day. Having had so many opportunities to practice our own acting skills, I’d like to think we did our routine convincingly. We used the standard script developed for these occasions. It’s one that all paramedics seem to have subconsciously downloaded into our psyches, possibly acquired subliminally when learning our protocols.

We start out with Dextrose and then deliver the Narcan, each time announcing to each other, with solemnity, that we hope the drugs work because the patient appears so seriously ill. We then kick up our level of resolve by moving to the standard, somber discussion about Thiamine.

“I guess we will have to give the Thiamine,” I announced with extreme concern.

“I know. I can’t believe the other drugs haven’t worked yet. We have no choice,” remarked my partner.

“But remember the last kid we gave it to? He’s a vegetable now, on permanent life support. I’m worried about its safety for teenagers. I don’t think they tested this enough on younger patients.”

“Yeah, but it’s still in protocol, at least until they settle the lawsuit. I’m not getting in trouble. Hand me the vial.”

“I don’t know, I really want no part of this,” I said with emphasis.

“It’s OK,” said my partner, nobly. “I’ll take complete responsibility.”

Miraculously, our 16-year-old made an instantaneous recovery in a matter of seconds. He sat up as if sleepy, wondering what was going on. What was happening? Did he have a seizure or something?

The dopey medical staff was also impressed, which had me seriously doubting the framed credentials hanging on the wall. We took him to the hospital to get “checked out”. We gave the ER staff a brief description of the psychedelic dancing he wanted to have interpreted as a seizure and they said they looked forward to the presentation.

A very short time after we dropped off the male, we were called back for a female. The juvenile center was certainly making up for lost time after all those years of handling the residents by themselves. Our second patient was 15-years-old and she was trying for the Academy Award in the Asthma category.

She had done a good job of convincing the inept staff that something asthma-like was going on. I wondered if they had ever dealt with a real asthma patient. The staff was in a panic, knocking things over and bumping into each other, trying to fill her nebulizer device. We, on the other hand, were extremely familiar with asthma and all of its manifestations. It made up a major percentage of our call volume. We gave her performance a decided thumbs down.

All of her ‘wheezing’ was caused by a concerted effort on her part to constrict her throat muscles. Her lungs were absolutely clear. Because she had to un-constrict her throat muscles to talk to us, her ‘asthma’ was temporarily abated when she answered our questions. I discreetly pointed out to one of the nurses how miraculous her recovery was. The nurse seemed to feel it was their quick action with the nebulizer that was responsible, despite a floor wet with spilled asthma medication. My faith in those accreditations on the wall continued to wane.

We took the asthma-girl to the same hospital as the seizure-boy because it was the closest. As per the policy of the detention facility, each trip to the hospital meant that two corrections officers were needed to accompany the patient. At the hospital, the two pairs of officers met up. They resented that their day had been interrupted by extraneous visits to the hospital, as it left them short-staffed at the facility. They too suspected the youngsters were faking their illnesses and they were furious.

About two days later the ‘asthma girl’ had another attack, despite a handful of new medications prescribed by the hospital. We had only gone to our newly-noticed juvenile facility three times at that point, but it was already growing tiresome.

When we wheeled her into the pediatric emergency room, lo and behold, the seizure boy was there again also! He had suffered another episode. It was a spectacular coincidence.

I noted the time on my watch and saw that the pair’s latest medical attacks had occurred at the same time of day as their previous episodes. Their amateurish performances were on a schedule.

I took one of the disgruntled correction officers aside and inquired about the relationship between the two and was shocked to discover that not only were they boyfriend and girlfriend, they had landed in the facility for committing the same crime together. I could have never predicted it.

The corrections officer had much dirt to spill for us. It turned out that the lovers were not just terrible actors, but terrible human beings as well. He, and later the other officers, told us that the young couple had attempted to kill the girl’s grandmother when she became an impediment to the young lover’s plans. She had not approved of her granddaughter’s dating choice and grounded her one weekend. The next day they put drain cleaner in her coffee. Despite the unusual smell and taste, the grandmother had ingested enough to cause severe burns to her esophagus and was in critical condition at a hospital. The pair had left the drain cleaner and the coffee cup containing the drain cleaner on the same counter, making it easy for the police to put two and two together. Their fingerprints were all over the bottle and the coffee cup and neither of them had called 911 when the grandmother began choking and writhing in pain. A neighbor happened to be walking past the apartment and heard the fall and the elderly woman’s attempts at screaming. The acting debut of the young criminal lovers, which consisted of pretending to be upset and shocked that grandma had drunk something so toxic, was not well received by the police or the neighbor.

Ever since their arrest, the two had been housed in separate areas of the same facility and there were never opportunities to come in contact with each other. It seemed that the only place the couple could be reunited was at the hospital, even if only for a short time. As a result, their “illnesses” became more and more chronic, wearing out the patience of the EMS community, and also the hospital staff. Many people we knew had taken at least one of them to the hospital at some point, and all of them, thankfully, mocked their poor interpretations of an asthma attack and a seizure.

Having witnessed the damage drain cleaners can do when ingested, I had zero empathy for the plight of the star-crossed lovers and their efforts to be together. Nor did any of the other EMTs and paramedics, who were getting a little tired of having to participate in their charade of a medical emergency. It was curious that those two were the only patients we were ever called for. How long would we all have to wait until they were sentenced and incarcerated elsewhere? We agreed that this thing needed to be nipped in the bud if we wanted to resume our ignorance of the large building on Pitkin Avenue.

We collectively decided that other hospitals should share in the poor acting abilities of the young would-be murderers. We were sure the corrections officers would be willing to assist us in the endeavor.

The next time we went there, it was for the female, who protested when we gave the name of our intended hospital destination. “Her doctors” were waiting for her at another hospital. Surprisingly, it was the same hospital her boyfriend had been transported to just an hour before. The corrections officers jumped right in and explained that their policy had been revamped to keep inmates separated outside the facility as well as inside.

During discussions of the new policy, our patient’s ‘asthma attack’ miraculously subsided and she decided that she no longer wanted to go. We had to take her anyway since she was not old enough to make the decision on her own and the facility required transportation. Since her reason for going had been thwarted she protested wildly over her desire to stay. But the concerned nurses at the infirmary noted how her disease had been progressing so badly as of late and they would not be comfortable with her staying there. The young actress was a victim of her own success.

Now that she was going against her will, she whined and complained about the waste of time it was for us to take her. Why was she going if she was OK now? She glared with hatred at me and the corrections officers when it was clear we weren’t going to turn the ambulance around, despite her best arguments.

After a short interval of quiet contemplation, she suddenly told us, and this was shocking, that she *didn’t* really* have* asthma! The whole thing had been a sham! Just to see her boyfriend! She had put one over on us, but good.

I couldn’t believe we had been tricked. I tried my best to convey how stupid we felt, that as medical professionals, we had not been able to tell. She smugly nodded, proud of the way she had manipulated us into believing her. She let us know that she was going to use the exact same skills to convince the jury that she shouldn’t go to prison. She admitted the case didn’t look good but she was sure no one would want to send a young girl to prison for killing someone with so little time left on the planet anyway. She was confident the acting skills she had honed on us could make a jury feel sorry for her, and probably her boyfriend too. After all, look at how many professionals had bought into her performance. She smiled a self-satisfied smile of superiority that I hoped would serve her well in prison when she got convicted.

The Panhandler’s Brawl

January 21, 2021 / Nancy Gwillym

No one expects panhandlers to keep banker’s hours, but having someone bang on your window, cup in hand, at 3 am is more than a little unnerving (and unlikely to result in a donation). For a woman working alone, it’s a huge a safety risk to roll down the window for a random stranger in the middle of the night. Even though the possibility exists for it to be a real request for assistance, in finding an address or to alert me about a possible medical problem, it’s not something I would normally do. But sometimes, particularly in the summer months, the absent-minded desire for a cool summer breeze brought about by an open window can make you fair game for the cash-soliciting opportunist.

Like every lieutenant, I have my regular locations where I park to take a break from driving. For a time, I had a rash of men asking for cash at not just one of my “spots”, but all of them, as if I had a strange GPS homing device attached to my command car. The odd thing was that all of the men universally told me they needed the money specifically for the purpose of buying baby formula. The details of their stories varied but the ending always involved a poor infant somewhere being deprived of sustenance.

In my head I would wonder where one would even purchase infant formula in the early hours of a new day. The location was never near a 24 hour supermarket or any other stores that might carry it. It fascinated me how so many different men used the same story. Where had they all come up with this idea? How could there be so many babies suffering, waiting for these men to return after successfully locating kindly strangers to pay for food, food which is advertised all over the city as being available for free with certain assistance from city agencies.

Luckily, at our station we actually had infant formula. It had been left over from a recent food drive or humanitarian aid campaign after the person giving it missed the donation deadline. As the supply waited in limbo for the next charity drive I noted a soon approaching expiration date on one of the containers, making it perfect to give away to the next stranger that interrupted my midnight hour me-time.

I carried the little canister with me every night I was on the road but it wasn’t long before another dedicated baby advocate made his way to my vehicle.

“Can you help me ma’am?” he asked. “I’ve got a new baby at home and we are out of formula at the moment. It’s not like I can talk to the social services people to get another voucher at this hour. Just a few dollars and I think I can get enough to feed the little guy until tomorrow.”

He would probably wonder about the incredible coincidence as I made his day, I thought. “You know what?” I told him, “You are in luck! I would love to assist your baby. What’s his name?”

The man’s face lit up as he told me “Henry”. It made my heart swell knowing I could provide a real service to this man who would no longer have to wander the streets in search of food for his new addition.

“You tell little Henry that we at EMS have his back and welcome him to the neighborhood!”

“I certainly will!” he said happily as I dug around behind my seat.

Finally, I pulled out the prize: Baby formula! It was exactly what he had asked me for.

I was surprised the man wasn’t ecstatic. His search had ended, the long walk was over. He didn’t even need to go to the store. He could go straight home now. The hero EMS lieutenant had taken care of all of it!

And yet I had never seen anyone so disappointed to receive exactly what he had asked for. For a moment it looked as if he was going to say something else but thought the better of it before walking away, dejected. He turned to give me a quiet ‘thank you’ before he did.

**************

A few weeks later I was approached for a hand-out while I was waiting behind another car at a traffic light. It was near the corner of a major thoroughfare and on the weekend, in the summer. It was early, around 3 or 4 am when the panhandler spoke to me through my foolishly half-way lowered window.

“Hey there boss-lady,” he said in an extremely friendly tone. “Can you please help a man out?”

Another man immediately appeared after that first one. This man tapped the first on the shoulder. “You should know better than to bother a woman all alone in her car!” Finally someone got it. If I was going to search through the seat cushions for change, and I wasn’t, he would have been the one entitled to it.

“It’s not safe out here!” the second man continued. “It’s the middle of the night, early morning even. We can’t expect a woman to roll down her window to a complete stranger!”

“But she’s EMS,” said the first man, as if that alone precluded me from the general safety concerns of other women.

“It don’t matter,” said the second guy. “It’s not safe. Would you want your daughter doing that? You should be ashamed of yourself.”

The original panhandler didn’t seem fully convinced but backed off, away anyway. When he had retreated away far enough the second guy came closer to my window. “Can you believe this guy?” he asked me, shaking his head. “But since I got rid of that guy for you, how about a small donation?” That was quite a slick maneuver I had to admit.

All this time I was behind a large SUV at the light. But the light had changed and the SUV wasn’t moving. I came to realize he was double parked but I had no real way of squeezing in between the space he had left next to him. I was essentially trapped. I noticed this around the same time a third man approach my vehicle.

“Listen, man,” said this third man to the #2 man. “This is my corner. Who told you this was OK?”

“I’m just helping the lady out,” said #2 to an unconvinced #3.

“It looks to me like you’re helping yourself out,” said #3. “You need to leave.”

A short exchange took place near the front corner of my vehicle as I desperately looked for the driver of car the blocking the road get out of my way. While I was looking around I noticed the first guy watching the exchange with interest. He slowly made his way back over.

“I didn’t leave just so that you could come over and take what was coming to me!” he announced to the #2 man with anger and great indignance.

I felt somewhat like an impala carcass being fought over by lions and hyenas. If anyone should be indignant it should be me. I wasn’t planning on handing out cash to anyone at this juncture and I was desperate for an escape plan. Now a fourth man meandered over. He seemed to come over to assist #3. This caused #1 and #2 to become temporary allies.

The angry discussion escalated very quickly in a short period of time. Fingers were pointed dangerously close to faces. Then, it was bound to happen, one of those fingers came in contact with a chest. It was barely perceptible to the average voyeur (me) and consisted only of the light brushing of a fingertip onto fabric but it was a move quickly met with more fingers clenched into a fist backed with considerable force.

#1 was the unlucky recipient of the brutal blow. He would have been smart to have remained sidelined earlier. He was the smallest of the four men and seemed to have been drinking enough to already have been impaired. #2 rose to his defense, punching back in return but #3 was a large hulk of a man who obviously used his panhandling income on gym membership. After being shoved back, #2 retreated but continued to complain and shout out angry statements.

While this was going on, I got on my radio and requested assistance for the injured man and other anticipated casualties. The double parked car in front of me had finally moved but I was still trapped at my location now that I had patient here.

The brawl had attracted the attention of several others who now made their way over. The newcomers seemed to be curious about what was going on and followed behind slowly. Some of them used the opportunity to complain about other onlookers who they were familiar with. Small little groups were forming and they were taking sides. They could also, possibly be sparring over other disagreements. All I knew was that there was a growing group of men angry at each other. Where had they all been hanging out? Why weren’t they all at home, in bed, where I wished I could be? Was this a late night for them or were they early risers?

I noticed that one of the curious onlookers was the recipient of my baby formula donation from a few weeks earlier. Shouldn’t he be home with the baby? Had he run out of formula again, already?

The fight started moving further up the street with #2 yelling and #3 following slowly. I got out my tech bag and went over to #1 and started bandaging his head. As I handed him an ice pack he told me that I was to blame for everything that had transpired. He didn’t want to, he told me, but he had no choice. He was going to sue me, personally, for what had happened to him. Benevolently however, he recommended a lawyer for me. “You used them?” I asked. No, the jingle was just stuck in his head.

What about the man who had actually hit him? #1 told me he could find his own lawyer, should he decide to sue me. “You’re not going to sue him for doing the actual hitting?” I asked.

“No,” he looked at me like I was crazy. “He doesn’t have any money. If he did he wouldn’t be out here at three in the morning. How would my lawyers get paid if he don’t have any money?”

Two police cars came to the scene and the crowd started to disperse. Several ambulances showed up behind them. My injured man got in one of them but some of the other ambulances found themselves with patients as well. A few of the onlookers decided to use this opportunity to seek care for long delayed medical concerns of a low priority. With the fight called off, they decided, they may as well go to the ER.

The Cryptkeeper and the Mole People (Part One)

January 12, 2021 / Nancy Gwillym

The dispatcher told us that our call involved a specific set of railway tracks and we were struggling to find them. Despite being very familiar with our area, we were going in circles and constantly referring to our paper map. Computer terminals had yet to be mounted into ambulances at that time and there was no way for us to access all of the call information the way we can now. The dispatcher, who was also juggling a screen full of dozens of other jobs to be handed out, did what he could to contact the agencies involved in requesting us, in order to provide us with some better details.

With it’s grid-like design Manhattan is considered by most people, to be the easiest of the five boroughs to navigate. The numbered streets and world known landmarks make it a far cry from my native Queens, for example, which is notorious for successive streets that are all numbered 60 (60th Place, 60th Lane…). But we weren’t exactly looking for a particular street. We needed to find a part of the infrastructure below the city and that was our problem.

Beyond the miles of roads and streets, an almost parallel world exists underneath, of tunnels and various other structures that make up a subterranean landscape set up to assist the city above it. There are miles of tunnels and pathways at many different subway stops and there are also numerous miles of track for the various railways that service the city. Several levels of infrastructure, some abandoned, are utilized by different agencies. Once we found the area where our purported man-hit-by-a-train would be, it would be another endeavor to find our way in.

We were eventually assisted by a few officials from the railway service who directed us 20 blocks south towards an entrance that was well-hidden from the general public. It led to more of an underworld city than a tunnel, almost looking like the framework for an underground building. They assured us no other trains were running and had us follow a small group of train representatives along one of the tracks. It was pitch black in some areas and then suddenly we would make our way to an area flooded with natural light. Then we’d be back in the tunnel and then, soon enough, in an open field-like area. It was in this field area that we had reached our destination. Here the train had come to a stop. It was surrounded by people in various official uniforms mulling around and consulting each other. We were directed to the front, where the train had slowly been moved backwards a few feet.

“Man under a train” tends to imply that a man will be found, perhaps underneath or thrown to the side, of a train. But when a human being is struck by a high speed locomotive he is, more often than not, disintegrated into hundreds of meaty pieces of flesh and blood. Part of a man was under this train, other parts were spread out across the gravel nearby. We had been sent to basically do paperwork on someone who, just an hour ago was a regular person like the rest of us, but had now completely transformed into a disorganized array of unidentifiable biological material.

The long trail of what had once been a human being was spread across a length of metal and machinery. Some was attached to the undercarriage of the train that had ripped him apart. A lone dirty sneaker, badly ripped, had been torn away and lay in the grass, surviving in better physical shape than the person who had worn it.

The train was carrying a high number of passengers but none had seen the impact. What they had seen was the man kneeling on the tracks, facing the oncoming train. They were visibly shaken, some were very upset and traumatized. They would forever have the image ingrained in their memory of a human being at once annihilated by the force of something they were inside of.

We found the train conductor surrounded by people from his agency. He was listening and nodding to things they were saying and seemed less shaken up than the passengers. We were going to see if he would come with us to, perhaps, speak to someone at the hospital. He initially told us no but we let him know we would be there for some time doing paperwork and should he change his mind in the interim, we would be happy to take him. He thanked us and continued to speak with his supervisors.

We interviewed some of the passengers as well. None of them wanted to go to the hospital either but they spoke to us about how eerie it was to see the young man sitting on the tracks awaiting the impact of the train. He knew the train was coming?

Oh yes, he definitely did.

We had no information on the victim. There was no ID, not even a description really. I was ready to do a call report that would basically have the word ‘unknown’ scrawled in every box. One of the railway officials, however, suggested I try asking among a small group of people huddled underneath the next section of tunnel. As I turned towards the three or four people looking at all of us in the darkness of the structure ahead, I asked who they were. The man smiled. “They live there. I think our victim might have been one of them.”

One of them?

I made my way over to the next overpass area where the little group was. They seemed surprised to see me coming towards them. One person backed up and walked away. They looked like they were in their early 20’s and had messy, long hair. One of them wore thick glasses with a deep, clear scratch across both lenses. Their skin was covered in a thick coating of dirt but underneath you could see that they were white, very pasty white.

“Did any of you see what happened? Did you know the victim?” I asked.

They looked at each other like they weren’t sure what to do. Eventually one of them, tall and very skinny, said “Yeah.” And nothing else.

“Which one? You saw what happened or you knew the victim?”

Nothing. Perhaps they were traumatized and in shock.

“I know this was a terrible accident…” I started.

“Oh it was no accident,” said the tallest in the group. “He waited on those tracks a long time.” The others nodded in agreement.

“So you saw him waiting on the tracks?” I asked.

“Yes.”

“Did you know him?” I asked. They all nodded.”What’s his name?”

“I think it’s Joseph,” said one of them.

“No, it’s Allen,” said the tall one.

“I called him Bo,” said the man with the glasses.

This didn’t seem like it was going to be helpful. “Can any of you tell me anything about him? Like his birthday? Where he lived?”

“He lived here,” said the man with the glasses.

“Here?” I asked, somewhat surprised. What was over here? How did these guys even find this place?

“Yes,” they said, “Back there. With the others.” They pointed into the darkness of the tunnel.

“People live in here?” I asked.

They looked at each other as if to say “of course.” They seemed surprised that I didn’t know.

“A lot of people live here.” said the man with the glasses.

At that point my partner had made his way over. He seemed very interested in the little group and curious about what was behind them in the darkness. “I’ve heard about these people,” he said.

“What people?” I asked.

“The community,” he answered. “It’s like a whole other city under here.” Then he turned to the other men and asked “Am I right?”

“Yes you are, sir,” said the tall man.

“Would you mind showing us around?” my partner asked.

The three men nodded cautiously. “There’s not that much to see,” said the man with the glasses. One of the train employees had also come over and asked if he could join in on the tour. Everyone seemed to know about this odd little group of people living here when just a half hour ago we couldn’t even find this place. I was curious about what the big deal was about this particular group of homeless people, when we had plenty of other homeless people in the city above this one.

Like tourists seeing the sights of a foreign culture we were directed by our reluctant guides. Two of the three men flicked on flashlights that I hadn’t noticed they had and they started walking slowly into the darkness of the wide tunnel. They were joined by another man along the way who also had glasses and dirty blondish hair. He was wearing pants with greasy stripes on them and appeared to be a little older than the other men. This man was far more amiable, as well. He seemed to welcome the chance to show visitors around.

“Hello!” he said. “My name is Mike. I suppose you’re all here because of the train hitting our friend, Eddie. I’ll show you where he stayed.” We thanked him and asked if he could give us some information about our patient. He told us no, no one here could. He explained that they all kept to themselves and there was no pressure to interact.

“How long have you been living here?” my partner asked Mike.

Mike stopped and looked like he was trying to figure out the question. “That’s very hard to say. We don’t really keep track of time down here. I couldn’t tell you what year it is, or even whether it’s spring or fall.” He went on. ” It’s very dark down here and difficult to know when one day ends and the next begins. It could be, I’ve been here three years. It could be 15.”

The more we made our way into the tunnel the stronger the smells became. There was a faint petroleum scent throughout but it was being overwhelmed by the odors of things rotting. It hung in the air like a physical presence.

We came to a little sitting area. As the light from the torch moved around, a few rats scampered away. There were some chairs and stools arranged into a crooked oval around what was probably a fire pit. Two people, a man and a woman, were sitting in two of the chairs but not near each other and not talking to each other. Without the flashlight there was not much anyone would be able to see, unless their eyes had adapted to a superhuman degree, so they were just sitting quietly in darkness together.

A few feet away were several milk crates that were filled with canned goods and some boxes. Others contained pots and pans and various other kitchen items. If they never went outside where did they get supplies? There were some larger boxes stacked up and what looked like a sink, though I didn’t see where a water source was hooked up. A few TV tray type tables were scattered around with chairs or upturned milk crates set up next to them. As we continued to follow the light of the flashlight I turned my head and looked back at the two people we had just passed by. There was some slight residual light from the flashlight and the end of the tunnel in the distance but it was mostly just darkness. And the two people were just sitting there, awake and not doing anything at all.

It was eerily quiet here, except for some occasional sounds, like water dripping or a sudden frightful yell that no one but us ‘outsiders’ took notice of. The air seemed stifling and there were pockets we passed through where the smell of decay and rot was more powerful.

Behind the kitchen area, we came to a row of makeshift apartments. They were all different sizes and made of different materials. Most of them had no roof with the gap between the walls and the ceiling of the tunnel being at least 5 feet. Some had doors that were closed and others had locks on them. As the flashlight passed by the open doors you could see that some were sparsely furnished while others had dividers with decided living and sleeping areas. Some had artwork or photographs tacked up on the walls. It was interesting to see how many random household items had been acquired by the residents. Many apartments had small television sets, one with a VCR and some movies lined up next to it. They had gotten sofas, wall units, and dressers down here. Perhaps there were other entrances that had facilitated this?

As we walked by one open door, we could see two rats curled up on the bed. They looked up as we walked by. “That’s Moe and Curley,” said the tall, skinny man. “Larry must be out hunting.” This was his residence.

Most of them seemed unorganized and dirty, though I suppose if you lived in almost complete darkness there was no need to do any dusting or cleaning. We came to one apartment, however, that was immaculate. That one, said Mike, had belonged to our patient.

With the door open, we asked to look for ID and Mike led the way. The apartment had a queen size bed set-up, made on top of a low set of drawers. The short dresser was topped with a box spring and mattress, and covered in a decorative duvet with matching pillows. He had built up one wall to be a shelving unit. His clothes were folded with precision, all were exactly the same width, and were arranged by color. There were a few books, some framed photos of NYC scenery, several cameras and some small decorative items. One shelf contained food items and two plates and two cups. Near the entrance stood a little desk with a small writing lamp. We switched it on to find a small pile of envelopes. On top of the envelopes was a drivers license. Our patient’s name was Arthur Lundgren. He was 28 years old and the license was from Wisconsin. There were six stamped and sealed envelopes with a note to “Please Mail”. They were addressed to people with Wisconsin addresses, presumably family and friends. There was also one addressed to Mike, which he opened. He said it was a list of who he wanted to give his belongings to, like a will.

Before leaving and turning off the light, I looked around at the many pictures Arthur had covered his wall with. Most of them were random places in the city, street corners, crowds of people, all of them bathed in bright sunlight. It might be incorrect, but you could assume the photos were taken by Arthur and his many cameras. It would make him an anomaly in this community that shunned daylight and the world above them.

For weeks to come, I would wonder about Arthur and the life he lived. The suicidal cases often had me asking myself what had caused them to lose all hope. I could almost understand why someone living here would feel despairing and depressed. It seemed like an awful place to live. The others seemed content and well- adjusted in some strange way. But in Arthur’s case, I thought that maybe he had come all the way to NYC for the vibrance and culture illustrated in his photos and yet, he found himself living in the darkness with people who knew nothing about him, not even his name.

(end of part one)

The Cryptkeeper and the Mole People (Part Two)

January 12, 2021 / Nancy Gwillym

A whole community had been created in a dark, abandoned section of train tunnel where they could live away from the world they either disliked or feared. They had created their own living quarters and their own little society, all while quietly living underneath the regular one. The two worlds were oblivious to each other.

My partner and I had gotten a tour of this alternate world after pronouncing a man from this underground community. With us was a man who worked for the train system that used these tunnels.

Mike, our guide to this underground city, told us that they occasionally made sojourns “upstairs”, as he called it, to get supplies. They searched for cans and cashed in their food stamps and then hurried back down. When enough cans were collected one person would get the deposits. They tried to complete these tasks necessary for survival in as few trips and as little time as possible. They no longer felt any connection to anything they found “up there” and took comfort in the darkness of the world below. He admitted there were conflicts that took place and personalities that clashed but for the most part, they felt that the ‘real’ world was too dangerous and required too many compromises and sacrifice. Down here, he said, they lived simply and helped one another. “Wasn’t it dangerous down here?” I asked.

“Yes,” he answered. “It was.” His sudden seriousness implied that it was worse.

As we toured their little complex of living quarters in search of information about our patient, who had killed himself, we noticed that most of the rooms were unoccupied at the moment and there were at least 30-40 separate ‘apartments’. Where was everyone?

“They all scattered when Eddie offed himself,” said Mike, speaking of our patient, who we had established was named Arthur Lundgren. “They knew a lot of people would be around. All of us down here tend to be anti-social. They’re probably further down the tunnel with the others.”

Who were the others? There were more?

Yes, apparently. There were several sets of “mole people”, a term Mike and his friends used to describe themselves. Some of them were transient and some of them didn’t like the rules at this encampment so they went about setting up separate groups. The alternative groups spent more time upstairs because they did their errands independently. Mike said there was no animosity between them but his face indicated he didn’t approve of them.

I was fascinated by all of it. They left regular society because they were ‘anti-social’ only to set up similar societies underground. I had no idea there were so many people who had turned their backs on the way of living most of us had been taught was the only way. They seemed to make it work for them. To me it was an incredibly undesirable life, surrounded by darkness, dirt and soot, rats running around, isolation, and apparently, danger. Mike admitted there were physical altercations and for women it was particularly dangerous. It didn’t say much for our world that so many people found this to be a viable alternative.

As we started to walk back to the train where our ambulance was parked, one of the less senior members of our representative tour group went over to Mike and whispered something to him. It led to a serious back and forth that I strained to hear, unsuccessfully. After a few minutes Mike just nodded and without saying anything, continued to lead us back out of that section of tunnel. The section we were in was long and dark and led to the small area where the train incident had taken place. That section was open to the sky and sun streamed in. You could look up and see buildings and faintly listen to the sounds of the big city the mole people shunned. But a few more yards further another, smaller, section of dark tunnel began and went on for about two or three miles.

When we reached the end of the dark section we were about to say good-bye when Mike stopped us and hesitatingly suggested we check out something in that other section of tunnel.

“There’s probably another body in the other tunnel that you might want to investigate for your records,” he said. “We know of a guy who lived there but we ain’t seen him in a while. We have a rumor that he’s still in his hole.”

What did that even mean?

“Are you saying there’s another DOA?” asked my partner. Mike lowered his head and nodded.

The active train route was set up on tracks on the east side of the tunnel area. The little city Mike had introduced us to was far west in the same structure. Several inactive tracks stood between the shanty town and the train that had stuck our patient. All of the people who lived down here were set up there, according to our guide. But now Mike pointed towards the east side, where the trains passed by semi-regularly. He said if we went down the tunnel we would find a “crypt” built into the wall and that it would probably be a good idea to check that out. He said he wasn’t going to take us there, we would have to find it ourselves. “But it’s there,” he said assuredly. “And, oh yeah, my name isn’t really Mike. Thought you should know.”

My partner updated the dispatcher, telling him that we were investigating another potential patient. We found a police officer and told him about the possibility of another body. He gave us a strange look but agreed to come with us. The man from the train company said he would “sit this one out”.

The three of us made our way down the tunnel. This side of the area seemed cleaner, almost. There was no debris and no mud, just gravel on the floor. It also seemed to get more light, not much more, but it was definitely better than the perpetual darkness of the other side.

The walls seemed to just be solid grey cement with nothing unusual noted. After walking what seemed like miles, we came across a square hole that had been built into the wall. It was high up, about 20 feet, so the passing windows of a moving train wouldn’t be able to see into it. There was a small ladder built into the wall as well, and my partner was eager to climb it. I went up after him and the cop followed me. Our flashlights lit up the small space and what we saw was both shocking and curiously interesting.

The space was small, about 15 feet by 15 feet by 10 feet. There was a small cot, a little table and a chair. In the chair, sat a man who had been dead for quite some time.

I have seen many dead bodies in various states of decay thanks to this line of work. I had brought many bodies to the morgue and witnessed even more states of decomposition there. I’ve seen skeletons, mangled bodies of trauma, the bloated slowly decomposing bodies, whose distinctive smell could make one retch and everything in between. But I have never witnessed someone partially decayed and in the process of petrification. I’ll admit, it was a little horrifying, especially because of the way the skin had decomposed around his mouth, which made his face to appear to be smiling, laughing almost. Yet I couldn’t take my eyes off of him. All of us just quietly stared, mesmerized by this unusual man before us.

He was fully dressed and looked very much like the zombies you see in the movies. Sitting upright at the table as if he had just eaten a meal he seemed almost posed, and fake. There were areas of his body where all that was left was bone but in many other places, including his face, skin and some muscle remained and where it remained it had become hardened. His eyes and nose were long gone. You could tell he had some gray facial hair and a missing front tooth. His socks, if he had worn any, had disintegrated, and his skeletal feet rested in his shoes. His hands were mostly bones but some grey-brown scaly skin also remained there, along with some long nails. He wore a blue jacket and a brown button down shirt with brown pants and he had on a vest with a pocket that looked as if there should have been the long chain of a pocket watch looped below it. He also had a blue train conductor type of hat on his head. He seemed very small but it was difficult to tell in his sitting position.

“There’s something you don’t see every day!” my partner said in awe.

The police officer had the look of regret that he had come with us. “I don’t even know where to start with all this,” he said. He rubbed his forehead as if he felt a headache coming on.

The man seemed to have scored some prime tunnel real estate. A penthouse, almost. The little room seemed very neat and tidy although there weren’t too many articles to displace. The cot was made up with a decorative pillow and didn’t look like it had been slept in. There was a plate on the little table but anything that might have been on it would have been eaten by the many rodents in the tunnel. How had he managed to get the table and cot up here? There was an initial intention to search for some ID but everything seemed to be delicate and the officer suggested that we not disturb the surroundings. A bigger investigation of the man’s living space would be carried out later, no doubt. I guess I was doing my “unknown” ambulance call report after all.

The isolation here must have been maddening. His fellow tunnel-dwellers lived far away. Perhaps he had joined them sometimes? I hoped so. It seemed like an incredibly lonely existence. But on the other hand, maybe he preferred it that way. It was hard to imagine that skeletal smiling face hadn’t wanted at least some, minimal social interaction.

We heard some noise and shined our flashlights down below to find two of the three men we had met when we first ventured into the other side of the tunnel. The two taller men had come to make sure we found “the crypt”. They seemed happy that we had.

When we came down the ladder the police officer asked them how long it had been since they had seen the man. They shrugged. “We don’t know what day it is.” There it was again, a blissful dismissal of something that seems so integral to the rest of us. They were never woken by the shriek of an alarm clock and were never late to any events. But there also were no events to speak of, or holidays and seasons.

They told us that they knew nothing about the man, except that they saw him come and go sometimes. They rarely went to this area of the tunnel but sometimes the man went past theirs. It seemed cryptkeeper led an incredibly solitary existence. I wondered if he really wanted it or if it was forced on him in some way, maybe by his own fears. I was curious if the two young men that were here were happy with this place or if they had just gotten used to it. “How did you know about this guy, that he was here?” I asked.

They said their neighbor kept very consistent habits, almost like a schedule, which was curious for people who don’t keep track of time, I thought. When they didn’t see him for a while they went over to look for him. One of their friends had climbed the ladder and saw that he was dead.

“So you didn’t report it to anyone?” The officer asked.

Once again they shrugged. “You mean other than to each other? How would we do that?” the tallest one asked. And then he said something both true and heartbreaking. “And why? No one was looking for him. No one even knew he was alive. Why would anyone need to know he was dead?”

The man had died as he had lived, anonymously, and perhaps that was all he had wanted.

Manhattan Real Estate

December 29, 2020 / Nancy Gwillym

On the long and diverse list of calls that make it to my “worst” list, one that vividly comes to mind involves the eviction of an elderly couple in Manhattan in the early 1990s. It still causes me immense sadness to remember this older couple haphazardly rummaging around their large two-bedroom apartment in midtown. This was probably the first time I had been called for someone who was being thrown out of their home, but definitely not the last. In the late 80’s and early ’90s, there were several eviction-related jobs I ended up responding to. A city marshal was involved and they often brought along a representative from social services, either Adult Protective Services or another agency. It was this representative who would call EMS.

When we arrived at this home, the door was wide open and we walked in. No one said anything to us except the building super and honestly, it was always the building super on the scene at any of these things, that had any humanity. He was a short, bald man with a Spanish accent who shook his head sadly and directed us to the couple. When we introduced ourselves to the woman she stopped what she was doing and looked up at us in a confused manner. She slowly looked towards the marshal who was busy marking off things on a clipboard. He never looked up but pointed to another man in the apartment. That man wore a lanyard with some sort of official ID and he had a clipboard of his own.

“Oh yeah,” he said when he saw us, as if calling for us had been a quickly forgotten detail. “You’re here for the gentleman. Ah, he has high blood pressure.” In his mind, that was sufficient explanation and he resumed whatever he was doing with his clipboard and walked away. We had been dismissed.

The woman had short brown hair and sad-looking eyes that predated the events of that day, as noted in several of the photos she took off of end tables and dressers to toss into bags they had quickly grabbed and started filling. The man was slim, balding, and wore thick-framed glasses. He seemed a little absent-minded, distracted, and more than a little embarrassed. Neither of them said much to each other as they moved around their apartment for the last time, trying to figure out what, out of 30+ years worth of living in that place, warranted immediate removal.

The couple seemed busy although they moved very slowly. It must have been difficult to prioritize all of their possessions. This had been their apartment since they had gotten married. They raised a daughter here, participated in activities, interacted with neighbors, and held family celebrations in these rooms. Everything they owned was inextricably tied to a lifetime of memories. They had a souvenir from the 1964 Worlds Fair that made it into the suitcase, along with several religious articles of their Jewish faith. A few changes of clothes went in as well.

The man was going through some papers in his desk, trying to figure out which were important and which were receipts he probably could have gotten rid of years before. “Sir,” I asked tentatively. “Are you not feeling well?”

He looked at me like I was out of my mind and I deserved it. Of course he wasn’t feeling well. He didn’t say anything to me for a long time, just continued shuffling through his papers. “Can I take your blood pressure?” I asked. He looked at me with the face of someone who was placating a child but he held out his arm.

His blood pressure was only slightly elevated, nothing unusual, and nothing that required an ER. I asked him if he had any medical problems. He told me only the hypertension. Then he remembered his prescription bottle and went to the kitchen to put it in one of the bags.

The couple continued doing their unorganized pack as if we weren’t there. A fat tabby cat was coerced into a carrier where she howled, fearfully looking at the strangers who had taken over her territory through the mesh of her small container. The woman carried the cat around with her as she looked for things to pack, holding up random items as she considered their importance.

Every once in a while a question was asked by either the husband or the wife and directed toward the marshal. The answer was always some version of ‘no’, with increasing levels of impatience. A defeated look would come over them and they would continue. The marshal seemed very annoyed, almost angry, with the couple. He rarely looked up from whatever important notes he was writing on his clipboard. It appeared that he had a long list of other families to throw out into the street that day and this couple was delaying his schedule.

I do not know the circumstances of that brought about that sad day. Probably, I assume, it was not one big thing but more likely hundreds of little disasters that lined up like inconvenient dominoes leading to that unwelcome knock on their door.

I’m sure the couple had received notices and warnings. Perhaps they were in denial or perhaps they thought they had more time to either fight the eviction or make other plans. Either way, when the marshal had shown up they were unprepared. I understand that evictions happen, that responsibilities need to be met, and that there are consequences for failing to meet them. But to be oblivious to the obvious distress this couple was experiencing was so callous. And the man sent there specifically to assist them couldn’t be bothered to do anything but call 911.

Both the marshal and the social services representative spent the time appearing busy, shuffling papers, and talking on the phone. I have no idea what services were available to the couple or what had been done prior to the eviction. But if there was nothing the social service man had to offer why was he there? I got the impression that he was not working for the couple but for the marshal, to make things easier for the eviction to proceed. The two men seemed to know each other although they did not interact with each other all that much. But when the marshal made a demand of the couple, either to hurry up or deny a request, the social service representative would reiterate what he said in some way, which came off as a supportive measure as if they were united and sometimes it appeared as if they were ganging up on the unfortunate pair, and us when we offered any assistance to the couple that didn’t involve rushing them out the door to our ambulance.

At first, my partner and I just stood around wondering what to do. The last thing we wanted was to interfere with the couple on one of the worst days of their lives. It was obvious the man wanted nothing to do with going to the hospital. We were standing near the man from social services when we started discussing how we were going to RMA [Refuse Medical Assistance]. It was enough to get him off the family’s phone he was using and stop writing on his clipboard.

“He needs to go. They both do. Take them to the hospital.” He tried to dismiss us again, expecting us to just follow his directions. It killed me to do his bidding but at the time we had an age discriminatory rule that he seemed to be exploiting.

Unfortunately, the man was 65, which in those days required us to call our telemetry doctor if he wanted to refuse. It was a terrible, ageist protocol that has thankfully gone the way of leeches and skull boreholes. But at the time we were bound to this archaic rule and the whole service revolved around it. We had been through this routine before with other patients who had reached an arbitrary milestone that rendered them incapable of making decisions that didn’t need to be second-guessed by a doctor. When we called telemetry, we would be asked why the man didn’t want to go. We could say that he didn’t need to, that he never called, that he was just being directed to go to the ER so that they could get him out of the apartment. And the doctor would tell us that it wasn’t our decision to make. When the man presumably got on the phone to speak to the telemetry doctor they would try and convince him to go, because everyone over 65 should have to go. There was a liability issue. The man could argue and they might let him refuse but before that happened there was a likely possibility he could be threatened with a visit from social services if he did so. The same social services agency that was assisting the marshal in kicking him out.

The man from social services started to rush the couple, lest we found the loophole we wanted that would have allowed them to skip the trip to the ER. “Come on, we need to get you to the hospital.” The couple looked at him with bewilderment.

The super stepped in and took the cat carrier from the wife. “I’ll look after Ophelia,” he told her. “And don’t worry, when you’re done at the hospital I’ll let you get the rest of your things.”

The marshal interjected, “Your things will be packed and put into storage. Have your lawyer give us a call and we’ll let you know where you can pick them up.”

The super then offered to put their items in the basement. The marshal told him he was not allowed to do that. The super offered to take some things into his apartment. The marshal now became impatient with the super as well. He spoke slowly, as if trying to reprimand a belligerent child, “You can only take what they give you right now.”

The man from social services stepped in and told the super that wasn’t going to happen because the couple had to go to the hospital right away.

“We can wait,” I yelled out, glad to throw another delay in the way of these two unfeeling individuals. My partner and I offered to help and immediately started putting random items into boxes. We found a crate and filled it with kitchen items. The super put them all in the hallway and called up his wife to take the cat.

Then, after a very short interval, the alarm clock on the marshal’s internal timetable went off and he put a stop to any more last minute packing. “This should have been done weeks ago. Time’s up. Just go to the hospital.”

The couple gave the super some of the bags and a box they had quickly packed. The woman looked around and started to cry.

The husband tried to comfort the wife. All the previous emotions in his face of determination, embarrassment, and confusion gave way to adoration towards this woman. He put his arm around her and looked at the two men who both looked away.

The couple moved slowly to the door, looking around the whole way. It was the last time they would see the home where they had spent their adult life. All the memories they made there would be tainted with this attached experience of being forced out.

The social service man suddenly became very friendly. He handed them his business card and told them to call with any questions or assistance they might need. It was incredibly disingenuous. During the entire time we had been there he had not offered any kind of assistance or made any arrangements on behalf of the couple, except to call EMS to rush them out of their apartment. They were only going to the hospital because he had no other place to offer them. He told the couple to contact the social worker at the hospital who, he assured them, would provide them with a place to stay. He had just passed this couple off for someone else to deal with. His presence on the scene had been as useless as ours was.

I attempted some small talk on the way to the ER but the couple remained silent. I’ll never forget how they just sat together without saying a word to each other.

At the hospital my partner and I asked the registration people about the social workers. They put us in touch with the one on duty and we talked to her about the situation. She became angry, complaining to us that all she could do was refer the couple back to the very same department the man on scene was from. “They pull this crap all the time!” she told us.

I gave her the phone number that I had written down from the business card. She called it up immediately and had a heated discussion with someone from his agency. Then she called the man’s supervisor. In the end she just shook her head and told us the couple was screwed. There was not much she could do for them except refer them to a shelter.

We went with her when she talked to the couple who had been sent to the waiting room. She asked if they had anyone they could call to stay with, she suggested their daughter. The wife started to cry and the husband told the social worker that their daughter had died almost a year earlier.

I have no idea what happened to them after that and I wonder all the time about them. How does someone pick themselves up from that situation? Where do you go from the lowest depths of tragedy to move forward? You would hope that there would be a safety net out there to help people that this happened to.

On many of our calls, we have patients or families in need of far more than we can provide them with, people living in squalor, people in need of counseling, people in need of basic necessities, and it’s often a catchall response for us that they just ‘speak to someone in social services. It’s what we were taught to do as a way to convince someone who doesn’t want to go, to take the ride to the ER (it’s all about getting them to go, I concluded) But now I knew that the advice and recommendation I had been giving had been far more limited than I would have ever thought.

Holes in Unusual Places

December 10, 2020 / Nancy Gwillym

It’s not uncommon for people in movies or on television to tuck their guns into their waistbands. It seems to be done for the expediency of the storyline. Often these characters are in a big hurry and need their hands free to, perhaps, climb their way to safety or find an important document in a file cabinet. It usually works out well enough in the world of crime dramas which is probably why it was emulated out in the streets of Brooklyn. Unfortunately, this amateurish approach to firearm safety coincided with a popular trend of wearing pants so large they sagged well below the waistline. It was a terrible combination that led to a rash of unusual injuries in sensitive areas. Some people learn the hard way, the importance of storing things properly, and how to keep the things you love safe.

We were stopped at the traffic light when there was a sudden banging on my door. Both of us turned to see two teenagers yelling at us through the window I was reluctant to roll down. They had concerned, almost frantic expressions on their faces.

“We called,” they were saying. “We’re the ones who called!”

“You called for an ambulance?” I asked skeptically. The radio had been unusually quiet that night and we had heard nothing come over in our area.

The young men looked at us like we were complete morons. “Yes! We called!” They looked healthy and OK. Would they be directing us to an emergency elsewhere? “Aren’t you here for us?” they asked.

Actually, we were there because our favorite Tex/Mex place was just a few blocks beyond this traffic light. I was working with Orlando, who had more facial expressions for frustrated contempt than there are tacos on the Super Taco mix and match menu. This one clearly said ‘I guess we aren’t eating tonight, let’s see what these two healthy looking guys want’. He indicated to them that they should get out of the street so that he could pull our truck over.

The teens went to the sidewalk and began talking to each other as we let the dispatcher know we had been ‘flagged down’. The dispatcher reacted as if we were telepathic since a call from that location had just popped up on his screen as soon as we mentioned it.

The young men were still engrossed in their intense interaction as we got out of our truck and opened the door to the rear compartment. Their conversation involved a lot of looking around along with suspicious glances at us. We waited patiently for a whole minute and a half before we reminded them that we were standing by. They gave us that wait-a-minute finger that induces people to sigh and roll their eyes. Another half minute went by and Orlando let them know they could call back when they were ready as he started to close the door.

The teens, who appeared to be either 17 or 18 years old, quickly ended their negotiation, with the one in the black hoodie handing the one in the grey hoodie an obvious firearm that he removed from the several-sizes-too-big pants he was wearing.

The young man in the grey hoodie made a quick look around and took off running as best as his fashion choices allowed while the kid in the black hoodie finally made his way to our open ambulance. We stopped him before he got in, asking if there were any more dangerous weapons he was hiding elsewhere in his ensemble. He looked at us like were were crazy since it must have been impossible for us to have witnessed their not-so-subtle transfer only seconds ago. My partner gave him another one of those priceless facial expressions as he asked him point blank if he was carrying. A police car, with it’s flashing lights was speeding to our corner and abruptly stopped as the teen sheepishly told us that he had nothing else on him in the vague-est way possible.

Our black hoodie’d patient stepped in and sat on the bench as a police officer came over. “This is the shooting?” he asked.

“Shooting?” my partner responded. “We were flagged down. You are here for a shooting?”

“Yeah,” he answered. “That’s how we got it. Dispute with a firearm.”

One officer got into the ambulance and sat down in the captains chair as my partner remained on the steps of our side entrance. The patient seemed comfortable and not in any distress at all. We asked the young man what happened to him and rather than present any kind of injury or trauma, he began what was a long tale reminiscent of an action/spy thriller.

Using colorful language, the youth told a story of young love that had soured.

He had decided to end a relationship several months before, after realizing that being with only one woman was far too restrictive. While he was out there enjoying his new playboy lifestyle his former paramour had gone “bat-shit crazy”. She started stalking him and bad-mouthing him to everyone in the neighborhood. He understood that it must have been devastating for her to be kicked to the curb by someone of such high desirability but for a time she harassed him, and any woman he had an interest in, with a high degree of vengeance. But soon he found out that his ex had a new man in her life and he thought he could breathe a little easier. He was happy that she had found someone else to nag and finance her diva lifestyle.

Unfortunately, he discovered that she had taken up with a rival entrepreneur whose business enterprises conflicted with his own. He felt that she wasn’t all that interested in his pharmaceutical competitor. It was his opinion that this was all just an attempt to drive our patient crazy with jealousy and anger. Of course it didn’t work, he had already moved on. But he developed some sympathy for the new man in her life, being manipulated by this shrewd woman. It must not have been easy to be compared to her ex all the time, given she still had a thing for him.

We started growing impatient with this long story that didn’t explain the need for an ambulance, when finally he told us what had happened on that day, specifically.

Our patient had been spending a casual evening with friends. The young man looked up randomly and saw his adversary on a fire escape nearby. He believed that the constant pressure of being unfavorably compared to his girlfriend’s former partner had finally taken its toll. He could distinctly see a gun aimed at him, in fact, it was aimed directly at his ‘junk’, probably because it was yet another area that he couldn’t compete, in our victim’s reasoning.

“Where did he get you?” we asked.

The teen undid his large jeans and they effortlessly crumpled to the floor. He then slowly lowered his rusty red-stained boxer briefs to reveal blotchy sections of mangled genitalia. The 17-year-old wouldn’t look down but I could see him watching the horrified facial expressions on the men behind me.

“This doesn’t hurt?” I asked skeptically, because it definitely looked like it should hurt. One side of his penis was bloody and ripped apart near the base with chunks of flesh unfolded outwards. His penis seemed to have been hit unevenly but there was a distinct round hole to one of his testicles where the bullet appeared to have lodged. There were small pieces of bloody flesh adhered to the boxer briefs. Despite this there was not much active bleeding.

The man shrugged as I uncomfortably tried to bandage or rather, just pack everything together, in his genital region. It’s not something they teach you in the academy, although they probably should. This was not an uncommon occurrence.

Many a newbie gun enthusiast has forgone safety in favor of style. I had already had several patients who had injured their buttocks by ‘securing’ guns into their rear waistbands and several others who had injured the more sensitive real estate in the front. Proper holster usage could have gone a long way in preventing some of this. The accessory was in need of a fashionable comeback.

Guns accidentally discharging into the gunslingers pants often come with incredible stories to explain the unintended holes in their reproductive organs. One prior patient came up with an explanation that actually seemed genuinely plausible. He told us that his enemy had found him at a vulnerable moment, urinating. Other aspects of the story didn’t really line up, like the lack of urine and the angle of the bullet hole (right through, from top to bottom, with no bleeding thanks to the seared edges of the clean little hole). But it was a good story and gave me a interesting chief complaint and narrative for my paperwork: “He shot the pee right out of me.”

Today’s version of not admitting to accidentally shooting their nether regions was the first we had heard with such dramatic lead in. It also, conveniently, took care of the patient’s rival. My partner leaned out the door and surveyed the buildings with the other cop who was still outside.

“That seems like spectacular marksmanship,” he said. “The nearest building with a fire escape is more than a full block away.”

“He knows how to shoot,” our young victim agreed.

“His accuracy is truly amazing,” my partner nodded. “With a handgun, not a rifle, right?” The cop who was in the back with us looked out of our truck as well and then just sat back down with a smirk, shaking his head.

“That was definitely some impressive aim,” I agreed. “He totally bypassed your pants. Not a hole anywhere. You can wear these jeans home when you get out of the hospital.”

“Well, you see,” the man explained. “I like to wear my pants big and well, they were kinda low when he got me.”

“He didn’t damage your underwear either. Were you exposing yourself?” said the cop with a tinge of sarcasm.

“No, no!” said the teen, getting a little nervous about his story unraveling. He assured us that physics existed somewhere that could verify his accounting of events. To get off the topic of his shooters pinpoint accuracy, he gave his assailants name to the police officer with a directive to, “make sure you get him.”

If the sniper-with-CIA-skills story didn’t convince us he was lying, the fact that he gave up his shooter did. Having spent much time in violent neighborhoods we knew that gang members never give up information on their assailants to the police, choosing instead to retaliate themselves. But our victim was very enthusiastically telling the police his name, address, and the locations and times where he could be picked up.

The cop rolled his eyes. “Why don’t you just admit your gun discharged in your pants. Everyone here knows it. You’re not convincing anyone.”

The young man put on his best look of fake-not-so-fake outrage. “What?! You think I’m lying? I’m not lying. I saw a man shoot me and I even know who did it. I will testify in court. This is an easy job, man. This could be your ticket to detective. I think you just don’t want to do your job so you SAY I’m lying. Well, can you believe that? Everyone I know says PD is lazy, but not me. I’m always out there saying PD got a tough job, PD out there putting their lives on the line… then I turn around and see this, that they’re all right about you. Cutting corners, not investigating anything. I may need to contact the review board.”

We were all kind of smiling during his tirade, even the cop, and when it was finished, even the kid. But he still wasn’t going to say it out loud and wasn’t going to recant his version of events. His version was far more spectacular, I’ll admit.

Free Onion Rings

October 14, 2020 / Nancy Gwillym

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?

Advertising Billboard

October 6, 2020 / Nancy Gwillym

Warning: there’s some profanity ahead. You can’t write about Liz without vulgarity being part of the dialog.

It had been a cold and stressful morning for Liz Moreno. An aggressive and violent woman, she had done far more ‘ass-kicking’ than usual that day. She had a black eye and several bruises. Her right arm was also severely painful. She tried to deaden the pain with alcohol, more alcohol than her usual allotment, but it had not done anything significant to help. If Liz felt the need to smack someone else today that disrespected or inconvenienced her, she would be at a disadvantage. Normally she was very quick to utilize the city’s ambulance resources but today she had some errands to do before she would spend more of her valuable time in a hospital. She also decided to turn over a new leaf by getting involved with a new religious philosophy.

Liz had never been one to embrace any religion or spiritually. Religion was for suckers she’d often say. With all it’s talk of being kind and good, it was just a way to keep people in their place. Turning the other cheek was for the weak and those who didn’t know how to fight. But her last stint in prison had taught her that churches and temples were good for more than just a free meal or a place to sleep. She had learned many things from another woman there, one who had fashioned her crucifix into a shank. Religious articles were less likely to be taken away. If they did, you could sue, claiming religious persecution, she had told her. Liz couldn’t believe she hadn’t known about this before. So much time had been wasted being unaffiliated.

She went to a second-hand store with a crucifix in mind. She was hoping to fashion a far more superior weapon than the one her mentor in prison had shown her. But the secondhand shop was low on religious articles. It seemed people didn’t like to part with their weapon making materials. The trip had not been wasted, however. She was able to find a Buddha figure and it was made out of a nice heavy concrete type of stone. As she fished around in her bra for the cash necessary to make the purchase, the cashier remarked that her arm didn’t look too good and suggested that she get it checked out. Liz suggested she mind her own fucking business and paid for her new religious representative. But after walking out the store and trying to hold her heavy new acquisition with her damaged limb she had a change of heart and asked the woman to call 911 for her.

“Look! I found God!” she laughed as she got into the ambulance. The crew who was familiar with the perpetually angry woman were a bit leery of this rare display of joy and the newfound love for heavy concrete objects in the hands of a perpetually angry woman. They splinted up her arm and took her to the hospital where she repeatedly told everyone with glee that she had “found God, his name is Buddha.”

Sometime after getting out of the hospital and enjoying her new prescription pain medications, an ambulance was again called for her when she was found unresponsive and barely breathing. “Where’s my Buddha?” she quickly asked when she awoke from her opioid reversal, via Narcan (naloxone). Her new spiritually had already become ingrained into her psyche.

The ambulance people had destroyed her high and she felt justified for lashing out at them. Even thought she always berated them for various perceived infractions this one was very different. She didn’t want to hear anything about ‘barely breathing’. Her prescription was LEGAL. They couldn’t do anything about it. Sure she had taken far more than the bottle instructed but it wasn’t the point. A doctor had given her these medications. She hadn’t gotten high off of something purchased from a man named Angel on the corner of Decatur and Wyckoff. She had done nothing wrong and didn’t deserve to be punished for it with Narcan.

As she argued with the crew she was comforted in knowing she now had two weapons-her concrete Buddha and her nifty new cast. “Look,” she showed the paramedics. “It’s like I got concrete stone on my arm too!”

“Nice little advertising billboard, you’ve got there,” said the paramedic.

What was he talking about? She looked to where he was looking. It took some contortions but she could tell something was written on her brand new cast. She studied it with her head bent at an uncomfortable angle.

“BLOW JOBS 75 CENTS – broken arm sale.”

It had been written in large lettering with a thick black marker. And the words faced outwards, like advertising, just as the man had said. You could practically see it from three blocks away. “What? The fuck? Man!” she screamed. Her cast had been on her arm less than 24 hours and someone had already vandalized it.

“When you’re passed out on Oxy worse things can happen,” said the medic, trying to console an inconsolable Liz.

“Shut the fuck up!” she told him. She was going to raise up her concrete Buddha as a warning but she couldn’t grab it in time. The crew had taken it away, out of her reach.

“You’ll get it back at the hospital,” they told her.

Didn’t they know it was a religious article? She was allowed to hold it. Her prison mentor had told her all about it.

“You know, there are some who say that Buddhism isn’t a religion. There’s no deity. It’s really more of a spiritual philosophy. I don’t know if it fits the same parameters,” one of the medics told her.

“What was she saying? What’s a parameter? Can I still sue if they take away a spiritual philosophy figure made out of heavy stone? They must just be fucking with me. If only I had my Buddha, I’d show them,” she thought. But there were other things to worry about. Who had defaced her cast? Who was she last with? That person was going to feel the full, literal weight of her spiritual philosopher.

Liz spent a few hours at the hospital, mostly being lectured about the right way to take pain medication. When she asked for more they gave her Tylenol. Tylenol! Didn’t they know that’s not the same?

The same paramedic crew found Liz a few days later. Someone had called for her when they saw her bleeding and laying on a street corner. Those paramedics thought they were going to her hit with the Narcan again, she laughed, but the joke was on them. She was just drunk. A battered and bruised Liz made her way to the ambulance anyway. At least at the hospital she could get some rest.

The crew had never seen Liz so battle-worn and that was saying something. She looked tired and had cuts and abrasions everywhere. Another tooth was gone from the already sparse lineup and one of her eyes was swollen. They asked her what happened. She showed them her cast. The “BLOW JOBS 75 CENTS- broken arm sale” had been mildly scribbled over with a blue ball point pen. You couldn’t even see that it had been crossed out unless you looked closely.

“I’ve never beat up so many people in my entire life,” she told them. “I got all kinds of mens coming over day and night with their one dollar bills, asking me for change. Fuck them! Who charges 75 cents for a blow job? I do a blow job I want a bag of tar or some blow! You keep your fucking dollar bills to yourself. Fucking assholes. They be throwing quarters at me! Quarters! You believe that? Buddha cracked a couple of skulls, I tell you. That thing is heavy but it do the job. Last thing they worry about now is their pee-pee.”

Buddha too, had gone through some physical changes. A few chips and scratches seemed to under line the story Liz told of her recent encounters. With all the violent karma she had been dishing out lately, Liz’s new religion hadn’t provided her with much peace.

Tag: ems stories

September 13, 2001

My First Baby Delivery

Young Thespians in Jail

The Panhandler’s Brawl

The Cryptkeeper and the Mole People (Part One)

The Cryptkeeper and the Mole People (Part Two)

Manhattan Real Estate

Holes in Unusual Places

Free Onion Rings

Advertising Billboard

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