Tag: paramedic 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’.

The Long Distance Girlfriend Experience

April 3, 2021 / Nancy Gwillym

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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.

A Dead Man Walking (and Arguing)

October 12, 2020 / Nancy Gwillym

Every paramedic gets the same types of medical scenarios in their certifying course or refresher class. There’s the grassy field where a bee will have been involved, causing an anaphylactic reaction. Another one will involve an elderly person at home in the summer with closed windows where your detective skills will surmise that a heat stroke has most likely led to his change in consciousness. And if there’s heart attack scenario it will usually involve someone shoveling snow.

Shoveling snow is considered to be such a cardiac risk specific mention of it is made in many cardiac journals and as a warning to patients who have had myocardial infarction (MI), or heart attacks, in the past or are at risk for it. The combination of sudden strenuous labor and the cold air that is already constricting your blood vessels make it especially dangerous for someone who is already compromised.

When you’re being tested on these scenarios, either acting them out with mannequins or describing what you’d do to an instructor one on one, there are rarely curve balls thrown in to confuse you. The instructors aren’t interested in your clever abilities in finding a hidden medication bottle or poking holes through the family’s story about how the event happened. They just want to know that you can remember the protocol and apply it properly.

Rarely in real life are scenarios this cut and dry. Real patients lie to get out of going to the hospital or exaggerate to get seen faster. Sometimes medication bottles, or a drug habit, are well hidden and require real sleuthing skills. Or sometimes the patients list of symptoms is so long it’s difficult to figure out what the real problem is. But once in a while everything is exactly the way it is in the textbooks, probably the reason why they’re used as examples.

It was a snowy, winter day that my partner and I had made our way to the far off corners of Brooklyn thanks to limited unit availability and the far away hospital requests of several patients. We enjoyed leaving the confines of our assigned area which gave us opportunities to eat better and deal with completely different hospital staffs. We now found ourselves assigned to a predominantly Russian-speaking area of the borough where my partner had worked as an EMT. He knew the streets well so we didn’t have to spend large amounts of time flipping pages in our paper map book trying to find the address.

When we got to the apartment our patient, a large dark haired man with a Russian accent, was exhibiting the classic ‘Levine sign’. It’s a sometimes subconscious act of holding a fist on the chest near the heart. If this were part of a training scenario it would be the first thing that would alert the paramedic to think ‘heart attack’ or ‘myocardial infarction’ (MI). The man seemed a bit preoccupied, one could describe it as anxious (#2 for sign and symptoms), and he said he had no patience for us. He was a busy man and would not be going to any hospital. His wife had been foolish to call.

The wife appeared annoyed but was also clearly worried. “Just let them check you. Please. If it’s nothing they can go,” she said. The man grew more irritated but he decided to appease the wife and get checked out, possibly just so he could show her what a waste of time this all was. He rolled up his sleeve and demanded that we take his blood pressure so his wife would see how healthy he was.

His skin was pale (#3), cool (#4), and very sweaty (#5). When I took his blood pressure it was high, very high (#6). Impatiently, he demanded that we should take it again, we must have gotten it wrong. But it was still high the second time. He rolled up his other sleeve. He now told us that his left arm was numb (#7) so the pressure couldn’t be accurate in that arm. A try with the right arm was really no different. The wife gave a smug nod that infuriated the patient.

He insisted that he was a strong person, physically and mentally. As the building manager, he had a very active schedule and many things were left to be done. He couldn’t rely on anyone else. The people of the building had become accustomed to things being fixed correctly and they knew he was the only man for the job. That morning, when other building managers would have slept in, waiting for the impending snow to actually fall, our man was out there salting the roadways ahead of time. Once we heard that he had done all the shoveling (#8), with an actual shovel and not even a snowblower, when the snow had finally came, we didn’t even need an EKG. This guy was having an MI.

But we put our patient on the monitor anyway, of course, and it showed a rapidly evolving, life threatening MI. When we presumptively diagnose a heart attack we are usually only looking for tiny incremental changes in the EKG. It’s often only a small, two millimeter height difference on the graph paper. But his were so high they didn’t even need to measured. We could see them from across the room. The shapes of his complexes are even called “tombstones”.

None of this convinced the patient however. He was fine, he told us. He wasn’t one of these “sissy-boys” who needed to see a doctor for every ache and pain. He would lay down for a few minutes and then, when his chest pain subsided, he would get back to work. More snow was coming. He had heard it on the news.

We told him in every way possible that he was having a heart attack and it was progressing. One or more of the vessels supplying his heart was clogged, which was depriving more and more areas of his heart of oxygen. With current treatments available this problem could very potentially be reversed if we got him to a STEMI center quickly. They would quickly put in a stent and blood flow could be restored. His heart would most likely function the way it had before. But he had already waited some time and it looked as if it was going to take even longer to convince him.

We explained about cardiac death and the whole ‘time equals muscle’ philosophy, meaning that the longer the heart goes without oxygen the more muscle mass that dies. He would not hear any of it. His chest hurt because he was sore from shoveling snow. We were stupid to not see that. Didn’t we know how strenuous it is to shovel snow? He had shoveled around the whole building, down pathways and parts of the parking lot. Of course he was sore, he had exerted himself the way he always does, giving 110% to his residents. Couldn’t we see how strong he was to be able to accomplish all he did today? We had probably never shoveled snow or we would have understood the muscle soreness.

He thought that we had taken his wife’s side in this argument. He would need to placate us, he felt, in order to get rid of us. So when he was offered a spray of nitroglycerine under his tongue he accepted. He also took the aspirin we gave him. We continued to watch his EKG and continued to take vital signs.

Shortly after the nitroglycerine his face lit up. “The pain. It’s gone. All gone,” he told us happily. “See? You cured me. Now you can leave.” It was hard to know if the pain was actually gone but saying that our spray had worked bolstered our argument that his pain was cardiac. Nitroglycerine wouldn’t have worked for regular muscle soreness. The building manager was frustrated that he had been tricked.

We spent a considerable amount of time trying to break through his wall of defensiveness. The internet existed back then and the couple had a computer so we had the man look up his signs and symptoms. We asked him to look up the EKGs of people having heart attacks and compare them to his. The best example we were able to Google had much smaller tombstone complexes. “Look,” he told us. “Mine are better!” The larger complexes, he explained, were due to his superior physical conditioning. The person with the EKG on the internet probably wouldn’t be able to shovel miles of snow the way he had.

Everything short of shadow puppets had been used to try and convince our patient to seek help at the hospital for an ongoing event that could very likely kill him. We tried to understand his fear of the hospital which he denied was the reason. We even offered to take him to a different hospital, one of his choice, but he was not interested. And he had every right to refuse. If he didn’t consent to go we couldn’t force him. The patient knew that we couldn’t force him.

“This is America. Not Communist Russia. No one can just come and force me to gulag. You understand gulag, correct?”

Yes we understood. But because he had an evolving, life-threatening event going on he would be required to speak to our doctor on our taped line and tell him that he was refusing. Perhaps even, our MD could convince him to go. We called up our telemetry number and told the physician what was going on. He initially thought we were doing a routine STEMI presentation so that he could notify the hospital. By going through this procedure the patient pretty much goes directly upstairs to the catherization lab, saving time and muscle. “OK, I’ll contact them immediately. What’s your ETA?” he asked.

“He doesn’t want to go,” we told him.

“Doesn’t want to go? That’s crazy. He will die.”

“Yup.”

We put the patient on the phone and heard him get defensive less than a minute into the call. We could hear the doctor patiently explain the entire thing, going into great detail about the heart and how it was being damaged and what would happen if he didn’t go. But none of it mattered. He wasn’t going. No one could make him. He was not having a heart attack. OK you think it’s a heart attack, big deal. I don’t care if it is, he told him. He was fine. He understood the risks. He told the doctor about the gulags of communist Russia. If anything changes he understood he could call back. He handed the phone back to us.

“Well, we did our best. Take the RMA (refusal of medical assistance)”

The patient breathed a big sigh of relief. Finally we were leaving. His personality did a complete turnabout now that the pressure was off. He was gracious and friendly as he signed our paper. He hoped we hadn’t been greatly inconvenienced. He was happy we could finally go out and help all the people who really needed us.

It’s so surreal to look at someone who is dying and know what is happening. You try to look for something different, maybe an aura. Or you try to feel something, to perhaps boost your intuitive powers so that the next time you get someone like this, but without the telltale signs, you’d know, you’d recognize that feeling. But there was nothing, no aura, no unusual sensation. On the outside, he was just a regular guy with elevated vitals who was turning a little gray. It makes you feel more helpless than ever. You can’t even learn from the experience. The one big thing that helps EMTs and paramedics to cross over a psychological hurdle, when you’ve got someone critical, is the knowledge that you can actively do something to help. Even if it doesn’t work in the end, you tried and you can console yourself with that. Knowing that you have it in your power to help stop the cascade of medical disasters occurring in that person but are unable to provide it makes you feel useless and small.

We asked again before leaving to please reconsider. His wife was crying and begging him to go. But he just happily opened the door and bid us good-bye.

After the call we went to the nearby station my partner had done his EMT years at. He said hello to some people he knew and used to work with and introduced me. Our radios were tuned to a different frequency because we belonged to a different section of the city, so we normally would not have heard the call go out for a cardiac arrest at the address we had just left from. But because we were talking to people who did work in that section we heard it come over on their radios. We just looked at each other sadly and shook our heads. It had been less than an hour. Shortly after that we heard the crews that responded give a signal indicating that resuscitative efforts had failed and that the patient had been pronounced on scene.

“You guys RMA’d that guy?” someone asked. “I guess you guys are in trouble now.” They looked at us as if we had happily taken his signature as soon as we walked in.

“No,” explained my partner to the young EMTs. “We tried. But this isn’t communist Russia where we can just haul you off to the gulag.”

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.

lost places, wall, pforphoto — a palatial mansion compared to where we were

And Somewhere Along the Way, She Was Shot

October 5, 2020 / Nancy Gwillym

This is one of those “worst” jobs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Where’s her rapist?” I asked.

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

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

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

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

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

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

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

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

What kind of notification would we be giving?

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

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

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

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

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

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

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

“That IS crazy!” I replied.

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

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

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

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

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

The Sign In Sheet

September 25, 2020 / Nancy Gwillym

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Certainly not!” he indignantly told her.

Tag: paramedic stories

September 13, 2001

The Long Distance Girlfriend Experience

Young Thespians in Jail

Holes in Unusual Places

A Dead Man Walking (and Arguing)

Advertising Billboard

And Somewhere Along the Way, She Was Shot

The Sign In Sheet

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