Tag: worst job ever

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.

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.”