You drive the streets of the city or towns where you work and you go by houses, intersections, businesses where you have done calls. The longer you are at it, the more memory pins are dropped on your street map.

Over here on our left was the great lumber yard fire. I sat on that standby for 11 hours. The first hour was fascinating, watching the spectacular flames jump and burn as fire companies from all over the region tried to douse it. But after a couple hours, I was bored. I was a new medic then and wanted to be doing calls, wanted to be in the action.

On the right is the Laundromat where we pick up the drunks, and do more than a fair share of seizures. Rest in peace, Eli, Papa Santo, Ronnie Ray, Annie Moore, and others whose names I have forgotten. I did a pedestrian struck up ahead here. I saw the entire thing happen, car hit the young man threw him straight up onto the windshield. I was on the radio when it happened. “471, we’re clear ref…Holy Shit!” Apologies to the FCC.

See the apartments back down behind the barber shop. I’ve done lots of calls in there, old people not feeling well mostly. There used to be a four hundred pounder up on the second floor who’d get back pain and couldn’t get out of bed. A BLS crew called us for a lift assist the first time I went there. I gave him 15 of morphine (in three doses of 5). Instead of us having to lift him and carry him down the stairs, he was able to stand and walk down to the ambulance. Worked every time after that. Out in the parking lot, I did a code — man behind the wheel still as death with an inhaler in his hand.

Let’s turn down this street up ahead. See that house – crack house, did lots of ODs in there. Gave narcan to some heroin ODs. Ran a strip and called the time on some others. Also did a major trauma out front. Guy jumped out of the window after being chased by the police. Landed on his face. He was seizing when we got there. Severe head injury with multiple fractures. We were in the trauma room in four minutes.

Over there we did a minor MVA. An insurance adjuster rear ended another car. By the time we got there seven people were either laying on the ground or walking around holding their backs all claiming to be hurt with more joining them. Only one of them had been in the car at the time of the accident. “I’m going to the hospital and I’m going to get paid,” a toothless woman cried. “Com’on Jimmy, Let’s go the hospital. We’re all going to get paid!”

Store on the corner, the grocer got shot. He was laying on the ground on his back, moving his arms, a snow angel blood print surrounding him. Behind him were several avacodos that had exploded, spreading guacamole on the shelves. That house there, I pulled up as the fire department was coming out of the house, two firefighters carrying a lifeless child. It was my second pedicode in a week. We didn’t have the EZ-IO then. After I tubed the child, I used a bone needle, screwing it into the leg, but the needle bent and I couldn’t get it out. I’m tugging and pulling and its stuck. I finally got it out just as we got to the ED. They worked the kid another thirty minutes, but he was asystole the entire time. Turns out he was a special needs kid and his death wasn’t unexpected. Still the family took it hard. The mother was beside herself. I was haunted by her primal wail.

Mrs. Jonesbury used to live on the first floor apartment of that house. She’d call in the middle of the night. Big heavy woman with swollen extremities, too weak to get off the toilet. We’d come in and wipe the shit off her legs and help her back into bed. Sometimes we’d bring in clean hospital sheets and change her bed for her. I wasn’t on the day they found her dead, and ran the six second strip. I would have liked to have been there for her, to say a couple of words beyond just calling out the time of presumption.

I have stories for almost every street on the city map. I can tell you about the poorest streets and I can tell you about the mansions on Scarborough and Prospect Streets, (the banker’s wife cutting her wrists sideways and laying in the bathtub waiting for us to come), the office suites up in city place where a man with a view looking out over all the city, crying that he might be dying, and wanting his attractive secretary to call his wife and her seeming upset by that, the man testifying before the legislature whose internal defibrillator kept going off every time he tried to answer a question, or the cook passed out on the grease caked floor of one of the city’s five-star restaurants, while the orders kept going out all around us.

This city like all cities has its stories. You could tour the historic homes, the insurance companies, the old state house, the parks, the art museum, the riverfront, and learn about Mark Twain and Harriet Beecher Stowe and Samuel Colt and other historical figures from the city’s past, or you could ride with me* on the medic’s grand tour.

“Step right up
Come on in…
There are things I could tell you,
Some things I know will chill you to the bone.”-The Grand Tour
George Jones

* Or any medic that has been here more than a couple years.

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We’re called for a child not breathing. The address is a convalescent home. It makes no sense.

Then we pull up. There is a car parked askance by the entrance, two front doors and a back door open. The engine still running.

In the front lobby two nurses and a police officer kneel over a small body– a boy of maybe six years. One nurse does chest compressions, while the other holds the bag valve mask over the boy’s face and tries to breath for him. The police officer attaches a defibrillator.

I kneel down by the head. The robotic voice from the defibrillator says, “No shock advised. Check pulse. If no pulse, continue CPR.”

The boy is lifeless. I feel for a pulse. None.

My partner Annie attaches the cardiac monitor to the patient while I take out my airway kit.

I slip the tube into his throat. I glance up at the monitor. Asystole. Flat line.

I look at his arms for a vein. I see nothing, so I take out an IO bone needle. I pull back his pant leg, swab his tibia, then twist the needle down hard like a screw. It pops as it goes through the bone.

I push epi and atropine. No response.

What happened? I ask now.

His parents were driving by, a nurse says. They brought him in, he wasn’t breathing. They said he wasn’t feeling well today. We started coding him right away.

I look up at a woman sitting in a chair, looking glazed. A man stands behind her, no hand on her shoulder. Then I notice a silent row of residents in their wheelchairs in a semicircle around us.

I see in my head this scene from above. Us kneeling around a lifeless child, trying to make his heart beat and to fill his lungs with air. The honor guard of the aged around us. The scene gets smaller and smaller as the camera view goes up through the roof, through the night clouds and up into the stars.

Reposted from August 2004

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Two months back in the city and I have already given more Narcan and Haldol than in the last two years in the suburbs.

I like the morning routine of punching in, getting the narc keys and computer, grabbing the ALS gear, checking it out fully, and then walking out to the ambulance and going through the vehicle. I have a different partner every day except Fridays, and I’m in a different ambulance each of my three work day, but I am easy about that. I have never bee particular about ambulances and I like all the partners I’ve had.

I’m over my anxiety of the new computer software and actually think it is a decent program.

I still know the streets, but I forgot how steep the stairs were in some of the city buildings.

Carry downs and carry ups, my arms are definitely more toned than when I was using the tractor stair chairs and the power stretcher, although we do have some of the tread stair chairs and rumor is we are getting the power stretchers in the city.

Today, at the hospital, I put my stretcher in the back of my old suburban ambulance by mistake.

Posting on street corners, and thus unable to ride my bike around the ambulance headquarters for exercise, I have entered my own pushup challenge. Putting my hands on a bath blanket to avoid rocks, glass shards and other nasties, I try to do 300 pushups a shift in groups of 100. I don’t do 100 in a row. I might do 30-20-30-20 over five minutes. The most I have done in a row is 61, but from 50-61 I was cheating, counting small bends at the elbow as full pushups. My dream is to one day do 100 in a row – 100 no cheating pushups. I’ve got a 150 done today with six hours to go in the shift.

“This is why my boots never go home.” A cop said this to me on our last call.

“I hear you,” I said.

GI bleed for three weeks, didn’t feel like going to the hospital. No one to check on him, until another boarder complained of the smell.

Doing lots of psychs, ODs and assaults.

I was worried I wouldn’t get as many opportunities to help people in pain as in the suburbs, but pain is pretty universal. Hip fractures, pancreatitis, burns. But here is who I didn’t medicate:

43-year old man with chronic back pain who claims he was mugged the day before and the thief stole his oxy.

22-year old female from the lockup with undifferentiated abd pain and a discharge diagnosis from the evening before for pelvic inflammatory disease.

37-year old man with arm pain and ETOH on his breath who says he was hit by a car three days ago and got tired walking to the hospital so he sat down on the side of the road and had someone call an ambulance for him.

I been eating a lot of pizza slices. Pizza slices are the best EMS food – hot, ready for pickup, reasonably priced. Available all over town and every place has their own unique style. Shout-outs to Lena’s First and last and Stretch’s.

Still eating the Spanish and Jamaican food. The other day, I ordered some Fish soup which comes in a Styrofoam coffee cup. I walked back out to the ambulance, opened the passenger door, and standing outside, I took the lid off and took a sip. I don’t know if you have ever seen the show 10,000 Ways to Die, but picture this as an episode. Medic sips fish soup – secret Jamaican spice, likely Scotch Bonnet Pepper is sucked into medic’s windpipe, causing immediate larengyospasm. Medic takes five big deep inhalations that bring no air in. My partner was reaching for the mike to call for another medic when I finally got some air in. 10,000 Ways to Die will have to wait.

Time for more pushups, but before I get halfway out the passenger door, its time for another assault.

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