When I was a precepting medic, I had a young boy as a patient. I heard a rumbling sound and my preceptor said “Look out!” Not a second later, the boy vomited all over me. “You’ll learn to recognize the signs,” my preceptor said, handing me a towel. The mark of an experienced medic is…
The patient had lost nearly two liters of blood and was barely responsive. I arrived shortly after the primary medic who told me to get the blood set up while he extricated the patient with his partner. As the rapid response medic, I carry the whole blood (0 negative) in a special cooler. I check…
The patient is lying under the slide at the playground jungle gym. It is a blistering hot day and this may have been the only shade she could find. She is unresponsive, cyanotic and breathing agonally. Her pupils are small. From the hard lines on her face and poor dentition, I surmise a life outdoors…
I received a book in the mail about a month ago. I slipped it into my briefcase to read while in between calls in the rapid response vehicle in Hartford. It sat there in its unopened package for weeks as I was too busy between calls and writing PCRs to take it out. Yesterday, Saturday,…
“You need to get that checked out,” I said. “I’m not going to the hospital. They treat me like shit there.” “I’m sorry they do, but that’s not getting better.” The woman has a nasty necrotic ulceration in her AC that has eaten away the skin and some of the tissue underneath. It is black…
The CDC recently released data from their 2020 State Unintentional Drug Overdose Reporting System (SUDORS), which describes the drugs involved in and circumstances surrounding drug overdose deaths in 28 states and the District of Columbia. It is available for download here: https://www.cdc.gov/drugoverdose/databriefs/pdf/SUDORS_Data-Brief_Number_1.pdf Four points from the report are crucial to understanding the death epidemic. 1. …
Our unconscious patient’s chest heaves again and he coughs up another gob of high flying trapeze pink froth that splats on the ambulance bench seat where seconds before my partner’s knee had been. As he secures the IV, I check the patient’s pupils. Midsize, unreactive. No one home. Ten minutes before, bystanders who found the…
A podcast I did recently on the Addiction and Recovery Network of the Life Change Center has now posted. https://recoveryandcompany.podbean.com/e/a-paramedics-dispatches-from-the-front-lines-of-the-opioid-epidemic-part-1-episode-14/ https://recoveryandcompany.podbean.com/e/a-paramedics-dispatches-from-the-front-lines-of-the-opioid-epidemic-part-2-episode-14/
A young EMT saw me at the hospital this week as we were both bringing patients in. She had a present for me, she said. After I got my patient situated in their assigned bed in the hallway and gave a report to the nurse, I went back outside and met the EMT. She reached…
I spoke on a panel a few weeks ago about safe injection sites, (SCS) also known as overdose prevention centers and supervised consumption spaces. These are places where drug users can use in a clean, safe environment under the watchful eyes of trained individuals, some medical personnel, other people who may have used themselves in…
The best TV show of all time to me is The Wire, a five-season drama about the city of Baltimore and the battles on its streets between the police and the drug dealers. The drama is crisp, the dialogue is authentic and there are no simple answers offered. The same people who did the Wire…
In EMS, we can’t take pictures of the dead. We can write about them, but we have to change the details so the person cannot be identified. I have done this on many occasions. In my head I have a photo gallery of the fallen in this opioid poisoning crisis. The photos are not blurred,…
In EMS, we are eyewitnesses to the inevitable decline of the human body and to death. That’s why when a young person dies it shakes us deeply. They are not supposed to die. It is hard to disassociate yourself from such an event. On those rare occasions that my Pandora’s box of bad EMS memories…
One of my lifelong heroes is Joshua Lawrence Chamberlain. He was the Maine school teacher who volunteered to fight in the Civil War and found himself leading the 20th Maine on Little Round Top, a rocky hill at the end of the Union line at Gettysburg. After repulsing several attacks, his battle weary men were…
A number of winters ago, I responded for the “welfare check” in a local apartment building. Carrying my gear I trudged through the snow to the door where the super met us and we walked through the bare lobby. He told us “his hands and feet are all blue.” By the way he said it,…
When I first started in EMS I was almost always the first on scene because our local fire department only responded to jaws of life calls and the PD usually only responded to reports of violence assaults. I loved getting their first. The scene was pristine. Sure I had a dispatch subject, but from early on…
According to the latest data from the Connecticut Medical Examiner’s office, 2021 opioid deaths rose 11% over 2020, marking the third year in a row of increases. Opioid deaths have increased in 8 of the last 9 years in the state. Fentanyl deaths have increased every year, with Fentanyl deaths representing 93% of all opioid…
I have been interviewed quite a bit over the last year both as a result of my book, Killing Season: A Paramedic’s Dispatches From the Front Lines of the Opioid Epidemic, and my role as part of the state’s overdose surveillance system. There have been times when I thought I was truly eloquent, but when…
Below is an excerpt from my novel, Mortal Men: Paramedics on the Streets of Hartford, that came out in 2012, and is still available on Kindle. In the book, while the main characters had fictional names, I used the names of real people who worked the streets as extras. I did it because I wanted…
You are on scene of an overdose. You have just resuscitated a man who was apneic and now admits to snorting heroin he was given by a friend. He just got out of jail and hadn’t used for over two years. You explain both the danger of the fentanyl that is on the street in…