I'll never forget a story my EMT instructor told me years ago about a call he'd gone on involving a 12-year-old girl. They'd been called because she was unconscious and completely unresponsive. They arrived to find her beaten half out of her wits and struggling to breathe. Police arrived and managed to wrangle an explanation out of her stepfather.
She had come home with a report card that her stepfather found unacceptable, so he put a book in each hand and made her stand with both arms straight out. Every time an arm drooped he'd take the book from her, hit her in the head with it, then give it back and make her take up her position again. He did this until she collapsed with severe head trauma. Each and every one of the men on that crew wanted to pick up those books and give that animal a taste of what his daughter had endured, but they quietly took her to the hospital, working feverishly to care for her. It was all for naught. She died in the hospital.
Fast forward to the present day. We've all seen those stories on the news of parents too young to be patient with a child losing their temper and shaking them or hitting them, causing often fatal injuries. We all know that the parents will clam up after they call 911; what little they do say never adds up. We all know that babies don't usually just die, particularly not with nosebleeds and bruises all over their bodies.
We all know that it's not a question of if, but WHEN we go on a call like that - a call where a parent, through either negligence or outright malice, has caused life-threatening injury to their child. When I saw that baby that morning, I knew full well what had happened even with his father standing there, looking me in the face, telling me that he had no idea what had happened. He said he'd gotten out of bed to check on the infant and found him completely unresponsive, laying on his back, his nose bleeding. Something must have registered in my expression as he said this to me because he didn't look at me again after that first explanation. He asked a couple of questions but he didn't look at me.
The thing that sucks the most about those calls is that we usually hear on the news that the child has died. I found that out not a few days after going on that call. I found out a lot of things about that young man afterward that I won't talk about here. I'm sure I'm not the only one who thinks about what it would feel like to be able to beat those people unconscious, to both help them understand exactly what they did to that defenseless child and set an example for those in the future who might lose their temper and do something that they can never undo.
Not I nor any of my brothers and sisters in this profession would ever break the law, no matter how badly we would like to take justice into our own hands. I believe, however, that we all feel when we do nothing in such moments we are showing mercy to a waste of space who refused to show it to a helpless, defenseless child who deserved far better.
I think we all know what's going to happen, too. This guy will get ten years in prison, be free by the age of 30, and will immediately go knock up another hapless girl who either really thinks this animal loves her or simply doesn't have any respect for herself. He won't learn anything behind bars except how to be a better crook and liar. I just hope that the next time he calls 911, I'm not on the crew that responds.
Saturday, December 11, 2010
Friday, November 12, 2010
The Job We Signed Up For
Few things get under my skin as quickly as the assumptions some people have about the job we do. The general public seems to have this idea that firefighters, paramedics and police officers are wearing the uniform solely for the purpose of putting ourselves in harm's way. Yes, we do that. We do it frequently. Our safety does not need to be in jeopardy all the time, however; prudence and a strong set of SOP's (Standard Operating Procedures) can mean the difference between coming home and going to the morgue. Consider these words, spoken by a man who was shot this past June in Aurora, Colorado:
"They signed up for it. They just need to do their job."
Of all the things I've heard a person say about our profession, that makes the hair stand up on the back of my neck. Those words were spoken by Adam Fisher recently as he recalled the June night when a drunken neighbor opened fire and hit him three times. A friend called 911, then as police responded to the scene that friend followed dispatchers' instructions to try to stop the bleeding. Firefighter/paramedics were dispatched to the scene, but because of SOP's - a requirement that police declare the scene safe before entering - fire crews staged about a mile away. They wouldn't enter the scene to treat Fisher until the officers at the scene declared that scene secure.
Recordings of radio transmissions during the incident show what the news report failed to touch on: the lack of communication on the part of police officers. I fail to understand why the firefighters' failure to move from staged to responding is all their fault, because I'm hearing what officers are saying over the radio and I hear quite a few dancing around whether it's safe. Nobody declared it safe. Then, when they got frustrated that firefighters weren't responding, I'd like to know why officers didn't send someone out to physically tell them, "hey, the scene is secure, we need some help."
How hard was it for them to simply declare the scene safe? There were 30 officers there, surely someone could have put two and two together.
Despite what seems to be glaringly obvious, this all gets laid at the feet of the firefighters. The victim and his friend don't have the first clue what the reasons are for not rushing in immediately and nobody has bothered to explain it to them.
Let me tell you about the job we signed up for. We signed up for public safety. We signed up to rescue the injured, treat the sick, and put out fires. We signed up knowing that the nature of the job requires that we accept a certain level of risk to our personal safety. The vast, overwhelming majority of us are adrenaline junkies, so that feeds the need to some degree. What we did NOT sign up for, though, was an expectation that no matter what's going on, no matter what danger, we will throw ourselves at the mercy of God because the public thinks we ought to.
If that were really the case, we'd stop issuing guns, night sticks, OC spray and tasers to police officers. God knows they've been persecuted for their use of every single one of those tools even though they're quite often justified in using them.
I've been burned before and it really isn't that bad. I've had broken bones; those often heal with minimal issues. I've had lacerations that required stitches. Each and every one of those injuries would have been far worse if it hadn't been for my training and PPE (Personal Protective Equipment). Unfortunately, I don't have anything that will really save me from a bullet. I don't wear a tactical vest that will protect my major organs. Since we're not living in the Matrix, I'm not capable of dodging bullets. If someone at a scene gets stupid and starts cracking off shots at me and my partner, we're just as susceptible to serious injury and death as the Joe Schmoe we're being called to help.
I'm not really afraid of dying. If I'm on a call and some unspeakable danger befalls us, I would much rather be the one to die rather than have to tell my partners' kids that I did the best I could. What I am more afraid of is surviving a gunshot wound. Survivors end up with all kinds of health issues; I'm sorry, but ending up with a colostomy bag, a hole in my skull complete with an inability to control my mouth and spending life in a wheelchair - all of which would keep me from ever doing the job I love again - are NOT what I and my brothers and sisters signed up for.
If someone is running around a scene with a gun, then I'm not going in blind. In some situations, I'd absolutely break that rule, and I'm not saying that I would wait until my dispatcher told me the scene was secure; if a cop came out and asked for my help, sure, I'd follow him. But if I'm sitting in my rig, watching scores of officers come sweeping in with guns drawn, you'd best believe I'm going to wait on them to clear it out.
In 1993, Denver firefighter Doug Konecny was shot and killed while extending a ladder to the window of a suicidal man. In 2004, Lexington firefighter Lieutenant Brenda Cowan was shot and killed trying to help a victim of a domestic dispute. In 2008, St. Louis firefighter Ryan Hummert was shot to death while trying to put out a vehicle fire. Others have been wounded and survived.
In this case Adam Fisher and his friend, Leah Lockert, are angry with firefighters. They believe the crews should have ignored the danger and come charging in full-code without regard for the situation. We cannot fall into the trap of believing that our lives are expendable simply to placate an angry public. We all know just how off-base the public often is.
Mr. Fisher, I will not, for one second, attempt to downplay your situation. I would ask you not to downplay ours. Don't think that those firefighters were being lazy. I promise you, they weren't standing outside their rigs with their arms folded, relaxed. They were anxious to help you. If they were anything like me and my boys, they were bouncing on the balls of their feet, muttering under their breath, raring to go. It's not fair that you got shot. It's equally unfair for you to expect us to put ourselves in mortal danger and run the risk of needing even more rescue crews to come help us.
"They signed up for it. They just need to do their job."
Of all the things I've heard a person say about our profession, that makes the hair stand up on the back of my neck. Those words were spoken by Adam Fisher recently as he recalled the June night when a drunken neighbor opened fire and hit him three times. A friend called 911, then as police responded to the scene that friend followed dispatchers' instructions to try to stop the bleeding. Firefighter/paramedics were dispatched to the scene, but because of SOP's - a requirement that police declare the scene safe before entering - fire crews staged about a mile away. They wouldn't enter the scene to treat Fisher until the officers at the scene declared that scene secure.
Recordings of radio transmissions during the incident show what the news report failed to touch on: the lack of communication on the part of police officers. I fail to understand why the firefighters' failure to move from staged to responding is all their fault, because I'm hearing what officers are saying over the radio and I hear quite a few dancing around whether it's safe. Nobody declared it safe. Then, when they got frustrated that firefighters weren't responding, I'd like to know why officers didn't send someone out to physically tell them, "hey, the scene is secure, we need some help."
How hard was it for them to simply declare the scene safe? There were 30 officers there, surely someone could have put two and two together.
Despite what seems to be glaringly obvious, this all gets laid at the feet of the firefighters. The victim and his friend don't have the first clue what the reasons are for not rushing in immediately and nobody has bothered to explain it to them.
Let me tell you about the job we signed up for. We signed up for public safety. We signed up to rescue the injured, treat the sick, and put out fires. We signed up knowing that the nature of the job requires that we accept a certain level of risk to our personal safety. The vast, overwhelming majority of us are adrenaline junkies, so that feeds the need to some degree. What we did NOT sign up for, though, was an expectation that no matter what's going on, no matter what danger, we will throw ourselves at the mercy of God because the public thinks we ought to.
If that were really the case, we'd stop issuing guns, night sticks, OC spray and tasers to police officers. God knows they've been persecuted for their use of every single one of those tools even though they're quite often justified in using them.
I've been burned before and it really isn't that bad. I've had broken bones; those often heal with minimal issues. I've had lacerations that required stitches. Each and every one of those injuries would have been far worse if it hadn't been for my training and PPE (Personal Protective Equipment). Unfortunately, I don't have anything that will really save me from a bullet. I don't wear a tactical vest that will protect my major organs. Since we're not living in the Matrix, I'm not capable of dodging bullets. If someone at a scene gets stupid and starts cracking off shots at me and my partner, we're just as susceptible to serious injury and death as the Joe Schmoe we're being called to help.
I'm not really afraid of dying. If I'm on a call and some unspeakable danger befalls us, I would much rather be the one to die rather than have to tell my partners' kids that I did the best I could. What I am more afraid of is surviving a gunshot wound. Survivors end up with all kinds of health issues; I'm sorry, but ending up with a colostomy bag, a hole in my skull complete with an inability to control my mouth and spending life in a wheelchair - all of which would keep me from ever doing the job I love again - are NOT what I and my brothers and sisters signed up for.
If someone is running around a scene with a gun, then I'm not going in blind. In some situations, I'd absolutely break that rule, and I'm not saying that I would wait until my dispatcher told me the scene was secure; if a cop came out and asked for my help, sure, I'd follow him. But if I'm sitting in my rig, watching scores of officers come sweeping in with guns drawn, you'd best believe I'm going to wait on them to clear it out.
In 1993, Denver firefighter Doug Konecny was shot and killed while extending a ladder to the window of a suicidal man. In 2004, Lexington firefighter Lieutenant Brenda Cowan was shot and killed trying to help a victim of a domestic dispute. In 2008, St. Louis firefighter Ryan Hummert was shot to death while trying to put out a vehicle fire. Others have been wounded and survived.
In this case Adam Fisher and his friend, Leah Lockert, are angry with firefighters. They believe the crews should have ignored the danger and come charging in full-code without regard for the situation. We cannot fall into the trap of believing that our lives are expendable simply to placate an angry public. We all know just how off-base the public often is.
Mr. Fisher, I will not, for one second, attempt to downplay your situation. I would ask you not to downplay ours. Don't think that those firefighters were being lazy. I promise you, they weren't standing outside their rigs with their arms folded, relaxed. They were anxious to help you. If they were anything like me and my boys, they were bouncing on the balls of their feet, muttering under their breath, raring to go. It's not fair that you got shot. It's equally unfair for you to expect us to put ourselves in mortal danger and run the risk of needing even more rescue crews to come help us.
Saturday, November 6, 2010
MOUSE!
Every cop, firefighter and EMT in America plays pranks on their brothers and sisters. I'm pretty sure pranking is in our DNA now; I've not worked a single shift where someone wasn't trying to either play a prank or guffawing about past pranks that have become the stuff of legend. When I was just a baby EMT, one of my new buddies pulled me out to the bay and giggled while he put a wide-mouthed cup of ice water in someone's turnout boot. If I had remembered where everyone's position was, I'd have known it was the captain. It was a good half hour before that crew got a call. Naturally, everyone starts sticking their stocking feet in their boots without looking and, as expected, the captain yowled at the top of his lungs and slung his foot out. He caught his toe on the inside of his boot and his momentum flung him straight back, tipped his boots over and spilled ice-cold water everywhere. He recovered quickly and they went on the call, but when they got back he was openly plotting revenge against everyone in the station.
By the end of the night, even he was laughing about it.
Several months later, I and a good friend were at a Toys R Us looking for a gift for his son's birthday. You wouldn't think that a couple of EMT's could get into much trouble at a store like that...at least you wouldn't if you're not from our profession. Halfway down the aisle housing remote-control cars, we both froze in front of a pack of tiny little remote-control cars. It happened in perfect unison; a light shone down from heaven, and the horns that held up our halos grew a little. "Hey," he said, "didn't we see fake rats back there?"
"We sure did," I replied with a devilish grin. I'm pretty sure my halo slid right off at that point, because I ran - I did not walk, I RAN - back to get a couple. He grabbed this four-pack of miniature remote-controlled cars. By the time we got back to my place (he has to hide his kids' gifts at my place now because they know where he hides them at home) I was practically bouncing with excitement over what we were going to do.
You with me so far? You'll love this.
These fake rats, not very big at all, were pretty realistic. They're always available around Halloween for decoration, and they were perfect. We cut out just enough of their undersides to fit the cars in (it wasn't easy, because if we put them in too far they wouldn't move, and if we didn't put them in far enough it looked cheesy and fake). We waited until the guys on the engine were out on a call and did a few dry runs. Once we had it down, we hid both of them between the refrigerators and waited for the right time.
Late in the evening, we'll all go on a call and when we come back, we check everything on the rigs and clean up if necessary then filter slowly back into the station to go to bed. I swear that night it took forever for us to have the right opportunity, and we were afraid it would never come - but come it did, and it came at the perfect time at night when the lights in common areas are dimmed. We got back from a call before they did and took our positions.
The first guy to come in, as we had prayed, went into the kitchen to get a drink. Right as he turned to walk out of the kitchen we did our thing - led the fake rat right through the kitchen, across the hallway, and around the corner into the extra barracks where we were hiding.
This six-foot-odd, burly, muscle-bound firefighter squealed "MOUSE!" like a little girl and turned and ran right back out to the bay.
You have no idea just how impossible it was to refrain from laughing out loud.
We still had one more, and the first guy came back with the other three in tow, one holding his ax as though this mouse was going to tear his face off. That alone would have been hilarious. My buddy hit the throttle on the second one and it tore off in the same fashion, the light hitting it just perfectly, and all four jumped straight up in the air. The guy with the ax went to throw it but ended up tossing it in a beautiful arc. The ax landed just a few feet in front of them (I half-expected the thrower to finish with a pirouette).
"Oh, Jesus, Mary and Joseph," the captain spat. "It's a goddamn mouse!"
"It's TWO of 'em!" the first victim wailed.
"They're MICE!" The captain retorted. "They're not gonna spit venom at you, let's just go find the little bastards!"
Now we were trapped in a barracks with no cover and had four piss-and-vinegar firefighters coming. We simply accepted our fate and stood, ready to face them. When the light was flicked on, we couldn't help it. We erupted in peals of hysterical laughter. My buddy nearly fell over. I was laughing so hard I nearly had a stroke. We carried on for what seemed like forever, four men capable of tearing us both to pieces looking on in fuming silence, before we finally straightened up.
The captain strode up to me, put one hand on my shoulder, and wagged a finger at me as he spoke. "Ranger...you better tell me you thought this through. I hope to all hell...I HOPE...you had a camera out there so we can win some damn money!"
By the end of the night, even he was laughing about it.
Several months later, I and a good friend were at a Toys R Us looking for a gift for his son's birthday. You wouldn't think that a couple of EMT's could get into much trouble at a store like that...at least you wouldn't if you're not from our profession. Halfway down the aisle housing remote-control cars, we both froze in front of a pack of tiny little remote-control cars. It happened in perfect unison; a light shone down from heaven, and the horns that held up our halos grew a little. "Hey," he said, "didn't we see fake rats back there?"
"We sure did," I replied with a devilish grin. I'm pretty sure my halo slid right off at that point, because I ran - I did not walk, I RAN - back to get a couple. He grabbed this four-pack of miniature remote-controlled cars. By the time we got back to my place (he has to hide his kids' gifts at my place now because they know where he hides them at home) I was practically bouncing with excitement over what we were going to do.
You with me so far? You'll love this.
These fake rats, not very big at all, were pretty realistic. They're always available around Halloween for decoration, and they were perfect. We cut out just enough of their undersides to fit the cars in (it wasn't easy, because if we put them in too far they wouldn't move, and if we didn't put them in far enough it looked cheesy and fake). We waited until the guys on the engine were out on a call and did a few dry runs. Once we had it down, we hid both of them between the refrigerators and waited for the right time.
Late in the evening, we'll all go on a call and when we come back, we check everything on the rigs and clean up if necessary then filter slowly back into the station to go to bed. I swear that night it took forever for us to have the right opportunity, and we were afraid it would never come - but come it did, and it came at the perfect time at night when the lights in common areas are dimmed. We got back from a call before they did and took our positions.
The first guy to come in, as we had prayed, went into the kitchen to get a drink. Right as he turned to walk out of the kitchen we did our thing - led the fake rat right through the kitchen, across the hallway, and around the corner into the extra barracks where we were hiding.
This six-foot-odd, burly, muscle-bound firefighter squealed "MOUSE!" like a little girl and turned and ran right back out to the bay.
You have no idea just how impossible it was to refrain from laughing out loud.
We still had one more, and the first guy came back with the other three in tow, one holding his ax as though this mouse was going to tear his face off. That alone would have been hilarious. My buddy hit the throttle on the second one and it tore off in the same fashion, the light hitting it just perfectly, and all four jumped straight up in the air. The guy with the ax went to throw it but ended up tossing it in a beautiful arc. The ax landed just a few feet in front of them (I half-expected the thrower to finish with a pirouette).
"Oh, Jesus, Mary and Joseph," the captain spat. "It's a goddamn mouse!"
"It's TWO of 'em!" the first victim wailed.
"They're MICE!" The captain retorted. "They're not gonna spit venom at you, let's just go find the little bastards!"
Now we were trapped in a barracks with no cover and had four piss-and-vinegar firefighters coming. We simply accepted our fate and stood, ready to face them. When the light was flicked on, we couldn't help it. We erupted in peals of hysterical laughter. My buddy nearly fell over. I was laughing so hard I nearly had a stroke. We carried on for what seemed like forever, four men capable of tearing us both to pieces looking on in fuming silence, before we finally straightened up.
The captain strode up to me, put one hand on my shoulder, and wagged a finger at me as he spoke. "Ranger...you better tell me you thought this through. I hope to all hell...I HOPE...you had a camera out there so we can win some damn money!"
Wednesday, October 27, 2010
Why?
In EMS and Fire, we deal with things that most people don't understand. We all have those stories that are so disturbing that we will never tell our spouses, parents, siblings or children. We've all seen things that most others would require serious therapy for. I wondered for a very long time if my ability to see those things and not be bothered by them meant something was very wrong with me. What tells me that I'm alright is the fact that I still can't imagine coming onto a scene and seeing someone I love like that.
Last week, I saw the face of a man I worked with on the news. Only two of the five local channels had picked up the story. We all know what to look for when we're trying to figure something out solely from the news, and I very quickly deduced what was likely. It twisted my stomach into massive knots. An off-duty cop assigned to an Air Rescue paramedic unit is found alone in his hotel room, dead, and the word is that no foul play is suspected - and the man is too young and seemingly too healthy for something like a pulmonary embolism. Very little is being said. If a death turns out to be suicide (unless it also involves murder), suddenly the media shuts up, and they did.
Several days later, I got to my station and my fear was confirmed. This man I'd worked with for over a year, whom I had a great deal of respect for and whose advice I'd sought, had committed suicide.
Being that I suspected it, I didn't think it would hit me as hard as it did.
I've lost track of the number of EMS calls I've gone on where someone was talking about suicide or had attempted suicide. Lately, I've been running on a lot of completed suicides. The people left behind when someone takes their own life all start out with that familiar stunned emptiness in their eyes. The longer I remain on scene the more their reactions differ. I've seen people shut down, open up, collapse, cry, scream, and had to restrain a few when a body was being removed. I've viewed bodies to determine whether or not it would be prudent to allow family members to see them before they're taken away (it's almost never a good idea, even when they OD).
None of that can possibly steel a person to withstand the news that a person they cared about ended their own life. I daresay it only makes it worse. I've been on those calls where someone is talking about suicide or has attempted it, and a friend or relative is standing there, irritated, saying, "they're just trying to get attention!" They only took a handful of pills, they say. The cuts were just superficial.
What I wish I could tell those people sometimes is that they need to wake up. Those kind of incidents are often the best indicator that someone needs help. Getting mad at them most times does no good. Offer to go with them to get help, talk to them, call 911 if you have to - but nobody knows how many completed suicides I've gone on where someone was left feeling hollow and alone, trying to figure out if there was some subtle sign dropped, wishing they'd seen something so obvious so they'd still have that person there.
I've been to that edge myself. It's been eight years now, but I looked over that edge and the experience has left me a very different person. Even now I still remember the feeling that things in my life would never get better, nobody could understand or fix things, and talking would not help. I felt deep depression and fear, then - nothing. I actually came to a peace that I had accepted the idea of dying. I won't say exactly what happened, but to this day I do not fear death. What I do fear is having to face God and answer for something like that.
Because of that experience, I feel like an enormous hypocrite for asking the question everyone is asking right now - "WHY?". He had a big heart, a handsome smile, and a concern for his patients that others I know have lost in the same amount of time in our profession. He had three beautiful, respectful kids who adored him. What on Earth could have been so intensely painful that he would remove himself from this world and rob it of the better place it would have been with him in it? What propelled him to give up so soon?
His family and closest friends will ask themselves for a very long time if they missed something that could have served as a warning that he was teetering on the edge. His adorable girls will wonder why daddy didn't love them enough to stick around. Everyone will feel guilt and an empty desperation that is unique to suicide survivors. I have learned that those things are absolutely unavoidable. It's natural for those things to happen. It's brutally unfair, though.
In our line of work, what we do sometimes weighs heavily on us. To all of my fellow Fire/Rescue/EMS addicts and to all of the cops out there, I give you an admonishment that I cannot make more heartfelt: take care of yourselves.
Last week, I saw the face of a man I worked with on the news. Only two of the five local channels had picked up the story. We all know what to look for when we're trying to figure something out solely from the news, and I very quickly deduced what was likely. It twisted my stomach into massive knots. An off-duty cop assigned to an Air Rescue paramedic unit is found alone in his hotel room, dead, and the word is that no foul play is suspected - and the man is too young and seemingly too healthy for something like a pulmonary embolism. Very little is being said. If a death turns out to be suicide (unless it also involves murder), suddenly the media shuts up, and they did.
Several days later, I got to my station and my fear was confirmed. This man I'd worked with for over a year, whom I had a great deal of respect for and whose advice I'd sought, had committed suicide.
Being that I suspected it, I didn't think it would hit me as hard as it did.
I've lost track of the number of EMS calls I've gone on where someone was talking about suicide or had attempted suicide. Lately, I've been running on a lot of completed suicides. The people left behind when someone takes their own life all start out with that familiar stunned emptiness in their eyes. The longer I remain on scene the more their reactions differ. I've seen people shut down, open up, collapse, cry, scream, and had to restrain a few when a body was being removed. I've viewed bodies to determine whether or not it would be prudent to allow family members to see them before they're taken away (it's almost never a good idea, even when they OD).
None of that can possibly steel a person to withstand the news that a person they cared about ended their own life. I daresay it only makes it worse. I've been on those calls where someone is talking about suicide or has attempted it, and a friend or relative is standing there, irritated, saying, "they're just trying to get attention!" They only took a handful of pills, they say. The cuts were just superficial.
What I wish I could tell those people sometimes is that they need to wake up. Those kind of incidents are often the best indicator that someone needs help. Getting mad at them most times does no good. Offer to go with them to get help, talk to them, call 911 if you have to - but nobody knows how many completed suicides I've gone on where someone was left feeling hollow and alone, trying to figure out if there was some subtle sign dropped, wishing they'd seen something so obvious so they'd still have that person there.
I've been to that edge myself. It's been eight years now, but I looked over that edge and the experience has left me a very different person. Even now I still remember the feeling that things in my life would never get better, nobody could understand or fix things, and talking would not help. I felt deep depression and fear, then - nothing. I actually came to a peace that I had accepted the idea of dying. I won't say exactly what happened, but to this day I do not fear death. What I do fear is having to face God and answer for something like that.
Because of that experience, I feel like an enormous hypocrite for asking the question everyone is asking right now - "WHY?". He had a big heart, a handsome smile, and a concern for his patients that others I know have lost in the same amount of time in our profession. He had three beautiful, respectful kids who adored him. What on Earth could have been so intensely painful that he would remove himself from this world and rob it of the better place it would have been with him in it? What propelled him to give up so soon?
His family and closest friends will ask themselves for a very long time if they missed something that could have served as a warning that he was teetering on the edge. His adorable girls will wonder why daddy didn't love them enough to stick around. Everyone will feel guilt and an empty desperation that is unique to suicide survivors. I have learned that those things are absolutely unavoidable. It's natural for those things to happen. It's brutally unfair, though.
In our line of work, what we do sometimes weighs heavily on us. To all of my fellow Fire/Rescue/EMS addicts and to all of the cops out there, I give you an admonishment that I cannot make more heartfelt: take care of yourselves.
Wednesday, October 13, 2010
Don't Ever Come to My House
Those were the words I heard most often in EMT-B school aside from "BSI, scene safety". Instructors and their aides do not wait until you have certain knowledge; from the second week, they were throwing scenarios at us on a daily basis to test us for knowledge absorption (they only waited until the second week because we spent the first week filling out paperwork and answering questions). At first, it consisted of an instructor pointing to a random student and saying something like, "okay, your buddy there is choking. He's got his hands on his throat and he's making no noise. What are you gonna do?"
That evolved three weeks later into another instructor running and screaming that high-pitched girl scream all the way through the room, up to the front, swept up in front of my partner and howled something unintelligible except for the words "not breathing" - and extended an infant-sized mannequin (yes, "manikin" is INCORRECT) to him. My partner froze, so I grabbed the fake child and started checking breathing and pulse and then began CPR.
(Now that you have that image in your head, imagine the instructor is a 6'9" wall of muscle-bound manliness doing the most amazing and ear-piercing girlie shriek ever attempted. I couldn't hear well for a week.)
By the final three weeks of class we were running fully-orchestrated scenarios, complete with our instructors friends, spouses and kids playing the victims. Throughout all of it, every single time someone would either freeze or do something absolutely idiotic one of the instructors would say, "please, if I call 911, don't ever come to my house."
I told you that story to tell you this one.
Just over a year ago, I got called to a child drowning. Drownings are extremely common in my neck of the sparse woods, 99% of them involving children. Usually they occur in pools, but I've seen kids drown in bathtubs, buckets, latrines and sinks. (NOTE FROM THE EDITOR: this is where I remind you that a child is eight times as likely to drown inside the house than to ever be even injured, let alone killed, by a gun - so it behooves you to watch ALL kids around water. I now return you to your regularly scheduled bloviating.) I've been to a few drownings at this point and they never get easier. I think they're easily the toughest calls we ever run on. Every single time there's a parent, grandparent or babysitter devastated beyond rational thought saying over and over, "I just turned around for a minute..."
This one was a little closer to home. I recognized the address, though I couldn't place where I knew it from at first. When we pulled up I realized it was the home of one of my friends from EMT school. We'd spent some time studying there. At the time, his older sister had just gotten married. I was about to find out she now had two children. It was the youngest, a one-year-old, who'd been pulled from the pool.
He hadn't gotten an EMS job. He'd planned to hold out for one of the local fire departments in Arizona, and that was the last I'd heard of him until this day. When we got to the backyard, he had just stopped performing CPR. As I stood there, the infant started spitting out water and mucus and my friend rolled the little boy over to let it all out. I stood there, shocked, my mouth hanging open, while my partner immediately got to work suctioning the baby's mouth. He had to remind me to start getting the Stryker ready.
We packaged the baby and headed for the nearest hospital, where my friend wrapped me in a bear hug (I'm obviously NOT like my six-foot-tall counterparts) and tearfully thanked me for responding so quickly. He then stepped back, laughing for the first time through his tears, and said, "you totally froze like a deer in headlights! What happened to you?"
Not knowing what else to say, I replied, "I guess I wasn't expecting to see you already doing my job!"
He poked me in the arm and said, "if I ever call 911 again..."
I interrupted, "yeah, yeah, yeah!"
And he finished, "you better have a bottle of Jaeger with you, you jerk!"
That evolved three weeks later into another instructor running and screaming that high-pitched girl scream all the way through the room, up to the front, swept up in front of my partner and howled something unintelligible except for the words "not breathing" - and extended an infant-sized mannequin (yes, "manikin" is INCORRECT) to him. My partner froze, so I grabbed the fake child and started checking breathing and pulse and then began CPR.
(Now that you have that image in your head, imagine the instructor is a 6'9" wall of muscle-bound manliness doing the most amazing and ear-piercing girlie shriek ever attempted. I couldn't hear well for a week.)
By the final three weeks of class we were running fully-orchestrated scenarios, complete with our instructors friends, spouses and kids playing the victims. Throughout all of it, every single time someone would either freeze or do something absolutely idiotic one of the instructors would say, "please, if I call 911, don't ever come to my house."
I told you that story to tell you this one.
Just over a year ago, I got called to a child drowning. Drownings are extremely common in my neck of the sparse woods, 99% of them involving children. Usually they occur in pools, but I've seen kids drown in bathtubs, buckets, latrines and sinks. (NOTE FROM THE EDITOR: this is where I remind you that a child is eight times as likely to drown inside the house than to ever be even injured, let alone killed, by a gun - so it behooves you to watch ALL kids around water. I now return you to your regularly scheduled bloviating.) I've been to a few drownings at this point and they never get easier. I think they're easily the toughest calls we ever run on. Every single time there's a parent, grandparent or babysitter devastated beyond rational thought saying over and over, "I just turned around for a minute..."
This one was a little closer to home. I recognized the address, though I couldn't place where I knew it from at first. When we pulled up I realized it was the home of one of my friends from EMT school. We'd spent some time studying there. At the time, his older sister had just gotten married. I was about to find out she now had two children. It was the youngest, a one-year-old, who'd been pulled from the pool.
He hadn't gotten an EMS job. He'd planned to hold out for one of the local fire departments in Arizona, and that was the last I'd heard of him until this day. When we got to the backyard, he had just stopped performing CPR. As I stood there, the infant started spitting out water and mucus and my friend rolled the little boy over to let it all out. I stood there, shocked, my mouth hanging open, while my partner immediately got to work suctioning the baby's mouth. He had to remind me to start getting the Stryker ready.
We packaged the baby and headed for the nearest hospital, where my friend wrapped me in a bear hug (I'm obviously NOT like my six-foot-tall counterparts) and tearfully thanked me for responding so quickly. He then stepped back, laughing for the first time through his tears, and said, "you totally froze like a deer in headlights! What happened to you?"
Not knowing what else to say, I replied, "I guess I wasn't expecting to see you already doing my job!"
He poked me in the arm and said, "if I ever call 911 again..."
I interrupted, "yeah, yeah, yeah!"
And he finished, "you better have a bottle of Jaeger with you, you jerk!"
Monday, October 4, 2010
THAT Guy
We've all been on those calls where a member of the public walked up and interrupted our work to ask what was going on. We've all wished we could be smarmy with them, sometimes wished we could be outright rude. After all, it's obvious that when there's an incident, we don't have time to answer questions.
Not long ago I was on one of those calls. Multiple fire units - engines, ladders, rescues and two BC's - are on scene from two cities' fire departments. When I first arrived flames had eaten up one side of the house and were now shooting well into the early-evening sky (this was a pretty big house, though, so the fire had a way to go). The situation was controlled quickly and the main fire was put out in good time. As is customary, police roped off the neighborhood so that moochers wouldn't try to show up and defraud the victims out of their insurance settlement or belongings inside the home once we were all gone.
That doesn't stop people from coming from all over the neighborhood to gawk. Often we have to ask police officers to come and escort them out of the fire ground. I have even seen some geniuses try to drive over our main 5" hose lines to get in close and see the action. To them, I often wish I could say, "please, if you really wanna know what it's like, join the fire department yourself." Movies like Backdraft (terrible film - Ladder 49 was WAY better, even if parts were unrealistic) don't help with all the glorification of fire itself.
Anyway, I'm at this scene, the fire is out, one BC has left and now one engine and the ladder are leaving. Three engines remained, however. Floodlights are still on the scene. I've had to ask several people myself to back away for their own safety. Most of the folks have figured out that the show is over, fire's out, there's really nothing left to see - then, that guy shows up.
We all know who THAT guy is. He's the one who has candle-moth syndrome times ten, who will stare at a scene with his mouth hanging open and a glitter in his eye that says the only words going through his mind are, "wow...cool!" He's the one who never has an intelligent question to ask, but will ask any dipshit question that comes to mind just to be able to tell his buddies later that he got his information from "the source". He's the dude everyone dreads when he wanders into a scene to check it out with a dumb grin on his face. THAT guy is the one you can never see coming, but you can feel his life force creeping up on you like a flashover...you get that gnawing feeling in the pit of your stomach as the temperature rises, see the smoke rising from every surface in the room, then SHIT! There he is!
THAT guy showed up in the form of a college-aged kid, stoned out of his squash, waltzing down the middle of the street wearing nothing but basketball shorts (he wasn't even wearing shoes). He walked right up to lil' ol' me, standing in front of one of the engines with an SCBA in each hand, with several guys packing up hose lines in the distance, and asks, "doooood...what happened?"
Hoping I could get him to leave, I flashed my best face-the-public smile and said, "we can't really discuss the particulars with the public right now. Sorry!"
Oh, it only went downhill from there. THAT guy got this grave look on his face and said, "holy fuck - it was a murder, wasn't it?"
I refused to let so much as an ounce of disdain register on my face. I looked at the small river running down the street along the curb, looked back at my subject, and with a stock-straight face I replied, "nope. Boating accident!"
Not long ago I was on one of those calls. Multiple fire units - engines, ladders, rescues and two BC's - are on scene from two cities' fire departments. When I first arrived flames had eaten up one side of the house and were now shooting well into the early-evening sky (this was a pretty big house, though, so the fire had a way to go). The situation was controlled quickly and the main fire was put out in good time. As is customary, police roped off the neighborhood so that moochers wouldn't try to show up and defraud the victims out of their insurance settlement or belongings inside the home once we were all gone.
That doesn't stop people from coming from all over the neighborhood to gawk. Often we have to ask police officers to come and escort them out of the fire ground. I have even seen some geniuses try to drive over our main 5" hose lines to get in close and see the action. To them, I often wish I could say, "please, if you really wanna know what it's like, join the fire department yourself." Movies like Backdraft (terrible film - Ladder 49 was WAY better, even if parts were unrealistic) don't help with all the glorification of fire itself.
Anyway, I'm at this scene, the fire is out, one BC has left and now one engine and the ladder are leaving. Three engines remained, however. Floodlights are still on the scene. I've had to ask several people myself to back away for their own safety. Most of the folks have figured out that the show is over, fire's out, there's really nothing left to see - then, that guy shows up.
We all know who THAT guy is. He's the one who has candle-moth syndrome times ten, who will stare at a scene with his mouth hanging open and a glitter in his eye that says the only words going through his mind are, "wow...cool!" He's the one who never has an intelligent question to ask, but will ask any dipshit question that comes to mind just to be able to tell his buddies later that he got his information from "the source". He's the dude everyone dreads when he wanders into a scene to check it out with a dumb grin on his face. THAT guy is the one you can never see coming, but you can feel his life force creeping up on you like a flashover...you get that gnawing feeling in the pit of your stomach as the temperature rises, see the smoke rising from every surface in the room, then SHIT! There he is!
THAT guy showed up in the form of a college-aged kid, stoned out of his squash, waltzing down the middle of the street wearing nothing but basketball shorts (he wasn't even wearing shoes). He walked right up to lil' ol' me, standing in front of one of the engines with an SCBA in each hand, with several guys packing up hose lines in the distance, and asks, "doooood...what happened?"
Hoping I could get him to leave, I flashed my best face-the-public smile and said, "we can't really discuss the particulars with the public right now. Sorry!"
Oh, it only went downhill from there. THAT guy got this grave look on his face and said, "holy fuck - it was a murder, wasn't it?"
I refused to let so much as an ounce of disdain register on my face. I looked at the small river running down the street along the curb, looked back at my subject, and with a stock-straight face I replied, "nope. Boating accident!"
Wednesday, July 21, 2010
The Benefit of the Doubt
It has recently been announced that FDNY EMT Jason Green, made famous for the December 9 incident where he and his girlfriend (fellow EMT Melissa Jackson) walked away from a woman having a seizure, will be buried with full honors. He was shot outside a SoHo nightclub known as the Greenhouse over the weekend after being forced into a fight that he repeatedly tried to walk away from.
We've all heard the original story. Right now, some in EMS are spitting nails over the fact that Green will be buried with full honors, since he supposedly watched a woman die. I would urge caution before jumping to this conclusion.
What do we really know about the case? We've heard an awful lot from the press, but we all know just how accurate the media is. We all know from experience because we've all wanted to pitch our remotes through the TV when we see our calls on the news and the reporters can't get it right. We shouldn't be surprised by this when it happens. Time and time again, however, we find ourselves drawn into the same trap that we get irritated with the unwashed masses for when they judge us unfairly. Don't crucify us, we beg of them. You haven't heard the whole story. Don't believe everything you see on TV.
Then, when something like the Au Bon Pain incident or the Pittsburgh incident happens, we're all over it like flies on a cowpie. You heartless bastards! How could you walk away from a dying patient? You have no business being in this profession! Voila - we have become that which we loathe.
The fact is that we know bare-bones facts and little else. To hear the media tell it, you'd think Green and Jackson sat sipping coffee while 25-year-old Eutisha Rennix collapsed behind the counter and began agonal breathing. In reality, the picture that I've seen painted by sources NOT in the media is that Rennix felt ill and left the counter area and retreated to a private break room where she either had a seizure or began having an asthma attack, at which point a co-worker approached the EMT's and asked them what to do.
How do we know that they saw anything? How do we know what the co-worker said when she asked the EMT's for help? If I were just getting off shift and a restaurant worker asked me what to do for someone complaining of difficulty breathing, I'd have done the exact same thing: tell them to call 911. Personally, I'd have offered to call myself so I could explain the situation calmly to the dispatcher and they'd know exactly who and what to send, but I'm not in New York.
Not to mention these weren't field EMT's with an ambulance waiting outside. They were dispatchers taking a break from their office in the building directly above the restaurant. If their dispatch center was busy, I can see their supervisors giving them strict instructions to return as quickly as humanly possible. Without base-level BSI and rudimentary equipment, there's nothing two EMT-B's could have done.
That said, I find it difficult to understand why so many in the EMS community are so quick to judge these two as pariahs not worthy of a proper burial. As in my previous post, I have to agree they could have done things differently, but we cannot be so quick to judge so harshly. Kelly Grayson has some words of wisdom for exactly this type of scenario.
I recall an incident in which I was off-duty, still in my uniform and headed home, when I came upon one of the worst wrecks I'd ever seen. I'll blog more about the details later, but when I walked up to the vehicle with the worst damage, a visual once-over told me all I needed to know; the driver was already dead. His color (or lack thereof, more appropriately), blown pupils and misshapen cranium told me what I didn't need to palpate a missing pulse for. There were other people hurt, so I moved on. The man who approached me when I pulled up behind the scene became very flustered and he very physically stopped me. "Where are you going? You can't just leave him there," he said. I explained that the man was beyond my help and there were other people who I could help, and he yelled, "how do you know? You didn't even touch him! You didn't try anything! You have to help him!"
None of us appreciate that sort of behavior. Yet in this case as in others we freely engage in it without taking a moment to give the situation some real thought.
I'd be willing to bet that after six years as an EMT and dispatcher, we'd likely hear many more stories about the good Green has done. We may well change our minds. Hindsight is always 20/20, and it's easy for us to point out mistakes once we know the outcome. As we should have in the Pittsburgh case, we should have given this brother the benefit of the doubt before we let the media tell us what to believe. Not one of us is perfect.
We've all heard the original story. Right now, some in EMS are spitting nails over the fact that Green will be buried with full honors, since he supposedly watched a woman die. I would urge caution before jumping to this conclusion.
What do we really know about the case? We've heard an awful lot from the press, but we all know just how accurate the media is. We all know from experience because we've all wanted to pitch our remotes through the TV when we see our calls on the news and the reporters can't get it right. We shouldn't be surprised by this when it happens. Time and time again, however, we find ourselves drawn into the same trap that we get irritated with the unwashed masses for when they judge us unfairly. Don't crucify us, we beg of them. You haven't heard the whole story. Don't believe everything you see on TV.
Then, when something like the Au Bon Pain incident or the Pittsburgh incident happens, we're all over it like flies on a cowpie. You heartless bastards! How could you walk away from a dying patient? You have no business being in this profession! Voila - we have become that which we loathe.
The fact is that we know bare-bones facts and little else. To hear the media tell it, you'd think Green and Jackson sat sipping coffee while 25-year-old Eutisha Rennix collapsed behind the counter and began agonal breathing. In reality, the picture that I've seen painted by sources NOT in the media is that Rennix felt ill and left the counter area and retreated to a private break room where she either had a seizure or began having an asthma attack, at which point a co-worker approached the EMT's and asked them what to do.
How do we know that they saw anything? How do we know what the co-worker said when she asked the EMT's for help? If I were just getting off shift and a restaurant worker asked me what to do for someone complaining of difficulty breathing, I'd have done the exact same thing: tell them to call 911. Personally, I'd have offered to call myself so I could explain the situation calmly to the dispatcher and they'd know exactly who and what to send, but I'm not in New York.
Not to mention these weren't field EMT's with an ambulance waiting outside. They were dispatchers taking a break from their office in the building directly above the restaurant. If their dispatch center was busy, I can see their supervisors giving them strict instructions to return as quickly as humanly possible. Without base-level BSI and rudimentary equipment, there's nothing two EMT-B's could have done.
That said, I find it difficult to understand why so many in the EMS community are so quick to judge these two as pariahs not worthy of a proper burial. As in my previous post, I have to agree they could have done things differently, but we cannot be so quick to judge so harshly. Kelly Grayson has some words of wisdom for exactly this type of scenario.
I recall an incident in which I was off-duty, still in my uniform and headed home, when I came upon one of the worst wrecks I'd ever seen. I'll blog more about the details later, but when I walked up to the vehicle with the worst damage, a visual once-over told me all I needed to know; the driver was already dead. His color (or lack thereof, more appropriately), blown pupils and misshapen cranium told me what I didn't need to palpate a missing pulse for. There were other people hurt, so I moved on. The man who approached me when I pulled up behind the scene became very flustered and he very physically stopped me. "Where are you going? You can't just leave him there," he said. I explained that the man was beyond my help and there were other people who I could help, and he yelled, "how do you know? You didn't even touch him! You didn't try anything! You have to help him!"
None of us appreciate that sort of behavior. Yet in this case as in others we freely engage in it without taking a moment to give the situation some real thought.
I'd be willing to bet that after six years as an EMT and dispatcher, we'd likely hear many more stories about the good Green has done. We may well change our minds. Hindsight is always 20/20, and it's easy for us to point out mistakes once we know the outcome. As we should have in the Pittsburgh case, we should have given this brother the benefit of the doubt before we let the media tell us what to believe. Not one of us is perfect.
Tuesday, July 13, 2010
What Would YOU Do?
Have you ever tried to walk through a foot and a half of snow - while the sky kept dumping more snow on you?
That's what Pittsburgh public safety director Michael Huss says paramedics on three different crews should have done on February 6. With the worst blizzard in recent memory howling outside, Sharon Edge called 911 at approximately 0200. Her fiancee, Curtis Mitchell, was complaining of abdominal pain that even his oxycodone wasn't helping much. At different times during the early hours of the morning, three different ALS crews were dispatched to the address.
The trouble was twofold. First, their neighborhood sat overlooking a river and was accessible only by a narrow bridge. With snow piled high by then, the ambulances couldn't pass over the bridge. The first two crews had 911 dispatchers call back and ask Mitchell to walk to them, but he was both too cold and his pain too intense to make it. At one point, a neighbor offered to drive him to the hospital but the snow was so thick that he couldn't shovel his car out of the mess.
The calls spanned the day of February 6 and into the night. Around 0800 on February 7, Edge called 911 one last time - to tell them that Mitchell was dead. Paramedics finally reached them and called it. He was 50 years old.
Every soul in the EMS field can Monday quarterback this situation to death. There are parts - albeit small - in Arizona where they do get snow, but it's rarely as horrid as the snow storms on the East Coast, far less often than Pittsburgh. Some of my colleagues in Northern Arizona have weighed in on this particular incident and none of them have been very nice about it. What are the facts, though?
Medic Trommashere brought up a couple of good points, but I'll start with the most obvious: walking through over a foot of snow for nearly a mile is not easy. EMS crews are not typically equipped for extreme weather rescues and, in this case, the city was ill-prepared for the deluge of calls that befell them when the blizzard dumped nearly two feet of snow and knocked out power. Cities like Pittsburgh were not necessarily built with ease of maneuverability in mind; a lot of big East Coast cities are old enough that modern EMS wasn't in mind when the cities began to grow exponentially. Naturally, there are areas that can be tough to reach in the best of conditions - much less during a bad blizzard. I'm not an Arizona native. I've lived in parts of the country that normally get a foot or more of snow annually. I can tell you that it is not easy to trudge through that much snow in near white-out conditions even when your hands are empty.
When the rig couldn't make it and they were expected to walk, what should they have done? Even if they put their jump bags and heart monitors on the stretcher, would the stretcher have made it? Under all that snow was guaranteed to be ice, and if they'd lost control of the stretcher, they would have lost it and would have had no safe mode of transportation (not to mention they'd have lost all the gear piled on it, that stuff isn't exactly made of air).
Huss then said, "you get out of the damn truck and you walk in...we coulda carried him out!"
Now there's a fantastic option. What about protocol? If it's not safe for me, I'm not going to do it. What if I do walk in there and find a man twice my size and weight? You still expect me to heave him over my shoulder and carry him for a mile through ice and snow? If we're in a fire, it's a distinct possibility. At least there won't be a mile of distance to cover and I won't be dancing on a sheet of ice. What would be worse would be to try to carry him out and drop him. Then the crew gets sued for acting outside their scope of practice (without special rescue skills, they would be), taking an unnecessary risk, and causing further injury to the patient, with pain and suffering besides. How much do you think that settlement will balance out to? A few million? If Mitchell had survived we'd be sitting here bitching about how he was abused by medics who should have found another way to get him out or maybe even waited.
In our culture, we tend to be very reactionary. When something bad happens, we all sit back and go, "coulda, shoulda, woulda" until we're blue in the face. When the outcome of an incident isn't what we wanted, we aim for someone's hide and promise that somebody, anybody, will pay. When that's the case they're never fair. I saw three good corrections officers lose their jobs because more seasoned officers weren't doing their jobs when something bad happened, and someone's head had to roll. How fair is that?
In this case, paramedic Josie Dimon was fired. Three others were suspended. Many laypeople who don't have a working knowledge of the EMS system have all but called for blood over this incident. What most news stories haven't told you was that Mitchell had actually been in pain for a week and had, until that day, refused to go to the hospital. He had a history of pancreatic inflammation and had recently been hospitalized. You didn't hear in the news about the report that said members of all three teams did get out of their rigs to try to find a way and - this is the clincher - they were canceled by dispatchers.
Did you catch that? When you're dispatched to a call, who do you depend on - the caller or your dispatcher? If you tell your dispatcher you're having a hard time getting to the patient, your rig won't make it, there are near whiteout conditions outside...it's then up to the dispatcher and their supervisor to determine the best course of action. It wasn't the medics that refused. It was the dispatchers, who were on the phone with Sharon Edge and Curtis Mitchell, who would have tried to come up with solutions.
Could things have been done differently? Yes. I can think of a few calls I've been on where I wish things had been done differently. Hindsight is 20/20. Before you pass judgment, though, try and think of how your agency would have handled it. You can't look at the incident with the end result in mind, either. You have to consider what you would have done if you were standing on ice, facing a wall of snow, your only route to your patient's house completely blocked, and your dispatcher telling you to disregard and go to another call where you actually CAN reach the patient.
Still think you'd have done what needed to be done?
That's what Pittsburgh public safety director Michael Huss says paramedics on three different crews should have done on February 6. With the worst blizzard in recent memory howling outside, Sharon Edge called 911 at approximately 0200. Her fiancee, Curtis Mitchell, was complaining of abdominal pain that even his oxycodone wasn't helping much. At different times during the early hours of the morning, three different ALS crews were dispatched to the address.
The trouble was twofold. First, their neighborhood sat overlooking a river and was accessible only by a narrow bridge. With snow piled high by then, the ambulances couldn't pass over the bridge. The first two crews had 911 dispatchers call back and ask Mitchell to walk to them, but he was both too cold and his pain too intense to make it. At one point, a neighbor offered to drive him to the hospital but the snow was so thick that he couldn't shovel his car out of the mess.
The calls spanned the day of February 6 and into the night. Around 0800 on February 7, Edge called 911 one last time - to tell them that Mitchell was dead. Paramedics finally reached them and called it. He was 50 years old.
Every soul in the EMS field can Monday quarterback this situation to death. There are parts - albeit small - in Arizona where they do get snow, but it's rarely as horrid as the snow storms on the East Coast, far less often than Pittsburgh. Some of my colleagues in Northern Arizona have weighed in on this particular incident and none of them have been very nice about it. What are the facts, though?
Medic Trommashere brought up a couple of good points, but I'll start with the most obvious: walking through over a foot of snow for nearly a mile is not easy. EMS crews are not typically equipped for extreme weather rescues and, in this case, the city was ill-prepared for the deluge of calls that befell them when the blizzard dumped nearly two feet of snow and knocked out power. Cities like Pittsburgh were not necessarily built with ease of maneuverability in mind; a lot of big East Coast cities are old enough that modern EMS wasn't in mind when the cities began to grow exponentially. Naturally, there are areas that can be tough to reach in the best of conditions - much less during a bad blizzard. I'm not an Arizona native. I've lived in parts of the country that normally get a foot or more of snow annually. I can tell you that it is not easy to trudge through that much snow in near white-out conditions even when your hands are empty.
When the rig couldn't make it and they were expected to walk, what should they have done? Even if they put their jump bags and heart monitors on the stretcher, would the stretcher have made it? Under all that snow was guaranteed to be ice, and if they'd lost control of the stretcher, they would have lost it and would have had no safe mode of transportation (not to mention they'd have lost all the gear piled on it, that stuff isn't exactly made of air).
Huss then said, "you get out of the damn truck and you walk in...we coulda carried him out!"
Now there's a fantastic option. What about protocol? If it's not safe for me, I'm not going to do it. What if I do walk in there and find a man twice my size and weight? You still expect me to heave him over my shoulder and carry him for a mile through ice and snow? If we're in a fire, it's a distinct possibility. At least there won't be a mile of distance to cover and I won't be dancing on a sheet of ice. What would be worse would be to try to carry him out and drop him. Then the crew gets sued for acting outside their scope of practice (without special rescue skills, they would be), taking an unnecessary risk, and causing further injury to the patient, with pain and suffering besides. How much do you think that settlement will balance out to? A few million? If Mitchell had survived we'd be sitting here bitching about how he was abused by medics who should have found another way to get him out or maybe even waited.
In our culture, we tend to be very reactionary. When something bad happens, we all sit back and go, "coulda, shoulda, woulda" until we're blue in the face. When the outcome of an incident isn't what we wanted, we aim for someone's hide and promise that somebody, anybody, will pay. When that's the case they're never fair. I saw three good corrections officers lose their jobs because more seasoned officers weren't doing their jobs when something bad happened, and someone's head had to roll. How fair is that?
In this case, paramedic Josie Dimon was fired. Three others were suspended. Many laypeople who don't have a working knowledge of the EMS system have all but called for blood over this incident. What most news stories haven't told you was that Mitchell had actually been in pain for a week and had, until that day, refused to go to the hospital. He had a history of pancreatic inflammation and had recently been hospitalized. You didn't hear in the news about the report that said members of all three teams did get out of their rigs to try to find a way and - this is the clincher - they were canceled by dispatchers.
Did you catch that? When you're dispatched to a call, who do you depend on - the caller or your dispatcher? If you tell your dispatcher you're having a hard time getting to the patient, your rig won't make it, there are near whiteout conditions outside...it's then up to the dispatcher and their supervisor to determine the best course of action. It wasn't the medics that refused. It was the dispatchers, who were on the phone with Sharon Edge and Curtis Mitchell, who would have tried to come up with solutions.
Could things have been done differently? Yes. I can think of a few calls I've been on where I wish things had been done differently. Hindsight is 20/20. Before you pass judgment, though, try and think of how your agency would have handled it. You can't look at the incident with the end result in mind, either. You have to consider what you would have done if you were standing on ice, facing a wall of snow, your only route to your patient's house completely blocked, and your dispatcher telling you to disregard and go to another call where you actually CAN reach the patient.
Still think you'd have done what needed to be done?
Saturday, July 10, 2010
The Boob Grab Story
Every EMT and paramedic has their personal embarrassment story. Most of them are absolutely hysterical (sometimes even to those involved). I have more than one, and if I'm at a party, whether the story has been told a hundred times or a thousand, I'll always hear, "hey, Ranger - tell us the boob grab story!"
Before I started working full-time on a rig I went on a ridealong with a couple of friends who had both taught as assistants in my original EMT course. They were both medics, so I was the one riding bitch; I was going to be taking vitals and acting as the packhorse. About halfway through the shift our gong goes off and we hear, "medic 999, call for a fall injury at assisted living facility X." We get in and the younger medic, whom I'll call Sparky, announces, "patient is an 80-year-old male, found on the floor, broken bones, acting strangely. Ranger, what'd we tell you about assisted living facilities in school?"
I shake my head and chuckle before answering, "one of three things is guaranteed to happen. One, the patient is new to the facility and nobody knows where his file is. Two, the nurse on duty just got on shift and doesn't know what's going on. Three, the nurse on duty is from the nurse pool and has never met any of the residents there..."
"...Or, if you're really lucky, all of the above!" the driver, whom I'll dub Yoda, pipes up. "Anybody wanna make a bet on which it is?"
Sparky looks at the address and says, "I've been there before. The nurse is ALWAYS from the pool!"
Yoda says, "I bet they throw you for a loop this time, buddy, I bet the patient is a new guy!"
Which leaves me: "I'm going for all of the above. I bet this is gonna be interesting."
I grab the splint kit and the jump bag, toss them on the stretcher and we all stroll through the front door. A doe-eyed nurse who looks young enough to have just finished school greets us with, "It's only my second shift here and this guy just got here today and it happened right after I got here so I have no idea..."
Score one for the plebe!
Sparky raised an eyebrow at me and we went down the hall, around the corner, down another hall and stopped at a room with three beds in it. Next to the first one in the door was a frail old man, laying prostrate on the floor, a pillow under his head. Despite the fact that an untrained puke like me could see the deformity in his hip, the man smiled at us when we walked in.
At some point, another resident said that they thought he had Alzheimer's, which explained his confusion. He couldn't remember how he got on the floor; he just knew that it hurt terribly to move. I watched as Yoda deftly palpated the man's head, neck, shoulders, arms, all the way down, asking at certain points, "does this hurt?" When he got to his hips he very gently pressed and the old man would've curled up if his body could have. We very gently rolled him onto a backboard, put him in full c-spine and lifted him onto the stretcher.
Somewhere in the maze between his room and the front door, the nurse was able to produce his file. I thought, "well, that'll be dandy, at least we'll be able to tell the docs what medication he's on." We went out and as we got things situated, I felt an interesting sensation about six inches below my neck.
That old coot was feeling me up.
I wasn't sure what to do. All I could say was, "uuuuummmmm..." Yoda and Sparky both looked up at me just in time for Hugh Hefner's lesser-known twin brother to latch onto one of my boobs. This wasn't a little squeeze, a little "honk" and we're done. Nope. He grabbed it like it was the Holy Grail being brought to restore his youth. Then he started rolling it around in his hand and before I could do anything, just as suddenly as it began, he stopped. He dropped his hand onto his stomach and said, "I've had better!"
My response came out of nowhere. It even surprised me. I didn't know what the hell else to say, so I just looked at him, patted him on the shoulder and said, "that's okay, hon. So have I."
We couldn't look at each other. All three of us knew that if we exchanged a single glance, we'd lose it. We just felt it better to not say one word until the coast was clear. We transported him to the nearest hospital, transferred care to the emergency staff (whom Yoda had already briefed quite meticulously while we were en route) and, without another word, went back to the nurses' break room.
There, the three of us looked at each other and in unison we burst into fits of hysterical laughter. We were laughing so hard I nearly passed out.
Before I started working full-time on a rig I went on a ridealong with a couple of friends who had both taught as assistants in my original EMT course. They were both medics, so I was the one riding bitch; I was going to be taking vitals and acting as the packhorse. About halfway through the shift our gong goes off and we hear, "medic 999, call for a fall injury at assisted living facility X." We get in and the younger medic, whom I'll call Sparky, announces, "patient is an 80-year-old male, found on the floor, broken bones, acting strangely. Ranger, what'd we tell you about assisted living facilities in school?"
I shake my head and chuckle before answering, "one of three things is guaranteed to happen. One, the patient is new to the facility and nobody knows where his file is. Two, the nurse on duty just got on shift and doesn't know what's going on. Three, the nurse on duty is from the nurse pool and has never met any of the residents there..."
"...Or, if you're really lucky, all of the above!" the driver, whom I'll dub Yoda, pipes up. "Anybody wanna make a bet on which it is?"
Sparky looks at the address and says, "I've been there before. The nurse is ALWAYS from the pool!"
Yoda says, "I bet they throw you for a loop this time, buddy, I bet the patient is a new guy!"
Which leaves me: "I'm going for all of the above. I bet this is gonna be interesting."
I grab the splint kit and the jump bag, toss them on the stretcher and we all stroll through the front door. A doe-eyed nurse who looks young enough to have just finished school greets us with, "It's only my second shift here and this guy just got here today and it happened right after I got here so I have no idea..."
Score one for the plebe!
Sparky raised an eyebrow at me and we went down the hall, around the corner, down another hall and stopped at a room with three beds in it. Next to the first one in the door was a frail old man, laying prostrate on the floor, a pillow under his head. Despite the fact that an untrained puke like me could see the deformity in his hip, the man smiled at us when we walked in.
At some point, another resident said that they thought he had Alzheimer's, which explained his confusion. He couldn't remember how he got on the floor; he just knew that it hurt terribly to move. I watched as Yoda deftly palpated the man's head, neck, shoulders, arms, all the way down, asking at certain points, "does this hurt?" When he got to his hips he very gently pressed and the old man would've curled up if his body could have. We very gently rolled him onto a backboard, put him in full c-spine and lifted him onto the stretcher.
Somewhere in the maze between his room and the front door, the nurse was able to produce his file. I thought, "well, that'll be dandy, at least we'll be able to tell the docs what medication he's on." We went out and as we got things situated, I felt an interesting sensation about six inches below my neck.
That old coot was feeling me up.
I wasn't sure what to do. All I could say was, "uuuuummmmm..." Yoda and Sparky both looked up at me just in time for Hugh Hefner's lesser-known twin brother to latch onto one of my boobs. This wasn't a little squeeze, a little "honk" and we're done. Nope. He grabbed it like it was the Holy Grail being brought to restore his youth. Then he started rolling it around in his hand and before I could do anything, just as suddenly as it began, he stopped. He dropped his hand onto his stomach and said, "I've had better!"
My response came out of nowhere. It even surprised me. I didn't know what the hell else to say, so I just looked at him, patted him on the shoulder and said, "that's okay, hon. So have I."
We couldn't look at each other. All three of us knew that if we exchanged a single glance, we'd lose it. We just felt it better to not say one word until the coast was clear. We transported him to the nearest hospital, transferred care to the emergency staff (whom Yoda had already briefed quite meticulously while we were en route) and, without another word, went back to the nurses' break room.
There, the three of us looked at each other and in unison we burst into fits of hysterical laughter. We were laughing so hard I nearly passed out.
Thursday, July 8, 2010
Check It, Fool
One of the most important lessons I learned early on was to check your gear before your shift begins. Always. ALWAYS.
I had only been on with a partner for a week when this became one of those hard-way lessons. The crew we were relieving had just come back from a call and we immediately got another one. Literally - they hit the button to show that the unit was available in quarters and the gong went off. They said the gear in the back was fine, nothing really needed to be replenished, "just get in the rig and go!" So off we went with our only information on our MCT being, "ALOC, 54yo male, (address)."
We get to a convenience store where our 54-year-old male is walking in circles with a combination angry/confused expression on his face and his wife is sitting in the car with the door open. There are three cops. One is trying to talk to our patient to no avail. One officer tells us they're about to take him to jail, they're just waiting for "sarge" to show up.
Thirty seconds with the man's wife tells us all we need to know. He's diabetic. He had begun to act strangely early in the day and had progressively gotten worse. She also said he'd been urinating like a race horse all day, but no amount of cajoling had convinced him to check his blood sugar. Without a word, I jog back to the rig for our blood glucometer and immediately stop short.
We have no lancets. None. The little compartment we keep them in doesn't need to be opened because I can see that it's empty. Feeling more than just a little sheepish, I grab a butterfly needle and the glucometer and trot back out to my partner, who looks at me with his head cocked to one side the way a dog would acknowledge a strange noise.
"No lancets," I mutter through pursed lips.
Sure enough, his blood sugar is way too high. He certainly didn't want to go anywhere with us, but with a little help from the cops we get him strapped down and we start moving.
What did I learn from this? Even if you see "GSW" on your rig's computer screen, if you haven't checked your gear you can at least take sixty seconds to hop in the back and make sure every compartment has something in it before you go to a call. Murphy has a cruel sense of humor.
I had only been on with a partner for a week when this became one of those hard-way lessons. The crew we were relieving had just come back from a call and we immediately got another one. Literally - they hit the button to show that the unit was available in quarters and the gong went off. They said the gear in the back was fine, nothing really needed to be replenished, "just get in the rig and go!" So off we went with our only information on our MCT being, "ALOC, 54yo male, (address)."
We get to a convenience store where our 54-year-old male is walking in circles with a combination angry/confused expression on his face and his wife is sitting in the car with the door open. There are three cops. One is trying to talk to our patient to no avail. One officer tells us they're about to take him to jail, they're just waiting for "sarge" to show up.
Thirty seconds with the man's wife tells us all we need to know. He's diabetic. He had begun to act strangely early in the day and had progressively gotten worse. She also said he'd been urinating like a race horse all day, but no amount of cajoling had convinced him to check his blood sugar. Without a word, I jog back to the rig for our blood glucometer and immediately stop short.
We have no lancets. None. The little compartment we keep them in doesn't need to be opened because I can see that it's empty. Feeling more than just a little sheepish, I grab a butterfly needle and the glucometer and trot back out to my partner, who looks at me with his head cocked to one side the way a dog would acknowledge a strange noise.
"No lancets," I mutter through pursed lips.
Sure enough, his blood sugar is way too high. He certainly didn't want to go anywhere with us, but with a little help from the cops we get him strapped down and we start moving.
What did I learn from this? Even if you see "GSW" on your rig's computer screen, if you haven't checked your gear you can at least take sixty seconds to hop in the back and make sure every compartment has something in it before you go to a call. Murphy has a cruel sense of humor.
Tuesday, July 6, 2010
Never Stop Learning
My name is...well, I won't tell you that. I'm in...um...Arizona. I can't tell you exactly where because it would be imprudent. I'm a professional EMT-B who recently discovered that it is possible to blog about the experiences of the job without running afoul of HIPAA or departmental rules and regulations. I've been an EMT for five years, actually working for three, and I've often clenched my teeth in frustration that there are precious few outlets for those in our profession. Or so I thought. Kelly Grayson over at Ambulance Driver Files was a recent find and through his blog I've been able to see several others through his blogroll.
So, here I go...
I remember my original EMT course almost like it was yesterday. A fire department captain with more than two decades of experience was our head instructor, and he was just about the coolest dude I'd ever seen. Not just because he was a fire captain, mind you - he was just cool. I had been in CPR and first responder classes as a teenager where the instructors spoke and acted as though they were God's gift to the general populace. My instructor definitely wasn't that kind of guy. He was very laid-back, well-spoken and always had a smile for everyone. He never bragged - in fact, he had no trouble telling us about the mistakes he'd made throughout his career. He and his assistants (who I believe he carefully chose) shared stories of actual calls they'd been on in an effort to prepare us for what we were getting ourselves into. He didn't have to be a jerk to weed out the ones who wouldn't make it because he knew that such tales would spur them to seek education elsewhere on their own.
To this day, I want to be like him. I haven't seen him in a while but I know he's still teaching and have even trained some of his latest students in the field. I'm hoping to be in his paramedic class next year.
I make jokes about my murse (man-purse) being my "instant ambulance" because I and everyone in my family and circle of friends knows that's exactly what it is. I can't take myself too seriously because I know I'm at the ass-end of the medical totem pole. I have been in it just long enough to have a twisted sense of humor and a little bit of bitterness about reality, but I don't ever want to become that medic whose personal boundaries are so strong that nobody wants to be around them. Having worked with enough medics I've become convinced that's why some of them come off as completely self-absorbed jerks.
(The popular joke in my station comes to mind: "What's the difference between a porcupine and an ALS unit? On an ALS unit, all the pricks are on the inside!")
I did tactical EMS long enough to know that I'd rather do it in the field, among the citizens outside the prison wire. Since I've gone civilian I've been on a plethora of calls. I've played the role of EMT, older sibling, crisis counselor, and best buddy. I've helped debrief fellow EMT's and medics and have needed to debrief myself. I'll never know it all, though, and I pray I never stop learning.
That's what this blog is going to be about. I won't talk politics much here; I blog about that plenty elsewhere. This site will be about my frustrations, celebrations, mourning and all the lessons learned along the way.
I remember the first-ever suicide call I went on. By the time I arrived it was clear I wasn't going to be offering much medical assistance. An ALS unit was already there. I got to hold mom's hand while a police officer explained that her teenage son had been declared dead after shooting himself with a .357. I grew up with guns and I knew what a mess a hand cannon like that could potentially make, so that part didn't affect me much. What was worse was later, when a detective brought some of her son's personal effects out to her, she showed me his school ID. Her son had been a vibrant, handsome young man.
I will never forget the feeling of powerlessness that washed over me as we left. I felt like we had left that poor woman just as empty as she'd been when we got there. It's a feeling that has never left me, partially because I've been on suicide calls since that turned out just as badly and have felt on each of them that I hadn't done enough. Not one of them has ever compared to the first.
It won't be my last. I've had plenty of happier endings since then, and I'm grateful for each one of them. I've been on calls where there really wasn't anything to do. Through it all I've learned that the most important lesson we can learn is to never stop learning. No matter how irritated, how stressed, or how happy we are, we can never allow ourselves to believe that we've seen it all.
Besides...if we did, that ol' bastard Murphy would stop in to kick us square in the backside with something we never thought we'd see. Lost condom call, anyone? ;-)
So, here I go...
I remember my original EMT course almost like it was yesterday. A fire department captain with more than two decades of experience was our head instructor, and he was just about the coolest dude I'd ever seen. Not just because he was a fire captain, mind you - he was just cool. I had been in CPR and first responder classes as a teenager where the instructors spoke and acted as though they were God's gift to the general populace. My instructor definitely wasn't that kind of guy. He was very laid-back, well-spoken and always had a smile for everyone. He never bragged - in fact, he had no trouble telling us about the mistakes he'd made throughout his career. He and his assistants (who I believe he carefully chose) shared stories of actual calls they'd been on in an effort to prepare us for what we were getting ourselves into. He didn't have to be a jerk to weed out the ones who wouldn't make it because he knew that such tales would spur them to seek education elsewhere on their own.
To this day, I want to be like him. I haven't seen him in a while but I know he's still teaching and have even trained some of his latest students in the field. I'm hoping to be in his paramedic class next year.
I make jokes about my murse (man-purse) being my "instant ambulance" because I and everyone in my family and circle of friends knows that's exactly what it is. I can't take myself too seriously because I know I'm at the ass-end of the medical totem pole. I have been in it just long enough to have a twisted sense of humor and a little bit of bitterness about reality, but I don't ever want to become that medic whose personal boundaries are so strong that nobody wants to be around them. Having worked with enough medics I've become convinced that's why some of them come off as completely self-absorbed jerks.
(The popular joke in my station comes to mind: "What's the difference between a porcupine and an ALS unit? On an ALS unit, all the pricks are on the inside!")
I did tactical EMS long enough to know that I'd rather do it in the field, among the citizens outside the prison wire. Since I've gone civilian I've been on a plethora of calls. I've played the role of EMT, older sibling, crisis counselor, and best buddy. I've helped debrief fellow EMT's and medics and have needed to debrief myself. I'll never know it all, though, and I pray I never stop learning.
That's what this blog is going to be about. I won't talk politics much here; I blog about that plenty elsewhere. This site will be about my frustrations, celebrations, mourning and all the lessons learned along the way.
I remember the first-ever suicide call I went on. By the time I arrived it was clear I wasn't going to be offering much medical assistance. An ALS unit was already there. I got to hold mom's hand while a police officer explained that her teenage son had been declared dead after shooting himself with a .357. I grew up with guns and I knew what a mess a hand cannon like that could potentially make, so that part didn't affect me much. What was worse was later, when a detective brought some of her son's personal effects out to her, she showed me his school ID. Her son had been a vibrant, handsome young man.
I will never forget the feeling of powerlessness that washed over me as we left. I felt like we had left that poor woman just as empty as she'd been when we got there. It's a feeling that has never left me, partially because I've been on suicide calls since that turned out just as badly and have felt on each of them that I hadn't done enough. Not one of them has ever compared to the first.
It won't be my last. I've had plenty of happier endings since then, and I'm grateful for each one of them. I've been on calls where there really wasn't anything to do. Through it all I've learned that the most important lesson we can learn is to never stop learning. No matter how irritated, how stressed, or how happy we are, we can never allow ourselves to believe that we've seen it all.
Besides...if we did, that ol' bastard Murphy would stop in to kick us square in the backside with something we never thought we'd see. Lost condom call, anyone? ;-)
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