Happy Endings?

Prostitution is legal in Providence. Asian spas have blossomed everywhere, offering "sensual massage." Every now and then the media does a story on the people behind the facade, subsequently the politicians make a little noise, then it all goes away.

It never goes away for the people providing the service. I've read accounts of young Asian women and girls lured from their homes with promises of a better life here in America, only to find themselves indebted to their supposed benefactors.

Little is known about this segment of our society. The very nature of the business assures discretion. I've often wondered about the people involved in this life, are they involved in some lurid sex slave ring, or are they merely providing a service with willing employees making a living at the oldest profession we know of.

Happy Endings should answer these questions, and a lot more.

Police and Thieves

2300 hrs. An hour till midnight. Desperate man breaks into bakery
2311 hrs. Desperate man spotted by concerned citizen
2318 hrs. Police arrive
2319 hrs. Desperate man steals van, chase ensues
2330 hrs. Chase ends on Rt. 195
2331 hrs. Desperate man jumps twenty-five feet from Rt. 195 onto grassy knoll, rolls over and runs into the Providence River.
2336 hrs. Providence Police drag desperate man from river bank.
2339 hrs. Rescue 5 and Engine 9 dispatched for "a man in the water."
2343 hrs. PFD on scene
2344 hrs. Desperate man treated, hypothermia, poss ankle fracture, poss spinal injury.
2348 hrs. Desperate man transported to RIH ER.
2355 hrs. Desperate man sedated
0015 hrs. Rescue 5 in quarters and off.

Any excuse to get The Clash on the blog will do. I was a high school sophmore when this song was released. To this day, whenever I hear The Clash it's like my first time. I can't think of anything else that feels as good. We'll, maybe one other thing but I was a high school senior when I found that!

Unwanted

She opened her door a crack and peered from the darkness, letting a cloud of smoke escape from her tiny apartment. She's fifty-four, lives alone, listens to forty year old records on an old turntable. She spends her days drinking and living in the past, her and her memories. I think she was pretty once.

"What do you have, Cheech and Chong hiding in there?" I asked, waving the smoke away.

"I'm not going to Rhode Island Hospital."

"Really."

"They don't know what they're doing."

"Yes they do."

"I'm not going anywhere. Just leave me alone!"

I put my foot in front of the door before she could close it. It bounced back on her. She backed up and sat on her bed.

"I'm sick and you don't care."

"Really."

"Nobody cares, I want to die!"

"Oh, come on now, if you wanted to die you wouldn't have called us."

"My belly hurts! I have Pancreatitis!"

"Then why did you drink?"

"Because I'm in pain!"

"You're in pain because you drank."

"Go away."

"You're coming with me."

"Not if we're going to Rhode Island."

"Rhode Island is the closest hospital, if you were looking for a ride you should have called a taxi."

"I knew you didn't care!"

"Oh, stop it, we'll take you to Miriam hospital."

"I'm not going anywhere!"

She lept from the bed and tried again to slam the door. Again it struck my foot and bounced back on her.

"That's it, I'm leaving. If you want to come meet me in the truck."

I closed the door behind me and retreated to the rescue. Before I made it my patient ran past me, opened the rear doors and threw herself onto the stretcher.

"The blood pressure cuff is next to you, do you mind getting your own vitals?"

She crossed her arms and didn't speak again until we arrived at the Miriam. There, she informed the Charge Nurse that she was leaving, and asked me if I would give her a ride home.

At first the people at Miriam were going to let her go. I advised them of her history and probable alcohol use, they decided she had better stay. They put her on a stretcher in the hallway, all the rooms were full.

She didn't want to be there, and they didn't want her. I think she has a long wait in front of her, and she doesn't have her records to keep her company.

The Handover, Volume 2, A Lesson Learned

The Happy Medic hosts this edition of The Handover. Click the title or you'll be late for class and get five nights detention!


http://yourhappymedic.blogspot.com/2009/03/handover-blog-carnival-volume-2.html

Wrong Way

Four a.m. I'm driving down 95 South toward an MVA on 95 North. Originally we were sent to Exit 19, nothing there, I radioed dispatch.

"Rescue 1 to fire alarm, 95 North is clear to the 195 split, any more information?"

"Stand by, Rescue 1, we have a report the accident is at Exit 16."

Received, turning around.

Six minutes had passed since the original dispatch.

"Fire Alarm to Rescue 1 and Engine 13, we're sending Engine 11 to cover the Northbound lanes.

"Roger."

Two more minutes passed.

"Engine 11 to fire Alarm." Miles, sounding like he was ordering a pizza, as usual.

""We've got a pedestrian struck, female in her twenties, have Rescue 1 step it up."

I looked over to the northbound lanes at the scene, 100 feet away seeming like 100 miles. A car was in the breakdown lane, emergency lights flashing. Twenty feet in front of the car was a person covered with a sheet.

"Rescue 1, received." I put the mike back in the cradle and did an inventory. The wife, home in bed, The kids, hopefully home in bed. Everybody else I know's kids, I couldn't think about it. Bottom line, some poor soul's kid was lying on 95 covered with a sheet. And I was heading south, waiting for the exit where I could turn it around, nothing to do but wait.

I can't think of a worse image than a person covered with a sheet, lying on Route 95 at four in the morning and a rescue heading in the opposite direction.

Adam did a great job getting us there in three minutes, should have taken four or five, I wasn't paying attention, just clearing my mind.

We stopped the rescue next to the victim. The crew from Engine 11 had an IV started, collar in place and ready to go. The girl, twenty-five years old, was still conscious. Her friend had run out of gas, she was putting a gallon in when a car sideswiped her. Luckily, it didn't hit full force, the impact spun her around, threw her ten or so feet in the air and landed her twenty feet away.

We did our thing, immobilized, IV 02, ekg and trauma assessment and got her to the hospital five minutes after our arrival. As we left the scene we passed a bright green highway sign, EXIT 19, 2 Miles. The original caller must have seen that sign and given the wrong location.

The patient was in Trauma 3 when I left, her friend who had run out of gas waiting outside.

It looks like she's going to make it.

Founding Fathers

Every day I'm forced to cater to a segment of our society who do nothing to contribute to the most successful country in the history of civilization. One of the many inspiring things about America is her ability to protect those who cannot protect themselves. Our collective charity defines us; a people capable of world conquest and domination yet content to stay peacefully within our borders, create wealth, produce food bountiful enough to feed the world and live our lives as productive protectors of freedom. The cost is staggering. Our many societal ills could be eradicated if we chose to close our borders and take care of our own.

Instead, we choose to let our own take care of themselves, the philosophy that we all have a right to pursue happiness proven more effective than happiness being provided to us by a collective system of wealth distribution. We struggle. We go hungry. We want. A healthy fear keeps us motivated; failure is not an option. Or is it?

I see a population beaten by promises made by modern day politicians who tell their constituents that they "deserve" everything we now consider necessities, not because they have earned it, rather because they live here, as though merely populating a land mass made great by those who have sacrificed, starved and died to provide it is enough.

Well, folks, existing is not enough. Giving to people who expect the charity of others as their right and privilege is not enough. Eventually the givers get tired of giving to those not worthy of their charity. Resentment grows as pockets empty. It is impossible for a person to stay productive for the benefit of another. We have reached the tipping point. Many have given up, and aspire only to stay below a mandated level of success, thus enslaving themselves to the "generosity" of the government. To rise above the poverty level means giving up free health care, subsidised housing and many more benefits keeping people poor and powerless.

Nobody "deserves" prosperity. Nobody "deserves" free health care. Nobody "deserves" anything other than what they have earned. Our generation has failed. Miserably. This is not the country I wish to live in, not in its present state.

I'll go on providing free rides to emergency rooms for people who lack the gumption to pass on a "free" service provided by the working taxpayers of this nation. I'll listen to them explain how they called 911 so they could access free medical care faster. I'll deliver them to the places that will give them their antibiotics for their sniffles, or take fifteen year old children to maternity wards so they can deliver their babies into a world of "benefits."

I'll do it because every now and then somebody truly needs help, and I'll be damned if I'll turn my back on somebody in need. Real need.

Watch the clip.

http://www.youtube.com/watch?v=nbv8LRVRTaA

Family

"Engine 10 to Rescue 1, eighty year old female, respiratory distress, possible CHF."

"Rescue 1, received."

We turned the corner onto a narrow dead end street just off of Broad. The door of the last house on the left was open, frenzied activity just beyond the threshold.

"Get the chair," I said to Adam and entered the home.

"230/115, pulsox 68%," said Ted as I approached the patient. She was struggling to breathe, her lungs full of fluid. The oxygen mask covered the bottom half of her face, her eyes were panicked. Adam set the chair up next to her, the guys from Engine 10 picked her from the couch and got her ready to move. Seven or eight family members stood nearby, some worried, some afraid, some near panic.

"What is her name?" I asked.

"Auriela," one of the women answered.

I took a nitro from the bottle I had put in my pocket and had the woman tell Auriela to put it under her tongue and let it melt. She struggled for a while, then understood. A minute later we were in the rescue, Ted applying EKG leads, Adam starting an IV and myself preparing an albuterol treatment.

"I'll give you a driver and an extra set of hands in back," Frank, the officer of Engine 10 said, closing the rear doors of the rescue.

"Let's roll."

We began our journey toward Rhode Island Hospital, three of us in the back with the patient, a firefighter from Engine 10 driving the rescue and Frank and Paul following with the engine. Another nitro en route, 40 ml of Lasix and the albuterol treatment seemed to be effective, Auriela's eyes stopped darting, her breathing slowed as her lungs cleared and she actually managed a little smile. The frantic activity in the back of the rescue slowed in rhythm with our patients breathing. There wasn't much more to do but comfort her, let her know she would be all right. She didn't speak a word of English, and we barely spoke a word of Spanish, but all of us knew she was out of the woods.

We arrived at the hospital. The rear doors of the rescue opened and there stood one of our guys, an off duty firefighter from Engine 11. I looked at him for a moment, confused.

"That's my grandmother," he said, helping us wheel her in.

Twenty minutes later he shook my hand as we were preparing to leave.

"Thanks, Mike, you guys were incredible."

I can't imagine a more satisfying job than the one I have.

What's in a Name?

She fell from her bed onto a carpeted floor, no obvious injury, cried immediately, then laughed. Her mom just "wanted her checked." The responsibility that people thrust upon me is a bit too much at times, so I did what any self-respecting EMT would do, thrust the responsibility onto somebody else. Off we went to Hasbro Children's Hospital.

It was a relatively long ride to the hospital, at least by Providence standards. Most of my transports can be done in less than ten minutes, a lot of them in less than five. This one took almost fifteen. I wish it took longer.

My patient, securely snuggled in her car seat that I had attached to the stretcher captivated me right from the start. She looked me in the eye as we got moving and didn't look away.

"She's beautiful," I said, looking up as I started my report.

"Her father is Intuit Indian, I'm half Egyptian and half Peurto Rican," said the proud mama.

An Egyptian Eskimo from Peurto Rico, right here in Providence, RI.

"What is her name?" I asked Mom.

"Karizma."

"No way."

"Yup. I just liked the way it sounds, like it fit her."

"It does."

"Her middle name is charming."

"What is it?" I asked.

"Charming."

"I know, what...never mind."

With a first name like Karizma could Charming be far behind?

"Karizma Charming Morales."

Perfect.

Up the Street

This one happened up the street from my fire station, lunchtime, at the entrance to Roger Williams Park. I'm just waiting for some genius to blame the "struggling economy" for all the bloodshed. The folks out here doing the shooting don't belong to a society that is effected by a "struggling economy." These people have their own underground economy, and business is booming.

Second Guess

People fall and hit their heads all the time. Some lose consciousness, some don't. Some want to go to the hospital, others refuse. Legalities aside, the EMT's that responded to Natasha Richardson's accident are in a difficult position.

Many patients of mine have signed a refusal after suffering a head injury. Just last week a guy fell on the ice at the Fleet Skating Center, striking the back of his head. A small bump and minor laceration presented, no loss of consciousness, alert and oriented. We talked for a while, he is on tour with the Army Band, visiting a dozen or so cities during a six week tour. He didn't want to go to the hospital, didn't want to get back on the ice either. I agreed with his descision and left him in the care of a friend, telling him if a persistant headache, confusion or dizziness developed to call us back.

I moved on to the next call, forgetting the guy with the head injury until reading about Natasha. I'm not sure how I would handle the call if it happened today. I'm sure there are a couple of EMT's in Canada doing some second guessing.



"After Richardson fell and hit her head on a beginner ski slope at the Mont Tremblant resort in Quebec, the first ambulance crew left upon spotting a sled taking the still-conscious actress away to the resort's on-site clinic.

A second 911 call was made two hours later from Richardson's luxury hotel room as the actress deteriorated. Medics tended to her for a half-hour before taking her to a hospital about a 40-minute drive away.

Centre Hospitalier Laurentien in Ste-Agathe does not specialize in head traumas, so her speedy transfer to Sacre Coeur Hospital in Montreal was critical, said Razek.

"It's one of the classic presentations of head injuries, `talking and dying,' where they may lose consciousness for a minute, but then feel fine," said Razek.

Richardson, 45, died Wednesday at Lenox Hill Hospital in New York. The New York City medical examiner's office ruled her death was an accident."

AP

Gangs of Providence

Not only is this a good look at the Gangs of Providence, in my humble opinion the way the Providence Journal presents the story may be the future of newspapers. I'll miss holding the paper and hearing the familiar sound when I turn the pages but I have to admit this is pretty good.

http://www.projo.com/extra/2008/gangs/ or click the title

Happy St. Patricks Day!

http://www.youtube.com/watch?v=_ZN3weW1udE

An Old Irish Blessing
May love and laughter light your days,
and warm your heart and home.
May good and faithful friends be yours,
wherever you may roam.
May peace and plenty bless your world
with joy that long endures.
May all life's passing seasons
bring the best to you and yours!

Poetic

Some of our patients are waging courageous battles against horrendous diseases. It can be easy to forget the struggles faced by so many we come in contact with. I have been linked to Susie Hemingway's poems of Love for a year or so, not because I know anything about poetry, I don't. But her words make me remember why I do what I do. The following poem took my breath away.

People need us. It is a huge responsibility.

Thank you Susie and Hamada, for making me a better firefighter, EMT, and hopefully , person.


" I Write For You" - by Susie Hemingway

As sun doth melt the silver days
and fresh green buds do chase away
the remnants of these chilly days,
I write for you...
you sleep and sleep my only love
you miss spring birds and clouds above,
in dreaming slumber, days do pass, and
even though against the breeze
the fragile words do come to me,
still sleep stays on those lovely eyes,
for days are shorter dear for you
the circle smaller, in violet blue,
again the sun will find it's rays
to warm your heart and fill your days
and I will spend my time with you
in quiet gentle solitude,
till this day, my only love,
I write for you...
soon once again, dear God for me
you'll sit on swing, beneath the trees,
to listen to the buzzing bees
the rustle of the summer leaves,
then you will snuggle close to me,
when smudges of my tears
do fall, to stain the ink,
and you will sleep,
and I will write
my words for thee...

Copyright @ 2009

There are many more, the link is on my bloglist.

Wisdom from the Mouth of Babes

I dragged myself into Rescue 5's office this morning, took the portable from Teresa and got ready to start another shift, this time looking forward to five o'clock so I could get back to Rescue 1 and start the countdown till 0700.

Every now and then a beacon of light enters my vision, so bright it's nearly blinding. I fumble through my days, always waiting for a shift to end, a call to be over, another cycle in the books. I keep the future in mind always, at ten years I had ten to go, fifteen five more, now at eighteen two more and out, time to "enjoy my life."

"I have no idea how I'm going to be able to do this for two more years," I said to Teresa. We work the same shift, "C" Group, her in charge of Rescue 5, me at Rescue 1, Zack at Rescue 4, a guy who doesn't want his name in my blog at 3 and an Acting Captain at 2. We've worked together for seven or eight years now, the officers steady with a steady stream of Rescue Technicians coming and going. Some of the techs stick around, Terry's partner John has been around for a while and doesn't look to be going anywhere any time soon. Can't say I blame him. Zack has Stephanie, almost a year now and holding steady. The six of us make a difficult job bearable, at times even fun.

"What if next week were your last?" asked Teresa, wanting to get home and get some rest but staying at work for a few extra minutes to talk some sense into somebody she cares about. "When you leave here you will never come back. A big part of your life will be over. Why would you want that to rush past you?"

"I don't know."

"You're not ready to leave, you love it too much. Think about your friends in the station, the hospitals, even the patients. This is an amazing ride, slow down and enjoy every minute, who knows if you'll even be alive in two years."

I don't think she is even thirty years old. I had been a firefighter for ten years when we met in EMT Cardiac class in 2000. She was just a kid who wanted to deliver babies some day. Two years later she was sworn is as a Providence Firefighter. A few weeks later she was assigned to Rescue 5. A couple of weeks after that she and JoeEMT who comments here responded to Thayer Street for a man in a car who put a gun to his head and pulled the trigger. I heard the call dispatched and knew the mess they were heading toward, worried how the sight would effect her. She did okay, and continues to thrive in a field where burnout is almost a prerequisite for employment.

She even dispenses some profound advice now and then. I think she's delivered a baby or two.

Thanks, Teresa. I believe it's going to be a good day...

Tense

There he sat, all 400 lbs of him, in the middle of the street, handcuffed, shirtless and ready to rumble. The bar crowd had already left, a few stragglers stumbled past as we lassoed the raging bull and tied him down. He snarled and spit and carried on like he was fighting for his life.

Good Guys 1
Raging Bull 0

They medicated him once we dragged him into the ER; he was still spitting and snarling when I left, though the snarling wasn't as ferocious and the spit was more like drool.

The guy on the stretcher next to him had taken a bullet to the head. As I walked out the Providence Police walked another guy in handcuffs past me. The alleged shooter? So I'm told. He didn't look like somebody capable of putting a bullet into somebodies head, but what does a person capable of doing that look like? A crowd of kids converged in the parking lot and waiting room, security and police cruisers in equal numbers stood by, waiting.

For Whom the Bell Tolls

I've gotten used to seeing them as I drive through the neighborhoods, young guys, most of them dressed in hoodies, slow walking, slouching, nowhere to go. They are seldom alone. Yesterday one of them leaned into the side window of a parked car and put four or five bullets into a seventeen year old kid. Gang members? Drug dealers? Maybe. Whatever they are, they are still human beings. I still can't get over the fact that I share the same streets with people capable of pointing a gun at somebody and pulling the trigger not once or twice, but emptying the clip into another person. There was no provocation or self defence, just cold blooded murder. Or attempted murder, but what difference does it make?


Rescue 1 and Engine 11 did their thing, the patient is out of surgery and in critical condition at Rhode Island Hospital. Chances are somebody else will be shot, sooner rather than later. At some point today, I probably crossed paths with people planning an execution. I'd rather not look the world and people in it like this, but it is impossible to ignore.

Quiet now, but any minute the bell could toll.

http://www.projo.com/news/content/PROVIDENCE_SHOOTING_03-13-09_QEDLRFP_v14.378a571.html (or click the title)

Great Links

There are some incredible EMS and Firefighting blogs out there, I just added three of my favorites, A Day in the Life of an Ambulance Driver, who I've been reading almost as long as I've been posting, The Happy Medic, who I found a month ago and Siren Voices, one of the best written blogs I've come across. They are on the side bar, one click of the mouse will take you there.

Just took a week off, more fun and adventure to follow...

Dangerously Fun Stuff

I've been reading The Paladin Press Book of Dangerously Fun Stuff for a few weeks now and have learned a few very important things, including, but not limited to How to Fight a Duel, Dealing with Potentially Violent Co-workers, How to Win a Knife Fight, How to Land an Airplane, and How to Become Invisible in the Woods.

My personal favorite chapter is A Rescue Firefighters Quick Course in First Aid, written by an extremely witty, fearsome and handsome firefighter from the East Coast.

Click on the title to listen to a podcast relating to the book, I think you will enjoy it.

How EMS Works

The Happy Medic has done a nice comparison of our 911 system and Medicblog999's 999 system in the UK. Give it a look, it's a good read.

Torch Run

My friend Carl from Ladder 2 on Messer Street asked if I could help raise some money for the Torch Run Plunge. Every bit helps, click on the title of this post to contribute. Thanks!


Mike,

We are trying to raise money for the annual "Torch Run Plunge" in Newport next
week for Special Olympics. I hope that you can help this worthy cause and
forward this along to anyone else that you think could contribute. Thanks.

Carl Richards
TL-2, D Group

http://www.firstgiving.com/carlrichards

Tired

Why are we called firefighters?

I first faced death on a cold winter afternoon in a hole twenty feet deep. An excavation job went horribly wrong, the foundation collapsed, burying the foreman. Twenty firefighters risked everything, frantically trying to dig him out. An hour later, long after the sun had set we got him out. One by one we climbed from the grave, happy to be alive yet sorry that we couldn't save him.

A few months later a grandmother and her baby were caught in the rear wheels of an eighteen wheeler as it cut a corner too tightly, trying to avoid a snowbank. The baby was dragged one hundred yards in the mangled carriage, the grandmother crushed next to the snow bank. The grandmother survived, the baby did not.

Not long after a man hid in some low shrubbery, waiting for a train. When the train drew close he ran in front of it. The engineer never had a chance to slow down. The man disintegrated on impact. I walked toward the carcass, trying to avoid hundreds of quarter sized pieces of meat, a surreal aura surrounding us as we covered what was left of the body.

With almost a year on the job I stood helplessly and watched my brother firefighters stumble from a fifteen foot storage tank. They had been attempting to rescue a worker who was overcome by fumes while cleaning the vat and died hanging from his safety harness. Later that week I saw my friend's brother hanging in a bedroom closet. He called 911, I showed up.

By the end of my first year I had seen more than I care to remember. Between all of these calls, and many more we did fight some fire. I was well into my second year when I got my first two fire victims. I remember bagging the three year old with one hand and doing compressions on the one year old until more help showed up.

Some things you never forget. I've got a lot on my mind after eighteen years, every one of those years filled with similar incidents.

Firefighters? Yeah, we're firefighters. And a whole lot more.

Why am I writing this now?

Maybe I'm a little tired of picking up the paper or turning on the news and hearing about the recent town or city that closed fire companies or reduced manning or layed firefighters off, of demanded pay cuts and benefit concessions.

Maybe I'm sick of hearing how "firefighters" shouldn't be able to shop for dinner, or retire after "just twenty years."

Maybe I'm just tired.