This one is for all the folks answering the 911 calls.
http://www.time.com/time/specials/packages/article/0,28804,1903486_1903487,00.html?artId=?contType=?chn=
I don't know how they do it!
Answering the Call
Wednesday, June 24, 2009Three in, Three Out
Friday, June 19, 2009So anyway, Providence is home to 180,000 official people. The real number is well over 200,000. Add to that, the 200,000 or so people who fill the city every workday, then come back to party.
Providence runs with six ALS vehicles and zero BLS vehicles. Six trucks handle 30,000 ALS calls per year and the number is growing. Can't seem to squeeze any more rescues out of the city without taking understaffed firefighters away from the trucks.
What to do?
Nothing. Run, boys, run.
And call for mutual aid.
1430 hrs, a minor fender bender on the south side. Three guys scurry around moving plastering equipment from the trunk of a barely damaged vehicle into the back of a pick-up. They see the rescue and stop, holding their backs.
I took two. Rescue 2 took another. A third rescue was called a minute later so the driver of the other car could get on the bandwagon.
Three rescues tied up for no reason other than fill the pockets of some lawyers and their prey.
Half of Providence's fleet gone in a blink.
Vacation begins in two hours.
Yay.
DOA
"You don't need all that, just bring a sheet."
The captain filled the doorway for a moment, then disappeared.
"Bring it," I said. Adam grabbed the monitor and 02, I carried the "blue bag."
Inside, a man lie dead on his couch. His body was filthy in life, in death it was blue and filthy. A dog whimpered from behind a closed door, weeks old food sat on a filthy stove, rotting in a filthy pan in a filthy kitchen. Bugs feasted.
I stood in the doorway which led outside, getting an occasional breath of fresh air, consoling a sobbing woman. I didn't ask if she was related, her grief was proof enough for me that she belonged here. A group of five others hovered around the dead man, the usual chatter, the usual questions, the usual tears.
"Lets go, move it outside," bellowed the captain. "Nothin here but a dead body and a lot of stink."
Adam told me later I had murder in my eyes.
For some inexplicable reason the people listened to the captain and started to leave.
"Get out of the way," he said to me. "I'm clearing this place out."
He's the fire captain. I'm the rescue lieutenant. We had been dispatched for an unresponsive male. I was in no mood for a pissing contest. I put the sheet over the deceased.
"You don't have to go anywhere," I said to the people as they left the dreadful place.
I can't wait for this shift to end.
Lessons
Wednesday, June 17, 2009So, it is time for Grasshopper to try to snatch the pebble from my hand. (RIP David Carradine)
The "new guy" has been driving for three months now, in three more months the department will put him in charge of a Providence Rescue. Will he be ready? We shall see.
First test, 0715, fifteen minutes into our first shift, cardiac arrest, 55 year old male.
I failed this test, couldn't relinquish command. Just couldn't. It's one thing to train somebody, another thing altogether to put him into an impossible situation and possibly do more harm to his confidence than good. Our patient was deceased. His extremities were cold to the touch. My guess was he had been gone for at least an hour.
The man's son, who happened to also be a CNA, felt his wrist, stated he had a pulse, then looked to us. The man's wife appeared from a rear bedroom and became hysterical. Many moons ago I may have declared the man dead. Time teaches. The family needed to know everything had been done for their husband, father, son.
I had Adam get the ET tube while we did CPR and monitored the heart. Asystolic. My IV attempts were dismal failures, we arrived at the ER before administering any meds through the tube. The hospital is a teaching hospital, they took over care. He was pronounced dead fifteen minutes later.
The day progressed, I drove for the first time in a while and my partner handled the patients. He was doing fine until 1430 hrs when we were called to a Family Services Center for a suicidal fifteen year old. Ashly sat in the office with her grandmother, sullen, petulant and annoyed, everything I was when I was fifteen. She had numerous attempts in her history and suggested to a councillor today that she wanted to die.
Adam sat in the Captains seat while I took the young lady's vital signs. I learned something on this run; I am truly incapable of keeping my big trap shut and letting other people shine.
"You know, Ashley," I said, "I hated being thirteen, fourteen, fifteen, sixteen, seventeen...actually I was miserable until i turned forty, only then did I manage to find happiness."
She looked me in the eye, unimpressed.
"Twenty-five is actually pretty good," chimed in my student, "he's just so old he can't remember."
Well, the suddenly animated Ashley and my "student" had a nice little chuckle for themselves as I slinked to the drivers seat and left them in the back.
I looked in my hand as we left the scene.
The pebble was gone.
Honest Mike's
Tuesday, June 16, 2009Here at HONEST MIKE'S we have a HUGE selection of SLIGHTLY USED rescues at prices so low we must be CRAZY!!!!
No, it's really just another tuesdat at RIH ER.
Dani's Anatomy
Monday, June 15, 2009http://medicdani.blogspot.com/
I want to be twenty again. No I don't. Yes I do. On second thought, no I don't. Well, yes I do. Well, maybe...
Just read the thing!
Anchor Rising Weighs In
Sunday, June 14, 2009http://www.anchorrising.com/barnacles/007990.html
I have to admit I love a good debate. Getting into the thick of things with equally passionate people, with intelligent discussion rather that insulting one line banter so prevalent in today's sound-byte world is what makes living in a free society so great. That we can coexist with different philosophies is a testament to free speech an other liberties so many take for granted.
I've been reading and commenting on Anchor Rising for years. With a few exceptions the talk there is thought provoking and well done.
It doesn't hurt that they appear to be leaning toward Local 799's side this time around either!
Weekend Activities
The first video is from The Gaspee Days Parade, an annual event here in Rhode Island. It is a celebration of one of the first demonstrations against tyranny in what was to become the United States of America.
The second video and following picture are from the demonstration against another tyrannical leader, this one Providence Mayor David Cicillini.
The bikes are The Rhode Island Firefighters Motorcycle Club, driving by offering support to the cause.
Wounded
Thursday, June 11, 2009The early morning sun had yet to break the horizon as we approached the two family home in the heart of South Providence. Places like this are everywhere in the neighborhoods, well kept multi-family homes, some a little dated, others freshly painted with ornate metal gates adorning the driveways. There was no gate here, just an old Ford parked next to the house, with a wounded combat veteran licence plate on the back.
A trend has resurfaced in this neighborhood. Somebody buys a two or three family home, Mom and pop live on the ground floor, the kids who own the place occupy the second and if available the third apartment is rented, sometimes to another family member, to help foot the bill. My own family started out like this, it actually sounds kind of nice. Absentee landlords still exploit the poor folks who settle here, their homes obviously lacking the TLC needed to maintain the old places.
I walked into the home. The old folks lived on the first floor. It looked like they had lived here for decades. Slumped in a kitchen chair was our patient, an eighty-five year old veteran named Joe. Engine 11 had arrived first, an IV was already established, vital signs taken and hi-flow oxygen being delivered through a non re-breather. Joe had tried to take a sip of his morning coffee, felt sudden weakness and spilled it all over his crisp, white t-shirt. There was obvious facial droop, and no strength on his left side when he squeezed my hands.
His wife of fifty years stood by, nervously wiping the spilled coffee from the green linoleum floor. "He goes to the VA," she said.
As the guys from the 11's and Adam helped Joe into the stair chair, having to strap him tight so he wouldn't tip to the left I took his wife to the side. I hated doing it.
"When did you notice something different?" I asked.
"Right before I called you, about ten minutes ago. He was fine, drinking his coffee like he does every day, then he dropped it and couldn't tell me what was wrong."
"I think Joe is having a stroke," I said as gently and quickly as I could. If we get him to the proper facility the damage can be stopped. We can help him but the VA isn't the best place for something like this.
She started to argue, insurance reasons maybe, familiarity more likely, but saw the urgency in my gaze and relented.
"I'll stay here and clean up," she replied, nervously wiping the kitchen table where the coffee stained paper sat, opened to the Sports Section.
In the truck Joe was in the stretcher, listing to the left.
"Let's go."
I reassessed his vital signs and tried to get him to speak. He tried valiantly but was frustrated and unable to articulate his thoughts.
As we sped to the ER I gave him the news. A wounded WWII vet deserved the truth.
"Joe, you are having a stroke. There are treatments available and we're within the time frame. We can stop the damage, you're not done fighting just yet."
His right hand gripped mine fiercely, he made eye contact, then he closed his eyes. We rode to the hospital in silence, him lost in his thoughts, me hoping I wasn't witnessing his last battle.
Circle the Wagons
Wednesday, June 10, 2009Some idiot got sprayed with mace. I have no idea how or why, all I know is I'm coughing, my face is on fire and my hands are itchy. Sure, I could have walked away, told him the pain subsides after a while, but a guy was in distress and I helped him. Simple as that. The fact that I got the stuff all over me while cleaning him up is irrelevant. The pain and itching will subside after a while.
A young girl got punched in the face a few nights ago. She stood outside of her three decker, bleeding from her bottom lip. She offered me money because she didn't have insurance. She told me she was a "dancer" at Cheaters, a notorious adult entertainment club down the road from my station. She opened her purse, a stack of twenties and a bunch of condoms lay inside. The girl was high, confused and needed help. I helped her. We put her in our truck, dressed her wound and had her put her money and condoms away. Her ID said she was twenty and lived in Connecticut. Her face said she was sixteen and lived on the streets. Her face was right, her ID a lie.
http://www.projo.com/news/content/girl_found_06-10-09_3GELSD4_v12.3db934c.html
I'd like to think our actions helped her find her way home, whatever hell that might be. I don't know. I do know that I have a job to do, a damned important one. Some day I'm going to get old, and when I look back on my life the proudest moments I'll recall will include those spent as a Providence Firefighter.
Right now, as I write this I'm listening to talk radio. Big mistake. My union has decided to picket some big deal Mayors conference in Providence. From the sound of the callers, and the letter writers and people on the street you would think we invited Satan into our midst to corrupt the youth of the world and pick the pockets of the taxpayers of Providence.
This event will pass, we will picket, life will go on. I'll still be a member of the Providence Fire Department, still stand proud, and still help people when they need it.
It is my honor and privilege to be part of the Fire Service, most recently serving as a Rescue Lieutenant. Sometimes we have to circle the wagons and stand together, knowing that ours is a profession unlike no other, whether it is appreciated or not.
Last Rights?
Tuesday, June 09, 2009By the time we got to him he was as good as dead. He had "quit his dialysis months ago," a neighbor informed us, "just gave up."
He was naked, lying on the floor of his one bedroom hi-rise apartment. No furniture, a mattress on the floor, no sheets. No food in the fridge. No medications anywhere. No mail. No nothing.
We found his birth certificate. Seventy-nine years old with nothing to show for it. Untreated bed sores covered his back, the skin on his back resembling an alligator's it was so dry. Urine covered the floor next to him, feces as well.
The faint pulse he had when we entered his world died after a few seconds. The neighbor who called us to check the well-being backed out of the place, the smell a bit too much for somebody not used to such things.
I looked into his dying eyes, saw the light go out and silently said goodbye.
We performed CPR on the dead body, attempted IV's and intubation and transported the corpse to the ER where they continued the life saving efforts.
Rest in peace, Lonely Old Man. I'm sorry I had to ruin your last moments.
Picket
Monday, June 08, 2009http://newsblog.projo.com/2009/06/cicilline-will-1.html
I'm not a fan of picket lines. I don't like walking around in circles, chanting, kind of makes me feel like a chimpanzee. I don't want to do anything that tarnishes the City of Providence. I want this place to reflect the people I work with, their dedication, honesty and work ethic. That would be the image I would wish to see written in newspapers, talked about on talk radio and displayed on television. Instead, the ugly picket line will be headlining things for a while, as the yearly Mayor's Conference visits Providence.
This should be a great moment for the city. National exposure, dignitaries, red carpets and all that. Instead, Providence firefighters and police officers must take to the picket line to bring to attention their situation as it pertains to contract negotiations with Mayor Cicillini's administration. Make no mistake, picket lines are ugly. There is not one person I know who looks forward to walking the line. When faced with a mayor who is a diabolical, bold faced liar we have no choice.
Mayor Cicillini asserts the firefighters refuse to share their healthcare costs. He states, in public and on the air that firefighters receive unsustainable 6% cost of living pension benefits. He claims firefighters are making upwards of $100,000 dollars a year in neighborhoods where families struggle, working three jobs just to make ends meet. He states alot of things that have no fraction of truth. What makes it worse, he is well aware that he is lying, and thinks he can get away with it. It is an insult to the people of Providence, some working three jobs, and dangerous to attempt to turn the citizens against public safety in an effort to bolster his own credibility.
The mayor is losing the battle of public perception, not because the firefighters have a better strategy. He is losing because the firefighters are honest, and right.
If you see a chimpanzee holding a picket sign while watching the news this week don't worry, it's only me. As much as I dislike pickets, I dislike liars even more.
Dear friends and family:
I ask that you please read the letter below from Internation Association of Fire Fighters' President Schaitberger. There are also links to press releases with more information. Once you have, if you are appreciative of Vice President Biden's efforts to help the Providence Fire Department, please take the time to visit www.whitehouse.gov and follow the links to VP Biden's page. Drop him a note and thank him for his support of Local 799 and his unwillingness to accept Mayor Cicilline's unfair treatment of them. Thank you!
Dear Affiliate Leader:
The Obama administration will honor picket lines planned by Providence, RI Local 799 for the U.S. Conference of Mayors' Annual Meeting being held June 12-16 in Providence, where our affiliate has been in a long-running dispute with that city's anti-union mayor, David Cicilline.
For more information:
IAFF Press Release: IAFF Thanks Obama Administration for Supporting Providence Fire Fighters
http://www.iaff.org/Comm/PDFs/Providence.pdf
Associated Press: Obama team skipping mayors' event over picket line
http://www.google.com/hostednews/ap/article/ALeqM5hANiyt4pbxLTclmVwYrvffSUwo4gD98KRM400
Providence Journal: Pickets prompt Biden, others to cancel their visit
http://www.projo.com/news/content/BOYCOT_MAYORS_CONFERENCE_06-06-09_UPEKNNF_v97.41281e9.html
I spoke directly with Vice President Joe Biden about the situation in Providence. And when the vice president offered to attempt to resolve the dispute amicably -- to see if we could avoid the picket lines -- and after discussions with Local 799 President Paul Doughty, we agreed to the proposed resolution. However, Mayor Cicilline refused any fair-minded discussions outright and insisted on continuing the dispute.
Based on that reaction, the vice president, Attorney General Eric Holder, senior Obama Adviser Valerie Jarrett, Commerce Secretary Gary Locke, Labor Secretary Hilda Solis and other administration officials informed the National Conference of Mayors that they will not cross our picket lines, cancelling the attendance of a number of administration officials.
We appreciate the Obama administration's support of fire fighters and our union. Just as important, please let your mayor know that the picket lines will be up, that President Obama and Vice President Biden have stated their refusal to cross our lines, and that they have a choice to make, as well.
Fraternally,
Harold Schaitberger
General President
The Difference
Thursday, June 04, 2009"Attention Engine 3 and Rescue 1, respond to 647 Broad Street for an MVA involving an unresponsive ten year old."
That will get you going.
We flew out of the station toward the incident. Engine 3 arrived on scene first and radioed their findings.
"Engine 3 to Fire Alarm, advise Rescue 1 we have a minor MVA, the ten-year old's mother wants the "have her checked." Alert and conscious, proceed Code C."
Code C lets us know the "emergency" is not really an emergency, just somebodies idea of an emergency that really isn't.
An old car had a minor scrape on its side. A middle aged woman sat in the drivers seat, her daughter occupying the seat behind her.
"You guys are all set," I said to the officer of Engine 3. They went back in service, I stayed with the police and talked to the mom.
"What happened?"
"A guy in a white car sideswiped me and kept on going. I called 911 from my cell phone and asked for the police. I was worried about Monique, she was sleeping in the back seat when the crash happened and didn't wake up."
I looked at Monique. Ten years old, dressed in clean hand-me downs, a little overweight and the weight of the world on her shoulders from the expression on her face.
"Are you okay?" I asked her. She shook her head, yes. She looked fine, minimal damage to the car, minimal damage to the occupants.
"We could take her to the hospital and have them do an exam if you like," I said to the mom. Monique looked at me as if I had just turned into Frankenstein's Monster. I checked my neck to see if any plugs had sprouted. Nope.
"Or, we could do some vital signs and you guys could go home."
Monique liked that idea, so did mom. Adam went to get the equipment, I sat in the back seat next to the little girl and asked a few questions. Did she know where she was. She did. Did she know what day it was. She did. Did she know who the president was. Boy, did she ever. A smile that could have lit up a coal mine turned her face from plain to beautiful.
As Adam assessed her vital signs, I told her mom, loud enough so she could hear that her daughter was absolutely adorable, and would surely break a lot of hearts as she got older. Monique's smile somehow grew.
We left them, mom and daughter feeling better about themselves than they did before the accident. At least I like to think so.
Please Allow me some self-indulgence for a minute, but these are the kind of things that let me to do this job over and over, year after year. I honestly believe that in some small way, by showing a lonely, possibly homely ten year old girl that she had her own brand of beauty that glowed when she smiled my actions have the chance of making a difference in her life. Maybe I over think things, perhaps I give myself too much credit; but I envision this girl years from now, looking in her mirror, maybe a little down, but remembering the fireman that said she was adorable and would break some hearts, and just maybe that little positive flow of energy will be enough to keep her from making poor choices that come with low self-esteem and poor body image. Maybe.
It's people like this who help me more than I help them. I need to think I actually do make a difference.
You Don't Say
Wednesday, June 03, 2009Say you are called to a private home for a person who was involved in a previous motor vehicle collision, and say that when you arrive at the address you find a man who you took to the hospital last week for severe complications from renal failure and diabetes, and say that you like this guy, whose luck and health are far worse than your own, and say that this man was in a private ambulance forty-five minutes ago, returning from a dialysis appointment, and say that the private ambulance was involved in a minor collision with a parked vehicle, and say that the ambulance crew neglected to report the incident, even though the patient stated he had been injured.
Just saying.
The Solution
Tuesday, June 02, 2009I'm running out of men twice as old as me, so the ninety-eight year old gentleman who occupied my stretcher was quite a novelty. He wasn't at all what I expected when dispatched to his assisted living facility at 0300 hrs. The call was for chest pain. I wrongly assumed I would be the one feeling most of the pain as I dragged my tired forty-seven year old body off the bunk and trudged down the stairs toward the truck. We didn't say much on the way, it's all business in the middle of the night, especially with both of us working overtime with thirty more hours to look forward to.
Our patient lives in a luxury facility, bordering the Providence River. I remember when they built the place, we were amazed at the cost, something like half a million to buy a unit, then another five grand a month to stay there. I always look at the name plates on the closed doors as we wheel the stretcher down the corridor toward the patients room, for some reason they always put them in the last room, all the way at the end of the corridor.
"We've got an emergency here, bring him to the last room. And make it snappy!"
Anyway, the names on the plates are indicative of the residents. Dr. and Mrs, Soandso. Admiral Whosit. The Honorable and Mrs. Youknowwho. Its a who's who of the upper crust of Rhode Island society.
Every now and then we pull a cranky old coot out of places like these, but for the most part the fabulously wealthy old folks who need us are polite, gracious and humble. I'm not sure if life's lessons taught them to be so, or if their demeanor had a lot to do with their success in life.
In the rescue, once all the procedures were done and we rode toward the hospital, Mr. Cohen asked me what I thought about President Obama's pick for the Supreme Court. I thought for a minute and gave him my honest reply. He grinned mischievously and agreed that the country is "in big trouble." He went on to explain how he grew up in South Providence, right off of Prairie Avenue, and how only Jews and Irish lived there then. Then he explained the division between the German and Austrian Jews and the new Jews, working class folks from Russia and Poland. I mentioned the Irish probably fit in better with the Russians and Poles.
"Half the Jewish people moved to Blackstone Boulevard, the other half stayed," he said.
"The Irish never got the memo," I replied. We just kept on working.
"Strange world," I mentioned, thankful for his historical perspective. "Everybody thinks racism is over now that Obama is in the White House, but I see some strange things. Black folks who have lived here for generations are resentful of the new African Immigrants, Dominicans don't like Peurto Ricans, Chinese don't like Koreans, it's a miracle we get anything done.
"I guess things haven't changed since I was a kid," he said. "I wonder if we'll ever figure it out."
"Me too."
I didn't want to leave on a sour note, so as we backed into the ambulance bay at the hospital I told him about the lady who called 911 because her breast were too large.
Never seen an old guy grin so wide. I guess you never get too old to think about certain things.
At three-thirty am the thought of large breasts solving the world's problems seemed almost conceivable.
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