Sunrise and CISD

The Martin boys were home from college, enjoying a night out on the town. Some time around midnight, the twin brothers decided they were too drunk to drive home. They did the right thing, like their parents taught them, and called their friend and neighbor ‘Joe’ for a ride. Unfortunately, Joe was also too drunk to drive and too drunk to know it.

The intersection had a stop sign. The street approaching it was a 25 MPH zone. The intersection sloped upward, creating a ski jump shape. Joe was a local boy and knew all of this. The accident investigation would reveal Joe’s car was going almost 60 MPH when it left the ground.Continue reading “Sunrise and CISD”

Emergency Medical Weather

We have a term to describe certain EMTs and Paramedics at work: White Cloud. A White Cloud is a crew member who never has anything critical happen around him. This is not to say big things don’t happen when a White Cloud is on duty, but he/she will be busy helping Mrs. Smith off the floor and back into bed when they do. It’s nothing deliberate, but through some strange quirk of probability nothing bad happens when a White Cloud is responsible.


Conversely, we also have Black Clouds. Death, destruction, and general mayhem seem to follow our Black Clouds whether on duty in the Big City or the Quiet Suburbs.


I know it’s all probability and not real, but we can be a superstitious bunch. It’s not that we want bad things to happen, but we train hard to be ready when they do. We need to use our skills now and then so that we stay sharp.


Regular Partner and I had developed a reputation as White Clouds. We had been working together exclusively for almost 8 months, so we weren’t sure which one of us was the good luck charm. We’d started off with a bang, having two major notable incidents during our first month together. Then six months of nothing.


We’d been doing minor chest pain calls, old ladies fallen out of bed, drunks, car crashes with no injuries; we had awakened a couple diabetics. I think we went almost 4 months before we had to put anyone on a backboard. We were beginning to get jumpy, feeling that God or karma or probability or whatever was saving up a Really Big One for us. The proverbial ‘bus full of hemophiliac nuns crashes into a plate glass truck’ kind of call.


Then it happened. RP got married and left on his honeymoon.


In the first 4 hours of my first shift without RP, Partner du Jour and I ran a cardiac arrest and an unresponsive with almost no blood pressure. We capped the evening with a pedestrian struck by a car.


So RP, enjoy your honeymoon. You should have plenty of good weather with you.

Edit: Before RP got back, we added an MVC with ejection, a STEMI, an aortic dissection, a CHF patient, and a few more which I don’t remember right now.


Ambulance 87, take the response. Maplewood Nursing*, on the second, for shortness of breath.”

Patrick* and I worked every Tuesday together and had become good friends. He was about my height, but maybe 30% bigger, and he liked to play hockey in his spare time. We lit up and responded out to the Maplewood.

Normally the Maplewood is an easy place to get in. They are more concerned about the residents getting out. We simply push the alarm-disable button outside and then walk right in. Getting out requires entering a code at an alarm panel, but the code is posted next to the keypad. I guess the theory is that the dementia patients won’t notice it.

All that changes at 8:00 PM. They lock the doors, and you have to use the intercom to get in.

We rang the bell as always. One of the night staff came to the door. I’ll be charitable and say she didn’t speak English as a first language. I’m not sure she spoke English at all. She stared at us, and cocked her head. Two men in uniforms with EMT patches on their sleeves, stretcher, portable oxygen tank, ambulance in the driveway still blinking its lights. Whatever could these guys want?

Patrick yelled through the door: “Let us in!”

She paused, looked at the keypad, and then punched the first number. <BEEP> She looked back at us for a minute. Second digit. <BEEP> Look, pause, <BEEP>. Look, pause, <BEEP>. The whole time, Patrick was yelling, “Just open the door, we can do the alarm,” and pointing to our button.

She punched the numbers so slowly, the system had forgotten the first one by the time she reached the end. She frowned at the keypad, stared at us for a few seconds, and started again. <BEEP>. Look, pause, <BEEP>. Same result.

Patrick was starting to get red. “Just open the damn door!”

She took one more look at us, and walked away.

A minute later a fellow employee arrived. Same language handicap, same lack of a clue, same result.

By now Patrick was livid. He was jumping up and down, pointing at the crash bar, and screaming, “Just open the F***ING door!” I thought he was about to break through the glass with his bare hands. She finally got the hint and pushed the emergency exit bar, but she stood in the doorway blocking our way. Patrick and I stormed in. He checked her out of the way, and we started for the elevator at a trot.

The offended employee ran after us, shouting, “Lucy! Loooooocy!” I have no idea what she wanted, but as the elevator doors closed I looked at Patrick and in my best Ricky-Riccardo accent said, “You got some ‘splainin’ to do.” We both cracked up laughing.

When the doors opened on the second floor, we could hear Mrs. Jones* struggling to breathe. We stopped giggling and went immediately to work. She’d been in severe distress the whole time we’d been negotiating the back door. Five precious minutes wasted because these folks couldn’t understand why an ambulance crew would want to get into a nursing home!


The room is dark and quiet. The other three patients stir in their corners, startled by our raucous arrival among them. They quickly settle, realizing as we make our way to the fourth bed that it is not their time.

Our patient starts awake as we approach. He is small and frail, a mere shadow with physical form. He looks at me with fearful eyes, and recoils when I touch his arm. The staff member says they called because he was hypotensive, but she cannot provide any more information. She hands a stack of papers to my partner.

Demographic sheet, valid Do Not Resuscitate orders, list of medications, and a notation that the patient has dementia.

The patient shows signs of dehydration; the staff admits that he hasn’t been eating or drinking well lately. I prepare to give him IV fluids, and I explain each step of the process. The patient returns a blank, interested stare, like a dog listening to its master.

When the needle penetrates the skin of his arm, he screams out; whether from pain or fear I cannot know. “Mommy! Help me!” We speak soft soothing words, calming him again.

Downstairs in the ambulance, he begins to communicate with me. He asks me where we are going and why. I explain, and he seems to comprehend. For ten seconds. “Mommy! Where are you, Mommy?” I explain again, and again, and again; he seems to understand for a few seconds.

“Mommy! Mommy! Please help me.”

I try a different tack, gently touching his shoulder and asking him where his Mom is.

His eyes focus on me for a second. “She’s dead. Why?”

My heart breaks a little more.


All is peaceful. The only sound is the whir of the Coke machine. A window pane rattles as the wind buffets one of the six garage doors. Suddenly, a klaxon blares out. There is a loud CLANG-CLANG-CLANG as the alarm sounds. All across town, men are awakened to the insistent BEEP BEEP of pagers.

All is again quiet in the building. After a few moments, there comes the thud and scrape of the first sleepy man trying to unlock the door. The building is filled with the sound of recently-awakened men stumbling inside. The air is filled with an urgent purpose, accompanied by the clomp of ill-fitting boots and the swish of fire-resistant coats.

There is the click of a switch, and the interior of the building is illuminated by flashing red and white lights. If anyone were listening, he would hear the soft whir of rotating beacons and the protesting ‘pwee-pwee’ of strobe lights, cold from days of non-use. No one is listening.

The walls of the building shake as the great, twelve-foot wide doors rumble up out of the way, and the air is filled with the clamor of “Low Oil” warning bells. With a ferocious roar, the Diesels come alive. The hiss of air brakes is the last sound to be heard before the scream of the siren drowns out all else. The deep bass of the air horn is added to the cacophony, as the trucks disappear down the street in a cloud of black smoke.

Eventually the sirens and horns fade away, and all is peaceful again. The building is left to itself, with only the few leaves blown through the open doors and a lingering smell of Diesel fuel to indicate that anyone has passed this way.

The preceding was written in a college creative writing course in 1989. The assignment was to describe a scene or place using a different sense than one would expect. It has always been one of my favorite creations and is presented here on the theory that Google Never Forgets.

3 A.M.

0300 hours exactly. The call is for a possible allergic reaction. The firemen are already rolling their eyes as we arrive.

I’m greeted by a woman with a history of diabetic neuropathy, with attendant foot pain. She tells me she had a cortisone shot in her knee at 1000 the previous day, and she’s afraid she’s having a reaction to it now. 17 hours later. Because her foot hurts.

Umm, yeah. (*sigh*) Just get in the ambulance. I’m not going to argue about it now; I can write the report and be back in bed by 0400.

Captain Mike

Twice the patient had called EMS, both times with a very serious complaint. When we arrived, both times, we found the patient had been drinking and wanted to go to the hospital for detox. He admitted in private that his more serious complaint was fabricated in an attempt to get a faster response. I would probably be annoyed, but something about the man reminded me of an old friend.

Captain Mike was an interesting character. When I knew him he lived his life alone in an old New England port city. ‘Captain’ was not merely a nickname; Mike was a real ship’s captain who had sailed all over the world. He had lived through a mutiny and spent most of his time on shore now.

In some ways Mike fit the stereotype of a sailor: he was a hard-drinking, functional alcoholic who lived with injuries sustained in his mutiny and with the scourge of diabetes. He wasn’t the old, grizzled, vulgar sea-captain of lore, though. He was a genuinely nice guy with lots of friends.

Almost 10 years ago now, we were saddened to learn that Captain Mike’s lifestyle had caught up with him. Drink and diabetes don’t mix. Mike had slipped into a coma and suffered alone for days before his body couldn’t survive any longer. Friends eventually found him in his apartment, but it was too late.

So Mike, here’s to you. You didn’t think you’d be doing good deeds on the mean streets of another city, all these years later, did you? Today you helped me see past the alcohol to a man’s soul. Hopefully we made a difference.