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Paramedics from Hell 20
From : Tae Kim 31 Oct 95
Subj : Paramedics from Hell 20
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Subject: Hot, humid, bloody
Fitchburg, Massachusetts.
The 'hilliest' city in the United States - sorry San Francisco. You want
hills - Fitchburg's got 'em. Another mill town victim of the
post-industrial textile decline and the lack of major highway access.
How sad. <snicker>
My tour starts off with the usual diff breathers and heroin overdoses.
Not much to 'em, really. The hot, humid summer night, with no breeze to
speak of, is usually an indicator of multiple responses for asthmatics,
and people with chronic bronchitis and emphysema. We arrive usually to
find some variation of the same theme: elderly, overweight - the women
wearing faded pink polyester house coats with food stains of various
ages; the men wearing undershirts gone grey with concentric circles of
dried and re-dried sweat-stains radiating from their arm-pits.
You find them sitting in the kitchen or the living room, hunkered over
rusty card-tables, using all their chest and _neck_ muscles to draw in a
deeper breath. The floor is littered with empty medication inhalers,
greasy paper plates, cups, newspapers. Every cup and dish in the place
is filled-to-overflowing with cigarette butts. Most of the time, if they
have cats, they have _many_ cats. I once started counting the number of
cats in a woman's apartment, and stopped at ten. The place was literally
_crawling_ with cats. With so many cats, it gets to be kind of a pain to
change the litter-box. So the cats shit all over the floor, and a new
layer of newspaper gets placed on top of the old. Ever enter an
apartment with a floor that's uneven and lumpy - and 'squishes' when
you walk over it? Take my advice: don't lift up the edge of the
newspaper - you won't have to pay for lunch again. But I digress.
They've usually run out of their medication, or are sucking the last
puffs of it from their inhaler like it was goddamn mother's milk.
Everyone's sweating like crazy - me and my partner, 'cause our uniform's
made of the same shit as Saran Wrap, the firefighters, 'cause they're
too fucking stupid to take off their turn-out coats, the patient, 'cause
it maximizes their 'digusto quotient' and makes my job that much more
*pleasant*.
Tea and crumpets? I think not.
Trying to put cardiac monitor electrodes on wet skin simply doesn't
happen. The damn things always seem to slip off at the worst times.
Using tincture of benzoin - which makes even wet skin sticky, works some
of time. But sometimes the 'trode will come off anyway - with a nice
layer of dead, grey, benzoin-coated skin. Next bright idea?
We give up trying to get a decent tracing - it's just not worth it.
'Sides, that abberrant cardiac rhythm we briefly saw was there before we
were born. We hope.
Give 'em a little oxygen, start an IV, and administer a nebulized
bronchodilator, and they're good to go.
'Needle and 'neb - that's all we do.
The heroin overdoses are pretty much the same: some guy in a back-alley,
or in some flop-house, found unconscious with his 'works' in a sloppy
pile next to him. Some people get pretty fancy with their 'works' - bent
spoon with a lighter taped to the handle, etc, but most people
eventually get too fucked-up to care. Your standard 'works' assortment:
- bent spoon
- disposable lighter
- alcohol swab
- insulin syringe
Once I had a guy come up to me and ask me for a 'clean needle' - 'cause
his was 'dirty'. Where are we - in fucking Amsterdam? So, I take his
tiny, little insulin needle, reach into my equipment bag, and pull out
the longest, biggest needle I could find - four inches long and about
the thickness of a pencil-lead, and give it to him. Hey, what the fuck -
it was sterile. But again, I digress.
It's the same old story: you show up and and there's some guy with
pinpoint pupils snoring away. You note the scarred criss-cross of veins
on each arm - hardened and dark from the caustic injections and site
infections, and count yourself lucky if you find some tiny vein between
his thumb and forefinger. You start an IV; and before you 'push' the
meds through the IV to reverse the overdose, you give a coupla' mgs of
the stuff intramuscularly. Otherwise, if you push the IV meds first,
you'll end up wrestling with the guy to give him the shot in the arm -
all the while denying he took anything; that he isn't a heroin user;
that yeah - sometimes he passes out in back-alleys and pisses himself
for no apparent reason - what the fuck's it to 'ya? He denies that
that's *his* bent spoon and needle that you're dumping into a bio-hazard
box; all the while looking at it longingly as you close the cover. The
scarred veins? 'Old accident.' Sure, pal. I've heard it all. Just shut
the fuck up.
That was the extent of it for most of the evening. That is, until we got
a call for a 'suicide attempt with a knife'.
All the way to the call, my partner and I bitch about the heat, the
paperwork that's piling up, the lack of a decent air conditioner, the
heat. We arrive just after the fire department. Several police cruisers
are parked outside of an apartment complex. We walk towards several cops
standing near their cruisers. The sergeant looks over and sees us - he
tells us that some guy slashed his own arm and was bleeding heavily.
I turn to the entrance of the apartment building, and notice a large,
congealing puddle of blood on the front steps. No patient.
"Sarge - where's the patient?" I ask.
"He's still up in his apartment."
"Did someone notice him walking around outside and call you guys?"
"Nah - he called it in himself - fucking pussy."
"Uh, so if he never left his apartment, why is there a big puddle of
blood _outside_?"
The cop just points to the third floor - and I see a man holding his arm
outside an apartment window. I look carefully at the puddle on the first
floor - every so often drops of blood fall from the man's arm and lands
in the puddle. I now see that the outer edges of the blood puddle are
darker and congealed; while the center of the puddle is brighter and
still liquid. Silly me, what was I thinking?
The walk up three flights of stairs is slow and tiring. At every
landing, apartment doors are slightly ajar; with eyes peering out. The
smell of paella; the sound of blaring TV sets; crying babies; the
occasional screaming-match - all from behind these doors. When I reach
the third floor, I am *completely* drenched in sweat. The tight weave of
the polyester monkey-suit I wear doesn't permit my sweat to evaporate,
so I stew in my own juices. I can actually feel beads of sweat running
down my leg - only to be absorbed by my socks. It's too damn hot.
I make my way to the right apartment by following the crackle of
portable radios. I enter the apartment - several cops are milling
inside, all talking about their pending divorces. I recognize a couple
of them, and nod as I make my way past them and into the bedroom where
someone is shouting incoherently. My guess is that's the patient.
There's the guy alright - still holding his arm out the window. Still
bleeding like crazy. I pause a moment to take in the entire room: cheesy
brown carpet littered with long-empty bottles of beer - again filled
with cigarette butts and an almost-black liquid slurry of ashes and flat
beer. There's an equally impressive-sized puddle of blood in the middle
of the carpet. The walls have blood spattered over them in lazy
horizontal lines - as if the guy had stood in the center of the room,
held his bleeding arm out, and spun around in a circle several times.
The most impressive thing was the mirror over the headboard of the bed.
A large, rectangular mirror, with the words "My girlfriend's a fucking
whore. I hate her," - presumably written by the man by dipping his
fingers in his own blood and smearing it on the mirror. Correct spelling
and punctuation - I'm impressed.
Finally, I walk over to the man - who's still shouting something about
his girlfriend, and tell him to shut the fuck up so I can look at his
arm. He thrusts his almost entirely red arm towards me, forcefully
enough for several drops of blood to spatter on my shoe, as if he were
proud of his achievement. Looking at the wound, I must say _I_ was
impressed: a clean, four-inch cut _across_ the bend of his arm. It
looked pretty deep, too, as I could clearly see layers of fat and tendon
in the wound. From the elbow down, his arm was paler than the rest of
him. I felt his hand - cool to the touch. No circulation.
I tried to stauch the flow of blood by taking a large piece of gauze and
pressing down _hard_ over the wound. Within seconds the white gauze
turned red and was soaked through. Time to get creative. Pulling a
blood-pressure cuff from my bag, I first place several more layers of
gauze over the wound, then wrapped the cuff over that. I inflated the
cuff until the needle of the pressure gauge almost reached the 300 mm Hg
mark. It slowed the bleeding a bit - but not by much. Time to go.
"My fucking girlfriend - this'll show her," he told me; his speech
slurred with booze and blood-loss.
"Uh - what?" I asked, trying to navigate him from the bedroom into the
living room.
"I did this to punish _her_, man. She fucked around on me."
"Okay, I see, you're punishing her, but you're the one that's bleeding.
Hmm."
"She'll think twice about doing that to me again, man."
The logic escapes me.
As we passed through the living room, I glanced into kitchen, and saw a
stringy-looking woman smoking a cigarette while talking in tired, hushed
tones to a cop. As we passed-by, she gave a quick glance to the man, who
was still obviously proud of what he'd accomplished. Her eyes showed no
concern for him; only a relief that he was finally leaving the
apartment.
I led him down the stairs to the waiting ambulance, where my partner had
already set up two IV's. We started both of them, and I was working on
a third, when we pulled into the hospital ambulance bay. We wheeled him
into one of the trauma rooms. A surgeon came in to examine the wound.
After removing the cuff, the layers of gauze were peeled back. It began
to bleed freely again - this time a translucent pink flow emerged.
"Shit, this guy has more saline than blood in him. Type and cross a
couple of units for him - stat."
I walked out into the humid night, to help my partner restock the
ambulance. The back of the ambulance was a mess - bloody gauze, gloves,
towels. The floor of the ambulance had zig-zagged line of blood; each
change in direction an indicator of a left or right turn. Shit.
"You know what?" my partner asked.
"No, tell me."
"We could really use a working air conditioner back here."
"I hear that."
After calling in-service, we drove to the Dairy Queen to get
raspberry-lime rickeys. God, the line was long...
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| Tae Hyong Kim, [email protected], [email protected] |
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| Paramedic '90 - Present, Tax Evader '91 - '93, Mr. Alt.Tasteless '94 |
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