Tuesday, April 15, 2008

Random Thoughts

These are few of the random thoughts I have written down over the years. I have not changed them since I wrote them over twenty years ago. 


The Street is always just below the surface. Scratch me and I bleed a story. 

There is a rhythm to the street. After a while you can tell with it is going to be a busy day. (Written on the back of a old set of standing orders sitting in the jump seat of Engine 10 on a busy day I had felt coming).

I’ve had babies die in my arms and some who lived who I wished had died, after the mess we left them in. I’ve had it come out bad so much of the time that I am always surprised and happy when it all works. When everything somehow falls into place. Not much like the TV shows.

It is difficult to understand how something that effects you so profoundly can be thought of as so trivial. That a meeting of the County Commissioners holds more important than what you had seen and what you had gone through and is front page news. While someone's tragic death is buried on page ten. 

We make people nervous. When they see our little equipment laden safari moving through their office or a restaurant, they always smile and make some sort of nervous joke about us. As if they the only way to deal with something going wrong is to minimize it. “Nothing serious”, they say as we leave so they can be reassured. And when something does go very wrong they ignore what is going on altogether. I worked a code in a restaurant once. We were in the middle of the floor. People around us continued to eat, as if ignoring what is going on will make it go away. 

Friday, April 11, 2008

You Never Know When you Might Make a Difference

I was traveling at the time. Traveling is being used to fill in where ever someone is out sick or on vacation. I was riding with Gary out of Station 6. We got a call to a man cut. Nothing more just a man cut. We arrived to find a well taken care of small middle class home. A mother and a son lived there alone. The son was in his twenties and had a debilitating disease. He was constantly in pain and the disease was slowing eating away at his body and his life. Out of frustration during an argument with his mother he had put his fist through a window. No big deal here just a laceration that I quickly bandaged. 


But as I bandaged his wound, Gary and I listened to them talk. He and his mother had been arguing over something trivial and he had exploded. As they talked it became clear that he was angry at his disease and not his mother. Here was a young man in his twenties watching his life slowly being taken from him. He would have no girlfriends. He would not hang out with his buddies at the bar. It would not be long before he would be confined to wheelchair. He could see all of this life around him. He could see the pretty young women. He could see the young men with the life he wanted, but was not going to have and he could do nothing but watch. 

As he talked it startled me because for the first time I saw life through eyes of someone who only wanted a simple normal life, yet was never going to have one. To see it so close yet not to be able to have it. I was not sure I would not be putting my fist through windows if I were in his shoes. 

Gary and I where old hands at the time. We both were had become paramedics early and had close to fifteen years on at that time. We had survived the busy trucks and were still medics. If we had had this run years before we might have just bandaged the guy up and left. Just a couple of tough guy medics who had their armor on. Nothing got to us. On to the next one. But we had survived that stage and this time without saying a word between us, we began to talk to them. His mother only wanted to help him through his pain. He only had his mother to lash out at in his frustration. He was punishing the only person in the world who was trying to help him. 

The son did not want to go to the hospital. Gary and I knew if he went they could see a social worker at the hospital they might be able to help them. I talked to the son and he talked to the mother. After a few minutes we were able to convince the son to let his mother take him to the hospital. They loaded up and drove off. Gary and I got back on the truck and went back to the station. Nothing to it. Just another social work call. Gary and I had been to thousands of them over the years. Not what we were trained to do, nor were we trying or wanting to be social workers. We were just trying to "clean it up" so we would not have to come back. I traveled to another station the next shift day and did not think about it again until Gary called me a few weeks later. 

Gary had a call and was returning to the station in the rescue when the mother flagged them down. She was thrilled when she saw it was Gary on the truck. She wanted to thank him for what we had done for them that night. When they went to the hospital they had seen the social worker. They had been referred to a consular and were getting help. She told Gary that we had changed their lives. Her son was more at peace with his disease and no longer had outbursts. She had someone she could talk to her about her own issues with helping her son. They now had someone to help them and it was working. 

Changed their lives. That still rings through me when I thing about it. At the time we had both seen enough to be as cynical as anyone. We had seen it all between us, but for whatever the reason that night we put our cynicism aside and simply talked to a couple of people and it changed their lives. You just never know. 

Friday, April 4, 2008

The Little Ones

 

            When I remember the street now, I always remember it at night, as if that were the only time there ever was on the street. The only time when things would happen to people, and I would have to pick up the pieces. But not just night, but middle of the night, that 3 in morning time when only the cops, the drunks and us are left to prowl around in some kind of three way dance, the kind of dance that leaves people lying in the gutter bleeding. My partner and I are heading back to the station after the 20th call since we had come on duty at 8 am the morning before. Not one of the calls serious, just another long shift filled with sick lame and lazy. The kind of shift that makes you question why you are a paramedic. Where are the people that need the saving, the world seems to be made up drunks and squirrels who think that calling the fire department will solve almost any real or imagined medical or personal problem.

            Just another night on Rescue 1 where your life seems to shift into fast-forward the moment you step on the truck in the morning. The experiences move by so fast, as you race from run to run, you could almost put your hand out the window let it surf through the them as they rush past. Like you did when you were a kid and used to stick your hand out of the window of the car as your parents drove home at night.

With the first run of the morning to the last run you just finished you get the same adrenaline shot each time. So by 3 in the morning the twenty or so adrenaline rushes leaves you exhausted and used up. You lean against the door of the Rescue, feeling as if you did lean against something to prop yourself up, you would fall over and go to sleep. It is as if someone presses the button on your life and the fast forward drops into standard play.

Suddenly in the Florida heat your uniform is damp and sticks you from the constant sweat of driving the streets of a Central Florida town with no air conditioning. Add to the mix lots of left over stress, that combines into this tired buzz, and you have truly unique physical feeling.  Your head is fuzzy and aches, your stomach trying to eats it’s way out after the 20 hours on duty and  adrenaline rushes have emptied your tank of anything you ate today or yesterday. The only lights are the bronze halogen streetlights that cast an eerie light that is somehow depressing. Your eyes feel as if someone has put a whole sand box under them each time you blink. All you want to do in the world is to lie down and go to sleep for just an uninterrupted hour. Just one silent quite hour.  Then through all of the fatigue, physical discomfort and just plain I don’t want to do this the radio in the truck blares.

            “Rescue 1 can you take another call.”

            You want to run screaming away from that radio to get away from another run, but you pick up the mike and say “Check”.

            “Unknown illness to a child. 1492 Paramore.”

            “Rescue 1 responding.”

            Through all the fatigue you flip on the lights and turn on the siren and head for the address. The box lights reflect off the windows of the stores and buildings of downtown as you head for the wrong side of things. Where you are the doctor to those that do not have the money or insurance for real doctors. It almost seems too melodramatic, red lights flashing on this night as the truck rushes through the empty streets.

When we turned on Amelia and went under the Interstate it was as if we had entered another reality one where you could almost taste the hopelessness, the anger and the frustration of these people who were so close to the money yet so far away. If any sense could capture the feeling of the poverty it was the sense of smell.  It is the reek of garbage in all the dimly lit hallways and outside on the dirt yards or the stench of urine in all back upped toilets. Poverty stinks and it can get in your nostrils and under your skin so even when you go home in the morning it ground into your so won’t come out.

            We find the address in front of a small two story apartment building. No lights are on, and everything seems locked up tight.  We cross the grey dirt strewn with beer cans and trash and walk up to the second story of the apartment on the concrete stairs. When we reach the apartment we each stand on either side of the door. You never stand in front of a door, you never know who is on the other side.

            “Fire Department. Did someone call?” I yell as I knock on the door.

            A girl immediately opens the door. She is somewhere in her late teens. She is holding a crying baby in her arms. A look of real concern is on her face.

            “What seems to be the problem?” I asked.

            “He’s running fever and coughing. I..”

            She handed me the baby and I looked down at him, I was immediately reminded of my own son at home. He felt exactly the same in my arms. The baby was hot to the touch, but not anymore than my own son the last time he ran a fever. We examined him and it looked as if the worst thing he had was a cold.

            “He’s fine. Looks like he has a cold. Do you have any Tylenol? It would make him sleep better tonight and you could take him to the doctor tomorrow?”

            “I don’t have any Tylenol?” her voice and the look on her face showed real fear.

            The concern and fear in her face let me know that what was really happening as much as anything. Here was a young girl all-alone with her first child and no one to go the drug store to get the Tylenol. She was out on a limb doing the best she could taking care of the baby by herself and had run out of energy dealing with the baby and herself. She needed some help. The apartment was clean and well furnished. It was obvious she was doing a good job no matter what her support system was day to day.

            “Look he is going to be fine he just need some Tylenol and some antibiotics. Do you want to go to the hospital with him?”

            “What do you think?”

            “Yes, I think that would be a good idea. We have an ambulance on the way do you want to go by ambulance?”

            “Yes. Yes I do.” the relief on her face was enormous. She just needed someone to help her solve a problem that had gotten too big for her to solve alone.

            As I stood there with the crying baby I could feel the relief in her as she gathered things for her diaper bag she would take to the hospital. She had the support she needed, it did not matter that it had came in a red rescue truck, she had someone to ask what to do and then they had the means to solve her problem. Not a big problem in scheme of things, but it was everything to her. When the ambulance arrived we walked her out to the rig and helped her into the back. It was not the type of problem the system was designed to handle, but it was the type of problem we faced daily. I resented these calls back then, because they took so much from you when you so little left in your tank. I was so tired and so ground down I would miss the meaning of them much of the time. But not this time, this time it stuck. No great skill needed or some show off medical decision-making, it took no special training just a willingness to help. It strange because now those are the ones that come to mind first when I think of the street now twenty-six years later.

The little ones that I thought I would forget as the big one piled on top, but its the little ones that come back. Only through years on the Street did I realize that maybe these have as lasting impression as the big ones. There were a lot more of these than the big ones, maybe why this one and the other little one stuck in the memory is the genuine appreciation for the help that was so apparent. With so many of the others the scenes were filled with anger at the system, resentment the of authority you represented, or frightening abdication of personal responsibility for even the most basic human survival skills, it was hard to glean out the fact that they did needed your help. So when these pure crystal clear moments happened they stand out through it all. The street does give back to you, but it buries them under the bad ones, the drunks, and the crazies, so if you are not paying close attention you loose them in all of the bullshit calls.

 

Wednesday, April 2, 2008

I am Writing this to Remember

I am writing this to remember, to understand, to document things, the things that I did and the things that others did. It is about the war we fought. Not in some far off country but in our hometown. It is about a war that is fought everyday in every hometown by men and women just like me. It is like the Stineyman said one day.

We were at some kind of training, a bunch of paramedics punching out some training requirement ticket between real runs. I don’t remember what the training or how our conversation got on the topic, but Stineyman summed it up best I ever heard.  Steiner was a big rambling bear of a man who moved with the grace of a natural athlete. He used to make bets that could out run much smaller and slimmer men at a local track. He usually won. Anyway in the midst of this training he said “we fight death when we come to work.” That was the truth.

We came to work to fight it. To fight it when we were new and young and thought we would save them all. We fought death when we were older, wiser and more experienced and knew we only save a few. We fought death when it did not seem we would ever save anyone again. We fought death when we finally understood that the point was not how many you saved but that you fought the fight. That you went to work and did what you did because that is what mattered and that is all that mattered. You continued the fight because that is what you did. The saving or not saving did not matter as much as showing up and doing it the best you could.

You did it day after day, week after week, month after month, year after year, decade after decade until you looked up and you could see the end of things. Retirement. You could feel the end in your knees as they ached and hurt most days. You feel the end was near in your back where it would hurt in exactly the place it used to kill you after working CPR for a long time. You felt the end in your should where you tore your rotator cup when you dislocated your shoulder years before throwing a ladder. You felt the end was near, when a partner dropped dead of cardiac at home one day after coming home from his second job. You could see the end was near when other guys quit, retired out with injuries, like Larry, Ray or DJ with wires in his back because they could not stop the pain any other way. You knew the end was near when you saw younger men and women come and go long before their time. But the fight continued. You still climbed onto the red trucks and fought the fight. It is a war with no end, no truce, and no sympathy. People continued to die not naturally but stupidly or carelessly and it was up to you to pick up the pieces. To fight the fight.

You finally after decades began to get some perspective, some wisdom from all the pain and suffering. You begin to under stand your role in a lot of the tragedies. It had been what you signed up for all of those many years ago whether you understood it or not. You became part of something few understood. As the end neared you wondered. Wondered if had been a good fight. If it had been worth it. If all that you saw and did really mattered or were like Stineyman in his races running in a circle real fast to show off.

Then you are sitting at a desk one day and it is 9/11. You watch the towers fall. You know that are hundreds of firefighters in those towers and you feel this huge rush of sadness. It had been a huge tragedy when six guys were killed in Massachusetts. This was so much bigger you could not get your mind around it. Maybe a hundred guys.  Then you heard the first reports of two hundred guys. Two hundred guys like me. Then three hundred and finally the number reaches 343. Three hundred forty three guys. Jesus. Then the sadness is replaced by pride. Pride to even be in the same profession as these guys. Guys who responded when the bell went off. No other priorities, no other goals. It was their job and they had signed on. To even be a part of a profession that produced such men was suddenly a source of huge pride. They were not extraordinary men, they were ordinary men who did an extraordinary thing. That is what made what they did so significant. Ordinary men called to an extraordinary thing and to a man stepping up and doing it.

They were just firefighters who went to work to fight death. That day they saved thousands as they died. In their death they made you realize just what you and all the others had done. Why the fight was important even in the small tragedies you saw every day. They made you proud of what you had done. They gave to you something that had gotten lost. They gave you understanding.

There were guys on their last shift and they went. They were guys on their first shift and they went. There were guys who called home to tell they families they loved before they went. There were guys who left notes to their families and they went. They went knowing that there was a good chance they were not coming back. They went because it was their job and if you signed up then you did the deed. No raise if you went. No bonuses. They went because they were there to fight death. To fight the fight, no matter what. And because they went they gave back to you something that had been lost, something that you needed back.

We all did it for our own reasons. But to me they gave me back why I had done it. And in so doing they gave back to me the smoking baby, the man with no arms, the drownings, the cardiacs, the accident with injuries, the shootings, the stabbing, the fires and all the rest with perspective. I had done it to fight the fight, day after day, month after month, year after year, decade after decade. No more and no less than that, to be there when someone called. To stand with men and women who no matter what, went when the bell hit. That was something. That mattered. And that is all that mattered.