Troy was at an Advanced Cardiac Life Support recertification class so I was working with Pat. Troy, while fun and entertaining, could also be dark, moody and unpredictable. Pat was a rock of calm. I never heard him say a bad word about anyone or anything. He was always on an even keel. He moved through the day with a quiet proficiency.
We had just dropped off a drunk at the Hartford Hospital ED when dispatch called. “I need a car to clear for a priority one. Respiratory arrest on Woodland Street.”
I was just putting the stretcher back in the ambulance, when Pat came out and said, “We’ll take it.”
“Your paperwork’s already done?” I asked.
“I did it on the way.”
Woodland was north, and it took us eight minutes of working through the morning traffic to get there.
The building was an elderly housing hi-rise. The manager led us to the apartment. We found a woman sitting in an arm chair in her bathrobe. A visiting nurse sat at the table filling out paperwork. There appeared to be no one in respiratory arrest.
“She’s a direct admit to Saint Francis,” the nurse said.
“We got the call for respiratory arrest,” I said.
“I meant distress. She has some swelling in her ankles and gets short of breath on exertion. The doctor wants her admitted for some tests.”
“Okay,” Pat said, stepping forward as he could see I was a little agitated after the drive, thinking someone wasn’t breathing. “We can do that. But since it’s a direct admit, we need to clear it through her insurance company before we can take her so she won’t get charged.”
“Oh, really?”
“It’s a paperwork thing. They pay for emergency calls, but since this isn’t going to the emergency room, it has to be cleared with the insurance.”
“I didn’t mean to cause a problem. The ambulance company told us it would be two hours.”
I imagined Troy on a similar call. “So you dialed 911?” he’d say, accusingly.
Pat was unphased.
“The doctor wants her in the hospital,” the nurse added.
“No, it’s not a problem at all. It’s just going to take a little time to get the insurance approved. By the way, my name is Pat and this is my partner Lee.”
He shook hands with the nurse and with the patient whose name was Mrs. Bierce. He got her insurance information, called dispatch and working through them, got the approval.
When we went to move the patient on to the stretcher, Pat said, “Who’s this attractive girl?” He pointed to a black and white snapshot of a girl in a bathing suit by the woman’s bed.
“Oh, that’s me, many years ago,” the woman said.
“Mrs. Bierce was a hottie, isn’t she? Lee?”
I could see the woman smiling. “Yes, she still is.”
“Oh, you boys,” she said, blushing.
“We’re just going to lift you on to our stretcher,” Pat said. “Keep your hands over your chest and let us do the work.”
“But I’m heavy.”
“Light as a ballerina,” Pat said as we moved her.
And she beamed.
I had to hand it to him. It was easy to get frustrated in the job, to drive lights and sirens through the cross town traffic only to find out the emergency wasn’t such an emergency after all, but Pat was always courteous to the patient, always making a point to introduce himself, get the patient’s name, and to use their name to make them feel more comfortable. To many paramedics, patients were hips or fevers, or TIAs or motor vehicles. If you were on the outside you might find fault with that attitude, but for many it was a coping mechanism, enabling them to do their job dispassionately, which for some meant doing it better, never letting emotion interfere with cold clinical judgement. With Pat they were always people first. And for that alone I respected him.
When we got to the hospital, the nurses, techs, docs, registrars, maintenance people – nearly everyone -- smiled on seeing Pat and said hello to him. He always moved the patient over using the sheet, rather than making them roll over themselves from our stretcher to the bed. “Light as a ballerina,” he’d say to the old women when we’d lift them across. “Hoo, someone had their breakfast,” he’d say to the men. Then always, before leaving, he’d touch them on the shoulder, wish them health and tell them they were in good hands at the hospital. When I took the stretcher back out to the ambulance to clean up, I’d find he’d already managed to clean up after himself. The house bag was restocked; the IV wrappings and latex gloves he’d used already put in the trash bucket. He was done with his run form in five minutes and we were ready to clear. There was no bitching, no dogging it, just doing his job the way the company expected.
“451, 45 Barber for the assault, PD on the way.”
I put us out as we drove into the parking lot of the apartment complex. I started to get out of the ambulance, when Pat said, “Hold up. We’ll wait for the cops.”
“Okay,” I said, a little hesitantly.
“You can’t be too careful around here. There’s a lot of weapons in this building. No sense in being a hero. It’s probably nothing, but we should wait for the cops. They said they were coming so we best believe it.”
I didn’t argue. The police were the designated first responders in the city, which meant they were supposed to go to every medical call, but we were often off the scene and en route to the hospital before they ever showed up. They were taxed to the maximum with police matters and it made little sense for them to show up at most of the calls which we could handle just fine on our own.
“A couple years ago,” Pat said, “an officer responding to a 911 hangup here, got jumped as soon as he walked in the door. He saw a woman crying, he went towards her, her husband was hiding behind the door, stabbed him in the neck and back. The cop managed to get in a radio call, and then fight the man off till help arrived. He hadn’t been so strong, he would have been dead. It could have been a medic walking in just as easy as a cop. You have to be careful.”
“I notice you and Troy don’t wear vests.”
“I think they give you a false sense of protection. My girlfriend’s after me to wear one –it’s a secret, but I think she’s getting me one for my birthday. I suppose I’ll have to wear one then. They’re hot and bulky. You really want to be safe, you should wear a crash helmet. Despite the dangers in this city, you’re still more likely to die in an ambulance crash than getting shot. I just try to be careful. I put my gloves on, most EMTs don’t, particularly the older one who should know better.”
“You’re right about that. When I started on the ambulance back in Maine, no one wore them, and it’s been hard to get in that mindset.”
“A lot of HIV in this city, a lot of Hepatitis – that’s the one you really have to be careful for. I know a medic had open cuts on his arms from doing yard work – he got splashed by body fluids when he was doing a carry down. A year later he’s out of work and on a list for a kidney transplant. A lot of ways you can get hurt in this job. My best advice is use caution, stay in shape, don’t take chances. It’s like they teach you in class -- scene safety comes first. You don’t take care of yourself, you can’t help someone else.”
When the squad cars finally arrived, we walked in with the officers. The apartment was on the second floor. We stood to the side of the door as the officer used his club to knock on the door. A woman with long stringing hair answered. She looked to be about thirty, but with some hard miles on her.
“My boyfriend smacked me,” she said. “I don’t need to go to the hospital. I just want you to bust his ass. He’s hanging out on Clay Street now I suspect.”
“Last two times we were here, in the same circumstances, you dropped charges, is that going to happen again?”
“He don’t make it up to me, let him spend the night in jail. Let him reflect on that.”
“You want EMS to look at you?”
“No, only thing he really hurt his chances of getting any more from me. Let’s go down to Clay Street, I’ll show you where he’s at.”
“We’re going to clear then,” Pat said to the cop.
The officer nodded. “Have a good one.”
“Good use of everyone’s time,” I said as we walked backed outside.
“Well, you never know what you’re going to find.”
“I guess that’s true. It’s a shame when we’re on BS and it makes us late to real calls.”
“I try to take it a call at a time.”
“What do you think about these newspaper articles?”
“It’s just a story for the paper. The problem isn’t the people on the street, the problem is the system. You can blame a private company, but we’re only out here because the city doesn’t want to pay for EMS. The police are short staffed, the schools are underfunded, the roads are a mess, the tax base is shrinking. The world’s fucked up, but you can’t write that in a news story. You’ve got to point a finger. I think we just have to keep our heads down and do our jobs, and weather the criticism. It will pass.”
That’s how Pat approached his work -- putting his head down, taking it one patient at a time. Each patient was special. He was great at eliciting what the patient was most proud of in their lives and then introducing them to the nursing staff at the hospital. “This is Mr. Irving who flew P-45 Spitfires in the war.” “This is Mrs. Tolski, from St. Petersburg, Mrs. Tolski, the countess.” “This is Mrs. Dales, if she looks familiar its because her granddaughter is the same Lady Husky you and I have watched tossing in those threes on TV, making the whole state proud.” And if someone was in pain, he was very aggressive with managing it with drugs. Anyone with a broken leg or dislocated shoulder Pat called medical control and got orders to give them morphine. He was very aggressive with pain management. It didn’t matter if it was crew change and he had plans for a date and we were five blocks from the hospital, he’d call for orders to administer morphine, even though it meant filling out paperwork for the DEA and us having to drive cross-town to the sponsor hospital to exchange narcotic kits. He took care of their pain.
His girlfriend, Allison Winters, was a triage nurse at Saint Francis. She was tall, with long red hair, beautiful and, like Pat, completely unflappable. Only twenty-seven, she commanded the same respect as the most senior nurses like Mary O’Toole. Victor and some of the other medics called her their dream wife. No one tried to hit on her, they just sat back and looked at her, did anything she asked. Even the drunks and psychos treated her with respect.
“Hey, good looking,” Pat said as we stopped by Saint Francis to pick up the narcotic kit at the pharmacy and found Allison coming back from the coffee shop.
She smiled brightly and gave him a kiss, then frowned and adjusted his collar. “Look at you,” she said. “You can’t even dress yourself.”
“I just do it so you’ll play with my shirt.”
“I’d like to play with more than that, but I’m at work.” She smiled at me now. “Hi, Lee. Keeping my man out of trouble?”
“You know it. He’s a piece of cake after Troy.”
“Troy? He’s got his devil side, but he’s not the devil. Did I say that?”
“I think you did.”
“No, I like Troy. He’s actually responsible for getting us together. Did you ever tell him the story, honey?”
Pat said, “First day she was working here, Troy bets me fifty bucks he can get her to go out with him before me. I tell her about the bet. She’s horrified but agrees to go out with me just to show him. He puts on all his charm, gets nowhere. Shot down repeatedly. So we go out for coffee and we hit it off. With Troy’s fifty bucks we go on a real date.”
“A story to tell your grandchildren.”
“We’re not there yet,” Allison said, then looked up at Pat, and jabbed him in the side with her finger.
“Patience,” Pat said, “is needed for all good things.”
“Patience, my fanny,” she said. “I have to get back to my post. Come with me. I’ve got some cookies for you.”
“I wouldn’t be waiting on that,” I said to Pat as we walked back out to the ambulance. “Not a day.”
“Troy says I have wild oats yet to sow.”
“Troy’s just jealous.”
“I don’t think Troy is capable of jealousy or if he was, he wouldn’t recognize it as anything more than unexplained unhappiness.”
“You may be right.”
