Three Lives

 The heroin epidemic continues unabated in Hartford. I called the time on two fatal overdoses in a recent week. Both men were in their 40's. One was in a low-rate motel. He sat by the window in his breeze-less room, the curtains pulled just enough so he could see the cars rolling past on the highway. His head had rolled back, his mouth open when he died. He was riggored in his chair, surrounded by half unpacked moving cartons that held his tattered belongings. The room was dirty. The TV showed footage of the Dallas shootings. The ashtrays overflowed with butts. There were scattered glassine envelopes with a monkey stamped on them. The other man was in the guest bedroom of a small apartment where he was staying with his sister and her four year old son. He lay back on the neatly made bed, his feet on the floor, his eyes staring at the ceiling, his skin cold and grayish blue. On the bureau was his prescription for Buprenorphine. His sister said he had been clean for three months. She and her son had spent the night at her mother's and returned in the morning to find him there.

The next day, I did a third overdose. A man spotted down an embankment in the bushes of a city park, across the street from a shopping area where I have treated multiple overdoses in the past. The fire department carried him up through the thickets to the sidewalk path, where we worked on him. He was apneic, but still had a pulse. 2 mgs up Narcan up the nares. While we waited for him to begin breathing on his own again, I bagged him. As I held a tight seal, and steadily squeezed the bag, I looked down on the park and could see the public swimming pool. It is one of the rare fifty yard pools in the country. It was in the 90's that day and the blue water was very inviting. Sometimes in the summer, I take my lunch break from my coordinator job and go to that same pool and swim laps. The water is cold and clear as I glide through it. When I am done, I lie for a few minutes on a towel and feel the sun on my skin and gaze up at the robin egg blue sky. Sometimes a community group comes and they splash and play under the eyes of the councilors and the city lifeguards. When I was a child I lived at the pool in the summer. Most of the mothers of my friends were stay home moms like mine, their job to ferry the kids around. My childhood was idyllic. While I have had my share of sorrow and heartbreaks in life, I have never had a feeling that no cared about me. The three lives I mentioned, one white, one black, one Hispanic could have come from any background. I don't know if they were rich or poor, from broken childhood home or not. All I know if that at some point they lost their way. Whether they got into the drug by getting hooked on prescription opiates following an injury, or through recreational use or to escape sadness, it does not matter. A highway motel. A guest bedroom. A city park. I do not believe that no one loved them, that there was not the possibility of renewal ahead for them. The one survivor denied that he used heroin when he finally came around. A firefighter told him to be honest with us. He had been near death and had his life saved. Had someone not seen him, and the firefighters not gone down into the thickets on ground with scattered human feces, and carried him up where we gave him narcan and breathed for him until he could breathe again on his own, he would have died. The man bowed his head and said nothing. I saw him staring at his swollen and pocked AC in the crook of left elbow. Most of his veins were pristine. He was new to the struggle.

Cat Burglar

One of my greatest joys on the job is the opportunity to play cat burglar. By this I do not mean the opportunity to break into homes to steal jewelry and works of art. I am talking about the chance to break into homes to rescue people (with police permission).

The person has fallen and can’t get up or, perhaps, it is a medical alarm, and no one knows if there is a person in distress or merely a false activation. We arrive on scene. All the doors are locked and there is no key under the flowerpot (almost as good as doing a second story entry is being the guy who finds the key under the flowerpot. Brilliant!).

I have broken into dozens of homes over the years. I consider myself a top tier cat burglar second story man. My three advantages are: 1) my height(and thinness), 2) my ability to lift myself up with my arms, and 3) my quickness to volunteer. After a boost from my partner or a police officer, I usually go in head first, my legs high in the air, providing a chuckle for the earth bound. I hit with arms extended to soften the landing, do a wheelbarrow crawl until my legs are in, then stand and commence the search. As Mighty Mouse used to sing: Here I Come to Save the Day!!!!

Many times no one is home. Often the person is on the ground by the bed. Occasionally, they are dead. Once I thought a man was dead. He was in a chair, his back to me as he watched TV, completely motionlessness and heedless of my call and all the banging and knocking that had preceded the window entry. Turns out he was just hard of hearing.

I have landed near a Scottish terrier and a dachshund. Fortunately, I have never landed in the same room as a rottweiler -- one of the hazards of being a second story man. I was on scene once where a police officer insisted he go in first. He landed on a sleeping cat, who awoke with a screech. Better him than me. It also turned out we were at the wrong house. The correct address was across the street. Whoops.

Ten years ago in a blog post,The Juice, I wrote:

My cold is still lingering, although I might say I am feeling a little better. Still after three back to back calls yesterday, I was getting tired of lugging my gear and lifting people. Everything seems heavier than it should be when you aren’t feeling 100%. I hate standing at the top of the stairs feeling my heart pound, my breathing quicker.

On our last call, when we got there the cops were still trying to get into the house. I saw that a window screen was just barely open, so I climbed out on a ledge and jimmied it open, then I passed the flower pots that were on the window sill to a police officer and had called for my partner to boost me just a touch so I could get my arms into the window enough to pull myself up and in up. I love being a second story cat burglar man, but even as I was preparing to do it, I was thinking I was crazy. Maybe when I was feeling better, I could try it. Here I was with two fit police officers in the late twenties, and me a forty-seven year old man, getting ready to go head first through a high window. I think I was trying to prove something to myself. Fortunately, someone finally came to the door, just as I was getting boosted up. The patient had soiled herself during a syncopal episode, so her daughter was cleaning her up in the shower and hadn't heard the knocks on the door.

I have been reading this book about Barry Bonds and steroids called Game of Shadows. It is a pretty amazing book about more than just Bonds. It meticulously details the drugs Bonds and other athletes, not just baseball players, but world class track and field athletes –were taking. They’d be over the hill, their careers on a downward slide, and then they’d get on this drug regime and start setting world records. They were taking up to 50 pills a day, but the main ones were undetectable steroids and human growth hormone. They’d also take insulin, clomid, a female fertility drug, and some stuff to make lean muscle in cattle.

I’m reading this book and thinking, you know I’ve been feeling run down and over the hill, maybe I could use this stuff. Let’s look at the public good here. Barry Bonds takes steroids to hit home runs, Marion Jones takes steroids to run fast, I would be taking steroids to help people. And I could go for a world record, too. Instead of hitting 73 home runs, I could carry 73 millions pounds of patients and equipment in a year. And steroids would prolong my career. Of course, I wouldn’t want to swallow all the pills, rub all the creme on, and stick myself with all the syringes Bonds used. Forget about the female fertility and the cow stuff, just give me the Clear and the Cream and HGB, along with the legal supplement ZMA — zinc and magnesium.

Worry about getting caught? No, the state doesn’t test medics for steroids. Not yet anyway. But, you know, I might be a standup guy anyway. What bugs me the most about these athletes is not that they took steroids, but that they lie about it. They deny what anyone with eyes can see. I wouldn’t be like that. If someone asks me how I lifted that 400-pounder all by myself, I’ll say, “It’s the juice! man. It’s the juice!”

Anyway, tomorrow I start taking my daily vitamins again.

***
Today I am fifty seven and not nearly as spry as I was at 47. Three years ago, I was quite fit. I ran in a Rugged Maniac, Warrior Dash, Spartan Race, Down and Dirty, Fitathlon, and the penultimate, a Tough Mudder. It was all the result of a year of purposeful training. I ran hills and trails and went to the playground with my daughter and climbed everything on the playscape. The one skill you have to master for those races is the ability to run and jump up a wall, getting your hands on the top, pull yourself up, and then swing your leg over. You do that all the time in these races. I was pretty decent at it. Unfortunately, the last Spartan race I have witnessed this year was on TV, while I sat with poor posture on my couch eating from a bag of Utz Sour Cream and Onion Ridged Potato Chips.

After my adventure race year, I developed plantar fasciitis, which made even walking quite painful so I abandoned mud runs and half marathons and have since been a dedicated swimmer, swimming in meets and open water swims. I swim very fast for my age, but my fitness beyond swimming has deteriorated significantly. The last two years I feel I have been in physical decline. My hearing is shot, I need glasses not just for 24s IVs, but for 20’s, intubations and to read the label on the Alleve package. I take thyroid medication every morning now, and once or twice a year I am afflicted with the gout (the sadness of the gout is I get it after only 1-2 beers on top of a couple days of red meat and bacon eating. I used to love beer drinking. But during my last gout attack (which comes on rapidly and at night, causing excruciating pain even at the feel of the wind on my big toe) I called out for Heroin. I called for it even knowing that if I tried it just once, I would likely begin a life spiral that would lead to the loss of my job, family, home and any vestige of self-regard. I would die alone and be buried in a potter’s field. That’s how bad the pain of gout is. It is tiny shards of glass in your swollen joint. Fortunately, no one heard my call and after a couple zillion years of agony, aided by the exhaustion of my tears, and a Benadryl, I was able to finally sleep for a few hours till the alarm awoke me, calling me back to the work. I picked up my shovel and using it as a crutch, I limped to my 2002 Honda and drove to the EMS mine. Another day older -- and no beer to look forward to at the end of the shift. Normally six to eight times a day, I am asked “How tall are you?” When I get the gout, instead I am asked, “Why are you walking so slow? Is your foot okay?” My answer instead of “six eight and a half -- I used to be six nine and a half, but my partner Jerry has beaten me down,” I say, “I’ve got the gout.”

My partner, Jerry, who has more silver in his hair than I do (mainly because he has more hair) enjoys putting a "Fall Risk" bracelet on my wrist every opportunity he gets while we wait at triage for our number to be called. He gets as big a kick out of it the eighth and ninth times as he did it as he did the first time. Oh, well, I did promise his mother I would look after him.

Which brings us all to today and my impetus for this post. No, I did not break into home to rescue a person -- it has been awhile since I have done that. We responded to an apartment building in the north end for a woman who couldn't walk. Her daughter met us at the door, and held it open so we could go up the stairs and into the apartment building. There a woman with a swollen knee for a month was requesting transportation to the hospital. While my partner and my preceptee put the patient in the stair chair, I carried the gear back out to the ambulance. When I returned, the outside door was locked. This apartment building had balconies that were about five feet off the ground. I raised my eyebrows, measuring just what I would have to do. I tried to reach my foot up to the balcony floor, and it was a tight stretch, and I just made it, then grabbing two of the the balcony railings I pulled myself up. Then I tried to swing my leg up to get over the top railing, but my leg wouldn’t stretch that far. I rested a moment, then tried again, swinging my leg against my stiff joints. Success. I swung my other leg up and over. There I was up on the balcony lickedy-split. I entered the room through the billowing curtains. “Walla,” I said. My partner, my preceptee, our patient and her daughter all looked up at me oddly like what was I doing there and what was I talking about, and then they resumed their conversation. I wanted to say “Walla” again to call the deserved attention to my Batman act, but instead, i just celebrated silently, realizing my feat had more meaning to me than to them.

This afternoon, I had my partner drive me to the playground off Oakwood Street, where I practiced some climbing.

I am not ready to retire the self-title of cat burglar second story man extraordinaire.