I come in at six and find the night crew is out on a call. A few minutes later they clear their scene with a refusal, but then are dispatched to a possible dead body/overdose at a local business. They ask me to respond in the second ambulance to meet them there in case it is a workable code.
I am almost there when they slow me down, telling me it is a 10-45 -- a presumption.
The address is a local transportation company that relies on contract workers as their drivers. I find the night crew standing in the doorway of the hallway bathroom. I glance in. A large naked man is sitting on the toilet, bent forward, his head down by his knees. His body is mottled and rigorous. There is a syringe on the ground next to him. While we are standing there, his cell phone starts to ring.
You have the urge to pick it up and answer it.
We're thinking "What do you say?"
1. Uh, hello...
2. Fred's phone.
3. Hades.
4. Lucifer.
5. He's not available right now, he's ahhh... he's still being processed.
6. He's in the can.
We just let it ring.
Maybe it was his dealer.
Maybe it was his girlfriend.
***
A number of years ago there was a business where an angry employee came to work with an assault rifle and killed several of his co-workers and injured a number more. A medic, who was there, told me how as he walked through the room past all the cubicles, phones were ringing everywhere, and as he was presuming one man, he could hear the guy's wife on the answering machine, leaving a message saying, "Honey, are you okay? I've been watching the news. I just need to know you're all right. Honey, I love you, honey..."
Monday, August 29, 2005
Saturday, August 27, 2005
Diamond in the Rough (Excerpt)
The first three chapters of an EMS novel-in-progress. I originally wrote this as a shorty story, then last November expanded it to a novel as part of "National Novel Writing Month" an event where participants have 30 days to produce a 50,000 word novel. You are not graded on content, just quantity. I finished a day or two early. The book was rough, full of misspellings, gramatical errors and plot holes, but I felt it had a good energy. While I am mirred down in a quagmire of my other novel, trying to figure out the problems I have having with it, I have turned back to Diamond in the Rough, and am having a blast rewriting it.
Chapter One
I know what I did was wrong. I just want people to understand I acted from the heart. I didn’t set out to become a thief. I was just looking for love.
It was a fact. I was no Tobey McGuire. I stood five-nine, one hundred twenty pounds. I had a shaved head, bad teeth, bony arms, and was so skinny people made TB and tape worm cracks about me. I was twenty-three, living in a boarding house, working as a maintenance man for a cab company and doing my best not to get my ass kicked. I had a flaming skeleton devil head tattoo on my right arm that I had gotten to make myself look tougher, but people even made fun of that. I had wanted a menacing specter, but people said my devil was a wussy, and what kind of skinny girlie cigarette was he smoking? they asked. Virginia Slims? It was true he did look more like a goofball than one of Satan’s crew. And once you are branded with indelible ink, it doesn’t come off easy.
I cleaned the office and garage at Speedy Cab, washed, vacummed and changed the oil on the rides, and when one wasn't signed out to a regular driver, the owner let me work the streets. I worked mainly at night, and split everything I took in with my boss. It wasn't the best deal, but it helped pay off the money I owed for burning down my neighbor's garage. They were never able to prove I had done it deliberately -- they thought I had in retaliation for my belief that he had poisoned my dog -- but since I agreed to pay the bastard back, they decided that was punishment enough, and it kept my adult record clean, my juvenile stupidities already purged on my eighteenth birthday.
I liked driving, working the city streets, both the customer contact and the knowledge of the roads, which came in handy for my later employ. If people wanted to talk, I was more than happy to converse with them. If, which was most often, they wanted me to just to drive, I easily assumed the role of the invisible man.
My mother didn't like me working at night, particularly in the North end, but she didn't complain when I kicked some cash her way every week for her Monday bus trip down to the casino. Our unwritten deal was if she hit the slots jackpot, I would receive an equal share, but any profit she ever made on any particular visit just went back into her general slot fund, which was always eventually returning to zero. That was all right. At least I got a motherly kiss and an I love you after Sunday dinner, which was more action than I was getting from women of my age.
The closest I came to any sex was the business that sometimes went on in the back seat of my cab. I'd pick up old men at the elderly housing and take them for a ride down Linmoore Street, where a crack whore would get in the back and give them the business for ten bucks. Sometimes the whores would just take the cash and bolt. Then I'd get stiffed because the poor old guys wouldn’t pay me the fare, blaming me that they'd been ripped off as if I were the pimp. Hell, I wasn't even getting a commission, not that I had the nerve to ask for a percentage nor the desire to profit from such trade.
Those crack whores were mean, nasty women, who no doubt had mean nasty upbringings that had dragged them to that point where they had sold their souls to the rock which made them do what at some point in their life must have been unthinkable acts. After awhile I learned which whores to avoid. The rip off artists, the ones who'd spit their exchange back out on the seat, and the ones who looked like cops. I promised not tell what the one who showed me a badge said to me. Let's just say silence is expensive and talking even more so. Everybody’s got a racket.
On Saturday nights I cruised downtown, particularly by the train station where all the young high school and college lovelies were dollied up and out drinking at the bars. One night a young redhead and her man came out of the Boar’s Snout Pub and hailed me as I came slowly down the street. She was skinny, blue eyed with a freckled nose. She looked real cute in her lime green sun dress. She couldn’t have been old enough to drink. He was older, maybe mid-twenties, broad-shouldered wearing a white shirt with a loosened red power tie, carrying a suit jacket. He looked like the kind of guy with a good job who could have whatever woman he wanted. He asked to go up to Winslow Street.
They hadn’t been in the back long enough for me to write their destination down on my manifest when she straddled him, and looked to be tugging at his belt. All that shifting around and groaning and in no time she was bouncing off him and telling him to keep doing what he was doing. At moments when she’d arch her back I could feel her long hair against my head.
At first I was embarrassed and leaned forward to avoid letting her hair touch me, but then I admit I kind of got excited myself. I don’t consider myself a pervert – I mean the only porn I ever bought myself was an occasional Penthouse or Playboy – a guy has to get by when he can’t afford the cover charge, a beer and a tips at the tittie bar – but hearing her say over and over what she was saying, well, I tried to imagine she was saying it to me. Her hair had a wonderful scent -- like bubble gum and strawberries. She was young and wild and crazy and I imagined she wanted me like girls in the movies want the hero. I drove as slowly as I could, then instead of parking right in front of the apartment, I pulled a little bit past to a spot not under a street lamp. I heard a groan then, and she tried to keep riding, but he said, his voice changed, “Easy.”
“Let’s go upstairs,” she said. “Play that song for me.” She kissed his neck, and as she did, his eyes met mine in the rear view mirror. He looked irritated.
“I’m tired,” he said to her.
“I’ll get you going again,” she said.
“Ow,” he said, “No, I need to sleep.” He sort of pushed her off him.
“What?” she said.
“I’m sorry, I’ve got a big day tomorrow.”
“That’s it?” she said as he buckled his pants.
He reached into his wallet and handed me twenty bucks. The meter only read “$5.45.” “This ought to cover it with a tip. Take her where she needs to go.”
“That’s it?” she said again.
“I’m sorry, I’ve been fighting a migrane all night. He’ll take you back downtown. Here’s my card. Call me. We can hook up another night.”
He handed her the card. She took it, then threw it back in his face. “I can’t believe you. I just made love to you and that’s it.”
“I’m sorry. I shouldn’t have encouraged you, but you’re so hot.”
“Get out,” she said. She hit him. “You fucking jerk!”
He looked at me as he stepped out of the car like she was the crazy one and maybe I had some male sympathy for him. I just shook my head. I couldn’t believe it either.
“I agree with you on that one,” I said to her.
“What!”
“I agree he’s a jerk.”
She just grunted.
What I wanted to say was something smooth, something soothing, and maybe a little funny, something to make her feel alright and maybe see me in a different light – as a man, not a witness to her humiliation. I didn't think anything I could think of would work. I told you I was no Tobey McGuire, because if I was she would have ended up home with me, not in my boarding house, but in my mansion over the city.
“Where can I take you?”
“Back downtown.”
She turned her face to the window.
I was silent as I drove her back to the Boar's Snout Pub where I waited while she went in, only to see her come out, and look around like a lost little girl.
I called to her. “You going to be all right?”
She looked at me at first like she was going to blow me off, like what kind of creep was I to be stalking her. But she had no friends at that moment. “They left,” she said.
"Where do you live?" I finally asked.
"What do you care?" she demanded.
"I'll drive you there."
"I have no money."
"It's on me," I said. "I'm done for the night anyway," which I wasn't. “Get in.”
I hit the meter off. “You can sit in the front if you want.”
“I’m fine back here,” she said.
“Okay, your preference.”
I put the radio on. Bob Seeger. “Night Moves. You like this?” I asked. “This is a great song.”
She didn’t answer. I keep glancing up in the rear view mirror as I drove. She was crying, but I couldn’t think of anything to say, and decided silence was best. If I couldn’t be the hero, I’d best not be a fool.
She lived about fifteen miles away in Applebury, in a big house at the end of many dark roads. When I approached the drive, she said, “Right out here is fine.” She got out, closed the door and tottered up the long drive, not a word to me.
Instead of going to Cousin John's on North Service Road where I sometimes went to see the dancing girls, I went home, and lay in my single bed and dreamed I had a different life. I dreamed that I lived in a big house at the end of a dark road, and that I was handsome and brave, and that at night, I made love to my cute red-headed wife who slept with her cheek on my strong chest knowing I would always keep her safe.
Chapter Two
Fred Waters and I went to high school together. We were best pals. Some called us Beavis and Butthead. I didn’t care for it, but in high school, you don’t choose your handle. We were motor heads -- into cars -- even though neither of us had one unless our moms let us use the family auto, which was rare after we got busted for underage drinking while watching the street racing down behind Kendall High School. Believe me we would have been too embarrassed to drive their rusted station wagons down there where souped up Civics and Mitsubishis ruled.
Fred had more luck with the girls than I did, though, and he wouldn’t have had any luck at all without grape juice and gin, which made Fred's ascension into a chick magnet more remarkable. Instead of juice and gin now, he had stories -- and good ones.
Fred was an EMT and worked for Capitol Ambulance in the city. He lost the bad haircut, got a military buzz cut, and started lifting weights. He got his sights set on becoming a paramedic firefighter and hooking on with a city pension job in East Springdale. So in the meantime, while he applied to medic school, he was just pounding out the hours on the ambulance, making good pay with the unlimited overtime -- pay enough to afford his own apartment, make payments on a new pickup, and have cash to spend on the ladies.
A couple nights a week when he'd get off work, I’d meet him and some of the guys he worked with at Whitey's Pub on Spring Street for beers and pizza. There was a regular crowd of women there, particularly on Thursday nights, and we often ended up with tables pushed together and pitchers of beer lined up on the table with plates of nachos, buffalo wings and potato skins. Fred would be wearing his black boots and navy blue "EMS in the jungle" tee-shirt, showing a medic swinging on a vine over the city rooftops on the front with CITY EMS on the back. Looking at his biceps, I was thinking a little time in the gym would do me well, but then again Ronnie Meyers – Fred’s partner was as scrawny as me and he always had a girl sitting on his lap. I thought what really made the difference were the stories they told, how they were always the center of attention. He and his buddies would tell their incredible tales, and the chicks would dig it. Me, I just sat like a little grinning idiot, happy if on any given night when they'd push the tables together, a girl would be stuck next to me, and I could at least go home with the scent of perfume on me.
"So we get called to Dodge Street," Fred goes, as a blonde named Candy refills his beer, and the brunette Mindy, a hairdresser from down the street who has been his choice of the month, rubs his neck. "We go to Dodge Street for the shooting. The address is the same one where we did that triple heroin overdose I told you about last week-- the one where Harper shoots one guy with the narcan, wakes his ass up and has him do CPR on one of his buddies while I pounded on the chest of the other, and Harper tubed them both while we waited for backup. That building is like EMS Central Training Academy. Shootings, overdoses, presumptions, assaults, fires, even a baby delivered there, but listen to this -- this one tops them all. We go charging in there because the junkie who met us out front is going nuts, and you know junkies never get excited about anything except getting their stash ripped off. We go flying up the stairs with the cops right behind us.
”I get up there and I see this guy lying on a mattress holding his groin. The guy's going "My dick! My dick!" The cop behind me shines his mag light on him, and where his dick should be there's nothing but a crater, a crater filled with blood.
”’He hit 'em with a shotgun,’ the junkie who led us up there declares. ‘A shotgun -- Boom, right in the fucking nuts!’
"’My dick! My dick!’ the guy screams.
”And you can see it laying there, hanging by a tiny piece of tissue, like he almost shot it completely off, floating in the bloody crater like a dead whale.
"’Who did this?’ the cop demands. ‘Was this over drugs?’
"’Drugs?’ the junkie goes. ‘He shot him in the dick!’
”Ronnie's running down to get the scoop stretcher so we can carry him down the stairs. I'm calling for a medic on the radio and dispatch is asking ‘What do you have? What do you have?’ I want to say, ‘He’s shot in the dick!’ but in deference to the FCC, I just say, ‘Shotgun blast to the groin!’
I put some gloves on. I don't mind a little blood, but this is nasty land and a guy needs to be careful. I wrap a couple trauma dressings around him, and Ronny comes back with the scoop and some straps, and then we are carrying the guy’s screaming ass down the cranky stairs. I'm thinking to myself I hope his dick doesn't fall completely off and drop to the floor, cause I'm imaging the scene in the trauma room where the doctor is going to say ‘Where's his dick?’
“I don’t know, doc, it was right here.’
“Well, go back and get it so we can sew it on!”
Then we have to go back and find his dick so they can reattach it. We get there and see a big rat making off with the weiner. We chase the rat all over the house, up and down the creaky stairs, trying to get the guy’s dick away from him. Next thing I know we’ve both fallen through a hole in the floor and are in the basement where these giant rats are sitting around a table playing poker. These rats are like state fair pig size rats – they’ve gotten so big from feasting dead junkies and homeless people. They see us, and its snack time. Except they get in an argument about which one of these gets to eat us, so they start fighting each other, slamming their snouts into the others’ bellies and its like a shark rat frenzy, blood and guts splashing everywhere while we Speedy Gonzales it up the basement stairs and out of that crazy place. No thank you! I’m not going back for anyone’s dick unless its my own.”
He has them rolling with laughter, and the girls are turning red, trying both to be ladylike and not to pee themselves because the way he is telling it is really funny.
"We get him in the ambulance, and I shout to Ronnie to drive because the only medic who is clear is coming from cross-town, and Saint Ann is just up the road.
”The guy is going, ‘Are they going to be able to save it? Are they going to be able to save it?’
”I say ‘Dude, you've got to worry about them saving your life. I mean first things first here.’
”And he gets all frantic and screams again ‘My dick! My dick!’
”We get to the hospital, and already there's a crack whore there. She’s got a swollen bloody face and she's yelling at him, ‘You don't know nothing, remember that, you know nothing! No one did this to you but yourself. It was an accident, you tell them!’
"’But he shot me in the dick,’ he protests.
"’I love you, but you shouldn't have gone boasting your mouth.’
"’He shot me in the dick!’
Then Ronnie stands and points to the TV, and there it is on the News.
Right there over the bar on the big TV, a shot of the Capitol ambulance, and Ronnie and Fred wheeling the patient into the back, surrounded by cops. Then the ambulance, red lights flashing, pulls away into the night. The announcer says. "The patient is in serious condition with unknown gun shot wound."
"Unknown," Ronnie says to laughter. "He got shot in the dick!"
Everyone laughs, and the two of them are like superheroes. This isn't the first time they've told their stories, and ended them just as the news confirms their tale. Amazing.
"So they couldn't really put it back on, could they?" Mindy asked.
"No, it’s probably back on by now," Fred said. "A couple inches shorter maybe, but they were going to put it back on."
"That's incredible."
"Many years from now,” Fred says mock solemly, “when my grandchildren ask me what I did on the great streets of the City, well, after tonight, I will never have to say, I didn't save dick."
And they all crack up again.
When the evening is over and the barmaid is wiping down the counter, and Fred and Ronnie are off with their women, and everyone else has paired off, the chubby barmaid approaches me, and says, "That's it for tonight. It's time to go home. Time for bed." She says it in such a disinterested way that is clear to me she doesn’t even see me as someone who might even in her dreams, take her home and to bed. I’m just another obstacle to her night ending, someone to be shooed away in the same manner as the bar wiped down and the chairs put up on the tables. She pulls the plug on the Doom video game I am playing.
“Com’on!” I protest.
She takes my quarter full mug of leftover beer off the table, and turns her back on me. I sit there shaking my head at the callousness of it all, then head out into the night, and walk the twelve blocks to my boarding house alone.
Chapter Three
That night I dreamed it was me, telling the stories. I stood six foot four, a muscled two hundred twenty, with tattoos on both my arms, screaming skulls who feared no one or thing, and as I held forth, the table was not the mixed motley crew of the regular Thursday night, but all the dancers I had seen at the Wild Blue and Cousin John's and Dahoot’s and the Culinary Palace down on the Turnpike, and they looked at me like I was the bouncer who kept them safe, and loved them true, and they all held a secret wish to marry me and bear my children. The dream ended badly of course, with my waking up to find the bar emptying out and Mindy saying "Have fun jerking off," as she and Fred exited arm and arm, or arm and shoulder, or arm and her humongous bosom. Later I sat out back by a campfire with the animated incarnation of the smiley skeleton head on my arm, and he was laughing at me so hard, he actually did pee enough to put the campfire out. "You are such a loser,” the jolly flaming skull said, "Why I hang with you? I don’t known."
"What does it take to get on at Capitol?" I asked Fred when he stopped by the taxi office when he saw me out front, washing the owner's white Cadillac de Ville.
"A pulse," Fred said.
"No, I'm serious."
"Hey, dude, we're hurting for bodies. You've got a pulse and a driver's license, they'll put you in the seat. That and an EMT card."
"How do I get that?"
"The Fire department's holding a course two nights a week starting in September. It’s free if you volunteer out there, riding a shift a month. That's how I got in it. It isn't that hard. You passed high school, you can pass the EMT. It might take you a time or too, but you have half a brain, so it shouldn’t be too hard. It’s good money with the overtime. I'm doing eighty hours a week now, and could do a hundred if I wasn't so busy getting laid."
"Maybe I'll look into that," I said.
"Let me know, I'll put in a word for you. You'll love it. It's a gas. Plus I'm going to go for my medic next year. I get there, put in a year in the city, and then you're talking fire department medic, you're talking a whole other class of broads when you get that. You get that, you get yourself a nurse who wants to do nothing but take care of you, then you learn to play golf, retire after twenty years with a city pension. That's the gold mine. That's where I'm headed."
He had me thinking, I’ll admit that. And it wasn't about the golf, or the pension. I just was thinking maybe, just maybe if I could get a job on the ambulance, I could get some stories of my own, get a little notice, get a girl. Maybe things would start going my way. I wasn’t picky, I’d settle for a nurse’s aide.
Chapter One
I know what I did was wrong. I just want people to understand I acted from the heart. I didn’t set out to become a thief. I was just looking for love.
It was a fact. I was no Tobey McGuire. I stood five-nine, one hundred twenty pounds. I had a shaved head, bad teeth, bony arms, and was so skinny people made TB and tape worm cracks about me. I was twenty-three, living in a boarding house, working as a maintenance man for a cab company and doing my best not to get my ass kicked. I had a flaming skeleton devil head tattoo on my right arm that I had gotten to make myself look tougher, but people even made fun of that. I had wanted a menacing specter, but people said my devil was a wussy, and what kind of skinny girlie cigarette was he smoking? they asked. Virginia Slims? It was true he did look more like a goofball than one of Satan’s crew. And once you are branded with indelible ink, it doesn’t come off easy.
I cleaned the office and garage at Speedy Cab, washed, vacummed and changed the oil on the rides, and when one wasn't signed out to a regular driver, the owner let me work the streets. I worked mainly at night, and split everything I took in with my boss. It wasn't the best deal, but it helped pay off the money I owed for burning down my neighbor's garage. They were never able to prove I had done it deliberately -- they thought I had in retaliation for my belief that he had poisoned my dog -- but since I agreed to pay the bastard back, they decided that was punishment enough, and it kept my adult record clean, my juvenile stupidities already purged on my eighteenth birthday.
I liked driving, working the city streets, both the customer contact and the knowledge of the roads, which came in handy for my later employ. If people wanted to talk, I was more than happy to converse with them. If, which was most often, they wanted me to just to drive, I easily assumed the role of the invisible man.
My mother didn't like me working at night, particularly in the North end, but she didn't complain when I kicked some cash her way every week for her Monday bus trip down to the casino. Our unwritten deal was if she hit the slots jackpot, I would receive an equal share, but any profit she ever made on any particular visit just went back into her general slot fund, which was always eventually returning to zero. That was all right. At least I got a motherly kiss and an I love you after Sunday dinner, which was more action than I was getting from women of my age.
The closest I came to any sex was the business that sometimes went on in the back seat of my cab. I'd pick up old men at the elderly housing and take them for a ride down Linmoore Street, where a crack whore would get in the back and give them the business for ten bucks. Sometimes the whores would just take the cash and bolt. Then I'd get stiffed because the poor old guys wouldn’t pay me the fare, blaming me that they'd been ripped off as if I were the pimp. Hell, I wasn't even getting a commission, not that I had the nerve to ask for a percentage nor the desire to profit from such trade.
Those crack whores were mean, nasty women, who no doubt had mean nasty upbringings that had dragged them to that point where they had sold their souls to the rock which made them do what at some point in their life must have been unthinkable acts. After awhile I learned which whores to avoid. The rip off artists, the ones who'd spit their exchange back out on the seat, and the ones who looked like cops. I promised not tell what the one who showed me a badge said to me. Let's just say silence is expensive and talking even more so. Everybody’s got a racket.
On Saturday nights I cruised downtown, particularly by the train station where all the young high school and college lovelies were dollied up and out drinking at the bars. One night a young redhead and her man came out of the Boar’s Snout Pub and hailed me as I came slowly down the street. She was skinny, blue eyed with a freckled nose. She looked real cute in her lime green sun dress. She couldn’t have been old enough to drink. He was older, maybe mid-twenties, broad-shouldered wearing a white shirt with a loosened red power tie, carrying a suit jacket. He looked like the kind of guy with a good job who could have whatever woman he wanted. He asked to go up to Winslow Street.
They hadn’t been in the back long enough for me to write their destination down on my manifest when she straddled him, and looked to be tugging at his belt. All that shifting around and groaning and in no time she was bouncing off him and telling him to keep doing what he was doing. At moments when she’d arch her back I could feel her long hair against my head.
At first I was embarrassed and leaned forward to avoid letting her hair touch me, but then I admit I kind of got excited myself. I don’t consider myself a pervert – I mean the only porn I ever bought myself was an occasional Penthouse or Playboy – a guy has to get by when he can’t afford the cover charge, a beer and a tips at the tittie bar – but hearing her say over and over what she was saying, well, I tried to imagine she was saying it to me. Her hair had a wonderful scent -- like bubble gum and strawberries. She was young and wild and crazy and I imagined she wanted me like girls in the movies want the hero. I drove as slowly as I could, then instead of parking right in front of the apartment, I pulled a little bit past to a spot not under a street lamp. I heard a groan then, and she tried to keep riding, but he said, his voice changed, “Easy.”
“Let’s go upstairs,” she said. “Play that song for me.” She kissed his neck, and as she did, his eyes met mine in the rear view mirror. He looked irritated.
“I’m tired,” he said to her.
“I’ll get you going again,” she said.
“Ow,” he said, “No, I need to sleep.” He sort of pushed her off him.
“What?” she said.
“I’m sorry, I’ve got a big day tomorrow.”
“That’s it?” she said as he buckled his pants.
He reached into his wallet and handed me twenty bucks. The meter only read “$5.45.” “This ought to cover it with a tip. Take her where she needs to go.”
“That’s it?” she said again.
“I’m sorry, I’ve been fighting a migrane all night. He’ll take you back downtown. Here’s my card. Call me. We can hook up another night.”
He handed her the card. She took it, then threw it back in his face. “I can’t believe you. I just made love to you and that’s it.”
“I’m sorry. I shouldn’t have encouraged you, but you’re so hot.”
“Get out,” she said. She hit him. “You fucking jerk!”
He looked at me as he stepped out of the car like she was the crazy one and maybe I had some male sympathy for him. I just shook my head. I couldn’t believe it either.
“I agree with you on that one,” I said to her.
“What!”
“I agree he’s a jerk.”
She just grunted.
What I wanted to say was something smooth, something soothing, and maybe a little funny, something to make her feel alright and maybe see me in a different light – as a man, not a witness to her humiliation. I didn't think anything I could think of would work. I told you I was no Tobey McGuire, because if I was she would have ended up home with me, not in my boarding house, but in my mansion over the city.
“Where can I take you?”
“Back downtown.”
She turned her face to the window.
I was silent as I drove her back to the Boar's Snout Pub where I waited while she went in, only to see her come out, and look around like a lost little girl.
I called to her. “You going to be all right?”
She looked at me at first like she was going to blow me off, like what kind of creep was I to be stalking her. But she had no friends at that moment. “They left,” she said.
"Where do you live?" I finally asked.
"What do you care?" she demanded.
"I'll drive you there."
"I have no money."
"It's on me," I said. "I'm done for the night anyway," which I wasn't. “Get in.”
I hit the meter off. “You can sit in the front if you want.”
“I’m fine back here,” she said.
“Okay, your preference.”
I put the radio on. Bob Seeger. “Night Moves. You like this?” I asked. “This is a great song.”
She didn’t answer. I keep glancing up in the rear view mirror as I drove. She was crying, but I couldn’t think of anything to say, and decided silence was best. If I couldn’t be the hero, I’d best not be a fool.
She lived about fifteen miles away in Applebury, in a big house at the end of many dark roads. When I approached the drive, she said, “Right out here is fine.” She got out, closed the door and tottered up the long drive, not a word to me.
Instead of going to Cousin John's on North Service Road where I sometimes went to see the dancing girls, I went home, and lay in my single bed and dreamed I had a different life. I dreamed that I lived in a big house at the end of a dark road, and that I was handsome and brave, and that at night, I made love to my cute red-headed wife who slept with her cheek on my strong chest knowing I would always keep her safe.
Chapter Two
Fred Waters and I went to high school together. We were best pals. Some called us Beavis and Butthead. I didn’t care for it, but in high school, you don’t choose your handle. We were motor heads -- into cars -- even though neither of us had one unless our moms let us use the family auto, which was rare after we got busted for underage drinking while watching the street racing down behind Kendall High School. Believe me we would have been too embarrassed to drive their rusted station wagons down there where souped up Civics and Mitsubishis ruled.
Fred had more luck with the girls than I did, though, and he wouldn’t have had any luck at all without grape juice and gin, which made Fred's ascension into a chick magnet more remarkable. Instead of juice and gin now, he had stories -- and good ones.
Fred was an EMT and worked for Capitol Ambulance in the city. He lost the bad haircut, got a military buzz cut, and started lifting weights. He got his sights set on becoming a paramedic firefighter and hooking on with a city pension job in East Springdale. So in the meantime, while he applied to medic school, he was just pounding out the hours on the ambulance, making good pay with the unlimited overtime -- pay enough to afford his own apartment, make payments on a new pickup, and have cash to spend on the ladies.
A couple nights a week when he'd get off work, I’d meet him and some of the guys he worked with at Whitey's Pub on Spring Street for beers and pizza. There was a regular crowd of women there, particularly on Thursday nights, and we often ended up with tables pushed together and pitchers of beer lined up on the table with plates of nachos, buffalo wings and potato skins. Fred would be wearing his black boots and navy blue "EMS in the jungle" tee-shirt, showing a medic swinging on a vine over the city rooftops on the front with CITY EMS on the back. Looking at his biceps, I was thinking a little time in the gym would do me well, but then again Ronnie Meyers – Fred’s partner was as scrawny as me and he always had a girl sitting on his lap. I thought what really made the difference were the stories they told, how they were always the center of attention. He and his buddies would tell their incredible tales, and the chicks would dig it. Me, I just sat like a little grinning idiot, happy if on any given night when they'd push the tables together, a girl would be stuck next to me, and I could at least go home with the scent of perfume on me.
"So we get called to Dodge Street," Fred goes, as a blonde named Candy refills his beer, and the brunette Mindy, a hairdresser from down the street who has been his choice of the month, rubs his neck. "We go to Dodge Street for the shooting. The address is the same one where we did that triple heroin overdose I told you about last week-- the one where Harper shoots one guy with the narcan, wakes his ass up and has him do CPR on one of his buddies while I pounded on the chest of the other, and Harper tubed them both while we waited for backup. That building is like EMS Central Training Academy. Shootings, overdoses, presumptions, assaults, fires, even a baby delivered there, but listen to this -- this one tops them all. We go charging in there because the junkie who met us out front is going nuts, and you know junkies never get excited about anything except getting their stash ripped off. We go flying up the stairs with the cops right behind us.
”I get up there and I see this guy lying on a mattress holding his groin. The guy's going "My dick! My dick!" The cop behind me shines his mag light on him, and where his dick should be there's nothing but a crater, a crater filled with blood.
”’He hit 'em with a shotgun,’ the junkie who led us up there declares. ‘A shotgun -- Boom, right in the fucking nuts!’
"’My dick! My dick!’ the guy screams.
”And you can see it laying there, hanging by a tiny piece of tissue, like he almost shot it completely off, floating in the bloody crater like a dead whale.
"’Who did this?’ the cop demands. ‘Was this over drugs?’
"’Drugs?’ the junkie goes. ‘He shot him in the dick!’
”Ronnie's running down to get the scoop stretcher so we can carry him down the stairs. I'm calling for a medic on the radio and dispatch is asking ‘What do you have? What do you have?’ I want to say, ‘He’s shot in the dick!’ but in deference to the FCC, I just say, ‘Shotgun blast to the groin!’
I put some gloves on. I don't mind a little blood, but this is nasty land and a guy needs to be careful. I wrap a couple trauma dressings around him, and Ronny comes back with the scoop and some straps, and then we are carrying the guy’s screaming ass down the cranky stairs. I'm thinking to myself I hope his dick doesn't fall completely off and drop to the floor, cause I'm imaging the scene in the trauma room where the doctor is going to say ‘Where's his dick?’
“I don’t know, doc, it was right here.’
“Well, go back and get it so we can sew it on!”
Then we have to go back and find his dick so they can reattach it. We get there and see a big rat making off with the weiner. We chase the rat all over the house, up and down the creaky stairs, trying to get the guy’s dick away from him. Next thing I know we’ve both fallen through a hole in the floor and are in the basement where these giant rats are sitting around a table playing poker. These rats are like state fair pig size rats – they’ve gotten so big from feasting dead junkies and homeless people. They see us, and its snack time. Except they get in an argument about which one of these gets to eat us, so they start fighting each other, slamming their snouts into the others’ bellies and its like a shark rat frenzy, blood and guts splashing everywhere while we Speedy Gonzales it up the basement stairs and out of that crazy place. No thank you! I’m not going back for anyone’s dick unless its my own.”
He has them rolling with laughter, and the girls are turning red, trying both to be ladylike and not to pee themselves because the way he is telling it is really funny.
"We get him in the ambulance, and I shout to Ronnie to drive because the only medic who is clear is coming from cross-town, and Saint Ann is just up the road.
”The guy is going, ‘Are they going to be able to save it? Are they going to be able to save it?’
”I say ‘Dude, you've got to worry about them saving your life. I mean first things first here.’
”And he gets all frantic and screams again ‘My dick! My dick!’
”We get to the hospital, and already there's a crack whore there. She’s got a swollen bloody face and she's yelling at him, ‘You don't know nothing, remember that, you know nothing! No one did this to you but yourself. It was an accident, you tell them!’
"’But he shot me in the dick,’ he protests.
"’I love you, but you shouldn't have gone boasting your mouth.’
"’He shot me in the dick!’
Then Ronnie stands and points to the TV, and there it is on the News.
Right there over the bar on the big TV, a shot of the Capitol ambulance, and Ronnie and Fred wheeling the patient into the back, surrounded by cops. Then the ambulance, red lights flashing, pulls away into the night. The announcer says. "The patient is in serious condition with unknown gun shot wound."
"Unknown," Ronnie says to laughter. "He got shot in the dick!"
Everyone laughs, and the two of them are like superheroes. This isn't the first time they've told their stories, and ended them just as the news confirms their tale. Amazing.
"So they couldn't really put it back on, could they?" Mindy asked.
"No, it’s probably back on by now," Fred said. "A couple inches shorter maybe, but they were going to put it back on."
"That's incredible."
"Many years from now,” Fred says mock solemly, “when my grandchildren ask me what I did on the great streets of the City, well, after tonight, I will never have to say, I didn't save dick."
And they all crack up again.
When the evening is over and the barmaid is wiping down the counter, and Fred and Ronnie are off with their women, and everyone else has paired off, the chubby barmaid approaches me, and says, "That's it for tonight. It's time to go home. Time for bed." She says it in such a disinterested way that is clear to me she doesn’t even see me as someone who might even in her dreams, take her home and to bed. I’m just another obstacle to her night ending, someone to be shooed away in the same manner as the bar wiped down and the chairs put up on the tables. She pulls the plug on the Doom video game I am playing.
“Com’on!” I protest.
She takes my quarter full mug of leftover beer off the table, and turns her back on me. I sit there shaking my head at the callousness of it all, then head out into the night, and walk the twelve blocks to my boarding house alone.
Chapter Three
That night I dreamed it was me, telling the stories. I stood six foot four, a muscled two hundred twenty, with tattoos on both my arms, screaming skulls who feared no one or thing, and as I held forth, the table was not the mixed motley crew of the regular Thursday night, but all the dancers I had seen at the Wild Blue and Cousin John's and Dahoot’s and the Culinary Palace down on the Turnpike, and they looked at me like I was the bouncer who kept them safe, and loved them true, and they all held a secret wish to marry me and bear my children. The dream ended badly of course, with my waking up to find the bar emptying out and Mindy saying "Have fun jerking off," as she and Fred exited arm and arm, or arm and shoulder, or arm and her humongous bosom. Later I sat out back by a campfire with the animated incarnation of the smiley skeleton head on my arm, and he was laughing at me so hard, he actually did pee enough to put the campfire out. "You are such a loser,” the jolly flaming skull said, "Why I hang with you? I don’t known."
"What does it take to get on at Capitol?" I asked Fred when he stopped by the taxi office when he saw me out front, washing the owner's white Cadillac de Ville.
"A pulse," Fred said.
"No, I'm serious."
"Hey, dude, we're hurting for bodies. You've got a pulse and a driver's license, they'll put you in the seat. That and an EMT card."
"How do I get that?"
"The Fire department's holding a course two nights a week starting in September. It’s free if you volunteer out there, riding a shift a month. That's how I got in it. It isn't that hard. You passed high school, you can pass the EMT. It might take you a time or too, but you have half a brain, so it shouldn’t be too hard. It’s good money with the overtime. I'm doing eighty hours a week now, and could do a hundred if I wasn't so busy getting laid."
"Maybe I'll look into that," I said.
"Let me know, I'll put in a word for you. You'll love it. It's a gas. Plus I'm going to go for my medic next year. I get there, put in a year in the city, and then you're talking fire department medic, you're talking a whole other class of broads when you get that. You get that, you get yourself a nurse who wants to do nothing but take care of you, then you learn to play golf, retire after twenty years with a city pension. That's the gold mine. That's where I'm headed."
He had me thinking, I’ll admit that. And it wasn't about the golf, or the pension. I just was thinking maybe, just maybe if I could get a job on the ambulance, I could get some stories of my own, get a little notice, get a girl. Maybe things would start going my way. I wasn’t picky, I’d settle for a nurse’s aide.
Thursday, August 25, 2005
Homer Jones
We get sent for a premature baby difficulty breathing. Lights and sirens response.
A minute later we get the update we want to hear, "Baby breathing normally."
We arrive to find a twenty-three-day-old baby sleeping comfortably on his mother's knee. She tells us he was born seven weeks prematurely. For about a minute his head turned purple and he stopped breathing. The same thing happened to him yesterday. The mother tells us which hospital she wants to go to. She hands me the baby then goes upstairs to get some shoes. I hold the tiny baby in my hands. It is the size of a small football. I am standing holding it now in the front yard. The two police officers and I are making goo-goo eyes at it.
The grass in the yard is lush. There is just the tiniest hint of September in the air. "Okay," I say to one of the officers. "You go down about ten yards and do a button hook." To the other I say, "Go deep."
They look at me like I am crazy.
"Ready on two," I say.
"You're nuts."
"Did you hear the famous story about Homer Jones?" I ask, "The legendary Alabama wide reciever?"
They shake their heads.
"There was a big fire in one of the dormitories -- you maybe heard about it on the news. There was a mother and her baby trapped on the roof -- too high for the ladder trucks to reach. They had no way to get her down. Then someone came up with the answer -- the great Homer Jones. He had over eighty receptions including twelve touchdowns for the Crimson Tide. He never dropped a pass. So Homer lines up. The mother calls "Hike!" and drops back. Homer takes off. The mother lets loose with the pass -- a perfect spiral. Homer is running and running and it looks like he might not get to the baby, when he puts on a last burst of speed, then leaps, flies through the air, and with outstretched hands and fingertips, catches the baby as he bellyflops across the grass. The crowd goes wild. Hollaring and cheering. Homer jumps up and spikes the baby."
The mother has her shoes now and is stepping out the front door to join us.
"You're going to hand the baby back to the mother now," one officer says.
"Of course," I say.
"Real slow," the other says.
A minute later we get the update we want to hear, "Baby breathing normally."
We arrive to find a twenty-three-day-old baby sleeping comfortably on his mother's knee. She tells us he was born seven weeks prematurely. For about a minute his head turned purple and he stopped breathing. The same thing happened to him yesterday. The mother tells us which hospital she wants to go to. She hands me the baby then goes upstairs to get some shoes. I hold the tiny baby in my hands. It is the size of a small football. I am standing holding it now in the front yard. The two police officers and I are making goo-goo eyes at it.
The grass in the yard is lush. There is just the tiniest hint of September in the air. "Okay," I say to one of the officers. "You go down about ten yards and do a button hook." To the other I say, "Go deep."
They look at me like I am crazy.
"Ready on two," I say.
"You're nuts."
"Did you hear the famous story about Homer Jones?" I ask, "The legendary Alabama wide reciever?"
They shake their heads.
"There was a big fire in one of the dormitories -- you maybe heard about it on the news. There was a mother and her baby trapped on the roof -- too high for the ladder trucks to reach. They had no way to get her down. Then someone came up with the answer -- the great Homer Jones. He had over eighty receptions including twelve touchdowns for the Crimson Tide. He never dropped a pass. So Homer lines up. The mother calls "Hike!" and drops back. Homer takes off. The mother lets loose with the pass -- a perfect spiral. Homer is running and running and it looks like he might not get to the baby, when he puts on a last burst of speed, then leaps, flies through the air, and with outstretched hands and fingertips, catches the baby as he bellyflops across the grass. The crowd goes wild. Hollaring and cheering. Homer jumps up and spikes the baby."
The mother has her shoes now and is stepping out the front door to join us.
"You're going to hand the baby back to the mother now," one officer says.
"Of course," I say.
"Real slow," the other says.
Monday, August 22, 2005
It is Unethical
230 lb guy slips in the shower, lands on his shoulder. When we get there he is in extreme pain and has an obviously deformed shoulder. It is either fractured, dislocated or both.
What do you do for pain?
Morphine.
Okay, now here's the catch. The location is a drug and alcohol rehab clinic, the patient is an ex-heroin user on methadone, who is there for cocaine/ETOH abuse.
I discuss the drug options with him. All I have is morphine. Does he have a problem with getting morphine seeing as he is going through rehab? And I tell him even if I give it to him, it may not touch him due to his past use. He's no doubt developed a certain tolerence.
He says he hurts bad. 10 out 10 on the pain scale. I can see that. I give him 5 milligrams, then another five milligrams.
10 of 10 goes down to an 8 of 10.
I call medical control for permission to give him another ten. I do it with some hesitation because I know when I tell them about his drug history they will probably deny me out of reflex.
Another 10 milligrams is a lot to ask for, but that's how much he needs. They say no. From the nurse's voice relaying the doctor's decision I feel they are saying "What are you crazy?"
At triage I show the nurse his deformed shoulder. "Just because he has a drug history, doesn't mean he shouldn't get pain relief," I say.
She smiles and says, "yes, dear." She and I are friends.
I talk to a doctor about it later. He says he is reluctant to give anyone 20 milligrams of morphine. But I argue that 10 is the standard weight based dose for someone of my patient's size just to start.
Another 10 is a lot, he says.
I argue that people are drastically undermedicated in ERs.
He doesn't disagree.
And I say because the patient has used opiates in the past he should get more medication, not less.
That could be true, the doctor says, but he says he would be relucatnt to give that much to someone he hasn't personally seen.
And I add just because I was only five minutes out doesn't mean the patient will he get meds in five minutes at the ER. It will be more like 40 minutes.
Well, that's not always true, the doctor says.
But as I am walking out -- this after I have brought another patient in -- this one for seizures, my patient with the messed up shoulder is just now an hour later getting more medicine. They give him 10 milligrams of morphine. Thank you.
I don't dispute a doctor's right to deny someone the extra morphine, but if we want to take people's pain away -- which is the goal -- we have to be more aggressive than we are.
I have been on a crusade to adequately medicate my patients. I considered it, but did not not let the patient's drug past affect me. Pain is pain.
***
I once had a patient who spilled boiling water on her arm. Entire arm one big painful raw blistering second degree burn. I gave her ten of morphine and called for orders for more. I was denied. When the doctor saw her as I was wheeling the patient in -- she was poor and black, the doctor said the ten probably didn't work because she was a drug addict. The doctor kept on walking down the hall. That really torqued me. She needed more pain relief right then.
Even if she was a drug addict, she was in obvious pain. Burns are very, very painful. And even if she was a drug seeking drug addict, if she poured boiling water on her arms to get a shot at getting high(unlikely and very stupid), then she deserves to get her prize.
What would you do to get morphine? I'd pour boiling water on my arm. Okay, I'll give it to you then.
Same with the guy, if somehow he concocted to break his shoulder so he could get a fix, well, he earned it. We set the bar high, and by golly, he jumped over it.
***
National Association of EMS Physicians Prehospital Pain Management Position Paper
"In spite of frequent contact with patients who have a painful condition, multiple investigators have demonstrated that prehospital personnel and emergency physicians fail to recognize and properly treat pain." - National Association of EMS Physicians Prehospital Pain Management Position Paper
Pain and Comfort, The Pathophysiology of Pain and Prehospital Treatment Options, JEMS 2003
"It's unethical to withhold appropriate analgesia based solely upon addiction concerns." - Jeff Meyers, DO, NREMT-P, JEMS 2003
What do you do for pain?
Morphine.
Okay, now here's the catch. The location is a drug and alcohol rehab clinic, the patient is an ex-heroin user on methadone, who is there for cocaine/ETOH abuse.
I discuss the drug options with him. All I have is morphine. Does he have a problem with getting morphine seeing as he is going through rehab? And I tell him even if I give it to him, it may not touch him due to his past use. He's no doubt developed a certain tolerence.
He says he hurts bad. 10 out 10 on the pain scale. I can see that. I give him 5 milligrams, then another five milligrams.
10 of 10 goes down to an 8 of 10.
I call medical control for permission to give him another ten. I do it with some hesitation because I know when I tell them about his drug history they will probably deny me out of reflex.
Another 10 milligrams is a lot to ask for, but that's how much he needs. They say no. From the nurse's voice relaying the doctor's decision I feel they are saying "What are you crazy?"
At triage I show the nurse his deformed shoulder. "Just because he has a drug history, doesn't mean he shouldn't get pain relief," I say.
She smiles and says, "yes, dear." She and I are friends.
I talk to a doctor about it later. He says he is reluctant to give anyone 20 milligrams of morphine. But I argue that 10 is the standard weight based dose for someone of my patient's size just to start.
Another 10 is a lot, he says.
I argue that people are drastically undermedicated in ERs.
He doesn't disagree.
And I say because the patient has used opiates in the past he should get more medication, not less.
That could be true, the doctor says, but he says he would be relucatnt to give that much to someone he hasn't personally seen.
And I add just because I was only five minutes out doesn't mean the patient will he get meds in five minutes at the ER. It will be more like 40 minutes.
Well, that's not always true, the doctor says.
But as I am walking out -- this after I have brought another patient in -- this one for seizures, my patient with the messed up shoulder is just now an hour later getting more medicine. They give him 10 milligrams of morphine. Thank you.
I don't dispute a doctor's right to deny someone the extra morphine, but if we want to take people's pain away -- which is the goal -- we have to be more aggressive than we are.
I have been on a crusade to adequately medicate my patients. I considered it, but did not not let the patient's drug past affect me. Pain is pain.
***
I once had a patient who spilled boiling water on her arm. Entire arm one big painful raw blistering second degree burn. I gave her ten of morphine and called for orders for more. I was denied. When the doctor saw her as I was wheeling the patient in -- she was poor and black, the doctor said the ten probably didn't work because she was a drug addict. The doctor kept on walking down the hall. That really torqued me. She needed more pain relief right then.
Even if she was a drug addict, she was in obvious pain. Burns are very, very painful. And even if she was a drug seeking drug addict, if she poured boiling water on her arms to get a shot at getting high(unlikely and very stupid), then she deserves to get her prize.
What would you do to get morphine? I'd pour boiling water on my arm. Okay, I'll give it to you then.
Same with the guy, if somehow he concocted to break his shoulder so he could get a fix, well, he earned it. We set the bar high, and by golly, he jumped over it.
***
National Association of EMS Physicians Prehospital Pain Management Position Paper
"In spite of frequent contact with patients who have a painful condition, multiple investigators have demonstrated that prehospital personnel and emergency physicians fail to recognize and properly treat pain." - National Association of EMS Physicians Prehospital Pain Management Position Paper
Pain and Comfort, The Pathophysiology of Pain and Prehospital Treatment Options, JEMS 2003
"It's unethical to withhold appropriate analgesia based solely upon addiction concerns." - Jeff Meyers, DO, NREMT-P, JEMS 2003
Thursday, August 18, 2005
School's Out/ The Grasshopper and The Ants
I love being a paramedic, but I periodically wonder about the future. How long can I continue in this field? Will my back hold up? Will 70-80 hours a week of work destroy my life? Will there continue to be 70-80 hours of work a week available for me? What will happen to me when I am old?
My mother used to say I reminded her of the grasshopper in the story about the ants and the grasshopper. The grasshopper spent the whole summer playing music and eating and generally enjoying himself while the ants worked like ants and did nothing but find, carry and store food.
***
The Ants and the Grasshopper
(Author Unknown)
The Ants were spending a fine winter's day drying grain collected in the summertime. A Grasshopper, perishing with famine, passed by and earnestly begged for a little food. The Ants inquired of him, "Why did you not treasure up food during the summer?' He replied, "I had not leisure enough. I passed the days in singing." They then said in derision: "If you were foolish enough to sing all the summer, you must dance supperless to bed in the winter."
***
Is my career in EMS as a paramedic like one long summer as a grasshopper? Am I enjoying myself so much that I am not thinking clearly enough about my needs later in life?
Now I can argue that I am more ant than grasshopper. For the last ten years I have pounded away at my 401K, storing the maximum just about every year. I have also worked hard to try to pay down my mortgage. What started as a thirty year mortgage in 1999 stands at less than eight today. But if I were to hurt myself today, what would I do for work tomorrow? Who will hire a man in his middle forties? What is I am hurt in the future. Who will hire a man in his fifties? Or a man in his sixties?I have a college degree, but no recent practical work experience other than being a medic.
I have thought at times of law school. I could go at night and continue to work. A law degree would do me well in my later years. But what of the four years it would take me to get the degree? What kind of life would I have studying all the time? No time to write. No time for fun.
Isn't there something to be said for living for the day? I see people knocked down in their prime all the time, as well as people who stroke out as soon as they retire. All that savings going to the nursing home.
Last year, during a break in my writing I heard about a nursing program that allowed paramedics to get college credit for self-study nursing exams. The degree would be recognized by 48 states. While I had no real desire to be a nurse, I thought it might be a good education and a good insurance policy in the event I hurt myself or overtime dried up. I saw myself working as an ER nurse part-time while still working as a medic full-time, and then maybe in later years I could always be a night nurse at a nursing home, sitting at the wing desk, telling the nurses' aides to go see what Mrs. Brown wants in room E109.
I banged out five courses in five months -- Gerentology, Life Span Development, Anatomy and Physiology, MicroBiology and Nursing 1 with three As and 2 Bs. I actually enjoyed the learning. Very interesting material, except the Nursing 1, which was very boring -- all about nursing care plans.
I took the tests in a nearby town on a computer. They took less than 2 hours and I got my grade each time before leaving. I was all set to take Nursing 2 when I realized while I could probably pass the test, I really hadn't studied at all and what was the point in taking the course if I wasn't intent on learning. I postponed the exam. Subsequently I became very busy both writing and working.
Part of the reason I had to work so much was I got divorced and have had to buy my wife out of the house, so to stay ahead of the game (both paying her off and manitaining the house I don't quite have the spare cash flow I did to pay for the exams and college enrollment costs or the free days off to study.)
Anyway, since I had already registered to take the Nursing 2 exam, I had a year to take it. If I didn't take it by September 1, I would forfiet the $200 exam fee. So a few weeks ago I scheduled myself to take the exam, but never really got around to picking up a book. My plan was just go down, do the best I can, and hope I passed. Here's what the exam was on: Nutrition, Elimination, Oxygenation, Fluid and Electrolyte Balance, Activity and Mobility, and Rest and Sleep.
I was done with the test in an hour. I actually thought I was doing okay. I knew half the questions outright -- particuarly the ones on oxygenation and fluid and electrolyte balance, but I was lost on the questions about enemas and colostomies. I chose the answers that I thought were reasonable. There were 160 questions and I was done in an hour. If I didn't know, I didn't sweat it. I just clicked an answer and moved on.
I failed.
Serves me right.
Instead of being the ant studying, I was the grasshopper, working extra medic shifts and writing or playing poker in my free time.
Does this mean, the end of my nursing path? I don't think so. I wasn't going to take another class for awhile anyway. After taking Nursing 2, you have to pay $800 if I want to enroll in the program. You have to be enrolled to take Nursing 3-7. Each test cost about $200. After completing those courses, you do a two day clinical, where you show them you can do IVs, foleys, put pills in paper cups, and then you have to take care of three patients, writing a nursing plan, and making certain you wash your hands all the time, while a grey faced nurse with a pointy hat makes notations on a clipboard. The practical only has a 60% pass rate and costs $1500 to take. I wouldn't want to fail that.
Maybe sometime when I get more time, I will bear down and try to bang my way through the course, doing some real studying this time, but for now I am somewhat relieved. I feel like the kid in the Alice Cooper song "School's Out!"
"Schools out for Summer!...
No more books!"
I don't have that big book sitting on my desk that I kept avoiding. I am free to work on my novel for awhile and keep working on the blog.
Free to keep being a paramedic.
Free to be the grasshopper again.
I'm also free when I return to the courses to really sit down and learn about colostomies and enemas and nutruition and the rest. It really was sort of interesting.
***
Here's a link to the college.
Excelsior College
***
I would also like to add, I don't see a nursing degree as a step up to being a paramedic, more like an add-on, as you add on with courses like CCEMT-P. I reguarly train nurses who are making the jump to becomming paramedics. A medic for them is also expansion as opposed to a jump up or down.
I have also been very interested in doing international relief work due to my experience with Medical Ministries in the Dominican Republic. I was today reading about the organization Doctors without Borders. They will take nurses, but and they are very explicit on their web site -- they don't take applications from paramedics. Or plastic surgeons. Its not just medics who are on the outside.
Doctors Without Borders
My mother used to say I reminded her of the grasshopper in the story about the ants and the grasshopper. The grasshopper spent the whole summer playing music and eating and generally enjoying himself while the ants worked like ants and did nothing but find, carry and store food.
***
The Ants and the Grasshopper
(Author Unknown)
The Ants were spending a fine winter's day drying grain collected in the summertime. A Grasshopper, perishing with famine, passed by and earnestly begged for a little food. The Ants inquired of him, "Why did you not treasure up food during the summer?' He replied, "I had not leisure enough. I passed the days in singing." They then said in derision: "If you were foolish enough to sing all the summer, you must dance supperless to bed in the winter."
***
Is my career in EMS as a paramedic like one long summer as a grasshopper? Am I enjoying myself so much that I am not thinking clearly enough about my needs later in life?
Now I can argue that I am more ant than grasshopper. For the last ten years I have pounded away at my 401K, storing the maximum just about every year. I have also worked hard to try to pay down my mortgage. What started as a thirty year mortgage in 1999 stands at less than eight today. But if I were to hurt myself today, what would I do for work tomorrow? Who will hire a man in his middle forties? What is I am hurt in the future. Who will hire a man in his fifties? Or a man in his sixties?I have a college degree, but no recent practical work experience other than being a medic.
I have thought at times of law school. I could go at night and continue to work. A law degree would do me well in my later years. But what of the four years it would take me to get the degree? What kind of life would I have studying all the time? No time to write. No time for fun.
Isn't there something to be said for living for the day? I see people knocked down in their prime all the time, as well as people who stroke out as soon as they retire. All that savings going to the nursing home.
Last year, during a break in my writing I heard about a nursing program that allowed paramedics to get college credit for self-study nursing exams. The degree would be recognized by 48 states. While I had no real desire to be a nurse, I thought it might be a good education and a good insurance policy in the event I hurt myself or overtime dried up. I saw myself working as an ER nurse part-time while still working as a medic full-time, and then maybe in later years I could always be a night nurse at a nursing home, sitting at the wing desk, telling the nurses' aides to go see what Mrs. Brown wants in room E109.
I banged out five courses in five months -- Gerentology, Life Span Development, Anatomy and Physiology, MicroBiology and Nursing 1 with three As and 2 Bs. I actually enjoyed the learning. Very interesting material, except the Nursing 1, which was very boring -- all about nursing care plans.
I took the tests in a nearby town on a computer. They took less than 2 hours and I got my grade each time before leaving. I was all set to take Nursing 2 when I realized while I could probably pass the test, I really hadn't studied at all and what was the point in taking the course if I wasn't intent on learning. I postponed the exam. Subsequently I became very busy both writing and working.
Part of the reason I had to work so much was I got divorced and have had to buy my wife out of the house, so to stay ahead of the game (both paying her off and manitaining the house I don't quite have the spare cash flow I did to pay for the exams and college enrollment costs or the free days off to study.)
Anyway, since I had already registered to take the Nursing 2 exam, I had a year to take it. If I didn't take it by September 1, I would forfiet the $200 exam fee. So a few weeks ago I scheduled myself to take the exam, but never really got around to picking up a book. My plan was just go down, do the best I can, and hope I passed. Here's what the exam was on: Nutrition, Elimination, Oxygenation, Fluid and Electrolyte Balance, Activity and Mobility, and Rest and Sleep.
I was done with the test in an hour. I actually thought I was doing okay. I knew half the questions outright -- particuarly the ones on oxygenation and fluid and electrolyte balance, but I was lost on the questions about enemas and colostomies. I chose the answers that I thought were reasonable. There were 160 questions and I was done in an hour. If I didn't know, I didn't sweat it. I just clicked an answer and moved on.
I failed.
Serves me right.
Instead of being the ant studying, I was the grasshopper, working extra medic shifts and writing or playing poker in my free time.
Does this mean, the end of my nursing path? I don't think so. I wasn't going to take another class for awhile anyway. After taking Nursing 2, you have to pay $800 if I want to enroll in the program. You have to be enrolled to take Nursing 3-7. Each test cost about $200. After completing those courses, you do a two day clinical, where you show them you can do IVs, foleys, put pills in paper cups, and then you have to take care of three patients, writing a nursing plan, and making certain you wash your hands all the time, while a grey faced nurse with a pointy hat makes notations on a clipboard. The practical only has a 60% pass rate and costs $1500 to take. I wouldn't want to fail that.
Maybe sometime when I get more time, I will bear down and try to bang my way through the course, doing some real studying this time, but for now I am somewhat relieved. I feel like the kid in the Alice Cooper song "School's Out!"
"Schools out for Summer!...
No more books!"
I don't have that big book sitting on my desk that I kept avoiding. I am free to work on my novel for awhile and keep working on the blog.
Free to keep being a paramedic.
Free to be the grasshopper again.
I'm also free when I return to the courses to really sit down and learn about colostomies and enemas and nutruition and the rest. It really was sort of interesting.
***
Here's a link to the college.
Excelsior College
***
I would also like to add, I don't see a nursing degree as a step up to being a paramedic, more like an add-on, as you add on with courses like CCEMT-P. I reguarly train nurses who are making the jump to becomming paramedics. A medic for them is also expansion as opposed to a jump up or down.
I have also been very interested in doing international relief work due to my experience with Medical Ministries in the Dominican Republic. I was today reading about the organization Doctors without Borders. They will take nurses, but and they are very explicit on their web site -- they don't take applications from paramedics. Or plastic surgeons. Its not just medics who are on the outside.
Doctors Without Borders
Thursday, August 11, 2005
Viva Las Vegas
I'm on the Strip in Las Vegas. A volcano erupts in front of the Mirage, giant spumes of electrical lava shoot up into the night sky. Outside Treasure Island, an attacking pirate ship blasts it cannons, setting the rigging of a merchant ship on fire. I'm walking across the street when I hear a loud crash, then hear a police siren approaching. I hear a strange wobbling sound and look to see a car coming toward me on blown out tires, and realize the car is not stopping. It crashes into a car waiting at the light, then the driver leaps out and starts running, followed by the police officer who has leapt out of his car. The man turns the corner, slips, then the police officer is on him, and another officer appears. They have drawn guns. I can see a red laser light on the man's chest, then suddenly, he is jumping up, then I hear a dull firecracker sound, and see the man holding his arm, and then I am swept up in the panicking crowd.
The whole time I am thinking, wow, I'm in the middle of a Cops episode. Police cars are screaming in from all directions. I see a Fire Department paramedic ambulance hurtle past.
I look in the paper the next day to see if there are any accounts of the shooting, but I don't see anything.
***
I’m out here playing in a series of poker tournaments. I play okay, but don’t make the money. In the last tournament – No Limit Hold’em. I push all in with AK suited, only to be called by a pair of Kings. The community cards dealt out in the middle are no help and I’m knocked out. I stand to leave. The dealer is already dealing out the next hand. The game goes on without me.
***
Aside from my entry fees, and a few coins tossed in a slot machine, I don’t gamble any. Still I spend too much money. I take in a show, go to a nice restaurant, a couple clubs. Everybody has their hand out for tips. Waitresses, bartenders, bouncers, bellman, cab drivers. I carry a roll of ones, passing out bills two at a time like a big shot.
***
It is my first time in Las Vegas and I get to see what it is all about: Well dressed couples getting out of limos, drunken college students staggering from one casino to the next, street people handing out flyers for Girls Girls Girls, and old people riding around on Larks(motorized wheelchair scooters) with their 02 tanks in the back.
***
I go into a pawn shop -- filled with diamond rings, guitars, even fax machines -- they say people are always bringing them in, but never coming back for them.
***
At a souvenir stand I buy a poker chip with a photo of Las Vegas Elvis in the middle for $1.50.
***
I think about all these huge resort casinos -- Bellagio, Mandalay Bay, The Luxor, the Venetian and the new Wynn -- all built on people's loses. Now I guess as long as you gamble for entertainment and lose what you can afford to, I guess it's okay.
***
I stay downtown on Freemont Street -- Glitter Gulch – the old Vegas. I have a room at the Plaza for $25 a night. Beers down here are only $3. On the Strip they are $6. I eat the 99 cent shrimp cocktail at the Golden Gate and the $10.99 Steak and Lobster at Tony Romas.
***
One morning sitting in front of the hotel, I see a box ambulance with a familiar logo pull up, followed by a Las Vegas Fire Department ambulance. There is a man sleeping on a bench. They rouse him. He teeters when he stands. “Move on,” they say. “Move on.” He staggers across the street. They get back in their ambulances and drive away.
The whole time I am thinking, wow, I'm in the middle of a Cops episode. Police cars are screaming in from all directions. I see a Fire Department paramedic ambulance hurtle past.
I look in the paper the next day to see if there are any accounts of the shooting, but I don't see anything.
***
I’m out here playing in a series of poker tournaments. I play okay, but don’t make the money. In the last tournament – No Limit Hold’em. I push all in with AK suited, only to be called by a pair of Kings. The community cards dealt out in the middle are no help and I’m knocked out. I stand to leave. The dealer is already dealing out the next hand. The game goes on without me.
***
Aside from my entry fees, and a few coins tossed in a slot machine, I don’t gamble any. Still I spend too much money. I take in a show, go to a nice restaurant, a couple clubs. Everybody has their hand out for tips. Waitresses, bartenders, bouncers, bellman, cab drivers. I carry a roll of ones, passing out bills two at a time like a big shot.
***
It is my first time in Las Vegas and I get to see what it is all about: Well dressed couples getting out of limos, drunken college students staggering from one casino to the next, street people handing out flyers for Girls Girls Girls, and old people riding around on Larks(motorized wheelchair scooters) with their 02 tanks in the back.
***
I go into a pawn shop -- filled with diamond rings, guitars, even fax machines -- they say people are always bringing them in, but never coming back for them.
***
At a souvenir stand I buy a poker chip with a photo of Las Vegas Elvis in the middle for $1.50.
***
I think about all these huge resort casinos -- Bellagio, Mandalay Bay, The Luxor, the Venetian and the new Wynn -- all built on people's loses. Now I guess as long as you gamble for entertainment and lose what you can afford to, I guess it's okay.
***
I stay downtown on Freemont Street -- Glitter Gulch – the old Vegas. I have a room at the Plaza for $25 a night. Beers down here are only $3. On the Strip they are $6. I eat the 99 cent shrimp cocktail at the Golden Gate and the $10.99 Steak and Lobster at Tony Romas.
***
One morning sitting in front of the hotel, I see a box ambulance with a familiar logo pull up, followed by a Las Vegas Fire Department ambulance. There is a man sleeping on a bench. They rouse him. He teeters when he stands. “Move on,” they say. “Move on.” He staggers across the street. They get back in their ambulances and drive away.
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