Straight Blade

 We are called for the violent psych and told to stage for police. Years ago we would have just been called for the violent psych. Once we got there, if we needed the police we would call for them, or depending on how the call came in, they might already be there.

This morning the call is at a nursing home and when we get there the cops are not there yet. We wait a few minutes, and then just decide to go in. It is not like we are entering a house with a violent mental patient barricaded inside. At the desk, they tell us he is up on the 2nd floor. As we wait for the elevator, the policewoman walks in the door. She is a petite woman, unlikely to be able to wrestle a raging maniac, but she does have a gun and night stick.

On the 2nd floor, the nurse points out the patient, sitting in a wheel chair by the desk with his eyes closed. He is large and muscular—built like a bull – with a scar on his hard face. He looks likes the strong man in the movies who the hero punches, but the punch does not even make the man flinch. Still his body appears relaxed, and he looks up at us without menace.

I introduce myself and my partner to him, and he nods and says hello. As I help him onto the stretcher, my partner asks the nurse what happened. To get on the stretcher, the patient locks the wheels of his chair and then moves himself over with his muscular arms, as I hold the stretcher in place. I notice then his right leg is amputated above the knee.

“He threatened to kill one of the patients here,” the nurse says. “He said he was going to stab her with a knife.”

“No,” he says. “I said I would slit her throat from ear to ear with my straight razor if I had it, but I no longer carry a straight razor.”

“Say what?” the officer says, “You want to repeat that for me, honey?”

“I said I would slit her from ear to ear. The dirty bitch stole my shirt. Everyday she steals from me, and they do nothing about it.”

“Where’s your knife?” the officer says. “He has a knife?”

“No, I am without weapons. I said I no longer carry a straight razor, nor do I have a gun at my side. I gave up my violent trade. I was just saying if I had my straight razor, she would bleed for what she does to me. The dirty whore, stealing from me and they do nothing.”

“What hospital are we going to?” I ask the nurse, as the officer stands there still trying to understand if a true threat has been made.

“Hospital B,” the nurse says.

“B,” my partner says. “We almost always go to A from this facility.”

“Yes,” the nurse says, “But we have learned when we send patients to A, they send them right back. If we send them to B, we do not see them for awhile.”

“There you go,” my partner says, and the nurses all laugh.

“Did you really mean to do violence?” the officer asks the man.

“How can I slit her throat when I no longer carry my straight blade? But if I did carry it, it would always be near my hand, and she would feel its edge.” He says, “I do not like to be stolen from, to be made a fool.”

We get our paperwork and take him to hospital B. On the way out, he sees another nurse and says. “You call for them to take me to jail, you better come down and pay to get me out. I know you have money.”

The nurse just laughs and shakes her head at him.

At the hospital, the triage nurse also shakes her head at his story.

After we transfer him over to the hospital bed, we ask, as we always do if there is anything more we can do for him. “If I might have my mouth swabbed,” he says. “It has has been several days since I have had my teeth cleaned, and I do not wish my breath to be foul.”

A Warm Kitchen

 I watch as he slices a pear, an orange, and a banana and sets them next to the red grapes on the plate. He pours me a glass of orange juice and then lays out plates of sausage, low sodium bacon, honey glazed ham, and potatoes. From the oven he takes out French toast.

A month before a supervisor handed me an envelope at work when I came in off 12 hours on the road. I opened it up that night, and found a two page, single spaced typed letter from a patient I’d taken care of this summer asking me to call him. He said while he does not remember much about the call, a nurse had told him at the hospital that he needed to find me and thank me. He said he wanted to do it in person. He is a chef and wanted to cook for me.

When he met me at his door, I told him he looked good, and he does. He says he has lost forty pounds, has a new medicine regime, goes to cardiac rehab, and now he has a defibrillator in his chest. He says he is grateful for each day.

We sit and eat and talk about our lives in the kitchen of his home. Like me he has a young daughter born later in his life. She calls while we are eating and asks him to find a folder she forgot to bring to school. Both of us talk about how having a child has changed our lives.

I don’t know why it took me almost three weeks to call him. But I am glad I did. In our line of work, we separate ourselves from our patients. We become a tribe unto ourselves. Here this morning, as the two of us talk about growing up in the area and raising families while doing the things we love, I feel like I am part of something larger – a part of the community. We rise in the darkness, go out into the world, and at the end of the working day, come home to our families. We are surrounded by others, grocers, bankers, electricians, teachers, factory workers. I am a paramedic and he is a chef.

He tells me how the French toast is made out of artisan bread. He sliced the bread into cubes and mixed the cubes with chunks of apple, then piled them on top of uncut slices of bread and baked them with just a touch of cinnamon. The toast is rich and delicious; the kitchen warm. We talk like old friends.

A Younger Man

The snow started in the afternoon earlier and harder than expected. I got the kids inside with some DVD’s and pizza. I cracked the thermostats up to give us some heat in the event we lost power that evening, which was the worry with the autumn trees still being so full of leaves and the snow predicted to be wet and heavy. The kids didn’t get halfway through RIO before the lights went out. They were impatient for it to come back on, but with daylight still present, and a quick call to Grandma confirming she had power, I packed them up with a couple days clothes and some food and drove through the storm. Once I had them safe, I headed back home to wait the storm out. Getting home was crazy. Power lines and trees down, streets blocked. I was happy to make it back to my driveway unscathed. All that night you could hear the trees cracking and the wind whistling. Occasionally the sky light up green as transformers blew. Instead of four inches, we’d gotten 12.

When the storm was over 800,000 plus in the state were out of power. Many of the towns like my own were 100% out. The devastation was rare to our area, which at worse gets a blizzard or a weakened hurricane. Many roads were impassable. Trees were down in nearly every yard.

I slept at night in long johns and under every blanket in the house. On the fifth night the temperature in the house dipped down to 48, and the cold took root in my bones. I came home the next afternoon to find the power finally on, although still no phone or cable service. I was lucky as many of my neighbors were still and are still in the dark. The utility company said everyone would have their power restored by midnight of the eight night, but it hasn’t happened.

This morning we responded to a fall. The house a nicely kept middle class home, not far from a commercial center, was dark and cold when we walked in. No power here. In the bedroom we found a 89 year old man in bed, skin pale and cool and dry, shivering under a mound of blankets, wearing a winter jacket and a baseball cap that said 101st Airbourne. A first responder told me the man’s legs had given out and he’d fallen against a table and bruised his chest. It was 42 degrees in the house, and now he couldn’t stop shaking.

“He was at the Siege of Bastonge,” the responder said.

There are place names that invoke awe. Bastonge is one of them. Late in World War II, the Germans mounted a massive surprise attack against the Allied lines in Belgium under the cover of severe weather. The 101st airborne were surrounded in the Ardennes forest near the town of Bastogne. Unable to be reinforced, they dug in in foxholes, fighting subzero temperatures, while being blasted by artillery. They were critically short on food, medicine and ammo, but they repeatedly refused entreaties to surrender. Some of them froze to death. Still they held the Nazis off for a week until General Patton’s tanks could come to their rescue. More commonly known as the Battle of the Bulge (the Bulge signifying the near break in the Allied lines), it was a key turning point in the war that devastated the Germans’ hopes to hold off the Allied advance.

“If you haven’t heard it enough, thank you.” I said to the old man, and then added, “I guess this cold now must all be like a summer day to you.”

“I was a younger man then,” he said, quietly. 

EMS Towns

 Many years ago, I was a taxi cab driver. Us cabbies used to talk about cab towns. What was a good cab town and what was a bad cab town? A good cab town was always hopping. People used cabs instead of cars. There were no traffic jams. The rides were of conversation distance. You wanted at least a $7 dollar fare. You hated the take me three blocks calls. In a good cab town, cops couldn’t be bothered to hassle cabbies. And in a good town, people knew how to tip proper. At least ten percent of the fare and lots of keep the change, buddys. You could make a living in a good cab town without having to hustle all the time, and if you did hustle all the time, which is what we did, you could make a fine living. A bad cab town, on the other hand, had short rides, dime tips, parking lot traffic, cops who like to bust on cabbies and a safe and functional bus system.

Having worked in more than a few towns in EMS, I can tell you there are good EMS towns and bad EMS towns. A good EMS town has single floor homes, not too many nursing homes, a populace educated enough not to call 911 for a genital wart, and enough highways, industrial buildings and driveways that need shoveling to ensure that when EMS is called, the people likely really do need a paramedic. A bad EMS town has three and four floor walkups, apartment buildings with broken elevators, nursing homes as a their cottage industry, a populace without cars and a dsyfunctional transportation system. A bad EMS town isn’t necessarily a poor city. Sometimes architecture alone can be a drawback. Some of these nice two story homes in upper class towns are such that the patient is always bedbound up on the second floor and there is little room to maneuver at the top of the stairs, and the staircases are narrow and steep, and there is artwork on the stairwell walls, and antiques on the landings. In bad EMS towns, they don't like bad weather boots on their carpets. I will take a town of humble single story homes any day over most anything.

It is hard to find a town with all the elements of a good EMS town. And of course, it varies with what you like to respond to. Don’t like trauma? You don’t want an interstate or windy back roads in your town, nor do you want hip hop clubs and crack houses. Don’t like sick old vomiting people? You don’t want an elderly population. If you like crazy people, the city is for you. If you don't like crazy people, I have news for you, crazy people are in every town! Tired of taking people two blocks to the hospital for a finger lac? Find a town without a hospital in it.

Me, I like variety, which I get now. I respond in several different towns during the day depending where system status management has me posted. Variety is good, but I also like decent calls. By decent I mean if someone is going to call 911; I like them to really need us. I like to have my skills and knowledge challenged. Although sometimes, I am content to not have to do more than be a taxi driver again. I don’t get tips anymore, but my paycheck has always been good at the bank.