Headline

 The headline in the paper catches me by surprise. “Iraq War Officially Ends.” With all the speculation leading up to the Invasion 10 years ago, the debate over weapons of mass destruction, then the shock and awe invasion, the fall of Bagdad, the Mission Accomplished banner, the resulting urban combat, the ICDs, flags flying at half mast. The Jessica Lynch story, the Iraqi prison scandal, the capture of Saddam, more urban combat and ICDs, more flags flying at half mast, it seems odd that the war is over just like that. There are no celebrations I know of, no couples kissing on Main Street, nothing seems to have changed. It is on the front page right there, but it has all the impact of a story buried deep in the paper. It is over? Was there a big battle we won or did we just decide enough is enough?

We get dispatched to the VA for a patient seeking detox. There are Christmas decorations in the lobby. A staff member wears a Santa hat. The doctor fills us in on our patient. The man admits to drinking a fifth of vodka a day. He apparently drinks nonstop. He is seeking detox. A nice man, the doctor says.

The patient, wearing brown fatigues, is sitting in a chair in the exam room. He is a giant – I’m guessing six six, two forty - but he struggles to get up from the chair. His body is stiff and his face contorts with pain as he moves. He hasn’t had a drink for three hours now, and already I can see the shakes in his big hands. We help him on the stretcher and try to get him comfortable. He says laying flat is best. He seems tense. I can see scars along his head and neck. He tells me has four purple hearts. He points out where shrapnel is still in his body. I ask him questions about the war. He was in both Afghanistan and Iraq. He was says he was part of an elite team that was there even before the invasion. He talks about dressing up like a sheik, wearing his beard long, gathering information. He tells funny stories about giving suitcases of heroin and bottles of Viagra to war lords for information. He had been in the army since he was he was 18. Almost twenty-five years.

For him he says it was all about his men. He has no interest in politics. Whether Washington or the chieftains he bribed for information and support, he says the nature of politicians is to change with circumstances to ensure their own survival. His loyalty was to his men, but with his injuries, he says he is of no use to them anymore. He is out now on 100% disability. “I haven’t been home but for two days since I got out,” he says. “I couldn’t stay there and let them see me like this. I live on the road now. I’ve got pain constantly and I can’t close my eyes without nightmares. I never drank till I got out. Now I can’t stop. I need help bad.”

I give him some fluid to ease the dehydration and 2 milligrams of Ativan to help with the withdrawal symptoms.

At the hospital, he thanks me, and I quickly thank him.

The paper can say what it wants. War doesn’t end.

Come on, People

 The young woman says her knee has given out. She thinks it is dislocated, but you can’t tell because you can’t even see the knee. She says she is five hundred pounds. She can’t get up on her own. One ambulance crew can’t do it. Try pulling her up by the arms and you will pull them right of their sockets. And if the sockets held, your backs wouldn’t. Also, we are on the third floor. No elevator. Tight corners in the apartment, lots of heavy furniture.

But then help is here. Now there are four of you. Throw in 10 mg of morphine and you have the start of a plan. The patient has said if you can just get her up to her feet, she may be able to hop down to the ambulance. Wishful thinking perhaps. Ever the optimist, I am. And if she can’t hobble, if you can get her to her feet, you can at least have her in a chair while you figure out your next move.

You go to old reliable to get her up. Get a board under her, strap her to the board. Sure she is hanging off both sides, but that’s what double belts are for. But first, you splint the knee. How do you splint a knee that wide. A KED -- wrap it around the knee like it is a torso. Now, its time to lift. Put one person on each side, one arm under the patients arm and the other holding a hole in the board. A third person at the feet to keep the person from sliding off the board as you lift it. And you, squatting down at the head end, and with a big grunt lifting, driving your legs up, as the two on each side, pull. Leverage. You have her standing in no time, and the four of you hold her up. My leg! My leg hurts! she says. So you quickly go to Plan B. The two chairs you have placed just to the side, and you quickly unstrap her and pivot her onto the chairs, where she now rests and lets out her breath. And then you turn and look behind you and see eight family members crowded into the room – every one of them holding a digital camera or video recorder, recording your every move.

You look at them and hold your hands up? You say nothing. You think what’s with the cameras, people, seriously? Is this to make fun of your sister? Is this to sue us? I admit that while I love my job and love the people of the great city where I work, in this moment, I am profoundly disappointed in these individuals.

The other medic on the call speaks to them professionally and succinctly and they put the cameras away. I am still shaking my head.

Come on, people.

***

The bottom line on the call was an hour and a half scene time, and only with an assist from our first responder friends at the fire department (who had not been dispatched to this call) and a hunt for a Stokes basket large enough to fit her into and with much pushing and hauling and moving of furniture and turning tight corners and going down a narrow stairway with wobbly wooden stairs, did we finally make our way outside. The other medic ended up taking the patient in, while I attended to and transported an injured responder. I haven’t yet found out whether or not the patient’s knee was dislocated. And as far as I know, we haven’t turned up on You Tube.

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.