A HUGE DUDE LOSES HIS CHIN AND HIS SHIT

 

Apparently, this cat was talking on his cell phone and then, for no clear reason, ate pavement. According to the witness, he just dropped. When we found him, his mouth was around someone front step and there was a pool of blood and some teeth nearby. Securing his spine, we rolled him over, back boarded him, got him on the bus, took a better look. He’d somehow managed to slice his chin almost off — it looked like the butt of a french roll of bread but it was still attached slightly so when we put the c-collar on the chin got flipped upwards and was resting on his mouth.
He was still completely knocked out when PD asked if we needed them and we said no thank you and pulled off and THEN homeboy decided to wake up. I was driving, but apparently his eyes popped open and he went right for the collar around his neck, Frankenstein style. Then, and this I heard along with probably half of the East Village, he said “WHAT THE FUCK!?!”
I pulled over the ambulance.
The dude I was working with is solid enough but we had a student that day, more or less the intern from 30 Rock, and the patient was easily 300 lbs and pissed. He had already unstrapped his upper body and was sitting up straight, swiping at the student and yelling “REALLY? YOU GONNA DO ME LIKE THAT? THIS IS HOW YOU GONNA DO ME? REALLY?” While the student just made little cooing noises and said “no, no, that’s not how we did you sir! We didn’t do you like that!”
The cops had been following us and when they saw me pull over they jumped out and we all rushed the back compartment. The guy had a big broken tooth grin on and he was looking back and forth at us with wide, uncomprehending eyes and giggling and repeating one of the above phrases like a damn Elmo doll on crack.
“Just lie down, buddy,” one of the cops said.
“REALLY THOUGH? WHAT THE-”
‘Lie down!”
You can’t reason with folks when they’re off the deep end like that. His chin was still flapping back and forth on his face and he was covered in blood and still grinning like an asshole.
Fuck it, my partner said, unimpressed. Just roll carefully.
And he was right. You’re not gonna win coming at the dude, he wont’ be talked into normalcy, and it’d take more than the two cops and three of us to wrastle him into any kind of submission. I rolled carefully and when we got to the ER and reeled him out he was still on that same shit, except now he was reaching into his mouth and trying to pull out shards of his own teeth. Which he then ate.
With some struggle, we got him into the ER and thru to the trauma room, where the assembled doctors asked us: What happened to this dude?
I let him answer that question himself.

NOTES ON ENABLING & A COMPLICATED EXTRACTION

There’s a scene in the Buddhacarita where the young Buddha-to-be is sneaking out of his palace one early morning after another night of debauchery. They spend about a full chapter doing the literary equivalent of a slow-pan over all these once gorgeous women all splayed out, makeup smudged, body parts erupting from their clothes in all kinds of rude ways – a total morning after fashion catastrophe.
My job is like that scene sometimes, most specifically between the hours of say 4 AM and noon, when folks that are trying to make it out home from the clubs for one reason or another don’t and end up in the back of my ambulance instead. And then puke.
It’s not the puke or pee or, worst of all the #2s that I mind so much…Okay, no, I take that back, it is. But what adds insult to, ugh, to injury, is the sheer regularity, the predictability factor that’s involved with ferrying the same, yes the same, damn drunks back and forth to the ER night after night after night. It’s to the point where you start to feel like an enabler, because really, that’s all you are: someone who gets these folks off the street and into a warm place so they can wander out a few hours later and do the whole thing again. And again and again. And you try, you really fucking try, not to let the regularity of all that depravity get to you and make you into some gigantic asshole. And usually you succeed. But it’s really that, moreso than the death or the danger or the severed body parts or exposed intestines or whatever, it’s THAT that makes this job so difficult and the burnout rates so high.

ANYWAY, that’s not what I’m here to talk about today.
Last week, we had a patient that weighed damn near 600 pounds, couldn’t get out of bed and had had her first seizure in ten years. Her husband was probably not playing with a full deck and stood WAY too close to people when he spoke. He also had the disconcerting habit of treating everyone like he knew them from waybackwhen. Not just in the buddy buddy way; he would go “Oh hey *mumbles*! How’s the *mumbles* from before thingy thing? Oh yeah? Great! And anyway *mumbles* remember?”
And we were like *nod nod* “No.”
But he was unfazed, dude just rambled along regardless.
We called for Fire because they’ve got a special basket for removing the extremely enormous. Crazy husband wanted to know why we didn’t just put her on the stretcher.
“The stretcher can only hold 400 pounds.”
“Oh! Well she’s about 475 so…” He looked at us like the explanation was obvious.
We looked at him like O_O
First of all, she was maybe 475 lbs at birth, but certainly not at this moment. Second of all…no. So Fire showed up, after that awesome conversation, and they’d already been there before. You could tell because as soon as they walked in they started stepping away from the Crazy Husband, who went right up waaay too close to the nearest fireman and said “Oh hey Theoihsofihdgdgjk! Remember the ohgiughdughdgd??”
The Fire Captain explained that the patient didn’t fit in their special basket, they’d already tried and they’d have to call Rescue, cuz they have an even specialer net system for such situations.
Meanwhile, the husband still didn’t understand why we couldn’t just put her on our damn stretcher and be done with the whole thing. For everyone’s sanity, we had to start tuning him out around this point. We’d been onscene for well over an hour, drifting in and out of the apartment as much as our noses could stand it  when Rescue made an appearance. They did indeed have a complicated gladiator-style cargo net contraption that we ended up wrapping around the woman and using to lower her onto a special sled. “You alright, dear?” I asked as eight of us guided her from the bed to the sled. She nodded, said she was fine thank you very much and asked how much longer all this would take. The whole thing took about two hours, not counting decon time (she had been in that bed a loooong time) but we finally got her onto our ambulance and around the corner, literally around the corner, to the hospital.

WEIRD LITTLE RUNNING GUY RUNS OFF

I know this job is gonna be ignorant the second it comes over because the text is telling me to go to a psyche facility to pick up a patient acting mentally unstable. I’m already deeply unimpressed and we haven’t even got on scene. However, I’m also happy: psych patients usually walk all by themselves and provide for good conversation to boot. This one, as if to prove my point. disappears up a flight and is gone the second we arrive. The guy running the place comes over looking exhausted.
“This guy’s acting fucking crazy!”
“Sir…this is a psychiatric facility, correct?”
(I shouldn’t even need to have this conversation)
“Yes, but he’s really acting bonkers man! He might set the place on fire or something.”
It’s amazing how two people can create total chaos all by themselves.
“We don’t chase people,” I say, putting down my bags and sitting my Cuban ass in a chair.

Usually PD is all over a job like this. They love gettn all hunkered down in their gear and tasering people or putting them in the slug outfit or whatever. But perhaps they gleamed from the job text how utterly ridiculous this was gonna be and didn’t bother. I get on the radio and ask for a squad car. Jumping on people is their job, not mine.
“I think he took too much of his meds,” the stressed out guy in charge tells me.
“You don’t mean too few?”
“No! Too many!” (maybe he’s not the only one?) “He was sitting right there and then he just started rolling around the floor! It was…crazy!”
Again…ah forget it.
Then the guy comes running past. He’s little, filthy, mustached. Wearing an Aerosmith shirt from circa 1976. And he’s fast! I barely realize he’s there before he’s out the door and off into the night.
“There goes your guy,” I tell the supervisor. He turns around and runs out the door too. I put some gum in my mouth.
Supervisor comes back in a minute later. Tells me PD showed up and took off after the guy down the block. My partner and i saunter outside, see PD reversing in a fury toward Fulton Street as homeboy cuts a hard left and disappears. We saunter into ambulance and at a saunterly pace roll around the block.

PD is having an extended negotiation with the dude when we show up, which is amusing mostly because they don’t speak Spanish and he barely speaks English. He’s carrying on about someone ganking his dinero, they’re all: ‘Sir, you’re gonna havta calm down. Sir.”
I tell him in Spanish he gotta go to the hospital, get on the ambulance right now.
He curses out all of us, all our mothers, all our sisters, all that we hold sacred but sheepishly complies.
In the ambulance, I notice he’s utterly wasted and won’t stop chewing. Not in the gum kinda way. In the way old people do all the time. Might be the Parkinson’s like effects of certain anti-pyschotic meds, or perhaps it’s just him being high. It doesn’t matter toooo much, and we roll of the hospital. When we get in the ER first thing he does is spit a walnut on the ground. Everyone groans.
I hate it when my patients are rude to the ER staff and I tell him. He looks at me like, meh? and he’s still chewing. Ugh. “Ju my frien’,” he informs me. “Ju too,” he tells my partner. Terrrrrific. While they’re taking his vital signs he produces an EKG electrode from somewhere in that mouth of his, regards it for a second and then puts it back in his mouth. I think me, my partner, the nurse and the registration lady all facepalmed at exactly the same moment.

THE SINGING HEART ATTACK

Fire men were standing in their usual confused huddle around a bench outside the Myrtle Ave projects. One of them came and met us on the walkway. “Um, he’s having chest pain, we think and he had a…seizure…maybe…”
And?
He looked nervous. “And he’s…singing.”
Indeed, the slurred, drunken strains of I’ll Be There were wafting out from the center of the firemen’s circle and we knew it was Singin’ Joe.
This dude calls every couple days when he’s lonely or cold or just too drunk to get home. He was sitting jauntily on the bench, looking back and forth at the confused FDNY dudes, singing at the top of his lungs thru his oxygen mask and punctuating his song with the occasional scream of “OH MY HEART!! OW! OW!…I’ll be thaayayare!!”
“Whatsa matter Singing Joe?”
“Oh I was at dis ol party on the second flo’ and I caught a heart atta- no wait I caught seizure. I caught a seizure. JUST REMEMBER…Yeah!”
“So you came down stairs?”
“Uh huh, I’ll be thaaaayaaaree!”
I wave at Fire. “You can take that oxygen mask off.”
One of the boys goes to pull off the little plastic piece and Joe rolls his eyes back and starts twitching, his great big fro waving back and forth like a peacock tail. The fireman jumps back, horrified. “I’m ca-a-a-tchin a see-e-e-e-iz-ure a-a-a-aga-a-a-ai-n!!! Oh my chest, FUCK!”
I’m biting my finger not to laugh. “Just get on my stretcher, Joe. Seriously. You can finish your seizure on the bus.”
He obligingly brings his shaking to a dramatic close and climbs up onto our stretcher (Singing Joe is fucking tiny, by the way- more fro than dude.)

All the ER nurses turn and smile when we wheel Joe in. He’s crooning at the top of his lungs again, waving at his adoring fans like the drunken king of Brooklyn.

THE GREAT ACID RAIN STINK BALL of 1995

It was 5:40 am and we get off at 6. They wanted us to go get a “DIFFBREATHER” on Nostrand and Lexington and I wasn’t mad at it cuz it was on the corner and corner jobs are usually grabngo.
As we roll up a little Mexican dude and wiley haired black guy are waving to us frantically. They both look happily trashed, neither is strugglin’ to breath, (no surprise there).
-You guys are heroes, the Mexican tells me in Spanish.
-Gracias, I say. Why are we here?
He points to the other dude, who’s either completely fucking Blitzed or completely fucking nuts.
-He came into my corner store, he tells me as if that explained it all.
-And?
-He looked…well, look at heem.
Whatever. We put the dude in the truck and the Mexican told us we were heroes again and went on his merry drunk way.

My partner Mr. C was lookin edgy but I didn’t know why cuz I was standing outside the ambulance on the bumper.
-Whats the problem today, sir?
-Where you in New York City in 1995? The guys asks Mr. C.
-Uh…no.
He looks at me. –What about you? New York City, 1995?
-nope.
The dude looked crestfallen.
-Why you wanna know?
-Acid rain.
That’s when I stepped into the ambulance and it hit me: a thick wave of the WORST most stankiest foulest most nastiest stanky stink E V E R was hovering like a brown cloud of shitstain. The guy smelled like the asshole of an armpit. I steadied myself with one hand.
-Alright what hospital you go to?
-He goes to the hospital we can get to fastest, Mr. C said.
I concurred and literally jumped out the back the ambulance. The dude picked something out of his ear and looked at nothing in particular with those big boggly eyes.

I was feelin kinda bad about leaving Mr C back there but then i hopped up front and realized the smell was not contained to the back cabinet. The foulness fucking surrounded me, demolished my whole sense of self for a few seconds until I cleared my head. I looked down and watched the milk in my coffee curdle (Ok, that’s not true- i never put milk in my coffee…)
All the windows on the ambulance rolled down simultaneously. I switched my heavy duty lights and get-the-fuck-out-my-way sirens on, hung my head out the drivers side window and hauled ass to the hospital past wilting flowers and dying squirrels. Made it there at 5:51, panting, and spent the last nine minutes of tour airing out ambulance.

TOO LITTLE TOO LATE

It’s amazing how many calls we get for old men that wanna complain about the “tiny little guys” running around their apartments. There must be an infestation of freaky leprechauns in the city. I know it’s gonna turn up in 1 of my short stories soon…
But anyway, that’s not today’s topic. Today’s we’re here to discuss the little dude that makes sandwhiches at one of the delis of 125th St in Harlem. He called because he was having pain all up and down his left side (came over as a CARDIAC job, because they included the chest in “all over”…smh). So he’s 32 years old, no medical problems, no medications and he’s basically rocking back and forth and going “OOOh it feels so WEIRD! It feels SO Weird!”
what’s weird?
My whole left side of my body!
Does it hurt?
No! I can’t feel it! Or it’s like pins and needles! Aiiiii!
How long it’s been going on?
Since the day before yesterday…
Anything else wrong?
Yeah, when I poop: blood comes out…
Oh boy…how long THAT been going on??
Since about…well, matterafact since the day before yesterday!
What the hell happened the day before yesterday?
I fell down the stairs.
How many stairs you fell down?
Shit…all of ‘em.
…And you’ve been shitting blood ever since?
Yep.
And you can’t feel half your body?
Uh huh. You think Imma be alright?
NO I DON’T THINK YER GONNA BE ALRIGHT! …jeeeeeze…(aside: do you really need me to tell you that?)
So you think I should go to the hospital?
No, I think you should’ve gone to the hospital 2 days ago when you ruptured your internal organs and severed your damn spinal cord but now u HAVE to go to the hospital…
Sigh….okay let’s go…
That is all.

2 CRAZY GERIS

TWO CRAZY GERIS
One of the crappiest parts about this job is the fact that no matter how fucked up your night was, no matter how tired you are, how many chests you pumped on or IVs you started or whining buttheads you dragged 2 the hospital, you can still get hit with an assignment right up until the minute you get off. So at 6:59 am, after a 12 hour tour, we can end up driving all the way up town for some nonsense. And the rule seems to be that those late jobs are always one form of clusterfuck or another- like, somehow, something always goes wrong.
Okay, not always. Sometimes we do a grab n go:
:::ambulance screeches up to Slightly Intoxicated Mexican dude with no shirt on:::
Me: Get in!
SIM: My neck feels funny…
Me: Get in the bus. We talk inside.
::::he gets in::::
Me: What hurts?
SIM: My neck, it doesn’t hurt but it feels funny.
Me: for how long?
SIM: Like, 2 weeks, guey.
Me (to my partner): Go go go!
:::ambulance screeches off::::
And then, sometimes we actually get home on time.
Last month, we got the job for the UNCONCIOUS at 6:30, which could’ve been a quickie but it was a old lady up in a apartment, so you know it’s gonna be slow. Most of the time, theyre really not unconscious, they’re either napping or felt a little woozy, unless they’re in a nursing home and then they’re usually dead.
This lady wasn’t in a nursing home and she wasn’t unconscious, in fact, she wouldn’t shut up. We heard her yelling from down the hall and us comin inside only made it worse.
“Me not going to the hospital! Just wanna drink me tea! Leave me ‘lone I tell you!”
It was one of these get gramma out the house for whatever reason things, probably cuz she’s won’t stop yelling, so call 911 and have us deal with her. We get that a lot towards the weekends…
Anyway, she also kinda had to go anyway, cuz she had like fourteen billion medical problems, was borderline insane and her toes were rotting off.
But she wasn’t having it. Her poor husband was actually dying of cancer in the other room, but I think he really just needed a good nights sleep. Then the daughter showed up and started cursing out the old lady “Just go with the goddamn ambulance people, ma, you always do this, ma, seriously, we go through this every FucKING WEEK!” and then to us: “I’m so sorry, boys, really…”
But without her tea it was a no go.
We sent someone to put the kettle on, but really it was a battle of wills. You could tell she was starting to cave when she got pouty and stopped yelling and carrying on- the non-logic of tea over amputated feet had been barreled over by the sheer strength of her daughter’s curseout.
“But I can get up me own self,” she insisted after finally relenting. “If I can make it to bathroom on me self and make it to kitchen to make me tea, why you think me can’t go to ambulance me self?”
Far be it for me to tell someone that I don’t have to carry their ass- I’m usually the first to agree. Unfortunately for everyone though, grammy’s feet were wrapped in leaking, yellow stained bandages that hadn’t been changed in…weeks at least. Damn near had to wrestle her onto the chair and she actually took a swipe at me as we carted her out, but all in all, granma made it to hosp and everyone else breathed a sigh of relief.
Then last week- we came for the DIFFBREATHER on top of one of those pjs along marcus garvey. The man was ancient! Skin like crinkled up paper, long boney legs bent into an antique wheelchair.
“did you ask for the police to come to?” he wanted to know when we came in. I put a message over the radio for them.
-what’s wrong today sir? You feel okay?
…yes. Yes feel alright.
The apartment was dusty and mostly empty.
-Do you wanna go to the hospital?
-Yes…Yes I think I do.
Ok…Any pain anywhere? Any trouble breathing?
No. None at all.
That’s nice. Why did you, ah…call…911…today…sir?
Lemme get back to talkin’ to my daughter for as sec, he says, indicating an empty corner behind him.
I was about to be able to explain the whole weird episode away as a oh he’s bonkers but then i saw the phone sitting there off the hook. I passed him the receiver.
No- he says- no, dear, it’s just something i have to do. I can’t stand him being here anymore. No, he’s out now. No…I know…It’s just the way it’s gotta be. Okay…alright.
He passed me the phone to hangup.
Popo couldn’t get much more outta him than we could.
Basically, the cop says, you just wanna go to the hospital but nothings wrong?
That was the gist of it. When I went to help him up from his wheel chair and into ours, he reached one long arm into the pillow behind his back, retrieved a 10” butcher knife and handed it nonchalantly to my partner with a curt: hold this for me.
“Uh…ok…” she gingerly placed on the dust covered kitchen table and we wheeled him the fuck out the door.

EMS WTF FAQ

Okay people- I realize as I’m scratching out all these stories that a lot of folks don’t have much idea what the this whole EMS thing is all about. So here’s a primer for those that’re interested.

Q: What the hell is EMS anyway?

A: EMS is the Emergency Medical Services. That’s the whole system. There’s the transport side, which is mostly when nursing homes, dialysis centers, etc have contracts with private companies and call an ambulance to get their clients towed back and forth inbetween, and then there’s 911- which is when you call 911 and someone at 9 Metrotech in downtown Brooklyn directs your call to EMS and a GPS system tells them which 911 ambulance is closer. 911 has private ambulance companies, hospital ambulances and FDNY ambulances in it, all doing the same job and each claiming the other is full of useless skells and lowlifes.

Q: What are you- EMT? Paramedic? What’s the difference?

A: There’s Basic Life Support and Advanced Life Support. EMT means Emergency Medical Technicians; they do BLS, which includes bandaging, immobilizing, bleeding management, delivery of oxygen and a few medications and transportation to the hospital. Paramedics (that’s me) do ALS, which involves more invasive procedures like giving IVs, intubation, needle cricothryoidotomy (putting a HUGE ass needle right below someone’s adam’s apple when they have an airway obstruction) and chest decompression (putting that same hugeass needle inbetween someone’s ribs to let the air out of their chest cavity when their lung collapses.) We also give medications, about 50 of them from Adenosine to Vasopressin, and are equipped to do for an asthma or heart attack what any Emergency Room would do in the first hour of treatment. If you call 911 and say you stubbed your toe they’ll send you EMTs. If you say you stubbed your toe and your chest hurts, you’ll probably get medics. If you tell them you stubbed your toe and now you’re dead, they’ll send both. It’s happened. Sometimes EMTs will get called for the sick and get there and find a heart attack, so they can call for us. You get shot, it’s EMTs unless you get so shot up your unconscious or dead. That’s why sometimes we medics keep an ear to PD radio and take a quick ride over when there’s a shooting. If you “feel weird” you get EMTs unless you’re especially old or diabetic, then you get us. It’s all a little ridiculous but also there’sa weird logic to it. I’ll just say, when the man called the other night to tell 911 that he was unconscious, they made the job an “UNCONSCIOUS” and sent us. If you just had a seizure it’s EMTs but if you’re having one, even if you’re the one saying you’re having one, it’s a “STAT EP” (status epilepticus) and it’s medics. Even the guy that calls every other weekend because he feels like he’s about to have a seizure, but never actually does, even he gets medics, even though he’s actually an EDP and EDPs get EMTs.

Q: What’s an EDP?

A: Emotionally Disturbed Person. Aaah we could go on for hours about the many wondrous events that happen when folks don’t take their psych meds or lose their shit for one reason or another. Any of us could go EDP at any given moment, far as I can tell, cuz they range the range across all borders. Many jobs will start as DIFF BREATHER and end up as EDP when we get there and patient says something like “I haven’t been able to exhale for like three days,” or “I haven’t taken my psyche meds and I want to fucking kill somebody.” Sometimes EDPs hide behind locked doors, which makes them BARRICADED EDPs, or hide weapons places (“that’s just my rock…i keep him in a sock…” which makes them VIOLENT EDPs. They can also stand up on high places, when they become the JUMPERUP, and then fall, when they become JUMPERDOWN.

NYPD is always getting into a hot mess over EDPs and then having to get retrained on how to deal with them. Usually its cuz they get confrontational with em, and the last person you need to argue with is someone who’s completely disengaged from reality (“Sir, you need to go to the hospital.” “I am in the hospital…” “uh…”). It’s like arguing with the last drunk guy at the party. (most recently see: Iman Morales, who was screaming naked on a Bed Stuy fire escape before PD tasered him, causing him to fall to his death.)

Q: Do you really drive the ambulance?

A: We do and yes it’s really cool but blowing lights and parting traffic jams like the red sea is really not nearly as cool as some of the shit that happens in the back of the ambulance. But people are usually more excited about the woop-woop.

Q: What’s like the craziest shit you’ve ever seen?

A: Why do people always ask that like they’re the first person to think of asking it? I dunno, depends on when you ask I guess. I’ll probably blog about it sometime…

Q: Do people really call for stubbed toes?

A: Stubbed toes, runny noses, burning genitalia, crying babies. “I feel: tired, sick, lonely, strange, different, okay, weird…” “I have an appointment at the hospital.” “I just needed to get out of my house for a while.” “I was bored.” “I hate my husband.” “Can you look at this huge cyst I have on my nuts?” “My tooth hurts since like, three weeks ago.” “I don’t want to talk about it.” “I’m bleeding from vagina, same as i was about a month ago.” “i can’t get out of my chair but i don’t want to got to the hospital, just help me…get…unstuck…”

Those are really the vast majority of our calls. About 80% let’s say is freakish dumbshit and then 15% is like mildly important medical situations and the last 5 is really good urgent crazy shit. Depends on the week though.

Finally, I’ll end with this one:
We were called for the CARDIAC- 78 year old with chest pain. We arrive to find a dapper little elderly gentleman sitting calmly in his East New York apartment.
Whats the trouble today sir?
My heart is broken.
Excuse me?
It’s broken I say.
Does it…hurt?
It hurts a lot.
How…long has it been going on?
Oh quite a few years now.
You want to…go to the emergency room?
Yes please.

And away we went.