Just Take a Shower

Apparently, this isn't just advice given to horny teenagers who have watched too many episodes in a row of "Dollhouse" on Hulu. Now, paramedics are giving the advice, to mothers of sick children, and people are dying.

On February 10th, paramedics responded to a home in Washington, D.C. The 5 a.m. call came in as a report of a child having difficulty breathing. The paramedic advised the child's mother to "run a hot shower" and have the child stand in it, to "clear out her lungs." Then, the ambulance left.

Eight hours later, another call went out from the same house. Difficulty breathing. Medics showed up again, and this time they transported the child, who died.

The female paramedic, who responded to the first call and gave her fatal advice to the family never filled out any paperwork concerning the first response, and she did not transport the child. Not only that, she did not have the adults present even fill out and sign a Refusal of Transport form, which is standard operating procedure in all emergency responses. Don't want to go to the hospital? If you're of sound mind and body, that's fine, but the law states that you have to be clearly informed of the risks of not seeking hospital care, and you must obtain a signature on that form, which will absolve you of responsibility when the patient up and dies ten minutes later.

Maybe it's because I'm gearing up for a return to the streets as an EMT, maybe it's because I'm working towards becoming a father, but I have nothing in my heart but disdain, disgust, and outright hatred for the behavior of this supposedly veteran paramedic who, to my unpleasant understanding also serves as a preceptor-- an instructor and mentor for newly-minted paramedics. Not only should she be stripped of her credentials-- she should be stabbed repeatedly with the badge pin. Here's a newsflash:

Everybody. Goes. To. The. Hospital.

Always. Transport.

Always.

It's not just a suggestion-- it's policy. When someone calls 911, and you show up, they go. If they don't want to go, and they're not whackier than an opium-laced Ritz cracker, they must sign the form-- otherwise, it's transport time. This EMS disaster happened for one reason and one reason only: laziness. This bitch didn't feel like schlepping this kid to the hospital. She was cocky and arrogant and, above all else, goddamn lazy. She just didn't feel like transporting, which, by the way, is just about the sum total of her fucking job that she shouldn't even be allowed to have anymore.

It's your job, sister. Don't like it? There's probably a UPS truck somewhere out there with your name on it. And you'll never have to worry about the boxes dying on you.

I understand apathy. I understand sometimes not giving a shit. I understand being overworked and being underpaid and incompetent supervisors riding your ass about bullshit-- poorly maintained equipment and trucks are all scratched and dented up and smell like old mustard. I understand stupid partners, and irrational dispatchers, and working outside in the goddamn wind and the rain and the blazing heat-- lifting Big Ass Bertha up three goddamn flights of stairs, or down. I know. It's a pain. But, if you wake up one morning and find that you just don't care enough to do even the bare minimum of your job-- throw the kid in the back of the truck and put two liters of oxygen on her and drive her to a fucking hospital that's probably less than ten minutes away, and then fill out some paperwork after you hand her over to the nurses-- well, then you're just nothing but a stinky old piece of shit.

EMS is a little too important to be left to the dregs of society, the people who can look into the eyes of the parents of a two-year-old little girl and tell them to run a hot shower because you'd rather go out and get coffee or talk on the cellphone inside your truck. It's a little too important. And maybe that's the savior in me talking-- maybe that's part of the reason I'm going back. Because I may not take the most accurate blood pressures in the world, and I'm not totally up-to-date on all my medical abbreviations, but I'm pretty sure that my ethics and my logic are still largely intact.

Everybody goes to the hospital.

Everybody.

Speedwagon Rides Again

If I understood everything that went on in my brain-- every calling, every craving, every interest and every inclination-- I think I'd be a goddamned genius. Either that or I'd be a twitching, incomprehensible, foul-smelling, eye-booger-eating societal reject who finger-paints on the walls of his cell with his own diarrhea.

Fortunately, I'm neither a genius or a... that.

I made the decision that, when my contract at my small non-profit is up in August, I will return to the streets as an emergency medical technician.

Last night in the kitchen, my wife, looking very nonplussed, I am relieved to say, said in reply,

"Can I ask why?"

"It's been calling to me," I said with a shrug and an assuredly earnest look in my eye. "It's been calling to me ever since I left."

And it has. And I don't know why.

She looked at me with the same love that has been in her eyes since we 2003 and said,

"Then you need to do what you need to do. And I love you."

There are so many things that I miss about the job-- the pride of putting on a uniform. Being of service to an organization and to a people. Taking charge and taking care. Driving an ambulance, lights on or off. The back-and-forth with dispatch. The indescribable feeling you get when it's time fo flip on the auxillary battery and turn those red lights on. The smiles people give you when they see you come in for a cup of coffee, that coffee sometimes free. The feeling of importance, of meaning. Of applying knowledge that I have, of getting my skills back. Of being able to say, "I am an EMT" without having to add, "but I don't work on the street anymore."

I worked from May, 2005 to February, 2007 and they were some of the best months and worst months of my entire life. I remember the day my first steady partner threatened to kill me, throwing a clipboard at me in the front of the ambulance, shattering the windshield instead of my face. I remember the day I got him fired. I remember transporting suicidal alcoholics and paranoid schizophrenics and homeless people with City Paper underwear and cardboard shoes. I remember bringing leftover slices of my wedding cake to my co-workers at base. I remember educating my Ukranian coworker about the Holocaust in the parking lot of a hospital. I remember busting my supervisor's balls, moving his van while he was inside the base taking a leak, and changing the radio station from country to classical, and placing a male urinal on his gearshift lever. I remember sitting next to the same man in the same ambulance every single day for thirteen months. I remember the patients-- the obese ones, the severely malnourished ones, the diabetics, the congestive heart failures, the addicts, the prisoners, the women in emergent labor. I remember the one neonate I transported, and I remember how petrified my partner and I were that we would kill it. I remember driving down I-95 with my lights on, going 40 miles per hour, fearful that every pothole would break its brand new ribs.

I remember careening down that same stretch of road with my siren wailing, in a desperate attempt to get a fire-fighter to the hospital after he had collapsed at the station of a heart attack while lifting weights. I remember his wife in the seat next to me, sobbing and thanking me as I drove, sweat pouring down my brow.

I remember a lot. And perhaps I remember too much, and perhaps I remember it in that skewed way in which we remember unpleasant things after some time has passed. I remember reading "The Passing of the Armies" which is a memoir written by Brevet Major-General Joshua Lawrence Chamberlain about his time rising through the ranks during the Civil War. He writes about war in a sympathetic, eloquent, flowing, almost romantic way-- the battles long cleansed of the blood and brains, smoke and horror over thirty or forty years. Maybe that's how I remember life on the street.

Maybe.

But, after a long time being chained to a desk, I find myself longing for an opportunity to jump into my car and roam, even if it's just to go to the post office to pick up mail from the P.O. Box. I would never call myself a wanderer, but I know now that I need to be out there, whatever "out there" means.

And, oh, I'm out there alright.

But I think you know what I mean.

For years and years I've struggled with what it means to work. Does a job need meaning? Does a job need to align with your perceived status or education level? Do you have some sort of familial or religious or societal obligation to seek a white collar job if it's what your parents sought, or your wife's family sought? Does being in possession of a Masters of Education degree obligate you to teach? Well, no-- just as my undergraduate degree in Theatre doesn't obligate me to whore myself out in the world of off-off-off-off Broadway or appear in local car commercials smiling while receiving the keys to some piece of shit Ford Focus.

I've come to understand that you've just got to do something, and it might as well be something interesting, engaging, rewarding, and maybe a little bit fun, even if it doesn't pay the best and you may run into elderly ladies who tell you they're going to "fucking kill" you as you're strapping them snugly into a stretcher and covering them with a blanket.

Sti(cke)r Crazy

Bumper-stickers always kind of got on my nerves, and so I never thought, growing up, that I would become the kind of person who'd want to put any on my own car.

Turns out, I was wrong about that.

Not only do I have several bumper-stickers on my car, I actually had one custom-made, just for me, and I'm pretty convinced that, because it was an original creation, I'm the only person in the world who drives a PT Cruiser with a bumper-sticker that says:

"WARNING: Gilbert & Sullivan Freak Behind Wheel"

After all, I think it's only fair to alert other unsuspecting motorists in the immediate vicinity that the vehicle rolling near them is being operated by a less-than-sane Anglophile who might, at that very moment, be singing the patter song, "My Name is John Wellington Wells" at the top of his lungs and rolling his "Rrrr's" while driving.

It's probably more dangerous than texting, though I don't think enough empirical research has yet been done.

I have another sticker on the back of my car, and it is the Pennsylvania Department of Health seal, which only certified Emergency Medical Technicians are permitted to display. While I no longer work on an ambulance, I am still certified by the Commonwealth of Pennsylvania as an EMT until 2011, at such time I will either have to renew my certification or, I guess, peel that sticker off my car.

There are lots of reasons why I keep that sticker on my car, even though I quit my ambulance gig back in 2007. First of all, it lets people know that the PT Cruiser with the blue dashboard light flashing that stops at the scene of a fresh car accident is supposed to have that light, and is supposed to be there, and contains someone useful who can be of service. It says that if you've been hit by a car or you've been shot in the back or you've just had a stroke, that this is a car you can stumble over to and ask the driver for help-- and I'll give you whatever help I can remember how to give. I've got an emergency EMS bag in the back with some tools of the trade-- not many, though.

More than any of this, I display the sticker because I'm proud of the work I put in to become an EMT. In my class of thirteen, only two of us hung around long enough to get to the State Certification test, and I was the only one who passed. I worked for seventeen months for crap pay, got a bullshit performance evaluation that resulted in a disgraceful 33-cent-an-hour raise, suffered through an endless stream of incompetent, irrational, psychotic, delusional, violent, unpleasant, odoriferous partners and patients and only crashed one truck and, damnit, if I'm entitled to slap a sticker on my car's ass, well, I'm going to.

The other sticker on my car is from a non-profit organization that I support, financially and through my writing. It's the Officer Down Memorial Page (www.odmp.org) and it was started by a young man named Chris Cosgriff, approximately my own age-- a civilian who, like me, found himself deeply moved at a very young age over the tragedies of law enforcement fatalities in this country. On opposite ends of the country, he and I share a lot in common, and, in our twenties, we both decided to do something about it. I wrote a book, Chris created a non-profit. The ODMP features a small profile of every single police officer who has ever died in the line of duty (either of natural or felonious causes) since the first recorded police fatality in 1791. There have been over 16,000 since then, and the ODMP honors every one of them. They have also been very kind to me, keeping the ever-flagging, modest sales of my book on life-support by stocking my book on their online giftshop.

A lot of people probably think I keep the www.odmp.org bumper-sticker on the back of my car so I don't get stopped by the police, so they know I'm a friend-- but I don't give a shit about what people think. Besides, it doesn't work anyway. I got banged for speeding just this year, and the fine was as steep as Mt. Olympus.

The three bumper-stickers on the back of the car that used to be owned by my wife tell the stories of three very different, very important parts of my life, and I like all three of them very much. I'm very interested by the things people choose to slap on the back of their own cars, these little tidbits of information that tell us things about the driver.

"Keep Honking, I'm Reloading."

"Like My Driving? Call 1-800-EAT-SHIT."

"YES, WE CAN!"

"Vote for Ron Paul"

"Abortion Stops a Beating Heart"

"Visualize World Peace"

"I <3 Jesus"

I wonder what Jesus thinks of "I <3 Jesus" bumper-stickers. No doubt he appreciates that there are deities out there who could benefit from publicity more than he. Even I know who he is. I say his name every time I hurt my knuckle on a doorway while carrying the laundry basket.

Autopsy Turvy

Tonight, Mrs. Apron and I slumped inertly on the couch and mechanically ate our dinner while watching a re-run of a "Jeopardy!" Teen Tournament. Our living room was stifling, the heat and humidity weighed down on us like a leatherpress, what else could we do? It was way too hot to initiate baby-making procedures in front of old Alex, so we just munched and zoned.

I remembered this episode in particular. During the usually painful interview section of the program, the slut on the right expressed her aspiration to be a doctor. She said that she had already witnessed lung surgery. "And I've held a brain!" she added with some enthusiasm.

Hmpf, I recalled, so have I.

In 2005, as I was nearing the end of my schooling, if you can call it that, to certify me as an emergency medical technician, there were three brief field stints I had to perform. First, logically, I had to complete one eight hour tour-of-duty on an ambulance. I did this at a Philadelphia hospital-based ambulance service, whose name I will neglect to mention so that I don't get sued for libel. I was positively giddy with excitement about my first real shift on an ambulance. Like most things I get positively giddy about in expectation, my shift on the ambulance didn't pan out exactly the way I had hoped.

It was a frigid day in February or thereabouts, and a layer of snow and slush covered the streets of Philadelphia. I arrived for my shift my customary twenty-five minutes early. I would have been even earlier, but I couldn't find the base. A security guard at the hospital directed me to the basement. Just so you know, if you're ever looking for a hospital-based ambulance company-- it's in the basement. There was a big conference table, but no one was sitting at it. There were four or five EMTs and paramedics all huddled around a smaller table atop which sat a fax machine. I soon gathered that they were all faxing their resumes to other ambulance companies.

The obese supervisor stepped in front of them and glowered at me, with my bright white EMT student polo shirt and my fresh-out-of-the-bag navy blue uniform pants and my stethoscope hanging around my neck. He hated me from the word "fag."

"Hi," I said nervously, "I'm, um, an EMT student."

He looked at me like he wanted to shit on his fist and hit me with it.

"Well, obviously," he replied, staring at my shirt.

"Oh."

He shoved a thick hand into his hip pocket and dug around. I assumed he had ringworm or something. He pulled his hand out and thrust a greasy key out in my face. "Move unit A-12," he commanded. "It's in the fucking way."

I took the key and navigated the complex stairs and halls of the hospital, getting lost three times on my way out to the alley where the ambulances were haphazardly parked as if they had been jumbled about by a tornado. In the fucking way of what? I wondered. They're all in the fucking way of... each other. Between the snow and the ridiculous way these things were parked, I didn't see how a single one of them could move anywhere. I arrived at unit A-12. A sorry excuse for an ambulance, it looked as if it had been gang-raped by a trio of 18-wheelers. When I opened the driver's side door, it almost fell off-- the hinges were rusted clean through. I hoisted myself into the vinyl driver's seat, which was carved up like a Christmas goose and I peered at the odometer.

289,600.

Well, I thought, at that rate, unit 12-A wouldn't be in the fucking way for much longer.

The second field placement I had to do was a tour-of-duty in the Emergency Room at the same hospital. EMTs often find gainful employment in emergency rooms across the country, where they go by the title "Critical Care Technician." Basically, they take vital signs on patients and do everything that nurses feel entitled to delegate to someone who makes considerably less money than they do, like lift up incredibly fat people and/or clean out bedpans and vomit basins. Fortunately, I didn't have to do any of that during my emergency room rotation, because I was completely and utterly ignored by the nurses. My presence was only marginally acknowledged upon my arrival (initial my time-sheet here) and upon my departure (initial my time-sheet here). I did finally manage to make my mark on the evening when a transsexual psych-patient locked herself in the bathroom and was refusing orders to come out. A nurse had gathered that not only was she probably doing drugs in there, but that she was armed with a knife. I was told to go get security but, just as I was passing the bathroom, she burst the door open and she bolted out of the exit of the hospital. Not thinking at all, I tore off in chase, racing down a dimly-lit Center City street after her.

"Stop right there!" I screamed at her, my brand-new boots pounding against the pavement.

"Jesus Christ! Stop!" I didn't realize that the security guard who yelled that out was yelling at me until I got within around four or five feet of her and he yelled, "Kid! Stop! Jesus, stop!"

So I stopped and doubled over, panting. I looked behind me and there was an elderly security guard, extremely overweight, about thirty feet back, his hands on his thighs, a nurse behind him, holding my stethoscope, which had flown off during the chase. The tranny turned down an alleyway whilst hooting and laughing and extending her middle finger in my direction.

"Kid," the huffing and puffing whale-of-a-guard said once he'd caught up to me, "once they're off the hospital property-- fuck 'em. She's the cops' problem now. God! You're fucking crazy-- she could have killed you. It's not worth it."

Last up on the field rotation: the autopsy. The rationale behind EMTs attending autopsies is that they ought to have empathy and compassion for the human condition, and attending an autopsy is also a good way to get seeing your first dead body up close and personal out of the way fast. It's kind of ironic that, in seventeen months on the street as an EMT, I never saw a dead body, except one in the ICU of a local hospital that was slumped half out of bed and half on the floor. The curtain hadn't been pulled shut yet and "The Golden Girls" was still playing on the patient's TV. But, yeah, if I had ever encountered a dead person, the autopsy would have been a good primer for that occurrence. Plus, it's a really awesome way to learn anatomy. Most EMTs-in-training, being dickheads in their early 20s, just think it's cool/sick/fucked up. The subject of the autopsy I attended was an elderly woman who had perished while in the hospital. I made sure to stare at her wrist bracelet, mostly so I wouldn't have to stare at any other part of her, but also because I wanted to remember how old she was.

Of course, that was four years ago, and I've forgotten now. She was either 78 or 87. Damned dyscalculia and Alzheimers.

Anyway, I don't know what other people remember about their first autopsy, but I remember the stench that infiltrated my nostrils upon the opening of the woman's bowels. That's a smell no amount of mental Snuggle can ever ameliorate. It was horrid, putrid and fetid. Basically, any adjective that ends with "id" would be accurate. I also remember the smell that emanated from the saw as it buzzed through the woman's skull. It was slightly burnt, slightly sulphuric, slightly nauseating. Once the attending coroner had cut her domepiece entirely off, he used a pair of long, thin scissors to cut through the glistening, gelatinous membrane covering her brain. He told me to cup my hands below what was formerly her head and I thought to myself, "Oh my God, in about six seconds, I'm going to be holding this woman's fucking brain, aren't I?" Then he made two final clips by her occipital lobe and *glorp!* I was holding this woman's fucking brain.

Can I go on "Jeopardy!" now?