Flatline: NYC

Quicksilver Tears

I picked up his body and rolled it over. His face and chest had turned purple, the result of lying there for so long. And by that, I mean a few hours. I pulled out my stethoscope to listen for heartbeat as I had been trained to do. I heard something, maybe it was the crackling of my stethoscope on his T-shirt. Maybe it was the echo of my own heartbeat, adrenaline still pumping.

I doubted myself not only because I was excited by the situation and surprised that the man was dead, but because he looked so obviously dead, the purple on his face and hands a sign known as post-mortem lividity. I also know I'd look stupid if I said something and it was a false alarm.

Lisa turned to the man's girlfriend. "He's dead," she proclaimed. "Muerte."

The woman began screaming and fell to the floor.

Without uttering a word, I patched the man up to the monitor and looked at the screen. His EKG was a perfect flatline. A slight wave of relief came over me as I hit the print button.

"What the hell are you doing?" asked Lisa.

"Oh," I said, "I just wanted to confirm..."

"Here, give me that," commanded Lisa, grabbing the EKG printout from my hand. "This goes in the trash."

I furrowed my brow. "But..." Looking around, I stopped myself, deciding that it was not the time for debate. And besides, she was doing the paperwork, so it wasn't really my place to tell her what to write or record. I mean, it was, but in this case, I'd ask her later.

The woman collected herself into a more organizaed version of panic. She pushed past us and climbed on top of the man's body. She lifted his limp, lifeless head to breast and cried out.

"No Papi! No! No Papi! Why? Why?"

The tears ran like quicksilver down her cheeks, falling fast off her chin.

A ray of stale light came in from the outside world, illuminating the vacant features of his face. His jaw was still clenched tight, tongue jutting out between his teeth, making us believe that he had had a seizure just before he died.

He had last been seen in bed at 3 hours prior. Then, someone knocked on the door, and there he was, face down on the floor, dead as doornail.

It was just another cold day in New York City. Another man dies. Another woman cries. And I go home to hang out with the guys.

Dad

I was wrestling on a frozen sidewalk with a psychotic senior citizen from Albania as the sun broke the horizon. It was dawn, a really cold, rosy-fingered dawn. The man, having been lured outside of the his house by an EMT wielding a cigarette, sat down on the pavement and refused to move as he clenched a match between his teeth, trying to light it with a cigarette. It was good that we got him away from the knives.

At first, I thought he was just crazy. But according to his sons, he had never acted this way before. He was a normal guy, maybe in his early sixties. And then I noticed the sweat gathering on his brow. There was a lot of sweat.

Pinning his arm to the ground, I stabbed a needle into his left shoulder, injecting him with Glucagon, a pancreatic hormone used to raise a person's blood sugar. He was diabetic, of course, but even though I hit him with the Glucagon, I didn't think that was the problem. He wasn't acting like a combative diabetic in Insulin shock. He was too coherent, too deliberate, too bizarre.

The devil has my soul, he screamed, speaking in Albanian.

Yes sirree, I thought, I believe he does.

In the  back of the bus, after one of the EMTs and myself tied the man down, I started a line. We gave him Dextrose and Thiamine to no avail. He kept sweating, soaking himself. Okay, time to go, I said, getting uncomfortable with the man's apparent deterioration. 

What the hell was wrong with this guy, I wondered. An electrolyte imbalance? An intercranial bleed?

At the hospital, he calmed down a bit. The doctors were equally puzzled.

Outside, it started to snow. I stepped into the cold air, watching the snowflakes fall, and wondered where my father was, how he was doing, and why I hadn't called him in a week.

the best job in the world

There is a tendency in EMS--at least in urban areas--for paramedics to diminish the importance of our work. I mean, don't get me wrong, we deal with a lot of nonsense, but still, it's not all bullshit.

Take today.

My plan was to come home and write a funny story about heroin addict we saved. The man shouted at us indignantly, "You didn't give me Narcan, did you?"

Well, in fact we did.

The man left the ER minutes after we arrived.

Note to self: don't do mouth-to-mouth on a junkie, even if you're alone. They don't deserve it.

But then we picked up an old guy with asthma. He didn't speak much English, and for that matter, he couldn't say a whole lot given his level of distress.

We hit him with the whole kit & capoodle: Albuterol x 4, 2 grams of Mag, and 125mg of Solu-Medrol. (For those of you who don't know, that's a fairly aggressive asthma treatment regimine). By the time we got to the ER, he didn't even need oxygen or his breathing treatment.

His daughter, who spoke broken English, thanked us profusely.

I smiled as I did the paperwork. There's this feeling, you know, when you feel like you really did the right thing. I didn't have to get on the phone and call for Mag or Solu-Medrol. I could have just taken him to the hospital, ya know, he would have lived. But he needed the good shit, he needed what we could give.

It was just so...so gratifying to see this guy 180. I mean, we fixed him, we did it.

The doctors in the ER give the orders. The nurses execute them. But me, I get to do both. I use my brain and my hands.

Last week one of the docs at work asked if I was thinking of med school. Nope, I said, what I'm doing no is my favorite part of medicine. I mean, being a doc would be cool, but you're not as directly involved in patient care. I mean, sometimes you are. But it's not your job to provide for the whole of the patient's needs. Doctors are the brains, nurses are the heart, but paramedics get to have both.

I mean, I'm young man, and EMS is a young man's profession. But still, I love my job. I love the fact that I get to make decisions--I mean, we're talking real decisions here, life or death shit--and then I get to execute them. It's just so damn gratifying.

In my other life, I am trying to be a writer. It's a cerebral world, ya know, but when I am here, at work, I feel present, I feel alive in way that I don't in anything else I do. I lose myself in medicine, and that...that is the best feeling in the world.