Flatline: NYC

Telemetry: Orders from Above

He was autistic, muscular, and in the bouts of a serious asthma attack. Walking into the room, I noticed the sweat glistening from his brow in large, irridescant drops.

Aww shit, this is gonna be a bad one, I thought.

We had a student with us, who listened to his lungs. "He's tight," he said, reffering to the severity of his wheezing.

Instantly, I reached for a nebulizer setup. Screw the hand-held thing, this kid needed a mask strapped to his face.

As my partner got vitals and my student got more of a history, I setup an IV and thought about what I'd ask for on the phone. Ahh, the phone. As paramedics, we can do a lot, but at some point, to do some things, we must call and confer with a doctor. The doctor, of course, is sitting somewhere cozy and quiet and far from our chaotic little scene. The good doctors cut us some slack when we need it, the bad ones just don't understand how things work in the chaotic field environment.

There was as issue with the kid. He was 19, a big, strong boy, and he didn't like us putting things in his face. The air hunger was making him frantic and combatitive, exacerbating the strain of being exposed to strangers. Autism is a hard disease to deal with. You must be patient, very patient, a quality rarely attributed to Paramedics. We practice medicine hard and fast. If you don't like what we're doing, we really don't care. Most people don't like what we're doing, and after a while, it makes you numb and impatient to people's varying sensitivities and complaints. I'm not saying it's a good thing, but it's reality, it's life on the streets, and god knows it's a far cry from utopia.

The kid didn't want the albuterol, by mask or any other way. Albuterol, though, is the first line treatment. It's that misty stuff they give you when you have asthma, and it works wonders, sometimes.

I got on the phone. Ok, I wanted Solu-Medrol--a steroid to decrease inflammation--and Magnesium Sulfate--a muscle relaxant used in moderate to severe asthma. Wait, it was Doctor Silverman, #80249. Damnit.

I told him the story.

"Unless you have an IV established right now, you need to stop what you're doing and initiate transport," he responded.

Jesus. This wasn't going well. We were on the 5th floor of a walkup apartment building with a narrow staircase. If we didn't stabilize this kid and get him to cooperate now, he might have to stop breathing or die before we could move him.

"Sir," I said, "this patient is autistic and extremely uncooperative. There's no way we're going to transport him unless we stabilize him first."

"I want you to start transporting immediately," he said, growing annoyed.

I glanced into the other room. The kid's uncle had convinced him to accept the albuterol treatment, an important success. Our student was struggling with the IV.

"Look, well, how about this," I suggested, rolling my eyes. "What if we start transporting right now and get an IV en route, can we then go ahead with some Mag and Solu-Medrol?"

"Well," he paused. "Okay, just as long as you start transporting right away."

Ahh, relief.

I stepped back into the living room, where my partner, my student, and the family stood huddled around the boy. He was looking better. The albuterol was working, thank god.

"It wasn't easy," I proclaimed, "but I got us Mag and Solu-Medrol...Oh, and Doctor Silverman wants us to transport right away."

My partner shot me a dirty look. "Yeah. Well, Doctor Silverman can wait," he said.

The boy was mostly calm by the time we finally go the IV. We decided to hold off on the big gun--the Mag--because the albuterol had worked so well. The Solu-Medrol would help prevent recurrence, at least for a day or so.

It was still a bitch to carry the kid down the stairs. He felt like dead weight, something that was intensified by the strange forward leaning position in which he sat. We carried him down five flights. Man, if he he had been fighting us, it would never have happened. Maybe he would have died, who knows, but we did out job, despite the ill-conceived orders from above.

The Prisoner

It hurt to watch. The Sergeant pulled the trigger, electrifying the man again. His body tensed and shit poured out of his ass, filling his pants.

"Put your hands behind your back!" yelled the Seargant. "Put your hands behind your back!"

And quickly, obediently, the man did.

We had been called for an "Injury" at the 15th Precint. A black man in his late twenties was pacing about a jail cell. Dried fecal matter ran from the toilet. Sweat glistened on his brow.

The cop pulled me aside before we went inside the jail. "Look man, this is a real interesting guy," he said. "He's says he doesn't know if he got bit or stabbed with an icepick in his back."

"Uh hu," I nodded. "Right."

As we approached, several cops escorted us to the man's cell. He was alone in the jail, stuck behind steel bars.

I asked him what's wrong.

"I think someone bit me last night, or maybe they stabbed me with an icepick."

"Oh," I said, "an icepick? Why do you think that?"

"I visualized it," he explained, lifting up his shirt.

There was no stab wound, just a minor scrape not even breaking the skin. I broke the news. The man let his shirt drop.

"Someone put poison in my food," he said. "It's in my stomach, it's been like that all day."

Right.

Once we broke the news, the man explained that he didn't want to go to the hospital. He was sweating a lot, which wasn't a good sign, and alcohol was on breath. Not only that, but we didn't have any vitals on him. I--for one--didn't want to get that close.

"EMS says your fine," barked the Seargant. "You still want to go to the hospital?"

"If they say I don't need to go," the man shrugged, "then I don't need to go."

I glanced over at my partner. It was a dicey refusal. We had no vitals. The man had alcohol and probably drugs in his system. But he had no stab wound and I really wanted to go back to sleep, so I gave him the piece of paper and put an X where he should sign.

The man pulled the paper away and--surprisingly--read it. "I ain't releasing nobody or 'their representatives' from liability," he shouted.

"Dude, if you don't sign on the line, you're going to the hospital, it's that simple," I explained.

The man signed.

As we walked out, he started yelling again and began banging on the prison bars, creating a loud noise. "I want my copy!" he yelled.

I turned to the cop next to me. "He doesn't get a copy," I muttered.

The Sergeant turned around, marching back to the man. "You don't get a copy, and you will not make a rucus in my jail. Do you understand me? Do you understand?" he shouted.

The noise stopped.

Just as we were out the front door, the clanging started again. Uh oh, I said, turning to my partner. This is gonna be interesting.

"Alright, that's it!" The seargent reached into a drawer and pulled out a yellow stun-gun called a Taser. Quickly, he inserted a new battery-pack and depressed the trigger. A sharp, crackling sound of electricity filled the police station.

"Oh, I gotta see this!" one of the cops exlaimed, overcome with excitement.

A gaggle of officers followed the Sergeant as almost everyone in the precint looked on.

"I want one officer to come with me," commanded the Sergeant. "EMS, standby."

The clanging continued.

The Sergeant approached the man. "What did I tell you? What the hell is your problem, son? What the fuck do you think you are doing?" he yelled. After a minute or two of booming commands, the clanging stopped and the Sergeant walked back out.

The was a palpable air of dissapointment in the station. "All that and I got a hard-on for nothing," said one cop, shaking his head.

We left for the ambulance again.

Then it happened, quieter now this time: Clang. Clang.

"Alright, that's it!" bellowed the Sergeant, storming back to the jail. "I told you that if you make one more noise, we're gonna have a big problem. Now we've got a problem!" The Sergeant squared himself toward the man, raising the Taser gun. An officer unlocked the cell. "Put your hands behind your back." commanded the Sergeant.

"But I was just..."

"Place your hands behind your back," he repeated, his voice steady.

"But..."

Pop.

The Taser fired two electrified darts into the man's chest. Connected to the gun by two wires, the electrical discharge lasted for five-seconds. The high-pitched crackle of electrcity filled the jail. Cops jumped over each other to see what was happening. The man fell forward, his body becoming stiff. "Ahh! Oww! Make it stop!" he pleaded.

"I think he just shit himself," my partner said, turning to me. I nodded.

"Place your hands behind your back," repeated the Sergeant.

The man hesitated, opening his mouth to say something.

The crackling sound returned, and his body became stiff again. He was silent this time.

"Place your hands behind your back," said the Sergeant again.

Quietly--the electricity still pulsing through his body--the man followed the Sergeant's command. Two officers cuffed him, placing shackles on his arms and legs. One cop turned to another. "Wow," he said, "now I've got a whole new level of respect for Night Sergeant." The other nodded in agreement, watching with glee.

They pulled the prisoner to his feet, making him face the Sergeant. "You feel like a real man now, don't ya?" said the prisoner. "Don't worry, I won't forget what you did to me. I won't forget. Time will come. You'll get yours. In a dark alley somewhere, you'll get yours."

My partner and I ran to grab the stretcher. As we wheeled the man out, two women who looked like prostitutes gazed on. "They know what you did to me! The man shot me when I was in handcuffs. He shot me!" the prisoner hollered, unceasing as we slid him into the ambulance. "When I come back. you're going to have to shoot me again! You'll get yours, trust me, you'll get yours!"

I started filling out paperwork in the back of the ambulance. A cop was with us in the back. He looked down at the prisoner, shaking his head, sounding a little sorry. "You know all of that was unneccesary. It didn't have to happen that way."

"Any allergies?" I asked.

"Yeah," he said, staring at the cop, "pork. You know, swine."

My partner turned back to me from the driver's seat. "How about a little music?"

When I was just a baby,
My Mama told me, "Son,
Always be a good boy,
Don't ever play with guns,"
But I shot a man in Reno,
Just to watch him die,
When I hear that whistle blowin',
I hang my head and cry.

"Sing it!" I said, turning to the prisoner. "You like Johnny Cash, don't ya?"

He returned a quizocal look. "Who?"

I turned back to my partner. "Try another one," I hollered. "I want to do a sing-a-long."

"Ok," he said, fumbling with the radio. "How about this one?"

Breakin’ rocks in the hot sun
I fought the law and the law won
I fought the law and the law won
I needed money ’cause I had none
I fought the law and the law won
I fought the law and...

"C'mon, sing it!" I said, repeating the words. "C'mon, man..." I eyed the officer, "sing it with me."

And so we strolled into the ER, singing softly and all together. "I fought the law and the law won, I fought the law and the law won..."

The Happy Family

The woman was on a bed, unconscious, foaming at the mouth.

I shook my head, trying to get it on straight.

"Umm, what's going on?" I asked.

The woman's daughter was scrambling around the apartment, desperately searching for her mother's medications. She's a diabetic, she said.

Then the arguing started.

A man in his twenties walked into the room. He was shirtless. From his ribcage hung an abundance of fat, collected in large rolls, some marked by strange bruises, as though he couldn't turn a corner without one of the rolls swinging up into the air and striking a table, a chair, or a payphone. And his breasts, oh his breasts, they sagged down almost to the bottom of his ribs, each terminating in a dark, round pancake of a nipple. It was hard to imagine him with his shirt on, hair in cornrows, strutting down the street and lookin' tough.

"I don't want to go to no hospital," he moaned, throwing down his arms.

His sister shot back, "I can't believe you're so selfish, Tyrone."

Amidst all this tertiary drama was the woman, now seizing. I rubbed my eyes, both wishing I hadn't drank so much the day before and half-glad the apartment was so poorly lit. My partner started the paperwork as I searched for a vein. I tried the AC. Nothing. I tried the hand. Nothing.

She was on her 3rd seizure when I decided to hit her in the shoulder with Glucagon, or "the sugar stuff," as my ever-so-brilliant partner referred to it.

Just in case you don't know, Dextrose, a.k.a. "D50", is sugar. Glucagon is a hormone that makes your body release sugar. But that's just a minor detail.

As we prepared to move the woman, another family member showed up. It was her husband. He was trying to buckle his belt using a steak knife. Whatever, I thought, it's New York City. Maybe it's a black thing.

It's not. It's a drunk thing.

Anyway, it was 9am and this woman's husband was totally smashed. I mean, he was so retarded that I figured he must have been on smack or sniffing glue or something. His daughter would yell at him, scream at him, and he would just stand there, yellow beanie falling off, staring ahead, a lost expression on his face

I wondered what it would be like to have such a man as a father.

Bitch Tits declared again that he didn't want to go to the hospital. His father stood there, unmoved, staring down at the knife in his hands. The daughter bustled around, gathering clothes for the trip to the hospital.

She grabbed my hand, pulling it away from her mother's abdomen. "Don't touch her stomach too hard, she's got something there, I can feel it." She touched her mother gently. "It's like it's moving around. If you press on it, you'll make her have a seizure again."

Oh, the innocence.

It's not her stomach that's making her have the seizure, I explained. It's that her blood sugar is too low.

She looked me warily, eyeing my hands.

The woman grew more alert as we flopped her onto the stretcher. At first she was just speaking gibberish, but after a few minutes hen she started babbling on about Medicaid.

Her daughter, poor thing, was taken in by this, and that's what I didn't understand. Clearly, this kind of thing happened all the time, and her daughter still didn't get the drill. Yes. She passes out. She has seizures. We give her something, her blood sugar goes up. At first she babbles. Then she gets agitated. Then—after a long while—she relaxes.

But the daughter was sucked in. She yells at Bitch Tits for being selfish. She yells at her dad for being drunk. I wondered why she let herself get caught up in the drama.

Maybe it was that she cared. I had forgotten what that looked like.

Either way, her disquiet was nothing compared to the voice of her mother.

"I was a police officer for twenty years!" she cried out. "All those people tried to kill me. And now you! You get away from me, so help me god," she glared at the empty eyes of her husband, "You fucking drunk."

In the ambulance, I sat quietly in the corner as the woman berated the man, occasionally glancing over my shoulder to see how close we were to the hospital.

Paperwork—I was doing paperwork—and what they had, their problem, I could not fix.

“I worked in a prison for twenty years!” she cried again, her voice growing more violent. “I’m gonna end up dead because of you, you fucking drunk! You fucking drunk!”

Her eyes smoldered as she stared his face. It was vacant, like a junkie’s. A stream of tears slid down the woman's cheek.

I glanced at the two of them and stepped out of the ambulance.

Ahh, I thought, spring is almost here.