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.

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.

the dead

A man died today, or maybe two weeks ago. But at 5:12pm, I made it official.

His pants were off, of course, and his hair was long and neatly styled. At first, I thought he was wearing nylons because his legs were so smooth. He had sumptuous breasts and an attractive figure.

He was in his mid-thirties, sitting--head curled--on the couch in his bedroom. Pictures of attractive, made-up women lined the walls. His skin had turned a greenish hue and was beginning to slough off. His penis was smooth and hairless. It hung, forlorn, drooped between two legs.

The neighbors called because blood was dripping from the ceiling.

I was working with Lisa, but the Angry Black Man was there too--picking up overtime on a BLS tour.

"You need to cut off a piece of his skin and attach it to the call report," he said, sounding nonchalant "it's in the protocols."

I laughed, knowing he was joking.

I had never seen someone who'd been so dead for so long before. I wasn't sure what to do exactly. Should I perform an exam? Check for a pulse? Part of me wanted to. I was afraid that somehow, someway, he wasn't dead and I'd get in trouble for pronouncing him. But I would have been laughed at had I done more than look at him, I knew that. So I pronounced him, observing only his stillness.

I laughed at the pool of dark liquid--perhaps blood--on the floor. I laughed at the man's breasts. I laughed at his bloated stomach and his smooth skin. I laughed because, to be honest, I didn't know how to feel, exactly. Was the man murdered? I don't know. His bedroom was well kept and there were no signs of a struggle. Did he kill himself? Maybe. But why were his pants down?

ABM was grumbling about how he had left his digital camera at home.

I chuckled as I filled out the report. Who was this guy, I wondered. What happened? What was his name.

Lisa suggested we fill out the paperwork downstairs. As we reached the bottom floor in the elevator, several children jumped into the elevator before we got out. A man was with them.

"Did you come for my brother?" he asked.

"3F?" I said, referring to the apartment.

"Yeah," he said, looking down to the ground. "I've been knocking on his door for a week."

"Oh," I said, searching for comforting words. "You should talk to the police."

I walked out into a cold, stiff wind. Trash was blowing in the air. I felt a chill and watched as the wind blew black garbage bags and empty styrofoam cups down the street. They dispersed them into the Bronx night, and I followed them, still wondering what the hell had happened,

True Love

The man shuffled slowly to the door, dragging his right foot. Opening it, he invited us in.

As he cracked the door, I could the man. He man had on a white shirt, neatly pressed, as though it had been meant for a tie. His back was bowed forward, as though he carried an invisible weight.

"What's going..." I asked, pausing midsentence.

As the door opened further, an old woman came into view. She was lying on the floor, naked and listless. Her dark features stood out against a backdrop of pink bedsheets.

"What the hell happened?" asked Lisa, squinting as she turned her head to one side.

I grabbed the monitor and the drug bag, stepping past the man.

"She fell off the bed," he explained. "I think she hit her head."

"Uh hu..." I said, nodding quizically. "I see."

The woman lay on a faded tile floor, her body drenched in a pond of urine. Notebooks, old medicine bottles, and half-eaten bags of Dorritos littered the floor around her. She felt cold.

"HELLO?" I called out, rubbing my knuckles into her chest. She recoiled slightly, moving her arms.

"I'm going to go get a backboard," said Lisa, handing me an IV setup. "You gonna be okay?"

"Yeah. Sure," I said. "I'll be fine."

As Lisa walked out of the room, I turned to the man. "What sort of medical problems does she have?" I asked.

"Umm..." he stammered in a slow, drawn out sort of way. "I hope I the right thing. I hope...Diabetes. I think she has Diabetes...I wasn't sure if I should call you."

"You did the right thing, sir." I said, trying to reassure him as I searched the woman's arm for a vein. "How long has she been like this?"

"Ohh...umm..." he shuffled forward, bringing a white hand to his blanched lips. "I think twenty, maybe thirty minutes."

"I...I see," I said, sliding an IV catheder into the old woman's arm. "Why did you wait so long to call?"

"I wasn't...I wasn't sure," he stammered slowly, his face turning from white to red.

After securing the IV, I prepped an amp of Dextrose. Pushing it into the vein, I rubbed on the woman's chest again. "Carmen," I said, "Carmen! IT'S TIME TO WAKE UP! I've got lunch here for ya. It's a ham sandwich in IV form. C'mon now. Wake up!"

"She doesn't speak any English," the man offered, reaching out his right hand.

"Ohh...Okay." I muttered, my brow furrowing. "Do you speak any Spanish?"

"No," he shook his head. "I don't."

"Right." I proclaimed, nodding blankly.

Just then, Lisa walked in with the backboard.

"Is Carmen your girlfriend?" I asked the old man.

"Yes," he nodded.

"Right," I nodded again, looking back up at him. "Right. " The truth dawned on me.

Lisa and I placed Carmen on the backboard, affixing a hard collar to her neck. After the Dextrose--the ham sandwich, as it were--she started to come around.

"Estoy frio," she muttered, shivering violently.

We covered her with a blanket as we made our way out to the ambulance. The old man stayed at home.

Carmen--the old woman--was fully conscious by the time we arrived at the hospital.

As we wheeled her through the door, I whispered in her ear. "Esta hombre en tu casa es tu novio?"

"Si," she said, still trembling uncontrollably.

"What's the story?" asked the doc.

Lisa pointed at me.

"Well," I said, "you're never going to believe this, but she was having sex with..."

"Wha??" the doctor quieried.

"You know," I explained, making a crude gesture with my hand, "doing the nasty." As I explained the story, a crowd of young doctors gathered. When I finished, they stood in stunned silence.

"Anything else?" the doctor asked, still blinking his eyes.

"Oh yeah," I said, flashing a smile. "She doesn't speak any English and her boyfriend doesn't speak any Spanish."

New Year's Eve

The acrid scent of catshit greeted us at the door. With it were two old women, short and fat.

It was New Year's Eve on 6 Kilo. Lisa was driving.

It had been one of those weeks. I hadn't had a day off in two weeks, and didn't have another one scheduled for another 10 days.

"What's going on today?" I asked, grimacing at the smell.

"My back's hurting, see," answered one of the women. "I need you to tell me what's wrong with me."

"Uh huh," I said, still trying not to breathe.

The woman was having low back pain. It had started in the morning, increased, then dissapated mostly by the time I'd arrived. And of course, she didn't want to go to the hospital. There's just one problem: in New York City, if you're over 65, you gotta go, unless you can convince a Telemetry doctor otherwise. It's kind of a bullshit rule, but we gotta follow it, regardless.

So we had to do the whole workup: multiple sets of vital signs, 12-lead EKG, blah blah blah.

I get down on my knee in front of the woman to place the EKG electrodes. "Okay ma'am," I explained, drawing forth a bundle of wires from the monitor, "I just need to lift up your shirt a little bit and put on these EKG stickies."

"You have such pretty eyes," she responded, smiling. "Do you have a date tonight?"

Lisa placed a hand over her mouth, trying to silence her chortling. "I'm going to leave you two alone," she said, walking out of the room, grinning from ear to ear.

I stared at her wryly. "Thanks," I said.

"You want a laugh?" the woman asked.

"Sure," I said, clicking the electrodes to the monitor, one by one, shaking my head.

"I live upstate," said the woman, "and a few years ago I was doing housework in the dead of summer. And it gets so hot in my house. I've got no AC. So I take my clothes off. I just walk around stark naked. ME...NAKED..."

I moved my head slightly to the right, straining to see the front door. A bitter taste began to develop in my mouth. "Yeah," I said, wincing slightly.

"...and I slipped on the wet floor and I couldn't get up. So I called 911 and the paramedics came. These two young, attractive guys came and they had a student with them. Their student was Jewish, one of these Rabbi-types. I don't think he'd ever seen a naked a Irish-Catholic before. And there I was, naked as the day I was born. The rabbi took off running. He knocked over some furniture and jumped over a fence. I don't think he'd ever seen a naked woman before."

"That's great," I said, frowning as I lifted up the woman's shirt to place the electrodes on her chest.

"Isn't that a laugh!" she proclaimed, farting loudly.

I used the back of my hand to lift the great mound that was her breast. Underneath it would go 4 electrodes. In my mind, I was swatting away images of the bare woman. I turned my head to the side, pulling away slightly.

"Do you want me to take off my brazier?" she asked, reaching for the clip in the back.

"No, No." I said, "Please No...It's just...it's fine. Really. Please. Just...No."

"Okay," she nodded. Flubber from her chin flapping dangerously close to me. "But I can do it if you want."

After I got everything I needed, I called telemetry. On the phone was the dreaded Dr. Silverman, a man universally despised by paramedics throughout the city.

"Okay, put her on the phone," he said.

I handed the phone to the woman with the oversized brazier. She started nodding vigorously, her speech punctuated by "yes's" every few seconds.

She handed the phone back to me. She was going to the hospital.

"I want you to carry me," she said, putting on her hat.

"What?" I asked.

"I want you to carry me to the ambulance," she said, farting again. "I'm paranoid of falling."

"Uhh," I hesistated. "I don't know about that. It's snowing outside and those steps are really steep. We dropped someone yesterday, ya know. How about if we help you?"

"I'm very paranoid," she repeated.

"I can see that," I said, turning bitterly to Lisa. "How about if we both help you."

"Okay," she said, "but I want you to carry me accross the street to the ambulance. I am very paranoid of falling."

"Sure. Whatever." I muttered, grabbing the cardiac monitor.

She farted again in the back of the ambulance.

At the hospital, we put her into a bed. She grabbed my hand as I walked away. "You really have such nice eyes," she said. "Thank you. You're so kind."

I smiled with one side of my face. "No problem," I said, pausing for a moment. "It's my job."

Xmas cont: the Broken Heart

The man was standing at the corner of the bed. His daughter had dark, chestnut-colored hair held together in tight, thick curls. She coughed as we entered the room.

"She's sick," he said, his gruff New York accent inflecting a harshness to the words. "She's had a cold for three days. I'd give her the machine...uhh, you know, the fuckin' albuterol machine but her mother has it. Can you believe it, the bitch took off with her breathing machine."

"Daddy..." the little girl said, casting him a long, chiding look.

Meeting her eyes, the man hung his head forward, his great, fat chin rubbing against the hair on his chest.

"I'm sorry Princess," he muttered.

I motioned for my paramedic student to listen to the girl's lungs. Lisa started filling out paperwork.

"So what kind of medical problems does she have?" I asked.

"I have asthma!" the little girl squeeked. "I've got one of those machines that makes the smoke."

"Yeah," the dad explained, making large, expressive gestures with his hands. "She's got asthma, and she takes...yeah, that one in your hand."

"Uh hu," I said, "and does she have any allergies to medications?"

"Can you believe it," the man said again, "I was with my wife for eight years. I worked my ass off everyday so I she could have this house. It's got three bedrooms, and look...come here, look at this kitchen." He waved for me to follow him.

"I put in all the tile myself," he continued, now in the other room.

"And look, look at this..." he returned to the bedroom holding a pair of red panties spread between two outstretched hands, "that's real silk. Victoria's Secret, ya know. I paid for them."

"Uh hu," I said, glancing at Lisa, "about those allergies..."

"Naw. No allergies," he shook his head, dropping the panties and lifting a large silver crucifix from his chest. "Look, I even got my own bling. It's a nice one... How could she leave me when I give her all this?"

Virgin Mary's and Coors Light posters covered the walls.

"So how long has she been sick?" I asked, trying to change the topic.

"My wife?" he said. "Oh, she's not sick, she just wants to leave me, says there's no love here. Can you fucking believe that? She says..."

"No, No. Your daughter, how long has she been..."

"Oh, yeah, right. Duh. Stupid," he shook his head again, hanging it slightly. "She's been sick since this morning."

My student tapped me on the shoulder. The little girl was wheezing, he said.

Okay, do your thing, I said, tossing him an albuterol setup.

"Is she coughing up anything?" I asked.

"Naw," her father explained, making a coughing gesture with his hand. "It's a real dry cough, like she can't cough anything up."

As my student handed the little girl the albuterol, the man closed the bedroom door, peering outside. "Guys, I need to tell you something."

He put his arm around my student's neck. "How old are you man? You married?"

"Uhh," my student looked up at him, slightly worried. "No, I'm only twenty."

"Good. Good. You are young. Now listen to me man," he said, tightening his grasp around my student's neck. "I've been married for ten years. I bought this beautiful house..."

Lisa and I glanced at each other, holding back laughter.

"...I gave her all this. I worked everyday and sometimes on weekends so they could have this life. But you know what she said," he said, hushing his voice and glancing suspiciously at Lisa. "She said there was 'no love' here. Can you believe it? If this isn't love, I don't know what is."

Lisa walked over to the little girl. "Okay honey, we're going to go to the hospital now!" she said, clapping. "Get your jacket!"

"Never," he said, holding my student even tighter, "loose the love. You know what I mean, man?"

My student nodded his head vigorously, looking straight ahead. The man let him go, patting him on the back.

As the girl bundled herself up, I took another listen to her lungs. The wheezing had faded and in its place a popping sound emerged. It was the sound of mucus gathered at the base of her lung, probably an early pneumonia.

I looked at my watch: fifteen minutes 'till shift change.

"Okay kiddo," I said, "let's get this show on the road."

In the back of the ambulance, I was having trouble fitting the seat belt around the man's waist. He was fat--too fat for our ambulance--so I tied two seatbelts together.

As we drove away, the girl asked: "Daddy, how are you going to get out of that?"

"Don't worry honey," he said, "the ambulance man will just untie the knot. "

When the backdoor opened again and Lisa saw the knot, she pulled on it and laughed. "What the hell is this?"

"Ohh, don't worry," I said, "I'm just gonna untie it."

I began fiddling with the knot. It wasn't coming undone. Hmf. I tried harder. Nope. Finally, after 5 minutes, Lisa and my student took the girl inside and left me to untie the knot.

"Just don't cut the seatbelt off," said Lisa as she walked away. "...Idiot."

With the stretcher gone, I got down on my knees in front of the man. He lifted up his sweatshirt to make more room. I yanked again on the knot. It was proving very stubborn. Exterting myself, I started making high-pitched grunting noises. As I yanked and pulled, my relief approached the back of the ambulance.

"Whatcha doing there," he laughed, "blowing the patient? Must be a new protocol..."

"Haha!" the man laughed, slapping me on the back. "Now that's true love! Haha!"

I glared up at him, freeing the knot.

We walked into the ER. "You should have seen this guy," he announced, spotting Lisa. "True love! Haha! Fuck my wife, I've got this guy!"

He slapped me on the back again, laughing loudly.

I shook my head, more than a little embittered. I can't fucking believe this, I thought, and walked away. When I returned, the man put his hand on my shoulder.

"Hey, seriously man," he said, his tone changing again, "thanks for what you've done. I really appreciate you guys taking care of my little girl."

"Yeah, no problem." I said, turning to walk away. "Merry Christmas."

He grabbed my hand, stopping me, and whispered forcefully into my ear. "Remember what I said. Never lose the love."

Free at Last...

He was tall--maybe 6'4"--and black, of course. We found him in the bathroom of a Sears, mostly naked and covered in sweat. He was hot, he said, as he pointed to his swollen left testicle. It was the size of butternut squash, only darker. (I'm not kidding, it was huge.)

"What's going on?" I said.

"Oh, nothing man, I'm fine," he said, "I'm just hot...ooh, I'm hot man, hot."

A large puddle of water settled in the floor. Next to it lay the bathroom sink, the pipes torn from wall.

"Trying to take a bath," I said to my partner, laughing. "You know, there's easier ways..."

He started to put his pants on again, with little success. He teetered back and forth as he attempted to put one foot in a pant leg. I watched the man fall to the floor with a mix of wonder and amusement while my partner called for police backup.

My partner was scared. A devout christian of foreign birth, he had never been around drugs or people on them. I had been immersed in the drug world since high school. To my annoyance, he insisted that we let the cops subdue the man first, before talking to him. But the guy was high--hell, high as a kite-- not belligerent.

"Hey, what's your name?" I asked. "You got any ID?"

"Dennis Wilkerson," he said, pulling a card out his pocket. It was an ID card from the New York State Penitentiary in White Plains. Release Date: Today. It showed a picture of him wearing thick, dark-rimmed glasses. In the picture he looked strangley sober and institutional. Glancing up at him, seeing his vain effort to put on the pant leg, unable to avoid the sight of his gigantic testicle, I thought of Martin Luther King.

"Free at last, free at last. Praise god almighty, free at last." I muttered, shaking my head "Jesus, so this is freedom..."

The cops had arrived by the time his pants were all the way on, but putting on his jacket was another ordeal. The man fell to the floor several times, attempting, somehow in vain, to fit one arm into the right armhole. I just watched.

Ten-minutes later, the jacket was still not on.

"Okay," I said, "forget the fucking jacket. Just, let's go. You'll be fine. Have a seat on our stretcher here and we'll take you to the hospital."

"I'm fine," he said, wiping sweat from his face, "I don't need no hospital."

The two cops stepped forward, extending their retractable steel batons with a metallic snap. "Get on the stretcher," the smaller one said, raising the baton. "We can do this the easy way, or the hard way."

"Whoa. Whoa.Be cool man," the man said, blocking his face. "Alright. Alright."

Tripping, he moved to the stretcher and sat down.

At the hospital, he took his shirt off again. "I'm thirsty, mothafucka. Oooh. Thirsty!" he said, rocking violently back and forth.

Next to us sat an innocent looking woman with her baby. Poor bastards, I thought.

After a few minutes, some EMTs wheeled in a drunk who claimed to be an inspector for the city. His face was bright red and dried shit stained the inside legs of his pants. He sat next to Dennis, against the wall.

"I werk for the mayor, goddamnit!" He yelled, swinging his cane into the air. "I deserve first class treatment."

"Water!" Yelled Dennis. "Sir..Sir, can you get me some water?" Young doctors walked by, staring openly.

Just then, Julio Tagan, aka Tagan aka Shorty Rock stumbled into the ER. He was another local drunk.

"Tagan!" We yelled.

He leaned into the wall behind Dennis and the inspector. "My chest hurts," he said, clutching at it.

In unison, that entire section of the ER started laughing. "It's the St. Mary's Hospital hall of fame!" I exclaimed, slapping my partner on the back. Watching them in all their pathetic glory, we laughed until we couldn't laugh anymore.

I walked past the pathetic trio to get a soda from the vending machine. The wretched men continued to yell and cry.

Poor bastards, I thought, looking again at woman with her child.

When I came back, Dennis was still screaming for water. it was against protocol, but finally, I brought him a glass. He waited on out stretcher for almost an hour. I left again to flirt with a young doctor. When I returned 20 minutes later, he was picking dead skin from his feet and eating it. The woman with the child was still there.

Poor bastards.

Finally, our convict got a bed.

"Yeah, this is probably gonna come back and bite us in the ass," explained the larger cop. "But I figure the guy just out of the slammer today and he decided to party. Fuck, I would too, ya know. So we're not gonna book him."

"Free at last," I said to the cop.

"Who?" he responded, "Me or him?"