Persevere, Improvise, Adapt, and Overcome

Sometimes I’m amazed we all stuck with it.  

I got hired in a group of three.  Of the two other guys one was my age (30) and the other a year or two older.  Our orientation was plagued with incidents, injuries, and ill advised training practices.  Looking back, I understand what they were trying to accomplish, but almost nothing worked out like it was supposed to.

The first day we reported to training we were met by the newly appointed training chief who was holding three brightly colored tie dyed t-shirts.  Wait, let me go back a step.  The normal uniform for PT is a blue t-shirt and shorts with the department logo on them.  As a means of instilling a goal in us, we were not allowed to wear a department t-shirt during orientation - we had to earn it. Instead we wore plain white tees and department shorts.  The Chief passed out the tie dyed shirts to us and told us to put them on.  He then took us on a three mile run around the city.  

                  

Now, we were firefighter recruits in pretty good shape, but not one of us was a “runner”.  This would prove important as the training wore on.  Apparently, the point of the tie dyed shirts was to instill in us the fact that everything we do is in the public eye and that they are watching our every move - we’d better get used to it and respect it.  Toe the line, someone is always watching.  

It really was not a big deal to us.  No one felt stupid wearing the shirts, we just didn’t really get it immediately.  But the message was driven home much more forcefully when the Chief got called on the carpet by his bosses for subjecting the new recruits to what someone else viewed as “hazing”.  So it was true, someone is always watching.

We were told that every morning, before 8 a.m. (the official start of training) we were to run this course together (the three of us) in less than 30 minutes.  So, taking three non-runners and having them run three miles a day on hard city streets before a day of puling hose and throwing ladders, etc. eventually took its toll on one of my classmate's knees and he had to stop running.  That left just two of us to do the run which would later become known as the “Bataan Death March” by the other line personnel.

                 

Shortly after the knee injury we got our first day of live fire training.  We would take turns advancing a hoseline into the burn room, feeling the heat, staying low, putting just enough water on the fire to darken it down and then let it build up again.  As we went in time and time again our gear and our gloves became wetter and wetter.  On the final pass, my, as yet uninjured, classmate felt his hand really heating up inside his glove but he wasn’t about to say anything and be dubbed the weakest link.  He was the last one to go through so the Chief told him to advance all the way in to the burn room and put the fire out completely. In the process of doing that, so much heat was generated that the water in his glove turned to steam and literally boiled his hand inside his glove.  He came out of the burn room and pulled off his glove along with a pretty decent amount of skin.  It looked something like this:

                       

The paramedic on the crew we were with that day treated the burn immediately and the Chief threw him in his car and drove him off to the hospital.  He didn't get pain meds until they reached the hospital and it was not a pleasant ride. Needless to say, the Chief heard quite a bit about that one too.

With one hand and nearly one knee out of commission the chiefs had to rearrange the entire training schedule and do anything and everything that wasn’t manipulative first.  With the burn to the hand, my classmate wasn’t even supposed to sweat so he couldn’t do the morning run either.  I asked the Chief if I was supposed to report early and still run by myself.  In a frustrated and somewhat defeated tone he said no.  It was supposed to have been a team building exercise and it wouldn’t serve any purpose for me to run alone.  So the morning run became a thing of the past.

In the long run, we all passed and moved on without permanent injury. Although, the rest of our orientation was not without further incident. But that will be a story for another day.

Well, that sucked.

When we get dispatched to a call we have 90 seconds from the time the alert tones go off to get dressed, get on the engine, and get going.  From that point we have four minutes to arrive at our destination.  The ambulance company doesn't have the same rules.  For one, the ambulance could be coming from anywhere: a staging location, the hospital, another city.  It all depends on how many units are available at the time of the call.  They also have a priority dispatching system which means an ambulance responding to a lower priority call may get diverted to a higher priority call and a new ambulance dispatched to the original one.  We always go Code 3, lights and siren, but the ambulance may only be coming Code 2, following all normal traffic rules.  Unfortunately I wasn't paying enough attention to the priority level of my ambulance when this call came down.

We were responding for an elderly female with abdominal pain.  Abdominal pain can mean a million different things and the severity of the pain makes all the difference in how quickly and aggressively we treat it.  My patient was in a lot of pain.  Also, it was new onset pain so something was definitely going on.

 

I knew I had to give this woman some pain relief. She already had a fentanyl pain patch on and had taken a percocet and she was still hurting.  I set about trying to get an IV established but this woman had extremely papery skin and only the tiniest of spider veins.  She apologized and said she knew that they always have a hard time getting a vein with her.  I guess I was pretty focused on finding a suitable site for access (mostly by braille) and wasn't paying attention to the radio traffic.  I felt what I thought might be a good enough vein, though I couldn't see it, and went for it.  Miraculously, I got the welcome flash of blood in the chamber that meant I was in the vein but it collapsed immediately and I could not advance the catheter even the slightest amount.

At this point I heard my captain say, "Oh wonderful".  I asked what happened and he said that our second ambulance had just been diverted. Damn, I hadn't realized they weren't coming code 3.  I told my captain to upgrade the new ambulance.  That's when I found out that my new ambulance was coming from over twenty miles away.

I wound up having to give this woman a morphine injection into the muscle which unfortunately takes much longer to take effect than if it were administered into the bloodstream.  She was also a diabetic with horrible circulation, so really I knew that this was almost pointless. I fished around on her other arm for IV access with no luck. I gave her another injection before the ambulance arrived forty minutes after the initial dispatch.

I knew it wasn't their fault and I was just mad at myself for not thinking about the response code from the get-go.  If I could have gotten the IV it might not have been so bad, but overall I just felt pretty useless.

Sucks when that happens.

Nice Save

My captain's wife and kids were out on a campout while he was at work with us. A little while into the shift he got a message from his wife that they couldn't find his youngest kids stuffed rabbit. It turned out it got left in the car that he took to the station. This was a very sentimental and important bunny and instead of just calling back that it got left behind he decided to go a different route.

We proceeded to take a series of pictures of the stuffed bunny helping out at the firehouse and taking part in all of our activities. The bunny in the gym lifting weights, sitting on the engine going to a call, wearing eye protection and holding wrenches while laying on the creeper to work on the engine. Best of all, we cut the fingertips off of a medical glove and put them on the bunny's hands so he could scrub toilets like a good firefighter. We even got a picture of the bunny flowing the big deck gun during one of our drills.

All these pictures were sent with a message to his kid, from the bunny, saying that the bunny forgot to say he was spending the tour at the firehouse with daddy during the campout. It was a big hit, the kid was no longer worried about the bunny and they anxiously awaited what pictures would be sent the next day.

Nice save Cap.

The Outskirts

There is a station in the farthest outlying area of my department that I got to work at for the first time recently. They respond mostly to auto wrecks on the one lane road that leads out there and grass fires. It is literally out in the middle of nowhere. There's is no cell reception, wifi, or anything else.  Well, I can't say nothing else. There are plenty of scorpions and rattlesnakes and other assorted critters. At this station you are not supposed to leave your gear on the floor of the apparatus bay because you never know what might end up inside them. In the kitchen, hanging next to the fly swatter, is a snake stick. Yeah, they keep it in the kitchen.

From the apparatus bay into the station you pass through sort of an airlock. One door leads into a little antechamber with sticky bug traps in all four corners. There is no shortage of crickets and other
bugs stuck there. You then pass through another door that leads into the dormitory hallway. By each dorm is another sticky trap (with, fortunately, considerably less guests stuck to them).

I saw no snakes or scorpions during my shift. I did, however, see a deer about fifty feet away at the station fence line and in the evening we had an after dinner visitor. A raccoon appeared at the kitchen slider. He is apparently a regular guest because, instead of shooing him away, the crew went to the fridge and got an egg, opened the slider, and left it for him. He tentatively approached, picked up the egg, trotted back a few feet and ate it. They then grabbed a piece of bread and laid it down right outside the slider. The raccoon again came right up grabbed the slice of bread, held it in his mouth and went trotting off.

It was a slow weekend day so nothing much happened as far as calls went but it was a different experience none the less.

Right Man At The Right Time

For the last month we have been running on a nuisance false alarm at a manufacturing warehouse in our district. Our shift alone has gone there ten times this month. The worst part about it for us is that we usually get the calls at about 9pm, 11pm, 1am, and 3am. And that's in the same shift. Spaced just perfectly enough to allow for almost zero sleep.

The place is open with workers inside until between 2-3am so at least there is usually someone there to let us in. We go in, we silence the alarm and reset the system and go back to the station. After 3am there is a security guard who sits in his personal car in the parking lot watching the building. He does not, however, have access to the building (I don't know if he even has a radio) and there is no fire department lock box for us.

It is only because we know this is a false alarm and that we are trying not to make the situation worse that we have not broken the door down when we go there after 3am. Nothing gets a business owners attention and lights a fire under them (so to speak) like property damage.

After our first call of the tour to this business we contacted the alarm company ourselves and were told that they required someone on the official contact list with a password to take the alarm offline. No one working in the plant had this info. The fire alarm rep was very honest in explaining that he was not surprised they had not received a repair order since that costs money and we were resetting the alarm for free. Unfortunately we can't just not go to the alarm so we decided that this would be the day that we break in if no one was there to let us in. The captain also sent the info off to Fire Prevention so the business would start being fined every time we went out there. We were done messing around.

We got our second call of the shift to the business around 9pm and we were silencing the alarm with our usual contact, the floor production manager, when a stern looking man with a clipboard and a camera appeared from the warehouse and followed us to the alarm panel.

He stated that he was the corporate safety inspector and just happened to be down here from Kansas City doing an audit of the facility. Without prompting, he informed us that, in his words, "They're failing by the way. This place is a shithole." We told him the whole saga of the month long alarms and he was not a happy camper. No one outside of the plant had been informed and he was pretty upset that this was the first he was hearing of it. He told us he would be calling corporate right away. Considering it would be 1am where he was calling I got the feeling he was going to get some attention and some action. He asked if he could get a picture of us as proof that we were here. I though it odd that they wouldn't believe him but we obliged and he snapped a picture of our big smiling crew with the floor manager.

We haven't been back since.

Will this be for pick-up or delivery?

I've seen a lot of people abuse the EMS system and use the ambulance as their personal taxi but this was a new one.

 

The call came in for a medical in the next district over. That engine was out on another call so we took it. On the way we got an update from dispatch that this was for someone who was in a car accident earlier and now wanted an ambulance. Already I felt that this would be a waste of time as this type of call usually is, but there's always a chance it's legit. We arrived at the address and knocked on the door. No answer. I rang the bell and knocked louder while announcing, "Fire Department"! I didn't see it, but the firefighter said someone peeked out of the blinds at us and then disappeared. Well somebody was obviously home. I knocked and called out again. Nothing.

We went around to the back of the unit and before I could even knock on the back door it opened and a woman (the same one who had peered out) stepped out. We told her someone had called 9-1-1 from here. She then told us that the person who had called had been in an auto accident and went to the hospital but had been waiting in the ER for a "long time" so they called an ambulance. Okay...well, let's take a look, where are they? She responded, "Oh, they're on their way back now".

Are you serious?

They left the hospital to come home to get an ambulance ride to the hospital?  And they pre-ordered the ambulance?!?!?! 

Oh, my captain was pissed. To his credit he was polite and we returned to the engine. He said we're giving this guy two minutes and then we are out of here. A few minutes came and went, the captain radioed dispatch that no one was here, and we returned to quarters. Just as I was pulling back in to the station the call came in for the same address. This time the in-district engine was available and they got the call but we wanted to let them know what went down and give these folks a little "education" so we headed back.

The other engine was on scene and into their assessment (no obvious injury or problem that anyone could find, by the way) when we arrived. We gave them the rundown of how this had all gone down. The ambulance arrived and got the rundown as well. The ambulance, of course, was taking them right back to the hospital they had left. The beauty of this was that they probably would have been seen within the hour they wasted coming home and going back in the ambulance. Now they would be starting the process all over again and adding an ambulance bill on top of it.

 

Here's the "education" part for those that don't know. For some reason, people think that arriving by ambulance to the hospital means you are seen quicker. This is not at all true. Everyone who comes in to the ER is triaged according to the severity of their condition or injury compared to everyone else in the ER. Those who are stable are going to wait longer, that's just the way it is; it doesn't matter how you get to the hospital. And I can guarantee that the triage nurse who had already triaged this guy, probably called his name while he was gone, and then sees him arrive again by ambulance is not going to put him at the front of the line. Just the opposite I suspect.

 

Hopefully he learned an expensive lesson about the EMS system today. You don't call 9-1-1 for take out.

They See Me Rollin'

We do a lot of lift assists in my district. Elderly folks who just slipped out of a chair or the bed or whatever and don't have the strength to get up again. For the most part we just pick them back up and put them to bed or wherever they would like to be. Usually they are pretty quick and easy unless the patient is very heavy or in an awkward position. This most recent one was easy but not quick.

When we arrived we were met by our patient's daughter, who turned out to be no help at all. She directed us to the bedroom where our patient was on the floor between the bed and the dresser. She had grabbed some pillows and propped herself up a bit but she had been on the floor for a couple of hours. She is 98 years old and very open and chatty. We got to hear all about the virtues of her 'underwear with pillows' (Depends diapers) and many details of her past few weeks and other completely unrelated subjects in between me trying to ask pertinent medical questions.

It turns out that she had been trying to get out of bed to go to the bathroom and slid down to the floor. We checked her for injuries and then lifted her up and back onto the bed. We suggested she go use the bathroom now so this doesn't happen again later. At first she said she would just rest first and that she would be fine to go later. We really didn't want to have to come back in a few hours so we again suggested that she go now. She agreed and we grabbed her wheeled walker for her. Meanwhile she somehow wriggled out of her diaper and kicked it off. We mentioned it to the daughter who did nothing. So, we began to help our patient down to the bathroom.

This is where it got funny. The bathroom is directly down the hall from the bedroom about 25 feet. Our patient began moving with the walker in that direction so unbelievably slowly I felt like I was  listening to a 45 rpm recording of Andy Griffith speaking played back at 33 and a 1/3. All I had to do to keep pace with her down the hall was lean forward slightly. All the while she was chatting on about this and that. It was frustratingly amusing, but I'm glad that I have a crew that just laughed it off and stuck with it to help this woman out. When we got to the bathroom we knew she might need some help. Again, the patients daughter was just standing there doing nothing. We asked her to please come up here and help her mother out. Our patient used the bathroom and began the long trek back down the hall to the bedroom where we put her back to bed and covered her up.

And speaking of rolling along:

Our next lift assist happened to be a 400 pound man who slipped in the shower. We were able to dry him off enough to get a carry-all behind him and lift him to standing. The funny part about this one was this couple's ingenuity. The wife was not as large as her husband but on her way. She was in a rolling desk chair and seemed to use that as her primary conveyance. She was also on home O2 with about a 50' tube. She had installed little hanger hooks all down the hallway and around the house to rest the tubing on so it didn't get tangled up as she scooted around the house. We were able to move our patient to a similar chair which I'm assuming he uses all the time as well. As we said goodbye and left the couple rolling around their house I noticed that everywhere you looked around the house were a variety of tongs strategically placed for reaching things from a sitting position.

That's just how they roll in my district.

From Drain To Crane

There's a man made lake in my old district that is home to a million geese and ducks. The little ducklings occasionally follow their parents right across the sewer grate and drop right down. They can't fly and so they end up trapped. Inevitably someone will call us to rescue the ducks. Most of the time it is a pretty simple operation: we lift up the sewer grate, drop a small ladder in, climb down, block off the other exit with a shovel so they don't run away and scoop up the ducklings. It's a happy ending, feel-good, positive PR kind of call. Unless, that is, you're the B-shift crew that this happened to:

The lake is also home to an annual fishing derby for kids. The city pays to stock the lake with hundreds of fish and hundreds of kids come out to the park to drop their lines in and pluck the unwary suckers out of the water.

It happened to be a beautiful day and there was a big turnout. Of course, with so many people around the avian residents were on the move and one little guy, as expected, dropped into the storm drain. The call went out and Engine 52 came to the rescue. With all the kids gathered around them they descended into the storm drain and heroically re-emerged with the duckling. The mama duck had retreated to the waters edge due to all the commotion. Amidst a chorus of cheering, the duckling was brought to the water and released, quickly falling in behind its mother and swimming out into the lake.

That is when, according to the crew, the shadow appeared and time slowed down. From somewhere in the trees behind them a crane took flight and passed right over their heads. It bore down on the rescued duckling, snatched it from the water, and flew off with it in its talons into the trees above the crowd. There it proceeded to eat the duckling as the shocked and horrified children drew silent. "Hey kids, how many of you have seen The Lion King? Circle of life remember? Right kids? Kids?" Of course, the actual exclamation from the firefighter was, I believe, "Oh my god! Did you see that god-damn vulture?"

 

The next morning I was on duty and this whole story was relaid to us with much laughing and teasing. Later that day we responded to a grass fire in an open field. After extinguishing the flames we traced the fire back to its starting point and found a very dead KFC (Kentucky Fried Crane). It had apparently landed on the power pole and spread its wings out contacting the wires and electrocuting itself. It must have caught fire and fell dead into the tall dry grass by the power pole. We all agreed that this must be the crane from the fishing derby and that karma is, indeed, a bitch. Lion King.

Tennis Anyone? or People of Walmart

We were returning from picking up some equipment and happened to be in another station's district when a call came in just a few blocks from us. We radioed dispatch and told them we would take it for the other engine. The call was for an assault in the WalMart parking lot with one suspect still inside the WalMart. Police were on scene with the victim as we rolled into the parking lot.

Our victim/combatant was pacing around with some cuts and bruising to his face and neck when I introduced myself. He explained that he was in his car leaving the parking lot when another guy started hitting him (through the open window) with a tennis racquet. I looked over at the other police car and saw two tennis racquets on the hood that were completely bent up and destroyed.

 

 My patient told me that he then stopped his car and got out to fight, naturally. Since there were two destroyed tennis racquets on the hood, I like to think that he got out, reached into his coat, and pulled out his own racquet, Highlander style, and the two began to duel.

 

I believe the truth is something closer to him leaping out of the car and charging a guy wielding two tennis rackets and getting beaten down windmill style. Either way, I bet it was a site to see.

Other than being very angry and quite bruised up my patient didn't have any serious injuries and declined ambulance transport. I have a feeling, though, that tomorrow he is going to look and feel like he was in a racquet fight.  "Jesus, man, what happened to you?"  "I got in a tennis racquet fight."  "Oh. Yeah, that looks about right."

The police came out shortly with the Andy Roddick of the WalMart parking lot. Instead of some wild eyed crazy random attacker he turned out to be a guy in his early 20s who looked pretty normal. He stated that the guy in the car ran in to him in the parking lot and didn't stop, which led to the beating. He was unharmed in the melee and needed no medical attention.  What a shock - the guy with two tennis racquets and the element of surprise won the fist fight.

What never ceases to amaze me is how surprised people are when they get arrested for the most obvious things. It seems they honestly don't understand why the cops are even talking to them. This kid was getting the bracelets hooked up as the officer explained that he was being charged with assault. He looked at her, aghast, saying "But he ran into me. Why am I in trouble?"

(should say, I Served Time)

The capper to this whole fiasco, though, was all the other drivers in the vast WalMart parking lot who could not figure out for the life of them how to deal with one aisle full of emergency vehicles and still go about their day. A whole line of cars pulled out and instead of going the opposite direction, headed straight down the aisle towards a fire engine, an ambulance, and two cop cars. They proceeded to just stack up in the aisle until I finally went and moved a bunch of shopping carts and started directing traffic away from us and into the next aisle. Meanwhile, a car parked right by one of the cop cars decided to back up and leave. They began backing up and my firefighter was directing them away from the cop car but they wouldn't turn. They just kept backing up towards the cop car, where incidentally the kid was getting cuffed. One of the officers went up to the passenger window and began telling the driver to turn the wheel. They turned the wrong way. He pointed and told them louder to turn the other way. They straightened the wheel. He opened the door and pointed again and said, "Turn the wheel that way and slowly back up!" They finally got turned the right direction and proceeded to back up at about 1/8th of a mile per hour. I didn't know cars could actually go that slowly and still be moving. The cop actually looked up at all of us, threw his hands in the air and said, "I did say slowly didn't I?"

This Just Pissed Me Off

The vast majority of ambulance crews who respond to our calls are good ones. On occasion you get the burnouts and it sucks. I hate being the caring professional who treats my patient with respect and then have to hand them over to some uncaring idiots. Normally it doesn't stick with me or bother me for long but for some reason I was fuming over these dipwads all four day.

Our patient was an elderly man who just went on hospice care a few days ago. He was having some difficulty breathing and really needed supportive care. We set him up with some increased O2 and did our best to comfort his wife as well. He was pretty much ready to go when the ambulance arrived.

This ambulance crew happened to have an intern with them. Now, I was an intern once and I know what it is like so I try to let them do their thing and kind of help them out. However, the regular ambulance crew came in and didn't say a word. Not one word to me, my crew, or their intern. I usually look to the preceptor to get an idea of what he expects out of the intern and how the guy is doing. I got nothing from this guy. So, I gave the intern a complete rundown and told him we would have to carry the patient out to the gurney. The intern asked if the patient had a DNR which was an excellent question although it was most likely not going to be needed on this call. The patient's wife said yes, but was obviously not prepared for this to come up so soon and was very flustered by the thought of him needing it. I tried to reassure her that we just needed to know what kind of directives he had but would not even be going lights and sirens to the hospital. She could not seem to locate the DNR and this seemed to be hanging up the intern. The other two "medical professionals" still had not said a word and were standing shoulder to shoulder in the doorway of the bedroom blocking any access or egress.

 

I went outside to see where the gurney was and which way it was facing so I could plan how to take the patient out. When I arrived back inside the scene was unchanged. Our patient needed to get to the hospital and this crew was still standing there doing nothing. My firefighter, probably reading the expression on my face, had taken up position behind the patient ready to help lift and carry him. My way was blocked by the ambulance tools so I merely looked my firefighter in the eye and said, quite loudly, "Are you ready?" and pushed my way unceremoniously into the room between them. I took the patient's legs and my firefighter took his upper body and we took him out to the gurney and started bringing the gurney to the ambulance.

Now, my firefighter and I do a lot of lifting and carrying of patients in our district and we don't mind it at all. But, when the ambulance crew doesn't even feign assistance and behave like these bozos did it really bothers me. Normally, I am able to just shake my head, talk smack and berate them when I get back in the engine, then move on and forget about it. But, for some reason, these clowns really got to me and every time I thought about it over the next few days it made me angry all over again.

Happy Windsday!

It was a very blustery day....

The day started off nice and sunny and we decided it would be a good day to get our new captain some practice at launching and recovering the rescue boat from the trailer (which he hadn't done yet). We were all set to go after lunch. However, all through the morning the wind continued to pick up and by the time we got to the marina there were waves and little white caps at the boat launch which is pretty unheard of. We, stupidly, decided to give it a try anyway. Based on the conditions I offered to try it out first to see how tough the recovery was going to be but the captain decided to give it a shot.  We figured if you can succeed in the worst conditions then all other attempts will be a piece of cake, right?

As soon as he backed the boat off the trailer the wind started pushing us back into the dock and towards the rocks. My captain struggled to get us straightened out and turned around for a run at the trailer. We were in a substantial crosswind and the cabin of our boat basically turns the middle and ass-end of the boat into a giant sail. 

The wind was coming from our left and as we made the approach to the trailer things were actually looking good. Then things started to go sideways...literally. The wind was pushing us sideways past the trailer and towards the starboard side dock. We have bumpers out to protect the boat and the firefighter at the trailer ran over to push the bow of the boat away while I leaned out and pushed against the dock from inside the boat. The firefighter suggested that we reposition the trailer and just pull the boat onto it by hand, a simple and practical solution. However, being a firefighter faced with a challenge and slipping into single-minded, "this thing isn't going to beat me" mode I said I wanted to give it one shot before we resorted to towing it in. I figured the worst that would happen is that we wind up in the same spot and go with the firefighters plan.

I backed the boat up and fought the wind to loop around for my run at the trailer. Now, normally in recovering the boat I only use one motor and only power it up to make steering adjustments with small on/off bursts. The expression we use is, "Slow is pro". This day, I found myself using both motors just to get lined up into position. I aimed for the corner of the port side dock to hopefully give myself some wiggle room and came in under power, though with only one motor. The rear of the boat immediately started swinging out to the right as I approached. I wound up coming in almost completely sideways to the trailer and under power, scary. Just before I got to the trailer I turned the bow hard right toward the trailer and killed the power. I got a thumbs up from the firefighter at the trailer and as the boat came up on the rollers and centered itself I popped it back into gear and drove up onto the trailer. The firefighter secured the bow hooks and  brought us out of the water. It was probably a one in a thousand lucky shot and I doubt I could possibly repeat it, but damn it felt good. That recovery alone made me happy all day.

We weren't the only ones battling the wind that day, though.

Our next call, after giving up on further boat ops and getting back to the station, was for a woman in the trailer park whose carport was being ripped apart by the wind and threatening to fly away. When we arrived we saw that two of the supports had already been pulled loose and the roof itself had buckled. The entire carport was about 40 feet long and made of corrugated metal.

My firefighter grabbed a pike pole and hooked it over the roof where it had buckled and pulled down to bring the roof back down to the sheared supports. He wrapped his legs around the pole like he was flying on a broomstick and even with that when a gust came along he was lifted off the ground about six inches. I threw a ladder for the captain and handed him tools while he tried to reattach the supports with some metal strapping. We soon discovered that the strapping was not going to hold and decided to try securing the whole thing with rope.  I found myself lying on my back on top of a shed under the carport with a sawzall cutting holes in the metal as the roof blew up away from me and bounced back down within a foot of my face. We fed ropes through the holes I had cut and tied them off to secure anchors on the ground. Of course the next gust that came along caused the rope to rip through the corrugated metal like butter.

Okay, that did it, this thing had to come down. We decided just to cut the damaged section of roof off entirely, a section about twenty feet long. I took over duty on the pike pole trying to keep the roof pinned down while my firefighter sat on the roof of the mobile home with the sawzall cutting the carport away from the home. The sheets of corrugated metal were pulling loose from the gutter/flashing I had hooked with the pike pole so every once in awhile when the firefighter cut a sheet loose it would whip back at him like he was holding onto an airplane wing. It's amazing none of us got hurt. But, it worked. We even went back the next day to check on it and make sure everything was okay and all was in order.

We rounded out the shift with an overdose, a combative woman with encephalopathy, and a DOA early the next morning.

Priorities

My last post mentioned priorities and how often, at least in our eyes as first responders, they can be quite skewed. Here's a good example:

We responded for a 55 year old male who was bleeding from a recent surgery site. When we arrived we were met outside by someone who told us the patient had undergone hernia surgery that same morning and must have popped a stitch getting in and out of the car when they went to run errands. We went inside and found that our patient was sitting in his kitchen typing on a laptop computer with no bleeding control measures in place at all. His jeans were saturated with blood from his waist to his knees.

 I wish I had taken the time to look at the screen to see what was so important that kept him sitting up, typing, and bleeding (maybe he was blogging about his experience). I asked him what was going on and the first thing he tells me is that he is feeling lightheaded and nauseous. Really? I can't imagine why. I told him to lay down immediately. His blood pressure laying down was 87 over 50.

I went to kneel down next to him and almost knelt right in a puddle of blood. I grabbed a nearby towel and laid it over the blood. His pants were undone and I lifted his shirt to see a completely clean surgical incision site. Weird. I told him I needed to remove his pants to examine the wound. He said okay but asked that I cover him with something, modesty I guess, but again - priorities, after all we were alone in his living room not in the mall. Turns out he was going commando but I barely had to move his pants down to see that the lower abdominal incision site was the one that was bleeding. I covered it with a trauma dressing and applied some pressure. I asked how long ago this happened and he said, "About an hour." An hour?!?! What have you been doing for the past hour? "Well, we just came back home from the store." A word of advice here, if you have surgery in the morning, don't go shopping in the afternoon. If you pop a stitch at the store and are soaking your jeans with blood, stay there and call an ambulance.

Next, I asked if he had any medical problems and he said he was diabetic. I asked if he took insulin or pills. He responded, "Oh god I take so many pills it's like a meal." Oh, okay, what for? "I'm HIV+." Oh. Now, I can understand not wanting to shout out to everyone who comes into your house your HIV status, but when you are covered in blood and the medical personnel ask if you have any medical problems, it might be the first one you mention. In fact, you might want to mention it in the very beginning. Of course we always wear gloves and take precautions against body fluid contact but it is still one of those things that makes you a little nervous and you like to know about as early as possible.

An I.V., some fluids, and an ambulance ride back to the hospital and this patient would be fine. I just really wish I knew what he was doing on that computer that was so important.

Can You Call Me A Cab

We had just pulled into the parking lot at the grocery store to shop for dinner when a man on a bicycle rode up to the engine. I stepped out of the rig to see what he wanted and in a very thick Phillipines accent he said, "Can you call me a cab?". Really? Who exactly does he think we are? I responded incredulously, "Can we call you a cab???". He said, "No. Can you call me a cob?" "A cob?...I don't understand. Cob? Wait, call you a cop?". "Yes. I been chot?"  "You've been shot?!!!"

Once again, I am always amazed by what people tend to think is important. Personally, if I'd been shot and was talking to a paramedic I would probably lead with the fact that I had been shot and worry about the police later.

I told him to sit down on the tailstep of the engine and tell me what had happened while I examined him. His story was as follows: He had been out for a bike ride and was going over the overpass from the neighboring town into ours when a car drove by, someone leaned out of the window, and shot at him. He felt a hot, sharp pain on his right side but kept riding. I found a small hole in his t-shirt and a small red mark on his side. It looked like it was just a pellet gun but it had enough force to go through his shirt and he easily could have crashed in the roadway. He declined an ambulance and we called the cops to take a statement from him.

He told us that in the Phillipines he had been a resistance fighter for many, many years and was never injured. It took coming to The United States and going on a pleasant sunny-day bike ride for him to get shot. 'Murica.

First Days

First days rarely go well. I've heard a lot of horror stories of peoples first days on various jobs. So, here are the stories of the first day of my EMT hospital time,  my first day working on an ambulance, and my first day on shift with the fire department.

Hospital time:

Becoming an EMT or a paramedic requires you to do clinical time in an ER before being certified. It pretty much immediately follows the didactic portion of the class and serves as your first real encounter with patients and all that you've been learning about. Bear in mind, I had zero experience at this point.

On the first day of my EMT basic clinical rotation I walked through the doors of the ER about 15 minutes before my shift was due to start. One of the nurses was heading toward a drawn curtain when she spotted me in my student/intern uniform. She stopped and asked if I was reporting in. I said yes and she immediately sighed and said, "Great! Go help Doug in Bed 2." I looked around the ER and saw that Bed 2 was the one with the drawn curtain and that the nurse had returned to the nurse's station. Eager to help but a little unsure of protocol, I quietly stepped around the curtain and there was Doug. To be more precise, there was Doug, a large opaque plastic sheet in his hands, and the naked corpse of a thin 90 year old man. He told me to come over and roll the body towards me so he could get the sheet under him. Now, I'd never even seen a dead body before, let alone handled one, but I did as instructed. We completely wrapped him in the plastic and taped it shut. Surprisingly none of it really bothered me. The part I found strange and a bit irreverent was when it came time to secure the extra plastic. The plastic was longer than the body and if it were a tootsie roll you would just twist the ends and leave it at that. In the case of this man, not being a tootsie roll, the extra plastic at the end was folded back over his face and secured by taping it repeatedly around his neck. Being dead, it didn't matter, but it was a strange sensation putting plastic over someones head and taping it around their neck. It seemed a little serial killer-y.

Well, having gotten the 'first corpse' thing out of the way, I reported back to the nurse's station. I was given a few random assignments but nothing too eventful until a patient came in with a bleeding arterial dialysis shunt. This is the implanted port used to remove blood, filter it, and put it back into the body during dialysis treatments.

The patient was a large African-American woman and the blood was under quite a bit of pressure since it was from the arterial side. I was assigned to hold direct pressure on the site with some gauze pads. Every once in a while the doctor would come in to see if the bleeding had stopped. He would ask me to relieve some pressure and fold down a corner of the bandage so he could see. At this point the blood would squirt out about 2-3 feet and he would say, "Not yet. Keep pressure on it." and then leave again. This went on for quite awhile with me just sitting in a chair next to this woman with both my hands wrapped around her large forearm and squeezing the best I could. They finally had to put a blood pressure cuff on her arm as a tourniquet to slow the bleeding. It was my job to sit there and watch the time and monitor the cuff. The cuff had to stay on for ten minutes at a time. It was pumped up very high in order to achieve the tourniquet effect and it was obviously painful to the patient. I could feel her hand getting cooler and see the color change in her skin. At the two minute mark she started asking if it was time to take it off yet. I had to do the, "Not much longer. Hang in there." dance with her to make it through the time. We did that dance at least two more times. All in all, that incident lasted almost three hours and pretty much took up my entire first shift in the ER.

Ambulance:

I worked part time on a BLS ambulance for awhile while going to paramedic school. We did mostly inter-facility transports, that is, taking elderly people from nursing homes to their doctors appointments or to the hospital. This pretty much just entails transferring the patient from the bed to the gurney and taking vital signs. Rarely do we travel lights and sirens and we don't respond to 9-1-1 calls. It is usually pretty uneventful.

I showed up at the barn and met my partner for the day. He informed me that he was a huge Eagles fan and that is what we will be listening to in the ambulance and if I didn't like it then that was too bad. Okay, good start. We left the barn and headed immediately to the gas station to fill up. I was the new guy, so I pumped the gas. I had no idea how low the tank was or what it even held because I wasn't driving. It was obvious it was full however, when the pump burped and gasoline came sloshing back out of the tank and all over my thigh.

Strike one.

My partner then informed me that, "Oh yeah, that can happen. Sorry I should have mentioned that." He was sincere, he hadn't set me up, however I had no other pants and now I reeked of gasoline. My partner told me he had some pants I could use and we went back to get them. His waist was about four inches bigger than mine and I'm sure I looked ridiculous in his oversize pants but I didn't really have any other option.

With a change into the clown pants we headed off to our first call. When we arrived at the house we found out that this patient was on a ventilator. Being only EMTs and not paramedics or nurses, we are not allowed to transport patients on ventilators and we had to explain that to the family and then hang around and wait for the ALS ambulance to show up. It's very awkward standing around with nothing to do and not much to say. It wasn't our fault we were the wrong ambulance, but we were the ones there and the family wasn't thrilled about it.

Strike two.

We ran a couple of nursing home transfers and then got a call to respond to a house. Most of our calls were to hospitals or nursing homes and usually not to private residences. When we arrived we found that our patient had been changing his catheter and encountered a problem. (Here comes the pitch.)
This was causing him to bleed from the site and the bleeding was not stopping. (Anyone else, sensing a pattern here?) Once again, as the new guy, it was up to me to deal with the bleeding while my partner drove. (He can't hit, he can't hit, he can't hit. Sssawing batta'.) So, yes, I got to hold direct pressure on a patient's penis all the way to the hospital. At least this time I didn't have to break out the blood pressure cuff.

Swing and a miss. Strike three.


Fire Department:

On your first day on shift in the firehouse everything is a test and everyone is watching you. How well do you do your job? Do you step up and do the chores and all the work in the station without being asked? Are you entertaining and do you tell good stories? Do you seem lost or at home? You are under a microscope and walking on eggshells. There are many firehouse rules or etiquette that should be followed and hopefully someone has clued you in ahead of time and not steered you wrong. One of these rules is never show up empty handed. On the fireground it means you always have a tool of some kind with you so you can do some work. On your first day it means you bring ice cream. This is where I was steered wrong.

The last week of my academy, just before starting on shift a particularly particular captain advised me that I need to show up with ice cream on the first day (and probably every day after that for awhile). Okay, thanks, good to know. He then informed me that I should bring something particularly good like Butter Pecan and none of that "mint chip shit". Okay, thanks, good tip. I of course didn't take into account that I would not be working for this captain or his crew and that bit me in the ass. More on that later.

 

I did all the cleaning and the chores and all that I was supposed to so there was no fodder for the cannon there. The getting to know you period, or third degree grilling as it turned out, was another matter. I am vegetarian, a relatively rare thing in the fire service, at least in that small department twelve years ago. There were many questions about why I chose vegetarianism and a million what-about-this-situation hypotheticals. I knew I was in trouble when I stated, "Look we can go over this for hours and it isn't going to change anything" and the answer I received was, "Oh no, no, no. We have 20 years to go over this."

It was somewhere around this time that the Butter Pecan was discovered. I knew this because I heard from the kitchen behind me, "Who brought in this shit?". I fessed up and told the story of the captain who had led me astray. At this point, the lead investigator in the vegetarian 'grilling' went to the blackboard to educate me. He drew a large C on the board. "Now pay attention. This is C shift, okay? C is for Chocolate. C is for Carnivore. C is for Catch and DON'T release." He wrote these all on the board; there were more but I probably blocked them out at this point. It reminded me of Mr. Hand from Fast Times At Ridgemont High putting Spicoli's "I don't know" on the board for all future classes to see.

I was then grilled about my cooking ability and it was determined before I'd ever made anything for them that I couldn't cook but merely heated things up. Then they informed me that I would be cooking tonight. There were six of us altogether at this station and I had never cooked for that many people, and honestly I didn't really have much of a repertoire anyway. So, I decided to go safe and make build your own burritos. I got a lot of food because the other rule is it is better to have too much than too little. I had prepped all the ingredients, made the guac, and set everything out. I was at the stove finishing the meat when the crew took their seats at the table. I had laid out the tortillas on the table already. The next thing I knew one of the other firefighters was standing next to me at the stove heating up his tortilla over one of the gas burners. He had no shirt on.

 

I did a little double take, said nothing, and went back to cooking. This firefighter was a little hyperactive and I figured that he was probably changing and decided midstream to get his tortilla ready first so it didn't really phase me. The meat was finally ready and I turned from the stove to put it on the table and found the entire crew waiting patiently at the table, shirtless. Their shirts were hung neatly over the back of their chairs and they eyed me expressionlessly. As I said, everything is a test. What I had to figure out quickly was what was the answer? Was it, am I stupid enough to fall for this, or was I supposed to join in? I decided, as ridiculous as it was, that it was the latter. I set the food on the table, looked at each one of them, peeled off my shirt and set it over the back of my chair and sat down.

Everyone dug in and we ate that way for about five long, silent minutes until the lead investigator broke and said, "I can't take this anymore. I can not eat and stare at you flabby, pasty, bare-chested fuckers." Everyone started laughing and I was high-fived by my captain. I had gotten it right. The funniest part was that they actually believed that they could convince me that this was the normal firehouse way of having dinner so that the first time I worked at another station or with another crew I would whip my shirt off at the table and embarrass myself.

And for the record, everyone ate the ice cream.

Skills

Firemen are supposed to be jacks of all trades. We are called to handle not only emergency situations but, for some reason, any possible situation that people can't handle on their own. We go to water leaks, lock outs, stuck wheel chairs, open cans of paint on the sidewalk, chemicals in the storm drain, ducklings in the storm drain, cats stuck in fences or up power poles, downed power lines or phone lines, and so on and on and on. I've responded code three for a man who, it turns out, couldn't get his voice mail on his answering machine. We are expected to mitigate any situation we are called for. We can't always do it, but we certainly try. Most of us therefore become jacks of all trades and masters of none. We know just enough about a lot of different things to hopefully do something about it and not get ourselves killed.

That...or we just wing it and hope for the best.

The cool thing about this aspect of the job is the exposure you get to these skills and tricks and access to the knowledge that each of us brings to the job from our own unique pasts. For example, just the other day we were responding to a lockout at the local elementary school. When the dispatch came in, we didn't know if it was a lock out of a building or a car. My firefighter quickly grabbed his lock pick tools in case it was a building we needed to get into. In the rig he informed us he had his tools. I responded, "Lock pick set? You have a lock pick set?" He replied very matter of factly, "Yeah, just in case."

Cool.

The call turned out to be for a car and they had it open before we got there but as soon as we got back to the station the questions began. Turns out this fireman had worked for a locksmith for a couple of years and learned a lot of great tricks for getting into locks.

 

I'm used to the fact that we normally just break things, in the cleanest way possible of course, to get in where we need to go so this peaked my interest. He had several tools for picking locks and I immediately went grabbed our door lock prop. This is basically a 16" by 20" solid piece of wood with four different door knobs it, each with a different style of lock. He proceeded to teach me about locking mechanisms, most of which I knew from basic firefighting books, and then how to pick the locks with different style tools. It's not easy and it is not an exact science but after only a few minutes I had successfully picked my first deadbolt lock.

I love learning new skills and getting to do things that I would never have learned, seen, or done in any other occupation. Now I can add cat burglar to that list.

Hazards Of The Job (In 3 parts)

ONE:
The increased risk of cancer in my profession is very high. Years of breathing in diesel fumes from our fire engines, smoke from fires, chemical vapors and anything else you can imagine coupled with the myriad problems and decreased immune response caused by sleep deprivation creates a ripe environment for the big C. 

These are known risks and risks we accept but try to minimize with safer work practices and better safety equipment, etc.

My very first chief retired three months after hiring me. He got sick and was dead within 6 months after that. He never saw a healthy day in retirement.

Most recently in my department, a beloved senior fireman -still on the job in his 60s- passed away from lung cancer. He never smoked a day in his life.

But, it is not always the retired guy or the senior guy who gets sick...

TWO:
Obscenity. Atrocity. Injustice. I don't use these words much, but they seem appropriate in this situation.

In the 12 years I have worked in the fire service I have worked with a lot of really good people. But, in that time, there have only been a handful (five to ten?) that I really connected with, would do things with off duty, and truly call real friends. Now, one of them is sick. Really sick. He has been diagnosed with Stage 4 colon cancer and just started chemotherapy.

He is 31 years old.

He has always been one of the most selfless people I know. If you need a trade, a ride, help moving, whatever it is, he's there for you. It could be argued that as a young guy with no kids he is in a position to do that. But, it's not that simple, it goes beyond that. It just is who he is.

I worked with him in his probie academy and when he was a brand new fire-medic as a sort of field mentor. We have a ten year age difference but hit it off right away. It could also be argued that this is because I live in a state of suspended adolescence (as most firemen do). But it's not that simple. We share a similar twisted sense of humor and love of movies and other pop culture geekery. We 'get' each other's references and what they might mean in the broader/deeper context of the conversation. Back at that field mentor time, we worked with a captain ten years my senior (20 years his) and I pretty much considered my role on that crew to be translator, explaining to him what the captain means and wants, and explaining to the captain what he needed and expected. There was definitely some butting of heads between those two and I think my role in the whole thing really helped bond us. He later got switched to a different shift, but still at my station, so I saw him in the mornings and when one of us got to work overtime with the other.

He just passed the test to become an engineer (my position) which means (when he promotes) we wouldn't get to work together anymore until one of us promoted to captain. The engineers exam is a tough test and I was proud of him and glad he did so well, but also bummed that we wouldn't have the opportunity to work on the same crew anymore.

I don't have much first hand experience with major illness or death and, I shouldn't be, but I've been surprised at how much this has bothered me and how often I'm thinking of him. I suppose it could be argued that it is simply the fact that it is the first time I've had to face this sort of thing on a personal level or that he is so young and this is so wrong.

But, it's not that simple, it goes beyond that.

THREE:
It is now a year and a half later. My friend has gone through chemo, surgery to remove part of the colon, weight loss, and weakness. He has been off of work this entire time. He was young and strong going into this ordeal and I think that made a huge difference. He never laid down or quit. He approached this as a fight he not only could win but would win.

He responded well to the treatments and the surgery got the rest of the cancer. He got stronger. He went from barely being able to walk around his block to jogging up the highest peaks in town. Stage 4 remission brings with it a high likelihood that the cancer may come back some day. But for now he is free and clear. He beat odds that were roughly 96% against him.

Yesterday I signed up for overtime and was expecting to get the vacancy at our old station. When they called me for the overtime they told me I was going to a different station. I checked the roster to see why I didn't get to go to my old house and found that my friend (and newly promoted engineer) was working in that spot that day. I hadn't seen his name on the roster for a year and a half without the workers comp code next to it. It was pretty amazing to see.

I'll take my second choice station any day to see that.