Paramedic
Paramedic “is a roller-coaster ride, with hills of happiness and troughs of depression.… The reader is swept along in the torrent of stories, enjoying the author’s euphoric highs and empathizing with his sad cries against poverty, drugs, violence, and abuse of the system.”
—Decatur Daily (AL)
“A vivid account of emergency medicine that should go a long way toward generating respect for paramedics … [Canning’s] daily life centers on the nitty-gritty of emergency medicine.… An unpredictable mix of tension, action, frustration … There are enough gory details here to satisfy anyone’s curiosity about just what it is that paramedics do and how they do it.”
—Kirkus Reviews
“FAST-PACED …
VIVID … EYE-OPENING.”
—The Hartford Courant
“The street is the toughest place to work.… It is truly medicine in the raw—stabilize, load, and go! Mr. Canning does a fine job in his descriptions of the internal battles the health care professional must face when working in the field—juggling feelings of frustration, compassion, and futility and the need to help. I have nothing but respect and admiration for these men and women who are the extreme front line.”
—ECHO HERON Bestselling author of Intensive Care
“A splendid work … Filled with scintillating yet astute vignettes of life and death … Canning not only captures the magic of working with patients in all sorts of acute medical and traumatic events but does so with considerable eloquence.”
—RICHARD L. JUDD President, Central Connecticut State University Professor of Emergency Medical Sciences
“An excellently written account of the lifesaving roles played by paramedics in an increasingly dangerous world … His book deserves the broadest possible audience.”
—JAMES ALAN MCPHERSON Pulitzer Prize–winning author of Elbow room
“The book is not just a series of adventures. Canning shares his doubts as he looks back on the calls that didn’t go exactly right. He reveals his impatience and his frustrations on the job. He relates his experience on the streets with the policies being set in the state office buildings on high. The poverty of people in the inner city, particularly the circumstances of the children, tear at his heart as he briefly touches their lives in an emergency.”
—Manchester Journal Inquirer (CT)
“Canning describes medical events of all kinds in the book, some dramatic, some routine. But the most moving passages revolve around what he sees in the neighborhoods he visits.… So listen this week for the wail of an ambulance. And if you know any EMTs, thank them for the gift of their vigilance, early dawns, and stormy nights and even on Christmas itself. Then, to show you understand, go buy them this book.”
—Record-Journal (CT)
An Ivy Book
Published by The Random House Publishing Group Copyright © 1997 by Peter Canning
All rights reserved.
Published in the United States by Ivy Books, an imprint of The Random House Publishing Group, a division of Random House, Inc., New York, and simultaneously in Canada by Random House of Canada Limited, Toronto.
Ivy Books and colophon are trademarks of Random House, Inc.
www.ballantinebooks.com
eISBN: 978-0-307-55893-0
First Hardcover Edition: September 1997
First Mass Market Edition: November 1998
v3.1
I would like to thank the following people:
Michelle Gordon for helping me become a paramedic with patience, support, and understanding.
My coworkers—paramedics, EMTs, dispatchers, supervisors, and other personnel—at the Professional Group and at Bloomfield Volunteer Ambulance Association, as well as former coworkers at East Windsor Volunteer Ambulance Association and Eastern Ambulance.
The people who recruited or hired me: Abdullah Rehayem at Eastern Ambulance, Anne Arcari at East Windsor, Al Ullring at Bloomfield, and Harvey Kagan at Professional. Also Jim Paturas, Steve Carden, and Jack Pickering for arranging my internship at Bridgeport Ambulance.
My EMS instructors: Judith Moore, who taught my basic-EMT class at Springfield College, Raffaella A. Coler of Hartford Hospital, who taught my EMT-Intermediate class, Jonathan Hibbard and Conrad Castonguay, who taught my EMT-Paramedic class at the UCONN Health Center.
The physicians, nurses, technicians, and clerical staffs in the Emergency Departments at Saint Francis Hospital, Mount Sinai Hospital, and Hartford Hospital. Special mention to the physicians who gave me medical control, Dr. R. Kent Sargent at Hartford Hospital, Dr. Allison Lane-Reiticker, and Dr. Cliff Wagner at Saint Francis Hospital. Also Debbie Haliscak, who is the EMS Coordinator at Saint Francis.
At the state health department, former commissioner Susan S. Addiss and Deputy Commissioner Yvette Melendez-Theisfield, for their friendship and support for EMS, and the dedicated staff at the Office of Emergency Medical Services (OEMS). Special thanks to Paul Winfield Smith for lending me all those books that make up the great EMS library I have today.
My father for encouraging me to read books.
James Alan McPherson for inspiring me as a writer.
Friends who have encouraged me over the years: Alan Stock, Tom Adkins, Sandy Fowler, Janet Kerr-Tener, Michael Scully, Lisa Davis, Leigh Allison Wilson, Rick Orluk, Tom Dudchik.
Susan Swift for her friendship, conversation, and support.
Jane Dystel, my agent, and Susan Randol, my editor, two special people who believed in me and this book. Thank you.
Contents
Cover
Title Page
Copyright
INTRODUCTION
Paramedic
LESSONS
The City
Checklist
Shootings and Stabbings
Lessons
Too Young
Maytag Repairman Syndrome
Drug Box
Deportee
Life and Death
Waiting
Can I Get a Heartbeat, Please?
Anaphylaxis
Kids
On My Own
PARTNERS
Image
Partners
“What Kind of House Do You Go Home To?”
A Smile
Cowboy
HIV
The Tube
Front Page
Circles
Intercept
Wrestlemania
A Little Touchy
The Park
EMT SPORTS PAGES
Trauma
Skip
Do Not Resuscitate
Nursing Homes
The Age of Love
The EMT Sports Pages
Worry
CHILDREN
Message
Albany and Main after Dark in the Rain
Fixed and Dilated
Politicians and Parents
The Ceiling
Bad Start
When
Whose Kids Are These?
VIEWPOINTS
Two Calls
Viewpoint
Brave Attempts
Incident Report
SIX MONTHS
Six Months
The Chain of Survival
Veins
Tricks of the Trade
WHIPPED
Baby Girl
Paramedic Amputates Leg on Scene to Save Life
Another Code
ATTACHMENTS
Change
Fear
Mothers
A Couple
CHANGES
Changes
On Guard
Long Day
Waiting for Weicker So I Can Say No
City Scenes
HEROES
TV
Race in America
I�
��m Open
Paramedics
Boots
Wiffle Ball
Trauma Regs
Celebrities
Off Duty
THANKSGIVING
Changing Seasons
A Heart History
Thanksgiving
Respect
Lift Me Up
Shoot-out on Amity Street
HEARTBEAT
Heartbeat
End of the Year
Seizure
The Meaning of Work
Dedication
Other Books by This Author
About the Author
INTRODUCTION
Paramedic
In November of 1988 when my boss, United States Senator Lowell Weicker, was defeated in his bid for a fourth term in office, I found myself at age thirty suddenly out of work and at a loss about what to do with my life. I had worked for the senator on and off since February of 1976, when I first arrived in his Washington office as a skinny six-feet-six seventeen-year-old with a Beatles haircut, wearing my grandfather’s blue blazer, a size too big for me in the shoulders. Twelve years later, my shoulders filled out and two inches taller, I was briefing my boss for debates, writing campaign literature, and traveling with him seven days a week, arriving at his house before breakfast and driving his thirty-seven-foot campaign bus gently home in the night as he dozed in his seat after a long day on the campaign trail. If he had won in 1988, the world would have been mine in a sense. I would have gone from a twenty-five-thousand-dollar speechwriter to a fifty- to sixty-thousand-dollar-a-year staff position in either Washington or Connecticut—my choice—but it didn’t happen. We lost by ten thousand votes out of over a million cast.
At the time of the loss, I was living with my girlfriend just north of Connecticut in an apartment on Main Street in Springfield, Massachusetts. In the ensuing weeks I spent hours lying on the couch. Sometimes I’d get up and walk the city streets. I’d usually buy three or four papers and end up sitting in the food court of the Bay State Mall that looked out over the downtown center. I’d have a slice of pepperoni pizza with a sprinkle of garlic powder and hot red pepper on it, and I’d nurse a large Coke as I tried to avoid the “Help Wanted” ads. As I sat there, just passing the time, I often saw ambulances race by on the street, and like anyone I wondered where they were going. One day I read an article about paramedics in the city—the excitement in their lives, the joys and defeats. Every day there were pictures of them in the paper, carrying babies out of buildings, working on patients trapped in cars. These were the same faces I saw picking up the drunk on the corner or sitting in an ambulance, waiting for a call. Real people. One afternoon I saw an ad for an EMT course taught at Springfield College starting in January. Later, at night, I lay in bed listening to the rap music from cars cruising the street and the wail of ambulances racing past. As I debated my future, the sounds called to me: Come have a closer look. Here is a new life, right outside on the street below. Here is a view that you have not seen. You’ve sat at a desk in Washington, D.C., that looked out over the U.S. Capital. You’ve helped write speeches about infant mortality, the war on drugs, and access to health care. Here is your chance to see it up close. Here is your chance to see life as it is without the TV screen protecting you from getting splashed by its grit.
In December I went back to Washington to attend a farewell party for Weicker and to say good-bye to my friends and former coworkers. After the main party broke up, we moved on to the bars on Pennsylvania Avenue, N.E., where I had spent many evenings and late nights celebrating victories on the Senate floor and on capita softball diamonds or just savoring the greatness of being young and fond of women, beer, and music. That night of the farewell party, under the eyes of the stuffed owl on the wall of the Tune Inn, my favorite Capitol Hill bar, with Conway Twitty and Merle Haggard on the jukebox, we all talked about what we were going to do and where we were going to go. Some spoke of hooking up with another legislator or a lobby firm, going to law school or trying decided to become an EMT. If I could no longer help people with my head, I told them, this would be my chance to at least do so with my hands. There is a scene in The Quest for the Holy Grail where Sir Gawain stands up and says he will lead the search for the sacred prize. As soon as the words have been spoken, he is gripped by fear, knowing that the quest will forever change his life. But he cannot take the words back. He has said them aloud and made them a true thing. My friends raised their glasses, called me a great, kind, noble crazy man, then drained their beers in my honor. No doubt in the morning they had forgotten my vow, but I hadn’t. I was committed. Besides, I had no other ideas about what to do with my sorry self.
In January of 1989 I started the basic EMT course at Springfield College. Though I already had a college degree (in English), I found the semester-long class demanding. I had little science background and had difficulty memorizing all the bones in the body and understanding the physiology of the human heart. Every night we had workbook assignments that our instructor meticulously checked and graded. Toward the end of the class we had to do ten hours of observation time in the emergency department at Bay State Hospital. As a precaution against vomiting at the first sight of blood, I carried a plastic kitchen bag in my pocket. Though I witnessed the intubation of an eighty-year-old grandmother whose lungs were so filled with phlegm she could no longer adequately breathe on her own, and the trauma-room treatment of a twenty-six-year-old female who had been hit by a car while crossing the street and who had a concussion, shattered leg, and lacerated liver, and who kept crying, “I’m going to the party. I’m just going to the party,” I was too fascinated to get sick.
I remember how nervous I was when I had to take the state practical examination, a day-long session of seven stations simulating various scenarios—shock, spinal immobilization, bandaging—in which you had to prove your skills on moulaged patients to impassive examiners. It was a humid summer day. In the unventilated room in the basement of a class building, I stabilized a victim’s fractured femur with one hand under the fracture site, and supported the lower leg with the other hand while my partner applied the splint. The examiner, noticing my sweat-soaked work shirt and paling, perspiring complexion, asked if I was all right. “No,” I said, “but I am not letting go of the leg.”
Three weeks later I received the test result in the mail. Nearly thirteen years before when I was applying to college I had had a similar wait. The question was what size envelope would I receive? A thin envelope like the one that Harvard, the college of my father and grandfather, had sent me two years in a row, denying my application (the last year even sending me an off-centered computer-generated letter)? Or a thick welcoming envelope like the one I eventually received from the University of Virginia that said at least somebody wanted to keep me from being homeless and destitute for the next four years? In my mailbox I found a large brown envelope with a return address from the state Office of Emergency Medical Services (OEMS). Inside were my passing test scores, a Massachusetts EMT patch, and a certificate suitable for framing. I did a Snoopy dance. The unexpected election defeat had shattered my confidence. Becoming an EMT held great meaning for me and lifted my spirits. I had worth again. I called up my instructor, Judy Moore, and thanked her. She had been a tough teacher and I appreciated that. She was glad for me, but reminded me that the best lesson an EMT student can take away from a class is that you don’t know anything. The learning begins on the street. The class is only the framework that allows you to learn.
I went to work at $5.50 an hour as an EMT for Eastern Ambulance, a small service that did 911 calls for several Springfield suburbs. At the basic level, the job of an EMT is to stabilize a person’s airway or any injuries, give him oxygen if he needs it, and transport rapidly, while taking a medical history to relay via radio to the hospital to help prioritize the patient’s care. One of my first patients was an elderly woman having mild chest pain. While everyone was gathered around her trying to make her comfortable, she lo
oked at my sweat-drenched face, and said, “Could someone get this poor dear a towel? Are you all right?”
My first trauma call was a head-on collision on the Boston Road in Wilbraham. We arrived to find a man lying against the front wheel of his car, having difficulty breathing due to what looked like broken ribs. A firefighter was already there attending to him. “He needs his ribs stabilized,” the firefighter said to me.
I nodded and did an about-face and went back to the ambulance, where I leaned dizzily against the side door, wondering whether or not I had made a serious mistake and was kidding myself about being an EMT. I looked at the fire engines, ambulances, twisted cars, broken glass, and people shouting. The chaos of the scene belonged on TV, not in front of my eyes. Now that I was actually doing it, I didn’t think I could do it. Then I remembered one of the lessons my teacher had taught our class. “If you can’t remember what else to do, remember to put your patient on the stretcher and take him to the hospital,” which I did. Sound advice.
In time I got better at the job. I learned from each call. I came to like the work more than anything I had ever done before. There is an incredible feeling when you come into a house, and a sick person looks up at you like you are an angel, that is both wonderful and humbling. My teacher had taught us that when you arrive the emergency is over, and even if you are scared, you have to show other people that they needn’t worry. A calm word and hand can do more at times than medicine.
Always I wanted to be better at what I did. I wanted to stay with it until I could save a life, until I could say that I had made a difference—that because of me someone walked and breathed and lived and loved who would not have.
In March of 1990, Senator Weicker called me at work and told me to be at the state capitol building in Hartford at 10:00 A.M. that coming Friday. I knew what it was about. For months, he’d been thinking about making a political comeback. He was going to run for governor.
That Friday I attended his announcement speech in the morning, and in the afternoon was back at work catching dark vomit in an emesis basin from an elderly patient with a gastrointestinal (GI) bleed.