Paramedic Read online

  I went to work as Weicker’s campaign issues director, but kept a Monday overnight shift at Eastern. I organized issue groups, wrote position papers and editorials, led the debate briefings, and worked with the paid media, who did our advertising. With a week to go and his closest opponent running strong negative commercials—the type of ads Weicker had refused to respond to in his 1988 defeat—we debated what to do. It had been incredibly painful two years before to take the barrage of innuendo cast at him, and not respond. We’d seen a sixteen-point lead evaporate overnight, and crowds that had hailed Weicker in May of 1988 as a returning hero had shunned him in the chill of late October, many crossing the street to avoid him or muttering after shaking his hand that he was a crook who didn’t pay his fair share of taxes, hated children, despoiled the wilderness, and never went to work. When he finally fought back, he did so only until he had the lead again; then his pride caused him to go back to positive ads for the last four days of the campaign, a decision that caused euphoria in his opponent’s camp. Perhaps the public’s guilt at voting out a man who had served them with distinction for twenty years and who was widely praised the day after his defeat by the leading papers as a great man had given him the lead in the three-way race for governor, but now that the attack ads were back on the tube, his slim lead was starting to shrink. His closest opponent in the polls was running an ad that accused him of violating the senate ethics code. We discovered the alleged violation was of a draft code that had never been approved, not the official code. Weicker had a letter from the ethics committee clearing him of any official wrongdoing. “He’s exposed—wide open for a blow, and he’s doesn’t think we’re going to hit him back,” I said of his opponent. “I say hit him back hard! In the balls!” Which we did—running an ad using newspaper editorial comments accusing him of falsehood and deceit. On election night I walked into a crowded hotel packed with supporters who slapped me on the back and hailed me as they did the others on our staff who worked so hard for redemption. I raised my mug high, enjoying and understanding the transitory nature of victory after having lived and breathed defeat.

  After the election, I was appointed to the state health department, which included the administration of the state’s EMS system. I had moved back to Connecticut by then and, despite the demands of my new job, began volunteering for my town ambulance in East Windsor, a rural town off I-91 twenty miles north of Hartford. (Connecticut is a state of 169 cities and towns, which prides itself on home rule. Consequently, while in another state, the five-thousand-square-mile area might be covered by five or six county or commercial services, Connecticut has over two hundred ambulance services, seventy percent of them volunteer.) Emergency medical services had gotten in my blood, and I wasn’t ready to let it go. In East Windsor, I soon became an EMT-Intermediate, which enabled me to start intravenous (IV) lines. I worked every Thursday night from 6:00 P.M. to 6:00 A.M. I had a portable radio, and when its tones went off, I kissed my sweetheart good-bye, raced out to the car, stuck my green whirly light on the dash-board, plugged it into the cigarette-lighter outlet, and headed off to the rescue. Hi–ho, Silver. While we rarely had more than a call a night and often had none, there were some days when I’d go into my office, shut the door, lay my head on my desk, and try to sleep after a night of doing cardiopulmonary resuscitation (CPR) on the side of the highway, carrying injured passengers on a heavy stretcher to the waiting Life-Star helicopter, or more likely just driving an old lady with an elevated temperature to the hospital.

  In 1992, I signed up for a nine-month six-hundred-hour paramedic course, which meant classes two nights a week with Saturdays spent doing hospital clinicals. I wasn’t doing enough calls in East Windsor to keep my skills up and I wanted to learn more. I also was frustrated with working in government. The state bureaucracy was a confounding nightmare, and even though I had the power to push it along, I was frustrated that I could not wave a magic wand and say make it be so. Under the state system, it once took me four months to get my answering machine at work fixed when I could have gone to the store that day and bought a new machine for less than it would cost the state to fix mine—except of course that wasn’t allowed. Worse, it once took us over a year to pass an emergency regulation to allow firefighters, certified as medical response technicians (MRTs), to use semiautomatic defibrillators—a truly life-saving matter. The new regulation consisted of a four-word change. There was no opposition to it. Still, it took over a year to move from one bureaucratic step to the next to the next to the next. In Washington, in the legislative branch, it was easy to be for health, education, and the disadvantaged—all you had to do was vote for it, and write laws claiming to help. In Connecticut, in an agency, you had to actually make things work, and that was not easy. In Washington we went from battle to battle on the strength of adrenaline highs, regularly working past midnight. In Connecticut on my first day at the health department I thought I would go home early and take some reading material with me. When I came out of the building at six in the evening, I looked around and wondered if maybe there had been a gas leak and nobody had told me about it. My car was the only one left in the entire parking lot.

  While I admired people who were good at government, and I came to know many who were and who worked hard, I didn’t feel I was cut out for it. I was too frustrated by the fact that any attempt to change anything meets resistance from one quarter or the other. I was spending a great deal of time organizing a statewide EMS advisory board with committees on every EMS issue from trauma to public information. Not only did I have to argue for EMS among all other competing health interests and problems, I had to argue among EMS groups to get them to agree among themselves—which was difficult given the competing interests between volunteer and commercial and municipal ambulances, regional EMS councils, hospitals, surgeons, emergency physicians, nurses, paramedics, EMTs and police and firefighters. There was an enormous amount of activity, but real progress that translated into change on the street seemed excruciatingly slow. While fire services had long ago learned to approach their elected representatives with a united front, and consequently heard things like, “And how many more fire engines would you like, captain?” EMS groups tended to point fingers at each other and shout and yell and send the legislators running for cover. Stay out of that mess.

  I took refuge in the paramedic class and my desire to be back out on the street. The class was fantastic even though I had to put in a great amount of additional work to make sense of everything I was taught. I loved the clinicals—working in emergency departments (ERs) and intensive care units. I also watched autopsies, even getting to hold in my hands a human heart, a pair of lungs, which were like giant Nerf sponges, and a heavy gelatinous brain. I saw three babies come into the world, which to me was as incredible and awesome a sight as seeing giant humpback whales leap out of the ocean. I got to march into an operating room, wearing a sterile mask and gowned in blue hospital scrubs. There with shining stainless-steel laryngoscope in hand, while the entire operating team looked on, I swept the sedated patient’s tongue to the side, lifted up on the jaw until I saw the vocal chords, then passed a tube into the trachea through which the patient would breathe. Then I blew imaginary kisses to the crowds as I backed out of the operating room, careful not to upend the tray of sterile instruments, and went on to the next performance. I rode in ambulances all over the state, and frequently ran into doctors, nurses, and paramedics whom I dealt with as part of the EMS Advisory Board. I felt it gave me credibility that, while during the day I was helping to govern the system, at night I was living it.

  I graduated in June 1993, and received a 94 percent score on the state paramedic exam. The staff of OEMS called me down from my office and presented me with my card. I was thrilled, but I knew that ability to do well on a written test didn’t count for squat in the street. It was there I wanted to prove myself, and it was there that I most enjoyed myself despite the stresses. I was prohibited from working for any commercial ambulance company
in the state while working at the health department, so in order to keep my skills up I volunteered with Bloomfield Volunteer Ambulance in a Hartford suburb. Unlike East Windsor, Bloomfield was a paramedic-level service. There I was able to use my new skills while working alongside their paid paramedic. I also arranged to do an internship with Bridgeport Ambulance, one of the busiest services in the state.

  What I liked about EMS was not just the act of trying to help someone, but the view of life, of people and society at their best and worst. In moments of crisis, love, betrayal, grief, and joy are unclothed before you. When I worked for the senator, I had most enjoyed the personal contact—talking to people and walking the streets of the cities and towns he represented. And that’s what I loved in EMS—the sense that I was seeing the world as it was, not the view from behind a desk piled with more memos and reports than I could read. And it gave me stories I could tell.

  On election night 1993 in Bridgeport while doing my internship there, we were dispatched to a restaurant on the waterfront to do a standby at the mayor’s victory party. In case any of the VIPs or other attendees got sick we would already be on scene. The parking lot was filled with luxury vehicles. Men in suits and women in evening gowns paraded into the restaurant to kiss the ring of the mayor, the man whose signs we had seen all over the city that day, on billboards, on top of cars, and held by campaign workers on downtown corners.

  The streets were busy that night, and soon we were called away from the reception—dispatched for a “man choking” in a nearby housing project. There, after walking down a dark graffiti-strewn corridor, we entered a dim apartment to find a young man who we learned had tried to kill himself by drinking dishwashing liquid. His false teeth lay on the dirty carpet amid watery vomit.

  He sat on the couch and said he was okay and didn’t want to go to the hospital. John Pelazza, the paramedic, said someone at the hospital could talk to him to try to help him with his problems, but still he didn’t want to go. Before we could leave, we had to ask him a few questions to ascertain his mental competency. You can’t take a person to the hospital against his will if he is of sound mind. After asking him where he was—his friend’s apartment—and what day of the week it was—Tuesday—John asked, “What’s going on in the city today, something that everybody is taking part in?”

  He thought for a moment, then said, “People get their city checks.”

  “Ah … yes,” John said. “Not the answer I was looking for, but we’ll allow it.”

  We walked out shaking our heads. A tale of two cities.

  I could have had a job created for me in the state government, though I might have been rightly laid off by the new administration, just as I had had a hand in laying off holdover appointees from the previous administration when we were ordered to make job cuts at the health department. I had taken nine months’ leave in 1994 to help my lifelong best friend, Brad, in his long-shot run for Congress in Massachusetts, and though he lost, I might have been able to parlay contacts into a good job in the Boston area where a suit and a tie and a briefcase of work would have brought in a good paycheck—and Fenway Park and my beloved Boston Red Sox would have been oh-so-close-by. Instead I applied for a job as a paramedic to work the city streets of Hartford.

  My reasons? The view of life, the chance to prove myself worthy of other paramedics I respect, and the opportunity to live full days where my heart beats strong and I know that I am alive.

  LESSONS

  The City

  I head south on Interstate 91 (I-91) on this January morning. It is a drive I have made many times over the years, first as a child coming to the city from the suburbs to visit my father at his office in Constitution Plaza. He’d take me shopping at G. Fox, Korvette’s, and Herb’s Sports Shop, and then to dinner at Honess’s, where we would eat bluefish and steamed clams, or to Valle’s for steaks. Later I drove to work myself, parking on the capitol grounds and entering that grand building on the hill with the gold dome where I worked for the governor. From the distance, above the countryside, Hartford’s skyline rises as impressive as the Land of Oz or the metropolis protected by Superman. I used to think of the city as a symbol of all that was good with America—progress, jobs. Yet I knew for all the light, there were also shadows. In 1968 when I was ten, the north end of the city was racked with riots in the wake of the assassination of Martin Luther King, Jr. One morning our biweekly cleaning woman who came from Hartford got out of her car, drunk and shouting that she wouldn’t get on her knees “to clean no floors for no white woman.” One year a coworker of my father’s had a bullet pierce a window of his station wagon on his commute to work, forcing my father and others to start using an alternate route. In later years working for Senator, then Governor Weicker, I accompanied him into the city’s poorer areas and saw the poverty through the windshield of our escorted car. And I researched and wrote the speeches, the ones that cited the fact that Hartford, despite being the capital of one of the wealthiest states in the union, was one of the country’s ten poorest cities, that its infant mortality rate rivaled that of third-world nations, that its schools were segregated and failed miserably to provide their students with equal educational opportunity.

  In recent years, in Shakespeare’s words, “sorrows” have come to Hartford, not as “single spies, but in battalions.” The city’s manufacturing base, which fueled its growth for nearly a century, is gone. The insurance companies and financial institutions that are at the city’s heart have undergone mergers, major downsizing, and layoffs. Long-standing stores and restaurants, like some of the ones my father took me to, have closed their doors forever. As the city’s tax base has eroded, the number of those needing assistance has risen dramatically. Crime, poverty, unemployment, homelessness, AIDS, and other diseases are at epidemic levels. Today Hartford’s population—its lowest since World War I—is predominantly black and Hispanic. The blacks live largely in the north end along North Main Street and Albany Avenue in crumbling private homes and apartment buildings and in notorious public housing projects like Bellevue Square and Stowe Village, centers of a thriving illegal drug trade. The south end, which still houses old Italian families, is increasingly Hispanic. And while there are still mansions in the west end, most of the city’s well-to-do residents have fled over the years to the affluent suburbs like West Hartford, Newington, and Simsbury, the town I grew up in. While Hartford was once a bastion of Protestant Yankees, today only 5 percent of its schoolchildren are Caucasian.

  Interstate 91 intersects with I-84 on the raised highway east of the city. I follow I-84 west, going through a short aboveground tunnel with its “Welcome to Hartford” message embedded in concrete. The road twists, turns, and rises above the streets. Below are empty factories with broken windows and deserted parking lots with grass sprouting through the cracks in the asphalt. I take the Flatbush Avenue exit and then turn on Newfield just before the railroad tracks. On the left is the Charter Oak public housing project, a collection of small two-story units with rusted bars on the outside windows, a scene of gang warfare, drug trafficking, and several of the city’s record fifty-eight homicides in 1994. As in other areas of the city, here a car can be forgiven for not stopping at a red light.

  I turn onto New Britain Avenue, passing check-cashing stores, garages, gas stations, doughnut shops. A few blocks away, just across the city line into West Hartford, are the offices and cavernous garage of the Professional Group, the home of Professional, L&M, Maple Hill, and Trinity ambulances. At this hour, young EMTs and paramedics go about checking their ambulances. They stock them with spare oxygen tanks, bandages, IV solutions, and long backboards. Others undo their bullet-proof vests and punch out after a long night of battling disease and violence on the city’s streets.

  I wish it were not my first morning. I wish that I had been working here for years, and that on walking into the garage and into the supervisor’s office, people will hail me by name and think, “It’s Peter Canning. He is a grizzled veteran, a great, prov
en paramedic. I would trust him with my life.” Few of them know me. I am a rookie with much to prove.

  Checklist

  The fundamental idea behind EMS is to commence medical treatment for injured and sick patients as early as possible—to bring the hospital to the patient at the same time the patient is being brought to the hospital. In the old days, the person who responded with the ambulance put the patient in back, got in front, and drove like hell to the hospital. (He often was the same person who drove the hearse the next day.) Today there are two main levels of prehospital care: basic and paramedic. The paramedic, the most highly trained, provides advanced life support—complex assessment and treatment including invasive procedures and the administration of drugs under the direction of an emergency medical physician both through standing orders and direct communication. The worst insult that can be hurled at an EMT or paramedic is to call him an ambulance driver. They are medical professionals, subject to continual education, testing, and medical oversight.

  Meg Domina will be my partner on Wednesdays. A nice freckled twenty-five-year-old paramedic, she has been working in the city for five years. With Meg I will function as a basic-level partner to her paramedic, though I will be able to use my paramedic skills if needed. On Thursdays and Fridays, Tom Harper will be my partner and preceptor. After thirty paramedic calls Tom will either recommend me for medical control to work as a paramedic with a basic partner or say I don’t make the grade, in which case I will be able to work only as a basic EMT. I do have a little bit of an inside advantage. When I volunteered as a paramedic in Bloomfield I worked with Michelle Gordon, who precepted Meg years ago, and had worked with Tom in the city back when he was just a basic EMT assigned to the city. I go out with her now, so she has put in a good word for me with them. While I do not like using a crutch such as this, I will take every advantage I can get. I am rusty, haven’t worked for the company before, and have a lot to learn from how to work the radios to how to be a good paramedic.