BurningTiger - Reborn!

Latest episode!

2011-05-29T05:41:00.000-07:00

Here's my latest episode of "Cooking Under the Influence"! Barbecued Shrimp. Hope you like!

A Beautiful Day For a Crackhead

2011-05-05T11:16:00.000-07:00

On My High, Thoroughbred Horse

Today is a beautiful day to go to Jazz Fest! Temperature in the low 70’s, nice breeze, low humidity and not a cloud in the sky! But I won’t be there. I doubt I’ll ever be there again. You see, I fell out of love with Jazz Fest some years ago. I was there with some friends trying to enjoy ourselves. It rained, but that didn’t bother anyone; rain is just one of those things you expect sooner or later. In fact the rain provided some entertainment. It was a hoot watching all the tourists slip down in the mud. But I took a look around me - we were high up on the track at the fairgrounds near the Acura tent, listening to some well known band. We couldn’t get any closer because of the throngs of hip-to-hip hippies (or wannabe hippies), most of whom stunk and were now covered in dirt. We couldn’t see the band, but we could see them on the big TV screens. They played with as much enthusiasm as they would at their own mothers’ funeral. I could hear the music clearly; it could be described as mediocre at best. We were near the port-a-potties and a beer tent. It smelled like Bourbon Street after a particularly debauched night. Even the [very expensive] food we had consumed had been so-so at best. Another tourist fell in the mud in front of me. I laughed and pointed out the poor soul, who also was laughing. I realized then that the muddy falls were the only thing that had made me smile in hours at Jazz Fest, perhaps all day. I didn’t spent all that money and effort to come to the thing to watch tourists slip in mud, yet that was the most entertaining thing I found at the festival. It was then that I realized I had fallen out of love with Jazz Fest.

I guess a big part of my disdain these days is hypocrisy, or at least false marketing. Back in the old days, twenty or thirty years ago, rarely would you see a singer or musician from outside the realm of the Deep South. Many were up-and-coming artists, hoping for a chance at fame, but happy that crowds were listening to them play and sing. Accidentally strolling by one of their stages and being captivated by their previously unknown music was one of the most appealing aspects of Jazz Fest. A couple of times while working the medical tent, Galactic, from Baton Rouge, would play their funky jazz at the stage behind us, and later I’d go buy their music. At EMS headquarters located right next to the Fairgrounds, we could hear Jermaine Bazzle, Fats Domino, Dr. John and the Nevilles. And in those days, there’d be maybe one nationally known pop singer or band on one stage on the last Sunday of Jazz Fest, without any particular ties to Louisiana or Jazz, like Paul Simon, but no one really minded.

That, it turned out, was the downfall of Jazz Fest, in my humble opinion. Now, the music schedule is peppered with nationally and internationally known singers and music with absolutely zero connections to Louisiana or jazz or anything to do with our heritage, for which, ironically (or hypocritically) the New Orleans Jazz & Heritage Festival is named. Oh, you can still see and hear the local bands and rich musical heritage for which New Orleans and Louisiana is famous. But those artists (and I use the word “artists” sincerely) take a back seat to the crowd-pleasers and big-draw names. Look at this year’s schedule. Kid Rock? John Mellencamp? Tom Jones? The Strokes? Lauryn Hill? What do any of them have to do with jazz, New Orleans or Louisiana heritage? And don’t get me wrong - I like each and every one of them and their music. What irks me is that when you hear people saying why they’re going to JazzFest, it’s because they want to see these performers, not our home-grown artists. JazzFest itself is culpable too, booking more and more of these types of acts as headliners while our fantastic local artists take a backseat, functioning as mere opening acts for the bigger names.

It’s to the point now that even the local news find it remarkable that local artists are playing at Jazz Fest. WDSU news plastered this headline: “Jazz Fest Thursday Opening Has Local Flair.” Local flair? We need to be reminded that the New Orleans Jazz and Heritage Festival has local flair? Gone are the days when the “local flair” was the Jazz Fest. The news article specifies that the festival is presented by Shell. This does not mean that Shell Oil felt the need to subsidize Jazz Fest to make the entrance fee free or reduced, out of appreciation for our oil-dependent local economy or out of a sense of responsibility of "giving something back;" it merely means that their ads are plastered over everything, like a pimp tattooing his own name on all the prostitutes he manages. It feels as if I had to cut off ties with a good friend or beloved family member because they got too dependent on drugs or alcohol. Or fame. And this is what makes me sad.

Random Thoughts (Regarding Transportation)

2011-04-21T09:07:00.000-07:00

When I was three, I was at the airport with my parents seeing my dad off for a business trip or something. Maybe it was a business trip, I was three, so who cares, right? I decided to explore the airport while my parents were busy with tickets, baggage and the like. “Here’s an interesting doorway” I thought. “My, what a long hallway!” was my impression after entering the interesting doorway. After venturing down the long hallway, I found a big, comfy seat and climbed up into it to make myself comfortable. A few minutes later, Patsy, my dad’s secretary, came and whisked me away from my comfy seat and brought me back to my mother and father who were visibly disturbed. Apparently in 1968, it was very easy to climb aboard any old plane bound for Las Vegas. There were no x-rays or full body scanners or whatever, Yet, somehow, civilization as we know it continued.

In fifth grade, my class had sold the most “America’s Finest” candy, and hence we were entitled to a pizza party at the nearby Shakey’s Pizza place. It did not occur to me to wonder at that tender age why the Corporate Executive Officer of the establishment might be named “Shakey.” Anyway, we had no school bus to transport us to Shakey’s, only four blocks away, so we walked. After having our fill of impossibly bland pizza (during which I distinctly remember singing along to Foreigner’s “Cold As Ice” [or was it Journey?]) while waiting for our pizza, my entire class walked back to the school. Upon arrival, we tarried at the entrance, during which time I decided to hop up onto a low wall bordering a garden. My butt overshot the trajectory and landed upon four feet of nothingness, causing the rest of my body to hurtle forth to the ground. Upon impact, my left arm struck a concrete cinderblock bordering the garden. When I arose from the tumble, I noticed that my hand was four inches lower than my arm - my wrist was broken!. This caused me no slight consternation, so naturally I screamed like a schoolgirl. Later, after my mom had collected me and brought me to the doctor, I had a splint wrapped with ace bandages around a rigid arm support. Since the outer covering of the splint was merely ace wraps rather than plaster, it was impossible for friends to sign, as friends of the cool kids did when they wore a real plaster cast for broken bones. With this physical and obvious reminder that I was not a "cool kid" to this day, I curse mere splints.

When I was eight, my mother and my two sisters flew to Tampa to visit my mother’s brother, my Uncle Merlin. Yes, Merlin, as in the wizard in the Knights of the Round Table. Don’t say anything bad about my Uncle Merlin; he’s one of the coolest people I know, and I’ll kick your ass if you do (cool kids be damned). My mom, my two sisters, my aunt Mimi and I were flying on National Airlines. During the flight, the plane was hit by lightning. All the lights went out. Since it was our first flight, my sisters and I thought it was just part of the ride. My mom and Mimi sort of freaked out.

At age twenty-eight, I got married. My dad died the next year and my Mom gave us his old Dodge K-Car. I had been driving a 1990 Ford Ranger, which I had kept nicely. The K-Car had been parked for years under the pine trees in front of my parents’ house, and was coated in the dried sap of the evergreens. It was a car preserved in amber. It could have been displayed in the Smithsonian alongside the prehistoric dragonflies and mosquitos that have been preserved through the millennia by the same mechanism. Shortly after having been bequeathed to me, the amber-preserved K-Car was my vehicle, while my new wife tooled about town in my nice pickup. I didn’t complain; something about a woman who drives a pickup always... stimulated me.

In 1998, my wife and I invited my mother and our friend Ingrid to join us in a trip to Ireland to visit my wife’s parents. Long story short, the airline owed us an upgrade for bumping us off the flight across the pond and subsequently losing all our luggage. On the return trip to the United States, we were bumped up to Business Class, which I highly recommend. But on the flight from Atlanta to New Orleans, we were back in pigs-and-chickens class, which I recommend not so highly. My mother was several rows behind us during the rather turbulent flight, which seating arrangement I highly recommend. During the bumpy parts of the flight, I could hear my mother, who has a fantastic singing voice, singing “Lady of Knock” to the other woman sitting next to her. At the baggage carousel, I gave that woman what I hoped would be interpreted as an envious, yet simultaneously apologetic, glance.

During my elementary school years, I rode bus number 22, driven by Mr. Jimmy, who was also my Catechism teacher. In the last year of school before Sam Barthe Athletic School For Boys was sold to Ecôle Classique, my younger brother also rode Mr. Jimmy’s bus number 22. Having seniority, and determined to take full advantage of it, as a seventh-grader I sat sullenly in the back of the bus with the upperclassmen, while I forced Patrick to sit in the front of the bus with the kids his own age.
Note: I had absolutely zero talent for athleticism, while Patrick was the quintessential athletic paradigm. I have yet to forgive him for that.

Would finding E.T. change our view of God?

2011-02-25T07:23:00.000-08:00

The following is a comment I made on an article addressing the question in the title of this post. The question has been posed for a while (I hesitate to say "millennia") and much effort has been spent anticipating humanity's reaction to the discovery of extraterrestrial intelligence (ETI). But I seldom see opinions discussing the alternative. So here's my two cents:

Humans may be going down a road with the destination forever far in the distance with this question. If we find ETI (or they find us), great, the question is answered. Chat show pundits, theologians, atheists and philosophers are in business for life (to paraphrase Douglas Adams).
On the other hand, what if we don't find ETI? When do we call it quits? At what point will we say "Yes, humans are alone in the universe"? What if the time comes when we've colonized every habitable planet in the Milky Way galaxy and still haven't found life? Right now, we look at the billions of stars out there and think "Surely, someone else is out there." But if humans are ever spread across the whole galaxy (unlikely) and no one else is there, will we say then that we're definitely alone or will we look to the trillions of other galaxies, each with billions of stars, and think "Maybe they're out there?" and devise ways to investigate that possibility? Given the virtually infinite size of the Universe and possibilities of life to examine, it seems that if we don't find other intelligent life, the search could easily continue till we die - all of us.
If you've ever looked for something that wasn't there (but you didn't KNOW it wasn't there), when do you stop looking? You looked under the bed, in the fridge, between the cushions and in your pockets. And later, you looked again in all those same places and some new ones, didn't you? Even when you said to yourself "I quit!" the question still gnawed at you. Where could that thing be? The same goes for the search for ET. Even if humanity, as a collective, "quits" searching, someone will still be wondering what else to try.
Until definitive proof is found that there is ETI out there, it seems that humanity's search will continue. If that search takes however many billions or trillions of years the Universe has left, I don't doubt that there will be someone who keeps searching.

The Not-So-Violent Toll Of Internet Shutdowns

2011-01-28T07:12:00.001-08:00

So today you can hardly turn on the media without hearing about Egypt. Protests, riots, tear gas, police cowering on rooftops... the works. One other noteworthy thing is that Egypt’s internet access has been shut down according to multiple sources, such as here. Now, this internet blackout isn’t noteworthy because it happened. It’s the response that’s noteworthy. This was brought to my attention by @BurbDoc on the Twitters. As he puts it, “Iran shuts down Internet, we get our panties in a wad. AssMubarak does the same shit, we DO NOTHING.”

As anyone on Twitter or Facebook can tell you, when Iran shut down internet access last year, vast swathes of humanity protested the lack of access. Thousands put up little green avatars (reminiscent of Iran’s flag) in “support” of their internet-deprived Iranian brethren. But as @BurbDoc puts so succinctly (which is kind of necessary in the 140 characters Twitter gives you), we who are flush with internet service now collectively say “Egypt’s internet is off? Oh, okay.”

I have no words of wisdom or inspiring quotes from Mohandas Ghandi, Thomas Jefferson, Jesus or Mohammed to quell the riots. I have no special insight into Egyptian thinking. In fact, I don’t even know what the Egyptian uproar is about (and I’d wager that the vast majority of Americans don’t either). But I do have a great imagination. And my imagination brings me to a special place where I envision the rest of the worlds’ reaction should various countries be deprived of internet access.

For example, if the headlines read “American Internet Access Shut Down!” the country would be in turmoil. A deep, sonorous hue and cry would be voiced. But since there’s no internet access, the voices would carry no farther than the next room, since no one could post their indignance on Facebook. The rest of the world would cry out against the shutdown, but secretly rejoice that the USA isn’t taking up all the bandwidth with their silly ignorance. China would offer us expensive, long-distance dialup internet, which we’d happily pay for.

“United Kingdom Loses Internet!” The rest of the world would protest the blackout, citing England’s long history of contributions to the world’s intellectual knowledge base (but forgetting that Wales, Scotland, Northern Ireland and the Isle of Mann are also part of the UK). The people of the UK would grumble mightily, but only over many, many drinks at the pub.

“Russia’s Internet Goes Dark!” The rest of the world offers condolences. “We’re so sorry for your loss,” they’d say, much as one uselessly offers the same line at a funeral while secretly hoping to sleep with the hot widow. The rest of the world quietly emails one another, saying it’s probably for the best that those Russians can’t get on the net.

“China Has No Internet!” The Chinese people are duped when the government immediately puts up fake “websites” that extol the virtues of China and Communism to which every Chinese internet user is rerouted. World of Warcraft gold farmers go bankrupt, since the only people that buy their game-gold are other Chinese Warcraft players. In the rest of the world, the entire real global economy collapses.

“Sweden’s Internet Is Shut Off!” The rest of the world writes, emails and protests the appropriate parties until the steady stream of Swedish internet porn is restored.

“France No Longer Has Internet!” The French are saddened but quickly resolve themselves to their fate, accepting their national loss. The rest of the world brings them restored internet access. As usual.

“Ireland Can’t Get in the Internet!” The Irish people immediately assume it must be their own fault and confess their sins to whoever will listen. Fifty billion “Hail Marys” and “Our Fathers” later, the Irish feel better and celebrate and/or drown their sorrows at the local pub. But still no internet.

“Argentina Loses Internet Access!” Access is quickly restored when five billion soccer fans get rowdy over their inability to check up on their team.

“Brazil’s Internet Is Shut Off!” The gay community creates their own internet and ships the entire structure to South America specifically so Brazilian guys can restart transmitting their photos and webcams.

“No Internet in Italy!” Nobody notices. Including the Italians.

“India’s Internet Goes Dark!” The rest of the world, looking for customer support, also completely loses internet access. The dark ages resume globally.

“Jamaicans Can’t Get on the Internet!” The rest of the world says “Jamaica had internet?” Jamaicans say “We had internet?”

On My Soapbox

2010-12-10T13:06:00.001-08:00

No really, I'm literally on about soap. You'd think it wouldn't be that challenging. All I want is a decent bar of soap. Not anything like "Dr. Ganja's Super Organic Earth Soap With Genuine Cannabis Naughtiness" or "Miss Victoria's Soothing Tiny Bubble Body Cleanser With Exfoliating Aromatherapy Modules" or even "Ultra-Macho Sweaty Guy Bodybuilder Body Wash With Genuine He-Man Pheromones (Women will throw their vaginas at your armpits!)".

I just want a bar of soap. Not body wash. One that I can get at the grocery store, not have to go to a boutique, or order from a stupid catalog. I've been trying various soaps and can't find one that's decent. Here are my experiment results:

Irish Spring: Smells nothing like Ireland or spring. Perhaps they mean the bed spring from an overly-scented Dublin whore's boudoir?
Safeguard: For when I want to smell like an old men's locker room.
Olay: Dead fish. 'Nuff said.
Ivory: 99.44% pure toxic chemicals. And what is that weird itch afterwards?
Lever 2000: For when you want to announce your presence to everyones' noses while you're still out in the parking lot.
Camay: For when I want to smell like an old ladies' locker room.
Dove: Out, out, damn'd soap! I need to use a loofah afterward to get the "moisturizing" cement off.
The dogs' shampoo: Remarkably, the least offensive surfactant in my bathroom!

So, those are the soaps that are commonly available at the store. If I've overlooked any, please recommend your suggestion so I can try it. Until then, I'll be enjoying my shiny coat and freedom from fleas.

My Living Will

2010-12-07T06:52:00.001-08:00

My “Living Will”

I, Sean Fitzmorris, being of sound mind & body, and the fact I’m posting this on the Internet notwithstanding, do hereby make this my request should I ever be incapacitated by injury, disease, or other life-threatening process.

Under no circumstances are any healthcare providers, paid or volunteer, to perform CPR on me, including artificial respirations or chest compressions. There are exceedingly few people that survive such therapy and frankly, I’d rather use that slim chance to win the lottery.

Should the preceding request go unheeded and I am on a ventilator, under no circumstances should artificial ventilation continue for more than one week. If I cannot be taken off the ventilator in that time, please remove the endotracheal tube or whatever artificial airway is in my body and turn off the ventilator. I will take my chances.

Under no circumstances am I to be fed. This includes tube feedings via any port in my body including intravenous, nasogastric, orogastric, percutaneous endogastric or duodenal routes, or even if someone should offer to cut up my food and/or feed it to me. Should the recommendation for such a form of nourishment be mentioned as part of my care, I summarily refuse it.

I refuse any procedure involving a cerebral angiogram.

I refuse any “clot-busting” agents, including tissue Plasminogen Activator, streptokinase, retavase or any other drug used for this purpose. I do not want to hemorrhage in my brain or any other organ I am using.

Any of my organs or tissues may be harvested for donation. However, if it is recommended that I receive any donated tissues or organs, I summarily refuse. I’ve seen those poor souls after getting an organ transplant, and it may be life, but not as I know it or want it.

Under no circumstances am I to be dialyzed, in any way, shape or form, including hemodialysis, CVVHD, SLED, or CAPD. I am a happy person, and dialysis is just sad.

Should the recommendation be made that I have artificial holes created in my body for the purpose of breathing, eating, nourishment, or excreting waste of any kind, I summarily refuse it. This includes tracheostomy, tracheotomy, cricothyrotomy, colostomy, nephrostomy, ileostomy, suprapubic catheter, PEG tube or any other ostomy.

Should the time ever come when I cannot clean my own anus under my own power, all medicines I am receiving are to be stopped, all nourishment is to be halted, and all hydration, oral or intravascular, is to be ceased. I will either get better or die; either is preferable to me.

Under no circumstances am I ever to be placed in a nursing home, skilled nursing facility, long-term care facility, or any other place of similar ilk. Allow me the dignity of dying in my own home or that of my loved ones.

Should the circumstances of my death be attributable to stupidity of my own causing, feel free to laugh and poke fun at my corpse. I would have loved the joke, too. But do not subject me to any of the situations I have outlined above. Thank you.

Sean Fitzmorris

7 December 2010

The Onus

2010-11-23T07:44:00.000-08:00

The Onus

When you come to the hospital or call an ambulance, you are expected to be the main agent in directing your own healthcare. You have the right to decide what you are willing to undergo toward your own care. You are encouraged to ask questions about what the staff is doing or planning to do, possible outcomes, side effects and alternatives. Every invasive procedure requires your informed consent, whether it is a lumbar puncture, surgery, a colonoscopy, a central IV line or anything that is beyond minimally invasive. At any time, you may decide that you do not want this or that. You can refuse any medication, any procedure or any tube that is inserted into your body. You may even leave the hospital whenever you want. The refusal of any aspect of your care that the healthcare providers deem necessary is accompanied by the possible consequences of your refusal. If you don’t want to go to the hospital after a car accident, the paramedics will explain why you should go and advise you that if you do not, you could suffer long-term injuries, paralysis or even death. If you still choose not to go, they will respect your wishes and have you sign a form stating this, despite the possible untoward outcomes. The same goes at the hospital. You could be in the process of actually dying, but if you don’t want the care that is offered, the doctor will say “You realize that you could/will die without this lifesaving treatment, don’t you?” After your affirmation of this, you will be allowed to leave and die in whatever way the Grim Reaper finds you.

There are obvious problems with this mentality, both on the part of the patients and that of the healthcare providers. Allow me to focus on the latter for a moment. As a healthcare professional (in the state of Louisiana, at least), when someone decides that they don’t want this or that type of care, you are required by law to respect their wishes, no matter how deleterious their refusal may be. UNLESS they tried to commit suicide. Or unless some third party says they "think" the patient might have maybe sort of tried to commit suicide or otherwise harm themselves. At that point the patient is committed under a Physician’s Emergency Commitment, or PEC. A PEC remains in force for 72 hours during which the patient is a ward of the hospital until a psychiatrist releases them from it. As one doctor recently explained to a patient who balked at a PEC, “you have no rights and cannot make any decisions for yourself because you’re a danger to yourself. You are a ward of the hospital for the next 72 hours.”

Now, the clear problem I have with this idea is this: people can decide for themselves what they can accept as “healthcare.” Even if not choosing a particular route will cause them to die. The doctors and nurses and paramedics must allow every patient who wants to do so to refuse care and die. The healthcare providers may view the patient’s refusal as suicide, but must nonetheless respect their wishes as long as they are informed of the consequences. Why is this not the case with someone who came in for a self-inflicted overdose or slashed wrists? Why can they not refuse care despite the obvious deleterious effects such a refusal can encompass? The congestive heart failure patient can leave the hospital after informing the staff that he is going to never take his meds, load up on pure sodium and pig out on the highest-fat food he can find and wash it down with gallons of alcohol and the hospital staff will happily wave good-bye to him as he shuffles on his swollen feet out the door. But if a perfectly healthy person wants to leave the ER after an ill-considered attention-getting gesture like scratching their wrist with a butter knife or taking an extra Ambien or Vicodin, that person is PEC’d, restrained and kept there against their will for days. Why the double standard, medical people? How is the CHF person not a danger to themselves or "gravely disabled," (as the PEC paperwork states is a condition of needing to be PEC'd)? I know that the horrible, black-magic “L” word is key here (liability). But if the refusal paperwork that the CHF patient signs is good enough to cover your asses when their cyanotic, swollen body is found buried under a mountain of fried chicken bones and bottles of Olde English 800, why isn’t it good enough for the person who wants to leave the hospital or ambulance after their silly little stunt? How is it that that person can’t direct their own healthcare, regardless of the possible deleterious outcomes?

Before you black-wearing, pill-popping, self-cutter emo people start cheering, though, allow me to direct a little insight in your general (though not specific) direction. People call the ambulance all the time for whatever problem they have. They show up at the ER all the time, again for whatever problem they have. Many are admitted to the hospital for said problems. Then after calling the ambulance or landing in an ER room or finding themselves in their hospital bed, they decide that they don’t want this or that thing. “Don’t stick me with a needle again!” “I don’t want those EKG wires pasted all over me!” I hate this catheter; take it out!” “I’m not going to take those pills!” they shriek. Then why on God’s green Earth did you come to the fucking hospital? If you don’t want to be in the hospital, why did you call the fucking ambulance? What the hell did you expect? Despite the recent explosions of feel-good advertising that hospitals have embraced over the last decade or two, being in the hospital sucks. It’s an unpleasant experience, fraught with frequent tests, poking, tubes & wires, questions, assessments and yes, needles (or worse). Being carted there in the ambulance is at least as unpleasant, with a rough ride, countless questions, no bathroom, no food or drink and yes, needles (or worse). The medical experience is not fluffy bunnies, warm blankets and bedtime stories. Did you think it was? If you have the many years of medical experience and education to make meaningful decisions about your care, then by all means, take matters into your own hands. If you do not, then shut up and the let the professionals do what you asked them to do. If you want to get better by the standards of Western medicine, then call 911 and go to the hospital and comply with all the stuff the paramedics & doctors & nurses tell you and do to you. If you don’t want to undergo the barrage of unpleasantness that is the hospital experience, then stay the fuck home and let nature take its course. Save everyone else the trouble and ass-pain.

Thank you. This message is brought to you by The Medical Industry, who doesn’t really give a shit about you or your problems, but are willing to deal with it as long as we get a paycheck.

My Kharma Greeting Card

2010-11-03T18:21:00.000-07:00

Feel free to copy & send to whomever is deserving!

Assorted Memories (Involving Food)

2010-10-12T08:54:00.000-07:00

Assorted Memories (Involving Food)

Around age 12, I poured rice down the sink for some reason. My parents are upset because there’s no garbage disposal. I suggest running water down the sink. They say that water doesn’t dissolve rice. They are stumped & irritated when I say, “Then why is water called the ‘universal solvent’?”

I’m 7. We’re at a restaurant with my uncle, aunt and cousins and my family. We place our order. An eternity and a half later, we still have no food. My dad inquires about our order. It turns out that our waiter has quit his job. He quit right after taking our order. I feel a little guilty because it’s hard to imagine that it wasn’t us who pushed him over the edge.

My grandparents take me out to brunch one Sunday at their favorite restaurant. The restaurant also happens to be where I work as a busboy at my first job, so I know all the staff there. Typical of a 14 year-old, I'm a little embarrassed to be seen out with my grandparents. It’s weird having my coworkers serve me. To make it even weirder, my grandfather throws up all over the table after brunch.

At age 25, I’m working as a waiter in a restaurant while I’m attending EMT school. I’m not very good at it. One of my tables is a single diner, an Asian woman. I try to keep all my other tables going and totally forget about this woman, and I leave her with a dirty plate in front of her for about 45 minutes. I apologize and bring her the check. She still leaves me a decent tip, and I’m fascinated that she signed her name on her credit card slip in Chinese characters. I show her signature to all the other waiters. They don’t care.

I’m in New York City for a vacation about 6 years ago. In Greenwich Village, I pass Anthony Bourdain hailing a cab. I’ve just read his book. I don’t say anything, but nod to him in such a way that I hope it conveys “Dude, you’re my favorite chef/author/TV host ever. Thanks for being awesome.”

On my wedding honeymoon, my new bride wants to impress me with her cooking. She makes what she calls a strawberry cheesecake. Instead of topping the cheesecake with strawberry stuff, she’s mixed a pack of strawberry Jello into the cheesecake filling. It is the color of Pepto-Bismol with radiation poisoning. I call it Plutonium Pink. She comments on the spaghetti and meatballs that I made; that she’s never had a meatball the size of a grapefruit. Touché.

Ten years ago, my mother-in-law served me a dish that she refused to name. It was some kind of meat pie, with two kinds of meat. She asked if I like it. I said I did, especially these bits of meat, which I point out. She says it is steak and kidney pie, and the meat I particularly like is kidney. Until then, organ meat grossed me out. I ask for seconds.

In Greece, my friend Mike and I sit down in a restaurant. It’s difficult reading Greek, so instead of trying to translate the menu, we ask the waiter to bring us something local, that he might like. We expect some souvlaki or lamb or grape leaves. Instead he brings us a huge platter with a large cooked octopus in some sort of spicy red sauce. It is delicious. We eat all of it.

When we were little, my sister Erin used to put A-1 steak sauce on everything. I watched her pour A-1 onto celery sticks and eat them. I tried it. It tasted like A-1 on celery.

Somehow, my wife and I start discussing pickles. I say something about the cucumbers that are made into pickles. She refuses to believe that pickles are made from cucumbers. I am bewildered that she doesn’t know this basic fact and sarcastically ask, “Where did you think they come from? The pickle bush?” She still refuses to believe me. Later at the grocery I point out to her the ingredient list on a jar of pickles. That was a bad idea.

Councilman Stokes Is an Explosion In an Idiot Factory

2010-09-30T06:24:00.000-07:00

Someone on Twitter, @RobRiscoe, asked my opinion on this fiasco:

The incident occurred in Jackson, Mississippi and there's been considerable hullabaloo in the EMS community regarding it. Normally I don't voice my opinion on things where the answer is as clear as this situation. But since I was asked...

As you can tell by the title of this article, Councilman Stokes has proved to the world that he knows absolutely nothing about the subject on which he has chosen to pontificate in hilarious ignorance.

"You got to take risks; you can't let citizens die!" In a backwards way, he is correct. The shooter and victim took their risks in whatever behavior preceded the shooting. The EMT's try not to let citizens die. But Councilman Stokes, I must ask you, had the EMT's arrived on an unsafe scene and gotten themselves shot and killed, then wouldn't there be two more citizens dead besides the first victim? We can continue this formula - then two more EMT's show up and get shot, and so on - until all the EMT's in the city are dead. You see, going into that scene and 'taking risks' might not be the best policy.

As every EMT is aware, even scenes that are declared "safe" often remain very unstable and can go downhill to "extremely unsafe" in a heartbeat.

(Should we tell Councilman Stokes about what we do when that happens? Actually leave the scene?)

One of the solutions for this "problem" that Stokes has proposed is having the city go into the ambulance business themselves, rather than contracting with AMR. That's fine. No offense to AMR, but certainly few would have a problem with there actually being more ambulances in the city. Tell us, Mr. Stokes, where will you find the EMT's to staff your city ambulances? No doubt you wouldn't want those wimps from AMR to come over and work for you, with all their insistence on "scene safety" or whatever they call it.

Councilman, I have news for you. Your "problem" isn't with AMR. Every EMT in this country, to be certified as an EMT, has to go through an EMT course approved by the nation's Department of Transportation. And in every single one of those classes, the first lesson on day 1 is "Scene Safety." During that class, it is ingrained into the brains of every prospective EMT that you do NOT go into scenes that are not safe! If the scene becomes unsafe, leave! Every practical exercise that the EMT's will perform during class must include the question "Is my scene safe?" If they do not ask that question and determine scene safety, then no matter how magnificently they perform the practical exercise, they will fail. Every day from day one, scene safety will be burned into their brain.

That, Councilman Stokes, is the culture of the pool of EMT's from which you have to staff your nascent city ambulance service.

Perhaps Councilman Stokes would prefer if the class would go something like this: "Hello and welcome to EMT class. The first thing you should know is if you are called to a scene where gunshots are still going off or cars are still colliding with each other or gangs are stabbing each other all over the place, don't worry, just go right ahead in. Everything will be fine and unicorns and rainbows will sprout from your footsteps."

Really, Councilman Stokes? Would you actually want EMT's who were schooled to take such risks? If they are willing to "take risks" with their own personal safety, then what kind of risks will they take with the care they deliver to their patients? When you're in the back of that ambulance one day, maybe when the medic pulls out some big scary tube or needle to put into your body, will you want the EMT's to say "I've never done this procedure before, but I'm willing to take the risk!" Or maybe "You don't have to sterilize the site where you're going to stick in that needle/tube/scary device. It's a risk that he may die from a horrible infection, but we're willing to take it!"

As a casual aside, according to the news video, which I trust more than the "facts" of either Councilman Stokes' or the outraged mother-in-law of the victim, I notice that AMR is accused of taking 21 minutes to arrive at the patient. But then later in the video, the dispatch, en route, arrival and at-patient times add up to only 7 minutes and 25 seconds. This is well under the national average of 9 minutes. Did Stokes even bother to actually investigate the details of the call? Or is he just taking the word of some emotional, angry woman off the street?

Councilman Stokes, you are a fucking idiot.

History According To The 64 Crayola Box

2010-09-29T17:48:00.000-07:00

All the "Flesh" in my box forced the "Indian Red" into a tiny corner. Then a bunch of "Brown" immigrated from another box, causing the "White" to create an uproar. They pleaded with the leader crayon, "Gray" to do something, but he was only worried about the "Pink" in the crayon military. Meantime, due to tax increases & healthcare reform, "Green" virtually disappeared from the box.

"Found Wanting" now available for everyone!

2010-09-25T16:36:00.000-07:00

Just wanted to announce the release of my book, "Found Wanting." If you've seen my Facebook profile, you know I've been yammering about various problems with its release. Well, finally, it's out now! It hasn't yet hit retailers like Amazon and the iPad app store, but it's available already! You can get it from the wholesale publishers (for a LOT cheaper than my original publisher!).

If you'd like the print version, a real, actual book, then click this link: http://www.lulu.com/product/paperback/found-wanting/12812792

Just click Add to Cart and checkout like any purchase!

If you'd like to download "Found Wanting" to your mobile device like iPhone, iPad, Kindle, Nook, Kobo, Stanza or other device, then click this link from your mobile device: http://www.smashwords.com/books/view/25111

You have to register (it's free) and select which format you want. Don't panic! Pretty much any device will read the .Epub format. If you have a Kindle, you can download the .Mobi file. You can also read a free preview of the book! Just remember to go back and purchase the full copy!

"Found Wanting" will be available via retail outlets like Amazon and the iPhone app store in 4 - 8 weeks, so get your copy now! Why wait?

Thanks to everyone, and enjoy "Found Wanting"! All the best!

-Sean

Assorted Memories - Regarding Vehicles (and Water)

2010-09-17T07:37:00.000-07:00

When I was small, my grandparents would take us to the Lakefront airport, a small airport for private and charter planes. They still referred to it as Shushan Airport, its name back in the old days, like when the Wright brothers were still around. We would watch the planes take off and land. It had a big, beautiful lobby that only much later would I appreciate as being classic art deco. Sometimes military planes would be there, old WW II planes that were still in service - big, gorgeous Constellations with three tail fins or awesome DC-3’s. There were lots of seaplanes too. I was always fascinated with the metal-cast scale models of airplanes in the huge display cases in the lobby. I wanted to be a pilot.

My mother took us to the Lakefront airport one weekend. My grandparents were out of town. She wasn’t quite sure of the way. She made a wrong turn and we found ourselves at the nearby boat launch. She made a big deal of it. She said “I almost drove into the lake!” about a zillion times. She had me thinking we had almost died.

I’m 12. We’re going to Pensacola to stay at the summer house of a friend of the family, Mr. Chanel. He’s French. And rich. My Dad is driving the station wagon to the beach. The bridge across the bay is very old, narrow and seems rickety. I’m scared the bridge will collapse from age. That night I have a dream which combines my memory of my Mother declaring our near-death by boat launch with the scary bridge. In my dream, we’re driving across a rickety bridge which angles down into the water. I wake up crying. The dream occasionally resurfaces even today, but I don’t cry anymore.

I’m 23. I have a part-time job driving a truck transporting mail at night. I drive from the main post office on Loyola Avenue to Picayune, Mississippi to meet another driver from Jackson, Mississippi. We’d swap trucks and I’d drive his mail truck back into New Orleans. My friend Mike and I share the job; he drives 3 nights a week, I drive the other three nights a week. One night Mike decides to ride with me even though it’s his night off. He wants to meet his girlfriend, Sherry. Sherry is driving back into town on the same highway from a trip. We meet Sherry. Her friend Iliana is riding with her. Mike gets into Sherry’s car and Iliana rides with me in the mail truck. Iliana is from Cuba. I’ve known Iliana for a few months and I like her. She holds my hand as I drive.

I’m 25. I live in Listowel, Co. Kerry, Ireland. My friend Mike has asked me to come with him on a tour of Europe. On the overnight ferry from Ireland to England, we are bored, so we make up a story to occupy the time. It tells of César and his friend (whose name I can’t remember) and their adventures. The story serves as a running theme for our own adventures all over Europe through the next month.

I’m 34. I have Eric as my permanent partner in the ambulance. He is also a paramedic, so we can swap duties - he drives one call, then I drive one call. We get along incredibly well. He is my partner at work and has also become a friend. I love going to work because we make each other’s day pleasant. Our partnership only lasts two months. I am then assigned to work with the medic that no one else can get along with. I spend several months with my new partner. I am miserable. Eventually, we start to get along. Eventually, I start to like working with my new partner. Eventually, I look forward to coming to work so I can be with my partner. Shortly thereafter, I am assigned a different partner, the latest one that no one wants to work with.

My sister Shannon is in the hospital. She is eleven; I am exactly one year older. We both have the same birthday, a year apart. Shannon is having her tonsils taken out at Hôtel Dieu Hospital. Children are not allowed in the hospital. My parents tell me and my other sister Erin to wait in the car. We do. It’s hot. We’re there forever, it seems.

I’m 30. My parents have entrusted me to keep their car while they’re out of town. My wife and I leave the house; we’re going to take their car to go wherever it is we were planning on going. Their car is no longer in front of our house. It’s been stolen. I file a police report. Four days later I’m working on the ambulance with my partner Mike (not the same Mike as I mentioned). My cell phone rings. It’s the police, saying they’ve found my parents’ car after a police chase and it’s been crashed into a parked car. The driver has been taken to the hospital. Mike and I drive to the scene where I confirm it is my parents’ car. Later at the hospital, I see the punk who stole the car. He’s lying on a spineboard, strapped down. It would be so easy to kill him, or at least beat the living daylights out of him. My partner Mike sees how angry I am and physically pulls me back, away from the teenage punk.

I’m 16. My year-younger sister has a license to drive. I do not. I’m in no rush to get one because I don’t really care if I can drive or not. She is driving to school and will drop me off at my school. We pick up her friend Michelle who goes to Shannon’s school. “1999” by Prince comes on the radio. Shannon and Michelle sing and car-dance to Prince. I don’t particularly care for Prince, so I stare glumly out the window.

I’m 3. The school bus picks me up for my first day of school. Mr. Jimmy drives Bus #22. Later, he would also teach Catechism, though it wasn’t a Catholic school. I ride Bus #22 for the next ten years. Forty years later I meet the brother of one of my co-workers. He also rode Mr. Jimmy’s bus, #22, though I don’t remember him. He didn’t go to Mr. Jimmy’s Catechism class because he was Jewish.

I’m newly married at age 28. My wife Grainne and I are driving across the Lake Pontchartrain Causeway. We watch the ducks, seagulls and cormorants flying and floating on the lake. While driving across the 24 mile-long bridge at 60 miles an hour, she locks the electric door locks. Mystified, I ask her why. She says “You never know who’s going to rob you.” I consider the logic of her statement but can find none. I ask her, “Who do you think is going to rob us? A rogue pelican?” She turns up the radio.

I’m 10. We’re going to Pontchartrain Beach, a local roller-coaster type theme park. My sisters and I take turns chanting “Pontchar” - “train” - “Beach!” each of us taking a portion of the name, splitting the four syllables as fairly as we could between only three children. I am dying to ride the Zephyr, the biggest roller-coaster New Orleans had ever seen. In the line for the ride, I confide to my Dad that I’m scared and I don’t actually want to ride the Zephyr anymore. We quietly leave the line.

Assorted Memories - Unassorted Memories

2010-09-16T09:06:00.000-07:00

Unassorted memories:

I’m 3 years old; I notice that the heavily stuccoed wall next to my bed has a plaster pattern that might be interpreted as a face. I spend the next 3 years talking to the tiny plaster face, wishing I didn’t know it would never understand what I said.

I’m 18. After some sporting event, possibly football, at the Superdome at which my friends Steve & Marty and I got rather drunk, I decide it would be appropriate to punch Steve in the face. Steve is 6’1”, easily 250 pounds and used to be a college linebacker not very long before. He hits me back, after carefully explaining why the recompense is at least as appropriate as my initial punch. I remember groaning on the ground shortly thereafter.

I’m 24. I’ve been in Ireland for a month. My flight home after my vacation is the next day. I use my new friend Henny’s phone to call my parents at home. My youngest brother Michael answers. I tell him to tell Mom & Dad that I won’t be on the flight home because I’ve decided to stay in Ireland. I remain in Ireland for a year.

I’m 6. My sisters Shannon and Erin and I have made a pastime of watching the new house get built next door. One day, we go to the window in our housekeeper’s bedroom to watch the heavy machinery do its thing. We eat ice cream. Shannon has chocolate. I have chocolate and vanilla. I discover the “swirl,” when your ice cream is just soft enough to swirl the flavors together, resulting in a delicious combination of breathtaking flavors (although it is a disgusting shade of brownish poop color, as Erin points out).

I’m in first grade. I’ve read a book called “Molecules” three times. I have questions about nuclear physics. I ask Ms. Surgi, my first-grade teacher about the cohesive properties of atoms, protons, neutrons & electrons. She is stumped.

I’m 39. My friend Greg and I are at a bar. I’ve recently moved out from the house my wife and I have shared for many years. We take turns discussing our “women problems.” After a few minutes, I literally cry into my beer for half an hour.

I’m 21. Still living with my parents, I’m walking through my brothers’ bedroom to get to my own bedroom, actually the garage that’s been turned into a garconniere. I ask my brother Patrick a casual question, to which he lies about the answer. I’m incensed that he lied. I recall my parents’ admonishment, “Don’t hit your brother! Don’t hit anyone unless they're your own size!” It occurs to me that Patrick, aged 17, is easily my size, perhaps even a bit bigger. I allow my anger to get the best of me and slug him several times. He gets a black eye, swollen and barely able to open it. The next day, my Dad has a photo shoot with a local magazine, as he’s running for public office. The photographer takes several pictures of our happy family. The photograph that appears in the magazine pictures my brother with one eye open, the other swollen shut. I’m smiling.

Speaking of photographs, there are very few family pictures in which I am not standing on my tippy-toes, to appear taller than everyone else.

I’m 26. I’ve just gotten back from a contract job in which I maintain aquariums through Bobby’s pet shop, where I work. Dr. McSwain calls Bobby, whose office aquariums I’ve maintained for a year. He’s complaining that ‘his fish are dying.’ Too embarrassed to go back, I ask my co-worker, Chip, to go to his office to check out the mysterious fish deaths. He returns later, and explains that I forgot to hook up an air tube that oxygenates the water in the aquarium. Two hundred dollars worth of tropical saltwater fish have died (this is about three actual fish; Dr. McSwain has a generous aquarium budget). I am too embarrassed to go back; I ask Chip to take over the account. Bobby never deducts the losses from my salary.

It’s my fortieth birthday. I’m in Anaheim, California, living as a refugee after Hurricane Katrina in New Orleans. I rejoice that I’m two thousand miles away from anyone that would have a “Lordy, Lordy, Look Who’s Forty” birthday party for me.

I’m one year old. It’s my birthday. I don’t understand the importance of the one-piece jumper my aunt has given me as a birthday present. I try to escape the festivities the adults are enjoying but the three steps up to the kitchen are too high for me to climb. I learn their drink preferences by overhearing their requests from my Dad, who rarely drinks, but is the party bartender. I don’t know what a “Martini” is yet. An “Old-Fashioned” mystifies me; at a year old, my idea of old-fashioned is last week’s stuff. The thought of a drink “on the rocks” will perplex me until my speech patterns are fixed enough to ask about it years later. Eventually I make it outside, where Maria, the girl next door, plays with me in my round strolly-walker thing.

Lasagna, Sean-style

2010-09-11T17:35:00.000-07:00

Well, I never thought this blog would turn into a cooking show, but like a thousand folks asked for my lasagna recipe just because I put a picture up on Facebook. Interestingly, I also tweeted the entire cooking experience on Twitter with photos., but hardly anyone responded. Slightly disgruntled at being underappreciated, I'm putting the recipe here like I Twittered it. Because really, who wants to read "spread evenly across the pan" or some crap like that? That's like the Ambien zombie of literature. Anyway, here's the recipe as posted on Twitter with links to pics! Click the http links if you want to have a friggin' clue what I'm talking about!

Welcome everyone to#seanskitchen!

Today's dish: lasagna! All you vegans out there, cover your eyes.

First orders of business when in #seanskitchen - preparation. Vodka & soda is a good choice. http://yfrog.com/nezdclj

If someone gives you shit about cocktals at 3:30pm, offer them a cocktail!

Second step in preparation for #seanskitchen - mood music. This is entirely up to you. http://yfrog.com/c9488hij

Get your shit together. If u don't like italian sausage, go hide with the vegans. #seanskitchen http://yfrog.com/ccj7waj

Get your biggest, most psycho-killer knife and chop up those tomatoes! Show them no mercy! #seanskitchen http://yfrog.com/6wkliwwj

Stick those tomatoes in a pot. Turn up the heat. Ignore those who say you should remove the seeds. They're pussies.http://yfrog.com/nbzbiaj

When it's all steamy, turn down the heat and torture those tomatoes. http://yfrog.com/n8ltbrj

Ad a lot of garlic! Did you think we're not gonna use fucking garlic? http://yfrog.com/56v89pj

Add some olive oil & italian seasoning. Use a lot! You're seasoning all the lasagna, not just a pot of tomatoes.http://yfrog.com/83wh7tj

Use whatever the hell tomatoes you want! Just use tomatoes!

Take your big scary knife and disembowel the hell out of some italian sausage! http://yfrog.com/mv8dssj

How u gonna cook that big ol' pasta? In a big ol' pan.http://yfrog.com/epwhgj

Take the skin off the sausage. Save it to make a festive costume. http://yfrog.com/b5zs4jj

Brown that fucking sausage. Use a goddamn bigger pan than me. http://yfrog.com/n3ao1cj

You're not cooking in #seanskitchen unless you use at least three burners. Fuck you, microwave.http://yfrog.com/mwgchyj

When some sausage falls on the ground, let the dog have it! This is why you need a bigger goddamn pan!http://yfrog.com/5c1sej

When it's browned, drain it & let the sausage rest. All meat needs to rest after heat! Even human meat!http://yfrog.com/mr2jmrj

You're still simmering those tomatoes, right? SIMMER DOWN! Don't make me come over there! http://yfrog.com/j3dohf

Use whatever crackpot way you want to tell when pasta is ready. Just put some olive oil on it, for Chrissakes!http://yfrog.com/ngqi2j

Let the tomatoes simmer while the meat rests, the pasta drains & you mix another adult beverage.http://yfrog.com/6lfvtj

Welcome back to #seanskitchen! Your pasta is drained, your italian sausage better have rested. Your tomato sauce is saucing.

Is your tomato sauce all thick & gooey now? Good! If you have an Italian grandma who says sauce needs to be cooked forever, kick her ass.

Make a layer of italian sausage in the bottom of a pan. Feel free to use real Italians. http://yfrog.com/49yqicj

Layer the pasta on the meat. That shit is still hot! It helps if you get pans to fit the pasta, unlike me.http://yfrog.com/ngj1xej

For God's sake, make a layer of ricotta cheese! Don't be stingy; what is this, weight watchers? #seanskitchen http://yfrog.com/htxl3zaj

Make another pasta layer. Add some veggies! I'm using artichoke hearts. Or spinach, eggplant, whatever. I don't care http://yfrog.com/b9b5uvj

Spread your awesome tomato sauce all over those veggies! Make 'em orgasm. http://yfrog.com/mtgzblj

Oh sweet Jesus, don't forget to preheat your oven!http://yfrog.com/mxk09nj

More pasta! Shred your mozarella! Do it now!http://yfrog.com/861x0qj

Put those pans in the freaking oven that Jesus reminded you to preheat. http://yfrog.com/7f7peuj

Leftover pasta? Eat it!

Now on #seanskitchen, baking time. I guess 20-25 minutes? We'll have another break

Those of you that take offense to #seanskitchen, no lasagna for you! Yeah, you!

That shit is DONE! this is what golden-brown looks like on#seanskitchen http://yfrog.com/mvbxnyj

Let that shit cool down! It's friggin' HOT! Distribute to friends when cool. Thanks for joining #seanskitchen!http://yfrog.com/j3cnaj

This is Freaking SWEET!

2010-08-19T06:45:00.000-07:00

This blog - yes, the one you are reading right this very minute- made number 7 in a list of the 50 Best EMS blogs on the web! http://www.medical-assistant.net/ems-blogs
Many thanks to my devout readers! Tooting my own horn? You bet I am!

In other news - For those of you that don't know despite my similar self-horn-tooting, my book, Found Wanting, is due to come out in print in the next few months! No idea yet exactly when or how much it will cost, but you should totally make plans to buy it! I'll sign it!

I wrote Found Wanting last year (2009), and had it on here for a while but took it down when I signed the contract. (Contract!) Here's a hint about the book: serial killer paramedic! I know you're just DYING to read more now! (Dying - haha, I made a funny!) Anyway, thank you so much for your support! Stay tuned!

-Sean Fitz

Ramp Rants - Partners

2010-06-11T10:39:00.000-07:00

Ramp Rants - Partners

In an ambulance, you spent a good portion of your life with your partner. In my service, I would spend 12 hours a day in the ambulance with the same person, for 7 out of 14 days. That’s 25% of my life. Being a partner in an ambulance is, in some ways, a closer relationship than marriage. My wife would work days and I usually worked nights. We would see each other for a few minutes in the morning, when I was getting home and she was leaving for work, and then a few more minutes at night, when the reverse was happening. But at work, I’d say hello to my partner and then spend 12 continuous, unbroken hours with him or her, talking with them, listening to each other’s music, smelling their food and seeing their face. With my partner, we would respond to crises throughout our entire shift. Our exasperation with stupidity would peak simultaneously, our adrenaline would flow together during life-or-death emergencies, our boredom at times would cascade into a common pool of ennui. You eventually get to know your partner’s quirks and pet peeves; you not only know, but understand what drives them; you even become personally acquainted with details you’d never imagine you’d know of another person, like what their farts smell like. The old saying goes “an experience shared is twice as sweet.” When you’re sharing those experiences in an ambulance responding to medical emergencies day in and day out, it has an effect more powerful as a shared experience than any sunset, dessert, wedding or vacation spot could ever hope to have. And unless your spouse, family or significant other is also in EMS (God help you if they are) EMS partners may well rank as of the most unintentionally intimate relationships human society has ever created.

Therefore, it behooves me to describe your partner. If you have been in EMS for years, no doubt you will recognize some of, if not all, the partners you have had. If you are new to the field, here’s an idea of what to expect in your nascent career.

"The Great Partner”

This is the person whom you should never expect to be paired with. In the extremely unlikely circumstance that you are, you will quickly come to appreciate this individual. He or she will have far more than a passing knowledge of EMS. You will be impressed with their knowledge of the profession and the care they deliver to your patients. You will be able to handle a complicated scene with them and know exactly what you and they need you to do and barely speak a word about it to each other. He or she will drive the ambulance carefully, not throwing you around the back of the truck. Alternately, he or she will thank you for a good ride when it was your turn to drive. You will both happily agree on the same place to get lunch. Your relationship will make it a pleasure to come to work, you’ll look forward to your time together and take mental notes of each others’ medical techniques. If something needs to be done and you can’t handle it all yourself, like triaging a multiple-casualty scene or calling in a report to the ER while you’re busy doing CPR, you will confidently delegate that task to your partner and you will not have to worry about them fucking it up. You will enjoy each others’ company even outside of work and be friends with their family. Once administration gets wind of how well you get along with your partner, you will immediately be split up... at which point you will find yourself with one of the following.

"The Talker”

This person will never stop talking. When you come to work and hope for an easy shift, the patients may be compliant with your wishes, but your Talker partner will continue to prattle on about their latest argument with their spouse, their patient they had last week who had a hangnail, their credit card bill, their kids, their trip to Cleveland, their mother, their child, their burger on a soggy bun from the drive-thru last week, their hairdo, their review of some movie you’ve never heard of and what they saw on TV last night. You will fall asleep at some point during your shift and when you wake up, your partner will still be yammering on uninterrupted, oblivious to your absence during your nap. You will be delayed from taking the next call because you had to go find your partner who was busy telling the emergency room doctor about the condition of someone’s clothes on an emergency run they handled last year.

If you’re not partnered with the Talker, you may find yourself with...

“The Chick That Thinks They’re Hot”

This will be a female, obviously. She is at best a mediocre EMT. She might be able to adequately apply a cervical collar and long spineboard, maybe even a bandage. But when you ask her why she thought it was necessary to spineboard the atraumatic grandfather with chest pains, she will thrust out her boobs at you, then make a quick turn on her heels so you can get a view of her glorious ass as she goes to make up the stretcher, or herself. Any coherent answer when asked about her erratic actions on the scene will not be forthcoming. Years after being at your EMS service, she will still not be able to adequately explain the mechanics behind CPR, she will still interpret a 12-lead EKG exactly as the EKG machine interprets it, and will she be not able start an IV under the best of circumstances. But... she will... um.... uh.... Dude! Check out those tits!

The Paragod

A close relative of the Chick That Thinks She’s Hot, the Paragod can be a male or female and has been everywhere, seen everything and knows everything there is to know about EMS. Even though he or she is known for jumping in the driver’s seat despite it being their turn to take the patient, the Paragod will insist that whatever their actions were on scene were the best possible actions to take, even if they deliberately stabbed the patient in the eyeball with an IV needle. This partner has responded to every possible permutation of anything that could ever go wrong with a human body, and the Paragod will fabricate a story to back up their claims. The Paragod responded to the World Trade Center on 9/11 and saved every survivor; they personally, physically carried the President of the United States to their ambulance when he was injured or unconscious; they wrote the medical protocols that some country with nuclear weapons uses in their EMS services. If you question the Paragod on why he licks sterile equipment prior to inserting it into a patient’s body, he will sneer down his nose at you, point to his advanced-level patch on his uniform, and say, “When you get one of these, then you can ask about why I do something.” The Paragod will be recognized when you find yourself daydreaming of actual plans to assassinate your partner.

“The Eternal Newbie”

This poor soul will have been at your service for twenty years, but every day will be their first day on the job. You will marvel that in twenty years, he or she will still not have picked up on the proper way to apply a nasal cannula, or splint a fracture, or read a map, or figure out the best way to get to the hospital. You can play dumb and offer your partner helpful advice, even though he or she far outranks you in seniority, to which he will reply “Oh yeah, I knew that! I must’ve had a brain fart.” This will be the same response he offers even if you call him out twenty times a day. Alternately, you can become insanely angry at their idiocy, jump and scream and insult them, to which your partner will give you a doe-eyed look that says ‘I have no idea what you’re talking about.’ Defeated, you will curl up into a metaphorical fetal-position (if not a literal fetal-position) and wonder how your partner ever passed his EMT exams, let alone made it through twenty years at the same EMS service.

“The Actual Newbie” (AKA “Ricky Rescue”)

Sooner of later, you will be partnered with the “new guy.” He or she will be fresh-faced and eager to save the world. Your partner will shout with joy when he turns on the lights and sirens. This eager beaver will lie on the radio, saying that your crew is miles closer to a “good call” than the crew that was actually dispatched. Ricky Rescue will shout driving instruction over the PA system to cars in front of your ambulance. He will become sullen and morose during slow periods between calls. He will become sullen, morose and angry when your emergency call is not some horrible trauma scene, such as when the gunshot call you were dispatched to actually turns out to be a little old lady with arthritis in her feet. He will drive 120 miles per hour to get to a motor vehicle accident, probably causing a few more accidents along the way. He will want to perform every procedure that an EMT can possibly perform, but will balk when you ask him to write the report. If it is Ricky’s turn to make up the stretcher and clean the back of the truck after a call, it will not be done. You will recognize the Actual Newbie/Ricky Rescue because he will show up to work on his first day wearing every possible accoutrement ever made with the label “Tactical,” including tactical flashlight, tactical knife, tactical boots, tactical window punch, tactical trauma shears, tactical baseball cap and tactical underwear.

“Crispy”

The Crispy partner will most likely be your first partner, a paramedic that was burnt-out since before you could spell “EMS.”. He or she will find no joy in his job and will do his or her best to bring you down into his or her bitterness. Every call will be a horrible waste of time to your partner, no matter how dire the circumstances were that caused EMS to be summoned, and no matter how significant a difference you make in the patient’s life and existence. Any call, no matter how serious or trivial, will be met with an angry “harrumph.” Be prepared for objects to be thrown around the cab of the ambulance when dispatch assigns you a call. Be prepared to slink away silently when the Emergency Department staff questions your partner about any of his actions or non-actions while transporting a patient, because your Crispy partner will launch into a frustrated diatribe describing the need or lack of need for whatever it was the staff was asking about. You will recognize Crispy as you approach his ambulance; there will be cracks in the windshield on his side of the ambulance from clipboards or computers hurled viciously onto the dashboard during his bouts of anger over getting assigned a call. One point to remember (to your advantage or disadvantage): in his eyes, YOU are the Newbie/Rickie Rescue, no matter how long you’ve been at your service.

“The Family Guy”

This person will wear out the battery of their cell phone several times a day. They will be on the phone all throughout your shift together as they talk about “family issues.” You will hear your partner’s side of the conversation all day as they argue with their spouse, discipline their children, fight with the cable guy doing work at the house, chat with various contractors regarding the lowest bid for work to be done on the house, whine to their lawyer about paying child support and during slow times at work, you partner will describe in nauseating detail all the goings-on in his or her family dynamic. After a week or two with the Family Guy, you will know all about their spouse and children in ways you don’t know your own spouse and children.

“The Walking Crisis”

The Walking Crisis never has a good day. Every day, no matter how benign the calls are, will be “the worst day ever.” The patients might have a minimum of problems, be extraordinarily cooperative with your partner and yourself, and thank you profusely for your service, maybe even offer you some food or drink, yet your partner will find something wrong with the call. “Oh my God, that was awful!” you partner will exclaim after every EMS run. If you enquire why they found the call so stressful, they will respond by elucidating some vague, unlikely, unobservable possibility, the repercussion of which invariably result in their suspension, firing, revocation of their certification and possibly jail time. Often the Walking Crisis will overlap with the Family Guy, as their “horrendous” job description spills over into their home life. Your partner will spend their time between EMS calls talking on the phone with family members about worst-case outcomes in whatever circumstances their family is in. “Junior got an A in math? Jesus Christ, I thought he wanted to be an artist! This will never work out!” your partner will say.

“The Slut”

The Slut will be recognized the first week of orientation. The Slut can be male or female. By the end of the first week, the Slut will have had sex with at least one fellow employee, often that employee will be his or her field training officer. If the Slut is a female, after six months of her employment, most of the male employees will obliquely refer to her skills at sexual prowess. There will be whispered references to her as “The Suction Device,” “The Bottomless Pit,” “The Sperm Bank,” “The Freak,” and other crass but recognizable names. If the Slut is a male, a meaningful fraction of the female employees will be taking maternity leave within a year of his hiring. The Slut may or may not be a good EMT, but to many of the people who make that determination, their professional skills will likely not matter much.

“The Gay”

You will find an extraordinary percentage of your EMS co-workers are gay. This can have both advantages and disadvantages. If you are a gay male and your partner is a gay male, your chances of getting laid just went up, as is also the case if you are both gay females. If you are a straight male partnered with a gay female, you can both have a good time ogling the attractive females that you encounter during your shift, and the crew with the gay male/straight female can have the same fun pointing out attractive males to each other. The disadvantages can be a problem, though. The Gay, if they are too horny, promiscuous, or opportunistic at work, can acquire the gay version of the label “The Slut” among that portion of the work community. If two gay males or females from EMS become an item, they run the risk of the dreadful “Family Guy” problems (and label) as a result of the shrieking drama that can be so endemic to gay relationships. Further, your straight co-workers will get endless fun pointing out the ongoing spectacle between you and your co-worker boyfriend or girlfriend.

“The Social Butterfly” (AKA "The Silent Treatment")

The Social Butterfly will usually be on his or her cell phone, texting updates to Facebook, Twitter, MySpace and various other social networking sites. Actually responding to EMS calls will be a chore, as actual EMS work tends to distract them from texting their boyfriend, girlfriend, or 3rd-grade classmates. Expect little in the way of conversation from the Social Butterfly; somehow actually interacting with another human being (you) is far too cumbersome an activity compared with the instant gratification and massive life-affirmation they receive when someone “likes” thier Facebook status (“OMG, my partner is so lame! He actually wants to TALK to me WTF?!!”).

“The Fighter”

The Fighter will be related to the Walking Crisis. Paranoid at every turn, your Fighter partner will call for police backup for every 2-month-old with a fever. The Fighter will manage to get into a difficult situation on a call with a patient who is completely alone and unresponsive. Be prepared to apply restraints to every patient because “They’re combative!” according to your partner. Even if you are not partnered with the Fighter, you will hear them on radio asking for another crew to help with the the “uncooperative” patient. The patient could be an arthritic little Grandma who offers you some of the chocolate chip cookies she baked earlier; somehow the Fighter will press assault charges on her when she reaches to give your partner a hug.

“Driving Miss Daisy”

Miss Daisy has an infinite number of personal errands to run. Don’t be fooled by the nomenclature “Miss” Daisy; this partner can just as easily be a “Mister.” It is unthinkable to Mister or Miss Daisy to run personal errands on their day off, while they’re off the clock. Be prepared to visit their mother, shop for groceries, stop off at the electric and water company so Miss Daisy can pay their bill, purchase their hardware at the Home Depot, pick up their kids from school in the ambulance, give friends a ride home from the bar in the ambulance and attend some school class in between calls. Miss Daisy will never make and/or bring her own lunch, so you will be meeting her boyfriend, girlfriend, spouse or other family member so lunch can be delivered to Miss Daisy while on duty. Note that the closest location that the friend can meet you and Miss Daisy is clear on the other side of town, as far away from your dispatch-assigned location as you can possibly be. Do not be surprised when Miss Daisy asks YOU to inform dispatch why you are forty miles from where you were expected to be when dispatch assigns you a call.

“Sleeper Cell”

Not unlike Miss Daisy, the Sleeper Cell will have personal duties to perform that probably should have been done on their time off. However, the duties will fall under only one category - sleep. This partner will do their best to sleep during their entire shift. You will wonder what activities could possibly be so exhausting that your partner actually falls asleep while attempting to intubate a non-breathing patient. The moment your stretcher is made up and secured back in the ambulance after a call, you partner will be stretched out on it, with “Zzzz’s” almost visible on their snoring breath.With some partners, the cause of their sleep deprivation isn’t too hard to find - the narcolepsy may be secondary to his off-duty antics being “The Slut.” Possibly, the partner schedules too much abuse during her time off as she cooks, cleans, sends the kids to school, and runs her errands on her days off (the Family Guy?) then looks forward to napping in the ambulance. You can recognize the Sleeper Cell easily - you will be responding to a call, lights and sirens blaring, potholes jostling the ambulance to the point that your heads are actually making contact with the ceiling but your partner is snoozing away, undisturbed, oblivious to the fact that your ambulance overturned upside-down just now.

“The Soldier of Fortune”

This die-hard ex-military person will sneer in the face of danger, insult you for calling for backup when six big guys attempt to shoot you with pneumatic spearguns and steal your ambulance, and will be packing a firearm somewhere on his person. Every conversation will start with “When I was in the military...” This partner will regale you with war stories (literal stories of genuine war). The Soldier of Fortune will actually purchase “Soldier of Fortune” magazine and point out articles, insisting you read the review of the latest X-10 Kill-o-Matic weaponry. No situation in your experience is as awful a crisis as “This one time, in the military...” The Soldier of Fortune will spend his time off engaging in re-enactments of the Civil War or collecting unlikely weaponry, like a catapult or a guillotine. Do not engage such a person in conversation, it can only end badly.

“The Partner of Questionable Hygiene”

This partner will be recognized the moment you climb into the ambulance. You will imagine that the previous crew, while cleaning, had missed some foul turd that a patient had left behind. You will inspect the ambulance for the cause of the aroma. Unsuccessful, you will fall into a deep depth of depression as you slowly begin to realize that the stench emanates from you partner - the partner who you will not only have for the rest of your shift, but have just been assigned to work with permanently. Bring extra tissue paper to wipe your eyes and blow your nose as the irritants of his personal gasses fill your ambulance. If you lower the window in the ambulance, they will raise it again, claiming he or she is “too hot” or “too cold,” as your partner seals you into your personal corner of stink-hell. There are advantages to the Partner of Questionable Hygiene. When you have a patient on your stretcher, if you fart, it will be easily attributed to your partner. Conversely, your patient may have an episode of uncontrollable, explosive, stinky, diarrhea incontinence on your stretcher, in which case the smell will be unnoticeable, obscured as it is by your partner’s personal odor. Recognize this partner when fellow employees anonymously present him or her with a basket of personal hygiene products, including, but not limited to deodorant, soap, shampoo, laxatives, tampons, Gas-X, Febreeze, laundry detergent and cologne.

“The Princess and the Pee”

Not necessarily a female, the Princess cannot, under any circumstances, get their hands dirty. Should a stray drop of blood, urine, vomit or bodily fluids mar their perfect uniform, the Princess must go home immediately and will most likely file a personal injury report. The Princess will arrive at work with her makeup perfectly applied, his hair immaculately coiffed. Any object or patient heavier than a newborn baby will require backup for lifting assistance. If the patient is actually a newborn baby, your partner will be unable to touch it, “in case it throws up or poops.” The Princess is a delicate winter blossom, unaccustomed to the hysteria that frequently accompanies emergency medical calls. Such hysteria paralyzes the Princess and they cannot possibly be expected to function when there is “drama” going on. Starting an IV or bandaging a wound is outside their scope of fragility. The Princess cannot ever be expected to get so physically close to an actual patient so as to assess vital signs or use a stethoscope.

"Mister Clean"

Mister Clean has an extraordinary need to keep the ambulance sterile. Probably diagnosable with obsessive-compulsive disorder , he or she will spend a large portion of their paycheck on cleaning items for the ambulance. Whatever cleaning equipment your company provides will be far inadequate for their needs. Mister Clean will have a large bin chock full of bleach, Windex, scrubber pads, Armor-All, sponges, brushes, brooms, mops, a vacuum cleaner and anti-bacterial soap. They may keep their own pressure washer machine to scrub the outside of the ambulance. At least once a shift or more often, this partner will launch into a cleaning frenzy to scrub, polish and straighten every item in the ambulance. When you look under the hood at the engine, the caps for brake fluid, radiator coolant, windshield washer fluid and oil will have colorful hand-made labels identifying each. Your eyes will frequently burn as the ammonia and bleach mixes during their cleaning fits. You dare not leave lunch leftovers anywhere as they will be thrown away the moment your partner finds them idle. Mister Clean will stare at the drop of the patient's blood that fell on the floor, transfixed, mesmerized at the fantasy of cleaning it up. Should you offer to help clean the ambulance, your hand will be slapped away when you reach for Mister Clean's stash of supplies, in the fear that you might disrupt the meticulous organization of their precious paper towels.

Thanks for reading! Hopefully you’ve found a little light to brighten your day. As you climb into your ambulance for another shift with your partner, I want you to ask yourself not only “Which one are they?” but also “Which one am I?” (And if I missed any partners out there, please describe them in the comments!)

Onward and upward.

The Darkest Secret of Nursing Revealed

2010-04-25T07:34:00.000-07:00

So last night I was absconded. Shocked actually. And it takes a lot to shock me.

“What is this terrible scandal to which you were exposed and subsequently shocked by?” you ask? It is this:

I work on the Neuro ICU. We get all the brain injuries. Strokes, head injuries, spinal surgery, nerve damage... that sort of thing. Last night we had a patient with a traumatic brain injury who was pronounced brain-dead. The rest of his body didn’t get the memo so his lungs, heart and all his other organs were functioning just fine ( fine, that is, in an intensive care unit sort of way). The family of the patient (God bless them) had seen fit to authorize the patient to be an organ donor. (By the way, when I die, please donate my organs too.) The Organ Procurement nurse was working on our unit doing her thing - prepping the patient for organ harvesting, contacting all the people that would be involved, and so on.

As I was working nearby, I overheard her conversation. She was working out the details of the organ procurement surgery. At one point in her telephone conversation, she asked about what time anesthesia would be available.

This struck me as odd. “Anesthesia?” I thought. “Why would a brain-dead person need anesthesia?” The purpose of anesthesia is to make sure the patient is so unconscious that no pain is felt as the surgeon cuts into them and does whatever he has to do. But why would someone with no brain function require such a service?

I asked one of the other nurses. “Why do they need anesthesia for someone who’s brain-dead”

The answer was stunning. “It’s to prevent cruelty and to maintain dignity. Just in case the patient can actually still feel pain.”

What? In all my years of medical experience I had always been taught, and told others, that someone who is brain-dead feels no pain. “Don’t worry, he’s not feeling any pain right now.” “If you’re worried about it, she felt no pain in her condition.” “No, it was a painless way to die.” Such were my responses to concerned family members and friends on many, many scenes of trauma, disease and death.

But now another medical professional had stirred those subtle doubts. “In case” they still feel pain? You might as well drill air holes into the coffin “in case” they might actually still be alive! All at once, the state of medicine in our modern day came to the front of my brain. With all our tests, amid all our technology, after thousands of years of medical observation and knowledge, we still don’t know if a brain-dead person feels pain? Seriously?

I have often said that as I learn more about medicine, alternative medical practices appeal to me more and more. But here was hard, concrete evidence that our medical world simply has no clue about what REALLY goes on in the mind! “In case” they still feel pain? Holy shit! What other senses might still be lingering? Hearing? Will they report to Saint Peter the snide remarks about the embarrassing mechanism of their death (that porn on the TV we found them “stiff” in front of?) Will they detail the smells surrounding their demise (it’s okay if I fart; they’re dead - they won’t mind)? How long does the sense of touch linger? (Hey cops! Look how far I can put my finger into this bullet hole!)

The implications are staggering! I want to be an organ donor, but if we’re so uncertain about what is and isn’t sensed by the dead brain... well, I dunno! I mean, little girl with the bad heart, I know it sucks having to live most of your childhood in a hospital. Grandma, it must be really painful to wonder if you’ll survive to see your new grandchild born before you get a new kidney. I’m sorry you have to worry about your baby, new mom, wondering if you’ll see him off for his first day of school if you get your new corneas. But jeez- will it hurt if you take that stuff outta me?

---------------------------------------

I totally intended to make this a sarcastic, ironic, doubt-inducing post. But after having written it and thought about it, I can still say - “Please, if I won’t need them, take my organs and give them to someone who will.” Even if it hurts some.

Spreading Around Easter Joy

2010-04-03T12:32:00.000-07:00

Easter can be a frustrating holiday. Gorge the kids on sugar and sweets then force them to sit still during church. Realize that your Easter bonnet isn’t as bonnetty as everyone else’s. No football during the family dinner. Here I’ve come up with a few ways to make Easter a lot more fun. Try a few of these suggestions to enhance your Easter merriment. Feel free to email them to Martha Stewart. It’s a good thing.

Fill your easter eggs with C4 explosives! Fun for the whole family!

You know the phrase "fuck like rabbits"? Apply that to your family Easter bunny diorama!

At Easter Mass, tell the parishioners that the apostles hid their Easter eggs in the Shroud of Turin.

When your mom's house is decorated with Easter lilies, remark "Did you ever notice how phallic Easter lilies are?"

When all the kids are enjoying chocolate at Easter morning, it's the perfect time to introduce Leroy, your new boyfriend.

Entertain the kids by showing them how mommy can peel an Easter egg without using her hands.

Make screaming noises whenever someone bites the head off a Peep.

You can wear white after Easter. Recruit the whole family to do experiments to make sure your tampon is up to the task.

Discuss with your family the homoerotic qualities of the name "Peter Cottontail."

Boil and dye a fertilized egg. Then crack it open and take photos of the children's joy. Then put them on Facebook.

For Easter, tell the family the story of how the giant bunny fell down Alice's hole.

Jesus' mom was one of the first ones to suspect that someone robbed her Son's grave & did terrible things to His corpse. Discuss.

Have the Easter bunny invite all the kids' moms to sit on his lap. Then have the kids do it and explain the "egg” in his pants.

Coloring eggs is fun, but once you’ve colored one, it’s just a repeat. Discover what else you can color. Add some dye to the toilet bowl.

Tell the tale of how if Jesus sees his shadow on Easter, then it’s six more weeks of Lent.

Instead of ham or fried chicken or whatever you usually have for Easter, make a delicious rabbit stew.

Hide your Easter eggs on ant hills. If you live in the south, fire ant hills. Enjoy the children’s screams of happiness.

Go to Communion by hopping up the church aisle and sing the Peter Cottontail song in appropriate lounge-lizard vocal style.

Instead of getting the kids a live bunny as an Easter gift, get them one that’s already skinned & cleaned. Encourage them to elaborate on why this is better.

Bite the ears & tail off the chocolate rabbits, and carefully re-wrap them before putting them in the Easter baskets. See what animals the kids decide they are.

And finally...
Put insulin and syringes in the Easter baskets. Watch the fun as the kids inject each other. Then after your fun-filled day of activities, enjoy the silence as they lapse into an insulin coma.

Happy Easter!

Hospital Clinicals - A Million Hours of Misery Or A Million Chances to Become an Excellent EMT?

2010-03-28T22:23:00.000-07:00

Hospital Clinicals - A Million Hours of Misery Or A Million Chances to Become an Excellent EMT?

You remember your hospital clinical hours, right? Maybe you're doing them now. They never seem to end. Back in the dinosaur days of EMS when I was in paramedic class, the only place we did clinicals was in the ER, because the emergency room is the most like EMS, right? And back then, EMS wasn’t exactly taken very seriously. Appreciated, yes, maybe even commended, but seldom taken seriously. Most of our clinical time (two hundred forty hours!) was spent watching the nurses start IV’s and push drugs, watching the doctors intubate patients and helping fetch and carry things thither and yon. Few of the nurses trusted us enough to actually stick a patient with an IV. We only practiced intubation after the patient was pronounced dead. 12-lead EKG’s took the same place as Egyptian hieroglyphics in our curriculum. At best, we might inspire enough confidence in the staff to allow us to give a pill or rub some ointment on a rash.

Nowadays, the curriculum includes over four hundred hours of hospital clinicals spanning not just the emergency department, but the ICU, med-surg floors, labor & delivery and surgery. On the surface it seems like the ways to be bored have increased exponentially. And if you’re looking for something to do, you may find yourself in the same predicament we did back in my class, when the Tyrannosaur was the king of the earth, and go look for an empty patient room to nap in.

One thing is for certain, when you take your hospital clinicals you’ll be a newbie. A “lowly” EMT (actually, you’ll be worse- an EMT student!), so judged by the nurses and doctors on the floors who don’t know you from Adam. You may be able to run circles around any other EMT, but there’s no way you’re going to prove that to crotchety old Nurse Ratchet. And she won’t care if you did.

So is there any benefit to the spectrum of torture your instructors are putting you through? If you want to be an excellent EMT, there most certainly is!

Maybe, just maybe, you’ll get to stick an IV. The CRNA or anesthesiologist might let you intubate a real, live person. Good, you need that. But it’s no big deal. Why? Because you can teach a monkey to intubate or start IV’s. All that takes is training. As an excellent EMT, you need to seek out education. And the hospital environment provides you with multiple opportunities to do so. Training teaches you how do do stuff: “Is my scene safe? I put on universal precautions. How many patients do I have?" Blah blah blah. What to do on every scene you’ll ever have. What education does is teach you how to think critically about your scene, especially when your scene is one of those “what if...” situations that EMT class can’t prepare you for. A great deal of education can be gleaned in the hospital.

Let’s look at some examples. One thing you’ll have to do on every call is write a run report. “Nobody’s gonna read this thing besides a lawyer,” you say to yourself. On the contrary! Many, many times the very first thing a physician or nurse will do when initially encountering your patient is read your run report. Your run report stays in the patient’s chart until he or she is discharged. It is referred to nearly every time a new doctor or nurse has any interaction with your patient. Even if they’ve been in the hospital for months and you’ve long forgotten about the call, your words are still being read and taken into consideration. If you are doing clinicals, try to take note of how often EMS reports are read. Now imagine those are your words being read. Is the report clear? Is the mechanism of injury and pertinent history accurate? What did you do for the patient? Why or why not? And be assured, your spelling, grammar and penmanship are under keen scrutiny. It is those words that will make the difference as to whether we EMT's are to be taken seriously by the medical community!

Speaking of what you did or didn’t do for the patient, another valuable lesson you can learn from hospital clinicals is the concept of continuity of care. Though your responsibilities may end when you hand over the patient to the emergency department staff, the patient’s care does not. More importantly, what you did while the patient was in your care has repercussions long after you’ve gone home and forgotten about the call.

Did you intubate the patient? Once your patient is intubated, you’ve assumed responsibility for the airway & breathing - two of the cardinal aspects of the ABC's. By intubating them, you’ve effectively made them vent-dependent. Once the body realizes it doesn’t have to breathe, many times it doesn’t start again. In your hospital clinicals, take a look at the patients who are intubated, particularly by EMS. A week or two after you’ve patted yourself on the back for “getting that tube” while hanging upside down in an overturned car in a ditch at night, that patient may well be getting a tracheostomy. That sweet grandma with CHF might not ever be able to speak the words to thank you for “saving her life” because she’s dying of ventilator-acquired pneumonia. Are you SURE you absolutely NEED to intubate that patient? Is there anything you can try to prevent an intubation and subsequent vent-dependency? The chest decompression you performed, the perhaps-less-than-aseptic IV and the hypotension you induced by walking your patient to the ambulance also all create a huge change in the continuing course of care for the patient.

The drugs you push have effects beyond the ER doors, too. Educating yourself about them can make the difference between an EMT who can pass his test and an excellent EMT. If you’re in clinicals, take a look at how the course of care is altered by drugs the EMT’s gave. Did EMS max out the patient on Atropine? The care changes. When EMS pushed labetalol on the hypertensive crisis, did the patient’s asthma kick in and now they have to be intubated? Another detour in the path of care. That patient with eclampsia - why is the ER giving them levophed after EMS pushed the magnesium sulfate? All those drugs have side effects, some of them deleterious. What may make you seem like a hero at the moment may cause an unnecessarily extensive hospital stay for the patient, added expense for insurers or taxpayers and a negative outcome in general.

In the hospital, you’ll encounter equipment that you’ll believe you will never have to think about again. Wrong! Many patients are discharged to home care with a variety of medical devices. As was stated earlier, the emergency room is the most like EMS right? Well, that’s no longer the case. A huge part of EMS calls nowadays have to do with ongoing care. That’s right- home health. People call EMS when their home oxygen machine breaks or their premature infant’s feeding tube is clogged. Imagine going to the home of a chronically ill patient who’s receiving tube feedings. The feedings are still running to the PEG tube and you have to disconnect it to package them for transport. How do you disconnect it? How do you flush it? Use your hospital clinical time to find out. Some patients go home with a Wound-Vac device to remove exudate from a surgical wound or pressure ulcer. When and how should you disconnect it? How long can it safely remain off? What should you do if it is accidentally dislodged? Again, pay attention and ask questions in the hospital. Some patients have a PICC line (Peripherally Inserted Central Catheter). Can you use that for IV’s? How should you access it? If it starts coming out, what should you do? There is a cornucopia of devices that you may not feel you need to know about, but in reality you will have to deal with frequently. Quinton cathers, Foley catheters, suprapubic catheters, colostomies, home ventilators, home CPAP and BiPAP machines and tracheostomies are only a few of the things you have a golden opportunity to learn about while doing your hospital clinicals, and you will be glad you did when you encounter them on scenes.

You can take note of other things too. True, cleaning a patient isn't a priority in EMS. But try to assist the nurses to turn and bathe that 600-pounder in the ICU. Help them keep the combative head bleed still for a minute during the CAT scan. Feel the soreness in your muscles the next day. The nurses will acquire a newfound respect for you and you will appreciate what they do when they have to do it without your help.

Use your hospital time to really learn about patient care, not just the bare minimum of EMS training. Understanding that what we do in the back of the ambulance has a lasting effect on our patients’ outcomes will make the difference between you being an adequate EMT and an excellent EMT. Remember, any trained monkey can start an IV and memorize ACLS algorithms. Being an excellent, educated EMT is not only what makes you stand out, but is also what truly makes a difference. And making a difference is one of the reasons we all started in this field, isn’t it?

Adoption

2010-03-18T11:10:00.000-07:00

Preface: I was adopted by my parents in 1965 as a six week-old infant. I’ve always known I was adopted, as have my two eldest sisters. There are six kids in our family, three of us adopted, three of us natural-born. I’ve never had any sort of a complex about being adopted; I deeply love my parents and my brothers & sisters. I’ve never been interested in finding my “birth parents;” I’ve never thought of my Mom and Dad and family as anything else but my family. Life goes by for forty-four years. And then...

There I was at work in my ICU, doing my little nursing thing, minding my own business. I get a new patient admitted from the emergency room. He’s had a stroke and is intubated and on a ventilator. He’s awake but the bleeding inside his head makes it impossible to communicate or recognize what’s going on. We’ll call him John (not his real name).

Anyway, I admit John and do my thing. I tried to find his family in the waiting room to find out more about his medical history, medicines, allergies, that sort of thing, but his wife had already gone home. No big deal. A while later the wife calls up on the phone to ask how he is, what are the visiting hours and so on. Before hanging up I say, “All right ma’am, my name is Sean, I’ll be taking care of him.”

“How do you spell your name?” she asks.

A lot of people ask me that. I’m very happy to spell it. “S-E-A-N. Spelled the right way,” I joke.

She continues: “This may sound strange, but how old are you?”

I raise my eyebrows, though this is a pointless action since I’m in a phone conversation. “Well, I’m forty-four,” I reply. “Why do you ask?”

She answers with what I interpret as a wistful tone, “It’s just that I had a son named Sean that I gave up for adoption. His birthday was 11/11.”

I stopped typing on the computer charting her husband’s assessment. “What did you say?” I asked.

“I had a son with John (the patient) named Sean. We gave him up for adoption. His birthday was November 11th.”

I said with a somewhat incredulous voice. “November 11th? Um, that’s MY birthday. What year?”

“November 11th, 1977.”

I breathed a sigh of relief, though I wasn’t entirely sure what exactly I was relieved of. I explained “That’s pretty wild, but it couldn’t be me. I was born in 1965.”

“1965? You know, it was so long ago, I may not be remembering right, and I’ve been so worried and tired with John in the hospital. It might have been 1965. We gave him up to Catholic Charities. Were you adopted, Sean?”

“Yes, I was. From St. Vincent’s.”

“St. Vincent’s? On Magazine Street? That’s who we gave him to!”

“Holy crap!” we both said simultaneously. She continued “Were you raised in a big Irish family?”

“Yes,” came my stunned reply.

“Did you grow up in Louisiana?” she asked.

“Yes.”

“Do you have blue eyes and dimples in your cheeks?”

“Um, yes.” I felt as faint as her husband must have.

“Do you have a full head of blond hair?”

“Y-y-yes,” I stuttered.

“Oh, my God!” she exclaimed.

I sat back in my chair, unable to move or speak. After a while, I collected my jaw off the floor and managed to bark out “Will you be here in the morning?”

“Yes,” she said. “I’d like to meet you.”

“Yes,” I agreed. “I want to meet you too. I’ll be here late after my shift for a class in the morning and I’ll come back to the ICU to meet you.”

“OK. I really want to meet you to,” she said, not saying the words we were both thinking, and hung up.

Could this be my birth mother? Could the guy in the hospital bed be my birth father? Is it possible?

I got up to take a closer look at my patient. Are there any resemblances? Does he look like me? As I examined him, I found frustration. I looked at his face and body. But he had been in a fire some time ago and was heavily scarred. His fingers had been burned off then and they were mostly nubs. He had pale, featureless skin grafts over most of his body and face. It was difficult to imagine a resemblance to anyone. He was sleeping. With my fingers I opened his eyes and gasped. The were the exact same blue as mine! I had explained my lengthy phone conversation to the other nurses. Two of them joined me in the room.

One of them said “You two have exactly the same nose.”

I looked closely. We did. And neither of them could deny the similarities in our eyes. A little while later I got him into a hospital gown, as the emergency room had stripped him naked. I noticed the pattern of the hair on his chest was the same as mine.

I needed some air. I had to take a few minutes to breathe, to sort out the storm of thoughts raging in my head. I went downstairs to have a cigarette.

I checked my own memory. I was born in 1965, right? I remembered the house on Chapelle Street we lived in till I was three. I remembered Vietnam, Watergate, the Apollo moon landing, Elvis and disco. I remembered the birth of all my brothers & sisters, all born before 1977. Yes, I couldn’t question my own memory. But I could question hers. Even she questioned hers.

I tried a different line of reasoning. What did I know about my birth parents? I had seldom asked, uninterested as I was in the subject. The only thing I know was that my birth mother was fifteen or sixteen and my birth father was seventeen. How old was my patient? When I admitted him, I had glanced at his hospital armband to verify his identity. It had said he was sixty-one. OK, so his age in 1965 he would have been... what? I couldn’t think enough to do the simple math. I pulled up the calculator on my phone. His age minus my age. Sixty-one minus forty-four. I punched in the digits and looked at the result. I blinked. I punched in the equation again. Seventeen.

Holy shit.

When I arrived back on the floor upstairs the phone was ringing. “ICU; this is Sean.”

“Hi Sean, it’s me again,” came the now-familiar voice of the wife. “I have to ask you, were you a blond baby but bald-headed? Did you used to walk around in a sort of circular stroller thing? With a round plastic thing around it that had toys attached to it?”

I thought back to my toddler days. I have an extraordinary memory for such things dating back to even before I could talk. It’s not quite a photographic memory; it’s called an eidetic memory. Images, the place of words in a book, the exact words of a conversation - all rattle around in my head with nowhere to go. I cross-referenced my own memory with the memories of photos I had seen of my own childhood. I clearly remembered my round walker/stroller thing. Some of my siblings had used it too.

“Yes, I did,” I answered. “How did you know?”

“Catholic Charities sent me a picture of Sean after his family had adopted him. I’m trying to find it now; I’m tearing up my house,” she said.

“That’s unbelievable!” I exclaimed.

“I know!” she said, also in disbelief. “I can’t believe I just called to see how John was doing and this happens!”

“Yes!” I replied. “I feel the same way!” I thought back to some of the information I didn’t have in my medical assessment to ask her, trying to seem a little bit professional, though all my emotions and thoughts were long gone. I could have asked about his immunizations, his prescriptions, his family medical history, social habits, anything. Instead I asked, “How tall is John? What’s his height?”

“He’s six foot one,” she answered.

It took a moment before I could say anything. “That’s my height.” I took a deep breath. “Ma’am, tell me your name again.”

(Again, not her real name) “My name is Beth. Beth Green Smith Brown.”

I insisted “Miss Beth, I know it’s four a.m., but would you be able to come down here to the hospital right now? I need to meet you.”

“I’ll be there in a few minutes,” she asserted.

Ten minutes later, the nurse I had informed of my experience told me, “Mr. John’s wife is in the waiting room. Are you nervous?”

“Yes, I’m very nervous,” I confided.

I met Beth. I won't go into a description of her so as to protect her privacy. I guided her to John’s room, holding her hand. It felt... I don’t know how it felt. Once in his room, I stalled. I tried to explain John’s medical condition to her. I stammered and choked. She said to him “It’s me John! And look who’s here! it’s Sean! Sean’s here!” John, with his swollen, bleeding brain, couldn’t comprehend.

Finally I decided I had to get down to brass tacks. “Tell me about this birth you gave up for adoption,” I instructed her.

She dug in her purse and pulled out an assortment of photographs. The first one was of a man in his thirties and a woman. His girlfriend or wife, I assumed. “That’s Brendan (not his real name). He’s my son. Or maybe, your... I don’t know, maybe he’s your... stepbrother?” she suggested. “I tore my house apart trying to find the pictures I have of Sean but I couldn’t find them.”

“Well, before we have a family reunion, let’s dig a little deeper. How long have you and John been together? I inquired.

“Since 1964,” she said.

The math fit perfectly. Crap.

“How old were you when you had this baby?”

“Twenty-four. I’m fifty-eight now.”

“And when did you have this baby you gave for adoption?” I pursued.

“1966,” she answered.

I paused. “I was born in 1965.”

She took a deep breath, sadness in her eyes. “Oh. I thought you had told me 1966.”

The math no longer worked.

“When was Brendan born?” I asked.

“He was born in 1971. He’s 38.” she answered.

“And was he your first child?”

“Yes,” she said. “It was my second child I gave up for adoption.” She went on to describe a conversation she had with Brendan in 1977 when he was very young, along the lines of Brendan asking her ‘why so-and-so’s mom can keep their baby, but you can’t.’ She gathered her thoughts. She knew that I had found the truth, that her second baby had indeed been born in 1977, not 1965. I suppose she had altered her story, errantly changing the year to 1966, having mistaken what I had said over the phone, in the hopeful desperation of locating her other son, and in her sad pursuit had altered the year to fit with my own life, though it would have made her pregnant at seven years old at the time of my birth. “I gave him up because I wasn’t going to be a welfare mom!” she asserted with a degree of pride in herself. I silently admired her desire for independence and self-sufficiency, even though her perception of time was somewhat… deluded.

“Do you think they might have lied to you about when you were born?” she asked with a shred of hope.

I pitied her for her husband’s illness and her lifelong desperation to find her lost child. I silently prayed that she would find some peace in her life, or at least that John would adequately recover from his stroke. I said to her, “No. I vividly remember being alive between 1965 and 1977. I’m sorry, but there’s no way I can be that son.”

We had little conversation after that. I was still distracted by the notion that I might have accidentally found my birth parents. After all, there was the incredibly identical story she had told me and there was the uncanny, unsolicited description of a child who sounded just like me. And there were John’s eyes.

I’m still not interested in finding out who my “birth parents” are. I’ll always have only one set of parents. But for the rest of my shift, I took care of John with, well, the kind of attention I’d take care of my Dad with. Good luck, John. And good luck, Beth. I’ll always remember you.

Metaphor Madness

2010-03-04T07:15:00.000-08:00

Most of us like to try to sound marginally intelligent in our conversations with others. Not all, but most of us. Even when we aren’t trying to impress someone, we don’t want our friends and acquaintances to think “God, I can’t stand listening to him!” This is one of the reasons that cliches are unacceptable in scholarly papers, news articles and any form of writing that is designed to be of a professional ilk. Likewise original thoughts and metaphors carry a heavier weight in verbal intercourse than tired-out cliches.

Nevertheless, worn old cliches and metaphors do serve a purpose. Some are so aptly put that it is difficult to come up with a better phrase to illustrate one’s point. “Between a rock and a hard place” is one metaphorical cliche that comes to mind. It carries an indefatigable image to which anyone can relate. The circumstances it describes are immediately understandable. And you and I both know that no amount of learning or eloquence will eradicate tired cliches and metaphors.

Therefore it seems time that rather than declaring a moratorium on such phrases, it is time for a quick lesson on their use and structure. As stated, no one wants to seem unintelligent in front of anyone. The act of using a cliche or threadbare metaphor treads thin ice (there’s one!), so let’s make sure that you know how to properly use them.

Let’s look at a few examples. “It’s six of one and a half-dozen of the other” is a benign starting point. If you are going to use this cliche, go to the trouble of actually saying “it’s six of one and a half-dozen of the other.” A popular bastardization of this phrase lately has been expressed as “it’s what and what.” Remember, we’re trying to sound marginally intelligent. Abandoning the imagery that “six of one and a half-dozen of the other” carries just sounds stupid. To say “what and what” simply portrays the speaker as one who rummages around in his brain for a simple thing, a thing that should be right there on top of everything else and, being unsuccessful, asks the listener two questions “what?’ and “what?” because he can't even finish his own thought. Do you want to be the type of conversationalist that your listener thinks of you: “Jesus Christ, he can’t even come up with a tired old metaphor! I don’t want to listen to someone who can’t even find his conversational ass with both hands.”

Here’s another one. “God-given” and God-forsaken” are NOT interchangeable. "God-forsaken" is a description of something that even the Creator of all things has left alone. If you have a God-given right to something, do not say it is God-forsaken. This will have the rest of us picturing you finding something after digging through a dumpster of hazardous waste and horrible, rotting garbage in the effort to cling to that thing which even the homeless would throw out. If you believe that you have a “God-forsaken right” to something, then by all means, indulge in it, but don’t whine to anyone that no one else wants to be around you. Even God would ask what that smell is.

Do you you have a girlfriend? A boyfriend? Significant other? Life partner? Mistress? Sweetheart? Fuck buddy? Then please let the world know this relationship! Do not refer to them as your “boo.” It sounds as if you were going to say “boyfriend” but then got tired mid-word and just left it at “boo” because you were too lazy to finish the syllables. At best, describing someone as your “boo” sounds as if the individual in question is the person who scares you every Halloween.

Do not try to improve upon cliches and well-known metaphors. If you must describe yourself as being stuck between two difficult, if not impossible obstacles, then say that you were “between a rock and a hard place.” Do not tell your audience that you were “trapped between a cliff and a mountain.” Nor should your say you were betwixt “a concrete wall and a cement rampart.” Your metaphor may be amusing to the odd geologist or structural architect, but for the most part, we will think of you as someone who has clearly never gotten laid.

One more tip, because I’m tired and I want to go to bed. Avoid dogs in your metaphors. Utilizing the imagery of a canine is confusing, and can make you look like more of an idiot. The common phrase “working like a dog” is not consistent with the also common phrase “it’s a dog’s life.” If you describe someone as working like a dog (rough, sweaty, difficult work) then how will we reconcile the leisurely, lying-around-but sometimes-licking-my-butt imagery that “a dog’s life” conveys? Are you “dog tired” because you were working “like a dog” or because you laid around in the sun doing nothing on a “dog day afternoon”? Yes, dogs in conversation are inconsistent, confusing and often embarrassing. Avoid them. You don’t want to give your friends the wrong impression when you greet them with “Yo, dawg!”

Stay tuned for more metaphor madness in days to come. In the meantime, try not to sound like an idiot. Yes, this may mean you might actually have to use your brain when speaking. But then, isn’t that what you want to sound like you’re doing?

The Science of Apathy (Or Maybe the Science Fiction of Apathy)

2010-03-01T11:55:00.000-08:00

The Science of Apathy (Or Maybe the Science Fiction of Apathy)

I love sci-fi. I love real life too. It’s always so much fun when I watch sci-fi movies about aliens and space travelers and such. They’re always trying to blend in with their disguises and their shape-shifting ways, only to be foiled by keen-eyed civilians or “the government.” Earth survives another day. Yay.

But then it comes down to real life. I’d love to believe in actual extraterrestrials. But I don’t. Why? I haven’t seen any. Nor have you. Or have we? How many times have you seen someone on the street that was just so ugly or deformed or unearthly beautiful? Did it ever cross your mind that they might be an alien? Of course not. Me neither. But here’s a fun thought: what if they are? I’m sure psychologists would say that our minds simply try to incorporate the unusual into our usual frames of reference. For example, a time-displaced caveman might refer to a helicopter as some sort of bird (remember that movie?). Likewise, we would probably just think of an alien as a different-looking human. We’d just say “Oh, they must just have Down Syndrome,” or “What a an unfortunate birth defect, having a head shaped like the Sydney opera house. She should get surgery for that.”

Which brings me back to sci-fi. Remember when Captain Kirk and crew returned to the 1980’s to retrieve their humpback whales? The Shat ordered his crew to remove their Starfleet insignia. Why? Who would care? Mr. Spock wore that bandana thing to hide his ears. Really? What was the point? (Pardon the pun.) I’ve seen lots of people with weird-shaped ears but it never once entered my mind that they might be an alien. I’d venture to say that you, dear reader, have done the same.

I’ve been a paramedic and a nurse for nearly twenty years. Many, many times I’ve listened to patients’ chests and heard heart tones on the right side as well as the left, or heard breath sounds when listening to an abdomen. Breath sounds in a belly or heart tones on the right side are exactly what you shouldn’t hear. But I never suspected that they might be a timelord like Dr. Who or other such alien with two hearts or otherworldly arranged internal architecture. I just figured that my stethoscope was really sensitive or the patient’s chest was particularly resonant.

The sci-fi show that I think strikes the nail on the head psychology-wise is “Invader Zim”, a Nickelodeon cartoon that only ran for a couple of seasons. In it, Zim is a green-skinned alien with no ears and pink eyes who lives in a freakish house. He goes to great lengths to disguise himself as he plots to annihilate the world. Zim needn’t bother. The only person who believes he is an alien is Dib. Everyone else is convinced Dib is insane. All the rest of humanity is completely apathetic about the unusual happenings surrounding Zim.

That’s pretty much how humanity really is. I don’t think that there are extraterrestrials living among us; which, if you’re an extraterrestrial, is the perfect disguise. The folks that believe in aliens are the “fringe” people, and they proclaim their stories of abduction and insidious alien plots between doses of Seroquel behind the revolving door of their psychiatric facility. What if they're actually right? Like I said, I’d like to believe in aliens, but I don’t. Does that make me as apathetic as the rest of the world? Probably, but I don’t particularly want to spend my days behind that revolving door in a Seroquel happy place.

So is there a happy medium? Can a normal person find a compromise between boring, sane apathy and the men in the white coats? Just for fun, next time you see someone unusual-looking, imagine that they might actually be an alien, instead of an unfortunate soul whose eyes are too far apart or in need of a good plastic surgeon to take care of that tail or proboscis. Just the other day, I saw a man who was odd-looking (I say he was a “man,” but who knows?) His eyes were really far apart and his skin was an odd shade, sort of like you would get by putting too much butter on burnt toast. His ears were odd too, almost star-shaped. My first thought? Some black guy born with fetal alcohol syndrome. My second thought? He could be an alien and no one else realizes, or cares! The second thought, that he might be an alien, was so much more fun than the depressing disease process thought! Try it! Just be careful who you talk to about it.

See you in the asylum!

Take On Me. Forever. I Don't Care If You're Sick of Me.

2010-02-27T02:55:00.001-08:00

“So, honey, don’t you think it’s time you got a job or something?”

“A job? What do you expect me to do?”

“Well, I’m sure you could find something. Maybe a motorcycle mechanic or an artist? I mean you have experience in both of those...”

“A mechanic? You think that just because I used to drive motorcycles in a comic book and can handle a pipe wrench in a fight that I can be a mechanic?”

“Well, honey it’s just that since you… you… whatever you did to get out of that comic book, you’ve just been sort of sitting around for the last few years. Don’t you think it’s time you became a part of the real world? I mean you busted out of the book so you could be in the real world. But instead you just sit around and read comic books all day.”

“No, sugar tits. I busted out of the book so I could be with what I thought was a hot piece of ass. But that ass has gotten kind of wide lately. Can’t help but notice."

“WIDE? Have you seen your gut lately? Talk about wide! Christ, what was I thinking, letting a fucking DRAWING crash at my house?! I could’ve been reading ‘Garfield’ for all the help you are around here.”

"Besides, I read comics so I can keep up with all my old comic book buddies. You're on goddamn Facebook all the time, chatting with your old buddies; I'm keeping in touch with my old friends. What’s wrong with you going to work every day?”

“Jesus, why can't you just get a freaking job?! God I hate you. Fuck you!”

“Fuck you too!” *sob*

Dear Suckbook;

2010-02-08T18:46:00.000-08:00

Dear Facebook;
I know you think you're being helpful to us by rearranging your layout. But like the waitress that refills your coffee or tea after 2 sips and wrecks all the perfect proportions of sweetener or lemon or milk that the customer has gone to great lengths to achieve, so you do with your new, “helpful” layout. We were just beginning to get used to Facebook's quirks and links. Now all the things we liked, well, let's not say “liked,” let's say “gotten used to,” have moved or been hidden or disappeared altogether.

Though I never played Mafia Wars or Farmville, I can see how some people might get into them. Unfortunately, Facebook, the main reason I signed up was so that I could quickly keep up with my friends' and acquaintances' lives at a glance. I could see their status updates, click their link of some interesting website, and breeze through their photos and smile with them and at them. Nowadays, the vast majority of my Facebook feed is taken up with updates of things that don't even exist. “So-and-so found a mysterious egg on their farm in Farmville,” or “Such-and-such paid off the cops in Mafia Wars.” I've been hit by virtual pillows in fictional fights, I've received countless binary drinks without so much as a hangover to show for it, and I know exactly what angel, New Moon character, New Orleans bar, neighborhood, Renaissance artist, dragon, color and vampire my friends and I are. Now I have learned that though these updates continue to flood my Facebook stream, the actual games involved have become far more difficult to locate should I ever, in a fit of bored delirium, actually want to play them.

To make things even more wonderfully efficient and handy, I also carry your mobile application on my iPhone. I remember when your first update came out from the old version. We iPhoners waited with 'bated breath for the blessed event. The old original application could do three things: status updates, photos and mail. Then the update came out and we were all perplexed at the dozens of choices we had (what exactly is the difference between “news feed” and “live feed”? I still don't know). Back in the day, status updates, new photos and web links were all in the same place and provided a fun mishmash of variety. Now you can see exactly one form of update at a time. Wanna see Mary Jo's comments on the happenings at the barbecue? You'd best not be looking at “links.” When Grandma asks to see the pictures of her grandkids before she dies, how do you explain to her that she should be looking at “photos” not “pages”? Oh, and while I'm talking about Facebook's iPhone app, why, why, WHY when I click on a link to a Facebook thingy in Facebook's iPhone app does it take me to Facebook's login screen? Then if I actually go to the trouble of logging in to Facebook (while already logged into Facebook [yeah, WTF?]) I can't even see or use the thingy I was clicking for in the first place? Now when I think back to the old, original Facebook iPhone application (and the old original Facebook, come to think of it) when all I could do was see and post status updates, photos and do Facebook email, I realize that's exactly what I wanted to do anyway!

Facebook, thanks for trying, really. I know there's a lot of effort going into trying to please all the people all the time. But I really don't care that a non-existent lonely chicken wandered onto Myrtle's non-existent farm in Farmville. I have no idea what I should do when I get super-poked or why anyone would want to do such a thing. The proper response to Monty becoming a fan of “If I get 10,000 fans I will eat a bug” eludes me. I used to know exactly what to do when a friend posted about their new house or their new baby or the death of someone or when they were having a terrific/terrible day. Such tangible connections to friendships are rare on Facebook these days and your most recent layout change has made it even more difficult to keep in touch. Ironically, wasn't keeping in touch with friends the main reason of creating Facebook in the first place?

Not to seem rude, Facebook, but if you keep it up, you'll be seeing my Assbook it out the door.

Ramp Rants - Welfare Queens, Drag Queens & TaySean

2009-11-17T14:08:00.000-08:00

Ramp Rants - Welfare Queens, Drag Queens and TaySean

Many moons ago, when the dinosaurs roamed the Earth, I was in paramedic school. It was fascinating learning how to treat the cavemen after the saber-toothed tiger attacks, or how to extricate a neanderthal from the horns of a triceratops. It was always exciting to see the pterodactyls swoop skyward when they were startled by our lights and sirens.

One particular day during my paramedic precepting, I was assigned to work with Lisa, one of the crusty old-time paramedics who still managed to make it seem like she cared about people. I was also partnered with Gretchen, another paramedic student who I did all my precepting with. She would ride with me and we would both get the required hours on the ambulance for class. Lisa’s task was to educate us on paramedic work with hands-on experience.

In those days, the St. Bernard housing project was a thriving mini-metropolis, sparkling with drugs, murders and welfare babies. On this particular day, our little team got a call in the St. Bernard for a female with “abdominal pain.” Dispatch didn’t tell us she was pregnant; they didn’t need to. It is automatically understood that any female in the projects between the ages of twelve and fifty is pregnant. It is one of the rules of EMS.

We arrived at the address and hauled our cookies up, up, up to the third floor of the tiny, twisting stairway where the apartment was. Sitting on the floor was our patient, a female of 18 years and about the same girth and weight of a grand piano. She was hollering as labor pains struck several times. Around the patient were several family members. The sister held her hand, the mother stood across the room drinking a beer and smoking a cigarette, encouraging her, specifically saying “Girl, you bettah have dat baby quick so you can get yo’ welfare check! I needs some o’ dat too!” The grandmother sat on the couch watching her soap operas. A male flitted about down the hallway, ducking in and out of one of the rooms like a nervous butterfly.

The patient felt like she needed to push, a sign of an imminent delivery. Upon inspection of her nether regions, after hauling the fat rolls away from her crotch, we could see the amniotic sac protruding from her cavernous vagina. None of us had seen a pregnancy where the sac was protruding out. We were worried that it may have involved placenta previa, the placenta blocking the cervical opening, which would necessitate a cesarean section. I got on the radio to medical control. “Doc, I have an 18 year old female, prima gravida, full term. Contractions are about a minute apart and the amniotic sac is presenting, still intact. I’d like to go ahead and deliver here.”

“Negative,” the doctor countered. “Get her to the hospital ASAP.”

“Doc, we’d really like to deliver here. We’re on the third floor of the projects and it’s going to be tough getting her out.”

“Do not deliver that baby in the field. Get her to the hospital immediately!” he reaffirmed.

Lisa, Gretchen and I quickly went over the logistics in our head of moving the patient’s ponderous bulk down the stairs. We would have to carry her, since walking her would likely hasten the impending birth. Lisa and Gretchen each grabbed a shoulder; I carried her by the knees. Halfway down the steps, another contraction came and she shrieked with the pain of it. It made me acutely aware that I, standing between her legs, was in the direct line of fire should she choose to launch her bundle of joy at that moment.

We finally made it downstairs and got her onto the stretcher. It was Gretchen’s turn to ride with the patient and Lisa in the back. I didn’t even get into the back of the truck to assess vital signs or start an IV; it was time to leave. I hopped into the driver’s seat as the male that had been flitting about alighted in the passenger seat. He wore regular clothes, but his eyebrows were carefully plucked and he had the remnants of fingernail polish still on, apparently from his last night out in drag. “Are you family to her?” I asked. It was not uncommon for complete strangers to jump into the ambulance as if they were kinfolk so they could get a ride into town.

“I’m her brother, Mister,” he said with a lisp so heavy that I thought it would have been more likely to assign him the relationship of sister, if you know what I mean.

“Okay,” I said as I pulled away. One block down the street, Lisa hollered from the back, “Sean, pull over!” Aw, crap.

I was glad I had the good sense to put a fresh pair of gloves on before I got out of the truck and came around to the back. The moment I opened the back doors to the ambulance, there was a massive explosion and a baby came skittering down the stretcher directly at me. I caught it, football-style, just before it shot out the back of the vehicle like some sort of James Bond weapon. Up until then, I had no idea that an umbilical cord is long enough to stretch from the gurney out the door. I now know that it is.

The baby was a healthy boy. I clamped and cut the cord, Gretchen assessed it while Lisa tended to the female. After a few minutes, we were ready to go again.

Back in the front, the brother was beginning to have a nellie fit over the goings-on in the back, with a similar intensity as if he had broken a high heel or he suddenly discovered that his purse didn’t match his miniskirt. “Oh, mister! What’s going on? Is she all right? Oh, my nerves is bad; I cain’t take this!” he exclaimed, fanning himself like Aunt Pittypat in Gone With the Wind.

I didn’t want him to have a full-blown conniption in the front of the ambulance as I drove. I reassured him that everything was all right. “Look, your sister’s fine and the baby’s fine. Just relax. It’s a boy. You can name him after me if you want,” I said jokingly, hoping to lighten him up a bit. Even though he was light in his loafers enough.

“Really mister? What’s your name?” he asked.

“I’m Sean.”

He turned to the little doorway to the back of the ambulance. “Shaniqua!” he screeched at his sister. “The paramedic say we can name the baby after him! His name be Sean; we can call the baby TaySean!”

“Ooh, I likes dat!” she answered back.

I sat in my seat unable to speak. I carefully reviewed the conversation in my head. “I’m Sean” were my exact words; I was sure of it. ‘TAY Sean? Where the HELL did that come from?’ I wondered, flabbergasted.

I flashed the queen next to me an inquisitive look, one that I hoped would convey the proper amount of ‘What the fuck?’ He just shrugged his shoulders and said “well, you know...”

At the hospital, Gretchen and Lisa brought the female and baby inside. I stayed and cleaned up the back of the truck. Amniotic fluid, blood and baby-birthing gunk had gotten everywhere from the mighty eruption resulting in the birth of little TaySean. As I wiped everything down and threw away half our equipment that had been soiled, I pictured TaySean growing up in the St. Bernard projects. He would ask his mother where he got his name. As she cashed her welfare check at the liquor store, she would explain about the circumstances of his birth, the trip down the stairs, the Richter scale reading on his delivery, and why his uncle is dressed like that. And she would mention me, Sean, the paramedic who offered his name. Later in life, I was sure I would have TaySean in my ambulance again, when he got shot from some drug deal gone bad or something.

There are some things you do in EMS that you’re proud of. There are some things you do you’re not proud of. The idea of my namesake growing up in the St. Bernard with his gigantic mother, welfare-money-hungry grandmother, drag queen uncle and my name made me cringe. Between pride and humiliation, where does TaySean fall in?

Infallible EMS Dispatch Gets Balloon Boy Call

2009-10-15T14:01:00.000-07:00

Emergency Computer Aided Dispatch system is put to the test...

Operator 1: “911, What is your emergency?”

Caller: “My 6 year-old son just drifted away in a helium balloon!”

Operator 1:“Can I have your phone number in case we get disconnected?”

Caller: “Yes, its 555-1234.” Oh, please, I don’t know what to do! It’s starting to drift away!”

Operator 1: “You say your son is floating away in a balloon?”

Caller: “Yes!”

Operator 1: “Hmm, I don’t see that in any of the emergency dispatch responses in the computer. Hold on a second.”
To Operator 2: “Hey, this lady says her kid's floating away in a balloon! Where is that in the computer?”

Operator 2: “Kid in a balloon? (scrolling through computer choices) I don’t see that either. Just go with “Generalized Weakness.”

Operator 1: “OK ma’am, I have it now. Is he conscious and breathing?”

Caller: “I guess so, he just climbed into the balloon. I can’t really see him right now. He’s a thousand feet overhead. Please send help!”

Operator 1: “I’ll send someone out. Is his breathing normal?”

Caller: “What? I don’t know! He’s breathing HELIUM!”

Operator 1: “Is he having any chest pain?”

Caller: “Are you kidding me? He’s in a freaking balloon!”

Operator 1: “I understand you’re anxious ma’am, but I need you to try and stay calm. I need you to answer my questions so we can get the proper response crews to you.”

Caller: (calming down) “OK, I’ll try. Please send someone; the balloon is drifting out of sight!”

Operator 1: “How old is he? Does he have any medical problems?”

Caller: “Six. And no, he’s perfectly healthy.”

Operator 1: “How long has he felt weak?”

Caller: “Weak? What are you talking about? Haven’t you been listening? He climbed into an experimental balloon I was building with my husband and it drifted away with him inside it?”

Operator 1: “Oh that’s right. Sorry, I’m trying to use the computer script for ‘Generalized Weakness.’"

Caller: “WHAT?”

Operator 1: “So the balloon drifted away with your 6 year-old husband and he’s feeling weak?”

Caller: “Oh my God!”

Operator 1: “OK ma’am, the ambulance is on its way. Do you want me to stay on the line till they arrive?”

Caller: “An ambulance? Why are you sending an ambulance? He’s in a freaking BALLOON! Thousands of feet in the air! What is an ambulance going to do?”

Operator 1: “Ma’am I need you to try to stay calm so I can send the proper response crews...”

Caller: “Oh sweet Jesus! Never mind, I’ll call CNN!” (Click)

Operator 1 to Operator 2: “What a bitch! Some people just don’t know how to speak to another human being.”

Operator 2: “So she canceled the call?”

Operator 1: “Yeah. Says she’s gonna call CNN. Freak. Like they’d be interested.”

Operator 2: “Hmph!”

(By the way, here is the ACTUAL 911 call: http://mp3.911dispatch.com.s3.amazonaws.com/fortcollins_balloon_911.mp3)

An Experiment in Sleep Deprivation

2009-10-15T13:31:00.000-07:00

I just got home from work a few minutes ago. Nothing remarkable, eh? Well, to tell the truth, I am currently hallucinating. I’ve been awake since 4am on Tuesday,; it’s 12:47am on Thursday. In a few minutes, that’ll be 45 hours straight with no sleep. I wantred to write this blog post under the influence of lack of sleep and the wierd things I keep seeing out of the corner of my eyes. I am not going to edit or correct what I write. I am just going to type and type like that dude what’s his name did. Oh yeah Jack Kerouac. He wrote “on the Road” on one hugely long continuous sheet of paper at one sitting, keeping himself wawke with drugs and God knows what. I loved that book.
Anyway, what’s ther eason for my 45 minute stint awake? It’s my own fault. I effed up my schedule and doub;e booked myself. Long story short, I worked a 12 hour EMS shift, then went to a 12 hour overnight nursing shift, then followed that up with another 14-hour EMS shift. I am exhausted. I was driiving home and caught myself wondering if I was driving in a dream or driving for real. When You;re this tired, everything takes on a distinct aura of unreality. You can talk and watch and eat and drink and work and read and whatever, but tghere is a odd sense that none of what you do matters, as if you are in a dream.I find it similar to lucid dreaming, that is, when you are aware that you are asleep and dreaming, but continue to dream anyway. With this wonderful knowledge, you are free to do whatever you want, because you know it is only a dream and will hold no consequences in real life when you wake up.
In a strange sens, being 45+ hours exhausted is something of the photographic negative of lucid dreaming. You get the impression that you are living in the real world, but still nothing matters. Same picture, but colored by different means.
\I hope I wasn’t a dick to my partner today. Jeremy is an excellent EMT, someone who I’d not mind being permanent partners with. I’d watch his back and I’m pretty sure he’d watch mine. I have no idea if I said or did anything to piss him off. When you’re lucid dreaming, or dreaming reality, it soedn’t realy matter. Whay tou do/,. I hope I dodn;t piss him off.

Oh by the way, I have a nw bottle of vordjka to help me on my way to the promised land of sleepy-byes.
I was hoping to type and type a la Jack Kerouac but I don’t have the same good drugs a s he had and i think I stopped making sense a coupel paragraphs ago. It’s so tempting to hit the backspace button! To be honest, I have hit it a few times, like maybe you wouldn’t know who Jack Kreouwac iswas. Waow I just glancesd at what I’m writng. It Super sucks!
Ok 45 hours is the limit. I’m so totally going to bed. allright- Laterz!

Glad I Could Help

2009-09-19T13:32:00.000-07:00

So just recently I was sitting at the coffee shop while on duty, enjoying one of the main food groups - caffeine. A man sat near me and we struck up a conversation about local news and my job as a paramedic. A few minutes into talking, he grew pensive, almost as if he was lost.

"Is is me that's just crazy, or has the whole world gone insane?" he asked.

I wondered what brought on such an abrupt shift in the conversation. I was unsure what he meant or how to answer him. As I pondered my next statement, the radio crackled to life to dispatch me to a call. "You're responding to a man with no legs who fell off his motorbike," the information came across clearly to me and the man I had been talking to.

The man repeated what he had heard over the radio, "A man with no legs riding a motorcycle?"

I confirmed it with dispatch. "Yes, that's correct," the dispatcher said.

I looked carefully into the man's eyes. "Does that answer your question?" I asked him.

"Yes, thank you. That makes me feel much better. It is the rest of the world."

"Glad I could help."

So Delightful to Meet You!

2009-09-12T13:07:00.000-07:00

9:30 am: I’m asleep in bed. I had gotten home from work at 4 am and was dead asleep from a long shift.

{Knock knock knock} on the door.
I’m sleeping in my underwear. As I get up to answer the door, I consider how embarrassing/fun it would have been to answer the door buck naked. My groggy head can’t be bothered with too many calculations, tired as I am, so I open the door in my boxer briefs. On my porch is a man, about 50, but looks closer to 65. He has scraggly, shoulder-length graying hair and a matching beard surrounding a mouth that houses gray, broken teeth. He is wearing a dirty t-shirt over his rotund torso and shorts that proudly display the cellulitis infection in his lower legs.

“Hi, I’m (whatthefuckever- I don’t remember). I’m moving into the house next door and I wanted to know if you mind me putting my boat in the public alley between our houses.

I briefly remember the “alley.” Back in the dinosaur days before the Interstate was built a few dozen yards from my house, there was an alley that divided the city block. Almost every block in Lakeview still has such an alley in use for people to park their cars in their rear driveways and the trash is picked up in the back alleys. However, the street layout on my block was rearranged when the interstate was built. My driveway runs right next to the land that is still technically designated a public alley, but the fence to my property effectively makes it my yard, and I’ve always thought of it that way.

“How long do you want to put it there?” I ask, expecting it to be parked there only as long as it takes him to move into the house.

“For as long as I need it,” he answers.

I envision his boat, currently on a trailer behind his pickup truck in the street, parked in my driveway forever. “Um, no, I’m sorry, I can’t let you park it there,” I respond in my just-woke-up voice.

He is prepared for just this situation. “Well, you know that that’s actually a public alley, so I CAN use it.”

I briefly consider his line of reasoning as best I can while my bed is calling me to come back to it. “I understand, but I really would rather you not park it there.”

“But it’s a public alley, so I can park it there.”

I have not the logic nor the will to continue too much farther in this circle, so I change tacks. “Well, then why did you bother asking me about it?”

“Out of courtesy,” he responds.

I courteously answer “Still, I’d really rather not have you park it there.”

“I am going to park it there.”

I shut the door. I climb back into bed. I’ll figure something out later. I really can’t be bothered right now.

10:00 am. I’m just about fully back to sleep.

{Knock knock knock}
Back out of bed, back to the door in my boxer briefs. “Now what?” I wonder, hoping it’s just the postman or Mormons.

“Hi, I’m Mrs (whatthefuckever). You were just talking to my husband about parking our boat in the public alley [she makes sure to refer to it as the “public alley” rather than “your yard”] and I think we may have gotten off on the wrong foot. That was his mother’s house; we renovated it and we’re moving in.

“Oh, you mean Mrs. Newman?” I ask.

“Yes!” she says, her smile revealing her own set of urine-colored teeth that match her urine-colored hair. She glances at me up and down, no doubt appreciating in the panorama of virility that is me, standing on the porch in my underwear. I return the favor and take in the view of her white shorts that reveal varicose-veined legs and the “Señor Frogs” tie-dyed t-shirt covering up her wizened, leathery 96-pound torso.

“That boat is my one source of serenity in this world. And Lord knows I don’t get to be serene very often. We certainly don’t use it as much as I’d like to...” she goes off on a tangent.

“I heard,” I answer. “I understand that the alley is technically public land, but it’s pretty much part of my yard, and I’d really rather not have you park it there.”

“Well, I understand, but it IS a PUBLIC alley and I don’t want something bad to happen to the boat or have it stolen,” she says.

“What difference will that make?”I try to reason. “How do you know it won’t get stolen or whatever from right there?”

“Well, there’s that phone pole right there.”

I consider the security functions inherent in a phone pole. I see few.

“Look, isn’t there some sort of compromise we can come to?” she offers.

My brain, in a fit of logic, comes up with a possible solution. “Yes, I think so,” I respond brightly. “There’s an empty lot right behind my house. The house that used to be there was torn down, so now it’s just an empty lot with an old slab and a perfectly good driveway. Why don’t you just put your boat in the driveway on the empty lot?” I point out the empty lot, its own driveway butted against the continuing “alley.”

She is unimpressed with my suggestion. “No, I don’t really want to do that. I don’t know who owns that property.”

I almost yelled “But you DO know that I own THIS property, and you don’t have a problem taking up MY yard.” But I didn’t. The husband was watching our exchange from his yard, muttering psychotically to himself. I had no doubt that I was already making myself look like an idiot simply talking to Mrs. Whatthefuckever, who looked like she had spent too many summers turning tricks at the beach while I stood on my front porch in my undies. A shouting match under the circumstances wouldn’t be... seemly.

Instead I calmly repeated my statement, “I’d really rather you not park your boat in my yard.”

She took up the circular argument that her husband had. “But it’s a public alley, so we CAN park it there.”

I chose not to continue a fruitless line of reasoning. “It seems that no matter what I say, you’re going to do what you want. So why did you bother asking me about parking it there?” I inquired for the second time this morning.

“I asked you out of courtesy. So we don’t get off on the wrong foot,” she repeated.

“Courtesy implies that my thoughts would be taken into consideration, but you haven’t done that. You seem prepared to do whatever you want to do regardless of what I say, so I don’t really see the courtesy in that,” I explain quite honestly.

“Well, we are going to park it there. I just didn’t want to get off on the wrong foot...”

“I see. Okay,” I sigh as I go back into my house and close the door.

Ah, having white trash neighbors is going to be so interesting! I'll have so much to write about! Let the games begin!

Stir Crazy

2009-04-29T10:34:00.000-07:00

This is NOT a chapter of my ongoing story "Found Wanting". Merely an intermission. This is from a dream I had recently. I laughed myself awake during the little girl's rant, so I'm not sure of the ending. Enjoy.

Stir Crazy

Manny and Marilyn noticed the kids were getting restless. It had been four days since they arrived. The boat that Manny’s boss had offered him to use for their summer vacation hadn’t left the dock. Marilyn had enjoyed going for dinner and cocktails at the yacht club, but cocktail parties wore thin rather quickly on the 11 and 7 year-old.

That morning Manny cranked up the motor and rigged the sails when the boat had cleared the harbor. They cruised up the shore, rhythmically bumping along as the waves rolled against the hull. Marilyn sat on the foredeck catching some sun while Manny took the rudder.

After a few hours, Manny set the autonav and went below to check on the kids. Ricky, the 7 year-old was busying himself with a puzzle. Stacy, the 11 year-old, looked sullen as she worked on a coloring book, having abandoned her dolls and jewelry-making kit earlier that morning. “What’s wrong, kids? It’s a beautiful day and you're sitting in here moping like it’s the end of the world!”

“We’re bored, Dad! There’s nothing to do! We’ve been here for four days,” Stacy complained. Ricky looked up briefly from his puzzle, saying nothing, childlike disgust clear on his young face.

“But we’re moving now,” Manny offered hopefully.

Stacy held her hand to her ear and spoke into an imaginary phone. “Hi Stephanie! You’re on vacation too? All your friends are there? Really? An amusement park? Rides? Shows? Parties at night? Wow. Me? Oh, we’re moving. No, not that kind of moving. We’re just moving. In a boat. Nope, nowhere in particular... just... moving around.”

“Stacy...” Manny tried to interject.

“I can’t wait to give my report next semester on what I did for my summer vacation. ‘Well, Mrs. Kirschenblatt, I moved. I didn’t move anywhere in particular, just moved from point A to point B in a boat. Of course there wasn’t really any point B, since we just went back to the same dock. So basically I just took a cruise in a big washing machine.’”

Manny looked dejected. He went back to the deck and took the rudder again. Marilyn passed him on her way to refill her drink. “What’s wrong?” she asked.

Manny looked up at her morosely. “I’m bored.”

Cluster Fuck

2008-12-29T18:17:00.000-08:00

Cluster Fuck

Vietnamese really kill me (not literally). I respect them because they rarely call 911. When they do, the patient is usually pretty sick and the ambulance is needed. However, like so many immigrants, we Americans are the ones who are expected to figure out how to communicate with them. I’ve learned no fewer than four languages, partly specifically so I could communicate in foreign countries. Such consideration is apparently not the norm when you are planning to move permanently to another country that does not speak your language. I learned Spanish quite involuntarily, picking it up from my patients and a couple trips to Cancun, since most Hispanic immigrants have absolutely no desire to pick up even the most basic of English phrases but insist on calling 911 on a regular basis.

But I digress. The Vietnamese. To wit: I was called once to a motor vehicle accident. One of the vehicles was a van with nine Vietnamese occupants. Fun. Of the nine, exactly one person had bothered to learn the slightest bit of pidgin English. He served as my translator for the scene, which meant that not only would I have to assess his injuries, medical history, name, address and so on, but he would have to be the intermediary for eight others for the same tedious questions. As I inquired about the rest of the van’s occupants, he would inform me of who they were. “That is my cousin,” or “that is my sister,” he would say.

“What is your sister’s name?” I would ask, scribbling on my life-saving clipboard.

“Um, I don’t know.”

“You don’t know? She is your SISTER, right?”

“Yes, I don’t know.”

“OK, how about that person?”

“That is my mother.”

“What is her name?”

“I don’t know.”

Dumbfounded, I wondered how the Vietnamese got along. How does one exist in a society where supposedly intimately acquainted relatives do not know the others’ names? Since I speak no Vietnamese, I can only speculate at their naming conventions. Noting that most Vietnamese are named Nguyen, I surmise that Nguyen is roughly translated “Hey you - person who I am somehow related to.” Another common Vietnamese name is Vu. Vu may mean “person living in house with others.” It is marvelously efficient to be able to distill these cumbersome English phrases into a single Vietnamese syllable, but for intangible reasons, it still seems preferable to have an actual name.

One day I was called to another MVA. It was another van. This time the van had tried to occupy the same space at the same time as the small tree was busy with the space. From the outside, very little damage was apparent, only the front end was messed up. A new radiator, a new bumper and the thing would be good as new. I approached the van while regarding the dozen or so silhouettes inside. I grumbled that this would be a time-consuming call, with lots of paperwork, as we would have a dozen patient refusals to write even in the best-case scenario. The driver, who was walking around on scene and had no complaint had already made it clear that he would not be taking responsibility for his passengers. I wondered who his passengers were, that he would be in their decision-making loop. I soon found out.

As I slid open the side door of the van, I was greeted by shrieks and howls of panic. Fourteen sets of dull, teary eyes stared back at me. Behind those eyes were swollen faces attached to oxen bodies. Few of the bodies made sounds which could be interpreted as actual communication. The van that had hit the tree was none other than the Short Bus. For adults. I had on my hands fourteen panicky, extremely strong, very large, very mentally disabled Down’s Syndrome patients. My worst nightmare come true.

For the most part, Down’s Syndrome patients are very sweet, happy, inoffensive people. Until you do something they don’t like. Like craashing their van into a tree. Or putting a cervical collar on them. Or strapping them to a backboard. If you have ever gone eight seconds on the back of a bull at a prison rodeo, I call you a pansy. Try riding one of these broncos. Or more specifically, getting them to ride with you.

As part of the first crew on scene, it was my job to triage all fourteen of them. None were obviously injured, and none were capable of informing me of any symptoms, what with all the bellowing and screaming and crying. All would have to be immobilized with cervical collars and spineboards and transported to hospitals. I called for extra units. Every clear ambulance in the city as well as several private-service units came to pick up their designated patients. As each crew appeared on scene and witnessed me trying to herd the c-collared behemoths, who were literally running around in circles, arms flailing in the air or ripping off the cervical collars I had placed, the medics stared at me as wide-eyed as my panicky patients. I wondered what they were startled with, they only had to deal with two patients each, I had fourteen! Slowly, we began to get each extra chromosome placed on the spineboards. It is significant to note that after dealing with our group of patients, who had no injuries, one of our EMT’s and two EMT’s from the responding private services had to go home with injuries sustained from caring for our little herd.

And to think I was complaining about the possibility of having to write a dozen refusals!

Another MVA involved a school bus. Forty-three third-graders were on a bus that got a ding in the back from a car inching forward in rush-hour traffic. There was NO damage to the bus, and only mild damage to the car. The car’s driver was perfectly fine and didn’t want EMS. There wasn’t a blessed thing wrong with any of the children on the bus. Naturally, the school bus driver nor the principal (who had miraculously bothered to show up) weren’t about to take the responsibility the children’s parents had entrusted them with. Neither would sign for the kids to not be transported by EMS. It was clear to a blind chimpanzee that there wasn’t a thing wrong with any of the kids, so instead of actually demonstrating that they had earned the position of responsibility that they held, both the principal and the driver thought it would be a better idea to deny an entire city of 350,000 people access to emergency medical services, because to transport all forty-three kids it would have taken every single one of our 911 ambulances, plus the vast majority of the private-service ambulances in the city.

I was not about to let these clowns do that to my city, nor make fools of our service. I said “Fine, if you want a paramedic to transport all these kids, this is what we’re gonna do. Driver, you’re going to drive this bus to Charity Hospital. My partner is going to stay on the bus so there will be a paramedic with all these children.” I hopped out of the bus, followed it in my ambulance to Charity, and informed the doctors and nurses what was going on.

In the process of triaging all forty-three, the New Orleans Public School system education quality became apparent even more. None of the children had names like Kevin or Sandra or Brian. Instead, these kids who were already at a spelling disadvantage because of their educational institution, were further burdened with ridiculous names by their parents, who were also alumni of New Orleans “education” system. There were names like LaKym’ia, Tr’jyn, K’eshi’qUitia’kaY’e’’’’ and some that were probably spelled ‘A’p’o’s’t’r’o’p’h’e’. I wondered when people were going to start incorporating numerals, ampersands, carats, asterisks and parentheses in names. These kids were all doomed to a life of drug dealing, medicaid and litters of welfare babies because their ignorant parents had given them stupid names and their school officials didn’t have the education or smarts that a blind chimpanzee has.

One morning, on my day off, my wife and I were dozing in bed, half asleep. Our house was near the Interstate and it was common for us to hear sirens and traffic, so we had grown pretty inured to the noise. But this particular morning, sirens persistently drove by for a good half-hour or so. We began to wonder what was going on. I decided to turn on my work radio to eavesdrop on the goings-on in the world of EMS. As I went to my radio, the phone rang, which my wife answered. I turned on the radio and heard one of our medics calling our administrator: “...at least fourteen dead, a couple dozen more with critical injuries...”

Holy shit! What the hell had happened? By the proximity of the sirens, I surmised that whatever it was must be pretty nearby. My wife hung up the phone. My sister, who was an emergency room nurse at the time had gotten a call from her then-boyfriend, who was one of our paramedics. He was on duty and was the first ambulance on the scene of a bus that had veered off the Interstate and crashed about a mile from my house! My sister had called to let us know she was going to the scene to assist and would we let our mother know she would be late preparing for the Mother’s Day crawfish boil we had planned for that day.

My wife and I stared at each other, wondering what the scene must be like. “Do you want to go?” she asked me. I said no, but she could tell I wasn’t really sincere. “You need to go there,” she said. I did want to go, not because I’m a trauma junky (I’m not, I got over that long ago), but because our EMS service was clearly overwhelmed and needed more hands for this event. Besides, we are expected to be prepared to respond for disasters, which this certainly was. I told her to get dressed and come with me.

We jumped into the car and headed to the interstate. A police car blocked the entrance. I informed the officer that I was off-duty EMS going to help with the scene. He asked me to prove it by showing him my city-issued radio. I did and he let us through. My wife asked what she was expected to do. I told her “anything.”

Upon arriving at the scene, I saw what had been the tour bus that had crashed. A full one third of its length was gone, crushed into a mangled mess at the front end. My administrator and several ambulance crews as well as an off-duty ER physician were tending to patients on the side of the road. My wife and I went to the patients and began helping get them on spineboards, splint fractures, start IV’s and apply oxygen. One woman who we cared for had, quite literally, every bone in her body broken, from the Laforte III facial fracture to the bilateral femur, tib-fib and ankle fractures, but was still awake and talking to us. My wife was not an EMT, but was able to assist greatly anyway. She had gotten first-hand education from the countless EMS stories I and my co-workers had related. We had run out of cardboard splints for fractures, and she began to fashion splints from various debris found lying on the ground. The physician and I were impressed by her ingenuity.

After the majority of the injured had been transported to hospitals, I climbed up into the wreckage to search for trapped survivors. The bus had veered off the road at a place where the interstate went over a concrete drainage canal. It flew over the canal and hit the far concrete wall, then bounced back up onto the side of the road. It collided so hard that most of the passengers had been thrown to the front, but even the ones still in the rear of the bus were dead from the violence of the impact.

The majority of the dead were in the smashed front of the bus. There was a pile of bodies that had spilled out of where the front had been. The passengers were mostly elderly folks who had chartered the bus from their nursing home in Lafayette to go to the casinos on the Gulf Coast. I stared at the pile of bodies and body parts. There was one woman’s dead face looking towards me; her face didn’t look quite right. I touched her head and it was squishy in exactly the way that one’s head shouldn’t be. I lifted up her head only to find that all that was attached to her body was a face and scalp. The skull that should have formed the framework for the flesh was gone, ripped out from its place atop the skeleton, leaving behind a grotesque mask where a proper head should have been.

Nearby I saw a wig - a blue-hair wig that might be expected in a bus of nursing home residents. Beneath the wig a bit of flesh peeked out. I assumed it was a brain, perhaps the brain of the skull-less woman. I moved the wig and gasped when I saw that the flesh was part of a severed arm lying on the ground. I placed the wig back on top of the arm, not knowing what else to do with it. I poked up into the wreckage above me. I noticed a woman’s face in the twisted metal above. I could barely reach her and could see less. I asked for an EKG monitor in case she still had a pulse; she was in such a spot that previous searchers might have easily missed her. As I tried to attach the EKG leads I managed to maneuver myself into a position to get a better view. What I thought was a seat cushion behind her head was in fact her own buttocks against the back of her head. I switched off the monitor. I had seen enough and climbed out of the wrecked bus.

Later that day, we had our crawfish boil as planned. After he got off duty, Frank, my sister’s boyfriend at the time, joined us. We talked about the crash, but tried not to dwell on it. The total was twenty-three dead on scene and twenty-four were transported to hospitals, with several of those transported dying later. We brought the extra crawfish to our headquarters for the other EMT’s to enjoy. Months later, the city awarded all who responded to the scene with a special commendation. The news interviewed me and my sister. I still think about it. It was probably the most trauma I’ve ever seen in one place.

I sometimes think of these experiences, most of the time I don’t. Regardless of whether I think about them or not, I believe I have learned the hard way the definition of “Cluster Fuck.” Pass the lube, please.

A Boxing Day Carol

2008-12-25T12:04:00.001-08:00

Once upon a time, long ago, there was a man named Jesus. Jesus got into a fight with another man named Santa. A great battle ensued. Santa won the battle, which ended with Jesus being knocked through a virgin vagina as a baby. The details of this phenomenon are complicated, so don’t ask.

When Jesus grew up, he challenged Santa to a rematch. Every year since then, the ongoing rivalry has resulted in a Death Match Ultimate Cage Fight. Wagers were staked on either Jesus or Santa. Wagers can take the form of cash or prizes. Today these wagers are called Christmas Gifts, since we now live in a more enlightened society. We’re not sure who has the advantage; Jesus lives in our hearts but Santa watches us all year. Somehow this surveillance has a bearing on the outcome of the fight, perhaps by gauging support for which contestant is our favorite.

In the uncertainty of the fight’s outcome and the inherent dangers of such a bout between two powerful pugilists each year, Christmas trees were invented. These brightly decorated trees are placed near windows and doors as a hedge to protect us in case one of the Death Match fighters gets knocked out of the arena into our houses.

Santa needs milk and cookies to refresh himself between rounds. These are placed near the stockings that are hung by the chimney with care. The stockings are used as makeshift boxing gloves in case Santa’s and Jesus’ wear out. Since the Christmas trees, garlands and wreaths block other entry points to houses, Santa must use the chimney to enter. Jesus has easier access; he can just return home to our hearts and exit through any of our body orifices into our houses. Jesus eats the Christmas dinner leftovers to refresh himself. Christmas dinners are deliberately made to have an excess of food specifically for this purpose.

Since more people seem to favor Santa over Jesus, experts are predicting him as this year’s winner. Results of the fight are posted on December 26th. And this, friends, is the reason December 26th is called Boxing Day. Merry Christmas!

Response to Readers

2008-11-08T01:20:00.000-08:00

A reader asked me some questions which I said I’d be happy to address. To wit:

Do you believe that collective consciousness is a force powerful enough to effect real change as we have seen in the phenomenal efforts of the american voters this election?
Or do you believe that the average "joe the plumber" or "nancy the nurse" will retreat back into their own world or personal consciousness, embracing and protecting their individual cultures while ignoring inequalities, gender discrimination, and ecological destruction?
And finally do you believe that we, as a people, have evolved sufficiently to awaken our capacity for collective knowing and conscious action?

“Collective consciousness” is an interesting concept, particularly when applied to an activity such as electing a president. My impression of a collective consciousness entails everyone in a particular group being on the same page; having the same idea about a particular subject; sympatico. This can be as simple as a family unit knowing exactly what is being referred to when the crazy cousin is mentioned or as broad as a nation experiencing a moment of homogeneity, for example, everyone understanding a pop culture reference like the expression “voted off the island.”

But do I believe that it is a force powerful enough to effect real change? Obviously there is a form of collective rallying that brings about change. Examples of this are the American Revolution, women’s suffrage and the civil rights movement. However I wouldn’t classify the source of these phenomena under the same category as “collective consciousness.” To me, the collective consciousness is the “awake version” of the collective unconscious, as described by Carl Jung. It is my opinion that such a consciousness is completely passive, in other words, knowledge about a thing that is shared by a homogenous social group, be it a family, a classroom, friends at a local pub, a town or a nation. The changes to which this reader refers and the instances I mentioned above take a far more active participation. The result of the recent presidential election was not really a function of the collective consciousness, although obviously a certain degree of being “on the same page” was involved. Certainly the majority of the nation was sympathetic to Barak Obama, but his actual election was carried out because of millions of actions by individuals, not because a lot of people were simply aware of Obama and his ideas. Non-Obama voters were aware of Obama and his ideas, but this didn’t help get him elected.

As an analogy, let's look at a mountain. Over time the mountain is eroded, worn down. Why? Not exactly because of “the rain” that falls or “the beach” at its base that scours. Just because weather and the forces of nature exist does not necessarily mean that they will affect the mountain. But each individual raindrop makes a tiny but indelible mark on the mountainside. Each individual grain of sand scours its own tiny groove in the mountain. Every glob of ice that freezes in the mountain’s cracks makes those cracks a tiny bit wider. If the rain or sand or ice are not in proximity to the mountain, they do nothing. Eventually, after enough actions of the tiny drops and sand and ice, the mountain is eroded down to nothing. Similarly, it was not the collective awareness of Barak Obama that got him elected just as the mere existence of weather will not erode the mountain, but the collective actions of millions of individuals that did so, much as the millions of raindrops and sand grains that, individually and collectively, accomplish their task. As I said before, this is a much more active participation than simple collective consciousness. Barack Obama (and John McCain and all the other candidates) had to not only exist, but inspire their constituents. This took work. Once inspired, the voters could not just sit home and cheer, but actually had to take action. This same process had to take place with the other examples listed above - the American Revolution, suffrage, civil rights, etc. In another analogy, a smoker may be conscious that his habit is harmful, but that knowledge is useless unless action is taken. Consciousness is necessary for any overhaul, whether involving an individual or group, yes, but collective action is a far more important step in implementing changes in a society.

Now I think the real question this reader wants to know is ‘do I think this “force for change” will continue?’ This is hinted at in the next questions asked. Will “Joe the plumber” and “Nancy the nurse” retreat back in their own little world and ignore the problems with society? Well, there have always been segments of society who are xenophobic, agoraphobic and any other phobia you can describe that involves anything new and different. The individuals making up these societal groups may vary, but the phobics will always be there. An even bigger question is: Will the people that rallied and supported and elected Obama continue their momentum and remain active participants in the process of “change,” or will they sit back and say “I’ve done my job; I voted; now let Obama do all the rest of the work”?

That seems to be a far more challenging question to answer. The American public has been motivated before to effect real change, such as in the other examples I’ve given. The American revolutionaries didn’t just get motivated for one day, it took years of action, work, suffering, meetings, fighting, and killing to accomplish their goals. Passion was not enough, action was what was needed. The same goes for women’s suffrage, civil rights and many other transformations in society. The real issue is whether or not Americans are willing to do their individual part in taking actual action in making things happen. Are we willing to make our voices heard, to speak to our neighbor, to make sacrifices for change?

But wait! What changes are we talking about? That’s another big question, isn’t it? Specifically, what is it we want changed? We’ve heard that word over and over and over. Change change change. Any reasonable person would want to know exactly what it is they are expected to sacrifice and work for. In our examples, the goals were very tangible: independence from an oppressive government, the right to vote, equal treatment regardless of race. In the current topic, I look forward to seeing what our new president plans on doing. But specifically what changes are we expected to strive toward? “Tax reform” seems a rather vague goal for everyday Americans to sacrifice for. “Universal health care” sounds nice, but what precisely am I expected to do about it? “Global warming” sounds like a good, solid cause to rally around, but there is no reason to expect that the country buying Toyota Priuses is going to restore the polar ice caps. The broad term “change” is entirely too nebulous for me to work toward. I’d be happy to do something, but what? At least in the American Revolution our forefathers were able to pick up a musket or sword and aim it at something tangible. Right now, not so much.

Lastly, I believe I’ve already answered this readers third question, namely if we have sufficiently evolved to awaken our collective knowing and capacity for conscious action. “Collective knowing” is just that. It requires no action beyond just being awake and somewhat aware of society around you. Collective action has been a part of human history since the dawn of civilization. In fact civilization would not exist were it not for some form of collective action, even if it is as simple as being part of a village in the most primitive hunter-gatherer society. The questions facing our society today are “Where and how should we direct our collective action? And are we willing to?’

Top 10 Good Thing Regardless of Who Wins

2008-11-03T02:03:00.000-08:00

I totally know my "also-ran" Presidential candidate is not going to win. Hence I've compiled a list of the "Top Ten" good things that will happen depending on the certain outcome of the election, no matter which candidate wins. Enjoy.

Top ten good things if McCain & Palin win:

10. Tina Fey has four years of steady work at SNL.
9. Free elk & moose hunting licenses for all.
8. Democrats sulk for four more years.
7. We get to petition the government for a bailout whenever we’re overdrawn (precedent, right?)
6. We explore the U.S. like Lewis and Clark because other countries want to kill Americans.
5. Satellite photos of Russians looking across the Bering Strait saying “I can’t see her house. What is she talking about?”
4. Revolving door at Mexican border furnished with plush carpeting and string orchestra.
3. George W. Bush captured by Iraquis and exiled to Isle of Elba, Napoleon-style.
2. Great Britain declares independence from United States.
1. David Letterman and Jay Leno have awesome monologs while Sarah Palin in office.

Top 10 good things if Obama & Biden win:

10. The look on welfare recipients faces who voted for Obama when they are now expected to get jobs.
9. The look on Obama’s face when welfare recipients refuse to get jobs.
8. Canada welcomes rich folks seeking tax refuge with open arms.
7. Other countries not quite so dangerous to visit.
6. Christians get first-hand experience dealing with those mysterious Muslims.
5. Huge reduction in military spending because the U.S. can’t afford it anymore, what with all the Socialist...er...”domestic” spending.
4. Everyone who shops at The Gap can look like the first lady. (4a. Fifth Avenue elite stores go out of business and the neighborhood becomes far more interesting.)
3. Revolving door at Mexican border replaced with one-way door into US, but no plush carpet or orchestra. Driver’s licenses handed out upon entry.
2. Universal healthcare clinics staffed by Obama voters. Affordable Chinese herbal medicines, rhinoceros tusks and chakri stones are the standard of care.
1. Russia, Cuba & China are our new best friends forever. Long live Obamunism!

Throwing Your Vote Away

2008-10-19T22:16:00.000-07:00

So lately I’ve made it known that I am planning to vote for an “also-ran” in the presidential election. I do this for several reasons. First, I firmly believe that you cannot complain about something you’re willing to do nothing about. A corollary of this principle is that those who live in a democratic society and do not vote have no right to complain about what the government does. For decades I never voted, and sat silently in my un-political corner, adhering to this principle. Now I have grown weary of silence, and I plan on doing plenty of complaining. Hence I will vote so as to support my habit.

Second, the particular candidate who I plan on voting for is someone who I believe has a firm grasp on many changes that would be a strong positive influence on America as a nation and as a society. He has had many years serving in the federal government and has plenty of experience with foreign policy. I have read his writings and find that the vast majority of his ideas not only make sense, but are entirely workable.

There are other reasons as well, but the main point of this particular diatribe is in response to friends and acquaintances who have confronted me with their challenge about why I am “throwing my vote away” on an “also-ran” candidate with no shot of winning the election. My response is this: The candidate I have in mind has the right idea to make the changes needed to at least boost, if not fix the economy. His views on foreign policy are exactly what the country needs to limit its vast expenditures overseas while simultaneously reforming the rest of the world's general despise of the USA. His ideas on tax reform are quite fair and workable. I do not believe he is some sort of messiah; no president could ever be. In fact, I strongly believe that being president precludes any sort of messianic aspirations one may have.

Neither front-runner candidate (McCain or Obama) has any sort of plan that is any more than a reshuffling of the deck chairs on this particular Titanic country. My friends have encouraged me to not “throw away” my vote. Some have pleaded with me to vote for Obama so that McCain doesn’t get into the White House. Others have begged that I vote for McCain so Obama doesn’t acquire the Presidency. Both camps have asked me to vote for the lesser of two evils.

Who is really the one throwing their vote away? The one who votes for the guy who might actually do something positive for our nation? Or the one who votes for the lesser of two evils? Imagine what a great nation we could have been if voters actually elected the right man for the job, rather than the one with the “best” political endorsements. I am the one asking you: please don’t throw your vote away.

New Mayor Ray Nagin Pinata!

2008-09-14T21:06:00.000-07:00

There is a new Halloween treat out this year! Chocolate City Industries would like to announce the availability of the new Mayor Ray Nagin Piñata! The papier maché figure is a fun treat that all can enjoy, both children and voters alike! The enormous head is suspended above all the mere mortals in an appropriate position from which to supervise and “monitor” the piñata party. Imagine the fun to be had by all as they beat Nagin about the face and head with long sticks!

But the fun doesn't end there. Just like it's namesake, it doesn't take much for the Mayor Ray Nagin Piñata to release its treats that party-goers and media personalities can chew on for a long, long time! To cut down on weight, the head is mostly empty, but the mouth part of the piñata is filled with goodness. Yes, after the fun of whacking Nagin's head for a while, the mouth opens and spills out a seemingly endless torrent of sweets with virtually no nutritional value!

From the Mayor Ray Nagin Piñata, there comes a delightful assortment of treats. You'll find no shortage of chocolate bars – Chunky's, Nestle's, Milky Ways and Hershey's (with and without nuts). As a unique feature, the piñata will also gush forth with fortune cookies, all featuring a classic Nagin gem as a fortune. “New York can't fix a hole in the ground,” “By the end of the day, this will be a Chocolate City,” “Everything is the media's fault,” and the latest Naginism, “Just ask for the Ray Nagin special” are among the fortunes you'll find. Trade with your friends and collect them all!

With the new Mayor Ray Nagin Piñata, you'll find that piñatas aren't just for kids anymore! Everyone's fantasies are indulged with the ability to physically beat Nagin as well as a Category 5 tempest of delicious sayings right from his mouth! Also available soon from Chocolate City Industries is the Mayor Ray Nagin Piñata Mark II, which features the Mayor's foot already inserted in the mouth. In addition, soon you can look for the Stealth Piñata – an image of the mayor's spokeswoman, Ceeon Quiett. The Stealth Piñata makes a great gag gift to give to anyone who appreciates an ironic sense of humor. You can poke her, beat her and otherwise coerce her, but she'll never let anything fall from her mouth (for advanced piñata users only).

If you're one of the first 500 to order, we'll throw in a piñata stick with which to beat the Mayor Ray Nagin Piñata. This is no ordinary stick; it's guaranteed to make the Nagin-beating experience 100% more enjoyable! How, you ask? It's tipped with a replica of the “Courage and Leadership in Recovery” award! But wait, that's not all! If you order now, we'll include free of charge a sheaf of apology letters from various city government and business associations addressed to anyone who might be injured or offended by Nagin's droppings. Get one today!

Nola.com Needs to Remove the "Comments" Section

2008-08-26T08:57:00.001-07:00

I've created a file I intend to post on the next Times-Picayune article on someone killed in New Orleans. Every crime article devolves into commentaries on race, public corruption and bleeding hearts in the comments section. I doubt my creation with thwart the tide of idiotic editorials, but hey, it's a start.

Article
Some person was killed in the nth hundred block of [Random Street] in some ghetto neighborhood. NOPD has no motive or suspect. Call Crimestoppers (yeah, right).

Comments
Posted by (Happy_Glad)
I'm just glad that there's one less thug to worry about on the streets. We can all be happy that the city's a little bit safer now. Let the thugs take each other out!

Posted by (White_Racist)
All these black people are ruining the Chocolate City. All black people are criminals and should be exported to the ocean!

Posted by (Black_Racist)
You're an idiot White_Racist. All crimes are committed by white folks. It's just that blacks are the only ones ever arrested.

Posted by (White_Racist)
No, you're the idiot.

Posted by (Black_Racist)
No, you are.

Posted by (White_Racist)
No you are.

Posted by (HolyMaryMotherofGod)
I just pray for the poor victims and their families! Oh, how forlorn the mother must feel! I pray for all victims of crimes because they must all be perfectly innocent!

Posted by (Pundidiot)
Well, I think all the crime in this city is because of [Public Official]'s greed and corruption! It's obvious that he/she is stupid and should be removed from earth! And It's all NOPD's fault too, because they should be able to stop people from even thinking about criminal acts! Get rid of all city officials!

Posted by (SaveTheChildren)
Were any children hurt in this shooting/stabbing/whatever? I hope not. Oh please let our poor fragile soap-bubble kids be okay...(boo hoo blubber blubber)!

Posted by (HurricaneHunter)
How can you people worry about murders and crime when there's a tropical storm in the gulf? We all know that all social ills are Katrina's fault anyway!

...And so on for about 100 posts. Thank you.

Crescent City Afternoon

2008-08-16T15:46:00.000-07:00

(One of my old articles from a few years ago I found on one of my travel web sites I write for.)

Crescent City Afternoon

New Orleans, Louisiana

I walked out from Canal Place into the French Quarter to do some research on art galleries for an assignment. It was a typical New Orleans afternoon - sultry and breezeless, but not nearly as hot as it could have been. Most of the tourists would be gasping at the heat of the afternoon, but three-plus decades in this city had inured me to the heat and I thought that eighty-eight degrees Fahrenheit was quite nice. I pressed on into the streets, pleased that I had chosen such a tolerable day for my little outing.

It just so happened to be the day after Southern Decadence, the big gay and lesbian festival that draws a retinue from all over the continent. Gay guys were all over the Quarter, wandering in their little groups in and out of antiques shops and souvenir stores, occasionally eyeing me up and down. I didn't care. You can't live in town like New Orleans and be offended every time some fellow looks at you funny. Especially since it was me entering their turf down here. I let them walk by.

I passed restaurants whose smells made me want to stop in and eat, even though I had just had lunch. I listened to tourists trying to pronounce words like pray-leens, cray-fish and New Orleenz. I laughed for a second, and then caught myself as I recalled having to ask people in Ireland to repeat themselves five times because I couldn't understand their dialect of my own language. I felt a little bad about my intolerance of outsiders' ignorance or our very unique culture and dialect. Even I sometimes had a hard time with Cajun names for our own local food!

As I ambled through the streets I occasionally paused to watch some street performer juggling or playing music. They varied in skill from one to another. I noticed that the possession of talent didn't necessarily mean that you could draw a crowd. Many of the performers who had the most money in their coffers were the ones who did the crowd-pleasers. Musicians who hacked out "New Orleans" jazz and beloved pop tunes always had more money than those who lovingly and painstakingly played original compositions, no matter how well performed or composed. The fire-jugglers made more cash than the jugglers who juggled simple balls, regardless of how many times the fire-throwers dropped their sticks or how ineptly they recited their plagiarized comedy lines. You could tell the experienced ones; forsaking art for whatever got bills and coins lobbed into their boxes and instrument cases at their feet. I guessed the phenomenon of being a "sellout" wasn't limited to bands with big names and influential record labels.

Up Royal Street I went, searching for the shops I was supposed to write about. I found the first one. Closed. Annoyed, I peered past my reflection in the glass to get a feel for the store in case I didn't get a chance to come back when it was open. Distant thunder pealed, alerting everyone to the oncoming routine afternoon rainstorm. I took a few quick notes and moved on up the street, appreciative of the breeze that the nearby storm was kicking up.

I got to my next shop. It, too, was closed. I was determined not to get too aggravated by my failure to find open shops and galleries, yet I couldn't help but argue with the shopkeepers in my mind. 'Don't you know my pieces are like free advertising? Besides, you're missing out on all kinds of art and antique sales with all these gay guys in town!' I recalled a business report on the positive impact of Decadence on the local economy and wondered why everyone wasn't taking advantage of it. Then I paused and looked around me at the old buildings and streets, largely unchanged since the Spanish and French settlement. I felt almost ashamed that I had succumbed to the pervasive Yankee spirit that seems determined to erode away New Orleans' traditional laissez-faire attitude towards everything.

I had always been appreciative of the laid-back ennui so prevalent in Catholic countries I had visited like Mexico, Ireland and Italy. New Orleans, being primarily a Spanish colony, reflects that same feeling and hence embraces any time off from doing work. If you need evidence of this, just take a look around anytime there's a tropical storm anywhere close to the Gulf of Mexico. People don't track storms here to calculate how much time they'll have to prepare for the worst, but rather to see if a hurricane is close enough to furnish a legitimate enough excuse to take off from work. Today was a perfect example of this: if you're supposed to be closed on a Monday, then dammit, you're going to be closed, no matter how many rich gays are in town with cash burning holes in their tight pants. It is in contrast to the frenetic work ethic that brought us Germans, New England and corporate America. I grew even more appreciative of my town for gently reminding me that a Monday afternoon could be spent on a slow roam around the Vieux Carre, drinking in the ambiance that I supposedly am steeped in.

The rain eventually made its way down to my vicinity. You can always tell the locals from the tourists when it rains. The tourists took refuge in doorways and under overhangs, staring up at the sky, as if that would drive back the deluge. The locals, simply press on with wherever they were going or whatever they were doing, maybe opening an umbrella, maybe just getting wet. I kept going. As I never bring an umbrella with me, I just got wet. I smiled to myself, pleased with my own damp courage as I passed the cowering visitors. But soon the rain no longer wanted to share center stage with anyone and began coming down in earnest, driving even locals to sheltered areas lest they be painfully pelted with the precipitation. I paused and stood under an awning. The water was coming down faster than the downspouts on the buildings could handle, and it spurted up in geysers at knee level where the pipes were ill fitted into the ground. Nowhere else but in New Orleans could you have a rainstorm that poured down from the sky and up from the ground simultaneously.

Thunder and lightning cracked from the sky. From my awning, I happened to look directly at the sky when a brilliant bolt of lightning seared across the clouds, followed by an earth shaking rumble that jarred my bones. God was taking flash pictures, and the heavenly hosts of angels were all shouting "Cheese!"

But it seldom lasts long, and shortly after it began the sheets of rain diminished to mere pillowcases and dust ruffles of rain. I ventured down the walkway past the gay musclemen hiding in the doorways to the last art gallery in walking distance. I found it, recognizing it as the same spot where my car had been towed a few months before. I ducked in out of the persisting weather and knocked over one of the potted trees on the steps. Smooth. I was sure that the gallery owner would have a great first impression of this writer even though it seemed to me that such an ornament was ill placed on such a public thoroughfare. Nice going.

But he was very pleasant after all. In fact, the shopkeeper was actually the artist himself and I had a fascinating conversation with him. He offered me an umbrella to take with me as I left the gallery, which I politely declined (after all, I was soaked to the skin already; I'm sure I looked like a drowned rat) though I was truly impressed by his hospitality. I stepped back out onto the sidewalk and knocked over the same plant again. I was sure it wasn't my fault.

As I ambled back up Royal Street, I began to listen to the sounds around me. The rain had made everything sodden and most of the background noise was a hiss of some kind or other. Car tires squished along the wet road, remaining trickles of water hissed down from balconies onto the pavement and the moisture sizzled almost imperceptibly as it began to evaporate from the hot concrete and flagstone. Then through the hissing, a baritone voice boomed down the streets. As I got nearer its source, I could hear the song it was projecting. The verses of "Swing Low, Sweet Chariot" came through in what was unquestionably the best rendition I have ever heard. The singer was an old black man who had taken up in an archway on Royal that certainly had the most serendipitously perfect acoustics of any outdoor structure in the Quarter. I stopped for a minute to listen in awe. I had stepped into one of those picture postcards in the souvenir shops. I looked at the box at his feet. There was no money in it.

My town had surprised me once again. It is easy to get so disenchanted with New Orleans when you live here. You get fed up with the crime, the weather, the corrupt politicians and so on that you become blinded to the uniqueness that draws so many to our city. It had been an afternoon in the heart of New Orleans, spent doing truly "New Orleans" things; things that I now hoped others could appreciate. I hoped that my fellow New Orleanians would spend a few lazy afternoons in their town without trying to fight the heat or beat the weather or sneer at the tourists before deciding that they hate it here and move out. I hoped that more would appreciate the things that have always made this a great city since before there was an NFL and regardless of who is in City Hall and whether or not we have a big fancy stadium. Newly impressed by my town, I determined to make sure that it would not be long before I spent another Crescent City afternoon.

Taco Bell Mexi-Mood

2008-08-12T18:39:00.000-07:00

So I was at my local Taco Bell today, hankering for some fat-laden, artery clogging grub. After all I did write this article yesterday. While there, I noticed this advertisement beckoning folks to come join their team.

It encourages prospective employees to "apply your energy!" In the photo on the ad, there is more energy than an all-gay Broadway production of "Hairspray." (Yes, I realize that "all-gay Broadway production" of anything is redundant.) Anyway, look at the energetic kids in this ad! Laughing, smiling, singing and dancing! You'd have to measure their joy on the Richter scale.

Impressed by the depiction of frenzied paradise that must surely be the "Taco Bell employment experience," I looked around my immediate environs for the thrill-ride reactions that the local employees must surely be displaying, since they were already 'applying their energy' to this particular establishment.

This was my finding. Initially I was slightly disappointed, but then I decided to give these fun kids the benefit of the doubt. All that energy expenditure must take a lot out of an individual. Perhaps it was just intermission. No doubt they were just briefly recharging their batteries for another wild, wacky episode of Evening Shift at the Taco Bell. Patiently I waited for the energy to infuse the room.

Tick, tock.

One girl cracked a smile. Was this it? Was that the cue for the energy explosion?

The smile faded. Tick, tock.

The drive up window cashier chatted briefly with the expediter. The cashier at the counter register ate something from a bowl. Some burritos were thrown into existence. Another employee stared at the wall for a bit. Tick, tock.

Slowly, it began to dawn on me that the energy depicted in the second picture was about as intense as it was going to get. I nearly broke down in tears at the letdown. There was no singing, no dancing, no jazz-hands. I had been hoping for a napalm-fueled happy bomb to go off. All I got was the Snap'n'Pop of Apathy.

I won't let that get me down, though! I am determined to find that Taco Bell where those advertisement people are employed. I want to apply my energy. I want to soak up their energy. There must be a Taco Bell establishment with enough energy to power a town, judging by the recruiting ad. I will find that restaurant. I will be guided by its glow. There will be jazz-hands. I will be joyful. Amen.

Physical Proof of New Orleans' Third-World Status!

2008-08-12T01:11:00.000-07:00

Along the periphery of the Lee Circle monument, a compass has been set up as a form of public art. It serves as a stellar example of classic backwards New Orleans third-worldism. The east marker points toward the West Bank. The north marker directs you downtown. The south marker beckons uptown. It seems completely wrong, but that's just the way New Orleans is. I love it here!

Stupid

2008-07-02T22:01:00.001-07:00

So George Carlin just died. That got me on YouTube and and I found this video http://www.youtube.com/watch?v=oboyox3L_MI
of him describing stupidity.
OMG, I couldn..'t have put it better!

We've all heard of "IQ." It's a measure of our intelligence. "IQ" stands for "intelligence quotient." As those who paid attention in school know, a quotient is a form of fraction. One's intelligence quotient is defined as one's comprehension divided by one's age multiplied by 100. In other words, If you are 15 years old and have the understanding of a 15 year old, then the level of your understanding (15) divided by your age (15) equals 1. 15/15=1. Multiply this by 100 for your IQ equation and you have 15/15 x 100 = 100. Fifteen divided by fifteen equals one; 1 times 100 equals 100. This same formula works for any developing human. 1/1 x 100 =100. 7/7 x 100 = 100. 18/18 x100 = 100.

If you need a comparison, let's say you are 10 years old but only have the comprehension of a 5 year-old. Comprehension divided by age is therefore 5/10, giving us 0.5. To calculate this IQ, 0.5 x 100 = 50. This person's IQ is 50. Now let's say you are 10 years old but have the understanding of a 15 year-old. Understanding divided by age is 15/10. 15/10 = 1.5. Multiply 1.5 by 100 and this person's IQ is 150. When we look at the entire population of all people with all comprehension levels, the average IQ of all people is therefore 100. Besides the people who have an actual IQ of 100 (comprehension/age x 100), there are an equal number of people on both the upper and lower sides of the equation. Again, by the law of averages, the average IQ of the population is 100.

This has staggering implications in our day-to-day life. It means that since the AVERAGE IQ of all people is 100, then fully half the people you encounter on any day have an IQ of less than 100. There is an equal number of people with IQ's above 100 as there are below 100. In other words, fully half the population has a quantifiable, verifiable likelihood that they are raging morons.

My only argument with this analysis is "only half?" My IQ, incidentally, has been measured at 164. I state this not to boast, but to lament. This means that statistically, there is someone roaming freely on the streets with an IQ of only 36 (I got his 64 points). I feel that I encounter this person in a different incarnation at least daily. Further, all of my friends that have an IQ over 100 have their own intellectual inverse twin roaming around in public, instigating others to their own depths of stupidity until one day they will take over the world. At that point, the exceedingly few remaining people with IQ's over 100 will be forced to lower the general average IQ to something else, something lower than 100, officially making Earth a planet of retards.
How far along that path are we already?

Ramp Rants - Katrina

2007-02-18T06:48:00.001-08:00

Preface:
This story is unfinished and will likely never be finished. It is a first draft and has plenty of spelling & grammatical errors. Writing it causes little more than sadness & anger and I don't need that. But I put a lot of work and heartache into writing it, not to mention into the events described herein! I thought it was important that what happened never be forgotten, and many have asked me about this story.
This is dedicated to all my fellow EMT's, those who know what it is like to give all you have in a thankless job. And especially to all those who were there with me - you've already saved my life, and you can do that for me again any day! You are truly the best!

Katrina

We were told months ago that in the event of a Category 3 hurricane or higher, New Orleans EMS would be evacuated well ahead of the storm and return when it was safe. That didn't happen. We all met at Headquarters on Moss Street, and were assigned to various locations around the city. Some went to the LSU Dental School, Some at the Bellsouth building in New Orleans East, some at the Monteleone Hotel in the French Quarter, some at the JW Marriot downtown and a few at Moss Street. I was assigned to the Monteleone along with about 23 other EMT's. We had a single king-sized bed and 4 people to our room. The first night, when the hurricane actually began to come ashore, was fine. I had brought a bottle of wine for our down time, and the other hotel guests were perfectly happy to share their beer, true hurricane party-style. It wasn't our first storm, and we knew we would lose electricity and water at some point. We had all brought several days worth of clothes, food and water. We had no idea what we were truly in for.

As city civil servants and emergency workers, we are expected to stay when a hurricane approaches. The rest of the city was under a mandatory evacuation. They were required to get out. Many thousands chose to stay, to tough it out. The media, the mayor, the police, everyone pleaded with the populace for 3 days to get out of the city any way they could. Yet thousands who had cars and other transportation ignored the warnings and remained behind.

The next morning saw Katrina building in force, as far as our point of view was. From the parking garage at the Monteleone, we saw debris flying down the street, heard windows breaking, and were pelted by rain flying at over 100 mile per hour in the wind. As expected, there was no electricity and no running water. Many people had sought refuge there and had nowhere to go in the height of the storm. The hotel had graciously offered them what few rooms they had left for free. As I knew full well would happen, those people who got the free rooms immediately began to complain that they didn't have any electricity! I know it seems shocking to those not from New Orleans, but as a paramedic, I deal with this mentality on a daily basis. The vast majority of New Orleanians have some sort of sense of entitlement that the world owes them something. Generations of families have grown up on welfare and Medicaid, waiting for handouts, never contributing a single cent or ounce of effort to the system upon which they depend. I have delivered babies to mothers who deliberately got pregnant so as to enlarge their government welfare check. I am not kidding. I have seen it with my own eyes on countless occasions. And here this was being perpetuated under the direst of circumstances, at the beginning of the greatest natural disaster ever to strike the United States.

The night of the hurricane itself wasn't to bad, protected as we were. There were some moments we found ourselves laughing hysterically at the circumstances. One or two other hotel guests had their windows blown in. We laughed when we heard about it; they said they were trapped in their room and couldn't open the door. We wondered, how does one could get trapped inside a room that locks from the inside? The guests later told us that they couldn't open the door because of the pressure from the inrushing wind. That impressed us about the power of the storm. Dave was one of the paramedics in my room and we rolled on the floor at him as he was afraid the magnetic key card wouldn't work in our door once we left the room because the electricity was out. I guess he figured that the door needed to be plugged in or something.

We spent Sunday morning huddled in the hall, in our rooms or in the parking garage wondering what we were going to do once the storm was past. We worried about our houses, our families, our things. All in all, a typical hurricane detail at the city.

I took up in the entrance to the parking garage on Bienville Street. About two dozen other people were there too. No one had a battery powered radio or TV, so the only outside information we could get was through our dispatch radios, listening to other EMS crews and police channels. We got word that the levee in the lower 9th ward had broken. I wondered at what that part of town must be like now. True, it was one of the worst parts of town, but it was part of my city. Many of my friends' parents and grandparents had grown up in the 9th ward. Despite the poverty and crime and rampant drug trafficking there, it had still maintained the character of New Orleans, with decrepit but still beautiful architecture and old-city feel to it. We had no idea how bad the devastation would be, but we knew it wouldn't be easily repairable.

The group of our co-workers at the Bellsouth building in New Orleans East reported in, saying that as daylight broke, they could see the floodwaters all around them. They had taken refuge on the higher floors and as far as the eye could see, water was enveloping the houses at least to the first floor. Many single-story houses were only visible by the roofs sticking out of the water. All their ambulances and other vehicles had been parked below, and were now destroyed. They had no way to get out.

At the LSU Dental School on Florida Blvd, the group called in to say that they too were trapped, as the storm was dumping tons of water on the city and the floods had risen high enough to trap them in the building. They were able to park their ambulances on a nearby overpass on Wisner Blvd. The ambulances were OK, but there was no way to get to them because of the intervening floods between the school and the overpass a half-mile away. At the moment, though, they were all right.

After the wind died down and the rain stopped, we ventured out into the city to retrieve our EMS units. We had parked our ambulances at the Superdome under the overhang for the protection it offered, so we piled into the one ambulance we had kept at the hotel and headed over there. In the few short blocks we drove, we were aghast at the amount of trees down and buildings demolished. In front of the Superdome on Poydras Street, every high-rise building as far as we could see looked as if it had been struck by a tornado, and in fact, they had. A 300-mile-wide tornado had broken windows on every floor and had ripped off façades on every building and skyscraper in New Orleans. Office papers, broken glass and debris continued to flutter down to street level, causing us to retreat to our ambulances to avoid getting hit. We had to keep convincing ourselves that this was real, that it wasn't a huge movie set, that we weren't sitting comfortably in a cinema watching some end-of-the-world film while we munched on popcorn and Goobers. As the shock began to settle in, we began hearing calls come in on the radio for the rescue of stranded and injured civilians. We began responding to emergency calls, but were at a loss as to what to do with the sick and injured because virtually every hospital was locked down and on emergency power with no water or any advanced life support services. Since there was little else we could do, we dropped those needing immediate medical care off at the hospital and those who only needed shelter or had minor complaints or injuries were brought to the shelter at the Superdome. It was a mob scene there. In the years that the Dome had been used as a shelter during hurricanes, it had only once gotten more than 1500 refugees seeking shelter; now there were 15,000. Quite few were poor or elderly, simple folks who just had no way out of the city. But many of these were people who simply chose to stay; of the mentality that “someone” would take care of them, that they needed to do nothing to take care of themselves. Many had functional vehicles, but chose to stay despite the repeated warnings to flee the city prior to the storm. I saw this myself the day before. I had taken my motorcycle to the parking garage at Tulane hospital where it would be safe. On the way I passed dozens of families and groups of people in front of their houses barbecuing and drinking, no doubt having what we call in New Orleans a “hurricane party,” all with vehicles in perfectly good shape out front, ignoring the warnings that had been sounded for three days to evacuate the danger zone.

We began to collect our thoughts, and focus on the task at hand. We moved away from the falling debris on Poydras and reassembled outside of the emergency room at Charity Hospital, our home-away-from-home. Floodwater had inundated the far end of the ambulance ramp on Gravier Street; the near end was still dry. The cross-street, Freret, was blocked by a fallen tree. EMT training teaches you that whenever you park your vehicle, make sure that there is a way for you to exit so you're not trapped. Where we were parked at the moment, we were trapped.

Earlier, I had noticed that one of our other paramedics, Ron Pelas, had brought a small chainsaw with him. I had poked fun of him at the time, thinking that the power tools was a tad bit of overkill. When he pulled it out and began sawing the tree on Freret Street, I realized that I should try to stick close to that guy. Several of us walked over and began clearing away the sawed-off boughs. When enough weight had been shed from the tree, it took about a dozen of us to move the trunk off the street so the road was passable. Doctors, nurses and civilians on the ambulance ramp across the street watched us and cheered as we cleared the road. They knew New Orleans EMS could handle a lot of weird situations, but that knowledge took on a whole new dimension as they added 'tree-clearing' to our already lengthy repertoire of skills.

By this time, several other units had been dispatched to respond to calls, and I was assigned to wait at Charity hospital until I was needed to respond. In addition to myself, Katrina Lewis, Tommy Evans and Katrina McCrary were assigned to my ambulance crew. As coworkers, I love both Katrina's but I would have more than enough “Katrina” in the days to come! While we were waiting, I decided to take my ambulance and drive to my house in Lakeview to see how my house had fared. As I drove up and down the Interstate, I saw nothing but water where streets should have been. At least the levees in this part of town hadn't broken. The flood that currently existed was bad, but no worse than the bad floods New Orleans had experienced before – like the May 8th flood twenty years earlier, the May 9th & 10th floods from ten years ago, Hurricane Betsy in 1965. I searched for a way into my neighborhood, but all the accesses were flooded. My neighborhood doesn't usually flood, but the surrounding areas do. There is an Interstate exit two blocks from my house, but I couldn't access that either, as the route goes through an underpass which was under 25 feet of water. Incidentally, it is that underpass at Metairie Road where I had found two men drowned after the May 9th &10th flood ten years earlier. I gave up trying to get to my neighborhood and asked over the radio what part of town we were expected to cover. They sent us to Algiers, the part of New Orleans across the Mississippi River, on the West Bank.

I drove across the Mississippi River Bridge, officially called the Crescent City Connection, or CCC for short. I was amazed to find that Algiers was dry. The West Bank is usually the first part of New Orleans to flood. We met up with the other two units assigned there at the Crescent City Connection police station at the foot of the bridge. We remained there for an hour or so when I noticed how quiet the radio was. I heard no one being dispatched to scenes, no crews advising their status. As I checked my radio to make sure it was still on, I saw that it was not receiving a signal from the trunking towers! Communications were out! I scrolled through the channels, trying to find an alternate tower from which to transmit a signal. The only one I could find was the tower at Moisant Airport (Louis Armstrong International), but the tower is at the far limit of our radios' range so communications were spotty at best. One other EMT, Jacob Oberman, had realized the situation; he was on the radio talking to me, but he was stranded by floodwaters at the LSU Dental School. I told him I would try to find the rest of our people and tell them to switch their radios to the functioning tower. Jacob also informed me that one of the police officers there had fallen down some stairs and appeared to have fractured his leg earlier that afternoon. The EMT's at the building had splinted it and given him an IV and morphine, but he would need to be evacuated to receive further care. At the time, though, there was no way to get him out.

One of the problems in getting everyone to the one working channel was the fact that many of our EMT's were relatively new, with fewer than 5 years of experience with New Orleans EMS, including our new Administrator, Dr. Saussy and our new Operations Manager, Mark Reis. and Mark had both been EMT's for New Orleans, but that was way back in the 80's, before we had gotten this radio system. They had only been part of EMS since January, 2005. New Orleans had gotten the radio system in early 1994, along with a comprehensive overview for the the employees of how the radios worked. Now most of those old-time EMT's were gone, having moved on to bigger and better things. Only a handful were still there that received the original training on the radios. I doubted Dr. Saussy and Mark had gotten a full briefing on the intricacies of switching to different transmission towers. I tried to call other EMT's on my cell phone, but the cell towers were down; there was no cell phone communication in addition to the very limited radio communication we now had. Along with being unable to contact one another within EMS, we couldn't contact anyone in what was now the outside world. We had no idea what had become of our families and loved ones who had evacuated New Orleans and we now on the outside, wondering what had become of us. We tried to put this anxiety out of our head, to focus on the immediate tasks at hand. We would have to make do with what we had.

I advised the other EMT's at the police station on the situation. I showed Clarence, Jeff and Carl how to switch channels so they could have communications, then drove back across the river to search for our ambulances with the message. A few units were still at Charity Hospital. The far end of the ambulance ramp was still underwater, but at least the ramp was still accessible. I walked up the ramp to find the EMT's. As I probed through the chaos of the emergency room, I bumped into Dr. Halton. Dr Halton was in charge of the ER and he asked if I could find some cans of gasoline. Since the main generator had failed, he was trying to power the emergency room with portable generators he had brought from his house. Along with the power failure, the laboratory had been flooded so the hospital was unable to run blood tests, the operating rooms had been damaged by wind and water that had entered through broken windows, and ventilators providing life support to critical patients had begun to fail, requiring hospital staff to stand at the patients' sides and manually breathe for them with Ambu bags. Without power, they couldn't even take X-rays. The hospital could now only provide more or less the same level of care that we could in the ambulance. And this was the case not just with Charity, but with every hospital in New Orleans. I didn't even want to think about what it would be like to be a patient at a hospital in the middle of this.

I tried to contact Brenda Carter about Charity's needs. She's one of our paramedic supervisors who was working in the Office of Emergency Preparedness (OEP) on the ninth floor of city hall. I got no response over the radio; she didn't know about the failure of the radio towers. Fortunately City Hall is only a few blocks from Charity so I drove over there to find Brenda. At OEP I discovered that even with the radio set to the proper channel, the concrete walls of City Hall prevent the signal from getting through! Worse yet, the landline telephones at City Hall were out of service too! Apparently there is no backup communications system in the backbone of our emergency system! OEP might as well have been located on the moon for all the help they were able to offer. Charity was just going to have to manage as best they could, just as the rest of us were. We assigned Katrina Lewis to remain at City Hall to assist Brenda, but I wasn't sure how much help an extra body would be at the all but useless OEP. Tommy, Katrina McCrary and myself left to try and re-establish communications with our remaining functioning crews.

I realized that we were going to have to try to coordinate our communications with the police and fire departments. At this point I heard that the prisoners had rioted in Central Lockup and taken over police headquarter at Tulane and Broad. Police headquarters is where their communications systems are! All 911 calls come in through that center! Even though the police had taken back headquarters in short order, it was clear that police communications were not going be under control anytime soon. Fire and EMS communications were at a separate location in the city, but those centers had been evacuated prior to the storm and had long ceased operations since the day before. I continued to try to find our people to tell them to switch to the Moisant tower. I met up with Frank Petta and Luke Strack and their crews. Actually, I almost got into an accident with Luke as we both blew our respective stop signs on adjoining streets! As I advised the various crews I encountered, I told them to spread the word to other crews so that we could have working communications again. Slowly, over the course of several hours, the rest of the crews got the message and reported in over the radio.

After my near-accident with Luke, my crew and I drove back to Charity to let Dr. Halton know the situation. I walked into the emergency room, through what had become utter chaos. As night began to fall, people by the hundreds had walked to Charity. Some had legitimate medical complaints, but most had arrived simply seeking shelter. Charity Hospital had given them free medical care for generations, so they figured that Charity would continue the free handouts. Many generated make-believe medical complaints to get them into the system as patients with a “need” to be there. The sheer number of people, coupled with the lack of services the hospital was able to provide and the growing darkness of night, made the emergency room an almost nightmarish place of confusion and desperation. Kathy, a nurse there who also worked with me at Tulane Hospital, broke down in tears at the bedlam. She, like us, had no idea what had become of her home, her family or her friends. And there was no end in sight of the deteriorating social order.

Amid the worsening confusion, I gave up trying to find Dr. Halton. All I had to deliver to him was bad news, anyway. I left the ER and walked down the ramp. To where my ambulance was parked. At the bottom of the ramp I stepped in water that was up to my ankles. As I shook the water off my boots, I thought about where the water level had been earlier in the day. It had covered the exit of the ramp down the street, but the entrance, closer up the street had been dry. Now there was nearly six inches of water at the ramp entrance! Why would the water be rising half a day after the rain had ended? The answer dawned on me like another hurricane on the horizon: the remaining levees that protected the central part of the city must have broken!

I envisioned the vast volume of water contained in Lake Pontchartrain. The lake is spanned by the longest bridge over water in the world, the Lake Pontchartrain Causeway. It is 24 miles long north to south. The lake is about twice that distance wide east to west. Under normal circumstances, the levees keep millions of tons of water outside the city. Now, though, the lake was swollen with extra millions of tons of rainwater and storm surge that had been dumped there by Hurricane Katrina.
The narrow concrete and dirt barriers had failed, allowing those thousands of cubic yards of water to begin to inundate the city that I had grown up in, gone to school in, worked in, gotten married in and was the setting for so many of my memories.

I couldn't imagine how bad it would get, but I knew there wasn't much time to dwell on the matter. New Orleans is, on average, six feet below sea level, some parts lower than that. With all the extra water in the lake, I knew that six feet of water in the city would be the best scenario we could hope for. In the few minutes I spent contemplating this, the water had risen visibly. We had to get to higher ground. In exploring the city earlier, I knew that the existing floods had already cut off any routes out. We would have to find refuge somewhere downtown. The only high ground we could drive to was the Superdome.

Most of the crews in town who still had ambulances were on the working radio channel. I interrupted someone's transmission and called out “6234 to all units. The water is rising in the city. I think the levees have broken. We're going to need to get to high ground to park our units. The Superdome is the only place you can get to if you're downtown. All units, 10-8 to the the Dome ASAP. Acknowledge!”

One by one, the other crews responded.
“Yeah I thought the water was getting higher.”
“10-4. We'll meet you there!”
“Copy that. Where should we meet at the dome?”

Crews continued to respond, and we gave directions to those who were unfamiliar with the process of getting their ambulance up onto the mezzanine level on the outside of the Superdome. As we drove up to the Superdome on Poydras Avenue, we passed by the spot where we had parked earlier, which had been dry just a few hours earlier. Now the corner of Poydras and LaSalle was under a foot and a half of water. Our ambulances would barely make it through. I pulled up to the big ramp in front of the Dome that leads up to the higher level. As we arrived on the mezzanine level, we were encountered a large crowd of refugees gathered outside to smoke or get some fresh air. The National Guard was keeping them in tight groups outside of the Superdome entrances. We pulled past the barricade and circled the Dome to where our units had been parked the night before during the storm. Military vehicles now occupied that space, so we found an empty spot near the ramp that adjoins the Superdome with the New Orleans Arena. I pleaded with the other units to come to the Dome as quickly as possible. The water around the area was barely passable; in less than a few hours, they would be unable to get to the Dome at all, and we needed to stay together. Eventually, all the functional ambulances had joined us, eight in all. About 35 EMT's were there. We parked our ambulances together and gathered our people. We surveyed our surroundings. There were about 15,000 people at the Dome who had come seeking refuge. In the night, with no water or electricity, the inside of the Dome was crowded, dark, hot and stunk like an unflushed toilet. There were plenty of National Guard vehicles around, but only about 200 Guardsmen. Some patrolled with M16 rifles slung over their shoulders. Cedric Palmisano, one of our paramedics, had served with the National Guard. He pointed out that those with weapons had no magazine clips in the rifles. Rifles with no bullets! They may as well have been carrying around baseball bats. I wondered how well they would be able to control the crowd. As we had been driving around the Dome, Tommy and I spied two separate fights break out in the crowds milling about the Dome entrances. Here were thousands of people all thrown together, who under normal circumstances would be out doing what they usually do. From an EMS standpoint, that meant they would be dealing and doing drugs, shooting, stabbing and beating each other up, and be busy having their medical issues that they didn't take their medicines for. I wondered how many people would have heart attacks, strokes, diabetic crises, seizures and asthma attacks and there wouldn't be a damn thing we could do for them. Now I discovered that should they riot or otherwise get violent, there would be little backup from the virtually unarmed National Guard.

We set ourselves up for what would certainly be a very, very long night.

“We NEED evacuation of this police officer!” Oberman shouted over the radio. Well, I never heard Jacob actually shout; he has something of a Zen quality about him. He always appears calm, cool, almost otherworldly. Hard to believe he's a black belt in three different schools of martial arts. But on this occasion, we could hear the stress in his voice. The policeman had been in the LSU Dental School since that morning with a broken leg. “We've given him morphine for the pain, but he's a diabetic, and there's no insulin around here. His blood sugar is increasing, and he's not doing well. He needs more care than we can provide,” Jacob explained over the radio.

“I have no way of getting him out of there, Jacob,” Yolanda explained over the radio. Yolanda Wilson was one of the supervisors who had made it to the Dome with us. She had been in the Monteleone Hotel with us the night before. Along with Kevin Hoag, another supervisor, they were the only two administrative personnel at the Superdome. At the time, the title 'Supervisor' held little weight anymore. We were alone. Alone, that is, with 15,000 other hurricane refugees. We still hadn't heard from Dr. Saussy or Mark. OEP was still silent. No city official had contacted us, and we had little way of communicating with the outside world. The only information we could get was through AM radio in the ambulances, and that told us little we didn't already know – that the levees had broken in five places and the city was screwed. We began to feel completely abandoned. No one was trying to help us, no one was coming to get us. Unlike the thousands of people in the Superdome with us, we knew what was going on in the “rescue” efforts – nothing. At least the civilian refugees had the illusion that something would happen, someone would help them. At least the National Guard was there with MRE's and bottled water. They brought us a few cases, and some of us had managed to bring some food that we had brought with us to the hotels the night before, but much of our personal effects were still there in the hotels.

I wanted to check out the surroundings. It was inadvisable to venture into the Superdome alone, we had already witnessed a few fights and individuals yelling at the National Guard, so I took a few people with me and headed into the stadium. The first thing I noticed was the stench. As I walked into the building, I was hit by the smell of those thousands of individuals who ordinarily bathed only infrequently. Now they had spent the better part of two days smashed together, with no electricity for air conditioning, and no water to flush a toilet with. I couldn't stand it for more than a few minutes, so I directed our little group to head back outside.

At least everyone had checked in. Everyone except Ray Mandola, Dave Wilson and Thomas Jordan who had all been at headquarters at Moss Street. We weren't sure what had happened to them. Last we heard, they had taken refuge in the upstairs loft where we kept all the supplies. But they were big boys, and we felt confident that they could take care of themselves. As long as looters didn't decide to hit Moss Street. Cliff Washington, the supervisor in the Bellsouth building in New Orleans East began calling over the radio, saying that civilians and looters were wading up to the building, shooting at the building, demanding to be let in. They had no intention of doing so, but the desperation in Cliff's voice was palpable. They felt just as abandoned as we did, and there were no bulletless National Guardsmen or any other images of authority with them, armed or otherwise.

Jacob continued calling out over the radio that the policeman was getting worse. They had reached the limit of the care they could provide and they needed to get him out. Still, no one responded. He had been calling all day for assistance, but none was forthcoming. I finally realized that if anyone was going to organize any kind of a rescue effort for those other city employees who were trapped, the effort was going to come from us individuals. We couldn't afford to have the same mentality as the refugees in the Dome, who expected everything to be simply handed to them. Generally though, we had a plan for most situations. Big events like Mardi Gras and Jazz Fest were planned for every year, and we were all accustomed to the big, unpredictable events. But now with the scope of devastation becoming more apparent, the lack of planning for a situation like this became clearer and clearer.

Listening to Jacob's repeated, unanswered pleas over the radio, I became convinced that if any action was to be taken to rescue the injured cop and the others at the Dental School, I was going to have to take the lead. I don't enjoy taking command of situations, but I'm very capable of doing so. 14 years of working for EMS and dealing with one unstable situation after another had sharpened my skills in doing so. Never, though, had I been in a situation like this. I considered my options and the logistics of the situation. I went over to the edge of the deck on the Superdome and surveyed the encroaching water. The street that had been bone dry just a few hours before was now covered with a lake at least three feet deep. I had no idea how much higher the water would rise, so any rescue effort would have to come now. There was a nearby group of National Guard. I walked up to one of them and explained he situation, that we needed rescue of an injured policeman and several other emergency workers. He said I'd need to talk to his commander. He pointed me to another Guardsman and I repeated my story. The commander said he would put me in touch with his General. I expected him to call over his radio to the central command. Then I realized he had no radio. The National Guard not only had no communications with the civilian world, they didn't have any communication among themselves! The commander assigned a soldier to lead me to the General. Their office had been set up on the exact opposite side of the Dome. We walked over there (a long way in the dark through the throngs of refugees gathered at the exits) and found the General. Once again I explained the situation. He said he'd be happy to detail one of his “deuce-and-a-half” trucks to help me out. The soldier I was with volunteered to drive, and he said he would be outside the office in the truck in twenty minutes.

I walked all the way back around the Stadium to inform Yolanda and the rest of our people what I was planning. Given the instability of the situation, my coworkers looked at me incredulously. We had heard the reports of looters and shooters in the city and they asked who I gotten to go on the rescue attempt. Considering my limited options, I said I would go. Becky Calvo, Faith Upton, Liz Farrell and Tommy Evans reluctantly wished me good luck and hugged me goodbye. I got the distinct impression that they did not want me to go. I knew though, that if the cop and the others were to get out of there, someone was going to have to take the lead.

I walked back to the office and contemplated how I was going to get to the school. What route would we take, how deep would the water be? Would it be too deep even for the big truck? As I walked, I heard Ron Pelas over the radio, the paramedic who had brought the chainsaw and cut up the tree across from Charity Hospital. Apparently he had gotten in touch with the Wildlife and Fisheries Department and was beginning to coordinate rescue efforts using their boats. Wildlife and Fisheries had a large contingent of skiffs, airboats and assorted other shallow-draft vessels. We had been hoping they would show up, and now there was a way to get our people out! I called Ron over the radio and let him know my plans for the cop at the Dental School. We conversed about the logistics of the situation and decided that he would send boats to the school to get the policeman and then they would head to the Interstate 610 where my truck would meet up and take him to Tulane Hospital.

I finally made it back to the office where my deuce-and-a-half was waiting. The deuce-and-a-half is a huge truck, designed for extreme situations. What a Hummer is to a Honda Civic, the deuce-and-a-half is to the Hummer. It's massive. The cab is about five feet off the ground; the back end of the cargo area is about six or seven feet off the ground. The tires are about five feet in diameter. It's big.

A Guardsman was waiting nearby. He came up to me and asked if I was the paramedic with the special mission. “Special mission?” I thought. That sounds pretty cool! I don't think I've ever had an official special mission before! My head inflated just a bit. I answered the guardsman “yes” and briefed (briefed!) him on the details of the plan. The other soldier walked up and told me to hop in, they were ready to go. I climbed in and told him the best way to get to the Interstate. Downtown was deeply flooded. There was no way our ambulances could have gotten through. One of the soldiers pointed out how high the water was on a car parked on Poydras that they had apparently been using as a depth gauge. The water was about six inches below the window. It had been a foot lower only two hours before. We navigated down LaSalle to Tulane Avenue where the on-ramp to the I-10 was. The water at the foot of the ramp was nearly too deep for the big truck, but we were able to make it. Finally we were on the elevated freeway. As I looked down to street level, all I could see was the glint of starlight on water where streets should have been. The waterline was well up on the sides of the houses and buildings, much higher than it had been earlier that day. I could only imagine what my neighborhood was like, and those of my family. The more I thought about it, the more depressed I got. I decided to make conversation with the soldiers.

“So how did you get the privilege of being at the dome?” I asked.

“We were sent here from Alexandria, Louisiana. Our mission is to 'feed the dome.'”

“'Feed the dome?'” I replied. “Not for security or rescue or anything? How many of you are there?”

“Nope, just to feed them. And security? Have you seen our weapons? The ones with no rounds?”

“Yes, I noticed that. Fat lot of good those are going to do. You know those people are going to riot, don't you?”

“We wouldn't be surprised.” The other soldier responded. “This afternoon we were handing out MRE's and water, 'feeding the dome' like we're supposed to, and this woman took the MRE, looked at and said 'I don't want this shit!' and threw it right back in my face!”
“Yeah the same thing happened to me this afternoon,” the first guardsman said.

The guardsman driving thought for a bit and said “You know, I just got back from Baghdad, from the war in Iraq. The conditions there were better and I felt safer in Baghdad than here.”

“Welcome to New Orleans, “ I replied. “Somehow I knew that if there were ever a major disaster here, this is how it would turn out – anarchy.”

We continued to drive down the Interstate; occasionally I would check on the radio with Ron to find out his progress. “We're not there yet. We're still getting all the boats in the water.” It would be a while. We stopped the deuce-and-a-half at the off-ramp at Elysian Fields Avenue and North Galvez. I was trying to picture where Ron wanted to meet us. For the moment I couldn't think how to get onto the I-610 from the I-10 without plowing through eight-foot deep water. I knew this city like the back of my hand, but the fatigue and anxiety was getting the best of me and I was drawing a blank.

As I tried to collect my thoughts, I stared out the window into the blackness around me. Across Elysian Fields on another Interstate ramp, groups of refugees climbed up out of the water. One of them had a boat, but apparently it wasn't working. They tried to get the engine started, but it wouldn't turn over. After watching them struggle for about ten or fifteen minutes, it seemed they figured out that the massive vehicle across the street (ours) was a military truck. Some of them began pushing the boat through the water with a pole toward us. I knew they were going to come ask us for aid, but we had no aid to offer. Besides Ron had called over the radio saying that his boats were heading for the LSU Dental school. Watching the group in the broken boat, I was reminded of the countless times that random people had strolled up to my ambulance asking me to “check their blood pressure” or to seek medical advice, usually for ridiculous problems. “Yeah, my uncle has cancer, and I started coughing last week. You think I caught cancer?” As annoying as that was, I thought back to the crowds at the Dome and the fearful looks I got when I said I was going on this mission, looks from my coworkers that said they feared for my life. I began to realize that the group of desperate, unpredictable people approaching us outnumbered me and the guards 3-to-1. The guards, too, had been unnerved by the barely-controlled throngs they had been dealing with for two days. I suggested we get the hell out of there before they reached us. They agreed and we started the truck and backed up the ramp. Back on the Interstate was a group of State Police and other law-enforcement agencies. We stopped and I asked the best way to get to the I-610 where we could meet the boat carrying the injured police officer. A Wildlife and Fisheries agent explained to take the I-10/610 split the wrong way and head back up the 610 the wrong way. Of course! Why couldn't I have figured that out? I guess I had a lot on my mind.

I contacted Ron on the radio to let him know we were almost at the meeting point. As we arrived at the 610 at the St. Bernard exit, we saw a number of fire trucks, State Police trailers and various other official-looking vehicles. As the road dipped down into the water, we could see the Wildlife and Fisheries boats arriving with civilians. I asked some of the agents about the rescue attempt of the EMS and Police from the school. They informed me that aside from the policeman, for some reason they refused to go. I tried calling Jacob about why they wouldn't get out of there; he said that they were OK and would try to get out in the morning. It was beyond me why they chose to stay when boats were right there, tonight. At any rate, W&F was now occupied with retrieving stranded survivors from the nearby St. Bernard housing projects. The policeman was waiting for us nearby, secured to a cardboard stretcher lying on the pavement. We found him and had to figure out a way to get him into the deuce-and-a-half. The truckbed was about seven feet off the ground and this cop easily weighed 300+ pounds. I recruited the guards and a couple of firemen and a W&F agent to help lift him. I doubted the structural strength of the cardboard litter he was attached to, but was impressed by it's design when it didn't buckle at all. As we slid the litter into the bare floor of the truck, Ruel Duvillier, a fireman who used to be a paramedic with EMS, ran up to us.

“Fitz, I need you to came check out a man who's been stabbed! He's right over there,” he shouted, pointing to a group of people that were yelling at each other. Several state troopers had some of them face down on the ground.

“Ruel, what's going on?” I asked.

“Well, Wildlife and Fisheries is trying to rescue them and they're all getting up to their usual ways. They've been here for about an hour and they're already up to their usual tricks. There's been at least three fights and now they've started stabbing each other. The guys in the boats say the people still in the projects are getting in fights and shooting each other too.”

“But why? That doesn't make any sense! It's all gone, what are they fighting over? These people here are being rescued and they're starting fights with each other and with the cops?” My patience was worn out. I no longer cared about these idiots who had stayed behind despite the days of pleading and their consequent ignoring of the warnings. Now they were arguing and fighting not only with each other, but even with the very ones they were depending on to rescue them. I told Ruel “I'm not going over there. It's not safe. If they want to kill each other, let 'em. They all said they were going to ride out the storm and its aftermath; well, let them ride it the fuck out!”

“You're right man. You go take the cop; I'll handle the situation here,” Ruel said.

“OK, man. Be careful.” I told the guardsmen that we were ready to go. He asked how to get to the hospital. I tried to give him very detailed instructions as I was going to be in the back of the truck and there was no window or anything between the cab and the back. If he got lost, there would be no way for me to redirect them.

I climbed up into the truck and tried to assess my patient. There was no light in the truck. I pulled out my pocket flashlight and tried to take a look. His leg was swollen and bruised, with a cardboard splint that the EMT's had applied at the school. He also had an IV, the bag of fluid was nearly empty. I tried to ask him questions about his age, medical history, medications, etc. He could barely speak to me. Jacob had said he was a diabetic and hadn't had his insulin in a couple of days. He seemed to be hyperglycemic, glucose building up in his blood with no insulin to get it into the body tissues. I had precious little equipment, other than my own jump bag. I pulled out a new bag of saline and spiked it onto the IV line to give him a saline bolus to try and dilute the concentration of glucose. I hesitated to give him any more morphine for pain, his level of consciousness was decreased enough already. After the truck had begun to to head back up the road, I contemplated how much rougher the ride was, compared to the back of an ambulance. It was nearly impossible to sit on the bench, so I assumed a place on the floor of the pitch-black truck next to the cop. I had to hold onto the cardboard litter to keep him from sliding around the truck bed. And at 300 pounds, that was no easy task. I vowed I would never complain about the rough ride in the back of an ambulance again.

The guards followed the route I had dictated, taking the interstate the wrong way back downtown. Our destination was Tulane Hospital, which was still somewhat functional. Its designers hadn't made the mistake of placing the emergency generators in the basement. But since we were heading up the road the wrong way, all the signs pointing out the exits were facing the wrong way, and I doubted the guards would recognize the way back. The only way I could point out the exit was if I hung out the side of the truck and hollered into the drivers side window. Sure enough, that's what I did. I pulled back the heavy canvas and hung as far out as as I could while moving at 60 mile per hour. I banged on the wall of the cab and yelled to get off at the next exit when the guard rolled down the window. Evidently he understood and pulled off at the right place. At the bottom of the ramp, the water was higher than it had been when we left. We slowly drove through the encroaching lake until we got to LaSalle Street, where Tulane's Emergency Department's ramp was. While not exactly high and dry, the water had not yet inundated the Emergency Room. And was only a few inches deep. The deuce-and-a-half made it up onto the ramp, completely occupying the entire space and barely clearing the overhead awning, which was now a bare metal frame since Katrina had removed it the night before. Was the hurricane only yesterday? It seemed like days. And the aftermath was just beginning.

John Mullins, Mike Condatore and Greg Gavel met us on the ramp. They were nurses at Tulane, Greg is one of my best friends and I had known him since he used to work as an EMT at NOHD ten years ago. I also worked at Tulane full-time as a nurse; my paramedic job was actually my part-time gig. I was happy to see that all my co-workers were safe there.

I asked to get a stretcher onto the ramp, since it was going be hard to get the cop out of the truck at all, let alone haul him into the hospital on the cardboard litter.
For some reason, Dr. Moises was unwilling to allow a stretcher to be brought out. I couldn't figure out why, but no matter. I said “OK, doc, in that case why don't you come out here and help us haul him out of the truck?” He looked at the size of the policeman and studied the height of the truck. He disappeared inside the hospital and moments later reappeared pushing a stretcher out onto the ramp to the back of the truck. John, Mike, the guards and I pulled the litter out onto the stretcher. Greg was still recovering from a fractured leg from a motorcycle accident. He had only been back at work two weeks and wasn't able to help pull the big guy out. I went directly upstairs with the cop to a hospital room since the ER wasn't functioning any longer due to the rising water. When I got back downstairs I tried to catch up with Greg. He had been my roommate for a few weeks till he broke his leg and couldn't get up the twisting, narrow Staircase of Death to my apartment on his crutches. Before the hurricane he had helped me relocate my motorcycle to the Tulane parking garage where it would be safer. We had had a conversation regarding the dozens of groups we saw remaining in New Orleans despite the repeated pleas to evacuate.

“None of these people have any idea how bad this might be,” I had told Greg. “We've both been through hurricanes before, but looking at the radar today, I started to get this sense that this one might be the Big One.”

“Can you imagine what will happen if it hits us directly? The bodies?” he had asked me.

“I think there'll be at least 10,000 dead with all these people staying here.” I had replied.

Now in Tulane's ER, in the light of the emergency illumination, we looked around where there had been a perfectly normal city just a day or so ago. The water was lapping at the door, the heat made just breathing an exhausting activity, and the hospital smell coupled with the raw sewage in the water made that breathing additionally unpleasant. Greg and the rest of the staff were occupied moving equipment and patients upstairs to the third floor in the endoscopy lab. He had finished his shift and was curiously attired in his pajama bottoms, t-shirt and Spongebob Squarepants fuzzy slippers. At least he hadn't lost his sense of humor. Humor, I sensed, was going to be crucial to our psychological survival over the coming days and weeks. “Remember the conversation we had yesterday about if the Big One hits New Orleans?”

He took a look around us at the ruined hospital and the disease-ridden water now pushing into the doors. “Yes, and the scary thing is, the hurricane missed us. This is all from a glancing blow.”

I confirmed that observation and talked a little more about the hospitals plans. Apparently they were moving the patients and staff all together to prepare for whatever evacuation plan might come to pass. Greg had no idea what that might be. At least he had gotten his cat, Rhett, and some of the other staff's pets and family members out of the hotel down the street where they were staying. He had used the inflatable raft I had helped him load into his truck a day or so earlier. I recalled that at the time I had poked fun at him for being over-prepared. Now I was impressed that he had had the foresight to bring all that food, water, raft, camping gear, cooking utensils and whatnot. I thought I had prepared myself well, but no matter how much I had brought, not of it would prove to be much use in the days to come.

After chatting with Greg for a while, I knew it was time to get back to the Superdome. I was exhausted and didn't want to think anymore; not about the flooding, rescuing people, where my family was, what we were going to to do, where the future would lead. It was about 11:00 pm by this time. Back at the truck, the guys were ready to head back, but none of us were looking forward to returning to the debacle of human suffering that awaited us at the Dome. Nonetheless, we piled into the truck and headed the four blocks back. Since we had left, the water had risen appreciably downtown. The tall truck was well able to handle it, but there were areas that the soldiers said were too deep, even for the deuce-and-a-half.
Back at the Dome, Melinda, Faith, Becky, Tommy and others gave me a very warm welcome. I was happy to see everyone. All the medics who weren't trapped in the Bellsouth building or the LSU Dental School were there, with the exception of a few who had remained on the West Bank. Everyone had checked in, and we at least knew where everyone was. Except Mark and Juliette; we hadn't heard from them since our briefing at Moss Street the day before. Had it only been a day? It seemed like weeks.

Many of the EMT's came up to me and asked about using the deuce-and-a-half to return to the Marriott and the Monteleone to recover their personal effects and the medical gear that had been left behind. I was a little reluctant to ask them for another journey out into the dark water in the middle of the night, but everyone seemed determined to get their stuff. I could hardly blame them; I too had my own things back there I needed. Finally I went back to the truck where the guards were still standing. I explained our situation, but I was afraid of overstepping my boundaries in the use of the truck that the federal government had loaned me. However the guys were more than happy to help us out. “This truck is assigned to you. We can help you do whatever you need.” God bless the U.S. Army!

I returned to our camp and told everyone that needed to get personal gear to be at the truck in twenty minutes. That was a great morale booster, everyone was thrilled that they could at least have the stuff they came with, since no on knew how badly their homes were damaged. Guesstimating city-wide damage from the rising water and the devastation from the storm, whatever was in those hotel rooms was all we had left in the world. In addition, much of our medical gear, radio and EKG monitor batteries, battery chargers and medications were still back there. Seeing as there were no hospitals functioning, our eight ambulances were all the city had as far as medical care went, besides the overwhelmed clinic downstairs at the Dome, and dealing with the ever-rising population there, providing emergency care for them was a daunting prospect. Many of the refugees were people who had barely marginal health in the best of times. On top of the asthma attacks, diabetic comas, seizures and chest pains, there were going to be fights, possibly shootings, people suffering withdrawals from their normally plentiful drugs and alcohol, and the enormous population of schizophrenics and psychiatric patients who were going to totally lose it with the lack of medicine and disruption in their lives.

Everyone who had left gear back at the hotels piled into the truck and we ventured out once again into the dark, wet city. We plowed through water four or five feet deep at Tulane and South Robertson, and the majority of water remained around three or four feet in depth till we got to the edge of the French Quarter as we headed first to the Monteleone. In the streets, the big deuce-and-a-half bucked over bricks and fallen walls as we passed damaged buildings. Some roads were impassable because of fallen trees or power lines, which were nearly invisible in the pitch dark, broken only by the trucks headlights. On Canal Street, there were dozens of groups of people who we at first thought were trying to get to the Dome or other high ground, but upon closer inspection, we saw that they were all looting the stores downtown. Men, women, little kids and old ladies were going from shop to shop, their arms ladened with purloined goods. Some had even fashioned rafts from floating debris and plastic tubs so as to be able to tote more stuff. In later days, I would see pictures of Canal Street with all the people wandering up and down the street. The captions on the pictures would describe the people as “displaced” or “searching for shelter.” I knew better; every single person in those pictures was a looter. I wondered how the store owners must feel, seeing their businesses not only torn apart by the storm, but also pillaged by the parasites that now, in the unfolding anarchy, could have their way with whatever goods they wanted. In the back of the truck, we all quietly discussed our hopes that they all either got shot or acquired some disease from the disgusting floodwaters.

Back at the Monteleone, we went back to our rooms to get whatever we had left. The hotel still had emergency generators working so we were able to use two of the elevators to move the heavy stuff. The magnetic card readers on the doors had quit however. I thought back to my conversation with Dave, when I had made fun of him about 'plugging the door in.' It turns out he was right, those things do quit working without electricity! We had to kick the doors in. After the frustration of the Dome, the looters, the lack of communications and the lack of any kind of a plan for the city, the act of brute force against the door was an enormously satisfying release of aggravation. I wanted to go down the hotel hallway kicking in all the doors, screaming at them the whole time. But that would have made me no better than the looters and vandals we had passed on the way. Most of the other EMT's were relatively new, and I didn't want to seem like I had lost control of myself, although I sure felt like I was barely keeping it together. I was happy to get my bag full of food and my clothes. My computer was back at the Dome, besides my two forays tonight, I made sure that my new laptop wasn't leaving my side. As it turned out, I never retrieved my glasses, so I was stuck with contact lenses for the duration. That was mildly annoying.

We piled back into the truck and headed to the J.W. Marriott, where the other group of medics had stayed. We again had to cross Canal Street, where the looters were busy in full force. None of them even took a second glance at the military truck passing amidst them. I wondered at the intelligence of them though. I saw hordes of people at the Athlete's Foot and similar stores; looters were hauling away armloads of cheap, ugly clothes and shoes, but next door at Adler's, New Orleans most expensive fine jewelry store, the doors were untouched! Across the street at the discount electronics shops people were hauling out video cameras, laptops, TV's and DVD players. I wondered what exactly they thought they were going to do with a bunch of waterlogged electronics in a city that had no electricity to plug those things into. This was a prime demonstration of the mentality of most of New Orleans residents. Gimme, gimme, gimme. Once the barriers of society crumbled, they simply helped themselves at the misfortune of others. But in all of it, their choice of booty demonstrated the depth of their intelligence: taking cheap, sweatshop-made shoes instead of diamonds and rubies; stealing unusable electronics. At Smith and Wollensky's Restaurant, I found out later, the idiot looters had pilfered all the beer and liquor behind the bar, whereas the glass case that contained the $4000-a-bottle Napoleon brandy remained untouched. When it finally dawned on their darkened brains to hit Adler's, they focused on taking the cheap gold-filled jewelry, while some of the cases containing solid gold and genuine gems were untouched, so I found out from an Adler's manager later on. Bright baubles for dim minds.

At the J.W. Marriott, most of the stretchers, EKG monitors, and medical bags had been left there. We loaded them into the truck and headed back to the Dome. By this time, it was nearly 3 am. In the darkness at the Dome, I looked up into the night sky. Without a single light on in the whole city, I could see the entire Milky Way galaxy, millions of stars up there. Normally you can see one or two dozen stars in New Orleans, and none from the middle of downtown. But here, in the dark, desperate Dome was a singular sight of beauty. Faith Upton and Melinda Guerra saw me staring up and they too were overwhelmed with awe at the incredible sight of the countless stars. I began to feel good. I had headed up two successful rescue missions, one for the injured cop and one for our stuff, and I had done it on my own, with no outside authority, flying by the seat of my pants. Melinda and Faith hugged me and said “you did a great job with everything tonight. You know you're a hero.”

“I don't know about all that. I felt just as scared as anyone else. Besides, somebody had to rescue the cop and our gear, and nobody else was doing it. I don't think we can count on the city for much anymore. We're on our own.” I laughed a little at the term 'hero,' then said “I don't think any of that makes me a hero, just a good improviser. But then again, working for New Orleans EMS, accomplishing so much with virtually nothing, makes us all good improvisers!”

They too laughed at the comparison and agreed. I headed for the ambulances and tried to find an empty spot to take a nap. The stretchers and bench seats were all already filled with exhausted medics trying to sleep. I found a unit with an empty driver's seat and climbed in. The driver's seat is my comfort zone. I've spent so many years behind the wheel of an ambulance that I can instantly make myself comfortable there. This night was no exception. The night air was tolerably warm, the noise was at a minimum, and some National Guards had taken it upon themselves to stand watch over our ambulances. Spent from the days activities, I quickly fell into a satisfying, if all too brief, sleep. I wondered what the dawn would bring. After a nap of maybe two hours, I found myself stirring towards consciousness, the sun warm on my face. Had I simply had an apocalyptic nightmare? Surely my city hadn't been destroyed; it was just a weird dream and I had only fallen asleep on duty. At worst, I had slept past the end of my shift and I would get off late and maybe be in a little trouble. I kept trying to convince myself that it was all a dream. It certainly seemed like one. But I opened my eyes, and all around me was crowds of refugees, National Guard, and fellow bewildered EMT's. I got out of the truck and was immediately hit by the odor of the Superdome, even though I was probably a thousand feet from the nearest entrance. As unpleasant as the smell was, it only promised to get worse as the heat of the day wore on. It was only about 6 am. and it would just get hotter and stinkier. I looked over the low wall down into the street. Or at least, where the street used to be. Now it was a lake. It was a lake with buildings sticking up from the dark, smelly water, huge trucks trying to make it through. The water was at least five feet high around the Superdome. I wasn't sure how deep the military trucks and semi's could withstand, but surely this was near their limit. Any deeper and they'd need submarines. The big tractor-trailers with “FEMA” on the side were making their way to the Superdome and the Arena next door. We let out private cheers for their efforts. All of us had been impressed with George Bush signing documents declaring a state of emergency two days before the hurricane had come. Here was the benefit, FEMA setting up operations in New Orleans the day after the storm! But all of us wondered if it would be enough. It seemed like no amount of resources would be enough, not just to rescue us and the all the other refugees, but the overwhelming task of getting the city livable again. Would it ever be back?

Unfortunately, human nature rarely makes its presence felt as ferociously as it does upon waking in the morning. Several other EMT's were in the same predicament, ravaged by the urges inherent in simply being alive. We had to go to the bathroom. But where to go? We certainly didn't have toilets in the units. I considered digging a hole in one of the potted plants along the perimeter of the Dome and simply squatting on the edge of the big concrete planters, but I wasn't sure that these desperate times had become quite that desperate. Several of us decided to go brave the interior of the Dome in a group and try to find a secret bathroom that might have a working toilet. We headed into the stinky, hot stadium and started climbing stairs. The refugees were being kept to the first three or four floors so we headed up to the nosebleed sections where no one else was allowed. Our uniforms had always served us well. Paramedics can go anywhere. Our magical suits allowed us to bypass metal detectors in airports and courthouses, they render us impervious to the “police line do not cross” yellow tape on crime scenes and even allow white EMT's to buy lunch at the food stores in the worst neighborhoods that always seem to have the best and cheapest soul food, places you would never set foot in as a white guy civilian without fearing for your life. Again, our uniforms, sweaty and bedraggled as they were, allowed us passage into the virginal upper levels of the Superdome past the scrutiny of the National Guard. We walked past them as though we were invisible.

On the sixth level, the corridors appeared quite deserted. People had obviously been there, judging from the raided concessions stands, but now it appeared we were the only ones there. We head down the darkened, steamy halls till we found a bathroom. It had been discovered and there were no clean toilets. In such an emergency state of affairs, few would worry much about finding a clean toilet and this were no exception, but the unbelievable extent of the filth was nauseating. Whatever beasts had found this bathroom earlier apparently did not have the sense of cleanliness that a rat has, as human excrement was piled not only in the toilets, but in mountainous heaps on the floor as well. We asked each other 'was that really necessary?' in reference to the beings that had defiled the bathroom with such disgusting force. To refer to them as animals would be an undeserved compliment.

Frustrated, we pressed on. We headed up to the next higher level. None of really knew that the floors of the dome went this high. Apparently, nobody else did either as we found another bathroom with at least a dozen toilets that had been as yet undiscovered! We were delighted! There was even toilet paper! Of course the toilets didn't flush, but heck, it was clean! We decided to keep this treasure as EMS' little secret.

Business and paperwork accomplished, we decided to explore a little more on this level, up amongst the clouds. We found where the private suites were, the rooms that people and businesses owned to impress clients by taking them to football games and having a little hotel-like room all to themselves. The suites were locked, and we weren't about to give away our presence by trying to break in. But down a pitch black, narrow hallway our little group came across “The Club Room,” the room where the suite owners could congregate and have private parties with cocktails and food. I wondered what undiscovered gems might be stashed away in there. We began a systematic search of the Club Room and hit paydirt! There were cases of soda, packets of mustard and ketchup, napkins, bottled water, chips and even baskets to carry the loot in! We piled whatever we could carry into the baskets and headed back down. We even found a cooler with ice in it! Instead of taking the ice with us, we memorized the location so Faith and Charlie could come back and store their insulin there. As we headed back down the stairs, we noticed several other refugees staring at our purloined goods, obviously wondering where we got it. It appeared a few headed down the hall trying to find where Cokes and chips were being handed out.

Back at our little camp, we were heroes! As we distributed the warm sodas and chips and condiments, our co-workers wondered where we got it all. One thing I found out, some people will offer you nearly anything for a Coca-Cola! But I was only too happy to distribute the goodies to any of us who wanted them. My only request from any of my co-workers was that they watch my ass as the natives were sure to grow more restless.

As the day wore on, we mingled around our staked-out territory, wondering what to do with ourselves. We still had not heard from Mark or and we had no direction. It also became apparent that the less we had to do to keep ourselves busy, the more sad and anxious we each got over our families, homes and possessions. Many of us had seen the looters the night before and we knew they were still out there. All anyone could envision was gangs of those sub-humans going through our personal things back home, stealing and vandalizing our homes. Dave Frezel was worried about his aunt who had stayed home for the storm. He had a growing suspicion that she was dead in the flood that had consumed the Lower 9th Ward and New Orleans East. We needed something to do to keep our minds off the dread in our thoughts.

Fortunately Ron Pelas had made it back to the Superdome. He had offered EMS' services to the National Guard. They were overseeing the one entry point in the Superdome where the refugees were being let in. They requested some EMT's to help them determine which of the thousands of people seeking refuge was a “special needs” case. They were defining “special needs” as people who were not acutely ill or injured, but couldn't take care of themselves, such as the very elderly and immobile and the mentally retarded, and such people were being assigned to a special part of the Dome. Another Paramedic, Becky Calvo and I volunteered to go help triage the incoming people.

We got down to the main entrance on Poydras Street and were overwhelmed at the volume of people waiting to come in. In the day or so since we had arrived at the Dome, the crowd had swelled from around 20,000 to probably 35,000. Now here at the entrance, we could see first-hand the thousands more people waiting to get in. People were lined up along barricades underneath the overhang and out into the water lapping up against the sidewalk. All kinds of people were there, black and white, young and old, families, couples and single people. All had the same shell-shocked expression on their face that didn't describe anger or joy or sadness or puzzlement but hinted at what could only be described as disbelief. I imagined that the people were going to riot to get in, but each time I walked outside and looked at the crowd, they were just standing there, waiting their turn to get in.

All the time they were waiting, others continued to be deposited at the entrance. They piled out of deuce-and-a-half's, boats, four wheel drive trucks that had made it through, and an array of makeshift watercraft. One man showed up towing his elderly neighbor on a piece of paneling that had been strapped to an inner tube. He had trod through the city about 2 miles with the old man on the “boat.” When he got to the Dome, he shouted to us “Where can I bring a dead body? I was trying to get my neighbor here from Pauger Street but he died on the way.” He seemed perfectly chipper about the whole affair, as if hauling a dead body for two miles through disease-ridden floodwaters in 95 degree heat was the least possible inconvenience he could have experienced; it seemed running out of milk midway through his morning coffee would have been far more devastating. We told him the refrigerator truck was at the loading dock at the back of the Dome and the National Guard offered him a ride to get back there but he said “no, I've walked this far with him, what's another couple of blocks?” All of us standing there were awestruck with respect for someone that really knew how to maintain a good attitude!

Becky and I went inside to where the National Guard had set up an area that they could do a quick check-in of all the refugees. Name, address, date of birth. You're in. Males were all subjected to a head-to-toe frisking to check for weapons. About 50% of the guys who were frisked had something pulled off them, maybe a gun, a knife, a crack pipe, whatever. I didn't see any of the women get body-searched, only their bags, but I knew from experience that they should have been. Several people in the Dome had already been treated for lacerations and stab wounds sustained in fights. Those stab wounds weren't inflicted with the plastic sporks that came in the MRE's. The women animals in New Orleans can be even more vicious than the men, so it would be no surprise that many might have weapons on them.

Actually, at the entrance we had no problems with anyone brandishing weapons. Becky and I were supposed to determine which incoming people had “special needs” and which ones didn't. The National Guard, God bless 'em, were overwhelmed with the volume of individuals being brought in, and when someone said they had diabetes or asthma and didn't have their medicine, the Guard didn't know any better and sent them over to us. All we could do was ask if they're having a problem right now. Most of them said no so we just sent them into the Dome. It's not like we had any inhalers or insulin or anything anyway. The handful that were having a problem got sent to the emergency clinic on the other side of the Dome. As we determined that some were special needs and others had acute problems, we began to realize the ludicrous setup that had been determined in the shelter. Perfectly healthy people, after entering the Superdome, could set up camp anywhere they wanted within the boundaries that the Guard had determined. However, people with acute problems, like an asthma attack or chest pains or lacerations were sent to the emergency clinic all the way on the opposite side of the Superdome. The shortest route to it was to walk across the entire football field in addition to the long corridors behind each goalpost. Or they could walk the circuitous route through the semicircular hallway on the edges. Either way, it was at least a quarter mile for someone having an immediate health problem. Even worse was the location reserved for the “special needs” people. Their designated area was not only on the opposite side of the Superdome from the entrance point, but also on the third and fourth level up! That meant that people who had to use crutches, walkers and wheelchairs not only had to traverse the quarter-mile around the Superdome, but also had to navigate up to at least the third level while the healthy people could stay on the first and second levels! Whose idea was this?

I was amazed at the stupidity I encountered with some of the incoming refugees. None of them could have known that the Superdome was a shelter without also hearing the words “Bring your own food, water, clothes and medicine. They will not be available at the Dome.” Of course, every single person I saw at the entrance had brought NOTHING with them. I think the closest thing I saw to provisions with someone was a woman who had a plastic bag with a bottle of water and some peanut butter crackers. Nobody else had a single change of underwear, a can of Coke or bag of chips. Three teenage mothers came in who had just given birth within the last week. They asked if there was any baby formula. At first we started to waste our time asking why they didn't get out of the city when they had a week-old infant but their responses could all be boiled down to “stupidity.” Becky and I told them “No, we don't have any baby formula, so welcome to breastfeeding class!” Becky took the three mothers along with three other women who had come looking for formula and gave a quickie how-to on the joys of breastfeeding. After about five minutes of that they were off, on their way to bond with their newborns. We told them to teach their friends.

Some people came in thinking that the shelter was some sort of free clinic. Dozens of people asked what I had for their sore throat or their stomach virus or their headache. It was all I could do to keep myself from slapping them in frustration. Not only did they come here without a single provision for themselves, but they also expect some sort of free medical care for whatever crappy complaint they've had for the last week or month? Others wanted to know where the free clothes were. I could only tell them “This isn't a drugstore or a clothes shop or a grocery. It's a shelter. You needed to bring that stuff with you. If you didn't, there's not a lot I can do for you.”

We stayed down at the entrance for several hours. Becky had commandeered one of the golf carts that belonged to the Superdome and began ferrying the special needs people and acutely ill to the appropriate places. We simply couldn't just tell elderly people on walkers and crutches to tromp all the way over to the designated areas without any assistance. But after several trips, the cart ran out of juice, stranding Becky upstairs in the special needs area. I couldn't get in touch with her and I had been at the entrance by myself for over an hour waiting for her to get back. I realized I wasn't really doing too much that the Guard couldn't do. I didn't have any medications with me or other kinds of treatments. My job basically consisted telling people where the special needs area was and saying “No, I don't have any medicine or baby food.”

Since Becky had disappeared, I figured she had been reassigned to something else. So I quietly left the entrance and went back up to EMS' campsite on the outer perimeter. By this time our people that had been stranded in the Bellsouth building in New Orleans East were at the Superdome. Cedric Palmisano had worked with Med-Evac National Guard unit based in New Orleans and had convinced his buddies there to airlift the stranded medics out from the East. We were happy to see that they were all OK. Keely Williams and Samantha Graham had taken photos of their flight. The devastation apparent in the pictures was unbelievable. While New Orleans East is certainly not the best part of the city, geographically it is a huge portion of Orleans Parish, and now it was inundated with water. For the most part, nothing but parts of rooftops were visible above the dark water, in some cases even the tops of the roofs were submerged. Many of the houses were on fire. To see the scope of the destruction of the city filled everyone with even more anxiety and depression. But we were happy to be reunited with our friends, and that they were all right. They told stories of the walls and windows blowing out during the storm, and having to deal with people coming up to the building trying to get in, threatening the personnel inside with weapons. They heard a lot of gunshots out in the East. We had heard a number of them throughout the day also coming from nearby neighborhoods. Since there was no traffic or city noise to drown them out, the crack of gunfire could travel quite a distance, so it was hard to estimate how far away from the Dome a particular shot might have been.

As the day wore on, though, the sound of helicopters coming and going began to drown out noises from the outside. The helicopters started to come in droves, bringing some that they had rescued off rooftops, and taking away the critically ill that had been in the emergency clinic downstairs in the Superdome. The FEMA trucks we had seen earlier were setting up an emergency area in the New Orleans Arena for the special needs people, since the one in the Dome was so clearly malapportioned. They would also have a few capabilities for some medical care for the chronically ill. It was going to be our job to transport them from the special needs area in the Superdome to the Arena. It wasn't going to be a big deal, since the Dome and the Arena are connected by two broad ramps. At least, that's what we thought.

Eventually we were given the go-ahead to transport the special needs people to the new care area. It had been set up in the front corridor of the Arena, right by the door adjacent the Superdome. We took our ambulance stretchers, and a couple of golf carts and headed up into the special needs area. People were arranged at the top of the escalator on cots, in wheelchairs and on the floor. There only seemed to be a couple dozen or so so we got busy moving them. We were strict about telling the people that were with the infirm that they could not come with us; there was only room for the actual special needs people. Many had schemed to get special treatment by saying they were “family” of the special needs, leading to an entourage of ten, twelve or fifteen “family” members who were all there to “take care” of the one sick person. These support groups often included babies, neighbors, vague acquaintances and random strangers who were hoping to catch some of the fallout of the special needs like a slightly better place to stay or better food. We weren't about to let any of that happen. We let exactly one person accompany the elderly and crippled, and they had to be able to prove that they were actually there for the other person. Often the only way to do this was to ask the special needs person who this other person was. Sadly, oftentimes the special needs person had no idea who the other one was, not because they were senile or ill, but simply because there were that many people who were trying to leech off them and had plopped themselves into the ostensible position of “caregiver.”

We weeded out the fake family members and got everyone in the area downstairs and across the ramp. It seemed too easy. As we went back for a final sweep for any stragglers some of us noticed a pitch-black hallway near the area. We shone our flashlights down the hall and saw several dozen more people in wheelchairs sitting in the dark. As we explored the corridor, it ended in a very large room that curved around. In it were hundreds of cots, mostly occupied by the very elderly, handicapped and mentally retarded. We gasped at the sight (and the smell) of so many infirm special needs people. I didn't know if there would be enough room in the Arena for all these people, but I called out to everyone in the room “Please gather your things together. We're here to take the special needs people over to the Arena where they'll be able to get some care. We're ONLY taking the people who have special needs, not the family and friends.” All the EMT's came back upstairs and began the task of moving everyone. Most of the people were there alone, with nobody to look after them. The first people I picked up from the back room was an elderly lady who was recovering from hip surgery. Her husband, on the cot next to her, was suffering from advanced Alzheimer's and had no idea who he was or what was going on. She was wearing an adult diaper that had not been changed in over two days. She was as sweet as could be and kept apologizing for the mess, but there hadn't been anyone to help her since she had gotten here before the storm. She also hadn't had much to eat. Others in the room had given her water and some of the MRE's they had. But she hadn't had her medicine, and there was no family there for her other than her delirious husband. She told me this as I changed her diaper and I found myself on the verge of tears at her story. Ashley Fain and I placed her on out stretcher and wheeled her downstairs as another crew took her husband.

After dropping them off at the Arena, we went back for another. This time we transported a frail older lady who hadn't had any medications or anything to eat or drink in over a day. As we rolled her across the ramp in the hot sun, I could see that she was barely conscious and her breathing was irregular. After I felt her thready, rapid pulse I realized that this woman was going to die. Today. Judging from the looks of many of the special needs people, a lot of them were going to die soon. I told Ashley about it and she confirmed my fears. I wasn't afraid of having all these elderly and infirm people die, I was afraid of what would happen when others started to realize that people were dying at the Dome. That might be just the trigger to set off all the frightened, desperate people there into a full-panic, maybe even a riot. I began to pass the word on to my co-workers that it was time for us get out. It wasn't going to be safe for us to be there anymore. These people were going to riot and there were only a couple hundred National Guards with no bullets. I barely had to remind them of the First Rule of EMS: If the scene's not safe, get out! A dead EMT can't help anyone.

There were still dozens of people to transport. I wasn't sure how many the FEMA people could handle; it looked like they were pretty full up already. But we went back to the dark hall and searched for others. The rain had caused huge sheets of ceiling to fall in. The carpet was soaked and covered with dissolved sheetrock and plaster. Combined with the sweltering heat and the smell of excrement from 40,000 people, I had a hard time imagining that a third-world prison could be much worse than this. In the beams of our flashlights, we saw concession carts belonging to the Superdome with people in wheelchairs tucked behind them. There were a few large sheets of ceiling material that had partially fallen, forming plaster curtains in the hall. I checked behind one of them and found and old black man propped up in a wheelchair. I asked if he had any family with him and he said he didn't know where they were. He told me his wife had come with him to the Superdome but hadn't seen her in “a long time.” He had been there since before the storm. He had been in the hallway since getting there. Apparently nobody had found him since the lights went out and he had been hidden behind the plaster for two days with no food or water. I gave him the bottle of water I had in my pocket which he accepted gratefully and asked me where his wife was. I said “I don't know, but we're taking all the people in wheelchairs over to the Arena where they can care for you and maybe help you find your wife, OK?” I hoped I wasn't telling a lie.

When I arrived at the Arena, the FEMA people told me that they were too full already and they couldn't take any more special needs people. I wanted to say the man in the wheelchair looked heartbroken, but more than anything else, I think he was simply numb. I thought I had been through a lot over the last two days, but I couldn't imagine losing your family in a shelter and being trapped behind a chunk of sheetrock in pitch-darkness with nothing to eat or drink and nobody even knowing you were there. I lied to the FEMA official “Look, we just brought his sick wife over here and he's had nothing to eat for two days. I don't want to separate them.” He relented and said “OK, you can bring him in.” I pushed his wheelchair into a corner behind the hundreds of wheelchair patients that were already there. I wished him good luck and he said to me “Son, if you find my wife, can you tell her that I'm here? Her name's Margie Smith. Thank you for all you've done.” I promised him I would, but knew that I'd never find Margie Smith.

As I walked outside the Arena into the blazing sun, I felt like I should cry for him, or at least be sad, but I didn't. I was as numb as Mr. Smith appeared to be. No, I wasn't numb, and I wasn't sad. I was angry. I was angry at the stupidity of thousands of people who had been pleaded with to get out of the city but they had chosen to stay. I found out months later that a study by the Red Cross showed that of all those tens of thousands, if not hundreds of thousands of people who had not evacuated, only 8% truly were not able to get out of town. Over 90% of the people the throngs I saw at the Superdome and on the streets looting the city had the means to leave but chose to stay and were now yelling and whining about why they had to put up such bad conditions!I was angry at the fact that fewer than 300 National Guard troops had been sent to the Dome for over 40,000 people, and they had not been given any bullets for their weapons. I was angry at the selfish, uncaring attitude of families who had evidently dumped off their elderly parents and grandparents at the Superdome with no one to feed or care for them as the rest had gone on their merry way to evacuate, or more likely, head out for a looting spree. I was angry that although New Orleans, a city deliberately built below sea level and surrounded by water, has had over 400 years to prepare itself for “the big one,” but not a single plan was in place to deal with the exact emergency that generations of people had warned about and was currently devolving all around. In addition, I had not seen a single city government official or administrator. I was angry that EMS had been operating for over two days with no leadership at all; we still hadn't heard from our EMS Administrator or Operations Manager for two days, nor had we seen a single city council member, and Mayor Nagin had jumped ship and was off in Dallas buying his new condo. It angered me to think of the mismanagement of the Superdome as a shelter. The sick, handicapped and elderly who were least able to get around were directed to one of the most inaccessible areas of the building, the furthest distance one could possibly get from the entrance. I thought back to other times when the Superdome had been used as a shelter during hurricanes, and that thought angered me too. The first time, about eight years earlier, about 2,000 people were sheltered there. None had brought their own provisions. They got angry that free food wasn't being served to them. In fact, that crowd had looted the Superdome itself; news cameras showed hundreds of people leaving the Dome carrying televisions, furniture, electronics and various other items they had stolen from the stadium. One man shouted on camera that this was recompense for “my being inconvenienced.” At that time people had again been pleaded with to evacuate the city, chose not to, then chose to go to the Superdome in order for their lives to be saved from potential floods and other hurricane hazards, then proceeded to steal the shelter's furniture in retaliation for being “inconvenienced!” I was angry that the city didn't learn from that mistake and several years later opened the Dome again as a “special needs only” shelter. That time the Superdome was to be used as a shelter only for people with specific medical needs, such as those on oxygen or who required dialysis or were on home ventilators. New Orleans had spent God-only-knows how much money and effort on staffing the “special needs only” shelter. There were over 500 medical personnel including doctors, nurses, paramedics, respiratory therapists, nurse's assistants, dialysis technicians and physical therapists, plus all the logistics people, police, fireman and administrators. After all that planning and effort, exactly fourteen patients showed up seeking shelter.

After those spectacular debacles involving the Superdome as a shelter, I had foolishly thought the city had learned its lesson. But as I stared across the Arena ramp back towards the Superdome, I was clear to me that it had not.

I looked out at the crowd, and the ambulances at the far end of the ramp. I realized that letting my anger get the best of me was not the best use of my time. I walked back to the ambulances and tried to figure out what to do with myself. We had moved all the special needs people that FEMA could take, and I really didn't want to go back to triaging incoming people who were looking for free handouts in the midst of this disaster. There wasn't much to do. I thought about my earlier realization that the crowd could very easily riot, once they figured out that people were dying. As I began meeting up with other medics, I quietly explained my thoughts to them to convince them that it was time to leave. We needed to figure out a way to get out of the Dome. But how? And where were we to go?

By this time, Wildlife & Fisheries had rescued the EMT's in the LSU Dental School in their boats and had gotten them back to the Superdome. Everyone was accounted for, except Mark and Juliette who we didn't have a clue about, and Ray Mandola, Thomas Jordan and Dave Wilson who were at the station on Moss Street last time we heard. We were concerned for them, but there wasn't a lot we could do for them at the moment. Besides, Tom and Ray were pretty big, tough guys and maybe a little on the far side of crazy, so we figured they were probably OK on their own. Raymond is a boxer with a little gleam of insanity in his eyes, and Thomas is an ex-Marine who is a really nice, quiet guy, but could probably be a master serial killer. Dave was pretty new at EMS, and we didn't know him too well, but if he stuck with the other two, he'd be pretty well off.

After some time talking to my fellow medics, we began to reach a consensus that we needed to leave. But my guys who had driven us around last night were out helping with rescue missions, and all the other deuce-and-a-half's were similarly occupied. The crowds were growing more unsettled. The numbers of refugees had grown from around 20,000 when we arrived at the Superdome to about 40,000. We witnessed more fights breaking out, and more people seemed to be in a greater state of panic. More National Guard had arrived (bulletless) but at least there was a slightly growing presence. We quietly brainstormed the idea of departure while we tried to occupy ourselves with other tasks.

At last, around four PM, Juliette and Mark showed up. They both looked as frazzled as the rest of us. I had no idea where they had been, but apparently they had managed to get all around the city for various tasks. Juliette had apparently been at police headquarters when the prisoners broke out of Orleans Parish Prison and took over the police department offices at Tulane and Broad. The riot didn't last long; she had been able to get to the overpass on Broad Street with the rest of NOPD and the Criminal Sheriff's Office as they planned to quell the rebellion, which occurred in short order. We were all angry at them that we hadn't seen them for three days and accused them of abandoning us, not having a plan, nor any idea of what to do now, and we were pissed that they had managed to get around the rest of the city but somehow not able to get to their people at the Dome. At one point Rhonda Serignet began hollering at Mark for his abandonment of his people and Mark lashed out at her, physically pushing her away from him. She began to push back and Jay Winston and Dave Frezel got between them to break them up. There was some more shouting, but others tried to calm them down, saying this wasn't helping, we needed to stick together and fight later. Right now we needed to focus on getting out of the Dome. No one could argue with that line of reasoning.

They told us to move our personal gear from the ambulances to the upper level of the Arena where it would supposedly be “safer.” I didn't really see the logic in this, at least some of us were constantly there at the units, keeping an eye on things, whereas the upper level of the Arena was relatively unguarded, and we saw random, unidentified people strolling down the hall where people's things were. I wasn't taking a chance with leaving my clothes, food and computer out in the open in the Arena, so that stuff stayed in the unit. Some of the medics complied and moved their things there.

After moving, we heard that the city's Director of the Health Department, Dr. Stevens, was at the Dome and wanted to meet with us. EMS at the time was governed by New Orleans' Health Department. We were eager to talk to Dr. Stevens, seeing that his Department had no medical plan for a disaster, other than the brilliant use of the Superdome. Because of this ingenious idea, we were now faced with the circumstances we now found ourselves, namely trapped there with 40,000 angry, desperate, panicky people with no way out and more arriving and virtually no security system in place other than 300 National Guards with bulletless guns, who may as well have been carrying flyswatters for all the protection their M16's offered.

Dr. Stevens showed up at the Arena nicely groomed, wearing a pressed maroon oxford button-down shirt, starched khaki pants and shiny loafers. We sweaty, unwashed, sleepless medics gathered around him on the upper deck of the Arena. We listened as he blustered about what a great job he was doing in the face of such adversity. He told us that he hadn't left City Hall since the storm. He was working day and night. He was doing a wonderful job in the face of huge adversity. Not once did he even say the word “you.”

Keely told him that none of us felt safe. The expression on Stevens' face indicated that the idea of whether or not the Dome was safe hadn't even occurred to him. “What do you mean you don't feel safe?” She mentioned the fights we saw, the hysteria of some of the refugees, the lack of weaponry of the Guard should things get any more out of hand. Melinda repeated the first lesson you learn from day one of EMT class: If the scene isn't safe, get out. He had no idea what she was talking about. Whatever little respect we may have had for him completely evaporated at that point. How can someone who hasn't the slightest clue about what our job entails be the head honcho over our department? We began to walk off, snickering to ourselves at the uselessness of Dr. Stevens, even as he continued to chatter on about his position and the importance of it and what a wonderful job he was doing. I suspect he was still there after we had all left, talking to the empty hall, listening to the hypnotic sound of his own voice.

We left the Arena and met up with Mark, who told us that he was going to try to arrange transportation out of the Dome for us. I talked to Guy and Steve. We decided that it was time to leave. Maybe Mark would get us out, but maybe not. Screw EMS. I was only there part time anyway. We weren't safe there and we needed to leave. I was convinced the city would never come back, that New Orleans was finished. Who would want to come back to a ruined city where the basic infrastructure of society was dissolving? There was no electricity, no water, no police, no fire protection, no EMS, no hospitals, no food, no schools, and the only people left over were those who were too stupid to leave and were now occupied with looting the remaining vestiges of civilization. Steve was panicked about his wife and child. Like the rest of us, he had no contact with his family since the storm. Guy was just tired of this whole scenario. We talked each other into it and we each gathered up our belongings and began to walk off. We could all but hear each other's thoughts. Was this the right thing to do? Were we really going to forge off into the chest-deep water, hoping to find a way out? We had walked to the entrance to the New Orleans Center, a shopping mall with a ramp adjoining the Superdome. We stopped and asked each other if this was the best idea. We reconsidered our decision. There were only three of us and we had no way to protect ourselves, or even a coherent plan of what to do or where to go. Plus Guy wasn't the brightest crayon in the box. He had once driven an ambulance past the big orange barriers and straight into the wet concrete of a re-paved section of roadway, with all the road workers watching him. Steve said he couldn't swim.

“Are we doing the right thing?” Steve asked. We paused and began to re-think our decision. At least at the Dome we had a hundred of us, rather than just three. If Mark could arrange transport, it would likely be safer than venturing out on our own. At the Dome, we had MRE's and bottled water. Not so out on the flooded streets. Slowly, we began to out-talk ourselves from leaving. It would likely be a better idea to remain where we were for the moment. We turned around and walked back to the group of ambulances. As I trod along, I felt ashamed. I had managed to keep it together this long, but I had succumbed to panic and lost sight of reason. Worse still, I was ready to abandon the people who I counted on, and who counted on me. If there was one unspoken rule in EMS, no matter how much you like or dislike your partner, you watch each other's backs. I had nearly left behind the people who I had worked with for so long and depended on, and they had watched my back. At that moment, I just wanted to crawl under an ambulance and cry. Fortunately, I hadn't told anyone about what we had done, but some had seen me gathering all my stuff and walking off. I quietly told them what had happened. Jeannie, Samantha and Donnie said they couldn't blame me for wanting to leave, but were glad I stayed. I said I was glad I did too. The time to leave would come, but it wasn't now.

It was getting to be evening, and there were probably 45,000 people at the Dome by now. We decided to buddy up and watch our partner's back, just in case the shit hit the fan. I chose to buddy up with Samantha. We would make sure the other one was OK and make sure that we stuck together if and when it finally came time to leave. No one had any idea where we would go, but anywhere had to be better than our current circumstances. In the meantime, Mark had asked us to help with hospital evacuees. The V.A. Hospital and Charity and University Hospitals were trying to evacuate their critical care patients and our services were needed to get them from the boats docking on Poydras Street to the helicopter landing zone atop the Dome parking garage. We had brought our stretchers to the LZ (landing zone) and met up with the deuce-and-a-half's. They were loaded with patients from the ICU and were on ventilators and had IV's with all kinds of medications dripping. These were people who stood little chance of survival, but what could the hospital staffs do? Just let them croak?

I helped unload the first patient from the huge truck. Fortunately we had more help than at Tulane with the cop. This patient needed all the help he could get. He weighed 450 pounds if he weighed an ounce. He was intubated and there was a V.A. Respiratory therapist rhythmically squeezing the Ambu bag, breathing for him. He had three IV's going, all with medications that needed to be finely regulated, but with no pumps attached to the IV's to do the job. The respiratory therapist wasn't sure what this patients underlying malfunction was, but he thought he had suffered a stroke. It didn't matter. We just needed to keep him alive till he could be loaded onto the helicopter. We lifted the huge man onto the stretcher and rolled it onto the LZ to await our turn. A paramedic from Acadian Ambulance was overseeing the patient loading, which patient was to go on which chopper. I had never seen so many choppers in the air and on the helipad. The noise from their rotors was deafening and the wind blew the patients hospital gown and stretcher sheets all over the place. I awaited our patient's turn, squeezing the bag, breathing for the patient, wondering how long he would live.

While I watched the helicopter operations, another crew was busy loading someone into a nearby helicopter. There was a commotion in the crowd on the other side of the low wall that divided the LZ from the plateau around the Dome where the refugees stood watching the helicopters. A young man jumped over the wall and ran screaming towards the helicopter. The National Guards wasted little time grabbing him and subduing him, delivering a few well-placed blows to the man's anatomy. He laid on the ground and faked a seizure. It wasn't a good seizure-faking, because the whole time he kept on shrieking at the top of his lungs. I couldn't make out what he was saying due to the noise of the whirling helicopter rotors, but I kept watching as an imposing older black woman walked over the scene of the ruckus and began shouting also, first at the National Guards, then at the man on the ground. The Acadian paramedic walked over and quickly checked him out. The Guards stood the man up and walked him back over to the wall he had jumped over, and practically tossed him back over into the crowd. I was very pleased to see that despite their lack of bullets in their weapons, the National Guard people weren't going to take any bullshit off the idiots they were forced to deal with.

As it neared our turn to load our patient, the paramedic came over to us and directed us to the helicopter designated for our patient. After placing him into the waiting chopper, I returned to the Acadian guy and asked him what had happened with the young man. He said that the man had jumped from the crowd because he had recognized his uncle being loaded into the chopper by the other EMS crew. He panicked and ran over shouting that he had to go with him in the helicopter. Obviously he couldn't go with him, he couldn't even be in the LZ as it was restricted from civilians, so he threw a tantrum at the National Guard, who promptly took him down, after which he faked a seizure. The man's mother came from the crowd, pissed off at the Guards, but when they explained the situation to her, she re-directed her anger to her son and shouted at him all the way back to the Dome, calling him a big sissy and saying “and what exactly do you think you can do fo' yo' uncle in dat helicopter? You just want a ride outta here! You supposed to be takin' care o' yo' baby brother and here you is acking like a baby...” I laughed briefly at the situation. I was happy that at least Big Mama was keeping her wits about her. But the people in the crowd that had witnessed the situation didn't seem as happy. All they saw was the National Guards subdue a black man. I'm sure the stories they would tell later would recount how the Guards beat up a black man for no reason. I wondered how long it would take for the crowd's resentment to grow. Combined with the obvious panic setting in, it would be a violent explosion when the two volatile emotions started mixing on a large scale.

I thought about this as we unloaded another patient from the deuce-and-a-half's. As we again waited our turn for a helicopter, I asked my partner, Liz Farrell to ventilate the patient while I went over to talk to Yolanda. When I approached Yolanda, she confided in me that she wasn't sure how long the Guards would be able to maintain order among the desperate crowds. She asked me to imagine what would happen if the scene we had just witnessed was repeated by 5,000 or 10,000 people. There would be no way that anyone would be able to restore order! I replied that I was having the exact same fears and we needed to get out of the Dome ASAP. She hoped Mark could secure us a place somewhere else.

I thought about this as Liz and I rolled our patient over to the helicopter. After we situated him on the cot in the chopper, the soldier in there shouted that they needed a flight medic; there was no flight medic to care for the patients in this chopper. In an instant, the scene with the panicked man on the LZ flashed through my mind, and my imagination repeated that scene 10,000 times over as Yolanda had suggested. I felt a wave of panic come over me and I opened my mouth to say I would stay on the helicopter and care for the patients. But in another instant, I thought about how ashamed I felt when I had almost left earlier. And I had told Samantha that I would look after her, and she was going to watch my back. I wasn't going to leave her, nor any of my fellow EMT's after we had gotten through so much together. I turned around and saw the Acadian paramedic who was overseeing the chopper loading. I told him that there was no flight medic on this chopper. He offered to go. I asked about who would oversee the helicopters. He explained that evacuation flights would shut down after the currently loaded helicopters left. It was no longer safe to fly because people in the city were shooting at the rescue and evacuation helicopters. I would have liked to say I was stunned at this news, but I wasn't. I knew just how stupid and malevolent the residents of this city could be. That they would fire guns at the people who were trying to save their lives was a tidbit that fit perfectly into the melange of idiocy in the image I had built up in my mind of the lawless and ignorant thugs of New Orleans.

Seeing as we had no new patients to transport onto choppers, we returned to our base camp by the ambulances. We explained why there were no more flights at the moment, and several EMT's said that in the limited communications they had with friends on the fire and police departments, people had begun shooting at the cop cars and fire trucks in addition to the helicopters. Perfect, I thought. We discussed the way that future interviews with Katrina refugees would appear on the news. We pictured people saying they were sitting on their rooftops or n the floodwaters waiting for someone to rescue them, but no one came. Of course they would leave out the part where they fired their AK-47's and various other ghetto blasters at passing helicopters, rescue vehicles or any symbol of authority. We imagined the media sympathizing with the shooters and placing blame on those who were being fired at. If people didn't get rescued because the people were shooting at the rescuers, naturally it would somehow be the fault of those who were trying to save the people's lives, not the poor, pathetic people who should have gotten out of the city ahead of time, and could have, but didn't.

Samantha described some of her experiences since being at the Dome. One teenage mother had walked up to her and handed her and infant, said “I can't take care of it,” and walked off, disappearing into the crowd. Others described incidents where parents had asked for help after their children had been raped by other refugees in the Superdome. At least three incidents like that occurred, involving girls aged 14, 11 and 7. Although no shootings were reported, several people had been stabbed and numerous fights continued to break out.

There wasn't a lot to do, but Mark told us that he had finally secured transport for us out of the Dome. We needed to get our stuff together and be ready to go at a moment's notice, because he wasn't sure when the military truck would be finished its current assignment and be ready to take us. We were to go to the Aquarium of the Americas, on the Riverfront. Apparently NOPD had set up a base camp there and they had food, water and protection with all the cops there. It took about two seconds for everyone in our group to imagine what it would be like sheltering at the Aquarium and begin speculating on what methods we might use to catch some of the tasty fish in the display tanks there. Redfish, shark, turtle, catfish, alligator and trout sounded a whole lot yummier than MRE's! We could be stuffing ourselves on seafood and sushi!

With no electricity and no water, the Aquarium wouldn't be more fun than a barrel of monkeys, but anywhere would be better than the Superdome. We gathered our things together, and Samantha put her stuff with mine. We made sure that we knew what each other's bags looked like so nothing would be left behind when it came time to go. We spent a couple of hours waiting in the dark, talking and wondering what the future would hold. As would happen when we had nothing to do, our thoughts turned to sad things. We worried about our families and friends and homes. I thought of all the memories I had, all of them set in the schools, streets, homes restaurants and bars of New Orleans. How many of them were set in locales that were now forever gone? We tried to ignore the threat of mass panic around us; we stuck together and tried to comfort those that had broken down again in tears. We tried to encourage one another to look forward to getting out of the Dome.

Eventually a big deuce-and-a-half pulled up and the driver announced that he was going to take us out. But there was only one truck and there were a hundred of us, plus all our bags and medical equipment from the units. We were going to have to make at least two trips. Samantha and I volunteered to stay behind and go with the next group. By this time it was about 9 pm and the helicopters had resumed operations for a while. At least we'd have something to do. After helping the first group get all their stuff in the big truck, we went back to the helipad and started unloading more patients onto our stretchers and then into the choppers. It was an impressive sight, all those helicopters. There were military choppers that could carry four patients at a time and little private-service choppers that could carry just one. While choppers were being loaded, others hovered in the air nearby, awaiting a spot in the LZ. Cedric had taken over operations that the Acadian paramedic was handling earlier. He seemed happy as a clam in his role. Cedric has one of those personalities that is jaunty and gleeful no matter how bad the circumstances. He reveled in his task and did a good job.

I received a patient from a truck and rolled him over to the helicopter. It was one of the single-patient private helicopters painted bright yellow, with a flight nurse and a paramedic on board. By this time I had quit asking about what was wrong with the patients; the Guardsmen in the trucks didn't know and there wasn't much I could do for them anyway sitting on the top of the parking garage, other than making sure they were still breathing and had a pulse. This was why I got frustrated when the flight nurse on board the helicopter began asking me questions about the patient's symptoms and vital signs and medical history and medications and lab results who the accepting doctor was at the destination hospital and so on. I told her I had no idea, that all I was doing was keeping these poor souls alive on my stretcher till they could be flown out of here. She wanted to know what I was planning on doing if they needed medications given. I said “what medication? You see what we're dealing with here, I have a stretcher and my two hands. That's it.”

“Well what are you planning on doing if they go into cardiac arrest?” she petulantly inquired.

“Send them down to the morgue trailer,” I replied flatly.

Her partner the flight paramedic flashed me an apologetic look. I think the gravity of our situation finally began to dawn on her as I huffed off and she looked around at the thousands of people behind the wall. She had obviously spent too much time in a cushy emergency room somewhere where everything was organized and accounted for. Here at the Dome, we were just trying to function as humans, let alone get detailed histories on every patient that we plopped onto our stretcher for the 1000-foot walk between the trucks and the LZ.

After an hour or so, operations were again stopped because of gunshots at the helicopters. I headed back to the EMS camp to see if the truck was back for us. Samantha had been calling me on the radio to see if I was on my way, because they had gotten word that the truck was heading back. It had been over two hours since it had left with the first group. None of us could figure out what was taking so long, as the Aquarium is maybe a mile from the Dome, and no one had more than three or four things to unload. At last, around 11:30 pm the truck was back! We hurriedly loaded all our things onto it and helped each other climb in. About 12 or 15 EMT's stayed behind to help with helicopter operations once they resumed. The National Guard had sensed the growing danger and they instructed the remaining EMT's to sleep on the LZ where the Guard had the greatest presence. Before moving there, the Guard asked the those EMT's to rearrange the ambulances in a way that would form a defensive barrier, in case there was a bad riot and the shit hit the fan. We bid our farewells and wished our coworkers luck as Samantha climbed into the deuce-and-a-half with forty or fifty other medics. We were almost cheerful to be leaving, but harbored concerns in the backs of our minds for our own safety and that of our remaining coworkers.

As the truck pulled around the Superdome to the ramp that led to the street level, there were far more people standing outside than there had been on the first day. I estimated around 40 or 45 thousand people were there by that time. No doubt many had chosen to stay outside because of the unbearable stench within the stadium. No doubt it was also because it was nighttime, and the Superdome was pretty dark inside during broad daylight with no electricity. I imagined it was impossible to see anything at night inside. I glanced at the sky; it was another beautiful, clear, moonless night, incongruous with the turmoil that was all but palpable among all the hurricane survivors. As we turned down the ramp towards the street, we saw several National Guard troops intervening in a large fight that was taking place amidst the crowd. “We're getting out just in time,” someone in the back of the truck muttered. We all nodded in silent agreement.

We had been told that the Aquarium wasn't able to house the influx of city workers. Their limited resources were already overwhelmed by the police and National Guard that had taken refuge there. The two hours that the truck had taken to return to the Dome had been spent trying to secure safe haven for the EMS workers somewhere else. I wasn't sure how it had come about, but the other group had been transported to the Hampton Inn on Convention Center Boulevard in the Warehouse District, across the street from the New Orleans Convention Center. We headed there.

For some reason, the driver took Canal Street, which was a bit out of the way to get to Convention Center Blvd. But as we headed down Canal, we took in a sight that we had imagined but hadn't comprehended until we saw it with our own eyes. For one thing, Canal Street remained flooded. The water was at least four or five feet high, up to the chests of the pedestrians meandering back and forth across the road. We made a joke that Canal Street had finally earned its name. However, what shocked us all was not the floodwaters, but the pedestrians. There were hundreds of people on Canal, far more than you might see during a normal business day, but none of them appeared to be heading towards higher ground in the French Quarter or the Superdome or towards the riverfront, which had remained dry. Instead, as we looked closely, they were all engaged in heading in and out of the many stores an shops that line downtown Canal Street. And every single person, including the old ladies and little kids were carrying clothes on hangers, boxes of shoes, televisions, video cameras, even huge plasma screen T.V.'s just like the night before. Many had constructed makeshift rafts out of barrels and were pulling large Rubbermaid bins behind them on ropes, all filled with loot. Some of us had seen the looters the night before when we went to retrieve our stuff from the Monteleone, but the sheer numbers tonight made the mind boggle! Apparently word had gotten around town that everything was there for the taking, and there were thousands taking advantage of the “invitation.”

We made it to the Hampton Inn. As we all hopped down from the big deuce-and-a-half we took our bags up to the second-floor ballroom where we were to bed down for the night. Downstairs, NOPD officers were barbecuing and seemed to be in a relatively good mood. I took this as a sign that bode well for us. I searched out a few square feet of space unoccupied space among the eighty or so other EMT's to place my things and then headed out to the courtyard. Some of us had brought beer and were happy to share it with the rest of us. There was a pool in the courtyard and all of stripped off the grubby, smelly clothes we had been wearing for the last three days and jumped in, despite the debris, bricks and tree branches in the bottom of the pool. It was the first time any of us had a chance to wash off the the sweat, the gunk of the floodwaters and the residual stench of the Superdome, and we all welcomed the refreshing water. Chris Guenard, Tim Stratton, Charlie Brown, Patty Hasney and I played like little kids at the beach in the cool water. Others were taking a much-needed break, recounting their experiences at the Dome, the dental school and the Bellsouth building. None of us knew what had happened to our homes and we had no way to contact our families to let them know we were OK and we were anxious over the disturbing scenes we had witnessed on the way over, and that hung in the back of our heads like a dark cloud, but now, for the first time in days, we could let our guard down and relax a little.

I had just finished my second beer when Tammy Guenard, our communications System Status Manager, walked into the courtyard with a look on her face that reflected shock and fear. “I need you all to listen carefully! Listen up!” After being without any organization for days, the thought of someone having something definite to announce to us galvanized our attention. Whatever it was couldn't be good.

“NOPD downstairs just said that the water is rising again at the Sixth District station. They don't know how high it may get, but that's only about a half mile from here. They say we need to pack a bag and get out of here.”

Silence hung over us for a moment as the gravity of the situation dawned on us. Another move, my fourth in three days, the fifth or sixth for others. None of us were happy, to say the least, but our desire to survive motivated us to get out of the friendly pool and head inside to change into dry clothes and pick what of my few remaining possessions I would take with me. I packed my uniforms, some water a couple of MRE's and my laptop (I wasn't losing that!) into my backpack. I also took my jump bag with my medical supplies. My co-workers pared down what little they had left also. We had reported to work with suitcases, coolers, clothes, DVD players, medicine and food. Much of that had been left at the hotels, the dental school, Bellsouth, the Superdome and some had simply been lost. I left half my clothes, my toiletries, most of my food and the book I had never gotten around to reading, confident that it would go unread.

We all made the same decisions about what to take and what to leave behind and gathered on the sidewalk downstairs. NOPD was climbing into their police cars and eight or ten Cadillac Escalades. None of them made any effort to help us get in or mention where we were to go. As the last of them got into the cars and trucks an awful thought dawned on us. Patty Hasney walked up to one of the cars and asked “Who's coming for us – EMS?” The cop shrugged his shoulders and said he didn't know. “Well can you take us with you? At least some of us?” He didn't answer her question but instead started driving off. As the Escalades rounded the corner and had to drive past the gathering of EMT's, they shouted “Get the fuck out of the way!” And were gone.

In disbelief we all stared at each other. Here we were, the EMT's who came to rescue the police when they got shot or hurt, and not only weren't they NOT helping escape this madness, but they felt they had to curse us out too? We tried to attribute it to the strain of the times, but needless to say, we were all pissed. Charlie Brown got on the radio and explained the situation to Juliette who was back at the Superdome. She said there wasn't any way to arrange any kind of transportation for us; that no one was coming to get us. “Just stick together, don't leave anyone behind, wherever you go,” were her only words of advice.

We stood out on Convention Center Boulevard discussing our options. Some wondered if we should head back upstairs and wait it out there at the hotel. It seemed like a good option, but then Perry Lew pointed out that the only protection we had had just driven off in a bunch of Cadillacs. In addition, some refugees were already starting to gather at the Convention Center across the street, and none of us felt comfortable staying within a stones throw of more of the desperate, unstable people we had just left at the Dome. With reports of the water rising again, we decided that there was only one place for us to go – the West Bank, where we knew it was still dry. But how to get there?

At that moment, a civilian truck headed up the road towards us. It was a large moving truck, and immediately we all knew what to do. Prior to the storm, the mayor had declared that city emergency workers could commandeer any private vehicles or buildings necessary for rescue operations En masse, we stood in the street, all eighty of us and blocked the path. The driver looked shocked as we shouted out “New Orleans EMS! We're commandeering this truck to take us to the West Bank.” I immediately got the impression that this was a looter, or someone engaged in some sort of illegal activity. We opened up the rear door of the truck and found it half-full of furniture. Inside the back of the truck also were two more men. All three of the people in the truck claimed they didn't know the others. But we didn't really care what they were up to; we just wanted to get the hell out of there.

However, about half our group felt uneasy about commandeering the truck, especially with the shady circumstances involved with its three occupants, and they refused to go with us. The one word of advice that we clung to was “stick together.” The rest of us relented and decided to stay with one another and find some other way of getting to the West Bank. We let the truck go on its way.

We were still there standing on Convention Center Boulevard. For all we knew, the water was minutes away from us. We heard gunshots in the distance. We could see looters a couple of blocks away, carrying their boxes and bags of stuff. People were milling around out front of the Convention Center, probably seeking refuge from the flood. Our options were few. It was decided that we'd take our chances walking across the Crescent City Connection, or CCC, the bridge that joined the West Bank of the Mississippi River with Downtown New Orleans on the East Bank. Most of the EMT's were complaining, shouting in anger over being abandoned repeatedly by the city government, the police and the federal government. Some just stood there and sobbed. Before we started moving up the street toward the bridge entrance, I tried to get everyones attention without shouting too loudly. “People, I know we all feel abandoned and we're all pissed off. Once we get to safety we can scream and cry all we want. But right now, we need to move out in the open to get to the West Bank. We only have three weapons amongst us, so it's important that we stay in one group and stay as quiet as possible. If we scream and shout, it'll just be like a beacon for looters and criminals to come after us! We're all in EMS uniform and the public knows we all carry our drugs with us, plus our personal belongings. Are we clear on this? Do not advertise our presence here by getting out the box and screaming and crying!” Everyone acknowledged, but it was hard not to let our frustrations get the best of us. As we trudged along the street, several others admonished their coworkers to maintain silence.

At the base of the bridge, we could see an NOPD car parked in the street with its flashing lights on. Perhaps the cop could give us an escort or a gun or something to help. But as we neared the vehicle, we saw it was abandoned. One of its tires was flat, and the other three had been stripped by looters. The trunk had been broken into and emptied, except for some books of traffic tickets left there. We plodded on. As we began heading up the ramp of the CCC, I began to realize how steep it was. I reassessed the load I was carrying and began to question the wisdom of lugging around my jump bag. All the equipment I had in it was for critical care emergencies, like cardiac arrests. If anyone coded here and now, none of it would be of much use, as there were no ambulances to respond and no hospitals to go to anyway. Besides we had left all our cardiac monitors and other medical equipment back at the Hampton Inn. I asked if anyone wanted my laryngoscopes, the only actually valuable things in there. I gave them to Francene Jones and left the bag and everything else in it on the CCC ramp.

We kept on walking. It was so steep that we had to take breaks frequently, stopping to catch our breath and rest our arms and legs while carrying our stuff. The march went on for what seemed like miles. Tammy Guenard asked if I could carry her bag for a little while, which I was happy to do, even though it felt like she had packed it full of bricks. Charlie Brown passed out, but was able to continue after resting some more. Samantha Graham had stayed with me the entire time and I kept making sure she was there nearby. Each time I looked at her it seemed like she was fighting harder and harder to hold back the tears over her home and family and her boyfriend Greg, who was also one of my best friends. I kept feeling like I, too, should feel the need to cry, but for some reason I didn't. I just felt the need to survive.

We trudged for what seemed like hours. About a third of the way across the bridge, I realized that I still had my radio on me! Perhaps some other emergency service had found the one working channel we had been using earlier. I flipped it on and began searching through the channels – NOPD, NOFD, Mutual Aid, Jefferson Parish, St Bernard Parish, Public Safety. Finally I heard voices on one of the channels. The trunking system was down, so there was no way to tell what department it was, because normally the little LCD screen pops up with the Department name and radio number. I gathered from the transmissions that it was some police department, but I couldn't tell which one. I waited for a silent moment on the air and keyed up. “New Orleans Health Department to anyone on this channel! How do copy me?”

The previous conversations continues without any of the voices acknowledging me. I kept trying, “New Orleans EMS to anyone on this channel! Do you copy?” After a few attempts I started to think that I was simply out of range, that I could hear them, but they couldn't hear me. Finally one voice came across saying “[Garbled ID] to New Orleans EMS on this channel. Go ahead!”

I continued as several other EMT's gathered around me, straining to hear. “This is New Orleans Emergency Medical Service. We are on foot on the Crescent City Connection, trying to get to the West Bank. We've been separated from our command and have no resources. Requesting assistance.”

The voice replied,”New Orleans EMS? What the hell are y'all doing? Why aren't you out here pulling people off of rooftops with the rest of us?”

“Sir, I repeat: we are on foot on the Crescent City Connection. All of our ambulances are stranded or destroyed. We are alone here and have no defenses. There are looters on the streets and there are gunshots going off around us. Can you spare a vehicle to help us get to safety, or at least help us by sending an escort, or a guard, or a gun? Anything?”

“Man, you need to be out here with us! Piss off, EMS!”

I looked around at the other EMT's nearby who had heard. Jon Bailey, Charlie, Tim, Samantha all had the same shocked look. It was one thing to tell us that they had no one to send to us, but for one emergency agency to tell another one to “piss off” was unheard of. I switched off my radio. Obviously no help was going to come from there.

As we walked across the bridge, conversation was too exhausting, so most of us walked along with our own thoughts kept to ourselves. I thought about what Mark had said about hearing people calling 911 for help during the storm and the dispatchers having to tell them that no help was coming. I thought about the frail, elderly people we had moved from the Dome to the Arena and how many of them would die before any definitive help could be offered. While I stewed over the looting and selfishness that was rampant around us, I pondered over what help was there for the thousands of genuinely helpless people that truly needed us. Having been a paramedic for so long, I was used to always knowing what to do, what to say, how to help in any situation that was thrown at me. We always had to have the answers, and if we didn't, we would improvise, or make do with what we had. But now we had nothing. We had no resources, no ambulances, no support, no medicine, no hospitals, no medical control, no communications. We were on foot in the middle of the night lugging all we had left on our backs. The only thing we had now was each other. That moment, there on the bridge, was when we finally felt all alone. It was our hardest moment, but also that moment where we knew that with nothing else at all, we could rely on each other. It will forever be a defining moment for all of us EMT's stuck there on the bridge, when we in future months we could say “I made that walk across the bridge,” and the others there would have the unspoken knowledge of the bond of solidarity we all felt for each other, when the city we had loved and lived in and worked for abandoned us.

Near the top of the bridge, a CCC police car pulled up from behind us. The cops face was aghast at the sight of the entire city's EMS force, in uniform, marching up the bridge. We briefly told him our situation and asked if he could transport a few of us across. We put Tammy and Charlie into his car and wished them well, not really knowing when we would see them again. We asked him to let others know that we were here and to send help, if possible.

As we neared the end of the bridge, I wondered where we would go. Some of us lived on the West Bank, but getting to those homes would be difficult, as the CCC ends in the middle of the Fisher Housing Project, one of the most notoriously unlawful housing projects in the city. And with no lights, no police backup and only three guns among us, I began to feel that at least one of us was going to die that night. Of course I didn't voice my fears to anyone, but the thought gnawed at me. I felt I had to hold that in, along with all my other fears and worries. There was nothing else we could do.

Just then, as we were almost to the end of the bridge, was one of the most beautiful sights we had seen in days. A fleet of New Orleans Fire Department trucks began pulling up to our group and told us to get in! We cheered and cried and thanked them as we all threw our stuff into the ladder trucks, pumpers, sprint cars and personal vehicles. I piled into one of the Dodge Durango sprint vehicles along with about eight other EMT's. We asked how they had found us and they explained that one of the firemen happened to be passing by when he was flagged down by one of our group that had made it across the bridge before the rest of us. He went back to NOFD's camp and gotten the rest of the firemen to drive out and pick up the rest of us. The Fire Department had commandeered the Mary Joseph Nursing Home in Algiers and had set up a base camp there since all the nursing home residents had been evacuated before the storm. The fireman driving the car said that they had water and food and weapons and electricity from one of their big generator trucks. We could all stay there as long as we needed to since there was plenty of room. As we arrived at the nursing home we all thanked the firemen profusely and tried to apologize for all the shit we had given them over the years that they had been first responders and declared that we were going to secede from the Health Department and make ourselves New Orleans Fire Department EMS. For the first time in days, someone had backed us up, had welcomed us and taken us into their care. We felt safe at last; the firemen had more weapons than all the National Guard had, and plenty of bullets and rounds to go into their guns, unlike the well-meaning but unprepared Guard.

Samantha and I searched around the nursing home for somewhere to lay out our stuff. We found a few feet of floor in a hall near a door where there was a slight breeze to relieve the sweltering heat. We called it our bedroom and went off to explore our new home. There was food in the kitchen, so we helped ourselves to good fireman cooking, then headed out front where they had set up a bar with all the beer and liquor they had brought from their homes or “found” in abandoned stores. Every fireman I saw I thanked and declared my hero. We drank and laughed that night, the first time any of us had laughed in days, trying to purge from our minds the horror that we had all witnessed, that was still occurring just across the river. None of us had slept more than a few minutes at a time for days, so it didn't take long for us to finally give in to the fatigue that had building up in us. I laid down on the hard floor, using my backpack as a pillow and at long last fell into a decent sleep.

The next day I awoke to footsteps and shouting. Apparently some civilian had strayed too close to our camp's perimeter and the firemen were scrambling to evict the intruder. It was mildly disconcerting, but I was grateful that our new hosts were so vigilant. I shook off the last remnants of sleep and tried to eat something. After a while the firemen and EMT's began to take stock of our situation. There had been 150 firefighters before we got there and with EMS added to the family, we had nearly 250 people to look after. With no news of any outside help arriving anytime soon, it was clear that sooner or later we would have to venture into the outside world for extra provisions. Some of the firefighters had been to the Wal-Mart on Behrman Highway the day before, and said that the police had secured it shortly after the looters had broken in. Apparently, they let the fireman have what they needed from the Wal-Mart. We decided we would form an armed expedition to head over there and resupply our people. We got together several pickup trucks and formed teams that would be assigned to each one. No truck had fewer than two armed members who would ride inside and outside. Civilians had set themselves up as snipers in buildings and were taking potshots at fire trucks, police cars, National Guard vehicles and helicopters. We set our radios to working channels and tested each one to make sure we had communications between us as well as with personnel back at the compound. Each person had a “shopping list” of necessary items that everyone could use: canned food, socks, clothes, sleeping bags, water, medicines, first aid stuff, tampons, etc.

We piled into our vehicles and first went to the firehouse on Woodlawn to pick up some tools we might need to cut through doors or locks or whatever. As we were loading up the tools, several cars began pulling into the firehouse lot with us. The armed medics and fireman readied their weapons for potential bandits, but a moment later, we began cheering as our new visitors were the EMT's we had left the night before at the Superdome to help with helicopter operations! Luke, Nick, Jay, Donnie, Mark, Juliette, St. John, Mike, Cedric and all the others were safe, thank God! The ones that owned four wheel drive trucks and SUV's were able to get them out of the back entrance of the New Orleans Center, where the water wasn't as high. In addition, They had commandeered a huge bobtail truck from somewhere they probably shouldn't have, but it wasn't a time to be conservative. We were happy to see them all, and as we listened to their account of the growing madness at the Dome, we wondered how a full-on riot hadn't taken place yet.

We quickly explained what we were doing and Ron followed us to the Wal-Mart with the big truck which would make hauling our supplies to our new home much easier. We had no trouble getting to the store, other than having to readjust our course several times to get around downed trees in the road, and when we showed up, NOPD was there, as expected. They were cautious with us at first, but when they realized that we were, in fact, EMS and NOFD, they let us in to gather the supplies we needed.
There I was, with my shopping cart, as if it were a perfectly normal day just shopping at the Wal-Mart. Except the other shoppers were all armed with automatic weapons.

Adventures In The Bathroom

2007-02-15T13:55:00.000-08:00

Adventures in the Bathroom

By Jack Riley

I think that public restrooms can be fascinating places. Now don't get me wrong; I'm not some perv that hangs out in public toilets to check out the action. It's just that sooner or later, everyone is forced to go to the toilet and if you’re at the movies or a restaurant or somewhere, you pretty much have to shuffle off to the public restroom with the rest of the schmucks. Not my favorite thing either, but you might as well make the best of the situation, right? All I mean is that these little trips can be a fascinating study in psychology - mine as well as everyone else's.

One of the things I've noticed over the last couple of years it the proliferation of those "midget urinals" in the men's room. You know, these are the urinals that are set like six inches off the floor. What's the deal with these things? Are they like mandated by federal law from the Small Humans Organization's Referendum on Toilets (S.H.O.R.T. for short)? I've never seen anyone using these that actually was so short that they genuinely needed the midget urinal. And a lot of times, they'll have like two or three in one restroom! Hello? What about us normal sized people who don't want to have to aim that well? Kids never use them; they go into the regular toilet stall with Dad to pee in there. I guess Junior’s afraid that he'll fall into the big gaping urinal. I'm sure the bathroom cleaning person is no more thrilled with these contrivances that the pisser is, what with all the “misses”.

One thing I always try to avoid is taking a dump in the public restroom. I'm not all paranoid about catching diseases or anything, but I always feel like I'm at my most vulnerable when I'm sitting there pushing. Like what would I do if some psycho burst into the bathroom kicking open stall doors looking for a fight or something? I'd probably try to just flush myself down. But sometimes you're having a bathroom emergency and you just have to go. When this happens I've found that I prefer to use the handicapped toilet. I guess everyone figures that some handicapped person will need to use it so they avoid it so it's usually cleaner than the terlets designated for the mere mortals. Plus it's more comfortable to sit on, being all up in the air like that, and there’s always way more space in the stall. Besides, the handicappers get all the best parking spots so I'm darn sure gonna use the best toilet, especially since I don't need to show a damn handicap placard. So there I am, feet barely touching the floor like I'm a little kid again, when someone comes in and sits down in the stall next to me. I totally clam up. I'm torn between the abdominal cramps raging in my belly and the fear of making a really loud, gross job. I'm worried that the guy in the next stall will study my shoes and point me out as the farty, smelly guy when we're both back outside. So I try to push "quietly" which never works of course and I try to finish before him so he won't be able to see me coming out of the bathroom and attach a face to the sounds and smells.

Peeing is infinitely simpler. If there's no one else in there, you have your choice of urinals (except the midget ones). I just walk right up to the middle one. That gives me the advantage over the next guy that walks in. Proper men's room etiquette requires a urinal's separation between guys (unless it's super crowded) so he'll have to either crowd up against the wall or be forced to use the midget urinal.

Sometimes you wind up next to a guy who's pee-shy. He can't pee when there's someone else nearby. Not that I stare at him trying to go, but you can always tell when there ain't nothing comin' out. So he stands there for a minute, not doing anything till he finally gives up and goes back out to the movie or whatever and sits there in agony because of whatever psychological malfunction he has going on. Unlike my "number two" phobia, I have no problem going number one with any number of bystanders. I guess this is because my kidneys seem to be on permanent overdrive so it's either pee every two hours or explode.

Now to address a matter of some controversy: do guys "check out" one another in the bathroom? Yes they do, but now let me qualify that statement. I don't go and actively seek out to see the next guy's "unit," but once in a while you'll just be standing there, minding your own business, when in your peripheral vision you'll catch a glimpse of some kind of motion and you happen to notice that Bubba next to you is waving around some kind of baseball bat of a package as he goes to shake or whatever. You just can't help but notice; I'm sure it's some kind of defense mechanism in case that thing gets out of hand and it might put an eye out or something. You've gotta be aware of your surroundings!

Of course there are always a couple of pervs hanging around the men's room. They're the guys who can't wait for you to sidle up next to them so they can try to get a peek at your stuff. One time I busted one of them. I was standing there doing my thing when he apparently saw my Prince Albert piercing and sort of gasped "Ouch!" I totally saw him staring over at me, violating all the boundaries of men's room etiquette. He couldn't do anything but turn beet red in the face and get the hell out of there. I love feeling superior.

Then of course you have the funny accidents, like when some dude loads up on soap to wash his hands only to discover that the sink doesn't work. Better him than me! Or when someone drops his watch or something in the toilet. Bummer. Or the water in the sink comes out at like a million pounds per square inch and splatters the dude with the baseball bat thing. Good for him, the bastard!

And of course sometimes you have the weird things happen, like the guy who sounds like he's exercising or working on heavy machinery behind the stall door. Or the dudes who hunch over the urinal like something's gonna bite off their thing if they don't protect it. Or the obsessive-compulsives who wash their hands thirty times. Or the guys who pee in several different urinals one after the other (what's up with that?).

Anyway, trips to the bathroom can be very entertaining, and a terrific exercise in social psychology. Remember - it's not just a toilet, it's an adventure!

A plethora of information for the new E.M.T.

2007-02-15T13:49:00.000-08:00

A plethora of information for the new E.M.T.

Contained here is the vast accumulated wealth of stuff they don't teach you in EMT class. You always seem to hear that "It's a little different on the streets than it is in the classroom." Well, that's like saying a 7.5 earthquake is a little different that a train passing by. Here are some jewels of wisdom I've gotten from my own experience, those of my co-workers and that sent in to me via e-mail from around the world. Also, if you'd like to send me one of yours, I'd be happy to put it up here. Just e-mail me at medicman@bellsouth.net.
Getting Started
Your first day on the job is going to be a stressful one. You're all gung ho, and come in to your new job with your crisp, brand-new uniform, your duty belt bulging with gear, some of which your not really sure what it's for. Of course everyone will notice all your scissors, shears, hemostats, window punch, oxygen key, flashlight, tourniquet, multi-function tool, buck knife, beeper, glove keeper and fanny pack and you will immediately become self-conscious. Especially when you go to sign out your equipment and realize that while squeezing all that other stuff onto your belt, you forgot to bring a pen. Don't worry, happens to all of us.
When you go to load your equipment, you'll realize that you have no idea where all your stuff is supposed to go. You also won't know where all the stuff you learned about is, such as non-rebreathers, 4x4's, kerlix or spineboards. You'll find it eventually. Expect to feel that you've just spent hundreds of dollars and months of your life to learn this stuff, and you have no idea what's going on.
Your first partner will be the crustiest, most burnt-out paramedic in the company who you'll find out was on the scene when Cain killed Abel. He'll have had a bad night with no sleep, and is even more grouchy to find out that he has to orient the "FNG". Since no one will tell you what FNG means, it means the F*****g New Guy. Don't worry, it happened to everybody.

Your First Day
Of course, your first inclination will be to turn on your radio, in case the city has been blown up and you're called upon to rescue it. Don't worry, it hasn't. When you first listen to the radio, more likely than not it will be a Babel of numbers and obscure codes. "10-4, 10-97, mileage 4286..." and so on. "Whoa, we never went over this in class!", you think to yourself. Welcome to the streets. It'll take a few days to figure out what all those codes mean, but eventually you'll find them sneaking into your personal life as you tell your wife "Ten-four" or, when asking someone to repeat themselves , you tell them to "Ten-nine".
Well, let's say you've mastered the codes ( or you will eventually ), and you get your first call. Dispatch calls your radio number and you anticipate your first emergency. Will it be a shooting? A train wreck? An airplane crash? Maybe a cardiac arrest? Let's listen...
"Unit 12, respond to 1234 Main St. on a medical emergency, 101-year-old female complaining of generalized weakness."
"Hmm", you think, "I wonder what this could be. You'd think that a 101 year old would be expected to be a little weak, wouldn't you? Well, I guess I'll find out."
So you respond with your lights blazing and your sirens blasting to the location. You leap from the unit and begin choking! What's wrong?! Oh yeah, oops... better unfasten the seat belt. That's better. You leap again from the unit (more carefully this time), grab every bit of gear you can carry, including the OB kit, and race into the house. You locate the patient who is lying in a hospital bed with a tube running from her belly to a bag filled with what looks like a milkshake. The patient's eyes are closed, but she is making strange groaning noises. Her limbs are twisted in the most bizarre angles that you think she's been dragged a few miles behind a truck. She seems about to die any minute, you think. Yet oddly, your partner seems quite unconcerned about the whole thing. Your partner is over there writing down information, copying names of medicines (all eighty-six of them) and seems unperturbed at your vital signs findings - pulse 120, pressure 70/50, respirations 30... aren't those consistent with shock? Isn't this an emergency? Finally you load the patient on the stretcher and take her to the hospital. The ER staff also seems mysteriously unconcerned. Why?
Well, before you get too outraged at everyone's callousness, let's think about this a bit. The patient is a HUNDRED AND ONE years old! Of course she's a little weak! No you don't need every bit of gear on your ambulance every time you respond to a little old lady who's a bit under the weather. That tube in her belly is a feeding tube. Lot's of bedridden people have them. In fact, people call ambulances a lot to bring patients to the doctor or ER to have them changed. The milkshake stuff is liquid food. It's gross, try not to fool with it. And don't worry about her twisted limbs, it's called contractures, it happens when people lie in bed for months or years at a time. Just don't try to straighten them or you will have an emergency on your hands. As for her vital signs, yes she's sick, but obviously she's been this way for a LONG time. Don't get all worked up over it. Just take her to the hospital and get it over with.
Well, how did you like your first call? Not too exciting was it? I have news or you - most EMS calls are like that. You study and prepare and practice for those major adrenaline-rush scenarios with critically injured patients where with your every move the patient's life hangs in the balance, but to be honest, it's just not like that all the time. In fact, those dull, little old lady calls are the order of the day most of the time.

Some hints
You will eventually get used to what equipment will be needed on what scenes. If you have to go up an elevator and it will take a while to get between your patient and your unit, bring all your resuscitative equipment. This will prevent your patient from being in cardiac arrest. Believe me, dragging all that gear up and down is much better than going up with only a stretcher and finding an arrested patient. If you don't bring it, I promise you you will need it.
If you run out of straps for a spineboard, tear some sheets up into strips about three inches wide and use those to secure your patients. Torn sheets also work well for restraints.
Speaking of restraining a patient, when you're trying to transport a psychiatric emergency, don't give them a choice of whether or not to go. Don't say "Why don't you let us take you to the hospital?". Tell them "Sit on my stretcher." If they really get out the box and you need to restrain someone who is violent, try and get some gung-ho cops to help you if they're there. Otherwise you'll have to do it yourself. My favorite method of holding a violent patient down is a knee on the side of the face at the head of the stretcher. That way I can hold down the head & chest with my knee and hold the patient's wrists with my hands while my partner gets the legs restrained. Some prefer to apply upward pressure with both thumbs just beneath and inward to both temporomandibular joints. This an effective control mechanism. Of course if it is not practical to get into such close proximity, then an oxygen cylinder or heavy flashlight, properly applied, can have just as satisfactory results. After all, they are going to the hospital anyway. It is also helpful to secure on arm above the head and the other to the side. That way the patient can't launch his head your way and take a bite out of your anatomy. If he spits, a facemask or sheet over the head will solve the problem.
You will find that three-inch tape solves a multitude of problems. I have seen it used to hold the siren emitter onto a unit, to hold wiring and hoses in place on an engine, to keep a broken stretcher together, to write notes on, to hold broken cabinets closed, to secure patients, to make cup holders, and even to fashion a crude oxygen regulator. As long as problems arise, the list of uses for tape will continue to grow.
No matter how slow a day it has been, you will get a call just as you try to get something to eat or sit down on the toilet.
Don't leave food around in your ambulance. Patients bring in roaches with the crust that's accumulated on their unwashed bodies and the roaches will set up house in your ambulance if they find food.
KY jelly, defibrillator gel and nitro paste (if your really nervy) stuck under door handles on the unit make great practical jokes. Just don't do it to your partner, you have to work with him.
Turning on all the lights, sirens, radio, windshield wipers, etc., while a coworker's unit is turned off so that they all come on when he starts up his unit is another good one.
Don't abuse places that offer you free drinks or food.
Tell your dispatchers what they want to hear and everyone will be happy.
If you get in trouble with your boss, don't try to justify yourself, even if you're right. Just say "You're right, I'm sorry, it'll never happen again."
Put seizure patients in your ambulance while they're still postictal and can't fight.
If a seizure patient is combative and really needs to go to the hospital, shine your penlight in their eyes a few times. This will often make them have another seizure, during which time you can place them on your stretcher and go en route to the hospital.
The more patients screech and holler that they're hurt, the less hurt they actually are.
Adapt, improvise and overcome.
I don't advise going on murder scenes without the police, but if you in yourself in that situation and it's safe, then it can be really cool.

** LANCE'S LAW OF EMS TRANSPORT **
- Don't waste your precious time trying to convince the public of why they are abusing
911 by calling an ambulance for this B.S. problem - you may as well be talking to your
O2 cylinder.
- Corollary #1: Your blood pressure is directly proportional to the amount of
hot air you waste trying to convince them of why they shouldn't have called 911.
- Corollary #2: Whenever you say "There's a city full of dying people who need
this ambulance more than you," take a listen to the other calls coming out on your radio
(weaknesses, seizures, drunks who fell, babies with fever, etc.) and realize the
alternative is no better.
- Corollary #3: If you haul *** on a scene to get a refusal so you can jump a
good call nearby (like a shooting or stabbing) it will be unfounded because they
probably went to the hospital in a car anyway.
- Corollary #4: If you accept that you are nothing more than a cab driver with
a siren and 90% of your patients expect nothing more from you than a ride you will be
well on your way to erasing job stress.

- Corollary #5: It's that 10% of the time where you must step up, perform
flawlessly, and save a life that keeps you coming back day after day.
- Corollary #6: When in doubt, transport.
(In case you didn't notice, my friend Lance is a little cynical.)

Well, that's about all for now. I'm sure I'll think up more.

Ramp Rants - Communication

2007-02-15T13:30:00.000-08:00

Good language skills are a must in New Orleans. Not only must you communicate with people of various language backgrounds, such as Spanish, Vietnamese and deaf people, but also with those who purportedly speak English, and they can be quite a challenge.

For example, in order to comprehend the many dialects of English in New Orleans, one must learn “Old Black Lady.” In this dialect, rarely is a straightforward answer to a question forthcoming. For instance, when showing up at a scene and asking the patient what emergency summoned us there, the response will often be something to the effect of “my arm” (or leg or toe or ear... you get the picture). That's it, just the answer “my arm.”

Working from there, one must try to delve into all the problems that could possibly go wrong with one's arm. So we ask “what's wrong with your arm?”

“It's wern me.”

Not much help, is it? First one must translate this cryptic message. I was a bit at a loss the first time I encountered this response. We had been called to a residence for an elderly female complaining of “a problem with her arm.” We arrived at the shotgun double, the patient was in the front room, sitting on the plastic-covered sofa. About a dozen family members were present including little kids, adults, and teenagers. I settled on the couch next to the patient and the family gathered around in a semicircle, like it was storytelling time. None had said a word to me; the only communication had been one or two teenage girls pointing at the old lady, presumably their grandmother or great-grandmother, indicating that this was my patient. The lady looked reasonably healthy, not in any apparent distress. I asked her what was wrong.

“It's wern me.”

“I'm sorry, what did you say?”

“My arm. It's wern me.”

To the family members nearby: “I'm sorry, did you understand what she said?”

At this point I got a look from all of them that seemed to say 'what's wrong with this stupid white boy? She's speaking to him perfectly clearly but he's asking us what she said!' After this brief deprecating stare, one of the disgusted family members piped up and said “She said it's her arm. It's worrying her.”

Hm. Well that wasn't much help either. Was she worried about her arm? Why would one be worried about their arm? Might she imagine it will detach itself and crawl off to find a better life elsewhere? Does the arm whisper worrisome thoughts to her that keep her up all night? I looked around at the family members who were staring at me as if I were a strange fish in an aquarium. I got the distinct impression that they expected me to immediately whip out some magic pill that would cure her worrisome arm once and for all, as if our five sentence conversation was all that anyone could possibly need to form a medical opinion and pick the right prescription for Worrisome Arm Disorder.

I would have to heighten their disgust for me by asking more questions. “Can you tell me what you mean by that? I'm not sure what you mean by 'your arm's worrying you.'”

At this point the old lady gave me a look as if to say 'how can you possibly not know what I'm talking about? I've been very clear as to my symptoms and you've even corroborated my story with my family. What further information could you need?'

She responded to my inquiry with further clarifying information. “It's my arm. It's been wern me.”

Ok, so asking the patient what's wrong wasn't going to work. I was going to have to change the exam from an essay-question test to a multiple-choice test. “All right ma'am, I understand it's your arm. Which one?”

“That one,” she responds without any indication or body language as to left or right. I began to suspect that she spent her life as a poker shark, since nothing in her demeanor was letting any information through to me.

I took a chance. Grasping her right hand and elbow, I asked, “This one?” Again she stared at me, letting her facial expression communicate clearly that she got the impression I was an idiotic quack.

“No, the other one,” she at last answered.

“And what's wrong with it? Does it hurt?”

“It's wern me.”

“I know, but I'm not sure what that means. Can you tell me if it hurts?”

“Yeah, it kind of hurts.”

Progress! I was pleased that I had at least found something to start with. I looked around at the family members who apparently couldn't believe that I had taken this long to understand.

I plodded on. “How long has it been hurting?”

At this point I encountered another communications impasse that is common in the field of New Orleans EMS - references to time. People's perception of time is a fascinating study in sociology, but it can be a pain in the ass when you're trying to figure out what's wrong with a patient. To illustrate, if I were asked the same question, 'how long has it been hurting?' I would likely give a time reference along the order of 'three hours' or 'since early this morning' or 'since 5:30.' Not so with most of the population EMS serves. Her reply was “it's been hurting.”

Back to the multiple-choice. “Yes, but how long? An hour? A day? A week? A month? Ten years?”

She narrowed it down. “It's been wern me for a while.”

AARGH! What the hell is 'a while'? I turned again to the family, who were still staring into my fishbowl. “How long has she been complaining about her arm worrying her?”

They looked at me, then to each other, then back at me, as if they were astounded that the fish had addressed them yet again, but the question was simply bizarre. I repeated, “how long has she been saying her arm hurts?”

“Since she got back from the doctor.”

Here was another time reference that had no meaning. “When did she get back from the doctor? An hour ago? A day ago?”

“Last week.”

Finally! Something to form a vague outline of what's going on and why I might be there at the house. Her left arm has been hurting for a week, and now there's a doctor involved. The plot thickens.

It was time for some empirical evidence. I lifted the patient's left arm to see her reaction, since I could tell that asking about the pain would be a fruitless endeavor. She grimaced as her arm went up. Ah hah! Pain with movement! At least that would likely indicate some sort of orthopedic involvement. But what? Arthritis? A fracture? Did she sleep on it wrong? Since she indicated another factor, her doctor's visit, I decided to focus on that. “Why did she go to the doctor?” I asked to anyone who might be willing to give me a coherent answer.

After a little more staring, someone offered “She went after she got in that car wreck.”

Bingo! “And what did the doctor say was wrong?” I knew I was pushing it, because I knew what the answer would be.

“They didn't tell her nothin'.” As expected, the standard reply. This highlighted another communication difficulty. In nearly every similar situation, when patients have previously been discharged from a doctor's office or a hospital, the patient will usually tell us that “they didn't tell us nothin'.” On the other hand, I have overheard and been directly involved with patient-doctor-nurse interactions and invariably have heard some reference to the patient's diagnosis and source of their troubles. 'You had a heart attack,' 'you have the flu,' 'you sprained your ankle,' 'your blood sugar was too low,' and so on are among the countless explanations given to patients by medical staff to explain their diagnoses. I am at a loss as why patients are unable or unwilling to incorporate this knowledge into their conscious mind, but now I was dealing with what would certainly be yet another example of this phenomenon.

If they were discharged from the hospital, they were no doubt given discharge instructions which should have their diagnosis on it. I gave it a shot. “Did they give you a paper when you left? Can I see it?”

“Yeah, awright,” One of the female family members replied with a sigh normally reserved for one who has just been tasked with the responsibility of moving a mountain from here to there using only a teaspoon. She brought out a sheaf of yellow papers, all discharge instructions from dozens of other doctor's visits. She located the right one and handed it to me. I read what the ER nurse had written on it: “Left arm contusion s/p MVA. Elevate arm, apply ice packs. Rx Vicodin.”

There it was. Left arm contusion (bruise) s/p (status post [after]) MVA (motor vehicle accident). Although it was somewhat ensconced in medical jargon, the diagnosis was written clearly on the yellow paper – she had a bruise on her arm from a car accident. It also indicated that she had been given a prescription for Vicodin and instruction to follow when she got home, namely to elevate her arm and apply ice packs.

“So she went to the doctor last week after her car wreck because her arm was hurting, right?” I asked the family.

“Yeah,” said the woman holding the wad of old discharge instructions. I reflected on the previous answer when they told me her arm was hurting since after leaving the doctor, subtly indicating that her pain was somehow the doctor's fault.

“And did you get the prescription filled?” I asked, knowing what the answer would be.

“No.”

“And have you been keeping her arm elevated with ice packs like it's written right here?” knowing what the answer would be.

“Well, when she got home we put some ice on it, but it's still hurting her.”

“You have to keep putting ice on it, and you have to keep elevating it. And that prescription was for pain medicine, so you need to get it filled and take the medicine. It's no wonder she's still having pain.” I turned back to my patient. “You don't need to go back to the emergency room for this; you've already been there for this same thing. What you need to do is follow up with what they told you do to make your pain stop. Understand?”

“But my arm's wern me.”

I was at the verge of exasperation. As I got the woman to sign the refusal, I tried once again to encourage them to follow up with their instructions and fill their prescription, but I knew I was now suffering from a communications disorder, Talking To A Brick Wall Syndrome.

The art of communication in EMS doesn't just apply to talking to patients. EMS has a whole Communications Center whose sole role, it sometimes seems, is to inhibit expeditious communications between dispatch and the street units. There is a bewildering array of police signals and “10-codes” that takes months to get used to. Nowhere else but in emergency services can you have a conversation consisting of nearly nothing but numbers. To wit:

Dispatch: “6201, take in 1604 Fourth, on a 34 secondary to a 103-F. Item is 682, 1322.”

Unit: “10-4. 980 from Charity. Gimme a little delay, my partner's 10-42.”

Dispatch: “10-4, 1323.”

The translation: Unit number 6201 is being sent to respond to a call at 1604 Fourth Street, where there is someone who's been beaten up (Signal 34) following a fight (Signal 103-F). The number used to keep track of the call is 682, and they were dispatched at 1:22 PM (1322 in military time).

The unit acknowledges (10-4). The beginning mileage on the odometer is 980 (to keep track of distance and response times) and they are leaving Charity Hospital. They also let dispatch know that there will be a slight delay in responding, because one of the medics is going to the bathroom (10-42).

Dispatch acknowledges the message (10-4) and gives them the updated time, now 1:23 PM (1323).

Once you get used to it, the numeric vocabulary is very efficient. In fact I often find myself away from work speaking to others using 10-codes such as 10-4, or 10-9 (could you repeat that?) or 10-20 (where are you?).

On the other hand, when we are sent to calls, no matter how efficient the numeric conversation might be, there always seems to be some sort of miscommunication. What dispatch tells us must generally be taken with a grain of salt. For instance, on several occasions I've been dispatched to a Signal 24 (medical emergency) in which the patient was a little old person feeling weak according to dispatch. When we actually arrived on scene, we entered the house only to find the little old person a little beyond generalized weakness and actually in cardiac arrest, or to put it in layman's terms, dead. That's pretty weak!

It's not always dispatch's fault, though. I've worked in communications many times and the majority of people who dial 911 have no idea about what's wrong with the patient, who the patient is, or even where they're calling from.

Many 911 calls go something like this:

Dispatcher: “Emergency medical services, do you have an emergency?”

Caller: “Yeah, uh, she be sick.”

Dispatcher: “What do you mean?

Caller: “She be sick, man. Just send us a ambalamps.”

Dispatcher: “Sir, can be a little more specific? What do you mean by 'sick'?”

Caller: “Dammit man! She be sick! What part of sick you don't unnerstand?”

Dispatcher: “Well, is she having pain, is she vomiting, is she having a seizure, any trouble breathing, is she in labor, or what? I just need to know what to tell the ambulance crew.”

Caller: “Yeah, she's havin all that!”

Dispatcher: Ok, lemme get this straight. She's in pain, vomiting, having a seizure, short of breath and in labor all at the same time? How old is she?”

Caller: “Yeah, all that. Hell I don't how old she is!”

Dispatcher: “Is this your family member?”

Caller: “Yeah, it's my mother, I guess she's like 89 or something.”

Dispatcher: “Ok, so your 89 year old mother is having labor pains on top of everything else. Right. What's your address?”

Caller: “I stay by my girlfriend's house on Claiborne.”

Dispatcher: “No, I mean where is the patient? I need to know where to send the ambulance.”

Caller: “Aw, hell, I don't know the damn address! Just send us a ambalamps!”

Dispatcher: “You don't know your own mother's address?”

Caller: “What the hell, man? Can't you just send us a ambalamps”

Dispatcher: “Sir, I'd be happy to, but exactly where should I send it?

At this point, the dispatcher might be able to look at the E911 display, which shows the address and phone number of the caller. However, often a caller will be using a pay phone some distance from where the ambulance is actually needed, or they may be on a cell phone, in which case the display gives the address of the cell tower. On occasion, 911 callers have dialed EMS from an entirely different state, requesting an ambulance for a family member back home in New Orleans. The most distant caller I ever spoke with was calling from Poland for his elderly father who lived uptown and wasn't answering his phone. Most commonly, the callers simply don't know their own address. Miraculously, though, they can figure out their address for their welfare application in order to have their government checks sent there. This is sometimes the only means of determining where the ambulance is needed.

Dispatcher: “Sir, can you tell me where her welfare checks are sent?”

Caller: “Oh yeah, that's 1301 Simon Bolivar, apartment 733.”

Dispatcher: “And is that where she is now?”

Caller: [light dawning] “Yeah, send 'em to 1301 Simon Bolivar in apartment 733.”

Dispatcher: “All right, we'll send them there.”

When the ambulance actually arrives on scene, rarely is the complaint specified really what's going on. Dispatch can listen to all the radio frequencies used in the city, so on a call like the one above, the dispatcher will often listen to the crew's report on the medical control channel, just to find out what's actually happening with the patient. In the above case, the report described an 80 (not 89) year old female who had been complaining about a dry cough for a couple of days. No pain, no seizures, no shortness of breath, no vomiting, and definitely no labor pains.

Many have been the times when I was sent to a shooting only to find out the patient was actually a little old lady complaining of weakness, that the person complaining of chest pains had actually been shot in the chest, that the motor vehicle accident was a drunk passed out on the side of the road, and that the 19 year old female with a vaginal bleed had actually just given birth to her fourth baby.

Further, the simple vocabulary of the populace is a factor to be reckoned with. It takes a bit of experience to figure out exactly what may be wrong with a patient. For instance, when asking a patient's medical history on has to extrapolate the vernacular into medical jargon. To wit: “Yeah, I gots da roaches in da liver,” translates to 'I have a medical history of cirrhosis of the liver.' “Smilin' mighty Jesuses” is actually 'spinal menigitis.” “Peanut butter balls” is phenobarbital.” “Fireballs in the Eucharist” translates to 'fibroids of the uterus.' I'm coughing up flegum” means “I'm coughing up phlegm.”

During one call, my partner Susan and I encountered a young mother whose son had a fever. She explained that she had rubbed him down with “akarol.”

“I beg your pardon?” I asked.

“He felt real hot so we rubbed him with akarol.”

She handed me the bottle. I read the label. “isopropyl alcohol” it read. “So you rubbed him down with ALCOHOL?” I inquired.

“Yeah, with alcohol.” came the answer I could understand.

At this point, the friend who was standing in the room chimed in. She said, “AKAROL! You rubbed him with AKAROL!”

“Yeah, I rubbed him down with akarol.” the girl replied.

“OK. I think I have the picture.” I responded.

Boy, did I have the picture!

Like I said, we need to take communications with a grain of salt, and a rather large grain at that.