It’s hard for people on the outside to understand why we do what we do.  There are spiritual benefits in the act of helping another.  There are financial benefits in getting a paycheck at the end of the week.  There is the benefit of social interaction with your co-workers.  The biggest benefit though is the rush of the call.  The sense of accomplishment when its over.  Even though it can be weeks since you do a really “good” job, there is an overall uber euphoric feeling when you do get one that just cannot be matched elsewhere.

It was around two o’clock in the morning.  Freakzilla and I were curled up in the front of our ambulance watching the comings and goings at Club Kalypso.  Nestled under the El train, the doors to the club would swing open and closed every minute or so allowing the reggae beats from within to wash over us like rhythmic waves.  The fluctuations between the flashing strobes harboring light hearted fun inside and the shadow encased corners for dark deeds on the outside was spellbinding.

This is our holy day service.  It is here that we sit to commiserate over the week past while those inside the club push the past week a little further along.  Usually the high point is signaled by the sounds of gunshots or the slick silence of highly polished metal separating meat from bone to release the red flow.  Our service is one that culminates in in pain and misery.  For those poor wretches we accept into our sanctuary and administer communion to them in the form of oxygen and bandages.  Deliverance comes with glow of rotating lights and the wailing banshees released from the box.  This is how it usually goes in the “good” times.

However on this night our lord, our dispatcher Marcus, called down to us in his raspy voice from up above, “One David, I need you for the intox.” My partner and I looked at the microphone, neither of us moving to take it.  “One David, I know you’re out there.  Answer the radio or I’m giving you the tone,” he called again.

While still staring at the microphone my hand disobeyed my conscious mind and reached out to lift it from its cradle.  Gently raising it from its resting place I brought it towards my mouth, caressed the cool plastic on the side and spoke my prayer, “Drop it on the screen.”

With that, our altar flickered to life and the bell chimed.  My prayer had been answered almost as soon as the words had passed my lips.  Clearing the top from the clutter of potato chips and peanut bags we could read that the commandment set before us was one of ill repute.  It was at Continental Avenue and Queens Boulevard, within the hole of the underdwellers.  Freakzilla shifted our iron temple into drive, bathed the street in the glow of our red rotators, and pierced the rhythm of the night with a blade of wailing sound sending us on our way.

Easing into the bus stop at Continental Avenue we ground to a halt as I brought the microphone forth once more and announced, “One David eighty-four.” Somewhere in the city someone was snickering at our misfortune.  Had it been a trauma call, they would have tried to snap it from under us without a second thought.  Instead this is something to occupy us while the real sick and injured are cared for by that snickering someone else.  Regardless we have a mission to fulfill.  The sooner we get it over with the better.

Freakzilla is already out of the truck with the stairchair and headed down into the hole as I reach inside for the bright orange trauma bag.  I sling the bag over my shoulders, slam the side doors shut, and follow his lead down the cement staircase.  The staircase ends in a white-tiled passageway lined with the flicker of fluorescent lights and the acidic smell of rot riding the cool breeze of displaced air as the mammoth metal worms make their way through the city’s underbelly.  About a hundred feet futher the corridor turns to the left.  It is around this corner that I can see my partner speaking loudly to an as of yet unseen and unheard companion.  As I walk to the turn, the rumble from below begins and the smell of decay grows stronger still.

I round the corner as the rumble mutes out all other sounds, yet my partner stands beside the wall with his lips still moving looking down.  My eyes fall upon the object of his unheard words.  Leaning against the wall, with his soot stained dungaree sheathed knees drawn up to his chest is Big Eared Jim.  His blond curly locks are stained with dirt and grime as they hang over his vacant gray eyes, and his olive drab army jacket is draped around him like a cloak.

“…an’t let you stay.  You need to go,” my partner finishes as the rumble disappears in the distance.  Big Eared Jim just sits there.  He is a veteran of the Gulf War suffering from a long list of ailments and who is a semi-regular transient in this area.  Since we see him about once a week, we consider him to be a “frequent flyer”… and more often than not he is really flying when we get him.  His primary choice of medication was alcohol, but he’ll gladly take any pain meds he can get.  Normally Big Eared Jim is more than happy to hop into the ambulance.  That isn’t the case tonight.

I kneel down through a more dense cloud of rot and extend a hand past his vacant eyes while asking “Jim, what happened?”

His muscles twitched for a second.  Then his eyes came back to life and he tells me, “I is havin’ seizes an mu foo hurts,” while finally unclasping a hand to point and indicate the foot on his right.  I look down to see the left foot covered by a combat boot and the other wrapped in gauze stained every color of the rainbow.  His foot is decomposing right out from under him.  To make matters worse he’s in alcohol withdrawal and probably having petite mal seizures because of it.

Freakzilla sets up the orange canvas chair with a white sheet over it while I grabbed a quick set of vital signs.  Once I was done, we each grabbed underneath an arm and we get Big Eared Jim up and into the white sheet.  Once Big Eared Jim is in the chair we wrap him like a mummy and strap him in like he’s going to be a fighter pilot.  Freakzilla rolls him to the bottom of the stairs while I sling the trauma bag over my shoulders and onto my back.

Going down into the hole is never the issue with only the equipment your carrying and gravity going in your direction.  Coming back up however is usually a different story.  Freakzilla turns so that his back is against the top of the chair with his hands holding onto the handles at the top.  “Ready,” he calls out.  I bend down and grab the handles at the bottom of the chair that are right next to where Big Eared Jim’s feet are resting on a metal bar.  I tilt the chair towards him and when he calls, “Lift!” then that’s what I do.

The chair goes up and onto his back as he begins the ascent and I lift from the bottom.  One step after another and we’re soon moving up the staircase with the patient seated between us.  Big Eared Jim seems to get heavier and heavier with every step I take… and with every step his rotting foot gets closer and closer to my nose.  Even though I’m breathing through my mouth the stench has crept into it as well.

Step after step.

My eyes begin watering.

Twenty-four steps total.

Finally we break through to the street level and into the night air.  I’m able to set Big Eared Jim and The Rotting Foot down to draw in a breath of cool smoggy New York City just before I begin to gag from the stench.  Freakzilla rolls him over to the curb next to the back of the truck.  I open the back doors and pull the stretcher out.  Once it is set-up we grab the sheet under Big Eared Jim, Freakzilla gives the nod, and we swing him over onto the clean mattress with the aroma of rotting meat hanging in the air.

We work silently, strapping him into place on the stretcher and loading him into the back.  We’ve been partners for a year and with that sort of committed work relationship there are just some things we don’t need to talk about anymore.  I climb into the back to sit on the bench next to Big Eared Jim and Freakzilla closes the doors after me.

There I am locked in the back with the smell of death.  I try to ignore, and I take Big Eared Jim‘s vitals again.  Not surprisingly, they’re better than my own.  Freakzilla climbs in upfront and we pull away from the curb.  I grab my paperwork and begin writing things out.  The stench assails my sense again causing a rise in my gorge.  I begin to feel lightheaded, and when I look down everything become blurry.

Instinctively I reach over Big Eared Jim and grab an oxygen mask.  I unwrap it from it’s plastic and attach the hose to the oxygen flowmeter that I crank to 15 liters per minute.  Big Eared Jim looks up at me, brushes his hair away from one gray eye, and says “Oh tanks.  Jus wat I nee.” A look of disappointment crosses his face when I place the mask over my own nose and mouth.  I inhale the sterile stale air and my eyes are back in focus.  The lightheaded sensation dissipates and I continue with the paperwork.  Big Eared Jim just leans back and enjoys the ride.

Once we get to the hospital we roll Big Eared Jim in without hesitation.  There is a welcoming chorus from the nurses who haven’t seen him in a month or so followed by promises of a desperately needed shower, clean clothes, and even an extra slice of the salisbury steak.  The triage nurses directs us to a bed where we can slide him over on the sheet, bid him adieu, and get our paperwork signed.

Big Eared Jim will probably be there for a week while they clean, debreed, and treat his infected foot.  They’ll get him back on medication that he won’t be able to afford once he leaves.  We’ll end up repeating this process but it’s the least we can do for someone who already gave for his country.  More importantly, until he gets out and can pick up a Forty ounce to self medicate, to keep the seizures away he’ll get his fix through regular medication.

The same kind of fix that we got from bringing him to the hospital… because we’re all addicts in our own ways.

The stories on this blog are in compliance with HIPPA regulation.  Identifying details have been changed to protect the patient’s identity.  If you think I am talking about you, I assure you that I am not.

In March 2000 I opened The Parkway Hospital EMS Unit 51 David (51D).  The unit was dispatched by the Fire Department Of New York Bureau Of Emergency Medical Service to emergencies and incidents that were called in through the New York City 911 system or from either the FDNY Fire Suppression Communications Center and the New York City Police Department.  The unit served primarily western Queens from a home atom of 102A.  The assigned Cross Street Location (CSL) for the unit to standby was at Queens Boulevard and Union Turnpike.

We were the only unit to come out of The Parkway Hospital and we entered into a cut throat territorial system from which we had to carve our piece.  During my time there I worked primarily the overnight shift starting my week on a Thursday night and ending on a Sunday night.  They were 12 hour tours, 48 hours a week, and 36 of those hours were usually spent with my partner known as Freakzilla… and I could have asked for no better.  We were The Lone Wolves In The Wild Wild West.

With an average nightly call volume of 10+ calls, there were a lot of things we did.  There were a lot of things we saw.  There were a lot of people we touched… and who touched us with their stories.  Due to things beyond our control, both political and budgetary in nature, in May 2005 Freakzilla and I took truck 5900 on it’s last ride as 51D.  While the unit may not be in the system anymore, its spirit of having the knowledge, the ability, and the desire to get it done lives on…

Photo Credit: A Helpless Addict by Tong!? on Flickr