How this mid-Spring story begins is the same way the story often goes. Repetition is the norm as call after call require little thought and each call is forgotten five minuets into the next. How repetition goes out the window happens in a way it only could in Center City. Early one rainy afternoon we are dispatched to a pedestrian struck four blocks ahead from we were sitting, and en route the dispatcher advises that “the mayor is on location” I jokily ask if he is the one involved and as we arrive on scene the mayors security staff are running around the street looking very secret service like with radios in hand. Our patient is a female lying on her side in the middle of the roadway, and appears to actually be injured unlike every other “pedestrian struck” call you get downtown. As we are packaging the patient I see the mayor walking down the street toward our direction, and as we try and cover the blanket with a sheet before leaving he reaches in to try and assist. My partner and I don’t make eye contact or say anything, because in retrospect what could you say? It is a random and yet totally unforgettable moment that is just another reason this job is better then any around.
Introduction Song: “Natural Reaction” -Gomez
One of the most frustrating things about an urban Fire Department that also runs EMS, is the fact that the fire department also runs EMS. That may sound simple or a bit repetitious but it is the root of nearly every problem. Most career fire departments in the major cities have been around for over a hundred years and Emergency Medical Services has only been present for about thirty years. As fire departments grew through time it became necessary for them to learn “first aid”, then “scoop and run” basic services then later train and hire Paramedics. Fire Prevention, sprinklers, and many other reasons caused fires to drop at the same time EMS demand skyrocketed. Now these fire departments that fought fires night after night in the “war years” are forced to realize that EMS is the major operation of the department. The reality of this imbalance comes to the street medic when you encounter accidents and other EMS based incidents where the street medic or Paramedic officer should be in charge but that doesn’t happen. With the impending schedule change for EMS, and continued struggle to meet the rising demand of emergency medical calls the war years of EMS will continue to reshape this department.
Segue Song: “Bixby Canyon Bridge” -Death Cab for Cutie
You were one of the first to ever give me a chance, regardless of what the rest had done or said.You were the medic the day the soon to be chief caught the truck on down wires and we laughed at the flashing light bar sprawled across the shattered windshield after the fact. You were the one who’s car I backed into one afternoon while trying to pick up something for lunch. I waked inside the station my face red with embracement and fear only to watch you handle it with total composure and control. You years later held me to a higher standard when I thought I was ready to break free and do this alone. Now that your gone I have no idea how the our little world of EMS will ever be the same. Now that your gone I have no idea how I was ever lucky enough to learn from someone as wise as you. Now I hope that when I do this job I can do it in a way that you would approve of. A giant in our world of EMS has fallen this week in a long battle with cancer. I found out Saturday afternoon while driving down Woodhaven Road that Chris Haber had died. I tried to hang up the phone and continue on to work without it effecting me but that would be like asking the sun not to set. After some time on the job you get so use to suppressing your emotions in the face of total sorrow that when something so personal happens you grieve in different ways. I remember not long ago while precepting with you how I believed I had finally demonstrated everything from a solid run code to basic ALS call and you caught me on my attention to detail. Now in the face of a warm Saturday night where the cities EMS system will explode over capacity I think of a giant that we have all lost and the legacy that will remain.
I’ve been to my share of funerals, and each is a different shade of sadness and depression. Those for the elderly in our lives all who we expected to pass before us are often more celebrations then suffering. Funerals for those who died in the line of duty are a bitter heroism laced in sorrow. You knew that it could happen and now hate that it did. Then there are funerals fro the ones that were to young to die. Maybe by there own hand, mistake, or illness. Regardless it is as if there story was cut to short and we hate to continue ours without them. The funeral for Chris Haber was something like the latter. He had cancer for two or three years and for a time seemed to have won. Now that he has died all that is left are pictures and memories. For an evening these pictures and flowers cover the inside of a funeral home, and in the days ahead it will be up to us to carry his legacy from this day to the next. The scene of this funeral reminds me of a similar one when Frank White died. Squad members in there dress blue uniforms tried to stand as soldiers but looked so broken instead. That funeral was held on a cold winter night but this one was a beautiful warm spring evening. The sun had yet to set and those who came stood in small groups for hours outside the funeral home. Some came from hundreds of miles around because the man now lost had touched so many lives. His story is over but this story will forever be influenced by the life of a great man.
Episode Song: “Hero” -Jars of Clay
Today’s Five Points
5-”hit a patch”, of what stupidity?
4-”D.P.S”
3-”attention to detail”
2-If I get swine flu I’m going to punch a pig
1-some nicknames never go away
In Memory of Christopher Haber, 4/18/2009
Tuesday, August 30, 2011
Wednesday, August 24, 2011
Murder On Mellon Street
Sunday, December 06, 2009
Season Thirteen: Episode Two “Murder on Mellon Street”
Those early beginning days as a new Paramedic have faded away. That exciting “fresh” feeling of beginning every shift, of treating each patient like your family and believing everything the patient said are no longer the same. The realization that your place in the system is low and typically your opinion isn’t heard or important begins to take over and even when you try and stand for what you think is right will likely get you in trouble in the end. I went head to head with a nurse one night at a hospital over the fact that unless we literally bring in a cardiac arrest anyone else will be placed in triage. I may have been right, but she filed a complaint and I lost. That complaint and a couple spars with patients, families, or bystanders has forced me to realize another aspect of the partner dynamic. My actions reflect on her, just like the classic “you’re only as good as your last call.” I may be satisfied going down in a flames of glory but I’d rather be engulfed in flames then do anything that would harm my partner. So recently I’ve tried to take a step back. I can still control the scene, treat critical patients, or treat non-critical patients with some degree of respect but will try and do it differently then how I have been in the last few months.
Introduction Song: “Needle and Haystack Life” -Switchfoot
Halloween one year ago and days earlier the Philadelphia Phillies won the World Series. That afternoon all normal city functions are suspended and a celebration parade takes place that many will remember for years to come. What I remember of that Parade is the aftermath. The subways filled with drug twenty something’s trying to get home. Piles of trash and overturned newspaper bins line the area. The sun would set that evening and the masses of people dressed in red changed into costume and after fourteen hours we set a record of nearly thirty calls in that shift. So needless to say come this Halloween we were ready for the same thing to happen. This year there would be no Phillies Parade as the Series wasn’t over yet, but later they would lose to the Yankee’s. But this year with daylight savings taking place at 0200 hours our typical twelve hour night would in reality be thirteen hours. Most nights begin busy, taper off to a small break around midnight then resurge at the drunk hour at 0200. This night there was no break at midnight, and around two that morning, the clocks changed and the rush continued. Our dispatchers struggled to keep pace as the computers no longer could indicate the actual time as calls overlapped the time change. Engine and Ladder’s waited for an available squad, and each tried to make there run sound more serious so they would get the next squad. Eventually the night ended and when all was said we tied the twelve hour shift record of twenty calls. The holiday season was soon to begin but in retrospect I had no idea how busy the November ahead.
Several years ago as I attended Drexel’s Paramedic program I routinely took the train from home to class nearly every day a week. During that time SEPTA went on strike and for five days the city was gridlocked and regional rail was a hot mess at the same time. During the last month a similar event occurred. The SEPTA union threatened to walk during the Phillies home stand of the World Series, but under political pressure they waited until hours after the game ended. Early the next morning the city again folded to the will of public transportation and for the next five days people learned to deal without the buses and trolley system. Eventually like years past the Union and SETPA reached settled on a new contract and the returned to the status quo.
Segue Song: “D.O.A (Death of Auto-Tune” –Jay-Z
Another night and another I find myself elbow deep in an airway and later covered knee to elbows in blood. A thirty-something female is lying near the entry way of her apartment in a pool of blood, stabbed through the chest multiple times she is in cardiac arrest. The police arrived first and after opening the door to let me upstairs to the apartment locked my partner and the Engine crew behind me out. I followed the officer upstairs and leaves me for what was only seconds but seemed like a lot longer when there was little one person could do but start CPR. Once everyone was in place our plan was to secure the airway, give the first round of drugs and transport but the best laid plans fall apart. As I struggled with the airway my partner struggled with an IV. The patient is in PEA, and finally on my third attempt I secure the tube. We carry the patient down to the truck, switching to the EZ-IO we have access and drugs on board. En route to the hospital it’s clear that this was a fatal wound and from the police perspective they have there suspect. There was another female on scene that said “She said she was going to kill me so I killed her first.” We arrive at the hospital with a crowd waiting; the trauma team performs a thoracotomy, transfuses blood but soon surrenders to the reality of the situation.
A few nights before the Murder on Mellon Street my partner and I responded to a call for a child stabbing around four in the morning. The Engine from that local responds, police from all over that district, and when we arrive there is a crowd of people outside screaming. I swear I hear from one of them “you killed my daughter” the crowd outside is equal to the crowd inside the house and inside the mother is screaming while holding her daughter in her lap. The firefighter pulls up the shirt and uncovers a basically superficial wound on her sternum. I try to calm the mother as we place the bandage but no sooner do we pick up the four year old, then the police have the mother in cuffs. Everyone on scene is blaming different people, but neither of us has yet to figure out why anyone awake let alone stabbing each other at this point of the night. On the way to the struck I ask the patient what happened and without a second thought she says who stabbed her. We bring a police officer over and have the patient tell him what she just said to us. This neighborhood nicknamed “da bottom” sits just a few blocks away from some of the most brilliant research and education areas of University City or the high rises and rich living of Center City. It’s never been a good area like the City of Chester was and it’s only the influx of college students that has changed some of the blocks from blight to something close to livable. So much violence on just one street I have no idea if the circle will ever be broken. The first snow of the season fell yesterday and with the holiday season in full swing the white flakes of innocence covered the city for the night before it turned to ice and melted into the next day.
Episode Song: “Red Eyes” -Switchfoot
Today’s Five Points
5-peak hour hoes
4-“she looks fantastic” –says the drunk patient
3-reaping away
2-22 ETI in 2009, one month to go
1-first snow of the season 12/5
Season Thirteen: Episode Two “Murder on Mellon Street”
Those early beginning days as a new Paramedic have faded away. That exciting “fresh” feeling of beginning every shift, of treating each patient like your family and believing everything the patient said are no longer the same. The realization that your place in the system is low and typically your opinion isn’t heard or important begins to take over and even when you try and stand for what you think is right will likely get you in trouble in the end. I went head to head with a nurse one night at a hospital over the fact that unless we literally bring in a cardiac arrest anyone else will be placed in triage. I may have been right, but she filed a complaint and I lost. That complaint and a couple spars with patients, families, or bystanders has forced me to realize another aspect of the partner dynamic. My actions reflect on her, just like the classic “you’re only as good as your last call.” I may be satisfied going down in a flames of glory but I’d rather be engulfed in flames then do anything that would harm my partner. So recently I’ve tried to take a step back. I can still control the scene, treat critical patients, or treat non-critical patients with some degree of respect but will try and do it differently then how I have been in the last few months.
Introduction Song: “Needle and Haystack Life” -Switchfoot
Halloween one year ago and days earlier the Philadelphia Phillies won the World Series. That afternoon all normal city functions are suspended and a celebration parade takes place that many will remember for years to come. What I remember of that Parade is the aftermath. The subways filled with drug twenty something’s trying to get home. Piles of trash and overturned newspaper bins line the area. The sun would set that evening and the masses of people dressed in red changed into costume and after fourteen hours we set a record of nearly thirty calls in that shift. So needless to say come this Halloween we were ready for the same thing to happen. This year there would be no Phillies Parade as the Series wasn’t over yet, but later they would lose to the Yankee’s. But this year with daylight savings taking place at 0200 hours our typical twelve hour night would in reality be thirteen hours. Most nights begin busy, taper off to a small break around midnight then resurge at the drunk hour at 0200. This night there was no break at midnight, and around two that morning, the clocks changed and the rush continued. Our dispatchers struggled to keep pace as the computers no longer could indicate the actual time as calls overlapped the time change. Engine and Ladder’s waited for an available squad, and each tried to make there run sound more serious so they would get the next squad. Eventually the night ended and when all was said we tied the twelve hour shift record of twenty calls. The holiday season was soon to begin but in retrospect I had no idea how busy the November ahead.
Several years ago as I attended Drexel’s Paramedic program I routinely took the train from home to class nearly every day a week. During that time SEPTA went on strike and for five days the city was gridlocked and regional rail was a hot mess at the same time. During the last month a similar event occurred. The SEPTA union threatened to walk during the Phillies home stand of the World Series, but under political pressure they waited until hours after the game ended. Early the next morning the city again folded to the will of public transportation and for the next five days people learned to deal without the buses and trolley system. Eventually like years past the Union and SETPA reached settled on a new contract and the returned to the status quo.
Segue Song: “D.O.A (Death of Auto-Tune” –Jay-Z
Another night and another I find myself elbow deep in an airway and later covered knee to elbows in blood. A thirty-something female is lying near the entry way of her apartment in a pool of blood, stabbed through the chest multiple times she is in cardiac arrest. The police arrived first and after opening the door to let me upstairs to the apartment locked my partner and the Engine crew behind me out. I followed the officer upstairs and leaves me for what was only seconds but seemed like a lot longer when there was little one person could do but start CPR. Once everyone was in place our plan was to secure the airway, give the first round of drugs and transport but the best laid plans fall apart. As I struggled with the airway my partner struggled with an IV. The patient is in PEA, and finally on my third attempt I secure the tube. We carry the patient down to the truck, switching to the EZ-IO we have access and drugs on board. En route to the hospital it’s clear that this was a fatal wound and from the police perspective they have there suspect. There was another female on scene that said “She said she was going to kill me so I killed her first.” We arrive at the hospital with a crowd waiting; the trauma team performs a thoracotomy, transfuses blood but soon surrenders to the reality of the situation.
A few nights before the Murder on Mellon Street my partner and I responded to a call for a child stabbing around four in the morning. The Engine from that local responds, police from all over that district, and when we arrive there is a crowd of people outside screaming. I swear I hear from one of them “you killed my daughter” the crowd outside is equal to the crowd inside the house and inside the mother is screaming while holding her daughter in her lap. The firefighter pulls up the shirt and uncovers a basically superficial wound on her sternum. I try to calm the mother as we place the bandage but no sooner do we pick up the four year old, then the police have the mother in cuffs. Everyone on scene is blaming different people, but neither of us has yet to figure out why anyone awake let alone stabbing each other at this point of the night. On the way to the struck I ask the patient what happened and without a second thought she says who stabbed her. We bring a police officer over and have the patient tell him what she just said to us. This neighborhood nicknamed “da bottom” sits just a few blocks away from some of the most brilliant research and education areas of University City or the high rises and rich living of Center City. It’s never been a good area like the City of Chester was and it’s only the influx of college students that has changed some of the blocks from blight to something close to livable. So much violence on just one street I have no idea if the circle will ever be broken. The first snow of the season fell yesterday and with the holiday season in full swing the white flakes of innocence covered the city for the night before it turned to ice and melted into the next day.
Episode Song: “Red Eyes” -Switchfoot
Today’s Five Points
5-peak hour hoes
4-“she looks fantastic” –says the drunk patient
3-reaping away
2-22 ETI in 2009, one month to go
1-first snow of the season 12/5
Tuesday, August 23, 2011
In Your Memory
8/23/2011
"In Your Memory"
I never knew you as a philly paramedic. I never knew half of the stories I heard til after you were gone. I never worked with you at tri-hampton as we were both paramedics but always looked foward to hearing you when I had to call the ME's office for a code I called in the field or patient that was dead on arrival.
The first peice of music that came to mind after I found out you had died was I believe an old poem turned to song where the lyrics say "Do not stand at my grave and cry, I am not there. I did not die" I first heard the song as apart of a Third Watch episode when a paramedic was killed and it was played at her funeral.
After moving my work scheudle around, and two MXT's thanks to Jenn Moore I was able to make the trip to your funeral in Niagra Falls, NY. We were far from close friends but this is what being in Emergency Services is about, paying your last respects and doing so even if that means driving 700mi round trip.
As apart of the trip we took your dog along to bring him to your family. Needless to say there is a ton of dog hair in my trail blazer, and a near fatal escape at a rest area made for an interesting trip. But, the heart felt thanks from your family made it while. I must say the falls were beatiful and the area a fitting place for your burial. Just as the poem said though your not at your grave, your in heaven.
A fellow paramedic said it best as we taked after services. "Everyone knows that you do enough time at Medic 3 you lose your compassion for people and he didn't." I heard so often in these last few days how much your cared for people, and if I could make one fitting memory to you it would be for me to do the same on the same city streets you served.
"In Your Memory"
I never knew you as a philly paramedic. I never knew half of the stories I heard til after you were gone. I never worked with you at tri-hampton as we were both paramedics but always looked foward to hearing you when I had to call the ME's office for a code I called in the field or patient that was dead on arrival.
The first peice of music that came to mind after I found out you had died was I believe an old poem turned to song where the lyrics say "Do not stand at my grave and cry, I am not there. I did not die" I first heard the song as apart of a Third Watch episode when a paramedic was killed and it was played at her funeral.
After moving my work scheudle around, and two MXT's thanks to Jenn Moore I was able to make the trip to your funeral in Niagra Falls, NY. We were far from close friends but this is what being in Emergency Services is about, paying your last respects and doing so even if that means driving 700mi round trip.
As apart of the trip we took your dog along to bring him to your family. Needless to say there is a ton of dog hair in my trail blazer, and a near fatal escape at a rest area made for an interesting trip. But, the heart felt thanks from your family made it while. I must say the falls were beatiful and the area a fitting place for your burial. Just as the poem said though your not at your grave, your in heaven.
A fellow paramedic said it best as we taked after services. "Everyone knows that you do enough time at Medic 3 you lose your compassion for people and he didn't." I heard so often in these last few days how much your cared for people, and if I could make one fitting memory to you it would be for me to do the same on the same city streets you served.
Tuesday, August 16, 2011
Live Life Returns
It's been more then a year since I formally put anything of worth together. I've written in my little black book. But now I'll try and refocus myself and tell my story of my job and my life again.
Resusitation
8/16/11
When we arrived you were lying half in bed, unconscious. The dispatch was for "unconscious/unresponsive" but thats a common dispatch and this wasn't a common call. Within the first couple of seconds it was clear you were pulseless and not breathing and the resusitation began.
The intubation simple, IO line placed and Asystole on the EKG. I didn't expect much here but my partner and I with the help of the firefighters did our best. At about 15min in there had been no change an I took your wife downatairs, sat her down and gave the first part of "the speech."
"When we arrived your husband wasn't breathing and his heart wasn't beating. We are breathing for him, doing CPR and giving him medicine. At this point its not working. If nothing changes within the next few minuets were going to stop. But, there is a slight chance something will and at that point you'll see alot of acitvity and we'll take him to the hospital."
The second part didn't happen in your case. First your heart went into VFIB which is still dead but progress. 360J later you had a pulse. My partner and I knew we were moments away from 'calling it' but now we were in a brisk rush of sucess we were going to the hospital.
I watched to make sure nothing got pulled, a few breaths got thrown in duing the carry, the hospital was notified, and someone saw to the wife and then we were off.
I doubt you'll walk out of the hospital but your a rare case of field resusitation and I wish your family that it gave them a chance to make peace with you in your end. As I cleaned up and my partner documented I said to him "We may not be the best of friends but we run a good code." He agreed and our day continued.
When we arrived you were lying half in bed, unconscious. The dispatch was for "unconscious/unresponsive" but thats a common dispatch and this wasn't a common call. Within the first couple of seconds it was clear you were pulseless and not breathing and the resusitation began.
The intubation simple, IO line placed and Asystole on the EKG. I didn't expect much here but my partner and I with the help of the firefighters did our best. At about 15min in there had been no change an I took your wife downatairs, sat her down and gave the first part of "the speech."
"When we arrived your husband wasn't breathing and his heart wasn't beating. We are breathing for him, doing CPR and giving him medicine. At this point its not working. If nothing changes within the next few minuets were going to stop. But, there is a slight chance something will and at that point you'll see alot of acitvity and we'll take him to the hospital."
The second part didn't happen in your case. First your heart went into VFIB which is still dead but progress. 360J later you had a pulse. My partner and I knew we were moments away from 'calling it' but now we were in a brisk rush of sucess we were going to the hospital.
I watched to make sure nothing got pulled, a few breaths got thrown in duing the carry, the hospital was notified, and someone saw to the wife and then we were off.
I doubt you'll walk out of the hospital but your a rare case of field resusitation and I wish your family that it gave them a chance to make peace with you in your end. As I cleaned up and my partner documented I said to him "We may not be the best of friends but we run a good code." He agreed and our day continued.
Thursday, August 4, 2011
Struggle
I struggle everyday. I hold my touge as the thoughts race through my head. My skills wasted on someone with foot pain while true emergencies wait. There is so much I want to say but I can't. I need this job. I need money to pay bills and need to make it through the day. I pray we get one person that needs more then basic ALS so I can feel I made a difference at least for 10min out of 12 hours.
I admire my partner for his people skills but wish we could find a middle ground. Honestly I have so many quirks I don't know if anyone but my old partner can really tolerate me. I still love being a paramedic but struggle to be the kind that lasts more then a few years.
I admire my partner for his people skills but wish we could find a middle ground. Honestly I have so many quirks I don't know if anyone but my old partner can really tolerate me. I still love being a paramedic but struggle to be the kind that lasts more then a few years.
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