Monday, September 21, 2009

Shut the @#$% up and load your patient,

Rescue 224 and Mayview ambulance 24 were dispatched to a reported medical aid at a residence. R224 arrived on scene to find several young adult males standing on the front porch of a single family house. They directed us inside the house, where we found an additional 5 to 7 adult males who asked us to stand by while they brought our patient out from the rear of the home.

After a short delay, a male subject, age 19, appeared from a hallway and identified himself as our patient. Pt. was fully ambulatory, fully oriented and alert. He was complaining of minor nausea, general illness and appeared to be in minimal distress.

R224 seated patient. in a chair and began patient. assessment. Pt. denied medical history, allergies to medications or medications. Pt. denied recreational drug or alcohol use within the past 48 hrs.  For complete medical assessment and treatment details, see Pre-Hospital Care Report # 980978.

Mayview ambulance #24 arrived on scene and we advised them of our assessment, findings and actions. After some discussion, Pt. opted to be transported to Kinda Big County Hospital by ambulance. Mayview #24 transported Pt. to K.B.C.H, R224 then returned to service.

If some of you wondered my writing style tends to be a little narrative in nature, now you know why. The vast majority of the writing in my adult life has been incident narratives, much like the one above. Below, is  a little more descriptive account of this event.

The evening was warm, allowing people to come outside and spend time on the street. The neighborhood was what we call a "wobbler" neighborhood - it could go either way. Street gangs from Los Angeles had been migrating north and east, changing the cultural climate in many of the neighborhoods in the community where I worked.

Older neighborhoods in one downtown area had been inhabited by a cross section of people, including young families who had bought houses built in the 1930s and 1940s and had restored them, large victorians that had been divided into apartments for lower income renters and a few estate size homes that were owned by long time residents.

A real estate slump had lowered prices a few years earlier, allowing investors to purchase numerous houses in the downtown area. These houses were largely turned into rentals, often owned by landlords who lived somewhere else, with no commitment to anything other than the collection of rent.

This proliferation of rentals was accompanied by the proliferation of crack cocaine and it's associated crime. The gangs that existed in this city before then were primarily hispanic gangs who were more concerned with turf and pride than with dope and cash. The introduction of L.A. style gangs was a shock to everyone - us, the P.D. and the old school gangs.

My partner and I were toned out to an unknown type medical aid. As we pulled up on the corner house, it was obvious that this was one of "those" houses. The presence of several young males, all wearing either baseball caps, jerseys or bandannas of the same color, the loud rap music coming from the porch and the silent hostility all worked to put me in a state of unease. One of the guys pointed to the door and told us "in there".

My unease escalated into mild anxiety as we stepped into the house and entered the living room. Through the dim light, I could tell there are five or six other young men, all with the same fashion sense as the guys in the front yard, all with the same hostile silence. The lack of older adults or females further added to my anxiety as there were no calming factors there.

They were mainly seated in the living room, with a few in the adjoinijng dining area. The furniture was early yard sale motif, but the T.V. was color, at least 27 inches across. MTV was on, most of the guys stared blankly at the screen. Over the noise of the TV, I could hear other people in the back of the house. One of the occupants stood and told us to "wait here".before disappearing down the hall.

We stood in the living room for a minute or so before a 19 yr. old male walked down the hallway and stood in front of us. We were informed that this was our patient and that he wasn't feeling well. I don't remember who told us this, but I am sure it wasn't our patient.. We asked the patient a few questions, which he answered in an appropriate manner. We grabbed a chair from the table and had him sit down.

The ambulance showed up at about this time. I was glad, because I just wanted out of there. If we can just get  this guy loaded up, we can do the assessment and any treatment in the ambulance. My happiness turns to disappointment as I see who entered the living room.

DeeDee was fairly new to the Mayview ambulance company. In the short time she had been there, I hade caught her lying to me at least twice, I had noted her awful personality, both to our customers, to us and to her co-workers. I had also noted her propensity to "dry-run" patients, a few of whom might have actually needed to go. She was the next to last medic that I wanted to see walk through that door and was one of the main reasons I supported our agency becoming an ALS provider.

As DeeDee was the only EMT-P on the scene, technically she was in charge of patient care. She immediately started her assessment, doing so in a rude, accusatory manner. The patient was cooperative but a little evasive as to what he was doing when he started to feel ill.. He just said that he was a little sick. His skins were normal and other than the "little sick" thing, he appeared to be in pretty good shape. What he wanted to do was go to the hospital. In an ambulance.

I was all for it. Load him up, lets get the hell out of there. DeeDee asked if he had access to a car. We all knew the answer to this, as we had to walk around a couple of lowered Buick Regals parked on the lawn. Our patient told us again that he wanted to go by ambulance.

DeeDee shrilly told him that he doesn't need an ambulance, but he appeared to be undeterred. Personally I agreed with her, but sometimes it's just easier to load and go. Dee Dee started in on him, telling him he could go by car, bus or taxi.

By now, this conversation had become more interesting than MTV and a few of the people in the room were starting to pay attention to our interaction with the patient. I could hear rumblings from the audience. Still, DeeDee wouldn't let it go, except now her conversation was directed more at us than the patient. "He don't need to go by ambulance, he can go by car. This is bullshit" she told us, loud enough so that the patient and his friends could hear.

This disturbs the individual who had retrieved the patient for us in the first place, to the point where he said "look, he wants to go in the ambulance,  take him". DeeDee was still too busy spewing her mantra, that she failed to notice the increased tension in the room and the increased grumblings from the crowd.

By now, I had enough. I looked DeeDee in the eye and told her "Why don't you shut the %$# up and load your patient."  I know the patient heard it, my partner heard it as did DeeDee's partner. I don't know how many people in the immediate area heard it. The main thing was that although she didn't really shut up, she did load the patient and we all safely left the scene.

I was so angry I thought about diming her off to the District Commander. I then realized that she would probably file a counter-complaint against me for inappropriate language and communication. As I was a firefighter at the time, I was trying to get promoted. Oh, did I mention that she was physically involved with a Captain in the next district? This type of event was a loser for everyone involved.

What bothered me the most was DeeDee's failure to recognize that she was in a house full of gangsters that were not the usual people she was used to dealing with. Fortunately, nothing ever came of my statement. She continued to be a bitch, I continued acknowledge the same. She left the district a few months later and began screwing things up down south. The last I heard, she hooked up with a state trooper and moved to the mountains. I don't miss her. Sometimes, it's just easier to load and go.


  1. She clearly needed to learn to pick her battles. You may have the high ground, but when outnumbered and outgunned, fall back and call in re-enforcements.

    I think the colorful language was well placed though, countering equally her language and speaking in terms those around you could easily understand. You defused what could have become a rough scene.

    And you said %&#@, always a plus.

  2. You made the right call.

    In fact, your account makes the hair on the back of my neck stand on end!

  3. I hadn't even noticed the narrative style of your writing. Guess I'm used to it from the years of doing it too.

    Wait, you don't have a cop respond with you on every call?? Much less a call in a questionable neighborhood??

    I must have been spoiled down here in So Florida. Cops responded on every call. I remember a few occasions where we arrived at domestics with injuries or at calls in questionable neighborhoods before the cops...we waited down the street until they arrived.

    Oh and what a bi-otch. I wanna slap people that have no common sense.

  4. First thing I would have done would have gotten the f--k out of there. I've dealth with those type of people before and it is not pretty.

  5. As anxious as I was, I felt the situation was more or less under control until DeeDee showed up. Then, I saw what could have become a spiral into chaos. I think DeeDee was shocked into action, it worked for me.

    As far as the cops go, they will respond with us on violence related calls and on calls where someone is not breathing. However, there are times where they are "code 9" meaning they don't have any units available. Sometimes, it is a long wait. I have another post in the works about that subject.

  6. Even if she hadn't been shocked into action, your words perhaps nicely aligned you and your partner with the hoods. Good move picking your side: A large group of (probably) armed young males instead of the rude beotch.

    After playing that card, your chances of escaping an escalation unharmed improved quite a bit, I bet.

  7. Most "hoods" do not see us as a threat so they leave us alone. Having a cop show up can seriously escalate the tension, especially if the cop wants to start looking around-which they all do for their own protection(as they should). We really have to keep our situational awareness up and continually evaluate the mood of the people around us.

  8. Perhaps you should have a word with DeeDee, and explain why you wanted to get out of there quickly. Especially if she's new, it may be that she's so naive she didn't realise the dangers.

    Always worth trying to keep your colleagues onside.

    (Word Verification - metense, somewhat appropriate!)

  9. It shocks me that anyone would want to hook up with such an annoying person.