In EMS, we are eyewitnesses to the inevitable decline of the human body and to death. That’s why when a young person dies it shakes us deeply. They are not supposed to die. It is hard to disassociate yourself from such an event. On those rare occasions that my Pandora’s box of bad EMS memories comes open, the emerging spirits that haunt me are the sights and sounds of those scenes, burned into the memory of my eyes and ears, undiminished by time.
When we start in EMS, for many of us, we believe that what we respond to will not happen to us, but as we age, immortality slips away along with our bravado. In my 60s now, I do truly appreciate each day, individual moments seem wondrous, I marvel that I am still here. An old girlfriend of mine, a true love, used to play Elton John’s “I’m Still Standing” at the end of the night, as beer cans littered the room and her cigarettes ran out and our bold dialogues and our love made us feel like gods. She’s been in the earth nearly fifteen years now and I can still see her face as plain as...
One of my lifelong heroes is Joshua Lawrence Chamberlain. He was the Maine school teacher who volunteered to fight in the Civil War and found himself leading the 20th Maine on Little Round Top, a rocky hill at the end of the Union line at Gettysburg. After repulsing several attacks, his battle weary men were out of ammunition and facing yet another Southern charge up the wooded slope. Chamberlain ordered his men to fix bayonets and charge down the hill in a sweeping movement. This resulted in a stunning rout, and the Union held the position. Had they been flanked, the battle and the war might well have gone the other way and what we know as the United States may have ended up as two separate countries.
Chamberlain, who was wounded in battle six times during the course of the war, was chosen by Ulysses S. Grant to accept the Southern surrender at Appomattox. There as Chamberlain watched what was left of the Southern Army coming down the road, heads bowed in defeat, he ordered his men to “Carry Arms!” standing at...
A number of winters ago, I responded for the “welfare check” in a local apartment building. Carrying my gear I trudged through the snow to the door where the super met us and we walked through the bare lobby. He told us “his hands and feet are all blue.” By the way he said it, I knew he was talking about a body and not a person who needed help. We walked up two stairwells to the third floor, where the super led us down a dim hallway and then opened the door of a one room apartment, and gestured for us to enter. On the floor, there was a collapsed clothesless body, head faced into the wall. The legs and arms were blue as the man said, and the rest of the body, a wazy white. There was vomit on the ground outside the open bathroom door. A small TV was turned on to the Andy Griffin show in black and white. The place smelled of cigarettes. There was uneaten food on the stove and the trash overflowed the bin. In the corner of the room there was an open rabbit cage. I knew it was a rabbit cage because I saw the rabbit...
When I first started in EMS I was almost always the first on scene because our local fire department only responded to jaws of life calls and the PD usually only responded to reports of violence assaults. I loved getting their first. The scene was pristine. Sure I had a dispatch subject, but from early on I knew that was rarely a reliable indicator of what I would find. The “Annie! Annie! Are you okay?” they taught us in EMT school in assessing a mannequin actually came in handy. I rarely arrived to find someone doing CPR. I was the one who shook the patient, applied my hand to their neck to feel for a pulse and listened for breathing. Soon enough I could determine if someone was dead by first sight on walking in the door. I remember finding a man at a card table, still as can be, and still holding his hand of five card stud, staring at two kings he would never play. I laid him on the floor and started compressions.
Over the years as fire departments started first responding, or in some towns,...
According to the latest data from the Connecticut Medical Examiner’s office, 2021 opioid deaths rose 11% over 2020, marking the third year in a row of increases. Opioid deaths have increased in 8 of the last 9 years in the state. Fentanyl deaths have increased every year, with Fentanyl deaths representing 93% of all opioid deaths in the state in 2021. No end in sight.
People will continue to die as long as illicit fentanyl remains predominate in the state’s drug supply. Because Fentanyl is so powerful and is so difficult for illicit dealers to mix evenly, users are not dying from traditional overdose (taking more doses than normal), they are being poisoned. They are unable to reliably determine how much active ingredient is in each dose (bag). When people use Fentanyl alone and they get a get a disproportionate amount of active ingredient in their standard dose, they suffer respiratory arrest and die if they are not quickly found.
To prevent Fentanyl deaths it is time to take the following steps:
I have been interviewed quite a bit over the last year both as a result of my book, Killing Season: A Paramedic’s Dispatches From the Front Lines of the Opioid Epidemic, and my role as part of the state’s overdose surveillance system. There have been times when I thought I was truly eloquent, but when I watched the interview on air, it came across as babbling. Other times when I thought I had been babbling and inarticulate while being interviewed, thanks to editing, I felt I was brilliant and silver-tongued!
Recently I was interviewed for over an hour about the opioid crisis. A couple days later someone told me they saw me on TV talking about EMS reimbursement as part of a story on response times. When I saw the story, I was only on for about ten seconds. I said something about EMS needing more reimbursement to help with stress. Nothing about opioids. I recalled the interviewer did ask me a few questions about response times. I talked about how lights and sirens were rarely needed, and EMS systems should be judged...
Below is an excerpt from my novel, Mortal Men: Paramedics on the Streets of Hartford, that came out in 2012, and is still available on Kindle. In the book, while the main characters had fictional names, I used the names of real people who worked the streets as extras. I did it because I wanted to reward and acknowledge their worth, and so that their names would be remembered.
In the past couple of years, we have lost a number of those. I count six, who sat in the front seat next to me as partners on many a long shift, who have passed on. Some died among their loved ones, others died alone. I Googled one of their names looking for obituary information and came up with a link to this chapter which I had posted online in 2009. It describes a night we all drank together. The evening was well-made.
I went out for a beer with Victor a few nights later at the Brickyard Pub on Park Street in West Hartford. He’d lost his medical control to practice as a paramedic pending investigation. He’d had an asthma patient...
You are on scene of an overdose. You have just resuscitated a man who was apneic and now admits to snorting heroin he was given by a friend. He just got out of jail and hadn’t used for over two years. You explain both the danger of the fentanyl that is on the street in place of heroin and the danger of his low tolerance for having not used for so long. The man agrees to go to the hospital. While you are looking around the scene, you spot two unused heroin bags on the dresser. You hold the bags up to the light and can see the white powder in them..
What do you do with the drugs? There are no police officers on scene.
Note: Keeping them for yourself is not an option.
For many years, I would take the drugs and either put them in the sharps container, or give them to a police officer if one was on scene, or bring them to the hospital to show them.
My choice seems to be either leave the drugs there on the dresser or take them and dispose of them.
Someone you care about is graduating from paramedic school. What is the best gift you buy them?
Only two choices in this exercise. 1. A high quality stethoscope with their name etched on it. 2. A good pair of boots.
When I graduated from paramedic school, I bought myself a Littmann cardiology 2. It was THE stethoscope to get at the time. I don’t remember how much I spent, but it was over $150, which was a lot for me at that time. I didn’t bother with the engraving. I wanted the stethoscope because I wasn’t very good at lung sounds and I wanted to hear as well as possible. I also wanted something to show I was professional. The Littmann Cardiology would show I was serious about the work.
When I lost the stethoscope after a year, I was distraught. I had misplaced it a few times over the year, but it always turned up — left in an ambulance or at the hospital and joyously found and reclaimed. When I truly lost it, I bit the bullet and bought another one. I lost that one too. Next time I...
When my book Killing Season came out, Amazon chose it as one of the best nonfiction books of April 2021. The book was also profiled on CSPAN books and I was interviewed by major networks including the BBC and ABC. I was hoping for a review in the New York Times Book Review, but no luck there.
Writing a book and getting a book published can be an emotional rollercoaster. The highs come when someone agrees to publish it, and then when the first copies arrive at your house and you get to hold it in your hands. The lows, at least for me, are after the book has been out a couple months and the buzz starts to fade. You check the Amazon sales rank and the number keeps falling. You feel like your work is already being forgotten and no one is reading it. It makes you question why you write and is it worth it to spend all that time and effort. You may work on another project, but it is just not coming together and you question yourself. The book will never amount to anything. Why even bother to write any more?