Baby Steps

There were three minutes left until the shift from hell was over with.  Just three minutes.  Three… Minutes. We were sitting at the door watching the seconds tick away when, of course, the phone rang.

Neither one of us dove for it.  Instead, J and I stared each other down.

J spoke first. “They’re not really going to stick us with a run at the end of the shift, are they?”

He’s serious, the poor, poor boy.  Bless his heart.

I picked up the phone.  Typically I answer with West Station… Today, not so much.

“Seriously?  This better be good!”  In ten hours we had done 12 runs, five of them 911 runs that were everything but emergencies.  Headaches, sore throats, and three episodes of diarrhea.  I waited for our dispatchers response.  The poor woman behind the radio mic was afraid of her own shadow, not at all what I was used to dealing with.  I’ve had dispatchers from the seventh level of Hell itself.  This one was more likely to take up residence in a field filled with daisies.  Surrounded by puppy dogs.  Cute puppies.  Or lolcatz or something.

“I’m so sorry to do this to you guys, I know the day you’ve had,” she started.

I instantly felt like shit for silently cursing her. “It’s okay,” I exhaled.  I grabbed the lucky Viagara pen from my squad pants and a slip of scratch paper from the desk.  “Please tell me that you’re not sending us out of town…”

“No no no, nothing like that, I have a direct for you… You know her…” I could practically hear her shaking, still. I could only think of a few patients we have who are considered “Frequent flyers” who would inspire this kind of fear in a dispatcher… The pronoun she threw in narrowed it down to one.  Just one person.

“Oh no.  Comeonnow…Really?”  I’m leaning against the metal wall of the garage with my day pack and my computer bag hanging on my shoulder.  My keys are in my hand.  I set them down on the floor. “Put us enroute to Seventh and D street.”

**********

The ride over to Seventh and D was riddled with potholes.  Don’t get me wrong, the entire city is riddled with potholes, but this particular neighborhood is somewhat more neglected as far as street repairs go.  I felt like I’d been thrown down a very rocky mountain by the time we pulled up to our patient’s address.  I made a mental note to schedule an appointment with the quack chiropractor.

(Remind me to do a post on how much I hate chiropractors.)

J and I climbed off the truck and met our patient, Emme, on the steps that led to her front porch.  Her bag was packed and hanging over her shoulder.  Kind of like mine was not so long ago.  Even though she was on dialysis three times a week for 4.5 hours at a time she was sucking down a 44 ounce soda from the local corner store.

I felt my heart shrink three sizes.

“Hey, Emme!  How are you feeling today?”  My voice comes out sounding significantly more cheerful than how I felt.  Possibly a little forced.  Possibly.

“Hey Miss Epi!  I’m so glad it’s you…  My stomach hurts, I want to go to *Rural ER, the only one who will still treat me within 12 hours*”

I looked her over.  Her color was good.  Her respiratory rate was good. She didn’t look any worse than my partner and I did after working a crazy 95-degree day on an ambulance with almost no a/c to speak of.   Except she outweighed us each by at least 250 pounds and she skipped dialysis yet again.

And as insane as it made me, she needed to be treated.  Not transported by ambulance, particularly when there was a car perfectly capable of taking her to the hospital sitting in front of the house.  But she needed to be treated.  Even if it was her own fault.  I fought back the urge to lecture her (what good would it do) and waited for her to climb aboard our lowered stretcher. My back screamed at me as we lifted her one click at a time, until we we’re high enough to clear the back of the ambulance.

Emme whined about everything from the amount of time it took us to get to her to the amount of time it took us to get her into the ambulance to the fact that she had to go to that ER because no one else would take her.

By the time that I had her settled in the back of the truck all I could do was sit on the bench seat and rub my temples. I was sweating like a whore in church praying at the alter of flexerils.  More importantly I was in a position that I’ve found myself in more and more lately.  I was hating my job.

I was hating my job.  And it pissed me off to no end that I was at this point.

As much as I wanted to strangle Emme for calling us for the fourth time in seven days, I treated her as I’d treat a family member.  I got over the way I felt and I pretended that she wasn’t abusing the hell out of medicaid.  I pretended that my employer would get paid for this run.  I pretended that J was more than just an “Ambulance Driver”, and that I was more than the person who happened to be riding in back.

Then I attempted to call in a radio report.  It’s never good when the charge nurse at the other end of the radio knows who you are bringing in before you are finished giving your report. “Triage,” the nurse responded after hearing me out. Impressive considering we were taking her to the slowest ER within 50 miles.  I don’t think that I’ve ever taken someone to triage at this particular ER since I’ve been working as an EMT.  I’ve only been doing this for a handful of years, but I have worked for some high volume agencies.

“Triage?!?!!” Emme shrieked, “They can’t put me in triage!  I’m hurting here…”

I sat back and closed my eyes.  “Emme, they’re busy.  They’re treating folks who are seriously ill.  Heart attacks, nasty car accidents…”  I was counting the minutes down until we pulled into the ER.  I knew the second I said it that I should have selected my words more carefully.

“LIKE HELL!  I’m HURTING!  My KIDNEYS DON’T WORK!  That’s an emergency!  I ain’t going to TRIAGE!!!”  Beads of sweat were accumulating on her forehead.  I’m not proud to say that I had already soaked through my polo shirt and squad pants.

I resumed rubbing my temples.  “Emme, I know that you are having an emergency.  I know you don’t want to sit in the waiting room.”

**********

“Itty Bitty EMS,” I announced as I hit the big green button on the wall just outside of the ER entrance.

“Triage,” The same tired female voice responded flatly.

J was unfamiliar with this hospital, so we swapped ends of the stretcher so I could lead him to the Promised Land.  The land of milk and honey for those of us working private EMS, those of us who were getting a little crispy around the edges from having to take someone to the ER at four in the morning for a stubbed toe or popped pimple…  The only proof that we have as EMT’s have that an ambulance ride does not guarantee you a direct admit to a comfy bed in the ER.

Triage. *The clouds part and the sun comes out… Angels sing*

Emme was not pleased.  She grabbed at J’s shirt and started screaming at the top of her lungs.  J’s eyes grew to the size of silver dollars.  I threw my hip into the front of the stretcher and bite my tongue hard.

“Let…go…of…my…partner.  NOW,” I growled.  Both Emme and J jumped a little.  Emme’s eyes were now the size of J’s.  The hallway was silent… empty except for the three of us.  I couldn’t help but imagine that this particular hallway had been the scene for the conversation that was about to take place in the past.  Probably several times. “Look,” I started, “First of all, you will not manhandle my partner or myself.  You will not scream or curse at us.”  I could feel my heart racing, but I was at my limit.

Surprisingly, Emme nodded.

“EXCELLENT.  This ER is busy tonight.  The Nurses and Doctors here are treating folks with more emergent problems than yours.  Are you understanding me so far?”

Emme nodded, again.

“An ambulance shows up three times a week to take you to dialysis at no charge to you.  There’s no reason you can’t go to dialysis.  There’s also no reason you should be sucking down a bucket of soda.  You keep putting yourself here.  Don’t put yourself in this position and continuously expect us to show up with smiles on our faces while you do it.  We’re going to show up every single time, because we have to.  But the more you call for your tired BS reasons, the less likely you are to be taken seriously should you have a real hand-to-God emergency.  Do you get what I’m saying?”

“I’m sorry, Miss Epi.  I was thirsty.”  Emme’s voice was shaky.  J looked like he was going to have a stroke.  No one had dared question Emme, at least outside of the confines of the back of an ambulance.

“Emme, I can’t fault you for taking a sip when you’re thirsty, but I’m not going to be happy and kissing your ass while you’re sucking down three times your daily limit of fluids right in front of me, particularly when you skipped your treatment.  Again.  And why in the hell are we taking you by ambulance when you go everywhere else by car?  I know full well that your uncle is going to show up in a few hours to drive you home…”  I could feel my jaw clenching.  I was crossing a line.   I was saying the very thing that I’ve wanted to scream at the top of my lungs hundreds of times.  And I was saying it with witnesses present.  I imagined the phone call my supervisor would be getting in an hour or two.  (Or twelve if the wait in the ER was as bad as it promised to be.)

Emme just stared at me.  “I’m sorry,” was all she could say.

I didn’t know what Emme was thinking at that point, there was no way to be sure.  I’m not so green and sparky to believe that she was hearing me… That would be asking too much, but there was a spark in her eye  that hinted that maybe she got it.  Or at least part of it.

“So I shouldn’t be drinking a big gulp when you show up next time?”  Emme was smiling now.

Baby steps, I guess.