Paramedic Notes From The Inside
Or, a New Appreciation For Vicks Vapour Rub: Part I of II
Working in EMS for any length of time, one begins to appreciate certain universal and timeless truisms. Two of which that immediately come to mind are:
If you drop the baby pick it up.
Well, what are you going to do, leave it there? For the record, no I have never dropped a baby.
If it’s wet, sticky, foul smelling, and not yours, leave it alone.
That one should be self explanatory. However, it is somewhat appropriate for what follows below.
A Saturday In Mid November, 2005
I am halfway through my coleslaw topped pulled pork BBQ sandwich from Memphis Jacks, when the radio barks with a request from dispatch for our current location. I feel the pager on my side vibrate, asking via text that same question. Dispatch is certainly thorough, if nothing else.
“ICU 248, what’s your 10–20?”
“ICU 248 is at Cooper and Bank, just getting some lunch.” I’m hoping that my addition of relevant context may spare us from the assignment sure to follow. No such luck.
“Sorry 248, I’m going to need you for an Alpha response on The Southway. Details to follow on your pager.”
Fuck, this is not going to be fun. An alpha response is a level 1 priority, meaning it is a non-emergency ambulance call. Call assignments are based on the skill level of the medics responding, and there is only one skill that a critical care crew possesses that would be used on a non-emergency call. The skill allowing us to pronounce and certify that death has occurred.
“ICU 248 10–8 to scene”, I respond, as I see Brie, my partner, crossing the street with her Memphis Jacks bag in hand. Jumping in the passenger seat, the former ballerina with the MA in comparative lit and my paramedic partner for the day, asks me if we got the update yet.
Reading my pager, I groan.
“No, not an alpha? Not when I’ve had half a pulled pork. Please tell me it’s not what I think it is?”
“Yep”, I answer, smiling, as I weave into the afternoon traffic, enroute to The Southway.
The details in our update indicate we are responding to the 9th floor of an apartment building. The call was relayed to us via a police operator who received the initial call from the building superintendent. The man was concerned about a rancid smell, one that had been getting worse for several days.
“I’ll get the Vicks”, Brie replies, dropping both our sandwiches into the garbage basket between the seats. We are almost at the address when dispatch barks another update.
“ICU 248, be advised that Response 9 and the FD are on scene and confirm you are needed for a Code 5.”
“ICU 248, copy that. We are 10–7 at scene. Can you cancel Response 9 and FD off the call?”
“Copy that, FD cancelled, Response 9 has requested to stay and assist.”
“10–4.”
I look at Brie who rolls her eyes, and with a grand show of faux enthusiasm says, “Great, we get to deal with a body and Mr. Grabby Hands. What a slacker.”
Mr. Grabby Hands, as he is known, is actually a response unit medic otherwise known as DJ. A Level I paramedic, he’s an old school guy who was required to update his certification or lose his job. DJ is one of the last of his breed. Brie’s description of him as a slacker, however, is more than accurate. There is absolutely no need for him to be here now. What he’s more than likely attempting to do by “assisting”, is kill an hour or so of responding to calls while we complete paperwork and deal with the coroner notification etc. Trained at a time when all you needed to work in an ambulance was your standard first aid and a chauffeurs license, DJ is the kind of guy who’s seen it all and done it all. At least in his mind, anyway. He also has quite the reputation with the female paramedics of our department, as an annoying flirt. Today, I’d change that description to blatant sexual harasser.
With the Vicks Vapour Rub generously applied to the inside of our nostrils, I zip the control pack into one of several zippered compartments in the leg of my paramedic jumpsuit, leaving our medical bag, trauma kit, spinal board, and stretcher behind. The “control pack”, as we call it, is black leather, about the size of a travel wallet. It has a zipper around three sides, and contains six rows of medication. Each row has a slot for six 1 ml ampules, the first three rows contain three varieties of opiates; the last three rows hold 3 varieties of benzodiazepines. Combined, they have a street value of just under 10 K; thus the reason they literally come with us everywhere we go.
Brie and I realize this call will be particularly rough when we hit the lobby. Our call is 9 floors up, yet we can smell the scent of the decomposing body from here.
As anyone who has been unfortunate enough to experience the scent of a dead body can tell you; once you smell it you will recognize it anywhere. It’s a powerfully rancid scent, similar to rotting meat, but with a distinct and sickly sweet twist. Similar to, say, BBQ sauce for pulled pork.
By the time we reach the apartment both the Vics Vapour Rub lining our nostrils, and surgical masks covering our mouths are of limited use. With the stench as bad as it is, breathing must be deliberate and only through the mouth, as one involuntary inhale via the nose will cause gagging, which often leads to worse. And trust me, you don’t want that, as vomitting can often be contagious.
Entering the apartment, Mr. Grabby Hands awaits us in the small living room. Looking up, he throws us a generous smile, and says, “Look who we got, Altocub and Black Swan. Good to see you as as always.”
Though his greeting is intended to be good natured, both of us are somewhat sick of the nicknames we have come to hold on the department. Altocub was harmless enough, I suppose. Originating from a fusion of my long time screen name of alto with cub, a term that in the gay community refers to a younger variety of bear (a gay man with a beard, often one who is hairy, and appears more traditionally masculine in deportment and style). As someone who made a choice to be open with my sexuality, I can’t really complain. It could have been worse.
Brie, on the other hand, is not as accepting of Black Swan. Nor should she be. Swan, from her dance history, obviously. But the movie of the same name has yet to come out, and I doubt most of the guys calling her that are familiar with the ballet. No, behind the “black” is a very clear, passive aggressive put down. For having the audacity to possess what by any definition would be considered super model looks, and a very limited tolerance for straight male sexist bullshit. As Brie herself says, it’s only slightly less offensive than “The Librarian Dominatrix”, the other term they sometimes use. Librarian referring to the French inspired chigon she pulls her hair into at work, dominatrix referring to the utter lack of interest she pays to the blatant attention guys shower her with. “The sexy, ice cold bitch.”
At any rate, Mr. Grabby Hands has of late seemed a bit nervous around me. My biggest fan, until learning I was gay, he has since confided to co-workers that he was surprised, since I was “just like all the other guys on the job.” Clearly, Mr. Grabby Hands was expecting all gay men to be little nelly limp wrists, belting out Broadway show-tunes at the drop of a hat. Anything else is just too complicated and challenging to the stereotypes defining his 1950’s inspired world. But today, around both of us, he’s nothing short of a babbling mess.
With foot firmly implanted in mouth, DJ proceeds to inform us that the deceased, who’s in the bedroom, “Is as queer as a three dollar bill, judging by all the girly shit around this place.”
Instantly my hackles go up, and I feel a flash of white, hot anger. Time and a few unpleasant, heated exchanges since taking this job have taught me to reign it in. Fast. Turning away, I silently count to ten. Thankfully, there is a benefit in having a partner who knows you almost as well as you know yourself. Not missing a beat, Brie steps in, taking it from here. Her impressive ability to look someone in the eye, while remaining completely expressionless for just slightly longer than required before speaking, is I’m sure another reason for her specific nickname.
“Thanks DJ, we can take it from here.”
“No way Black Swan. I wouldn’t dream of it.” The poor boy just cannot read social cues.
“Perhaps I wasn’t clear, DJ. Your presence here is no longer required, ” Brie says, with a closed mouth smile, then squeezes the radio microphone. When dispatch answers, she clears Mr. Grabby Hands.
“Alrighty then, you people have a great day.”
I smile, realizing he can’t get out quick enough. Closing the door behind him, I look at Brie and roll my eyes.
“Ready to do this?” I ask my partner.
“Never”, she says. The answer giving away just slightly more than Brie may have intended, and I have a moment of unexpected softness for my partner and friend, the woman most see as an ice queen.
I hastily decide to give away just as much. It’s only fair. “Neither I am I. Let’s go.”
With that, we move to the bedroom, where we begin to do our job. The surprisingly complicated job of bearing witness to a life lived, through documenting, thereby legitimizing, its passing.
Part II below:
Out of both professional and legal obligations to maintain strict patient confidentiality, and in the interest of protecting privacy, all places, including street address, street names, and specific neighbourhoods, as well as individuals names, including on occasion some identifying details, have been changed. The sole exception is my former paramedic partner Brie, who has given consent to use her name and describe her part in all events in this series.
Paramedic Term Glossary
Terms below are ones that were common across various parts of Canada and the US when I was employed full time in EMS. They are not meant to describe all terms used in all regions.
10–8: In service, enroute to.
10–7: Arrived at, out of service.
10:20 Specific location.
Alpha Response: The least serious priority ambulance call, considered either non emergency or low level emergency.
CODE 5: Obviously dead (Rigidity, Decomposition, Decapitation, Trans-section).
CODE 6: Legally dead (As pronounced by MD, the coroner, or an ICU medic crew).
Response (unit #): A paramedic, primary or advanced level, often in a high call volume urban area who works alone in a non patient transporting vehicle so as to arrive quickly, often first during emergency calls to begin treatment.
ICU (unit#): Intensive Care Unit Ambulance. Staffed with the highest level of paramedic, usually called level 3, often referred to as “bringing the ICU to the patient.
FD: Fire Department. Often dispatched to medical emergencies in large urban centers.
