Showtime for the ambulance started with a bang. It was a two-car accident with seven people on board. Four of the victims were drunk. The three sober people were all kids. As the old saying goes, “God favors drunks, small children and the cataclysmically stoned.” Both drunks and children do tend to fare relatively well in accidents because they bounce. Kids are more flexible than adults and are better protected by their car seats, so they tend to have less severe injuries. Drunks are anaesthetized, so their muscles remain relaxed during an accident and they bounce around freely, usually with little damage. We once found a drunk woman in the trunk of a car after an accident. She was thrown clear through the back seat and into the trunk by the force of the impact and was uninjured, asking for another drink. In this case, of the seven people in two cars only two had minor injuries and needed to go to the hospital.
The patient on our next call was not drunk, and not so lucky. A 55-year-old man was having a heart attack. We went running up to the sixth floor of a project apartment building in the bad part of town, also known as no-man’s land, and found an obese man on the floor, not breathing, with the rest of the family standing around looking at him. They were too drunk to be of assistance. Warren and I immediately got down to business and started CPR. We did chest compressions and respirations to keep oxygenated blood flowing to his brain while we packaged the man up for his ride to the hospital. We told the family that the wife could get a ride to the hospital with the police, but found out that she was out visiting friends and delivering gifts. I immediately had nightmare visions of a screaming wife who had left her family happy and healthy on Christmas Day, only to return as a widow. Yes, widow, because there was little hope for this man. Nonetheless we did our best for him.
The emergency room was still jammed from the previous accident and the rest of the city’s hectic holiday. The ED staff ran the gamut of procedures to try to save our heart attack victim, but with no success. He was pronounced dead about an hour after we received the call. Warren and I got out of there before the grieving wife arrived. We didn’t want to be there if she went into a state we called “staticus princess.” (This Latinsounding condition is a play on words: staticus means “prolonged state,” and princess indicates a spoiled or privileged female.) A widow or mother in hysterical grief can be scary to see for family and emergency personnel alike.
The next call came in as “wife cannot wake her husband.” Frequently you get that with older people, because one of them dies quietly in their sleep. If it were 7 a.m., I would not have been surprised and would have expected to find a deceased spouse in bed. You spend the call supporting the grieving spouse and getting the body out of bed and off to the hospital. The main reason we move the body in these cases is to give the grieving spouse a chance to come to grips with their loss. It also gives them the small consolation that they did all the right things and that we are giving care to their loved one. A lot of what we do is just applying psychological Band-Aids. But it was now 5 p.m., and it was unusual and unnerving to be dispatched to this type of call so late in the day.
When we got there, there was a beautiful 25-year-old blonde, blue-eyed woman waiting for us. Giggling, she said her husband Dave had had too much to drink last night and that she could not wake him.
Giggle, giggle. “He’s not supposed to drink, but it is Christmas.” More giggling as she led us up the stairs of a spacious brownstone. Giggle, giggle. “I let him sleep because he looked so peaceful and downright cute, but I figured he would want to see some of Christmas. The day is almost over, so I tried to wake him.”
“What?” I said. “How long has he been sleeping?”
Giggle, giggle. “Since last night. He went to bed without dinner because he was drinking all day. He knows he shouldn’t do that. It messes up his blood sugar,” she said matter-of-factly.
“Oh, no,” I groaned. “Do you mean he is a diabetic who was drinking and has not eaten or taken insulin in over 24 hours?”
Giggle, giggle. “Yeah, he should have been taking it, so this morning I injected him with some insulin. He taught me to do that, you know.” She said it with pride. “Please tell me you also gave him some sugar after injecting him,” I pleaded.
“No, silly, he was asleep, so how could he eat?”
This was perhaps the worst thing she could have done. The insulin would have caused his blood sugar to fall, and without some additional sugar there would be none in his bloodstream to supply the brain. She had let him sleep because he looked so cute, but that wasn’t sleep— that was a coma. I know many diabetic people, and the first thing they all do is teach their spouses to make sure that they don’t go too long without food as well as insulin. She was probably taught that, but apparently didn’t remember to do it for her comatose husband.
Warren and I did what we could for our patient. We transported him to the ED and gave the report to Holly, the new nursing student I had met in anatomy class. I had come to know that Holly was a strong and intelligent young woman who loved her career and her cats.
Dave survived his wife-assisted insulin coma, but with severe brain damage. After that he was just as goofy as his wife. Warren summed it up with, “That is what I call a real airhead.”
The only restaurant open in our area that night was a very expensive Chinese place. “What a disappointment,” I said sarcastically. Our supervisor didn’t give us a spending limit, so off we went to Ho Yen Wa for a Chinese Christmas dinner. I had never gone there before, and when we opened the menus and saw the prices, it was obvious why. The food was great and so was the service because they had almost no other customers and were glad for the business.
I was working with Warren again just three days later. We hadn’t even finished the regular checkout of the ambulance at the start of the shift when we got a call—a “psych call.” These were always a nightmare. You never knew what you were getting into with a psychotic patient, especially if they were PFN (plain fucking nuts). They were crazy—the calls, that is. Sometimes you got harmless people who thought they were George Washington and were afraid of Benedict Arnold. But other times there were people who thought that voices were telling them to kill all ambulance personnel. I was a little worried about the latter group.
Warren and I prepared ourselves silently while driving to the call. This entailed removing all pens, pencils, scissors and sharp implements that could be taken and used as a weapon. It is a process called “getting soft.” Warren went in the back of the ambulance to get out the restraints we might need. We could only use restraints to protect a patient from furthering injuring themselves or other people (such as ambulance personnel!). We had to keep the leather arm and leg restraints in a locked box in the ambulance because people kept stealing them for recreational purposes. They were the same leather restraints you find in sex shops. We arrived at the address in less than five minutes. It was a funeral home and there were people dressed in black milling around outside. Inside, we were informed, was a woman named Eve who had become inconsolable and eventually violent during her husband’s wake. Some of the mourners were injured with cuts and bruises from what must have been a huge struggle. A violent person—whether they are male or female and no matter what size they are—can be extremely strong.
Warren and I walked into the funeral home, leaving the stretcher and restraints at the door. We could hear loud sobs as we entered. On the floor was a smartly dressed, overweight man who looked strangely familiar. Next to him was an empty casket whose contents had spilled onto the floor. The dead man on the floor was our Christmas Day heart attack victim. Eve seemed to appear from nowhere in a flowing black gown, with flowers in her hair and a veil partially covering her face. She seemed to float through the air like a ghost as she headed in Warren’s direction, which made me worry that she was going to attack him.
“I know you,” she said with her voice trailing as in song. But how could she? She wasn’t there when we tried to save her husband. Eve pointed to him and repeated, “I know you.” Then I noticed she was looking at Warren’s name tag, which read “W. McCain.” “Cain, my son,” Eve said with joy. She obviously thought she was the biblical Eve and that Warren McCain was her son Cain. What a psycho.
Cautiously, she turned her attention towards me. She studied my name tag, which read “Joseph,”