Ambulance Driver

Very quiet Sunday. The department handled a total of 56 runs in my 12 hour shift. Ambulance Driver was assigned 3, but 2 were cancelled prior to our arrival. So, to make a short  story even shorter:

1) An elderly gentleman fell in his apartment resulting in some vague pain in pelvis area. No obvious fracture.

Since it was obvious that today was going to be very slow, at 1030am I jotted down the runs my department was responding to at that moment:

1) A person who slipped and fell in a church parking lot.

2) A baby vomiting and coughing

3) Chest pain in a person with  a history of a heart attack

4) Child who had a seizure

5) An elderly patient who fell in the home

6) A pregnant woman with vaginal bleeding after trauma the night before.

That will do it. We will see if tomorrow is any busier.

Mitch Berg at Shot in the Dark had a terrific post yesterday about a story on National Public Radio. It tells what happens when you provide a high value service for little or no cost.

Kinda like how Medicaid is and how ObamaCare would be.

I urge you to follow the link Mitch provides to the NPR story (where you can read the transcript or listen to the playback) and then read his thoughts.

It is the beginning of a new work week. That makes it time for the latest edition of 911 Update.

1) The first call of the day was for a toothache, which is not as unusual as one may think. This was also the second call for this patient in the last 8 hours. Had gotten pennicillin and a pain medication on the first visit. The tooth still hurt. But, you can hardly blame the patient for running up several thousand dollars in medical bills, they are on Medical Assistance and those folks don’t pay a cent for the care they receive.

2) This patient fell on the ice this morning. Poor English. Has a history of  liver disease and is a diabetic. The fall resulted in back pain with the severity of the injury unknown, but not thought to be serious. This patient is on General Assistance Medical Care.

3) This patient was intoxicated, lying on the sidewalk not able to walk. Has a history of mental health problems. On Medical Assistance.

4) This patient fell on the ice and had pelvic pain with no obvious fractures. This patient had private insurance with premiums that are made more expensive due to patients like 1), 2) and 3).

5) Was a seizure patient at one of the shelters. He recovered quickly said he lived out of state and his ID showed that. HE was on General Assistance Medical Care.

6) Was an elderly lady with diabetes and whose feet were so bad she finally couldn’t get around. Grandson had tried to transport, but just couldn’t manage it.

7) False medical alarm, cancelled upon arrival.

Was for an auto accident with no injuries.

Yep, it was a rainy, icy windy day and the Ambulance Driver arrived home in a grumpy mood.

Go Vikings

For some reason my 8’s show as a smiley face. I’m too stupid to know why and too lazy to find out. Read nothing into it.

It was September 10^th 1989, the Houston Oilers were in town to play the Minnesota Vikings for the season opener. Don Criqui and Ahmad Rashad were in the booth calling the game for NBC. Future Hall of Famers Warren Moon, Bruce Matthews, Randall McDaniel and Gary Zimmerman were on the field. Jerry Burns was the Vikings coach and his counterpart, Jerry Glanville, was across the way.

The Ambulance Driver was there.

As I remember, the Oilers were favored and during the preceding week Glanville had been shooting off his mouth in the papers which resulted in a rather fired-up Vikings team.

Ambulance Driver was in his normal spot, standing just outside the 35 yard line where the trainers could signal us onto the field in case of a serious injury to a player or official. I’ve never received that signal but have taken injured players from the locker room to the hospital. This game was injury free from our perspective, however, and standing on the 35 yard line is a heck of a place to watch a professional football game. It also gave me the perfect vantage point for what was almost the first case of premeditated murder in the history of the National Football League.

As stated, the Vikes were fired up from the get-go and things only got hotter on our side of the field due to the continuous commentary by the original trash-talker, Chris Dishman, the Oilers strong safety. Dishman was a second year player out of Purdue and ended up having a long, serviceable, though not stellar career. The kid really had a mouth on him and he seemed to think that insulting opposing players shouldn’t be taken personally.

Well, the Vikings did take it personally, but none more so than Joey Browner.

Browner was the Vikings strong safety, and a big one. He was tall and built like a linebacker. Known as one of the surest tacklers in the NFL, Joey Browner was a rare 4 time All-American at USC, a first round draft choice, named to 6 Pro-Bowls and a member of the NFL’s All-Decade team.

Browner always sat in the same spot – at the end of the bench just over my right shoulder. He’d take his helmet off, put his elbows on his knees and would sit there just looking mean. Nobody sat near him.

At one point, early in the game, Dishman was directly down the line from me and was laughing and carrying on about something. Suddenly I was shouldered aside by Joey Browner with steam coming out of his ears.

“Dishman,” he hollered “CHRIS DISHMAN.”

Dishman heard his name and looked over our way.

“If you don’t shut the (bleep) up, I’m gonna come out there and kick your ass!”

Well, Dishman obviously couldn’t hear what was being said as he cupped his hand to his ear and started to walk over to see what kind of advice the famous Joey Browner had to impart to him..

What followed was a loud, profane, prolonged and very specific description of how Browner was going to kill him right there in front of 60,000 people and a national television audience if he heard one more word from him. It was a Bob Knight-like performance.

And the Ambulance Driver believed him – as did Chris Dishman.

During Browner’s diatribe Dishman seemed to melt as he meekly nodded his head. I wasn’t close enough to see but I bet tears came to his eyes. He may even have peed his pants, I know I almost did.

“I think he heard you that time.” I observed.

Joey Browner glared at me and said, “He’d better!” and with one last shake of his fist, Browner resumed his seat on the bench.

Needless to say, the trash talking was over.

The Vikings defeated the Oilers 38-7.

Today’s 911 Update combines runs made yesterday and today. Both were eight hour shifts. During those sixteen hours our department received 112 calls for help. Ambulance Driver responded to ten of them.

1) Fall in a nursing home. Patient had gotten up from wheelchair and was found several feet away, lying on the floor and bleeding from a head laceration. No known loss of consciousness. Probable fractured hip.

2) Patient is developmentally disabled with history of frequent seizures and had one today in apartment. Living in an independent living situation attempting to move to assisted living. From the looks of things, that needs to happen. Patient needs more help.

3) This run was cancelled while we were enroute. Seems a nursing home patient called 911 stating they were having a heart attack. On call back to nursing home, the charge nurse went to the patient’s room and found the resident was not in distress. Apparently this patient had done this several times before.

4) This was an accidental death that occured under tragic circumstances that I won’t go into.

5) Was for a patient with a history of mental illness and has had suicidal thoughts for a week. Went to see his physician who arranged for hospital admission. We were called for transport. Patient was cooperative.

6) Nursing home patient with severe shortness of breath from pulmonary edema. Poor vital signs. Hospital of choice too far away, in our view, so patient transported to closest appropriate hospital for emergency treatment.

7) Patient with history of back problems. Back “went out” during a job interview. Was very uncomfortable. Morphine given to make patient more comfortable during transport.

 This patient is elderly and lives at home. Is complaining of shortness of breath and is very anxious. Patient was wheezing but not nearly as sick as she seemed to think she was. Speaks in full sentences. Not hypertensive. Moves a lot of air. Neb enroute to hospital fixed her up.

9) This middle aged patient was at methodone clinic and was having symptoms related to chronic liver disease. Was mildly confused and complaining for abdominal pain.

10) This homeless patient has a history of seizures and suffered one while at the shelter.

That concludes this week week and I will enjoy my three days off.

Yesterday’s election of Republican Scott Brown in the Massachusetts special election to fill the seat held by Sen. Ted Kennedy can only be labeled a disaster for the current health care reform efforts in Congress. Already many members of both the Senate and House are getting Tony Romo-like “happy feet” in the face of the repudiation of a liberal candidate running for a seat once held by a liberal icon in the most liberal state in the country.

One could excuse them from thinking, “Am I next?”           

Consequently, don’t expect Democratic leadership to be able to keep their majorities in lock-step and push something through to the President’s desk. Many moderate votes that seemed solid as late as last week are going to switch to “no.”

ObamaCare is deader than Julius Caesar.

But that’s not the only thing to learn from this bombshell of an election. The Brown campaign is now saying that while voter opposition to Congress’ health care reform was strong, their internal polling pointed to Brown’s stance on terrorism to be his biggest wedge issue.

Brown was consistent in his message that terrorists did not have a right to a tax-payer funded lawyer, that they should be brought before military tribunals and not the Federal Courts, that detaining them without trial was fine with him and that waterboarding was not torture and was a technique that should be used to garner information.

Ambulance Driver believes that a vast majority of Americans agree with this and those elected officials who have misjudged the electorate on this issue now have a lot to think about.                      

Last Monday WWE Raw was in town and Ambulance Driver was on hand in case one of the performers actually got hurt. I’ve never worked a wrestling match before but thought it would be an interesting experience.

I wasn’t disappointed.

We arrived two hours ahead of time and met with the troupe’s physician and trainer. Their instructions were simple enough. If a certain signal was given, we were to come out with our stretcher and equipment. It was the same sort of procedure that we use at Twins, Vikings, Timberwolves and Gophers.

We were also asked a question that we were prepared for, “Would you guys like to be part of the show?” We politely declined although both myself and my partner for the night are experienced actors (he said with tongue firmly planted in his cheek) having appeared in the comedy series, Let’s Bowl.

We were then able to watch the rehearsal which basically was to teach the guess star, Mike Tyson, what his role was to be. Shortly, after they were done, Tyson exited the arena and walked right past us. Tyson looked me right in the eye and said, “Sir, how are you doing tonight?”

That’s right,  Iron Mike Tyson called me “sir.”

The other thing that struck me is that he is at least 2 inches shorter than me and I stand 5’ 11”. The years haven’t been particularly kind to him either. My partner noted, “He looks like us.” It wasn’t meant to be a compliment.

As the show started, we took our places behind the stage that was set up and put in our ear plugs. There were quite a few pyrotechnics that were periodically shot off within 30 feet of our position. A red light was positioned so all the crew in the vicinity would be warned prior to detonation – and detonation is the correct word. The explosions were loud.

There was a large projection screen where we could watch the action and still keep an eye on the ring-side physician.

We figured there were about 12,000 in attendance. They were loud, enthusiastic and surprisingly (at least to me) sober.

The performers were very athletic. I really am surprised that they rarely get seriously hurt during the show given all the awkward falls they appear to take. Apparently they have this stuff down to a science.

Even though I never watch shows like this, I was vaguely aware that there is a story line that is carried week to week. What I didn’t know is just how invested the crowd was in this soap opera. WWE is certainly giving these people what they want – entertainment. Things like this really are a big production and this outfit has it down pat – they are organized.

After 6 hours, and soon after the show was over, we were released by the staff. It was an interesting experience and one I’d do again.

It was a rather slow Monday for the old Ambulance Driver. We responded to just 4 of the 49 calls that came in to the Department. As always, information has been garbled in order to insure patient confidentiality.

1) Patient awoke with a buring sensation in his stomach. Was mildly nauseated but had not vomited. Up and walking around with no complaints of weakness. Was anxious but not overly so. The patient’s vital signs were stable. Our exam included a 12 lead EKG which appeared normal. Nitro did not effect discomfort.

2) Was for a false medical alarm in a private residence.

3) This nursing home patient had a leaky in-dwelling foley catheter that needed changed. By the way, EMS doesn’t do that – we transport.

4) This patient had driven their vehicle into a snowbank in a western suburb. Was found slumped over the wheel when police arrived. A medic alert tag indicated a diabetes history. Blood sugar found to be 28. An IV dose of 25 grams of dextrose woke him up in about 3 minutes. No injury from the low speed enounter with the snowbank. Was left with police and instructions to eat a meal as soon as he got home.

And that was that for this day. See you tomorrow.

At a young age I received the book “The Celebrated Cases of Sherlock Holmes.”  My favorite Holmes story has always been The Man with the Twisted Lip. It tells the tale of Neville St. Clair, who found he could earn more in a day of begging than he could in a week as a reporter for an evening newspaper.

Across the nation, in metropolitan areas, one sees a great many folks standing along the road holding signs speaking of their desperation. I’ve often thought of Mr. St. Clair and wondered just how much money they were taking in during their day’s work.  A few months ago, the Ambulance Driver was given an inside glimpse at a panhandler’s life style.

We responded to a call on the near south side of the city for a man who had fallen. There we found a fellow that was bleeding from a badly lacerated hand. He was mid-forties, but could have passed for a younger man. He had good teeth, erect bearing, passable grammar and was sober. The reason these attributes stood out was that he obviously was a “street person.” He was grimy, but not filthy. He carried a backpack stuffed with most of his worldly possessions, one of which was a sign that read, ”Desperate Please Help.”

As I bandaged his hand, I thought of Neville St. Clair and decided to see just how talkative my patient was going to be on the trip to the hospital.

He responded to my inquiries as follows:

He had been panhandling on the Nicollet Mall for several months. His reserved spot was near the entrance of a well known department store. Apparently there is some sort of unwritten rule that no one dare panhandle in his spot as long as he was around. He is there Monday through Friday, appearing sometime just before lunch time and staying until he makes his “mark.” He has become a well-know fixture. Certain people never fail to drop some money in his “cup.” Women who work in the area often buy him a sandwich and soda for lunch and drop it by.

His “mark” is his collection goal. It was disappointing to hear that it was a mere $10.  Collections, oddly enough, come quicker in poor weather than when the sun was shining. Whether it comes as quickly as ten minutes or as long as a couple of hours, as soon as the mark is made he packs up and heads for the nearest liquor store for a cheap bottle of vodka and a pack of smokes.   

He is enrolled in the state’s General Assistance Program where he receives $203 a month in cash benefits. He doesn’t eat free at Mary Jo Copeland’s Sharing and Caring Hands because her rules are too strict. Instead he uses his state provided EBT card (like a debit card) to buy cheap food at a local convenience store. I’m not sure how much the state puts in his EBT account every month but $150 is a pretty good estimate, I think. He also is a General Assistance Medical Care recipient, where medical care is all but free.

He is married and his wife is also a General Assistance enrollee with an EBT card. She, however, has a state subsidized apartment where he can’t officially live, “because the state won’t let me.” He sleeps there anyway. (Ambulance Driver has a pretty good idea on why the state won’t let him live with his wife. As a married couple they are only eligible for a single GA payment of $260, not two separate payments of $203).

His long term goal is to qualify for several Federal Programs due to his chemical dependency.

We had just enough time for him to tell me about the “Heroin Bitch” who has a  spot was just a block down from him. She is the leader of a band of four that panhandle six to eight hours a day. He claims they earn $2000 a week, total, and spend it on street drugs.

I didn’t have the heart to tell him that a bunch of dopers had more ambition than he had.

Since that encounter, I’ve often thought about this life style and the culture that enables this type of behavior. This guy is perfectly able to work but has chosen, instead, to live off the generosity of the state and those of us who supply the money for his booze.

I’m not done with this subject.  The Neville St. Clair’s of this world fascinate me. Stay tuned.

Today marks Martin Luther King Jr. Day. While many of us think of it as a vacation day from work, a day out of school or a day of free parking in downtown Minneapolis, Mitch Berg of Shot in the Dark reminds us what this great man was really about. King’s ministry of equality and freedom left him subject to personal danger. Despite that, he was always on the front lines – unafraid and unbowed.

On April 3rd, 1968, Dr King was in Memphis to help rally black sanitation workers who were striking for equal standing with their white counterparts. That afternoon he gave his final speech. The next day he was gone.

So sit down here and take 20 minutes to hear one of history’s greatest Americans speak for the final time. Better yet, grab your kids and have them listen with you.