Bad Call Read online

  The ER is small, with seats for about twenty people. Even though it’s quiet for us on the ambulance today, the ER seats are almost filled to capacity, with mostly trivial injuries like minor burns, scrapes—really nonemergencies. Most people don’t have the faintest concept of ordinary first aid and so come here to get their boo-boos kissed, figuratively speaking. We also have a regular Sunday-morning contingent that comes in for B12 shots. I’m told most of them are alcoholics getting these shots as a kind of tonic—it seems to make them feel better, but I think that’s largely a placebo effect. Whatever works.

  The nurse in charge today is a force of nature. Boudicca in white. It is simply not possible to be more Irish-Catholic-Celtic than she is. If I were going to cast her part in a hospital-ER movie, the role could be played only by Maureen O’Hara. Hard as nails is an accurate but inadequate cliché to describe this nurse, whom I shall call Pegeen because I’m actually afraid of what she might do if she sees I had the sand to use her real name. I think Pegeen is Irish enough to do the job. She’s in her late forties, I guess. Around six feet in her white nurse stockings. Maybe taller than that. And big boned.

  She’s always giving me shit, in the way of a cantankerous longshoreman. If we bring in a bad one, she gives us that banshee look, the Irish stink eye. It makes me feel that if she had a ruler on her, she’d smack us across the knuckles, or worse.

  Once, when I had finished a shift, I walked up Fifty-Seventh Avenue to my father’s gas station to meet him there so we could ride home together. My cousin George was there with his new used bike. It had drop handlebars, which, for reasons only known to him, he had turned up—so that he could sit more upright, I suppose. The result of this modification was to place the brake levers in a position where they could only be actuated by leaning back and using your thumbs. He asked me if I wanted to take it for a spin. I hopped on.

  I had not gone a block when I reached an intersection. A car was coming on my right. In an instant, I could see he didn’t see me. Apparently, he didn’t see the stop sign, either. I instinctively reached for the brakes, which of course weren’t where they were supposed to be. I knew he was going to hit me. I tried to relax. The impact slammed the bike out from under me. I slid up the length of the hood to the windshield, smacked into that, and was launched high into the air, clear across the intersection. To my great amazement, I landed on my feet, shoeless. My canvas boat shoes, still perfectly tied, lay under the bike, just as if I had pushed them off and left them there, side by side. I have seen this quite a few times on the ambulance and always wondered how it happens—what’s the science. I know about inertia, but it’s hard for me to believe the impact could have forced me out of those lightweight shoes. Anyway, it happens, and now it has happened to me.

  I was okay except that my wrist had gotten whacked by the insanely positioned brake lever when the handlebars were twisted out of my hands from the impact. I duly walked what was left of the bike back to George and then started down the street to St. John’s.

  Pegeen was there to greet me with scorn that was exceptionally keen, even for her. I told her what had happened. I thought my wrist might be broken, and she said if it were, she’d eat her hat. When the X-ray showed it was chipped and I demanded she eat her hat, I actually thought she was going to belt me one.

  That’s our Boudicca. Hard, cynical, and Celtic to the core. But it’s quiet today and I’m absorbed in the crossword and Pegeen is out of sight in the OR, treating patients.

  I’m gradually becoming aware of a stir in the ER. A rustle of murmurs is passing through the waiting patients and their escorts. They’re staring toward the double doors that lead into the ER. There’s a man standing very still, looking around, clearly dazed and very feeble. He’s dressed in filthy rags.

  Under these rags, every square inch of him is completely covered with thick, caked-on shit. It’s as if he’s been iced by some demented baker.

  We’re all staring at him in silent shock. God, he stinks so bad—and I am no stranger to stink. I can’t imagine what the patients must think. I’m wondering how dried feces could smell so bad—shouldn’t they be more or less descented by the time they turn into adobe. He must have been shitting himself for weeks. Maybe months. How the hell did it get up to his neck and his head and in his hair—was he pooping upside down.

  Everyone in the room is frozen. The guy is frozen. I’m trying to decide if I should press the buzzer to alert security. If I do, what will I say. What kind of an incident is this.

  The doors to the OR are opening. It’s Pegeen. Her sixth sense and the quiet in the ER must have told her something was up—she really doesn’t miss a thing. She immediately zeroes in on our visitor. I have never seen her face like this.

  Imagine the Virgin Mary with a new puppy, and you will begin to visualize the look of benignity on the feral Pegeen’s face.

  Talk about your angels of mercy—I’m looking at one right now. Who is this person. All eyes have shifted from shit man to her as she walks toward him, her expression never changing, and takes him by the filth-covered arm. She’s speaking to him in a low voice, sounding so sweet; noises like you make when you talk to a baby or a kitten or a loved one or someone who’s dying. Where is she taking him. She’s asking me to come with and, of course, I do. Everyone always does what she tells them, even though this time she’s asking, not telling. I’m transfixed and completely in her power.

  There’s an area where we never go, adjacent to the ER. It’s a cozy bedroom reserved for the doctor on call, seriously off-limits to anyone else. In it, there is a large walk-in shower. Pegeen is leading this man to the stall. Holy Christ. She’s going to give him a shower. She’s turning on the shower, but she’s not tossing him in. She’s not asking me to do a thing. Am I here to help, or simply stand guard.

  Maybe she just wants someone to know who she really is.

  Instead of putting him in the shower fully dressed, which would make sense, she’s removing his clothing. It is beyond disgusting, but she’s not wearing gloves. She is gingerly—make that tenderly—taking off his garments and dropping them on the floor of the shower. I’m trying to observe without staring. I don’t want to violate what little self-esteem the man has left.

  Pegeen is filling a basin with shower water and squirting in some pHisoHex. Now she has a sponge and she’s soaking it in the soapy water. She’s going in to wash the man by hand, as if he were a baby.

  We’ve all seen the paintings of Christ’s body being cleaned for burial. This is like that. It is a moment of such impossible charity and tenderness that it has brought me to the verge of tears. I cannot allow her to see me cry. I’d never live it down. She’d see to that. I’m out of here.

  The next time we see this man, he looks brand-new. He’s clean and wearing newly laundered surgical scrubs and disposable slippers. Even his hair is combed.

  It’s almost impossible to believe, but Pegeen’s starched white nurse’s vestments are completely spotless. It’s like a miracle.

  Boudicca turns and shoots me a fierce look that tells me I’d better keep my mouth shut if I know what’s good for me.

  I do, and I do.

  Death of a Cynic

  I love weddings, and this one seems better than the usual. For one thing, it’s a nice hall, not too schmaltzy. My sisters (two out of three) are obsessed about having their reception at Leonard’s of Great Neck, having been there for a couple of dos and having seen the gilded extravagances (my view) firsthand. They’ll have to wait, since they’re fourteen and ten right now. Sister number 3 is a toddler, so she has yet to weigh in on the subject. They’re all here somewhere, I assume with Mom and Dad or some cousins, or sitting at the bar having Shirley Temples. They love to sit at the bar. We call them bar fleas, in light of their tender years. This is a cousin wedding. Cousin Ralph. He’s my favorite cousin. We spent a lot of time hanging out as small kids, and I’m happy to be here.

  I’ve had more than a few drinks, but I’m doing okay. In New York,
the drinking age is eighteen, which means we’ve all been drinking since a few years before that. So it isn’t hitting me like a ton of lead. I’m in a second- or third-tier crowd—no one seems to have any clear relationship to the principals: the lucky couple, their parents, whoever. I think one of these invitees works with someone who’s related to someone who works with the bride. What that makes him is anybody’s guess.

  We’re all talking about what we do. For a living, school, what. My turn finally comes, and I start telling them that I work for St. John’s (which is literally a mile down Queens Boulevard from where we are right now) on the ambulance, and the one who’s related to someone immediately zooms in on what I’m saying.

  He’s telling me that a couple of months ago his mother was in an accident on Queens Boulevard and she was picked up by St. John’s ambulance and taken to the hospital, where she was admitted for a severely broken neck. It’s a miracle she wasn’t paralyzed, and so forth. This is very interesting to me. When did this happen, where, what time of day, I ask. He describes a call that I remember very well, having been half of the team that responded.

  I am overcome by a tremendous shock. It feels the way you feel when you’ve come close to serious harm, like almost stepping back off the edge of a very high place. The adrenaline rush is palpable. My heart is pounding, and it isn’t from the ethanol. Yes, I remember this call exceptionally clearly.

  We’re living in the age of a medical (and legal) phenomenon called whiplash. I’m not sure the word even existed before a year or so ago, outside of pirate ships or torture chambers. Not in the context in which it’s being used today, at any rate.

  People in NYC get really smart really fast, especially when there’s a buck in it. It became known by millions, almost overnight, that a small bump on the back of your car could have dollar signs attached. Accidents that for years went unreported were suddenly being backed up with legal briefs that could choke a horse. Everyone—anyone, driver or passengers—could file a claim for whiplash if the car they were riding in was hit from behind. I’m sure huge numbers of claims were filed even when the claimants weren’t hit from behind—fault is almost always assigned to whoever hits you, anywhere but the very front of your car. The sides and rear are whiplash territory.

  Overnight, simple sprained necks were turning into a cash bonanza for the car-riding public at large, not to mention the legal and medical professions. It’s no exaggeration to say that nearly every accident we respond to, not counting those where the victims are truly injured or dead, involves the word whiplash. Neck pain is always noted on our pink call slips. These slips are official documents, and I suppose they can be subpoenaed as evidence in a whiplash lawsuit, even though most of these suits are pretty pro forma. The claimant wears a neck brace for a while. The action is filed. The money is paid. The neck brace goes into the garbage. Or it’s reserved for another family member. Waste not, want not, as the saying goes.

  The woman we picked up on Queens Boulevard that day, the only person claiming injury in the accident, was complaining about her neck. She didn’t have to say the w-word; I knew where this was heading. That day, I was working with a guy about my age. I think he is from one of the -stans in central Asia. He has a very slight accent, and his name is Richie. I try to imagine what his -stan name is, but for the life of me, I can’t back out of Richie into anything that makes sense. I’ll have to ask him someday. Richie is in medical school. He has finished his first year and done well. Richie is affable, not too serious, and very smart. I like working with him, but I don’t have a chance to often, which is too bad.

  I was just about to take Richie aside and lay Yet another frigging whiplash on him when a strange look came over his face. Not weird strange, just serious, which was strange for him. He was worried about her neck, he said. Let’s put on a neck splint, he said. A what, I said. You’re shitting me, I thought. I must have been dozing off when they taught neck splints. Never heard of one. Never saw one. I’ve seen those orthopedic neck braces but never a splint, per se. As far as I knew, we didn’t have any under the bench or below the floor in the ambulance, where we keep all our stuff.

  Richie, we don’t have any neck splints, do we, I asked. Richie didn’t skip a beat: We’re going to make one. I had been a Boy Scout and knew how to improvise all kinds of things, from emergency shelters to rope bridges to drinking cups from tree bark. Richie’s plan intrigued me. He started rummaging under the bench and came up with two stretcher sheets and a wide roll of adhesive tape. He was very methodical, moving slowly. Or he only seemed slow, in contrast to the speed at which traffic was passing us on either side of the ambulance. People rarely slow down for accidents. You have to be very deliberate in your movements when you’re working around an ambulance, treating people out in the street. If not, you could end up needing treatment yourself. It happens often enough.

  Richie decided he only needed one sheet after all. He folded that one a couple of times and rolled it up tight. Then we went over to our patient, who had been very nice while we were making our preparations. Richie had me carefully raise the woman’s head and shoulders together as he eased the roll under and around her neck so that both ends of the roll were even in front. He then began to bind the rolled ends together with adhesive tape. The result was what they call a horse collar. (This I found out later, in the course of my remedial neck-splint research.) It did the job perfectly—immobilizing the neck—and I complimented Richie, although he didn’t seem to hear me.

  We lifted her gently into the ambulance and took her to St. John’s.

  This was the mother who could have been paralyzed because I allowed myself to be cynical about whiplash and almost didn’t take her seriously. The very mother whose actual son is now thanking me profusely to my face for the care I gave her that afternoon on Queens Boulevard. Oh man.

  Thank God for Richie.

  Who cares what his real name is.

  A Date for the Prom

  It’s around lunchtime on a Tuesday, and we’re on the way to another psycho. It’s our third one today. I can’t understand it. There’s no full moon. Sometimes you get similar kinds of calls bunched up like this, and then you don’t get any for a long while.

  One week it seemed like every other fender bender we went to ended up being a major conflagration. There must have been something in the atmospheric conditions that made them burn so easily. We’re talking fatalities where there normally would have been cuts and bruises. Another time, we had three stabbings in a row, in the space of an afternoon.

  I’m out with Jose today. Jose is from Peru, and he looks exactly as if he has been reanimated from a pre-Columbian pictograph carved on the side of an Aztec or a Mayan temple. He has a wonderful native Mesoamerican profile, and it’s really striking. He’s shorter than I am, and I’m not tall by any means. I’d say he’s about five foot three or so. He is barrel chested and, like all the other guys I work with, really strong—and not just for his size. He’s nothing, if not cheerful. He’s actually funny as hell. In fact, he’s a bona-fide pisser.

  Jose likes girls a lot. He has a repertoire of appreciative noises that he uses when he sees a woman he admires, which includes just about everyone with two X chromosomes. These noises include: a rapid inhalation of breath (like the sound you’d make if you had just burned yourself on a hot stove), a kissy noise, and a kissy noise combined with a clicky noise combined with a grunt.

  Jose has a catalog of gestures as well, which are more or less universal in meaning.

  In fairness to Jose, I need to say that none of these noises or gestures is ever directed toward patients, nor are they apparent to the public, since they are almost always expressed inside the ambulance, clearly for my benefit—in reference to individuals he sees on the street.

  Jose is the most energetic guy I work with, by a good margin. He literally never stops moving or talking (when he isn’t making mating calls), and he kind of wears me out, funny as he is. When he does quiet down, all he has to do is make
a face to get me laughing uncontrollably. That wears me out even further. A shift with Jose is like being at a kid’s birthday party with an overcaffeinated clown. Stimulating, but you can’t wait for it to be over. On the plus side, he helps me practice my Spanish, and we sometimes spend the greater part of a shift speaking in that language only.

  We arrive at a very nice building in Forest Hills. Quite fancy. There’s a cop waiting to take us upstairs. The apartment is as nice as the building we’re in, which isn’t always the case. There’s another cop here and three other people: Mom, Dad, and a little girl about seven or eight years old. So who’s the psycho.

  It turns out that Mom and Dad have documents for their daughter that will admit her for psych treatment (or internment) in an appropriate facility, which in this case is Elmhurst General Hospital—St. John’s doesn’t have a psych ward. The only other place we take psych patients besides EGH, and rarely at that, is the forbidding G Building at Kings County.

  None of these facilities is a long-term psych hospital. The long-term places I know of are Creedmoor in Queens Village and (make the Sign of the Cross when you say this) Pilgrim State, out in Brentwood. Grim and grimmer.

  This little girl is a lamb. Goldilocks. Alice in Wonderland. The whole call has me puzzled. You don’t call an ambulance over a kid like this. You call when someone’s possibly violent to themselves or to others or causing a major disturbance. It may be that we have a Dr. Jekyll and Miss Hyde here, but it sure doesn’t look like it. Maybe the parents don’t drive or don’t have a car. But seriously, we’re not a taxi service. We’re kind of in a gray area right now. We could legally refuse this call. Of course, we won’t. That would be, I don’t know…rude, to say the least. Or even immoral. These people seem so nice. Then again the little girl reminds me of one of my sisters, who is perfectly normal, whatever that is, but acts much crazier than this little girl is behaving. I’m starting to feel really sad about this call. How could such a sweet kid be mentally ill enough to have to be taken to the hospital—in an ambulance, no less. It’s hard to believe. I mean, I don’t want to believe it.