By Joseph Tsidulko
By Patrick Range McDonald
By David Futch
By Hillel Aron
By Dennis Romero
By Jill Stewart
By Dennis Romero
By Dennis Romero
I assure her, hang up, put the paper slip back. I drive again, my hands at a perfect 10 and 2 on the wheel. I know where I’m headed, easy does it, this is a simple transfer, I’m just tired, no problem, but before I know it, one tear rolls down, and then another. Ridiculous, I say out loud. I wipe my face and say it again, softer and under my breath. Ridiculous. I hope my partner doesn’t see or hear me being a fool up front, but then I stop caring about that and give myself over to it. The tears flow steadily now; I have no idea where they’re coming from or why. Something about that concerned voice on the phone, and the empty, dark streets, and the sad, lonely character in back, the one who doesn’t remember where she lives, who didn’t tell her sister about her medical problems, who is now a double amputee.
When we get to the house and struggle to fit her through the narrow, cluttered hallways in her new wheelchair, she tells us to lock the door on our way out; there are seven dead bolts and nothing inside worth stealing. I remind her, with a sense of responsibility and my own familial guilt: Call your sister, okay? She looks at me, nods reluctantly, and, just before we squeeze ourselves out and into the night, gasping for fresh air, I see her pick up the old rotary receiver and stare at it.
We eat fried chicken, potatochips, burritos, pizza. We microwave a frozen dinner and follow it with ice cream; we drink coffee, soda, energy drinks, liquid crack. If caffeine via IV were available, we would jab it into our veins; if filling meals existed cheaper than $5, we would consume them unapologetically. We smoke cigarettes right outside the hospital, chew tobacco and spit it into cups, careful not to stain our uniforms. We get scattered sleep but have perfected catnaps: We know how to park the rig in the shade, lean the seat back, and even in our sleep, we can filter noises from the radio, only waking when Dispatch calls our rig number. We fry our brains on television and video games during the day at station; we sleep as hard as we can for as long as we can, knowing we will never make it through the night, knowing there will always be at least one call. We know how to stumble out to the rig with a half-buttoned shirt, peer sleepy-eyed at the map book, flip on lights and sirens, drive relentlessly fast, and get on scene within time. Get there and have the shirt tucked in, gloves on, equipment ready. Get there and be alert, helpful, polite. Stumble back to sleep when it is done. In the morning there is coffee. In the morning there are bags under our eyes. In the morning we have dry skin, wrinkled uniforms, our first cigarettes. Meanwhile, the firefighters are switching out crews and the fresh ER hospital staff are just arriving, pouring coffee, hearing stories of the night before.
Our patients have diabetes, heart problems, chronic respiratory disease, renal failure, hypertension. Often they have spent years killing themselves slowly with their vices; their lists of medicines are long, their trips to the doctor often. Their pain scares them, wakes them in the night, and their fear of dying lives under their skin like a parasite. They feel it is unfair, their poor quality of life. But they remember to bring their cigarettes to the hospital even when their ambulance ride is spent wheezing. They sit and watch TV on tiny beds, complaining of nonfatty, compartmentalized food, even as their feet grow bluer from pooling, noncirculating blood; they stare blankly at the doctor when he advises them to exercise.
And we, the emergency medicine providers, the first responders, the paper pushers and gurney loaders, we hand off these patients to caffeine-ridden nurses, stressed-out and sleep-deprived doctors, overweight administrators. We hand them over and we roll our eyes and cluck our tongues: Here we go again, this frequent flyer is back, same chief complaint of chest pain. They survived this time, but we know one day they won’t. One day we will be pulling them through hospital doors in a flurry of action: chest compressions, ventilations, IV bag in tow, the paramedic pushing atropine and epinephrine through the narrow tube. If it is someone we like, we will feel frustrated, sad, helpless. Come back, come back, we lost you this time, your heart finally up and quit. We told you, we tried to tell you, now there is nothing we can do.
All the same, we refuse to think of our own mortality.
Somehow it feels like the only way we can survive this job is to have these same vices as an outlet, as if the cigarettes and caffeine and cheap fast food are just as necessary as the gloves and uniform and gear. As if being able to choose what we put in our body makes our poor choices irrelevant. We think our youth will save us, but we are only throwing useful artillery to the enemy, only turning a blind eye to the shrinking distance between us and our patients.