Rocky Mountain Medic

Sunday Morning.

2008-03-09T22:05:00.004-06:00

The plastic alarm next my warm, pillow-topped bed clicks on and The Rolling Stones serenade me out of my slumber, telling me "I can't get no satisfaction." With the blink of an eye the night has escaped me like Houdini handcuffed in a watertight box. I roll to my side, sigh, and fumble for the snooze button. Half asleep, my eyes still soggy from sleep and my mind full of fresh memories from the dreams before, I quickly do an algebraic equation in my head to determine how many more times I can hit the snooze button.

The metal tags on my dog's collar rattle and I hear him stir from his embroidered nest on the floor. The sun casts its shadow on the window at the head of my head and the neighbor's dog barks at the white, plastic security door, pleading to be let back in the house.

I can delay the inevitable no longer and throw the down filled comforter off my warm, well rested body. The shock of the cold air stings and I am forced to quickly jump out of bed and start my day. I swing my feet off to the side, bend down to pet my dog "good morning", and stand. My day has begun.

The bathroom is still warm from my wife, the condensation dripping from the ceiling and the floor damp with fresh water. The mirror is fogged and the chrome on the sink glistens like morning dew of my front yard after a fresh May rain shower.

I slide myself into the shower and the warm water blankets my dry skin and begins to rejuvenate my soul. I wash away all the worries from the night and cleanse myself, preparing for the week ahead. I am awake now and, unfortunately, I can disdain reality no more.

The rest of the morning passes in a blur. My workweek has begun and the carefreeness of the weekend past is now just a distant memory.

My hands grip the leather steering wheel as I weave in and out of Sunday morning traffic. Like a hidden voyeur on an Italian beach, I admiringly gaze into the vehicles of passer-byers. "Where are they going? What are they doing? Why can't that be me”? All fleeting thoughts in my clear mind as I drive down the highway.

With the light morning Sunday traffic I arrive to work much earlier than expected. I slowly ease my SUV down the street like a suspicious solicitor looking for a house to rob. I find a meter across from the garage and ease my truck backwards in between a large Land Rover and a silver Honda hybrid. I don't have to pay today because it is Sunday. The classical music from my stereo softy plays from the large black speakers in the door. Tchaikovsky's symbolic serenade about conquering the New World is abruptly, and symbolically, ended with a slam of my door.

I swipe my white badge reader on the dulled, black reader outside the nondescript metal door. It beeps and a light flashes from red to green. Entrance, once again, has been allowed.

I step forward, cross the metal threshold of the entrance and my eyes dilate. The steam from the carwash and the dimly lit fluorescent bulbs coldly slap me in the face as I enter. An ambulance is backed into the wash bay directly in front of me by someone wearing all blue who seems to be practicing graffiti in the streaking wet, dirt on the side of the boxed vehicle.

In the not-so-far distance music is playing loudly from another ambulance being stocked in the next ambulance bay. All its doors are open and, even though it is early in the morning on a Sunday, it sounds like a Saturday night at a downtown club. The ambulance vibrates and the papered cones of the speakers split, as they are unable to sustain the vibration from the Hip-Hop music being transmitted from the FM radio.

The concrete ceiling, the concrete walls, the concrete floor are all cold and damp. Warmth does not exist here and each step has to be carefully placed, as to avoid the wads of spit sprinkled on the floor like landmines.

I make myy way to my ambulance and find my partner in the back. Personal belongings are sitting in the driver's seat, insinuating to me that they would prefer to drive -again. I unload my pack like a Sherpa on the base camp of Everest, find my computer, slide my radio in its holster, and close my eyes.

Here we go again.

Saturday Night.

2008-03-01T14:26:00.003-07:00

Saturday night and the sun slowly sets behind my water stained wooden fence. The orange hue of the fading sun floats lazily from north to south like stagnant smoke from a cigarette. The Rocky Mountains hold the remaining minutes of daylight hostage and its glowing warmth radiating from the white snowcaps prolongs my day a few more minutes.

The brown eyes of my golden dog casually look up from the white, hollow bone between his long legs as he licks out the peanut butter filling. One quick glance as he lays in the brown, brittle grass of the backyard and a conversation of one thousands words is exchanged. He sees right through me, can see into my soul, and is sympathetic towards how I feel.

My wife’s warm hands hug a labeled pint glass of fresh raspberry iced tea. Her legs propped comfortably on the bench seat of our deck –shoes off, her head rocking back and forth as she illustrates a story of words with her body to her mother on the other end of the telephone line. I glance at her, she smiles.

An old blues song hovers from inside the house. The light, fluorescent from the lamps, blankets the two kittens cuddling in the sill of the wooden window. Their gray, spotted coats lean against the black mesh screen and they wish with all their lives that they, too, could be outside.

A single engine plane tugs in the distance, its engine churning furiously to keep the plane above ground and its occupants safe from the world below. The shadow precedes the noise and the silhouette dances across the suburban rooftops like a rabbit running from a vicious canine.

The clouds hover gracefully above my head, teasing my imagination into creating images remembered from the warm summer days of my childhood. Floating between the still, naked branches of the dormant winter trees in my backyard the vastness of the sky, the birds, the clouds, and the squirrel that lives in my Aspen, all taunt me into seriously re-examining my faith. They look at me and ask me to ask the questions that everyone should examine in their own lives. They remind that there is more to life than an occupation. That it is the journey itself that life is about.

But, with the inevitability of a Death Row conviction, the second hand of time marches forward regardless of my emotion. The sun sets, the moon rises, the day ends and my mood changes. Sullen. Sad. A little stressed. It is my Sunday night on this Saturday eve and tomorrow I will return to work. Tomorrow my shield goes up and I will try and protect what little inner salvation I have left from this draining job.

The wild things are out there -waiting ominously. Managers, coworkers, passer-byers, and patients all feverishly rubbing their hands together like a villain in a silent film, all waiting and hoping to stain my soul with their very own sadness, anger, and immaturity. My shield will be ready and my strength renewed.

I sigh, stand and open my flimsy screen door into the family room. Where did the weekend go?

And why can't I do this for a living?

Trying it again.

2008-02-29T14:59:00.000-07:00

I'm gonna try it again.

1 a week. 4 a month. 48 a year.

This time, a whole lot more honest.

Coffee Shop.

2007-08-22T17:52:00.000-06:00

My dirty green SUV, with dog toenail scratches on the passenger side door and greasy, light-brown grime from the previous blizzard of more than five months ago, eases slowly into the most appropriate, almost-closest parking space in the cramped lot. Nestled between an SUV and another SUV, the reflections of a yellow building on a developing hill blind my eyes. I squint and fall out of my trusty steel, grabbing my Mountainsmith Man Purse before I clod my way up the newly laid pavement to my new local coffee shop. The eager-for-business Veterinarian inside the new building, made of glass windows and doors, waves as he relaxes in his office chair with the very cup of cold java that I intend to sip on while I write this narrative. I love the suburbs.

You see, I'm back from a month’s vacation and have some writing to do. And what better place to pen a story than from the hip, beatnik inspired, soulful coffee cafe. The sad thing is, I don't like coffee.

That yellow building, soon to be a fitness center or organic grocery store or locally owned incense store, ricochets the reflection of that fiery yellow ball in the sky, deflecting the heated rays directly into the large windowpanes of the coffee shop. Giving the cafe the effect of, which really uneases me, a large two-way mirror. The suburbanite hipsters can all see out and assumingly all gather round to "once-over" the new guy approaching from the parking lot.

"He looks like Oscar on that old show, you know the messy guy."

"God, what's he doing here? Doesn't he know this is a cafe, not an outdoor store?"

"Ohh isn't that cute. He brought his laptop. Maybe he wants to be a writer."

I grab the aluminum handle of the glass door and swing it open. Time stands still.

Left foot in, then the right. The door swings closed violently quick and bumps me in the rear. My olive Old Navy cargo pants swat my posterior as the pressure in the cafe, like on a jet plane, is re-established. All eyes on me.

I scan, like the Terminator, to find a reasonable seat. It needs to be small and surrounded by at least two walls. Near an electrical outlet, preferably. No large cushy chairs and no bar tables, I'm here to write and need to be comfortable. My attention need be one hundred and ten percent, for I have written nothing in a month.

In the corner, near an outlet and next to one of those uncomfortably large den chairs is my table. Every other seat in the house is taken, so it has to be my table. The guy ahead of me, probably a poetry major or one of those people that rap text from old school literature books, also sees the one and only remaining table. I cut like A.I. (Allen Iverson) between the green wood chairs and the group of aging women discussing what happened today at their Botox seminar.

I step over a red Mountainsmith bag identical to mine. "Nice bag," I say to myself as I see the owner is a woman, and she is using it as a purse. Three large steps, a wiggle of the waist, and a slow saunter, I put my bag on the table. VICTORY! I may be new here, but I'm a paramedic damn-it! I deal with emergencies.

An evil leer meets my eye as I pass the looser as he seats himself in one of those ginormous leather chairs, not conducive to a laptop. Even though they are laptops.

I'm greeted at the counter with a smile. "Welcome, what can I get you to drink?" The young girl smocked in a large black apron asks.

"Uhm, well I don't reaqlly like coffee," I say out loud. "I'm really here to use the atmosphere to ignite my renewed fury for writing." I say to myself.

I grab my twenty ounce, venti, iced, chai, latte, no frills, no whip, no coffee drink and take my winner's lap slowly back to my table. The spoils have gone to the victor! And those spoils are one cold, non-coffee drink and a nice, little, wooden table in the corner. Next to an outlet.

I pull out from my man purse my white laptop -actually it is my wife's. But, regardless of the true owner, the white color of this laptop alone billboards the fact that regardless of how I dress, that I have fashion. The transparent apple on the lid illuminates as it "wakes up."

With my chai to my left, my Blackberry to my right (in case my wife calls), and my computer center-stage I prepare to write. Dave Matthews sings about some American Baby and my mental groove is set. Let the stories begin.

My eyes wander to my left. The looser of the chase sits sullen in that large, leather chair. His 20-pound Dell bobs up and down rhythmically on his Polo'd shirt belly. He can't focus. He can't type. He has no place to sit his drink and his knees are aching to scratch his chin, they're so close. His hair is reminiscent of that old poster from the '60's, the one with John, George, Paul, and the other guy all wearing black suits and standing in an English street. Bowl cuts must have been the fad back then. I look at the looser of my recent, non-televised Amazing Race and begin to feel sorry for him. "He should have been faster, smarter, stronger." I say to myself.

My laptop screen in white, as white as the plastic cover advertising it's sought after brand.

My eyes are caught once again. It's the commuting community college kid wearing a black tee with silver writing on his chest stating, "zero." At first glance, his white ear buds tucked into his large, round ears lead all to believe that what is being pumped into his head are downloaded tunes from his iPod. This is not the case. He, the man sitting in front of me, is a complex riddle of assumptions. I can see his screen and notice little boxes scattered throughout his desktop. As confusing as he is to me, he is very popular with others. And in each little box he types feverishly, conversations with possibly people from around the world, or just across the cafe.

Back to my screen. Nothing. I don't even have any friends to fill my screen up with little chat boxes. I sip from my disappearing Chai and Sheryl Crow strums her acoustic as she wails about every time she hears the rolling thunder.

Again, mine eyes are distracted. This time it's the red-capped lesbian sitting in the adjacent corner looking at all the girls as they pass. Mr. Zero and Ms. Red Cap scan the room simultaneously, both locking onto the same targets -the girl with the red bandana on her head, the girl crouched over a table with her bosom hanging out, and the black-smocked apron girls gallivanting about the cafe. Another Amazing Race is about to begin.

Back to the screen. Nothing. Miles Davis croons on his horn as Herbie Hancock tickles the ivories. Impromptu jazz at its best. My mind wanders up and down as the walking bass line hypnotizes me into another lull. I shake it off like a punch from George Foreman and steady my mind. It is time to write.

The sun is now setting behind the blue and white mountain tops to the west. The air is clean and my chai is gone. I came her to relax and have been distracted at every attempt to tap on my keyboard. Ray Charles is now singing the blues. I have lost all motivation to write. I want to be an old, blind, bluesman.

I close the lid to my laptop and shake the beads of water off the bottom of my clear plastic cup. My Blackberry is tucked back into the front right pocket of my cargo pants, the wife never called. I grab my man purse, slyly looking about for other women misusing the same bag for its unintended purposes -a purse. I stand, turn, and slowly walk out from my corner of this passing, frenetic world.

As I exit I turn to make sure I retrieved all my items, it's the OCD in me. And already sitting in my seat, laptop open and drink on the table is the bowl-cut Beatle wanna-be. I nod to him as I exit.

Maybe it wasn't he who lost the race. He is a professional cafe-goer and can confidently sit in that same seat and accomplish his goals. His fingers dance on the keyboard as I exit, my rear once again being slapped uncomfortably as I exit the building.

This is only a job.

2007-07-22T14:45:00.000-06:00

I slide my new black shoes onto my warm, damp feet. The cotton from my socks stick to my sweaty feet and makes it even more difficult to easily slide them into the steel-toed shoes. I'm already wearing my blue cargo pants and a blue, cotton tee. My black belt already interlaced between the small loops encircling my waistband and supporting two leather items; a holster for my flashlight and a mechanical metal and leather contraption created to hold my portable radio. That is all that is on my waist. I am no superhero with a hidden identity setting out to save the world from deranged villains. I am just a paramedic.

The hot sun is already unbearable this morning. It shines through the tinted window of my elevated rear lift gate, canopied open so as to protect me from the elements as I finish putting my uniform on. In the back, in a bag, are the tools needed to successfully manage my ten-hour shift. Tools only. Enhancers allowing me to more easily do my job. A stethoscope, tangled in a knot from my previous shift. A pager, allowing me to recall where we need to go and giving me pertinent billing information. And a little green book. My diary of drugs and drug names.

Finally, before putting on my white work uniform shirt, I secure over my thorax a bulletproof vest. Again, not because I am there to heroically protect a damsel in distress as a speeding bullet courses it's way towards it's objective, but because I am scared. Scared I may be the one who gets hurt. Scared that someone more powerful, much meaner, and with a lot less to loose might take out his life frustrations on me. I am just a paramedic. This is only a job.

I shut the gate and push the green button on my remote to lock the doors. The yellow lights flash and I turn to cross the street.

I walk into the moderately climate-controlled garage and swipe my badge. I clock-in. It's a blue-collar job guised by white shirts and bright lights. I am going to sweat, lift, poke, carry, and physically work my way through this ten hour, hourly-waged day. There is nothing intoxicating or mysterious about that.

Orange handles of trauma sheers are tucked in the waistbands of others. Trauma sheers not placed there for their physical purpose to later cut and expose, but for their mental support and reassurance. Their tactical belts securing their tactical BDU's full of tactical toys. Hundred dollar flashlights, the size of an index finger, originally created for gun-yielding SWAT members, are showcased around the waists next to the little black pouches, multiple pagers, cell phones and other trinkets not to be used for the remainder of the day.

I exit into the bright light of the sun's heat and quickly begin my day.

I'm sent to my destiny at the discretion of the dispatchers. I am just a bleep on the computer screen, a hypothetical tool on their arsenal around their waist.

Thoughout the day I encounter multiple paramedics with multiple agencies. Some wearing only T-shirts with stenciled white lettering, some in blue, button-up polyester shirts, and some more formally dressed with a badge on their breast.

All of them, though, tell misguided stories of mishap that float suffocatingly in the air. The feelings of the true hero that recently lay on their bed ignored. Memories of familial and patient respect are quickly treaded upon as the ego-stroking stories are swapped between staggering paramedics. One story always better, and one more unbelievable than the next. Like roosters in a pen, tail feathers plume wildly.

And all the while, the elderly one who called, and is slowly loosing his battle, sits quietly on the bed. Another notch on their belts and another story to exaggerate, he sits respectfully and honorably.

He has stories to tell, but doesn't. He remembers storming a beach, or jumping from a plane, or being shot, or working two jobs twelve hours a day, or standing in line for food, or having to walk -not ride. He, the quiet one before them, to me, is the truly better man, for he doesn't reminisce or tell tall fables, he just lives his life, honestly.

So, I am no hero. Don't call me a hero or even think that I may be. I am not better than you and my job does not elevate my standing in this world. I am no superhero and have no intention of being one. Just because I wear a uniform and drive around the city with flashing lights does not make me better, or truer, or more deserved than you. I whine and cry and am scared of things to come.

And although I may wear that white collared uniform that others stain with grandeur, I realize that it’s only a blue collared world we live in. And all the tall tales, large egos, and staggered gait doesn't change that fact.

I am better than no one.

Thank You's are in order.

2007-07-21T16:11:00.000-06:00

I've been nominated for a blog award.

And in this blog world, this is actually very suprising to me. I feel like the geeky kid in the corner of gym that was, suprisingly, asked to dance with the hottest cheerleader in the school. No one saw it coming, especially me.

So, thank you.

OH, by the way, I was asked to dance by Monkey Girl, at Musings of a Highly Trained Monkey Read it. It's good!

Here is what she said:

Rocky Mountain Medic. This is one of the best written blogs out there. He is an incredible writer, and I can literally picture whatever he's writing about. I wish he had time to write more, because I could read it all day. Some of the things that he writes give you goosebumps, some just make you think, some make you laugh. He's multi-purpose.

Below, is an explaination of the award.

"This award should make you reflect on five bloggers who have been an encouragement, a source of love, impacted you in some way, and have been a Godly example to you. Five Bloggers who when you reflect on them you get a sense of pride and joy… of knowing them and being blessed by them.”
Here are the rules for this one:

1. Copy this post (meaning the rules).
2. Reflect on five bloggers and write a least a paragraph about each one.
3. Make sure you link this post so others can read it and the rules.
4. Go leave your chosen bloggers a comment and let them know they’ve been given the award.
5. Put the award icon on your site.

So here are my 5!

1) Random Acts of Reality.

It was this site that got me started. I had never been a big blog reader, but when I read about the life and times of this London-based EMS service, I was hooked. It's amazing that across that large pond of ours that the same type of experiences are occurring with someone else in my same profession. Differenct accent, same ole crap! Check him out here!

2) Musings of a Highly Trained Monkey.

Of course, even though she nominated me, this site is on my list of favorites. She is ABSOLUTELY hillarious. I love the wit and sarcasm and am jealous my tongue is not as sharp. I promise you, once you start reading, you won't stop. Musings of a Highly Trained Monkey

3) A day in the Life on an Ambulance Driver.

This guy is a great writer. It was the Englishman that got me started, it was the Ambulance Driver that kept me going. In the beginning, he supported me and the majority of my links and readers came from him. He tells wonderful stories and is sure to impress. Ambulance Driver

4) Mr. Hassle's Long Underpants.

A doc with his ear to the gorund. Great stories. I love going to his site. Plus, he's from the Rockies. Mr. Hassle's

5) Street Watch: Notes of a Paramedic.

Wanna learn something? And enjoy it? Go to this site. A great mix of personal essays with CE quality lessons. I enjoy reading his posts. He is a very informed and intelligent paramedic. Street Watch

Baptism.

2007-07-09T22:14:00.000-06:00

The stained, dust-ridden, electrical glass doors whish open, inviting the new out-of-towners into a world they never knew existed. A world they won't be able to wait to leave.

The wheelchair pushing the initiate, graffitied with white paint on the back and advertising the name of the hospital, is cautiously wheeled over the metal door frames into the foyer of this altered world by the close friend of the unfortunate one seated.

A silver, rectangular-boxed wall fan circulates the stale, urine-soaked air in this suffocating entryway. It's the doormat of this amazing underworld that passerbyers wipe their feet on. And, like the blessed holy water in that marbled pedestal, all that enter are baptized into this new, dream-like, chaotic world.

The tracks of the electronic door scratch as the glass doors close behind them. Like a book falling from a shelf and slamming onto the aged, wooden floor, a loud thud advertises those who have passed through have now come forth.

The two women jump uneasily as their arrival is announced.

"Lighters? Matches? Knives? Guns? Do you have any of those?" The security guard, gloved in sea-blue gloves fondles the pockets, waistband, and ankles of these new initiates. A glance at one another and a furrow of their brows initiates a quick, justifying quip by the security guard, "You can never be to safe, ladies."

Another whish, scratch, and thud.

Longhaired and greasy, with his hands cuffed behind his back stands a mediocre man in jean shorts and a striped, Izod crew. No socks and untied shoes. No belt. Stains of tears chalk his red cheeks. Two men, badged in green short-sleeved polyester shirts flank his sides. Pressed and tucked, official and important, these two chaperones of justice are but transient visitors in this chaotic world.

An oversized wheelchair strolls backwards from the triage desk. Backwards, and with disregard, it forges its way into the ever-tightening lobby of the women's altered world. Its grey handle pokes the pleats of the cotton skirt of the friend with the friend. Her eyes bulge and her body stiffens. She steps closer to the resemblance of the world she once knew and squeezes her hand.

"Say my brother, what happened to your feet?" His IV tubing filling with blood as he holds the bag shoulder level like a tray of hors d'ourves. He is strolling the linoleumed floor crammed with beds. His eyes are on the exit.

A grunt and a miff. The bloody-faced transient with matted hair stares emptily into the inquisitors face. His amputated feet are gift wrapped in the full-length red sweats, knotted at the cuffs. He turns and rolls onto his side, pressing his face into the stains of blood on the sheet.

The two women from out of town clutch one another as though walking down a dark alley in Gotham. One, confused as to exactly what is happening in this world, quietly exclaims justifications as to why she doesn't feel she belongs here.

"We're from out of town. Our friends are shopping."

Whish. Scratch. Thud.

"Excuse me, sir. EXCUSE ME, SIR! Have you been discharged?" Security amasses the fleeing, IV'd patron and corals him back into the world that he obviously belongs. His IV tubing now full of blood. The bag, resting on his shoulder like a wool scarf in fall, pinkens with the mixture of blood and saline.

"Ladies," he says with a tip of his imaginary hat.

They clutch one another. And with the obvious bond like those on a sinking ship, or a crashing plane, or a burning building, they move sure-footedly forward into the center of the triage area, next in line for the hurried triage nurse.

"Medical Assessment triage, medical assessment triage!" Crackled overhead by a tired guard, this welcome summons the charge nurse once again.

They take some deep breaths and hold one another tight. They can see the depths of this frightening world. Clocks drip from the wall like Salvador Dali's imagination and people's faces silently scream like the expressionist painting by Munch of the man screaming affront a blood red sky. All seven layers of hell are visible from where they stand.

The charge approaches and mumbles with another nurse in the tight quarters. The look at one another, then the foreign women, then at one another again. Their future is determined and like the gavel of a courtroom judge on his wooden bench, their room number is assigned with a loud rap. "Room number 11, please."

The wheelchair is unlocked and its occupant is once again pushed farther into the underworld. And, with the loyalty of a Golden Retriever, her one and only friend, the one who could be shopping now with their other friends, clutches her hand even tighter and shadows her down the hall.

"We're from out of town. We could be shopping, now." She says, as they slide deeper into their own nightmare.

6 days.

2007-07-03T22:49:00.000-06:00

Discolored beads of sweat created chalk lines down his furrowed, brown forehead. His eyes, twitching at the ultraviolet rays bouncing off the windshield of his old, blue van, were stained red and blinked frantically, trying to keep the figures leaning inside his van in focus.

His white tank-top T-shirt was stained brown under the sweaty armpits. His jeans stained with sweat from the 100-degree heat. His brown palms, dusted with the white powder of the peanuts he had been selling on the street to wandering baseball fans, held the polyester fabric of the front seat he was struggling in.

He shifted left, then right. Forward, then back. As if he were sitting on a bed of hot coals, he repeatedly adjusted his body in the cramped front seat, looking for that one perfect, comfortable, forgiving position.

The roar of the cars on the street passing by became louder and louder. The chatter of the near-intoxicated baseball fans chewed at his consciousness as the barrage of questions from the sweaty, bunkered firemen assaulted his mind. The oldies on the am radio in the van became up-tempo and louder; the symbols of the drummer crashed every fourth beat and rattled his brain like a bird in a cage.

The sun's heat boiled his blood, dried his skin, and suffocated his breathing. The radiant heat off the blinding concrete singed the hair on his arms and dried his mouth. It became harder to swallow and the warm drool from his mouth dangled off his lower lip and hung over his heaving belly.

The questions got louder and faster. His heart raced and his hands twitched. His eyes bounced back and forth like that white plastic ball on a ping-pong table. The blood in his wrist pulsated. And as he glanced down at his damp skin, he could see the tidal waves of red blood coursing through his arm. Time slowed as his surroundings sped up.

Words became noises and the faces of the responders blurred only into colors. He felt as though he was suffocating and drowning at the same time. Alive, but dead. Awake, but asleep.

He stood, after pouring the chilled remains of the glacier-captured water down the back of his neck. His legs wobbled and buckled and he felt as though he were floating. The chilled water ran down his sore back and evaporated by the time it made it to his waistband. The cotton from the T-shirt fought with the dehydrated body for the rights to this refreshing oasis.

The clouds swiftly streamed across the sky and left white, hypnotic tracers. The flashing lights of the emergency vehicles merged into one kaleidoscope of color and the background voices of the portable radios, affixed to everyone’s waist, surrounded him and assaulted his senses. As if he were falling down a tunnel, he sat himself down onto the stainless steel bed.

The plastic from the seatbelts seemed to suffocate his breathing. The ones loosely tied around his legs grabbed him like a hungry python and tried to squeeze the life out of him. He felt as though he was floating and the world was 100 feet below him as he was slid into the back of the ambulance.

The box grew smaller and smaller and the red and green lights on the control switch to his right blinked with the intensity of the sun. The handrail grew hands and sank from above, trying to push him further into the bed. The oxygen was noxious and loud and the clear plastic tubing seemed to be transforming into a rope around his neck. And the slow, slurred, speech of the paramedic trying to reassure him drifted slowly off into the distance, eventually becoming only an echo.

He sat there wrestling with his mind. Deciphering reality from fiction, truth from hallucination, he struggled to maintain his sanity. What was real, what wasn't? Was this even happening? Was this a dream, or a nightmare? If it was, should he wake or remain asleep?

For he hadn't slept in 6 days.

Watching the world go by.

2007-06-24T22:33:00.000-06:00

I sit on the uncomfortable, white-sheeted, black mattress and remove my blue, bloodstained gloves. Sweat, pooled in the fingertips, pours out of the reversed, disposed gloves and drips off my fingers onto the floor. I run them across the side of my pants and waft them in the cool emergency room air. The pads of my fingers wrinkled like bloodshot eyes squinting at the sun.

My feet dangle off the side of the mechanical hospital bed. Evidence of dried blood is crusted on the hinges of the chrome rails; bleach radiates from the mattress pad and mixes itself with the other smells of urine, vomit, and sweat. My scuffed black boots float above the stale linoleum floor. It's hot outside, and I sit here at the proverbial fork in the road, typing my report and watching the world go by.

In front of me, a yellow plastic sign warning all passerbyers that the "piso es mojado". The streaks of the overused, infected mop radiate from under the fluorescent ceiling lights. Crocs, tennis shoes, boots, and dress shoes hurry pass the sign with indifference.

A look to my left reveals a row of beds like the one I'm sitting on. Like cars in a mid-day traffic jam, they sit their eagerly awaiting their purpose. Their patched, black mattresses lean against the wall showing the skeletons of the beds. Green oxygen bottles are tucked beneath the heads of the beds and wire baskets hang haphazardly under the sides. Large, white foot pedals with red and green ends protrude from the feet of the beds. Collapsible black handles are their imaginary headboards.

To my right, security and triage. A rectangular cubbyhole with scrubbed nurses, rolling blood pressure cuffs, a pediatric scale, a sink and some out-dated computers funnel the walk-in traffic of people's emergencies. Blue, plastic chairs with chrome, triangular legs attempt to contain the hysterical patients sitting in them. Swollen eyes, bloodied lips, and destroyed lives all pass through this gateway. Each, like the summer run-off of a mountain reservoir, are released in their own good time.

Another hole houses men in pale blue polyester shirts. Leather gun belts packed with tools of the trade rest on the hips of the uniformed security guards. A door to their left and a desk in front of them, they juggle the demands of the patients and family in the waiting room and the urgencies of the paramedics entering the sliding glass doors.

Those doors whoosh open and close with each motion detected by the electronic eye. In comes in a steady stream of paramedics from every agency in the city. Some, sick and in need of immediate attention, quickly bypass this area and scream down the hall, firefighters and paramedics in tow. Some, more often than not, await their inevitable passing of judgment by the ED charge nurse.

And with all this in front of me, I sit and type as the world creeps by. Restrained, crying teenagers spit at the authoritative police figures. Handcuffed inmates in bright orange jumpsuits shuffle their shackled feet towards their rooms. Wheelchair bound, homeless men with plastic walking casts berate all that pass. And, more often than need be, someone fighting for their very life, breathing either way too fast or way too slow, passes by my personal voyeur window of this world.

And there I remain, feet dangling and fingers typing, waiting to be called out on the next one. So I can bring them here and start the process all over.

That peach colored box.

2007-06-15T23:22:00.000-06:00

There he rested. On his back, white belly sunny-side up. The zipper on his 501's halfway down, the metal button carrying the stressful burden of keeping his blue jeans on. White socks, stained by the dirty concrete parking lot, peeked out from under the frayed cuffs of his dirty jeans. One foot crowned yellow, the other stamped with the Hanes logo.

Thick, black hair crowned his head like a Halloween costume. Sideburns, thick and reminiscent of Elvis, crawled down his puffy cheeks, in front of his sun burnt ears, to his thick jaw line. Chapped lips and a pot-marked nose with large hairs crawling from each nare sat atop his puffy, round face. His eyes squinted at the sun as he lay resting, trying to stay awake, on the graveled lot of the bar-b-que joint.

I approached the vision and saw his fat belly slowly rise and fall. He was flat on his back in the parking lot, next to someone else's car, overdosed on heroin. Another two steps, and I saw his drunken eyes floating back and forth at all the towering uniformed people standing above him. His superferlous nipple greeted me as I bent closer to speak to him.

Beads of sweat framed his hairline like dimples on a baby. I bent down close to him and talked forcefully.

"If you're nice to me, I'll be nice to you," I said as my shadow casted authoritatively over his poor soul.

"Where are your needles? I don't want to get poked. That makes paramedics very angry when they get poked."

As he slid his worn hands down his body towards his pocket, I reminded him once again.

"If I get poked, I'm gonna be mad," I said.

He rummaged around his tight blue jean pocket. Out came a red lighter, some gas receipts, and more folded papers.

"I don't have any," he slurred trying to keep his eyes open.

I patted him down like a cop in a dark, back alley. I pinched his pockets and rolled him from side to side, scanning his back pockets as well. I grabbed his ankles and pulled the frayed cuffs up, looking for needles tucked into his socks. I moved to his waistband and pulled the belt loop from his sweaty belly, keeping an eye out for needles tucked around his waistband and in his groin.

I grabbed his ankles, the firemen grabbed his arms, and like a burlap sack of potatoes, we lifted him onto the bed. He slept peacefully in the suns heat as we exerted ourselves to move to lethargic 250 pounds of overdosed flesh.

"Thanks guys," I said to the firemen as they closed the back doors.

"Don't give me any of that narcun," he slurred as I grabbed a sweaty arm for a blood pressure.

"My friends overdosed and you guys gave him some of that stuff, and he looked horrible because of that."

"I tell you what," I replied. My mood was surprisingly patient. "If you stay awake, I won't give you any."

The metal box bounced down the highway, the sun setting as its rays made last attempts to shine through the snow-covered mountains in the distance. I sat with my laptop and punched buttons as we bounced down the highway. Then, from the front of the ambulance, my partner turned the black dial on the am/fm radio. The volume increased and George Thoroughgood's voice rasped an old blues song about whiskey, scotch, and beer.

"I love this song," he said as he laid his head back, closed his eyes, and began to enjoy his high again.

His mouth moved sluggishly as he worded the lyrics of the song to himself. He had forgotten that he had overdosed, that he was under arrest, and that he was going to jail. He had forgotten that, under these circumstances, the ride in this ambulance was not supposed to be a high-enhancer. We weren't there to safely transport him from one place to another so he could remain high on heroin.

I grabbed the small black, metal box. Popped the silver hinge and thumbed my way through the colored boxes. Finally, in a row like soldiers, were the peach colored boxes I was looking for. I grabbed the small, rectangular box, popped the cardboard top, and slid the small, glass tube out. I popped off all the red safety features and screwed it into the plastic administrator.

He tapped his fingers on the railing and, like Jimmi Hendrix, visualized the music in his head.

I screwed the Narcan into the plastic IV port, straightened out the IV tubing, and shot 1 milligram of the life -saving liquid into his veins.

I sat next to him and waited.

Thirty seconds later he opened his eyes. He gasped a couple of times and turned pale in the face. He sat bolt upright and squeezed the handrail with his restrained hands. Then, he looked at me.

"What the f*ck did you give me!" he screamed.

"You broke our deal," I said.

"What the f*ck did you give me!" he screamed.

And with sobriety slapping him in the face, he gradually pieced everything together. Thoroughgood had stopped singing and the colors of the music had disappeared. He had stopped taping his fingers and had returned from wherever he was. He closed his eyes and began to cry.

He was not high anymore. And he was not enjoying the ride.

I discarded the peach-colored box and went back to typing my report.

The men in blue!

2007-06-13T09:34:00.000-06:00

Rain drizzled from the sky and the sun's last rays reflected off the mirrored walls of the downtown high-rises. Approaching the intersection, sirens and horns echoing through the downtown streets, the two emergency vehicles met. I, sitting in a rather large box of an ambulance still realized I was the smaller of the two, flipped my right hand along the emergency switches and extinguished the rotating strobes of my light bar like a flame between two fingers. The fire engine roared through the intersection.

We tucked in behind the large white truck and drafted ourselves the remainder of the way to the call. We pulled around the truck and parked at an opposing angle, creating a safe little box for all the emergency personnel from the slightly intoxicated, road-raged, curious drivers of downtown.

A man with wafty hair ran towards us all, shouting nonsensical words. His advancements halted with the verbal leash of a friend inside the bar. He stopped, smiled, turned, and ran back into the bar.

On the ground, wrestling his ripped shirt, was a bloodied man. A diamond studded belt buckle held up tight blue jeans. His white oxford was half on, half off. Buttons popped off the stitching and rolled like marbles on the wet concrete sidewalk.

We approached, and I quickly turned back to the ambulance, knowing that this vision of inebriated chaos was coming with us.

"He's beyond detox," said a fireman.

The man shouted slurred obscenities and waved his tangled, bloodied hands.

I returned with the bed, a backboard (because they are more or less disposable and we can leave them at the ED for them to clean), a cervical collar, a blanket and a sheet.

"The sheet is because he is so bloody," I hinted to the fireman helping me unload all this gear.

"Optimistic, are you?"

We wheeled the bed past the diner's windows. Patrons inside strained their necks as they looked over their shoulders. The waitress, with mouth wide open, held a steaming pot of coffee. Their world was on pause.

I approached and all I saw was blood. Hands covered in dripping clots of red. Hi mouth bubbling bright red as his jaw bounced up and down with every slur. His white shirt stained bright red. And little pools of diluted blood ran through cracks in the sidewalk down into the street.

I "net" him with the white sheet and everyone grabbed a hand. Another gloved the mouth that spat blood with every obscenity. And like a frat boy holding a baby, we awkwardly, and uncomfortably, lifted him onto the backboard and placed him on the bed. Hands were Velcroed and his knees and chest were seat belted in. The streetlight framed his face and everyone was now able to see the reason for the bleeding.

We all stepped back and asked one another questions.

"Do I have blood on my face?"

"No, do I?"

After self-inspecting, we get back to work.

"What happened?" asked my partner.

No response.

"What's your name?"

No response.

We wrapped his head with gauze like a combat soldier and held pressure at the point of bleeding.

As we wheeedl him past the fishbowl of Diner patrons he finally decided to coherently talk.

And like a zombie in a B-flick movie, he thrusted his bloodied, bandaged head upward to the sky. Spitting foamy bubbles of blood, he turned his head towards the frightened crowd within and screamed. Everyone inside flinched, coffee was spilt and coins were dropped. The waitress turned and briskly walked away.

"THE MEN IN BLUE!"

"THE MEN IN BLUE!"

"THE MEN IN BLUE!"

Dream Catcher.

2007-06-04T22:50:00.000-06:00

He pulled the dented car over onto the side of the highway. Rush hour traffic screamed by him in the other three lanes. Horns whistled as the irate drivers raced dangerously close to his driver's side door, angrily flipping him off as he sat in his car weeping. The trashy small sedan reeked of cigarette smoke and the front windshield was stained with the yellow fog from every nicotine-laced exhalation. A dream catcher hung religiously from the bent rear view mirror. It hadn't worked in years.

The sun was at 2 o'clock. It's warm rays reflecting off the chrome gauges inside the piece of shit car. The car that he hated, but had to love, because it was all that was left. It was all he had in this world, and even though it stalled at every red light and sputtered along at 45 in the 55 mph zone, it allowed him what freedom he felt he had left.

Hands clutched to the steering wheel his mind raced. Bills, women, family, hopes and dreams all flashed before his eyes like a mirage. Good memories were shadowed by bad. The sun shining everywhere but on him. It was a warm spring day, yet he felt so cold.

He opened the driver's door recklessly, swinging it wide open into oncoming traffic. He didn't care. Maybe a car would hit him and save him from having to talk himself into doing what he was about to do. The cars veered, still honking and cursing him, as they maneuvered around the obstruction on the shoulder of the highway.

He placed his left foot out. Puffed fanatically on the burning cigarette in his hands and tossed the glowing-embered stump out the door and onto the warm, white pavement. He swung his other boot out from the rotting foot well and twisted its heel into the smoking cotton filter of his cigarette. The knobless radio still played his favorite cassette as he stood and exited his vehicle, leaving all his personal belongings inside. The engine misfired irregularly and the keychain with only one key rattled in the ignition.

The sand from the previous winter had all drifted to the side of the highway. It crunched with each step under his black boots. He made his way to the front of his car, stepping over blown-tire remnants and broken glass. He paused as the clouds framed the mountains in the west and the rays from the sun reflected off the broken glass near his feet. A gust of wind pushed through the open driver's door and rattled the dream catcher. He stood and watched it spin. Everything seemed as though it were underwater, his eyes floating in tears.

He grasped the concrete barrier and felt the coarseness irritate his hands. The black dirt under his fingernails contrasted the white, newly painted barrier. He knew what had to be done. He had every intention of following through.

He swung one leg over the barrier and straddled it like Clint Eastwood in a Spaghetti Western. His heart raced and his mind cleared.

He swung his other leg over. Now, he was sitting with his back to the highway. His butt securely planted on the concrete barrier with his heels wedged into a small lip of the outer-side of the bridge. His palms steadied him on this tight wire as his legs dangled over the side of the bridge. It was already as though he was floating, he could only see sky before him.

Behind him, the world raced by. No one cared about what was going on on this ledge. No one cared that a life was about to be destroyed. No one wanted to notice or even had the time. Alone, with his feet dangling 70 feet over a concrete sidewalk and paved rode, sat a crushed man about to end all the misery in his miserable life.

Then, sirens. From the distance and approaching fast. The wail seemed sharper and louder the closer it got.

He wedged his heels into the side of the bridge. He stood and his outstretched arms secured him as he neared death, his knees shaking.

The siren was here. He could see the light from the approaching ambulance. Flashing back and forth, the headlights of the boxy ambulance announced its presence.

And one last time, through weeping eyes, he looked back at his car. The dream catcher from the rearview mirror, spinning in the wind, had failed yet again. His dreams were lost and so too were his hopes.

He looked forward. Closed his eyes. And jumped.

You were dead, you know!

2007-05-27T21:13:00.000-06:00

As the rain fell from the large, white, ominous clouds above, we weaved in and out of traffic. The oily streets created soapy puddles in the intersections as we crossed. The large wiper blades worked overtime, slapping the windshield from left to right. As I floored the accelerator peddle on the stained, carpeted floor, the turbo diesel engine pulled the large box forward. The large disc brakes reined it back into control.

It was a straight shot down the Avenue. Drivers, still confused by the sudden rainstorm, debated with themselves whether to pull over or not. Most, although in a large, congested, traffic jam, isolated themselves from every other driver on the road. Radios played loudly inside some of the sedans. Some drivers chatted on the cell phones propped precariously between their necks and ears, and some, with both hands clasped onto the leather steering wheels, focused straight ahead, hoping to maintain their course in this worsening storm.

The lights of the ambulance deflected off the falling raindrops. A prism of colors reflected off the newly dampened streets. And the siren echoed off the large, glass windows of the downtown buildings.

We approached the scene and I slid the ambulance to a stop in the number one lane of the one-way street. Already tending to the patient was a group of helmeted firemen, deflecting the drops of rain off their large brimmed plastic hats. Their bunker gear beading the raindrops on their lapels like a newly waxed car.

Outstretched on the pavement of the sidewalk, resting flat on her back under a public payphone, was an unconscious female. Like the Wicked Witch of the East, her black boots protruded from the round, reflective huddle of firemen. Her black leggings soaked the rain drops like a sponge, her knee high maroon skirt and velvet top looked straight from a Steely Dan street vendor. She had a hand woven bag interlaced between her arms and sterling silver rings matched her bracelet and necklace. If you were standing next to her in line at the grocery store, as I'm sure many people have before, you would have never thought she was high on heroin. She looked like an aging hippie from the seventies.

As we approached, I saw she was barely breathing. The plastic mask pressed against her face billowed oxygen into her lungs with each forceful squeeze. The bag providing the oxygen, manned by the fireman, whistled each time the large bulb reinflated.

Next to her, in the small stream of water creating its own eroding force down the sidewalk into the gutter, were some broken sunglasses, a saturated cigarette swollen twice its normal size, and some various papers.

We loaded her onto the bed and wheeled her into the back of the ambulance. Rain danced on the square rooftop with the rhythm of a Vaudeville tap dancer. The side door remained closed and at the open back doors firemen stood sopping up the rain from the slow-moving rainstorm.

I moved the handmade Santa-Fe jewelry up her forearm so I could palpate a radial pulse. Her wrist was wet and her hands cold. As I felt around her radius I noticed bruises on her wrists and arms. One, close to where I was searching for a pulse, was grape-purple in color and seemed very fresh.

We restrained her arms and began our work. Both, my partner and myself, began our duties as we talked with one another. I agreed, it had been a long time since I've run a decent call like this.

IV's were started, blood pressures acquired, heart rates counted and blood glucoses registered. As my partner worked his way down his "unconscious / altered mentation" protocol, I rummaged through one of her three handbags.

I unzipped the large, black, faux leather bag and carefully examined its contents. Like a child searching for the right colored M&M, I shuffled papers, compacts, and condoms around the inside. Then, tucked under a pair of worn, soiled, K-mart panties, I found a small black, zippered bag. Without looking inside I knew what I had found.

I pulled it out and sat it on the bench next to me. Like a NBC game show host on a Friday night, I dramatically announced that this could be the million-dollar case. My partner paused drawing blood from the hub of the IV in her neck and smiled.

As if booby-trapped, I unzipped the small black case. Inside was a businessman's card, folded haphazardly upon itself so it could carry her precious recent purchases. Black, chalky residue imbedded itself into the raised font of the unknown businessman's card. It was what was left of the heroin she had just bought from some shady, downtown corner, drug-dealer.

I poked around more. A couple of lighters, a small plastic bottle of clear liquid, the cotton from the filters of cigarettes. And then, hidden at the bottom of this small, black case of paraphernalia, was a loaded syringe of heroin. The small 1cc syringe was, thankfully, capped and tucked into a plastic wrapper. I pulled it out carefully examined it closely. The black heroin floated like the lava in a lava lamp in the clear, unknown liquid. It sat there, its toxins prepared to alter her consciousness, ready to be injected into her blood system.

As I made this discovery she was steadily awakening from her comatose state. The medicine in the peach-colored box had worked its magic and taken away her high. Her pupils dilated, her breathing increased, her color pinkened, and she slowly awoke from the cold clutches of impending death. Her stomach turned, and as she became nauseated, she instantly went into withdrawals.

I leaned in front of her and asked her to pay close attention.

"How much heroin did you do?" I asked.

She, like every other addict in the world, adamantly, and expectedly, denied that she had used any drugs at all.

Again, I asked her the same question. This time producing the capped syringe found in her bag.

"How much heroin did you use?"

"You were dead, you know!" reinforced my partner sitting at the head of the bed.

She fell silent. Shaking and shivering, as she vomited into the yellow basin, she repeatedly denied that she had used.

I opened the back doors and exited the ambulance. The rain had stopped. Sun broke through the dense clouds above and illuminated the wet streets. I closed the back doors, walked to the front of the ambulance, and drove us all to the hospital.

The Fax. (part one)

2007-05-20T16:38:00.000-06:00

I sit, again, cramped in the front of the ambulance. A red light at the large intersection steadily pulsates its constant amber glow at the impatient, eager, road-raged drivers. Engines idle and clutches burn as cars position themselves at the thick, white pedestrian crosswalk on the street. Tethered like fighter jets on the deck of an aircraft carrier, they are cocked and ready to race to the next bright, red light, to start the process all over again.

I squirm in the uncomfortable seat of the ambulance and watch every one of God's little creatures scurry about in the radiating heat of the glowing sun. My left knee aches. Not hurting, but constantly reminding me that ten hours cramped in this box is going to be a chore, both for me, and my joints. I try to outstretch and hope it pops, relieving me of the mildly uncomfortable feeling of a sore joint. No luck.

The solid white, two-inch man on the crosswalk light disappears. Replacing the pleasant action figure is a bright red, flashing hand. The pedestrians, only a quarter of the way across the street, are in absolutely no hurry. The majority of them have no idea what those benign figures on the pole mean, they just watch the crowd they are with and do what they do.

As the slumped, disgruntled, silhouettes of humans shuffle across the street, my ambulance slowly eases into an appropriate lane on my favorite street in Denver. The street that runs all the way across the city, east to west. The street where on one corner you might be witness to a suit-clad politician carrying a briefcase to the capital and then, not but a block away, an unconscious homeless man, incontinent of all bodily fluids, resting peacefully on the concrete next to a tipped over garbage can.

Colfax Avenue. The fax. Where with one simple trip along a latitudinal traverse you can quickly witness how beautiful life can be, or how beautifully cruel it actually is.

We are heading to our post. And instead of taking the more direct, efficient route, we chose to slowly motor up this avenue. Windows rolled down and eyes wide open, we begin our trek through the kaleidoscope of life.

The gold dome of the capital is to my right. The beautifully manicured lawn slopes downward towards the row of yellow school buses. Children climb the concrete steps, not interested in what all the poster-board signs say and why those people are shouting. Suits scuttle around the grounds and each follows one another like lemmings on a field trip.

The rows of lights ahead are all red. This is the only street where one hopes to get caught at a red light. Because at each block, something new is sure to astound.

We sit. Crossing the street in front of us, heading towards the bus bench in front of the McDonalds, are figures clad in every outfit imaginable. Some wear coats and hats and have bundled themselves up on this warm spring day. Some barely wear any clothes at all. Tattooed backs and chests clothe them as their baggy pants hang precariously from their lower buttock, of course their boxers visible to the entire world.

Like zombies, they all shuffle across the street. I wait for the moment for one of them to turn and look at me with their empty eyes, grunting and slobbering as they rigidly walk to the ambulance with outstretched arms.

Green light.

We continue east. To my left is a line wrapping around the block. Pre-teens, with painted faces, stand on the sidewalk shuffling their newest pairs of skater shoes. Black shirts and black pants. Black hair and piercings. The motley crew has been standing on the soiled sidewalk for hours hoping to catch a glimpse of one of their favorite members of the band. Insane Clown Posse seems to really like this venue. And not but a block away, greasy-haired men exit a concrete building with black plastic sacks. The porn magazines they just bought secretly secured under their arms. They melt back into the scenery and are gone in the blink of an eye.

To my right, Volvos and Saabs enter the congested parking lot of the local liquor store. High heels and jeans click on the stained pavement as women from the other side of town fill their trunks with expensive bottles of wine and scotch for their dinner party that night. On the corner, with an outstretched hand, sits the alcoholic hoping to get enough change so he can too enter the same store and exit with a bottle of Night Train.

Red light.

A cop sits in his running car, the windows down as he fills out paperwork from the arrest of the drug dealer in the 7-11 parking lot. Congregating behind the car wash are the remainder of his crew, waiting for the moment that white squad car pulls out of the parking lot so they can continue their business.

A stain runs from the bus stop bench to the curb. Connecting the dots, I see a homeless man curled up under the wooden bus stop bench. Urine soaked pants are obviously the source of the already evaporated urine on the sidewalk. His buddies continue to slur at one another and work as hard as they can to get as drunk as possible.

Green light.

The street opens up. A hole in the wall chicken joint, Arbys, another 7-11, and bar after bar line both sides of the street. At this intersection, children play with one another as they cross the street. The church's basketball court is packed and skins versus shirts are running back and forth, full court. The chain net rattles as the jump shot bounces of the doubled-casted iron rim onto the metal backboard. Teens do their hair and talk on their phones as the world passes by them.

Moving from hole-in-the-wall bars and fast-food joints, I now witness more restaurants and pubs. Places that, with their neon beer signs, entice all who pass to come in and try the new fare. Catchy names and valets are now becoming more and more.

Miles away.

2007-05-12T14:14:00.000-06:00

The cool, crisp wind blows on my warm, sunburned face. High above the peaks of the Rocky Mountains, the warm glow of the sun creates shadows that fall behind the large Aspen trees like toothpicks scattered on a dirt floor. Above my head an eagle, with its wingspan fluttering in the current as it circles the tree tops, soars in the distance. Birds sing and chirp at one another as ripples on the blue lake float peacefully towards my feet submerged in the cool, clear, river water.

My orange fly line whips behind my head, the tiny handmade fly following the arc of my line as it passes my brow. The river is flowing slowly, and although it is murky from the runoff of the peaks in the Continental Divide, it slowly streams past my feet and invites me to wade in deeper. The air is clean and crisp and my breath seems at ease. Everything slows down into a dream-like trance.

"F*ck you! Untie me, you a**hole! You're only doing this because..."

"Because you're drunk and mean"

"I am not," is slurred from the bearded, crusty mouth.

In front of me sits reality. Black shoes, untied and knotted, have been slipped on over multiple layers of socks and plastic grocery sacks. The uncoordinated colors of the stained socks carry pieces of feces and vomit from nights before. Multiple pairs of waxy jeans, encrusted in dirt and grime, are secured at the waistline by an oversized, woven brown belt. Its tag end dangles from the loose knot at waistline down to the groin. Under the heavy, black sweatshirt rests a couple of undershirts. Soiled patches, like half moons, show evidence of dripping sweat rings turned white over time. A bearded chin, with various street artifact embedded deep within, attempts to overgrow and overtake the pot-marked, scarred face.

"I'm (slur) kill you! You (slur) (slur) man. I am not (slur) (slur) detox! I'm gonna (slur) (slur)."

I lean my head down.

And open my eyes. The green leaves whistle in the breeze and small mayflies chase each other on the surface of the water. My orange fly line floats slowly down the river like Huck Finn's homemade raft on the great Mississippi. At the very tip, laced to the hair-thin tippet, floats my handmade fly. It's white parachute wings bobbing up and down with every bump in the current. It nearly floats out of site, and with no bite witnessed, I reel the line, and the fly, back towards the rocky bank I'm standing on. Another attempt will shortly be made.

"I was in Vietnam. I'm a SEAL!" slurs more lies from the aging face in front of me.

"I can kill you with one hand," he threatens as the pungent odor of digested alcohol wafts from his chapped lips.

"Talk to me, you a**hole! I'm sick and you have to take care of me."

"You're not sick. You're drunk. And you're wasting my..."

I stop midsentence. I almost took the bait. Like that fish in the river, he casted his trap and dangled it in front of me. I swam near and was enticed by the colorful language, ready to bite and stoop down to his level and start exchanging profanities. I nibbled and quickly realized what it was, a trap.

He was too late to set the hook and my mind, again, resumed wandering.

I'm sitting right next to him, but I am miles away.

Speechless.

2007-05-09T22:35:00.002-06:00

The click click click of the rotating sprinkler head sang a welcoming song as we made our way from the ambulance to the opened front door of her house. I walked up the paved driveway, spied a deragotory bumper sticker in the back window of an aging Buick, and turned left behind the large pine tree being soaked with water from the automatic sprinkler system in the front yard. Three large flat rocks, resting peacefully on a bed of smaller pebbles, led the way to the front door of the small, yellow house. The crooked house numbers above the screen door welcomed all who entered this warm home.

Inside, directly in front of me, sat a woman in red shorts and a white T-shirt. Red blood, matching her shorts like a paint sample from Home Depot, polka-dotted her white T-shirt with a remarkable style. The elevated hand had been cut while doing the dishes. And the blood seeping from the small gauze provided by the fire department was doing little to prevent its path down her arm and onto her shirt. Soap bubbles still perched on her fingers as if she had been blowing bubbles with a grandchild.

I knelt beside her and introduced myself. She awkwardly attempted to shake my hand. Behind her, and out of her line of sight, the firefighter gave me a brief report. Like in a game of charades, he contorted his face and his fingers to relay a point contrary to what was coming out of his mouth. How many syllables? I thought to myself.

"She said she had a stroke eight years ago," he said clearly expressing only four digits on his hand.

"She said she is 78," he articulated like a robot as he shook his head back and forth in dramatic disagreeance.

Being as sharp as I am, most of the time, I did my best "I understand what you are saying" look and made him feel like the grand prize winner of the family game of charades.

I knelt beside her and started talking. I asked her to explain what had happened and how, exactly, she cut herself.

She took a few small breaths and began speaking. Choppy sentences, like a two year old repeating the cuss words Dad said earlier with his friends, fell from her mouth. She, like the fireman, resorted to body language and began moving her arms and coiling her lips as she tried to express what was happening. Her mind was working, her lips were not.

I immediately slowed down my questions. Someone from the corner of the room shouted she had had a stroke before. I gently touched her knee and had her look only at me so she could reset, so she could calm down and start over. I began talking to her as though she were trapped in a well. I saw a person, and I saw she wanted to communicate, but the exterior shell wouldn't allow her.

"I know you can understand me. I know this is frustrating and very scary. I promise to take good care of you," I calmy told her as the firemen and my partner scurried to get the bed.

"Do you hurt anywhere?" I asked.

She nodded no, then yes. She stammered a few seconds and then blurted out "hand".

She began crying and as tears filled her swollen, red eyes I moved her to my bed and told her what I was going to do.

I barraged her with questions like a nervous prom date and slowly came to the conclusion she was not having a stroke. Her eyes desperately wanted to tell me something and her brain wouldn't allow it. Her words were being held hostage and no amount of ransom could set them free.

As the firemen closed the two doors on the back of the ambulance I sat next to her and did nothing. Everything came to a halt and the hurried actions of everyone around her seized. She slowed her breathing down and attempted to talk, stuttering more than before but successfully articulating words.

"I don't think you are having a stroke," I said as I nonchalantly put the stained blood pressure cough on her left arm, hoping my poker face would work. "I think this is a defecit from your previous stroke."

She nodded emphatically up and down. Her eyes swelled even more, like a teenage girl realizing she got a brand new car for her sixteenth birthday.

"Becuase of all the excitement, you cutting your hand, the firemen coming to your house, the paramedics putting you in their ambulance; your difficulty speaking is more pronounced than usual," I guessed outloud.

She grabbed my hand and squeezed it. She rested her head back and visible weight off her shoulders disappeared. She closed her eyes and slowed her breathing. Words were beginning to form.

"We're just going to sit here for a moment and see if it clears up. I want you to relax and use the oxygen in your nose."

My partner shifted uncomfortably. I knew what was being processed in that other paramedic mind and quickly doubted myself. What if she is having another stroke? What is what I'm doing is wasting time and hurting her even more?

I removed the blood pressure cuff with a quick jerk and tossed it behind my back. I leaned forward and was about to speak when I was interrupted.

"Thank you," she said.

I stared at her and took that opportunity to quiz her more, making sure this wasn't a transient blood clot in her brain and that I was actually correct in my medical assumption.

I asked, she answered.

My suspicions were right on. She told me that due to her stroke she has, at times, difficulty speaking. When she is tired, it is much worse. And when she is scared, it is really really bad. And when she is tired, scared, and overwhelmed with firemen and paramedics in her house, her speech just shuts off.

We pulled into the ambulance bay of the ED and she grabbed my hand.

"Thank you," she said. "Thank you for taking a little time and slowing everything down. If not for that, I'd still be stuttering to you, trying to tell you this is normal."

I stuttered.

She smiled at me, "You see, now you know how it feels."

I was the one that was speechless now.

Rat in a cage.

2007-05-02T01:19:00.000-06:00

Sometimes I feel like a rat in a cage, with the world peering over the cardboard sides of the shoebox as I run frantically, and furiously, on the revolving wheel of life, only to break a sweat and end up where I started.

It ain't easy, sometimes. And it's even harder when you least suspect it.

The best way I can explain it is like this:

Go find yourself a large clear, Plexiglas box six feet wide by twelve feet long. In it, place yourself and two assistants. These two assistants need to have less training than yourself and should be half asleep, but will have the loyalty of a Golden Retriever and the eagerness to help like a excited student on the first day of his first clinical.

Strategically place in this box all the tools you need in awkwardly arranged cabinets. Then, as you attempt to perform possibly life-saving maneuvers, have an intoxicated loved one leer through the thin glass screaming at you to save her life. Have it shake and rattle violently, tossing you left to right, front to back, up to down as you attempt to interview the medically uncooperative, extremely short of breath patient restrained on the bed in front of you, doing her very best not to die in front of you.

You have no idea what has happened. And no one around you has the ability, or the faculties, or the breath, to explain the circumstances leading up to this event. All you see is a woman struggling to breathe, an intoxicated husband who won't let you do your job, and five other guys not realizing the urgency in your step; but want more than anything to help the best they can.

What do you do?

What is it? Is it asthma? Is it hyperventilation? Is it an assault? A choking, and the bruises on her neck are from the forefinger and thumb of the angry assailant? Is her throat crushed and her vocal chords spasming? Is it nothing? Or, is she dieing in front of you?

Quick, you need to make a decision.

But don't make the wrong one. You have a reputation to uphold, you know.

You can put her on continuous positive airway pressure (CPAP); an oxygen delivery device reserved for only the truly sick that forces air into her lungs like a jet turbine. Then give her subcutaneous epinephrine and nebulized medicine mixed with the oxygen, as you quickly start large bore IV's and think of the next line of drugs to give her.

That is if it's asthma.

Or do you hold off, and wait on the sideline to see if it's anxiety and she is severely hyperventilating?

You don't want to make the wrong decision. If you sway to the extreme; do all the invasive medical procedures and nothing is wrong, you look like that new guy in the corner with the white, pressed shirt and new blue cargo pants. The one with too many tools on his belt and pockets full of medical guides. The guy who wants to be a hero but has yet fought a day in the trenches.

Or, you can do nothing. Let your years of experience and nonchalance influence everyone into believing that this is no emergency and that you know exactly what is going on with her -you hope. You can go with your gut reaction and hope she is hyperventilating, praying it isn't a fatal asthma attack, or reactive airway disease, induced by the trauma of prolonged hyperventilation.

You can't calm her, if you can't calm yourself.

So, if you're like me, you think of the worst-case scenario and try to fix that problem. Toss the ego out the window and hope that you're making a wise decision. Better to over treat someone than let them die right in front of you.

And all this happens in a span of three minutes.

On a good day, it takes me all afternoon to decide what to eat for lunch!

What else could we do?

2007-04-30T23:50:00.000-06:00

The headlights danced on the oil stained concrete like silver dollars. The welts in the road shook the old ambulance as we bounced down the street, shaking the large, rectangular silver mirrors. The fisheye mirror, sitting squarely atop the larger, side view mirror, distorted the peripheral world as we passed it by.

The moon was full and round, like a baby's belly, and was floating effortlessly in the starry, blue sky. Thick, hand-drawn clouds lounged in the sky, floating from the mountains and drifting towards the towering, glass buildings of downtown. And harmonizing music, a relaxing backdrop to all the radio chatter of our dispatch coming from the small, plastic speakers bolted to the ceiling above our heads, soothed my ears of the nonstop madness being dispatched in the city.

My arm rested on the well-worn armrest. My head fell back into the top of the seat and the restlessness of my legs calmed. My mind began to relax from the previous call and I looked forward to the post we were headed to, a post where an evening could be spent with your feet propped on the open door, dangling in the warm breeze of the night air. A post where one could enjoy a book, or a movie, or even a quiet little nap. Things were looking up.

Then, like a snow leopard chasing it's prey on the rocky preface of a mountain, a large, red, pickup truck pulled along side of us. It's old, stained, yellow headlights ominously bled into our lane. It's engine growled as they accelerated and barked as they slowed. It smelled of gasoline and tequila and it's black, tinted windows masked the souls within.

I subconsciously took note. The milky white beams of the moon breaking through the thick clouds above intoxicated me and lulled me into the peaceful state I sorely hoped to maintain throughout the rest of my shift. The music in the background calmed me and the anticipation of removing myself from this world with my new, used paperback book in my backpack eased my sharp nature.

Lurching forward, then falling back again, the red pickup begged for our attention. I glanced to my right and the black, opaque window was rolled down. Inside, a man with a cowboy hat, black mustache and large, cauliflower nose cursed into the moving air. His angry red eyes squinted as his lips spewed defamatory phrases in multiple languages. The shadow to his right remained that, always a shadow.

My partner increased our speed. Sixty in a forty-five. The truck mimicked and sped up. My partner braked, slowing the awkward emergency box to an uneasy fifteen in a forty-five. The evil, blood red truck reciprocated. It remained by our side, to our right, always within arms reach.

The calmness of the music had disappeared and the restlessness in my legs reappeared. The chatter on the radio seemed even more overwhelming and the clouds cooled the warmth of the moon hovering above head.

A side view mirror, small and black pushed itself into my frame of reference. It almost hit my window as the swerving truck tried to force us off the road. Inside, still, an angry, sunburnt face of a man I had never met before. His left hand at twelve o'clock on the worn steering wheel. His right hand, hiding something in his lap.

We continued down the road, playing cat and mouse with the seemingly fictional characters to my right. Each block I thought, I hoped, they would break off and speed away into the stifling darkness. They didn't.

I reached for the black microphone wedged into the silver clip on the dash. I pulled it out, it's tangled cord stretching into my lap. I lifted it close to my mouth, and without pushing the button, talked to my partner about the situation under the pretense of me reporting them to the police, a trick that normally frightens angry citizens into believing we are calling the police.

And like a seasoned Texas Hold-em champ, my bluff was called. The red truck continued to attempt to hit us and run us off the road. It's engine intimidating us with every revolution.

The slurs got louder and more intense. The mustached character driving this angry beast was clearly getting angrier and angrier. The shadowy figure next to him became more animated and seemed to feed fuel to the fire.

This time, I actually clicked the button. This time, I gave a description as clearly and calmly as I could and tried to remember where I was. I tried articulating the series of events and nothing but stutters broke my lips. My partner grabbed another radio and switched it to the police district we were in. He, holding the portable radio in his lap, hiding it from the character next to us just as he was hiding something from us, talked clearly into the stale air now filling the ambulance.

Units from every part of the city began responding. The mention of a possible weapon sounded through the airwaves like an air raid siren of World War II. Engines screamed and sirens wailed as police officers told dispatch they were enroute.

The whites of my eyes thinned as my pupils got larger. I began breathing faster and rehearsed in my mind what I was to do, and say, if a weapon was brandished and pointed in my direction. And as I finally came up with a logical answer to this hypothetical question, the red, dented truck sharply turned right and sped off into the darkness, it's engine howling into the night.

We got back on our radios and cancelled all the cover. We cancelled the four district cops, the sergeant, and the other ambulance speeding our way from their far away post. We slowed down, took a breath, and looked at one another and laughed. We laughed not because it was funny, but because we didn't know what else to do.

As we pulled into post, the one I had previously been dreaming about, the phone in the ambulance rang.

My partner nodded, yes'd, and uh-hum'd the person on the other line. I sat next to him like child on Christmas morning waiting to open his presents, waiting for him to hang up the phone.

He clicked the red "end" button and tossed the phone onto the floor.

The police were looking for those two people fitting the very description we aired. The police were looking for a red, dented truck driving up and down that street all night.

The ones that had been shooting innocent people as the rumbled past them.

We parked the ambulance quietly in a dark, hidden parking lot and look at one another. My partner laughed, uncomfortably, and so did I.

What else could we do?

Zero to ohh crap.

2007-04-25T01:36:00.000-06:00

It seems all I run, everyday, every shift, every week, on every street, in every abode is chest pain or shortness of breath. While all the other ambulance are waiting for cover on the suicidal party with a gun, or returning emergently back to the hospital with someone fighting the clammy, suffocating grip of near death, I sit in my ambulance waiting for one of the only two types of calls I ever run.

The seventies male with chest pain, the thirteen year girl old with shortness of breath, the thirty-one year old male with chest pain or the guy standing at a phone book in the 7-11 parking lot, in the rain, with a touch of both, are just samples on my recent playlist.

There I sat cramped in a fogging ambulance with rain and white clumps of snow melting on the heated front window. Claustrophobia, allowing the warm spring weather to tease me briefly, had returned with a vengeance. The small DVD player sat propped on the dash with a box of tissues under the right corner to compensate for the slant in the dash. Donnie Brasco was burying himself deeper in the underbelly of wise guys, teasing me with his excitement of being an undercover FBI agent.

On the ambulance radio, calls were being dispatched all throughout the city. Auto vs. pedestrian, rollover accident, cardiac arrest, uncontrollably violent suicidal party, and a car in a lake -parties trapped. I shuffled back and forth in my seat fighting with the growing aches in my restless legs.

They called me on the radio. I answered with my location and briefly, just briefly, hoped for something more than the usual. Maybe a shooting or a stabbing. I'd even take a status seizure or a multiple casualty car accident. Please lord, anything but chest pain or shortness of breath.

I was wrong.

Chest pain. A seventy-one year old male with chest pain. Again!

We zipped through the wet streets not breaking any land speed records. I complained about the nature of the call. "Chest pain, shortness of breath, chest pain, shortness of breath, that is ALL I ever go on!" I whined.

I started my report, knowing this would be like every other chest pain call I had run over the last month. Someone felt a tinge in their chest, got scared, and called 911. I would get there, talk to them and receive uneducated and evasive answers and quickly determine it wasn't worth continuing to question the patient. I would load them up, check their vitals -all of which would be fine, and hook them up to the heart monitor -again, all of which would be fine. A little O2, a little aspirin, and the obligatory nitro under the tongue would fill our time on the way to the ED. Another chest pain call under my belt. Another false alarm.

We walked into the apartment and the short man sat laughing and smiling with the fire department. He wasn't sweating and wasn't white as a sheet. He wasn't having any difficulty breathing and his anxiety level was less than mine. His knees were crossed and he nonchalantly complained about some nondescript pain in his chest.

"What does it feel like? Can you explain how it feels?" I questioned, going through my flowchart of cardiac questions.

A long pause, a smile at a fireman, and a wink to his toothless girlfriend shouting in the hall. "It just hurts."

Of course it does, I think to myself. "Well, lets get going then."

He takes two steps to my bed, the oxygen mask tethering him to the blue canvas bag holding the green oxygen cylinder. He sits and worries about everything else. My mind wanders and I shush the screaming woman in the hall. "We can here you just fine. There's no need to yell," I said.

The elevator lurches floor to floor and I take this opportunity to interview the patient more thoroughly. He doesn't really want to play this game. He'd rather talk about something else. I feel his heart pumping thick blood through his circulatory system with my two fingers on his flaky, white-skinned wrist.

We load him into the ambulance and the firemen return to the meal simmering on the stove. I shut the doors and cover him with a blanket. "Let's do it all," I said to my partner.

I go through the motions like a robot. Lean and grab the blood pressure cuff. Stand and open the clear cabinet holding all the IV's. He sits there chewing the aspirin I gave him in the elevator.

My partner hooks him up to the heart monitor and out of the corner of my eye I see an abnormality.

"Maybe we should do a 12-lead?" my partner says as the dieing tissue in the patient’s heart makes itself known.

My partner unbuttons his shirt as the short man declares he is feeling much better. Six white, square stickies are placed strategically along his chest. From his right nipple all the way around the left side of his chest, wires are dangling from his hairy chest. We beg him not to move so we can get a clear picture on the print out.

He's having a huge heart attack. The anterior and lateral aspects of his heart are dieing rapidly in front of me.

"How's your pain?" I ask with a little more urgency.

"It's down to about a zero," he laughs. "Why? Am I sick?"

I explain what is going on with and tell him things are going to move a little faster now. We are going to go lights and sirens to the hospital and I'm going to need to do a whole lot more. "You're going to need to answer all my questions the best you can," I shouted over the loud sirens.

And with that, my luck turned drastically. Sitting in front of me was the acutely ill person I had been hoping to help for the last few weeks.

The ambulance his sixty, in twenty seconds. And I went from zero, to ohh crap in half as many.

Tears.

2007-04-24T01:33:00.000-06:00

The rain danced on the windshield between sweeps of the large wiper blades. The emergency lights reflected off the falling drops as they shattered into the large, clear window. The water, asleep on the street, trapped all the flashing colors of the light bar on our ambulance like a prism and disoriented me. I eased off the gas, gripped the wheel tighter, and squinted my eyes from the rainbow of colors reflecting off the wet surfaces passing by my driver's side window.

The siren seemed louder. It reverberated off the large glass pane windows of the Starbucks and echoed between the brick walls of the restaurants closely packed next to one another. The wiper blades slapped back and forth and made every image seem like animation, as though they were drawn on index cards and flipping through the palm of my hand.

We were on the way to a possible stroke. It was a nice neighborhood, one where people only call 911 when they really need it. A neighborhood that apologizes for interrupting our imagined busy lives and is embarrassed by all the decorative, flashing apparatus outside their manicured lawns.

I walked up the driveway, rain defying gravity and dropping upwards from beneath my hat. A freshly paved drive was surrounded by manicured lawn. At the top of the hill, next to the steps that led inside the brick home, was a four-door Cadillac. It was silver, and clean, but certainly not out of date. A car that was probably paid for by a social security check and a pension from 30 years with the same company.

We opened the glass-paned front doors and dripped cold rain onto the warm wooden floors. Our shoes squeaked as we traversed the living room to the ornamental couch. A stand up piano sat in the corner next to the gas fireplace. On its mantle sat framed pictures of generations of loved family.

My partner turned and started out towards the ambulance. "I'm going to see if that hospital will take her," he said. "She's within that window for a stroke alert.

I stepped forward, raindrops freckling her face as I blinked at her through my glasses. Her shirt was tucked in, her hair was combed, and her pants had evidence of incontinence. She lied on her back with her eyes wide open and her mouth closed, drooping significantly on the left side. As though someone had flipped a switch on the left side of her body, all motor skills and means of gesturing were on pause. I raised her left arm, asked her to hold it in the air with her eyes closed, and let go. It dropped like the electric ball in Times Square on New Year's Eve.

She closed her eyes. A tear formed only in her right eye.

We picked her up and placed her on the bed with damp sheets from the rain. The firemen coordinated buckling her in as I found a blanket to cover her up. The plastic oxygen mask rattled on her face and fogged with each breath. "We're going to be doing a lot of things at once when we get outside, okay?" I said as we began wheeling her out the door. "We're going to take good care of you."

In her mind, she spoke clearly and eloquently, like her favorite author from the book club she had recently joined. I heard nothing but slurs and broken sentences. It was as though she was speaking a foreign language and no one around here could translate.

"I know it's scary, and I know you're trying to say something to me," I said. "We can figure this out together."

The night's sky sifted water drops on us from the sky above like a baker over a cutting board. We opened the double doors of the ambulance and slid her, and the metal bed she was uncomfortably resting on, into the two locking mechanisms. My partner sat on one side, and I crammed myself on the small square seat to her right. Both arms were grabbed and as I strapped a blood pressure cuff on her right arm, my partner poked a green-hubbed needle into her other. We talked medically to one another as she sat below the yellow lights listening to rain drops burst on the top of the ambulance.

I crawled out from my cramped hole as my partner talked to her softly. He did more neurological exams and explained what was going on with her. She attempted to smile, crookedly, and still cried softly from one eye.

We arrived to the ED in four minutes. It had been 14 minutes since she called 911 and 24 minutes since the onset of all her stroke symptoms. We pushed her down the hall and into a large room where a young lady sat in the corner in pink scrubs with a brown clipboard in her white hands. The doctor followed in behind us.

The story was told quickly and precisely. Medical terminology lofted back and forth in front of her like a heated tennis match. Her eyes, flinching left, then right, bounced back and forth. Monitors beeped and techs spoke in code to one another. They talked about her as if she wasn't there.

"Let's send the blood and get her off to C.T.," commanded the doctor.

No one had talked to her yet. I removed our bed from the hospital room and push it into the crowded hall, next to an elderly man in a wheelchair watching the commotion in front of him. I leaned my shoulder on the metal frame of the large double door and watched and listened.

The doctor asked her some quick, cold questions and she attempted to respond, but was unable. The doctor, already mentally twenty minutes in the future, abruptly attempted to explain what was going to happen. The ED tech unlocked the bed and grabbed the two black handles at the head. The monitor sat propped to her left and the blood pressure unit rested to her right.

Everyone was doing what they were supposed to be doing. And everyone also forgot the most important thing they should have been doing. As they wheeled her past me I grabbed the black rail to her left. "Everything is going to be alright," I said.

She blinked twice and tears ran down her cheeks. Tears, like raindrops, fell from both eyes.

Old and cranky. And rightfully so.

2007-04-23T02:02:00.000-06:00

The narrow downtown street was framed with parked cars. Bumper to bumper they sat crowding the passing traffic along the one-way street. Trees, developing new, green leaves, sat majestically along the uneven concrete sidewalk. The hilly front yards were turning from patches of brown and rust, to a dark, green luscious grass. Spring had arrived and, as the sun shined through the thick cotton-ball clouds above my head, my partner parked the ambulance behind the old fire engine sitting in the middle of the street.

The one-way street was cluttered with brownstones converted into multiple occupancy apartments. Each had their own set of worn steps that broke away from the city concrete sidewalk. Inviting names like "Aspen Home" and "Mountain Place" hung above the double-entry security doors. Some in neon, some formed out of ornamental iron.

I slowly exited the ambulance and took in the view of the mountains. This was my first call on my first day back from my three days off, and my mind was elsewhere. I could see the apartment building, the double doors propped wide open by fire's wooden wedges, and figures inside the long hall shuffling around. I rounded the corner and narrowed my thoughts.

Four steps up, a small landing, and another four steps and I was standing in the entrance of the aptly names apartment building. The white doors, three on one side and three on another, sat invitingly to all those who entered. Numbers nailed to the center were accented by personal affects of the residents inside. Stickers from local bands, flowers from their garden, and grease stains from a hard days work all forecasted what may be inside that white door to all those who passed.

The door I saw had nothing on it.

Lying on the worn carpet, wrapped in a white blanket with two blue stripes, was an elderly man. Firemen stood wiping their brows over the elderly man struggling to get comfortable on the dirty, uncomfortable floor. They had just carried him out from his apartment that reeked of urine and feces. The naked man was wrapped like a butterfly in a cocoon and squirmed as he cussed everyone around him.

I approached and was greeted by a pungent smell. One that smelled like sour eggs boiled in gym socks. A smell that was sharp, like a French cheese, and assaulted your senses like a car salesman on crack. I choked back my attempts to gag and quickly took report from the firemen. As he talked, my mind reminisced about the last few days away from work.

"Do you want to see?" asked a fireman.

"Well, not really. But, I suppose I half to."

The fireman opened the blanket and the grumpy, naked man grumbled obscenities. I looked down at his waist, where his legs met his hips, and saw a gaping, infected, hole-dripping white clots of infection. The hairs on my arms stood at attention and my mouth quickly lubed itself with sputum in preparation of me vomiting. The hole seemed bottomless. It was at least 6 inches long and was cavernous as a spelunkers dream. I quickly covered him up, I had seen enough, and he continued to slander all standing near.

"I hate paramedics and I hate doctors," he spat as he tried to make himself comfortable in the makeshift swaddle.

I attempted to talk to him but he continued to berate me. "You killed my mother," he argued.

We loaded him into the ambulance and the firemen fled like immigrants crossing the border illegally. I opened all the windows in the back and attempted to circulate the stale ambulance.

"You killed my mother!" he screamed.

"Did I kill her?" I asked. "Was I the one personally responsible for the death of your mother?"

"No, not you specifically, but it was you paramedics. You guys, and the doctors, killed my mother."

I attempted to talk to him more but he just wiggled under the layers of white blankets. Rotting skin contained bilious fluid that leaked from his groin and saturated the white sheets. The smell lingered in the moving ambulance like lead smoke, reminding me of the disease and infection trying to kill this old man.

We bounced down the road and he grunted with every pothole. Slander dripped from his tongue as his evil eyes stared through my soul. I sat there, with his left arm resting on my knee as I taped the IV, and tried to communicate with him. Anger and hatred enveloped him and despair radiated like heat on a blacktop highway.

"All this anger is going to kill you," I said. "It's going to drive you to your grave."

A snarl and roll of the eyes. A flinch of the shoulder and he turned on his side, his back facing me. His bony, pale white shoulder protruded from the blanket. He quivered a little and grunted under his breath.

"Are you cold?" I asked.

"No response. He closed his eyes in disgust and ignored all of my gestures.

I slid down the blue bench seat and reached into the cabinet where we keep the blankets. He snarled and cussed me once more. I opened the blanket and wafted it over him like fresh linen on a pillow top bed. It landed on him precisely and I tucked in the edges to prevent the draft from chilling his infected body. He continued to ignore me.

As we pulled into the ambulance bay and bounced the rear wheels off the yellow parking block I began unplugging all the equipment from the ambulance interior. I switched the lights off, grabbed my information and made my way to the back doors. I passed on his left and whisper broke the infected air.

"Thank you for the blanket. You were very nice."

If you don't want my help, why did you call?

2007-04-17T01:27:00.000-06:00

It was my seventh call in five hours. And I was tired.

We sped from the south side of town to the north, cutting through lanes like a supped-up stock car. The evening traffic had made its angry way home and only a few, random stragglers strayed along the night streets. The four-lane highway was clear for but a few random headlights bouncing in the distance. My partner pushed the accelerator all the way to the floor and the engine's governor only allowed the ambulance to max out at 95 mph. The bright box whistled in the night air as we flew from one end of town to another.

We exited the highway and made a right on the large boulevard, the traffic seperating like Moses parting the red sea. The opticom above the stained light bar flickered into the future, causing the string of red lights ahead to turn green. We kept a steady speed, people ominously moved to the right, and we arrived on scene with the siren still echoing in the distance and the smell of burning brakes still lingering in the air.

I hopped out the uncomfortable seat and fell to the graveled lot. A black man stood in the shadows smoking a cigarette; it's cherry pulsating from bright red to a cool amber. We approached and he nodded.

We walked into the entrance of the fire department, which was also the entrance to the city's YMCA and the city's library. It was a large business building, tan on the outside with long, rectangular windows preventing any of its occupants from enjoying the nature that surrounded them. It was a peculiar place for a fire department, especially in such a large city, but the spray-painted signs didn't lie. It was just at the end of the ply board walkway.

Firemen in blue sweatshirts and tangled hair stood outside their front door. All of who were just asleep, and all of whom were trying to stay awake. One with a clipboard stood officially under a construction light penning any important history he found relevant. The newest of the crew, the boot, was kneeling beside a large, half-dressed angry man on a stairwell. I approached and with an obvious sigh of relief, the probie stood up, gave me a brief report, and moved back into the shadows.

An oxygen mask was strapped to the irritated man. He sat on the fourth step, resting his large feet on the first. He had no shirt and was only wearing a pair of denim jeans. Like a silk tie from Brooks Brothers, a scar hung from his neck to his chest. Below, like buttons on a dinner jacket, three scars sat horizontally on his large belly.

I quickly determined from his body language that he wanted nothing to do with anybody. He sat cussing and flailing and berated the very people he had walked to for help. I was disgusted with how someone who obviously wanted help refused any courtesies offered.

I approached and introduced myself. Repeated the story to him and he disgustedly agreed. I pointed over my shoulder and said, "Let's walk to the ambulance, then."

He stood, his 6 foot 5 inch frame towering over the sleepy group of people in front of him. He ripped the plastic mask from his face and threw it to the ground. "I don't need this shit, anymore!" he said.

I walked in front of him, he moaned and flailed and like a Broadway Star, exaggerated his condition along the fifteen-step trek. I continued walking. If he really wanted help, he knew where to go and knew how to get there. He cussed the night sky and punched his chest like a giant ape climbing the Empire State building.

"Sit there," I said, pointing to the bed with an already stained sheet on it.

"I need to do a couple of things"

His large frame engulfed the bed and his feet hung from the sides. His body quaked with each defamatory statement.

"Take me to the fucking hospital," he demanded.

"I need to do.."

"I said take me to the fucking hospital!"

I stopped what I was doing and tossed everything into the well of the bench. I was tired, sleepy as the firemen, and was in no mood to deal with this. I briefly thought about barking back but realized it would be a waste of time, like trying to rationalize with an intoxicated person. I leaned back against the blue, cushioned wall and looked him in the eye, "There's no need to be a dick to those who want to help you," I said.

He looked to his left and realized I was serious. He opened his mouth to say something, whether it was something nice or mean I don't know, because I was in the process of standing up and moving to the seat behind him. If he didn't want my help, he wasn't going to get it. And I certainly wasn't going to nestle up next to him and baby him like he probably always wanted his mother to do, but didn't.

So, we drifted from the scene and bounced down the road to his hospital of choice, one I wouldn't have necessarily chosen in the first place. He sat in front of me stomping his feet, wailing his arms, swearing to Jesus as he pounded his chest. I sat behind him, legs comfortably resting on the head of the bed doing my paperwork.

He played his cards early in the game and I called his bluff. A 35-year-old man acting like a 5-year-old child with the vocabulary of a 16 year old. If I was such a bother why did he call us? Why not walk yourself to the hospital? That way, you don't have to deal with sleepy firemen and "inept" paramedics.

I'll never understand why people are like that. They're sick, they call 911, and then they treat everyone around them like an unwanted child.

If you don't want my help, why did you call?

Her nightmare of a life.

2007-04-11T11:12:00.000-06:00

Her black T-shirt was on inside out and backwards. The Russell Athletics tag hung around her neck like a thrift store necklace. Her hair was mated and greasy and hadn't been combed in quite a while. She wore black athletic pants that were, again, two sizes too large. And stains, from who knows what, were the only designer insignia she could afford for her disposable wardrobe.

I heard the toilet flush as I rounded the corner of the beige hallway. Four metal doors sat next to one another with large, square Plexiglas windows. Like animals in an exhibit, the inmate’s privacy and freedom had been revoked. The officers were able to walk down the hall and witness everything the trapped animal was doing. The officer spoke loudly to the inmate through the large window and metal door and finally waved me forward.

The candy bar-sized skeleton key clanked the machinery inside the heavy door. With a twist and a grunt from the officer, the door popped open. Inside you could count the yellow cinderblocks suffocating the inmate from floor to ceiling. Incorporated into the wall, was a concrete bench with a rounded corner. There was nothing sharp in the cell and everything dulled your senses. Bolted into the concrete bench was a round, silver eye of a hook. It was there to handcuff the felon to the concrete bench and restrict any already-restricted freedom of movement. As if the eight foot by six-foot cell didn't already do that.

She sat twitching on the scuffed abutment of the depressing wall. Names of gangs had been scratched into the stained concrete. Gang quotes of defiance stained the bench as if Thoreau had tutored all in the art of Civil Disobedience.

I entered just as the toilet had finished filling the stainless steel bowl. It sat to my left as she attempted to sit calmly directly in front of me. Crack was coursing through her veins.

I approached her cautiously and began talking to her. She, like most ever inebriated felon, began to tell me how today's event was related to something last week and felt it important to detail every event from then to now. I interrupted her, held her intoxicated attention for a few precious seconds, and asked her again what she had told the police was hurting her.

As if she were sitting on hot coals, she bounced up and down, left and right and mumbled something about her belly. I quickly came to the realization that this was going nowhere quickly and exited the cell. She sat flinching as if she were catching fireflies. She stuttered nonsense as phlegm ran down her nose onto her chin. An aging face framed wild eyes. Although she was in her twenties, she looked like she had already lived a life of my nightmares. Occasionally, she looked sharply over her right shoulder as if someone was teasing her in the corner of the cell.

The cocaine, baking soda, Drano, and whatever else the manufacturer of that crack rock decided to put it in was poisoning her body as it coursed through her dirty veins.

I stood her up and walked her 5 feet from the bench to my stainless steel bed. She walked like a newborn giraffe from the cell to my bed, kicking her feet and wobbling her legs. Arms flinched and eyelashes twitched. The crack was circulating.

She plopped onto the bed and attempted to remain still. She couldn't. We wheeled her out to the ambulance and began patient care.

We left for the hospital and the farther we got from that tiny, claustrophobic cell, the more she started talking. The more I started asking questions.

It all started when she was forced to smoke a rock of crack dipped in Pennzoil motor oil with a loaded gun to her head. Her brother was just killed by the same gang members threatening her. She had been high everyday since; her three children were at home with her husband, the one who gives her $100 a day so she can support her habit.

She would have her kids stay with her mother, if they could. But, normally, she was as high on crack as she was. You see, they smoke it together.

I lectured her, tried to make her feel bad so as to break through the fog of nonchalance of the cocaine high. She started crying and said she wanted to die.

And for a moment, I thought to myself. Maybe that wasn't such a horrible request.

If my nightmares were as bad as here everyday life, maybe I'd think that too.

Shattered.

2007-04-05T12:33:00.000-06:00

He loaded the last clear, plastic water bottle into the back of the white cargo van, slammed the metal double doors shut and made his way to the driver's seat. He pulled the black vertical handle on the dented door and stepped up into the cab. The grey, upholstered seat bounced slightly as his full weight rested in the seat. He reached out to his left and grabbed the worn handle and pulled the heavy door closed. It slammed and shook the various papers resting on the dust-ridden dash. The wrappers from his fast-food breakfast rustled under the large, heat magnifying front window. He tilted his wrist so as to allow his watch to slide out from under his coat jacket sleeve; it was 4:30 and Friday. He reached down onto his waist, unclasped the palm-sized phone from the plastic holder and punched 3 buttons; his wife was speed dial #1.

The pink flip-phone vibrated and sang a melody from her favorite sitcom television show. She fumbled in her purse as she searched for the source. Standing in the express checkout line with more than the allowed fifteen items, she shuffled through paper receipts, chapstick, her beige compact, apple-flavored gum, and the bottle of Bath and Bodywork's Magnolia Blossom Body Lotion. She found it flashing colors and lifted it out of her black Coach purse, flipping open the receiver with her thumb.

He spoke into the phone with an angry tone. It was time to go home and yet, on the other end of the line, was his boss who had now ordered him to deliver one more trailer load before the end of the workweek. He couldn't believe it, his horrible week only seemed to get worse. All he wanted to do was to clock out and go to his favorite, local bar and drown the scars of the week in the foam of his favorite 12-ounce draft. He turned over the ignition and the large semi engine rumbled to a start. It was already warm from driving around the city all day from doing deliveries. The rubber on its eighteen wheels was already soft and warm. The semi-truck was quickly loaded to allow him time for one last timely delivery of its important contents. The airbrakes hissed and the cab shook as he shifted the eighteen-wheeler into gear. Just one more delivery and his week would be over with. He floored the enormous vehicle and a plume of black smoke mushroomed into the air. His boss would know that he was mad. He sped through the city streets and found the on ramp to the highway. As he barreled down the ramp and onto the already congested highway, he reached for the radio and found his favorite country radio station.

He pulled his hand back from the volume knob as the talk-radio on AM radio filled the small white van's passenger compartment. His week was long, like usual, but he was happy it was Friday. He had talked to his wife and she was on her way home with a brown sack of groceries that would be his dinner that night. The kids were at his grandmother's house and all that awaited him at home was his wonderful wife and his golden puppy. Both, he knew, would be ecstatic the minute he walked in the door. Tonight was date night, and even though he had to work tomorrow afternoon, he didn't mind having to drive home the company van in rush hour traffic. The sun began to set and shot beautiful rays of white light directly into his windshield, causing him to fold down his visor, causing him to squint his tired eyes. He reached into a compartment looking for his sunglasses.

He placed the black, wrap-around sunglasses over his scared, worn face and slid the semi's transmission into a higher gear. He accelerated and weaved in and out of traffic, the sooner he delivered the trailer's contents, the sooner he could get back home and start his weekend. The sun, stretching from behind him and casting his own shadow in front of him, set behind the mountains. He pushed on the accelerator.

As he eased off the accelerator of the cargo van, because the slowing traffic in front of him, he saw an opening in the left lane. He signaled, looked carefully over his left shoulder, and eased the white van into the number one lane. He was going seventy in a fifty-five, but was alright with that because everyone else was too. He was on his way home. It was date night.

She moved the dial to forty-five minutes. The oven timer was set strategically for her husband’s arrival. She hoped to hear the garage door open, and her husband pull in, as the oven timer began it’s beeping.

The beep from the small sedan bounced off the large semi. It didn't startle him in the least. He didn't hear it because he was moving so quickly and the radio was dialed all the way to max. The sun at his back, he accelerated.

Moving quickly, accelerating to pass the slower vehicle leaking a cloud of white, pungent odor from its exhaust, he grasped the steering wheel with both hands. The roads were becoming thinner, trickier to navigate. He hated driving the white van this fast.

She set the table, put what food was ready on the new table linen she bought at Crate & Barrel. She went to the refrigerator and bent down looking for the chilled bottle of sparkling wine.

He looked up from the floorboard of the semi where he dropped his invoice and was surprised to see the SUV in front of him. He swerved right, but then realized the lane was occupied. He swerved left.

The van braked suddenly. Red lights flashed in the near distance. Why were people slowing? Why were they swerving right?

She stopped, causing her sneakers to squeak on the white, linoleum kitchen floor. She had forgotten the wine glasses.

He turned the large semi wheel to the left, overcorrecting. The brakes locked and the large trailer began to slide away from him, smoke steamed from the burning rubber on the highway.

In front of him, on the other side of the highway divided by a concrete barrier, he saw the cause for the braking cars. Smoke was lifting off the highway like steam. He looked to his right. A car. To his left, the concrete barrier. Ahead, a semi out of control.

He over-adjusted the large semi steering wheel once again, attempting to force the large beast back to the right and away from the barrier and the oncoming traffic. The tires turned but the semi continued on its destructive path. There was no going back.

He slammed his right foot on the large rectangular brake pedal. It felt as though he had pushed it through the floorboard of the white van.

The large left wheel of the semi climbed the concrete barrier. The force of the weight of cargo continued to push him forward. The front cab of the semi was lifted into the air.

It sailed in slow motion ahead of him. A white semi cab aloft in the mountain air, its shadow, from the setting sun, ominously engulfing his field of vision. The sharp rays of the sun were now gone. It was instantly cold. Shadow enveloped his world. His life went into slow motion. Who would tell his wife?

The fragile glass exploded all over the ground. She stood there, momentarily, as she was engulfed with a feeling of loss. She knelt down and tried to pick up the pieces, but couldn't.

Flames from the white cargo van exploded from under the large semi. The driver, afraid of an explosion, climbed out of the passenger door of the semi and fell to the highway tarmac, landing on broken glass and shards of metal. Traffic stopped and he ran across the highway.

She fell to a chair, exhausted. What was wrong? Her stomach turned and her knees weakened. What was wrong?

Behind him, his large semi sat atop a white cargo van. Flames billowed out the shattered windows and smoke poured into the sunset. He knelt on the ground as he watched the trapped man attempt to free himself from the burning van.

He cried for help.

And so did the semi driver.

And as she sat on her wooden kitchen chair she looked over her shoulder into the other room. The television was on and Chopper 9 was panning the wreckage on the highway. It zoomed in on the smoldering white cargo van.

She began crying and instantly thought about picking up the pieces in front of her.

But, she couldn't.

How would she tell the kids?

Man, I love this job.

2007-03-26T10:31:00.000-06:00

The lights slice through the dark night sky, the dispatcher on the radio sharply informs us to "wait for cover". The diesel engine grumbles as the automatic transmission struggles to keep up with the constant pressure on the gas peddle. As we cross over the large eight-lane highway on a small two-lane bridge, my partner turns all the switches on that transform our ambulance into a moving firecracker.

I reach up and turn the interior light off. My seatbelt constantly applying pressure to my chest as we skid left and swerve right. My feet, cramped in the foot well, ache from sitting for hours. I slide my elbow off the windowsill and push the small black button that cautiously rolls the window up. The sirens are echoing off the small, white houses sitting atop the hill that overlooks the highway. I straighten my back, sit up in my seat, slid my other hand down to the radio and gingerly turn up the volume.

The wailing changes from long, drawn out screams to sharp, quick blasts. The sounds reverberate off the artful metal accents of the new, contemporary lofts in the old, beat-up neighborhood. Although I've done this a thousand times before, my senses became sharper and my pupils dilate.

Then, like a harmonizing tenor in a church choir, more sirens approach in the darkness. I don't know where they are coming from and they confuse my senses. I struggle, like a fighter pilot in a dogfight, to look out all our windows and determine their avenue of approach.

We break through a triangle intersection and charge up hill, black smoke from the diesel polluting the mile high air. The new sirens assault our ambulance and are right on top of us. I glance in the side view mirror and my eyes squint as the flashing high beams of the police cruiser illuminate the rectangular mirror. He's going where we are going, and we both are racing down this dark, residential street to someone who has a weapon.

The dips in the road bottom the heavy ambulance out as we try and maintain our speed. The police cruiser, chasing us in the dark exhaust fumes, rides close to our bumper. I can almost make out the face of the officer.

We pull over, slightly, and allow the quicker and more maneuverable cruiser to pass. It's engine screams like a banshee as the transmission drops a gear and it rockets past us. Quickly, the red taillights and yellow flashing lights on the roof disappear into the distance. We try and keep up, but are just to heavy and slow. The large dips in the road seem to launch the cruiser into the night as he speeds away.

He shuts his lights and siren off and skids around a corner like a ballplayer sliding into home plate. We do the same. The fire engine awaits at an intersection, its occupants still fighting to stay awake.

The cruiser's driver gets out and we pull up behind him. He pulls his large mag light out from his seat and approaches me. Together, we begin walking the block looking for the out-of-control, suicidal person. The ambulance, and my partner, creeps behind us as we walk.

Suddenly, the officer begins to sprint. His hand on his holstered weapon, he quickly accelerates from me. I begin running, my hand on my awkward radio slapping me on the thigh. My partner slams on the gas and makes the large ambulance lurch forward. The flashing ambulance box turns the corner, as I cut through the yard, and is abruptly slammed into park.

The officer tackles the suicidal person. My partner, like a ballerina, falls out of the freshly parked ambulance as I hurdle patches of grass and concrete. Together, we land on the crazed person and help the officer restrain this angry person with a sharp putty knife.

She screams, kicks, fights, and spits. The dispatcher on the police radio becomes worried that no one has answered her call and sends out an emergency tone. Officers from everywhere in the city scream into their radios saying they are on their way. More sirens, from every direction, again confuse my senses. Lights illuminate the trio fighting the person on the ground as the other officers and their cruisers come to a loud, screeching halt. Burning brakes waft into the air.

We restrain the patient and load her in the ambulance. Still screaming and spitting and fighting I start an IV. It's like trying to brush the teeth of a rabid dog, but I successfully get one in her hand. The chemical restraint is beginning to course through her blood stream after being poked in her deltoid. Benedryl in the IV quickly makes her drowsy and tired. She fights to stay awake, like the firefighters before, and her screams slowly turn into moans.

I sit back, feet on the pram and blood on my gloves, and take a breather. The lights above my head illuminate the inside to the ambulance as two paramedics sit back and one patient begins to doze off into a heavy sleep.

My partner smiles at me and removes his gloves.

I smile at him and think,

Man, I love this job.