with Featured Artwork by Ray Paradiso
Good times, or perhaps just times. Times with folks good and bad. Times spent with the good, however, stay with you longer…
I came in for my regular shift amidst the smells of diesel exhaust and cigarette smoke. The sun was shining, and it was warm outside. I punched in and checked in with the station boss. My ambulance sat parked on the apron of the large four-bay garage at EMS headquarters. I walked over to put my gear in the bus and along came Bobby.
Bobby was a stout, bald-headed, fifty-something Irishman with a round red face and a bushy, white, nicotine-stained mustache sitting atop a stubborn smile. He was a people person with a heart of gold. He was comedic, worldly, well-read, and utterly disgruntled with life and with a job that repeatedly mistreated him in the worst ways. If Bobby had one fatal flaw, it was that he cared too much for people; he cared too much for ethics. Some flaw.
“It’s my last day.” He said between mixed conversation about the goings-on at the MC (or medical center) of which northern New Jersey city I won’t mention. We talked about the perpetual flowing sludge of drama and scandal, poor leadership, absent leadership, funny stories, and the like.
“You’re finally out of here, huh?” I said.
“Dude, I’m done.” He replied gruffly.
Before coming into work, I had known that my regular partner had called out sick, and I could tell from the split-second stall in conversation with Bobby that something was up. “Am I working with you?” I asked.
Smoking his cigarette, one of countless more to come, he replied. “Yes sir. The bus is good; everything’s stocked. I’m gonna hit the head.” Bobby flicked his cigarette into the street and walked off to the men’s room. I stowed my bag in the truck and got myself situated for the busy day ahead. Bobby returned from the men’s room and off we went to tackle the many calls that we knew would cascade down upon us.
The day played out like nearly every other day before it. We were dispatched to emergency calls, figured out what was happening, and handled our business. There were lulls throughout the day that were filled with conversation about internal politics, union concerns, national politics, Bobby’s son’s service in the Navy, my service in the Air Force, old friends, new hires who didn’t know what they were doing, silence, and lots of cigarette smoking.
Despite this being Bobby’s last day, it wasn’t filled with any particularly heavy, somber, jubilant, or unordinary emotional undertones. The day went on like any other. The sun had set. We worked 10am to 10pm, and we entered Bobby’s final hour of his EMS career. This, this is when surrealism and heavy emotional undertones presented themselves in a manner that was far from ordinary.
Another unit was dispatched to meet a medevac chopper at a ball field beside the housing projects that were situated just two blocks from our headquarters. They were to assist with loading the flight nurse and flight medic’s equipment onto the bus and then transport the personnel and the equipment to the ER. Once in the ER, the doctors and nurses would transfer care of the patient to the flight crew, and the ambulance crew would transport the patient, the flight crew, and their equipment back to the landing zone, assist them into the chopper, and off the bird would go into the night to whatever specialized hospital the patient needed to get to.
Well, this was a hell of a job. Working in the city, we didn’t use a medevac that often. This is because you could spit from anywhere you were and hit a hospital. Diesel Treatment, hauling-ass to the hospital, was the modus operandi on critical calls. Bobby called dispatch on his cell phone, got the details of the job, and asked to take it; after all, we were near headquarters and the closest unit to the landing zone. Wish granted. The job was reassigned to us.
I read the dispatch notes on the MDT, the on-board computer that we used to communicate with dispatch. The patient was a child, four years old, and put it plainly, the kid was screwed. He had gone into cardiac arrest earlier and needed immediate transport to a pediatric center about twenty miles away. Our own SCTU ambulance, a unit manned by one paramedic and one nurse specially trained to perform high-risk inter-facility patient transport, refused to do the transport because the kid was so unstable.
He was sedated, attached to a ventilator, and had multiple IV lines running to his little veins. He had suffered a devastating asthma attack earlier in the day and had been experiencing cardiac arrest intermittently ever since. Each time the SCTU crew tried to move him, his tiny heart would stop pumping. He needed the bird; he and his family needed someone like Bobby, and I think Bobby needed this assignment.
We made our way to the landing zone, along with multiple fire engines that needed to standby, just in case the chopper crashed. While waiting for the bird to arrive, Bobby and I spoke. He had done jobs like these when he worked for his previous employer and had quite a bit of experience working with paramedics and nurses on an SCTU; he was better suited for assisting the flight crew with the patient than I was, but it was his turn to drive. “Why don’t you stay in the back for this one, Bobby? You’ve done this before. I’ll drive us.” I said.
Bobby laughed and ribbed me a little, but he was excited. He wasn’t excited out of some morbid curiosity or because he was a white knight or a “whacker”, EMS folks who think they’re superheroes; he was excited because he cared. Bobby, with his whole heart, genuinely cared about helping people. And, with this being his last day in EMS, helping a gravely sick kid and supporting his distraught family during a medevac would be so representative of Bobby’s time in this job; it would be the perfect, albeit terribly sad, last call for an EMS provider of his character.
After sitting around for a while, twiddling our thumbs, we heard the unmistakable whirring of the approaching helicopter. It approached from the west and grew louder as it approached the landing zone. At first, all we could see were its flashing red lights against the darkness of the night sky. It flew closer and closer and began hovering down to the earth. It was deafeningly loud and its rotor wash flung grass and all other sorts of inner-city debris all over the place. I took cover behind our bus; Bobby watched the pilot masterfully lower this aircraft to the ground as the air became saturated with exhaust fumes.
The pilot cut the engine, and the flight crew hopped out in their royal blue flight suits and began offloading their gear. We helped them haul it all over to our bus; they jumped in the back, Bobby closed the doors, and we were off to the MC, right down the road.
We parked the bus, and the four of us entered the ER. We found the kid in one of the two ER trauma rooms. His family surrounded him with forlorn faces and eyes that were welled with tears. Bobby turned his charm and sympathy up to eleven and did his best to comfort them. It worked.
They were clearly still upset, but there was a weight lifted off their chests; it was palpable, one of those uniquely nuanced human perceptions that need to be experienced in person. The flight crew plugged the patient into their equipment and Bobby and I prepared the ambulance stretcher to accept this child, who struggled with all his might to stay alive.
Just like it happened with the SCTU crew earlier, we moved the kid and he plummeted into cardiac arrest. Then he was stable. Arrest. Stable. Arrest. Stable… enough. We transferred him to the stretcher and made a beeline for the bus. We loaded him up and had his mother sit up front with me. With everyone in place, Bobby closed the ambulance doors. Arrest.
“Just go.” The flight nurse said to me. I put the truck in gear and gave this boy the Diesel Treatment.
Bobby and the flight crew worked expertly in concert, doing everything in their power to keep that tiny heart beating. I raced to the landing zone as smoothly as the pothole-ridden city streets would allow me to. Two minutes later, we were there.
I ushered the mother from the front seat and helped Bobby and company get the boy out of the bus. Stable. Arrest. Stable… enough. In the streetlight dimness of night and under the scrutiny of curious locals who were roused from their homes by the helicopter, we wheeled him and all the equipment over to the chopper.
We crouched down and transferred the kid to the helicopter’s cot and through the loading doors beneath the aircraft’s tail. Arrest. Arrest. The flight crew helped the mother aboard and squeezed themselves into the bird’s crammed patient compartment. Bobby and I backed off as the pilot fired up the helicopter’s engine, sending its rotor blades into a slow, laborious spin that quickly revved into a whirling torrent of wind and cacophony.
Bobby and I watched as the chopper, with that wavering young soul onboard, ascended into the night sky and quickly disappeared into the distance. It was 9:59 P.M. Bobby and I got into our truck and notified dispatch that the job was complete. The fire trucks slowly rumbled back to their sleepy firehouses, and Bobby wore a bittersweet expression of pride and gloom.
We made the quick trip back to headquarters and began offloading the piles of gear and equipment that we were forced to carry every shift. Bobby took his portable radio in his hand and signed off for the last time. “Goodbye, all. It was a hell of a time.” That’s what sign-offs are meant to convey. A handful of people responded over the airwaves, though not as many as should have. There weren’t a whole lot of good guys who worked with me and Bobby, and their lack of response was an indicator of that.
“Eff ‘em anyway; they’re all a bunch of tools,” Bobby said to me. I smirked. We brought everything in, punched out, and smoked our last cigarettes together. Then, while standing on the fluorescently lit sidewalk outside of EMS headquarters, we shared an unspoken moment of sadness with one another, but dared not show it; we were jaded, rough, cynical urban EMT’s and as such, it wouldn’t be proper to show such emotion. Bobby hit the bar afterward, and I made the long drive back to my home in New York.
Every now and again, Bobby will call me, or I’ll call him. We talk about politics, drama, scandal, funny stories, old friends, his son’s service in the Navy, my service in the Air Force, and that night when we put an unfortunate little boy and his mother on a helicopter that sat on a ball field near some housing projects.
The tone of the conversation changes and I can hear the emotion saturate Bobby’s quivering words. “I’ll always remember that last call.” He’ll say.
“Do you think he made it?” I’ll ask.
“It doesn’t matter. In my mind, he made it. I couldn’t ask for a better sendoff and I couldn’t ask for a better partner.”
I can hear his stubborn smile and tear-swelled eyes through the phone and reply, “I couldn’t agree more, Bobby.”