July 22, 2009
“Jesus Christ!” Psycho Sal braced against the dashboard. “What did I tell you about the fucking brakes?” “I’m sorry, Sal.” Glenn St. Pierre was relieved he hadn’t just crashed into the car in front of them. It was only his second day on A-Shift as chauffeur of Rescue 1. His boss, Lt. Salvatore Giametti, was easy to read since he pretty much existed on the edge of a perpetual meltdown. St. Pierre knew all of the stories, how Sal, formerly known as "Straightline Sal" because of his attention to detail, had his rescue career blown apart after a string of horrendous runs he could not process. There was the single mom stabbed forty-nine times, the ten-year-old girl that hung herself in her closet, two dead babies, and a carful of teenagers turned into ground beef when their car hit a bridge abutment at 70 MPH. This was over a two month period in 2005, and after that he was never the same. But St. Pierre was determined to stay positive. He said, “It’s kind of incredible how poorly these things are maintained.” “Welcome to the rescue division.” Psycho Sal lit a cigarette. “Hope you enjoy getting your nuts punched in all day long.” “How old is this truck?” “2006.” “What? It’s only three years old?” “I thought you were supposed to be some kind of genius? Guess your big brain can’t wrap itself around the fact that these trucks run day and night.” “Guess that’s true.” “Besides, the Receiver shit-canned most of the mechanics.” “Fire Alarm to Rescue 1.” Psycho Sal grabbed the mic. “Rescue 1, go.” “Start responding to 516 Cantwell Street for a possible overdose.” “Roger.” Psycho Sal turned to his new partner and said, “Ten gets you twenty we play Jesus and raise the dead.” “No bet. Sounds like you’ve been there before.” “And we’ll be going back again. Place’s a total shooting gallery.” Fire Alarm hit the Alert Tone and announced, “Attention Rescue 1 and Engine 1, Still Alarm. 516 Cantwell Street, apartment 2, for a possible overdose …” St. Pierre fired up the lights and sirens while fumbling with his phone. He had no idea where Cantwell Street was. “Are you kidding me?” Sal puffed on the cigarette. “Put that phone down before you kill us both. Take a right.” “I’m sorry—” “You better learn your goddamn streets, newbie. This ain’t Fire Alarm.” St. Pierre tried not to be discouraged. Despite hitting every IV and three flawless runs so far today, he felt all of it had been erased in the last five minutes. He tried not to cough through the fog Sal’s chain-smoking produced. “Take a left.” Sal leaned forward, scanning the block. “Just passed 421. It’s gonna be on your side.” St. Pierre’s pulse was pounding. He tried avoiding parked cars on either side of the road while hunting for the address. “I think that’s—” “Watch out!” A police car responding to the same call blew the stop sign. After St. Pierre slammed on the brakes and sent Sal into the windshield, his cigarette exploded into a burst of sparks. “He’s not even using his siren!” St. Pierre struggled to maintain his composure. “That was close.” Sal had his door open before they even stopped. He went straight to the cop’s window and said, “That was some great driving, superhero, you almost killed us!” “Don’t be so dramatic—” “Didn’t you hear our siren?” St. Pierre went for the First-In bag, which was a backpack stuffed with an oxygen tank and every conceivable breathing attachment—nasal cannulas, non-rebreather masks, bag-valve masks, nebulizers and steroid ampules for treating asthmatics or anyone with COPD. There was also a glucometer for diabetics, oral glucose, stethoscope, blood pressure cuff, pulse and SpO2 gauge, epinephrine for allergic reactions, narcan to reverse opiate overdoses, and various sized needles to administer both. 516 Cantwell was a bombed out triple-decker in the worst part of District 1. Home to the city’s open air drug market for cocaine, heroin, and crack, there were whole blocks of foreclosed triple and quadruple-decker homes. Built a century before to house thousands of workers that had once flooded the mills, these massive houses were now vacant hellholes filled with the worst things people could do to themselves and one another. Zombie junkies and tooth-grinding meth-heads scavenged for cash doing whatever needed to be done. Female addicts transformed into bedraggled prostitutes that stepped out of shadowy doorways. Nicknamed the “Kitchen,” this ghetto straddled the border of both the “Knock Out Kings” and the “Fifth Street Vatos.” They shared a fortified DMZ along Claiborne Avenue where atrocities, traded in an endless cycle of provocation and retribution, were just a part of doing business. As Psycho Sal and the cop argued, St. Pierre shouldered the First-In bag and a book-sized AED, which was a portable cardiac defibrillator. He took the stairs two at a time. There was no front door, and the dark hallway was strewn with garbage and used diapers ripened in the July heat. “Fire Department!” St. Pierre banged on the door to number 2. The stench was overpowering. “Hello! Open the door!” “Hello?” He tried the handle. “Fire Department!” He slowly pushed open the door. A white man and woman sat at a filthy table in a long destroyed kitchen. Their arms were bruised pathways tattooed by the needle. The woman was barely awake and had a long drool oozing from the corner of her mouth. The man, a lesion-filled mess, cackled loudly at her expense. He had leaky brown eyes surrounded by the hollow sockets created by emaciation and addiction. He was thin and wearing dirty boxers and a stained T-shirt. He said, “I woke up first and thought she was sitting there dead!” He laughed again. “Guess I was wrong.” “Sir.” St. Pierre did not know where to begin. “Have you both been using drugs today?” The man laughed even harder. “Naw, she’s alright. She’s a tough old goat. But I won’t let her shoot no more today.” “Ma’am.” St. Pierre approached her. “Can you tell me what day it is?” She turned her head as the long drool let go and splashed across her deflated breast. “Tuesday?” “Long as you’re here …” the man jerked a thumb over his shoulder. “It’s been awful quiet. I think there’s something wrong with the baby.” “What baby?” St. Pierre was confused. “There’s a baby here?” “Yeah. She’s in that room right there. She’s been sick.” Convinced the man was just high, St. Pierre kicked aside beer cans and trash. He pushed open the bedroom door. He saw the empty crib and stepped closer. “There’s no baby in here.” “You’re a funny guy. No baby …” The guy laughed. As St. Pierre left the room, something in the bathroom across the hall caught his eye. He took another step and then dropped the backpack and AED, screaming, “Sal!” “Who’s Sal?” St. Pierre dove at the tub and pulled out a toddler. “Sal! Oh Jesus.” He desperately searched for a pulse. “Come on, kid. Sal!” “What’s going on?” The junkie appeared in the doorway. “Oh no. Oh shit! Linda was gonna take a bath—” “Get out of the way!” St. Pierre was doing CPR on the still warm child. He ran out the door and straight for the truck. “Sal!” Sal and the cop stopped threatening each other long enough to register the panic on St. Pierre’s face. Sal blinked. “Was that a baby?” Inside the truck, St. Pierre laid the kid on the stretcher, doing CPR while hooking up the defibrillator pads. He turned on the monitor as Sal hopped in and said, “What the fuck is going on?” “I don’t know, man! There were two junkies just sitting at the table and the kid, the kid was in the tub—” “Gimme that.” Sal hooked up the pads in case the monitor called for an electric shock. “Stop CPR.” They both watched the screen and, sadly, saw the rhythm was P.E.A. A soothing voice said, “No shock advised. Continue CPR.” “Fuck me, man.” Sal ripped open the IV drawer. “Keep going with the CPR.” “We should be able to get her back if she just drowned, right?” “Do you know how long she was down for?” “No. That junkie—” Sal turned to the cop. “Go in and get that fucking guy.” The cop was all cop and tore off for the house. Sal, reminiscent of the gifted medic he used to be, found a tiny vein and sunk the IV while CPR continued, no small feat. St. Pierre, pumping away, was in awe. “Where’s the epi?” Sal spun for the med-drawer, drew up the appropriate pediatric dose of epinephrine, and had it going into the IV line thirty seconds later. Next, he cranked back the kid’s head, intubated him in one shot, and hooked up a bag valve mask, pumping pure oxygen into the tiny chest. “Where the fuck is the engine?” “Didn’t you have your radio on? They called responding from County Street. They were on a Box Alarm.” “Of course they were.” Sal drew up another dose of epinephrine and toggled his mic. “Rescue 1 to Engine 1.” “Engine 1, go.” “Approximate fifteen-month-old, Code 99. Expedite.” “Roger that.” “I don’t think so …” Sal pumped the bag-valve mask every ten seconds. “That’s not how this is gonna go down.” Engine 1 tore around the corner. Three men jumped down and ran for the rescue. Lt. Stokes got there first. “Whaddaya got, lou?” “Looks like a drowning. I need one man back here with us to run the code and one to drive. Like right fucking now.” Lt. Stokes said, “Bugsy, you drive. Finn, do what you do.” Kevin Finnegan was no ordinary twenty-year guy. The first five of years of his career had been spent on Rescue 1 working for Capt. LeClaire, and the next five he partnered up with Lt. Killmoor to learn the other side of the city. Since he was taught by both department pioneers in EMS, Finnegan was widely regarded as one of the best rescue guys on the job. But 135 Eddings Street finished that. A mother shot her three kids in the head and then herself. Finnegan had two small kids of his own and knew he was drowning in the ghosts. He said, “What do you need, lou?” “Can you get another epi ready?” Sal pumped the bag-valve mask. “Talk to me, Finn, what’re you thinking, bro?” “Nothing, man. You got the line, the tube, the epi, the CPR … I can’t think of anything else except some good pavement medicine.” “Bugsy!” Sal screamed. “Let’s roll, dude!” “Roger that!” Sal toggled his mic. “Rescue 1 to Fire Alarm.” “Fire Alarm’s on, Rescue 1.” “Advise St. E’s we’re coming in with an approximate fifteen-month-old found face down and unresponsive in a bathtub. Unknown on time. She’s currently P.E.A. We have a twenty-four gauge IV in the left AC, two rounds of epi are on board, and we’re about to drop a third. Kid’s intubated, CPR’s in progress, we’re six minutes out.” “Roger.” Rescue 1 was barely parked before its back doors shot open. St. Pierre hopped out and grabbed the stretcher while Finnegan continued CPR and Sal pumped the mask. Ideally, they knew Hasbro Children’s Hospital in Providence would have been better suited to handle this situation, but state protocol called for all pulseless people to be transported to the closet Emergency Room. The ER doctor on call at St. Elizabeth’s wore an expression that seemed to reflect this, that he was about to become the wrong man in the wrong place at the right time. “Doc, we got an approximately fifteen-month-old female found face down in a bathtub.” They wheeled her into Critical Care Room 1 where an army awaited. Sal continued his report, “She’s been P.E.A. the whole time. Don’t know how long she’s been down. Four rounds of epi on board. No vomiting of water or stomach distension, twenty-four in the left AC.” The nurses motioned that they were ready for the transfer, so they moved the child from the stretcher to the bed. As they did so, the mask moved. The doctor approached. “Halt CPR.” “What?” Finnegan was pounding out a steady rhythm. “Look at this.” The doctor pulled away the mask and pointed at her blue lips. Then he motioned toward her mottled skin. “Lividity has not yet set in but it’s close.” “She was still warm! Blue lips could mean she’s hypoxic!” “Sal …” St. Pierre tried to step in. The anxious room did not know what to do. “You ain’t calling it.” Sal made it sound like a threat. “You haven’t even done anything!” “I’m sorry, lieutenant. Our protocols are pretty explicit.” “You’re a piece of shit.” Sal seemed to think of it. “It’s a little girl, man.” “Lieutenant—” “You ain’t even gonna try?” Finnegan said, “I’m continuing with CPR. Fuck this guy.” The doctor said, “The water probably kept her warm. You don’t even know how long she was down for.” “I know …” Sal deflated. “A little fucking girl, man.” He shrugged. “I’m all filled up. This one’s on you, med-school.” Then he left the room.
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AuthorTom Trabulsi was born in the Midwest, attended high school in Rhode Island, and graduated from Boston University with a degree in American History. He was a bike courier in Boston and New York City, worked construction in the mountain west and east coast, and is currently a firefighter in a northeast city. Archives
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