When their ambulance is dispatched to a 9-1-1 call, paramedics attempt to cherry-pick a diagnosis based on the age and the one-sentence description they get of the patient’s complaint. We occasionally nail it, most times not, with humor, sarcasm, gloom or fatal cheer. There are often curveballs; it’s hard to streamline individual patients and their array of needs with our quick-and-dirty prehospital tools.
I work as an ambulance paramedic. Nowadays, on every call that meets the criteria for COVID-19, my colleagues and I wear masks, gloves, eye shields and gowns. We stand six feet away from our patients as we interrogate them about the presence of fever, cough, body aches, or breathing problems.
Our overall 9-1-1 volume is down, as people stay home instead of driving drunk, as they decide to stay away from hospitals, as most of them (minus the over-advertised outliers) shelter in place. But I notice more secondary symptoms: domestic abuse, assault, anxiety, mental illness, loss of sobriety.
Beverly called the ambulance because she couldn’t walk anymore. Her feet were edematous after ten days of radiation treatment for metastatic lung cancer, and her heart was slowly overfilling with fluid, backlogging into her body. She was stoically resigned to her pain and newfound infirmity, but she kept a wry sense of humor, cracking jokes about being waited upon and the “magic carpet ride” sling we lifted her onto.
During transport to the hospital, Beverly told me she grew protea: pale red, pink and cream-colored flowers native to South Africa. Her family sells them at local farmer’s markets in bouquets. When I inquired further, Beverly perked up and gave me the rundown:
I ambled with squirrels and rabbits on an urban trail overflowing with chaparral and mossy oak. Early morning bird chatter, drone of bugs in rays of sun, and the crackle of underbrush beneath my feet kept me company. My thoughts wandered brisk as the sound of river water on rock.
A man wearing a holey T-shirt and sweatpants approached me, accompanied by a large German Shepherd. The dog was off leash but seemed friendly. The man had a vacant stare, and as I passed him I gave a perfunctory smile and “Good morning.”
He didn’t even note my existence nor change his faraway gaze, and I immediately snickered at his lack of basic human decency. Shaking my head, I glanced back at him. He had stopped, looking up at the cloud-threshed sky, and suddenly emitted an unearthly wail.
The hospital-style bed lurks emptily alive in the pale living room. Rust flecks along its silver rails pock my distorted reflection. Cold sheets triangulate like sagging tepees, housing the smell of long-term illness. These are the ghostly remains of hospice care.
I used to always walk in the woods
before I became crippled.
— from a dying woman
I respond to a ranch house at twilight. An old woman is dying from metastatic lung cancer, vomiting blood. In between episodes of dry heaving and spitting dark clots, she reaches her hand out, sometimes grabbing my arm, other times involuntarily seeking the sky. We both know what her family refuses to see: she will be dead in a few hours.
“We lock the door and shut the curtains, and, when its all clear, we line up in a special order and listen to what our teachers tell us.” –My kindergarten daughter, Zelia
They say work to live not live to work but how do you come home crushed by a forty-eight-hour shift on sixty minutes of broken sleep and kiss your babies and tell them it’s all going to be okay when their school is on lockdown due to a nearby shooting and the suspected gunman is still on the loose as you tend to a patient with suspicious wounds while the world keeps debating nuclear stories around you, and you think this small town ain’t so bad: the knife and gun club has low enrollment compared to the gang-ridden inner city you grew up in where shots fired were barely flinched at (because they weren’t en masse), and hella felons ran through your property with cops and helicopters giving chase.
We take a man home on hospice from the hospital: end stage cancer, metastatic. His Power of Attorney requested one last pain shot of Dilaudid. We cinch belongings into bags, gather discharge papers and old flowers in vases. He groans being moved from cot to gurney, and again over the bumpy roads. It’s his final ride; we are his transporters.