Wednesday, April 09, 2008

He's a Doctor

We get sent for a difficulty breathing to the rectory at St Michael's Church in Manchester. The fire alarm dispatchers have a series of questions they need to ask callers in order to prioritize responses and apparently the denizens of the city have learned that difficulty breathing means that the big red truck and the ER on wheels will get there faster.
A homeless guy with a ZZ Top beard and glasses two sizes two small is waving frantically for us when we show up, one of the rare occasions when we actually beat the engine to the scene. I hop on and grab the jump bag, following a growing crowd of people who really don't need to be there in to a half frozen swamp behind the drop off for a St Vincent De Paul society clothing donation kiosk.
"He's comin' off a bad drunk." The first homeless guy points to his friend, a severely emaciated and clearly unwashed man with an equally long beard laying half out of a small tent fashioned from tarps and tree branches. Beast ice bear cans litter the area and it smells like a cheap0 brewery
One look at the patient tells us we are in trouble, his eyes are glazed, mouth crusted shut as he refuses to answer any of our questions. The firefighter end up trouping down through the muck and the captain starts telling the man to get out of his tent. Eventually we end up cutting the ropes and dismantling the damn thing around him, slipping and slidding in beer cans. I help a Manchester jake toss him onto the cot and we get him in the back of the truck. He stinks of beer and age old piss.
When I try for vitals he tries to bite me, I feel his skin is ice cold. Dead bodies have been warmer than this guy. I start piling on blankets and patch into CMC in order to let them know we are on the way in.
"CMC, CMC, Rockingham ALS 3 about five from your facility, status three traffic."
"CMC online."
"Good afternoon, Rock 3 about five out. I have an approximately 45, four five, year old male found living in a hovel behind the church. Patient is cold to the touch and combative to vital signs. Have a room ready for me, might wanna have security on standby."
When we get there we put him on room five, a common exam room with no real facilities for emergency procedures. I sit in the EMS room and write up my report. When I go to get a signature from the staff, I find he has been moved to Trauma One and that they are about to intubate him. His core temperature was 81 degrees, far lower than the 98.6 that most of us our. The doctor asks me why I didn't have an IV.
"He tried to bite me, I only have two hands, I really counldn't hold him down and do one." I piled blankets on the guy, hoping for the best.
We get called from the hospital for a stroke at a local adult daycare, it turns out to be a diabetic semi emergency and we do our little thing, bringing her to the Elliot. I still have to finish paperwork so we head back to CMC. Once there we find the Trauma team in full swing doing their central lines and suction and such. I find a nurse I kind of know and ask her to sign some paperwork. She tells me to go see the guy in the waiting room wearing a red polo shirt.
He's old, a bit on the chubby side but looks like he can still play a pretty decent game of touch football.
"You wanted to see me?" I ask.
"I'm Father McNally." He extends his hand, I shake it, feeling uncomfortable as me and Catholicism have always had a bad relationship. "The man you took in, from the woods behind my church, I know him well. I let him and his friend sleep on the property back there, a bit of charity. It's sad really, did you know he's a doctor?"
I snort through my nose in surprise. "Sure that isnt just an urban legend?"
"Quite sure."
I restrain the urge to ask him how charitable it is to let a homeless drunk nearly freeze to death on his property and make some half assed excuse about needing to clean my ambulance.