I just finished reading an article about how everyone is all upset about the changing of the name of the "Freedom Tower" in New York City. For those that don't know the Freedom Tower project was supposed to be a tower that was deliberately set at 1,776 feet as a tribute to American freedom and all of the chest thumping and patriotic hoohah that could possibly be wrapped up in a massive skyscraper on the site of what is essentially a common mass grave for the thousands of friends and family members of countless Americans.
I understand that Ground Zero could not be made into a park, a sort of oasis in the hustle and bustle of a massive megalopolis in order to honor the memory of innocent souls. Come on, we can't possibly lose that real estate. So what it if its holy ground because of the blood that went into the soil. We bulldozed and built on Indian burial grounds for years. A hundred years from now there will be horror stories written about how the walls of the tower bleed and ghosts of the dead killed in the attacks haunt silicone injected botox bimbos while they have sex with their bosses for corporate advancement.
If I sound bitter, I am.
The biggest controversy surrounding this abomination is the name of it. Nearly three thousand people were killed on this site and we build an office complex. People will argue that if we don't rebuild the terrorists have won. Well heres a bit of news for you. I take my shoes off at the airport and I can't bring shaving gel in my carry on any more....... you figgure out whose really afraid of who and remember Tzu Sun's definition of terrorism next time a guy with a turban on sits next to you on a plane.
Ground Zero should be made into a park. Put a nice wall up with all the names of the dead so that we trully will "Never Forget." All that Lee Greenwood country music proud to be an American bullshit won't mean anything when the kids born in this generation are walking through Lower Manhattan, point to the ungodly monument to American avarice and tell their children. "See that big office building? We built that after some Arabs blew up the other ones. I'll show you the Nicolas Cage movie when we get home."
Everyone says they will remember, they have the FDNY 343 stickers and the T shirts and the I heart NY shirts. But if they actually remembered the pain, the suffering and the fear, the terrbile fear that day caused they wouldn't dream of putting up another building there. I can clearly remember calling my father from school that day. As we were talking the plane hit the Pentagon. My father, the man I've always thought had no fear broke into tears over the phone and said "God, they just hit the Pentagon. Its the end of the world." Remember that fear, that pain next time you send your credit card bills to grave of your friends and relatives.
Shit, Gettysburgh is open, lets put an office complex in there.
Aushwitz is prime real estate, bull doze those ovens and put in a KFC.
Pearl Harbor is clogged with sunken ships, dredge that fucker and put in a resort.
Why is it that the site of the biggest mass murder in the history of the world is being turned into an office park? Does my cousin deserve to have the only grave that inters her remains turned into an office building.
If the site of the World Trade Center attacks is not considered holy enough ground not to build on then the debate about whether to call it "the Freedom Tower" or "One World Trade Center" is totally pointless. The tragedy is not that we're being unpatriotic in not calling it the Freedom Tower, instead a mortal and irrevocable sin is being commited in building an office building on the grave of close to three thousand people.
If I lost you as a reader after this article then so be it. I'm so disgusted right now I can't stomach to even write any more about this travesty. I can't even title the damn thing.

Repeat or Sequel in a Trilogy?

Things happen in cycles.
Its around half past midnight when we finally get to bed after bringing a diff breather who, in reality, just needed to calm down, to the hospital. I drift off to sleep in the recliner as the beds are not very comfortable.
Little more than an hour latter the phone starts ringing and I can hear my partner, Jay, in one of the bunk rooms fumbling around for the handset. I hear him answer it and then it starts ringing again. Apparently the caller keeps hanging up.
We go down stairs to try and catch the caller ID so we can have the cops check it out. It wouldn't be the first time some one called the firestation instead of 911 and needed help.
I don't think too much of the extra car in our parking lot untill the tones go off for a delta level chest pain in the parking lot. Still clearing the sleep from my brain I grab my flashlight and head outside while Jay pulls the bus out.
The woman's husband is smoking a cigarette, seemingly unconcerned that his morbidly obesse wife is vomitting in the parking lot and complaining of severe chest pain going into her left arm and her jaw.
"Wanna just go?" Jay asks and I nod, hastily spit out a "Yep" and we bundle her into the back.
"Hon, you have any cardiac history?" I ask as her husband starts climbing into the back with his butt still lit. "No, dude you can't ride back here." I tell him, more because his wife is so big I have barely any room to move than because of his cigarette. He shrugs and drives off in his car without saying goodbye or even telling us if he's going to the hospital.
"All I have is diabetes." We're moving now and Jay tells me he'll pull over when I want a 12 lead. The woman is pale, cool to the touch and covered in sweat. She's also dry heaving into a bucket and complaining of severe pain. I tell him to go as fast as he can safely go.
The monitor shows a sinus complex with severely elevated T waves right on the three lead, for those non medical people the whole squiggle is supposed to be fairly uniform. If it goes up at a right angle it usually means something very bad is either happening or had in the past. These elevations are more apt to show up on the 12 lead than the four lead, seeing them in the four lead is a bad sign.
She gets asprin and her blood pressure is at about 90/palp. She had told me she had a history of high blood pressure and with all the chest pain she should have been through the roof. I ask how long the pain has been going on for.
"Two hours, it just keeps getting worse."
Shit.
She's in the end stages of her MI, a piece of soemthing has occluded an artery in her heart and now she is about to die. Initialy the blood pressure will be very high, as they start to decline they are slipping closer and closer to cardiac arrest. The heart is no longer injured but dying. Despite the low blood pressure I give her a nitro which knocks her pain down to a six but unfournately her pressure drops to 80. I start running fluids because I want to get that nitro in her to drop the workload on the heart and buy some more time.
But her pressure stays low. Shes getting less and less coherent. I call her in as a status two and tell Concord to have a full team waiting for me.
When a person is having a heart attack, its a race from the onset of the pain to the cath lab. The cath lab is the only difintive treatment as they have to go in and unblock the artery in order to restore oxygenated blood flow.
The woman who showed up in the firehouse parking lot had already waited dangerously too long before seeking treatment.
I sigh with relief when we back into the ambulance bay at Concord. By now I have exhausted all I can do. She had her baby asprin and her nitro. Her pressure was too soft for more nitro and morphine was out because it too would drop the pressure. She was barely coherent now and I didn't want to totally snow her with Fentanyl.
Dr. Carter was waiting just inside the ambulane bay doors, he'd gotten to know me since I started at Northern and realized it was me coming in with a potential problem. I don't make it a point to call for a team for everything so he rightly assumed they should assemble.
I give a quick handover report telling him all that I did and showing him the 12 leads. His eyes go wide and he mouths "Oooo, shit." As we transfer her over to the hospital bed, the cath lab guys are showing up.
Then she slumps into full unconciousness, stops breathing and the monitor shows V Fib. Her heart stopped beating and was basically quivering.
We shove her over onto the hospital gurney, dropping the head of the bed and calling everyone to clear. She gets defribilated and the electricity shocks her heart back into beating, it also causes her a lot of pain because she screams. "Don't fuckin' do that again."
They end up shocking her twice more before she went up to the cath lab. I lost track of her after that and I haven't been back to the hospital since so I'm not sure how she made out.
On the ride back I remember what my father always said about strange events or deaths. "They happen in threes."
I could really do with him being wrong on walk in medicals.

Rude Awakening

I wake up nearly every morning at around 0500. Whether I get out of bed or not is debatable but come Five AM I am awake. If I'm not due in at the firehouse I usually get up, hit the bathroom, check the weather report and go back to bed. If I have to work I shower and start my day.
When I'm at work, I wake up at about the same time and hit the laterine. Sometimes I'll check the weather or work out just to be up for the day. Occasionally I'll be really ambitious and start cleaning the ambulance and getting breakfast ready for the on coming crew.
My last tour I woke up, like clockwork with no pun intended and pulled on my boots to go downstairs and take a whiz. I'd been laying in bed for about fifteen minutes or so when I'd decided to give into the call of nature. It was one of those rare tours where we had a three man crew covering the house, myself, BT (station 1's lieutenant) and DG, a firefighter EMT. Downstairs there was a clattering sound like one of the screens on the outter windows had been torn loose and was swinging in the wind, so I pulled on my sweatshirt and didn't bother with a pair of socks, leaving my boots unzipped.
To get to the restroom, you need to walk through the front foyer, past the main entrance.
A guy in a denim work uniform emblazoned with a plumbing company logo was pounding for all he was worth on the front door, his brow damp with sweat and a grimace on his face.
"Shit," I muttered. At five in the morning his pounding on the door could herald nothing good.
When I let him in he blurted out. "My chest really hurts. I don't have my nitro. You guys have some, right?"
As I ushered him into the back of the ambulance he tells me he's had three heart attacks and this feels worse than his other ones. I pull a nitro out of the drug box and place it under his tongue. Then I hop upstairs to wake my crewmates up to get me some help.
We do a 12 lead and find elevations in V 3 and V 4. A 16 guage IV goes into his left AC and he gets another nitro tab before we pull out of the bay. He states his doctor's found a 75 to 80 per cent blockage on the right side of his heart and I catch a memory of the V 4 R technique my medic instructor beat into us in school.
I move the V 4 lead to his right side but find inconclusive evidence of a right side involvment. He gets another nitro with no relief so I move onto morphine and end up giving him the full 4mg before the pain lessens.
We transmit both EKGs to the hospital, surprsing them with the V 4 R.
From the time he banged on the door at the station to the time he was on the table in the cath lab was exactly forty one minutes. I should also point out that is with a brief pee break before starting transport.

Younger

One of my most vivid memories from childhood focuses on a family trip to Florida. My parents were young, just starting a family, I was only about five years old. My brother was an infant or thereabouts. We didn't have a lot of money, not poor but in the conservative boat that my wife and I now find ourselves in.
My parents wanted to take their kids down to Disneyland, or World, whichever one is down in Flordia. Flying would have been too expensive so they decided to drive the family down in a 1988 Izzu Trooper. I still remember that car, it was an early SUV with a wimpy little four cylinder engine and a stick shift that would later burn out on a family trip to Canada to see Niagra Falls. But the Disney trip started early in the morning, before the sun came up on a March vacation. It was still cold out and my parents had set up a sort of bed for me and Doug to sleep on in the back of the Trooper, the seats were folded down and there were pillows and blankets. It was chilly but the blankets were warm and it felt like a little cocoon against the world. I remember the night before my dad had let me stay up and watch a Roy Scheider movie about a police helicopter pilot who is in control of a super gunship....and of course that morning, the back of the Trooper became that gunship and I was too excited to sleep. I was up imagining little adventures, imaging being grown up and wearing a uniform and a badge and saving peoples lives. My head was far away from the car and the many miles my father was going to put in driving down to Florida. All I knew was that in three days we would be swimming and going to the Magic Kingdom and the big silver golfball.....I couldn't remember what it was called back then and I still can't think of the name.
Twenty years later I found myself wrapped up in the back of another vehicle, in the chilly dark living out a different adventure. I was bundled into turnout gear, ear plugs to keep the din of the open cab Ladder truck's engine out of my brain, a knit cap pulled low over my head to keep as much heat in as possible. I stunk of smoke, my shoulders and back ached from the weighted chain I had spent four hours dragging up and down a fifteen foot chimney.
Exhausted I leaned back against the jumpseat, the dim glow from the firefighter in the seat next to me texting her husband gave an errie comic book light to the whole situation. Twinkling farmhouse windows zipped past the truck, as we chugged back to the firehouse.
I'd seen at least 12 feet of active burning chimney, so hot the bricks were cracking and the slate cover was disentegrating. Steam had billowed from the top of the flu when crews inside started spraying the flames with water cans, nearly enveloping us had it not been for the operator's quick manuvering. Bricks had exploded from the heat, pelting my helmet and the air mask I almost didn't put on, thinking "It's just a chimney fire, not like we're making entry or anything."
But on the ride back my mind was 20 years removed from the night's activities. After we'd cleaned up and left the scene, I was in the back of that car awed by the possibilities before a five year old. Imaging what my life would be like, 20 years in the future.
That's what amazed me most, I think. When I was younger I'd dream about being older, being a "grown up" and being able to stay up past nine PM. Last night at quarter to 10, true, past 9 PM, I was drifting off to sleep, dreaming of what it was like to be younger.

Helping Someone

The first med call I ran at Northern was a 56 year old man who had been arguing with his wife about buying paper towels. He started to feel light headed and dizzy, he broke out in a cold sweat and felt like his heart was pounding out of his chest. We ended up taking him into Concord Hospital with nitro, morphine, two large bore IVs and several 12 leads along the way.
Last night as I was cleaning up after dinner, with a movie playing on the TV, I was pretty much convinced that this shift would go the way of the rest with another 24 hours devoid of calls. I should add that because of my previous shift's lack of calls I was able to find a great recipe for shrimp scampi that was a fairly big hit.
When the tones came through it was just starting to snow fliggy out, nothing really earth shattering but just enough to let us know that the storm was in fact coming. The ride in the ambulance was totally different in the dark. I knew the address sounded familar but I wasn't sure why. Out front one of the vollies had parked his F350 with his red light bar going, as good a roadsign as any.
The patient was inside sitting on the couch, feet up on the coffee table with a strained look on his face. My Captain, MR, was working with me out of station 2 just as she was on my first shift. I start looking around and admiring the very nice wood stove they have blasting heat into their nice little home.
"What's up, bud? I'm Nick."
"I know, we met back in August. You missed an IV in my hand." He smiles good naturedly and explains that his heart is bothering him again though not as bad as before. Sure enough the monitor shows a sinus rthym with complex dropping here and there and a few PVCs. Denying pain he tells us his chest feels tight and that he doesn't know if he should go to the hospital. His skin seems a bit pale but the only light in the room is from the stove so I don't really let it set off any bells.
The vollies end up bringing him out to the truck while I spike a bag and get my drug box ready. A quick 12 lead shows nothing scary and he states that he feels a lot better. My only real concern is that the guy was an Air Force drill instructor for 25 years who still runs and swims religously, and his blood pressure is 190s over 100s. The first IV poke into his left AC drops him down to a more resonable 150 over 90, still not great but I really don't want to give nitro to someone denying any cardiac symptoms.
We transport him to Concord again, his blood pressure going down to 130s over 80s. Another line goes in his right AC just to be safe and I do another 12 lead, again finding nothing. His anxiety seems to have abated and he asks me how I like working in town. I tell him I'm very happy because its a nice town with nice people who, for the most part, behave themselves. I bust his chops a bit by saying "Except this one AirForce guy with a heart problem...he's a real asshole." He laughes and punches me playfully in the leg and tells me he feels silly going into the hospital for what he thinks of as being tired.
"My mom had a couple of heart attacks a year or two ago," I tell him. "Once in a while she gets a chest cold or something and she gets nervous and does the same thing. I'd rather come and pick you up for a cold then have you wait too long and have to do some real work on you."
We drive through the night with him telling me that he and his wife have since split up, they're still close but "It just didn't work. You know, no hard feelings or nothing. She's living here at my house until the spring. Then we'll sell it and go our seperate ways." She's sitting up front telling the same story to my captain.
I tell Concord Hospital what I'm coming in with and they give us a room. When we drop him off, I give my report and tell him "Look, no offense but I really don't ever want to see you again." He laughes and says its a mutual thing.
Most of the time, my career has brought me into contact with frequent flyers-- people who use the ambulance enough that you get to know who they are, they're families and they're problems-- and most of the time those frequent flyers are drunks and system abusers. Every now and again its nice to get a frequent flyer who is amicable and doesn't smell of urine and booze. My guy last night is a nice guy and the drunks and druggies I've taken might be the nicest people in the world but I never see it. Last night I saw a geuniely nice guy who needed some help and because of all the different stuff I've forced myself to go through, I was able to give him that help.
It wasn't a really dramatic or even overly interesting call but it was nice to know that I was helping someone.