Tag Archives: Pimp

Traffic 2/2

As I push the gurney through the sally port towards the ambulance with our police escorts, I’m able to have a few moments to myself to ponder the situation. I’ve transported many prisoners in the past and often pick up violent offenders off the streets fresh from a well deserved police “attitude adjustment” requiring a trip to the ED. But somehow this is different. This isn’t a random act of violence or even a simple premeditated crime. This man is potentially the perpetrator of organized subjugation of innocent children. The level of pure evil that spawns this behavior is unfathomable to me and I’m having a bit of a hard time with the whole situation.

I load the gurney into the ambulance and tell Kevin that I’m just going to fire off a quick 12-lead and we can start transporting. It won’t affect my transport decision as the police requested a hospital that is also a cardiac receiving center, but I need to know if this warrants alerting the cath-team if my new patient actually is having a STEMI (S-T Elevation Myocardial Infarction – heart attack). Given his skin signs and level of distress, though, I highly doubt he is.

With the 12-lead complete – normal as expected – the police cruiser pulls in behind us for an escort to the ED as we start transporting. The rote task of taking vitals and applying the monitor to a patient that I can’t talk to gives me a few more minutes to contemplate my emotional state. On the one hand I may have evil incarnate strapped to my gurney, sitting only inches from me, and that brings a flood of emotions to the surface that I’m entirely uncomfortable experiencing. On the other hand, this is a patient and I’m a Paramedic – end of story! My job is to treat the problem in front of me and be an advocate for a patient who can’t even convey his needs due to a language barrier. Conflicting emotions and logical arguments fly through my head at synaptic speed – like strobes on an ambulance – and quickly resolve in the blink of an eye.

I fall into the sequential tasks of treating my non-English speaking patient for chest pain; aspirin, oxygen, vitals, IV, nitroglycerine, vitals, nitro, etc… “Here, chew this up, don’t swallow,” I tell him as I make a chewing motion with my mouth and move my hand like a hungry sock puppet and hand him the aspirin. “Did you take any Viagra today?” Stupid question, he’s in jail, I’m a little off my game here. He shrugs in non-comprehension. I spray the nitro in his mouth. Whatever, if I crash his blood pressure out I’ll try to fix it and apologize to the docs at the ED.

The ambulance comes to a stop on the freeway as there is an accident in front of us. We heard it get dispatched as we responded to this call but I guess Kevin is a little off of his game as well since he didn’t use surface streets to bypass the congestion. I can see the police escort sitting just behind us – in the stopped traffic – through the back window of the rig.

Pulling the stethoscope from my ears after the latest check on vitals my patient turns to look me square in the eyes. In heavily accented broken English he speaks to me in a quiet voice. “I can see that you a very nice man. Is all a mistake. They not my bitches, they my sisters… I have much money. I give you. You let me go!”

  • Child trafficking is one of the fastest growing crimes in the world.
  • There are 2.5 million child sex slaves in the world today, some as young as 4 and 5.
  • More than 1,000,000 children worldwide will become victims of child trafficking this year.
  • Over 100,000 children in the U.S. are currently exploited through commercial sex, and 300,000 children in the U.S. are at risk every year for commercial sexual exploitation.
  • Investigators and researchers estimate the average predator in the U.S. can make more than $200,000 a year off one young girl.
  • The global market of child trafficking is over $12 billion a year.
  • The total market value of illicit human trafficking is estimated to be over $32 billion a year.
  • An estimated 14,500-17,500 foreign nationals are trafficked into the U.S. each year.
  • Approximately 80% of human trafficking victims are women and girls and up to 50% are minors.
  • 600,000-800,000 people are bought and sold across international borders each year; 50% are children, most are female.  The majority of these victims are forced into the sex trade.
  • There are open sex slavery cases in all 50 states.
  • U.S. citizen child victims are often runaway and homeless youth.
  • Runaways, orphans and the poor are targets for sexual predators.
  • Approximately 80% of trafficking involves sexual exploitation, and 19% involves labor exploitation.
  • There are more slaves today than ever before in human history.

Information from various sources ~ U.S. Dept. of Justice, U.S. Dept. of State, UNICEF, UN, UNODC

As long as the mind is enslaved, the body can never be free. Psychological freedom, a firm sense of self-esteem, is the most powerful weapon against the long night of physical slavery.

Martin Luther King, 1967

Traffic 1/2

traf·fic

1 : the passage of people or vehicles along routes of transportation; traffic congestion

2 : dealings, business, or intercourse

3 : social or verbal exchange; communication

4 : buying and selling; barter; trade, sometimes of a wrong or illegal kind

5 : to carry on trade or business, especially of an illicit kind; human trafficking

The lock on the heavy jail cell door releases and the door slides open with mechanical precision, making a loud clunk which reverberates off of the austere concrete walls of the sally port (a double-door safety system that they have in prisons. From the outside, you go through one door, and when it closes and locks, the second door opens to let you into the interior). Standing in front of me is the fire captain who’s taking information from the jail’s processing officer – he looks up long enough to point us down a hall. We continue walking down the hallway of holding cells and I see freshly processed prisoners, still wearing their street clothes, sitting on benches in their cells watching the procession of uniforms glide past their limited view through the bars. In the open cell at the end of the hall I finally see my patient – a man in handcuffs, leg shackles, and an orange jump-suit – sitting on the bench with firefighters taking vitals and four very large officers keeping an eye on things.

Finally, I see a friendly face – the fire medic stands up to give me a quick report. “Hey KC, so it’s your basic incarceritis. Forty-eight year old male, chest pain by three hours, vitals normal, no primary symptoms. That’s about all we have unless you speak Mandarin.”

“Sweet! No problem.” I step around the medic and address the prisoner. “Ni hao ma?” In perfect intonation I ask him how he’s doing in a typical Mandarin greeting. Fortunately I grew up in the Chinese community of my home city and know enough Chinese to order dinner, get my face slapped, and yell like a drill sergeant at a class full of kung-fu students. Unfortunately, it’s all in Cantonese and I just exhausted my Mandarin repertoire.

The prisoner stands up with a hopeful look on his face and fires off an excited string of Mandarin. “好. 这些人不相信我. 我有胸部疼痛.”

In unison the firefighters and officers look at me to see if I can tell them what’s going on. “Sorry man, that’s all I got, let’s go to the hospital.” I motion to the gurney as he does the shackled penguin waddle out of the holding cell. Kevin and I put on the leather hand restraints as the officer takes off the handcuffs. I’ll need access to his arms to treat him, yet he’s still in custody.

As we’re walking past the rows of holding cells I’m asking one of the officers what’s going on. “Yeah, we used the translation service on the phone, he said he has chest pain and knows that no one will believe him so we called you guys.”

“What’s he in for?” I always ask as I want to get an idea of how dangerous someone is – it doesn’t affect my treatment but it’s nice to get a heads up if I’m going to be sitting in close proximity to a violent criminal.

“We picked him up yesterday on a sting-op. Busted about a dozen brothels in a couple different counties. These guys were trafficking young girls from Asia on container ships and forcing them into prostitution. This guy was pimping out girls as young as thirteen! I tell ya’, right now, I hope he is having a heart attack – he deserves it!” Damn!

 



 

Service 4/4

As I open the back doors of the rig I see the two extra firefighters in the back of the patient compartment. CPR is in progress and having extra people to help out is always better so the medic took a few riders. We help them unload the patient while keeping an eye on IV lines and monitor cables. I hand the monitor to Brittany and tell her to keep close as we roll the gurney into the waiting team of doctors and nurses. One of the fire fighters is “riding the rails” – he’s standing on the bottom rail of the gurney, one hand holding on and one arm applying as much of a compression to the patient’s chest as is possible on a moving gurney.

As the paramedic is giving a verbal hand off to the medical team we disconnect the monitor leads and transfer the patient over to the bed. A flurry of motion ensues as the hospital staff go to work picking up the code where we left off. I take Brittany to the corner of the room where we are out of the way and I can explain what’s happening as the team administers more drugs and shocks the patient a few times.

After ten minutes it’s obvious this person isn’t going to come back to the living. They are going through the last few motions of working a code – throwing the “Hail Mary” drugs at him in the hopes that something was overlooked or an underlying unknown condition is preventing the resuscitation from working. The ED tech doing compressions is a friend of mine and he’s getting a bit fatigued from doing CPR for the last five minutes.

“Hey Nick, you want some relief? My ride-along needs the practice.” Nick gives an exhausted nod of his head as drips of perspiration land on the pale patient below him. Brittany bounds up to the step stool at the side of the bed and trades off with Nick without missing a beat. I coach her on hand placement and compression rate as she furiously puts all of her heart into keeping this man’s heart working.

While Brittany continuously pumps on the man’s chest, I’m standing next to her explaining some of the things she’s feeling and giving pointers. “Don’t worry about the broken ribs, keep pushing, he’s got bigger problems. Give the chest a full recoil, let it inflate after every compression.” I push my fingers into the man’s femoral artery. “Push a little harder, there you go, now I can feel his pulse in the femoral from every compression.”

After two rounds Brittany is completely exhausted but she’s still pushing for all she’s worth. Nick catches my eye as we stand behind Brittany. “They’re about to call it, you want me to take the last round?”

I pull Brittany from the stool as Nick jumps in for the final round of CPR. Nick’s a good man – he knows that we were all just going through the motions on this one but Brittany doesn’t need to be the last person doing CPR when they decide to stop. She did a great job and it’s best to leave on a high note rather than a depressing coast out.

This was our last call of the day and as we take the quiet roads back to the deployment center Brittany has a flurry of questions and observations from her day on the streets. Kevin and I have quiet smiles on our faces as we discuss the day and her performance. Her enthusiasm is contagious and we were just happy to provide her some experiences to help prepare her for the unknown that awaits her overseas.

Back at the deployment center I’m filling out Brittany’s evaluation form where I give her high marks in all categories. Brittany puts her form in the camouflage backpack and joins her camouflaged classmates in the lounge as they compare stories of their day in the Big City. I suspect Brittany has some of the best stories of the group today.

She’s a shining example of the young people that are making sacrifices for our country every day. These are young men and women from across the country who take an oath, put on a uniform, and deploy across the world. Many of them will find themselves in dangerous situations, and maybe some of the things they learned in our Big City will be of use in future deployments.

Service 3/4

After the call I’m driving through the hood so Brittany can see some prostitutes as our last call brought that into the conversation. With Brittany squealing with excitement after watching a young woman get into a car with a complete stranger I’m passed by the Big City PD who’s moving fast.

“Brittany, you might actually get a real call today. PD just passed us and another one is coming up behind us.” We get used to the driving patterns of PD as they have a particular mode of travel when going to a real call. Despite the cop shows that depict officers traveling Code-3 to every call our local PD tends to just light up at intersections and occasionally hit the air horn to get someone’s attention. They are the urban land-sharks of the hood that gracefully slide through traffic following the scent of blood to the crime scene.

A few seconds later the radio comes to life. “Medic-40, respond code-3 for the GSW at the corner of really bad street and even worse street, please stage out, your scene is not secure.” Brittany has her gloves on before the dispatcher finishes the sentence and wearing her camouflage battle dress uniform all I can see in the rear view mirror are her bright shiny teeth in a big smile. I light up the rig and head in the direction that PD was going.

Just as I’m thinking about shutting down to stage and wait for the officers to secure the scene the dispatcher comes back and clears us to proceed. We arrive to find police cruisers blocking the street and yellow tape being rolled out to keep the crowd back. There’s a cluster of officers standing next to a young man who’s collapsed on the sidewalk with a small pool of blood forming under him. It’s Kevin’s tech so he’s first out and walks up with the fire crew that just arrived. Brittany is staying with me as I’m getting the equipment out of the rig.

I hand her a set of trauma shears and motion towards Kevin who’s kneeling by the young man. “go on – get in there and cut some clothes off.” I don’t think I’ve ever seen anyone skip in combat boots yet that’s pretty much what it looks like as Brittany joins the others in cutting clothes and looking for bullet wounds.

It’s the perfect textbook scenario for rapid assessment and treatment of a trauma victim. Four minutes from the time the call went out to arriving on scene with fire and EMS pulling up at the same time. Seven minutes spent on scene stripping clothing off, controlling the bleeding, and putting the patient on a back board. He has two entry wounds, one in the neck and one in the upper chest. Both appear to be small caliber and bleeding from the chest wound is controlled with a chest seal to reduce the possibility of developing a collapsed lung. We decide to use a hard back board because of the close proximity of the neck wound to the spinal column.

With strobes flashing and siren wailing, I make the five minute Code-3 drive to the trauma hospital with my police escort just behind me. Kevin’s reassessing for neurological deficits and starting IVs as Brittany is doing her best to take vitals in the back of an ambulance running Code-3. She’s using all the techniques we showed her on the previous non-emergent calls: slipping the bell of the stethoscope under the cuff so you can corroborate the auscultation by feeling the palpated systolic pressure with the other hand, and supporting the arm on your leg while lifting the heel of your boot to isolate noise and vibration. She’s a quick study and is keeping her cool on a highly stressful call. Seventeen minutes after getting the call we are pushing the gurney into the trauma bay, which is already crowded with the trauma team of doctors and nurses. By the time Kevin is finished with his paperwork the young man was already headed for the operating table.

Brittany is helping me clean up the ambulance as another rig comes in to the trauma bay. I could hear the siren from a few blocks away and see their lights flashing as they entered the parking lot. Brittany and I change gloves so we can help out the crew – they are bringing in a critical patient.

Service 2/4

As we drive from call to call and post to post in the Big City, Brittany is a constant source of questions and enthusiasm. Despite the poverty stricken streets that are ripe with urban violence, gangs, drugs, and everything else – I actually like my Big City and enjoy the opportunity to play tour guide to the underbelly of urban street life.

This is Brittany’s first visit to this state and only the third state she’s ever been in. Having grown up in Maine, she lived a rather sheltered life up until now. She’s loving every minute of the day even though we are getting the less than emergent – some might even say annoyance – calls all day long. We call it “third man syndrome” – it seems that every time we get a rider we get the nuisance calls and seldom get the dramatic high profile calls that the rider is hoping for.

Brittany was a good sport when we got called for the fifty year old lady who had a headache for the last three days. There’s really nothing to treat here yet it was a chance for Brittany to practice taking a history and get used to the frustrating reality of how difficult it is to take vitals in a moving ambulance.

From the mouth of babes come the rational observations, and Brittany made a very apt one after the call as we’re cleaning up the rig. “Why didn’t she just take an aspirin?” I don’t have any good answers for that one except to say that calling 911 is a learned pattern from her environment and when someone demands that we take them to the hospital we are obligated to do just that.

As if to hammer the point home our very next call is to an address that I am familiar with as I’ve been there many times. It’s a woman with every chronic problem you can imagine, taking all the regular medications, with the same complaint every time. Yet today we’re here for her twenty two year old daughter – I’ve never transported her before.

It turns out she has a back ache because she slipped yesterday. Of course she’s wearing five inch stilettos – my keen diagnostic abilities tell me they may have contributed to the slip. Dressed like a prostitute in tight pants, high heels, and a skimpy halter top she struts to the gurney and plops down so we can transport her to her favorite hospital.

It’s an interesting situation that boarders on scamming the system. Her mother is considered disabled by the state due to so many chronic illnesses. In conversations with her over the years I come to find out the daughter is listed as her “home health care provider” despite having no medical training. The state pays her $800 dollars a month to live at home with her mother. And the daughter has apparently learned from the mother that you call 911 whenever you have a problem because it’s cheaper to let Medi-Cal pick up the tab than to call a taxi – and a taxi is exactly what we are on this call.

Service 1/4

ser·vice

1 : of or relating to the armed forces of a nation

2 : work done for others as an occupation, business, or calling

3 : services, such as free medical care, provided by a government for its disadvantaged citizens, often used in the plural

4 : the act of a male animal copulating with a female animal

Consciously or unconsciously, every one of us does render some service or other. If we cultivate the habit of doing this service deliberately, our desire for service will steadily grow stronger, and will make, not only our own happiness, but that of the world at large. ~Mahatma Gandhi

“Prostitute at five-o’clock, look out the back window to your left.”

“Really!!?” Brittany scuttles to the back of the rig and peers out the rear windows like a ten year old looking under the tent flap at the circus.

“See the bored looking guy with the baggy pants, about twenty yards up the street? That’s the pimp.”

“Oh my god!! She just got in the car!” Brittany is actually squealing with excitement.

The back of the rig is dark and I can just barely make out Brittany’s silhouette in the rear-view mirror as her digital camouflage fades her into the background.

I met Brittany this morning as I was checking out my equipment from the deployment coordinator and he told me I have a ride-along today. Looking behind me I see a young woman in military digital camouflage; her hair is pulled tight into a bun at the back of her head and she’s standing in the corner holding a matching backpack, curiously looking around at the ambulance bay and the bustle of other crews stocking their rigs.

We often get EMT student ride-alongs in this county – it’s a mandatory component of graduation to ride with an ambulance crew on the streets. Some ride-alongs are from the military while others are from the local schools, and they span the full range of personalities and competency. For many of the local students, this is just a necessary yet annoying stepping stone on the way to the elusive job in a fire department. Some will make it that far but most will fall by the wayside. The military ride-alongs take it much more seriously, and as a result I much more enjoy having them. We get riders from the Army, Marines, Navy, and Coast Guard. These tend to be dedicated young men and women who are disciplined, motivated, and courteous. Because of the constant state of war over the last decade these young people know that the skills they learn in EMT school could vary well make a difference in future deployments. They tend to be very motivated, ask lots of questions, and are respectful to patients and personnel from the other agencies that we work with throughout the day. The military commanders know that the best chance of seeing domestic urban warfare happens to be on the streets of my Big City so we tend to get a lot of riders from the different branches of the military.

As I’m introducing myself to Brittany and handing her my computer to carry to the rig I hear another military ride-along nervously talking to the deployment coordinator. “Are you serious, you don’t issue flack jackets?” Brittany’s eyes get big and round at that question – a look that I see repeatedly throughout the day.

Brittany helps Kevin and I check out the rig as we explain where all of the equipment is stored and promise to get her as much hands on experience with patients as possible. As we clear the deployment center and notify dispatch that we are available for the Big City, Brittany looks down at the body armor poking out of my gear bag and her big round eyes meet mine in the rear view mirror.

“Don’t worry about it, we’ll keep you safe. We haven’t lost a rider yet.”

“So you’re not counting the last guy?” Kevin comes back at me with our well rehearsed schtick.

“Nah, he doesn’t count, he was an idiot! Brittany’s much smarter than him.”


Gangsta Rap 2/3

Kevin and I are dumb-founded. It was actually a good rap, despite the disturbing subject matter, and Lil’G seems to have some talent. I’d much rather listen to him rhyme than watch him tear the place apart.

“Lil’G man, you got some talent, you write that when you’re in prison?” I’m honestly curious.

“Nah man, I gots too much to do when I’m in the joint.” He’s dismissive with a wave of his hand.

“Too much to do? What, you working out all the time? Gotta build up those guns?” Referring to his biceps. Yet a tickling on the back of my neck reminds me that we didn’t exactly search him before he got in the ambulance with chest pain a few minutes ago. I hope Kevin did the “EMS pat down” as he put the monitor leads on him.

“Nah, I don’t work out in the joint. I’m too busy keepin’ an eye on all those niggas. Don’t never know when some fool’s gonna come up and try to stick me. Gotta be ready for a smack down, you know?”

After what seemed like an eternity PD shows up. Fortunately they pulled up to the front of the rig and I’m able to brief them before Lil’G notices they are here. The officers walk around the back of the rig so Lil’G can see them and it’s obvious by his expression that he’s not surprised. He knew this was happening all along. He’s been in this situation before and knows the drill just about as well as we do.

After a quick conversation and some paperwork the green sheet is finished and we can start to transport to the Emergency Psychological Services (EPS). Lil’G will get a psych evaluation and maybe stay a day or two for observation. It all depends on how he answers the questions.

It’s Kevin’s tech so I’m up front driving to EPS while Kevin finishes off the paper work. It turns out that no restraints or sedatives were necessary as Lil’G seems to want to go to the EPS. I can only imagine the life he’s led up to this point and how it may actually be comforting for him to rest in a relatively safe institution for a few days.

Growing up in the hood he presumably had few positive role models. He must have been in harm’s way often and exposed to some traumatic events. Just as a soldier comes back from a war with PTSD, I can imagine that life in the hood can create the same effect. Then at a formative age he’s placed in prison with its strict routine and lack of freedom accompanied by the ever-present danger of prison violence. Past traumatic experiences have created at least as many mental/emotional scars as physical ones.

Yet even with these obstacles this man has made it to his forth decade of life, which is rare for people in his situation. He seems to focus his energy on his rhymes, which he presents in all modalities of communication, with a harmony of visual/kinesthetic/auditory artistry. A man with limited education and vocabulary is able to access his inner emotions and express his feelings, dark and violent as they may be, to others and himself.

Pulling into EPS I hear the disturbing rhymes from the back of the rig.

I chop your head off… let it roll in a buck-et.

I punch your eyes out… so I can skull fuck-it.

 

But I aint trippin’ nigga… I won’t beg.

I drink the blood… from a bull dog’s left leg.

 

I told you once nigga… I ain’t even trippin’.

You get found nigga… by three old men fishin’.

 

We can do some shit… I might bust your brain.

But on the tip of my shoes… I’m leavin’ doo-stains.


Gangsta Rap 1/3

gang·sta

1  :  black slang; a gang member

2  :  a type of rap music featuring aggressive misogynistic lyrics, often with reference to gang violence and urban street life

rap

1  :  to hit sharply and swiftly; strike

2  :  a criminal charge; a prison sentence

3  :  music; to talk using rhythm and rhyme, usually over a strong musical beat

4  :  to have a long informal conversation with friends

Violence is a part of America. I don’t want to single out rap music. Let’s be honest. America’s the most violent country in the history of the world, that’s just the way it is. We’re all affected by it. That’s one of the frailties of the human condition; people fear that which is not familiar.

Spike Lee

“Ya’ see, I didn’t really call you here because I was havin’ chest pain. It nothin’ like that at all. Ya see, I thinkin’ about killin’ myself.” As the fire engine accelerates away from us Kevin and I have a very different call on our hands than the one we thought it was going to be just a few seconds ago.

Getting called to the middle of the hood for chest pain is a common enough thing and we answer these calls on a daily basis. Today we happened to be just a few blocks away when the call information arrived on the Mobile Data Terminal (MDT). I turned the ambulance around and we were on scene in less than two minutes.

Sitting on a chair in front of an urban church outreach center was a man in his early forties. The pastor and church volunteers are comforting him as we walk up to see what’s going on. Holding his chest he tells us of the pain he’s feeling and how he wants to get checked out at the hospital. It’s an easy call and the assessment and treatment are so rote that we fall into auto pilot as we go through the motions.

Seeing the fire engine approaching from down the street I write the man’s name and birthday on my glove and hold my hand up high so the fire lieutenant can copy it down for his records without having to exit the engine. In seconds they are off to the next call and we are alone with the patient. Of course, that was before I knew the true nature of the call.

After our patient drops the bombshell on us, Kevin and I take a collective deep breath and one look between us confirms the sudden detour this call has taken. In our business suicidal ideation is taken very seriously. A person who is truly suicidal, who has ceased to care about their own life, may not care about other people’s lives. Therefore, we can be in danger when dealing with these people.

Our new patient, Lil’G, is quite a formidable man. He has scars on his face, one of which is consistent with a knife wound. He’s 240 pounds of compact, short, boxer’s build with huge upper body development. He’s seriously built like a smaller Mike Tyson. He jokes with Kevin because he had to pull out the fat person blood pressure cuff just to fit around his huge biceps. He does a muscle man flex and smiles showing me a gold tooth. I’m feeling very uneasy about this. I give Kevin a look that he understands. “I’ll be back in a second.”

“Hey, where you goin’?” He’s quick with predatory instincts, watching every movement – nothing escapes him.

“I just have to get the computer from the front.” It’s a half truth which I hope he doesn’t see through.

Walking up to the front of the rig I turn on the portable radio on my belt. Opening the front door I grab the computer and turn off the rig radio which can be heard from the patient area in the back. I stand in front of the engine compartment so I can keep an eye on Kevin through the windshield as I call in to dispatch on my portable.

“Medic-40 go ahead.” The radio crackles back to me.

“Medic-40, please send PD to our location, code-2, our chest pain call just turned into a 5150 with suicidal ideation. We’re code-4, for now.” The code-4 tells my dispatcher that we are not currently in danger. The ‘for now’ tells her that I don’t know how long that’s going to last.

I’m standing outside of the back doors as Kevin is doing further assessments on Lil’G. Kevin knows the drill: we have to stall as long as possible so PD can get here to write up the green sheet (5150). Without it we have fewer of the options we may well need in this case, like restraints and chemical sedation.

I’m watching Lil’G as Kevin continues with the 12-lead EKG. Lifting up his shirt I see the multiple GSW (gun shot wound) scars.

“Lil’G, how many times you been shot?” Anything to distract him and buy us some time.

“Yo, I been shot four times, stabbed two, and sliced up a couple. It’s hard man, growin’ up in the 70s.” He’s not referring to the decade – to him the 70s are the street numbers in his corner of the hood.

“You ever do time?” I’m thinking prison ripped could explain the boxer physique.

“Yeah, I did six year, fo’ bangin’. You know; sellin’ a little, had sum ho’s, and a little bit a shootn’.” He’s not talking about shooting up with heroin. “Yeah, I got a strike on me.” In this state it’s three strikes for felony convictions and you’re in prison for good.

Kevin’s still trying to stretch out the assessment as I’m typing on the computer. “You got any medical problems?”

“Yeah, I got PTSD, bipolar, paranoid schizophrenia, and depression, but I ain’t takin’ no meds for it.” FUCK ME!!! I’ve got a bipolar psych patient who’s off his meds, built like Tyson, and thinking about killing himself. I really need a raise.

Lil’G could shred both Kevin and I if he put his mind to it. Not to mention tear the ambulance apart. We’re walking a fine line here and we have to keep him on the good side of his bipolar disorder. I’ve watched manic bipolar patients cycle from happy to violent a dozen times in the course of a single transport. If this guy cycles on us we’re fucked.

Despite the lethal potential of Lil’G he’s actually pretty engaging. He has a fast wit and keen observation skills. He decides I look like the silver terminator from Judgment Day, in reference to my hair style and clean cut white boy appearance. Seeing as the terminator impersonated a cop through most of the movie I’m not sure I like the reference.

“Yo man, that’s your new name, I’m gonna call you T2.” He has a full bodied laugh with muscles rippling to the diaphragmatic contractions. Great, I have a street name.

And just like that Lil’G cycles on us. Yet not to a violent nature – quite the contrary. Right there in the back of the ambulance he starts rapping. With perfect tempo and surprisingly colorful depictions he tells us what’s on his mind in the only way he knows how.

I’m on the microphone… gotta do it quick.

But never give a care… I ain’t scared to hit a bitch.

Gotta hit her from the back… nigga back side.

I don’t give a fuck nigga… it’s time for a wild ride.

 

Call me Lil’G… when you see me.

I see niggas on the street… trying to be me.

I got these knuckles man… I make ‘em laugh man.

Never give a care… put ‘em in a bath man.

 

Gotta do it good… cuz you know what’s right.

I never give a care nigga… cuz I’m hell’a tight.

I come from 69ville… nigga eight-five.

Never give a care… boy I don’t duck and hide.

 

I’m born on the east side… I’m going east bound.

You a block head… whose name is Charlie Brown.



Lachrymatory 3/3

We’re standing in the triage room of the county hospital and I’m giving a report to the nurse so she can assign us the proper room. The officer catches up to us and is working on his report as Scottie is taking some vitals on Anika. I catch the officer’s eye and do the head twitch to ask him to come over next to me. Still talking to the nurse I raise my voice just a little so the officer can overhear my report. “She was also treated for similar injuries at this facility two weeks ago; no ambulance that time and no police involvement.” The officer understands the game and scribbles in his notebook. He’ll question her about it later when he’s taking her statement.

Strictly speaking, that’s not a breach of patient confidentiality. If I know of a crime I have to report it yet everyone in the medical community is so touchy on the subject it’s best to use discretion. Above all else I am an advocate for my patients and will do what is necessary to make sure they get the help they need, be it medical, emotional, or involving law enforcement. Right now Anika is a minor who doesn’t have a single advocate.

We get Anika settled into a room and the officer sits next to her doing some paperwork. I give a quick report to the nurse that’s going to take over and start to walk back to the rig.

Turning the corner towards the exit I see Sasha. As she sees me she does a little dance in the hallway and does a fast high heel shuffle to give me a hug. Sasha is a bundle of flirtatious energy in an otherwise drab sea of scrubs. She’s always dressed like she’s headed to the club for drinks and has a smile for everyone. Her job is to handle the HIV screening for the county hospital and as such she has access to all of the records for the ED and offers screening for at risk patients.

“Hey pretty lady, how you doing today?”

“I’m doing fabulous! It’s good to see you. Are being safe out there?” Sasha always worries about us in EMS. She knows the hood and the people who live there by way of her work and always checks to make sure we are being safe.

“You know I’m always safe, I gotta come back to visit you.” We have an ongoing flirtation that’s a fun distraction from the realities of our respective jobs. “Hey, you want to do me a favor and talk some sense into a girl who needs a little help right now?”

“Sure, what you got?”

I explain whats going on with Anika and how she not only needs the HIV screening she needs someone to talk to that she can identify with. Sasha is the perfect person to set her straight on what she needs to do. Sasha says she’ll go talk to Anika and also try to get her screened. As she starts to walk off, she asks me a question that shakes me to the core.

“Is the boyfriend pimp’n her on the streets? That’s what they do. Especially a foster kid – she’s an easy target.” Damn! I actually didn’t put that together. 

Sasha has more street smarts than I do – she deals with this sort of thing all the time. And she’s right – that’s exactly what this was all about. This was a pimp beat down and I missed it. I’m relieved that I bumped into Sasha, knowing that she’ll know what to say to Anika and be able to get her set up with some domestic violence services for women.

I go back outside the ED to the rig and put the final touches on my paperwork before transmitting an electronic copy to the county and receiving hospital. Scottie is still engrossed in the word game on his iPhone. The wipers are still on delay, wiping away the rain every few seconds as if someone is wiping away the tears that are shed in the city on a daily basis. I transmit my patient care report (PCR) on the laptop and pick up the mic.

“Medic-40, we’re available, where would you like us…?”

Lachrymatory 2/3

The grumpy crime scene tech finally arrives and climbs into the ambulance with a camera to document the injuries. He’s a middle-aged bald guy with a goatee and a belly, wearing a jumpsuit and a badge. In big yellow letters on his back it says; crime scene investigator. I see him often and we have a running joke. “Man, CSI Hood, I sure thought you’d be prettier.” He just growls at me. I guess he is in a bad mood.

Once the photos have been taken we start driving to the county hospital. The officer tells me he’s going to meet us there so he can finish taking a statement form Anika.

Now that we’re away from the crime scene and alone in the back of the ambulance the reality of the situation starts to sink into Anika. She’s a minor who’s dealing with some very adult problems. She’s emotionally unprepared for everything that’s happening around her and has no active parents or advocate. The system has let her down and she’s quickly falling through the cracks.

Scottie did most of my paperwork on the computer while we waited for the not so pretty CSI tech, so I spend the ride talking to Anika and trying to calm her down. But it’s not working.

I had initially planned to just do basic treatment and only give her an ice pack for the pain and swelling. Yet with her emotional state I decide to more aggressively treat the pain with some Morphine. It will help with the pain a little but even more important it will calm her down so she can make some rational decisions in the next few hours.

As the Morphine slowly drips into her vein I watch the waveform of her respirations change to reflect a more relaxed state. Now that she’s calm we can have a more productive conversation. I continue where the officer left off in pushing her to press charges. I give examples of things I’ve seen on the streets in the hopes that it leaves an impression. I have a special affinity for kids in the foster system. I know from personal experience what they are going through and how the deck is stacked against them.

The statistics are grim. According to a local foster advocacy organization, youth in foster care are 44% less likely to graduate from high school. Less than half of former foster youth are employed 2.5-4 years after leaving foster care, and only 38% have maintained employment for at least one year. Sixty percent (60%) of women who emancipate from foster care become parents within 2.5-4 years after exiting care. Girls in foster care are six times more likely to give birth before the age of 21 than the general population. Parents with a history of having been in foster care themselves are almost twice as likely as parents with no such history to see their own children placed in foster care or become homeless.

I don’t give Anika these statistics – she’s had a bad enough day as it is. Yet it’s all in the back of my mind as I talk to her on the way to the hospital. She really doesn’t deserve this.

She’s much more relaxed now that the Morphine has taken full effect. I can tell by the way it’s effecting her that she has a clean system. She had no track-marks or signs of drug use. I think she’s just a good kid in a bad situation. She starts to feel comfortable with me and talks about her life. She mentions that she was in the same hospital two weeks ago.

“Why were you there two weeks ago?” I already know the answer…

“I got beat up and thought my nose was broken.” She has a slight slur to her speech from the Morphine. I noticed the minor swelling to her nose but thought it was from today’s beating.

“Did you go in by ambulance?”

“No, my boyfriend took me on the bus.”

“Is he the one who hit you two weeks ago?” She just nods her head.