Engine 43 covers an area comprised of an industrial waterfront, unaffordable homes on the bluff, and a portion of downtown, a colorful mix of decaying hundred year-old brick structures and newer construction. Historical buildings, vestiges of the lumber boom, some dating to the 1800's, house enterprises hawking cell phones, video games, and incensed New Age supplies. Cross the street, go next door; if you need auto parts, a sandwich, or a valve for a boiler system, you will find that too. Sleek banks rub shoulders with apartments, bump elbows with churches. The courthouse and the jail dominate their landscaped blocks with authoritative institutional concrete architecture. Sprinkled around the City, like candles on a cake, are the various huts promising drive-through convenience and Cafe Latte of dubious pedigree.
Taverns and hipster watering holes are abundantly represented in
the business district, as are their patrons, some of which constitute a steady stream of repeat business for the fire department. We find them in doorways, alleys, parking lots, the waypoints of the ambitious alcoholic's business travel. It's hard work, poisoning your body, and a short nap might be required, demanded even, on the stumbled path to elsewhere. Rare is the shift that we aren't dispatched to a man down, often called in by an anonymous do-gooder on a cell phone, from a passing car.The call to the Empire Street address was unusual, not for the time of day (2300 being a drunk's witching hour), but because we don't usually see this issue in the nicer neighborhoods, peripheral as they are to the commerce of intoxication. Brian, my captain, was suspicious that this was, once again, "Lieutenant Dan", a recently-arrived career inebriate. Lt. Dan, named after the character in Forrest Gump, lacks both legs, but, in his wheelchair, enjoys a vexing mobility. En route to 2514 Empire, our dispatcher verified, via a call back to the reporting party, that this patient was indeed possessing of both legs.
As we approached the address, someone stepped into the street, waving a flashlight, continuing even as we rolled to stop next to the aforementioned pickup. Brian trained the spotlight on the young man sitting cross-legged in front of the truck, and I stepped out, grabbing the kits from behind my seat.
Nicely dressed, this kid wasn't the bum I had expected, but flecks of vomit stained his shirt, clung to his cropped hair. "What's going on?" I asked, snapping the aid kit open. Gregg, our driver, joined me, adjusting the stocking cap on his shaved head.
"Where's my buddies?"
"I'd say they left you." I clipped the Oh-Two meter to a clean finger, "What's your name?"
"Jake."
"Been drinking?" (I have to ask.)
"Oh, yeah."
"What city are you in?" It's a standard question, intended to assess a patient's orientation to location, and I'll give the really drunk ones partial credit if they're in the right county.
"Uh... San Diego?"
Our captain was listening to the exchange, writing his report in the warmth of the engine's cab, "Ha! Try a place that's a little colder."
It was a surprising answer, but after the 22 year-old haltingly explained that he lived and worked on an aircraft carrier, hailed from a small town in Wisconsin, and remembered precisely where his parents and siblings lived, I gave him the benefit of my doubt. Gregg and I quickly worked together, collecting vital signs, which I relayed to my captain, standing below his open window.
I turned at the sound of retching, to see "Jake" vomiting copiously on the asphalt. The street gently sloped toward the gutter, and a tide of puke was flooding toward his pleated jeans. Ah... shit. Grabbing an elbow and his belt, I hoisted him to higher ground, preserving his remaining cleanliness and dignity.
"What did you have for dinner? Spaghetti-O's?" I am such a card."No. Nothing."
"Looks like you enjoyed a few appetizers..." The humor in the situation suddenly evaporated as the smell slammed into my brain. A hearty dinner of meatloaf and mashed potatoes, tenderly prepared by the medics, bubbled heavily in my stomach, boiled up, into the foreground of my awareness. I fought to contain the rising gorge and stepped into the cold breeze, inhaling deeply through my nose.
I stood upwind, at a distance, keeping an eye on my patient, waiting with my crew for the requested ambulance. The aid kit - my aid kit - lay open on the grass strip beside the curb, yawning up to the night sky, but I could collect it, and the airway kit, from the hot zone later.
Jake began to heave again, and, concerned that he might inhale vomitus, aspirate, Gregg and I moved in to steady him, holding his shoulders. Another fountain of pungent spew splattered on the pavement, and we clutched at his clothing, lifting him away from the viscous mess. Distracted by the task at hand, I gave no thought to my previous nausea.
And suddenly, standing there without focus, awash in that foul air, I was visited anew by the angry ghost of meatloaf past.Gregg fetched a towel to clean up Jake, dabbing at his face and shirt. I removed myself for another dose of fresh air. The ambulance arrived, and our captain described the situation to the EMT's.
"What exactly is his medical complaint?" It was an asshole question. Granted, I wouldn't want him in the back of my AMB either, but this patient clearly deserved transport, and, I thought, a little respect.
Gregg spoke up, "He's at risk for acute alcohol poisoning."
One more time, we entered the ralph zone to scoop Jake up and onto the stretcher, positioning him on his side lest he vomit again. The AMB guys wrapped him in a blanket, and buckled the straps, while Gregg retrieved the kits.
We climbed up into the warm cab. The ambulance pulled around us and then pulled over, presumably to take their own vitals and call the hospital. Gregg reached up and flipped the switch for the emergency lights. A few minutes later, Engine 43 was back in the barn. I wandered toward the kitchen, hoping to satisfy a mysterious craving for noodles in tomato sauce.
