Rooker | The Positive Paramedic Project | #110 You’re not dead?!

Norm

This is a repub of a 2008 Norm Rooker column.

“You’re not dead?!”

Just what is the correct response when this is the initial greeting from someone who knew you from back when? The occasion was the 2008 Fire-Rescue Med Conference in Las Vegas. I was attending the national roll out for the Ambulance Strike Team Leader class. (A good program and one well worth taking by EMS supervisory and middle management types.)

It was the opening part of the class where each of us stood up and introduced ourselves, who we worked for and how long we had been involved in EMS. Because this was a roll out, there were a number of us older dog medics taking the program to evaluate it for our services or areas, so my almost 35 years of EMS experience only earned me a fifth place seniority ranking in the class.

One of those ahead of me turned out to be a coworker for a service I worked for back in the late 70’s after graduating from paramedic school and prior to being hired by the City of St. Louis EMS. After he introduced himself and I was thinking that he looked familiar he turned to me and uttered those words.

We all had a good laugh and when you’re greeted with a public comment like that from a senior medic your class reputation is well on the way to being established. The ASTL course progressed and while we ran a little long with anecdotes about EMS responses to Hurricane Katrina, various earthquakes in California from the 1989 Loma Prieta Earthquake to the North Ridge Earthquake and more recently, the EMS response to last October’s wildland fires in southern California and even the recent papal visit to Washington, DC, the material was all relevant for the tasks that needed to be accomplished.

Afterwards I pondered my former coworker’s statement. This was not the first time I had heard this sentiment. Fourteen years earlier at my 20 year high school reunion I ran into Mr. Petty, one of my senior year English teachers. He was walking towards me and when we got close but before I could say hello he stopped dead in his tracks.

He looked at my name badge. After all I had filled out some since graduation and was well on the way to balding, make that bald. Some of that by nature and maternal genetics and the rest enhanced by an ambulance accident where I flew head first into the front cabinets and avulsed the top of my head down to the skull.

While I had serious railroad tracks and a growing yamaka spot, I still had hair on top of my head until that moment. They had to do a skin graft to cover the wound and I was darn lucky that I hadn’t broken my neck. I still have an arthritic thoracic vertebra from that accident. But that was five years prior to the reunion and I was healed up now.

Anyway Mr. Petty looked at me, looked at my name tag again, sighed and stated something along the lines that I was one of the ones that he was sure would be listed as among the honored dead by this reunion and that he had actually been surprised to see me at the 10-year reunion.

I just snorted and said ‘Nope, I was still here and planned to be for awhile’ but at the same time I was a bit taken aback by his comments. After all, it wasn’t like I was a hood, stoner or troublemaker in school. It was more that I was not what you would call a low maintenance student or employee.

Well that and the fact that I was not afraid of confrontation.

I attribute this to the times and to my parents. And for that matter my grandparents. My maternal grandmother was an active young lady who lived in the fast lane of her times. Think of the musical CABARET. Grandma Stamat was a flapper and was living the Berlin cabaret and nightlife scene when Hitler’s Brown shirts did Krystal Nacht. Being an American citizen she was able to get out but almost my entire maternal family line for her side of the family was lost to the Holocaust.

Her second husband, my mother’s step-dad but the man I knew as my grandfather was a loud character. A merchant seaman stuck in Hong Kong during the Boxer Rebellion, a US Calvary man who was part of the American Expeditionary Forces that chased Pancho Via into Mexico and a few years later was in one of the first units to go to France in World War One. He left the Army after the war and worked a number of jobs including being a union “enforcer” in the Chicago area during the labor troubles and organizing in the post war and depression.

My father was an Iowa share cropper’s son, the third of six kids, born on my grandmother’s 20th birthday. He was an all-state athlete who battled with an abusive father, dropped out of high school at the end of the football season his senior year. And in the American tradition, after meeting and falling in love with my mother, and powering through my grandfather’s initial disapproval, pulled himself up by the bootstraps, worked his way through college and became a very successful Chemical Engineer.

I was the oldest of three kids. My brother JD and my sister Meredith were three years younger. My sister was very severely mentally retarded and had both Down’s Syndrome and Hurler’s Syndrome. So from a young age I always had to come straight home form school to help take care of my brother and sister so mom could do chores like grocery shopping and getting dinner ready, etc.

As we kids grew, my parents were moving into the middle to upper middle class. We were living in a suburb of New York City and had the benefits of their hard work. But my parents wanted us to appreciate how well we had it compared to what they had when they were growing up. So my mom came up with the Christmas letter program.

Each year she would go down to the main post office in New York City and read through the letters to Santa Claus. She and my dad would select a destitute family, contact the parent or parents and make sure it was OK, and then get my brother and I involved in providing Christmas presents and dinner for them.

Everything from going through our own toys and picking out something that was in good condition that the letter identified these kids would like, to purchasing, and gift wrapping other presents. Then as a family we would drive into some of the worst parts of New York City and make the delivery.

It was an eye opener and a tradition that Vicki and I continued for several years with our own children.

It was also a time of the early civil rights and women’s liberation movements. When I was 11 my mother and father signed up for the Fresh Air Program. This was a program where we would host two inner city kids, Larry and Marshal, for what turned out to be the next four summers.

All this BS about race and other differences mostly disappear when kids just get to be kids. I learned that not all black people are natural athletes. That they were able to get sunburned, too.

Each summer we would go down to Fenwick Island near Ocean City, Maryland. It wasn’t until much later that I realized that these weren’t really vacations for my parents, however we kids always had a great time.

Swimming, fishing, crabbing and learning how to play draw and stud poker for sea shells. (I ended up with a pretty neat shell collection which I held onto until my junior year in high school when I passed it on to a lovely young lady.)

This was during the mid to late 60’s and race relations weren’t exactly all they could be in that locale back then. One or the other of my parents had to get up early every morning and accompany us four boys to the beach or to the bay to ensure our safety.

We didn’t appreciate this sacrifice back then. We were just four boys between the ages of 8 and 12 having fun. All four of us would be at the beach playing in the ocean and sand all day. The third day we were there was a particularly bright and brilliant day and boy did we pay for it that night and the next day.

Larry and Marshal became such a part of our family that when my parents decided to divorce after my sister died, they waited until the Christmas Holidays so all four of us kids were together before they announced it.

Prior to that sad moment, my mother had also became involved in the Women’s Liberation Movement. I was 14 when she began hosting women’s self help medical exams at our house the third Sunday of every month. While I had no idea what this meant, it was pretty cool because my brother and I got to go to the movies those afternoons.

I didn’t find out what was actually going on until a few months later when my mom sent me up to her room to grab a flashlight out of her bedside drawer and I found a plastic speculum. My 14 year old mind did not have a clue what this was for but I brought it downstairs with the flashlight, holding it upside down and making quacking noises as I asked my mom what it was.

That old cliché about being careful about what you ask for comes back to mind as I was sat down and learned way more than I ever wanted to. At least at that time in my life.

My sophomore year of high school I was on the wrestling team. After a long six weeks of hard practices I had made the decision that it was time for me to bring my jock strap home and wash it. (You know it’s got to be bad when a 15-year-old boy decides this garment is to gross even for him.)

By now my brother and I had been doing our own laundry for a couple years. While I was sorting my clothing my mother was trying to come up with a poster idea for the first parade for the ratification of the Equal Rights Amendment by the New York State Legislature.

This is where being a creative smart butt sort of got me into trouble, again. As I was moving my crusty bit of athletic apparel to the whites pile I said something along the lines about putting a bra and a jock on a poster with something about equality.

My mom yells “Brilliant!” and snatches this stained and crusty item from my hands. My pleas to at least let me wash it first fell on deaf ears and that is why my jock strap along with one of my mother’s black brassieres and the words, “Ratify the ERA, Connecticut NOW” appeared in what turned out to be one of the most photographed posters of the rally with numerous shots of it in the New York Times and the New York Daily Post.

Needless to say, backing down or shying away from a challenge or trouble was not a family trait.

At that time in my life I was somewhat active in sports. Not a great athlete but game, if a bit on the lazy side. I was active in Boy Scouts and a cadet in the Civil Air Patrol. My squadron ran a ground SAR team.

Through these organizations I took basic and advanced first aid training as well as both the American Red Cross junior and senior lifesaving programs.

I was also in Future Teachers of America and I taught swimming Friday afternoons to the developmentally disabled class as well as wrote and worked on the student newspaper. All of these activities taught me to question what I didn’t think was right or pursue the question until I understood it.

The upside was that all of these activities led me to be selected for the second pilot EMT course they ran in the State of Connecticut in 1973 over the summer between my junior and senior years.

One of the downsides was that I sometimes clashed with or challenged authority. Never, ever in a destructive or mean spirited way. Well, I was suspended for fighting once my senior year but that was a provoked situation and testosterone rather than thinking things through got me in trouble on that one. I made the best of it and spent my entire suspension teaching PE over at Western Junior High School.

But overall I was a good kid. I accepted no for an answer, eventually. Never in trouble with the law and a decent, if underachieving student.

The fall of 1974 I reported to Ripon College, in Ripon, Wisconsin. A small enough school that it was possible to be a walk-on and actually make the football team. I had never played organized football before but I was just big enough and apparently just good enough to make the team.

I was a nose tackle. I had never thought of myself as being particularly small but I quickly learned that at 5’10” I was shortest lineman on the team. It turned out I was the shortest defensive lineman in the entire conference.

I learned very quickly, actually with the “help” of my philosophy instructor that physical size was only part of the equation when it came to battle on the line. You see, my Introduction to Philosophy professor also happened to be the offensive line coach.

If I “discussed” an opposing point of view too much in his class that morning, that afternoon he would “borrow” me from the defensive line unit to run what can be best described by Gary Shaw’s 1972 book, MEAT ON THE HOOF: The Hidden World of Texas Football, as Shit Drills.

I would go one on one with each member of the offensive line. Pass rushing as well as just your standard one on one confrontation for dominance of the line. Then there was the two-on-one, trap blocking drill. This is where the center or offensive guard in front of me would pull away and I would be hit by the offensive guard or tackle next to him.

But my absolute “favorite” was the interception drill.

I would be pass rushing against five of them protecting the coach who would toss the football just over their heads. I would have to leap up and catch it and they would have to react to my “interception” by stopping me from gaining any yardage. I crawled home from those practices.

Heck, I was the third shortest member of the team. I was lining up against guys so much taller than me that at eye level, I was looking at their neck and in two cases, the number on their chest when we both stood up straight.

For that matter only two of our cheerleaders were my height or shorter.

As a lineman I was mediocre at best. But I learned how to hold my own and think through ways to use what I had to my advantage. And I never did seem to learn the other lesson my philosophy instructor was attempting to teach me.

As a nose tackle, I was third-string on a two-string team. Ripon being a small college. But on special teams, that was an entirely different story. Man, for an AADD type, it was the best gig on the team. For me, that was where it was at! All that building excitement and noise leading up to the ball being kicked and running down field, the crowd roaring and the wind whistling through the ear holes of my helmet as I lined up on one or two members of the receiving team and just piled into them.

As with many things in my life, it was a matter of luck and opportunity coming together to help me in ultimately being named “Bomber of the Year” by the coaches. But as usual, I am getting ahead of myself.

In 1975, the NCAA, in an effort to cut down on knee injuries made it illegal to throw a cross body block below the waist on kickoffs. Guys that had been playing football since Jr. High and High School had all been taught the cross body block method or to slide feet first into the opponent.

Consequently, in this first season of the new rule, none of them really knew how to hit or block their opponent on kick offs. I learned by accident the first time. I stumbled while trying to turn to adjust to the ball carrier and in a high speed stumbling fall just happened to wipe out the guy in front of me. That’s when it occurred to me.

Most people don’t want to be hit. No matter what their size. They would rather push and shove. Fortunately I played for a pretty good team and was able to put my theory to test in the next quarter. I picked the biggest guy on the receiving team and cleaned his clock.

After that I would just sail down field, pick my target and take them out — opening up a hole in the wall for the other members of my team to take down the ball carrier. I never once directly tackled the receiver, although one time I did hit a blocker with enough force that he took out his own ball carrier.

Between the values my parents and grandparents taught me, the responsibility for taking care of those less fortunate or weaker than me from an early age, to that lessons I learned on the football field, to finally, the lessons Liz taught me (see March 16th’s column Tough Enough) I apparently was what you might call a high profile EMT and later paramedic.

Staying below the radar just wasn’t in my nature.

I never abused patients or derelicts. I never picked fights. For that matter, I never, ever punched anyone. That is an offensive tactic. My father taught me that there will always be someone bigger stronger or faster so fighting is always an option of last resort.

But if you do take that course. You don’t do it to come in second. And you never do it to showoff, or bully.

This has been my philosophy throughout my career on and off of the streets.

That included Special Operations such as rope rescue, structural collapse rescue, firefighting, Tactical Medic, etc.. Along with some of the interactions at certain fire houses after our “merger of equals” where the Paramedic Division was removed form the San Francisco Department of Public Health and inserted into the SF Fire Department in 1997.

But getting back to last week’s Fire-Rescue Med Conference, I ran into another former coworker, Jonathan Chin, who Vicki and I had worked with at Medevac in Santa Clara County, CA back in 1985/86 while we were waiting for the City of San Francisco to pick us up. Medevac had the contract to provide EMS for the southern half of the City of San Jose and Santa Clara County.

Jonathan is a handsome and articulate Chinese-American who quietly radiates leadership and charm. While neither of us were ever partnered up with Jonathan, we often ran into him and his partner, Cindy Petretto at various hospitals. They were a good solid crew. Medically dialed in and they always pulled their share of the load.

One day my partner and I had brought in a middling-serious trauma patient from a motor vehicle accident to Valley Medical Center — The Big Valley, a level one trauma center. At that time the ER was one long room with gurneys down either side, a nursing station in the center, two trauma rooms and in the back, a sort of three-bed quiet area for less acute patients and folks that needed sobering up.

While I was writing up my PCR, Jonathan and Cindy came in with a huge biker type. I mean pro-wrestler size. Multiple abrasions and reeking of alcohol. As they were wheeling him towards the “Quiet Room” he kept muttering abuse towards Jonathan.

“You Gook”, F***ing Gook”, “You slimy Gook”, ‘You..”, well, you get the picture.

Jonathan ignored him and Cindy rolled her eyes at us as they wheeled him past and into the Quiet Room. A minute later Cindy came bursting back out.

“Help! He’s going to kill Jonathan!”

Paperwork went flying as my partner and I and another crew from SCV, the company that had the EMS contract for the northern half of San Jose and Santa Clara County beat feet for the room while a nurse called security.

I was first through the door and there was Jonathan trapped in a corner between the walls and a hospital gurney. His angry patient was towering over him. But Jonathan wasn’t cowering or blustering. He was standing tall in a neutral stance looking up at the belligerent biker.

As I started to take my leap to tackle this guy high I heard Jonathan say, “Lets get one thing straight. It’s not gook, it’s Chink!”

Now that’s being calm under fire. Jonathan has since gone on to obtain his master’s degree in administration of EMS, has been the EMS Director for the State of Oregon and now runs EMS for a large county in northern Oregon.

While we were catching up on each others lives, respective families and careers I mentioned the comment in class about a coworker acting surprised that I was not dead by now.

He smiled and stated that while I was never a bully or troublemaker, per say, even with union activities, that the reason some people might get that impression is that I was always in the middle of things. That no matter what, an assault on a coworker, a working condition or a protocol or procedure controversy, I always stepped in and did what needed to be done or said what needed to be stated. And for those that sat on the sidelines, that level of risk taking was seen as either threatening or something that could lead to unfortunate or negative consequences.

I smiled back as his observations made sense to me. And yes, there have been rewards, triumphs, consequences and scars. So Mr. Petty, Professor Boweles and countless others I have known, worked with or for over the decades — I’m still here and plan to be for years to come.

Be well. Practice big medicine.

Norm Rooker

Tough enough

It has been a long winter up here in the mountains of southwestern Colorado. 158% of normal snowfall and it’s still coming with another 12-16 inches predicted for tomorrow. I was talking to one of my neighbors this afternoon and he mentioned that he was ready for this winter to end. That he was about out of tough.

We talked some more but his words kept echoing in my mind. Sort of like when you hear an insipid song and can’t get the lyrics out of your head for the rest of the day. Which got me to thinking, just what is my definition of tough?

Over the years one hears numerous trite clichés for toughness. You know, “Cowboy up!” “When the going gets tough, the tough get going.” “Soldier on”, “Quit your crying and put your big girl panties on!” I actually overheard one of my volunteers say this to a whining patient last year and if it wasn’t for the fact that it was both true and my volunteer was also a woman, I might have had to act on that last one.
Some other clichés we’ve all heard include “Don’t be a wuss” and “Don’t be a puss.”

Digressing here for a minute on this last one. Puss, short for pussy which actually has nothing to do with either a feline or a part of a woman’s anatomy. According to one of my former partners and longtime friend, Russ Zimmerman, a high-speed, low-drag medic of the old school variety who also has a fascination with words and word origins, Pussy is slang for Pusillanimous. Which means to be faint-hearted, cowardly or afraid.

But one of the most recent terms I’ve heard that while I can appreciate the sentiment behind it, rubs me the wrong way is “Man up.” Used in a sentence like, “C’mon and man up!”.

The reason for my annoyance, aside from the shear sexism of it, is the toughest person I’ve known or worked with, indeed my definition of tough is a former partner of mine, Liz Crawford.

Set the way back machine for 1981. I was a newish paramedic employed by the City of St. Louis EMS. St. Louis was one of the oldest municipal ambulance services in the US. Created shortly after the end of the Civil War. St. Louis was a tough city by anyone’s definition. Heck, back then each police station, with one exception, had an ambulance assigned to it.

This was both because of the central locations in the various neighborhoods of the city, but also because back then, St. Louis PD had the culture of being pretty darn stick heavy. Dirty Harry would have been just an average member of the St. Louis PD.

On the negative side, St. Louis EMS was listed as one of the three worst municipal ambulance services in the US in a 1979 article in the now defunct EMT Journal. That same year the St. Louis EMS administration made the decision to make all the ambulance crews salt and pepper, so to speak.

Heck, I learned one of the main reasons I was hired on in January of 1980 was that I had done my paramedic training in Detroit so administration figured that I was one white medic that they would not have a problem placing in the north side of St. Louis. Which was true.

Racially St. Louis was a bit behind the times. In the fall of 1980 the courts were just getting around to ordering bussing to balance the racial make ups of the public schools. And while they were some mixed working class neighborhoods, there were still plenty of all black and all white neighborhoods as well.

So into this violent and racially charged mix, I began my civil service career as a paramedic. Heck my 4th night on the job I was in quarters at the 6th District Police Station with my partner Ace Boyd, an older EMT in his 50s who was trying to show me the ropes and explain how things really worked. Ace had been working for the city as an ambulance driver since the early 1960’s, back when they ran one man ambulances and shared a lot of great stories about the system but I would be digressing again if I repeated them here.

Anyway, Ace was just telling about how he would drive the ambulance up to City Hospital Number One and ring the bell mounted on the ambulance one time if he needed a wheel chair and twice if he needed a hospital gurney for his patient when we heard a shotgun blast go off close by.

Make that inside the police station. A psych patient, or OBS as they were known in the local vernacular, had ripped a shotgun out of the rack of an unlocked police car and gone inside and shot the desk sergeant. The only other officer in the station was the lieutenant who fired at the fleeing perp with his service revolver.

The perp ran across the street into a cemetery while we were being dragged into the station to treat the sergeant. As he took his last agonal breaths, sirens were coming from everywhere. I intubated him, and he was my first ever field tube, and then began CPR on a chest that was mush from the blast while a major gunfight ensued. In the meantime Ace ran out and got the ambulance gurney and a backboard.

We worked the dying sergeant up a little more. Enough time to sink an external jugular IV, secure both it and the tube and then we loaded him into our ambulance for a wild ride to Fermin Desloge Hospital at up to 80 mph through city streets with a flying squadron of a police escorts clearing the route for us. All the time with me doing CPR in the back pausing only long enough to ventilate or push the occasional drug. It wasn’t pretty.

This was a “Humpty Dumpty” resus. All the king’s horses and all the king’s medics could not revive this man and he was pronounced dead shortly after our arrival at the hospital.

The perpetrator suffered a similar fate with over a dozen gunshot wounds and two sets of tire tracks across his torso.

And as for me, I had definitely jumped into the deep end of urban EMS. It was sink or swim and as the ALS part of a one medic, one EMT unit, I had to either swim or drown. So swim I did. Not always gracefully or with style.

But we always made it while giving the best possible care we could for our patients. Although in retrospect, while I have to acknowledge that I learned my craft at some of their expense, it was never malicious.
What management hadn’t counted on was that along with becoming a competent medic, I also both read the rule book and had a low tolerance for bad management and unequal application of the rules.

The reward for being right and catching them out on a work rule violation, again, was to be moved arbitrarily during the next sign-up period to a day watch on Medic 8 with EMT Liz Crawford.

Liz was a few years older than me and had quite the reputation. She was known as the Black Widow among the paramedics, who were mostly white males, because she had a habit of eating male partners alive. She was also known by various other monikers such as “Dynamite Liz” because she was known to have an explosive temper. And by some shallow types as “Liz-a-bitch”.

But in talking to my previous partners, all black, I learned that she was a good EMT who cared about her patients. Strongly. I figured that was all I really needed to form a good working team.

So our first couple watches together were interesting. And I’m not using the word in that east coast, New England way. You know. When you can’t think of anything nice to say, you say it was, “interesting.”

Getting back to the first few shifts with Liz and myself as partners.

Well, think pack mentality. Two alphas approach, circle, sniff and check each other out. The fact that I cared that the ambulance should be adequately stocked and after calls restocked, but didn’t dump the entire responsibility onto her played into my favor. After checking each other out on calls we found we had a fairly similar approach to patient care and fortunately, I didn’t try to boss her around or attempt to play para-god with her.

I also believe that the fact that I had a strong EMT background. Six years before going to medic school and then taking my first job out of school with a private ambulance service that had the 911 contract for Washtenaw County, MI that was about to go ALS but hadn’t yet. At the time, as a paramedic all I could do above BLS was hook the patient up to a heart monitor, a LifePak 4, and once they went into cardiac arrest, insert an EOA. What this screwed-up system, that never did go ALS and ultimately went out of business did teach me was that the basics worked. With a paramedic education and the assistance of just a couple of tools, I relearned that BLS before ALS except in a very few circumstances, worked most of the time.

So consequently, by the time Liz and I were partnered up, I had developed the reputation as not being one of those paramedics that had forgotten where he had come from and didn’t try to treat every problem by wanting to establish an IV or hook the patient up to the heart monitor.

But what sealed the deal for us was that certain elements of management liked to screw with Liz just to watch her get angry. Our fourth watch together Liz had relaxed enough around me to vent about the latest mind screwing, phrased differently at the time, she was receiving from a certain EMS supervisor and deputy chief.

A few minutes into this I learned that she had filed a written complaint and it had been ignored, again. I mentioned to her that according to the rules, that management had three business days to answer a complaint and if they did not, then the employee had the right to resubmit the complaint to the next level of authority along with a comment that the original complaint had not been acted on within the specified timeline.

At first she just looked at me like I was on drugs. But after we returned to quarters and I showed her the section in our employee manual, and then went on to point out that the bosses had to answer to their bosses as well and they could get in trouble for ignoring her, she shook her head and walked away.

I figured that was the last of it. When I returned from our three days off Liz had a big smile on her face and was waving both an acknowledgment of her complaint and a written apology from the same supervisor and deputy chief for not acting on her complaint in a timely manner.

The same portion of management that thought they were teaching both of us a lesson by putting us together suddenly were starting to have second thoughts.

In the mean time Liz and I, while opposites in many ways, became a tight crew and grew to be pretty good friends. We banged the calls out and would even jump other crews’ calls. By God! We were getting paid for 10 hours of work per shift and nothing made the watch go by faster than banging out the calls. Especially the good ones. And in 1981 St. Louis had beat out Miami for murder capitol USA so there were plenty of hot calls.

(Miami, frustrated that we had snatched their 1979 & 1980 titles away from them, reclaimed the title in 1982. I would like to think that it was in part because we had a better EMS then they did and more of our victims survived the event then did theirs. But that is probably just fanciful thinking.)

I also learned first hand that Liz was tough. I mean pure mad dog mean and tough. There was no backing down with that EMT. We would roll up on a call and someone would start screwing with us. Usually by attempting to play the race card on me.

I never had to say a word. Liz would be up in their face. And size didn’t matter, Liz was 5′ 7″ and rail thin but, well as that old cliché goes, “It’s not the size of the dog in the fight…”

Before I could even say a word she would be cutting the line of racist drivel off. It usually went something like, “Look you called for a paramedic, well Mr. Rookah is a paramedic. If you are or whoever you called for is doing so well that you can run your jaws about his color rather than have him look at your friend, then your friend can’t be all that sick!”

That’s putting it politely. It was usually a whole lot more colorful and intense.

By now the hapless individual, usually a male, would be backing up and trying to figure out how they were going to get themselves out of this problem. She would be staring them down and I would step in and say something like, “why don’t you show me where your mother is” or “why don’t you get your wife’s medications for me” or some such line.

These poor guys were usually in such a state of shock that they would mumble something like she’s over here and all thoughts of race went out the window. Which was a good thing. Because if I didn’t step in, about half the time, the hapless male who had started things would try to recover his dignity and the game would be on.

And it would pretty much always end the same way. Eventually he would get around to saying something along the lines of “You can’t say that to me. I’m a man!”

I could be doing CPR and when I would hear those words I would leap up because I had another life to save. I would insert myself between the two of them and redirect the guy on to some task because if I didn’t, the next words out of Liz’s mouth would be, “Just because you got that between your legs don’t make you no man!”

And then the fight would be on. And Liz would win and I would have a second, now wining patient to deal with and paperwork to fill out. I never got directly involved in these conflicts. There was no need to. I just covered Liz’s back and stood down anyone else who attempted to jump in, which was infrequent and occasionally got it on with the rare fool who tried. As a crew we never picked a fight. But we never, ever came in second either.

We had a good working relationship with the coppers in our station. The way the system in St. Louis worked back then, we almost never ran with the fire department, unless it was for a fire or a vehicle accident. If we had a cardiac arrest we ran a two person code until a second ambulance arrived to assist with the code and transport. If we needed a lift assist, our district police officers would respond to help us out.

As I mentioned, we had a great working relationship with our police officers. Both on the street and in the station. Where we would frequently be called upon for a curbside consult on some injury or medical condition that one of them or a family member might be having.
Hopefully I have set the stage for the call where Liz went from being a tough partner in the good way to becoming my definition of tough.

It was a sunny late March weekday morning and we were dispatched to an apartment building to evaluate an elderly woman on an unknown medical. We were met at the door by one of our police officers who had just gotten off the night watch.

His mother was a widow and he usually called her each night and again in the morning when he got off before going to bed. He hadn’t been able to reach her all night and when she didn’t pick up the phone this morning he went over to check on her. And then called us.

Liz and I followed the officer into the very neat apartment to find a woman in her 70’s laying on the floor, staring at us but unable to speak or respond to us. It was only 08:45 but her electric clock, which was unplugged and laying on the floor next to her read 9:17.

Just then she had a grand mal seizure. Liz and I rolled her into the recovery position and placed her on a high flow oxygen with a non-rebreather mask. The officer remained calm and told us his mother did not have a seizure history and the only medications she was taking was for high blood pressure.

The seizure quickly ended and she almost immediately returned to staring at us like she understood what was going on but could not respond or move. Her vitals were elevated and her BP was sky high. There was no doubt in either Liz’s or my minds that this woman was having a stroke and it had started over 11 hours ago.

The officer and I sit-picked his mom and carried her into the front room of the apartment. In the meantime Liz grabbed the jump bag and ran out to the ambulance and single-handedly unloaded our Ferno two-man gurney, dragged it through the snow, up the seven front steps and in to us.

The three of us loaded the woman onto the gurney, who was starting to have another seizure, and made our way out to the ambulance.
Some of you may be wondering why we didn’t start and IV and break the seizures with a dose or two of Valium. The answer is as simple as it was stupid. We didn’t have any.

We carried it when I had been hired in January of 1980. But in 1981 it had been pulled from all of the units. Not because we didn’t know how to use it or there were inventory control problems with it in the field. No.

It seems that five units of Valium went missing out of the drug locker in the EMS supervisor’s office. Management’s solution. Remove Valium from our drug inventory.

So we were back to the ABCDs for taking care of this patient. And unfortunately the D did not stand for Diazepam, but rather diesel.

We were at the back doors of the ambulance. We had just lowered the gurney down to the ground and were about to pick it up when our patient went into her third seizure. Liz and I picked the gurney up and had just gotten the front wheels up onto the ambulance deck when disaster struck. I felt the gurney start to pull back on me as I was pushing it in and out of the corner of my left eye I saw Liz’s right knee buckle and bend backwards in way that it was not designed to do so.

I stopped the backwards movement of the gurney and shoved it in from my side dragging Liz up to the back ambulance door. I looked at Liz half bent over, clutching the door with her left arm to keep from falling over and her knee with her right hand. Her face was a mask of guarded pain.

I quickly made one of those medic decisions reformulating a course of action I thought would take care of both of my patient’s problems. Like I was in charge or something.

“Look Liz, let me get a line started on our patient and then I’m going to put you in the captains chair. Just guard her airway and I’ll have another crew meet us at the hospital.”

Liz looked up and grabbed me by the front of my shirt with her right hand.

She was still hanging onto the ambulance door with her left hand and she fixed me with “that look”. The kind where you suddenly start hearing the song from the final gunfight in the movie “The Good, The Bad and the Ugly” in your head. The kind that made me know that there was only right answer and everything else would be pain or worse.

“That lady needs a paramedic so get your paramedic butt in there and take care of her!” She gave me a shove and then turned to close the doors.

As I got our now postictal patient hooked up to the heart monitor and switched her over to the onboard oxygen I heard Liz clawing her way down the side of the ambulance, dragging herself by the rain gutter along the roof and painfully pulling herself half step by half step to the driver’s door.

I listened as she let out a little cry/grunt of pain as she pulled herself into the driver’s seat, start the unit up and proceed to give us a very smooth code three ride to Barnes Hospital. All the while driving and braking with her left foot.

I got two IVs established and radioed ahead for a crew and a supervisor to meet us at the hospital. That my partner had blown her knee out and that we were code three with a seizing stroke patient.

Liz got us to the hospital where we were met by two crews, followed shortly thereafter by both EMS supervisors, the deputy chief and the chief. Liz consented to let us unload the patient without her help.

After giving a quick hand-off report to the ED staff I left the other crews to move the patient to the hospital gurney, grabbed a wheel chair, because I knew Liz would not tolerate a hospital gurney, and went back out to the ambulance.

I would like to say that Liz started to pull herself out and this time I grabbed her by the front of her uniform with both of my hands and firmly pushed her back into the seat. “You’re not going anywhere until I splint that leg.”

And you know what, she let me.

I bound her good leg to her injured leg and then picked her up in my arms and set her down in the wheel chair. One of the other medics handed her an ice pack which she put on her knee and I wheeled her into the ED and over to a hospital gurney. I picked her and put her on it as gently as possible.

When the grimace cleared from her face she smiled at me and whispered, “Not bad for a white boy.”

But that’s not how it happened. I brought the wheel chair out and went to pick her up from the driver’s seat to place her in the wheel chair.

She pushed me away while saying “Get your hand off of my butt.” It was said with a smile through the pain as she lowered herself out of the ambulance and sat down in the wheel chair.

I wheeled her in to the designated ED cubical and she did consent to let me support her injured knee and leg while she climbed out of the chair and up into the bed.

But the call wasn’t over. By now I had two other EMS crews and the entire EMS administration behind me. I turned around to the bosses and firmly but quietly stated, I was told later, hissed, that Liz was going to be taken care of right here. At Barnes Hospital. That I didn’t care what the rules said, we were not going to transfer her to City Hospital Number One.

Apparently some of Liz’s toughness and reputation had rubbed off on me and both chiefs quickly reassured me that this was exactly what was going to happen. And it did.

Two days post-surgery I brought 3 of Liz’s favorite things up to her. A two-liter bottle of Pepsi and two large bags of bar-b-que potato chips. She was pretty doped up on pain meds but was with it enough to thank me.

But the best was the “IV”. I had emptied a 250 cc bag of D5W and refilled it with a half pint of scotch and spiked it with macro drip tubing. I grabbed a medication label from the nurses station and marked it as such. I made sure all the nurses knew that it was scotch and not to plug the line into her and then hung it up by her bedside with the tubing within her reach.

I pretty much finished my career with the City of St. Louis on Medic 8 and worked with several more good partners but those are stories for other columns. Liz was a long time in returning to the street. We partnered up again for one watch and then went our different ways, me ultimately relocating out to San Francisco in 1985.

During the course of my EMS journey, I have had the good fortune to work on some good units with mostly good to some great partners. Along the way I also had the chance to become a SWAT medic, a structural collapse/USAR technician and medic, a surf rescue swimmer and a cliff rescue type. A lot of opportunities for testosterone and adventures.

But throughout my 34-year-and-still-going career in EMS, Liz Crawford stands out as my platinum standard for tough. Partner tough and loyal. EMS tough and getting the job done. Street tough without crossing the line and becoming a bully.

Thanks Liz.