He’s seen a few presidents, and he’s known a few good decades. Right now, he’s hanging out with me, because his head laceration is impressive. Fire did a great job of bandaging the wound up, but no one’s addressed the puddle of blood just yet. His speech is slurred, refined but slurred. I’m making his acquaintance as I put on my three lead, take my first blood pressure, scope out the oxygen saturation level. Everything checks out within normal parameters, so I press on. No odor of alcohol, blood sugar also within what I’d like to see. He cocks his head, then, looks at me.

“I sound funny.”

“Funny ha, ha?” I ask lightly, carefully watching him. 

“My words – like I’ve been drinking. I haven’t been.”

There it is, then. Altered from his baseline – and he knows it. Assessment continues, he denies loss of consciousness, denies any neck pain, CMS is intact, on down the line. Cervical collar in place, we assist him to a standing position and with the cot positioned behind, guide him to be seated. Securing him with straps, wheeling him to the truck, loading him within. Once inside, transport begins as secondary assessment shows no new findings. Eyes equal, round and reactive to light – I go on down the familiar road of assessment. I keep up a light banter about the weather, the circumstances surrounding the purpose of my arrival at his home today. I circle back around some details so he ends up re-answering questions he’s already answered. His answers remain on point, consistent.

Radio report complete, we walk inside wheeling the cot and I give report at bedside; turn over care. We remake the cot, get the face sheet, scan it in the system, mop the floor where the cot wheels left their salty tracks, return to service. Rolling out the opening garage doors into the bright sunlight, I blink and reach for my sunglasses. My partner is telling a story of a shift a few days ago, and as the cab fills with our laughter, I tell myself I’ll follow up on this slurred speech head laceration gentleman.

When I return later, no one from that shift is still on. No one can tell me the outcome. The patient isn’t in the room anymore.

I walk down the hall and the sense of sand shifting beneath my feet is so incongruous in Wisconsin winter.

*~*~*~*~*~*~*~*~*~*~*

We’re heating up our leftovers from home and the station is filling with good smells. Well, you know what happens then, so often as it does now. Overhead, “bleedle bleedle bleedle, 302 you have a call at blah blah blah, female ate some fish, now feeling gaggy.”

I look at him, he looks at me and I imagine my face looks much like his.

“Gaggy?”

Food back in containers hastily, containers in fridge. Grab a water bottle in case I don’t see the station again for a few hours, throw the radio strap over my left shoulder and hook it on my right rear belt loop. I climb in, hit the garage door and hold my key fob up to the ignition until it beeps so the on board system knows who’s driving. Door goes up and we wheel right, then right again.

“MedComm, 302 updated, en route.”

“302, blah blah blah address, female ate some fish earlier, now feeling gaggy. This will be a non-emergent response, room X”  

The address, once a motel now month by month rental residence, one room and bathroom equaling one tenant’s allotted space. We arrive just behind fire. The patient is ambulatory outside as my partner puts the truck in park. Fire is making contact, clipboard in hand – but she’s headed straight for the side door of the truck. My partner has care on this call, I’m just the driver. He directs her to the captain’s seat and assists her with the seatbelt. I determine receiving facility from fire, chit chat with them a few minutes and then we’re on our way down the street. In back, the conversation:

“So what’s going on tonight, what made you call 911?”

“My neighbor, he made some fish, I had some. Now I’m feeling so….gaggy.”

“Did you throw up, then? Diarrhea?” 

“No. Just feel a little gaggy, like maybe I could puke if I smelled it again.”

My partner falls silent then. I put on my blinker, turn, continue down the familiar dog track route to one of the two receiving facilities in the city. In back, he attempts again.

“So, do you have a medical history of any problems associated with GI issues? Problems I should know about so I can tell the doctor? What made this necessitate an ambulance tonight, ma’am?”

“No medical problems, I just can’t afford a taxi and I wanted something to stop feeling gaggy.”

Silence ensues. We arrive, I park, the three of us walk in together. I break off before the entrance doors to the Emergency Room itself, find the ladie’s restroom. Washing my hands, staring in the mirror. Trying not to think about the status red I heard while we were getting out of the truck as she met us outside her residence. The call holding because there were no trucks to send. That caller needing help, then the call pending, waiting for a truck to clear.

I hope they’re ok. I hope a truck was able to get to them in time.

~*~*~*~*~*~*~*~*~*~*~*

We’re sitting at the posting parking lot, and we’ve got the giggles. Somehow it came up that neither of us are much good without a map, or a GPS, even after all this time. He’s been a medic somewhere around the two-decade mark. Me, seven years – but I dispatched this service in this town for six years before that. But once he lost his partner inside a house while he circled the block in their truck as the partner gave him directions, and once my partner and I loaded and transported our patient in another crew’s truck without noticing for a solid ten minutes. We have snacks, though, so we decide if we get hopelessly lost, at least we won’t starve.  We spoof off this until we have tears from laughing so hard.

It’s the middle of the night, we’re 18 hours into our 24-hour shift. We’re the only truck left in the city, and whatever happens next for a range of maybe 40 miles – it’s mine. I’m up for care. My legs want out of the cab, but I’m not willing to brave the cold to oblige them with a walk outside. An occasional car passes on its way to the interstate on-ramp half a mile to our north, the only movement except for a forgotten Cheetos bag mournfully bopping thru the snirt as the puny wind half-heartedly backhands it. I ate clean all week, but in my guilty hands I hold without apology one chocolate milk, and one cheese filled Danish.

Today lies in the dust behind us. I’ve already forgotten the name of the man with slurred speech. I can still smell the urine wiped off the captain’s chair from the gaggy lady, though. A hundred more just like them, and nothing like them, I’ve met, treated, cut the cord of one, called time of death on a number I don’t care to retain.

Autonomy. Empathy. Tact. Tongues bitten in half and an ear to listen, a partner to laugh with at two o’clock in the morning and gas station food, lest we get too lofty an opinion of ourselves.

These are drops in the ocean of paramedicine. This job that weaves itself into you until you can’t remember who you were, before. We witness and echoes linger sometimes for an hour, sometimes for years.

I am the sum of my experiences – and theirs. I am 911.