The husband leads us to the basement, where she’s sitting. Trendy sweatpants and a shell shocked expression are my first impressions. He’s keeping the small ones at bay as they try to see around him, wondering “what’s wrong with Mommy?” Mommy’s stomach hurt and she was closer to the basement restroom when she sat down and she hasn’t gone far. There’s a small throw rug in front of the toilet that matches the shower curtain and the valance at the small half window. A hand towel, in keeping with the scheme, lies folded in half a short distance away. My partner, a male, steps outside at my nod and begins to get demographics. The pt and I regard each other, then the towel. 14 weeks, she tells me. She’s still processing, and her eyes are dry as she tells me she just had a stomachache, she had no idea. This was their third. I hear my voice saying I lost a baby at 14 weeks too and she suddenly hugs me. We do vitals, we stand up and find a towel for the sweatpants and then she turns to walk out to my truck, leaning on her clearly heartbroken husband. She asks if I can bring the towel, and then I’m alone. I pick up the towel like it’s a precious jewel – because it is. The small form inside is nearly weightless and I feel almost unworthy as I carry it past the first responders in this rough fabric. When I get to the truck she asks me if it’s too early to tell if it’s a boy or a girl, and I nod. She asks if I looked and I say no, she says “me either”. She asks me if I will look with her, and as we back out of the driveway, backup alarm beeping, we regard the small still form. She whispers, “I love you” and I think I haven’t seen anything so awful and beautiful in months.

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

He was dizzy, and she was worried. He didn’t feel any medical need, he was more interested in finding some pants as his living room suddenly housed strangers at one am.  My partner began the assessment and she began giving me patient information. She was 89, he was 92. She interrupted herself as she saw him beginning to feed a foot thru a cuff. “Leave ‘em off, Dad, so I can look at ya” – and she leers, wiggling her eyebrows. He flushes, grins and we all laugh. God, a love like that – those words remain with me, nearly five years later, as my favorite ever comment on a call.

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

He’s called twice so far and ultimately refused transport each time. He’s constipated, I’ve given him the spiel about increased water intake and stool softeners from the corner drugstore five blocks away. This time he shows me the pink bottle of GI upset fixer, and asks why it’s not working. I advise that helps diarrhea, and remind him it’s been less than fifteen minutes since we spoke. He shrugs and says, “I want to go now, take me”. We walk to the truck in silence. En route the four blocks to the emergency room, I ask if he walked to get the stool softeners. He scoffs, “I can’t afford them”. I give report and as I hang up the mike, he says with relish, “this I don’t have to pay for – you do.”

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

The directions are vague and the destination is what’s colloquially known as the hobo camp. My partner parks by a footbridge marked by two deserted squad cars, red and blue lights the beacon we followed to this far removed wooden bridge. We take the cot, kit and monitor, lock the truck and begin to walk. The pitch blackness around us is unrelieved by any streetlights – we’re too far out in the woods. I’m in front and I regret heartily my active imagination. We emerge from the woods and the bridge to a group of people, fire and law enforcement, gathered around a very loud and angry individual. He tried to run from law enforcement after a domestic incident and he was stopped by the taser. The barbs remain in him, and as my partner removes them, the skin tents and his howls increase. I realize my toes are curling in my boots and looking around, every face is wincing. He’s on our cot after enough posturing to ensure his opposition to all uniforms, then he settles down except for the occasional insult hurled back over his shoulder at the officers, as we set off for the pitch black footbridge thru the trees. This time I push the head of the cot, and let my partner go first, pulling the feet. It’s arguably worse, letting the darkness follow you. Hairs on the back of one’s neck are not a euphemism.

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

Her accent is England, her jacket I help her into is Prada, and I compliment her, saying I’ve never had a better dressed patient. Her current indignity forgotten, she smiles and the sun comes out from behind the scowl she was wearing. I nod at the Louis Vuitton luggage and she asks, “doesn’t everyone?” and I shake my head in regret. She looks at my navy blue EMS pants, sweater, boots -  tips her head and without irony says “so sorry, love”.

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

Difficulty swallowing and coming thru the door, my step slows to a normal pace as I see the relaxed body language of fire on scene, patient side. Patient report received, patient was woken by a feeling of throat pain. He’s been feeling ill, had some post nasal drip. Sounds relatively minor and I turn to my patient. He is full on terrified. Jerky body movements on the 1970s couch, eyes darting around the room frozen in time. He can’t be much older than I but he is non stop chattering, asking if I think he’s going to be ok. Throat shows some minor swelling in the tonsil area, negative obvious swelling of neck glands. He’s producing saliva and swallowing easily in his loop of recounting awakening with the pain. I ask if he lives alone and he nods. Asking again if I think he’s going to be ok, he heads for the ambulance. We drive the eight blocks and I keep my body language open and relaxed as I face him, hoping he’ll follow suit. I keep my voice light and tell him the even adults can have swollen or infected tonsils, that I’ve been watching and he is swallowing ok. I tell him I had my tonsils out and maybe if he’s lucky he’ll get some ice cream. Earnestly, he nods, “uh huh, uh huh, oh I hope it’s nothing serious.” Walking to the ER bed, he recounts yet again his terror of awakening in such a manner.

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

She’s apologizing for bothering us, and as my eyes burn, we reassure her that she is certainly not bothering us. One leg is visibly shortened and it’s rotated outward. By the smell of things, she’s been here awhile. I ask gently how long she’s laid on the floor before calling, and she answers “since early Sunday morning.” It’s 9am on Monday now, and as we go to address pain management and consider extrication, my heart cracks a little when she explains “I waited until the work week would begin and you kids wouldn’t be bothered in the middle of the night”.

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