The Thin Ice of My Life

It was an early weekday morning in Oakland and we had been experiencing some of the most unusual weather patterns on recent record. One moment, the sun would be out without a cloud in the sky. Status Californius. Then without warning, a foreboding silver and black cloud would pull a drive by, dumping buckets of wind-driven rain as the unsuspecting population ducks for cover. As quickly as it came, it was over. The glorious sun returned as the howling wind died down leaving behind a sodden if not bewildered city. The cycle repeated without warning nor prejudice. The commuters were caught up as reluctant pawns in the series of meteorological tempests that had a grip on the East Bay.

The final knot in the knurled up ball of muck that morning commute had become came fast and furiously in the form of hail. Ice fell from the sky in various sizes from those rivaling golf balls down to minute pebbles. The roadway was coated and in California, nobody adjusts driving speed for anything, least of all weather; an accident was imminent.

The call was for a part of the freeway where one freeway splits up into two others. The lanes peel off to the left and right with signage to direct. There are several choices and often times people make either last minute decisions to change lanes, or more likely realize they are on the wrong path and abruptly adjust. The latter was the suspected cause of the call we were going on.

“Five-oh-Six, Five-oh-Six copy code three.” The dispatcher said in a calm voice devoid of emotion.

“Five-oh-Six.”

“Five-oh-Six, I have a code three for you. It’s for the MVA, unknown injuries, bus involved, possible MCI, I’ll start an advisory. Please advise additional units upon arrival.” And we were given the location.

“Five-oh-Six, we copy the call. Ten-Eight.”

We were rolling code three down the shoulder of the freeway. The crunching of the tires against the new-fallen ice cubes made for a unique experience. It was loud enough in the cab that it was difficult to talk over when added to the siren. We were only about a half-mile from the reported location of the call and traffic was already backed up in a disjointed, slow-moving queue. All of the motorists jockeying for position made the lines of traffic bob and weave like rows of snakes in the throws of death. The shoulder was our only refuge, but we had to take it slow given the severity of the ice storm we were in and the suspicion that a driver would get frustrated and pull into our path on the wide-open shoulder. It was a gamble, but our only option.

The hail suddenly stopped as if a water faucet had been turned off and the sun again came out, keeping the daily promise of California sunshine alive. The sun was riding very low on the horizon and was illuminating all of the ice, now covering the freeway, sending blinding glares in all directions.

“Oh man, this is going to cause some serious accidents.” My partner said to me.

“Town biz for sure. Good thing traffic is pretty much stopped. Hard to get into an accident at five miles an hour.”

“Oh, they can figure out a way.” My partner joked.

We got up to the accident at the head of the line of cars and it was a simple fender bender already moving over to the side with CHP on scene. There was no bus in site. I rolled down my window and my partner crept the ambulance up to the officer directing traffic and moving along the rubber-neckers.

“What do you got?” I asked the CHP officer, yelling over the traffic crunching the ice balls on the freeway.

“Non-injury. Should be cleaned up in five.”

“Where’s the bus?”

His eyebrows raised a bit and a smile crept across his face. “Oh, you are on that call.” He said with a knowing nod as he chewed his gum. I remember his teeth looking a brilliant white illuminated by the argent glare of the sun off of the hail. I could see myself squinting in the reflection of his mirrored aviator sunglasses. He pointed down the freeway and against the extreme glare of the sun on all the ice I could see a dark blue bus on the side of the road with a few other cars haphazardly positioned on the freeway. I could hear the fire engine about five hundred yards behind us laying on the horn to get the commuters to just give them an inch so they can get by. There were a couple CHP cruisers on scene and they were running around a bit. This would be some action. “Enjoy!” he said slamming his clipboard shut and turning back to his task.

“Great.”

I was worried. Traffic was picking up from zero to sixty just past the minor accident once everyone got an eyeful of nothing. They were accelerating like horses out of a race gate without knowledge of what they were driving into.

As I got closer I realized that the accident was spread out, maybe even more than one accident. There was a pair of cars against the center K-rail that looked like maybe just a minor fender-bender. The occupants had self-extricated and made their way over to the shoulder on foot and appeared to be exchanging documents. Traffic was zipping by and cars were obviously having trouble navigating the slick road as they fishtailed around. There were two other cars and a dark blue bus on the far right shoulder. Five lanes total so there was plenty of room for cars to zip through and CHP had not been able to control traffic. This would be a confusing call to triage.

It didn’t look like there was anyone in the cars so I went over to the bus. As I approached it, I noted the bars on the windows. This was a prison transport bus! I popped my head in and saw there were several officers inside taking inventory on the prisoners and triaging their complaints. Of course everyone had a complaint but a couple were legitimate. The officer approached me.

“We have two head bleeds, a broken hand, a skinned knee and a broken forearm. Everyone else is neck and back pain.” He said mocking fake neck pain.

I thought this seemed like a lot of injuries for a crash like this with minimum mechanism until I noticed they were all handcuffed. They had no way to break their fall into the seats and railings in front of them. “How horrible would that be?” I thought. It was time to report what we had and call for more resources. I ran back to the ambulance to get my partner.

“Call an MCI and get a sup here. Tell them we need at least three more ambulances and when you are done get in there with some BLS supplies. Mostly minor traumas. They are all prisoners so we’ll need restraints.”

Just as I turned around the fire engine was pulling up. I gave report to the captain and he directed his guys what to do to help out with triage and bandaging everyone up and preparing for transport.

I looked down the freeway to the other smaller accident and noticed it was cleared. The CHP officer had opened the lanes and it looked like the start of a drag race. Everyone was accelerating towards us. The freeway surface was still covered with millions of little ice cubes and the sun was still refracting the light in every which way possible. This was going to be a disaster. The first few cars zipped by hardly even noticing we were there. Then the rubber-necking started. Car after car of drivers craning their necks towards us to see what we were doing on the shoulder only looking forward again at the last second and narrowly avoiding the unsuspected stalled cars in the number one lane.

As luck would have it eventually somebody plowed hard into one of the cars. The sound of the locked up tires grinding the ice on the cement was unnerving. The point of impact was parallel to where the fire captain and I were standing so we had front row seats to a show we did not want to be at. The small, silver sedan hit the stalled cars so hard her rear wheels lifted off the ground. I could feel the vibration through the pavement and the crash itself was deafening. There was an immediate stress reaction that made my heart sink and took my breath away. Very similar to the feeling when you get dumped by a girlfriend or get some equally bad news.

“Holy shit!” said the captain.

I instinctively turned to avoid the debris from the crash. Some did come our way, but nothing that was too threatening and nobody got hurt.

“Call for another unit” I said to the captain and he did immediately. “And more CHP, we need this mess shut down before someone gets killed.”

My partner returned from the bus to give me a count and progress report on what the firefighters were doing. The three of us were staring at the car that had just stacked up behind the already stalled car. We could tell there was a small person in the driver’s seat. Probably a woman judging from the small size. It was very hard to see with all the glare. She was franticly moving around in the front seat. We were pretty sure she was going to get out of the car. The last thing we wanted her to do. We were yelling to her and waving our arms around to get her attention but she seemed very focused and not interested in our input one bit.

Her door opened on the opposite side of us as we were looking at her across five lanes of aggressively moving traffic. We saw her feet below the car silhouetted against the glaring background and her head appear above the car. She was going to make a run for it. This could not end well. Now some of the cops had joined in yelling to her to stay in the car, but she either could not understand us or was not listening. She moved to the back door and opened it up.

“What is she doing?” asked the captain, more to himself than any of us.

“Maybe she needs to get her phone or her briefcase or something” my partner suggested.

“What can be so important?” I asked.

“Maybe she got her bell rung and she is altered?” my partner added. This was certainly possible.

We speculated only for a moment later, for the answer came and it was not the one we were looking for.

Two little toddler feet were added to the adult feet already seen under the car. I felt like someone had just punched me in the gut. “NO!” I said instinctively. I thought I was going to pass out for a second. She was going to put a little kid into this traffic and we were going to witness a horrible, traumatic death of a child just feet in front of us.

The chorus of emergency workers trying to make her reconsider her suicide run was growing louder. She lifted the child up, or at least the feet disappeared and she came around the back of the car. We now had our first look at her. She was a small Asian woman. Perhaps five feet tall, maybe ninety pounds if she was lucky. She was in professional dress and her eyes were ablaze with fear and determination. She was clutching the small child to her chest under some kind of blanket. We could not see the child’s face or head, but the little legs were sticking out below the blanket. Without checking the traffic she just hunkered down and ran full speed across five lanes towards us like a macabre live action version of “Frogger” but without any judgment or timing. I had played that game enough times as a child to know that if you play it like that, the frog always dies.

I couldn’t look, but I had to. Our eyes were riveted to see how this would play out.

The scene was reminiscent of Vietnam era movies when you see the mother tucking and running with a child at her bosom against a backdrop of napalm exploding. She ran into the traffic and somehow managed to thread the deadly needle ending up on the shoulder next to us in fetal position. She would not let go of the child and was sobbing uncontrollably. There was no way to assess her for injuries as she not only did not speak English, but was not allowing us to touch or assess her in any way. We decided to give her a moment to calm down.

I left a firefighter with her and headed back to the bus. The other ambulances and cops were now arriving and we had all the help we needed. The freeway was shut down and tow trucks came to move the wreckage to the shoulder. The rest of the call went like clockwork, but was a challenge because we were spent from adrenalin overload. My EMT and the firefighters were able to quickly triage and bandage up all the prisoners and transport everyone who wanted to be seen. The woman eventually was able to calm down enough to let go of the child and let us assess them both. No injuries, just shaken up. We still transported them to the hospital since the mechanism of the crash was so brutal.

This call took a long time to get out of my head. There were so many things that could have gone wrong and they all ran through my mind and haunted me regardless of the fact that they did not materialize. There were a dozen scenarios, all of them much worse than the actual outcome that could have easily come to pass on that brilliant morning in Oakland. Sometimes, at the psychological level, the suggestion of what could happen is worse than reality.

copywright 2011 Jon Kuppinger

Party Boy

It was a miserable rainy morning on the east side of Oakland. The run down neighborhoods and their unfortunate residents seem to look more desperate when they are soaking wet and put against a background of brooding, rain laden clouds. It was very close to Christmas and this time of year and a few of the bungalow style homes had some cheap lights strung haphazardly to combat the annual blahs that plague California in the rainy season.

You can ask anyone in the emergency business, this time of year our calls take on a different light. I don’t know if there is any documentation to back this up or if it is just superstition because we are more sensitive around Christmas. Perhaps it is just how shocking it is to see some of the scenes we walk in on against the familiar backdrop of red and green holiday decorations that for the first half of our lives invoked cheer, magic, and wonderment.

For our patients, and really everyone in general, there are indeed more stresses this time of year. There are many unwanted family interactions ending in violence and sometimes even death. Depression is common even among people who do not normally exhibit psychological problems throughout the year; and for those who are normally clinically depressed, it can be more profound in the face of the expectation they must be happy. People also tend to eat much more than they normally would; gorging ones self can compound any of the pre-existing medical complications they already have. Anyone who has ever tried to be on a diet during this time of year knows the pressures to make poor food choices are crushing at best.

There is one other seasonal factor that is responsible for bringing Party Boy, the subject of this story, into my life. Typically around the holidays, people tend to overindulge in the intoxicant of their choice, be it alcohol, narcotics, or whatever else they can get their hands on.

The call came in for a residence that was on one of those strange little streets that keep starting and stopping depending on which block you were on. You would hit the dead end, but then go around a block and pick it up again. Of course the map book does not reflect these little idiosyncracies. This made us a little later to the call than we like to be, but still well within our allotted time.

The house was a multi-unit, single story house and the address we were looking for was in the back of the building. The door was open and we were met by one of the firefighters walking out.

“You guys might want to bring some extra sheets and towels, he’s all covered in vomit and blood” she said punctuating with a look of exaggerated disgust.

“What’s the deal?” I asked. We still didn’t know. The call was for “unknown medical” which could be anything from a hangnail to dead.

“We don’t know yet, he’s spitting up blood and has vomit all over him.” She said.

“Great”. I said not meaning it at all.

“I’ll get the blankets and tarp” my partner said, “you can go ahead and see what we have”. She was telling me not to worry about the equipment, she would get it for us. Partners who are helpful in this way are like gold.

I walked down the walk with the firefighter and she and I made small talk. She had been in the house and knew what she was about to walk back into. I didn’t but had a pretty good idea. We wanted the next twenty feet to at least be somewhat pleasant.

I stepped up the steps and knocked as I usually do on the doorframe even though the door was open to announce my entrance.

The apartment was shockingly neat and tidy on the inside betraying the shabby exterior. Recently refinished hardwood floors. Modern colored paint on the walls with white crown molding. The kitchen looked like it had been updated recently. Not at all what I expected from the outside. There was a thirty-something young lady sitting on the couch in an oversized white T-shirt pulled over her black legging covered legs. Her knees were drawn up to her chest under the shirt and she looked as if she had been crying. She had long dyed black hair and acne and piercings on her face. Her look screamed “I just woke up!” She just pointed to the bedroom off to the side.

As I entered the bedroom, I couldn’t see exactly what was going on but could hear guttural and inhuman noises coming out of the room as if someone had captured some prehistoric animal. The firefighters were shifting their weight back and forth like they were trying to trap the animal.

It was then I first saw Party Boy.

Party Boy was about thirty years old, Caucasian, short black hair, dark eyes, and shaved hairless. Everywhere. He was completely naked, very thin, covered in random tattoos, vomit, and had blood streaked all down the front of his chest from his obviously broken nose and busted lip. He had a wild, wide-eyed stare that matched the bizarre noises coming out of his mouth. His head twitched back and forth over-reacting to every noise, but with a thousand yard stare that seemingly looked through walls. He was fully sexually aroused and was attempting to manually pleasure himself while using his free hand to ward off the would be captors. His mouth was hanging open except when he closed it to gather bloody saliva which he spit at the firefighters. They did their best to dodge the flying blood globules. I felt like they were doing a great job, nothing I needed to get involved in, so I backed out of the room and approached the young lady.

“Who is he to you?” I asked her.

“She’s the girlfriend” the clipboard wielding lieutenant responded for her. “But she doesn’t seem to know much about him at all.”

“EX-girlfriend!” she corrected with emphasis on the “ex”. “As of right now, phhssssssstt” she said drawing her hand across her throat in the universal symbol for cutting. I felt like I was in the movie Scarface.

“Oh excuse me” the lieutenant said feigning respect “The EX-girlfriend says our guy in there has an addiction to GHB and took too much of it.” He said with mock emphasis on the “ex” and an additional eye roll.

GHB is a powerful illegal drug that works as an intoxicant as well as an amnesiac. It’s used mostly as either in small doses as a performance enhancement drug for athletes or in larger doses as a date rape drug. Some more adventurous types take it themselves to get ultra-high.

“Do you know anything else about him?” I asked the freshly available ex-girlfriend over the crashing of what sounded like a lamp hitting the floor in the bedroom.

“You know what?” she said springing to action and jumping off the couch with a sudden burst of happy energy. “I have the number to the perfect person to ask about him” she ran to the kitchen where she rummaged around in a drawer before producing a small telephone number book. She thumbed through the book, mumbling names to herself as she passed through them alphabetically before exclaiming in success “Here it is!” She held out the book and pointed to a name and number “She will tell you all you need to know about him” she said with a smile, proud of herself for setting up this little piece of drama.

“Is this a family member?” I asked.

“Nope, this is the bitch who was his girlfriend before me. She would looooove a call from you guys. She can have him back, I’m done with him. Her problem now I guess” She said with finality and a smirk that seemed to indicate that her role in this was over.

“So this is the number to the EX-EX-girlfriend?” the lieutenant teased pointing to the number.

“Yeah, something like that” she said with an icy look.

The mood in the room was broken by the arrival of my partner.

“So what do we have?” she asked me.

“Probably OD, they have their hands full in there.” I motioned over to the room with all the commotion in it. “He’s naked and filthy.”

“Who’s this?” my partner thumbed to the ex-girlfriend.

“The girlfriend, but she’s not helping much.” I said loud enough so she could hear.

“EX-girlfriend!” she corrected. This was getting comical.

Now that everyone had arrived, it was time to corral Party Boy and get him out of the ex-girlfriend’s house.

“How do you want to do this?” I asked the lieutenant.

“I guess we just grab him and go.”

“I’ll get the straps and the gurney ready” my partner said and stepped out.

One of the firefighters went high, the other went low and quickly he was off his feet and struggling. The rest of us jumped in, everyone got a limb. We were walking in short little steps since Party Boy was doing everything possible to free himself by writhing around and flailing his restrained arms and legs. I was walking down the steps backwards when stepped in something squishy. Immediately everyone smelled it.

“Who stepped in the dog crap?” one of the firefighters asked wrinkling his nose as we negotiated the corner on the landing.

I knew it was me. Great, this was all I needed to make this call better. A naked guy, his pain in the butt ex-girlfriend, blood, vomit, and now dog poo on my boots. Just great.

“I don’t think it’s our guy” one of the firefighters said looking for feces and not seeing any.

“No, that would be me.” I said. “I stepped in it on the steps.” I would have to clean that up later. Right now, it was time to take care of Party Boy before he hurts himself worse.

As soon as he hit the gurney we wrapped him up and tied him down. He had a wild look in his eye like he wanted to communicate, but his brain was way too blotto to allow for words to be formed. Instead, he was left with grunts and snorts to work with.

We wheeled him into the ambulance and I was for the first time able to really assess him. He had a broken nose, from what I am not sure. He kept opening his mouth so I could see there was no other oral trauma other than his split lip and the nose. I think the blood was from his nosebleed dripping down the back of his throat. I had to sit on him to get a blood pressure and pulse since he was thrashing around careful to avoid his erection standing at full mast under the blanket. Then it came to me, all the while he was pleasuring himself as we were trying to corral him, that was what he wanted to do. I freed one of his hands and he immediately went to work on his penis under the blankets. It significantly cut down on his manic behavior, but the way he was staring right through my partner with this hypersexual behavior was giving me and her the creeps. His grunts and snorts switched to noises that sounded happier, so I guess we were meeting the need of reducing his suffering. This distraction bought me time to get an IV and get some Benadryl on board to calm him down which significantly reduced his manic behavior.

We brought him into the hospital, masturbating vigorously the entire time through the ER and onto the hospital bed. I gave my report and left, happy to be rid of Party Boy. Besides, I had to hose the doggy doo off the bottom of my boot.

About three hours later we were back at the same hospital wrapping things up with a different patient and we saw Party Boy in one of the observation rooms. He was awake, sitting up in bed and looking bewildered. His hair was messed up and he was now clothed. He had a look in his eye that told me he was much more oriented. It’s funny how when the lights are on inside someone they look like a different person, almost unrecognizable as the wild man we had met earlier. I decided to pop in and ask him some questions since I was missing a lot of info from my report and I wanted to be sure we could bill him for this one.

“Hey dude, how are you feeling?” I asked.

“Like crap. He said.”

“I need to get some info from you” I asked getting what I needed out of the way. I got his name, address, phone number, SSN, and insurance info.

“You don’t remember me do you.” I said.

“Nope. I don’t remember anything.” He said genuinely.

“You OD’d on GHB. I brought you in.” I said.

“What? What the heck is GHB?” he said. He was a skilled liar.

“It’s a drug. Some people call it a date rape drug. It’s an anesthetic used recreationally as a hypnotic.”

“Never heard of it. I don’t do any drugs. That can’t be. I’m totally clean.” He said flatly.

“That’s funny, your girlfriend, uh I mean EX-girlfriend says you are addicted to it.”

“I don’t know anything about that.” He said knowing that I knew very well that he was lying. “Can I go home now?” he said.

“Not my call, bud. That’s up to the doctor. Feel better.” I said and left the room.

He was yelling after me tugging on his wrist restraints as I left and that was the last I saw of him. Fitting given the hell he gave us back at the house.

I stopped back in about an hour after that and asked the nurse about him.

“So where’s Party Boy?” he knew exactly who I was talking about.

“We took the restraints off and he took off leaving the hospital in his gown only. He didn’t have shoes, a wallet, phone, nothing. “

“Did he ever cop to the GHB?” I asked.

“Nah, he just kept on denying. Deny, deny, deny.”

“How did his tox screen come back” I asked.

“Pretty much positive for everything. He was tanked up on everything including alcohol. I’m gonna say that was one hell of a party going on in his head.”

“Yeah, something tells me we will be seeing him again.” I said.

“For sure.” The nurse said before turning and getting back to his other duties.

I turned and walked back out of the sliding double doors feeling the cold blast of damp air hit my face. It was still pouring rain out there. Another call was out there waiting for me. Another adventure just over the horizon.