A Thousand Naked Strangers (4 page)

I'm brand-new and all but useless. I feel nothing but intimidation.

Finally, two Grady medics emerge from the shadows in cobbled-together uniforms—more utilitarian than official, more mercenary than medic. They nod and tell me to get in, and before I know it, before I'm ready, I'm sitting in the back of an ambulance rumbling through the heart of a sleeping city.

All ambulances carry the same smell, a dizzying cocktail of disinfectant, plastic, and diesel fuel mingled with scents leaking in from the outside world. But there's something else, a smell you can't quite put your finger on and which, in truth, doesn't exist. It comes not from any physical source but from the knowledge that people have sweated, bled, and died in here. The fact that so much has happened in so small a space will
immediately dispel the notion that those who die in violent or sudden circumstances forever haunt the site of their demise. An ambulance, at its most spacious, is a five-by-ten rolling memorial to the abruptly and tragically dead. How many have slipped away in any one of them is simply unknowable, and yet not one story exists of lonely and angry specters whispering threats to frightened paramedics.

My rumpled preceptors wear all this death with style. The job has changed a good deal over the years, and the two guys I'm paired with, Pike and Wooten, came up in the brawling Wild West days when Atlanta was the murder capital and surviving the daily parade of shootings and stabbings required a hard-bitten and ruthless approach. Pike is wiry, rangy, with a thick goatee straight out of the Civil War; he chain-smokes and pounds coffee with the manic energy of a guy who never sleeps. Wooten is silent and bitter, his thickness a testament to the poor diet so common among public safety workers. While Wooten sits silently in the passenger seat, Pike drives like a madman, talking without stop, without prompting. “This whole area, everything you see,” he says, waving his arm indiscriminately at all we pass, “is a fucking shithole.”

The shithole he's referring to is an area known locally as the Bluff—five square miles of drug houses, flophouses, abandoned buildings, squatters, drugs, violence, desperation, and the constant
woop-woop
of sirens. The Bluff is Atlanta's answer to Compton, to Chicago's South Side, and to the Heartland's countless and nameless meth-riddled trailer parks. It is where all of Atlanta's heroin is sold and most of its crack is consumed. People here live in aging projects or derelict bungalows; when they aren't getting into trouble, Pike says, they're calling 911. He
stomps on the gas and tears open the air with a long, loud burst of siren.

Wake up, motherfuckers!

•  •  •

My father-in-law spent a year of his life in Vietnam, an experience that affected him deeply and about which he's generally tight-lipped. There are some topics, however, he
is
willing to discuss, one of them being the futile efforts of the 1960s-era army to prepare its conscripts for jungle warfare. For instance, he loves to tell how he trained with an M14, never even laying hands on an M16—the weapon with which he was expected to fight and win a war—until after he was already in Southeast Asia. And he'll laugh as he describes the World War II–style combat tactics taught to him by his drill instructors, men who'd never seen a jungle and who never once addressed the unique difficulties and strategies of jungle warfare. All of the skills he eventually acquired for keeping himself alive came from war-weary nineteen-year-old kids who'd gotten there a week before he did.

EMS training is not nearly as inadequate, but the very nature of practicing medicine in streets, bathrooms, living rooms, elevators, construction sites—literally anywhere—renders obsolete many of the rigid procedures drilled into our heads during school. And so Pike is standing next to the ambulance, a cigarette dangling from his lips, rattling off a list of techniques I've learned in school that aren't only poorly suited for the streets but could, in some cases, get me or my partner hurt.

“Backboarding,” he says. “Do it like they show you, straps running crosswise over their body? Fuckers'll slide right out.”

“Slide out?”

“What happens when you got 'em strapped like that and you try carrying them down stairs?”

“They slide out?”

“They fucking slide out.” He takes a heavy drag, followed by a languorous exhale. “Run those straps between their legs,” he says, “and crisscross them over their chest. Fuckers aren't going anywhere.”

On and on it goes.

“Now, when it comes to fighting patients—”

“Wait, what?”

“What?”

“Fighting? You said fighting?”

He laughs. “You think all these fuckers are glad to see you? That they're gonna hop on out to the ambulance for a quiet ride to the hospital?”

I ask why anyone—especially a person who presumably has called for my help—would attack me just for showing up. Pike shakes his head as though I'm almost too dumb to help, then ticks off a list that includes seizure patients, drug overdoses, violent psychs, drunks, head injuries, pissed-off family members, and those who, for no good reason, are simply pissed off at the world and to whom I represent a great place to start exacting revenge. “It's all how I approach them,” Pike says, “the way I assert my authority.” He goes on to describe a tricky blend of rigidity and leniency—where he draws the line and what he does the moment they cross it—that determines the direction these calls will take.

“Handle it right and you'll be fine. Fuck it up and you're in for a long afternoon,” he says. He grabs a pack of patient
restraints and asks if I know the proper way to restrain a patient. I don't, but before he can show me, we catch our first call.

For the next few hours, I watch Pike and Wooten run calls from the close and inescapable confines of an ambulance. I'm mesmerized. We run calls in projects and high-rises and on the litter-strewn shoulder of I-85. We pick up a child with a fever, drop off a woman with abdominal pain, and bandage a man who's been sliced open by his girlfriend during a domestic dispute. There is a fluidity to these medics' movements that borders on grace. I don't see how I could ever be this good.

Around midafternoon it finally gets quiet. There's no scheduled downtime in EMS, no lunch hour, no bathroom breaks, no nothing, and when it's busy, you just run. So you eat what you can, when you can. That afternoon we eat greasy chicken from a dirty fast-food restaurant, then fall into a stupor. I'm just starting to drift off to sleep when the ambulance starts moving. We've got another call.

I haven't yet shaken off the fog of grease when the ambulance jerks to a halt and, for the first time all day, I hear Wooten's voice: “Holy fucking shit.”

Strange things happen in this world. One of them happens today. A man none of us knows and whom we'll never see again spent all last night bingeing on a strange mixture of cocaine and heroin known as a speedball—one drug to cut the trail for you, another to send you down it. Heroin, being what it is, calms while the cocaine fuels. The problem is that the heroin has a shorter life span than the cocaine, and so, out of nowhere, that smooth high suddenly becomes all sweat and frustration and grinding teeth. After his buzz turned sour, our patient spent
the afternoon homicidally racing his car through the streets. Eventually he lost control, sped down a ravine, and smashed into a tree. The impact broke both legs, but he's too strung out to notice. Confused and combative, he simply hopped out and took off running—and the broken bone ends immediately poked through his skin. By the time we arrive, the damage is so extensive that the upper and lower sections are jutting out in a grotesque sort of crisscross pattern.

For the first time all day, Pike is quiet. Wooten suggests perhaps we should get out. I stand next to them in front of the ambulance—heart pounding, pupils dilated—partially horrified, partially hypnotized, and totally unsure what to do. Once Pike has drawn up a sedative, we approach the patient like zookeepers sneaking up on an unruly bear. Our quarry sees us, hesitates, and squares his shoulders. Pike and Wooten recognize what's about to happen. I do not.

They jump out of the way. I'm frozen. The patient—wild eyes, hulking mass, broken and scissoring leg bones—charges me. I never even react. Just before he plows me over, Wooten, more agile than his body bloat suggests, leaps out and knocks him down. Pike piles on top. I watch as the three of them roll around until Pike screams out in pain, whales the guy with a wild elbow, and yells for me to grab the needle. Somewhere in the tussle, he dropped the sedative, and it's now out of his reach. This snaps me out of my daze. I grab the syringe, pop off the top, and jab it into the man's ass.

Then I back up. Pike and Wooten slowly untangle themselves and watch as the drugs work their magic. The man rolls onto his back, twitches, and starts snoring. Pike grabs the stretcher, and the three of us snatch him up and load him into the ambulance.
Once the doors are closed, Pike and Wooten laugh and exchange the weary glance—part exasperation, part celebration—that always passes between partners after the dust settles and you find yourselves sweating and exhausted but alive and in one piece. Wooten takes out a pair of scissors and cuts off the guy's pants. Pike and I set to work on tying restraints.

My crash course on tying someone's hands and feet to a stretcher with soft restraints is contained in a single sentence: The legs should be spread wide and tied at the ankles; left arm is down at the side; right arm is up by the ear. Careful consideration should be given to the knot itself. Pike assumes I'm good with knots. That assumption is incorrect.

We're only a few minutes down the road when our patient begins to stir. Sure, he's been sedated, but there's still all that cocaine. His eyes open. He twitches, jerks—a wild animal caught in a snare. He turns to me and shakes his head in fury, then flops back, sits up, kicks his legs, and blows out a lungful of hot anger. He pulls against the restraints. His right hand, the one Pike tied to the stretcher near his right ear, doesn't budge. But the left hand? The one I tied? It's already coming loose. He runs his fingers over the shoelace-style knot and smiles. Or maybe not, it's hard to tell through my rising panic. Either way, he yanks on the knot and his hand is free. Just like that, he's up. Wooten throws a sheet over the patient's face and holds him down. I reach for his free arm but miss. A paralyzing pain shoots through me.

Dude has grabbed my nuts.

I try to endure the pain, swat away his hand, and regain control of the situation. Instead I let out a scream that is terrified and desperate and too high-pitched to be mine. Pike stops the ambulance. He jumps in the back, and together he and Wooten
properly restrain the patient. The transport continues, though I hardly notice. There is nothing but the pain, the echo of my long humiliating scream, and a quiet period of huddled convalescence.

At some point we drop the patient off, then run more calls. The day ends. I go home, and whatever I tell Sabrina or my classmates of that first day is edited for content. There are other ride-alongs, more classroom hours. There are other things I do right, other moments I live up to. But as always, lessons are drawn from mistakes, not victories.

So I learn that knots are knots, that patients will turn on you, and that what happens in the ambulance—well, it's best that it stay there.

U
nlike the first four months, the second half of my EMT course speeds by. We attend class, do our ride-alongs, and work shifts at a local hospital. All this is background noise; nothing matters anymore except the impending doom of the National Registry exam. Alan devotes a chunk of every class to the exam—passing along his tips and warning us not to panic, not to let Registry become a huge stumbling block.

National Registry consists of two parts—the written and the practical—and sports a fail rate somewhere near 50 percent. Everyone is anxious. If I don't pass, I can't work. It's that simple. If I choke, I'm just a paperboy who took an EMT course. Alan assures us that we can retest but only so many times—after that, it's back to school. I silently voice to myself the things I must remember:
Know the material, trust your instincts, avoid the fatal mistakes—scene safety, scene safety, scene safety.
We study. We prepare. We wait.

Our course work ends in mid-December. After eight months, it's strange to be set free from the three-nights-a-week mooring we've relied on for so long. School, even technical school, becomes an end in itself. On the last night we do a few scenarios, and then Alan asks if we have any final questions. Not one hand
goes up. We're simply ready to leave. After class I head to a Mexican restaurant with my little group of five. We drink, we laugh, we reminisce about this strange bubble we've been living in for the last eight months. Nothing about tonight feels final until the tab is paid and we're drifting out the door one by one. Life is a series of cycles—each nothing but new people, new memories, and eventually, a new ending.

That weekend Justin and I drive to Savannah to take our exam. We don't leave much time to spare on the drive down, and rather abruptly, we go from sitting in the car to sitting in a medical annex building, staring at a test booklet. I finish in an hour, and even as I'm walking out, I can't remember a single question. We have dinner, sleep, wake up, and take our practical exam.

In contrast to the written, the practical portion is agonizingly slow. There are five stations and a hundred testers. We sit for hours in a stuffy room waiting our turn. Finally, everyone cycles through and it's over. We line up outside a door and enter the room one by one to see who passed and who failed. More waiting, more waiting, holy fuck, the waiting. Justin goes in first. He emerges shaking his head—he's failed and will have to retest. Things have just gotten real. I go next, close the door, and smile at the five assembled faces. Someone asks my name. He shuffles through a stack of papers and nods. “You pass. Congratulations.”