A Thousand Naked Strangers (8 page)

There are others. A couple of recent grads cycle through, people who had too much fun in college and need to bolster their résumés so they can get into med school. There are small-business owners—a contractor, a landscaper, a tax attorney—who need benefits and a steady paycheck during the lean months. There is a former cook and sommelier who has absolutely no idea how he ended up on an ambulance and wants out.

Among the Tourists, I finally begin to feel at home—that I can fit in, that I can last. They aren't freaks, they aren't scary, they don't know everything, they're doing a job.
Why
they chose this work over something else is because it's interesting. Each person has other things going on, and this job gives them just enough without getting in the way. From them, I learn that I can
be
here without being
of
here. I can be a dilettante. A Tourist.

•  •  •

“What the hell is that?”

My partner, a part-timer who's in and out so quickly that I never learn his name, says, “A balloon pump.”

“And that's what, exactly?”

I'm standing in a stranger's living room. There's yellow shag carpet trampled to brown pulp by years of foot traffic; flowery wallpaper; and a TV but no couch. In fact, no furniture at all except a hospital bed, which has been wheeled in and made permanent—a double-wide trailer in miniature. Our patient is flopped on the bed. He has the soft, flabby look of a man who hasn't stood in a year, maybe more. He's in a diaper and smells like he gets nothing but sponge baths. He's attached to an IV pump and a feeding tube. He's been intubated, and machines breathe for him. Among other things, he's kept alive by something called a balloon pump.

My partner asks for the history, and the patient's around-the-clock nurse reads from a packet of papers. She mentions the balloon pump and the IV pump, rattles off medications and drip rates, diagnoses, complications, procedures. I don't understand any of it. I realize that for the last few months, I've gotten only a tiny peek at, taken the smallest bite of, this field. Until now, I've dealt with people having an acute and specific problem, people who—aside from having lost a few toes—are more or less healthy.

This is different.

Whatever confidence I've built up is gone. I back up and get out of the way, unsure what I'm supposed to do. I'm given very simple, direct instructions and still I screw it up.

The hospital, when we get there, is a relief. Get him out, walk away. Forget patients like this exist. It was tricky getting him onto our bed, and it'll be tricky getting him off. Nurses crowd the room; my partner confers with a doctor. An ER tech walks in. He sees that I'm overwhelmed and comes to take over the job I'm failing to do. “Mind if I get in here?”

I jump back, hands up. “Not at all, you're the pro.”

“So what's that make you?”

He says it without looking, without breaking stride.
What's that make you?
It's not a question but an accusation. I want to explain that I'm here to have fun, to watch. A Tourist. But I realize in that instant how vacant the words are. The man on the bed is real, and so are all the devices keeping him alive. All of this is real. Except me. I've been sleepwalking through someone else's life.

This isn't new. Since graduating from college, I've been merely working a job. I've been present but never invested. There's been no passion, no professionalism, no dedication. I arrive on time and do what's required but nothing more. That attitude has carried through to EMS. Though I spent eight months in school, and though I nominally understand the responsibilities I've taken on, I've been going about my tasks without full commitment. I play along without joining up, I treat without caring. In not aiming to be better than good enough, I've been merely gawking. I'm a Peeping Tom.

U
ltimately, it's Chris who leads me out of exile. Chris is a career medic, equal parts junkie and devotee. He's an EMS proselytizer, a True Believer. There will be no Tourists on his bus.

He's a member of the small but powerful contingent of medics who came of age in the back of an ambulance, which is an odd place to learn about the world. Chris, like all True Believers, is something of a savant. He can quickly and with great certainty determine whether a patient's shortness of breath is caused by asthma or congestive heart failure. He can also control a crowd, deliver a child, and stop even the heaviest of bleeding—but he can't find Norway on a map.

“No matter,” he says. “I'm not here to save Norwegians.”

He grew up wanting to be a medic. His first job after high school was with a tiny fire department in a rural county south of Atlanta. Chris drove the county's lone fire engine. It was so rural and the service was so small that it relied almost entirely on volunteers. When Chris was working, he'd be the only paid member on duty, meaning that once he relieved the guy who'd worked the day before, he'd be by himself in the fire station. He would eat, clean, watch TV, and sleep alone. He would also show up to calls alone, never knowing how many volunteers, if
any, would arrive to help. He stayed there for a while, then went to paramedic school.

When he started working in the city in the mid-1990s, Atlanta was still a very rough place. The Olympics hadn't arrived yet, and the first wave of scorched earth–style urban development and gentrification policies hadn't occurred yet. All of the city's housing projects were still open, so at six
P.M.
the businessmen fled the city, leaving it to the homeless, the hookers, the drugged out, the violent, and those too poor to escape. Drug dealers were so in control, so brazen, that they'd set up shop anywhere they chose. On more than one occasion, medics would emerge from an apartment only to find a drug deal going down on the hood of their ambulance. The medics would watch idly as the dealer exchanged brittle crack rocks for damp and crinkled dollar bills, then wait until the junkie shuffled off and the dealer swaggered back into the shadows before loading their patient. One night a dozen Atlanta police officers crowded into an ambulance, drove it to a project, and carried out a surprise raid. This temporarily broke the truce between EMS and the community, and for the better part of a year Chris wore a bulletproof vest to work.

Whatever the dangers, the job was everything he'd hoped for. One afternoon he found himself lying on the highway, slipping a breathing tube down the trachea of a badly injured patient. He paused to take stock of his situation—the wail of sirens, the dizzying smell of spilled gasoline mixed with the acrid smoke of a car fire, the thrum of traffic in the southbound lane, the grooves in the pavement below him—and couldn't believe this was his luck, his job, his life.

After a few years on the street, he took a job at a children's
hospital but returned to EMS when he was offered a supervisor's position. He was the one who noticed Jerry's girlfriend illegally running calls. Suddenly a medic slot was open on the busiest ambulance in South Fulton County. This moment came at a strange time in Chris's life. He'd been a medic for twelve years, had worked at fire departments, on ambulances, in hospitals, and as a supervisor. His marriage was on shaky ground. He'd reached the limits of what EMS could teach him. He was at the exact moment when the burned out either leave or turn into Killers. But Chris was a True Believer. For him there was nothing like being on an ambulance, having dinner interrupted by a shooting, being woken late at night to work a cardiac arrest, to laugh with the old and the infirm and the insane.

In all likelihood, he would have given up his supervisor's white shirt and jumped back on an ambulance eventually, but I hastened his decision. When he showed up that day and sniffed out Jerry's lie, he saw a young EMT, someone whose eyes were still wide to the wonder of EMS. Chris recognized an opportunity to start fresh, to love it again.

From day one, almost before Chris and I run our first call, EMS begins to click for me. Not merely as a distraction but as a career. As a calling. We laugh, we pull pranks, we run a shitload of calls. He leads patient care and I watch. He teaches me how to walk the fine line between exerting my authority and pissing people off, to casually check a patient's fingers for the telltale burn marks of a crack user, to begin clocking my path of escape—either with or without the patient—from the moment I arrive on-scene. Chris never says it, but the implication is clear: He's converting me into a True Believer.

T
he dispatcher never stops talking. Talking to us, talking to other crews, talking to supervisors, occasionally talking to herself. Her voice is the one constant of this job, and though we hear everything she says, no words get our attention quite like
cardiac arrest.
Of all the calls we run, this one looms largest. A patient in cardiac arrest is essentially dead—his heart has stopped beating—but if we get there fast enough, we can change that. Working an arrest is our opportunity to not merely save a life but raise the dead.

By Thanksgiving, I still haven't run one. I'm brand-new and desperate to put my skills to use, and when you boil down that statement, what it really means is I'm hoping for something bad to happen to a perfect stranger. Morbid? Maybe. But it's going to happen anyway. I might as well be there when it does. So I wait. And I hope. I get frustrated.

Chris knows better. The holidays are approaching. People always die during the holidays. He says that in his ten-plus years of EMS, he can't recall a single major holiday when he hasn't worked a cardiac arrest. “Don't worry,” he says. “We're due.”

Thanksgiving starts out unusually quiet. The radio hardly makes a sound. We watch the parade, we watch football, we
cook dinner. Just a few miles away, there is a family doing the same thing. They're a big group, brothers, sisters, aunts, uncles, cousins, Mom, Dad, even Dad's girlfriend. Grandma totters around the kitchen in a brightly colored muumuu, cooking and trying not to think about Granddad, who, stroked out and wearing diapers, is groaning on a mattress in the back bedroom. Two of her children have never gotten along. In years past, Granddad—tipsy but imperious—kept everyone in check. This year, emboldened by Granddad's absence, the brothers have argued nonstop.

They snap at each other over turkey, over stuffing, over sweet potatoes and collards and cheap wine. Grandma, now occupying the head of the table, stabs her fork into the broccoli and tells them to stop. This is Thanksgiving. Be happy, be nice. Be thankful. They get quiet just long enough for Grandma to stuff the entire floret of broccoli in her mouth. And then another dig. The younger brother, furious, yells back. Both men stand and Grandma slams her fork down. Mouth full of broccoli, she takes an ill-advised breath before telling them to stop, once and for all. This is the moment the family's been waiting for—Grandma, aging but in charge, throwing her significant weight around and putting these half-drunk men in their place.

But not a word comes. There's silence from the head of the table. A tangible silence that seems for the briefest of moments like the calm before the storm. Of course, there's no storm, just a desperate grunt, the final whiff of air sneaking out of Grandma's fully blocked airway. She bangs her hand on the table as the stringy, pulpy greenness that is death by broccoli becomes a very real possibility in her mind. The shouting stops, but only for an instant. There's confusion, recognition, shock, terror.
Then more shouting. Dishes and chairs are knocked over in the panic. Grandma's eyes go wide, mouth open. Her hands go to her throat, then, like a drowning swimmer, she flails, grabbing at anyone within reach.

Someone slaps her back. Fingers reach into Grandma's mouth—a desperate attempt to yank out the broccoli, which only loosens the dentures, which become yet another obstacle. Grandma's head bobs forward; her wig slips down over her face. She dies—loudly and ceremoniously—under the table during Thanksgiving dinner.

Someone dials 911.

No one tells us about the broccoli. All we hear is that someone's dead under the table and could we please hurry. And so we do, accompanied by a four-man fire crew aboard their engine. An ambulance rushing through the streets is not particularly dramatic; the truck itself is not imposing or intimidating, and the sirens, while loud, are not earsplitting. But a fire truck at full throttle is something altogether different. It's loud and terrible, ten thousand pounds of speeding menace with the lunatic wail of a screaming banshee. It's red-painted steel and a thousand gallons of sloshing water, a street-bound locomotive that can't stop, so get the hell out of its way, because it's coming. It's dangerous to the point of recklessness—a loaded gun in the hands of a felon—and seeing one in your rearview will make you move.

And so we drive. Sirens and blown intersections and me pushing pushing pushing to stay ahead of the engine, a gorilla breathing down our neck. Chris works the map book. In the days before GPS, this was as important and elusive a skill as any on the ambulance. A lot of people couldn't do it and got flustered and fucked it up. But Chris can work a map.

And so we arrive.

On the way there's conversation—about anything, about nothing—but once we're on-scene, it's deadly serious until we know what we have. A quick survey is all-important, and even when it's worse than expected, at least we know. There's solace in knowing. As soon as we pile out, I get hot. On the way here, driving, I'd gotten cold, almost to the point of a visible shiver. This is my tell, an invisible tic that surfaces every time I run a serious call. I get cold and remain cold until I arrive on-scene and then instantly warm up.

We hop out. Before I pull out the stretcher, Chris tells me to get a backboard. You can't do CPR on a mattress. The patient just sinks down with each compression. We need something firm to work against. I slide a backboard out from its chute, drop it on the stretcher, and Chris throws on the cardiac monitor, the drug bag, and an oxygen bottle. I yank the jump bag off the bench seat, and it goes on, too.