Night Shift (part one)

January 2008     San Francisco

Working the overnight shift on the ambulance is good and bad.  Not much supervision, no traffic, maybe some sleep, but the freaks and junkies come out at night and sometimes the wee hours bring out the weird in all of us.

Taking home a very large black woman to the Western Addition projects in time for Thanksgiving wasn’t so bad. I’m not sure if the elevator worked or not, but it was being used for storage, and she lived on the third floor. Ah, gravity.

We strapped her into a stair-chair, which is similar to a wheelchair but with small wheels. Facing her away from the stairs, I heaved on the upper handles behind her, and stepped back and up the stairs. My partner Mike was the unfortunate one, not only for being an orange-haired Irishman, but because he had the lower, heavier end, facing her. On the slow journey up, Momma chuckled and steadily adopted Mike.

“Mmmmmmmphh……you so pale!………..Son, you come on by here tomorrah to see me. I’m a-gonna deep-fry us a great big turkey…………what’s your name?……..We gonna put some soul food in you…….darken up that skin of yours real real nice…….”

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We brought an 80-year-old Italian woman back home to Little Italy from SF General Hospital with a left ankle fracture after a recent fall. She was a widow, a sharp and funny woman, living alone in a two million dollar apartment, seemingly without any help from her extended family. Where were they tonight?  They were not around, though their names were stickered on each of the furnishings and the paintings.  Nice.  She told us stories, including how her older brother once blocked her from dating their neighbor Joe DiMaggio, on the grounds of the age difference.

We made her a ham sandwich and put her to bed, but the process had begun. The following week she fell again and broke her right hip, and at that age, the slow motionless recovery would have consequences. We might see her again.  I wondered if any of her family showed up this time.

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At General Hospital delivering a patient, I looked up and saw a street thug bleeding and limping into the ER, all by himself. After some time we found out that he had been sitting in his car when a drug deal went sour, and he took a bullet. He had an entrance wound in his upper outer right thigh, an exit wound in his upper inner right thigh, a clear through-and-out shot to his pecker and then another entrance wound in his upper inner left thigh, where the bullet had lodged in his femur. Jacked up on meth, he apparently didn’t feel much pain or realize that the end of his ding-dong was gone forever. Off with his head!

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This is a rough one. If you choose to read it, be sure and read to the end because it goes off subject and then lightens up a bit.

We were sent out to pick up a burn injury, no details. On arrival, we faced a 17-month-old girl with second degree burns to the arms, chest and entire face after turning over a hot pot of water. Most of that skin had blistered, burst and was oozing. A fat, healthy little Chinese girl, most distressed, as were the first-time parents.

On the upside, the agent wasn’t chemical, grease or open flame, and her airway and eyes were unaffected. I couldn’t be sure that this wasn’t a permanently deep-scarring but mostly painless third-degree burn. It looked more like a second-degree burn, which doesn’t scar, but is pure, distilled pain. She eased up quite a bit after a single drop of morphine.  I did not: This is the first call that sickened me, (patches of her skin were now sliding off) and it surely didn’t comfort the young parents in the back with me to watch me heave into a bucket. Now how’s that for bedside manner? I am so damn green.

The burn center is top-flight, but quietly unsettling. The reconstruction surgeon explained to the parents (and me) the sure chance of a 100% full recovery, with no disfigurement. This was welcome news in a wing where people stare up at the ceiling through irrigated eyes.

My more experienced partner ragged on me due to my response to the relatively common and short-term nature of the injury, but I don’t know if I’ll get used to that. I start prerequisites tomorrow to train to be a Physician’s Assistant, which requires two years of med school and then interning, and I’m taking a close look at relocating to Afghanistan for some time in order to pay for it. This 30-minute burn experience gave me an idea of how bad things could get over there, or in any war zone, really. I suppose the nausea will fade away.

When my friend Ted Bracken was a very young pup, he was standing in a filling bathtub when the regulator broke on the water heater, resulting in third-degree burns from his ankle down to his now-webbed toes. Teddy won $50 in college in a beach bar for an ugly-feet contest. His feet don’t know pain. Ted has ugly feet.

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