I flop along beside her, shaking and wet.
We head back to the waiting ambulance, parked outside the ER. I climb into the back with Bernice. The paramedic’s car has been driven to the hospital by one of the firemen. In the back of the rig the lights are now lowered; it resembles a medical cocktail lounge, dim and antiseptic. Without the distraction of a patient my mind starts to think of claustrophobia and other reasons why I shouldn’t be here.
“Dunkin’ Donuts or McDonald’s, ladies?” comes the voice from behind the steering wheel.
“Doughnuts,” Bernice and I call out in unison.
How scary can this be if we get to eat doughnuts afterward? I think of what I am going to eat. My ass is drying. I like the neatly folded blanket on the cot, and the smell of the disinfectant.
“Good job,” Bernice says to me.
I feel flushed with happiness.
“I did it,” I tell Tom Knox during my shrink session. He smiles broadly as I tell him how I was able to sit in the back of the ambulance and not freak out. “I knew you could do it,” he says. I inhale the comforting aroma of his office, I try to fix it in my mind to pull out like a snapshot for when things get rough.
9
I have been so focused on the ambulance that I have forgotten that I am now a member of a fire department and I have about thirty-five new people in my life that I have to get to know.
Life at the Georgetown firehouse runs by a schedule. Every Monday night there is a meeting. The first Monday of the month is a business meeting where the secretary reads the minutes of the last meeting and new business is attended to. On the other Mondays we have drills, which can range from staging a mock mass casualty to being really lazy and going out in the ambulance for ice cream.
Between Monday nights there are work details. They are called whenever something needs doing, which can range from scrubbing the ambulance to sweeping out the fire engine bays to hauling the Christmas lights down from the attic.
I have showed up on a Saturday afternoon to help sweep out the fire bays. The engines are all pulled out, and I sensibly wear jeans and a work shirt and heavy boots. I am looking forward to hanging out with the firemen. I love firemen.
When Michael and I used to live in another Connecticut town many years ago, a batty old lady lived in the apartment above us and always fell asleep while cooking something on her stove. On a regular basis she would set off fire alarms in her house and the town fire department would race to our building to snuff out a blazing chicken breast or a scorched steak. I liked the old lady’s fires because I was mad for the firemen. They were out of
Playgirl
magazine, big handsome hunks of men, wearing skintight T-shirts and yellow fire pants held up with red suspenders. They knew they looked hot and they were big flirts, casting a wink at me, flexing an arm muscle lazily as they put on their gear. I dreamed of their bunk-house, of how spectacular it would be to sit with them at a long table and share a meal.
Now I had dozens of firemen of my own. I had seen them around town, racing to fires or washing the fire trucks in back of the firehouse, but never met them. I had admired their fire gear, the hats and jackets with their names on the back hanging on hooks, their boots and pants lined up and ready to leap into at the first call of trouble. The fire bay smelled like smoke and rubber; the huge fire trucks gleamed, the chrome polished like something in a jeweler’s case.
When I arrived on Saturday morning for the work detail, a dozen firemen were already scrubbing and sweeping the bays. I was the only woman who showed up. When I appeared everyone grew silent. Only minutes before I could hear the banter, the curse words, the happy chatter; and now with me there, they acted like a nun had walked in on their fun. They swept the floors grim-faced and with eyes cast downward.
I tried to make conversation, but could think of nothing to say. We all swept in silence for an hour and then I could see a huddle forming. Someone was going out to the deli to get egg and bacon sandwiches and coffee. A fireman named Chris was taking orders and money. I kept sweeping. I didn’t know what to do, I was too shy to ask them to pick something up for me. They were too shy to ask me. In the deathly quiet of the bay I heard someone mumble, “Do you think
she
wants something?”
“I dunno,” said another.
They stood and looked at me sweep but no one said anything. The egg sandwich guy got in his pickup truck and drove the half mile to the deli. My stomach was rumbling by the time he came back. The guys stopped work and all got their sandwiches and steaming cups of coffee.
In silence they unwrapped their fried eggs and bacon sandwiches and started to eat. They sipped coffee. I swept. I was now standing in the middle of a semicircle of eaters. I felt my cheeks flush. I wanted to put the broom down and run away. I could feel a blister start to form on my thumb where the heavy push broom had made a groove.
I could see an extra egg sandwich and a cup of coffee in the cardboard box.
Finally one of the firemen walked up to me. The other guys looked at their feet. “There’s a sannich for you and some coffee,” he said.
I beamed. “Thanks, what do I owe you?”
Caught off guard, he didn’t answer, instead picked up a broom and started sweeping next to me.
I looked at the guys. No one would make eye contact. I walked over and peeled the wrappings back from the sandwich. I took a swig of coffee. I never take sugar in my coffee, and this was prepared the way all the guys drink it: “regular” . . . with milk and sugar.
“Thanks,” I said with a mouth full of food. No one looked up. Nothing ever tasted so good to me.
I am having an attack of “firsts.” Here is what I dread and what I have yet to endure as an EMT. Top of the list are dead people. I have not yet met the dead, either cold and old ones or the new and still warm. I have not been puked on, I have not seen feces, domestic abuse, child abuse, or amputations. I run through the list in my head in the same way I would a shopping list of what to buy at the supermarket. If you are ever unlucky enough to ride in an ambulance as a patient, there are two unofficial rules you should know if you want the EMTs to like you: don’t die and don’t barf. The former makes us look bad, the latter makes us as sick as you.
Little do I know I am about to meet my first dead person. I forget how the call was toned out, but it didn’t sound all that bad, maybe something like “Ambulance, please respond to 776 Old Borden Highway for man with loss of consciousness.” I run out the door and into my car. It is broad daylight, nice and sunny, nothing creepy in the air. I drive a mile and pull into the driveway. As usual, the ambulance has already beat me there. I am without a doubt the slowest EMT in the world, although I feel I am driving so fast I am flying. I imagine flames shooting out from under my Subaru’s tires.
At the bottom of the stairway is a man with a broom. He is sweeping dirt off the exterior stairs that lead up to an apartment. By the look of the scene the call is nothing much, maybe someone fainted. I tap on his shoulder. He spins around to acknowledge my presence.
He has the largest goiter I have ever seen; it practically envelops his face.
I resist my urge to freak out. He is oddly nonchalant as he sweeps. “My brother is upstairs.” He points with the end of the broom. “He is not looking well.”
I can see that Bernice and a bunch of firemen have already arrived on the scene, so, not to crowd them, I stay downstairs and take out my pad and start writing.
“Your brother’s name, please,” I ask, then scribble it down.
“Does he have any allergies?”
“When was his last meal?”
“Any medications that he is on?”
As I go down the list my attention is drawn away from the man with the goiter. I look up to see four of our biggest firemen carrying a lifeless figure down the narrow staircase on a stretcher. The man is blue-gray; he is also enormously fat, can’t weigh less than 300 pounds. He is naked, and his face is damp and covered with drying Cheerios and milk.
Bernice points to the ambulance and at me. “Can you ride with us?” she asks. I jump in without thinking.
The paramedic has appeared and the CPR that was started upstairs in the man’s apartment is now being continued in back of the ambulance. I am at his head. I have a plastic device called a bag valve mask in my hands. It is hooked up to the oxygen tank, and with this I force air down his throat as Bernice and the paramedic take turns doing compressions on his chest.
The dead have little dignity in the back of an ambulance, even less if they are blue, naked, fat, and covered with cereal. Between beats I have to ask Bernice, “What the hell happened?”
She is catching her breath as the paramedic does the chest compressions and I continue to bag.
“I don’t know. He was this color when we got there. Looks like he has been dead for some time. He was sitting naked at the kitchen table with his face in his cereal bowl.”
“Shit, this guy is huge,” says the paramedic as he pushes hard on the chest.
I don’t even begin to know what to ask Bernice next. I want to know why his brother has a goiter the size of a football and why he didn’t notice sooner that his sibling was blue. Where to begin? And then I am struck by the fact that not only am I sitting in the back of the ambulance but that the big head that I have clutched between my knees belongs to a DEAD person. The dead man is looking at me with his dead eyes. His pupils are fixed and dilated, the eyes themselves a blue-gray like his skin. His eyes are open; I am using both hands to “bag” him, so I can’t close them. They look like the eyes of a big dead fish on display at a seafood store.
The oxygen line to the main tank slips off the end of my bag mask. I panic. “Don’t worry,” says the paramedic, still doing compressions. “You can’t hurt him.” This is a confirmation that he is truly dead, beyond our help or ability to hurt. We are just going through the motions. By law we have to continue CPR until we get him to the hospital and he is pronounced officially dead by an MD.
When this thought sinks in, I start to relax. I am so happy that his life doesn’t rest in my hands that I forget that I am afraid of dead people. My experience with the dead has been very limited. The only dead person I have seen was my mother in her coffin, embalmed and poufed up with a pink chiffon turban on her bald head from where the chemotherapy had denuded her. I thought all dead people looked like that.
I had always heard that dead people smelled bad and they leaked pee and shit and their tongues lolled out. This man didn’t do any of these things, at least not yet.
We ride wordlessly in the ambulance, the dead man’s head in my lap. I poke at his cheek with a gloved forefinger just to see what he feels like. He feels like a human being. After we arrive at the hospital we wheel him out on the stretcher and continue doing CPR all the way to the Trauma Room, when Dr. Blasco, a slight, dour woman in a starched white coat, comes in. She takes one look at him and tells us to stop CPR. He is now officially proclaimed dead. The time is recorded.
I start to wonder if his brother is on the way to the hospital, I still want to ask about his goiter. Bernice tells me he is coming to the ER in his own car. “What’s wrong with his face?” I stammer.
“Remember last year there was the call about the guy who fell down in his garage and got stuck between the washer and dryer?”
I shake my head. Bernice forgets I am new at all this.
“That was him.”
“Is that how he grew the goiter?” I ask.
“No, he had it at that time, he was stuck between the washer and dryer and the firemen had to pry him out.”
“Why didn’t he call 911 earlier today? Why didn’t he know his brother was dead when he was blue?” I ask.
I am asking the unanswerable questions. Why? Why do people live or die, or love or hate or see things or are oblivious to them?
“That was my first dead guy,” I tell the paramedic, who is pulling the twelve-lead heart monitor lines off the big man’s chest.
“Cool,” he says, and slaps my shoulder.
In the ambulance heading back I start to feel antsy. “That was my first dead man,” I tell Bernice.
“Really?” She always forgets that I have just started. “We better celebrate,” she says; so we make a date to meet the next day for tea and scones with lemon curd at a “ladies’ lunch” place a mile or so from the firehouse.
We sit among the potpourri and crisp lace-edged napkins and talk about the dead man. Bernice looks elegant; I am dressed up too. The waitress takes our order and is oblivious to what we mean when we say, “He went from blue to pink.” She probably thinks we are talking about an interior decorator who changed a bedroom color scheme. I feel like I am in a secret society, a special club of people who know the dead, have met them personally. Now I can cross that one off my list.
10
Most people in the firehouse clutch before answering a call to the AIDS hospice, which is housed in a modest house down on Portland Avenue. The AIDS hospice is controversial. Many residents of Georgetown don’t even know it is there. To others in the town its existence here is a source of great pride and it is the recipient of charity benefits. And then there are the few who think of it like a turn-of-the-century pestilence house, a place to run past and hold your breath.
Bernice has told me that as a new recruit I should not be a “first responder” there. She tells me I should wait for other people to sign on before I go. She is protecting me from walking into a scene I can’t handle, and maybe she is also protecting the patients from a rookie EMT who might do something drastically wrong.
It is 2 A.M. and the tone goes off. I swim out of my sleep and write the address down on my pad next to the bed. Suddenly I remember this is the AIDS hospice, where I am not to go alone. I pull on my jumpsuit and listen for Bernice and a few others to sign on, and then I get going.
This place is also high on my list of scary things. I don’t know what I will see when I get through the door. I know that our protocol is to wear not only gloves but a mask that covers the nose and mouth, and a paper gown over our clothes if the patient is vomiting or hemorrhaging. I get to the scene and find a very frightened-looking local cop standing outside. “I don’t have a mask or gloves with me,” he says, as if to convince me that he is better off staying outside.
“That’s okay,” I say. “I’ll go in.”
I am so used to being fearful that when I do something brave it seems almost unreal. I find that I have the capacity to worry things into the ground, to talk to Tom Knox about them until we are both beyond bored, to go into intricate relentless detail with Michael, and then— boom—out of the blue, all the fear just falls away and I am doing the undoable. I now think I am the type of person who would faint at the sight of a spider but could run into a burning building to save a baby. Fear is like a hologram. It seems filled with substance and when you go beyond it you realize it was just an illusion.
I put on my gloves and a mask. Immediately I realize that the mask is a hideous invention. It prevents me from breathing in fine particulates, but it also seems to stop 99 percent of the air, too. I feel like I am suffocating. I pull it off every few seconds to take a breath. How stupid is this; I am defeating the whole point of the mask, which I am now wearing just for show, pulling it off my face at every opportunity.
One of the night hospice workers, a stout black lady, glowers at me. “You don’t need that on your face, ain’t nobody in there going to hurt you,” she says. I mumble something incomprehensible back at her through the mask, something about the mask being used for the protection of the patients as well as for us.
She says, “Whatever,” and points me and Bernice to an upstairs bedroom. In bed is a thin black woman with wild hair. Her room at the hospice looks like a child’s bedroom. It is filled with teddy bears and pictures of rainbows and balloons. It is hard to tell how old she is because she is so sick. She could be eighteen or eighty.
The stout woman hands me a computer printout of this woman’s medical history, and tells us that she is to be taken to Stamford Hospital. We explain that our ambulance does not go to Stamford Hospital, just Norwalk and Danbury. This results in a debate with the hospice worker. “I guess Norwalk,” she finally says, throwing up her hands. As I walk down the stairs to the ambulance I look at the patient’s computer printout. She is a mess. She should be dead ten times over. She has AIDS, hepatitis, TB, thrush, and has had major brain surgery. Tonight 911 was called because she had a seizure.
She slurs when she talks, and sounds very angry. She sounds drunk, although she isn’t.
“Hello, I’m Jane from the ambulance,” I say.
“Fuck you,” she replies.
“Are you in pain?” I ask.
“Fuck you,” she says again. Can’t blame her. What a stupid question. She is lying there with half a brain in her head and terminal AIDS; how could she feel anything but lousy?
“Honey,” I say (I have taken to calling patients Honey or Dear, just as I was taught not to do in class, as it is disrespectful), “we are going to take you to the hospital.”
Honey and Dear are handy if you suck at remembering people’s names in a stressful situation. I imagine that I will be regarded with the same affection given an efficient diner waitress who calls everyone “hon.”
“Ready to go to the hospital?” I say brightly, like you would ask a kid to go to the zoo.
“Fuck you,” she intones rather gravely. I wonder if this is all that is left in her surgically altered brain. Maybe it is just a one-size-fits-all expression. I do not take offense.
When a patient is so sick, and yet stable, it is a long ride to the hospital because there isn’t much you can do for them but try to keep them comfortable. I am riding alone with the patient in the back of the rig. Another EMT drives us to the hospital.
I turn the overhead lights on in the rig, and after I have placed an oxygen mask on her face, and comforted her as best as I am able with layers of our white woven blankets, I sit back and reread the printout that I will give to the hospital nurse. Her name is Melba Coulter and she is thirty-three years old. No previous address. No family members. No next of kin. Her whole life as it is presented to me is just a list of medicines and symptoms and illnesses. Above the oxygen mask her crusted eyes are regarding me. She may have just come off a long seizure but there is a spark in there. I pick up her arm; it is cold and dry, thin as a Popsicle stick. I feel around for a pulse. I take a blood pressure reading. Both are low.
I go back to reading her chart. I am uncomfortable and looking for something to do, to try to make it seem like I am of some actual use. At the bottom of the chart there is one line that catches my attention:
hobbies.
How odd, I think, but I read on. Melba’s hobbies are sewing and gospel singing. I cannot sew; I can replace a shirt button, but that is all. I try to imagine this skeletal woman engaged in her hobby. What did she sew? Did she have a sewing basket at one time and a place to live and clothes to repair? Maybe she sewed quilts, maybe she sewed for a living. What happened? I wonder if she can see well enough now to thread a needle.
I know more about gospel music than I do about sewing. I love gospel music. As I look at Melba, I think of my travels through the South with Michael and how we collected many tapes and CDs of groups like the Mighty Clouds of Joy and The Dixie Hummingbirds, which we listen to in the car. My mind wanders back to a trip to Los Angeles many years ago when we ducked out of the blazing midday sun and into a darkened movie theater, where we saw the movie
Gospel,
a documentary like
Woodstock
but with black sacred church music instead of stoned white hippies. I was so moved by
Gospel
that halfway through it I had to stand up and dance in the aisle. I testified, I witnessed, I was slain in the spirit. Not bad for a New York Jew on vacation.
Now in the back of the ambulance I start humming a snatch of gospel music to myself. One of my ten wishes would be to sing like Mahalia Jackson. I can’t, but it is fun to pretend. “Melba, it says here you like gospel music,” I say.
I am expecting a “fuck you,” but it doesn’t come. Maybe I can’t hear it over the swish of the oxygen mask.
“I really like Shirley Caesar,” I tell her, thinking of her showstopping performance in
Gospel
. Ageless Shirley— short, powerful, and snub-nosed—pantomimes carrying the heavy cross Jesus was crucified on. She sings “No Charge,” a heartbreaking song about a mother’s priceless love for her ungrateful son. She jumps as if she is on a pogo stick, and wipes the sweat from her furrowed brow as she pours her soul into every word.
Melba’s crusted eyes move rapidly back and forth. I wonder if she is about to have another seizure. If she does I should put on the full protective gear because she will lose control of her saliva and her bowels, and I am scared of all her diseases.
“I like her too,” she says weakly beneath the oxygen mask.
I am stunned that she can speak. That she is lucid.
“My husband really likes the Clark Sisters,” I say, thinking of the three robust gospel divas who have a five-octave range and enough power in their dancing to rock the house.
I wonder: before AIDS emaciated Melba, was she herself as fat and sassy as one of the Clark Sisters? I start naming gospel singers, and with each name she nods back, and I see her try to smile. The whoosh of oxygen is loud in the rig. If she is talking, I can’t hear her.
I am not a singer, and I never will be Mahalia Jackson, but I try to quietly sing a few lyrics that I know from
Trouble of This World
. I have a captive audience of one. I hope the driver in the front of the ambulance doesn’t hear me. It is a private thing for me to do. It is not unthinkable that Melba might die between the hospice and the hospital, that I will be the last face she sees and the last voice she hears. I want to say something meaningful to her, something more than “Where does it hurt?” So I sing secret lullabies, parts of songs. I hold her hand in my gloved hand. My mask makes it hard for her to hear me, her oxygen mask makes it hard to hear her. In movie deathbed scenes people do not wear masks and gloves, last words are whispered and heard, and all the tubes and gloves and masks of modern medicines are not intrusive.
We arrive at the hospital. It is late at night and the nurses are their usual stressed-out selves. When I first started as an EMT I took their behavior personally. They didn’t smile and look happy to see me. I have come to understand that what an ER nurse or doctor must feel is the way I feel after my most exhausting ambulance ride, multiplied a dozen times over.
As we wheel Melba in on the stretcher I give some information to one of the nurses and tell her that this patient wants to go to Stamford Hospital.
“Well, why did you bring her here?” the nurse asks.
“Because Georgetown doesn’t take people to Stamford,” I say.
“Well, somebody will have to arrange transport for her there,” she says, reading her chart.
We stand in the hall with Melba lying stiffly on the cot, all of us waiting for something to change.
“Okay, for now take her to Room 8. We will evaluate her and see if she is stable enough to send to Stamford.”
I see one of the other nurses is on the phone with the hospice trying to arrange transport for her to Stamford. My fellow EMT who drove the rig has now cleaned and sanitized the ambulance while I was talking to the nurses and has come in to locate me. I can tell he wants to get going, but I still have to fill out the run form, the long and detailed paperwork that goes along with each 911 call. I see him fidget, wanting to get out of here. Melba has been taken off our ambulance stretcher and placed in one of the curtained ER rooms. She is all alone. Her eyes have retreated back in her head. I see a nurse push the curtains aside and ask her a question. I can see her mouth forming the words “fuck you” through her clear oxygen mask.
I walk over to her. I touch my hand to her shoulder blade, which juts starkly through her nightgown. “ ’Bye, Melba,” I say. I have taken off my mask, so she can hear me better. She fixes her eyes on me but doesn’t say anything.
“Take care of yourself,” I say, knowing she is unable to care for herself.
She takes one long last look at me and turns her face to the wall to wait for the next ambulance and the next ride.
By the time I climb back in the ambulance, the driver has folded all the clean blankets and sheets, rolled up the blood pressure cuff and stethoscope. It is like a fresh hotel room. There is no trace of Melba anymore.
“Let’s go,” I say, and we take off for home. I feel like crying but my eyes remain dry, like Melba’s.
“Hobbies:
sewing and gospel music,”
I repeat to myself, and turn out the overhead lights on the ceiling of the ambulance as we glide through the night toward home in darkness on a trip where someone will be happily waiting for me at the other end. I am very fortunate.