other people's emergencies: random thoughts of an urban paramedic

For more than twenty years I've worked as a paramedic for the city of Boston, Massachusetts. The opinions expressed in this diary are mine alone, and do not represent the views of Boston EMS. Names, dates, locations, and physical characteristics have been changed to ensure patient confidentiality.

Monday, December 24, 2007

Christmas Eve

It happened more than a decade ago, but every year on this day I think about it.

We received the call as a potential suicide. The crew of a commercial ambulance, transferring a psychiatric patient to a Boston hospital from a suburban mental health facility, spotted the patient on the Tobin Bridge. He was standing at the edge of the roadway, looking out over the water. They didn't feel comfortable stopping to investigate because they already had a patient of their own.

I felt cheerful as we headed up onto the bridge. Unlike most people, I've always enjoyed working on Christmas Eve. This is the one night during the year when everyone we encounter seems to be in a good mood, and nobody gives us a hard time. Plus, during the night of Christmas Eve, I always look forward to the next day, to the gathering of my family.

The Tobin Bridge is not an unusual place for suicides. It is, however, an unusual place for suicidal attempts. More than 300 feet tall, it provides the ideal platform from which to jump. We've had a handful of people survive leaps from the Tobin over the years, but they die far more often than they survive.

We arrived to find a motorcycle parked in the breakdown lane, with nobody around. I wondered if the man had already jumped. A police cruiser was ahead of us, having crossed the bridge into Chelsea moments earlier without locating anyone.

We stopped at the motorcycle and looked up and down the bridge. It was a cold night, with a bright moon. I remember every detail about that night, after all this time.

Ahead, a man climbed up from beneath the bridge. Until that night, I'd never known that a catwalk runs beneath the deck, allowing the bottom to be repainted without scaffolding. The man had hopped over the railing and shimmied down onto the catwalk upon the approach of the police officer. Then he'd climbed back up, not expecting us to come along immediately afterward.

He was a young man, not much older than 20. He appeared healthy and physically fit. When he saw the ambulance, he froze, standing outside the railing, gripping it tightly with both hands.

I opened my door and and approached slowly. Putting my hands in my pockets to appear nonchalant, I asked, "What's going on?"

In retrospect, this sounds pretty silly. But they don't give you any scripts in paramedic school. You make everything up as you go along. I had to start someplace.

The man looked at me. I could tell he'd been crying. "Why'd she have to do it tonight?" he asked. "Of all nights, why tonight?"

"Who?" I asked. "Who are you talking about?"

"My wife. We've been married a month. And tonight she announces that she made a mistake. She doesn't want to be married to me any more. On Christmas Eve she tells me this! After just a month! She couldn't wait two or three more days?"

"Is it really worth ending your life?" I asked. "There's no possibility that you'll ever find anyone else?"

At this point he removed one of his hands from the railing. He was leaning back slightly, with only the fingers of one hand keeping him from falling.

"I've been out drinking all night," he said. "I went from one bar to another. I thought it would make me feel better. It didn't."

He leaned back further. He held the rail with just his fingertips now. Three hundred feet of air stood between him and the harbor. We winced.

The police car had crossed into the neighboring city of Chelsea, and had circled around to come up behind us. The police officer walked up behind me.

Suddenly the man performed an incredibly thoughtful act. He didn't want us to feel as if we'd failed. Pointing to each of us in turn, he said, "It's not your fault, and not your fault, and not your fault. But I'm going."

With that, he turned and leaped headfirst over the edge. All three of us rushed forward, but we weren't nearly close enough to stop him. We got to the railing just in time to see his body splash into the water far below.

For an instant, none of us moved. Between the cop, my partner, and me, we had more than thirty years of experience, and all three of us had seen many people die. But nothing can prepare you for a moment like this. At that moment, I thought to myself, I just saw a man kill himself. It was the first and only time anyone has committed suicide right in front of me.

Then I snapped out of it. I keyed my microphone and reported what had happened to the dispatcher. I told him we would continue across the bridge. From there we would make our way to the waterfront.

We flew into Chelsea with the police officer right behind us. He, too, was calling for help. Since Chelsea is a different city, we don't know our way around. We doubled back, taking a guess at which way to go, aiming in the general direction of the harbor.

Soon we found ourselves at a yacht club. My partner grabbed a pair of bolt cutters from a rear compartment and snipped the chain on the gate. We drove up the clubhouse. There we scaled a fence and ran out onto the network of piers.

Before long, the harbor came alive with red and blue lights. The city's fireboat arrived. And a pair of police boats. The Coast Guard. Vessels zigzagged beneath the bridge, scanning the water with searchlights.

Since we were the ones who'd seen the man go in, we had the best idea of where he might be. The fire boat picked us up at the pier. We directed the captain to a location directly beneath we're we'd talked to the young man.

Over at the pier, a team of police divers suited up. The wind was bitterly cold, and I couldn't imagine jumping into the water to conduct a search. But that's the duty they volunteer to do.

The police boat ferried the divers to our location. They went in two at a time, alternating every ten minutes or so. Occasionally we'd catch a glimpse of a flashlight underwater, but mostly the water appeared black. I don't know how they managed to see anything down there.

The fireboat captain asked me to show him exactly where the man had jumped. I pointed. "They won't find him tonight," he said, shaking his head. "There's a ridge on each side of the channel, then it drops off to deeper water in the center, where it's dredged. He went into the center of the channel, where the mud is softest. I'll bet he went twenty or thirty feet into the mud. A couple of days from now, the gasses in his body will expand, and he'll become buoyant, and he'll come to the surface. With the tides and currents this time of year, they'll find him over by the airport."

It was hard to believe that anyone could know so much about the subject. But that's what comes from a quarter-century of experience, I suppose.

The divers returned to the boat. They gave us the wave-off sign. They hadn't found a trace of the man.

A Coast Guard helicopter had been called up from Cape Cod. It arrived just as the divers were returning to the pier. It hovered low, beneath the bridge--something I'd never seen before. After a few minutes, it raced off into the sky. The fireboat's radio told us why: A five-alarm fire was blazing not far away, near the Chelsea waterfront. It was interfering with the helicopter's infrared scanning equipment. When the crewman adjusted the gain upward, he could see only the heat of the fire. When he adjusted it downward, there wasn't enough sensitivity to pick up the man's body temperature. Bad timing, and bad luck, pure and simple.

The fireboat dropped us off. An EMS supervisor asked if wanted the rest of the night off, or if we wanted counseling. Both of us declined. It was a sad call, but I didn't feel particularly distraught.

I think I underestimated the effect it had on me, though. Later, when I went home to bed, I dreamed about the call. It wasn't a nightmare, exactly, more like a replay of the entire event. I woke up, realized it was just a dream, and went back to sleep. The dream started all over again. And the next night, it happened again. This was the only time in my twenty-three-year career that I ever dreamed about a call more than once.

Three days after the man jumped, a fisherman spotted a body in the water. This happened right near the end of a runway at Logan Airport, just as the fireboat captain had predicted. A police boat removed him from the harbor. He was identified by the medical examiner as the man who had committed suicide in front of us.

He'd turned up precisely where the fireboat captain had predicted. The estimate had been off by just one day.

17 Comments:

Blogger DPL said...

It's sad that this time of year brings back such tragic memories for you. Despite his ill-fated choice, I'm glad he had the sense not to let any fingers get pointed because of it.

I know you're experienced enough not to get rattled much by recollections like that (especially after so long) so Happy Holidays, TS.

Dan

1:19 PM  
Blogger TS said...

Thank you, Dan. And to you as well.

No, it doesn't ruin the holiday for me, or anything like that. It's just something that I recall every year right before Christmas.

3:07 PM  
Anonymous Anonymous said...

Wow.

Just.

Wow.

11:30 AM  
Blogger amusings_bnl said...

that's a sad and amazing story. i do believe that you tried, everyone tried. and i wonder about the aftermath... the wife who dumped him, the family on both sides... the friends.

barenaked ladies has an amazing song called "War On Drugs" which is about people who try to commit suicide.

"Near where I live there's a viaduct
Where people jump when they're out of luck
Raining down on the cars and trucks below

They've put a net there to catch their fall
Like it'll stop anyone at all
What they don't know is when nature calls, you go

They say that Jesus and mental health
Are just for those who can help themselves
But what good is that when you live in hell on earth?"

not exactly the kind of lyrics one expects from the "If I had a million dollars" guys... I'll think of your story, your jumper, when i hear this song now.

3:32 PM  
Blogger TS said...

BNL happens to be among my favorite groups. I know that song well, and I agree with you: It's a really good one, and an unusual one for them.

Good observation.

5:03 PM  
Blogger Brendan said...

"BNL happens to be among my favorite groups. "

I knew there was a reason I liked you. ;-)

10:21 PM  
Blogger Dale said...

It's funny but I don't think this is really sad. Or, no... it's really sad, but it's not bad that it's sad. Sometimes people need sadness in their life, it's unfortunate that it often comes at the expense of someone else. But he was thoughtful enough through his pain to let you all off the hook.

One bright, cool day I was driving from work to pick up some lunch, it was wintertime but I don't think it was Christmas.

I took a side road through a small business park, and at an intersection, a two-way stop, there was a motorcycle, bright green, chartreuse actually, strewn across the intersection. There was a dark colored Honda Accord past the intersection that looked like it had hit the bike.

The rider was also wearing bright green to match his bike, his helmet was off, he was trying to get up but people were urging him to stay down. There was a crowd of people, and a woman dressed in a dark overcoat was holding her hands to her face. It took it that it was her Honda, that she had hit the bike.

I had no reason to stop, so I drove slowly past the scene, slowly so as not to disturb anyone. I figured the rider was hurt but he was mobile, so it wasn't too bad.

Driving back from lunch, the people were gone, the road was mostly cleaned up, everything seemed alright. But then a couple of days later I drove through the same intersection, there was a little memorial.

Oh man, that hurt to see that, it hurts now to remember. It's funny how much we understand indirectly, through symbols and shadows. There were flowers in a vase, and a sheet of paper attached to a pole, fluttering in the wind. I never do this, but this time I parked the car and went over to see.

A photo printed on computer paper of a young man with two other young men and a young woman - comrades in a happier time. He was a commercial artist with a small company. I tried to remember his name, and succeeded for a day, maybe.

I still think of him sometimes, and of his friends - it makes me sad, but... it gives me the opportunity to be sad. It seems self-serving to use another's misfortune for one's own benefit, but that's part of living too.

1:04 AM  
Anonymous Anonymous said...

our emotions are too strong for our survival instinct to kick in when we are too weak emotionally.


must ....not...give....in.....


to be 20 and to let existence go is so very, very sad. his family and friends I'm sure were crushed by his selfish deed. but I can understand why he did this to himself. we have feet of clay and are so easily broken. we must embrace our brokenness, as a distinguished humanitarian has written.

4:29 AM  
Anonymous Anonymous said...

Women are evil. But think how many more he could've had revenge on!! Fool!!

7:14 AM  
Anonymous maverickrem said...

been a while since I commented on her. I have had the unfortunate experience of having to work 11 out of 15 years on the 24th. For all but 2 of those 11 Christmas eve's I've had a death, be it a triple zero, or some violent crime. I know the pain that you have from memories, just remember you may have been called because you and your partner were the 2 strongest on that night, and could handle the mental aftermath. That's always been the way I've looked at it. Be safe this year.

8:25 AM  
Blogger msouth said...

There is something that people can possibly take away from this in case they are ever in a situation where they are so depressed/without hope/whatever that they think about ending it all. You look at this guy, 20 years old or so, devastated by a relationship event, and you say "OK, I understand that it _really_ _really_ hurts now, but it's temporary. Give yourself time and there is a very good chance you will find meaning and purpose again." You, me, anyone on the outside, we _know_ that the course of action he is choosing is not rational, but he just can't or won't see it.

This is true for (practically) every suicide. And if you are ever contemplating it, it's practically 100% certain that it's true for you. Maybe you can think back and remember this story and say "OK, I feel like there's no point in continuing and I just want the pain to end, but somewhere deep down, rationally, I know I'm thinking about doing the same thing that kid did all those years ago."

Maybe you can use this to save yourself. Think of this thoughtful young man who didn't want these uninvolved people to suffer and took the time to let them know it wasn't their fault, and extend his memory a little longer by pulling yourself back from the brink.

Thoughts of suicide occur to a lot of people. Don't think it could never happen to you, or it might take you by surprise. Instead, plan to use this story as your link back to reality if it ever happens that you get to the same place that this guy did.

10:50 AM  
Anonymous Anonymous said...

As sad as this might seem at least he died quickly. If we ever can belive in a 'true' love or one person in the world for us then we have to accept that when these relationships turn sour that most people quickly turn to suicide.

This man probably should have waited a little longer before making the choice and definetly should not have been drunk but I can tell you, when somebody you love tells you to go away and never come back suicide seems a humane and realistic option. It doesn't always get better over time and it can easily ruin your life in the same manner as cancer or aids except its your mind and soul that rots here.

Suicide is all about the victim, not the audience. If it makes you feel bad that is something you have to deal with - but dont expect other suicidal people to suddenly feel happy because you want them too. Some problems cannot be solved. That man had a right to end his life, and he is no longer in pain. There is some good in that.

12:02 PM  
Anonymous Nick said...

My view is that there are moments of weakness that certain things can happen and 'trigger' such kind of emotions. Especially if you are a person that risk in your life you can understand this. In the end from my experience, if someone is patient enough, in time you learn to cope and survive any situations or people that do not have a place in your life and do without certain bad types of people.

12:28 PM  
Anonymous Anonymous said...

For some of us, ending our existence is the only solution that seems practical. Spending a lifetime trying to fix the problems in our head that seem like they can't be fixed seems foolish. Not everyone has the capacity to live within the bounds society and those around us set up for us. Some thrive and serve as inspiration for most people to work harder. Some see the ease at which others succeed in life as even more of an acknowledgment of our own inherent deficiency, our own inherent worthlessness.

To have so much despair and know that it will never go away is sometimes too much to bare. For others to claim suicide is selfish is selfish in its own right. Wanting to rid oneself of pain and rid the world of the pain of dealing with that person seems gracious. Who is anyone to make another feel they must live for them, if only to not hurt those who care about that person?

I want to die every day, but I don't let myself make that choice because I know the hatred others would feel for me. I'd rather be forgotten than hated, so I stay.

1:38 PM  
Anonymous Anonymous said...

freaky. my buddies at Trader Joe's were just telling me how they saw the medical resuce team on route 28, then I came home and read this. Tears came to my eyes.

Bad behavior from women like that (dumping a guy on Christmas eve) shouldn't be tolerated by men. Chances are, there were other signs, and his happiness should have come from other places outside his relationship.

1:52 PM  
Blogger msouth said...

@anonymous:

I agree that it is wrong for other people to expect you to live for them. Also that you should have the right to take your own life, simply a matter of personal liberty. And I would like to say that I am not necessarily saying that all suicide is a bad reaction to a temporary problem.

Regarding people for whom success seems to come easily: keep in mind that people tend to pay attention to and concentrate others' attention around successes. For every startup that makes a bazillion dollars there are probably a hundred or more that fail, but only the one that made the money makes the news.

Also, when people look successful, a lot of times they are still empty inside. People pour all their time into making their business successful then turn around one day and realize they don't even know their own children. They can never get that time back. Many, many people who look happy do so because they are trying to keep up that appearance. I definitely feel the pressure to do that in many, many social situations.

If all hope seems lost, you might try losing yourself in helping other people. Prisons and nursing homes are full of people who never get visited, and just going there and sitting with someone can make a big difference in their life. I'm not trying to fix your problems, I just think it is possible that you could keep living, be happier, and make someone else happier at the same time. And that would make me happier, too. I'm being selfish. But I'm encouraging you to be selfish, too. Serve yourself by helping someone out. If you can talk, listen, understand, you can help someone going through a worse hell than you. It probably won't hurt you any worse to try. It won't suddenly make life easy and won't permanently improve anything, but it might give you an example of a kind of activity that you can engage in of your own will that helps lessen the pain.

I respect what you are saying and I know that I have no way of really knowing what you are going through, and, like I said, I'm posting this in my own self interest. If you have decided, at least for now, that you don't want to take the option of suicide, this is something that it might make sense to consider, and that you can do completely on your own terms.

2:16 PM  
Anonymous Anonymous said...

The sad thing about suicide is that people don't necessarily want to die, they just want things to be different. If a young person has had a life without tragedy then when the first one comes along they don't know how to deal with it.
I know of a 17-year-old Greek boy who got drunk and had unprotected sex with a girl he didn't know. He was devastated because he thought he might have AIDS. Lucky him, he lived and realized that suicide was a longterm solution to a life situation.
I know of an Arab boy in my daughter's class who took 80 Xanax
because he didn't make as high a mark on his exam as his parents expected. I don't know how much culture played in these two cases.
In my extended family there have been four suicides. The youngest was eleven the oldest sixty. I also had a boyfriend who killed himself (we had a six year relationship). I am no stranger to suicide. Everyone of them did it because of depression. There are some people who just need someone to talk to and there are some people who will commit suicide no matter what anyone does. It's a hell of a thing to do. Every person who does it is in a state of crazy at the time.

2:36 PM  

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