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.

Saturday, July 05, 2008

July Fourth

I love working on Independence Day.

Each year, the City of Boston hosts a spectacular party on the Fourth of July, with a Boston Pops concert on the Charles River, followed by a thirty-minute fireworks display. A half million people turn out for this event every year, and with so many people crowded into such a small area - many of whom drink to excess, despite an overwhelming police presence - the whole thing invariably devolves into chaos by the end of the night.

Many of my colleagues have decided that the annoyance is not worth the overtime money. Scores of tourists seek directions. Drunk and obnoxious people cause havoc. And, of course, there's always a crushing stampede at the show's conclusion. This is not a good event to work if you don't like crowds. But for me, it's one of the best events of the year. I don't mind giving directions; I don't mind drunks; and there's no better place to people-watch.

I worked a double shift, from 8 a.m. until well into the next morning, on a bike. Early on, as the first spectators were gathering in front of the Hatch Shell, I saw an elderly man pedalling his own bicycle down Storrow Drive, the highway that parallels the Esplanade and the river. There was nothing inherently wrong with this, since Storrow had been closed to traffic for the day, and people love to take advantage of this by roller-blading or bicycling up the middle of the street. What made this sight unusual was that man carried four chihuahuas on his bike: two in a basket on the front, a la Dorothy and Toto, and one in each saddlebag on the side. Each dog wore a knitted sweater.

Approaching the back of the Hatch Shell, the man ran into a State Police horse trailer - almost literally. A trooper was backing the trailer onto a grassy spot, and the bicyclist, who wasn't watching where he was going, swerved at the last moment to avoid it. The bike toppled over, and the dogs tumbled out. Neither the man nor the chihuahuas were hurt, and the trooper apologized, even though it had not been his fault. The man gathered up his dogs, uttered a few choice expletives, and rode away.

Later, as the crowds began to grow, I spotted a young woman walking her bunny on a leash down the middle of the same highway.

By noon, I was receiving a steady flow of information requests. Most people asked about the best place to view the fireworks. Some wanted restaurant suggestions. My favorite question came early in the evening, when the bulk of the spectators were arriving. "Are we on the Boston side of the river, or the Cambridge side?" one of several young women asked.

"People ask us for directions all the time," I told her, "But this is the first time someone has approached me without knowing what city they're in!" The women all laughed, including the one who'd asked the question.

She took a map from her pocketbook. "Welcome to Boston," I said. "Now that we've established where you are, where are you trying to go?" This drew another round of laughter.

Not everyone was so jovial. A man and a woman strolled up to me with an eight-year-old boy in tow. "Where's the fireworks!" the man shouted. It sounded more like a statement than a question.

"They get launched from a barge over there, in the middle of the riv..."

The woman interrupted. Pointing in the opposite direction, she said, "We can see it from over there, right?"

"Well, yeah, but..."

"See?" she barked at her companion. "I told you we could go over there!"

The man glared at her. "I KNOW we can go over there! But we can see it better from over here!"

The man looked to me as referee. "Don't you think we should go that way?"

The boy had been standing quietly, but now he asked politely, "Excuse me, but if you were going to watch the fireworks, where would you go?"

I gave him my answer, and unlike his mother and stepfather, he listened patiently to the answer. The grown-ups, meanwhile, started bickering again. The boy tried to settle the argument himself, saying, "Mom! Dave! He says we should go this way!" The grownups continued to quarrel as they walked away, with the boy trailing after them, pleading with them to listen to my advice. I felt badly for him.

This year, the crowd was mercifully tame. A report came over the radio about a spectator falling onto Storrow Drive from a bridge, but we saw only a fraction of the alcohol-related injuries of past years. With the concert underway, we received a report of a foot injury not far from where we were standing with our bikes. We rode through the crowd to a park bench, where a state police officer stood over a young man. An EMT was already there, having arrived in a six-wheeled all-terrain vehicle. "I can handle it," he told us. "It's just a stubbed toe." Looking down at the man's foot with my flashlight, I could see what he meant. The injury was nothing more than a scratch.

A short time later, we responded to another call from a trooper. This time, the patient was a young woman, four months pregnant, who had tripped and fallen over a curb in the dark.

"Where are you hurt?" I asked.

"I'm not hurt, really," she said. "I just have a funny feeling, like butterflies in my stomach."

"Do you feel like you're bleeding down there?"

"Nope."

"Do you feel dizzy, or nauseous, or anything else unusual?"

"Nope."

I took her blood pressure and heart rate. They were normal. "There's really not much else we can do for you out here," I told her. "But if you're concerned, we can get you a ride to the hospital. They can do a more thorough examination there, just to be safe."

"I don't need that. I'm going to be okay, right?"

I hesitated, choosing my words carefully. "Probably. But I can't check you very well out here. In the hospital, the doctor can do a complete examination."

"I'm not in my first trimester. The baby's only in danger if it gets injured in the first trimester. Isn't that true?" The woman knew what she wanted for an answer, and she was intent on getting me to say it.

"Well, generally, yes. But if a baby gets slammed hard enough, it can be injured at any stage of the pregnancy."

"I didn't fall that hard!" she snapped angrily. "So the baby's going to fine, right?" She'd gone from wanting my opinion, to arguing with me over the answer, and back to asking for my opinion again - all in one brief conversation. Incredible.

"I wasn't here," I said. "I didn't see what happened to you. I have no idea how hard you fell. The baby will probably be fine, but the only way to be certain is to go to the hospital."

This only made the woman angrier. "Is my baby going to be okay or not?"

"Probably. But I don't have x-ray vision. Like I said, the only way to be sure is to go to the hospital."

"I don't want to go. I think the baby's fine."

"Are you sure?"

"Yeah. I'm fine."

"Well, if you change your mind, or if you feel worse, tell one of the troopers, and he'll call us back over."

"Fine."

The state police officer looked surprised to see us leaving. "She says she doesn't hurt," I told him. "She says she just feels funny. I told her to let you know if she feels worse."

"Um, okay," the trooper said. "Thanks."

By this time, the fireworks were almost over. We returned to the place where we'd been standing. During a brief lull in the show, a young couple approached us.

"When do the fireworks start?" the man asked.

"When do they start?" I asked, unable to concel my amazement. "They've already started. In fact, they're almost over. All that smoke over there - that's from the fireworks."

An expression of shock came to his face. His girlfriend looked disappointed. "Why don't they last for an hour?" he demanded, as if I were personally responsible for dictating the length of the program.

"I don't know why. They just don't. The fireworks have always lasted about thirty minutes."

"This is it, then?" he said with extraordinary sarcasm. "Boston's big Fourth of July show? Not very impressive, if you ask me." He wheeled and left, his girlfriend trudging sadly behind him.

"Sorry to have disappointed you," I said with my own touch of sarcasm, in a voice too low for the man to hear.

We handled a few more calls as the crowd departed, including a combative, intoxicated man in protective custody at a nearby police station. After that, our long day was over. At some point, I learned, a little girl had become separated from her mother. That was a scary thought. Search parties were organized among the various police agencies, the National Guard, and EMS, but after two hours, as we prepared to leave, she still hadn't been located. As we returned to Special Operations headquarters, I heard one of the National Guardsmen saying to another, "They want us to search again, and this time they want us to check all the trash barrels."

An ominous comment, if ever there was one.

13 Comments:

Anonymous Anonymous said...

I was there last night, not in the crowds, but watching from a 10th floor balconey on Comm. Ave., near the Citgo sign. It was a spectacular show, even if it was only 30 minutes. I'm glad that you enjoy working on the 4th, there seem to be a lot of calls. You had a better night than Boston Fire Ladder 15, anyway. They bottomed out on the endless construction on Comm. Ave en route to a call, and spilled diesel fuel in a long trail down the road.
I hope they find the missing child. Have you heard any more?
You're old friends from Boston Medflight seemed to be having a good time, making a big loop around the fireworks display in the large chopper.
Thanks for being there. I have always been grateful for people willing to work when the rest of us just want to celebrate.

4:05 PM  
Blogger TS said...

Thanks. No word yet about the child.

7:18 PM  
Anonymous Anonymous said...

im surprised you didnt mention anything about the shootings going on last night...thankfully you probably werent near any of them being by the festivities all day, but i myself happened upon a BEMS crew, including a former member of the company i currently work for, putting on his vest. apparently hed just loaded up his patient, a shooting victim, when the bullets again started to fly. its a shame this has to happen in what is supposed to be the best place to be on the 4th.

10:34 PM  
Anonymous brendan said...

Hope you got a refusal from the pregnant biatch, for your own sake.

10:54 AM  
Blogger 42 said...

You have the patience of a saint. I'd have snapped it right back to every one of these jackholes.

Thanks for your service!

11:08 AM  
Blogger TS said...

ANONYMOUS: I didn't mention the shootings because, to be honest, I didn't know anything about them.
July 4 is one of the few events so complex that it must be controlled by a seperate dispatcher, on a separate radio frequency, temporarily creating two independent EMS systems for the suration of the event. Thos eof us at the Esplanade had no idea what was happening in the rest of the city, and the citywide crews had no idea what was happeneing where we were.

9:51 PM  
Anonymous Anonymous said...

Out of curiosity, is there a plan or a way to sync them up in the case of a city emergency? Could the dispatchers work together if needed, or are they physically separated locations? I can understand separating them for the logistics that need to in place, but I also hope it’s as easy as flipping a switch to all get back on the same page.

Seems like that could be a hindrance in the case of a city wide emergency, ala what happened to responders during 9/11.

10:55 AM  
Anonymous Anonymous said...

Hi - I am looking forward to starting E.M.T. training this fall. I am 42 and I work out quit a bit. I also have a career in a different feild already. I thought if I am going to take on another job it should be something that matters and will have an impact. Where could I go to get an idea of benifitsor earning potential or any other insights into becoming an e.m.t

11:34 AM  
Anonymous Anonymous said...

--is there a plan or a way to sync them up in the case of a city emergency? Could the dispatchers work together if needed, or are they physically separated locations?-- the two dispatchers sit next to each other and figure out which radio frequency / units should handle the call. As for the missing child- the version I heard was this was reported by a 17 year old and after further questioning the story just didn't add up and he finally admitted to making the whole thing up.

10:19 PM  
Blogger TS said...

ANONYMOUS: The cities of Boston and Cambridge have combined with the state to create a sophisticated joint communications center. At big events like First Night and July 4, communications experts from many different entities - Boston and Cambridge Police and Fire, Boston EMS, MBTA, State Police, National Guard, Coast Guard, and others - operate in one huge room equipped with all sorts of communications and surveillance equipment. I've seen it myself, and it's an impressive operation.

11:48 AM  
Blogger TS said...

ANONYMOUS: To learn about the EMS field in general, you might contact the National Association of EMTs (NAEMT). They operate a national credentialling system that some states (but not Massachusetts) accept in lieu of taking a state examination. You could visit your local municipal EMS system or ambulance company and ask questions. There are dozens of good websites that run onine forums in which you can pose questions to experienced EMTs and paramedics.

It sounds like you're a good candidate. Best of luck.

11:53 AM  
Blogger Gertrude said...

I too enjoy working the 4th. It never fails to bring me much entertainment. Unfortunately ( or fortunately depending on who you are) the rain storms came in early and everyone stayed in. The most excitement I had was the huge party across from the station with the DJ playing music that made me dance on the front ramp. Which of course made everyone laugh and the party goers yell across for me to come over. Did they ever find that little girl?

1:04 PM  
Blogger TS said...

I suspect so, since it never made the newspapers. But nobody seems to know anything about it.

3:01 AM  

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