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.

Tuesday, May 26, 2009

Memorial Day

The man on the ground was supposed to be unconscious. But we knew he'd be drunk. He was sprawled across the concrete plaza near the Park Street MBTA station, where every patient we treat seems to be homeless and intoxicated.

I tapped him on his shoulder. He opened his eyes. "Don't fuck with me," he growled.

"Whoa," my partner said calmly. "Let's not start that."

"C'mon," I said to the man. "We're going to help you sit up."

The man seemed to sense that we hadn't come to give him a hard time. With our assistance, he sat up on the sidewalk. "Let's move to that bench over there," I said.

Unsteadily, and with one of us on each side, he took a seat on a nearby park bench. By this time a pair of EMTs--one male and one female--had arrived. "You in the military?" the man asked the male EMT. Even now, I have no idea what made him pose this question.

The EMT held out his arm, exposing a long tattoo based on the Army Airborne insignia. "I think this says it all," he told the man.

He turned to me. "How about you? Did you do any military service?"

"I'm a JAG guy," I said.

"What branch?"

"Army Reserve."

"And you?" he asked, looking at my partner.

"Aviation medic," he said. "National Guard."

The male EMT sat beside him on the bench. I sat on his other side. It was a glorious spring afternoon, and the tourists swarmed around us in full force. It struck me as odd that just a few minutes earlier he'd been a passed-out drunk awakened by us on a sidewalk. Now, because of a common connection, we were sitting in the sun, chatting like old friends.

"So, how about you?" I asked. "You must have been in the military. Otherwise, you wouldn't have asked all those questions."

"I was in Vietnam," he said. "Nineteen seventeen-one to nineteen-seventy-three. A grunt."

He talked a bit longer. We were genuinely interested in his experiences, but there came a time when we had to move on to the next call.

"You want something to eat?" one of the EMTs asked.

"Sure," he said.

"We'll, come with me. We'll take you to the hospital. They'll keep an eye on you, and you can have a sandwich or something."

As we escorted him to the ambulance, I found myself wondering why, with so many resources available to veterans, this guy wound up living on the streets. The government gives veterans all sorts of loans, and educational benefits, and housing assistance, and health care. There's a shelter, exclusively for veterans, right up the street. Yet this guy wound up homeless, drunk, and asleep on the sidewalk.

The answer, of course, is that veterans' assistance, extensive as it may be, does not come close to meeting the needs of every veteran. Some have too many psychological problems to blend in with society. Others have such terrible substance abuse problems that they can't hold a job or even seek out the necessary services. And this is a shame, because of all the people who need public assistance in this country, veterans deserve it the most. They stood up when the nation needed them, and now that they need help, they should get it, whatever the cost.

We helped the man into the ambulance. "Thanks a lot," he said.

"You're welcome," I told him. "And happy Memorial Day."


Blogger Last Angry Man said...

You know TS, I am not only semi-retired from the Veteran's Shelter here due to my service-connected disabilities, I also left because of the sheer, heartbreaking frustration of it all. For every Veteran I helped out the door, back into a successful life, there were two or three or more who just didn't make it. It was just plain wearing me down.

Sometimes I wonder if it was all worth it. Then I will run into one of my former clients who is doing great, and I gain just a bit of hope that maybe it was worth it after all.

But it's a game without end, until our nation wakes up to how they ignore and discard their Veterans so casually.

People will spend endless hours chatting about American Idol or their favorite pop star, as if their affairs are of world-class import - while walking right past the bum "stemming" (panhandling), without ever realizing that this guy had seen and lived through the worst imaginable. Worse, not caring who he is, or what he's done for all of us.

It's a mystery to me.

I know the guy you helped really appreciated it. Thanks for giving a damn.

8:19 AM  
Blogger Michael A. Burstein said...

Thank you for sharing this story.

8:22 AM  
Anonymous Anonymous said...

Hold on here...resources were not so readily available to Vietnam Vets. They were shunned and cast aside like garbage. It is only recently that we as a country have shown outrage at how our vets are treated. So please do not sit there wondering why this guy is living on the streets. That is a sad fact of life for many of them.

You made a difference to this man for one day and for that I am sure he is grateful. But he has been living a nightmare for decades and for that we all need to hang our heads in shame.

9:38 AM  
Blogger TS said...

Last Angry Man:

To be honest, I expected to take some flak for being hypocritical. In this post, I seem to give a pass to homeless and alcoholic veterans, after all, when I don't necessarily give a similar break to non-veterans in the same predicament.

But the way I see it, these men and women have substance abuse problems, and psychological problems, and medical problems like traumatic brain injury, only because of their service to the United States. Some of them might have become alcoholics or addicts anyway, but I think it's fair to say that in most cases, their impairment is directly related to the job they did for this country.

Since we as a nation caused their problems, then we must do whatever we can to alleviate them. But that's just how I see it.


9:43 AM  
Blogger TS said...


I didn't mean to say that I didn't understand how he came to be on the street. I've talked to a lot of these guys--the Vietnam-era ones especially--and the reasons for that are obvious. Unlike today's veterans, the ones from the Vietnam era generally were not volunteers. Rather, they were forced into an unpopular war they didn't want to fight. Physically and emotionally wrecked, they returned to a nation that not only didn't appreciate them, the way returning Iraq and Aghanistan vets are appreciated, but actually held their service against them. Under those circumstances, it's amazing that ANY of them turned out OK.

I get all all of that. My point was that US government has created many programs for veterans recently, but it still isn't nearly enough. It wasn't enough during the Vietnam era, and it's not enough now. More needs to be done.

Thanks for bringing out the need for clarification.

10:07 AM  
Blogger Norma said...

The resources and benefits available to veterans are not only not enough, they are not "advertised" -- a lot of people who have served have no idea what they're entitled to, let alone how to obtain it. And, as I've said before, the fact that there is a need for a homeless shelter specifically for veterans is an abomination. I know that you can lead a horse to water and there will always be some population who refuse shelter for their own reasons, but the amount of veterans who struggle in poverty, poor health, addiction, untreated mental illness, etc. is mind-boggling. Nice in this case, TS, that you and the other responders made a connection with him and at least got him somewhere safe and sober for even a few hours

10:45 AM  
Blogger Last Angry Man said...

This comment has been removed by the author.

12:55 PM  
Blogger Last Angry Man said...


No, no hypocrisy. People end up in their situations for a reason. Many won't look past the person's situation and try to see the root cause, the why's and wherefore's of how they ended up there. You do. That's going beyond and above your job, and I know such people as the Veteran you mentioned appreciate it profoundly, even if they don't say as much.

Many of them have little if anything. Small things are very important. A kind word, a helping hand, a little understanding. It goes much farther than people would believe.

12:55 PM  
Anonymous LoveMyMarine said...

Being married to a Vietnam Vet, I know very little about the struggle these men have endured. My husband is a professional, lives his life peaceably, but will never be the 20 year-old that cam back from Vietnam in 1969. He doesn't share much, but I know a piece of him is missing in the horror of war.

These men, just everyone else, have dealt with and continue to deal with Vietnam in their individual ways. They may know that these benefits exist, but many choose (forty years later) to not partake in them. They remember the shabby way they were treated upon returning to US soil, the names they were called, etc. They were not celebrated as heroes, their service not commended. Many gave back medals, as they represented a false or shallow "thank-you".

The question we should ask is: WHY are 25% of all homeless veterans? WHY aren't there more subsidized housing programs available? They don't want to be remade, but many need a place to live.

The lesson learned is that LOVE is the most important thing of all.

1:42 PM  
Blogger Linda said...

I was only 9 years old when my Dad came back from his tour in Danang in January of 1968 but I know he came back a different person than the one who went over. He never talked about the hell he went through for his tour of duty in 'Nam and never showed any signs of PTSD but years later his exposure to Agent Orange would kill him in the form of non-Hodgkins lymphoma. Fortunately, when he came home he had a great support system in my mother who loved and supported him unconditionally and he was never one to drink either so I'm sure that helped keep him from a life that could have been as messed up as a lot of our other less-fortunate veterans.

I guess what I'm trying to say here is that "there, but for the grace of God" go a lot of men who fought in a horrible and ugly war. There are way too many who are still suffering and it's a very sad situation.

Everyone thinks they're doing such a great job now of patting our vets on the back and telling them what a great job they're doing but where were they in 1968 or 1969 or even 1972? And where are they when people like this poor guy end up spending Memorial Day drunk by the side of the T?

We've come a long ways but there is still a long ways to go.

Now, after all that rant, thank you for your service to our country.

8:17 PM  
Blogger Patpacer said...

For decades our government has done a very good job of saving taxpayers’ money with inadequate Veterans Affairs funding.

President Obama recently made excellent leadership appointments to Veterans Affairs. Even with their proven leadership abilities, and impeccable credentials, both Secretary Eric Shinseki and Deputy Secretary W. Scott Gould are facing the cumulative inadequacies of decades past. The tiny fuse of overmedication that has kept this whole VA system operational for 30-some years now desperately needs to be replaced with major re-wiring.

This young generation of veterans should not have to experience the palliative treatment of health care most veterans using the VA have experienced for decades. It would be great to see the VA step into the 21st century as the leader in world-class health care.

But after decades of under-funding, this proposed new VA budget is not enough. For our new leadership to achieve its full potential along with world-class VA health care, a one-time, additional funding of at least $17 billion is desperately needed.

The VA has many good doctors working there who will feel much relief to actually have the opportunity to treat their patients instead of just medicating their symptoms.

8:22 AM  
Anonymous Beverly said...

My very first job as a teenager was as a nurses aide at a VA hospital in 1971. It was a spinal cord injury unit and I lasted 2 months. The pain, anger, misery and humiliation these guys endured was just too much for my little white suburban girl's soul. I was the consummate coward and they didn't need me at all. I still get a lump in my throat when I think about that job and how I failed those men. Vietnam still sears our souls 40 years later.

9:19 AM  
Blogger TS said...


Thanks for the honest self-assessment. That must be difficult to think about.

9:57 AM  
Blogger Music Medic said...

Good Article, It makes one think.... I considered The Military to pay for Medic school but decided against it mostly because I want to jump right into a busy city FD, Although I think I would really enjoy being a Military Medic.

12:53 PM  

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