Monday, November 30, 2009

Finding the Dead

When it comes down to it, late afternoon is as good a time as any to find the dead. The air is slowly making its transformation from humid afternoon sweat to cool evening breeze, the streets growing quiet as the world settles in for the night. The end of day, the beginning of a long dark night. It would appear, perhaps, this transition carries with it some symbolic parallel to the journey our patient has just made but the reality is no more poetic than this: I simply find this time of day relaxing.

Right now we’re headed to an abandoned school in southeast Atlanta. There’s a cop down there who thinks he’s found something but can’t be sure.

Cool air sweeps through the cab of the ambulance as we ease our way south. I have gotten this call too many times to count. Someone is down, no one knows who or how or why. Simply that they saw something, or didn’t. Sometimes the eyes play tricks. In the movies they call it DOA for dead on arrival. Officially we call it a 48, ten code for dead. Unofficially, well, a lot of things are said. DRT: Dead Right There. I once heard someone say NLPR, which means No Longer Playing Records. These have always struck me as a touch cheesy. Usually I'll wander outside and tell the fire crew that’s hustling in behind us ‘Hey you guys can take off. He’s already stiff.’ Or, to the concerned rookie cop who’s never worked a 48 and isn’t sure how to react, I’ll say ‘Just call the ME, you can smell him from the door.’ Back inside, my partner and I will dig through his pockets and rifle through his drawers looking for ID, for meds, for clues to what might’ve happened. We’ll speculate on how long he’s been here, whether he fell going to or coming from the bathroom. One way or another we’ll all be present for this conversation someday.

When we pull up to the school there’s a traffic patrol officer parked on the curb. There are so many police agencies, each with dozens of sub-sets, to list even a fraction of those prowling our streets right now would make your head spin. After six years I still find new ones and today, as we pull-up on scene, the Atlanta Traffic Enforcement truck is new to me. A fat guy lumbers out of the passenger seat and tells me he was driving by when a junkie flagged him down and said there was someone inside. He tried to investigate but didn’t have a flashlight. So he called us.

It been years since the school was full of children. Its power has been cut, the windows boarded up. But it’s definitely still in use. Like the junkies, whores and lunatics who fill its classrooms today, we slip through a hole in the chain-link fence and cross the schoolyard on a well-worn path through the weeds. Finding a body in a place like this has advantages, first among them the near-certain guarantee that whoever lies inside will not be tended to by a crowd of anxious loved ones.

Usually we find them in houses. Always upstairs, always in a tiny room. The sick and dying tend to know something is wrong and, if they can, they make their way to the bathroom. I’ve seen countless bodies, stiff and swelling, pinned between the toilet and the tub. Even when they’re in the bedroom or the kitchen the bathroom light is on, the medicine cabinet open and pawed through. By the time we’re called no one has spoken with him in days and a son or daughter has come to check on him. Usually they get no closer than the front door when their worst fears are confirmed. Once a woman rotted in her stifling hot apartment for two weeks before someone finally called. As we walked around, faces covered with towels, her neighbors were so ashamed they wouldn’t meet our eyes. ‘I just thought it was a rat in the wall,’ one woman told me. The smell was drifting out into the street and I asked her how big a rat did she think it was. She shook her head, embarrassed, then went back inside and locked her door.

Sometimes, though, the family is home. A man feels ill, lies down in bed and never gets up. Two hours later his wife goes to check on him and notices his feet are blue. Occasionally a family wakes to find their infant cold and stiff in her crib. Overcome with emotion, they are frantic, violent and totally inconsolable. One cold morning I stood in a trailer park and informed a Spanish-speaking family of their infant’s death through the only available translator: their nine-year-old niece.

As soon as we enter the school we are swallowed by darkness. An abandoned building is creepy to begin with but when you know your journey will end with a dead body it takes on a life of its own. I click on my flashlight and am amazed at its uselessness. This beam of light is my lifeline, what I will use to get to the patient and, eventually, what I’ll use to get out again. And it’s only 12 inches wide. Somewhere in the darkness something moves and I swing my light. I hope to God it’s only a rat but I know we’re not alone in here.

We shuffle through the auditorium, stepping over fallen pieces of ceiling and piles of turd that dot the floor like a dysenteric mine field. As we go deeper in things get much worse. We’re in a hallway now, dark as night and shockingly narrow. The plaster ceiling sags and buckles with water damage, long strips hanging down like fly paper. I jump out of my shoes every time I bump into one. And the walls. Also plaster, they heave forward, lumpy shapeless arms reaching out to grab me as I stumble forward, tripping over debris.

And all the while I can’t see. Cup your hands tightly over your eyes and you begin to imagine what our field of vision is. A tiny dot in the darkness. I look left and can’t see what’s coming from my right. Look forward and have no idea what lurks behind me. And all the while the place is alive with groans and creaks, the distant moaning of a drug-crazed lunatic, himself not far from death.

We round another corner and for the first time we catch a whiff of what lies ahead. Decomposition is a terrible, sickly sweet smell but at least today it tells us we’re on the right path. Our trail will end down the next hall. When we round the corner we’re blinded by a flash of light and immediately stop. Disoriented from stumbling through the darkness it takes a minute for me to realize what I’m looking at: the door at the end of the hall is half glass, my light is bouncing off and shining back in our eyes.

We continue on, the smell becoming more intense with each step and the cop beside me, a traffic enforcement officer after all, begins to mumble. Five feet from the door he says he’s never seen a dead body. ‘Well, I guess you can check that one off your list,’ I tell him. When I reach the glass the smell is over-powering. It’s been more than a week, possibly two. I have to place my light on the glass to cut back on the reflection. What’s on the other side is Hollywood. A man in the fetal position, guarded by flies, tended to by maggots. Large sections that should be there simply aren’t. When a body is left untended words we do not normally associate with humans begin to apply: bloating, liquefying, bursting, rotting. These have all happened. It’s the ultimate lesson in humility. We are nothing more than meat and, if circumstances allow, we will end up no differently than a possum lying on the side of the road.

The cop groans and twitches, this is more than he bargained for. I’ve seen all I need to see and step back. To keep the light from reflecting off the glass and shining in my eyes I point it at the ground. And there, at my feet, are drag marks.

It takes a second for my brain to process this information but once it does there is a tingle at the base of my spine. Slowly, I trace them down the hall, back the way we’ve just come. ‘Um’ is all I manage to say. It turns out our patient didn’t slink back here to die in peace. He was dragged, perhaps kicking and screaming, to this dark corner of a long abandoned building and killed. The cop sees what I see. He fidgets with his keys. ‘You might wanna go ahead and call homicide,’ I say.

Outside it is bright. We have spent so much time scratching through the bowels of that building that even the fading light of day is intense in comparison. I write up a short report and have the traffic enforcement cop sign it. He is still shaken, his skin itching all over and his jaw hits the floor when he sees my partner take a bite of his dinner. He lingers just long enough for a beat cop to arrive before disappearing down the road, off to write tickets and reveling, no doubt, in the mundane nature of traffic enforcement.

We disappear, too. A mile down the road we get another call. A child with a fever. He plays with his mother’s keys as we drive to the hospital. His mother, seat-belted into the bench seat, looks around at the assortment of equipment we carry and says, ‘I bet y’all see some crazy stuff, huh?’ I keep writing, shrug. ‘It has its moments.’

Tuesday, November 24, 2009

Friday Morning

It’s Friday morning. That’s not nearly as succinct or accurate a description as it sounds. My Friday is not your Friday. Not necessarily. My forty-hour week is crammed into three days, the last of which is Friday, regardless of what calendar day it falls on. It’s also not necessarily morning. When you work nights whatever time you crawl out of bed, brain wobbling in the confused orange glow of mid-afternoon, that’s morning.

I take a shower, make some coffee and call my wife. Say what you will but I am quite simply lost at sea when she doesn’t answer. That isn’t to say I’m incapable of running the house in her absence. I’m the cook, the housekeeper, the gardener, shopper, unskilled laborer and arbiter of neighborhood disputes. I simply don’t care to start my day without first talking to her. Which is strange because when I call, her day is almost over. It’s after five and she’s worn down from solving petty disagreements, stomaching excuses and weathering an unending storm of accusations. In short, from straining under the burden managers the world over must carry. She’s tired from a long day and I’m fresh out of bed and ready to start mine. On days I work we are truly two ships passing in the night.

And it’s not just her. By the time I hop into my car the world is finished for the day, evidenced by the steadily increasing stream of cars heading in the opposite direction. They’re all going home for an evening of whatever it is they do and I’m still thinking about what to eat for breakfast. If nothing else, shift work teaches you the world is a window through which no two people will share the same view.

Of course, things are different on Monday. When you come in on Monday you’ve been gone from the place, washed it from your skin and returning is a shock to the system. On Monday the smell hits your nose like a jab and instantly triggers memories in a moment not at all unlike walking through the halls on the first day of school. By Friday that’s all gone and the smell is a part of you, your body coiled and ready to spring when the dispatch comes in. There is also, on Monday, a cleanliness. It’s in your boots, your clothes, your hands. Everything has been laundered and polished and left to rest. By Friday there will be dirt, mud, clay, flecks of blood, the grime of homeless shelters and back alleys, unswept dust from decrepit houses and the slight stickiness of the river of bodily fluids you have passed through in nursing homes, bathrooms and in the crowded din of countless trauma bays. You’ll scrub these stains. Wipe them off, hose them off, remove them from sight and yet they linger on. Imperceptible, perhaps, but present. And so when Friday is over and you’re done for the week, the stains follow you home only to be removed by the sandblaster that is time spent away from the siren.

By now my day is in full-swing. My partner and I are perfectly synched from spending two long shifts shoulder-to-shoulder wrestling drunks and carrying the large, naked and infirmed from their houses. We check-off the truck, fire up the engine and put ourselves in-service. The sky is slowly going dark blue and streetlights begin to flicker on. Somewhere out there our first patient of the night does not yet know they need an ambulance.

And maybe they don’t. Sometimes they call seeking advice, reassurance or even a quiet alternative to the city bus they typically ride. None of this may be proper in the strictest sense of when you should summon the service of an emergency ambulance but they are realities of the modern 911 system those of us who comprise it accept as fact.

At a gas station in a dangerous part of town I buy a bottle of water and am invited to cut in front of the long line of men waiting to buy lotto tickets. Outside my partner has the windows down and our radio works and the moon is slowly beginning to overtake the sun. It’s the perfect start to the night and, at the moment, all is quiet.

That won’t last. Tonight we will run non-stop. We will be spit at, argued with, vomited on and threatened. We will work the nightmare call we all know is out there yet never mention for fear of summoning it from the muck. Tonight we will sweat, our hearts pounding as our efforts fail and everything goes quickly to shit. Someone will die as we walk through the door and the family will blame our slow response. All hell will break loose in the ambulance and nothing will go according to plan and when we arrive at the hospital a doctor will shake his head, having no idea what we went through to achieve even the modest degree of order he has inherited. Later we will sit in the ambulance plagued with doubt, wondering how things could’ve gone better, wondering what our peers will say and what they might’ve done differently.

But right now we don’t know any of that. Right now all is good, the sky dark and peaceful. Right now it’s Friday morning.