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The Downwind WalkA USAR Paramedic's Experiences after the Terrorist Attacks on September 11, 2001
By Steve Kanarian
AuthorHouseCopyright © 2011 Steven E. Kanarian, EMT-P, MPH
All right reserved.
Chapter OneSweet Summer's End. Friday September 7, 2001
I slowly climbed the old wrought iron steps to the apparatus floor as I started another day at work. I was always mystified how I do a sixteen-hour tour and then come back the next day at 06:30 hours, on time. I held my cup of tea firmly as I climbed the stairs. The tea gives me the jumpstart I need to get up to operating speed.
I was working at EMS Battalion 55 for the Fire Department of New York (FDNY) Emergency Medical Services (EMS) Command. Holding my tea as I reached the top of the stairs, in front of me I saw a closet that used to house the hay for the horses that pulled the steam fire engines in the early 1900s. The bright morning sun glared in through the security gate enclosed window, warming my face. I was glad this summer was coming to an end because overtime and the summer heat had left me tired. My tea gave me energy and the solitude to prepare for the events of the day.
Our station is referred to as Old Engine 71 in FDNY parlance. This station was built in 1906 and housed Engine 71 for over eighty years. The firehouse was then used to house the Bronx Base of the Fire Marshals and is now shared by the Fire Marshals and EMS. The structure of Battalion 55 is classic red brick and concrete with sculpted concrete details in the front of the building. The history of the FDNY may be lost on many who pass through this building daily, but I appreciate the legacy and history of this building and the FDNY.
As a teenager, I read a book called Report from Engine Company 82 by Dennis Smith. I was impressed at the seriousness of firefighting and the tenacity of the Bronx. I was proud to be serving with the FDNY in an historic building like this even though my journey into the FDNY was convoluted. I rode in the Bronx in July of 1984 as a paramedic student from the Northeastern University Paramedic Program and started working for New York City Health and Hospital EMS, otherwise known as NYC EMS. Mayor Giuliani merged the NYC EMS with the FDNY on March 17, 1996 to optimize resources and help save response time to rescue patients in cardiac arrest.
As I walked across the apparatus floor, I saw Lieutenant John McBride in the Lieutenants' office. To begin my morning ritual I said, "Good morning John."
"Steve.... What the....." John grinned from ear to ear. "You couldn't bring me a coffee?" he said in a patronizing way.
Annoyed due to my tired condition I apologized saying, "John, I'm sorry. I'm so tired today."
John is a redheaded Irish man who loves the fire service. He comes from a family of civil servants and chose to be a paramedic. His father is a police officer and his brother works for sanitation. John volunteers as a firefighter on his days off and works as a paramedic at a local ambulance service on Long Island to maintain his skills. He smiled and opened his arms in a sweeping gesture revealing the red suspenders he likes to wear.
I said, "John, just tell me what is going on?"
He replied, "Steve, you're running one hundred percent of your units today. Nineteen-Charlie is picking up crew at Battalion Fourteen. J.J. is already on patrol dropping overtime personnel back at Battalion 17. I reviewed defibrillator protocols with the EMTs; we checked all the expirations on the defibrillators and the pads. Steve, I'm hurt you didn't bring me coffee."
Only slightly embarrassed, I said, "Stay, John. I'll go pick one up for you after I check the radios and complete the rundown."
He answered, "Nah, I got to run. I'm working on the Island today."
"Take care," I replied as Lt. McBride slips out of the office and down the stairs to his car. I thought it was strange John didn't stay to chat. He likes a joke as much as the next guy, or maybe more, but he also takes time to train the EMTs and medics in patient care and safety. John takes great pride in describing the detail and on the job knowledge about running calls to his employees. John is always saying, "The devil is in the detail, Steve." I thought, "He will probably be in the Haz Tac unit one day."
I started my daily routine by accounting for the radios and equipment, and logging on to the dispatch computer. The computer monitors all the units and assignments in the area we cover, the South Bronx. J.J. was on patrol as Conditions 5-5 and I had "desk duty." A Conditions car is the term used for an EMS lieutenant who responds to help units in the field. We were called "patrol bosses" until we were merged with the fire department.
The vehicle that belongs to our designation is a 1998 Chevrolet Suburban that runs seven days a week, twenty-four hours a day. These vehicles put up with abuse and rough roads that would make a Michigan test track driver run for cover.
We give our in-service signal by logging in using a notebook computer mounted in the truck, which allows us to look up the status of our units, hospitals and call information. When EMS units are dispatched to a job, the call data comes up on their screen. Status signals such as 10-63 responding, 10-88 at scene and 10-82 transporting to the hospital are entered electronically to save radio airtime. We average in excess of 3,000 calls daily over ten radio frequencies. On the busiest days in the high summer heat or a winter blizzard our system sometimes exceeds 4,000 ambulance calls a day.
By using the Mobile Data Terminal (MDT) to transmit "signals" we help free up radio time for radio communications. We are trained to stay off the radio as much as possible to allow the constant radio traffic of assigning jobs and dealing with problems to continue so people needing an ambulance do not have to wait an extraordinarily long time. The saying, "Every second counts" is very true in emergency medicine.
I returned to the office to finish preparing a Tour Three roster of units we were running on a report we call a Tour Rundown. FDNY EMS runs three tours a day. Tour One is midnights, Tour Two is days, and Tour Three is the evening shift. Our units are either advanced life support with two paramedics or basic life support with two emergency medical technicians called EMTs.
As I was filling in the Tour Three run down with names and shield numbers of personnel and the status of vehicles assigned to the station, I was interrupted by a Tour One unit member walking into the office who said, "Lou, we need a spare vehicle, our side compartment door doesn't lock."
I stopped what I was doing, grabbed some graphite from the drawer and walked outside to check their vehicle. The door was intact, but the lock mechanism was jammed. A small dose of graphite does not resolve the problem.
I asked the EMT, "How did you go all night with a door that doesn't secure?"
EMT Smith replied while smirking, "L-T, we just noticed it now."
"Yeah, right," I thought.
I looked at them with suspicion. I wondered, "Did they not check their vehicle or did it really just happen now? No matter, we have to get the unit in service."
I told the EMTs, "OK, take vehicle ninety-seven, it's spare, I'll put you off-service." The phone rings and I briskly walked back to the office.
"Good morning Lieutenant, I need your Tour Three Rundown," the RCC (Resource Coordination Center) EMT states curtly.
I nicely reply with "You'll have it in a few minutes. I just walked in the door. Please put 19-Charlie Tour One off-service mechanical, switching into vehicle ninety-seven."
I heard a "Will do!" and then a click, as the EMT at RCC abruptly hung up the phone. "Nice day to you too!" I thought. I returned to finishing the rundown.
Then I remembered my cup of tea. I wondered, "Where is my tea? Did I leave it in the locker room?" I walked over the apparatus floor to my locker; no tea on top. Did I leave it in my car, no. I walked in with it. Where could it be?" The phone rang.
I jogged back to the office; I answered the phone "Good morning, Lieutenant Kanarian, Battalion 55."
On the other end I heard, "Stevie, my lad, how many times must I tell you, I take my tea, milk with no sugar!"
"John!" I thought. "John, don't mess with my tea, I'm serious."
"Ha, Ha, Ha," John chuckled to me on the phone. "Oh by the way, I hope you have a Quiet day. I had a big breakfast and now I am going to bed."
"Damn that guy, I thought." John chuckled again as he hung up.
Humor and good-natured joking around are part of the EMS culture. EMS providers have a dark-sided sense of humor we call gallows humor, which is not understood by the average person. This offbeat sense of humor is a way for us to balance the stress of the job and to deal in some way with the death and dying we see. It is also a way of sharing the brotherhood of our job.
However, Joking around for John is much deeper. It is a way of life for him to joke around and "get you" when he can.
"That's ok; I'll get him down the road," I thought, smiling about the possible options I have to make a strong comeback.
Mike Condon arrived in my office and greeted me with, "Good Morning, Steve."
"Hi Mike, how are you?"
"Margaret here yet?" he asked as he looked over the rundown and what to expect for the day.
"Not yet." I replied.
Mike is an experienced EMT with more than fifteen years experience. We call Mike the "Mayor" of Hunts Point because he has been on the same unit for so long that he knows all the cops, the business owners and the homeless people in Hunts Point. A warm "What's wrong, Ma?" from Mike puts most patients at ease.
Mike had first name status with me because of his experience. Most guys call you boss or Lou, short for Lieutenant, but for guys like Mike — whom I have broken ribs with during CPR (cardiopulmonary resuscitation), backed up, and lifted patients with for many years — the respect runs deep.
His partner, Margaret, is also an experienced EMT who is glad to be on a slower unit in Hunts Point with a partner who does not attract attention. Margaret is a single mom raising a teen. She makes super "gravy," which is what true Italians call sauce, I am told. The best of all things with Mike is that he and I can disagree and yell one day and the next day he greets you with the same "G'mornin, Bossman." Mike sees the big picture and does not easily get stressed. He helps me keep an even keel — kind of like a buoy on stormy seas.
With the stress involved working EMS in the Bronx, co-workers often find fault with each other or bump heads on issues and build resentment. But, we have a true, mature relationship. We like to work as a team, but in reality the challenges of dealing with the stress and unrelenting nature of the job sometimes drives us apart. However, when the chips are down, everybody works together to get the job done. My job as a lieutenant was to realize the issues people have and to know how best to get them to do their work and balance their needs as well as the needs of the patients they serve.
Mike continued on with his greeting, "Good morning my brother, how are you today? Stressing already with Tour One BS?"
I said, "John took my tea."
Mike laughs and said, "Ohh, no, not your tea! Mel-low my brother, mel-low," as he effortlessly breezed out of the office.
It's amazing how such a big guy can move so quietly. Mike is about six foot three and naturally very strong. He speaks with an accent even though he is from New York City. I think the accent is just his way of dealing with stress and focusing it back into the world where it came from. Some employees require a lot of attention; others, like Mike, do what they are supposed to do and require very little maintenance. Mike is a pleasure to have in my station. Mike logs on to the MDT, gives his in-service signal and disappears into the streets.
Units in our system are deployed to Cross Street Locations (CSL) to ensure a quicker response time. With over seventy ambulances in the Bronx this system of posting units on street corners expedites response times. However, it is not the most comfortable experience when you have to sit on a street corner for sixteen hours.
I had one hour until the next unit arrived for tour change. I completed the rundown putting down personnel names and shield numbers, vehicle numbers, listing who was out sick and what vehicles were out for repair, then faxed the rundown to RCC and stapled the confirmation sheet to the rundown. Next, I walked out to the apparatus floor and looked around the garage. More often than not, I loaded the supplies into the rack on the apparatus floor then swept the floor. I like a well-stocked and clean station. This is probably a throwback to working in my uncle's grocery store as a teen where I maintained the supplies in the basement and kept the shelves stocked. I also worked as the paramedic coordinator in Queens where I kept the medic room stocked and checked the spare medic equipment. I liked to have the shelves stocked and the station swept so people coming to work get a good start.
I saw an ambulance pull up in front of the station and start to back in. The sun was bright and warm as the light reflected off the ambulance's trademark red, yellow and white FDNY colors. I thought, "What a beautiful day. Soon autumn will bring the cool weather and temperatures will not be so hot all day."
EMT Buccieri, who we call "Booch," walked in uttering "Hi boss. I need some defib (defibrillator) pads, lost another one."
"How old?" I inquired.
He answered, "Seventy-nine year old woman."
"Practice makes perfect Booch," I replied, trying to make light of a bad situation and continued with "Good morning Booch."
"If it is I hadn't noticed." He grunted. I asked Booch what was bothering him. He replies with "Oh, late night with the boys is all." Booch turned his head a little and continued, "Actually I wish I had worked out more for that fire physical. I would be graduating from the Fire Academy today."
Booch was from a family of firefighters. His father and stepfather were both FDNY Lieutenants. He had grown up hanging out at firehouses with his dad. Unfortunately, he had not scored a 100% on the firefighter physical. It seemed like Booch knew most of the older firemen on the job in the South Bronx. He is a young guy who will probably be better prepared for the physical test next time. He continued lamenting, "If I had done better on that physical I would be graduating this week and working a real job."
I asked, "You don't think that woman in arrest thought what happened was real? Was she alone?"
He grunts, "No, she had her husband there."
"Geez, Booch, for the husband that is as real as it gets. How long where they married for? Thirty or forty years?"
Booch answered, "I don't know boss. I've stopped asking."
"Hell, I know. I'm just bummed she died and wish the City paid us more."
I tried to console him by remarking, "I know. Better luck with the FDNY physical next time Booch."
I sat down at the desk and pulled the office chair in close. I thought, "Time to update the log and complete some of the daily paperwork, then get some quiet time for some tea, and watch ESPN to see how the Jets and Giants are doing." My quiet time was interrupted with a Beep, beep, beep. Damn, that was a quick ten minutes. What now, I wondered. I saw vehicle 399 backing into the garage. I thought, "Mike and Margaret are back? What could be wrong? They just left the station." Mike eases out of the ambulance giving his knees a chance to adjust, then settling into his usual limp.
"Stevie, here is a hot tea, large, milk and sugar, just the way you like it. Enjoy, Boss Man."
I'm touched by his thoughtfulness. I let loose a great big grin of happiness knowing I have the respect of my coworkers and together we get through the day. I turned to Mike and said, "Thank you, Mike. Thank you very much."
"We have to look out for each other, Boss Man." Mike replied, as he walked back to the ambulance.
"Yes we do Mike, have a great day!"
Excerpted from The Downwind Walk by Steve Kanarian Copyright © 2011 by Steven E. Kanarian, EMT-P, MPH. Excerpted by permission of AuthorHouse. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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