My Favorite Rescue

As of this point, my favorite rescue happened one night around 11pm when my partner and I were at the station when we got the call for a traffic collision. This in no way excited us, as they are quite common and are usually only fender benders where people decide to go to the hospital on a full backboard so they can sue later on if they need to. However, this night, when the call came over the radio we were told:

“For a person trapped in vehicle”.

It got better.

“Be advised: One of the vehicles involved is an armed robbery getaway car”

It got waaaaay better.

“PD has their guns drawn on suspects”

This was going to be sweet.

I was driving that shift so my partner and I immediately stepped on it and safely raced to the call. Five sheriff squad cars bolted past me. They must have been going 100. I judge how good a call is going to be by how many police squad cars are there. We got on scene to find multiple police cruisers, fire trucks, and bystanders crowding in the middle of the street. Police were patting down the suspects from the getaway vehicle that smashed into a small sedan. That was our patient.

Our guy, a male in his 20s, had his car crushed in around him by these knuckleheads in their SUV. My partner immediately jumped in the car to assess the patient. He had a broken femur and a punctured lung, both of which can be fatal. My partner held spinal precaution and yelled for me to bring him safety goggles.

My partner and I geared up and worked with the medics to get an IV line on this guy as the Fire Department cut the entire roof off the car while we were inside it. We hunkered down and protected the patient as glass flew everywhere. When I looked up, the sedan was a convertible.

Meanwhile, as we’re doing this, there were at least 30 neighborhood bystanders that had come out and were filming the whole event with their cell phones, a fire department Battalion Chief was standing behind me, looking over my shoulder, a news crew was filming the event, and a police helicopter was circling overhead shining the spotlight down on the car. It was insane. All these eyes were focused on this one-trapped injured man, and my partner and I were right there in the middle of it with him.

We slid a backboard behind the patient and pulled him out the back of the car as we walked on top of glass across the trunk. We loaded him up and I hauled out of there to the closest trauma center. Despite his injuries, the patient lived, the robbery suspects were arrested, and my partner and I spent the rest of the night shaking glass out of our clothes. It was a helluva operation.

When I first interviewed for this job, my boss said, “Son, this is greatest show on earth”. I didn’t fully realize what he meant until that night. Being part of emergency services, working with Police, Fire, and EMS, all together amidst crazed traumatic situations really is one of the most amazing sights to see. Certainly the best thing to be a part of.

The greatest show on earth.

When Kids Die

The other night I ran a call that came out as a Pediatric Full Arrest. This is pretty much the worst call in EMS. Fortunately, when we got there, the boy had a pulse, and after pushing air into his lungs, he quickly started breathing again and was soon fine. However, the feeling I got when we received the call got me thinking about the subject of losing a kid on the job.

As of now, I have not had a patient die on me that was a child. Yet, I’ve had a few close calls that I’ve gone into wondering to myself,

“Am I going to have a kid die on me tonight?”

Because the reality is, the longer you do this job the more your odds increase of having a pediatric patient die on your watch. It’s just like rolling the dice. Do it enough and you’ll get that rare result. You don’t go into every shift wondering this. But when that call for an unconscious child comes out, I must admit, it can run through the back of my head. Fire, Police, and EMS personnel all encounter this.

I’ll never forget the image of busting into a wedding banquet to find a four year old little black girl in a gown unconscious on the floor.

After this recent call about the boy, I found myself thinking it over that night. Why is this such an issue? I’ve had multiple people die on me before, and although they’re negative experiences, I’m always able to handle them with ease. But even close calls with pediatrics put me in a very somber contemplative state. Why is this?

We must feel there really is something unnatural about a child dying. Death is hard enough without a sense of tragedy I suppose.  The idea of innocence plays into it, I’m sure. Also, kids are the only patients that EMTs carry in our arms by ourselves. I think when you pick up and carry an injured child who isn’t breathing, you create a different personal type of connection.

One of my co-workers and a good friend of my mine once described to me his worst call. A two year old got run over by a car and he held spinal precautions on this bleeding child before it died in the ambulance. These are the calls you don’t forget. Extremely rare, but when they hit they never really leave you.

As an EMT, we emotionally disconnect from the patient because not caring is the best way to care for someone in an emergency situation. However, this emotional disconnect is more like a threshold. At a certain point, it spills over and you feel the emotion on the call. This is very rare, but it happens, most often on horrible pediatric calls. Regardless, like any trying experience, you process it in a healthy way, learn from it, and move on.

I wonder how I’ll handle these things when I’m a father. I imagine difficult calls involving children will remind me of my own and hurt all the more. I guess I’ll have to see.

If I were to keep doing EMT work, eventually a kid would die on me. It’s possible I will get to switch over to Police work before this happens, but in that case, my odds of seeing horrible tragedy with a child will only increase, just in a different context.

As with any of the life and death issues we deal with in this world, I do my best to hand this over to a God I believe is just, loving, and ultimately, in control.

East Africa As A Spiritual Bullseye -Part 2

Part II

Where there is Light

In my last Post, I discussed the presence of evil in East Africa

Yet, as all this evil, tragedy, and pain is going on in East Africa, the hope and good is equally as great. The church has been exploding more in Africa than anywhere in the world, outside of China. People are coming to know a God who loves them in a whole new way. Christian organizations like World Vision and the International Justice Mission have given millions in aid, but more importantly, human effort to help, to give justice, and to rebuild. 

Aids has dramatically decreased in Uganda in the last decade, thanks to education and awareness programs made by the government, as well as American, English, and German doctors coming in to do testing and education.  HIV infections in Uganda have fallen from 21 percent to 6 percent between 1991 and 2000.

Rwanda is focusing more on women’s rights, largely in part to their female president. Orphanages are springing up everywhere for children of genocides and diseases. Then there’s Sam Childers, a biker and preacher from Pennsylvania who goes into the bush with a small militia and rescues children from Joseph Kony’s LRA, then rehabilitates them. Childers is called “The White Ghost” in the bush, because he too can not be killed, despite the multiple hits that have been put out on his life by the LRA. Perhaps most importantly, hope has returned to East Africa.

Sudan, Uganda, Rwanda, and the Congo. They border each other in an area no bigger than the U.S. East Coast. I feel there is some connection between these places and something unique about this region. Irish Monks believed there are certain places in the world where the wall between our world and the spirit world is very thin. They called these “Thin Places”. It was believed some of these places were so thin that spirits, good and evil, would pass into our world easier than others, creating hotbeds of spiritual activity. 

I believe East Africa is a Thin Place. A spiritual bull’s-eye of sorts. Possibly the greatest one in the world. So much spiritual activity, good and evil seems to happen in this one concentrated area. The more I talk to people who go there, the more I find this to be true. Even in my own experiences, there’s no place like it. 

As time goes on, the good seems to be getting better, and the bad is getting worse. I bring all this up because this is an important area. Something is going on over there. Something big. I feel it is important for Americans, and Christians to get involved and serve in East Africa. 

I’m looking to take another medical team to East Africa to give aid to villagers in need of treatment, education, and prayer, much like we did last year (please see video). I strongly feel called to this post. If you do too, please contact me about coming along. 

After all, what greater place to be a light, than in the Heart of Darkness.

Join us.

Last Year’s Trip: Video

Recommended Films To Watch:

An Unconventional War (docu)

Invisible Children (docu)

Last King of Scotland

Tears of the Sun

Blood Diamond

Hotel Rwanda

The Ghost and the Darkness

Recommended Books To Read:

Another Man’s War- Sam Childers

The Hole in our Gospel – Richard Stearns

Good News About Injustice- Gary Hogan

Heart Of Darkness- Joseph Conrad

Maneaters of Tsavo- Lt. Col. John Patterson

East Africa As A Spiritual Bullseye

 Part I:
Heart of Darkness

Recently, I've been considering going back to East Africa. The idea of returning to the land of red dirt has turned in my head, but more specifically my heart. Something about East Africa calls to me. It did before I went, and after I went last year. For many people in my field, East Africa gets under your skin. Why is this? 

In putting the pieces together I realize there is something special about this place. Something good and something, shall we call it, evil. Author Joseph Conrad described it as The Heart Of Darkness. But if it actually was? What if this region was a central core of good and evil?

In part 1 of this entry, I'd like to examine the case for centralized evil:

Africa as a whole has been a hotbed of tragic activity, from slavery to genocide, to the blood diamond trade, but I feel, specifically, East Africa is the most concentrated area of terror. Rwanda, Uganda, Sudan, Kenya, Ethiopia, and The Congo, all connected, have become a bull’s-eye of the greatest sorrow this world has to offer.

East Africa has been described as, and often called, “The Heart Of The World” because many believe it is where civilization first sprang up from. It was the center of the formed earth when the continents were combined. Also, one of the tribes of Israel settled in Ethiopia, and this is considered to possibly be the final resting place of the Ark of the Covenant, whatever state it is in.

But specifically in the last 100 years, like the rest of the world, violence has increased exponentially. Take the Man-eaters of Tsavo, two male lions that killed over a hundred people in Kenya, coming back night after night for human flesh, until they were killed by the hunter Lt. Col. John Patterson. Their stuffed bodies can still be seen at the Chicago Natural History Museum. 

In the 70s, Idi Amin was a horrendous Dictator who killed 500,000 of his own Ugandans. In Rwanda in 1994, one of the bloodiest genocides in history took place as Tutsi Rwandans killed 800,000 Hutus (20% of the population), largely by hacking them to death with machetes. The country is still recovering from this travesty. 

HIV infects 33 million people, 70 percent of which live in Africa. Tyrants, mutilation, murder, and cannibalism is part of Uganda’s history. Ethiopia has dealt with devastating droughts and famine. Somolia is the worst port of piracy in the world. In the Sudan, tribal war has killed and displaced millions in the Darfur region. 

Women’s issues in the Congo are possibly the worst in the world. The numbers of rape, torture, genital mutilation, clitorodectomies, among tribes, villages, cities, and displacement camps are unfathomable.

Uganda hosts the most Witch Doctors in Africa. Black Magic and the occult are common through much of Africa and South America, but here, Ugandan Witch Doctors practice human sacrifice. Currently, it would seem The Democratic Republic of the Congo, is the worst country in Africa. Due to recent tribal warfare, millions have murdered and displaced. It has become the wild west of Africa.

In my opinion, the most troubling of all these events in East Africa is Joseph Kony and the Lord’s Resistance Army (LRA) of Uganda, a rebel army deeply active in the occult. Besides continuous village massacres, for the last 20 years, Kony has kidnapped and brainwashed 50,000 children into fighting the Ugandan military for him as rebels. He does this by making them kill or eat their families so they feel shamed and can never return to their village. 

Kony gives the children a mix of cocaine and gunpowder, which not only makes them dependent, but he tells them it will make them bulletproof. They kill and are killed for this mad man, who actually invokes the power of Satan. The taken girls of only 7 or 8 are given to the commanding officers as wives, and raped continually.

Kony, who claims to be the son of God, comes from a family of cult leaders and demonic witch doctors. He is one of the greatest villains this world has ever seen, and almost nobody seems to know about him. And nobody can kill him. Without explanation, he has evaded the Ugandan Military for 20 years. Stories have come out of the military from Colonels of Kony being surrounded by opposing soldiers, and then disappearing in the blink of an eye. 

The multiple stories of his demonic powers could be cultural superstition, but with the amount of evil he’s done, and with the amount of success, and his ability to predict government raids, I am inclined to believe it. He is currently thought to be hiding in the jungles of the Congo.

But where there is darkness, there is greater light. More to come…

The Devil's Hour

4 AM is the Devil’s Hour. I’m convinced.

Nothing good happens at 4 am. If you get woken up for a call at 3 am, it’s just a really late night. Often times, you’re still up. If you get a call at 5 am, it’s just a really early morning. That’s close to when I wake up for work anyway. No problem. But 4 am… of our 24 hour shift, it is the absolute worst hour. Here’s why:

When we get woken up at the station for a call, we have 60 seconds from the time of the call to get our uniform on, grab any gear, run down the stairs, through the parking lot, and get on the radio in our ambulances. This means during the night, you go from complete shut down to adrenaline fueled driving with screaming sirens in 1 MINUTE.

Often times, this isn’t that hard as we’re used to it, but at 4 am, good grief. Somehow, right at 4, I am always at the deepest part of my REM cycle sleep and thus it is the hardest to pull out of. It’s the type of awakening that leaves you confused and with a headache at first. Of course, at this point you’re also hungry and have to pee. Badly. But there’s no time for that.

Next is the type of calls we get at 4 am. They are always one of two types of calls. Absolute BS, or Horrible Trauma. For some reason, there’s seems to be no in between.

Absolute BS: When awoken at such an hour, it’s always for “Toe Pain” (Yes, these are actual reasons people call 911). I had a buddy once get a call for a woman who had a nightmare. It’s often chronic pain problems like back pain. When I ask, “Ma’am, how long have you had this back pain?”, they often answer “3 days”. SO WHY DID YOU WAIT TIL 4AM TODAY TO CALL?? Whatever the complaint is, foot pain, anxiety, being cold (we gave her a blanket), or a combative crack whore threatening to slit my throat (did not give her a blanket), it is almost never reason to call 911. It’s basically adding insult to injury for us.

Horrible Trauma: The other half of the time, it’s for some absolutely crazy call. Guns shots, brutal beatings, or multi casualty incidents. My partner and I once ran a traffic collision call on the 405 south. We came around the bend in the freeway to find two wrecked cars, one completely engulfed in flame, and a woman on the ground with a broken back. It was a chaotic scene of screams and wreckage. We got the call at exactly 4 am. The worst call my partner ever ran was a head on suicide collision on PCH, where one party had to be airlifted out and the suicidal driver burned to death. 4 am. My partner still has flashbacks at times and remembers the horrible smell of charred flesh.

Now, I am not suggesting that the devil himself has the rights to one hour of our night. It’s just an expression. But if he did, by God, it would be 4 am.

Am I Going To Die?

I’ve had a Patient ask me so many times “Am I going to die?” Do they really think an EMT or Paramedic would ever respond, “Yes. You’re going to die”. Of course not, yet they keep asking.

What possible scenario could exist where the emergency responder would reply with anything other than “No, you’re not going to die.” What are we going to say? “Yeah, sorry about this, but you’ve only got a few moments left to live. You better make some phone calls.” There is not a single scenario where they would ever say “Yes.”

This question is ridiculous for two reasons.

1. If you are asking if you’re going to live, you are TALKING and thus are conscious and relatively okay. The very fact that you are able to form this morbid thought and then articulate it means your brain and vital organs are functioning adequately and you are in good shape. The ones who are actually in danger of biting it are those who are unconscious, and thus do not speak.

2. If you are asking this absurd question to me, an EMT, it means you or someone has already activated the 911 system and you are getting help as we speak. You’d only be in danger when you’re conscious if you were in the middle of nowhere or alone and could circle the drain over a long period of time. Your 127 HOURS survival scenario.

So in short, if you’re talking (not unconscious or altered) and you’re talking to me (someone who is currently taking you to an emergency room) you are FINE.

This rule also applies to “Am I going to be okay?”. Of course you are. And even if you somehow weren’t, would I really say, “Naw, you’re Effed.” ?

The reality is, people just want the comfort of hearing us say “You’re going to be alright”. And I get that. But when you call 911 for nausea/vomiting, get over yourself. You’re fine.

So in short, if you are ever having a medical emergency, CALM DOWN. It’s the best thing for you and for us.

The 500 lb. Naked Man

You read that right. This was my other grossest call. We got a private call (not 911) to a home of a man who needed transport to the hospital for an appointment. He lied in bed. He was 500lbs. And he was naked. Why, you ask?

Well, he claims medication made her obese and it’s not his fault. I’ve heard this exact line from every morbid obese person I’ve ran on. “It’s not my fault”. Some medications can make you retain weight, but not 500 pounds worth.  And he was naked because a worker comes once a month to bathe him, and this was the day he was to be cleaned. So in addition to the sight, the smell was atrocious as well.

In cases like these, it takes up to 6 men to move him. We needed two other units to come in and perform what is called “A Lift Assist”. All in all, 3 Ambulances were taken out of commission in a very busy area during peak 911 hours. As a result, other units had to cover a greater area and scramble to make due. So when someone had a real legitimate emergency, the response time for an ambulance would be delayed because the unit is coming from further away. All because this man had a doctor’s appointment.

So there we were, six young men standing around the bed of a naked 500 lb. man, who hasn’t moved from his side in six months, trying to figure out how to get him off the bed and onto our gurney. At this point, I said, “Think smarter, not harder, guys.” I suggested we use the thick comforter already under him to move him. It took great strength and care to comfortably and respectfully move him, but we did it.

Three ambulances and a hospital visit was paid for by Medicare, so by you, the taxpayer. Obesity, a preventable disease mind you, causes all Americans to pay 100 MILLION dollars a year. But it’s not just that. Ambulances, Fire Department, and Doctors have to spend 3x as much time dealing with obese patients, which leaves them less time and availability to help you. In England, ambulance services have to buy larger rigs to accommodate the growing rate over obesity. See Link

This man was young and it was very sad this is what his life had become, but when obesity weighs down others, I find it hard to have sympathy.

Shock To The Heart

Ever seen someone get shocked while still conscious? Neither had I.

I recently ran a call on a 30-year-old woman who was having chest pain. She was Indian and there was a language barrier. We tried getting the story from the husband, but he was little help. Her vitals were good and we couldn’t figure out why she was in such distress. Her clinic “doctor” had diagnosed her with anxiety the night before, so perhaps this was emotional.

We got her into the ambulance and put her on an EKG heart monitor, at which point we realized she had an outrageously high pulse rate of 200 beats per minute. The firefighter on scene had taken a horribly inaccurate pulse. This was the highest pulse rate I’ve ever seen on a patient. Her heart was beating out of her chest and the monitor just showed scribbled lines. We all kicked into high gear.

On this day I was driving the rig and the medic in the back was unable to get an IV line on her to give her drugs to slow her dangerously high heart rate down. It was at this point that I heard him say,

“I can’t get a line, so… really push it”.

It my entire time as an EMT, I have NEVER had a medic tell me to drive faster. But the reality was, we couldn’t slow her heart in the field and any minute her heart could give up and stop.

If you think you’ve got road rage, try driving an ambulance during rush hour. Every lane is blocked; people are idiots on the road and get in your way. I hauled with screaming sirens, opposing traffic and swerving around cars. I kept hearing “we’re almost at the hospital. Just hang on”. This poor woman was about to go into cardiac arrest.

For some reason, this was more nerve-racking than someone who is already in full arrest. A full arrest patient is already technically dead, and you’re trying to bring them back, but when someone is on the verge, or circling the drain, it’s all on you. It takes a lot to get my adrenaline going these days, but this certainly did it.

Once we got her to the hospital, the doctors immediately tried giving her drugs, but they didn’t slow her heart. They only had one last resort left. They had to shock her heart to restart it. The trouble was, she was still conscious. I’ve only seen this done on people who are unconscious.

Everyone stood back and the doctor told her, “Ma’am, you’re going to feel a shock.” 

Yeah,.. I’ll say. As the charging sound rang, I didn’t know what kind of reaction to expect. What followed almost made me burst out laughing in the room. I know, terrible, right? The woman reacted like a confused drunk who has a huge hiccup. Her upper body jumped, and she wearily faded back with a priceless look of confusion on her face. And boom, her heart restarted itself back to a healthy rate of 104 bpm.

Turns out the woman was having a heart attack, and shocking her saved her life. Still, I’d never want to be awake for that.

Heat Waves, Booze, and Full Moons

When you come in to work for a shift, you never know what the following 24 hours holds, but the best indicators of how busy your shift is going to be are weather, drinking events, and the moon.

Weather:

How hot or cold a day is determines how busy our shift will be more than any other factor. There’s less crime when it rains, because even criminals don’t want to get wet. If it’s cold, people just stay inside and keep warm, but if it’s hot outside, for some reason, they all go outside and go crazy in the heat. On a hot day we get many more assault calls. Hot days are not only miserable to work in, but they’re outrageously busy. Cold dreary days are awesome. But if it rains too much, then you have a ton more car accidents.

The busiest day in the history of Los Angeles 911 system was September 26^th 2010. That was also the hottest day in the history of Los Angeles with 113 degrees in downtown. This was no coincidence. The entire city went out of its mind, and I worked that day. A call would go out over the radio every two seconds. Every hospital was saturated. It was non-stop all day. People were dropping in the streets. Los Angeles slipped into a deeper circle of hell that day and I had the busiest shift of my life.

Booze:

The longer I live, the more I am convinced alcohol actually is the devil’s urine. Intoxication is a precursor to so many different types of calls. And drunken patients are the worst to deal with. Drinking holidays are our busiest days of the year. New Year’s Eve is our busiest night followed closely by Halloween.

But the worst by far is the 4^th of July, usually the busiest 911 day of the year. Here’s why: People are traveling, so more car accidents. It’s hot, so people go crazy. There are barbeques and parties, so people are drinking. It goes day and night, …and, oh yeah, THERE ARE FIREWORKS. As if people weren’t dumb enough when drunk, now we give them explosives.

Traveling+Heat+Drinking+Explosives=EMTs hating their lives.

The best chill days to work are non-drinking holidays where people have the day off work, but they don’t go out celebrating, like Veterans Day, or Memorial Day, or MLK day. God, do I love MLK day.

The Moon:

If it’s a full moon, it’s going to be a busy night. I don’t know what it is, but full moons make people go crazy. You may think this is all astrology BS, but it’s not. Multiple times I’ve been in the rig and the moment a full moon comes over the horizon I hear all these calls go out over the radio. It’s nuts. And it’s everything; car crashes, assaults, difficulty breathing, you name it. It was a full moon when I got the gun shot wound to the head traumatic full arrest, my craziest call ever.

A co-worker once put it to me like this: Our brains tightly float in water and if the moon has enough gravitational pull to move the entire ocean tide, it must have enough pull on our brains to slightly through some people off, creating the increase in crime and weird events.

How many people have emergencies in a day is organic and can never be truly predicted, but the weather, alcohol, and the moon are strong indicators whether or not you’re going to get worked.