A Tale of Two Newborns

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They had entirely different responses, one sobbing quietly, the other remarkably calm – the mothers.

They were crying insistently and incessantly and with definite purpose – the patients.

The patients in both stories were newborns, one but a week old.

Brand new souls entrusted to brand new mothers.

New mothers who made good and sometimes preposterous decisions.

Decisions that would have unfortunate consequences.

Consequences that would involve – you guessed it – yours truly.

 

One would hope that the most serious calls would get the fastest response. But that’s not always the case. In fact in the forthcoming tales I was on scene in mere seconds, when the emergency was, well, not really an emergency.

 

Tale 1 – Good Judgment

I was literally sitting on my bike, talking on the phone, immediately outside the building wherein the emergency occurred. Lightning fast response, for an absolutely immaterial call. What a waste.

Murphy’s Law 1 – The Desperate and Needy 0

 

The beeper said:

2 Week old Baby – Miscellaneous medical problems – Ingrown Toenail.

I know – I did a double take as well – how could that possibly be true? Don’t ingrown toenails take weeks to develop and involve some fault on behalf of the subject, such as cutting too close?

I was on location before the mother had put down with Control.

 

Act One:

“Hello Madam – what seems to be the problem?” I asked the stoically calm Kimpeturin.

“My baby had an ingrown toenail – treated several days ago by a podiatrist – and is now behaving curiously,” was the ‘matter of fact’ response.

Still no wiser – neither about the toe nor about the baby.

I asked the same question again, phrased differently – and got the same response, phrased differently.

 

Act Two:

Do a once over of the infant.

Get a comprehensive medical history.

Procure a complete set of vitals.

 

This was sure to uncover the underlying problem. But – it didn’t.

 

Act Three:

Pretend you understand the whole situation.

Make believe everything is under control.

Get the baby to a hospital.

 

Worked like a charm.

 

I had now been on scene for about 3 minutes when Unit #22 joined the baby shower, bearing a heavy EMT knapsack, instead of gifts.

“What’s going on?” he asks, breathless from the 2 flights and his decade seniority.

“Her baby had an ingrown toenail – treated several days ago by a podiatrist – and is now behaving curiously,” I repeat verbatim, with a hundredth of a tinge of sarcasm in my voice. #22 immediately knows what I am insinuating and takes the mothers side.

I could sense the speech coming. My mentor had lectured me tens of times on this matter. And so it begins…

“A Mother always knows best. If a mother says that something is wrong with her child, you have to trust her unconditionally, irrespective of your clinical findings!”

Aye Aye Captain.

Ambulance comes, transports mum and child, and, if you must know, there was something awry with the baby and she spent several days in hospital recovering.

From what? Only Mum knows.

 

Tale 2 – Bad Judgment

No I don’t normally sit around on my bike, on my phone, waiting for calls, but;

I was literally sitting on my bike, talking on the phone, immediately outside the building wherein the emergency occurred. Lightning fast response, for an absolutely immaterial call. What a waste.

Murphy’s Law 2 – The Desperate and Needy 0

The Beeper said:

1 Week old Baby – Miscellaneous medical problems – Too Relaxed.

I know – I did a double take as well – how could that possibly be true? Don’t mothers hope and pray that they give birth to children who remain calm and relaxed and sleep through the night?

I jog to the door of the building and meet the mother in the hallway coming towards me from her apartment located at entrance level. She hands me the baby, as is the custom in times of panic, and for good measure yelped “Help!”

I do a one second observation. Infant Conscious – Yes. Infant Breathing – Yes. Great; let’s move to the couch in the house please, its pitch black in the hallway.

 

Act One:

“Hello Madam – what seems to be the problem?” I asked the uncontrollably hysterical mother.

“My baby was crying, and so I gave her a few drops of ‘RELAX’ to calm her down,” she said between sobs.

“And…”

“And now she is too relaxed. Look at her, she is barely moving!”

 

Several Important Pointers:

  1. She was right – the baby was hardly moving. Not quite unconscious, but certainly dispirited.
  2. ‘RELAX’ is a herbal concoction so strong, it could make an elephant count sheep whilst lying wistfully on its back.
  3. The mother had given the newborn several drops of this innocent concoction in the hopes of having a quiet night.
  4. She would now not have a quiet night.
  5. I have a wild imagination, but could never ever make something like this up.

 

Act Two:

Do a once over of the infant.

Get a comprehensive medical history.

Procure a complete set of vitals.

 

Vitals were thankfully normal:

Pulse: 150

Sats: 97%

Respirations: 26

Blood Pressure: No chance on an arm that small

 

Act Three:

Baby is transported to hospital and makes complete recovery. No charges filed against the new mother. RELAX is pleased to learn that their product does indeed work, but adds a caution to the label:

“Not for use on Restless Newborns”

Always wanted to know how those absurd warnings get onto product labels?

Now you know!

 

 

Postscript

Not all Mothers always know best – but mine certainly does. Happy 27th Birthday Mum!

Shooting at the Western Wall

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There is a simple, absolute rule that I have created for myself.

“Shmeel: Always take all your equipment.”

Always.

So that when you find yourself in the right place at the right time, you also have the right tools.

Let me qualify this though. It doesn’t mean that I need to carry around a defibrillator at my kid’s school graduation.

 

Take to Graduation List

Camera

Water

Snacks

Defibrillator

 

That wouldn’t go down well with my wife, or my kids, or the school, or my self-image.

What it does mean is that:

  1. Always carry your communication devices on your person, so that you can be alerted to an emergency in your vicinity. It would be a shame to be shopping in Store #1, oblivious to someone dying in Store #2.
  2. When responding to an emergency, always take all your equipment. Don’t assume the EMT that arrived before you followed protocol, and don’t assume you won’t need that Burn cream. Because actually, you will.

 

But I find it hard to follow rules; even my own – which brings me to the beginning of my story.

 

I zip through the opening between the barriers and head towards Jerusalem’s Old City. Private cars are no longer allowed to enter the old city area and the municipality has set up a barrier that scans license plates and only opens for public transportation or emergency services. It’s a completely automated system and no amount of Israeli Chutzpah will help.

Authorized = Open Sesame.

Unauthorized = Shut as a clam

I whiz through the cobblestone streets – Jaffa Gate on my left and King David’s Tower on my right; my final destination is the Western Wall. Ambucycles are not allowed into the actual Kotel compound unless there is a medical emergency. So I park my bike in a dedicated but unofficial motorcycle parking area and dismount.

Security is tight at the entrance, not dissimilar to what you would find at an airport. Every entrance is manned by several armed guards and visitors need to pass through a metal detector, while their bags get a ride through an X-ray machine.

I beep whenever I go through the detector. Actually I don’t just beep, I chorus. The reason is simple – the extensive collection of electronic devices on my belt. I always seem to forget a radio, or beeper, or keys, or small change and make a fool of myself with a manual search.

Not this time. This time I would leave all my paraphernalia locked up under the seat of the bike and pass security, without a symphony.

“There won’t be an emergency in the next few minutes anyway, right?”

WRONG!

I make it to the wall and Pray. Several minutes pass and all is calm around me. It is early evening and the sun is setting swiftly. There is a cool breeze blowing and except for the birds chirping, men praying, and kids laughing, all is serene.

 

BOOM – First a quiet one and then,

BOOM – A louder one.

 

Most people run away from an explosion. We run towards it.

 

When I say ‘we’ I mean ‘I’ and when I say ‘I’ I mean ‘I would normally run towards the sound, IF I thought it was an emergency.

But I didn’t think it was an emergency. The absurd reality of a Jerusalemite’s existence lately, is that loud explosion type noises are part and parcel of daily life.

 

It might be the Iron Dome intercepting a Hamas missile.

It might be typical construction type sounds from one of the countless building sites.

It might even be fireworks emanating from E. Jerusalem celebrating the end of Ramadan.

 

“It’s certainly not an emergency, right?”

WRONG!

I end my prayers, take several steps backwards, and head towards the exit. The exit, however, is blocked by several burly guards.

“You ain’t going anywhere, brother!”

As it dawns on me that something is drastically wrong, a medic in uniform and carrying a backpack EMT kit brushes past me. The guards wave him through.

“I’m with him,” I blurt out, “I’m an Ambucycle medic!”

“And I’m Elvis Presley – Show me some ID,” came the cynical reply.

“I don’t have any. All my stuff is in the bike.” Even as the words came out, I knew it sounded meek.

“You ain’t going anywhere, brother!”

So I peek over the barricade and behold. A lady, covered from head to toe in ‘coverings’ is lying on the floor and about a dozen army / police / security stand around her. Something funky is definitely going on! I’m about to make another go at convincing my captors to let me free, when the all-clear is given and civilians are allowed to wander once more. I run towards the center of attention and glean the following from the EMS personnel on scene.

The lady, covered entirely with only her eyes showing, had attempted to bypass security and rush into the complex. An ever alert policeman noticed the breach and shouted for her to stop. She ignored the call and he fired a warning shot in the air. She continued walking, and fearing the worst he shot at her legs. The bullet grazed her foot and she fell to the floor. She was found not to be carrying any weapons, but the reason for her strange behavior was as yet unclear.

She was loaded into the waiting ambulance and sent to hospital with a police chaperon.

 

All’s well that ends well, but like I said at the start;

 

“Shmeel: Always take all your equipment.”

Always.

The Circus

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The United Nations (UN):

An international stage where the whole world hears you – but no one is listening.

Just saying.

 

The Red Crescent (RC):

Does a wonderful job of transporting people from A to B – but then so does a surfboard.

Just saying.

 

The Good Guys (US):

Helping those who need help – always. Period.

 

In a utopian world we would be looked up to and emulated.

In the real world we are criticized and ostracized.

Just saying.

 

P.S.

Who can our antagonists turn to in their time of need?

US.

 

The Circus – Act 1

We find ourselves treating and transporting patients who either do or do not hold Israeli citizenship and either do or do not agree with my right to exist. I’m not talking red white and blue “all talk and no play.” I’m talking about ‘patients’ who truly live their ideologies. I say live, but what I mean is die for their ideologies; and they hope to take as many innocents as possible with them, to the other side. Yes, it is often these exact persons that I risk my life to save.

A Circus indeed.

Essentially, all assistance given is gifted pro bono (unofficially). These people don’t pay; they don’t even pretend to intend to pay. Billing addresses aren’t provided, or don’t exist; either way, someone is losing out, and it ain’t the terrorist or his posse.

 

“Why do you do it?” you ask.

“You shouldn’t do it!” you exclaim.

 

You might be right. But selfless giving and indiscriminate kindness is in our blood, since Abraham’s times.

Others inherited other values.

 

“So there is no financial compensation, but how about plain, uncomplicated, absolutely gratis gratitude?”

Nope.

No thanks from the subjects, nor recognition from the international community. Instead, we are vilified worldwide as occupiers, terrorizing the virtuous.

 

OK! Shmeel. Enough rhetoric. I’ve heard it all before.

You probably have; but have you raced, sirens blazing, to their rescue.

I have.

 

The Circus – Act 2

Recently there was a horrible motor vehicle accident, ‘on the other side’. They requested, nay, they begged for our help. We dispatched 3 Orange and 3 White ambulances. A true sacrifice, because this amounts to a dangerously large percentage of available ambulances during any one shift.

 

“Thank you so much” ?!?!

Never.

 

Instead, the State of Israel will suffer resentment, detestation and eventually protest. Deadly protest.

It didn’t take long.

The accident occurred at the SW checkpoint. Less than 24 hours later the “thank you” arrived, and I quote from mainstream media, Dozens protest violently against Israel at SW Checkpoint!”

“Protest altruism!” you gasp.

Yes! – How did you know? – Have you heard this story before?

 

The Circus – Act 3

Even the security of the attendant, during treatment, is not ensured. We are constantly bombarded and abused with verbal and even physical attacks.

In the ancient past, at the culmination of an unsuccessful CPR, our Medics were often threatened with their life, should they ‘refuse’ to bring back the departed. For this reason, amongst others, new protocol was introduced:

  1. When in a dangerous area, death is not declared on scene. In all instances, even in cases of totally dead patients (an ‘X’) and certainly in cases of partially dead patients (VF Cardiac Arrest) our teams are now instructed to initiate transport to a hospital where the family can be told, with a security presence, that the patient is no longer amongst the living.

 

  1. When there is a distress call in a dangerous area, our teams receive a police escort to the location. The cops remain during treatment, and escort us back out. Control synchronizes the response with the Blues, and a specific location or coordinate is designated as the meeting point. This spiel has, on occasion, delayed the medical response and that is unfortunate. Unfortunate for them, because they need help; and unfortunate for me, because I want to help.

 

But I didn’t create this reality. Terrorism did.

 

Conclusion

There is no conclusion.

This whole saga is still a work in progress and we wait, pray and hope for G-d’s mercy.

But I began this whole train of thought due to a beeper I received which said:

“Emergency Medical Event – E. Jerusalem”

These calls are normally signed off by the dispatcher as “Security Escort Necessary” – except on this occasion she mistakenly typed “A Coat is Necessary!”

Don’t know how much a coat is going to help.

 

Unless of course it’s bulletproof.

GPS

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“10 Maine Ave – 4th floor – Male 65 Years old – Irregular Heartbeat”

Does something seem peculiar with the aforementioned information?

I didn’t think so either. Except for the irregular heartbeat, the call looked perfectly regular.

(Sorry – I couldn’t help myself.)

All seemed legit – until GPS got on the radio waves.

GPS is the nickname honorably elected to a gentleman called Aaron. I say gentleman, but in fact, he would be better described as a machine; and this particular machine has an affinity to maps, streets, house numbers, and all things boring. He knows, at the tip of his fingers, and I kid you not – every single house in Jerusalem, and soon, the world. If he had the aspiration, and he doesn’t, he’d be out there working for NASA counting stars or something.

“Don’t be silly,” my grandfather would say, “You’re exaggerating.”

“No – I’m not!”

GPS doesn’t respond physically to many emergency calls, but instead monitors the ‘situation’ from his daytime job at a large bakery.

“What good is a medic who prefers baking?” asks my ever pragmatic grandfather.

Actually, a great deal of good and I’ll explain.

He clearly has a photographic memory and knows not only the number of buildings on each street, but also the number of apartments in each building.

Absurd – Yes.

Extremely helpful – Oh Yes.

 

Case Study #1

DISPATCHER: “Minor Injury at Bus Stop on Park Ave”

GPS: There is no bus stop on Park Ave.

Short and to the point: He needn’t say more. Control now knows with absolute certainty, that someone, somewhere, has made a mistake and that the data needs to be revisited and revised.

 

Case Study #2

DISPATCHER: “10 Maine Ave – 4th floor – Male 65 Years old – Irregular Heartbeat”

GPS: On Maine Avenue, house #10 is a villa; and there is certainly no apartment on the 4th floor. The correct address must therefore be Main Street, where #10 has 5 floors. Over and out.

The ‘new’ address is in a completely different neck of the woods. My neck of the woods.

“Unit #18 en route.”

I arrive simultaneously with Unit #24. We grab our kits and head to the elevator. Inside, I press number 4, and notice there are 5 floors.

GPS – Spot on.

Elevator doesn’t budge, so we go up manually. Yes, that means we took the stairs.

I knock on the door. No response. I begin to let myself in and am stopped by #24 who, a touch more fastidious than me, would never enter uninvited.

“It’s not correct etiquette!”

I politely disagree.

“This isn’t just an emergency call – it’s an intensive care ALS call. The patient might very well be lying on the floor, unconscious, alone, fading, perishing, expiring, declining, dying, decaying.”

OK, I went too far.

But still, the reality is that someone has called for an ambulance, and is now suspiciously quiet.

“I vote we knock, announce ourselves, and walk straight in.”

“All in favor say Aye!”

#24 is silent, contemplating the validity of my theory.

Or perhaps I had lost him at “decaying” – either way I let myself in, and start searching the small apartment.

I find the gentleman in the lounge on the floor; alive, breathing and conscious, but too weak to get up. I want to say “I told you so,” but fight the urge and focus on the patient.

One minute and several questions later, I learn that he is normally a healthy individual, but had suddenly felt terribly weak and dizzy. So weak in fact, that his legs had buckled under him, and he found himself dialing the emergency services. The rest is history.

 

His pulse was a touch fast – 120.

His systolic was a touch low – 100.

 

Actually come to think of it, my pulse was probably also 120. But I had a valid excuse;

4 flights + 184 pounds (me) + 30 pounds (EMT bag) = Cardio Workout.

Whereas he was just lazing about on the floor.

The ALS crew walked in, and I gave over the information that I had gleaned, including his fast pulse.

To be precise I said, “Pulse 120.”

The paramedic nodded at me as if I was being rather silly and juvenile. She asked me to step back, and proceeded to ask the exact same questions as I had moments before.

The patient looked confused, and so was I.

She proceeded to take his pulse and exclaimed aloud in utter disbelief “This man has Sinus Tachycardia!”

Her crew looked shocked and taken aback at this unforeseen twist.

(For the uninitiated, a pulse of 120 is by definition Tachycardia, except the latter is a more important word.)

I thought it an opportune time to leave, before I regurgitated all over her and her ego. This time #24 agreed, and we headed back down the four flights.

 

I’d vote for unpretentious GPS over conceited ALS any day – wouldn’t you?