Hard Knock Life

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I was at a fire the other day and the firefighters did a wonderful job; as they always do.

Fast, dedicated, professional, brave, strong, courageous, daring – and that was just the EMS response.

The Fire crews were even better.

BUT

Judging by their tanned faces, healthy demeanor, positive attitude and well-built physique, something tells me these guys are somewhat underworked.

To prove my thesis, I went on an undercover mission to Engine Company #26 to find out what goes on behind the scenes. The results were shocking.

 

A Day in the life of a Firefighter

 

0700      Alarm clock rings – With incredible alacrity – the Fire Chief presses the snooze button

0900      The crew is rudely awakened by a passing ambulance with sirens blazing. Chutzpah!

1100      Chief does a roll call and requests that, “He who finished the milk – go buy more”

1300      Chief does a roll call and asks whether the crew prefers falafel or shwarma for lunch

1500      The crew is hard at work – pumping iron in the backyard of the station

1700      The crew is hard at work – cleaning and polishing Ladder 26

1900      Some personnel stay to play Xbox while others attend a “Fireman appreciation ceremony”

2100      Actually it’s rather quiet at 9pm

2300      The dispatcher is overheard on the phone “Sir – We don’t remove cats from trees unless they have beens stuck for 48 hours”

0100      The dispatcher is overheard on the phone “Ma’am – Can’t you put it out by yourself, it’s just a fire in a bin for heavens sake!”

0300      The dispatcher is overheard on the phone “Why are you calling so late – it’s in middle of the night!”

0500      Phone rings five times and then:

“You have reached the voicemail of ‘Engine 26’ – if this is an emergency, call EMS. Those guys never sleep”

 

Postscript:

Dearest Firefighter,

We both know that at least half of the above is untrue. Please pardon my extensive use of poetic license, also known as artistic license. Please know that artistic license is a generally accepted practice, particularly when the result is widely acclaimed.

This blog is widely acclaimed – by my wife at least.

My brother is less keen.

Artistic license, also known as dramatic license, glamorizes real-world occupations for the sake of an exciting reader’s experience. For example, in the above schedule I omitted some of the more mundane aspects of the job such as paperwork, reports, and administrative duties, which in reality often constitute the majority of a fireman’s work. As was probably immediately obvious, even to the uninformed reader, there were many aspects of the day that I failed to mention. Items such as, who the milk culprit actually was, and whether the old lady did indeed manage to the put the fire out herself, were excluded for the sake of brevity.

On the other hand, I also presented other duties with much more action, suspense or drama than would be experienced in reality. On most days, (excluding public holidays), there is absolutely no free choice for lunch – the chief unabashedly plays dictator at the takeout place.

BUT

Absolutely all joking aside;

I have found the firefighters in Jerusalem to be a really amazing group of people. They might respond to fewer emergencies per hour than their EMS brothers, but when they do get off the couch, they are unbelievably talented and dedicated. Aside from the obvious job description of putting out fires, these guys are expected to have a myriad of other talents, and they perform, every time. Their street-smarts are truly a marvel to behold, and I have seen them work miracles tens of times – always with their trademark humility and caring.

When you really need help, in any sticky situation, call the Jerusalem Fire Department.

Between the hours of 9 to 5, that is.

At all other times, please call EMS – those guys never sleep.

Humble Gratitude

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“Who is it?”

The door opened slowly, deliberately, and in the doorway was a well-kept lady in her seventies.

“Who is it?” she asked again, this time with urgency.

And yet, with humility.

She was looking directly at me. I was wearing my neon orange vest, and in my hand, a bright red EMT bag.

“Uh, I’m with EMS,” I answered somewhat confused.

“Oh, thank you for coming so quickly; please do come inside.”

“Is there anyone else?” she asked, looking squarely at the ambulance driver standing behind me.

 

She was blind.

 

We entered, suddenly less important, less proud.

She beckoned me to the back of the house. “It’s my husband, David. His chest has been bothering him all day and I’m worried it’s his heart.”

David was sitting in an armchair, his hands clutching his chest. Hearing footsteps, he directed his face toward me and asked, “Who’s there?”

 

He was blind.

 

“I’m Shmeel and I am with the emergency services. What seems to be the problem, sir?”

“I’m having some chest pain but I’m sure it’s nothing. I told Michal not to call for an ambulance but she worries about me. I hate to bother you boys.”

Why is it that the people who actually need an ambulance tend to apologize for the inconvenience, whilst others with inconsequential ailments will yell at us for not moving quick enough?

Perhaps it’s because real illness makes us feel vulnerable and unpretentious.

Perhaps it’s because we suddenly realize, no matter how important and busy and significant we were a moment ago, suddenly, like a flash of lightning, we know the truth. The truth that we are but flesh and blood: mortal and limited. Millionaire chief executive and penniless homeless-man, suddenly understand that they were never actually in control, at all.

But David didn’t need the forewarning of illness. He was humble from birth.

“It’s no bother at all, Sir. We’re here to help. Why don’t you tell me exactly how you feel?”

He described his symptoms as his wife stood next to him, touching his shoulder reassuringly. She interjected every so often with facts he had forgotten. It was moving to see how completely devoted they were to each other.

I took his vitals and a complete medical history. He wasn’t pale, diaphoretic, dizzy, nauseous, nor having any trouble breathing. He did have a very distinct pain in his chest though, and I feared he might be having some form of asymptomatic myocardial infarction – in laymen’s terms, a heart attack without the usual signs or symptoms. We needed to get him to the hospital. Fast.

I shared my hunch with the ambulance driver, and he concurred.

He dialed Control, “G’day, this is Ambulance #80 requesting ALS backup for a possible MI.”

“Ambulance #80 be advised that the only Natan available is in a different city, 20 minute ETA, do you still want them?”

(It was a particularly busy time, and there were no local ALS units available.)

“Negative, I’ll transport myself.”

The reasoning was simple. The BLS ambulance, with Lights and Sirens, would almost certainly get to the hospital before the Natan had even entered the city. It was the right thing to do.

“Are there any family members we can notify so you won’t be alone in the hospital?” I asked Michal, as my colleagues eased David into the ambulance chair.

“No. It’s just me and David. We have each other, thank G-d. I don’t know what I would do if something were to happen to him.” She whispered.

I rarely get a lump in my throat.

We readied the patient for transport and wheeled him to the door amidst a constant stream of thanks and appreciation. The elevator was out of service and so we carried him down manually, for the lack of a better word. The men did the heavy lifting and the two female members of the team, assisted Michal down the stairs.

“Thank you so much – I’m so sorry – I hope it’s not too much of a bother,” said husband and wife, in a harmony of humble gratitude.

I got to the bottom of the stairs tired yet inspired, by these people who, challenged with obvious and difficult handicaps, had nonetheless made the utmost of their lives. They seemed genuinely happy with their lot and were leading a productive and fruitful existence despite the hurdles they faced. Or perhaps because of the hurdles they faced.

They managed to whisper one more ‘thank you’ as I closed the ambulance door.

“Thank YOU,” I wanted to say.

Thank you so very much.

 

Postscript: “The most special people I know are those who have encountered adversity, confronted hardship, endured pain, withstood misfortune, and have dug their way out of the mire. These individuals have an immense appreciation for life and living, and an abundance of simple faith and hope. Their suffering has not brought them down, but instead lifted them up to an existence of humility, gratitude and compassion. Virtue isn’t born of happenstance; it is acquired through sincere application.”

Emergency Landing

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For those of you busy businesspeople without a second to spare – here is a quick synopsis:

Was he faking chest pain on an airplane?

Did he cause an emergency landing in Dnepropetrovsk in order to visit family there?

Can you sprain your wrist whilst having a heart attack?

Why do folks think they can fake medical emergencies in front of persons (me) who have seen them all before?

 

The unemployed amongst us – please do keep reading.

I am happy to join with you today in what will go down in history as the greatest demonstration of coolness in the history of our nation. Five score years ago, a great American, on whose website you stand today, signed the EMS vow and became an EMT. This momentous decree came as a great beacon light of hope to millions of the sick of Israel who had been seared in the flames of withering injustice. It came as a joyous daybreak to end the long night of their illness and suffering.

But one hundred years later, still no emergency call on a car. One hundred years later, still no call on a boat. One hundred years later, still no call on a plane.

So we have come here today to dramatize a shameful condition. But let us not wallow in the valley of despair. I say to you today, my friends, even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream.

I have a dream that one day this nation will rise up to the heavens in great metal ships with wings.

I have a dream that one day in the fluffy clouds, miles high in the atmosphere, someone will urgently need help.

I have a dream that my four little children will one day live in a nation where they will stand safely back on the ground, their Dad having saved a life in the sky.

I have a dream today.

Back to the present – and if you haven’t yet guessed, my dream, is to be called upon to save a life on a plane. We have all heard it, the familiar ding of the airplane’s PA system; purser gets on and asks in a calm and yet petrified voice – “Is there a medic on board?”

YES! There is! And he has been waiting for this day for the longest time.

I walked to the front of the plane, and introduced myself.

“How can I help?” I said in the most professional, deep, manly voice I could muster.

“What seems to be the problem?” I said in the most qualified, profound, macho voice known to man.

“Stop it with the theatrics, Mister,” said the stewardess, “This man is having a heart attack.” And with that she disappeared to get the dying man a cup of water.

I looked at the man and the man looked at me.

30 seconds go by.

“No he’s not,” I wanted to say, but then nobody would believe me.

So I started from the top.

SHMEEL: Hello Sir, my name is Shmeel and I am an EMT – What seems to be the problem?

MAN: Ищу сердечный приступ

Oops – translator needed. Another PA announcement: “Is there anyone on board that speaks Russian?”

149 people raise their hands.

“What I meant to say was, is there anyone on board that speaks Russian and English?”

One candidate.

She makes her way over to us and we are now a quartet. Patient, Stewardess, Doctor and Translator; a team that can’t be beat.

I ask again, he responds, and the translator translates. Let’s call them the Duo.

DUO: I am looking for a heart attack.

ME: Look no further… No seriously, what’s bothering you?

DUO: I got the pain in my stomach.

To maximize the effect, he points to where he thinks his heart is – near his left shoulder.

Wrong. The heart is located anterior to the vertebral column and posterior to the sternum. For those of us that don’t speak French, it is in the middle of the chest, with an inclination towards the left. Somebody having a heart attack feels pain, sometimes described as pressure, exactly in the middle, and normally points with his whole hand and not just a finger.

ME: How bad is the pain on a scale of 1 – 10; ten being the worst?

DUO: (he looks up at the seat numbers on the overhead lockers) About 23.

ME: When did the pain start, and is it constant?

DUO: He started many years ago, and was still hurt.

Due to the excitement of the moment, I made a silly rookie gaffe and asked him a closed ended question. Big mistake; the answer is almost always a resounding, “Yes!”

ME: Do you have pain in your arm?

DUO: YES! Much pain in my arm, right here, (points to his wrist.)

End of the exam.

Let’s revise what I had gleaned so far;

The man is looking for a heart attack near his shoulder, is sitting in seat 23, and has pain in his wrist.

Oh and before I forget, he was red faced, slurring his words, and had 7 empty bottles of scotch on his tray table in front of him.

If you answered Drunk – I hereby award you with your pilot’s license.

But – and this is critical, so listen carefully; you can never really know. I firmly believe that anyone with any sort of chest pain should get it checked out as soon as possible.

The excitement continues. Inflight entertainment was abandoned by all on board, and 298 eyes are looking at us. Airfare very well spent, if you ask me.

I was invited to the cockpit to present my findings to the pilot and advise on the best course of action. The stewardess leads the way, with me, translator, and drunk in tow. She turns around and says “No, no – only the Doctor comes with me.” The Duo return to their seats, dejected.

I try to explain that I am but a lowly EMT. She wouldn’t hear of it. We get to the locked and bolted door of the cockpit (since 9/11) and the stewardess does a secret knock that sounds like Vivaldi’s Four Seasons.

Door opens and I am ushered in.

“Do we need to do an emergency landing in Dnepropetrovsk, or not?” asks the Captain. I can’t tell whether he is joking or serious. A glance at the first officer tells me he is not sure either.

“Well, in my humble opinion, it seems as though the patient is just intoxicated. However, we can’t rule out a Myocardial Infarction unless we do an ECG and blood work to check for cardiac biomarkers.”

“Go ahead, order the tests,” says the Captain, turning his face back to the controls.

“But all we have on board is a blood pressure cuff and an empty oxygen canister, Sir.”

“Ah, well, that’s a different story then, isn’t it!” He is deep in thought now. “Well, we are only about an hour out now; perhaps we could just ‘put the pedal to the metal’ and have EMS await us on arrival.”

I concurred, and so it came to be. We landed safely in Kiev and a team came on board and ushered the dying man into their idling vehicle. I looked out of the window and could have sworn it said Boryspil Cleaning Crew on the side!?

I never did find out if he made it, but was nonetheless very proud of my performance.

 

“A call at last! A call at last! Thank G-d Almighty, a call at last!”

 

(Many thanks to MLK Jr. for his help with this post.)

Little Old Lady

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“I give thanks before you, King, living and eternal, for you have returned within me my soul with compassion – abundant is your faithfulness,” I whispered as I drove through the empty streets.

Jerusalem in the early morning mid-spring: nothing quite like it. Israelis are early risers no doubt, but the streets are still relatively calm at 0630. The noisy bakery trucks have already made their rounds, leaving the birds to sing solo. The air is crisp, the sky blue, and the sun shines brighter than anywhere else in the world.

So bright in fact, that I had my visor down as I made my way to “MVA – Serious Injury,” on a street 4 minutes away.

“Four minutes?!” exclaim those with intimate knowledge of our response times, “Why would you do a thing like that?”

Indeed the call was on the edge of my self-designated perimeter, but I had good reason for going: Nobody else had. EMT and civilian alike, everyone was still sleeping. Everyone that is, except for the young lady that had managed to flip her car sideways on a small, residential, 30kph speed limit street. My prophetic vision told me she had been going faster than 30, and that she might, maybe, possibly, have been texting.

Lesson One: Don’t text and drive.

But, I gave her the benefit of the doubt and besides, even idiots deserve medical treatment in an emergency.

Luckily, this particular idiot had listened to her mother and had her seatbelt on. It saved her life.

Lesson Two: Always listen to your Mother.

I got there to find the ‘injured’ lady already extricated from the vehicle and standing on the side of the road. Next to her was a very concerned looking postal worker. Concerned at the state of the car that is; the lady didn’t even have a scratch on her. I asked her several questions about her wellbeing and confirmed that I had been schlepped out of bed for naught. She refused transport to hospital and I left the duo taking selfies in front of the wreck.

Lesson Three: After you wreck your car, take a Selfie.

I mounted my horse bike (yes, like a cowboy) and headed home. Not so fast mister; the beeper beeped and I took another call. This time it was a “Danger to Human Life” and I was literally a few meters away from the location. This category of call normally means that the health of a patient behind locked doors is in question. In these situations, all three services are called; The BLUES – to give authorization to knock the door down, REDS – to knock the door down, and EMS – to treat whoever lies behind the door.

Well, EMS was already on scene, and the other services were, to be perfectly blunt, still in bed. I dismounted the bike (yes, like a cowboy) and went inside to investigate.

I investigate as well, by the way; gotta remember to add that to my resume. Boy, this is an ambidextrous job.

Note to all English Literature students out there: Don’t bother emailing, I know it’s the wrong use of the word, and I did it anyway.

Lesson Four: My Blog = My Rules.

Inside, on the first floor, I found a very concerned, actually downright alarmed, grandson. He was pacing back and forth outside his grandmother’s door. I, too, was startled. What was a teenager doing up so early in the morning? Something was definitely amiss.

Turns out, the lad had spoken to grandma last night and she had complained of not feeling well. He thought nothing of it at the time, but now that she wasn’t answering the door, he feared the worst.

I, too, had feared the worst on my first few ‘Danger to Human Life’ calls. Now I know that we have statistics on our side and there is a good chance that there is some absolutely flawless reason that grandma isn’t answering.

Lesson Five: Don’t worry, be happy.

But just for the record, I’ll tell you that the more sinister option was that she had fallen, and couldn’t get up on her own. The downright disturbing option was that she had passed away in her sleep.

Blues eventually arrived, and I told them what I had learnt. As far as they were concerned, there was enough evidence to knock down the door, and permission was granted accordingly. Now we had EMS + Blues + Permission. But no Reds. I went outside to look for them, as if I could draw them closer by just glaring down the street. Lo and behold, there they were, clumsily making their way down the narrow road. No fault of their own, those trucks are really hard to maneuver.

The firemen went upstairs to assess the door and decide on the tools, whilst I stayed down to make sure none of us got a parking ticket.

The arrival of the array of emergency vehicles had by now attracted quite a crowd, who were squabbling loudly at the entrance of the building. I thought I would do a bit of crowd control, (another item to add to the resume,) and so I tried to impose law and order.

“Back everyone, please!” I shouted.

Useless. I was in my Pajamas. Nobody was going to listen to me.

And then a little old lady came forward and asked me,

  1. Whether she could fetch me a blanket from her house, because I looked cold, and
  2. If I knew what the commotion was about, because she wanted to go back home and the groceries were getting quite heavy.

I told her no thank you on the blanket, and then, it hit me.

“You don’t happen to live on the first floor, do you Madam?”

“I most certainly do,” she replied.

 

Case Closed.

 

Lesson Six: Always go groceries shopping in the early morning. There are fewer customers then.