Emergency Landing

No Comments

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

No Comments

“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.

Silly American

No Comments

“Silly American!” I thought as I ran towards my bike. My screen read;

“Allergic reaction – 20 Year old male – conference call with 100/Police”

“Conference call?!” you ask.

“Why should EMS call Police?” you wonder.

Answer = Silly American.

Ladies and Gentleman of the United States, United Kingdom and the Philippines.

The number for the ambulance service in Israel is 101.

Not 718 230 1000 (Yes – that too has happened before.)

Not 100. Not 102. Not 112. Not 911. Not 999. Not 000 (thumbs up easygoing Australians).

Fun Fact: Did you know that the emergency number in the Republic of Djibouti is 351351. The absolute paradigm of simplicity, I couldn’t have come up with an easier number myself.

Our dear patient, bless him, had called the police complaining of an allergic reaction to an unknown substance. The police confirmed that the substance wasn’t white and powder-like, and then moved onto the next step in their crisis algorithm – call EMS.

They now have our number written on yellow-stickies all over the office, ever since that uncomfortable incident when they mistakenly called environmental protection – long story.

Eventually, the conference call was put into motion:

 

POLICE: Hello, is this EMS?

AMERICAN: No, it’s still me!

EMS: Yes, we are here as well.

POLICE: Go ahead please Sir…

EMS: I am not a Sir, I’m a madam!

POLICE: No, no, the American.

AMERICAN: Guys, stop fooling around, I can’t breathe!

EMS: Where are you?

AMERICAN: At home.

EMS: Where do you live?

POLICE: He is from America.

AMERICAN: I’m in Hebrew U.

EMS: What happened?

POLICE: He took a substance that was not white and powder-like.

EMS: Please let the American answer!

AMERICAN: I am having an allergic reaction!

EMS: Do you want an ambulance?

POLICE: I don’t think so; he called us.

AMERICAN: I need help, I can’t move my lips, they’re stuck!

POLICE: Stuck! Let me get FIRE on the line…

FIRE: Wassup boys?

EMS: Good!

POLICE: Great!

AMERICAN: Help !!!

 

I was eventually dispatched and ran towards my bike.

I try to start it – the engine stutters.

I try again, this time whispering Psalms. The engine roars (meekly) to life.

I love my bike and my bike loves me, but we are reaching the end now. We have already been through one heart engine transplant, and recently there have been some recurring health issues.

It’s been an amazing journey; the highs, the lows, and everything in the middle. I refer of course to the steep inclines and valleys of Jerusalem, which are quite frankly partly to blame for the relatively short life span of my bike. That, and the incessant accelerating and braking which is typical of this line of work.

My very kind Boss at United has offered countless times to give me a new updated model, but I refuse. I would like to continue riding it, “until death do us part.” Besides, the new model is larger, heavier and faster – qualities that I simply don’t need.

I weave in and out of midday traffic and finally reach my secret shortcut to this address.

Not so secret; there’s another ambucycle right on my tail. He knows, that I know, that he knows the secret path. I think I see him smirking under the visor; not for long though. Lo and behold, the opening of the path is 80cm wide. My wingspan (yes, I pretend to be a plane) is 87, but if I retract my mirrors, I am a very slim 77cm – exactly trim enough to make it through. The freshly frowning guy behind me has a new fancy shmancy model and doesn’t fit, no matter what he tries. I land at the location, glance over my starboard wing and notice him taking the long ring road.

Old School – ONE

Hot Shot – NIL

I take my equipment, speed up the steps, and make one of the most embarrassing mistakes of my career. I open the door, see the patient’s face, and shout “WOW!”

His lips were just that big – swollen to fivefold their regular size, because of the reaction.

“Whaaths whong?” he thays, “Whhy you thouwting?”

I apologize, ask him a bunch of questions, take his vitals; and this is what I gleaned.

He is not allergic to anything.

He doesn’t know what he ate (In his words – the school lunch has no humanoid name.)

He was sleeping and felt his lips exploding, but no other signs of a reaction on his person.

His vitals are Pulse:85 – BP:135/70 – O2 Sats 97%

All within normal ranges.

But his tongue is starting to swell, and that is no good. I put on an oxygen mask and open to 10lpm. I rummage in my bag for IV equipment to start a line, but then glance back at him and notice something odd. His lips are now more like a beak; yes a beak, as in a bird, and the mask is dangling a centimetre away from his face.

“What’s that you ask?” – “Did I take a picture and whatsapp to the masses?”

No, I certainly did not. I never ever ever do that.

Old School – TWO  Hot Shot – NIL

The Natan arrives and listens attentively (yeah right) to my hand-over. The signs and symptoms are a bit conflicting here. On the one hand, he has a clear reaction + swelling (bad), but his BP isn’t dropping (good). The paramedics decide to open a vein and then transport on Urgent to the ER.

The second they left, the diagnosis popped into my head. He had probably gotten a bite from a spider or another creepy crawly. This explained the very local swelling, and normal vitals.

Old School – THREE  Hot Shot – NIL

I drop by two days later to see how he is doing. His lips are now down to double normal, and he actually kinda likes the new look.

The ER did some tests, gave him tons of anti-histamine type meds, and sent him back home.

POLICE: Home to AMERICA, you mean.

EMS: Shut up!

FIRE: Do you still need us, or can we go back to sleep?

Conflicting Reports

No Comments

T’was early evening in the Shmeel residence, and the hero of our story was doing what he does best: bath time. Kids screaming, bubbles flying, beeper beeping, baby crying, and water splashing; pretty much a normal day.

“Beeper beeping?” did I hear you say.

“Indeed I did. And wouldn’t you like to know what it said.”

“Indeed I do sir; please sir, what did the beeper say?”

“Ah well, said the hero; you shall just have to wait and see.”

 

And so began the bedtime story, I was telling my kids.

I often tell them of my escapades, and the stories always have a wonderfully bright and happy ending. My oldest has begun to question, why, if every story is so joyful, how is it that I often return from a call looking a bit discouraged.

I’ll delay telling them the whole truth and nothing but the truth as long as I can.

In the meantime, the escapades have a weightier purpose. My true intention, far beyond persuasive entertainment, is to instill in my family essential values and critical life tools.

I pray that the tales impart thankfulness, a joy of life and living, an appreciation of being, and gratitude to our Creator for His interminable and infinite kindness. I hope to impart to my kids that even when the going gets tough; especially when the going gets tough, the answer, beyond the lights and sirens, is faith and hope.

I have been there, I have done that, and bear witness that our abilities are severely limited, and that salvation will come but from a connection with the Divine.

Back to our story.

A unique feature of EMS over all other professions or pursuits is that you never, ever, know what the next minute might bring. Sometimes there are three calls back to back in the early morning and then silence for the rest of the day. Sometimes you get weekly furloughs and then an MI, PE and GMG within half an hour. What this means for emergency personnel, is that we need to be prepared to get interrupted at any time, in any place, and during any given activity, to go and save a life.

Particularly popular places to be when a call comes in include: la toilette, the WC, el inodoro, the bathroom, tas tualetas and die toilette. The volunteer can be undressed, partially dressed, or almost dressed. Getting a call when you are absolutely ready for it, is rare. I know someone it happened to once, but even then, he forgot his glasses at home and spent the better part of 5 minutes trying to find the entrance of the building.

Back to our story.

This particular call found me with my hands full of soap, giving my son a bath. Kneeling next to the bathtub, I felt the beeper vibrating in its holster. I had a feeling the call was in my jurisdiction, so I quickly dried my hands and fumbled for the beeper; I was right.

“MVA – Car vs. ‘Child on bike’ – Minor Injury.”

These calls are common in our youngster-rich neighborhood, but thankfully most conclude with only minor scratches and bruises. In any event, an accident involving a child and a car needs immediate attention, and so I deputized my wife for bath duty:

By the power vested in me by the State of New York, I hereby pronounce you ‘woman in charge’. You may now give the kids a bath.

I got to the scene to find a kid standing on the side of the road, pale-faced and crying.

The conflicting reports began. Conflicting is too timid a word; the story was downright odd.

The taxi driver seemed very annoyed, “The kid just rode into the middle of the street without looking! I tried to stop in time but it all happened too quickly.” Then he began to mumble to himself, “Kids nowadays…”

The boy, on the other hand, insisted that he had been riding on the sidewalk and had not been hit by a car at all, but rather had “fallen.”

Something about the boy’s wide brown eyes, and nervous blinking told me that he was lying and desperately didn’t want his mother to know that he had been cycling on the main road.

Furthermore, I have yet to meet a taxi driver that would admit to hitting a little boy on a bike if it hadn’t really occurred!?

I looked the boy over, took some vitals, heard witness reports of the kinematics of the accident and came to the joyous conclusion that the boy would go on to live a long and prosperous life.

The mother soon arrived and excitedly hugged the child, thankful that he would be coming home for supper in one piece. She declined transport to hospital and just before she left, youngen in tow, I silently slipped a pack of winkies into his top shirt pocket. He smiled; grateful for the candy, happy he had survived the accident, and relieved his mother hadn’t told him off (yet).

When I got home, my four year old asked me flippantly, “So, what was it?”

He is an expert on all types of calls, you see.

I told him what had happened.

“Did you give him winkies?”

I assured him I did.

“Good job, Daddy!” he said proudly.

We smiled knowingly at each other as I slipped his pajama shirt over his head.

 

… and they lived happily ever after.