First Responders on the Streets of Tacoma Washington
We walked into a dimly lit bathroom in a bar in downtown Tacoma. It was 7 pm, not late enough, on a Friday night, for things to really start thumping in this hard edged, blue-collar working town.
A woman with thin pale limbs and bleached blonde hair was collapsed on the dirty bathroom floor, wedged under the divider between two toilets. On her right arm was a tourniquet, with a needle sticking out from a vein running along the interior of her forearm.
She was dressed for an evening in this bar, slightly more respectable than dives up on South Tacoma Way. Here, at least, was a thin veneer of employment. Maybe she thought she'd find true love or at least someone to spend the night with who would buy her drinks, or maybe she was just there to score.
The bathroom was tiny and quickly filled beyond capacity as my older and rounder senior partner and two firefighters crowded in to take care of her. I stood in the doorway, not wanting to shoehorn myself into this mess.
After some discussion, we carried her out of the bathroom to work on saving her life. As we did, she quit breathing, so we took over breathing for her with a manual ventilation mask. My partner started to look for a viable vein to start an I.V. to give her Narcan, a drug that would reverse the effects of a Heroin overdose.
The entrance was darker than the bathroom, so we used a penlight to expand the search for any vein into which we could "plug a line into." Her arms were "used up." A term we used to describe the scarred sclerotic veins of a long-term I.V. drug user. The firefighter continued to push air into her lungs as we searched.
We found lines of scars marching up and down the routes of her blood vessels as we searched her arms, then her forehead, neck, hands, and finally, her feet. Each promise dashed as the entrance of our needle didn't enter a reliable blood vessel. The tension from so many failures began to build. There had to be one we could use.
Suddenly from the bar came lyrics and an infectious beat;
If you want it, you got it, ah If you want it, baby, you got it (just bust a move), ah If you want it, you got it, ah If you want it, baby, you got it (move it, boy)
My partner and I started swaying our hips to the music and singing as we tried again to find an I.V. Suddenly, a success. A tiny vein on the ridge of her foot in between scars. My partner carefully threaded our smallest needle into the vein. Then he slowly pushed the Narcan into the tubing that carried it into her bloodstream. If he gave it too fast, the fragile blood vessel could burst, and then we'd start again at zero.
As if on cue, the patient gasped with her first breath. Swearing quickly followed this as she attempted to thrash her arms and legs about. We knew the drill and were positioned on each limb before giving the medication. We held her down to protect her from dislodging the hard-won I.V. and sending us back to square one. The remedy would only last so long before she'd need another dose.
"Hold still. You're making this harder than it needs to be."
"Fuck you! Just let me go."
"We can't. We just gave you Narcan to wake you up. You weren't breathing. You would have died."
"FUUUUCCCK YOOU!" She screamed and strained with a strength that seemed impossible for someone her size. The big firefighters strained to keep her in place.
Realizing she wasn't getting anywhere, she finally released her fight. Then her whole body shook from the instant withdrawal that accompanies the Narcan. Narcan blocks the effects of narcotics, and the addicted user is quickly thrown into withdrawals. Propelling them from feeling comfortably numb to shock raging from every nerve fiber.
She lay on the concrete floor, alive but unhappy we had ruined her high. We knew that we were the stopgap between now and the inevitable. Today she was alive. Another day, she probably wouldn't be so lucky. Maybe she'd O.D., and no one would find her until it was too late. Maybe she'd die of some other disease that ravaged her from a dirty needle.
We couldn't change the trajectory of her life in the long run. We showed up between the first time she tried Heroin and the last. Our only job was to take care of her immediate need…to breathe.
Working in Tacoma was a deep dive into the world of addiction. If we weren't scraping drunks off the pavement in the aftermath of a drunk driving accident, we were administering Narcan to heroin overdoses or coaxing people on psychedelics off the ledges of their delusions. Then there were the shootings, domestics, and assaults. All part of the sex, drugs, and rock-n-roll generation.
It made for an exciting job as a first responder, but it was a tragic snapshot of people caught in the gutter with little hope of escape.
As first responders, we see the darkest side of addiction, including death. Sometimes, because we see such a devastating side, we can fail to see the subtle or not so subtle signs in ourselves. Throw in the incredible stress of our job, and we might even feel justified in having a few too many drinks. If you think your drinking or other addictions are getting out of hand, seek help. For resources for first responders, visit: https://www.iaffrecoverycenter.com/
If you or anyone you know is dealing with opioids or other addictions, just know that it won't get better, only worse. For help, here is a place to start: https://www.cdc.gov/opioids/overdoseprevention/help-resources.html
You can also contact me, and I may be able to help you with additional resources.
This story above is an emergency call from my time working private ambulance during my college years.
While I was in college studying Liberal Arts at Evergreen State College, I worked part-time in Tacoma, Washington as an Emergency Medical Technician for Shepard Ambulance. I worked with a partner who was a paramedic. My job was to drive and his was to be a paramedic.
Thrown into the fire, so to speak, I found myself getting an education about the darkest recesses of life. I was also learning that to be an EMT for a private ambulance on an ALS rig meant learning on the job. If you couldn’t handle the stress of not having enough mentoring or support, then this wasn’t the job for you. There were many moments during my time with Shepard Ambulance that were some of the most challenging of my life. For some reason, I kept coming back for more.
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