Michael Morse - Rescuing Providence

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The elephant in the emergency room

Thu, 04/19/2018 - 03:09

It is difficult for me to expose what most of know, as reluctant as we may be to admit it, as truth. EMS is held together not by highly trained professionals willing, trained and eager to respond to medical emergencies , but rather by billing, revenue and opportunity to increase wealth. Those of us who have chosen EMS as our livelihood are reticent to speak up, knowing that by doing so we are only hurting ourselves and future Paramedics and EMT’s. Providing rides to medical appointments is perfectly legitimate, unfortunately, we are not being honest about the work we do, which makes us part of the problem. Operating under the illusion of necessity is no way to run a business, and make no mistake; EMS is more of a business than it is a public safety agency. Our very name implies something that we are mostly not; Emergency Medical Responders.

It took some time for me to realize that we had lost the war. For the longest time I truly believed that my job as a person responding to 911 emergencies was of utmost importance to the citizens and taxpayers of this great nation. It wasn’t until those very citizens and taxpayers beat me down did I become a taxi driver who charged ridiculous rates for my services.

Of course, my service could charge anything they want; the people who call 911 for stubbed toes during blizzards have zero intention of paying anyway, but I digress. Somehow, the nation’s 911 system has been turned into a socialized transportation program that entitles people savvy enough to utilize the resources at their disposal the right to beckon trained and courteous medical professionals to their homes, places of employment or anywhere they may be.

And we, the providers happily go along with the debacle. It is far easier to give in, and take the people who call us in than to argue, explain, lecture or refuse transport. It’s a game we play now, and I call it “Getting Through the Shift.”

90% of 911 calls are for non-emergencies. Of that 90%, maybe half probably would benefit from some kind of professional medical evaluation and treatment, but could find the means to get them to the treatment they desire on their own. The other half would be just as safe if they opened their medicine cabinets, used peroxide, aspirin, Tylenol and a band-aid. Of course, many believe that the government should provide these things. The local pharmacy charges for band-aids, but 911 does not-unless you are dumb enough to pay the bill.

Here are a few random examples of 911 calls we respond to every day, everywhere:

My Cramps are “extra bad.”

I tasted nail polish remover and it’s eating my tongue

I broke up with my boyfriend and feel sad

I’m tired.

I took some vitamins and now I can’t stop kicking the wall.

The Oxycontin isn’t working!

My tooth hurts.

I need a breast reduction.

I think I’m hurt

I had a nightmare and I’m scared, real bad.

 

These examples are nothing new to those of us in the trenches, and the people we complain to. But there are vast amounts of people who have no idea just how badly they are being taken advantage of. When resources are squandered, and real emergencies happen, people die. It’s all fun and games taking people to the hospital in an advanced life support vehicle for foot pain-until the cardiac arrest happens while you are tied up with a non-emergent person.

While the nation’s EMS crews are running around town like idiots, caring for people who have no business calling 911, other people are dying, and that is a fact. It is absolutely absurd how we allow so much of the populace to squander our vital resources.

One popular answer to the problem is add MORE resources to cater to an abusive public. A common complaint heard among overworked EMT’s and Paramedics is “we need more crews.”

Truth is, we need less crews answering fewer 911 calls.

I answered 911 calls for nearly 25 years. When I left EMS, my truck responded to well over 6000 calls a year. Maybe 500 of those rescue runs made a difference in the person who calleds overall health and well-being.

The rest? We made absolutely no difference at all. And the beat goes on. Until it doesn’t, because the closest ALS unit is busy transporting a perfectly healthy but crying infant to the ER.

Categories: Syndicated Columnists

Engine Co. EMS; Giving Birth

Mon, 04/16/2018 - 09:59
 

By Michael Morse

They are the best of calls, they are the worst of calls…

Just about every firefighter I know would rather enter a fully involved, occupied fertilizer factory without a charged line than deliver a baby. Until, that is, they deliver one. Field deliveries are a bit unnerving, but they can be one of the most gratifying moments in a firefighter’s career. Sure, your patient load doubles, and it can be a bit messy, but I have found little more satisfying that pressing the mic button with my sweaty fingers, asking dispatch for a time check, and then announcing over the air, “It’s a girl; time of birth 2330 hours.” Even the people listening get a moment of pride and satisfaction and feel a part of something bigger than the job.

 

Making that announcement is more involved than just saying the words; training and experience certainly help. Having a member of the crew who was present during delivery of a child of his own or who has actually done a field delivery is a luxury and will definitely ease the tension. Understanding our role as health care providers and being proficient is essential.

 Chaos is never welcome at any emergency scene, and considering the birth of a child anywhere but in a controlled environment is foolish. Calming the scene and creating a serene atmosphere once you realize that delivery is imminent can be accomplished while attending to the task at hand. The expectant mother and others in attendance need to know that things are as under control as they can be, and it is up to us to be the bringers of calm. By being confident and capable, we do just that.  

Some Things to Consider. . .

The rest is here, thanks for following the link, you will be glad you did!

http://www.fireengineering.com/articles/2018/04/engine-company-ems-childbirth.html

Categories: Syndicated Columnists

Why would you allow your children to be put in danger?

Tue, 04/10/2018 - 07:12

My new article at Fire Engineering talks about our kids joining us as firefighters. Thanks for reading.

“…Firefighting is the life we have lived. We are fully aware of the danger and the hardship. We know that there will be dark days ahead for most, if not all, firefighters…”

http://www.fireengineering.com/articles/fire_life/articles/2018/april/the-next-generation.html

Image by Eric Norberg

Categories: Syndicated Columnists

More will be said and done!

Mon, 04/09/2018 - 10:12

Tradition…

Bagpipes, the dress blues, stories of friendship, of sacrifice, of bravery, camaraderie and accomplishment; these are the things that drew me to the fire service. The bucket brigade, Jakes and Pikemen, then Laddermen and Hose Jockeys, horses in the barn pulling the steamers, dalmatians, bells and whistles, airhorns, sirens, flashing lights and everything that ties us to the past and brings us into the future have a solid place in my heart, and always will.

I am a fireman. My kids know it, and their children will know it, and with any luck, their kids will too. My helmet will probably hang on a hook in a garage not yet built, gathering dust until a child finds it, and puts it on his head, and begins the journey that I have taken. I wish him well.

Tradition.

For my last twelve plus years I worked in the Providence Fire Department’s EMS division. It isn’t often now that I have the opportunity to don the turnout gear, and put the helmet on my head. I miss it. But I have no regrets.

EMS traditions are not as glamorous, or colorful, or respected by most. They never will be. Funny thing is, I’m more proud of the 12 years spent on a rescue than I am the dozen I spent on engine and ladder companies. There is something about the personal nature of this job that attracted me to it. And, a few traditions that mean more to me than anything else.

Professionalism. Compassion. Competence. Excellence.

Providence firefighters wheel to the rescue truck the man who was rescued by Providence firefighters when he became trapped by a cave in of a wall while doing sewer work for Armando Ricci and Sons, Inc. on Parade Street. The Providence Journal/Mary Murphy

Every time, without fail, that a family member or friend needed an EMS response, those responders were excellent. Not good, not adequate, but exceptional. My father, who in the final stages of cancer would hallucinate and become unmanageable at home was treated by EMT’s from the Warwick Fire Department, not like a nuisance, or a silly old man, but like a Korean War Veteran, and engineer, and son and father who needed help in his last hours. My mother, the victim of a massive stroke while visiting family in North Carolina; by all accounts the EMT’s who responded acted the same way, and managed the scene with grace and dignity. The Paramedics from the air ambulance that flew her home, with me on board exuded such expertise I never worried about a thing. They helped my parents, and in doing so helped everybody whose lives they had touched.

I often hear about people who were involved in a car accident, or had an allergic reaction, or whose grandmother was choking at the restaurant, or the million different reasons we are called. One thing remains the same, by all accounts. EMS was simply awesome.

Tradition.

Big boots to fill. I’m proud to fill them.

My wish is that some day, when the kids find my dusty helmet hanging in the garage, one of them sees the worn jacket, the one with the Providence Fire Department patch on one sleeve, and the EMT patch on the other, and I hope he puts it on.

And I hope he never looks back.

Categories: Syndicated Columnists

When all is said and done…

Sun, 04/08/2018 - 13:19

Is it the day he puts in his papers?

Image by Eric Norberg

 

 

 

 

 

 

 

 

 

The last night in the station?

Driving away from the station after the final shift?

When he says, “I’m home,” and stays there?

 

 

Or is it when the fire in his heart diminishes and the thrill of responding to emergencies in the dead of winter is no longer there, but he does his job and leads by example and never lets “the kids” know that he knows the end is near?

Image by Eric Norberg

Is it when the thought of working a holiday is no longer acceptable, and unused sick or vacation time begins getting used?

Or when “the tones” at 3:00 a.m. sound like the bells of hell rather than a subtle way to say get up, get dressed, and get on the truck?

Image by Eric Norberg

Is a firefighter through when he makes rank?

Or if he chooses a different career path, like EMS or Fire Prevention?

Image by Eric Norberg

Or arson investigator?

Is a firefighter no longer a firefighter when the years of injury finally make it impossible for him to do his job without putting himself, his crew, and the people he is sworn to protect in danger?

Does he become less of a firefighter if he retires on a disability?

Image by Eric Norberg

It’s none of those things. A firefighter is no longer a firefighter when he stops breathing. Then he is a dead firefighter. Three days later, he will be a dead and buried firefighter. Then, he will live forever with the rest of the firefighters who came before him and lived the life and loved the job even when it became more and more difficult to feel it the way they once did.

     A firefighter is no longer a firefighter only when he chooses to no longer be a firefighter. Nobody can make that choice but the firefighter. What makes a firefighter a firefighter resides deep inside, and nobody can change that unless the firefighter chooses it. Simply hanging up the turnout gear for the last time does not strip a firefighter of his status.  

Nobody can take away the things that make us firefighters. Nobody can strip us of our memories, our heart and soul, or our willingness to put it all on the line when needed. Nobody can take the friends we make during our journey away. Nobody can make us forget those friends we have lost.

Being a firefighter is for life. There is no such thing as a retired firefighter. We can’t even die without being remembered as a firefighter. And after living the life, and feeling the heat, and knowing exactly how good it feels to do the job, who would want to?

Categories: Syndicated Columnists

The Dangers of Firefighting

Thu, 04/05/2018 - 10:30

Uniform Stories used words

from one of my articles and created this short film.

https://www.firerescue1.com/health/articles/134918018-The-ugly-truth-about-firefighting-the-public-doesnt-understand/

 

Seeing what somebody else envisioned when reading my words is surreal.

Here’s what I wrote that got the project underway:

Much thanks to Rebecca at Uniform Stories.

 

We know what we see is real. We know how it feels. We live with the memories, and know that more will come.

We are tuned in to every aspect of the firefighting life. We know when a brother or sister is lost, and we mourn in our own way, no matter how far away the incident was that took them from us. We don’t have to know the name of the deceased, or their story, because we are the people who make the ultimate sacrifice. Inside every one of us lives a small part of the rest, and we feel the loss more profoundly than people could imagine.

The truth is, this is not the easy life that the general public wants to think it is. This is far more than shopping for lunch, parades, Dalmatians, and Fire Prevention Week. This is life, and loss, and tragedy. This is insomnia, and injury, and depression. None of us gets through it unscathed. None of us expect to. Some of us will not get out alive, and we know all too well that the someone could be us.

So we protect the public from whatever misfortune comes their way, and put out their fires, and tend their wounded, and keep them as safe as we can. We pull the dead from the car wrecks, and cover the bodies at fire scenes so the news cameras won’t bring the horror into the nation’s living rooms. We protect our people from more than just the physical; we keep them from knowing the truth.

The truth is ugly, and devastating. People will tell us that they can imagine how horrific it was for us, but they will never, in a million years, really imagine the depth of that horror.

They will never have to deal with the guilt, the constant mental playback, wondering if only I were a little bit faster, a little bit better, a little more poised, a little more heroic. They will never feel the profound sadness that we do as a result of seeing too much. They will never breathe in the smell of death as it lingers on the recently deceased, before the undertaker does his work. They will never wonder how they will even make it home, and get on with things after what they’ve witnessed.

They don’t have to know about any of it. We let them imagine how bad it can be, and allow them the luxury of thinking that they have imagined it right. They don’t have to bear the burden of life at its most raw and powerful. They have the luxury of watching the world go by through their screens that don’t scream, screens that don’t burn, or bleed.

We let them think that life is fair, with an occasional aberration. We allow them the luxury of the illusion of safety and fairness as life barrels along. They do not need to know how often things veer out of control. They don’t have to know what we know. We remember how it felt to be innocent. We know exactly how good it feels to not see the brutal realities that linger just out of sight. We don’t want them to know about any of it.

All we want is to keep the people who depend on us far away from the things we dread, and we want to survive this career with our hope, health, and sanity intact.

 

Categories: Syndicated Columnists

A little respect

Wed, 04/04/2018 - 09:45

She spends hours at the gym, had her nails done, a pedicure, her hair is perfect and she spent a few hours getting ready for a fun night out dancing in Providence with her friends. She is beautiful, and looks fantastic, and people notice, and she doesn’t mind, as long as they are not creepy about it.

Some moron crashed into their car at two in the morning spoiling a great night. She had a few drinks, but was far from intoxicated, and wasn’t driving anyway. She was hurt in the accident, and needed to be seen at the ER for some stitches and x-rays.

Sometimes, all we can do for our patients is make them feel better during transport. The high tech equipment and highly trained EMT was reduced to performing one of the simplest, kindest and most ancient of all medical techniques.

I covered her with a blanket. Her anxiety level dropped in half. The beautiful body that she showed off earlier in the night, and did so with class and style was no longer on display.

Categories: Syndicated Columnists

“Ralph Waldo Emerson wold have been a fine medic” – Michael Morse

Tue, 04/03/2018 - 15:17

“To know one life has breathed easier because you have lived. This is to have succeeded.” —Ralph Waldo Emerson

“Engine 10 to Rescue 1, eighty year old female, respiratory distress, possible CHF.”

“Rescue 1, received.”

We turned the corner onto a narrow dead end street. The door of the last house on the left was open with frenzied activity just beyond the threshold.

“Get the chair,” I said to Adam and entered the home.

“230/115, pulsox 68%,” says Ted, as I approached the patient. She was struggling to breathe, as her lungs were full of fluid. The oxygen mask covered the bottom half of her face, and her eyes were panicked.

Adam set the chair up next to her. The guys from Engine 10 picked her up from the couch and got her ready to move. Seven or eight family members stood nearby, some worried, some afraid and some near panic.

“What is her name?” I asked.

“Auriela,” one of the women answered.

I took a nitro from the bottle I had in my pocket and had the woman tell Auriela to put it under her tongue and let it melt. She struggled for a while then understood. A minute later we were in the rescue. Ted was applying EKG leads, and Adam was starting an IV. I was preparing an albuterol treatment.

“I’ll give you a driver and an extra set of hands in back,” Frank, the officer of Engine 10 says, closing the rear doors of the rescue.

“Let’s roll.”

We began our journey toward Rhode Island Hospital with three of us in the back with the patient, a firefighter from Engine 10 driving the rescue and Frank and Paul following with the engine. Another nitro en route, 40 ml of Lasix and the albuterol treatment seemed to be effective. Auriela’s eyes stopped darting, her breathing slowed as her lungs cleared and she managed a little smile. The frantic activity in the back of the rescue slowed in rhythm with our patient’s breathing. There wasn’t much more to do but comfort her and let her know she would be all right. She didn’t speak a word of English, and we barely spoke a word of Spanish, but all of us knew she was out of the woods.

We arrived at the hospital. The rear doors of the rescue opened and there stood one of our guys, an off duty firefighter from Engine 11. I looked at him for a moment, confused.

“That’s my grandmother,” he says as he helped us wheel her in.

Twenty minutes later he shook my hand as we were preparing to leave.

“Thanks, Mike, you guys were incredible,” he says.

I can’t imagine a more satisfying job than the one I have.

How do you like them apples, Ralph Waldo Emerson.

And speaking of Ralph, here’s another;

“Every man is entitled to be valued by his best moments.”

Entitlement and reality are far different entities. While I’m in a scholarly mood, I figured I would mention William Shakespeare addressing reality in a speech from Julius Caesar;

“The evil that men do lives long after them, the good is oft interred with their bones.”

So it is in the fire and EMS business. We are only as good as our last act. Today’s hero is tomorrow’s villain, and tomorrow’s villain will still be a villain even if the day after tomorrow he becomes a hero.

It takes time to erase a major mistake. For some strange reason we love nothing more than to focus on people’s shortcomings. Perhaps we feel better about ourselves when others are exposed as having human frailties.

Just keep in mind, everybody gets a turn, and ours is coming. It’s just the way it is. So relish those moments when everything goes as planned, and savor the fleeting seconds when you can bask in your own greatness. Keep striving to do great things, and maybe you will be valued by your best moments, and the dumb things we do will be interred with our bones.

Categories: Syndicated Columnists

Rescuing Providence, by Michael Morse

Mon, 04/02/2018 - 09:32

This is the home of Rescuing Providence, written by Michael Morse. Michael is a retired Captain with the Providence, RI Fire Department. He started his career in 1991 and retired in 2016. After graduating from the 42nd training academy he was temporarily assigned to Special Hazards 1, then moved to Ladder Co. 7, Engine Co. 2, Ladder Co. 4, and  Engine Co. 9. In 2001 he was assigned to the department’s EMS division for a six month tour. In a blink, six months became 15 years. He was a rescue technician on Rescue Co. 1 for a year, them became Lieutenant of Rescue Co. 3 until transferring back to Rescue 1 as Lieutenant where he served for eight years until being promoted to Captain, Rescue Co, 5.

Morse began writing about his experiences in 2004, and started this blog in 2006. His first book, Rescuing Providence was published by Paladin Press in 2007. Since then he has written four more books, Rescue 1 Responding, which is the sequel to Rescuing Providence, City Life, a collection of short stories, Rescue 911, another collection and Mr. Wilson Makes it Home which tells the story of Morse moving into the next chapter of life after the fire service.

He is currently a columnist with EMS1, Fire Engineering and The Providence Journal.

Michael and his family live in Rhode Island, travel a little, work a little and live a lot.

Categories: Syndicated Columnists

Horror (bringing bedbugs home)

Mon, 04/02/2018 - 09:13

Call to 911 for flu-like symptoms?

.25 cents

Rapid response by rescue 5?

$300.00

Expert EMS treatment and transport?

$425.00

The look on the EMT’s face when he sees a bedbug in the middle of the stretcher after transporting?

Priceless.

Returning to quarters with bedbugs and infesting the firehouse?

Beyond priceless!

 

https://www.tipsbulletin.com/home-remedies-to-get-rid-of-bed-bugs/

Categories: Syndicated Columnists

Being There

Mon, 04/02/2018 - 07:16

By Michael Morse

When I see images from a disaster,

    Photo credit Eric Norberg

terrorist attack, or mass shooting flash across my screen, my eyes are drawn to the rescuers, not the victims. I focus on the job at hand and the people doing it. I wonder what they are thinking, how they are managing, what emotions they are ignoring, and how they will cope.

I think of the people behind the uniforms and the mass of chemicals that are accumulating in their bodies; the adrenaline, cortisone, dopamine, and others I do not remember that give them the fortitude to perform in horrific conditions. I remember stepping over bodies of obviously dead people to get to the living, how sometimes I had to lie across a body to get to a victim, and waiting for the hydraulic rescue tools to free us. I remember thinking I was okay, it was part of the job, we all do it, we all survive, and we all do it again.

Little did I know I would never forget.

If who we become is a direct result of what we have done, it is imperative that we focus on the lives we saved, not the ones we stepped over. I do not see the face of the guy dead in the driver’s seat anymore; I see the girl in the passenger seat who survived. I even remember her name. The body is just that, in my mind anyway; I cannot think of him, I don’t think of him, he is gone, and we are not.

If there is one thing I know better than everything else, it is this; what we do may not define us, but it certainly shapes who we become. Our personalities are fluid; we never stop changing. Life experience changes us subtly; we do not notice those gradual shifts in perception. It is only when looking back, often through the eyes of the people who are actively responding to emergencies, that everything becomes clear:

We are not hard; we are not machines; we are not tools to be used, put away, and used again until there is no more life left and a replacement is needed. We are human beings, made exactly like the people who need us.

It is human beings who have to be there when things get ugly. And if not us, then who?

Who will they call when the bullets are hitting their targets?

When they are hunkered down, bleeding, dying.

When sirens in the distance are the only thing they have to hold on to.

When all is lost.

Who will they call?

They call us. First Responders. The Army isn’t coming, the Marines either. It’s their neighbors who respond, their fathers, their sisters, their friends. It’s the people they see at the market in their street clothes, the ones standing in line with them at the coffee shop, and the ones on duty, in uniform and prepared for the unimaginable. When their world descends to madness and nothing makes sense, we respond.

We are everywhere we are needed, nestled in neighborhoods, patrolling the streets, sitting on corners in our ambulances waiting for the call. We are in the crowd that comes under attack, never really off duty, once trained and experienced it matters not when we are needed, only that we are.

Most of us will never be called to a mass casualty or be present when tragedy strikes. All of us carry with us the know-how and presence of mind to act in an emergency. None of us wants our training, experience, and demeanor to be needed.

Every time tragedy hits home it’s the police, the firefighters, and the EMTs running toward the gunfire. Somehow we make careers out of it and walk among our families, friends, and neighbors as if we are just like everybody else. But deep down I think every one of us knows that we are different. And if we don’t know it now, we will definitely find out.

Photo credit; Eric Norberg

Categories: Syndicated Columnists

I’m as free as a bird now…

Wed, 03/28/2018 - 09:50

It’s not all heroic rescues, trauma codes, waving to kids and CPR, it’s so much more. It’s really all about people, and trying to do what is right, or at the very least, what you hope is right. . .

Nothing on the floor but dirt, roaches and him. The carpet was stained beyond repair; food, beer, piss and shit mostly. That would have to be replaced in a few weeks when they finally got rid of the tennant. Three weeks at the most, probably one or two, it wouldn’t be long, now.

“Jake” stood guard. The smell that nearly knocked me over didn’t bother him, he circled his master, protecting him from the intruders.

“Easy Jake,” said Richard from the floor. Eighty pounds, bald, yellow and brown underwear and nothing else, no blanket or sheet to cover him, no pillows or other comforts, spilled warm cheap beer next to him, some old smokes in an overflowing ashtray, Lynyard Skynard cranking from the Sylvania Hi-Fi in the corner.

“I got cancer,” he said.

“A lot of people have cancer, sir.”

“Poor souls.”

“We have to get you to a hospital.”

“Been there, ain’t going back. Me and Jake till the end,” he grinned from his spot on the floor. Jake wagged his tail and enjoyed the massage from the bony hand between his ears.

He wanted to get back in bed, where the remote was, and the piss bucket, and the warm 12-pack.

“If shit didn’t stink I wouldn’t bother to get out of bed.”

“I’m not leaving you here.”

“The fuck you ain’t”

Jake eyeballed me suspiciously when I moved toward him. The dirty little terrier had some heart, I’ll give him that.

“What am I going to do then, let you die on the floor?”

“Put me back in bed and let me die there.”

I got him onto the bed, gathered some pillows and blankets, put his beer in arms reach, moved the piss bucket closer and fed the dog.

“Turn that up!”  he said when Freebird came on. “I love that song!”

I lifted the cover to the console, saw the eight-track in it’s place next to the turntable, found the volume knob and turned it up.

Categories: Syndicated Columnists