Rescuing Providence: Part 1 - 1036 Hours Through 1339 Hours, a Book by Michael Morse
Monday, April 04, 2016
I always thought that a day in the life of a Providence Firefighter assigned to the EMS division would make a great book. One day I decided to take notes. I used one of those little yellow Post it note pads and scribbled away for four days. The books Rescuing Providence and Rescue 1 Responding are the result of those early nearly indecipherable thoughts.
I’m glad I took the time to document what happens during a typical tour on an advanced life support rig in Rhode Island’s capitol city. Looking back, I can hardly believe I lived it. But I did, and now you can too. Many thanks to GoLocalProv.com for publishing the chapters of my books on a weekly basis from now until they are through. I hope that people come away from the experience with a better understanding of what their first responders do, who they are and how we do our best to hold it all together,
Enjoy the ride, and stay safe!
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTCaptain Michael Morse (ret.)
Providence Fire Department
The book is available at local bookstores and can be found HERE.
Note from the author;
In this part an elderly resident called 911 for dizziness. There has been a lot of talk about fire departments sending an engine or ladder company on medical emergency calls. This is a great illustration why. Dizziness can be just that, a momentary spell that rights itself, or it can be life threatening. The people answering the 911 calls follow protocols that send the appropriate resources. Very few people experiencing serious medical conditions complain about too much help arriving at their door
1036 HOURS ELEVATED HEART RATE
“Engine 10 and Rescue 1, a still alarm.” The voice booms from the loudspeaker. Engine 10 is located on Broad Street, a few miles from my station. In 20 seconds, the time it should take to get to the truck from anywhere in the building, the dispatcher tells us our destination: “Engine 10 and Rescue 1, respond to 75 Lexington Avenue for a woman complaining of dizziness.”
I leave my reports on the desk in my office and slide the pole to the floor. Mike is rinsing the truck. Only my side got washed, but half-clean is better than no-clean. He will finish when he has time. He shuts down the hose and puts it aside; we both get in and head out the door into the bright sunlight.
Lexington Avenue is in our district, South Providence. At the turn of the century this was the place to live. Industry was thriving, money was plentiful, and beautiful homes were popping up everywhere. Some of the streets boast mansions on every corner. Victorian homes dominate the streets. The workmanship in these places is phenomenal. Ornate entryways, scrollwork, and wrought iron are abundant. Stained glass fills windows. Inside, carved woodwork, spiral staircases, wood floors with inlaid patterns, and ceramic tile fireplaces are among the treasures to be found. To build one of these homes today would be nearly impossible; that quality of workmanship and material no longer exists.
I am the descendant of Swedish and Irish immigrants. One great-grandfather was a carpenter who worked on a lot of the homes in this area. He and my great-grandmother settled in Providence, worked here, and raised their family. I don’t know which houses he worked on, so I imagine that every one bears his stamp. I never knew him, but I feel his presence as I drive through the once grand, now poverty-stricken neighborhood.
The wealthy families that once filled these beautiful homes moved to areas with more privacy. They rented their properties and stopped giving them the attention they needed. I imagine that the old homes retained their dignity for a decade or two, only to slide into disrepair. As time progressed and the properties became more run down, the rents decreased and the old places were no longer profitable. I’ve fought many fires in these houses. When their value is less than what the insurance will cover, arson becomes an option for those with no scruples. Fires of suspicious origin happen at an alarming rate in this area.
Many nights while smashing through a beautiful carved oak door or breaking stained glass windows with my ax to ventilate a building, I think of the people who toiled countless hours to create such beauty. Hauling a charged 1 3/4 hose-line up a flight of mahogany stairs to hit the fire as it roars over an antique tin ceiling, with the sound of the fire filling my ears and destruction all around, I am filled with helplessness and rage. Greed and instant gratification have destroyed the work left by my great-grandfather, his claims of immortality reduced to ashes.
Mike and I pull in front of the house and park behind Engine 10. The officer, Dan, walks out the front door and gives me the initial report. “Elderly lady doesn’t look so good,” he tells me while walking back to the engine. A lot of seasoned firefighters resent the amount of rescue runs they have to do. They would prefer to do only firefighting duty, but times have changed and with that change comes the added responsibility of emergency medical services (EMS). In Providence, as in most cities, the fire department handles EMS. Some places have private companies working with the firefighters but not here.
Mike brings the stair chair from the back of the rescue, and we walk into the house. A little pug greets us. He runs over to me, barks and sniffs for a while, decides that I am all right, and then sits in a corner to observe. A young man holding a baby sits in a chair in the kitchen.
The family lives on the first floor of a three-floor house. From the look of the place, it once was a one-family home but is now modified to fit three or four apartments. More rent. The walls are adorned with pictures of Jesus.
“Blood pressure is 80/40, and I can’t feel a pulse,” says Keith, one of the firefighters from Engine 10.
“What is your name?” I ask the woman, hoping that she speaks English.
“Maria,” she replies in English accentuated with Spanish. She adds, “I’ve been feeling dizzy all morning and weak. I just feel terrible.”
“We’re going to get you to the doctor and figure out what’s wrong.”
I notice that the patient is pale and covered with sweat. Her blood pressure is extremely low, and her weakened state indicates a potentially serious situation. We pick her up out of her bed, put her in the stair chair, and transfer her to the stretcher and into the truck in about a minute.
“Is she all right?” asks the young man from the kitchen, still holding the crying infant.
“We’re taking her to the hospital. How long has she been sick?” I ask.
“Just for the last 15 minutes. She got really weak and dizzy and had to lie down. I thought she was having a heart attack or something. Which hospital are you taking her to?”
“Rhode Island.” I head to the back of the truck where Mike has her on oxygen and hooked up to the heart monitor. Her heart rate is 174, not good. It’s no wonder she feels horrible; her heart is racing out of her chest. Her blood pressure is low because her heart isn’t beating properly, merely fluttering and not providing decent pressure to fill her veins.
“Maria, are you in any pain?” I ask.
“No, I just feel weak.”
We start an IV and recheck her blood pressure. I look at the EKG and see that her heart is still racing in a rhythm called supraventricular tachycardia (SVT). The hospital is three minutes away. I have the choice of treating the patient with a medication 28 called adenosine or transporting her quickly to the ER. Sometimes the adenosine is effective at slowing the heart, sometimes not. If it is effective, the heart actually stops beating for approximately 30 seconds before resuming a normal rhythm. I consider the patient’s age and frail condition. A team of doctors and specialists can be assembled at a minute’s notice if necessary at the hospital. If I were the patient, I would rather have my heart stopped in a hospital room than the back of a truck.
“Let’s go.”
Mike and I stay in back with Maria while Roland, from Engine 10, drives. The three-minute ride goes quickly. I am worried about this patient.
The triage area at Rhode Island Hospital is in full swing, the pace frantic. Three rescues are ahead of us, their patients lying on stretchers lined up in the doorway. Since my patient is a priority, we pass the other people in the hall and talk to Melissa, another RN working with Ron at triage.
“I’ve got a 74-year-old with a heart rate of 174, hypotensive, diaphoretic, and weak. No pain at this time but complaining of dizziness.” Melissa takes one look at Maria and points to the corridor leading to the trauma rooms, where the most critically ill or injured patients go. While wheeling her back I hear the hospital’s PA system calling for a medical team to Trauma 2, one of the six trauma rooms in the ER. We head there. While we transfer Maria from our stretcher to the hospital’s, the medical team begins to assemble. An ER doctor, two or three trauma RNs, and additional support staff are in the room when the patient gets there. Melissa gives the report, repeating word for word what I told her at the triage desk. Maria looks worse than she did in the truck. They hook her up to the heart monitor, check the IV line, start another one, and try to ask her some questions. They are too late; Maria has slipped into unconsciousness, her condition critical. Her heart rhythm has gone from SVT to ventricular tachycardia, one step away from asystole and death.
In seconds, the team administers medication through the IV and assists with ventilations, and Maria is stabilized, breathing normally. The drugs that were administered are effective; I see her heart return to a normal rhythm. Things happen fast in the ER.
All this time, Mike has been busy restocking and cleaning the truck. He has no idea of what just happened.
“Code 99 in the trauma room,” I say.
“Who? Not Maria.”
“Maria.”
“Is she all right?”
“We made it here just in time. Imagine if she had coded in the truck. We’d still be doing CPR.”
“I’m starving,” says Mike, as we get into the truck.
“Me, too. What else is new?”
We head back to the station in hopes of having some lunch. The ride back to quarters from the hospital takes us through Providence’s thriving adult entertainment section. There are other ways to get back to quarters, but we choose the most colorful one. We slow the truck as we drive by Cheaters, a three-story pink building adorned with huge signs painted on plywood advertising “Girls, Girls, Girls.” The strippers should be coming to work right about now. We look around but see nothing. We pass another establishment offering a fully equipped dungeon with hourly rates. A club catering to gay men is another popular spot in the area. An adult book and novelty store completes the block. We don’t get too many calls here; discretion keeps people from attracting unwanted attention. When we do get called to one of these places, it is serious. The last two times I was here the patients died. It is good time to call home.
“Hey, babe, how are you?” I say into the cell phone, “We’re driving by Cheaters right now. Naked women everywhere.”
“Good for you. How is your day?”
“The usual. Are we having Easter dinner at our house?” I ask.
“I’m not ready to give that up.”
“I know. I wish I was there to help. Damn overtime.”
“I’ll manage.”
“Have the kids help.”
“Yeah, right. Can you pick up the manicotti? My mother loved the ones you got at Christmas.”
“No problem. I’ll pick them up as soon as I have time.”
“Don’t forget.”
“Never happen.”
“Maybe I should get them myself.”
“Don’t worry about a thing; they will be there on Easter morning.”
“Rescue 1 and Engine 8, a still alarm,” booms the truck radio.
“I’ve got to go. How are you feeling?”
“Better than yesterday. Please, don’t forget the manicotti.”
“I won’t. Love you, bye.”
“Love you too.”
1147 HOURS AMPUTATION
“Rescue 1 and Engine 8, respond to Springfield Avenue at the elementary school for a 5-year-old with an amputated finger.”
“Rescue 1 responding,” I say into the mike as I press the off button on the cell phone. Mike turns on the lights and siren and hits the gas. The quicker we get there, the better the chances of saving the finger. Theoretically, all of our responses are emergencies; some are just more of an emergency, and we drive accordingly.
“Do you put amputated body parts directly on ice, or do you wrap them first?” I ask Mike.
“I don’t remember; look it up.” He is focused on the road, his aloof demeanor hiding his true concern.
The elementary school is at least five minutes away, so I have time to refresh my memory by reading the state protocol book. Every rescue carries one, and every rescue worker should have it memorized. When you have too much time to think, you have a tendency to question your memory. I’ve responded to a few amputations and have always done the right thing, but it never hurts to be sure.
“The protocol says pack severed body part in sterile dressing moistened with saline, wrap in towel or plastic bag, place ice over bag,” I read out loud. “Let’s hope it’s not as bad as it sounds,” I say to Mike as we pull off the highway and close in on our destination. “I hope it’s not the middle finger; that’s the most important one,” he responds. “You can always use the one on the other hand.”
“But you’ll never be able to pull off a double royal salute.”
“Now that is a tragedy.”
The radio transmits the preliminary report from Engine 8:
“Engine 8 to fire alarm: advise Rescue 1 we have a 5-year-old male with a minor laceration to his right index finger. No amputation.”
“Rescue 1 received,” I say into the mike as Mike slows down.
“People should get their facts straight before they call. We could have been killed getting here,” grumbles Mike.
In the distance, the school comes into view. Four giant crayons held a canopy high above the entrance. The kids who go to school here must be impressed; I certainly am. The school-age population has exploded in Providence, and new schools have been built to keep up with the demand. Most of the new students don’t speak English.
Mike goes to the rescue’s side compartment to get the trauma bag, and I walk under the canopy into the school. I am directed to the nurse’s office where firefighters, teachers, and the school nurse surround a little boy, Pedro. He looks amused by all the attention. One of the firefighters from Engine 8 has inflated a protective glove and given it to him. When the bright purple gloves are inflated, the fingers resemble cow’s udders. It looks pretty bizarre, which is why the kids like them so much. The boy’s finger has been wrapped in sterile gauze that had been moistened with saline.
“He had his finger closed in a door,” says Miles, one of the firefighters from Engine 8.
“Nothing seems broken, he has good movement, but there is a laceration almost completely around the finger under the first knuckle.”
“There was so much blood I thought his finger was gone,” adds the school nurse.
“Have the parents been notified?” I ask.
“Not yet, we can’t find the mother,” replies one of the women in the room.
“I’ll need his records, and we’ll take him to Hasbro.”
Hasbro Children’s Hospital is where we take all patients under 16. Located next to Rhode Island Hospital, it is a great facility specializing in pediatric health care.
Miles picks Pedro up and carries him outside into the rescue. The school nurse accompanies us to the ER. I retrieve the necessary paperwork from the office, and we are on our way.
We place Pedro on the stretcher, and he sits on it like the king of the world being taken to his palace. I have no idea what his home life is like, but it is obvious that the attention and love that he is shown by the firefighters and school staff are enough to make him forget the pain in his finger. For a lot of these kids, the best part of their day comes when they are away from home. While responding to homes in the city, I have seen living conditions unfit for animals. People unable to care for themselves bring children into the world with no idea about what it takes to raise them. When child abuse or neglect is suspected, we follow procedures but have no way of finding out if our recommendations have been followed.
Pedro looks out the back window of the rescue, his eyes wide open. From inside the truck the sirens can be heard, but they are not as loud as on the outside. Things are actually peaceful during the transport.
“I can’t believe how calm everybody acted,” says the nurse, fidgeting on the bench seat next to Pedro. “This is my first day at this school and my first year in Providence. Nobody got very excited over this; I was the only one who did anything.”
“Did you make the 911 call?” I ask.
“Nobody else would; they just stood there. If it weren’t for me, they probably wouldn’t even have called you. They were looking for Band-Aids.”
“It probably wasn’t a very good idea to tell the dispatchers that there was an amputation,” I casually try to explain to her, knowing my words are not being heard.
“Well, at least you got here fast. Everybody else was taking their time.”
I sense indignation in her words, so I let it rest. She was under the impression that she alone saved the boy from severe disfigurement and possible death from blood loss. I let her bask in her moment of glory and start my report. Being lost in paperwork is a good way to avoid conversation, especially one I don’t want to engage in.
At Hasbro we wheel Pedro through the ER doors and into the waiting room. Children’s books are in abundance; toys and games fill boxes next to the seats. People are sitting in those seats, their children either on their laps or otherwise engaged. There’s plenty to keep the kids busy, as the place was constructed with children in mind. Hand rails on the stairs come up to my knees, and water fountains are at the same height. A real fire engine sits on the front lawn. Art by children adorns the walls of the corridors heading to the elevators. The upper floors are full of patients. I seldom go up to those floors; the suffering is too much to bear. The sick kids seem to deal with leukemia, asthma, cystic fibrosis, and other rare and deadly diseases better than their parents or rescue workers. They face their uncertain future with courage and dignity, seemingly baffled by the despair evident on the faces of their caregivers.
Pedro is checked in, and he gives me a high five with his good hand as I leave the ER.
“Enough of this; let’s eat,” Mike says as I open the passenger door.
“My thoughts exactly.”
As we head back to the station, the dispatchers are sending rescues all over the city for a variety of reasons. A Cranston rescue is going to Waverly Street for an intoxicated male; an East Providence rescue is responding to Waterman and Ives for a car accident with no injuries—the car’s occupants “just want to be checked.” Rescue 3 is on the way to Smith Street for an elderly female who is dehydrated, and Rescue 5 is on the scene with a 2- year-old with a fever. Rescue 1 is going to try to get some lunch— we have a long afternoon ahead.
Back at the station, the guys from Engine 13 have finished with lunch and are nowhere to be found. They are somewhere in the building, since the engine is in the bay. Sitting on the kitchen counter are two plates wrapped in tin foil, and dishes and pans are drying next to the sink.
“What do you think this is?” I ask Mike.
“I don’t care, as long as it’s hot—and a lot,” he responds.
We open the foil to find ravioli and sausage. The 13s must have gone to Venda, which reminds me that I have to go over there later and get the manicotti for Easter dinner at my house. Venda Ravioli has been a part of the city for almost as long as the fire department. The shop is located on Federal Hill, one of my favorite parts in the city. Italian immigrants made this section their home in the early 1900s.
If you leave downtown Providence and head west onto Atwells Avenue you will enter Federal Hill. An arch stands as a gateway into the area. A giant bronze pineapple, or pinecone depending on to whom you talk, hangs over the street from the middle of the arch, a symbol of hospitality welcoming you in. I remember as a child spending weekends at my grandmother’s house. We sometimes rode the bus to shop at the Outlet, a giant down-city department store that served as the retail center of the region before the suburban malls took over. After a few hours of shopping, we would walk the mile or so from downtown to “the hill.”
We would walk under the arch and enter a different world. Here, people spoke Italian. The smell of garlic and onions simmering in olive oil wafting from the many restaurants and bistros that lined the streets enhanced the mystique of the area. Shopkeepers would greet us with a smile and a tip of the cap as we walked past them on the wide sidewalk. There was no worry of crime; the streets were safe at all times. The Patriarca family, reputed to be the head of organized crime in New England, did business in an office on the street, a small sign outside simply stating “Coin Operated Vending,” a vast understatement of the influence the family had in the area.
Good manners and a bustling, friendly atmosphere would surround us while I hauled the bags from the Outlet as my grandmother held my free hand. If organized crime existed here then, it was better than the unorganized crime of today.
My grandmother and I always stopped at Providence Cheese. Behind the counter stood a very old man waiting to take our order. Next to him sat a tiny coffee cup with a twist of lemon floating on top of the black liquid. The meats and cheeses he had just hung in the display windows still swung from the momentum he supplied.
“One pound of grated parmesan and half a pound of ham, thinly sliced, please,” my grandmother would say to the man. He would translate the order from English to Italian and shout over his shoulder. The order was prepared by hand, meat sliced with sharp knives and cheese grated the old-fashioned way with handheld graters, by a group of Italian-speaking ladies “in the back.” The order was filled, money was exchanged, and the next person in line waited on.
Venda Ravioli was next, two doors down.
“Two dozen cheese,” my grandmother would say, which put the ladies in the back into action. The pasta would be rolled flat, filled with cheese, and cut into squares. The ladies never stopped talking and laughing as they went about their work. The ravioli was placed on wax paper, put into a cardboard box, and then wrapped with a red ribbon. We would pay and then head home to make the sauce (the Italians call it gravy) and have a feast.
“This ravioli tastes like homemade,” says Mike, a dribble of gravy rolling down his chin.
“It is,” I answer, reluctantly returning to the present.
“Rescue 1 and Engine 10, a still alarm.” The voice in the loudspeaker brings me back.
1339 HOURS MATERNITY
“Rescue 1 and Engine 10, respond to 9 Peace Street at St. Joseph’s Hospital for a maternity.”
We rewrap our unfinished lunch with the tinfoil and put it aside for later. We have staved off the hunger for a while but aren’t really satisfied. We are back in the rescue with lights flashing and sirens blaring a minute later. What little lunch we had is going to have to get us through the afternoon.
“Did you call a rescue for Amy when she was ready to deliver?” I ask Mike.
“What are you crazy?” he responds,
“I put her in the car and drove her to the hospital. We had nine months to get ready; it wasn’t an emergency until we got to the delivery room.”
“How much blood did she lose?” “Almost 2 liters. I couldn’t even see her for three hours after the delivery; she was in intensive care.”
“How are they doing now?”
“Perfectly healthy,” he responds like the proud papa, “we wanted to have six kids—two might have to do it.”
“Two is enough. Your whole life will revolve around them from now on. I wonder if bringing up boys will be any easier than girls; my two are still driving me crazy.”
“Speaking of girls, how are the wedding plans going?” asks Mike.
“Right on schedule, I guess. Cheryl is doing all the work; I haven’t had time to do anything. Danielle as usual has every detail planned. It’s funny—all I do is walk her down the aisle, but I get all the credit.”
“That’s the way it should be.”
We pull in front of St. Joseph’s Hospital as crew members from Engine 10 walk out with two women, a mother and daughter. The younger looks ready to deliver a child right there. We are taking her to Women and Infants because it is the preferred hospital for deliveries.
“Contractions 12 minutes apart, water not broken, a real emergency,” says Dan, as he helps the girl and her mother into the rescue. The fire department sends an engine company with the rescue when called for a maternity response. We have delivered thousands of babies over the years. Years ago, if somebody called 911 for assistance for a pregnant woman, delivery was imminent. Now, we are called for rides to the hospital for checkups. Mike places the girl on the stretcher, with her mother on the bench seat next to her. It doesn’t give us a lot of room to work. I sit in the captain’s chair at the head of the patient. Mike starts to take her vital signs, and I begin the interview.
“What is your name”?
“No comprendo inglés,” she says with a smile. I look to her mother for help, but she smiles also and shakes her head no.
“ID,” I say as I hold my thumb and forefinger as if holding a card. The girl smiles and reaches into her purse to retrieve a medical card with her name and date of birth on it. The state has a program that provides medical coverage to the poor. I see these cards a lot during the course of a day.
I copy the information while Mike tries to communicate with the pregnant woman and her mother.
“Blood pressure 148/90, pulse 98, pulsox 98 percent.
Contractions about 10 minutes apart. She was at her doctor’s office when the contractions began; he called us for a ride to Women and Infants. This is her first pregnancy, no complications, due date 10 days.”
“How did you find all that out?” I ask, knowing that his knowledge of Spanish is only slightly better than mine.
“It’s my job, man,” he replies and heads to the front of the truck to drive, leaving me mystified in the back with two Spanish speaking women. They are all smiles, their happiness contagious as I smile with them. An old Springsteen song accompanies us to Women and Infants; I fill out the rest of the report on the way, humming along with “My Hometown.”
Later, after delivering the women to Women and Infants, I say to Mike, “Let’s finish lunch,”
“That sausage is giving me gas,” he replies, the evidence pungently filling the cab of the rescue.
I look over at him, see that he is pleased by his latest contribution to global warming, and ask, “What’s the matter with you— you couldn’t have left that outside?”
“I wanted to share it with you,” he replies.
“Five hundred people on the job, and I get you.”
“I’ve got more bad news,” he says while maneuvering the busy lunchtime traffic surrounding the hospitals. “I’m bidding Engine 15.”
The day I have dreaded has finally arrived. My heart sinks to the floor of the rescue, my emotional response to this news stronger than I would have ever imagined. I’ve had other partners since being promoted, but Mike and I are like brothers. His presence makes an always difficult and sometimes impossible job bearable. Things have been going so well I haven’t thought about losing another partner. Having a good partner is vital to your well being and sanity on a rescue truck in Providence. I am happy for Mike. Engine 15 is a busy truck that sees a lot of fire. I’ve told everybody I work rescue with the same thing: make sure you do time on a fire truck before it is too late. When our days are closing in and we look back at our lives, what we will be most proud of will probably be the years spent as a firefighter. I want everybody to experience the thrill I’ve felt while battling a fully involved house fire. There is nothing like strapping on a Scott air pack, grabbing a line, and facing what most men fear. Working to the brink of exhaustion, then finding a little more when needed and ultimately beating the beast, is priceless.
“Rescue 5 a still alarm.”
“I hope that’s not in our district,” I say, hoping to make it back to the station, choosing to ignore Mike’s news until I’ve had time to sort things out.
“Rescue 5 respond to 1035 Broad Street at the pay phone for an intoxicated male.”
Our district. Damn.
“Darryl,” we say simultaneously. I key the mike.
Michael Morse lives in Warwick, RI with his wife, Cheryl, two Maine Coon cats, Lunabelle and Victoria Mae and Mr. Wilson, their dog. Daughters Danielle and Brittany and their families live nearby. Michael spent twenty-three years working in Providence, (RI) as a firefighter/EMT before retiring in 2013 as Captain, Rescue Co. 5. His books, Rescuing Providence, Rescue 1 Responding, Mr. Wilson Makes it Home and his latest, City Life offer a poignant glimpse into one person’s journey through life, work and hope for the future. Morse was awarded the prestigious Macoll-Johnson Fellowship from The Rhode Island Foundation.
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