Tuesday, March 31, 2009

The Ungrateful Suicide

Saturday Night. Gentrification has created these weird pockets of extreme wealth in that ambiguous part of town where Bed-Stuy and Prospect Heights overlap. Me and C wind our way through the corridors of some converted warehouse. It’s dim and dank and smells funny until we step suddenly into an ornately decorated apartment with frilly columns, oriental rugs and wall-to-wall theater memorabilia. A distraught, exhausted middle-aged woman ushers us into the bedroom where we find cops and volunteer EMTs swarming around a fat white male, obtunded like a goddamn beached whale and not breathing on the floor beside his king-sized bed.

My partner C was here last time this guy tried this, and he’s asking the wife what our patient took tonight but she won’t say. The EMTs get the bag-valve mask on to giving him respirations and I’m driving tonight, so i set up the IV while C gets down to where the patient is and starts looking for a vein. The guy’s teenage son is coming in and out, I’m trying to get a coherent story while squeezing saline into lines and ripping open plastic bags, but all we can get is that the guy was drinking all night, has been depressed, has tried this before, etc etc. There’s a not that says “Dear so-n-so i love you and i’m sorry’ and then it’s all garbly chicken scratch. PD was here a few months back cuz our man locked himself in a room with a gun (a BARRICADED EDP- more on that some other time…). He’s h e a v y like you wouldn’t believe and out like a pile a rocks. I pass C the tourniquet, then the catheter (a smallish one, cuz the fellow’s fat so he’s a tougher stick and there’s no reason for anything big), and when he reports that he’s in i hand over the iv lock and a flush of saline water along with the stickies to hold it on.

The pupils are pinpoint and his respirations are still almost none, so we have good reason to suspect a narcotics overdose. I pass C a needle with 2 mg of narcan- a medication so notorious in the heroin circles all you have to do is mention it and many addicts will come jumping out of their stupor just to beg you not to give it. Basically, it blocks all the opiate receptors in your body and completely and utterly deprives of you of any possible high you mighta had. Then, you go into instant withdrawal which can mean anything from extreme irritability to severe hibijibis to simultaneous shitting and vomiting to seizures. That’s why, to avoid prolonged cleanup/resuscitation sessions, narcan is best given a) in small polite doses and b) no more than two seconds before the patient gets moved out of the ambulance and into the er.
The Dreaded Narcan...


But a suicide is a horse of a slightly different color than a typical addict OD, especially when the guy is HUGE, has taken unknown mountains of unknown narcs and is already pretty far gone. So we drop in the two mgs, enough to make your average user do the shitnpuke right quick, and it doesn’t even touch him. Practically bounces off the guy. He’s still pinpoint, obtunded, not-breathing. A hot mess. And we’re all still wedged into this awkward space between the bed and the wall. I pass C an amp of dextrose, sugar water, in case on top of everything else he happens to be diabetic and hypoglycemic as well, and then another 2 mg of narcan. Then we start packaging to go, cuz he’s still not responding and we’re reaching our limit of options. It takes about five of us to get him, strap him to a board and get him moving. We’ve all carried some fatties, but this guy is solid, dead weight and managed to collapse into a particularly un-reachable corner of the master bedroom. So we heave and ho and finally begin carting him through the windy passage ways back towards the street.

Just before we make it back out I see his arm start to raise up, and slowly he blinks back into consciousness. He looks around groggily. His hands are taped together to keep them from flopping out of the stretcher. He has an iv in him. He’s surrounded by cops and medics. He looks each of us in the eye and says:
”Fuck you guys, why didn’t you leave me the fuck alone…” and then falls grumpily back into his stupor. Then he wakes up again as we loading him up. “Damn you. Damn you all. Motherfuckers…”

What do you say to a dude like this? I mean, none of us are really in it for the thank yous, but shiet- if yer gonna be hufuckingmongous and a big a-hole to boot, yer ass can walk to the ambulance or just keep it to yerself. But in the end, you say nothing. You chuckle. Brush it off and take homeboy to the hospital, where he proceeds to curse out each and every one of the nurses, security guards and techs and then falls back asleep.
And then you go get dinner.

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