Don’t Stop Believing. Or breathing.

I’m trying to imagine the thought process that begins with I need to pick up a few things from the store and ends with I should probably stop in the bathroom real quick and snort a shit-ton of oxycodone. Maybe if we can wake this gentleman up I’ll make some inquiries but right now his respiratory drive has gone night-night. Which is just a fancy way of saying his body gives no fucks about breathing. That’s why Tommy is on his knees in the pharmacy section of Publix bagging this dude.

"We’re gonna intubate him right?" TJ is excited. TJ would very much like to intubate somebody. I don’t blame him for that, interns are supposed to be excited about intubating people.

"I hope not," I reply while unzipping a compartment on the jumpbag.

"Why not El? He’s breathing like two times a minute," TJ sounds disappointed.

“Oh my God is he dying?” Drama Queen asks, eliciting gasps from other onlookers. Drama Queen is definitely middle-aged but dressed like she’s middle-twenties and I’m pretty sure she’s live-streaming us on Facebook right now. She happened upon this little medical drama today while browsing her local grocer and it’s obviously the most exciting thing that’s happened to her since she gave Bret Michaels a lap dance backstage at the Civic Center in ‘89. Now she’s doing her very best to be a part of this little tragedy.

In short, she is all up in our business and it’s really pissing me off.

“El,” TJ says, “he’s barely breathing.”

"Right, but what did we find in his pockets?" I ask.

TJ is in the middle of setting up his IV kit and he falters for a moment before replying, "um, we found his phone, keys, oxycodone and some other crap."

"Right," I rummage through the assorted drugs and pull out a little pink-ish, rectangular box. Our Sacred Mother Naloxone, hallowed be thy name, "so we have a man down, in a pharmacy, barely breathing who just picked up 40 tabs of oxy."

TJ’s face screws up and I can see the wheels turning, then his face changes and I can tell he’s got it. "Narcan," he says and I’m proud to see it’s not a question.

"Bingo," I toss him the box. He catches it and looks at it for a couple seconds like he has no idea what the hell it is. "Of course you are gonna need that line," I prompt.  He goes back to starting an IV, stretching a blue rubber tourniquet around the guy’s bicep.

“Shouldn’t you be doing CPR?” Drama Queen announces, “he’s like totally unresponsive, they taught us that in first aid class.”

I’m trying really hard to just ignore her.

“Where’s the manager?” she calls out, “you guys should go get the AED. Please tell me this store has an AED.”

The manager clears her throat from somewhere behind me, “Should I go get the AED?”

I decide I should probably make a definitive statement for the benefit of the other onlookers, “No ma’am, you do not need to get an AED, this man’s heart is fine. We don’t need to do CPR,” I lock eyes with DQ and make instant enemies, “we just need to help him breath and we are already doing that.”

I’m about to leave it at that but decide to see if I can use the manager to my advantage, “What you could do for us ma’am is get all these people-” another sharp look at DQ, “out of here.”

Well that has absolutely no affect so I decide to go back to work. TJ is still dicking with his IV and I see he has once again elected to go for the largest possible catheter size available. I see no need to stop him. I figure if you overdose on narcotics and some medic intern decides to stab you with a needle the size and diameter of a coffee straw, well, that just comes with the territory.  I locate the driver’s license of Mr. Todd O’Connell. Todd lives on Poplar Trace and I’m happy to note he is an organ donor. Probably not his liver, or kidneys but at least he’s taking it easy on his lungs today.

I dub you Todd OxyConnell.

"That’s a really good deal on whey protein man," Tommy says from out of nowhere. I follow his gaze to an endcap where huge plastic jugs of whey protein powder are on sale. While looking at that I can’t help but notice the crowd is getting bigger. There is a lot of animated gesturing and loud whispering from Drama Queen. Smart phones are starting to come out all over the place. The onlookers seem concerned. It gets me to thinking that maybe we’re being a little too casual about this whole situation. I make the tactical decision to do something medical as fuck.

"Tommy are you still getting good compliance with those manual ventilations?" I inquire with authority. Tommy gives me a dirty look and after a second shoots back:

"Affirmative paramedic Elson I have good compliance and a fully syncopated waveform."

Which is some old bullshit he just made up but it sounds good.

"Got it," TJ announces triumphantly, "I’m going to push two milligrams of narcan."

"Hang back on that champ. Let’s try one and see what that does," I reply.

"Protocol says two," TJ counters.

"Yeah well the guy who wrote that protocol ain’t gonna be the guy getting puked on in the middle of Publix," Tommy chimes in. This statement doesn’t help TJ with his decision making. He looks to me again.

"Just give him one. We can always put more in we can’t take it back out," I say. TJ nods and consults the preloaded syringe to figure out the dosing.

"You wanna hand me an end tidal?" Tommy gestures towards the jump bag with his chin.

"Yeah, sorry man," I dig around in the airway compartment of the bag until I find the little device Tommy wants. I open the package, unroll it and plug it into the monitor, handing the business end to Tommy. He wraps it around Todd OxyConnell’s head so that there are two tiny plastic prongs in his nose monitoring his exhaled carbon dioxide. This is a really good way for us to measure how well Todd is breathing. While we’re doing this TJ announces that he’s pushing narcan. Hooray.

Right now all along Todd’s central nervous system there is a bunch of oxycodone hugged up tight on his opioid receptors keeping him totally chilled out. Too chilled out. So chilled out he’s not breathing enough to stay alive. Hopefully that’s all about to change. TJ has just injected a whole lot of little chemical bouncers and they’re about to throw that oxy straight out the fuckin’ club, yo.

While that’s going on we’ve got some more blue collar stuff to do.

“Let’s get ready to move him,” I say. Probably a pointless thing to announce but I’m never really sure if TJ knows what the hell is happening. We starting policing up our stuff so as not to leave a mess in the vitamin aisle of this fine shopping establishment. OxyConnell’s a pretty small dude so lifting him shouldn’t present any big problem. Tommy grabs him under the shoulders, I grab him behind the knees and we just heave his ass up on the gurney.

As we’re picking up gear he starts to come around. He coughs a couple times and makes a half-assed attempt to push the mask away from his face. Tommy pulls it back and says, “Hey man, can you hear me?”

“Huh?” Todd manages, “Uh, wha?”

There’s a sigh of relief from the onlookers. Maybe even a little cheer or two. DQ seems disappointed and I assume goes back to her shopping since I don’t hear any more color commentary. OxyConnell’s eyes roll left and right in total confusion but at least he’s breathing on his own.

“Sweet,” I say, “let’s go.”

We start to roll him out of the store. I let Tommy and TJ handle the gurney work while I carry the jumpbag. The monitor is stuffed between OxyConnell’s legs. I have to admit it’s pretty fun to watch everybody stop and stare while we roll by pretending to be all heroic and shit. It’s not exactly my strong suit but this is where Tommy really shines.

Todd stops breathing twice on the way out of the store causing an alarm to sound. The first time TJ looks back at me, eyes wide.

“Go ahead and give him the rest of that narcan,” I say.

TJ pushes another milligram of narcan into Todd’s IV. By the time we’re at the front doors he’s awake again.

Outside in the fire lane we load OxyConnell in the back of the rig. Normally the fire department would have been here but I canceled them. I figured the three of us could handle it.

I climb into the airway seat above Todd’s head and TJ takes the bench seat. Other than having knocked out his will to breath, Todd is doing great so I decide to just let TJ go free range on this call.

“It’s your show man, you call it,” I say.

He makes a destination decision (Abby’s hospital, give the rookie points for that one) and decides we’ll go emergency which isn’t strictly necessary but who cares? Let the kid fire it up if he wants.

Tommy nods and slams the doors.

At this point Mr. Todd OxyConnel is exactly where I want him to be. Breathing fine but barely awake. If we give him too much narcan he might go into withdrawal, start throwing up and shit. Ain’t nobody got time for that so I try to just keep him breathing.

The only drawback to this approach is that ‘ol Todd just wants to snooze and when Todd starts to snooze, Todd starts to not breath so great. TJ has to constantly wake and shake him, which is fine by me, it gives him something to do.

“Hey wake up man!” TJ yells.

“I need you to stay awake for me, sir,” TJ shouts.

“Dude! Do not fall asleep on me again!” TJ hollers.

I could and probably should tell TJ to hit the guy with a little more Narcan so he’ll stop trying to nod off on us but honestly, this is just fun to watch.

TJ grabs the mic to call in his report. I lean back against the bulkhead and can hear a familiar piano riff coming through from the front of the ambulance. It instantly brings a smile to my face.

“Tommy!” I slam a palm on the bulkhead and stick my face upfront, “turn that shit up and pipe it back here, dude!”

TJ looks confused and a little concerned, “what are you guys doing? I’m trying to call report El.”

“You better call it quick, buddy.”

The hospital comes back over the radio waiting for his report. It’s Abby.

Perfection.

I spin around and lean over OxyConnell, “Hey Todd, were by any chance a city boy born and raised in South Detroit?”

Todd’s eyes flutter open at me, “Wha?”

And then Tommy hits us with the tunes. Journey’s classic rock anthem blasts through the cabin.

“Todd, did you take that midnight train going anywhere?” I start to sing.

I hear TJ trying to make report but it gets drown out by Tommy from up front, “a singer in a smokey room.”

“Smell of wine and cheap perfume!”

Todd looks at me like an alien just burst out of my chest, “What the fuck man?”

“For a smile they can share the night, it goes on and on and on!” Tommy and I belt it out in unison.

“Medic twenty two can you please repeat that traffic?” I hear Abby on the radio. I think she’s laughing.

It might not be professional but it sure as hell keeps Todd awake. TJ tries to repeat his report but all I know is, “Strangers waiting, up and down the boulevard. Their shadows searching in the night!”

Damn! Tommy is giving it hell up there and he’s got those old school gospel pipes. Making me bring my A-game today.

“Working hard to get my fill, everybody wants a thrill, payin’ anything to roll the dice just one more time!”

TJ has now hung up the mic and is starting to sing along a little bit. Maybe we’ll make a medic out of this kid yet.

“Some will win, some will lose, some were born to sing the blues. Oh, the movie never ends it goes on and on, and on, and on…”

We burst through the ER doors like we’re in a fucking musical, “Don’t stop, breathing! Todd, hold on to that feeling. Snorting, Oxy is bad!”

Yes, I’ve had time to tailor the song to Todd’s particular situation. We get some dirty looks from a few people but I know I hear at least three nurses and one doctor singing as they go about their business.

Abby directs us to a room where we deliver Todd OxyConnell into the caring bosom of New Hope Hospital. Godspeed Todd. Don’t stop believing. Or breathing.

Abby is in a great mood and is delighted by our shockingly unprofessional behavior. She agrees to meet us after work at a place where Tommy and I like to go play trivia. TJ agrees to come even though technically he wasn’t invited which causes Brandy to agree to come because she wants to get in TJ’s pants. Brandy agreeing to come encourages Rachel and Simone to agree to come because they’re all twenty two years old and insist on doing everything together. All the kids deciding to come forces Tommy to ask Javina along because she keeps the youngsters from hitting on him. Plus I think they used to date anyway and Javina is hilarious so that’s all good news in my book.

By the time trivia starts we have a party of eight and it’s a great evening. Even though it turns out none of us knows shit about the history of US presidents.

At the end of the night Abby lets me stay over.

Perfection.

Next Chapter: Mac N’ Cheese