A Cultured Cokehead

It's 1 a.m. on a chilly night. Bronson and I are sound asleep in the ambulance with the engine running and the heat going when the call comes in for an "MVA with injuries" — a motor vehicle accident on Poly Place and Seventh Avenue, near Poly Prep and the Fort Hamilton Army Base, in Bay Ridge.

Bronson and I have often driven around the elite private school's campus during the summer, watching the ducks waddle around by the pond. Now, it's dark. "This school is apparently fabulous," I say.

Bronson shrugs. "Give me the top public schools any day," he says.

I know what he's thinking: Children in private schools do drugs. "There's good and bad everywhere," I say, sounding like my mother.

The computer beeps again, and the call is altered to a "pin job," meaning the victim is pinned inside the vehicle. We pull up to the scene and see a white van crashed and leaning slanted against a wall, almost on its side. The man behind the wheel looks to be about 20 years old. We call for additional resources: PD and ESU, the emergency services unit of the police department, to help cut him out of the van.

Bronson climbs onto the side of the van and breaks the windshield with a window punch, a pen like device with a steel tip that shatters glass. He checks the man's eyes and notes a slight dilation, but that could be because it's nighttime. He talks to the man: "Hey buddy, how ya doin'?"

The man is hanging behind the wheel, not seatbelted in but pinned in place by a bent steering wheel shaft and a twisted front seat. Bronson opens the man's shirt and checks his chest for signs of blunt trauma. There are none, but the driver claims his head and neck hurt and says he thinks he passed out but doesn't remember. One leg is pinned under his seat and he can't pull it out. "Okay, man, don't move," Bronson says.

He climbs out with difficulty, as there's not a lot of room in the van, and orders me inside to maintain head stabilization on the man, who may have suffered a head injury. Bronson is 6-foot-1 and I'm 5-foot-2. "You're tiny," he says, and pushes me toward the vehicle. "Get in there."

I climb into the van sideways, grasp the man's head from the back seat, apply a cervical collar, and try to hold his head steady. Meanwhile, a couple of ESU officers have arrived, along with PD, and together they pop the side door of the van with some sort of Halligan tool, stick their heads inside, and remark that the man is pretty well pinned in. I look at them from my sideways position and say, "Gee. Ya think?"

They get inside and try to cut the car seat and dashboard in order to extricate the man. While they're doing this, I monitor his vitals: pulse, breathing, skin color, condition, and temperature. He's breathing quickly and his heart rate is fast, but that could be adrenaline and fear. I ask him how he's feeling.

"I haven't slept in five days," he says. "I must have fallen asleep behind the wheel."

Five days? "Why haven't you slept in five days?"

He points to the cops, then puts his finger to his lips.

We're finally able to slide him out onto a longboard, and Bronson straps him securely to it and rolls him into the ambulance. He gives a notification to Lutheran Medical Center, the nearest Trauma One ER, and I thank the cops and ESU, hop in back with the patient, and we're off.

I take out my paperwork and get the guy's name, Social Security number, and date of birth. "Okay, the cops are gone," I say, taking his blood pressure, which is high. "Why haven't you slept in five days?" His pulse has not slowed down even though he's out of the car wreck and should feel more relaxed.

He closes his eyes, then opens them. They remain dilated even under the bright ceiling lights of the ambulance. "Been on a cocaine binge," he says. "I wanted to look at the ducks by the pond. I used to go to Poly."

This would confirm Bronson's worst suspicions about drug use in the city's private schools. I sigh and wonder if Brooklyn's top public schools — Tech, Madison, Midwood, or Murrow — have graduates like these. Probably. I sigh again and look at his eyes. Dilated pupils can also mean head trauma, an intracranial bleed, or a skull fracture. I hope, for his sake, that the only thing he's suffering from is drug abuse, and that if so, maybe this will be his wake-up call.

But I doubt it.

Ms. Klopsis is an emergency medical technician on an ambulance in Brooklyn. This column details her observations and experiences. Some names and identifying details have been changed to protect the privacy of patients.