Bronson and I get a call for an overdose in what, while now ambitiously called Park Slope, is really just Fourth Avenue, a no-man's-land of auto repair shops and flats-fixed places. Supposedly, a 40-year-old male has overdosed on heroin and is in the basement of one of the dingy two-story houses covered in aluminum siding that can be seen nestled between the empty lots.
En route, we talk about the 1999 movie "Bringing Out The Dead," which starred Nicolas Cage as a burned-out New York City paramedic who saw the "ghosts" of a dead patient he couldn't save. I look at Bronson — tall, skinny, and nervous — and voice exactly what I'm thinking: "You'll probably get burned out like Cage did before you even become a paramedic."
As we pull up to a decrepit house of nondescript color, he laughs and says he's already burned out. He rings the bell. It doesn't work. He kicks the door with his boot. It opens.
"Hello?" I shout. "Ambulance!" Bronson calls out.
We go down a dark flight of airless stairs into a dimly lit basement.The only furniture is the bare mattresses on the concrete floor. "Welcome to the Ritz," Bronson mutters. Two cadaverous men and a skeletal woman point to an unconscious male lying on his back on one of the mattresses. "Heroin," they mumble.
Of more concern than his unconsciousness is that he is breathing at about four times a minute. "Respiratory distress," I say. Total respiratory arrest seems imminent; this has all the earmarks of a classic overdose. Bronson radios for an ETA for medics as I start ventilating the patient with a bag valve mask and supplemental oxygen. He's pale and wretched looking. We take him outside via a scoop stretcher, a flat metal device that comes apart into two halves that fit under the patient and then snap back together. Luckily, he's skinny, so getting him up the stairs isn't too difficult. Then, as we're carrying him across the sidewalk a passer-by stops and stands in our path to the ambulance.
"Get outta the way!" Bronson shouts. The person stares blankly, then walks on. Bronson shakes his head. "Another brain surgeon," he mutters.
"This place is not exactly the campus at Yale," I offer.
We lift the junkie into our ambulance as the medics arrive. "Okay," one says, rubbing his hands together. "Time for a little science experiment."
They open up their medic bag and select an intramuscular injection of naloxone, better known as narcan, which reverses the effects of an opiate overdose. They try to give very little — just enough to raise the guy's respiratory rate. If they give too much, the patient might wake-up and become aggressive because his high was ruined. A junkie will go from "on the nod" to sick, shaking, and vomiting in just minutes. He'll lash out at the person that ruined his high, even though he's just been saved from a deadly overdose.
Bronson watches everything, making tiny comments here and there based on things he's learned in his paramedic class. He says he thinks the medics are giving the patient too much narcan. This annoys the medics, and one says, "Keep yer yap shut." As if on cue and straight out of a movie, the patient stirs, starts to wake, and promptly throws up on the medic. I hide a smile as I get paper towels and halfheartedly clean up the mess. "I guess you gave him too much," I say.
Bronson gets behind the wheel and starts the bus. One of the medics gets into his unit and follows us. I ride in the back of our ambulance with the medic who made the snide comment to Bronson. He says nothing. I say nothing.
The patient is discombobulated and miserable, dry-heaving onto the sheeted stretcher. I sigh, open the side window to air out the bus, and peer at the passing scenery: rows of elegant brownstones with children playing on the Victorian-era slate sidewalks, boutiques on Seventh Avenue, Methodist Hospital, with its new brick buildings. I can remember in the 1970s and '80s, when Methodist was a dingy little hospital that nobody wanted to live near, much less be treated in. Now, judging from the quiet and well-run ER, the clientele is more upscale.
As we roll him, our patient is kicking at the stretcher and pulling at the sheets, bucking like an animal and cursing wildly. The nursing staff is not used to this sort of thing. "He almost died, but we caught him in time," the medic says. I whisk off the soiled sheets, peel off my contaminated gloves, and wash my hands with soap and lots of hot water.
The triage nurse gloves up twice, then smiles politely at the junkie. "How … lovely," she says.
Ms. Klopsis is an emergency medical technician who works 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.
Correction from September 19, 2006:
Eugenia Klopsis writes the EMT Diary. The byline was missing from the column on page 2 of yesterday's New York Sun.