A Thousand Naked Strangers (14 page)

When it's all over, my partner and I laugh and then run more calls. She's unaware how close I was to coming unglued, how close she was to issuing my death sentence by telling everyone that I'm no good.

•  •  •

It continues like this day after day, calls coming in and me on the very edge of panic. It's only a matter of time before the Big One shows up. Every new medic knows his first real test is out there, so I wait—half dreading it, half breathless with
anticipation. When other medics speak, I hang on every word, peppering them with questions. I try to be discreet, but my desperation shows.
What did you do? How'd you know to do that? What were the signs? Had you seen someone catch on fire before, or was the treatment something you learned in school?
I'm looking for answers or help or peace of mind—an indication that I'll be able to handle the moment when it's my turn. I casually solicit tips and advice, anything that'll tell me what I should already know, what I'm paid to know. For my peers, we're talking shop and telling war stories. Everyone else is looking for a laugh; I'm looking for advice.

Then one day it arrives. My first real test comes without warning, as just another call, though it's not. This stranger, the one whose death will fall in my lap, appears from nowhere to read my fortune and decide whether my future holds a transfer to a quiet fire service or a decade of riding out the madness on an ambulance.

My partner and I are sitting around talking when the call comes in. Our radio crackles with static and then the words—
person shot, multiple wounds
. My skin goes cold. She's twenty-nine, and she's been shot six times at close range. What that is—being shot six times at close range—is beyond malice or anger. It's pure hate. It's death by a loved one. It happens on the far edge of town.

We're a long way out when the dispatch comes in, and with traffic, we're slow to arrive. I hop out of the truck, and even from here I can see her, floating in a thick pool of blood that's congealed into red pudding. The crowd is screaming, all emotion and panic. They know the victim and the perp, they know the police can't control them. Over the shouting, I hear the
patient gurgling through blood and clenched teeth. This is the real thing. Someone has been shot but not killed, and now I'm here, alone, to deal with it. My partner is competent but new, and just an EMT, so it's all on me. No one to fall back on, no one to help, no time to think. The patient, my patient, is dying.

We lower the stretcher. She's nothing but holes, blood, and a pair of brown eyes locked to the right and staring at a serious brain bleed. Someone is screaming for everyone to back up, to stop touching us, to give us room. I think it's my partner, but it could be me. It's hard to say. My brain's in a blender. I suction the patient's mouth, watch blood swirl up the tubing. Then we strap her to a backboard and the stretcher's up and moving. More suctioning. In the ambulance, air conditioner's blowing warm air. Counting holes. Ventilating. Suctioning. Finding more holes. An IV in each arm. Fluids. Lots of fluids. A call to the hospital interrupted by a seizure. Enough seizure-stopping Versed to put down a horse. Finally, serenity.

Right before we get to the hospital, I do a final count for holes. Three in her chest, one in the neck, one in the face. I've slipped a hand under her head to check for head shots when her eyes pop open. I let go. Her eyes close. I press again. Her eyes pop open. There's a firefighter riding with us, and we look at each other as it becomes clear: My finger has slipped through a bullet hole and into her skull, and whatever I'm poking in there is making her eyes open and close. I say that's probably not good, and he nods. “No, I don't think that's good.”

“I'm not gonna do that again.”

“Probably best.”

At the hospital, she's quickly assessed, further sedated, intubated, and taken to surgery.

The woman dies a little while later, though her boyfriend—barricaded in his apartment—hangs on for a few more hours. We clean the truck, restock what we used, and go back in service. We run more calls. I'm not good yet, but I can lay to rest the question of whether I'll panic when the Big One comes. I am and always will be a Grady medic.

22
The Private Life of a Public Hospital

G
rady isn't a hospital. It's a trauma center and a stroke center, a burn unit, a psychiatric facility, an enormous public resource. It's a creaking bureaucracy, underfunded, overburdened, and struggling to pay its bills. Its campus is dotted with clinics and sprawls across an immodest number of city blocks in downtown Atlanta. So it's a hospital, yes. But it's more than that.

Grady is an ecosystem. Swirling around it at all hours of the night are creatures from every level of the food chain. There's a woman who lives in the bus enclosure out front and sings at the top of her lungs. She's not singing songs but hymns, and when we arrive in the morning, we aren't merely punching in to work—we're receiving communion. Out in the streets, just beyond Grady's front doors, are ambulances, doctors, nurses, visitors, the homeless, half-medicated lunatics and patients who've dragged their IV poles outside to smoke. Huddled together on the sidewalks—which are dotted with chewing gum and droplets of blood and the occasional human turd—are anxious family circles praying for loved ones, and the local news reporter who's camped out because something tragic has happened. Something tragic always happens.

There's a McDonald's beneath the parking deck. Hospital
trash is taken out a few yards from the ramp where ambulances bring patients in. This ramp is new. The old one was smaller and faced a different direction and was bordered on one side by a wall. Regulars—vagrants and homeless and down-on-their-luck locals—would sit on the wall and smoke cigarettes. Every time an ambulance came in, they'd clap and cheer. That wall became known as the Rooter Wall, the people perched on its ledge Rooters. To this day, patients transported repeatedly to Grady are called Rooters, and everyone who works here walks a fine line between love and hate when it comes to Rooters.

All this before we get inside.

Grady was built in 1892, and the original building still stands. The main hospital is much newer and infinitely larger and was once segregated into two facilities: one for whites, the other for blacks. Jim Crow is gone but not by much, and poor blacks, ever mindful of their separate-but-equal past, still refer to the hospital—the place they were born, where they're healed, and eventually, where they'll die—as the Gradys.

There's a main entrance with an atrium—marble floors and high ceilings, a receptionist, mounted plaques—but anyone sick, anyone coming by ambulance, enters through triage. Triage is a three-ring circus, and its main attraction is the human body gone suddenly, maybe irrevocably, wrong. Triage is run by two nurses, and at any given time it's occupied by a couple dozen patients in various states of need. The main floor is home to the waiting room and its hundreds of souls in limbo. It's also home to the ECC—what you'd call the ER. The Red Zone houses trauma; the Blue Zone houses medical. Both have a couple dozen rooms, plus twice as many informal hall spots where patients end up, despite having been shot, because someone
has confirmed the wound isn't life-threatening. The Red Zone includes the trauma bays where the most critically injured are treated. It's also home to Red Obs, which is a cramped parking lot for violent psych patients too sedated or too in need of medical help to head upstairs.

The Blue Zone has no trauma bays, but it has the CPR room, four critical-care rooms, an asthma room, and the hospital's detention area. Prisoners from the city or county jail, the men locked up in the federal penitentiary, all get handcuffed to a bed and brought to detention.

The ECC is a wild place overflowing with patients, competitive doctors, overworked nurses, and a ballooning coterie of support staff. It was built in the nineties, designed to replace an ER that took the worst the city had to offer, that functioned with a chaotic precision and whose tile walls sported a handful of bullet holes until it was demolished.

The cafeteria is on the second floor; labor and delivery is on the fourth. Every time a baby is born—a child known from that moment on as a Grady Baby—a lullaby is played over the hospital's PA system so everyone knows another life has entered the world. This city has a lot of Grady Babies, thousands, and the song has announced the arrival of so many for so long that halfway through, it fades and hiccups only to gain strength toward the end.

The morgue is in the basement. The psych ward is on thirteen.

Grady is a strange place and very much a part of this city's fabric. The EMS department is no different. Wearing a Grady uniform, driving a Grady ambulance, gets me into and (more important)
out of
countless dangerous situations. People walking
down the street, all of them Rooters, many of them Grady Babies, stop and wave as we drive by.
Hey there, Grady
is yelled every day from every frayed corner of this city. But it's not easy. The call volume is enormous—over a hundred thousand a year—and the patients (mostly homeless, many drunk) are a handful. Turnover's so high that people who've been around a while won't speak to me until I've made it six months. That's the first threshold. If I haven't been fired or quit or killed by then, I'll probably make it. In the meantime, they ignore me.

Outside of work, on the street and among friends, it's different. The minute I say I work for Grady, I have everyone's attention. The place is so revered, so feared, so mythologized that saying I work here gets the same reaction every time:
I bet you see some crazy shit.

And I do. I've treated a woman stabbed by a stingray at the aquarium. I've run calls on football players, washed-up actors, and hysterical strippers. I've been called out to the projects, the Capitol building, the high-rises, the highway, the jails and churches, even Tent City—a squatters' refuge on the edge of town. The hospital itself, yeah, it's crazy, too. In some ways, a little
too
crazy. Like right now, for instance. I'm sitting in a small auditorium on the edge of campus listening to a speech on booby traps. Nobody's sure who's setting them or why, but we all agree the perpetrator needs to die. Slowly. Painfully.

Every few weeks another booby trap shows up. Maybe it's a dirty needle, uncapped and taped to the bottom of a seat. Maybe the needle has been stuck through the foam blocks we use to immobilize patients. Maybe it's poking out from under the hood. Today we're listening to an administrator who has placed a picture on the overhead projector. He flicks it on, and
the image—projected onto a screen at a terrifying twelve feet by twelve feet—is of a plastic bag filled with piss and bristling with uncapped needles. “This was found in an ambulance yesterday,” he says. “It was just sitting there in an overhead compartment.” He keeps talking but we care about only one thing—who's doing it? He doesn't know. Doesn't want to speculate, isn't here to talk about that. He's telling us to be careful, to check our ambulances carefully. To police ourselves. This isn't what we want to hear. Someone's already been stuck, so no, we don't want to hear that we can minimize our chance of exposure by showing up early and double-checking the truck. We want to hear that the fucker's been caught, that he's tied up outside for us to look at:
Here he is, guys! Take a swing.
Instead, someone has left a bag of piss needles in an ambulance, and we're told to police ourselves. I can't even answer the why of such a situation, let alone speculate on the who. “Okay,” he says, snapping off the overhead projector and slipping the photo back into a manila folder. “That's all I have.”

We file out of the room and, despite our reservations, clock in. We grab our equipment and head out to the ramp. We enter our ambulances very, very slowly.

23
There's Been a Prison Break

S
till, I love it here. Forget the booby traps and anonymous terrorists, the plastic bags full of piss and needles. Grady is the only place I want to be. It's nothing but history and controversy, and its medics—all those people who won't speak to me—are the best around. I want desperately to earn their respect. I thought the shooting would do it—that maybe people would notice how I sped to the far end of town for a woman shot too many times at too close a range to be anything but an organ donor. How I stayed calm, did my job, and delivered her in better shape than I found her. But it was just one call among a hundred thousand, and I'm just one among two dozen new guys. Nobody noticed and nobody knows my name. Not the other medics and certainly not the director of operations.

Until now.

It's dark outside, not even seven in the morning, and I'm standing before the director of EMS operations. She runs our department, and until this morning she'd had neither a reason nor the time to form an opinion of me. Now she's considering my future. This isn't good. It's been three years since I got into EMS. In that time, I worked my way onto a 911 ambulance, graduated from paramedic school, and got hired at the only place
I've ever wanted to work EMS. There are harder paths, but this one's mine. Or was, anyway. It's hard to say what'll happen from here.

The director is stone-faced and serious, because the charges—and people
are
threatening charges—have gotten serious. She wants to know what in hell I was thinking, but I have no answer. I fidget. My eyes flick around the room as I try to imagine what I'll say to Sabrina when I call. That I've been fired? That I've been arrested? That things are about to change because I couldn't keep my hands off the radio?

“I'm going to make this simple,” she says, hands pressed flat against her desk. “Tell me
exactly
what you said. Word for word.” She holds up a written complaint. “Because this? It doesn't make sense.”

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