I’ve been told I have an excellent BS detector and am lucky enough to have a career that lets me keep it in tip top shape.  This evening was no different.  But like many of my clients lying to me, I had heard this story 1,000 times before.

THE EMERGENCY

A woman is calling to report a motor vehicle accident.

THE ACTION

We’re dispatched to the parking lot of a grocery store and waved down near the rear of the lot by a woman who appears to be in no distress.

I make contact and can tell right away exactly what my next 20 minutes will include:

1. An employer

2. An employee

3. A shift start time

4. An imagined auto accident

5. The misunderstanding that an EMS report can be your “get out of work” card.

After our primary and secondary assessments yield no sign of illness or injury I am able to delve deeper into her story and unravel it without her realizing it.

“Where was your car hit?” I ask looking at the rear bumper.

“On the bridge.” is her answer.

I quickly do the math and realize that no matter which bridge she was on she drove another 30 minutes to this location.

“No, I mean your car, what part of your car?” as my dipping and leaning for a hint of smudged paint looks like an odd modern dance routine.

“Um, I left home on time and I got rear ended on the bridge, it wasn’t my fault.” BINGO! Time frame.

As I discuss her options, including going in to work, she asks to see a copy of my report.  She wants to make sure I document how injured she is and what happened on the bridge.  She needs it to prove to her boss why she was late.

I do my best to remain the Happy Medic and explain to her how our reports are written and that in my report will be the findings of my physical assessment, her vital signs and the lack f damage to her vehicle.  I will then include that she requested the report for a personnel matter.  But of course she is welcome to review the report prior to my filing it, but she will need to wait the 7-10 days to obtain a copy.

Furious is not the word to describe her distaste at the facts.  In her tirade she mentioned, sarcastically, that maybe she should just drive herself to the hospital.  hehe. I agreed and, honestly, even that was unnecessary.

When offered the refusal portion of our forms, she advised me her lawyer will need to review anything before she signs it.   When I handed her my phone to call her attorney so he can charge her for this, she paused, looked at the plain language on the form and signed.  When I offered her the HIPAA notice, which also needs to be signed for, she again raised protest stating she does not have to sign anything.

It was soon after that that she dropped the phrase that is starting to pop up a little too often for my taste: “Why won’t you just do your job already?’

Deep breaths…deep breaths.

I was recently dispatched to the residence of an elderly woman who’s caretaker wanted to go home early.  No better way to make that happen than to call 911, report the woman unconscious, then just make it up as you go.

But this day I was in a great mood speaking with my patient.  So much so I tuned out the lying caretaker and focused on my new friend.

THE EMERGENCY

A woman reports the woman she cares for is unconscious.

THE ACTION

Up the stairs of the very well apportioned house I am unsure where the patient may be.

“Hello? Fire Department!” We call out.

“Yes,” a soft voice replies from upstairs.

“Where are you?” we ask as we mount the stairs, gear in tow.

“Up here,” is the reply.

“Can you keep talking so we can find you?” There are rooms off of hallways, sets of stairs to other levels, the place would be a nightmare to lead a line in case of a fire.

“OK,” then silence.

“KEEP TALKING!” I shouted, now disoriented somewhere on the second floor.

It was then I heard the second voice.  A frail voice at first that grew to a roar as I finally found our client and her carer.

“Who are you people? I want you out, now!” screams the woman on the bedside commode.  The carer standing nearby, purse over the shoulder, jacket on, tells us the woman seated next to her was unconscious just a moment ago.

“Call the Police!  This is private property!” The owner of the palacial home is screaming.  She seems to be in good health, aside from the sudden paranoia of the engine company entering the room.

“Who are you people?” She is shouting.

“My name is Happy and I’m here to make sure you’re all right.  Are you in any pain or discomfort?”  Barely left my lips as I reached for a radial pulse and began to ask permission to do so.

“Don’t you lay a filthy hand on me.  You have no business here!”  She’s pointing to the door we came in and I’m close to following her instructions.

I looked to the caretaker who rolled her eyes and told me she goes to St Farthest hospital.  We spoke for a few brief moments and it was clear she had not contacted the woman’s doctor, nursing staff, anyone but us for what seemed to be described as a woman falling asleep.  I of course couldn’t rule out a cardiac origin, considering her seated location, but without being allowed to touch her, I was stuck observing for now.

“Who called you people here to my house? Get out! Who are you anyway?” She is so angry that the JVD is allowing me to check her pulse by watching it…good, in the 70s…that’ll work for now.  It was trapped in my mathematical stupor that I let fly the phrase we try not to use with folks over a certain age:

“I’m from the Fire Department.”  Try as I might I couldn’t grab that back before she heard it.  It was cold outside and I am wearing my turnout coat.

“But there’s no fire here.  Who are you really?”  It was then that the EMT slid a chair from the other side of the room for me to sit and explain the mission of the modern fire service.  I had my iphone with me, I could have pulled up charts, graphs and pictures, but I decided to use our uniforms to my advantage.

“Officer, thank goodness you’re here.” I said to the EMT, conveniently looking like a police officer in his station duty uniform, sans coat.

“I want this man out of here!” She cried and I was starting to move when the ambulance crew arrived and, as luck would have it, a Paramedic intern walks in to take report.

Over an hour later we heard them on the radio clearing the scene with a non-emergent transport.  I can only imagine what tactics they employed, it could not have been easy.  I was lucky enough to make the woman happy by leaving.

Transient is defined as passing, or only in one place for a short time.  I try not to use this term when describing the homeless population in my area because they seem to flock here from other cities on the recommendations from those cities to head for “a fresh start.”

A recent emergency response illustrated this perfectly.

THE EMERGENCY

A basserby has called for a third party who sas she is having a seizure in the bus stop.

THE ACTION

Somehow, seizure calls seem to increase as the weather turns, but actual seizures seem to have no correlation with the increase in calls.  Our new friend supports my observations to date.

Sitting in the bus stop as the engine approaches, Federal Q siren blaring, our reporting party seems startled that a giant fire engine has responded.

HM – “Did you report an emergency?”

BT (Benefits Tourist) – “I had a seizure, I need an ambulance.”

We did our assessment finding, wait for it, no signs of illness or injury, so I expanded on the symptoms and history of current event.

Our friend begins to go into detail about her disability benefits for a bad wrist, which prevents her from working…at all apparently and I begin my holistic detective assessment.  She is wearing new construction type boots with clean edges, she hasn’t slept on the street yet.  Brand new backpacking style back pack, full.  Hasn’t been robbed or had to sell anything yet.  Removing her arm from a sleeve of the heavy Army surplus jacket, I notice it too has not been dirtied or stolen.

HM – “Been in town just a few days, huh?”

BT – “No, I’m from here.”

HM – “Lying to me makes me unhappy, let’s try again.  Where are you from?’

BT – “Indiana/Nevada/Montana” (You can imagine one)

HM – “Ah.  Do you have family here or work lined up?”

BT – “No, I’m here to make a fresh start.”

HM – “You picked an expensive crowded place for your fresh start.  Was here your first choice?”

BT – “I had options, but San Francisco is the City of Love.”

HM – “Actually I think that’s St Paul, Minnesota.  Anyway, did you really have a seizure or is that just how you’re used to getting services where you’re from?”

BT – “I didn’t know who else to call.  There’s no outreach at the bus station.  How am I supposed to get detox?”

Watch out, other shoes are falling like rain.

I explained that regardless of how it’s done back home, we operate a little differently.  We have the resource available to activate a free van ride to a local shelter, provided the person is able to walk and get into the van unassisted.  The person also has to wait, something more and more of my clients are unwilling to do.  30-40 minutes for a free ride?  I’ve waited longer for a city bus where I used to live.  And then I paid for it.

We made the appointment for the van ride and I took this opportunity to have a chat with my new friend.  I recommended using the services she needs here, then returning home, provided it is a safe environment.  I’ve learned over the years that some folks can only escape abuse by running as far as they can as fast as they can, so sending folks right back home isn’t always the answer.

We gave her a blanket, partly to keep warm and mostly so the van can spot her amongst the commuters using the bus shelter as a waiting point for the bus.

In all reality she likely wandered off before the van arrived and will call again when she gets hungry or tired.  She’ll learn that from the others she is likely to gravitate to while here.  In the process she’ll lose the nice backpack, warm clothes and rugged boots.  All because someone somewhere else wanted her gone and was willing to give her a bus ticket instead of addressing her issues close to home.

I’ll go into more detail soon about a great program we used to have that dealt specifically with issues like this, but was shuttered when the budget axe came swinging.