Dancing in
Dreamland
Memoires of a Post-Neo Dharma Bum
and
Confessions of a Mad Philosopher
Jesse Jones
Table of Contents
Prologue
Memoires of a Post-Neo Dharma Bum
One Man’s Meat
About Tonglin
It’s All in the Moment
The Last Raccoon in Central Park
Somewhere Between Nothingness and Eternity
Introduction
Freedom
Fun and Games
The Chicken, or the Egg
Nobody calls 911 Just to Say Hello
Why it’s all Fun and Games
Confessions of a Mad Philosopher
Enlightenment is Not the Everlasting Kiss
If you want a Happy Ending
Tigers above, Tigers Below
Clyde and the Tree
Would you die for your Beliefs?
If you should meet The Buddha
Dreamland Dancing
Would You Kill for Your Religion?
(Yet Another Digression)
Would you Live for Your Beliefs?
Form Is Form, Emptiness is Emptiness
The Frog Sings, but Gives no Wool or Milk
Modes of Transport
Special Circumstances
Form is Emptiness, Emptiness is Form
Miguel and Sonja
The Tables are Turned
Neither Matter nor Energy
No Form, No Emptiness
Wheels Down
To Be the Hero of One’s Own Hero
Love and Marriage
Is It Possible to be Afraid of Too Much Truth?
The Mouse eats Cat-Food, but the Cat-Bowl is Broken
A Career in EMS
The Mouse eats Cat-Food, but the Cat-Bowl is Broken
Déjà-What?
We Judge Others by Their Actions
If All Things Return to the One
Stella Wakes Up
Shark-Filled Waters
Three Hundred Channels…
A Fix-Up Life
If You Are Going to Save the World
War Stories and Fairy Tales
Drug Abuse
Celebrity Quirks and Co-Incidences
High Above the Republic
Real vs. Symbolic Power
Arrival
Assessment and Report
Perspective as it Influences…
Code Blue on the Ninth Floor
The Tables are Turned
Conservation of Mass and Energy
Meanwhile, Somewhere in Ft. Lauderdale
Love and Marriage
My Eternal Beloved
Real vs. Symbolic
Assessment and Report
Perspective as it Influences your Plan of Action
Code Blue on the Ninth Floor
Life on the Road
A New Wrinkle
The Importance of Re-Assessment
The Cavalry Arrives
Go With the Flow, Don’t Piss Off the Locals
Transportation of the Sick and Injured
Amazing Grace
Comparative Diagnosis
El Hospital
God Gives Us but One Face
World Peace
The Performance
Love/Hate
That Which Passes for Philosophy
Good Acting Is Not Bad Medicine
Outside the Box
Memoires of a Post-Neo-Dharma Bum
More Like A Short Conclusion
Would You Die for Your Beliefs?
Casual Criminals
Outlaws
Your Standard of Living
Impermanence
Until You Can Remember
Faces of Death
No Way to Treat a Lady
No Last Kiss
We Own the House of God
Transfer Logistics
Rewind
Improvise, Adapt, and Overcome.
Logistics, Logistics, Logistics
Or Else
Re-Animation
Perpetuate your Illusions
More a Matter of Image Than Principle
Wheels Up
The Point of No Return
Confessions of a Mad Philosopher
Your Entire Life is an Illusion
Who Will Protect Us from Our Protectors?
The Best Justice Money Can Buy
Deconstruction and Displacement
God Gives Us But One Face
Shrimps that Sleep
Something is Happening
Back to Business
Are There Any Beliefs for which You Would Die?
Three Card Monty
Diversion
You Always Do Everything the Hard Way
The Long Way Home
You’re Not a Real Paramedic…
How Can You Tell?
(More Memoires of a Dharma Bum)
How Many People?
There are Things Much Worse than Death
All Too Often….
The Boulevard of Lost Memories
For Those Who Feel
Your Conscience
Seeking Enlightenment
If You Think Death
One Big Family
Author’s Note
Never Underestimate
The Answer to the Question
Zero
Post-Neo-Survivalist
The End
The Snake only Sheds its Skin
Is There Enough Heaven?
Is There Life After Zen?
Hellfire and Damnation
Some People Hear Voices
Final Confessions, Rants, Lost Rights, Last Rites and
Wrongs
Prologue
One Man’s meat is another man’s Poison.
One Man’s ceiling is another man’s Floor.
One man’s mate is another man’s Person.
One man’s Princess is another man’s Whore.
Data is not information; information is not is not logic; logic is not
truth; truth is not wisdom; wisdom is not beauty; beauty is not love;
love is not music; music is not data. (Apologies to Frank Zappa.)
And (inhale)
Five (exhale).
And (inhale)
Four (exhale)
And (inhale)
Three (exhale)
And (inhale)
Two (exhale)
And (inhale)
One (exhale)
And (inhale)
Zero (exhale)
Repeat, prn.
(Zen Breathing Meditation Technique, Tonglin Practice)
About Tonglin
We instinctively cling to joy, and try to avoid sorrow, or anything
unpleasant. In the process, we make fearful babies of ourselves.
During meditation, while counting down to zero from five as they
breathe in and out, many practitioners of Zen Meditation try to
breathe out the Sorrow and Pain, and breathe in the Love and the
Joy. This is a very good thing, but it is not the only thing. It takes the
heart of a true Warrior to breathe in Sadness, Disappointment, Pain,
and even Death, and breathe out Love and Joy.
I was introduced to Korean Zen Buddhism sometime during the
Nineties by a friend and EMS associate who shared our mutual
general interest in Buddhism in general and Zen in particular. One
book centered upon the teachings of Tonglin practice. It is called
Dropping Ashes on the Buddha. Tibetan Buddhism and Pema
Chodron’s The Wisdom of No Escape were also major influences at
that time.
In my own experience, first, I meditated about external Sorrow, the
Sorrows of the World. Racism, Hatred, Ethnic Cleansing, Fear, Guilt,
Shame, Greed, Envy, Jealousy, Intolerance, Malice, Ignorance, and
Cruelty swarmed upon me like malevolent disembodied spirits in a
haunted house. As I struggled with visions bred by both personal
experience as well as news headlines, I felt like I was having my
breath sucked out of me, as the really terrifying realization of how
overwhelming the personal sorrow and disappointments in my life
had become.
I had railed against the Principles and Theoretical Constructs that
embodied External Sorrow, perhaps to distract myself from the nature
and degree of my own personal suffering. I felt unable to
acknowledge any Joy, and as I began to acknowledge the extent of
my own self-doubts, it became increasingly difficult to believe or take
any comfort in believing that anyone really loved me.
All I could do was try to focus on my love for my children. Fear
overtook me again, as I realized that I was far from my own parents,
who were not long for this earth. Too many years had slipped through
our fingers, and a lifetime of regrets and disappointments that could
never be set right were coming to an end, and I was powerless to
even go visit them, as my own level of impoverishment had reached
an all-time record. I thought: “I guess that’s just the way it is. Your
children grow up and leave you to die alone.”
Depression and Despair overwhelmed me. I felt empty. I was gripped
with fear of having no Love to call upon to breathe out. I did not feel
any anger or hatred. I was paralyzed, like some Haitian Voodoo
Zombie. I came to realize how completely my marriage was failed,
and how immersed in denial I had been about it, but I could not even
feel anger concerning my bitter disappointment over losing the Love
of My Life. Already the Arrow had Passed Downtown.
I try to think of Reasons to Carry
On
I can think of Nothing.
I try to Think of Ways to keep
going
I come up with Nothing.
I try to Imagine Someplace Else
I can think of Nowhere.
I haven’t the strength
To even Care.
I had become an empty vessel, if only for a moment. What happened
next can only be described by a childhood memory of the terrified
fascination with which I had watched the recently released motion
pictures that had been taken by the Army during the testing of the
Atomic Bomb. I remembered an old clapboard two-story house. The
initial shock wave destroyed the house piece by piece and blew it
away as if it had never existed in the first place, even blowing away
huge amounts of soil, burning everything, and fusing the sand into
glass. Then, like a hurricane whose eye has passed over, the
tremendous winds reversed direction with at least equal force. Those
test sites were referred to by the codename Dreamland, the same
name used for radio transmissions from Area 51.
I felt the same sort of fascination and terror as I realized that the Blast
that was hitting me was the realization of my Life, as if it was
returning to me. More visions and memories than I had ever dreamed
possible, let alone remembered, that had been the Gestalt of my
existence thus far, and glimmers of recognition of past, as well as yet
unidentified experiences, more like Feelings of Empathy for strangely
familiar, but previously unknown existences.
Next came the first shocks of realizations of all the Deepest Secret
Fears that I had been suppressing for nearly fifty years. I was staring
down the Great Realizations I had subconsciously avoided facing,
and they were staring back. Imagine suddenly realizing that the
feeling of Déjà Vu that I had believed to be a precursor of some great
epiphany turned out to be a deep-seated impulse to recoil from facing
those Fears.
It must be different for each of us, but for me it started with realizing
that everything I did was impermanent, and probably inconsequential
in the scheme of things, even within the next hundred years here on
earth…I wondered how many worlds there were elsewhere. So many
planets and suns, in so many galaxies in our known universe…even if
God did not exist, it’s a miracle beyond the probabilities of pedestrian
mathematics that we are here, and alive, and yet with infinite time
(oxymoron) and nearly infinite opportunities, it is also inevitable that
there would be life on other planets. In fact, for the estimated number
of planets similar to ours in the known universe, it is quite improbable
that there would not be life on other planets just by random chance.
What is Life? What does it mean? What is our purpose? What is
Time? From where did all that original Matter and Energy come? I
questioned every activity in which I had participated in terms of why I
did what I did. What was based on Assumption? On Image? Habit?
Socialization? All activity of any kind was simply Passing the Time as
we tried to delay the inevitable.
Then it came to me: Here I am, preoccupied with Death, and making
Death as the World, preoccupied and hypnotized by the unexamined
Life, writhes in Suffering, overcome with Desire, seeking only
Pleasure…If the string is too taught, it will break…if too loose…it will
not sound. Find the Middle Path.
I was overwhelmed. I felt as equally indifferent to the impending
Doom of all of our mortal existences as I did exhilarated in
anticipation of what lies before the end of the road. My regrets only
fueled my determination, having realized the incredible richness of
experiences thus far. As much for the sake of my sins, as well as my
salvation, I was renewed.
It’s All in the moment.
The Moment is All.
The Ever-Present, Never-Present
Moment.
Although neither my financial or romantic status at present have
improved, and could just as well get worse before they get any better,
my enthusiasm has returned. Not to argue, but to understand. Not to
fight, but to prevail. Not so much to gain, as to be content with what I
have, and how I am. Right here, right now. Face your Demons. Make
them your Friends, Pets, and Lovers. Face your Sorrows and find
your Solace.
Most of my life has been lived, not so much as an imposter as an
actor. Not so much a hobo, as a Nomad. A college-educated Tramp.
A Knight of the Road, if not the Realm.
Many of us would try to perfect Logical Rationality, while others would
utilize Emotion and Feelings to control and shape their worlds. As
systems, they define the behaviors of those who would manipulate
them, failing to realize that either approach is simply and most
basically a system of rationalizations to do whatever it is you wanted
to do in the first place, which is to say, to follow one’s nature.
In the end, we all seek in one way or another to manipulate our
environments to our satisfaction. Beyond that, the personae of those
subjective environments are as diverse as a cabin in the woods is to
a high-rise apartment in the city.
I Feel like the
Last
Raccoon in
Central Park.
My heart and my brain are on honeymoon, dancing to the Music born
of Fire by Friction between Love and Logic, Romance and Reason in
a place called Dreamland.
Life is a song about a dream. If Art imitates Life, how is it possible
that the Creation exceeds the Inspiration? In some ways, it frequently
does. A song about being in love allows us to project our feelings
using the vehicle of the song to do our own interpretive waveriding.
The song only focuses our attention on what the singer wants you to
experience, so it is not Love; it is a Song about Love.
Sometimes Love is a song about a Song about Love.
Happiness is a choice.
As humans, we are an enigma of self-awareness and oblivion.
Self-awareness can be unbalanced by self-consciousness.
Step away from yourself and you step closer to God. Step away from
God, and eventually the emptiness and stillness that precedes the
backrush of everyday life provides a moment of Clarity and Peace. In
it, all is stillness and nothingness. An interlude outside of time that is
shattered and consumed by the backrush…the return of Nothing
Special. As we dance in Dreamland, we are all dancing The Ghost
Dance.
Memoires of a Post-Neo Dharma Bum
This is not just a story about the air ambulance industry, because in
order to tell this story, seemingly random asides and references to
Emergency Medical Services and other background references are
necessary to lend perspective.
The central theme revolves around an air transport of a critically
injured man out of the Caribbean to more definitive care in Miami.
Jeff, the Lead Medic for the flight medical crew was also a major
contributor for much of the material presented herein, including tall
tales, bon mots, and rhetoric. Nevertheless, this is more than just a
story about one man’s life, or just that one incident. Within that
context, sordid details, flashbacks, rationalizations, and humorous
anecdotes are swirled together to provide an inside point of view,
which is at least, potentially more sympathetic. In this respect, Art
imitates Journalism, although the relationship between the
Participants, who were also the Eyewitnesses and the reporter are
purposefully blurred beyond recognition. The narration is done (with
considerable apologies) within the subtext of Zen Buddhism.
The apologies are offered to the true followers of Zen who have
devoted their entire lives to the study and practice of Zen Buddhism,
as well as to the readers who have not. Zen is, in my estimation more
of a practice than a religion, that embraces the Eternally Questioning
Mind, rather than devotional worship. In this respect, both Jeff and I
were more practitioners than devotees or True Believers. Also, my
opinions and observations are just that…they are my own, and not
official Zen doctrine, if indeed such a thing exists. In other words, you
may or may not agree…that is axiomatic to Zen, considering that one
premise of Zen is that…If you open your mouth to speak, already you
are wrong. This is at best, a view of Zen. The apologies to the
readers are prompted by the fact that although the numerous
references to Zen may seem to be either distracting or unrelated to
the story line, they are central to the state of mind of both Jeff and
myself in the same way that the references to Jeff’s marriage and
personal relationships did. Zen provided me the incentive, courage,
and perspective to assimilate the various cultural, emotional, and
spiritual shocks that I was encountering throughout that time.
Eventually, the eternal questioning not only led to my breakdown, but
also my eventual recovery. Zen is not necessarily for everyone, as it
does not offer much in the way of external comfort, sense of purpose,
salvation, or promises of eternal life in heaven. You may choose to
believe or disbelieve in anything, but whatever it is, you will have to
find it for yourself.
The Zen quotations are taken almost entirely from the sayings of
Seung-Sahn, a Korean Zen Patriarch.
The main character, Jeff inspired me to write this story when he told
me about what had happened on that transport. Several years
beforehand, another associate of ours had told me of plans to write
an assemblage of EMS-related stories, using a number of authors to
provide their input, based on actual experiences. He had asked me to
contribute any story of my choice, as he had often been entertained
by more than a few experiences that I had shared with him. Although
I fully intended to contribute, we both went our separate ways before
we had a chance to collaborate. Later, I realized that in order to make
a work like this possible, as well as accessible to non-EMS readers, I
would have to provide an inside perspective that would give readers
an opportunity to imagine, understand and empathize with the
situations that are described here. In most horror stories, you
empathize with either the heroes, or victims, but usually not the
monster. In this story, the heroes, the victims, and the monsters are
one.
For any number of reasons, that we will examine later, it goes without
saying that few normal people actually plan on a career in Emergency
Services, at least once they attain, say ten years of age or so.
Cowboys, police officers, firefighters, and paramedics are traditional
childhood heroes…at least until you begin to find out what those
careers actually demand of you. Most of us were driven to those
choices by any number of forces that made it seem like it was not
even a choice in the first place.
Once that first step is taken, everything that happens afterwards
changes you forever. Like the snake that swallows its own tail,
everything turns back upon itself. All thoughts, all beliefs, and most of
all, all words are as equally beautiful as they are ugly, and as perfect
as they are innately dangerously insane. The paradox of trying to
explain the sublime (or that which transcends words and
explanations) has never stopped anyone from trying to describe the
indescribable. Life itself is an enigma, a terminal condition for which
the only cure is death. Life will literally kill you. Desire is suffering, but
unless we learn to participate in it joyously, we will never come to
achieve any understanding of either. What’s more, as long as we
seek the attainment of understanding, we will never achieve it.
Truth, wisdom, beauty, or love, for instance, are in the eyes, mouths,
and hearts of their beholders on a moment-by moment basis, and any
idea, carried to it logical conclusion, is nonsense. The question
remains: why are we constantly arguing with each other (and
ourselves), instead of simply enjoying the moment?
This story is an attempt to capture a series of moments occurring
within several other series of moments. They are as connected as
they are separate, which is to say that in context, they need to be
viewed as one continuous event, as if it were held at armslength, and
at the same time up close, intimate, and personal, in the same way
that it was for the participants at the time it was happening.
Somewhere Between Nothingness
And
Eternity
We love to lust after things, all the while trying to avoid Suffering. In
so doing we continue to separate everything into Good and Bad. I
desired Enlightenment, so I suffered for it, so I lost my
desire….Imagine my surprise to discover…NOTHING….The stillness
between the blast and the backrush. Others are doing the Ghost
Dance in Dreamland. I am a lone observer:
An endless parade of
Witches to be burned
Virgins to be sacrificed
Communists to be purged
Holocausts
Ethnic cleansings
Crusades to be waged
Holy Wars
Patriot Acts
Cultural Wars
Each scenario precludes listening to the Lone Voice of Reason
screaming: “Are you fucking serious?”
No time to listen or think…we’re too busy stacking bodies.
The glut of prosperity of the Fifties led to the social unrest of the
Sixties. Those who have are no longer willing to risk it all for the sake
of those who have not. Everyone believes that they have too much
too loose to rock the boat, so our current economic depression
equals compliance. Only in America do you drive to the
unemployment office in a six thousand dollar car.
Introduction
It has been claimed that members of the crew of Christopher
Columbus’ three ships were responsible for introducing Syphilis to the
native and indigenous peoples of what was soon to be called The
New World. It would later be called America. They would soon be
called Indians, but contrary to popular myth, not because Columbus
thought that he was in India, since at that time, India was referred to
as Hindustan. He had, however, referred to them as “Una gente en
Dios” (a people of God) because he was impressed by their
profoundly spiritual nature.
Also, it should be noted that “Injun” is not a slang term for “Indian” but
rather a phonetic corruption of a word used by the Lakota Sioux to
mean Human Being. And, it was in fact a New World only to the selfcentered peoples of Europe, but I digress….
I mention this because it is not without a certain degree of trepidation
that I find myself writing this introduction. There is a high degree of
certainty that many people will find themselves highly offended by
any number of remarks, statements, or even casual references made
within the following story. Some might even consider it Dangerous….
There was a time when we had a much better sense of humor about
ourselves, and even giving offense was much better tolerated than it
is now. Then again, like the difference between inference and
implication, if those of us who find ourselves so easily offended in the
first place would take responsibility for our own actions and regard
the process as taking offense, then we might more easily shed this
mantle of self-righteousness that is causing us to lose our sense of
humor, as well as our capacity for tolerance.
While the United States was seriously considering the boycott of
Venezuelan Oil, simply because their presidente referred to our
president as “El Diablo” I realized that we were in fact in dangerous
waters indeed.
At least at the time of this writing, there is no universal rating system
for books. At least not yet, but the current state of affairs will
undoubtedly get much worse before it gets any better. No one with
whom I would seek rational discourse pays much attention to
Religious Warnings.
On a certain level, I would be a little disappointed if this book was
NOT banned in Boston. Regardless, I would suggest that this
introduction be also considered either a warning, or disclaimer, if you
will, for the thin-skinned, the narrow-minded, and the weak of heart,
(and sadly) of humor.
Regard this writing in the same way that you would one of cable TV’s
darkest, most profane, sexually provocative, and dangerously
controversial episodes imaginable. This story is only for mature
adults with a broad-minded sense of humor. If you believe yourself to
be one of these increasingly rare individuals, then you will probably
enjoy this story, but it is by no means any guarantee that you won’t
still find yourself either uncomfortable, offended, abraded, or
provoked at one point or another. Fritz Pearls frequently said that
there is no growth without pain, and I believe that if you really are a
mature, broad-minded adult, then you will have nothing to fear,
because it is fear that has so empowered the manipulators of our
culture who are the self-proclaimed protectors of the weak. There is
no reason that a story cannot be both entertaining and culturally
significant at the same time, but if all else fails, just consider it as
entertainment.
The first drafts of this book began about seven years ago. Three
years into the venture, Jeff, the protagonist, and mentor/technical
advisor as regards Emergency Medical Services, as well as War
Stories in general, took his life, after suffering profound depression for
years. His widow no longer speaks to me.
Sometime thereafter I suffered a nervous breakdown, and was forced
to “rely upon the Charity of friends” before I could get a grip again. All
during that period of time, I wrote profusely, but very little of it was
coherent enough to be of any use at all. Nonetheless, I do believe
that those rantings helped me find my way back out.
Most of the writing (as well as the drowning) took place in real time,
insofar as I often had no idea how any individual writing session
would begin or end until it was already being written. That is not really
as surprising as it may seem.
The story, i.e. The Narrative in terms of physical action is relatively
straightforward. The dramatic action has a lot more twists and turns
to it, but it is still on that level, largely plot-driven. As reader/viewers, it
is very easy to become jaded as to how one might regard the real
effects that most of those experiences would have on real people’s
minds. I wanted to expose the reader to experiences and states of
mind that would more easily explain how a once-normal person
makes decisions that lead to choices that a normal person would
probably not want to imagine, let alone choose. That has everything
to do with state of mind. And because I believe that each of us can
empathize with momentary states, or potentials for unhappier sorts of
results, than you could have experienced yourself, I also believe that
you will be drawn into just such a preposterous series of described
events as easily as I was, and but by the grace of God...any of us
might go.
I also know that there are many of us still out there, regardless of
social privilege or economic station, who still are haunted by those
vagabond impulses of humor, and sexuality, like St. Elmo’s Fire, or
the Aurora Borealis, just zapping from here to there like aberrant
radio waves of Music You Never Heard Before but were instantly So
Damn Glad That You Just Did. The Music of the Survivors. The
Symphonies of the Post-Neo Dharma Bums.
With a decade and a half of dangerous living culminating in twenty
years of EMS experiences, the picture is still incomplete without
realizing how it is that of those worlds either can be alternately
foreground or background to the even larger picture of One’s Own
Life.
In my case, this represents the chronicle of my quest to discover if
there really is Life after 911. Although my experiences may have
been extreme, they are far from as isolated as they should be. Keep
in mind, EMS providers are masters of denial, as well as disguise as
regards hiding their symptoms and signs.
This is a story of crisis, of disappointments, of Loss, and Confusion.
Huge Critical Stress Incidents overlaid on a backdrop of debilitating,
Chronic Stress.
Out of my delirium grew a realization, an elusive and undefined
feeling that somehow, I had been given a gift, even if it was only the
ability to recognize the third lifeboat, in spite of the fact that I had no
idea where the lifeboat would take me, or what was waiting for me
there. (Reference to the drowning man who prays for God to save him, all the while turning
away three rescuers while awaiting the arrival of the Almighty in Person)
As time passed, and situations deteriorated further, my zeal waned.
Answers were replaced by questions without answers, but since all I
wanted was to finish the book, I failed to recognize how that which
passes for truth usually only answers improper questions that were
no use at all in the first place. It had become just another story about
something. I thought that the disintegration of my so-called Life had
no real bearing on anything but my own misery. I did not realize that
in order to find the answers I sought to my questions, I would have to
open Pandora’s Box, and in the process face a Cure more debilitating
than the Disease. (Anyone who has listened to, or read the potential side effects, Benefits
vs. Risks, and general precautions listed for most prescription medications knows this is not as
uncommon as it sounds. It just all depends on how you feel about trading Halitosis for alopecia,
neutropenia and ‘certain’ (unspecified)’…sexual effects’…. Don’t worry, if those effects included
hypertrophy, Priapism, or gave you the stamina of a satyr, IT WOULD SAY SO IN VERY LARGE
LETTERS, IN NON-LATIN WORDS AND COST MORE MONEY THAN YOU COULD AFFORD,
BECAUSE YOUR INSURANCE WOULDN’T COVER IT.)
This is a story about my search for The Cure, as well as how to
survive it.
The book was floundering in shoal waters, largely because I had at
that time begun to believe that this was indeed, a dangerous book, at
least to me. Inadvertently, I had asked myself questions for which I
could find no answers. Although I frequently read the more comical
sections of those drafts to my children, either to amuse them, or tell
EMS War Stories in the great American tradition of the Tall Tale,
many sections were never introduced to them at that time. I was very
much concerned about the effect of the entire book upon them. I am
not sure anyone less than eighteen years of age should read it. Some
days I still think of it as a dangerous book.
In truth, there are no real dangers. Lies are dangerous. Denial is
dangerous. Fear is dangerous.
Freedom involves Risks.
Freedom is frequently
Dangerous,
Noisy,
Inefficient,
Disorganized,
Irresponsible,
And Selfish
(…but there is a down side….)
And Yes Virginia, It
is all Fun and
Games until
somebody puts an
eye out….
(Then it’s time to call 911)
,
Ever since I began working EMS people have always
asked one question. “What is the worst call you ever ran?”
That is a tricky question for several reasons. First, there are
just so many different types of really bad calls, depending on
how you judge or categorize them. Many of my associates
would call them good calls, meaning that they were
challenging or may have provided excellent opportunities to
utilize their best skills. Aside from challenging vs. boring, the
worst calls would be categorized into something like:
 The bloodiest, or the most disgusting, in terms of common
standards.
 The most heart wrenching or emotionally disturbing.
 The Strange, The Weird, and The Peculiar.
 The most dangerous or challenging rescue operations.
 The Stuff People Put up their Asses.
The bloodiest calls would be anybody vs. a train. The train always
wins. Trains literally deconstruct their victims. One or two passengers
inside a car hit by a train can provide more than enough gore and goo
to completely coat the inside of the vehicle with the insides of the
passengers. Same thing goes for anyone who falls more than three
stories, especially onto concrete. Not that it matters much, as the
decelerating injuries onto any surface, even water, can explode the
internal organs. Eviscerated bowels and brain matter are especially
disarming, although the most initially disarming thing I ever saw was
a prolapsed uterus secondary to a motor vehicle vs. pedestrian
accident. Nevertheless, for Bloody/Gory/Disarming all at once, you
can’t beat any suicide involving a twelve-gauge shotgun.
The most heart wrenching would have to be pronouncing a fifteen
year-old boy dead after he shot himself in the chest with a shotgun.
The family discovered him in the bathroom upon return to their home.
Our job was to obtain an ECG strip, and write a report on our findings
in order to pronounce him officially DOA. In the ten or so minutes I
was in the house, his family was in the living room with several
detectives. Just remembering hearing their grief makes me choke up
even now, twenty years later.
The strangest and weirdest calls usually involved drag queens,
although I do not say that in derogation. My previous life experiences
involving The Arts, Music, and Theater as well as Education provided
me ample opportunities to experience and observe Gay, Lesbian,
Transvestite, Transgender, and Cross-Dressing individuals in a much
more unguarded and “natural” state, where acceptance and
understanding were considered de rigueur. Indeed, in those settings I
frequently felt like an intruder into their world, like Jane Goodall
among the chimpanzees. If I was going to learn and prosper within
the setting of a foreign and often closed culture, I would have to
check my prejudices at the door if I intended to be tolerated and
accepted as an unobtrusive observer. That having been said, there
were still occasions within the framework of rescue operations, when
I was unprepared for the sort of surprises that a career in EMS has
the opportunity to provide, like…
“Med Three to XXXXXX Hospital Medcom.”
“This is XXXXXX Hospital; go ahead.”
“Show us in route to your facility with an unconscious, unresponsive
female in her mid-thirties who was involved in a high-speed, head-on
motor vehicle crash with significant front-end deformity to both
vehicles and marked intrusion into the passenger compartment. Seat
belts were in use and both airbags deployed with mild to moderate
contusions and abrasions to the face secondary to the airbag. Patient
is negative for obvious deformities, frank hemorrhage, or compound
fractures…Uhhh…(long
vocalized
pause,
slightly
off
mike)…What?...(another long pause)…Update to follow shortly….”
“Correction. We are in route to your facility with a mid-thirties MALE
involved in the previously described motor vehicle crash….”
In the course of conducting the secondary exam and survey, which
involves removal of clothing to inspect for occult injuries, it was
discovered that the patient had a little something extra to present for
which the medic was just not prepared. Of course it did not change
the treatment or level of care which the patient received, at least not a
few miles north of Key West…I wouldn’t care to speculate about Utah
or Montana, however.
In the Sixties and early Seventies, when mind-altering drugs like LSD,
mescaline, peyote, or psilocybin mushrooms were commonly used,
and marijuana use was almost assumed, the more untoward
reactions could frequently be managed by counseling in a quiet, nonthreatening atmosphere. The occasional violent or overtly psychotic
reactions were usually managed by Thorazine administration, but
were relatively rare. I remember. I was there in the thick of it. By the
Eighties and Nineties, Cocaine, Crack, Ice, PCP (Angel Dust),
Heroin, Ketamine, Quaaludes, Rohypnol (Rufies), MDMA (Ecstasy),
THC, Valium, Halcion, Amyl Nitrate, and many other legal, illegal, or
even designer drugs were readily available everywhere. Their use in
the Gay community was pandemic.
Drag in itself involves a great deal of fantasy, imagination, and
varying degrees of the Willing Suspension of Disbelief, especially in
Gender Dysmorphic individuals who believe that they are a woman
trapped in the body of a man. The Club Kids of the Eighties carried
costume to the extreme, even masquerading as aliens or animals.
Drag has everything to do with State of Mind. When you stop and
think about it, there isn’t that much difference between a Civil War reenactor and a drag queen. One uses black powder and the other
uses face powder. One is primarily concerned with muzzle loaders,
while the other employs both muzzle loaders and breech loaders
freely. Both involve fantasy, masquerade, and costuming. For the
Civil War re-enactor, the drug of choice would invariably be alcohol,
(preferably after the performance), but with drag queens, you had to
add the possibility of unknown quantities of unknown medications
with almost limitless possibilities for synergy and/or cross-reactions,
and it could make for some of the most bizarre and unnerving
encounters and conversations you can imagine, at least in the
Eighties and Nineties.
One particular evening, we were dispatched to a report of a naked
woman walking down the median strip on Los Olas Boulevard in Fort
Lauderdale. Upon our arrival, police officers transferred custody of a
somewhat delirious recently post-operative transgendered individual
intent upon showing “her” goodies to anyone who was interested,
consequently accusing anyone who even looked remotely in her
direction of being either gay or bi-curious…Of course I
looked…besides, it was part of my job, right?
Another time, during Spring Break, we were dispatched to a bar on
the “Strip” in Fort Lauderdale referenced “unconscious person”. Upon
our arrival, we were presented with a heavily mustachioed male in his
early thirties lying on the floor dressed in black motorcycle boots and
cap, as well as a black leather motorcycle jacket covering a pink
ballet tutu. Although it was the first time I had ever encountered such
an incongruous mix of clothing styles, no one in the bar seemed to
pay any special notice. In fact, they were all standing around him
drinking and talking as if it was the most natural thing in the world, at
least at that bar. I recall they said he was a regular.
Not all of these categories are clear-cut by any means. One call in
particular managed to encompass strange, bizarre, peculiar,
disarming, and bloody/gory in an instant.
We were dispatched to the southeast edge of the county just south of
a major interchange of three major highways that was still under
construction. We were unfamiliar with the new roadways as they now
involved circular on and off ramps, elevated sections, and were not
especially well-marked as to exactly where you were at any given
point, lacking even mile-markers, although the new exchange was
just recently opened to the public only days before. The call was
referenced simply “signal twenty” (psychiatric), which also became
the label we used to refer to the patients we treated. Upon our arrival,
we saw both Highway Patrol and County Sherriff’s Deputies standing
near a naked man behind a maroon Buick Cutlass with the trunk lid
open. The man was obviously distraught and sweating profusely, in
spite of the fact that it was about three am in December in South
Florida, or that he was unclothed. His hair was disheveled, and his
gestures were exaggerated, but the look in his eyes was clearly one
of a totally irrational being. When the officers got too close, he would
start to become even more agitated, so as a result, one deputy stood
about three feet from him as he attempted to reason with the man, as
they others stood back, so as not to crowd him. The high intensity
sodium vapor lights cast a sort of flamingo-pink hue down upon the
scene as our stark white Halogen headlights provided an
exaggerated modeling effect upon the group, like Caravaggio on acid.
The pulsating red, white, and blue strobes of our combined
emergency lights created a disarming final touch to this vision of one
man’s personal Hell.
As we arrived, and took our stretcher out, we tried to approach the
subject as unobtrusively as possible, given the bizarre scene
encountered, as we did not want the patient to feel any more
defensive, or become alarmed by our approach and perhaps run out
into traffic. The officers involved were clearly nearly as uncomfortable
as their suspect, and couldn’t wait to relinquish responsibility of this
naked madman to us. Without warning, he suddenly spun around
towards the trunk of the car and slammed the lid down violently as he
howled a blood-curdling scream. As the cops attempted to subdue
him, he spun around again several times, trying to avoid their grasp,
revealing that he had indeed slammed the trunk lid down upon his
penis and scrotum, inflicting a guillotine amputation which was now
spurting blood from a severe arterial bleed. They reflexively jumped
back, but were nonetheless soaked by the blood spray, although they
quickly regained what was left of their composure enough to subdue
him sufficiently to secure him to our stretcher using twisted, knotted
sheets rather than handcuffs, as was our practice in those days,
since he was now our patient, rather than their prisoner, and state
regulations did not allow us to carry the leather restraints normally
used in hospitals.
Once restrained, our treatment predominantly involved applying bulky
surgical dressings to the affected areas with very firm direct pressure.
The patient was in serious danger of exsanguination in a very short
time without definitive treatment. Emergency treatment also involved
establishing two large-bore intravenous lines running lactated
Ringer’s solution at rate sufficient to maintain a viable pulse and
blood pressure, and high-flow oxygen administration. Since the
intravenous crystalloid fluid administration is a volume replacement
only, it does effectively dilute the remaining blood supply, which is
why it has to be done judiciously so as to not force out the remaining
blood. Add to this the further complication that I was obligated to
apply continuous pressure, and that immediate transport could not be
delayed by IV administration, or that I needed to maintain the
presence of mind to request the officers on scene to unlock the trunk
to retrieve the amputated part before we left (which they were none
too keen on touching) or the fact that we were all drenched in blood
within seconds, and you can easily see why this call still remains on
my top-ten list of worst calls, no matter what your criterion. To the
best of my recollection, that was at least the first time I was obligated
to grab (and hold) the crotch of an insane man. It would not, however
be the last time, but that is another story for another time….
The most revolting call involved being dispatched reference “worms”.
Upon arrival, a small boy about ten years old came out of the house.
We asked if anybody had called 911. The boy nodded. We asked if
they called because of worms. The boy nodded again. We asked if it
was he. He nodded a third time, and then opened his mouth to reveal
pinworms crawling up his esophagus and into his mouth like a
handful of angel hair pasta.
Challenging and dangerous rescue operations that stand out in my
mind would involve extricating a shooting victim in the middle of a riot,
water rescue of a motor vehicle crash victim in shark-infested waters
at night, and water rescue of a baby from the back seat of a car in a
canal.
The first call was dispatched as a man down secondary to gunshot
wounds. On arrival, we discovered that a half-dozen sheriff’s deputies
were on scene in a vacant lot trying to disperse a mob of what looked
like a hundred or so people, and a man lying face down about twenty
feet away. We had no idea what was the relationship between the
shooting victim and the crowd, but they were extremely agitated, and
would probably have overrun the deputies, were it not for the
presence of three or four canines who looked like they couldn’t wait to
take a bite of fresh meat, as well as the shotguns the deputies were
brandishing in a most menacing manner. We arrived in a squad unit,
and our ambulance arrived separately with two EMT’s to assist.
In a situation like this, even the most basic assessment procedures
will be done later. For now, the object is to “swoop and scoop” to
safely remove the victim from the crime scene. There was no
additional information as far as what events had precipitated the
shooting, or even if the shooter was still on scene, or somewhere
close enough to still represent a threat. Full trauma precautions
involve spinal immobilization with a “Philly Collar”, a long spine board,
and cross-strapping. In less than a minute, the four of us log-rolled
the patient onto the board and carried him into the ambulance, which
was parked in the middle of the lot. My partner quickly transferred our
ALS gear into the ambulance via the side doors as I prepared to work
the patient, assisted by one of the EMT’s who arrived with the
transport unit. Everyone was very excited at this point, and
unbeknown to the driver, my partner was still standing between the
two open side doors. Suddenly, the driver put the unit in gear and
floored it. The driver also did not realize that the right side of the unit
had been parked much too close to a no parking sign, which he
sideswiped, knocking the door shut, and narrowly missing my partner
in the process.
The victim was in full cardiopulmonary arrest, although strangely
enough, there was little blood on scene, and only two very smallcaliber bullet wounds in the middle of both deltoid muscles, almost
identically placed. Later X-rays revealed that one of the two wounds
was an entrance wound, and the other a very non-characteristic exit
wound. The bizarre part of this scenario was that the path of the
bullet went from entering at the deltoid muscle, glancing off the
scapula, ricocheting off the base of the skull into the first two cervical
vertebrae, which it vaporized, only to finally glance downward, off the
opposite scapula, and out the other deltoid muscle. This kind of injury
is characteristic of the .223 caliber bullet used in the M16 assault rifle.
Regardless of where the bullet enters, it can tumble and ricochet all
over the body, and exit almost anywhere.
The water rescue was necessary to locate a MVC (Motor Vehicle Crash)
victim who had been ejected from an eighties-era Trans-Am through
the T-top. We were first on scene; it was after eleven P.M. and I was
new to the area. The driver stated that his friend had been ejected
into the water. There was blood everywhere on the passenger side of
the vehicle. I immediately grabbed a mask, snorkel, fins and a light
and went into the water. About thirty yards from the shore, I found the
victim floating face down in chest-deep water. He had no skull above
the eyebrow line. I brought him to shore about the time the volunteer
firemen arrived. They later told me a story about a legendary
hammerhead shark, a behemoth over seventeen feet long that was
often known to inhabit that particular stretch of water, and had
terrorized anglers and local residents alike for years.
The last rescue was referenced car in canal. On arrival, we found a
Florida Power and Light employee and several bystanders trying to
use one of the poles the employee had on a trailer to try to wedge it
under the vehicle to prevent it from falling completely into the water.
Along this stretch of road, the canals are dug into bare coral rock,
with sheer walls, almost twenty feet deep, and about as wide as the
length of the car. The back wheels were still on land as we arrived,
but shortly afterward, the car rolled off the pole, and started to go
nose-down into the water, Although the mother had jumped clear of
the driver’s seat, her baby was strapped into a car seat in the back.
My partner immediately jumped into the water and swam into the car
as it disappeared from sight, only to surface several moments later,
holding the child.
Eventually, the last subject will come up, if there is sufficient time,
booze, or weed to provoke such discussion. People frequently ask it
a great deal more often than you might suspect. It seems like
everyone has heard of rumors about it, but no one seems to claim
having personally known anyone to whom it has happened, and NO
ONE EVER admits to having had to call 911 because of something
they stuck up their ass, although on more than one occasion, I have
suspected that it was more than just idle curiosity about an urban
legend that prompted the question in the first place. “Does that really
happen? Have you ever seen anything like that?” and my own
personal favorite “Is that actually possible?” all tend to make me
suspect that what they really want to know is “Could that actually
happen to me?”
In case you are still wondering, the answer is yes. As regards softer
and less dangerous objects, (like dildoes, cucumbers, and those
embarrassing looking squash you see in the grocery store) the main
principle is What Goes In, Must Come Out, at least eventually. Pain
and fear usually provoke panic, which will produce muscle clenching
enough to thwart initial removal. ER treatment is usually centered
around getting the patient to relax long enough for nature to take its
course, but I know of a surgical RN who has a sort of rogues’ gallery
of Xerox copies of x-rays of pickle jars, bottles, a thermos, and
similarly dangerous objects that did have to be surgically removed.
Add the challenge of emergency extrication and what we call
disentanglement if the patient has managed to squeeze the faucet
from their bathtub up there while it was still attached to the wall…
(and yes, that really did happen).
The Chicken or the Egg?
There are numerous references to both Zen Buddhism and
Emergency Medical Services throughout this story. They do
represent pivotal points of reference, if not an actual horizon line
within this account.
Although the author is experienced in both subjects, he does not wish
to be considered a spokesperson for either of them, any more than
they would want him as a spokesperson. He also does not consider
himself to be religious; religion demands too much commitment, due
to its essentially political nature. Spirituality, on the other hand,
demands only that one should pay attention,
The members of the EMS community seem more prone to regarding
their realm as sacred than do the followers of Zen. It is in fact the
separation of religiosity from Zen that distinguishes it from the rest of
Buddhism. If you don’t try to label and judge anything as either
sacred or profane in and of itself, you just might be able to strip away
a few of the Illusions, like the Dance of the Seven Veils. At least, that
is the author’s contention, although he would himself encourage you
to decide that for yourselves.
There is a frequent flaw in logic that is referred to as sic hoc ergo
propter hoc, meaning after this, therefore because of this. The author
claims not to remember which came first. Regardless, of any
speculation over the chicken or the egg, it is the author’s contention
that although his involvement with Zen as well as his career in EMS
did influence each other significantly, they should be regarded as
nothing more than a series of interestingly appropriate coincidences.
Although parallel lines never intersect, once you see the connectivity
of everything in the universe, Cause and Effect represent one field of
view only. Everything else is both connected and separate. Even
coincidences are perhaps more accurately regarded as influences.
One of Jeff’s mentors, “Fat Tony”, was an ex-partner in EMS and the
godfather of his eldest son. He used to say: “Everybody is a signal 20
(person with psychological problems), one way or another, but there
are good signal 20’s and bad signal 20’s. You gotta be crazy to be in
this line of work in the first place, but if you’re a good signal twenty
you can still do good things, and help some people in the process,
including the bad signal 20’s without getting hurt, or hurting anybody
else who doesn’t already deserve it. In fact, being a good signal
twenty can actually prevent you from becoming a bad signal 20.”
This was about the time that CISD (Critical Incident Stress
Debriefing) was just beginning to gain popularity. In the meantime,
advice and council such as this was handed down from generation to
generation as a way of protecting ourselves from The Madness…a
generation back then lasted about five years. By that time, the
squeamish and weak of heart were already culled from the herd, and
all that would be left were either seasoned veterans or the
dangerously insane, with varying mixtures of both. If you worked in a
busy system, you soon saw it all. Twenty years’ experience was more
like your first years’ experience repeated twenty different ways.
Much like a news cameraman, an EMS provider’s focus becomes
riveted on the perverse, the grotesque, the gruesome, and the
sorrowful aspects of the human condition.
Nobody calls 911
just to say Hello
Why It’s All Fun and Games until Somebody Pokes
out an Eye
Even in the busiest EMS systems in America, there is some down
time. The scarcer it is, the more precious it becomes. How you use
that time is largely a reflection of the character of the individual, and
may even be factored into your yearly re-evaluations during
recertification periods.
In the very busiest downtown urban zones, there is a minimum of
activity until perhaps as late as 3 PM. If you are smart, you inspect
and stock your truck, eat, and go back to station to nap and relax
ASAP. Downtown stations often run more than thirty calls in twentyfour hours, and usually run all night. Suburban areas, especially if
they have large proportions of retired and elderly people, like
Tamarac or Plantation, Florida will also keep you running all night
running medical calls. Downtown, the trauma of man’s inhumanity to
man predominates. In the Burbs, it is medical. Heart attacks (now
called coronary incidents), strokes, diabetic emergencies, and acute
abdomens round out even rookie medics’ range of experiences in
less than a year. This is why we call Florida God’s Waiting Room. In
one part of town, The Knife and Gun Club is offering short, lifetime
memberships. Other areas specialize in Better Living through
Chemistry. Another area may have a Cardiac Canyon, Lined with
high-rise mausoleums.
Because of the long duty hours, most medics try to make the best
use of their available time while on shift. Paying bills or making phone
calls for their outside businesses is one of the more typical
approaches. Some like to read or study. The profession requires
around forty hours of continuing education units to be completed
every two years to qualify for recertification. Other medics may
choose to study toward Registered Nurse and Physician’s Assistant
programs, or pursue one the several degree programs in EMS
Administration, but virtually no one is satisfied with who they are at
that particular point. Most medics still have not figured out what they
want to be when they grow up.
Now, many departments do not allow ambulances to go out at large,
unless they are being dispatched to an emergency call. Some
dispatchers even send out otherwise non-dispatched units to do
“zone coverage” at a particular fixed point to await the next available
call. You hear a lot of senior medics refer to “back in the day…” as
they smile and reminisce. Well, back in the day, you could take an
ambulance anywhere in your zone by telling dispatch you were 10-8,
doing zone familiarization. Before the advent of GPS systems and
onboard computer maps, this was a legitimate concern for medics
and EMTs who needed to know the quickest routes to and from
anywhere within your zone, and a great excuse for exploring.
This could include side trips to the end of the airstrip at the naval
base to watch touch-and go landings and take-offs of fighter jets and
other military aircraft whose personnel had flight quotas to fulfill.
Ambulances and fire trucks are generally admonished from being
seen in the parking lots of bars, and especially strip clubs, but a fire
alarm or bomb threat can generate more municipal workers than you
even knew could be on the payroll, and you can be sure they will be
quick to respond, but slow to clear the scene.
Jeff once worked for a municipal service that covered a motel that
featured a performing dolphin. Local legend had it that the trainer was
the former male lead for the TV series Flipper that was shot in Miami.
Jeff and Mark used to take the ambulance to the lodge every morning
at the start of shift to eat breakfast and watch the dolphin show.
Jeff and Mark had been partnered for over six months, and were
nearly finished the three-month rotation they were scheduled to serve
at this station, which they shared with the sheriff’s department. Jeff
was hired approximately six months earlier, and still had not worked a
single “code blue” (cardiac arrest) since his arrival. Jeff’s initial hiring
had been ballyhooed a bit too much for his liking. He had just left a
very busy urban state-of-the-art municipal 911 system, in favor of a
more laid-back county system that catered to the interests of their
considerable tourist industry. Comprised of a series of small seaside
resort communities, it was originally staffed by volunteers. Later, it
was run by one of the three hospitals within the county before
developing into a countywide 911-dispatched system. Many of their
medics had little serious critical care experience, which only fueled
resentments and suspicion towards all new arrivals.
Although Jeff badly needed the “vacation” aspect of his new position,
doldrums and boredom had begun to set in. Mark, Jeff’s partner, and
EMT\Driver was also a commercial fisherman, and no stranger to the
pleasures of cannabis sativa. Jeff was no stranger either, but to Jeff,
as a medic, work was work and play was play although he had turned
his head for the first several months and ignored his partner’s
indulgences, Jeff had never smoked dope the same day he worked,
and rarely smoked it the night before., but with little to challenge him,
next to no supervision, and little chance of discovery, he decided
maybe it was time to relax and unwind a bit. He was in the throes of
his fifth divorce and suffered regular anxiety attacks. He figured it
would be a great way to kick back during one of their typical two-hour
breakfasts while they watched the dolphin show.
Mark was completely taken aback when Jeff had requested “a hit”,
and cautioned Jeff to “take it easy” and further warned him “look,
man, this is some really strong shit, and I don’t know if you can
handle this weed. You better take it easy…no more than one
toke…really.”
“Fuck you man! Jeff quipped. I was smokin’ East Asian dope when
you were still in grammar school sneaking cigarettes in the bathroom.
Trust me; I can handle anything you got.” With that, Jeff perfunctorily
took two very deep drags of the proffered joint, sat back, and blew
smoke rings back at his partner.
Of course, thirty seconds later, the alarm tones sounded over the
radio summonsing the ambulance to a cardiac arrest. They looked at
each other and just laughed. This was a bit of a kick in the nuts, but
they had both been around the block enough to fake it for whatever
was awaiting them.
Indeed. On arrival, they first discovered that their stretcher would not
fit down the hallway where the victim lay, due to bundles of
magazines piled floor to ceiling along one wall. There was barely
enough room for a single person to walk, due to the bundles of
National Geographic, Scientific American, and similar publications.
“Great! Just the sort of job to keep the volunteers out of the way while
we do our magic.” so while Jeff and Mark went down the hall with
their gear, the firemen set out to do enough housecleaning to get the
patient out, once she was stabilized and/or ready for transport.
The family stated that they had last seen “grandma” alive about
twenty minutes ago (which means forty minutes to an hour). Upon
exam, she was pulseless and apnic. When she was connected to the
ECG monitor, it revealed what is called an agonal rhythm of less than
thirty per minute. This represents the last dying electrical impulses of
the heart, and may be either pulsed, or pulseless, but of course,
today it would be the latter. CPR was initiated, an IV line was
established, and atropine and epinephrine were administered, as the
patient was endotracheally intubated. The patient quickly went from
sinus tachycardia to ventricular fibrillation in less than two minutes.
Now countershock would be administered in a series of three
“stacked” shocks of increasing strength with pulse checks in between
the shocks. Remarkably, she responded with pulses and a blood
pressure, but no spontaneous respirations. In fact, the resuscitation
had proceeded so quickly that the volunteer firemen had not yet
gotten the hallway cleared. Moments later, the patient went back into
v-fib, so lidocaine was bloused and a drip was hung while CPR was
initiated again.
This particular system still used “The Thumper”, an oxygen-powered
mechanical CPR device that performed chest compressions and
ventilated the patient. Because of the long transport times and
shortage of qualified personnel, this was a real plus for situations like
these.
Once the hallway was cleared and the patient was loaded and ready
for transport, they sped away to the hospital, about sixteen miles
away. Enroute, the patient regained pulses and lost them several
more times, but at each juncture, the crew performed flawlessly, and
the patient responded accordingly, for the exception that she never
initiated spontaneous respirations or regained consciousness. Mark
and Jeff were determined that they would deliver a live patient to the
ER. Never before had Jeff run such a perfect code blue, in spite of
the patient’s attempts to die on their watch.
Just as they were entering the hospital ER entrance, the patient’s
pulses and rhythm returned. As they raced into the ER, the Doctor,
who happened to be the patient’s personal physician proclaimed
“What the fuck is this? She is a DNR!!!
It is not altogether unusual that the family should have forgotten to
mention that the patient was terminal and had already had Do Not
Resuscitate orders signed, but once they were called out, the crew
had a duty to act in the absence of seeing those orders. As a result,
the crew was instructed to place the patient in a side room, remove
the oxygen from the patient, stop ventilations, and let her die in
peace.
This was by no means a typical “day in the life”, even for those two
clowns, but it does point up a couple of issues. First, this does not
represent any attempt to rationalize drug experimentation or usage
while entrusted with the care, health, and safety of the public. This
can only be described at best as “a very bad idea”. The criminal and
moral aspects of their actions could have had dire consequences.
That they chose to disregard what amounts to a sacred trust with the
lives of others only points up what a sad and sorry state of mind that
allowed them to indulge themselves like that in the first place. How
they managed to rationalize their bad behaviors only points up how
warped the judgment of an otherwise good person who has chosen a
career devoted to the care and safety of other human beings can get.
It does point out another aspect of the persona of many EMS
professionals, and that is the fact that many, if not most of them were
risk-takers by nature, especially in the early days. Besides, these
same men and women who don’t take NO for an answer also don’t
take DEAD for an answer or DANGEROUS as a prohibition.
You can’t live every minute of your life coiled like a snake ready to
strike. Somewhere you have to assert yourself just to step outside the
paramilitary atmosphere long enough to remind yourself that you are
still a human being. The trick is in being able to find your escape in a
way that precludes detection. I knew of a female paramedic who once
told me she only wore the sexiest bras and panties she could find to
wear under her uniform while she was on duty, just to help remind her
of her feminine nature, no matter how tough she had to be on the
outside. EMS does not, as a rule do much to nurture or comfort its
own. It takes no small amount of panache to push the envelope and
yet not become labeled a “flake” or a “red ass”.
During the eighties, the subject of “burnout” was a regular topic of
EMS lectures and many seminars. CISD or Critical Incident Stress
Debriefing was the hot new topic of the day. Although it enjoyed a
level of support and acceptance by most of the EMS community as
far as lip service was concerned, few people ever willingly sought out
help until they could no longer hide the signs and symptoms, which
meant they screwed up in some way. In the vast majority of cases,
being caught or being forced to acknowledge your dysfunction was
the only wakeup call you got, and nobody was immune, not even
supervisors or CISD facilitators themselves. Divorce, infidelity,
violence, financial irresponsibility, substance abuse, and other forms
of compulsive and obsessive-compulsive behaviors ran rampant in
many systems until there was no pace left for denial. It can make the
most conscientious, and caring human being into a monster in a great
deal less than five years.
During his first year in EMS, a veteran fire captain once told him:
“You gotta be very suspicious of anyone who runs into a building
when the rats and the cockroaches are running out!” The author
believes that Zen was his personal coping mechanism for the pain of
being human. Zen also teaches you to embrace difficult questions,
and to leave no stone unturned in terms of your questioning. No one
forces you to do it. When you work in EMS, you cannot afford to look
away from even the most gruesome spectacles of human depravity or
tragedy. Zen can teach you to embrace your fears. Zen can teach
you to question everything, although it cannot give you the answers
you seek to the questions you ask, it can help you find them for
yourself. The risk is that like Pandora’s Box, once it is opened, there
is no turning back and there is no respite once the questions are
asked.
This is not to say that job stress was the only issue, either, since so
much of Jeff’s life had been lived like living in the eye of a tornado. As
long as you keep up with the storm, life can be relatively calm. Then
again, there was a time when Jeff first realized that, for once, if he
encountered an over dose, or even a dead person lying on the floor,
the chances were very good that it was not someone Jeff actually
knew personally, which caused a certain calm to settle over Jeff that
he had not known in years. EMS tends to attract risk-takers in
general, and few can live up to the idealized image that is expected of
them. Many were non-conformists who gravitated to a field filled with
rigid conformity and uniformity.
Confessions of a Mad Philosopher
Understand that you are being warned: This may well be the most
dangerous book you will ever read, depending on what it provokes in
you, or if you have lived most of your life being force-fed Dogma, by
ideologues who do not want any unauthorized questions asked at all.
If you don’t believe that it is possible to ask yourself questions that
are capable of cracking your own reality, then you haven’t been using
your imagination to its fullest potential. True realizations often come
as a result of admissions of the potential truth of something we most
greatly fear. If not, you may consider yourself a seeker of the truth,
even a bit of a risk-taker. I still have serious concerns for the wellbeing of unbalanced individuals who might read this book, but fuck
them anyway. A man should be allowed to choose his own Poison.
If you get stuck, put the book down for awhile and just think about it.
Then stop thinking about it for a while. If you are still stuck, start
reading it again, but never give up on yourself. You just haven’t
gotten it yet. I read a book about Korean Zen, off and on, for about
seven years before I even scratched the surface, in terms of
understanding anything about anything…I tried so very hard to
achieve understanding, that I missed it right under my nose until I
blew it, so to speak. The answer was “Nothing”.
There were numerous times that I put down everything, Zen, EMS,
Desire, Looking for a way to Finish This Book (…or more accurately,
to realize a way to End The Story…). Jeff and I both wrestled like
Job with our respective marriages, relationships, and finances, and
lost. Then Jeff lost hope and died, while I swam in a sea of legal,
prescription, psych medications…, and drowned. I watched my latest
career choice circle the drain as the time clock seemed to be running
out.
I sat, meditated, went to work, came home, ate, drank, shit, bathed
and slept. I was full and empty at the same time. A long time ago, I
was simply delirious, and intoxicated by my new, unexamined Life. I
started asking dangerous questions, and eventually began to look for
answers. Back then, I believed I had all the time in the world. It later
came to my attention that these were such important questions, that I
should seek these answers myself, rather than to entrust the purpose
and direction, or more properly the nature of my search, to anybody
else, so as to avoid taking serious council from those with an axe to
grind, and in the process, a profit to be made.
Sometimes, it’s not so much a matter of answering questions as it is
recognizing false answers and improper questions. Your choice of
how and what questions you do ask are more important initially than
the answers (and motives) of those who want to answer.
Enlightenment is not the
EVERLASTING KISS
Most of us think about enlightenment as being eternal bliss, as if,
once attained, we would no longer feel anger, or disappointment,
envy, or sadness. The Eternal Life in Heaven. The road to hell is not
only paved with good intentions, but it is also charted by unrealistic
expectations.
The analogy of the everlasting kiss works well because it represents
a desire within most of us to prolong a momentary state of bliss into a
perpetual one. Although most of us recognize that even everlasting
love represents a continual, dynamic state of flux, we still hold onto
ideals of an ice cream cone that never melts, much like a child who
has never had to bury a beloved pet…or mother.
Imagine being on the best (or worst) roller-coaster ride ever built, and
then imagine never being able to get off it. Better yet, imagine the
everlasting orgasm…two, maybe three days tops before it turned into
unending torture….
It is unlikely that any of us will attain true enlightenment if we attempt
to attain it, so in the meantime, we could all be a lot happier if we
make friends with ourselves, accept our present temporary state of
affairs, and realize that all we will ever need we already have, and
everything we will ever need to be, we already are. Everyone and
everything that we encounter is here to teach us something, so long
as we are willing to learn.
If you want a Happy
Ending,
Try an Asian
Massage Parlor.
This Book is not
for You….
A Zen master is chased to the edge of a cliff by a tiger,
and scrambles over the edge, clutching a small bush
growing out of the side of the precipice, just beyond the
reach of the tiger. He looks below, and sees two more
tigers. He then realizes that the bush cannot support his
weight for long, as a small mouse gnaws the roots of
the bush; beside him, a small bunch of strawberries are
also growing out from the same cliff…
Tigers above, Tigers
below…The Strawberries
were sweet.
Clyde and The Tree
(The Importance of Unrelenting Persistence)
When Jeff was hired by his first municipal 911 EMS system, all new
employees were on probationary status for one full year, even if you
were already paying union dues, they could not offer any protection
against being fired for any reason…even no reason. That first year
involved a sort of hazing of all new hires, but the ones with whom
they were already familiar got off easily. The rest were considered
fresh meat. The unspoken rule was to wash out two of the weakest
candidates during training in order to give some opportunities to the
candidates with slightly lower test scores, but a proven record within
the community.
Jeff had very high test scores, but was relatively unknown in that
county, as all his previous BLS experience had been in Miami, and
even that had been extremely limited. He was too slow to treat and
much too cerebral in his initial approach. His transition was not easy,
and his training was not going well. He seriously feared for his job.
This tended to make him “choke” under pressure, so his training
officers just turned up the heat that much farther. If you are going to
“crack up”, they want it to happen now, rather than later.
By the end of three months, Jeff was desperate; his own fears and
anxiety were getting the best of his considerable knowledge and
skills. He could feel himself start to choke every time the alarm
sounded. He already began to dread going to work for what he had
considered to be his “dream job”. At thirty-seven years of age, he had
made a serious commitment to a goal he had set, and he was not
accustomed to failing at anything; he felt like he was going into a flat
spiral.
Jeff had started doing Zen meditation about a year earlier, and tried
to apply it to his everyday life. He applied the same diligence to his
study of Zen as he had to emergency medicine. In retrospect, Jeff
was probably too high-strung to work in EMS, and he probably
sensed it. He wanted to believe Zen could give him the clarity and
inner peace he so desperately needed.
Jeff also had a dog, an eighty-pound pit bull named Clyde, and he
used to take Clyde to the edge of a canal that bordered their property.
He would put the dog in the back of his pickup truck and drive over
the dike that surrounded the development in which he lived. He would
sometimes just let the dog loose, so he could chase Jeff’s truck as
they raced along the edge of the canal. Other times, he would throw a
tennis ball into the canal, so the dog could swim to it and retrieve the
ball.
One day, after a particularly heavy thunderstorm, Jeff discovered that
a very large tree had washed up on the bank of the canal where he
and his dog would run. This was not just a log, but rather an entire
tree, maybe forty feet tall, branches, roots, and everything. It was
stuck on a small spit of sand along the edge of the bank. The minute
that Clyde saw the tree, he ran up to it, grabbed a branch with his
jaws, and tried to drag it back into the water, but it was much too big
and heavy, and quite firmly stuck in the sand. The utter impossibility
of the task did not deter the dog’s efforts to drag the tree as he
furiously latched on and pulled with all his might. Every day was a
repeat of the day before. The dog never seemed the least bit
discouraged as each day, he attacked the tree with seemingly
newfound intensity as soon as they returned to the canal. Both the
dog’s determination and the futility of his efforts amused Jeff each
time they returned.
The pressure at work was becoming worse, and now seemed to
occupy Jeff’s every waking thought, which hung like ominous storm
clouds over his head.
A month passed with no progress or improvement in his situation as
each shift, he feared might be his last. One morning, the water level
on the canal was a little higher than usual, due to heavy rains for
several days. The rains had been so heavy for so long, that Jeff and
Clyde did not bother to go to the canal at all for two days. On this
particular morning, as the dog latched on the tree, it actually began to
move. The dog barked loudly, as if jubilant over his success. As he
continued to pull on the branches of the tree, it began to roll over, and
pulled the surprised terrier under the water as it rolled. Clyde
eventually freed himself from the branches, and continued to swim
with the tree as he now tried to pull it back to shore, with absolutely
no success whatsoever.
Jeff began to laugh hysterically as he realized the analogy that the
tree seemed to point up about his own life. He let out a huge sigh of
relief, and said “All right!”, if only to himself, as the dog began his
swim back to the shore. (Clyde finally had to give up, as the tree
quickly went nearly one hundred yards downstream in almost no time
at all.)
Jeff always believed that this scene had been an omen that was
responsible for his breakthrough. From that point on, he was more
confident, less easily rattled, and filled with newfound resolve to
succeed. Although Clyde had struggled daily against seemingly
insurmountable odds, he never gave up. In Fact, in retrospect, the
dog seemed to relish the challenge, and was clearly disappointed
when his success resulted in the loss of the tree.
So much of what we do in our own lives is not really all that much
different. Our character is as much determined by the challenges of
our adversaries as we are by our successes and the support of our
allies. Never give up. Failure may be just one more effort short of
success, but even the victory over an adversity does not come
without some loss. We may fail to recognize that the challenges we
face in our lives bring out the very best in each of us, and we are in
fact mutually interdependent. For Jeff, that meant whatever was
meant to be would happen according to its own schedule, so long as
he persevered and kept faith in his own best efforts. He had been his
own worst enemy all along, and all he needed to do was simply pay
attention long enough to recognize the connection and meaning of
what he had just witnessed.
Long before it was a television catch phrase for a gambling resort, the
unwritten law was “What happens in the ambulance STAYS in the
ambulance.” That is not an environment that lends itself well to any
sort of written account of this industry other than propaganda, heroworship, or whitewash, despite the fact that every alarm, every call,
has the potential to contain an entire novel’s worth of drama, intrigue,
humor, and adventure before you get back to station. Because of the
necessity of anonymity, it is the stuff of which Urban Legends are
made….
Would You Die for your Beliefs?
It should go without saying that the main character of this story is no
hero, but he himself would have been the first to deny that he was a
victim either. (That’s why they call it denial…) We are connected to
our actions, and their results. It is said that nature abhors a vacuum,
and when we lose our illusions, something else will have to take their
place. As long as we use words, and thoughts created by our minds
to rationalize and justify our actions, we will just as likely replace one
illusion with another. Labels are just as dangerous as preconceived
notions, blanket judgments, and all other forms of prejudice. Jeff often
did bad things for good reasons, and good things for bad reasons.
Jeff was not a bad person, but it took him a long time to recognize
that simply not being bad doesn’t necessarily make you very good,
either.
Even at his very best, Jeff was like a slightly flawed or failed
experiment in contradictory dialectic synergism. A degenerate saint, a
knight in stolen armor, a mad scientist turned suspect philosopher, a
heretic monk, a Boy Scout prankster, a hobo prince performing highclass low-brow, and a rogue gentleman with ulterior motives for acts
of selfless kindness. As good as he could be, and as badly as he
sometimes behaved, he was as good as he was as bad as he was. It
was an addiction that for Jeff, there was no cure because no matter
how much he suffered for it, it was as if it was his raison d’etre and
compulsive pleasure.
If you should meet the
Buddha while Traveling
along the Road, you
should Kill him, and Feed
his Body to a Hungry Dog.
(For ten years, I struggled with the meaning of this Koan. Fellow students, teachers, and mentors alike repeated it,
regardless of their level of understanding of its meaning. Its words evoke strong feelings of the necessity of Dharma
Action…but How? What? It wasn’t until after I Thought I had Achieved an understanding of it that I simultaneously realized
what I was to Do.)
Epiphanies are usually the
result of having stripped away
the layers of illusion that we
create that obscure true
understanding. Once these
illusions are removed, we have
the opportunity to see
everything exactly as it is…just
like this…the world as it is,
before words…before
thinking….just this, only this.
Dreamland
Dancing
(Black screen. Fade in slowly on extreme close-up of very full
lips, heavily covered in fire-engine red lipstick.)
“Happy birthday to you”
(Slowly zoom out to face. Very tight shot of eyes, face to chin
and forehead, showing blonde bangs. Very wide-eyed, and
expressive face of a Marilyn Monroe impersonator.)
“Happy Birthday to you…”
(Slow zoom out to reveal MM on all fours, on top of a long
table, dressed in only a black lace bra and panties. The rest of
the room is dark.)
“Happy Birthday Mister President…”
Zoom out to reveal a long, tapered dinner-table candle
protruding from the ass of MM. It is lit.)
“Happy Birthday to You!”
(Long shot of room, lights have been turned on. MM
impersonator jumps up, revealing that it is a male, gleefully
clapping hands together, jumping up and down. Falsies pop out
of a bra. A half-dozen men in EMS uniforms clap and generally
camp it up. It is as if the entire troupe of the Village People is
now in the employ of one of the local private ambulance
services.)
Welcome to a private ambulance service in the early Eighties in
Miami.
(Cut to close-up of the face of Jeff, a paramedic asleep in the
cabin of an air ambulance. His eyes snap open in a startled
expression that instantly explodes into laughter.)
All this was a replay of a memory from Jeff’s first ambulance
job, about twenty years ago. As bizarre as it may seem, it is not
an especially isolated event in his memory bank from this
period of time, or for that matter, from any other period of time
in his life. It is as if the bizarre has been the connecting thread
that had run through most of his life. Then again, it all depends
upon your perspective. If you focus on the bizarre, then the
picture you reveal as you connect the dots will be a great deal
different than if you attempt to ignore, or block out those same
experiences. And of course, there is no accounting for just how
much of a magnet some people are for the weird.
Take for instance, the episode that immediately prompted Jeff’s
journey into the dayroom of that Miami ambulance company.
He had been sleeping in the lower bunk in the crew room at
their main station. It was a large room with about ten bunks in it.
The overhead light was rarely ever turned on, day or night,
since there was almost always someone sleeping in it. Twentyfour hour shifts, and lots of overtime, frequently resulting in
forty-eight or seventy-two hours of continuous ambulance duty.
(At that time, “full-time” employees were forced to work “more than”
seventy-two hours per week to either get benefits as “full-time” employees,
or even be paid time-and a-half rates.) One-hundred-plus hour
workweeks were not uncommon then. Whenever possible, day
or night, you slept.
At approximately three am, he was awakened by the steel bunk
bed in which he had been sleeping creaking and rocking,
accompanied by muffled groans. He eventually realized that his
partner, a fellow EMT, was having sex with another (male)
EMT. It was like some low-rent grade-B, XXX-rated prison
movie that never ended. Now that he was awake, this kind of
thing would be hard to just ignore, so he decided to go outside
to have a smoke, and went by way of the dayroom so he could
take a leak first, resulting in yet another indelible “Kodak
Moment” being burned into his memory banks.
If this seems too disturbing, or too offensive an image to be
associated with medical professionals upon whom people
routinely entrust their very lives, then you really won’t like
hearing about the ambulance that used to station itself every
Friday afternoon in the parking lot across from the Orange
Bowl, dealing cocaine to fellow ambulance personnel, and
friends. Sometime before noon, an Ohaus Triple-Beam scale
was extracted from a black gym bag, and grams of cocaine
would be weighed and placed into tiny zip-lock baggies and
sold for fifty dollars each. Just like that. It seemed like everyone
knew about it, and yet it went on like it was the most natural
thing in the world, either ignored, or tolerated by those in whom
it held no appeal. A third of the company personnel openly
smoked weed, and made no bones about it. Another third did
so, but tried to keep it a secret from the third of those who
didn’t.
Imagine it is your first day of work as an EMT. It is a little after
0800 hrs. Suddenly the radio begins to “broadcast” from one of
the ambulances, which is to say, the microphone has gone
“live” due to having the transmit button being accidentally held
in, either by a leg, or some piece of personal gear. Every word
being spoken in the rig is now being heard by not only dispatch,
but also every other rig that is on the road, and 10-8 with the
radio on. (In New York, for instance, an ambulance is called a
“car”, e.g.: “six o’clock car”. In Florida, they are more likely to be
called a “truck”, or a “rig”. Some locales use the initialization:
“ERV” (Emergency Response Vehicle), or similar references.)
“Cummon, nigga! Ya gonna smoke dat whole spliff yo’ self? I toned
you on yestiday, ya cheap-ass muthafucka!”
“You’ll get ya share when I is good an’ Goddamn ready…dat shit you
braht yestaday was nuthin’ but a bunch a’ Mexican bush-weed. Dis
‘ere is da real ting…sinsemilla. Two tokes gonna put ya on da floor
trippin’. So shut ya mout’ an’ wait yo’ turn, bitch!”
“Who is you callin’ bitch, yo’ nappy-headed assho?”
“Speakin’ a nappy-headed bitches, tell yo Mama I lef the money on
the dressa, and I’ll see her tamarra night.”
This dialogue continued for more than twenty minutes before the
supervisor eventually recognized the voices, and intercepted them at
their next scheduled pickup. They were not fired, nor were they even
officially identified or the subject of any known disciplinary action, only
unsubstantiated rumors about their suspected complicity. Speculation
aside, the conversation was real, and heard by everyone who was on
duty that day, including Jeff.
Eventually, one of the company’s top collectors was arrested in
uniform, with the ambulance parked outside, while trying to enter a
Miami crack house while it was being busted. Phone calls were
made, but it never became a news item. This was before mandatory
pre-employment, or even post-accident urine testing for drugs.
(Bonuses were awarded each month for drivers who collected the
most money for their transports-COD. The top collector for the year
usually received a paid vacation in Hawaii. Some even had creditcard imprinters (just like the most elite Miami prostitutes), and some
even were known to take their patients through the drive-through
lanes of local banks on the way to their destinations.)
Would you Kill for
your Religion?
This is the way it was, over twenty years ago, like it or not. In
nineteen eighty four, EMT’s were paid a little over three dollars an
hour to work for a private ambulance company. Commercial painters
were paid over eight dollars an hour starting salary.
It should be made clear, however, that private, non-municipal
ambulance companies represent the absolute bottom of the barrel, so
to speak, of an industry that, in its infancy was one of those lint-traps
for human behavior that required people to work for shitty, low wages
to do work no one else wanted to do. (The food service industry and
house painting are similar examples; although painting pays better; it
seems to be the safe harbor for semi-respectable alcoholics and drug
users.) A private-service non-municipal EMT is to the Medical
profession what a waitress is to the Food Service Industry. Even
prostitutes have been known to say: “At least it beats being a
waitress”.
For every hundred EMT’s that enroll in EMT classes, only one in
three would actually pass the four-month training they received, then
go on to pass the state certification exam. Of those, less than a
dozen would actually go back to school to successfully complete the
next year of training and state certification exams to become
Paramedics. Less than a quarter of them were hired as municipal 911
rescue Paramedics. The left-overs worked for private services,
“slinging lizards” (transporting geriatric patients) back and forth from
the nursing homes to the ER’s, and interfacility transports from one
hospital to another. Industrial Paramedics. Like at the nuclear plant,
or the local jails and prisons. Like the School Nurse only with Drugs,
needles, and a defibrillator/monitor. It is a business with a high
attrition rate, and poor longevity. All things considered, your chances
of a long and financially successful career, and retirement are about
the same as a professional athlete’s. Top salary, if you make Captain,
or Chief, might be around a hundred thousand a year at the end of
twenty years if you work for one of the top ten departments in your
state. The minimum for a rookie professional baseball player is
something like one hundred fifty thousand. A rookie Paramedic is
very lucky to make forty grand a year, before overtime. The State of
Florida currently spends about eight thousand dollars more per year
to incarcerate convicted felons than any department will pay as
starting salary for a paramedic.
There is currently a shortage of paramedics, and although the wages
are much higher now in total dollars, they do not support the standard
of living, due to inflation, and (ironically), healthcare costs. It is
predicted that the situation will actually get worse. It is becoming
harder every year to recruit personnel. No one wants to pay better
wages, so the proposed answer has been to consider lowering the
entrance requirements, and test score minimums, rather than attempt
to recruit better people by offering better wages.
But even an enviable position in a professional municipal EMS
service does not preclude compulsively bad behaviors…
(Yet Another Digression…)
Sometimes, Art imitates Life imitating Art, and Urban Legends spawn
swarms of posers attempting performances of acts and situations that
had theretofore existed only in mythological states.
Witness the “Mile High Club”: It rarely takes very long for people
discovering new territories, avocations, hobbies, industry, or states of
mind or body to quickly develop more than just an idle curiosity about
what it would be like to fuck (or to be fucked) while experiencing
them, much like the marijuana smoker who considers weed to be an
enhancement to just about anything. (It is my suspicion that it starts
shortly after just doing it right at all no longer demands total
concentration, but also well before it becomes routine…). Also, the
only way to achieve confirmation of legends is when their
perpetrators get killed, or otherwise caught, which potentially
represents the Perfect Crime when they don’t. They are the stuff of
which Headlines and SoundBits are made.
For instance: You would think that by now, EVERYBODY would have
heard that it is an extremely bad idea for ANYONE to stick either
their, (or anyone else’s) Penis into either a vacuum cleaner hose OR
any of the orifices related to Swimming Pools, Hot Tubs, or similar
devices. But No… Every few years, (depending on the strictness of
local Standards and Practices of the broadcast media) news stations
run stories about some Asshole who tries it again. The traffic on the
dispatch channels for local Emergency Services, is overheard by the
news media, who quickly swarm and contaminate the Emergency
Scene, and turn it into a News Scene, and thereby confirm that it is
Still Not a Good Idea to Stick a Penis into Either of those Two Items,
and simultaneously transform it from Urban Legend to Confirmed
Stupidity. In EMS, it represents the unspoken consolation prize for
having seen too much…and that is: Job Security. I was once
criticized by a Pollyanna Paramedic for walking into an EMS station
wearing a baseball cap that said “I’d hate to be accused of
advocating the use of drugs, sex, and violence, but they’ve always
worked for me…” (re: Hunter Thompson discussing his sources of
inspiration). My reply was “If it wasn’t for sex, drugs, and
violence...we’d all be out of work.”
So let’s just leave it to say that we all know about the Mile High Club.
In more than two EMS Services, let us also just say that there is also
a Code Three Club involving sex with Emergency Services personnel
in an Emergency Vehicle while speeding down the road with lights
and sirens operating. This is not to be confused with having sex with
a patient (especially psych patients) in an ambulance, which is pretty
much generally considered abuse no matter where you go, or who
you ask.
First of all, you have to find a roadway where no one will see you and
an excuse if anybody does. Then you also have to find a willing
participant, either a stretcher bunny or a siren slut...or, say a civilian
videographer, assigned to ride with you for twenty-four hours to shoot
footage for a documentary she is making. (The two charming sexist
monikers usually refer to female EMT’s who work for private
ambulance services, and non-EMS women who like to hang out in
fire stations or near ambulance entrances at hospitals. They are the
“groupies” of EMS. God Bless them, wherever they are.)
High Jinks in general help to relieve both the stress and the boredom
inherent to professional EMS. Although I have heard variations of this
story many times, in many different parts of the country, I was
personally familiar with a crew who may have themselves taken this
Urban Legend up to the level of confirmed stupidity.
It was a particularly boring stretch of summer, at a station in one of
our westernmost areas of the county, which was particularly isolated,
and one of the few last “slow” stations left, where Medics were briefly
“pastured” for a few weeks of rotation, while they received
certification in various areas of training when they had the time.
About twenty-two hundred hours (ten PM), a fireman from another
station called, to let the crew know that the Chief had just left their
station and was on his way home. It had been a “surprise” inspection,
and both crews anticipated their station would be next. The crew
decided it would be funny to arrange a semi-circle of chairs in the
area of the equipment bay usually occupied by the ambulance. They
then turned out the lights in the bay, took off all of their clothing, and
waited for the arrival of the Chief dressed in only fire helmets, bunker
boots and gloves, pretending to play cards. One member of the crew
was a female, not to be outdone in such a notoriously chauvinistic
profession; she was as naked as the rest. And so they waited, in the
dark, until the chief finally drove into the driveway. Using his garage
door opener, he drove right up to the bay, headlights on high beam.
The crew had not been told that the Chief would be bringing his wife
and children….
Jeff’s career had swung in both directions between the two extremes
of great expectations and mind-numbing disappointment. He had
worked private non-emergency services with some of the worst.
Twice, he had been hired to work for municipal, 911 rescue services.
Often he was either Lead Paramedic, Training Officer, or Supervisor
for private, municipal, or hospital-based operations. If he had been a
little wiser, and a lot less high-strung, he would still be working for
one or the other of them.
His knowledge and skills levels were exemplary, and he had
managed to acquire a reputation as a top-notch medic with a volatile
temper, unpredictable mood swings, and an overbearing personality
who was difficult to tolerate for twenty four hours at a time. He was
high-strung, and tended to verbalize his frustrations incessantly. He
had a foul mouth, and a generally perverse sense of humor that
alarmed more than a few of his colleagues in a business in which
“ambulance humor” was already notoriously dark. People either loved
him, or hated him. Believe it or not, there were more than a few
medics who held him in the highest regard. I was one of them.
One of his closest friends had compared him to a pit-bull: fiercely
loyal, tenaciously stubborn, and suicidally fearless. He routinely
exhibited long-suffering patience and compassion for his patients. If
he trusted and respected them, he might show a similar quality for his
co-workers. If he did not, he was notoriously short-fused. He seemed
to have no time for weakness among his fellow employees, and
frequently referred to EMS as “the business that eats its own young”.
He had a penchant for professional self-sabotage that had similar
roots in his personal life. He rarely stayed anywhere more than five or
six years. Although he generally stayed out of any serious trouble, he
seemed inexplicably drawn to controversy, and constantly pushed the
envelope. He challenged his supervisors incessantly in a way that
alienated him to them, in spite of awards, commendations, and many
letters of gratitude from the public he served. He found himself
frequently regarded as quite unlikable by people who would have
preferred to treat him like the fair-haired boy, had he given them the
opportunity. Eventually, he would start to feel stifled by this world of
his own creation, and move on.
Would You Live for
your Beliefs?
Air ambulance seemed like it would be his Saving Grace. He was
assigned to work with a very attractive and intelligent flight nurse who
had considerable experience working ICU and Surgical Recovery.
They both had an uncanny knack for anticipating each other’s moves,
and their capacity for teamwork was quite remarkable from the first
day. Because she had no flight experience, when necessary, she
would take directions from Jeff more graciously than even Jeff
expected. Although they both were very much concerned with
maintaining an absolutely professional relationship, they were also
becoming very fond of each other. This created an atmosphere that
lent a note of intrigue, and a fascinating tension that neither of them
wanted to end by consummation, at least any time soon. They were
both married, and had enough problems already. Oddly enough, they
both believed that as long as they didn’t start anything, it didn’t have
to end, because when you have no claim, you can’t make any
criticisms. He came to believe that the very thing that attracts you to a
person is the same thing that leads you to do things that bring the
mutual validation to an end.
He also had numerous opportunities to speak either French or
Spanish, as needed, although his flight nurse was much more fluent
in French than he was. Sometimes, the captains or first officers would
let him hand-fly the aircraft when there were no patients on board,
and he got flying lessons he could have never afforded on aircraft he
could never normally fly without certifications he would never be able
to get.
This particular service sent their flight crews out for two weeks at a
time, with two weeks off. The pay wasn’t great, but it wasn’t bad, and
the per diem allowances were better than most. It seemed he had
finally found his niche. His crew got along famously, and in spite of
his quirks, and temperamental outbursts, he felt not only tolerated,
but also genuinely liked and appreciated, and respected, both as a
medic and as a human being. He was a genuinely colorful character
among people who were to some extent at least, cut from the same
cloth.
Not only was this not Jeff’s first job as a paramedic, this was far from
his first career, having only started his education and training as a
medic at the age of thirty-five. Prior to that, he had been a faculty
member at a local community college, a chemist, an electronic
equipment installation technician, a TV repairman, a telemarketer, a
body guard, private investigator, armed guard, cable TV installer,
long-distance truck driver, guitarist, and proprietor of a small music
recording studio he had built for producing demos for a record label
and talent consultant firm he had set up to promote the musicians he
had recorded.
This was definitely not his first rodeo, and more than anything, Jeff
desperately hoped it would not be his last. It just wasn’t fun anymore.
It was time to move on, and he didn’t know which way to turn. He
seemed to be able to do just about anything he set his mind to, just
not for very long. He had been a medic for over twenty years now,
and the walls seemed to be closing in around him.
Jeff was in his early fifties, and tried to stay in shape, but not very
hard. He often referred to himself as a Buddhist, but he was not a
very good one. He looked at least ten years younger than his age, but
had grown weary in spirit. He had lost his enthusiasm. He was short,
but muscular, although he was about twenty pounds overweight, and
had what women often call “rugged good looks”. When he was
younger, he had a somewhat boyish cute look about him, and all
things considered, he had been very fortunate to age so well. Of
course, this was no consolation to him.
He had been in the same predicament twenty years ago, after he
closed down his recording studio. It was like everything he had done
since college had been a prelude to a dead end, and there was no
turning back. Then his estranged wife went back to her drugs, and
got herself killed in the process.
Eventually, he met a nurse named Inga who advised him to go back
to school to become a paramedic. At the time, he was working as an
in-house cable TV Installer. He had been assigned to install cable in
her house, and she had invited him back that night for “dinner”. He
ended up spending the night, and they started dating. Although she
seemed to like him, his current occupation was too proletarian for her
rather snobbish bourgeois tastes. She kept telling him he was not
living up to his potential, and that he should start thinking about his
future. Her initial encouragement was at best, a sort of left-handed
compliment. She said: “You could be a paramedic if you wanted. In
less than two years’ time, you could have a new career that would
change your life. You have a good knowledge of science, and a flair
for learning, and you are definitely the biggest bull-shit artist I ever
met.”
In one sentence, she had fairly well summarized how most nurses
regard paramedics in general.
Although Inga was not very tall, she was by no means petite. Her
figure was decidedly more on the voluptuous side, or as some might
say, Reubanesque. Large, full, pendulous breasts offset a
surprisingly small waist, broad hips, and a very generously round
bottom. She seemed to ooze sexuality and mischief in every
movement she made. Her eyes were quite large, expressive, and
deep blue. Blonde hair and a fair complexion complemented her fine
Scandinavian features. She seemed inordinately preoccupied with
status, money, and appearances for Jeff’s liking, but sexually, she
was fun loving, lustful, and imaginative. They both had sex with
anyone else they desired, but attempted some degree of discretion,
although they were quite frank and honest with each other as regards
their peccadilloes.
Her father had been a high-ranking military officer from some place in
Mississippi. When he died, they named an airfield after him. She had
a penchant for emulating that snobbish, haughty condescension so
often typical of self-impressed Southern aristocracy in decay.
From the day they met, she constantly proclaimed that she did not
want a relationship, and did not need a boyfriend. Jeff had heartily
agreed and often stated, “A woman without a husband is like a fish
without a bicycle”. Despite their supposed agreement on the subject,
every time Jeff went back to his house, she would eventually show up
on his doorstep in tears, professing her undying love, only to toss his
shoes amid caustic remarks if he stayed much more than overnight.
This was more than simply disconcerting, because Jeff lived more
than twenty-five miles away. It was also damn inconvenient.
Theirs had been a love/hate relationship at best, but in some ways, it
characterized the professional relationship between medics and
nurses. She had promised to help him through school, and said she
could coach him and help study for exams. She even lent him the
tuition money to enroll in his first semester, an EMT class, and EVOC
(emergency vehicle operator’s course) certification, only to break up
with him for no real apparent or stated reason during the first week of
classes. In the meantime, he met his next future ex-wife. As soon as
he got the money to pay Inga back, he called her up.
The minute he got through the door, she threw herself at him. For six
months, they had been on this seesaw romance, and he knew he
would not be doing this again, and he suspected she felt the same
way. They became one mass of tongues, fingers, and bodies as they
ripped each other’s clothes off. They were naked before they got to
the bedroom door, fucking like animals, finally collapsing, breathless,
and in a heap, falling off the bed onto the carpeted floor. As they lay
there gasping, she started to giggle which grew into nearly hysterical
laughter. Their bodies glistened with sweat, he-goo and Vulvaline 50
weight, that marvelously fragrant industrial lubricant of Humanity. He
leaned over to kiss her face as a large bead of sweat dripped from
the tip of his nose onto her face, barely missing her left eye. Still
laughing uncontrollably, she pushed him away, proclaiming “Your
face smells like pussy!” Not in the least deterred by her remark, he
said “Don’t even try to pretend that you don’t like it; It wouldn’t be
your first taste…or is it just because it’s yours?” She giggled impishly
and turned her face away. Next, he rolled her over, his still-rigid
member glistening and dripping with their co-mingled human stewbroth, parted the generous mounds of her round and sticky buttocks
as he pressed insistently with his Pride and Joy against her stillslippery sphincter which parted easily to swallow the impatient
intruder and heartily grasped his cock like a politician shaking hands
at a convention. She resisted half-heartedly, moaned licentiously and
raised her ass upwards to accommodate his thrusts as he plowed
and planted deeply into her backyard playground with newfound zeal,
increasing the tempo and force of his pelvic thrusts as her felt her
clenching spasmodically until he could stand it no more, shuddering
and spewing what felt like every last drop of moisture from his body.
Even his mouth felt dry by the time he had stopped although both
their eyes glistened in the semi-darkness of her room. As the last
paroxysmal contraction seized her body, she gaped cavernously and
spit him out with considerable force, comingled viscous humors,
audible vapors, and yet more laughter. Then, for the moment, all was
stillness between them, save for the sound of their breathing and the
air conditioning. A stillness and calm passed over them as Jeff broke
the silence, only to barely breathe the words “Le Petite Mort”, for
once not choosing to compulsively explain his reference to “The Little
Death”…she may have come from Metairie, Louisiana, but at that
moment, he cared little about her comprehension of French. Though
they shared this moment, for him, it was his moment. Even years
later, in the occasional reverie in which each of us indulges ourselves
for no apparent provocation, it always seemed to be a galvanizing
experience of empowerment and serenity.
This had nothing to do with domination, humiliation, or any other sort
of sexual politics. As bad as she was for him, she had influenced his
life more significantly than he was yet to realize, and he had loved her
more than was probably good for him, or for her. She helped inspire
him to launch a career that would span over twenty years as he
saved countless lives, but their moment on his timeline was just that,
a moment. He never saw her again after that day. He doubted that
his influence on her had been as important as hers had been on him,
but then again, she reeked of a loneliness that she clearly despised
within herself, as if torn between her need for companionship and her
perception of independence. She had been badly hurt by an abusive
husband, and avowed to never be so needy ever again. Her lust was
her undoing, but if she could have coped with being so well-done, she
wouldn’t have been so conflicted. In reality, Jeff was just an animated
sex-toy to Inga, and maybe that was all she really needed.
Afterwards, he simply got up, put on his pants, put the borrowed
tuition money on the dresser, and walked out the door. The only other
contact he ever had with her was about two weeks later, when she
left a note on his windshield while his car was parked at school; it
said: “Maybe it wasn’t so much because you didn’t even say goodbye, but the way you left the money on the dresser made me feel so
cheap, even though six hundred dollars is a lot more than I get
downtown. (ha ha). Give me a call, and I might let you make it up to
me.”
He knew better than to respond. He was certain that the only reason
she had left the note was to get a chance to get the upper hand
again. For once, there had been no harsh judgments or words
between them when they parted, and all in all, he felt it had ended on
a rather upbeat note. From his perspective, it was better to not look
back. She was not his first nurse, and she would not be his last.
Although Calamity seemed to walk on his shadow, he considered
himself lucky beyond the telling. Even people who didn’t much care
for him either admired or envied him. It was his friends, however, who
were the first to realize how shitty his judgment was, or at least, they
were the first to share this observation with him. Unfortunately, they
had no idea how to explain it to him, and he was none too quick to
recognize it himself. Sometimes, he had the weird personae of an
idiot savant. At other times, he was completely self-absorbed, to the
point of appearing naïve; the next minute he could take on this
character of sharp, biting wit, and clever repartee, with a razor-like
intensity. Or he could stare through you with the most un-focused
thousand-yard stare that would make you feel exactly like he was
walking on your grave, right then, somewhere far away.
At other times, it seemed like he would never catch on as to the full
extent of his obsessively poor judgment.
Form is Form. Emptiness is Emptiness.
In late June, just around the solstice, Six PM in Miami still feels like
afternoon. Eastbound, on 36th Street, headed into Allapata, with the
sun coming through the back windows of the Ford van the Coroner’s
Office uses to transport the (usually) more or less recently dead, it’s
hard to tell Two PM from Six, except for the angle of the sun. It’s still
stinking hot; especially inside this particular van, whose third,
horizontal passenger no longer feels even the slightest shame about
the sporadic emissions of flatulence that seem to punctuate each jolt,
or bump in this jointed concrete road as it approaches Miami Jackson
High School. (The process of decomposition starts within minutes,
and the gases produced are capable of very strange phenomena,
especially after several hours, like the farts of the dead, or full, round,
firm breasts on eighty-year-old dead women.) The stench inside the
van is so astonishing, that even with the front windows open, and the
air conditioning on MAX, the two attendants, long-time veterans,
cannot even blunt the acrid vapors with the two Esplendido they have
lit.
The Cuban-American community in Miami is as decidedly divided in
their opinions about genuine Havana cigars as they are about the
now more than forty-year embargo of their homeland itself. Most
share the essentially ancestral hatred of Castro, who long ago
dubbed them “Los Gusanos Amarillo” (The Yellow Worms), for having
fled their homeland. The last three generations have never seen their
“homeland” which is still depicted with tearful fondness by their
elders. Some of them still belong to Alpha 66, an extremely
determined, heavily armed, and well-funded paramilitary group bent
upon the overthrow of Fidel Castro, even adopting the image of an
angry yellow worm, with gritted teeth clenching a stogie, wearing an
army helmet, and brandishing a Thompson machine gun.
It is difficult to grasp how to justify an embargo that progressively has
starved parents, siblings, and other family members unable to escape
the island, living in abject poverty, on the brink of desperation, but the
Cubans of Miami are themselves an enigma on many levels, and
unless you have lived and worked with them long enough to really
know and love them simply for who they are, as they are, they will
seem to be a formidably incomprehensible series of contradictions.
Several years ago, after his heart attack, Fidel Castro denounced the
same Havana cigar that had been his trademark for so many years
previous. And in Miami, many otherwise politically correct CubanAmericans pay top dollar for smuggled “Cubans”, be they flesh or
tobacco….
Artie and Oscar had been partners for over twenty years, and are two
of the most unflappable characters you will ever meet. They share a
point of view that few people will ever know, except nurses,
paramedics, and the very few ER doctors who aren’t too full of
themselves as to be above what is called Ambulance Humor.
Sometimes you have to laugh to keep from crying, at least in front of
your peers.
Hey Oscar!
WWWWWWWWhat, djew wan, AAAAAArtie?
Hey Oscar!
Eeeescuse Me?
Why, did you just fart?
NNNNNNNo, AAAAAArtie, wwwwhy?
Conyo! You mean you always smell this way? Cabron!
I don’t think I’m going to want to fuck you in the ass tonight. You sure
you didn’t shit your pants?
NNNNNNNo, Artie, I don’t think so…
I don’t just mean today.
But I took a chower.
What about our “hitchhiker”?
DDDDDjew wan me to axe heem?
They break into paroxysms of gasping laughter as both of them hang
their heads out the windows. Completely self-entertained, most of any
shift they work together is punctuated by shtick such as this, whether
they have an audience or not. Their department chronicled stories of
interns so shocked by their antics that they did not return from lunch.
Today, they have a short hiatus to complete before depositing their
cargo to the coroner’s office. The traffic this time of day is so bad, that
no one will notice the slight delay incurred in stopping at a funeral
home just a few blocks off their route to I-95 south.
They pull around to the back of the mortuary, and back into the space
normally reserved for the hearses. Everything is done very quickly,
and precisely, the same way it has always been done when they
make one of these “runs” into this establishment to “unload”.
“A Puerto te! We have to be in and out in less than fifteen minutes!”
Artie is the more assertive, and animated of the pair, and a CubanAmerican. Oscar is laconic, bucolic and a relatively phlegmatic,
nationalized Colombian-American who usually functions as the
straight man for their one-liners and slight gags. Oscar tends to
stutter and stammer, which also helps set up the straight lines for
Artie. Both verbal and physical humor were their trademarks in a
profession where humor is rare, and considered inappropriate at best,
and seldom tolerated.
Now they move with the swiftness and precision of true professionals.
Although they do not appear to be rushed, not a movement or
moment is wasted, and they do nothing to attract attention to
themselves. They are focused, and deadly serious in both their intent,
and actions. The back doors are opened, the stretcher is unloaded,
as the undercarriage drops to the asphalt and they glide effortlessly
backwards into the open doors of the establishment. This is, by the
way, no mean feat, considering their cargo, plus the stretcher weighs
well over five hundred pounds. He is enclosed in a dark-grey-black
“body bag”, which only augments his immense size.
“Chingao! What did you do, free Willy?”
The funeral home attendant, a slight, but wiry man in his sixties has a
hawkish look about him; his sharp, prominent nose and intense eyes
give him the look of a bird of prey, and his thin, heavily oiled hair is
combed straight back. Like an eagle, or falcon, with the same quick,
precise but slight head and eye movements that focus instantly on his
intended subject.
“No, Padron. This whale did not wash up on the beach, but fell from
the sky like a giant piñatas!
“Si, yo entiendo. I was told we got over ten kilos of excess baggage
to remove. Conyo! This jackass will be the mother-of-all mules! We
could never get this much shit down the gullet of a live one and even
a dead maricon couldn’t take this much up the ass. We were lucky he
had so much recent surgery to cover up the way they stuffed him like
a gringo turkey for thanksgiving. Now it is time for us to be swift and
very thankful for our good fortune, so let’s slice this guanajo and be
on our way.”
Recent sutures, too new to even heal, are quickly snipped and
removed. The abdomen and thorax are opened, and many bags of
white powder, encased in plastic, are removed from where the spleen
and most of the liver had been. The lungs have been displaced
upward so as to allow the placement of even more tightly compacted
bags. In all, fourteen kilograms of contraband are removed. The
funeral attendant, once a surgeon in Havana “opens and closes the
case” almost as one would unzip a suitcase, remove a shaving kit,
and zip it back up. Long, bony fingers replace the sutures so well that
one would not even suspect that they had been removed in the first
place. The “patient” had not even been removed from the body bag,
but rather simply “unzipped”, and re-sutured in less than ten minutes
while the three of them sipped buchitos (small paper cups of oily,
black Cuban coffee, with a thin layer of brown foam, heavily sugared,
and chased with ice water). A small dab of Vicks Vapo-Rub under the
nostrils helps disguise the odor of a morbidly obese, recently
deceased man who has just spent the last four and a half hours in the
cabin of a small private jet sitting on the tarmac in the sun while
quarantined at Customs. The last two hours, it had reached over one
hundred thirty degrees inside the plane after it had landed at Miami
International Airport.)
Meanwhile, the trio discussed the evening Jai-Alai lineup, and made
tentative plans to reunite later for wagering, drinking, and “a couple
bumps of perico”. In less than ten minutes they were back out the
door and back on 36th street, headed for the morgue at the coroner’s
office.
“It’s a good thing Alberto held things up at Customs as long as he did,
or else we’d have been back before the suits left. I hate those fucking
guys! Always sniffing around, like it’s a federal case…of course it
would be if they ever got their noses out of each other’s asses long
enough to get a whiff of what’s really going on…always playing
politics for pennies like they were somebody important, and all the
same, the whole bunch of them don’t make what either one of us do
in a year. Fucking pendejos! Those cabrones always looking down
their noses at us…two, maybe three years more, and we will be
done; retired and living large like country gentlemen, while they keep
fighting like dogs over scraps.”
Artie rarely got worked up like that, but it takes a lot to rationalize his
“situation”, given his background. The son of a doctor in Cuba, his
family had fled the island with nothing, and his father had died
suddenly of a heart attack, a broken man, who had never regained
either the medical license or social and financial stature that had
been his dream when he expatriated his homeland.
Artie was ten years old when his family came to America, and the
transition had been hard. He had once been a privileged eldest son,
and adjusting to life on Calle Ocho had made him grow up quickly,
and harshly. He was not very large in stature, so his wit, humor, and
cunning had been his salvation. He was well-liked in high school, but
always on the edge of trouble. He was bright, good-looking, and
showed much promise. He could talk his way out of just about
anything. His ambitions, however, had taken him down a few paths
he thought would be only shortcuts to a life he only now saw as a real
possibility.
Although he wished he could somehow make his father proud of his
recently acquired wealth, he also knew that if his father could look
down from heaven to see his son mixed up with drugas, it would
break his heart. They say there is a broken heart for every light on
Broadway, and Los Angeles has the Boulevard of Broken Dreams.
Miami, once dubbed the Shanghai of the Western Hemisphere, is no
stranger to broken dreams, hearts, or promises.
Oscar, on the other hand, bore more than a slight resemblance to
Manuel Noriega, and stammered almost constantly. He was very
good-natured, and possessed the more subtle wit of the two.
Although Artie often made Oscar the butt of his jokes, Oscar was
more than a little shy and insecure, so allowing Artie to play Oscar as
the clown nonetheless gave Oscar the spotlight a great deal of the
time. They were a legend on the streets of Miami, especially among
the police officers and detectives with whom they rubbed elbows on a
daily basis. Ironically, it was their benign comical personae that
allowed them the unfettered passage they required to accomplish
their hidden agendas without suspicion.
The frog sings, but gives
no wool or milk.
(Cuban Proverb)
In the scheme of things great and small, this operation would not be
especially noteworthy in and of itself in a city where, as a port of entry
to the US, a major smuggling operation can move several hundred
kilos of narcotics at a time. It is not even an especially well-kept
secret that a number of banks in the Metro Miami-Dade area owed
their existence to laundered drug money acquired in the seventies
and eighties. Mid-level dealers are the only ones who have a hard
time here now, since the place has been dubbed “too hot” due to the
increased DEA presence.
Small time street dealers flourish everywhere, but mid-level upwardly
mobile nouveau professionals are the fish just big enough to appease
the agents who have quotas to fill, and they are fed to the
government sharks by the really big fish in order to maintain the
status quo. During the seventies, The Black Tuna Gang made
sensational headlines because of the Metro Dade Police involvement
in cocaine trafficking, home invasions, and murder. It was neither the
first, nor the last time such a thing would happen here, but the real
professionals got a lot more careful after that. Everything is relative,
but everything is also connected.
MODES OF TRANSPORTATION OF
THE SICK AND INJURED.
When Jeff first became involved in EMS, the last of the Cadillac
hearses were being phased out of service. In its infancy, ambulances
were furnished by local funeral homes. Many acted as removal
services for the recently deceased. Nobody seemed inclined to
suggest that this arrangement may have represented something of a
conflict of interest, and besides oxygen, a stretcher, and some
bandages and splints, they may just as well have been hearses
anyway. The hearses were too expensive, the patient care/transport
area was too low, and they were generally ill suited for actual
treatment of viable patients. In many cases, the attendant would not
even ride in the back with the patient, but would sit up front with the
driver to catch a smoke on the way to the hospital. This is how it was
possible for Jimi Hendrix to die aspirating his own vomit while lying on
his back on a stretcher in an English ambulance.
The development of the Ford conversion van for ambulance work
was a quantum leap for EMS. The ceilings were raised enough to
accommodate treatment and movement within the patient
compartment. Oxygen, suctioning, and monitoring devices were
readily available, as well as electrical power, radios to Medical
Control, and access to numerous medications for treatment and
stabilization prior to arrival at the hospital Emergency Department.
Another milestone came in the form of battery-powered infusion
pumps and portable EKG monitor/defibrillators. Jeff was accustomed
to using the IVAC/Seimens Mini-Med, which was a multiple channel
intravenous pump that had provision for up to six separate infusion
rates and dosages for accurate administration of fluids and
medications at a controlled rate that was independent of ambient
pressure, or elevation of the IV bag above the patient. His aircraft
carried two pumps, for up to a total of six separate lines of
medications and fluids, as well as being a redundant back-up in case
one pump failed.
The next major milestone was the development of the portable
ventilator. Impact Industries had developed a model that was very
nearly comparable to the more bulky and heavy ventilators used in
hospitals, that usually required the services of a respiratory tech to
operate, and generally unsuitable for any sort of ambulance use.
There had been other models marketed by other companies before,
but they used much more oxygen, and were not suitable for more
sophisticated treatments required by the most difficult patients. Not
everyone could use them effectively in all situations, but Jeff never
encountered a setting or problem he couldn’t solve. Whether it
involved electronics or other forms of technology, he was first and
foremost a technician, and all good paramedics have to utilize their
best troubleshooting skills on a more or less daily basis. It’s just the
nature of the game. Emergency situations often involve series’ of
uncontrolled variables that require you to shoot from the
hip…Improvise, Adapt and Overcome…Always.
Later on, much larger modular ambulances began to replace the Ford
conversion vans in many locales, but the vans still remain in service
all over the country.
The Korean War saw the advent of the use of helicopters as
medevac vehicles. The patient rode outside the bubble cab of the
helicopter on a Stokes Basket-style stretcher, so no care could be
rendered enroute, but they could rapidly access nearly inaccessible
locations and quickly deliver patients to field surgical locations. As
this tradition continued, the level of patient care while in flight has
improved concurrently. For rapid evacuation from nearly inaccessible
locations as well as rapid means for relatively short distances directly
to receiving facilities, helicopters remain without equal.
Longer transports require the use of fixed-wing aircraft. By far, the
two most preferred aircraft for that purpose were the Beechcraft KingAir 300 and the Lear 25. The King-Air is a turbo-prop, which means it
is much slower, but requires less take-off and landing room. It has a
much lower altitude ceiling, and stands much higher off the tarmac,
making placement of the patient into the aircraft more difficult, but
once you get up in the plane, it is substantially roomier. It is also
considerably less expensive to own, operate, and maintain.
The Lear 25 series was built during the sixties through the early
seventies. By the nineties, the average age of the first officers and
captains was between twenty-two and early thirty-something, which
means that in most cases, the planes were older than the pilots.
Legend has it that originally Bill Lear bought the aircraft design from a
company that had intended to use it to build a sub-sonic fighter
aircraft for the Swiss. The wings and airframe were designed to
withstand something like eleven G’s, but the plans did not include
engines or tail structures. The next several attempts at tail design
took the lives of numerous test pilots before a configuration could be
found that did not tear loose from the body, thereby causing a crash
while attempting the “military maneuvers” for which it would later
become legendary, including its alleged ability to take off on one
engine only, or to climb at a reputed 88 degree angle on takeoff,
commonly referred to as “yanking and banking”. At the time of this
writing, the Lear 25 still had the fastest rate of climb of any nonmilitary production aircraft. It was the aircraft that inspired the Byrds
to write the song “Eight Miles High”, referring to the forty-five
thousand foot ceiling of which the aircraft was capable of attaining.
From that height, you can see the effects of the curvature of the
earth. You can watch the literal edge of night as it crawls upon cities
to your east that are already below the horizon line of the sun as it
appears to them.
For many aircraft owners, air ambulance charters represent a way of
making jet ownership possible. Even sitting still in a hangar, a jet
aircraft bleeds money in silence. Maintenance intervals, insurance
premiums, licensing, and even storage fees are fixed requirements
that can be calculated down to cost per hour, including amortization.
The more time it spends in the air, the more it costs to keep it up
there, but it only makes money while it’s in the air. The options
include private/corporate charter, freight, and air ambulance.
To fly an air ambulance, the aircraft must be inspected, and licensed
by the state in which it is officially hangared. It must have provisions
for oxygen administration and an inverter capable of providing
sufficient 120-volt alternating current to operate all the monitoring
devices, infusion pumps, ventilator, and respiratory equipment. It also
has to have some sort of provisions for supporting and securing the
stretcher upon which the patient is on and off-loaded. Many air
ambulance flights are brokered by agencies that provide the
equipment and personnel, as well as the clients, and who charter the
aircraft for a specific mission.
This has both advantages as well as drawbacks for both parties. On
the one hand, the owner/operator of the aircraft is responsible for all
the logistical support and general operations of his aircraft. This is
good for the owner, who doesn’t have to be overloaded with medical
details beyond the transportation of the patient. This is good for the
air ambulance service because they don’t have to be plagued by
aviation issues beyond chartering the flight. These flights are
commonly called “out and backs”, a round trip that also includes
returning home at the end of the mission. Occasionally, a “back flight”
is booked, if there is a client in need of transportation. Everyone
considers these to be extremely fortuitous, as extra money is made
by everyone without incurring any significant additional fuel costs,
and without having to arrange a completely new charter. For this
reason, “back flights” are frequently sold for much less than a primary
flight would cost.
The disadvantages include missing opportunities for all the additional
flights that could be chartered like pearls on a string, thereby
eliminating a great deal of replicated return flights, (commonly called
“dead heading”), as the crew members are not usually available for
more than one to two days at a time. Most Flight crew members have
“real jobs” working for hospital or EMS systems. Medics
characteristically work 24 hours on, with 48 hours time off, while
hospital personnel usually work four tens or three twelve’s for shifts
that are usually arranged a month in advance. Both timeframes allow
for enough idle time to either spend money, or make more money,
and most choose the latter over the former, at least eventually. This
tends to cause conflicts for all parties concerned if the aircraft is
grounded by weather or mechanical problems because the medical
crewmembers’ time is usually spoken for beyond the specified
charter. Unless the crewmembers have a good reliable back-up
person who will cover their shifts when they get held over, most
personnel leave the business after a few years, or as soon as it starts
to jeopardize their “real” jobs. Working on-call for an air ambulance
service rarely pays enough to be sufficient by itself.
A very few air ambulance companies actually own their own aircraft.
Most still broker additional flights when their plane is busy, but it
allows the company to have unlimited access to an aircraft as well as
a flight medical crew on practically a moment’s notice. Eventually,
Jeff ended up working for one of these services.
This means that the aircraft is configured for ambulance use 24/7,
eliminating the hour-plus set-up time required on chartered planes. It
also means you have two full crews of flight and medical personnel.
Sometimes, it may be cheaper to fly your relief in to a local
commercial airport, rather than bring the plane back to headquarters,
but at least it means that the aircraft will remain stocked and
configured for ambulance use at all times. It also means that four
people are destined to live half of their lives away from their regular
homes and families. You actually spend more waking, interactive time
with your “alternate family” than you do with your spouses and
children. This lends itself to some very unusual dynamics on all
fronts.
Special Circumstances
There are any number of situations peculiar to air ambulance that
involve using special techniques or special allowances for the unique
set of dynamics peculiar to hyperbarics, acceleration/deceleration,
ascending and descending altitudes, etc. Most of them are covered in
depth in the training manual. This one is not, for reasons that will be
apparent very shortly.
There is a medication called isoproterenol, or Isuprel. It is a synthetic
form of norepinephrine, a form of adrenaline. It is a very powerful
alpha and beta-adrenergic catecholamine used to increase blood
pressure, and well as increasing the force and contractility of the
heart muscle. Powerful enough to make an old leather boot jump up
and do a tap-dance. In the past, it was used as a last-ditch measure
to produce a heartbeat, pulse, and blood pressure in patients who
were in low-output cardiac failure, especially when refractory to longterm dopamine administration. A number of years ago, The American
Heart Association re-classified Isuprel (or Levophed) administration
from a recommended, possibly helpful action to a non-recommended,
potentially harmful action, due largely to the fact that frequently its
resulting inotropic and chronotropic cardiac effects were generated at
the expense of mesenteric and peripheral perfusion, which is to say
that sometime within about four days of administration, end-organ
failure may result. This means that I can give you Levophed to
produce a pulse in a blood pressure today by giving your
gastrointestinal tract, your liver, and your kidneys a ninety-six hour
stay of execution by way of necrosis.
One may well be tempted to ask why a modern, state-of-the-art air
ambulance service would even consider adding it to their rather
considerable armamentarium of life-saving medications known to
have proven positive effects on patient mortality and morbidity. The
answer is this: if a family pays a fifty per cent non-refundable deposit
on a ten to twenty thousand dollar air ambulance transport to bring
grandpa from Missouri to Los Angeles so the family can say their
goodbyes before he dies, everyone involved will be VERY
DISAPPOINTED if grandpa arrives DOA.
If grandpa is already dying, an extra four days’ time for the family to
say goodbye is a good thing, and no one will be disappointed. For
patients with life expectancies of more than ninety-six hours, it would
not be considered a wise decision by anyone. Hence the adage:
“Levophed or leave ‘em dead”.
The service for which Jeff worked carried Isuprel for cases where the
former, rather than the latter circumstances prevailed.
Another set of special circumstances would involve the addition of
family members, pets, and luggage into the logistics of how it all gets
done. Especially on return flights to foreign countries, the family will
sometimes attempt to overload the aircraft with microwave ovens, TV.
sets, and other consumer goods, presumably to avoid tariffs and
taxes that would otherwise have to be paid. The pets were either
caged and/or muzzled. Similarly, provisions were also made for the
administration of sedatives to particularly unruly, high-strung, or
uncooperative family members (or pets), “…as needed to maintain
flight safety”.
Other circumstances may involve details like arriving at a foreign
hospital after hours to find out that copies have not been made of the
charts and records. The Business Office and Medical Records
Departments may have the only copiers available in the entire
hospital.
Bed sheets and pillowcases are a sort of barter commodity in this
business when you are out of country. It is not uncommon to have a
nurse standing in your way demanding trade of clean sheets for every
sheet with which the patient leaves. More than once, flights have
been delayed at the airport while a customs agent checks a special
list to see if the patient owes money to anyone important enough to
prevent their exodus.
Form is Emptiness.
Emptiness is form.
Miguel and Sonja
From the first moment that Miguel saw Sonja, he knew that they
shared a common destiny. In their world, abstractions like Love, (or
for that matter) Destiny were unknown. They shared a world we
would consider to be filled with only the harsh realities defined by the
Real and the Finite. And yet, as mean and minimalist as their worlds
had been, they both felt a heretofore unknown attraction stirring
within themselves that left them both mesmerized and spellbound.
Being relatively young, they shared the reckless impulse of youth.
Unaccustomed to the sort of culturally-determined cautions with
which most of us have been poisoned, it was with a new found frenzy
that they embraced and copulated in reckless abandon.
This was not, however, a product of either their tropical, or their
Catholic Caribbean/Hispanic-influenced environment. Although they
had only known each other for less than five minutes, nether knew
that they would both be dead within the year. They were young and
impetuous and had no concept of impregnation, let alone
contraception. This was not unusual in their world. For Blattodea
Periplaneta (cockroaches), it was a way of life.
Not far away, more sinister activities would prove to be the harbinger
of Death.
The Tables are Turned
A man kneels; his eyes covered with a dirty blindfold half-soaked with
blood. His face is swollen almost beyond recognition. His hands are
tied behind his back. In North America, he could have been a model
for some “Big and Tall” mall outlets for men’s clothing. Doubtless,
there must have been some point when hope of pleading for his life
had left, or even a point where he still felt fearful, but that was now
long gone. It seemed a lifetime ago, and in fact, almost was. Sixty or
so years now seemed, in retrospect, to have passed incredibly
quickly, with the exception of the last four terrifying and excruciating
hours. Resignation had settled until all that was left was the waiting,
and an occasional sigh.
“Cabron! You don’t look so proud or arrogant now, do you?” Although
he can no longer see any of his captors, the voice is familiar. A halfdozen men stand around him. They are all sweating, and none of
them have escaped being stained from the gore, like picadors at a
bullfight. The largest of them, a menacing young man, perhaps in his
late twenties, leans next to the ear of his hostage. A giant of a man,
perhaps six and a half feet tall; his intimidating demeanor is further
augmented by his sheer muscularity. His bulk, as well as his lanternjawed facial features would suggest he is no stranger to injectable
anabolic steroids. He speaks in a stage whisper, as his victim flinches
by the mere sound of his tormentor’s voice.
“Where are all your friends in high places now, puto” He spits into the
face of the captive man to punctuate his contempt. “Now that you are
no more use to them, you’ve become a liability that even they don’t
want to have to deny. You strutted around here like some kind of
rooster for a very long time, but roosters don’t fly so good. I wonder
how well you can fly.”
They are standing on a second-story veranda that overlooks the front
of the villa. A car is approaching the estate by way of the long, treeshaded drive. Oblivious to the witnesses within the vehicle, the large
young man grabs his hostage by the belt and the back of his shirt and
tosses him over the railing. He lands face down into a flower bed with
a dull thud, motionless.
“Conyo! Mamma is going to be muy encojonado if you messed up her
flowers!
Carlos, the smaller, older man is visibly shaken by the recent actions,
but they all burst into nervous laughter at the incongruity of the slight
man’s concern over the flowerbed. As he looks over the edge of the
railing, a well-dressed man in his sixties exits the back seat of the
limousine that has just now pulled around the circular drive in front of
the villa. For a man as large and as old as he, he leaps from the
vehicle like a panther. He removes the dark esplendido stogy from his
clenched teeth as he looks first at the man lying prone and
motionless in the flower bed, and then back up at the men on the
veranda. He repeats these motions several times, in disbelief. His
face glows a florid purple as he shouts.
“Chingao! Rueben, have you lost your mind? What do you think you
are doing?”
Ola, Poppy! The man on the balcony responds nonchalantly. “Nada
mui importante, really. Just throwing out the trash. Old stuff we don’t
need anymore… solamente uno poco basura”
“Come down here, right now”, the old man shouts. “Every time I leave
this place for more than a day or two, you start acting like you run the
place, but until you learn to start thinking before you do something
stupid, that is not going to happen until I die. But I swear to God that
you are going to give me a heart attack and put me in an early grave!
Is that what you are trying to do?”
The younger man deftly does a side hurdle over the railing and lands
next to his father as nimbly as a cat, oblivious of the twelve or so feet
that had been separating them. The old man flinches and shakes his
head, but smiles as he cuffs the younger man on the back of the
head. As he kneels next to the man in the flowerbed, he rolls the
motionless victim over, the still-blindfolded man gasps, which startles
both the other men who leap backwards, stumble, and fall.
“Carajo!” they both exclaim in unison as they cross themselves.
“Esperde! The old man strokes his chin with his right hand, the large
stogy trapped between his index and middle fingers. “I got an
idea…put this culo in the back of your jeep and call the doctor. Tell
him to meet you at the hospital. Maybe we can turn this into
something smart yet….
Rueben, who had been sitting on the grass where he had fallen, now
leaps to his feet, but not before Sonja had taken the opportunity to
crawl into one of the cuffs of Rueben’s victim’s trousers. She had no
idea where she was going, but she acting on pure impulse, as if on a
mission. Forces beyond her comprehension motivated her actions
now. Miguel was not even a distant memory, a mere anecdotal
footnote on her timeline. This was all about the perpetuation of the
species and the cycle of life. This is the real stuff of which women’s
intuition is made. Although women may understand a little of it, men
have absolutely no clue at all. God was Alive and Magic was Afoot,
and the stew of future generations simmering in Sonja’s abdomen,
like Dr. Frankenstein’s progeny, only needed that vital spark of life
that was soon to be discharged, one way, or another.
There are probably as many theories about the nature of life and the
existence (or non-existence) of the Soul as there are logical and
ethical incongruities in the platforms of either American political party.
And that is precisely what they are: theories. Speculation. Faith is
what we believe in the absence of proof.
So, let us just agree to consider the following items as possibilities.
Neither matter nor energy can be created nor can it be destroyed, but
it can be changed in form from one to the other. That which can be
said to possess Life also possesses certain measurable forms of
energy, and these energies possess predictable patterns, and in
some cases, even rhythms. That which we call inanimate does not
possess these energies, at least as far as we know, or generally
speculate.
When something ceases to be alive, where does the energy go?
When a new life begins, from where does this new, individual source
of energy come? There are those among us who are inclined to
believe that the Laws of Conservation of Mass and Energy might
apply to the realms of the Spiritual as well as the Physical Universe.
Now imagine Sonja, pregnant and heavy with newly fertilized eggs,
nestling in the cuff of the pants of a man whose life energies are
draining from his body almost as fast as the internal hemorrhaging
from his bruised and ruptured internal organs are distending his
abdomen and collapsing his lungs.
If you place a magnet against a piece of ferrous metal long enough,
eventually some of the magnetic energy will be transferred. Transfers
are often accomplished by way of concentration gradients.
Sometimes gradually, and sometimes very quickly.
Neither Matter nor Energy
can be created, or
destroyed, but they can be
changed in form.
(Just the same, God or no God…where the fuck did it all come from?)
(Sometime later, in Fort Lauderdale…)
Two pilots sit at a bar, hunched over their drinks. The establishment’s
décor is the kind of generic aviation theme that you could see at just
about any private airport bar, but this particular one is decidedly
tropical in motif. In addition to the obligatory antique propellers and
faded photographs of vintage aircraft (and pilots) of days long gone,
the walls are paneled in pecky cypress, that gray-brown, worm-eaten
wood so stereotypically indigenous not so much to the Florida
Everglades as to Florida bars. In the previous hundred years, there
were never that many “cracker shacks”, fish camps, or hunting
lodges, as there now are Everglades theme bars. As a result, the
once plentiful and cheap local cypress is so scarce and costly that
imitation distressed lumber is more likely to adorn anything built less
than thirty years ago.
This particular bar is located within walking distance of the FBO
(Fixed Base of Operations) where they have recently hangared their
jet. Although they are on “standby”, they have been told that it will not
be long before their next flight. The business they are discussing now
may indirectly involve company operations, but it is not anything that
they would have wanted to discuss in the presence of the ubiquitous
on-board cockpit recorder. Even now, their voices are so subdued
and obviously surreptitious that, had anyone else been within
earshot, or even seated at the bar, it would have been suspect for
clandestine content.
“Are you sure this is safe?”
“Nothing except War, Death, and Taxes are certain.”
“And the truly wealthy don’t pay taxes.”
“I know a lot of rich people that pay taxes.”
“I didn’t say rich, I said wealthy.”
“What’s the difference?”
“Between rich and wealthy?”
“Yeah, what do you mean?”
“The guy that owns that aircraft…he might be rich, but the guy who
owns the company that makes that aircraft is wealthy!”
They both laugh, and shake their heads. Truth was that most owners
maintained a visibly affluent lifestyle of conspicuous consumption,
never paid any bill they didn’t have to, and frequently cheated on their
taxes. Both Jake and Ross had been stranded in distant cities all over
the US after landing in some FBO, only to be greeted by Federal
Marshals with warrants and court orders to seize the very aircraft they
had just landed, because the “loaner” engines that they had been
using while the originals were being rebuilt were more than six
months overdue. Sometimes the owners had the money to pay, and
sometimes they didn’t, but it is not uncommon to have to get a court
order to get paid. (And really wealthy people don’t need to cheat on
their taxes, because they can legally avoid paying them in the first
place.)
“Jake, all I can say is this: just keep your mouth shut, and you get an
easy three grand. I know this guy from when I used to run freight out
of here. For the price of my captain’s cash, I can get a kilo of blow. I
have a guy waiting in Ft. Lauderdale who will pay me enough to more
than make it worth our while. Best of all, the owner will never know
because I can use our fuel card for expenses, and what we make will
provide the money to replace the captain’s cash, plus our profits.”
“What about the pick-up and delivery? There are all kinds of people
watching any unusual activity in these places, and plenty of incentive
to dime us out, once they get their money from us, or even kill us, and
keep the whole thing.”
“I am telling you, this is a lock, and here’s why: we don’t even have to
leave the airport to take delivery, because the supplier has a vested
interest in our safety.”
“How so?”
“Because he’s also our client.”
“Are you shitting me?”
“It’s a fact. When I saw the name on the manifest, I made a call to
one of the sons, who had done business with me before. I expected
him to be a little offended with trying to do business in the middle of a
family tragedy, but he said that was OK by him, ‘cause it gave them a
chance to recoup some of the cost of the flight, and after all, business
is business. Truth is, I was a little surprised with how matter-of-fact he
was about the whole thing. Then again, it’s been my experience that
these spics would sell their own children, if the price was right.”
“What do you expect from people who learn how to conduct business
by pimping their own mothers and sisters?”
They both break into paroxysms of laughter again. In fact, they both
needed the money. Ross, the captain, was too old to ever get hired
by a major airline, and had only recently made the transition from
freight to charter. Although charter was considerably more lucrative,
he had already realized that his life had fallen far short of his dreams,
and if he was going to ever save enough money to retire before he
was too old to fly, he was going to have to capitalize on whatever
opportunities he could.
Jake, on the other hand, was not only younger and smarter, but he
was a better pilot as well. Although he had been earmarked for the
Air Force Academy, one winter in Montana, while flying freight, his
crew had overloaded his “Super Connie” so badly that between the
icing, and the extra weight, he failed to clear the trees at the end of
the runway, and crashed, fracturing both his femurs in the process.
The FAA had ruled the crash was due to “pilot error”, in spite of the
fact that he had been ordered by his boss to take the flight, against
his objections over the weather and the fact that the crews routinely
overloaded the planes, and lied on the manifests (at the unspoken
urgings of the owner).
That was a customary FAA ruling. If it isn’t an obvious mechanical
failure (that couldn’t be spotted during the pre-flight), then it will be
ruled “pilot error”. After the ruling, even his father, a retired Colonel,
had not been able to pull enough strings to get him into the academy.
Nor was Jake ever able to win his way back into his father’s favor.
No Form, no Emptiness.
Wheels Down
Forty-three thousand feet. Around two miles higher than any
commercial flight. Mach 0.82. Five hundred miles per hour airspeed,
more or less, plus your tailwind or minus your headwind. (The Jet
stream sometimes travels at over two hundred and fifty miles per hour. Although
your relative ground speed could easily exceed the speed of sound (with a
tailwind), your actual airspeed is still relative to the air around you. At somewhere
above Mach 0.8, the Lear 25 will start to buffet and shake, although the airspeed
alarms are set to go off well below that point.)The End of the Innocence
heralds arrival into Hispaniola in Jeff’s headphones as we begin the
long descent into Dominican airspace.
“You’re more than a few decades late, Don.” He mused.
”…Innocence?
Why
not
announce
The
End
of
Relativity?…Wait!…better still: The End of the Relative Innocence….”
Jeff forgets that he is the only one to question Mr. Henley’s
relevance…(“The Relevance of the End of the Relative Innocence?”)
due to the fact that both the musical selection itself, as well as his
clever repartee are trapped within the virtual space between his own
noise-cancelling headphones, and the musical selections are his and
his alone. Also, at O-Three Eighteen Atlantic Time, it is doubtful that
anyone else really gives a shit as You’ll Never Make a Saint of Me
continues to conjure the ambience of a climate so steamy and dank
that even the roaches carry their own towels. It is the same climate
responsible for the venerable Cohiba. Bridges to Babylon indeed.
Thanks, Mick. If you’re a rock star, being a bad boy is a prerequisite,
but if you are a paramedic, it is a definite liability.
He often wondered if other people spent so much of their lives like
impostors, actors, or undercover operatives just trying to get through
an average day…whatever that was. One man’s ceiling may be
another man’s floor, but the life of any paramedic, let alone an
international flight medic, does not encompass any frame of
reference common to the average citizen. Cops experience a similar
kind of isolation, but most possess a more simplistic and
fundamentalist point of view and belief system that also insulates
them, and gives them a sense of belonging, or fraternity within their
own ranks not common to most medics. Some call it “Traditional
Family Values”. Less kind individuals might be more inclined to call it
a substitute for rational or creative thinking.
Being possessed was no substitute for belonging, especially in a
profession that thrives while eating its own young. Even an Advanced
Aero Medical Transportation Specialist is at its basest denomination,
just a glorified, high-tech airborne teamster…a mover of living meat.
No True Believer in much of anything, his independence had
rendered him the proverbial man without a country, an expatriate
Dharma-Bum with “tendencies…toward a multiple personality
disorder” and “bipolar features”. (…professionals denied he had any true
manifestations of Multiple Personality Disorder…)
They bank, pick up the next vector, and continue the descent into
what might yet prove to be The Heart of Darkness. If he was trying to
set up his own foreshadowing, it was lost, at least as far as he was
concerned. His mind was elsewhere. As the former Eagles drummer
extols the virtues of Forgiveness, he contemplates the pearl of an
epiphany that has taken him well over two and a half decades and six
matrimonial…well, let’s refer to them as romantic expeditions (more
like continuous Leaps of Faith from frying pan, to fire, to broiler, to
fire, or frying pan to frying pan…) to comprehend. It was unfolding like
the petals of a Lotus blossom as the common ground, the Gestalt,
and the connectivity revealed themselves, introduced the next factor,
and moved on like the links of a Caterpillar Tractor tread as it clanked
through the jungles of Hispaniola.
To be the hero of
One’s Own Hero is
to Steal Fire form
the Gods
(from Navajo wedding vows)
Love and Marriage
Those matrimonial Leaps of Faith usually proved to be not so much
“from the frying pan to the fire”, as to “from one frying pan to
another”…you can’t really escape your Karma, or your problems with
what might appear to be a quick fix. For one thing, as overwhelming
as some of our lives appear to be, they are our present situation, or
our present circumstances, even though they are the sequelae of our
basic natures.
Marriage is of course, a complex series of compromises involving two
sets of Karma. As complicated as that can get, it really comes down
to the fact that two lonely, unhappy, and/or misguided people do not
equal one happy couple. Although Jeff believed that Love was the
one true purpose of life, he still defined it in terms of how good it
made him feel, as if the right love with the right woman would make
him happy. So until you actually break the cycle, you don’t escape
your problems, you just exchange them, like returning a faulty blender
to a department store, only to trade it for a faulty VCR.
Of course, the real problem is that although we may realize true
happiness through love, as long as we require reciprocation, we are
still stuck in the same cycle of desire and sorrow. It is not until we can
experience love independently of its return that we can know it for
what it is. It is our expectations that lead us to our disappointments.
Fear, risk-taking, and danger are thrills to be enjoyed that cannot be
transcended without having been experienced. But whether you call it
cyclo-thymic, or manic-depressive, or bipolar, the roller coaster is not
the only ride at the carnival.
When you can love another selflessly, just to love them for who they
are, as they are, without limiting that love in terms of how they
complete your ego, you can love fearlessly. And if you can love one
person unselfishly, eventually, you may learn how to love everyone
as yourself, because once you see the interconnection between us
all, life and love become seamless. Not perfect. Every day is not
bliss, but you can learn to embrace the inevitable with style. Jeff was
not unfamiliar with these tenants in much the same way that many
learned people have at least been introduced to the concept of
Relativity, without necessarily fully grasping how it applies to their
everyday lives, and recognizing those connections.
And so it was that Jeff had exchanged a Lace-Curtain Mick PrincessHeiress for an Arabian Slum-Goddess Call-girl, for a Hillbilly Cocaine
Cowgirl, for a Shanty-Irish ex-Nun/Nurse who couldn’t kick her dirty
habits, and a Child-Bride Stretcher-Bunny before he had met Stella.
Although Jewish by birth, she was essentially a Nihilist with an
obsessive-compulsive disorder. She was also fourteen years younger
than Jeff, which is to say that the year that she entered Kindergarten;
Jeff was commencing his sophomore year of college. In high school,
she had become a Stoner, and one of the many casualties of the
Southern California School System who had dropped out after her
brother had died and her parents had divorced, only to return, finish
school, and finally receive a nursing certificate.
Ironically, she had originally enrolled in an EMT course, but had been
“bumped out” by a Los Angeles fireman who decided to enroll at the
last minute, and got preference. Although she was a damn good
nurse, it had not been her first choice, but it was a choice she had
made that led her and Jeff together. Later, she would embrace
Wicca. For a time, her spirit flourished with her new-found belief
system, but the surgeries, and the pain medications had left her spirit
as impaired as her body had become, and she lost her will, as well as
her way. Although she would experience episodes that seemed as if
her powers, as well as her raison d’être had returned, her coping
skills with the mundane details of everyday life were not especially
strong, and proved to be no match for analgesics and Xanax.
And now the soundtrack for this movie we call Jeff’s life segues, as
Counting Crow’s A Murder of One chronicles one of his deepest
secret fears: …”All your life is just a shame, shame, shame. All your
love is just a dream, dream, dream…Open up your eyes and see the
flames, flames, flames…Your wasted life is such a shame, shame,
shame….”
How could one life be so simultaneously rich in experience, and yet
so financially impoverished? How is it that a man could know the
love of so many women and still be so lonely…lonely, yet never
alone, yet on so many levels always alone?
He had been taught that somehow, happiness, satisfaction, and the
comfort of a life well lived was something that could only be discerned
in relative terms, in the twilight of one’s life, and in retrospect.
Both classical Western intellectual dogma and Zen seemed to
converge on that one axiom, that you spend your whole life preparing
to die…properly, where one viewed the vast tapestry of your life, saw
that it was good, took your last breath, and exhaled the satisfaction
known only to those who knew that they were going to a better place,
or at the very least, moving on, transported by means of tickets paid
for by the life well-lived. That was what he had been taught, yet it
seemed far more likely that no matter which path one took, no matter
what you did, at the end, your final realization was not whether or not
you “blew it”, but rather a long series of revelations of when and
where you “blew it”.
Every choice you make precludes some other choice that would have
resulted in some other consequence. If it only involved choosing
between good and evil, heaven or hell, the lady or the tiger, or life vs.
death, it all would be easy to divine. In fact, most of his choices had
been between whether to get a good night’s sleep before the SAT
exams or practice for some Battle of the Bands, followed by a few
stolen hours and kisses with Ms. Right Now. (Of course, she thinks
she’s Ms. Right…but more likely at best, a future ex-wife). While
“watching the submarine races” may be a term indigenous to the
South Jersey Shore, every town has a Firestone Alley…(it’s where
the rubber meets the road). The guy who gets the academic
scholarship to Harvard probably doesn’t spend much time down
Firestone Alley, but years later, when he realizes it’s too late, he will
be left to wonder…no better off than the under-achieving adventurer
struck late in life by ambition and avarice.
Most people view the lives of others with envy because they never
realize the price each of us pays for the choices we make, and the
consequences that are their sequelae.
Is it possible to be
afraid of too much
truth?
The mouse eats cat food,
but the cat-bowl is broken.
(Zen Koan)
Later on, other versions of the big and little choices made between
responsibility and pleasure still point to the same conclusion: it’s not
“…always either sadness or euphoria…” but at the time, it’s just
another choice gone unnoticed as soon as it is made, and the thread
that connects it to the great tapestry of our lives is no more
recognized than the slow, inevitable progression away from where we
thought we were headed.
Déjà…what?
The other preoccupation that had dogged him for years was a feeling
of being just a hairsbreadth from some sort of huge realization that
would free him from the enigma, the dilemma in which he felt so
trapped…(before shaking loose the mortal coil of existence). And at
the same time, he could actually feel himself avoiding it, recoiling with
the fear of standing on the precipice of some great abyss in order to
view one’s life from afar, but terrified somehow of the realization he
thought he desired, for reasons he did not understand. It would not be
until several years later that he would come to realize, through
reading Pema Chodron, and doing Tonglin Practice that the very
realization that would set him free would also suck the breath from his
brain, and his soul. His Deepest Secret Fear was a realization that
had the capacity to rob him of his sanity more easily than enlighten
him. Once you face your ultimate truth, it has the capacity to stun
your spirit beyond recovery. In this case, Jeff was lucky beyond the
telling, as most of his life had been. At least, that was how he viewed
it. Where others may see only calamity and tragedy, he would be the
first to point out that he was still alive, un-incarcerated, noncommitted (to the care of any specific facility), employed, and married
with children. In his mind, he still had options, even though he had
hedged his bets to their limits. His children somehow gave him a
unique sense of purpose he had not known until then.
Everyone has a different ULTIMATE TRUTH with the ultimate
potential to crack your reality, although it appears that the real
differences come mainly from perspective, or point of view. But that is
for another time, later on, as you will see….
As “A Murder of One” continued, he thought:
“That’s it! There you are, trying to protect what you think you have,
only to realize that you are imprisoned by what you limit…why is it
that women blame the men in their lives if they aren’t satisfied with
their lives…’not fulfilled’ (…and I don’t mean sexually)? Who said it
was my job? If some really exciting stranger comes along, and he
convinces her that I ‘tell her when she’s happy…tell her when she’s
wrong’…like some bird in a cage…she will resent me for trying to
keep her. It’s no wonder that so many men are afraid to make a
‘commitment’. If you try to protect her, she resents it…resents you.
You’re not supposed to fix her problems; you’re supposed to listen to
them. The very things you do to be responsible and stable, make you
boring. By the time you get finished trying to bend your nature to her
will, you might as well be her girlfriend.”
It’s ironic that women are rarely attracted to what they make of the
men with whom they fell in love. Later, when an attractive stranger
comes along, now you seem boring.
Each of us is responsible for our own happiness. Trying to convince
anyone that if you don’t make them happy, it is somehow your fault is
emotional blackmail. If you buy into that, it will suck the life out of you
like a vampire on a fourteen year old boy.”
Jeff was on a roll…”embrace your deepest secret fears, for they will
set you free…throw yourself into the void…it’s not the fall that kills
you…it’s that damn sudden stop…you either learn to fly, or else…(or
else you don’t)…but fear and boredom will kill you more surely…it
just takes longer…like trying to pull a Band-Aid off a very hairy
place…it’s best done like you mean to do it…fearlessly…it will hurt a
whole lot less….”
“Fidelity” was re-affirming everything he had already realized. Once
again, Todd Rundgren was doing the score for this film of his life. Of
course, Jeff was the one who had put these songs together…it’s like
we already know everything we need to know, even when we don’t
understand what it means, because we are trying so hard to wake
ourselves up from that hypnotized dance we call our lives.
There was that story about Walt Disney being cryogenically frozen…a
friend had suggested he wasn’t dead, just in suspended animation.
Well, if death is suspended animation, then the Un-Dead, the
Zombies who are so afraid of Death that they are also afraid to really
live are in an Animated Suspension. The doomed…missing links who
take up space and diminish the life force…sucking up energy and
subsisting on about half a soul at best while they do the Saint Vitas
Dance to a tune written on waves of polypeptides…talk about ‘Sweet
Emotions’. …someday the glove will be on the other hand…”
We Judge Others by their Actions,
but we Judge Ourselves by our
Intentions.
(LSD-Induced observation, c. 1969)
He kept thinking about the letter that he had finally left…the one he
had written several dozen times before, but never let her read. ”By
the time I get to Santiago, she’ll still be sleeping…hell, by one p.m.
she’ll still be sleeping…if she keeps eating those Xanax like they
were Tic-Tacs, she may not even notice the letter taped to the
mirror.”
What can you say about a drug that’s also a palindrome?
“Xanax…no wonder you can’t tell if you’re coming or going…” Not
likely to be a marketing slogan any time soon, but you have to
admit…it sure seems to be more than a coincidence.
The real problem was that there had ceased to be any purpose to
either the comings, or the goings, at least as far as imperatives were
concerned. She had worked so hard, and suffered so much. He
thought that if he removed the necessity of daily work at a job, she
might have the opportunity to pursue the more esoteric and sublime
aspects of Life. Jobs may come and go, but the work of our lives
remains, whether or not we realize the difference between the two.
Instead, she had completely lost her bearings, her horizon line, and
her frame of reference. The road to hell is paved with good intentions.
The road to her hell had been paved with his good intentions.
And in reality, as much as Jeff believed that he would have to solve
Stella’s problems to find his own happiness, it would be years before
he would come to realize that his own happiness was right in front of
him all along. If you withhold your enjoyment of the present moment,
as it is here and now, then it is you who are your own worst enemy.
Placing expectations of what conditions must be present for you to
allow yourself the ecstasy of the present moment is to deny your own
joy. You don’t have to bury your head in the sands of denial. Just
accept what is, as it is, and keep moving. To focus on whatever
becomes the past as soon as it happens, or to worry about what
hasn’t even happened yet will only drown you in either negativity and
criticism or fear. Sure, things could be better, but they also could just
as easily have been worse. Forget better or worse and you might just
stumble upon gratitude all by itself. Abandon the distraction of
criticism of others as a scapegoat to prevent facing your own selfimagined shortcomings, and you might just strip away the hypnotic
illusion of the fear with which we surround ourselves. If you recognize
that with or without a God, our existence in the Universe is a miracle
beyond our imagination or comprehension, then you don’t even need
to wonder where all that matter and energy came from in the first
place, or if there was a first place at all.
“If all things return to The One, to
where does The One
return?”
(another Zen Koan)
Stella Wakes Up…(well, sort of)….
Stella’s day would begin pretty much like every other day;
uneventfully, with a cigarette. Whatever. Six o’clock, nine o’clock,
eleven o’clock. Whenever. When Jeff was gone, the kids got
themselves up for school. They fixed their own breakfast, walked the
dog, and got themselves to the bus stop on time. When they got
home, they did their homework, and usually fixed their own dinner,
and washed their own dishes. Jeff had taught them to be selfsufficient. On the weekends, they often did their own laundry. Stella
had taught them not to expect too much.
She took off the headphones, and looked for something to drink to
wash down her morning medications. First, something to wake her
up, then another cigarette. When all went well, she managed to
actually finish it and put it out in the ashtray before she fell back
asleep. In forty minutes to an hour, she would usually be back awake,
once the medications took effect. When they didn’t go well, she was
awakened to find herself on fire, having ignited her bathrobe with her
cigarette, which their youngest son had some time ago re-named her
“smoking jacket”.
Next, the trip to the bathroom. Emptiness all around. The kids are
ready in school. The dog is asleep in the living room. She returns to
her chair.
“(Shit…three hundred fucking channels and nothing to watch that is
worth a damn. Nothing at least that I haven’t already seen four or five
times.)”
Nobody to even complain to about it. When she does finally get up, if
she finds chores undone, or not properly done, she goes into a rage,
but there is still no one to hear it until the kids or Jeff get home. But
when it all has been done and done well, she gets depressed. That is
probably why it is so hard to please her. At least when she knows
why she is upset, and she has someone to whom she can vent. How
do you discuss feeling useless and lonely, especially when you can’t
quite put your finger on what it is that makes you feel so bad?
Suppose you never let yourself admit what you feel? Substitute fear
with anger; you can run, but you can't hide from yourself. If you
compound the illusions long enough however, you can lose yourself.
It wasn’t that her pain wasn’t real. For some people, pain is an
obstacle to be overcome in order to do whatever it is that gives
passion to their lives. Without the passion, without the raison d’être,
the pain becomes the focus, and no amount of narcotics can erase
the pain of a life without purpose. And so, she became her disease.
Five operations and endless diagnostic procedures later, she barely
functioned any more. Eight years of moving backwards. She so
wanted to feel whole again, but didn’t know where to start, let alone
identify what the real problem was. She blamed her husband for
working too hard, or too many hours, yet the longer he was home, the
less she functioned. The kids left her exhausted, and overwhelmed.
When they were at school, she was adrift and aimless, but when they
were home, all she could do was rant. She might get out of her chair
every five to ten days, and go decerebrate over all the household
chores left undone or not done to her exact specifications. Three
boys doing two or three loads of laundry every two or three days, plus
their own dinners, dishes and homework go unnoticed if you never
get out of the chair.
Then there were the semi-regular “crises” that occurred when she ran
out of either cigarettes, or Xanax, or one of her narcotics or
amphetamines. Even the slightest attention to detail would have
allowed for a plan to renew the prescriptions, or get another carton of
cigarettes. Instead, at eleven PM, or fifteen minutes before Jeff’s
departure for a flight, Stella would announce that she was about to
run out of one of her necessary addictions.
On the rare occasions that she woke up (courtesy of copious
quantities of prescription amphetamines) with enough initiative to
undertake some “project”, she would labor maniacally without regard
for fatigue or injuries, only to collapse, in spasms and pain, back into
the chair, followed by the perfunctory self-administered narcotics, in a
seemingly endless cycle, devoid of either satisfaction or respite. On
other occasions, she would get so “tweaked” that she would
compulsively take apart some household appliance, the Water pic, or
the lawn mower for no apparent reason, with no clue how to restore it
to working condition. Sometimes, she achieved amazing results, but
more often than not, it would result in the demise of the offending
devise.
Even the house in which they were living was a testimonial to the
essential insanity of their lives. Two consecutive hurricanes in one
month had made their previous home uninhabitable. The real estate
housing boom was reaching its apex as the fastest-growing county in
North America burgeoned. While “blue roofs” covered in FEMA-issue
plastic were everywhere to be seen, investors with suitcases full of
money where coming to Florida like a second wave of
Carpetbaggers, driving the prices of everything—with or without a
roof sky-high to nearly double the price of what it had been less than
a year before. (This of course, was several years before the economy, as well
as the real estate market “tanked”.)
After several court actions, they were staring down the barrel of a
verdict they could not escape, with no prospects of shelter anywhere
on the horizon, when less than a week before the sheriff’s office was
scheduled to start removing their possessions from their home, they
received an offer they couldn’t refuse for a price they couldn’t afford.
A giant rental, filled with trash and garbage from the previous tenants,
who had stiffed their landlord for the last three months. Literally
hundreds of roaches dropped from the ceilings onto anyone who
dared enter the premises, scrambling everywhere you looked,
feeding on rotting garbage and hiding in piles of dirty clothes in every
corner. When the power went off during the hurricane, a giant dead
sea turtle had begun to rot in the refrigerator. It was waiting for them
when they arrived.
The landlady was so desperate that by the time she had been
referred to Jeff, she failed to recognize Jeff’s own desperation.
Although she had tried to jack up the price by two hundred dollars a
month more than the previous tenants had been unable to pay, she
finally agreed to take four hundred dollars less, in exchange for
moving in “as-is” and to take on the daunting task of all repairs of a
house that had great potential, but had been neglected for at least six
or seven years. It was still more than they could afford….
If you find yourself
standing on the burning
deck of a sinking ship, you
will jump into shark-filled
waters.
The house was haunted by more than one extremely malevolent
spirit. One of the previous tenants had gone completely insane,
claiming that the neighbor’s dog wouldn’t stop staring at her, and had
to be carried out in restraints, screaming obscenities as the neighbors
stood on their lawns, gawking like hillbilly tourists at DollyLand. Jeff
and Stella were prepared for the cleaning, disinfecting, painting and
repairs that were required. They even recruited the services of Jeff’s
cousin to facilitate the ordeal, but they were not prepared to conduct
an exorcism, at least not at first, but as luck would have it, both Stella
and Dee were practicing witches.
When Jeff’s long-lost favorite cousin had first contacted them, several
months before the move (she was also one of “the black sheep” of
the family), she was fresh out of rehab and a bad twenty-plus year
marriage, and looking for a place to land. Stella and Dee hit it off right
from the start, and they often chatted like old friends for hours before
they ever met face-to-face. Both were a bit closed and guarded about
volunteering their “secrets” to others, but eventually the black cat was
out of the bag, and the idea of two witches joining forces had
intrigued them both, even if they had not planned on being called
upon in that capacity before they had completely moved into their
new home.
That was about the time they realized that their new home was
haunted….
Doors opened and slammed shut all by themselves. Ominous moans,
whispers, laughter, voices, and the sound of walking while dragging
something heavy over the tile floors could be heard almost daily.
Recordings were made. The women put their heads together, read,
and consorted with spirit guides. Rooms were smudged, incantations
were recited, and rituals were performed. Although they discussed it,
they agreed that since haunted houses frequently burned down
mysteriously within a year of exorcism, they would try to practice
containment of the malevolent spirits. It was an uneasy peace at best.
Photographs taken during that time revealed eyes and faces in the
wooden paneling that were not visible to the naked eye. Some
pictures contained shadows and swirls of light resembling
disembodied spirits. Majik was definitely afoot….
Three Hundred Channels and There’s Nothin’ On….
Somewhere between the “wake up meds” and the fourth or fifth
cigarette, she noticed the note taped to the mirror. Stella did not
realize that it had been up there for two days, but something made
her feel uneasy about seeing it up there. Jeff often left notes for her,
either on her side table beside the chair, or next to the television
controller, in her lap. Call it women’s intuition, or what you will, she
felt an ominous portent before she arose to open it.
“My Eternal Beloved,
Please understand that everything I say to you is out of love, and
comes out of my best intentions. We haven’t even had a real
conversation in months. When I try to speak to you about my
concerns, you ask me if it has to be ‘now’ only to forestall any
attempts at real communication. You can read this at your leisure,
without interruption, and come back to it as you see fit. No
arguments, just read and try to understand, instead of defending
yourself. Even if you don’t agree with my perspective, or
observations, try to understand that these are also my feelings.
You will find a video on the dresser. Please watch it first. Perhaps
then you will be able to remember…and understand.”
She rolled her eyes, and lit another cigarette, sighing deeply, only to
suddenly realize that her charade was for herself, and with no
audience, it seemed pathetic, without purpose, and an external
manifestation of the kind of internal chattering of dialogues and noise
in which we engage ourselves within our own minds. Relived
arguments, anticipated convocations, self-indulgent rationalizations,
reveries, and ruminations, all to block out the deafening silence that
we are so accustomed to fear.
Jeff had been a talented filmmaker and videographer, as well as a
musician and studio engineer long before turned to emergency
medicine as a career, and long before he had ever met Stella. He had
even won an award for a documentary he had done around the time
they first met, so she was not surprised that the videotape was handlabeled, and one of Jeff’s own productions, simply titled “Try to
Remember”. She was not, however, prepared for what she was about
to see.
Black screen. Music fades in. “The End of the Innocence” fills Stella’s
ears as her eyes fill with tears as she watches the screen fade in on a
scene from a picnic on Key Biscayne over fifteen years earlier, when
they first had met, shortly before they were married. ”Remember
when the days were long in the road beneath the clear blue sky.
Didn’t have a care in the world, Mommy and Daddy standing by…”
The images change, and fade to scenes from the Florida Keys. The
boat races at Islamorada. Sunsets at Mallory Square and Big Pine
Key. Takeoffs and landings they had shot together at night from
Perimeter Road at Miami International. Scenes around the pool at
their first house. Holidays and birthdays with family. Touching
memories, even though they had been tinged with a sense of
foreboding of things they had never anticipated.
The screen fades, and Gimme Shelter opens to scenes of Hurricane
Andrew. While they were treating victims and patients with special
needs at a shelter, their home was destroyed, and their possessions
were looted.
Later scenes of the birth of their first child, and their new homes, and
various re-locations followed. It had always seemed as if no matter
what kind of adversity that had been thrown their way, they always
rose again, like the Phoenix, out of the ashes, as if it was all a test for
whatever was yet to come. And through it all, they had remained
very, very much in love with each other.
The last scene was a single-lens head and shoulders shot of Jeff.
“Can We still Be Friends?” by Todd Rundgren fades in. All he said
was this:
“Through all of this, I have loved you more than I had ever thought
possible. I believed that we completed each other. Most especially, I
believed that in completing you, I would complete myself. Somewhere
along the way, I became an enabler. We need to separate, if only
within our home. The kids would only suffer from separate
residences, and we can’t afford it. It’s time we thought about what is
best for the children, as well as for you. They are too smart not to
already know that this is not what a real marriage is about, and we
can at least be honest, and loving with them, and hope they can learn
from our mistakes. I can live in the guest room. Hopefully, we can
maintain some continuity and love within our household. Other than
that, I will try to work as much as possible, and stay far enough away
that you will need to learn to stand on your own two feet again. I had
always believed that we would grow old together. Now I don’t know
which upsets me more, the thought of not spending the rest of my life
with you, or the thought of spending the rest of my life with you.
There’s a big difference between taking me for granted, and
forgetting about me completely. In spite of all the song lyrics to the
contrary, I’d rather see you happy with another man, than to watch
you slowly die a day at a time while you blame everyone else for your
misery. It’s time we went our separate ways together.”
“I can’t expect you to get sober, lose weight, exercise, fix your hair,
bathe or dress up for me if you won’t even do it for yourself. Even if it
takes hating me enough for moving on with my life to do the same
with yours, eventually, you will realize that you have got to clean up
your act to find the kind of man you really want. A long time ago, I
thought that I was that man. I love you enough to stand aside so you
can find out. My love for you is my choice. No one can take that from
me, not even you.”
“Shortly after we first met, I remember telling you that I was
convinced that eventually we would go our separate ways, not
because we didn’t love each other, but because eventually, you
would need to learn other lessons that I wouldn’t be able to teach
you. Eventually, you will need to move on, to grow and experience
Life in your own way, and on you own terms. As much as I loved you,
even then, I knew that I loved you enough to let you go. Maybe I
hoped that the road you took might lead you back to me, but I always
believed that both our lives would be richer and fuller for having
known and loved each other.”
“Now I know that I am in love with a ghost, and that I am in a
perpetual state of mourning for you. It’s not just because you’ve
changed. With evolution, change is inevitable, and something to be
embraced with graceful acceptance. You have become a malevolent
spirit that refuses to accept that you are already dead, and with
death, comes decay.”
“Because I Love you
It’s time to go.
I knew the first time I saw you
I told you so.
Not in vindication
and certainly not without regrets.
Go in Peace with my
Blessings.”
Then he leaned forward, very close to the camera, and whispered:
“What have you done with my Goddess?”
As she read the last remark, she began to cry, and then to sob. The
last remark was the title of a poem he had written for her about a year
earlier. It had seemed for a time that it had made an impression on
her. Now it appeared that it had actually reached her on a deeply
emotional level.
A Fix-up Life…for a Fix-up Wife
There are a few elements common to many emergency services
professionals that are often referred to as “rescuer syndrome”. No
matter how well-adjusted the individual appears to be on the surface,
they always feel the need to do more and be more, and rarely take
more than a moment to rest on their laurels, or smell the roses. They
never seem to lose sight of the next achievement, just over the crest
of the next hill in the road ahead.
Another feature is that they are constantly trying to fix everything
around them. Some rescue stray and injured animals. Others
renovate run-down houses that have been repossessed, or fix up old
cars. It should come as no surprise to anyone but them that they all
too often try to do the same thing with the people with whom they
become romantically involved. This usually results in becoming an
enabler, and the results are often not pretty at all. Much like an
untrained person who tries to rescue a drowning swimmer, the
rescuer also becomes a victim.
Jeff was a medic who was about to marry his fifth future ex-wife when
he met Stella on a double date. Stella was a nurse who kept
bouncing back and forth between LA and Ft. Lauderdale (the homes
of her divorced parents). At that time, her bi-polar mom was out of
work again, and Stella was turning over her checks to her mother to
pay the rent, and expenses, (ironically including co-dependency
therapy for herself and her mother), while her car payments were
going into default. (Once again, we see how the victim victimizes the
rescuer.) Both Jeff and Stella were brilliant, charming, and very
attractive, but both had serious issues concerning self-sabotage. Jeff
even married for a fifth time, despite the fact that he was already
(also) in love with Stella, who had also become his fiancé’s best
friend. He imagined they would eventually all live together…a house
by the sea.
If you are going to
save
the world, first you
have to start with
yourself.
(As obvious as this may seem)
What is the difference between an EMS
War-Story and a Fairy-Tale?
(A fairy-Tale starts out: “Once upon a time…” and
an EMS War-story starts out: Now this ain’t no
bullshit; this really happened…”)
Jeff was enrolled in his Paramedic training courses when he met
Jack. At the time, Jeff was working as an armed guard for a security
company, and Jack was working as a bouncer at a local nightclub.
Jeff’s hair was relatively short, but permanently disheveled, and he
was frequently forced to show up to class in his guard’s uniform.
Polyester, and midnight blue, it looked curiously similar to a City of
Miami police uniform, except for a few patches. Jack’s hair was
nearly shaved over most of his head, but he had grown a cue that
had been braided that extended down well past the middle of his
back. Motorcycle (engineer) boots, a sleeveless t-shirt, and a black
motorcycle jacket completed the ensemble. Jack was tall, and lanky.
Jeff was short, and muscular. During breaks, when small groups of
the students would stand around together, if Jeff and Jack ended up
in the same group, it was Jack who was first to display open
contempt and mocking disdain toward Jeff, (who was quite
comfortable around all sorts of real Outlaws), who generally regarded
Jack as a poser, or self-proclaimed Culture Hero, bent on becoming a
legend in his own mind.
As Fate would have it, there were two main groups of the better
students; true believers and cowboys. Jack was as surprised to learn
that Jeff wasn’t a completely straight, but somehow degenerate cop
wanna-be as Jeff was to realize that Jack was also in about the top
ten percent of a fairly large class. Regardless, Jeff quickly realized
that both he and Jack were both essentially outcasts, as neither one
of them had municipal department endorsement or support, and in
fact, neither of them was currently employed in the emergency
medical (ambulance) service by anybody. The ambulance company
and fire department personnel seemed to be enjoying bear-baiting
the two of them against each other. Snide innuendos, japes, jibes,
peppered with barbed invective were tossed back and forth like
catcalls across a fence. Both were surprised by the quality of thought
and the cleverness of the other. Eventually, it was Jack who would
quote both Sylvia Plath and Erica Jong in front of Jeff, who had
recently won a statewide poetry contest before they finally realized
they were destined to be brothers.
A few months later, it was Jeff who was the first of the two to land a
job working for a local ambulance company. Jack had migrated south
after being fired for who-knows-what at the company for which he had
been working. Eventually, they managed to get partnered on a BLS
rig….
A dozen or so shifts passed uneventfully. Segue to a nondescript
house in a slightly rundown suburban neighborhood on the outskirts
of the city proper (in more ways than one), where the ambulance sits
parked, with its motor and air conditioning running, with Jeff in the
front passenger seat, waiting, and monitoring the radio for calls. Jack
drove the rig to this location, and jumped out, stating that he would be
right back, and told Jeff to toot the horn twice if they got a call.
Possibly fifteen minutes pass before the dispatcher requests a QTH
(location) from Jeff. Before he answers the radio, he quickly toots the
regular (truck) horn on the ambulance. He responds, and Dispatch
requests he stand by. Two more, slightly longer toots. Minutes pass.
No Jack. Jeff switches on the air horns. Two short, succinct, but
insistent blasts that could rattle the fillings in the teeth of the suddenly
awakened Dead…No Jack. Dispatch gives a location in the central
downtown area of the city. Jeff is already agitated over having gone
about three miles outside their zone in the first place, and precious
time is being lost. Jeff sets loose a short wail from the siren. He
acknowledges the call and address, and states they are in route,
trying to circumvent giving his present location. No dice; Dispatch
requests it anyway. To lend verisimilitude, he now has to actually
start the siren, and in annoyance, as Jack is still nowhere to be found,
he turns on the emergency lights, flashers, and strobes. He states
“10-9?” (Last contact unintelligible, please repeat.) He is stalling.
Dispatch repeats the request. He requests they stand by. Time
passes. Jack finally saunters out of the house to the ambulance as if
he is strolling in the park. Jeff tells him they have a call, gives the
location of it, and tells Jack to handle dispatch.
If Jack seems a bit distracted, it is probably because, as Jeff was only
to learn much later, Jack has been inside all that time, smoking crack.
Small wonder that, in trying to think up a plausible lie, he tells them
they are at a location even closer to their intended destination. By
national, as well as county standards, they have only six minutes to
get there. They are fucked.
Jeff is angry, but determined. He has climbed into the driver’s seat of
the rig while waiting for Jack’s return, and does not intend to fail
without a fight. He takes off like Meatloaf’s recently released album,
“Bat Out Of Hell”.
In those days, most private ambulance companies utilized the Ford
E350 chassis van with a special conversion package that was
retrofitted into something suitable for ambulance applications by any
one of several companies that did custom van conversions. They
were still powered by gasoline engines, usually the 454 Lincoln,
topped with a mammoth four-barrel carburetor capable of producing
over six hundred and fifty cubic feet of vaporized fuel per minute.
Oversize, extra wide tires and Cragar chrome reverse rims helped
compensate for the higher center of gravity, (as well as the
notoriously low wages.) Even with an automatic transmission, a new
rig could smoke the tires from a standing start.
Lights and siren (called “Code Three” response) can do a great deal
to not only facilitate an emergent response to a specific destination,
but to also inflate the egos of newly-recruited EMT-Drivers. Already
adrenaline junkies by nature, making traffic pull to the nearest curb at
your command, like Moses parting the Red Sea helps span the gap
between your dreams and that sinking realization that comes every
two weeks on payday, when you sigh, and think: “Yeah at least I’m
not a waitress!…they make more money!”
Jack had a microphone in one hand, and a map book in the other,
trying to find the shortest, quickest route to their destination as he
continues to try to bamboozle Dispatch as to their location. Again, he
eventually gives Dispatch a location that is actually closer to the
destination than they really are.
They are now officially and totally FUCKED….
As they race down two-lane streets with cars parked along both
sides, weaving and passing in and out of their lane, Jeff tries mostly
to “thread the needle” down the centerline of the street. (To drive
between two lines of cars, whether oncoming, or the same direction,
by straddling the white line.) They both knew that they were betting
on their margins.
Suddenly, the car in front locks up its brakes, and pulls right toward
the nearest curb, despite the continuous line of parked vehicles along
both sides of the street, which leaves the ass-end of a new BMW
directly blocking their lane. No problem, swing left, pass, and drop in
front again. Except for one thing: a car has just turned around the
corner, into their oncoming lane, just as Jeff starts to pass the
Beamer. There is not enough width, or distance, let alone time to go
around these obstacles without passing through one, or even both of
them under normal circumstances….
What happens next is a little difficult to explain, let alone understand,
unless you either were there, or have done something similar before,
but it goes something like this:
First of all, if Jeff had been forced to plan his actions, they both would
have probably died that afternoon. Everything that was done was part
of a series of reflex arcs that had been learned at some point or
another, even if not in exactly that sequence, except for the parts that
were pure bullshit speculation, or SWAG: (Sophisticated Wild-Ass
Guess).
Jeff braked hard and spun the wheel hard left (never do this). This put
the ambulance into a skid that was so strong, that the right side of the
ambulance left the ground. There are mystics who claim that it is
possible to bend time. Einstein postulated that both time and space
are essentially already bent. Anyone who has ever experienced
distortions in the time-space continuum will generally describe the
impression that all activities around them have slowed down to some
degree or another. From a non-metaphysical standpoint, it may be
that under extreme duress, our reactions and perceptions may speed
up far beyond normal perception. Under those conditions, it might
appear that everything else has relatively slowed down. Regardless
of how you analyze it, this was what Jeff experienced. In slow motion,
he observed his terrified partner rise what looked like two feet above
him, only to release the brake pressure, as he swerved hard to the
right, which was a good thing, because while the left wheels were up
in the air, with the brakes locked, the unit still moved in an essentially
forward direction. As the brake was released just as he was making
the right turn, the unit swung wildly to the right, missing the Beamer
by no more than half a coat of paint at best, as he jammed the brakes
yet again, only to put the left-side wheels up in the air, skidding again.
There they were, riding right on the very edges of the right-side tires,
which were squealing, and moaning like dinosaurs in the throes of
orgasm as the ambulance listed on a gracefully sickening angle, like
a sailboat with no crew to hike out on the side-rails. Jeff was now high
above Jack, who was locked in a white-knuckle tetany, as if already
braced for the inevitable impact. For that brief instant, it seemed like
there could have been time to reach for a pack of cigarettes and light
one with the electric lighter in the dashboard. It was a fine, clear
moment, when an angel could have danced on the edge of a razor.
For that one brief moment, Jeff was that angel. Finally, he released
the brakes as he steered the vehicle back into the lane, and dropping
the two left tires VERY firmly onto the pavement, followed by several
very wobbly skids, as he continued to try to correct for the
overwhelming inertia of the vehicle. Somehow, impossibly, they had
skidded and slid around two inevitable impacts.
Once he corrected the trajectory, Jeff continued to accelerate through
the next open stretch. Jack was the first to speak:
“Fuck…that was amazing!”
“What?” was all that Jeff had to say (He was determined not to admit
he was just as astonished by what he had just witnessed as his
partner was…maybe more so).
And so it goes. It was hardly the kind of story that can be told openly.
Drug abuse leading to public endangerment and wanton disregard for
the public safety. The preposterously unlikely sort of events of which
urban legends are made. Jeff believed he would never have willingly
put himself in that position, and yet that was exactly what he had
done. In the process, through adversity, he transcended the mundane
and commonplace events of his life, and experienced the sublime.
About eighteen months later, Jack tried to slide a rig through a red
light more or less sideways, at three o’clock in the morning in
downtown Miami, on DuPont Circle, and ended up destroying a new
ambulance, and doing something like $100,000 damages to the
jewelry store he hit. He later married, and then divorced the EMT that
was riding as his partner that day, but in between, he joined the
Army, and was given a D.D. for running a black market operation out
of the Quartermaster’s Supply by selling antibiotics to a large
percentage of the whores in South Korea. He made a small fortune,
until he got caught.
Regarding Drug Abuse:
(No Drugs Were Harmed in the Events Described Herein.)
Celebrity Quirks and Coincidences
Cut to Long Beach Airport, in an FBO of some considerable
elegance, where it is not unusual to see celebrities of all sorts….
Jeff is seated on one of the long leather couches that ring a
conversation pit in the center of the facility. He is wearing his more
formal uniform, which is a true “flight suit”; one piece, front-zip, twotone (Navy and Black), and more pockets than…(you can imagine). A
stretch limo pulls up and stops, whereupon a man emerges from the
driver’s seat, dressed somewhat vaguely like a chauffeur…perhaps it
was the hat…passes around to the back of the vehicle like a
pro…ducks head, pivots on left foot as it exits the vehicle. Right foot
plants facing the rear as it comes out in one fluid movement and he
stands tall and walks briskly as his left hand touches the leading edge
of the left rear fender, just in time to pivot again on the left foot as the
right foot does a reverse 270-degree turn so as to plant both heels
simultaneously, now facing forward, as the trunk opens. The man
leans forward in a brisk, almost robot-like singular motion, and grasps
the handles of two leather bags. Both are lifted, pivoted and swung
outwards, clear of the rear lip of the trunk (this time in a clockwise
fashion, so as not to encounter the higher clearance of the top of the
left rear fender). He faces forward, then veers toward the Lounge of
the FBO.
The walls of the building are predominately glass, upwards of thirty
feet in some places, and at ground level it is usually easy to see all
the way through the building to the tarmac on the other side, where
the jets are parked. It is the straightest route to his destination, a
beautiful Gulfstream, already fired up, screaming mechanical
choruses of Industrial Motor Noise, Pakistani Jazz, and Venus Gas
Music…broad, vast bands of frequencies, rhythms, and beats
punctuated by sharper frequencies that shift with the Rpm’s of the
engines. Slowly, almost imperceptibly, as mixtures, pitches, and
Other Variables are synchronized, the vast noise takes on a musical
character that for some is never or seldom heard (i.e. noticed or
recognized), yet for others is startlingly apparent. It is so loud, it is
dangerous, like the reputed Voice of God, that would “shatter asunder
any man”…who should hear the Voice directly. If you work outside at
an FBO it is required that you wear hearing protection. Initially, it does
not sound so much like music, as much as it is to become aware of
the harmonization of this vast range of frequencies commonly
regarded as noise…Jeff eventually came to realize that all his favorite
pilots seemed to wrestle harmonies from those engines and airframes
that were conspicuous in their absence when forced to entrust his life
to lesser pilots…. On long flights, especially at night the harmonies,
melodies, beats and counterpoint would reveal themselves to him as
majestic symphonies to drown out the earworms of Top Forty Radio
and commercial jingles that so frequently fed upon his brain like
maggots on a rib eye. Jeff almost always heard Music. His dreams
had soundtracks, and he usually awoke to daily anthems and ballads
alike. They frequently set the stage, as well as the mood and tenor of
his day. On some days, only motor noise, screaming or gunfire could
drive out the earworms.
Jeff looks up from the magazine he had just picked up from the glasstopped table (a copy of SO RICH AND GLAMOROUS: DON’T YOU
Wish You were Me? […a big favorite in places where Conspicuous
Consumption is so norm de rigor to the point that it goes unnoticed]).
He picked it up because a picture of Joey Pantoliano was on the
cover, and the caption alluded to an interview inside. As he looked
up, he noticed the face of the “chauffeur”, as they locked in, eye-toeye, only the heads turned on axis, pivoting, almost owllike…something very familiar about this fellow…but why?…Jeff
knows only about two dozen people in all of California (mostly North
Hollywood or Van Nuys), and his mind races through the rogues’gallery (…”who? where? Was I ever in his home?”…Oh Shit! It’s
Henry Winkler….).
“Oh Hi!” He blurts out reflexively, like a monkey discovering a
heretofore unnoticed banana.
“Well Hello!” Henry responds in a coyly humorous manner that ever
so gently satirizes the familiarity between them.
“So how have you been?” Jeff inquires. It would seem that Jeff had
managed to broach that great divide that normally separates the
Celebrities from the Hoi Palloi, as both parties were enjoying the
seemingly inappropriate familiarity of the exchange.
“Great!…or so they tell me”, he shrugged, “and you?” For just an
instant, he had dropped the crisp intensity of focus that had seemed
to grant him anonymous passage. He smiled broadly, like Just Plain
Henry.
“Just about as fine as frog’s hair…” (What?!?)
“Well, keep up the good work.” Henry chuckled.
Henry now faced forward again, still walking, bag in each hand, but
his head tilted backward less than 27 degrees.
As a “Ramp-Rat” (Demeaning moniker for an entry-level worker in the
private aviation industry.) opens the door for Mr. Winkler, Jeff shouts:
“See you around”. A final incongruous conclusion to this humorous
repartee, at least for now….
Cut to Teterboro Airport…Conan O’Brien is towering over everyone
around him, a gaggle of at least a dozen people who are all acting
like their very lives, or at least livelihoods depend upon this alarmingly
tall individual. But something is wrong, it seems, to Jeff, but he can’t
put his finger on it…he hadn’t even noticed when they came in. He
had been reading a copy of SEEN CAVORTING IN THE
HAMPTONS, another ghastly publication devoted to inflating the
egos of people privileged enough to warrant notice, and insecure
enough to need it.
At first, he thought that Mr. O’Brien was pissed off about something,
or that there was about to be an incident, like gradually noticing an
unpleasant odor in a room full of people disinclined to acknowledge it.
Soon it occurred to Jeff that it was simply the fact that the patently
goofy persona so characterized by his television personality was
gone. In its place was a sterner visage of a man who was definitely in
charge, and not being paid to make anybody laugh, but looked like he
should have been paying somebody to make him laugh. Although the
Teterboro FBO had a considerably larger lobby, and Mr. O’Brien was
at least fifty feet away, there was a conspicuous lack of mirth to be
seen anywhere, even for New Jersey.
Cut back to Long Beach Airport, several months later. Jeff looks up
from a copy of Cigar Aficionado just in time to catch the gaze of the
notable Mr. Henry Winkler. This time, both parties seemed to
recognize each other at about the same time, but this time, it seemed
Henry was more piqued by the coincidence…but it was Jeff who
spoke first, again.
“Hey, it’s you again! What, do you work here?”
“…Actually, It’s always been me…just as it has always been you.” He
did not so much even stop as to very slightly slow down as he passed
while making the remark.
“Loved you in Little Nicky…” (Where the “much-beloved” cameo
appears covered in bees).
“Oh, wow!” He chuckled “…You are a deeply disturbed individual…”
he quipped, smiling, and shaking his head, amused.
“What do you expect? You gotta be sick to fly with me…besides, it
WAS pretty funny…” Jeff made an imploring gesture with his palms
upward.
“See you around, Hank.”
Jeff never saw Henry Winkler again.
High Above The Republic
The aircraft banked hard and the real descent began, down through
the clouds…a little bit of weather, and a few buffets. Under power,
Lear 25’s have the trajectory of a bullet. A few bumps in a Lear would
be more like wind shear in a commercial “cattle car”. He had grown to
hate the commercial flights; the Lears had spoiled him…of course,
without power, they have the trajectory of a brick…if you fly long
enough, you learn to recognize a “flame-out”…shit happens (once in
a while). Up to a point, a good pilot can cover up for piss-poor
maintenance, but you learn to work for only the best flying services if
you are smart.
In the last year alone, he had survived several major flame-outs, two
engine fires, a near-miss from a meteor, been struck by lightning, hit
a Condor at seven thousand feet, and was nearly blown off the
runway by a forty-two knot crosswind while landing in the middle of a
“Nor’easter”.
Real vs. Symbolic Power
Soon they would be on the edge of the jungle outside Santiago. La
Vega; actually between Santiago and La Vega. At Four AM Atlantic
Time, the military still has responsibility for the security of the airport.
At four AM Atlantic time, the Army of the Dominican Republic looks
more like a grade-B movie stereotype of guerilla rebel forces, and
that’s just the ones in charge…you can tell who’s in charge because
they are wearing shoes, and have radios.
In many parts of Central America or The Caribbean, uniforms are
nondescript, rag-tag, and in fact, anything but uniform. It would
appear that insignias are somewhat optional, not especially related to
denoting rank, specialty, or branch, and more related to depicting the
soldier’s favorite animal…usually something from the jungle, and very
ferocious. Again, these are the uniforms of the jefes, at least until
dawn…or nine or ten o’clock, or whenever somebody in authority who
has the keys to actually open and run the airport shows up. The rest
of them look more like paramilitary headhunters (more than a
coincidence?…you be the judge). Fatigue shirts are generally open to
the waist, and may or may not be tucked into the shorts, jeans,
loincloths, or whatever is worn from the waist down. Did I forget to
mention the beads, shells, religious icons, feathers and bones
fashioned into the festive necklaces?
Remember Manuel Noriega? That guy from Panama that thought a
chrome machete was an audio-visual aid for emphasizing key points
in a speech by banging it against the podium? It’s another big seller
in all the third-world countries in the Western Hemisphere. And
whether hanging from a belt by a scabbard, or dangling from the wrist
by a leather thong, it does lend a distinctive je ne se quoi to the total
picture of the well-dressed militiaman or bystander in this particular
corner of the Caribbean.
One might be misled to think thus far, that these fellows would
present much too comical a picture to command any real respect at
all, but I have left out the piece de resistance that makes all the
difference in the world. From Mexico to the Caribbean, indeed, most
of the entire Western Hemisphere’s hot climates, it is either the fully
automatic, Colt-manufactured M-16 or the Soviet-manufactured
Kalashnikov that makes the man. Four-and-a-half-foot-tall Mayans
who look no more than twelve years old share this one philosophical
tenant with no less than some of the greatest military minds of the
nineteenth, twentieth, and twenty-first centuries, and it is this: God did
NOT create all men equal…Sam Colt did. The fact that the M-16 was
originally ArmaLite Industry’s brainchild, or that Sam took the great
dirt-nap long before it was even a gleam in any modern armorer’s eye
is a moot point. Perhaps nowhere else in the known world was this
more evident that right here, right now, and by that, I mean the everpresent never-present moment, which is essentially any time
someone else has an M-16 and you don’t. Time and power may
indeed be both relative and absolute, which brings us to our next
point.
Arrival
Although the patient he had been dispatched to transfer was critically
injured, it is truly beyond the ken of most air-ambulance salespersons
to grasp the concept that at four AM Atlantic time, nothing will go into
or out of that airport until…But then again, you have to realize that
although most serious members of the aviation community operate
on GMT, or Greenwich or ZULU time for good reason, “the guys in
sales just get things too confused…” (In spite of the fact that the
entire sales pit is ringed by clocks depicting real time in virtually every
corner of this earth.) Ironically, these hyenas borne of mutant jackals
make several times the salaries of any of the medics, nurses, the
flight coordinator, or even the Medical Director. With limited
knowledge, and even less ethics, they will make side deals,
kickbacks, and broker’s fees even the owner either doesn’t know or
care about, at least until the next time his irresponsible “business
entertainment expenses and promotional expenditures” threaten to
endanger the jewelry, private schools, country club memberships, or
vacations that seem to flow so freely as he wails his sad tale of woe
about forestalled salaries and shitty healthcare programs.
So Eastern Standard, or Daylight Savings, or Atlantic Time aside, the
real issue is that the local militia is in charge of the airport, which is
essentially shut down until the guy with the keys, the shoes, the white
shirt and the tie shows up, and that won’t be for several hours.
The firemen (there is no need for the more politically correct term
“firefighter” in the Caribbean, because there is no such thing as a
female fireman here) are as similarly rag-tag and disheveled looking
as their military counterparts. When the jet lands, they wander out of
their station. There is also no such thing as sleeping through a Lear
jet landing, but they seem to emerge more out of curiosity than
anything else.
The older jets, like the Lear 25, were “pure jet” engines manufactured
by General Electric, unlike the fan-jet engines, such as the Garrett,
which uses a fraction of the fuel, and produces a similar fraction of
the noise decibels, at the expense of pure thrust. The Lear 25 had the
fastest rate of climb in the business, but because of prohibitively
expensive safety requirements, like the RVSM (Reduced Vertical
Space Minimum), their excessive fuel consumption, and their
extremely noisy exhaust, they are destined to become dinosaurs
within the next few years. They are already banned from most major
airports in the US, unless they are operating as air ambulances,
simply because of the federal noise abatement regulations. But
tonight, this jet has center stage to an audience of clowns. All are
either barefoot, or wearing sandals, except for the ones that are
wearing shorts and fire boots. The ones wearing bunker coats
probably are not wearing helmets, and the ones wearing bunker
pants and helmets are probably shirtless, and in suspenders.
“Mañana”, they keep saying (because it is still dark, as if “tomorrow”
arrives with the sunlight). An interesting quirk about the Spanish
language: Mañana means both tomorrow as well as morning. Jeff’s
Spanish is limited, and the locals speak a dialect so full of various
Indian nuances and idiomatics that he can’t really tell whether he is
outside Santiago, or Santo Domingo. And all he has been told was
that his destination is “La XXXXX”. (Never mind exactly where….)
The night air is relatively cool. It is not actually cool, but you can tell it
was much hotter during the day by the way the air feels so damp, and
a light dew has settled on everything the air touches. As a slight
breeze blows air from the jungle onto the tarmac, the dank, organic
aroma of the local flora and fauna envelops everyone.
“We’re definitely not in Kansas anymore.” quips Jeff, if only to himself.
At altitude, the air inside the jet, especially at night, is usually very
cold, and extremely dry. The pilots don’t tend to use the bleed air
from the engines, (which would raise the temperature) any more than
they absolutely have to, so it is not unusual to see a flight crew exit
the aircraft taking off jackets. The problem is that the bleed air
controls never really seem to work the way they are supposed to, and
tend to be either “on” (too hot), or “off” (too cold). On Monday, you
could be landing in Panama, and on Wednesday, you could be in
Yellow Knife, Canada, just below the Arctic Circle. No matter what the
season, a flight crew that goes out for two weeks at a time has to
dress for any occasion, or season. Tonight, the warm, damp air feels
good by comparison.
At altitude, (45,000 ft.) depending on the season, the outside air is
usually between minus sixty and two hundred degrees below zero.
Depending upon the speed of the descent, it is not unusual to see a
recently-landed Lear covered in frost as vapor trails of evaporating
moisture waft from the fuselage like smoke. These are the kinds of
images that one never sees when traveling on commercial airlines.
From that altitude, you can see the curvature of the earth. If you take
off at sunset, you may observe four or more sunsets, before you
reach altitude. There is an otherworldly quality to this kind of flight,
especially at night, and when you land, you feel like you just arrived
on the space shuttle. You may grow accustomed to it, but you will
damn sure miss it when it is all over.
Initially, the screaming jet engines drowned out everything, but
gradually, the sounds of the jungle have begun to tiptoe back onto the
tarmac like a jaguar stalking its prey. Night birds, parrots, and Godknows-what resume the cacophony that is native to the region. The
quieter it is on the runway, the more the jungle begins to intrude back
onto the airstrip, slithering, crawling, creeping, flying, stalking on
tiptoes, wings or bellies relentlessly attempting to reclaim what once
was theirs alone.
Assessment and Report
About six hours ago, as Jeff was leaving the Florida Turnpike to drive
the last few miles home from the previous two flights, his cell phone
had rung again, and after the perfunctory apologies and humorous
expletives were exchanged, he had turned around, to begin the
nearly hundred-mile drive back to Executive Airport.
This was not his usual gig, but the company aircraft was grounded,
and his usual steady paycheck was not guaranteed unless he took all
the flights he could get. The full-time crew worked two weeks out, and
two weeks home, Part-timers had to settle for the “out and backs”,
which would eventually terminate where they had begun, but this was
not his supplemental income, or second job, so he had to compete.
This time, however, it seemed he was considered essential, and
would be accompanying a nurse and another less “worldly” medic.
The flight coordinator had already sensed that they would
undoubtedly be more to this flight than was expected. It wasn’t just
about experience. Jeff had an uncanny sense about trouble-shooting,
and could improvise solutions out of thin air, seeming at times to
connect the seemingly unconnected into a fluid line. And when he
was inspired, he could charm the birds right out of the trees.
A name, and a brief medical report describing a form of injury referred
to as Traumatic Asphyxia (imagine a train wreck turned into a science
project), and the name of the town where the hospital was located
was all he had been told (over the phone, while driving, no less). Not
that it really mattered all that much. This is a business that can drown
you in details, and you have to stay focused on what at least appears
at any given moment, to be the important details.
Perspective as it Influences Plan of Action
Of course, what one paramedic considers an important detail may
seem insignificant to another, and vice-versa. Paramedics are
notorious for their tunnel-vision, which accounts for the adage:
“Paramedics may save lives, but EMTs save paramedics.
Years before, Jeff had the opportunity to work for a relatively new
county-wide EMS system that catered to a series of seaside resort
towns. He and his partner were on their way to breakfast one morning
when they were flagged down by their operations manager, who was
also a medic. At more or less the same time, dispatch was informing
them of what was already obvious. A signal four (also called an MVA,
for motor vehicle accident, but now called an MVC, for motor vehicle
crash) involving a LEO (law enforcement officer). I say obvious,
because it is clearly an auto crash, because the rear end of the
deputy’s vehicle is visibly protruding from the mangroves into which it
has crashed, perhaps thirty-five yards from the roadway It is also
even more obvious that it involved a law enforcement officer,
because he was lying supine, unconscious beside the roadway, and
everyone passing the scene on the one road that connects every
town in the county can clearly see his sheriff’s deputy’s badge pinned
to his sheriff’s deputy’s white class-A uniform shirt. Unfortunately,
everyone who passes this scene also cannot miss the fact that his
sheriff’s deputy’s uniform pants are missing, revealing his non-county
sheriff’s department issue “whitey-tighties”. The deputy should have
had full trauma precautions (cervical immobilization and long spine
board) before he was moved. Although the vehicle had crashed into
mangroves, only the front wheels were in any water, which was not
deep, and the vehicle was firmly wedged in the undergrowth. There
was no fire hazard.
The operations manager had no medical or extrication gear with him,
so the primary objective should have been to protect the victim’s
airway and manually immobilize his cervical spine, and call for an
ambulance. All the above-listed details are at worst, explainable as a
good example of how not to manage this kind of rescue scenario, but
they are, at least explainable. What to this day, more than fifteen
years later, remains unexplainable is why the operations manager
chose to remove the pants from this deputy, after having chosen to
place him on display, like some roadside attraction? And if he should
remove the pants, why not the shirt (and badge) that so clearly
identifies him as a sheriff’s deputy? Sometimes it is necessary to
disregard modesty in the best interests of a patient’s health and wellbeing, but not to the point of putting them on display. And when all
else fails, at least give them some opportunity for anonymity. (Given
only a washcloth to cover my nakedness in some public place, I
would choose to cover my face.) In a sense, the sheriff’s badge and
shirt are more of an issue than the man’s face, at least as far as not
disrespecting the uniform, which is to say, the office of the sheriff. It
should have been all or none.
Code Blue on the Ninth Floor
For about eighteen months Jeff worked full-time for a hospital in
south Florida. Jeff was no stranger to hospital ER’s, but this would be
the first time that he would work for only one hospital full-time. His job
was to work Triage and Intake for the district’s Emergency
Department. Additionally, he would assist in any area within the
department, as needed, starting intravenous lines, assisting
transportation or performing additional tasks as required, or
requested by senior personnel. He already knew the experience
would prove to be stultifying at its worst, but thoroughly
underestimated the hospital system’s ability to limit any initiative as
regards patient care.
Shortly after his initial orientation, he attended a seminar where he
ran into a nurse whom he had known for several years while he
worked as a medic in the north end of the county. She no longer
worked in the ER because she had been promoted to act as the head
of the code team for the hospital, which meant that whenever a
cardiopulmonary arrest occurred anywhere within the hospital except
for the ER, she would be the first to arrive to initiate treatment. She
was in her forty-somethings and had been a registered nurse since
Jesus was a teenager, and was extremely knowledgeable and skilled.
At the seminar, Jeff noticed that her wrist and forearm were in a
brace. She told him she had strained it working a code blue several
nights before while administering chest compressions.
“I thought that was what orderlies were for” Jeff quipped “…I mean
patient care technicians…” he corrected himself to use the more
politically correct term that was now en vogue.
“I couldn’t use them.” she said.
“Why not?” he inquired.
“Because PCTs are not allowed to do CPR up on the floors.”
“Why not?” he repeated.
“It’s called the Hospital Standard of Care”
“I don’t understand. You can’t be effectively running a code while
doing CPR at the same time.”
“In the hospital, only a doctor can actually run a code blue.”
“So what do you do until the Doctor gets there?”
“CPR.”
“You can’t be serious.”
“As a heart attack, if you’ll pardon the pun…do you remember three
nights ago when you worked the double trauma code in the ER?”
“Yeah, I was down there.”
“Well after midnight, the only doctor in the entire hospital was down in
the ER running those two trauma codes. I was up on the ninth floor”
she said.
“Doing CPR.”
“It took the doc more than twenty minutes to get up to nine, only to
call the code the minute he walked in.”
“More than twenty minutes?”
“Yep”
“Doing CPR only?”
“Yep”
“You know I am not the brightest guy in the world, but it seems to me
that if that ever happens again, why don’t you call transportation to
come help you take the patient down to the parking lot. You could
have had a real code working in about six minutes from the time you
call 911. We have a duty to act, and no hospital standards to live
down to.”
She laughed, but unknown to Jeff they were overheard by someone
from administration, who filed a complaint with Jeff’s supervisor in the
ER. That was just the first time Jeff was ‘written up” while working for
the hospital district.
Life on The Road
This is an aspect of the air ambulance business that is more than a
little difficult to describe. For starters, you fly to most of the places you
go, so most of your work is done up in the air, but when your day is
over, whatever life you do live is on the ground, and away from home.
It is a surrogate life, or perhaps more accurately, your alternate life,
but make no mistake, as a traveler who spends half of their life away
from whatever it is you call Home, everywhere else is On The Road,
and yet it is also your home beside the road. Your family probably
lives in a house on a street, yet you do not think of them as being on
the street. Away from home, you are on the road, no matter how
luxurious your accommodations may be.
Keep in mind, that flight support, back at the office, has no way of
knowing what your actual accommodations will be like, unless they
have booked you there before. Cost, proximity to either the airport, or
the hospital, and reputation all enter into the equation. And if some
event, like a major league game, or a convention or trade show is in
town, the results can yield dire consequences. Chain operations, like
Hampton Inn, or Marriot, are predictably efficient, clean, and the staff
is predictably polite and helpful. Individual operations can run the
entire gamut, from charming and unique to abominable. (If you find
yourself contemplating the name the capital of the state that the stain
on your ceiling most nearly matches, you are probably at a La
Quinta.)
At first, your life may seem amorphous, and totally lacking any
structure, anonymously adrift in a seemingly endless series of
isolated missions. You may deeply and significantly affect the lives of
total strangers. They may remember your names, but it is highly
unlikely you will ever see them again, and their names will most likely
be quickly forgotten, even though some of your deeds,
accomplishments, successes and failures will become legendary and
unite you and your flight crew with your charges. They are not just
cases, as often happens in ground transports and hospital care.
Much the same way as with emergency care initiated in someone’s
home, you remember the people, the settings, the relatives and
friends in a more intimate way than you do when you just scoop them
off the street, or whisk them away from their jobs for a six minute ride
to the hospital. Spending several hours rendering care to a patient
(and often, at least one family member) in the cramped confines of a
small private jet aircraft is strangely like driving cross-country on
vacation in a station wagon with somebody else’s family.
Your flight crew becomes your family while you are on the road. You
see pictures of their spouses or significant others, their children, pets,
and their homes and prized possessions. You learn their names and
hear their stories. You may even learn about their dreams and
disappointments. You may disagree about politics, social issues and
anything else of which people are capable of having opinions, just like
any other family. Somehow though, it is easier to respectfully
disagree with each other in a way that most families cannot. We
frequently put too many expectations on our blood relations, which
makes us more subject to disappointments and resentments than you
would with your crew, even though you spend more significant
waking time with them than with your “real” family. And because you
are responsible for working as a team, you are more likely to be more
conscientious with each other.
You have to pack for two weeks. You have to learn to separate what
is essential for that seemingly short time, vs. what is superfluous.
That does not mean two weeks of clothes. More like four sets of
scrubs for hot climates and lounging, and your two flight uniforms,
and enough underwear and socks for say, four days, plus maybe one
pair of slacks and a shirt or two for when you get the chance to eat at
anyplace close enough to your accommodations for the end of the
day, which means washing everything every couple of days when you
have the chance. Plus thermal underwear, a light jacket, and a heavy
coat, some really good leather athletic shoes, and the ubiquitous
tactical boots.
Next comes the essential gear like you stethoscope, a small Maglite,
trauma shears, a center punch, a tactical knife that folds and doesn’t
look too Rambo, and a small emergency tool kit. Most of it needs to fit
into your belt holster, plus a small tanker’s bag. Things like a small
volt-ohm meter, wire strippers, electrical tape, a few wrenches and
Allen keys, a soldering iron, and some light-gauge solder. Jeff lived
for the unexpected events that would shut down less ingenious, or
worldly medics. If one of the knobs came off the dash on the jet, you
could bet that Jeff had the right size Torx wrench to fix it in flight. He
frequently repaired broken transformer leads, sensor wires and leaky
ventilator connectors. He also brought some amateur radio gear, and
was once able to replace a transponder unit that failed in Canada, so
they could fly back to the US to find an FAA-approved avionics tech
who could certify what Jeff had already done.
Whether you work municipal rescue, or air ambulance, there is a
certain kind of ritualistic preparation for either you next shift, or your
next mission, and a kind of fetishistic attention to detail unique to the
profession. Flashy, spit-shined combat-style boots demand an
attention to detail much like what a gear-head will lavish on a prized
sports or muscle car. That can take up to an hour, given that there is
sufficient time. Show me a medic that doesn’t follow the ritual of the
Five S’s (Shit, Shower, Shampoo, Shave and Shine) before the start
of each shift, and I will bet you he is already in trouble. It’s as if the
facade we put on is a kind of symbolic armor to ward off injury and
evil, but it is also more than that.
Jeff was an apostle of Schwartz’s Law: forget Murphy (too much of an
optimist); eventually everything East of the San Andreas fault was
going to slide into the Atlantic Ocean, and Jeff intended to be
prepared for it. He lived for it. “Improvise, adapt, and overcome” was
his motto. He was always looking for the hidden flaw, or the
unnoticed fly in the ointment, preferably before it turned into what he
would call a “cat’s-ass-trophy”. It drove everybody except his
regularly assigned flight nurse crazy, but he maintained that the best
way to save a life was to not kill the patient in the first place with
carelessness or laziness.
Of course, he wouldn’t have been the first well-intentioned person to
be drawn into EMS as a way of compensating for deep-seated
feelings of personal inadequacy. Well-adjusted, self-actualized
individuals do not need to be heroes. There are plenty of accidental
heroes, who suddenly find themselves in situations whereby their
knowledge, skills and their character are called upon to do those
extraordinary acts while bystanders just gawk, or turn away. Jeff
admired those people so much that he purposefully sought out
situations that provided him the opportunity…especially if it put him in
harm’s way, and he had an attraction for controversy that was not at
all healthy, at least not for him….
You also have to know what it is that you can bring with you to
sustain your self. Jeff frequently relied on electronics texts, gun
magazines, and novels by authors that challenged him. Almost every
hotel worth more than four hours of your life has a gym, sauna, steam
room, a hot tub, and a pool.
The range of quality of their accommodations, sometimes most
conspicuous in their absence provided endless opportunities for
adventure.
FBO stands for Fixed Base of Operations. The large commercial
airports, as well as the smaller private airports all have facilities to
accommodate the needs of private aircraft, including air ambulances.
They provide a transition point between life in the air and life on the
ground. The accommodations can range from opulent to Spartan. At
the very least, they will offer fueling services, charts, navigation and
weather information, as well as some amount of hangaring, minor
repairs, washing and detailing. There is usually some sort of a
counter with a display case containing flight-related items for sale.
Often, there is a separate flight shop with a more extensive range of
items. Caps, shirts, sunglasses, clipboards, flashlights, UHF
handheld radios, small to medium sized tool kits, coffee mugs, flight
wings and other insignia, aviation calculators, pens and highlighters
enough to fill a small room await your perusal during the intervals
between landing and “wheels up”. Another thing that police officers,
firemen, paramedics, and pilots have in common is impulse buying of
items they believe to be necessary or specially designed for their
profession. In an FBO, factors like weather, or other factors
determining the time between the next leg of your mission, and
fatigue, boredom and curiosity may account for many of the
purchases made.
If the crew will be “overnighting”, the FBO will either arrange for some
sort of shuttle service to the hotel, or provide a loaner vehicle. Some
FBO’s may have a small restaurant, or sandwich shop, or your home
office may order food to be delivered by a service that specializes in
flight-related catering. If there is time to eat elsewhere, the FBO will
usually have a map and directions, sometimes with either
recommendations or precautions about where and where not to eat;
then the crew boards a loaner vehicle in search of nourishment.
The diversity of regional cuisines is one of the factors that make life
on the road an adventure in itself whether it be for the quick bite or
your real meal at the end of the day. Seafood, beef, pork or even
something exotic, like bison or some other local specialty may be
deep-fried, steamed, boiled, blackened, barbequed, sautéed, braised,
smoked, or raw. As long as they were in the US, Jeff ate whatever
the locals ate, except rhubarb, which made him retch, and did not
endear him in the South, where it was often proudly offered, and
usually home-made, but even the smell of it prevented him from ever
putting it near his lips.
Another interesting fact is that even the best pilots were often terrible
drivers, and even worse navigators. Jeff believed that it was a
combination of the fact that although aircraft travel much faster than
automobiles, they moved within a considerably vaster environment.
Flight, even in executing “military maneuvers”, required a much more
subtle grace than traffic’s close-quartered, rapid demands. Plus the
fact that without GPS, radar, and flight plans, most pilots were
essentially disoriented. Nonetheless, most pilots insisted on driving.
Pilots, nurses, and paramedics are all control freaks, but pilots will be
pilots, and unless it involves something medical, if it moves, they
consider themselves to be in charge. Once it was established that the
pilot indeed had absolutely no idea of where they were, or how to get
to their intended destination, the appointed Nagravator (usually either
Jeff, or his nurse) would try to give instruction and support. They
eventually learned to pay attention while the pilot or first officer was
getting them lost, by following their progress (either real or imagined)
on a local map. This was several years before useful and affordable
GPS units designed specifically for streets or highways became
available. Neither Jeff or his nurse ever actually told the pilots about
their unspoken, but well-anticipated precautionary assignment, which
was usually determined by whoever rode “shotgun”, but then again,
there were quite a few items they chose not to necessarily share with
the rest of the flight crew….
No discourse about Life on the Road would be complete without
discussing what kind of factor that Fatigue played in their lives. FAA
regulations stringently (in theory) determine how long a pilot and his
first officer can fly in any single day. Strictly speaking, the regulations
cover what is referred to as on duty, which is supposed to determine
not just “wheels up” to “wheels down”, but the actual time they are
working. There are many ways to creatively document everything
except actual flight time, and a smart pilot knows how to juggle the
numbers without putting everyone’s life in jeopardy, and still
accomplish the mission. There was also a provision referred to as
something like “Article Seventy-Two” that allowed the pilots to fly their
crew only (no patients or paid passengers) to their final destination for
the day.
It should be duly noted that no such regulations exist for the medical
crew. More than once, “fresh” pilots were sent to relieve “timed out”
Captains and FO’s by meeting them at a scheduled fuel stop without
even considering the fatigue of the medical crew, who frequently had
to start several hours earlier than everyone else, to meet the ground
ambulance to take them to the hospital where they would pick up the
patient, take report from the hospital staff, and prepare the patient for
transport. The entire process frequently ran from an hour to ninety
minutes or more, and the destination involved a reversal of this
procedure. It was not especially unusual for the pilots to be showered
and changed, or even waiting for the medical crew in the bar or
designated restaurant before the nurse and medic had even gotten
into their rooms.
It was also not unusual for the pilots to do everything possible to
prepare for the medical crew’s arrival, like getting their bags into their
rooms, and getting a table at the restaurant for all of them. They all
did everything possible to support and nurture each other whenever
the occasion arose. They were not merely strangers who worked
together. They were Family. Jeff’s nurse helped create the
atmosphere of bonding and love that flowed freely between all of
them. This is not necessarily true of all nurses by any means. It was
just her nature to nurture them all, according to their needs. She
loved to provide the feminine balance to all that testosterone, and had
no issues about proving herself, or imagining being taken for granted,
or establishing her pecking order within the group. It simply wasn’t
necessary, because her knowledge and skills were the perfect
complement to Jeff’s, and frankly, they all loved her. She could be
quite tough when the occasion called for it, and as salty as the ocean
when she felt like it, but she wasn’t afraid to be tender, and they all
enjoyed protecting her on a certain level that allowed her to feel safe
just following her nature. Also, she was not merely “Jeff’s Nurse”, as if
he was the HMFIC (Head Motherfucker in Charge), because he also
regarded himself as “Her Medic”. Everything flowed freely in both
directions in an exchange as natural as the coming and goings of the
moon and the sun.
It is not at all uncommon to find one’s self feeling anger, resentment,
or even hatred for a badly matched partner, especially the later in the
day (or night) that it becomes. Training Officers for municipal Medics
frequently evaluate the new recruits by comparing how they function
in the daytime vs. their “after midnight” personalities to see how
fatigue affects both their judgment as well as their temperament. In
this respect, Jeff was especially blessed. Katie was very tolerant of
Jeff’s generally lascivious nature, foul mouth, disarming humor, and
quick temper because he did not direct it at her, and they both
believed that she brought out the best in him, and he in her.
Exhaustion is a central theme of Life on the Road. When Jeff worked
as a municipal medic, it was a matter of twenty-four hours, plus
whatever overtime you chose to pick up. When he started working air
ambulance, the flights were “out and back” during the forty-eight
hours between twenty-four hour shifts, notwithstanding layovers due
to weather, repairs, “time-outs”, and extra flights booked (usually after
the fact) for the back trip. Once he had begun working full-time on a
flight medical crew, it was for two weeks at a time. In theory that is. If
your relief had a National Guard commitment, you may have to start
your tour a few days earlier than you had planned, or you may be
asked to work for an extra few days. Or the aircraft may be scheduled
for routine maintenance, so they send the on-duty crew home early,
and then call you in a few days earlier than usual, if a flight is
pending.
In the morning, you may start with a flight that picks up in Jamaica
(~eighty-eight degrees), with a destination in Ottawa in December,
where it is a balmy twenty-four degrees below zero. Anytime you go
to altitude, the temperature outside is at least sixty degrees below
zero. Using bleed air from the engines is usually an off or on
proposition, so unless a patient is freezing their ass off, it is best not
to distract the pilots, so you alternately either bundle up, or strip
down. Temperature-induced fatigue is no joke, either.
Noise levels are very high. Altitude changes fuck with your middle
ears constantly, and high-altitude pulmonary edema becomes a very
real risk. Food and alcohol become substitutes for any number of
items that may be lacking in your life, and if you exercise too little
control over when you consume either of them, many bad judgments
get made in the process.
Before the end of most tours, you are so fucking slap-happy and out
of sync with everything, that you skip the swims in the pool, the
exercise rooms, the saunas and steam rooms, and all the activities
that you already know are supposed to keep you sane and
healthy…and then what?....
When Jeff finally made it back home, he tried to plan at least one trip
to the gun range, just to calm down. He loved the Power and Control
of the experience. Not over others…he got enough of that just being
a Medic. It is an extremely demanding avocation that requires
precision, responsibility, and a taste for controlled violence and loud
noise that has the ability to drive out the accumulated fecal matter
that Everyday Life, as well as Uncommon Stress exudes into our
consciousnesses. Freudian analytical second-guessing aside, there
was a profoundly sexual pleasure to it. Orgasms and explosions bear
so many similarities that to the uninitiated, they may be regarded as
substitutes for each other. Nothing could be further from the truth. We
all need to cum; some may need it more than others, especially the
ones who don’t realize how much they need it, but only some
individuals also benefit psychologically and physiologically…even
spiritually from the Other Big Bang. Although after really great sex,
one may be disinclined to immediately discharge a firearm, after a
session at the range, Jeff often felt so emotionally and physically
purged of the poisonous humors of stress, yet charged by the
experience and heightened sensations that he felt compelled to
discharge his “gun” as soon as practically feasible once he got home.
(I know…I know…before you try to label the remark as sublimated
violence against Women, just realize that IT’S JUST A FUCKING
METAPHOR (literally) based on an obvious pun.) Both Jeff as well as
myself love, revere, admire, adore, and perhaps even envy
Womanhood in its most gloriously lavish and powerful, yet inscrutable
manifestations far too much to even fantasize about harming
them…and neither of us ever referred to either a firearm or a weapon
as a Gun.
A New Wrinkle
This is a business that requires a person to “shoot from the hip” more
often than not, because of the subtle and unsubtle details that are
either essentially the same, or different from one scenario to another.
Some actions need to function like a reflex arc, automatically. No
thinking, just do it. The ABC’s of EMS are: airway, breathing, and
circulation (as well as C-spine protection). Almost everything else is
variable, and can represent an overwhelming sea of details that can
drown you if you don’t have the ability to triage the important vs. the
unimportant elements.
Right now, one of the more salient points would appear to be that Jeff
is the only crew member that can speak any Spanish, and the owner
of the aircraft that was leased for this fight (who is no doubt, in bed
sleeping) has screwed up the details for refueling. His pilot is useless.
He speaks no Spanish. His credit card is only good for the brands of
fuel in Santo Domingo, more than a hundred miles away, and there
appears to be a shortage of the legendary “Captain’s Cash”, intended
to forestall such difficulties. (At least now we know that we are closer
to Santiago.) Normally, “Captain’s Cash” can instantly cut through
local regulations, bureaucratic red tape, and even overcome cultural
taboos, superstition, and religion with equal aplomb in ways no
diplomat or even an ecumenical council could accomplish in a
decade. Their American cell phones are also useless, as the owner of
the company has been endlessly stalling over picayune details
regarding the lease of a satellite phone. Previous attempts to locate a
working telephone had been futile, but now that the guy with the fuel
truck has arrived, Jeff learns that the fuel station office has a working
telephone. He explains to the rest of his crew that he will be going to
this phone, and now finds himself following some nondescript
character off the airfield, and several hundred yards into the jungle,
past a guard’s shack…into the jungle, until a clearing is reached, to
reveal a “tank farm”, as it is called, that includes a small structure that
houses a telephone.
The Importance of Re-Assessment
From time to time, each of us finds ourselves in situations that, as
they unfold, start to resemble a bad dream. This was more like finding
one’s self the lead character in someone else’s nightmare. You think
you are headed toward a solution to an increasingly unsavory
problem, only to find yourself following some guy you don’t even
really know away from the last vestiges of civilization (relatively), off
the airstrip, and into the jungle of a foreign country as nonchalantly as
if it were a stroll around the corner.
No witnesses except parrots, snakes, maybe a panther…(one of the
favorite insignia of most Caribbean militia). It’s about then that you
start to think, “What the fuck am I doing here?” The fact that there
really was a tank farm, and an office, with a telephone instead of a
clearing with several dozen Gringo heads atop spears was such a
relief that the realization that none of the phone numbers were any
good did not surprise or even especially disappoint him. He thought
about his kids. Just for a moment, he imagined what it would be like
for them to find out, or never really know, and have to grow up
without their Dad. And he thought about Stella. Would that be her
defining moment, or the beginning of the end? Every time one door
closes, another one opens. To him, at that moment, his own
existence was inconsequential, except in terms of what it meant to
the significant others in his life.
Whether it was an error by flight support (bad number), or Jeff’s lack
of familiarity with the Dominican phone system (maybe some area
code, or prefix was missing), the phone failed to produce any results.
No family. No hospital. No home office. Neither the fuel truck driver or
the local directory is any help, but at least the whole ordeal helps
pass the time until the ambulance arrives to take the medical crew to
the hospital. In places like this, one has to focus on the pleasant
surprises like, “I really expected the diarrhea to last a lot longer than
that” or “I’m just glad it was only a flesh wound”, or “Hey, be GLAD it
was only banditos, and not the Policia…they would have ass-fucked
and killed you before they robbed you.” At this point, Jeff’s
experiences revolved around an airport, a drive through the slums to
a hospital, and back. He had not even seen Punta Cana’s opulence.
During the walk back to the aircraft, it suddenly occurred to him that
small children probably walked through paths like this every day,
without a moments’ hesitation. To Jeff, it may have been a jungle, full
of mysterious portent and ominous overtones, but to the natives it
must be just as natural as a walk through the woods in Ohio. He
consoled himself for his fearfulness by reminding himself that this
jungle was nonetheless likely to hold snakes, poisonous lizards,
jaguars, maybe even insects that can kill you. Every day, children
walk to school through neighborhoods just as dangerous and hostile
to the uninitiated, even in North America. The farther North you go in
North America, the more likely it is that the climate or terrain could kill
you in the winter. The farther South you go, the more likely it seems
that the animals, environment, and insects will. The American
Southwest’s climate can be equally deadly to the uninitiated. And that
is just in the uninhabited regions. In the cities, all bets are off,
because no matter where you go, on any continent, Man is the most
consistently violent, treacherous, and bloodthirsty being on the
planet, as well as the most loving, and benevolent.
The Cavalry Arrives
Remember Bluto from the old Max Fleischer Popeye cartoons? Well,
here is an interesting point: Bruto in Spanish means stupid, and to a
gringo pendejo, the rolled R sounds more like an L. I mention this
because his body double is standing beside the jet when Jeff returns
from the tank farm. He is wearing a pair of Buddy Holly style blackrimmed glasses, and both of his huge, muscular arms are covered
with tribal tattoos right up to where the sleeves had been cut off of his
shirt. Jeff soon learns he is one of the sons of our patient, and has
brought the ambulance that is supposed to take us to El Hospital de
La Vega to pick up the patient.
Despite his rather unorthodox appearance, it is quite clear that
Rueben’s authority is as vast as his size. He is not much over twenty
years old, but well over six and a half feet tall, and probably weighs
over three hundred pounds, lean, muscular and commanding in
appearance. Once he learns of the refueling dilemma, he speaks first
to the pilots, and then to the driver of the fuel truck. With a wave of
his hand, all problems disappear, as Jet A is being dispensed.
Now they can actually fly back with their patient without having to
consider (even if only for a moment to which they will never confess)
having to sell their nurse into a white slave ring for money for fuel. (At
least, for now.) As Alice would say, “…things just keep getting
curiouser and curiouser…” (Go ask Alice when she’s ten feet tall…).
Better yet, go ask her after two years in a Dominican brothel, having
been forced to commit unspeakable acts for dark and mysterious,
sweaty gentlemen of indeterminate racial mixtures, never to be seen
by her family or friends again, until late one night when her father,
having retired to his den, discovers an internet porn site that causes
him to suffer a massive heart attack.)…But ah! I digress….
Go With the Flow, and Don’t Piss Off the Locals
Paramedics are not the only ones to be touched with more than a
little hubris. Rookie Captains are often similarly afflicted. Jeff’s first
trip to the Caribbean with a young pilot who had just made Captain
taught him the importance of keeping your delusions of grandeur to
yourself.
Upon landing, they were met by a gentleman who is referred to as a
Handler, which means that he handles all the details concerning
refueling, airport fees, and whatever logistics are required to get out
of where you just arrived as efficiently as possible.
As the door of the Lear jet opened, the Handler introduced himself
and extended his hand to the Captain, who rebuffed the man as he
explained that he would be doing all the arrangements for himself,
adding, rather arrogantly to the rest of the crew: “They can speak
English. I’ll take it from here.”
When the crew returned from the hospital with the patient, the
captain’s cash (about two thousand dollars), as well as all the
personal money of the pilot and first officer did not prove to be
sufficient to pay all the fees that had been assessed, and two
militiamen with automatic weapons had seized the aircraft.
It was not until the Puerto Rican EMT who had been brought along
specifically to handle translation went into the Airport Director’s office
and did his best impersonation of a physician that the fees suddenly
shrank to the customary amounts, and the aircraft was allowed to
leave with the critically injured patient.
Transportation of the Sick and Injured
And then there was the ambulance. A Toyota van with emergency
lights. Oxygen most of the time, but always emergency lights. A
nasal cannula dangles, wrapped around the O-2 regulator. (If you are
lucky, they will have “cleaned” it between patients with a little
alcohol…). The stretcher will either be something that was sold from
a North American ambulance company (for twice the price, after it
was too old and worn out to be fixed any more), or locally made with
aluminum tubing (if you are lucky) and a welding machine.
If the Smithsonian ever decides to put out an exhibit about the history
of the ambulance service, it will eventually have to go to all the Third
World countries to round up all the equipment we used thirty years
ago. The ambulance windows are open because the air conditioner
does not work. Indeed, in many of these countries’ hospitals, only
Surgery and Intensive Care units have air conditioning. As a result,
the flies are as ubiquitous as Coca-Cola, Mickey Mouse, and Jesus
on the cross. Since most of the roads are unpaved, the dust that
covers everything with its soft patina goes unnoticed, like some ThirdWorld version of Florentine finish. If you ask if anything works, they
will tell you yes, only to later clarify that the batteries, however, are
dead.
(A slight aside: Coca-Cola bottled in the Dominican Republic bears
the motto (in Spanish) ”bottled exclusively for drinking”…anyone
familiar with earlier practices involving “…the pause that refreshes…”
for either feminine hygiene and/or birth control (and the theme of an
old Fuggs’ song) will appreciate the ironic import of the motto, or
disclaimer, depending upon your point of view.)
The difference between Mr. Toad’s Wild Ride and the trip to the
hospital is that one is a cartoon, set to rollicking, light-hearted music,
and the other is real-time; a Keystone Cop cinéma vérité set to
Dominican Merengue. Oh yes, and the other difference: one is
entertainment. In the other scenario, you can die in an instant, or
worse yet, get horribly injured, wait for what seems an eternity for
another air ambulance crew to show up to take you back to Miami,
and then either die in a few days, or worse yet, exist in some sort of
torturous limbo for six eternities in the ninth circle of hell before a
medication error, or some night-shift negligence mercifully allows you
to slip the mortal coil, throw off the veil of tears, and then die.
There are a number of places around the world where you are likely
to feel your life was in danger just trying to survive a trip across town,
whether it be via a rental car, or even a local taxi. Saigon and Rome
are frequently cited by tourists as being intimidating to the uninitiated
traveler. Rush hour is particularly daunting in any of these places. It is
nothing compared to a code-three ambulance ride through any
number of Caribbean cities, but Grenada, Kingston, and Santo
Domingo stand out in Jeff’s mind. In Grenada, the Hospital was at the
top of the mountain on the island. Although the road to the top is
barely wide enough to negotiate two normal sized autos, the local
ambulance drivers travel so fast that they cover most of the road,
oblivious to the hundred-plus foot precipice with no guard rail. In
Jamaica, the local medical director, a legendary figure well-known to
almost everyone on the island, occasionally escorts the airambulance transfers straight through downtown Kingston in his black
Mercedes at what feels like eighty miles an hour with only a magnetic
emergency Kojac light, pursued by two ambulances running lights
and siren, that can rarely ever keep up with him. (In the seventies TV.
serial Kojac, Telli Savalas used a portable magnetic emergency light,
which he plugged into his dash via a “coil-cord” and placed out the
window onto his roof as he went into code three pursuit. They are still
popular with many volunteers today.)
Both of these trips caused Jeff to “white-knuckle” all the way from the
airport to the hospital and back, but neither trip could compare to a
previous ride he had taken in Santo Domingo several years before,
during rush hour. The main thoroughfares have three or four very
narrow lanes in each direction, and the traffic flows at about sixty
miles an hour with only a three-inch-high “barrier” separating
oncoming traffic by what looks like about eighteen inches. Virtually
every car on the road has a great deal of visible body damage, and
the frequent minor collisions are punctuated by cursing, and
gesturing, the waving of arms (and sometimes brandished
machetes), but no one stops, or even really slows down. Imagine
high-speed bumper cars driven by escaped mental patients on
Rufinol (Rohypnol). Once, leaving the airport to go to the hospital at
rush hour, Jeff noticed a small blue Honda tailgating the ambulance
more recklessly than the others were. Next Jeff noticed the driver was
openly drinking from a liter bottle of the local rum while swerving
dangerously close to the rear of the ambulance as it recklessly
careened through traffic that barely parted for the ambulance. The
real shock was when he recognized the driver as one of the officials
from the airport they had just left, still in uniform, but merely another
face in a sea of crazed locals just trying to get home.
(The Rise and Fall from…) The
State of Amazing Grace
Of course, it all just depends on what you are used to, when you are
in your own domain. Most “old-school” Medics and EMT’s believe that
they are somehow protected, in some special state of grace, when
they are acting in the course of their duties. Jeff recalled one night,
during his training for his first municipal rescue service, driving at well
over a hundred miles an hour at night to a wreck on a two-lane
blacktop that ran between two adjacent counties. Two ambulances
had been dispatched to the forty-plus mile distance that separated
them from their patients. One of the Medics in the other ambulance
had run out of cigarettes, and wanted a smoke on the way (this was
the eighties). Jeff was driving. His training officer handed him three
cigarettes, told him to roll down the window, and hand them to the
other Medic in the passenger seat of the other ambulance, which was
now alongside his unit. This was as much a Rite of Passage and test
of Jeff’s nerve (what some might call “Balls”) as anything else. If he
passed, there would be no mention of it in any evaluation, but if he
did not, although it would also not be mentioned, his career would be,
to put it bluntly, Fucked.
Now, risk-management specialists write regulations that forbid the
driver from using his radio while driving. Back then, another training
officer had told him: “Hell, son, if you can’t drive Code Three (within
ninety seconds after the plectrum tones have sounded) out of the
garage bay while lighting your cigarette and answering the radio
without spilling your coffee, you just ain’t worth a shit!”
Later, Jeff and one of his partners would make it such a common
practice to for instance, go into the water to rescue victims before
either Fire Department or Coast Guard personnel arrived, that the
county administrators required them both to sign a “quit claim” waiver
against civil lawsuits arising from their demise or disability secondary
to their disregard for their own safety.
Both together, and separately, they more than once received awards
for heroism and county-issued Written Corrective Actions either on
the same day, or for the same actions.
Comparative Diagnosis
La Vega makes you realize how much we take for granted in North
America. The roads are the area where the pavement is more
prevalent than the holes…which look large enough for an ambulance
to disappear into, only to be sucked straight into an even sweatier
and hotter version of The Inferno than the one he is currently
occupying. There seems to be a dead dog on every other corner. I
don’t know why…it’s just a Western-Hemisphere-Third-World thing.
El Hospital
Then there was the hospital. Imagine a North American urban
hospital from Philly, Baltimore, or New York that was condemned
sometime around nineteen fifty-six. Institutional green. Here in La
Vega, it was everything medical that there was. Only Intensive Care
and Surgery have air conditioning here in the tropics, that is to say,
the only place where the windows aren’t open, and the flies don’t get
the first claim on anything they want….
God Gives Us but One Face
Although the nurses and orderlies are only a slightly different
genotype than the militia at the airport, it suddenly occurred to Jeff
that his perceptions were only weird to him, because he was the
outsider, and this was their world. It was at this exact moment that
this realization started to crystallize and precipitate right before his
eyes. Even the idea that he was the outsider was something that he
could either create or negate by a simple realization. He was the one
who was making differences, judgments, and creating fear and
prejudice. As his preconceived notions began to dissolve, he was
also aware of the fact that it was his choice whether he was
accepted, or despised by these people who now seemed to be only
as different as he chose to see them. We are not talking about phony
pseudo-liberal condescension. This was a profound breakthrough in
perception. It was as if he suddenly saw that each and every one of
the people he beheld had an exact counterpart in someone he had
known before, because he was not looking at their skin, or even their
appearance, but rather at their countenance, their being, devoid of all
superficial appearances.
As they stood together, awaiting a decision on what was to transpire
next, one of the orderlies offered Jeff a small cup of Mate Yerba
(grass tea). It is a popular drink in Miami in the Latin community, and
a real favorite of Jeff’s. They seemed a little surprised to find out that
he not only knew what it was, but that he liked it so much. For Jeff, it
was a moment of transcendent bliss.
One could say that this would have been a very inconvenient time to
have such a realization, but that very sort of statement is just the kind
of judgment that would be made by someone who hadn’t reached this
particular state of mind. In fact, this was exactly the time to be having
this realization, so long as he could just put down all his previous
preconceived notions and see that everything was “…just like this…”
He thought of the story of the Buddhist monk who meets one of the
Bodhisattvas while walking along the road. The monk has left his
monastery to go to the most remote cave he can find in the highest
mountain in the country so that he can attain enlightenment. The
Bodhisattva is dressed as a beggar carrying a heavy load upon his
back, which has him nearly bent double. He asks the monk where he
is going, and upon hearing his reply, the monk suddenly realizes he is
standing in the presence of a great master.
The monk then asks the Bodhisattva what it takes to achieve
enlightenment, whereupon the master simply smiles, throws down his
load, and stands upright. At this moment, the monk realizes his
enlightenment, and achieves a moment of clarity, or the clear light of
mind, whereupon he then asks: “What do I do next?” The Bodhisattva
then simply smiles, and bows, and picks up his load again, and
continues on his journey.
All this occurred in a great deal less time than it takes to tell the story.
Once you stop the internal chatter, many fairly profound things can
happen very quickly, so long as you don’t require announcing them,
either to yourself or everybody else who happens to be standing
there. And for a very long time, that had been Jeff’s undoing, but not
today…it’s not as if he didn’t see everything exactly as it is, it’s just a
matter of not injecting prejudice, judgment, or condescension into his
perceptions. In fact, “…everything is just like this…only this…before
thoughts…before words.”
How many people
does it take to
achieve world
peace?
The Performance
Of course, the elevator will not accommodate the stretcher and the
flight crew, so while someone from the hospital who is authorized to
run the elevator accompanies the stretcher, Jeff and the other two
members of the crew walk up the stairs to ICU. As they turn up the
last flight of stairs, the relative quiet commotion of the hospital is
shattered by a lone female scream, followed by mixed shouting,
wailing, and a sort of collective “NOOOOO!!!” that fills every corner of
this end of the hospital.
Ten seconds later, they are in front of the unit, only to be confronted
by the assembled multitude of the entire family. It is quickly
established that “Poppy is dead”, having expired only moments
before their arrival. They enter the unit to observe a giant of a man
lying supine on a bed with a tube in virtually every orifice that will
accommodate one, plus two chest tubes and an abdominal drain. The
body is over four hundred and fifty pounds, and is additionally bloated
even further from surgeries to remove the spleen, repair the liver,
terminate unknown bleeders in the abdomen, and thorax, as well as
having received over sixteen units of blood since last night.
Even closed, the eyes are bulging as if they are ready to pop right out
of their sockets, and he has the unmistakable mask of “coon’s eyes”
suggestive of a skull fracture, as well as what those in the business
refer to as a “Laforte Three”, which essentially means that all the
bones that are normally attached to the front of the skull, like the
nose, the cheeks and the upper mandible have become detached,
like a Halloween mask, from the skull itself. The face is so swollen
that the skin is stretched tight enough to give it a shiny appearance.
The bruises range in color from a reddish purple to the color of slate.
This condition does not have a prognosis consistent with a long and
healthy life, and is rarely seen on living beings, even for short periods
of time.
The doctor in charge tells us “Poppy” has expired less than five
minutes ago, which does not seem consistent with the dependent
lividity which is present in all the lowest portions of his body, which is
to say that a dark pooling of blood has already accumulated in the
skin of his back, buttocks, and the backs of his arms and legs.
Although rigor mortis has not yet set in, it would indicate his death
occurred much earlier than anyone will allow at this point.
Jeff then retreats back out into the waiting area to console the family.
Imagine trying to stop a Freightliner eighteen-wheeler loaded with
pigs from Wheeling, West Virginia, travelling down a thirty-per-cent
grade at eighty miles per hour, with no brakes, by parking your
Volkswagen across the road in front of it. Although the Volkswagen
undoubtedly has a better chance of success, somehow Jeff manages
to establish what passes for empathy with the family. Nevertheless,
the oldest brother indicates that the family, by virtue of what was their
father’s last request, is now insisting that he should be buried “en
Miami”. They also indicate that they want him to go now, on the air
ambulance, for which they have already paid a non-refundable fiftyper-cent upfront down payment. Jeff indicates that he will “see what I
can do”, knowing full well that the regulations, international laws, and
local red tape are going to present an almost insurmountable
obstacle, regardless of how adamant the family is about the matter.
Then again, it has become exceedingly clear, almost from the
moment they arrived in the Dominican, that this family owns the town,
and everything and everyone in or even near it. To refuse their
request, (which is to say, while it is still in the form of a request) would
be foolhardy in the same manner that refusing a Kodiak bear’s
inherent right to your recently-caught salmon would be bordering on a
suicidal ideation. When you are out of town, you don’t piss off the
locals, and if you are smart, you go with the flow of power.
None of this is even slightly comprehensible to the rest of his crew.
Both of them were good people, and reasonably competent in their
chosen professions, just oblivious. Jeff tries to explain to the request
of the flight nurse, who immediately tells him to “Just shut your mouth
before you get us all into a lot of trouble"! (The only one who speaks
any Spanish at all [which is to say, Cuban-American “Spanglish”
acquired on the streets of Miami], and all of a sudden, he is the
asshole….)
Needless to say, this is not well received by any of the family who
pick up on the drama of what has just happened. Male or female, in
the Caribbean, Mexico, or either Central or South America, everyone
knows that Chauvinism is a way of life. Hispanic Chauvinism bears
no apologetic self-consciousness.
Unlike their more guilt-ridden American counterparts, Latin men wear
their Machismo like a battle ribbon, and their swagger and bravado is
not only tolerated by Latina women, but it is encouraged. Any male
who does not possess it is considered suspect. Don’t get me wrong;
women still know how to control the upper hand in Latin America just
as well as they do everywhere else in the world, but here it is done
under the guise of male domination.
If you forget that, you lose credibility, and things can get very
unstable in a hurry. The sudden silence is punctuated by both rapid,
and slow turning of heads to see “What now?…” Jeff quickly
recovers, and says (in Spanish) “Of course, I have to clear everything
with ‘La Jefa’ first, and he shrugs his shoulders and rolls his eyes
skyward, which is punctuated by a relieved sigh of laughter by the
group. “La Jefa” is a derisive way for a male to identify a woman who
clearly doesn’t know her place. “El Jefe” means “the boss”, and it is
delineated in masculine gender for a very good reason, which many
Latinos would equate to God’s will. By making a joke of it, he relieved
the tension and restored credibility in addition to indicating that all is
not lost in their quest to have “Poppy’s” last wishes followed.
The oldest brother takes the lead, and offers to let Jeff use his cell
phone to call the states, so that he can get in touch with the medical
director for final approval.
Meanwhile, the other medic (who has somewhere around eighteen
years less experience) goes into a meltdown and takes a mental and
verbal shit on everything in sight, ranting about how “…This just isn’t
right…I don’t think it’s even legal…we’re not a removal service…this
isn’t our job”…blah, blah, blah. Fortunately, although he is CubanAmerican, he speaks not even a word of Spanish, and is very young.
So intent was his mother to “Americanize” him that he was named
Brandon. That, plus the fear in his eyes score him zero credibility, so
he is quickly discounted as an inexperienced, babbling Gringo
Pendejo, who Jeff easily dismisses.
The conversation with the medical director, however, turns everything
around, and puts it all in a clear perspective that borders on genius.
That the flight nurse should try to dominate and control the situation is
not surprising. In North America, it is downright commonplace. There
has been a longstanding feud between nurses and paramedics from
the time that the first EMT ever hit the streets.
This was not the case between Jeff and his regular flight-nurse. Their
relationship was based on mutual respect and a natural teamwork
and rapport that started the first time they had ever worked together.
No competition. They both were very good at what they did, and even
when they did not agree, which was not often, they managed to make
it all look seamless. But this was not his regular nurse, and she had
been taught to follow an agenda that involved putting medics in their
place. It is rooted in a turf-war mentality that has crippled the
ambulance transportation business since its earliest days.
Love/Hate
It is the same way with nurses and medics everywhere. Nurses
regard paramedics as a threat to their profession. They are allowed to
do a lot of things that only doctors can do, and their training is narrow,
and intensive, as compared to the more broad and expansive
education that nurses are required to complete. And then there is the
swagger, the chauvinistic egotism so full of itself that appears to be
standard issue with the shiny boots and the badge. Medics have
done a lot to create the ill will to which they have been subjected, and
it is not likely to change any time soon.
Oddly enough, a lot of nurses and medics marry, and even raise
families. From an anthropological point of view, the whole profession
is very new. If Darwin were alive today, I’m sure that he would agree
that if nurses, medics, firefighters, and cops keep intermarrying, that
one day we will see a new species of human with a jaw that can
unhinge like a snake’s, so that they can swallow a whole roast before
the start of a shift, with two gallon bladders, and the eyes of a cat for
seeing in the dark.
This Medical Director in particular took his knowledge several giant
steps further still. He realized that there is a great deal more potential
power in controlling action than there is in limiting it. Give the medics
as broad and sweeping a set of protocols as the state of Florida will
allow, but demand strict obedience to certain guidelines and
principals that are clearly reinforced in monthly Quality Assurance
meetings. That is real power for all concerned parties.
The Medics were essentially in charge of the field operations, due to
the fact that they were allowed to operate on protocols, as set by the
Medical Director, while the Nurses were in theory limited by The
Nursing Practices Act. Only a Paramedic could intubate, or perform
invasive or surgical procedures like crycothyroidotomies, or chest
decompressions. Nurse anesthetists and Nurse Practitioners are
notable exceptions. The stature of their qualifications ensures them
salaries that are prohibitive to Air Ambulance employment. Strictly
speaking, Nurses were prohibited from being allowed to write the run
reports required by the State Health Department.
The nurse’s conversation with the Medical Director was brief and
extremely succinct. What could be heard was this: “Yes, he’s right
here…Well, I’m not entirely sure, he’s the only one that speaks any
Spanish, but that seems to be true…OK.”
She then offered Jeff the phone. “He wants to talk to you.” What was
not heard, but well reinforced to Jeff was summed up by the Medical
Director in one sentence, and it was this: “If that man has not been
legally declared dead, then he is not dead until I say that he is dead!
Now before someone does something we can’t undo, please
transport him to Miami for more definitive care.”
For a brief moment, Jeff’s head began to swim. Not because the
concept of transporting a “Show-Code” was all that unfamiliar, but
because it now meant that a very complex set of actions would have
to commence immediately, and they would have to be carried off
more flawlessly than if the patient’s life were at stake. And that was
because now several lives and reputations would hang in the balance
based on the credibility of a theatrical performance.
That Which Passes for Philosophy
Twenty years ago, when Jeff was a paramedic student, he and his
classmates had taken up a continuation of a discussion that their
instructor had started earlier that afternoon. A bull session fueled by
beer and Buffalo wings, centered around the debate of whether
Emergency Medicine was an Art or a Science. Somewhere around
the second or third pitcher, Jeff had a moment of clarity quite
uncommon for him at that point in his life. I say uncommon, because
for once, he was able to state something profound without wallowing
in minutia for fifteen minutes just to get to the heart of the matter.
What he said was this: “First of all, we are not just involved in
Emergency Medicine. We care treat and transport the sick and
injured, which means we do so to an audience…the general public. I
say that our job is a Performing Art that uses science as a tool to give
us credibility.
When it’s all said and done, it’s not as important whether the patient
lives or dies as it is that we appear to be competent. Most people
don’t really know what they think about God, or Life, or Death, and
Religion. Priests have lost their hold on our consciences because
they don’t offer the kind of consolation that we need, but we do
believe in Science in a way based on greater faith than any religious
zealot would admit.
What religion calls Faith, the Scientific Community calls axiomatic.
We believe that we have proof in our belief in Science, and that has
become our God. When the family, or bystanders observe our
actions, if they believe that we gave that patient the very best chance,
and that there was nothing more that anybody could do, then they will
feel content, and their grief will be mitigated by their focus on our
competence, and our compassion.”
Good Acting is not Bad Medicine
What was called for now was to be able to simulate a critical care
transport on a dead man, and to do so in a way so well performed
that it was capable of convincing the bystanders at the hospital, the
local ground ambulance crew, and the pilot and co-pilot of the aircraft,
as well as everyone of any importance at the airport.
We all make choices in our life every day. Sometimes it is as simple
as “…the turkey, or the fish?”, and sometimes, it does not even
appear to be a choice. When faced with a number of unpleasant
alternatives, it is important to recognize that there is still a choice to
be made. You may not be entirely happy with the menu, but if you are
in public, and the choice is to shit or go blind, you do not have a lot of
time to waste whining about what is or is not fair, legal, hygienic, or
even pleasant. It is not even a matter of what is acceptable. Terms
like damage control are more appropriate. What is clear is that
anyone who can afford to pay about $10,000 for a non-refundable
fifty per-cent down payment just to get there in this corner of the third
world, can pretty much snap their fingers and be obeyed, because
they live like sultans, at least compared to everyone else, and it is
everyone else who will do their bidding. Dirty deeds done dirt-cheap.
Don’t get me wrong; their hosts have been gracious, and extremely
polite, but it is also clear that everyone they encounter so far literally
hangs on their every word. And just as surely, if they even think that
they have been dishonored by anyone, it would be just as easy to
push a button, and someone will hang….
From a strictly pragmatic view, it goes something like this: a dead
man leaving the Dominican Republic means “mucho trabajo” and
would entail several days (and miles) worth of bureaucratic red tape.
(It is interesting to note that in Spanish, the word for “work” is also
synonymous “trouble” or “hardship”...) Regardless, it is not an option.
Refusing the transport, and leaving without refunding their money is
also not an option, since the crew is dependent upon their hosts for
transportation back to the airport, and it is a long way through the
jungle to get there, and many bad things that could happen along the
way, and presumably do so on a more or less regular basis.
I am not implying that their clients are thugs, at least not in light of
their circumstances. What I mean by that is this: laws (among other
things, like perhaps necks) have always been made to be broken by
men of wealth, power, and social station. The vast majority of these
people in North America would be referred to as privileged, but in the
Third World, the operant condition is power, as in “…first we get the
money, then we get the power…” and “If given the choice between
being loved and being feared, it is better to be feared.” Being
bushwhacked by a couple of gringo pendejos would not go unnoticed
in this corner of the world. It would give the impression of weakness.
Although dealing very harshly with these bushwhackers would not go
unnoticed either, it would just be as if it had never happened, and
would reinforce the message that it is always bad business to go
against the locals when they are in a position of power. It is also
obvious that although these people are indeed feared, they are also
loved because they take very good care of their own. Not so good
that the locals get too independent, but well enough that they are
needed. Our hosts are genteel (at least in the context of the
surroundings), and extremely polite, but it is as if one is watching
gorillas in tuxedos quoting Shakespeare. One wrong move, and the
whole deal could turn on a dime. Jeff’s current state of mind is such
that he can see all of this in a very clear, albeit peculiar perspective.
(…If you think outside the box long enough,
eventually there is no box at all….)
Memoires of a PostNeo Dharma Bum
(More Like a Short conclusion based on Long Evidence….)
For some folks, this all may seem to be a very long conclusion based
on very short evidence, but not for Jeff, and I will attempt to explain
why. First, he is a “Boomer”, a term he hated, having coined (or
adopted, he does not recall which) the moniker “War Baby”, owing to
his affiliation with all the other “Post WWII Baby-Boomers” who
eventually became candidates to become fresh meat for the Viet
Nam conflict.
To Jeff, the term “War Baby” reduced the equation for his generation
to its simplest terms. He was part of the human tidal wave of children
born in the aftermath of World War II, which could well be said to be a
defining condition for his generation. The Vietnam War was the single
most significant defining moment for his generation, as well as for
almost everyone alive during those years. The world would never be
the same again, as the result of the conflicts that were created by that
conflict.
From a strictly Machiavellian (or perhaps more correctly Malthusian)
point of view, if the generals and corporate chiefs had had their way,
the overpopulation created by the “War Babies” would not have been
so significant. Had the war gone on longer, with casualties anywhere
near those of WW II, there wouldn’t have been so many of them left.
When Jeff was in school, there was such a shortage of teachers that
the common wisdom was that no matter what you studied in college:
“get a teaching certificate.” By the time Jeff had graduated, even the
sheepskin itself did not guarantee any of them very much. As Bob
Dylan had already proclaimed: “Sixteen years of schoolin’ and they
put you on the day shift”.
The American Dream was already becoming a nightmare. No longer
could anyone afford such a large family as before, and “the pill” was
making planned parenthood an actual reality. Fewer babies resulted
in fewer students, so schools were being either consolidated or shut
down altogether, and it pretty much took a Ph.D. to get hired to teach
elementary school.
Over the years that followed, whether it was education, or computer
programming, or whenever a really lucrative opportunity would arise,
the sheer number of “war babies” that rushed to join the ranks would
blow out the demand for them, and business (as well as its formerly
lucrative salaries) would be back to their minimalist self in no time at
all. If the number of casualties associated with World War II had been
inflicted upon “The Boomers” there would not have been such a glut
in the population. They were their own worst enemies, just by their
sheer numbers.
The dynamics of what happened as they moved along the timeline
may have changed, but the principals have not. As more of the War
Babies reach the age of retirement, those principles will again rear
their heads to upset the economy, social welfare, and healthcare in
general.
Southeast Asia marked a turning point for good people all over
America. If the bigotry, intolerance, and injustices of McCarthyism
and Institutionalized Racism stretching from the railroading of the
Rosenbergs to the assassinations of JFK, RFK, MLK, and indeed,
even Larry Flint had bred cynicism and suspicion in the hearts and
minds of the “War Babies”, Viet Nam had dealt the death blow to the
vision of the American Dream that most of them had been raised to
believe in and, indeed, even cherish. And all that was necessary for
tyranny to flourish was for “…good people to do nothing…” But
because they had been raised to be “good people”, they felt forced to
do something, and that meant becoming involved. That involvement
eventually entailed a criminal record for many who mistakenly or not,
believed necessitated being arrested while engaged in various forms
of social and political protest.
Would You Die for Your
Beliefs?
JFK had been quoted as saying: “When you make peaceful revolution
impossible, you make violent revolution inevitable”. Most importantly,
the government had long ago made violent revolution suicidal. The
very cornerstone premise of our own founding fathers, in terms of
forced accountability of the government (of the people) to the people
would now necessitate total self-sacrifice. Security and materialism
are the undoing of true freedom, at least as far as maintaining it.
Peaceful revolution seemed impossible; but if violent revolution was
also impossible, then something else would have to take its place.
Most of us did not even initially believe as much in revolution, as in
evolution, but the rich, the powerful, and the established allowed, or
even authorized the FBI and the CIA to do anything deemed
necessary to prevent any unauthorized changes from occurring, and
the result was that the suppression itself bred a sort of cancer within.
(By this point, most people would not understand the irony of the
statement that the government was trying to take over the country.)
The War Babies changed the world, for a while, but in the process,
they were taught that they could face martyrdom, or at least public
ruin, and many opted to “go underground” for their causes. Yet
another “nation within a nation”, except in this case, the “nation within
a nation” spawned a “nation under a nation. After the Hippy
Movement flopped, Jeff preferred to call them Post-Neo Survivalists.
Marijuana and LSD became sacraments of the Neo-Religious New
Nation Underground. Once again, the government chose to treat this
as a criminal matter, rather than a health problem, just as they had
chosen to treat political issues as criminal. It’s not a simple matter of
whether or not either of these two issues was “Right” or “Wrong”,
but that the people who ran the government made them criminal
matters. There was great deal of idealism bred into these young
people of this time. Most had been raised by “good people” to “do the
right thing”. At first it was a hard choice to make, to become criminals
for a cause, but eventually, it became so easy that almost no one
even noticed that they had become “casual criminals” in order to
conduct their daily lives as they had chosen.
“Casual
Criminals”… (blue
jeans allowed.)
“We are all outlaws in the eyes of America.
In order to survive we steal, lie cheat,
forge, fuck, hide and deal.
We are obscene, lawless, hideous,
dangerous, dirty, violent
And Young.”
Jefferson Airplane
They did not view themselves as “Career Criminals” because they did
not set out to specifically commit crimes to make a living, it just turned
out that their lifestyles were being declared illegal by the people who
were making a living of preventing any serious changes to the status
quo.
In the process, a new breed of “Outlaw” was created, even though
the distinctions implied by either label went largely unnoticed by
nearly everyone.
Ironically, it was Dr. Timothy Leary (while he was still considered a
legitimate doctor) who had postulated the theory of Set Setting that
stated that if you treat people as criminals simply for the sake of
compliance and enforcement, otherwise “good people” will begin to
behave as criminals.
A very happy and economically successful generation of parents who
wanted the very best for their children had sent them off to colleges
all over the USA. Ethical, right-minded good citizens who had raised
their children to be “good people” unintentionally saw to it that their
offspring became too well-educated to buy into the hypocritical horse
shit that seemed to cover this country knee-deep, everywhere they
looked. It is certainly no accident that we shall never see that kind of
prosperity, or idealism again in this country. Some would blame it on
the drugs, or the music, but the real villain was a liberal arts college
education. Unfortunately, it would appear that ownership of property
might be linked to certain forms of amnesia…an affliction to which
Jeff was in no danger of succumbing.
Unfortunately, the horse-shit is every bit as deep as it ever was, if not
even deeper, but the “War Babies” that went into advertising and
merchandising have seen to it that the other members of their
generation are fairly universally convinced that it is actually chocolate
pudding. The holy trinity of drugs of choice have changed from
marijuana, LSD, and cocaine to Alcohol, Rogaine, and Viagra. All of it
set to the music of the Sixties and Seventies.
Would You Kill to
Protect Your
Standard of Living?
Although Jeff was certainly a product of the sixties, he was by no
means limited by them. We’ve all known sad cases of people who get
so stuck in one generation or another that they seem trapped by it,
oblivious to the passage of time, and generally unable to adapt or
assimilate. This was not true of Jeff, but he did bear an unmistakable
stamp of the kind of defining moments that shaped his character
throughout the sixties and seventies in particular. Those defining
moments determine a great deal about how you cope with Life and its
progressions after those points. The trick is to not get stuck or unable
to adapt to the inevitable series of changes and progressions that
follow.
Many people would link the overall mood and character of the Sixties
and Seventies to Sex, and Drugs and Rock and Roll, but they were
really more like symptoms than primary causative agents. That is not
to say that they did not set a great many things in motion in and of
themselves, but the reason that they came of age when they did was
because of the forces and influences that came to bear in the fifties.
The simple fact is that the sixties were ripe for rebellion as well as
challenges to the existing order and nature of everything. The rebirth
of the eternally questioning mind had come to bear upon the West.
And it took a rebellion to dislodge the mores and values that had
become so firmly entrenched within our culture. As a result, they took
on the mantle of Freak and Outlaw within an underground culture
fraught with subterfuge and secrecy, which they accepted as an
identity, as well as modus operandi long after the trappings of the
counterculture had fallen away.
The Sixties was a decade that took twenty years to live out. It
represented a cultural impasse between the Old and the New. In a
culture that was bent upon making war, this represented a war of
ideals and ideas, as well as ways of doing business and pleasure,
although the war that was waged started more like a rebellion
amongst its practitioners. The Arts changed. Music changed. Clothing
styles changed. Not as a marketing tool, at least not initially, but
rather a series of what seemed to be natural progressions emanating
seemingly out of thin air spontaneously. Madness and genius alike
stood hand in hand the whole world round. It was as if something in
the air, like radio waves tuned to human receivers provided the
atmosphere or common realizations to fit together, like a puzzle that
was not yet defined or recognized, that was solving itself. The very
fact that Art, Music, Philosophy and Culture enjoyed such preeminent
status and importance within a world-wide community of like-minded
individuals attests to just how definitively the times represented a
quantum leap in social evolution. There had been precedents of
many of the individual aspects of the counterculture (Utopian
societies, Free Love or Anti-War movements, etc.) that had reared
their heads before, yet they were out of sync with the other elements
necessary for them to prosper, so they died almost unnoticed, like a
species of plants or animals destined for extinction. The sixties was a
time when all the necessary components required to nurture the
origin of a new species came to fruition simultaneously. Like evolution
itself, it had all the time in the world to wait for its defining moment.
From that point on, Jeff had subconsciously perceived himself as a
wildcard, a round peg pretending to fit into a square hole insofar as
he desired both the comfort and security of semi-respectable
occupations and an outwardly comfortable middle-class existence
that allowed him a safe haven to take drugs, play whatever kind of
music that suited his tastes and whims as loud as he wanted
whenever he wanted while he indulged in every imaginable
exploration into whatever sexual encounter, excursion, perversion or
experimentation that crossed his mind or tickled his fancy. This
usually prompted him to choose either industrial neighborhoods or
really “bad” neighborhoods bordering on industrial zones.
He had been successfully employed in so many outwardly
respectable occupations for so long that by the time he had become a
paramedic, it was second nature to him to lead a double life
somewhere between Batman and a Fellow Traveler. His intelligence
allowed him a great deal of latitude for acceptance of his eccentricity
within his chosen profession of the moment, as he frequently
employed unorthodox solutions to difficult situations and problems
with quite remarkable success. Although he moved freely among his
peers, he was never really one of them, yet they generally tolerated
his offbeat and frequently off color speech and actions.
It was as if the changes he encountered as the world turned on its
course were following some occult grand scheme that kept preparing
him for each new challenge he encountered. It wasn’t easy, but he
didn’t even realize that there was any other way of doing things, given
his proclivity for his more bohemian tastes.
And so it was that the events leading him and his crew to this juncture
would seem to have been orchestrated by some divine hand that
already knew the outcome long before any of the antecedent events
had been set in motion. Whether conjured by some Higher Power, or
a product of Chaos, one thing follows another.
The key point being that the polymorphous perverse would appear to
have been the operant principle for most of Jeff’s life. Bad, evil, and
greedy people not only got away with murder, quite literally, but
managed to make a profit at it, while good people found themselves
enslaved by trying to live by the rules that the privileged wrote to
empower themselves at the expense of those who lived by them. For
Jeff, most conventions of society were, at best, somebody else’s
rules. It’s not as if he got up that morning and said to himself: “Hey,
what the fuck, I think I’ll smuggle a dead body out of a foreign country
just to see if I can get away with it”. But given the prologue of the
previous thirty years’ experiences, it was just not that much of a
stretch, especially since it provided him with a reasonably good
opportunity to keep his head connected to his body. The so-called
patient was already dead, and when he got to his destination, he
would still be dead. No harm, no foul.
Impermanence
This would represent a major ethical dilemma for some, but Jeff was
no stranger to ethical dilemmas…but his life represented, in many
ways, The Death of Dreams. A surely as he would learn to love
something, or someone, he would be forced to lose it. He had
developed a decidedly fatalistic outlook about it, yet still he stubbornly
tried to hold onto his idealism, his ideals, and his infatuations,
regardless of their legality.
From his earliest memories, he had wanted to be a musician,
specifically, a guitarist. He had followed that dream, even built a
recording studio to support it, only to find himself selling his guitars
and amps, as well as drugs, just to keep the studio open, and spent
all his time working to sell other people’s dreams, and frequently not
getting paid for doing it. He eventually learned that most rock
musicians are like overgrown children. Expecting them to pay his bills
when they frequently didn’t even pay their own rent is like going to a
seafood restaurant with no money, and hoping to pay the bill by
finding a pearl in one of the oysters.
After it was all over, for the next four years, he didn’t even have a
radio in his truck.
Later, he had pursued a lifelong goal to become a licensed amateur
radio operator, like his father, and his grandfather. He built a station
that operated on UHF, VHF, and long-range high frequency
worldwide. Most of it was tube-powered antiques, and had been
hand-built, or salvaged. Now he rarely could find either the time or
energy to get on the air. Three hurricanes in twelve months had torn
down four separate towers built to support his hand-made antennas.
Auto mechanics had been a passion of his, and after first pursuing
imported sports cars, then muscle cars, he had gotten the bug for
four-wheel drive vehicles. He loved dogs, hunting, fishing and scuba
diving, and his Suburban Assault Vehicle was the steed of choice for
transportation involving these pursuits. His motto was: “great trucks
are built, not bought” and although his Toyota was new when he
purchased it, he immediately began the upgrade and redesign
process indigenous to the sport. Bigger tires, more power, wider
wheels, a winch, lifted suspension, a second battery, etc. Now, with
over three hundred fifty thousand miles behind him, he would soon
have to rebuild and restore, if he could ever find either the money or
the time…not that he got much opportunity to use it for anything other
than going to work.
He owned two full sets of dive gear that hadn’t been wet in five years.
Time and money, Time and Money. All he ever seemed to do
anymore was work, pay bills, and prepare for his next move. Four
moves in five years were exhausting his enthusiasm for much of
anything.
And then there was Stella, the love of his life, after five previous failed
attempts at marriage. She was fourteen years his junior, and had
been vibrant, enthusiastic, sexually breathtaking, and an inspiration.
Now she was morose, sullen, addicted, disabled, dysfunctional, and
needy. Bad-tempered outbursts of criticisms designed to divert
attention away from her own shortcomings did not even fool the
children, but it did hurt them, and confused and alienated them more
than she seemed to realize.
Until you can remember
when you first decided to
settle for less than what
you wanted, you can never
really find your way back
home.
(Courtesy of: The Home for Wayward Souls)
The Death of Dreams had definitely dulled his ability to feel any
pangs from the seemingly endless stream of ethical dilemmas that
seemed more prevalent than ever. Previous occupations and careers
not so prone to altruism should have been easier, but not for Jeff, and
now it seemed to never end. He had much higher expectations for not
only himself, but also his peers, who seemed to thrive on capitalizing
on the misfortune or misery of others. He could recall specific
instances when he felt his ability to care drain from him like blood
from a deep, but not exsanguinating wound.
One such instance came on a single motor-vehicle crash one night
while he was working as a municipal paramedic. While attempting to
stabilize the patient’s spine, a great deal of money was discovered
strapped to the patient’s body in a money belt. As soon as Jeff
realized what it was, he had called for a police officer to hold it for
safekeeping, and to prevent any questions to be raised later as to his,
or his partner’s involvement. Neither the county deputies, not the
highway patrol had arrived yet, but suddenly, a DEA agent appeared,
and took the money. Later, at the hospital, a highway patrolman had
remarked about the amount of cash involved, stating that it had been
“almost two thousand dollars, in hundred dollar bills”. The actual
amount, by even the most conservative estimate, should have been
ten times that figure. It would have been very easy to have pretended
not to notice what Jeff had discovered, and split the cash with his
partner, but Jeff was something of a “Boy Scout” back then, at least
as far as matters concerning this career were concerned. It had been
a valuable object lesson.
Faces of Death
The irony of how it could be that caring for the sick and injured
involved so many dehumanizing elements was not lost on Jeff. It was
his contention that you either embraced Life in all its most grisly and
horrific splendor with intellectually detached, clinical curiosity as well
as fearless humor, or else you could just try to shut it out, and cover
your shock with denial; in which case, your chances of remaining
spiritually and emotionally intact would reduce to about zero. What
Jeff had not anticipated, however was how quickly he would come to
recognize the faces of death.
It was initially a mildly disturbing feeling that he would experience
what he attributed to the extremely graphic visual impact of gunshot
wounds to the face, cut throats, severed heads, or disemboweled
victims. As a protective measure, he would allow his intellectual
curiosity full rein. He next realized that there was a certain
exhilaration that he identified as feeling guiltless, since it was now his
job to make accurate and quick observations, and then act upon
them, but there was no denying the Authorized Rush that no “rubbernecking” motorist will ever know. Jeff once described it as “the feeling
you get in the pit of your balls if an elevator drops too fast, or during
wind shear”. (Several female Paramedics later confided to Jeff that
they experience a similar sensation in their perineal region.)
Once he learned to approximate that which passes for composure, he
noticed an unnerving familiarity to the faces, and the circumstances.
Sometimes, he visualized the preceding moments just prior to death
with alarming clarity. He NEVER spoke with anyone about those
visions, or the Déjà-vu he felt.
For instance, imagine a long-forgotten Jack-O-Lantern on the Sunday
after Thanksgiving. It would appear that sometimes, if you put a
shotgun muzzle in your mouth and pull the trigger, that is what you
will look like when people discover you. For Jeff, it seemed as if for
every “new” face, there was at least one to match it in the archives of
his brain, even though he had no conscious prior recollection of them.
Remember how your Mom told you not to make a particular kind of
face because one day it will stay like that? It would appear that if you
make a really ugly face right before you die, it does stay that way.
Perhaps the most unnerving of all was the beatific look on the faces
of The Jungle Boys (Homeless Viet Nam War Veterans living near
Pompano Beach) every full moon or so when one of them would
“take the train”. At least, the ones that still had faces…imagine
embracing a train traveling forty miles per hour, head-on. Imagine
doing it joyously, with fearless conviction. It would appear that if you
do, your face stays that way, too…(At least as long as your face stays
attached to the front of your head).
Nothing will ever displace the image of a fifteen-year old boy who put
a shotgun to his chest to try to stop the pain. The blast more or less
liquefied the area where his heart had been, but it could not wipe off
that look of confusion and pain that had driven him to abandon his
life, his family, and himself.
Perhaps even more unsettling is the first time you stare through the
pupils of the recently deceased. Penlight in hand, as you open the
eyelids to no resistance, you will note that the pupils are fixed and
dilated. During the first hour or so, the corneas are still shiny and
clear, like clean porch windows on a recently abandoned house.
When you look inside, the rooms are all empty, and somehow, you
sense a stillness that is not natural to an inhabited structure. Elvis has
definitely left the building. The thought, or the feeling has long
passed, but the expression remains to mark the moment when the
last soul abandoned ship and jumped out.
That’s No Way to Treat a Lady
The next event was a great deal more bizarre, and for Jeff, a great
deal more difficult to reconcile in his own mind. In spite of the fact that
he had acted “honorably”, and according to the training he had
received, he had done nothing “wrong”. In fact, had he done anything
other than what he did, it would have been considered criminal, had it
been held up to scrutiny, but nonetheless, the experience had upset
him, and remains unreconciled, at least for him.
He was working, once again, as a municipal rescue paramedic.
Sometime around 10 PM, they had been dispatched to transport a
terminal cancer patient to the hospital. She was a rather attractive,
mid-fortyish woman with metastatic brain cancer. Although the
ravages of the disease had not devastated her appearance
(presumably because it had been discovered “too late” for either
chemotherapy or radiation), she was heavily sedated, and he had
been told that she had not been lucid for several days. She was in no
acute distress, but it was obvious that she did not have much time
left. He was told that she had experienced three seizures since noon
that day. It wasn’t until they started toward the hospital that things
started to go wrong.
In order to place the blood pressure cuff on her arm, it was necessary
to extend it, palm up, and he had placed the back of her left hand
upon his left knee. Before he could apply the blood pressure cuff to
her upper arm, she had turned her hand over, and quickly ran it up
his inner thigh, grabbing his crotch. Although her eyes were closed,
and she showed no other signs of consciousness, she sighed deeply,
and smiled a broad, knowing smile as she began to rub his cock the
way a wife would do when she is about to prepare her husband for an
intimate encounter. There was no hint of salaciousness, or selfconsciousness, like one would expect in such a situation. It was as if
she was dreaming, presumably about happier times. Or perhaps not.
Maybe she knew, somewhere in her subconscious mind, that the end
was near. Whatever was in her mind, we shall never know, except
that she was unselfconsciously joyous and unabashed by her actions
in a way that implied she believed she was doing something familiar
with someone with whom she was very familiar.
No Last Kiss
Jeff, although taken aback by this sudden turn of events, coolly and
professionally placed her hand back where it was, and spoke her
name, changing the subject, and hoping to right this seemingly
innocent wrong without even acting as if he was rejecting her, but
rather re-directing her attentions back to a more appropriate focus. To
no avail, however, as she almost instantly stuck out her bottom lip,
like a two-year-old girl might do, in pouting, and a tear began to run
down her left cheek. Again, she sighed deeply, as she quietly began
to cry. Jeff tried to console her with words that would have no effect.
She never opened her eyes. He knew it was a sham to expect her to
feel better. Wherever she was, in her mind at that moment, this was
not how she wanted it to end. Jeff felt helpless, and his knowledge
that he had acted “professionally” and “ethically” did nothing to
assuage his discomfort. They brought her to the ER, and she was
admitted to a floor shortly after that. Jeff did not mention the
occurrence to his partner as they rode back to their station.
The next morning, he stopped in to the hospital, to inquire as to how
she was doing. “She died about two hours after you guys brought her
in.” was all that he was told by the admitting clerk.
He was never able to shake off the feeling that he had somehow
denied a dying woman her last request; and that in the process, he
had left her feeling alone, rejected, and heartbroken as she was
preparing herself to face the single most terrifying and significant
moment of her life. Sometimes doing the right thing can be the wrong
thing. It would have been, in either case, but he would be changed by
that experience forever. He hadn’t known what to expect, didn’t know
what to do, and was left with no easy answer. It certainly isn’t the kind
of question you can bring up in an ACLS (Advanced Cardiac Life
Support) class, even if you are discussing the ethics chapter….
Not that ethics seemed to plague many of his cohorts. One had even
supposedly had sex with a mental patient in restraints during a longdistance transport from one county to another, (both of which would
be best left unnamed). When Jeff had casually questioned the
perpetrator about it, he was told: “It’s not like she wasn’t into it…hell,
she actually suggested it”. (As if this made it OK.) As he stood there,
he found himself recalling Alfred E. Neuman’s idiotic expression,
extolling “What, me worry?”
During the Iran/Contra Senate Subcommittee Hearings he had the
same reaction to watching Oliver North testify, but then again, “Ollie”
also bore more than a casual physical resemblance to Mad
Magazine’s poster child of denial.
We Own the House of God
But that was then, and this was now (at least it was back then), and
such matters, even if they had worn away his pre-conceived notions
about right and wrong, were the farthest thing from his mind as he
prepared himself to initiate life-saving measures designed
predominantly to save the lives of himself and his crew. Over the
years, he had learned to pick locks, tap phones, and hotwire cars, as
well as other seemingly nefarious skills partly of necessity and partly
out of a natural curiosity for autonomy pertaining to forbidden access
to items of interest to him. He was not fond of taking no for an
answer, and in many ways, his proclivity for a general disregard for
limitations in general seemed to have been a prelude to this situation.
He grabbed the arm of Manuel, the older, more diminutive of the two
brothers, and pulled him aside.
“Excuse me, senior, but I need your help. If we are going to get
Poppy back to Miami, there is only one way to do it, and the Doctor
may not really understand my more subtle meanings in my Spanish,
so I want you to translate for me so he understands what we must do.
It will help insure that we can follow your father’s wishes.”
“Of course. Tell me what you want done, and I will see to it that the
doctor cooperates.”
“I hope so…doctors can tend to be very…how should I say, well,
strong-willed about being told what to do. I think we need to be as
diplomatic as possible to make sure we don’t offend him.”
“Excuse me for saying this, but I think you are forgetting something.”
“What is that?”
My family owned this building, before it was a hospital, and before
that, there was no hospital within four hours of here. First, we
donated the building, and then we renovated it. It almost pays for
itself over the last few years, between volunteer work that is done by
former patients, and whatever barter can be arranged for those who
cannot pay at all, sometimes it is food, or labor, but my family pays
for whatever it takes to make sure our town has a hospital. Oh yes,
and one other thing…”
“What is that?”
“We pay the doctor’s salary every year. We brought him here, put him
in a house, and see to it that he wants for little. Trust me, senior, you
will find him to be the model of cooperation”.
“Well, good. Do you know if there has been a death certificate signed
yet?”
“No, there has not. I believe he only passed away as you were
coming up the stairs, or very shortly before that. I only arrived about
five minutes before you, and had not seen him yet. My mother stayed
here all night with him.”
“We need to make sure the doctor makes no official pronouncement,
or signs anything, then. It will be as if he never passed away, at least
not yet, then we can take him to Miami for treatment. If he does pass
away before we land, and we are closer to our destination, we can
land with him in Miami, and your father’s wishes can be followed.
Anything beyond halfway is called the point of no return.”
“Just between the two of us, I hope that you realize we have already
passed that point a long time ago”.
“Si. Yo entiendo. I will inform my crew to prepare for the transport”.
“Muchas Gracias.”
Jeff then came back around the corner and motioned for the other
two crew members to approach him, so he could explain their
rationale, as well as their game plan.
Brandon, the younger paramedic began protesting immediately.
“Excuse me,” Jeff interrupted “…but somehow I must have given you
the mistaken impression that this was an item for discussion. It is not,
however, and little time remains for us to salvage what is left of this
mission, maintain our dignity, and hopefully keep our heads
connected to our bodies. If you cannot, or will not contribute to this
mission, just stay the fuck out of my way. Otherwise, I will not lift a
finger to prevent our clients from doing whatever it is they do down
here to people who get in their way. Forgive me if I seem blunt, but it
is time, my esteemed colleagues, to either fish, cut bait or swim”.
From this point on, things started happening very quickly. A portable
ventilator was attached to the dead man’s endotracheal tube. Very
small volume, very slow inspiratory time. Very slow exhalation of a
very small volume of air. This is necessary because the lungs will not
inflate any further than that. Titrate to effect of visible chest rise.
Somewhere
between
pulmonary
edema,
bi-lateral
hemopneumothorax,
subcutaneous
emphysema,
abdominal
distention, unknown actual time of death, and who-knows-what-else,
this is the most the situation will allow, and still look and sound like a
patient being artificially ventilated on a respirator. No chest
compressions. You don’t start an air ambulance transport running a
full-blown Code Blue. The patient has to be stable enough for
transport before you start. Of course in this case, the patient is
extremely stable, given the fact that he is already DEAD, insofar as
his condition is not going to change, as regards any deterioration of
his state of health. From this point on, the only deterioration will
involve decomposition
Transfer Logistics
Early in the training of every nurse, paramedic, orderly, or doctor you
are taught to never attempt to actually lift a patient from one place to
another if at all possible. Instead, you use a draw sheet to slide, or
roll them from one side of the bed to another or even one bed to
another. If your patient weighs as much as this one does, you use at
least two sheets so they don’t tear. After nearly twenty-four hours of
emergency care, there can be half a dozen sheets bunched up
around the patient. Eventually, they would be removed if he were to
be kept much longer, but there has not been much time for what
passes for housekeeping since his arrival. As a result, Sonja
manages to stay hidden from view deep in the folds of the numerous
sheets beneath her host.
IV solutions, medications, and blood transfusions are all re-initiated,
and placed on battery-powered portable infusion controllers, only to
be run at the most miniscule rate possible, just to make things look
good. Interestingly enough, it takes a great deal of skill, and
imagination to pull of such a deceptive fraud as this entails, because
normal values won’t work, and yet you still have to make it look good
to everyone who is any position to see, or judge, or draw suspicion
upon this charade. Once the patient reaches his destination, there will
be the added element of having to explain everything well enough to
convince the coroner in Miami. Jeff has already thought about this,
but does not intend to bring it up yet to the Flight Nurse, who is by
now, just barely managing to maintain her composure well enough to
function at all. One thing at a time….
Meanwhile, the family is going through its own set of last-minute
changes as well. It seems that, although Rueben (“Bluto”) was
originally listed on the manifest to be the sole passenger to
accompany the patient, it now seems that somehow, there are
“problemas” with his passport, and he won’t be going. Instead,
Poppy’s younger brother from New York will be going to Miami.
Although Jeff notices that it seems as if no one in this family has even
the slightest resemblance to anyone else in the family, this is not the
sort of thing one brings to anyone else’s attention. There is a reggae
song called Shame and Scandal; in it, a young man meets and falls in
love with a girl whom he later comes to believe to be his half-sister by
way of an affair his father had engaged in years ago..., who says ”the
girl is your sister, but your Momma don’t know.” Crestfallen by his
dilemma, his mother asks him why he is so sad. Upon hearing his
source of woe, she sings: “Go Ahead…Marry the girl…your Daddy
ain’t your Daddy, but your Daddy don’t know….” Bloodlines and
formal marriages in equatorial third-world countries are not quite as
cut and dried as they are in many parts of North America. In the
scheme of things, it seems like a minor matter.
Rewind
The ride back to the airport is relatively uneventful; at least to the
extent that once you have survived the ride to the hospital, playing it
in reverse is not that big a deal. Many Viet Nam vets will tell you that
once you have died the first time, every day above ground is a
freebee.
Thus far, no one has questioned, or indicated the slightest suspicion
about the condition of their patient. In the scheme of things, this is not
surprising. Critical Care Air Ambulance teams are regarded like demigods in these waters, and there are not too many people in any
position to question their ops in the first place. Not to mention the
fact, that for all intents and purposes, it looks like a very well-run
operation, because Jeff and Tracey know their jobs, and everything
being done is not all that much of a stretch from what they would
have done for an actual living patient. Short of drooling, or babbling
and soiling his clothes, the other medic has distinguished himself by
remaining completely useless, a muttering zombie who at least so far
has not managed to attract enough attention to himself to constitute a
threat to the ops.
Improvise, Adapt, and Overcome
The ability to establish and maintain credibility throughout this
operation was essential, and fortunately for Jeff, one of his
specialties, even in relatively unsavory circumstances. This was what
a former girlfriend had recognized when she had advised him to
become a paramedic because he was such an accomplished bullshit
artist. When he was in his early forties, he had attended an Italian
wedding. The brother of one of his best friends was getting married.
The reception was pure old-world stuff, including the tradition of the
placing of the garter on the leg of the girl who catches the bouquet. It
seems that it is customary that the man who catches the garter is to
place it very high up the leg of the girl who catches the bridal bouquet
because each inch above the knee is supposed to bring ten years of
marital bliss the newlyweds.
The girl who caught the bouquet is at best no more than eighteen
years old, and very shy. Jeff was between marriages at the time, and
had caught the garter. Sitting in front of Jeff, she appears terribly
embarrassed, and has the look of a deer staring down the headlights
of an oncoming car. Italian music played as the MC explains the
tradition. Everyone begins to clap in unison as the entire scene
begins to take on a carnival atmosphere. The girl alternately looks as
if she either wishes she could disappear, or that Jeff would.
Jeff looks straight into her eyes, smiles slightly, and motions ever so
subtly for her to lean forward, so he can whisper something to her,
which she does. His right hand is poised with the garter just below
her knee, at the edge of her dress. He looks deeply into her eyes,
leans forward as if to share a secret, and whispers: “Don’t worry, it’s
OK…I’m a paramedic.” “Oh…” is all she has time to utter. She visibly
exhales as her shoulders drop in relaxation and her legs similarly
extend forward slightly. She is completely open and unguarded, if
only for the instant it takes for Jeff to slide the garter all the way up
her leg until the backs of the second and third fingers of his right hand
are ever so lightly brushing against the crotch of her panties before
she has the time to analyze what bearing Jeff’s remark actually has
upon the current situation. An instant later, her rationality, as well as
her modesty would return, but that was all the time needed for his
flimsy charade to work.
Air Ambulance transportation requires more improvisation and
adaptation than most other aspects of Emergency Medicine. Eight
miles above the earth, if you don’t already have it, you may need to
either adapt something like it, or do without it. In the absence of CAT
scans, MRI’s, or even blood labs or X-rays, many of the old hands-on
diagnostic methods of physicians of eighty or more years ago have a
definite validity in the absence of more definitive methods.
About two years earlier, Jeff had been assigned to back-up his
supervisor on a particularly complicated air transport of a patient with
numerous cardio-vascular and pulmonary complications. Shortly after
take-off, the blood pressure monitor failed. No problem; they had
back-up in the form of a conventional manual blood pressure cuff.
Unfortunately, pulse oximetry was a secondary function of the B/P
monitor. The adaptation for this predicament is a little trickier, but can
be compensated for with regular assessments of skin condition and
color, oral and conjunctival mucosa color and capillary refill.
The flight was supposed to arrive at a scheduled time, due to the
inability of the receiving facility(a long-term respiratory care center) to
accept the patient after hours. The patient had required much more
oxygen than was originally anticipated, and back-up oxygen was now
calculated to be slightly short of what was now needed to run the
flight continuously, as scheduled. A call was made to the next
available airport to see if supplemental oxygen could be procured.
This would undoubtedly take more time that the anticipated arrival at
the scheduled destination, due to the lateness of the hour. The
alternative would be to declare an emergency, make an unscheduled
stop, go to the nearest hospital ER, and wait for the morning. This
could also easily eat up all the anticipated profit from the transport,
and mar the reputation of the company in the process. Not an
acceptable alternative, if the health and safety of the patient could be
maintained by any other means….
Jeff had already read the History and Physical Reports, and
consultations of the reporting physicians. He recalled that the
cardiologist had stated that the patient presented with frequent
premature ventricular contractions at a rate of less than six per
minute throughout her admission in the ICU. So far, they had
maintained her with sufficient oxygen that she showed no PVC’S
throughout the flight thus far. Jeff decided that if they lowered the
FIO2 (Inspired oxygen content) on the ventilator until she presented
with a rate of say, four PVC’S per minute, then they would have more
than enough oxygen to reach their destination. It bought them more
than enough time to safely complete the flight as scheduled.
Sometimes, an instant is all you need. Sometimes it is a matter of
minutes. This was not one of those times. Today would require
boilerplate authenticity from start to finish. Nothing short of flawless
and seamless would do, but if a glitch did occur, it would require
credible improvisation.
In music, one can only really improvise if you are fluent within the
framework of the genre you are playing, but thinking about what you
are about to do will cause you to choke every time. In Karate, when
you perform the kata, you must know the complex series of moves so
well that any thoughts about an individual movement would interrupt
the flow, sometimes to the point of causing you to freeze altogether.
Most of his adult life, Jeff had felt like an imposter, or a child playing
grown-up in adult clothes. (Really great uniforms help facilitate the
masquerade, but authenticity requires true character.) Twenty years
of practice had led him to this moment. There was no room or time for
considering the consequences if he failed.
Logistics, Logistics, Logistics…
Once the crew is on the tarmac beside the aircraft, a new demon
rears its ugly head. The patient weighs well over 350 pounds, and
sprawls cross-strapped to a long spine board, along with at least
eighty pounds of equipment, and fluids attached to him, that now
have to be loaded into a very small private jet, almost straight up
about six feet, only to be tilted about ninety degrees and pivoted so
as to clear the bulkhead that blocks unobstructed entry into the plane.
Not to mention the fact that he has to go in feet first, which makes it
that much harder to prevent the arms from flapping around, and
slapping someone in the head or face. And everything seems to want
to drain from every orifice, just as he is nearly upside-down, onto
everyone under him, trying to push him into the aircraft.
The reason that this is so much more difficult than usual is because
the company’s own Lear 25 was downed for maintenance, requiring
the use of a leased Sabre jet. This Sabre was ill-suited for air
ambulance transport. The flight deck was higher than the Lear, for
starters, and the door was too narrow, which compounds the problem
with a bulkhead so strategically ill-placed that one would suspect it
had been done on purpose, to thwart any effort to ever press them
into this sort of service. Because of this, as the patient was pushed
and lifted almost straight up, before the end of the long spine board
was inside the aircraft, it was then necessary to turn the board and
patient 90 degrees into a left-lateral position in order to pivot the
entire mess toward the rear of the aircraft, with the feet pointed
toward the tail.
Meanwhile, Sonja burrows deeply into the furthest recesses of the
tangled sheets to prevent discovery. It is instinctive. Although there is
no refrigerator under which she can scramble, the patient is nearly as
large and heavy as one. Blattodea Periplanetae will eat and digest
almost anything…Nothing is too disgusting for their palates. The
rest is left to the reader’s imagination.
Or Else
At this point, everyone races to get to the nearest (forget clean)
bathroom before takeoff. (Of course, Jeff and his nurse have to go in
shifts, since somebody has to watch the patient while the other uses
whatever facilities are available...you could say they have to relieve
each other in order to relieve themselves.)
Interestingly enough, day or night, in this area of the world, there is
usually a “cleaning woman” with a mop and a bucket standing in the
middle of the men’s bathroom, yet no one seems to pay any attention
to the fact that she is there, or the fact that the bathroom is never
clean.
Small private jets do not have what could actually be referred to as a
bathroom per se, but rather a "“potty seat”, which is to say that the
jump seat, facing the door to the aircraft may contain a small portable
“toilet”. (You pick up the cushion and sit on a hole in the pedestal that
has a red bio-hazard bag in it. Most jets of this size have range of
about three hours. The altitude and pressure changes have a
tendency to push gases and fluids around in strange ways that can
be very disconcerting to the uninitiated. In addition, it is an unwritten
understanding that “if you use it, you clean it”. Add to this the fact that
if you are forced to avail yourself of this “facility”, it will have to be
done in the full view of everyone else in the aircraft, save for a
shabby curtain hung up expressly for this purpose. All in all, you
might as well just shit or piss in your own clothing, and wait in shame
to land.
Jeff was well familiar with this, and knew to “govern himself
accordingly”. His first experience along these lines had occurred
nearly twenty years before, while working ground ambulance on his
first paramedic job. The experience made a most indelible impression
upon him.
Re-Animation
He and his partner, an EMT, had been dispatched to a hospital in
Hollywood to pick up a status-post cardiac arrest patient who needed
to be transferred to a higher level of care in Miami. The patient had
experienced a full arrest, with a return of spontaneous breathing and
heartbeat, but had not yet regained consciousness, and had
experienced several seizures, possibly the result of the lidocaine
“drip” that was being infused. He was receiving three other
medications via battery-controlled intravenous infusion pumps. Back
in the mid-eighties, each of these pumps weighed about ten pounds
each, and only controlled one medication. The patient was a “science
project” of critical care nightmares for a newly-certified paramedic,
and would take at least two hours transport time in heavy daytime
traffic.
As if this were not enough, the night before, Jeff had been out with
several of his friends at a local Mexican restaurant. A large quantity of
beer was consumed. Were it not bad enough that Jeff’s tastes in
cuisine such as this ran toward the excessively spicy end of the
spectrum, in retrospect, it now appeared that the bacterial content of
his repast may have been equally high. This is always a bad
combination.
If you work in an office, you may be able to excuse yourself long
enough to purge the contents of your colon sufficiently to allow
yourself enough time to get home before the next wave of explosive
diarrhea renders you essentially useless as a productive member of
polite society. On an ambulance, destined for a two-hour transport of
a critical patient, it approaches entering the ninth ring of hell.
If you have ever experienced true Orthomyxoviridae Influenza, you
may have an idea of what is about to ensue. For some reason, the
initial onset is often preceded by a sharp, cramping sensation that
may be caused by the passage of the relatively dry, firm bolus of
fecal matter slightly ahead of the deluge that is forcing the last normal
turd through the lower regions of your alimentary canal at a rate much
faster than it would normally be moving.
Like the immovable object vs. the irresistible force, we have a
biological paradox waging war within our own body. The spiciness of
the food in this case is now adding an additional dimension to the
scenario that cannot be underestimated. Scotch Bonnet or Habanero
peppers are at the extreme end of the spectrum of spiciness.
Aficionados of these gems have even devised a rating system,
measured in Sackville units, to compare the amount of Capsicum
Oleoresin (that which makes them “hot”) contained therein. Some of
the closest competition, for instance, the Thai Chili, is but a fraction of
the potency. In a moment of reckless abandon, perhaps fueled by
excessive consumption of ethanol-containing beverages, it is possible
to ingest enough of these fiery devils to produce a phenomenon
referred to as tenesmus, which is a condition wherein the bowels
attempt the purge their contents so forcefully that the rectum may
actually prolapse. This is much like dry heaves for the intestines,
except that it is exceedingly fare rarer that one would ever face the
prospect of vomiting up one’s own stomach. At best, by the end of
this ordeal, the victim’s rectum will more probably resemble a florid
purple cauliflower than a normal asshole.
Jeff was nervously anticipating his impending gastrointestinal
predicament when he realized just how bad a turn this was beginning
to take. The ambulance was now several miles from the originating
hospital, headed east on Hollywood Boulevard, when he realized that
they were indeed trapped in the mother of all traffic jams, the result of
multiple head-on vehicle crashes several miles east of them. In both
directions the road had become an impenetrable parking lot. A
Marathon gas station was a few yards ahead on their right. It might as
well have been a mirage, for all the good it would do.
His partner, an EMT, was not qualified to care for, or even monitor his
patient, who was at best, only marginally stable from moment to
moment. Had Jeff chosen to take an ill-advised chance in a matter
such as this, he knew all too well that Murphy’s Law (or worse) would
prevail. He had come to believe that in matters pertaining to the care
and transportation of the sick and injured, one day everything East of
the San Andreas Fault line will eventually crash into the Atlantic
Ocean.
It was also doubtful that his partner would agree to take on such
responsibilities beyond his level of training or certification. This was
not going to “only take a minute”. He had been here before, on a
lesser level, and once the purge began, it would no doubt consume
the next twenty or thirty minutes of his life, his consciousness, and
every other element of his being. He already knew this, as anyone
who has ever been in these circumstances can well attest.
When the “bolus” is expelled, for instance, it will be with such force
that the splash from the water in the bowl will soak his entire ass. The
spray from the stream of shit exploding out of him will resemble
brown adobe, far up, under the rim forming deposits impossible to
explain in terms of normal trajectory. And it will not be quick, or
merciful. It will come in waves. Each time you think you are finished,
and attempt to clean yourself, you will be overcome with yet another
paroxysm of spastic expulsions, just about the time you try to stand
up and fasten your belt. But you will try to clean yourself frequently,
because even though you know it is futile and in fact, counterproductive, the burning sensation caused by the combination of
stomach acid and its contents, gastric secretions, and the remnants
of the hot peppers will be overpowering. Unfortunately, soon your ass
will become so sore from wiping that a level of despair will eventually
supplant most all other rational thought. Jeff already knew this, and
he was most concerned.
Keep in mind, however, that Jeff’s primary concern is still the welfare
of his patient. He was at odds to produce a plan of action that would
not endanger this unfortunate individual. Just then, the solution came
to him: on numerous occasions, he has handed urinals or bedpans to
his patients during transports. He was always summarily dismissive
about his patient’s protestations of modesty or embarrassment,
although now it appeared that the glove was about to be on the other
hand.
Jeff’s mind raced as he looked about the interior of the ambulance. A
regular bedpan was unquestionably inadequate to contain the
impending tsunami. A plan began to form. A trashcan, lined with a
“red bag” (for biohazardous waste) would serve as a commode.
Crouching behind his patient, with his back almost against the
partition door between the driver’s compartment, he dropped his
pants and squatted over the trash can. The ambulance was almost
instantly bathed in an acrid vapor so foul that one would have
expected the air to turn brown. Methane, bile, and stomach acids
seemed to fill the air. Jeff’s partner was now gagging, retching, and
shouting obscenities. He turned the PA on, and directed the attention
of their fellow stranded motorists toward the rear of the ambulance.
Although he was howling with laughter, Jeff was thoroughly
humiliated. Without warning, the patient suddenly sat bolt upright. He
did not direct his gaze either right or left, as he suddenly proclaimed:
“My God, man! Do I need to get up? Are you sure you don’t need to
be lying here? I think you must be much sicker than I am!” Without
further ado, he then fell backward onto the stretcher, never to speak
again in their presence.
Would You Live to
Perpetuate Your
Illusions?
More a Matter of Image than Principle
Idealism is fine, and empathy will make you a better caregiver, but
there is a reason why medical professionals distance themselves
from their patients. Forget about sweat, more important: Never let
them see you shit. This was a hard-won lesson, not soon to be
forgotten, and a necessary precaution he never skipped. Regardless
of beer, whiskey, spicy food, bad sushi or not, there is not an
ambulance anywhere, in the air, or on the ground in which you want
to have to take a dump. Not with a patient, or even simply your fellow
crew members. Patient care, professionalism, and your own
elimination process do not mix. If you were to vomit directly onto your
patient (as they are often want to do to you, by the way), you could
still maintain your dignity. One of Jeff’s associates once vomited onto
an especially gory trauma patient’s face, neck, and chest while
working for a local county fire department, but he lost his job. You can
feel compassion for their distress, or their embarrassment over such
matters, but I adamantly believe with every fiber of my being that they
want us to be accessible, but almost aloof, sympathetic, but strangely
dispassionate. They don’t want to trust their very lives to someone
they just watched take a dump in front of them. In the case of this
patient, it is a moot point, but in terms of the comfort and dignity of all
of the flight crew, it is a pivotal and salient point.
Wheels Up
Flight plan, clearances, and the go-ahead for take-off seem to go
relatively seamlessly, and soon the aircraft is climbing to altitude.
Baggage has been checked, and our passenger has been loaded
onto the aircraft last, with just one small bag that was thoroughly
checked by several customs agents. This is somewhat odd, because
Customs usually checks your passengers and luggage on entry, not
on departure, but many of these countries require extensive
clearances before allowing anyone to depart their land, just in case
they owe the government (including the hospital), or somebody
important, any amount of money. Sometimes it is so bad, that you
have to either trade, or give back the sheets the patients are lying
upon before they will let you leave.
The Point of No Return
They are fortunate enough to get clearance to fly over Cuba, which
saves a tremendous amount of fuel. Jeff already knows that once
they are over Havana, it will be time to finally declare that the patient
has expired, because they will be past the point of no return, and will
be obligated to finish the flight into Miami as planned. The flight crew
does not take this information at all well. Then again, this being a
leased aircraft; they are not a part of the team, and have not been on
the inside track, so to speak. It should also be noted that these pilots
are midgets in a profession of giants, relatively speaking, and the fact
that nothing truly disastrous has happened up to this point is
miraculous. Jeff has to spoon-feed instructions to the flight crew
about the procedures for landing with a DOA, because neither the
Captain, nor the First Officer have ever done this sort of thing before,
and didn’t know what to do. For that matter, Jeff has never lost a
patient in transit before, although he had already learned the
procedures, “just in case…belt and suspenders”. In this business, it’s
ok to be inexperienced, but it is never acceptable to be ignorant. The
only reason for being ignorant is laziness, because there is a written
protocol for everything a pilot will ever have to do. Choosing to be
lazy and ignorant is just plain stupid.
Good jet pilots are some of the most amazing humans you will ever
meet. They are required to virtually memorize, like a reflex-arc,
thousands of sequences of procedures, regulations, and protocols for
even the most routine operations, like an uneventful take-off, or
landing. Then they get sent to Flight Safety, or any number of other
schools, to learn what to do in any emergency. They are then put
through a series of simulations of potentially catastrophic situations
that it might take years of flying to ever encounter, and that they
would be unlikely to survive without prior knowledge of exactly what
to do, and be prepared to do it instantly. Upon reflection, it would be
more accurate to state that merely good pilots can get you killed in a
hurry, and anything less than a great pilot is dangerous in a business
where it’s all about numbers. You may get away with being stupid
once in a while, but if you make a habit out of it, sooner or later, the
law of averages will reduce you to a pile of charred and steaming
wreckage buried deep into a gouged-out hole in the earth lined with
shredded tin that was flown by an average pilot. If a nurse, or
paramedic screws up, a patient dies; if a pilot screws up, everybody
dies.
Eventually, the pilot and first officer. get on the radio, and call Miami
to declare an emergency. Now, instead of being simply met by
Customs upon arrival, they are to be greeted by the Miami-Dade
Sheriff’s Department, as well as two homicide detectives, if not the
FBI and the DEA.
Confessions
of a Mad
Philosopher
Your entire life is an illusion
created by your mind.
If you accept the above statement as being essentially true, it would
logically follow that you are the source, and yet, if you believe that
you are, then you detach yourself from the infinite if you regard your
world as separate from yourself. Imagine. No inside/outside. No
me/you. No separate/connected. Our logical minds want to separate
things into opposites. Although this is true on one level, unless you
understand the connection between the opposites, you limit your
understanding.
Being only the source is exhausting unless you can visualize this
source as being a tiny pinpoint of the infinite. In their opposition,
opposites are interdependent. Good encircles Evil. Black encircles
White. Man encircles Woman. Hungry encircles Satiated. Empty
encircles Full. Desire encircles Fulfillment. Fulfillment encircles
Suffering. Big circles made of an infinite progression of smaller
circles, as well as an infinite progression of larger circles. So it is that
Yin encircles Yang. The belief system of Dialectics touches on this,
but it is not everything.
Everything is connected, but it is not seamless because even the
connections have increasingly smaller spaces. Our minds that create
differences with words, logic, or mathematics are self-limiting. The
mind that can simultaneously see the separate points of opposition of
words and logic while experiencing the feeling of the fluid connections
between them has the potential to understand that there is no same,
or different. There is only this, just this.
As long as you muzzle your questioning and thinking by succumbing
to commonly held notions about poor taste, political correctness,
blasphemy, obscenity, profanity, etiquette, manners, or other
obligatory strictures imposed by polite society, you will never free
yourself from the illusions they promote.
There are a great deal many more illusions as well. The Illusion of
Freedom. The Illusion of Autonomy. The Illusion of Safety. The
Illusion of Health. The Illusion of Choices. The Illusion of Love. The
Illusion of Possessions.
For instance, our health care system costs more than any other
country in the world, and yet, the quality of our healthcare, in terms of
survival rates, quality of life, longevity, and infant mortality are poorer
than many other, less affluent countries. It is actually cheaper (and
possibly safer) for the Canadian government to pay over ten
thousand dollars for an air ambulance to transport a cardiac patient
back to Canada than it is to treat them in this country. The
percentage of medical errors, misdiagnoses and misadventures is
rising dramatically. Healthcare insurance now consumes more of our
paychecks than taxes or social security combined, but the disallowed
medications, treatments and non-covered expenses still threaten to
bankrupt anyone at any given moment. The entire insurance industry
is based on cost containment via a routine practice of attrition of
claims by way of successive and arbitrary denials.
And Freedom? The most patriotic of us are quick to claim that we are
the freest society in the world. That is seriously questionable. We are
only as free as our government allows us to be, and that represents a
rapidly diminishing quotient at best. We have lost more civil liberties
and freedoms in the past forty years than we have gained in the
previous two hundred.
The Supreme Court and the FCC have ruled that it is no longer
necessary to present equal access to all opposing points of view.
Broadcasting is no longer protected from monopolization.
What would once have constituted entrapment is now regarded as a
“reverse sting operation” and tolerated in criminal court cases.
DCF investigators are not bound by evidentiary rules, habeas corpus
or due process, such as a warrant any more than Fish and Game
Officers are. (At least the Fish and Game officers are duly sworn
police.)
Then came the Patriot Act. As long as politicians can talk people into
giving up their civil liberties and freedoms in order to claim to protect
Freedom, there is little hope for things to get better any time soon.
Who will Protect us
from our
Protectors?
What about safety? Frivolous, as well as legitimate lawsuits and
endless product recalls against corporations that consider Risk
Management to be an issue of weighing the cost of safer products
against the cost of Financial Liability do not account for much in a
society that regards our Second Amendment right of self-defense as
a Public Safety issue, and labels it vigilantism.
It costs more to fund a fire department for a year than it would to
replace everything that burned.
How often do you ever hear about the Police stopping the burglary of
an occupied home? Or preventing a violent crime? Or even stopping
a crime in progress? While we are on the subject, who decided that
Crime Prevention meant taking away your ability to control the means
to commit a crime? If that is the kind of (for lack of a better term),
Logic that we are going to condescend into, I hope I don’t live long
enough to hear about Rape Prevention.
If you have ever been unfortunate enough to have something stolen,
did you ever get any of it back? Did you even hear anything about
them catching the perpetrators? The rate of apprehension and
conviction of Murderers is so statistically low that as long as they
don’t live with the victim, and haven’t publicly threatened or attacked
them, they will probably get away with it. And new DNA testing
suggests that an alarmingly high percentage of our previously
convicted killers are INNOCENT!
What about justice? Unlike Civil Court, (an oxymoron), Criminal
Justice is becoming more and more of a self-fulfilling prophesy. We
have among the highest per capita rates of legal institutionalization in
the world, including all the notorious “totalitarian” regimes and “police
states” that do not embrace Democracy. (Speaking of which, New
Jersey should really seriously consider renaming itself “The Police
State” instead of “The Garden State” in the interest of accuracy. For a
long time now, there have been a lot more cops than there are
gardens.)
Justice is more likely determined by skin pigmentation and money
than any other single factor. Add insult to injury by allowing the same
racists who would promote business as usual to cite as EVIDENCE
the fact that more non-whites are incarcerated than whites because
“they” are more prone to criminal activity. (If you can’t identify circular
logic, then you probably shouldn’t be allowed to vote.)
You are entitled to
the very best
Justice that money
can buy.
Mandatory Sentencing is currently insuring that (due to overcrowding
of the jails) convicted murderers, rapists, and other violent criminals
are released in favor of people whose worst crime is to have a portion
of a marijuana cigarette in their ashtray as they drive within five
hundred yards of a public school, after being stopped for a defective
tail light.
Working EMS was having the effect of turning Jeff’s life into a
deconstruction process. Life, as it deconstructs, falls away like
dominos from some starting point that began the whole unraveling.
First, you get to see people physically deconstructed, either by
observing the spirit being separated from the body, or piece by piece,
as in what happens secondary to severe physical trauma. If you
encounter them in their home habitats, you may also notice the effect
of separating from their daily physical lives, their clothes, their
houses, and all their possessions.
Step back a little further, and you can see how they are separated
from their families, friends, associates, and even enemies. Their hair,
their looks, their physiques, their money, influence, and their egos.
As all these connections are severed, moment by moment, molecule
by molecule, life dissolves into oblivion, even to the point of
decomposition.
In the same way that Life is
deconstructed by Death, so also
Death is displaced by Life.
Although we live in the only country where you can drive a tenthousand dollar car to pick up an Unemployment Check, it is also
possible to have a job and become homeless. Unless you have ever
been homeless, you have no concept of how much hatred the
Homeless are subjected. Without a home, most of us would lose our
jobs, as well as all those possessions that we thought without which,
life would not be possible. Although we were taught in school that in
America, there is no such thing as Debtor’s Prison, you can be found
guilty of Contempt of Court for Failure to Pay. There are people who
have faced felony charges and up to twenty years in jail for Contempt
of Court, as Don King would say: “Only in America”.
Although America is one of the wealthiest countries in the World, in
terms of GNP, Kuwaitis are per capita, one of the wealthiest people
on the planet, due to the fact that they are willing to share their good
fortune with their other citizens, even though they are nonetheless
capitalists. This is similar to the annual checks that Alaskan citizens
receive. In the United States, less than ten percent of the population
controls almost ninety percent of the wealth.
God gives us but
one true face. We
put on the others for
everyone else.
(a Koan)
Shrimps that sleep are
soon carried away by the
tide.
(Another Cuban proverb)
Something Is Happening, but You Don’t Know What it
Is, Do you, Mr. Jones?
(Bob Dylan)
Back to Business
Jeff had grown increasingly suspicious of the circumstances
surrounding this flight for some time after he had finally gotten the
opportunity to relax (relatively speaking), once the flight had gone
airborne, and he and Tracey, the fight nurse, had gotten their version
of how the patient care report was to be written agreed upon. This is
sometimes referred to as “buffing the report”.
They say History is Lies Agreed Upon. In terms of this transport,
there were just too many inconsistencies. (In the scenario, not the
report). Like the older brother going at the last minute instead of the
son, a detail that was overlooked initially in terms of the manifest, that
would haunt them later, or the fact that they had just now learned that
someone had forgotten to see to it that “Poppy’s” passport (or any
other identification, for that matter) went with him on the aircraft. It
was also fairly clear, the longer that he was in the air, that this
gentleman had not expired quite so nearly exactly upon arrival of the
flight crew at the hospital, but more than a few moments before.
There had been extensive surgery done to this patient. And most
notably of all, was the absence of the slightest semblance of grief
from this dead man’s “older brother”. In the awkward silence that
ensued at one point, the “brother” began to speak. It was as much
what he said as it was what he didn’t say that began to connect the
dots…perhaps he realized or at least sensed Jeff’s suspicions, and
wanted to draw him out, lest the guise be revealed at the wrong
moment, like on the ground, in front of the authorities. It may have
been viewed as a moment of opportunity to decide what to do
next…just in case.
About ninety miles from Cuba to Key West. About one hundred thirty
miles from Key West to MIA, at least by roads. A Lear jet covers a
mile in about ten seconds. Even with approaches, and the descent
(which is very rapid during an on-board air emergency), they would
be on the ground in less than twenty minutes.
“My grandmother used to say: Harsh judgments and selfrighteousness are not likely to come from the mouths of those who
have stood in the shoes of those they would condemn.”
“And Los camerones que se duerme se vente para la corriente.
(“Shrimps that sleep are soon carried away by the tide.”) Jeff’s quick
retort (even in Jeff’s clumsy Spanish, no less) takes the man by
surprise.
“Si, but that is a Cuban proverb, not from my country.”
“’Ta el mismos…mas u menos, no si pero?
“You even speak Espanish like a Cuban, Como?
Donde mas? En Miami? You work for over twenty years here, and
you pick up a lot more than just an accent…but thank-you, senior.
“I didn’t necessarily mean it as a compliment.”
“But I chose to take it as one, nonetheless. I would rather speak
Spanglish like a Cuban, than tell lies like a gringo.”
“What does gringo mean to you?”
“Somebody who thinks everybody is supposed to speak English to
them, when they serve them their hamburgers.”
The brother finds this very amusing, and relaxes noticeably.
“It doesn’t sound like you are a big fan of John Wayne and Manifest
Destiny.”
“My grandmother was Cherokee, what do you think?”
“Then maybe you know what it’s like to be outside looking in, Como
no?”
“Si, Jo entiendo, todo y mas.”
“I don’t mean to offend you, but you know, my English is a lot better
than your Spanish.”
“No offense taken, but, for one thing, it won’t get any better if I don’t
try. Yo puedo me trato.”
“And for another?”
“As a courtesy.”
“To me?”
“And your brother.”
“Thank-you, but not everything is quite exactly as it seems, senior.”
“I was beginning to suspect as much.”
“Sometimes, it is healthy to suspect, yet better not to know too much.”
“That’s why I haven’t been asking too many questions about things
that are too obvious to ignore, too difficult to explain, or too
dangerous to know.”
“You know, I don’t think you could be a gringo if you tried.”
“Thanks, but sometimes it is good to be able to pass for one, at least
to get by in my world.”
“We all do what we have to do.”
“And just what is it you have to do?”
“Take out the trash.”
“Excuse me?’
“My family had a problem. A very large and greedy raton had invaded
their ranch. He would have eaten my family out of house and home if
they would have allowed it. He thought that he would be protected
because he had friends in both your military and ours. He knew
things that allowed him to be tolerated for awhile, but the things he
knew about those people became recognized as a liability, once he
became too greedy, and as I said, he was tolerated for quite awhile
because no one knew quite how to rid the family of this pest without
attracting too much attention to things best left unnoticed.”
“So why do you tell me these things?”
“I can tell you know more than you pretend not to know, and I need to
know what you might do with that knowledge.”
“Suppose I don’t care?”
“First of all, I don’t believe that. You are a paramedico, and you are
curious, it is a part of your nature. I don’t think you would actually do
something you thought was really wrong, but you might be persuaded
to re-evaluate, or at least temper your judgments about certain things.
Very few things are actually as black as coal, or as white as fresh
snow, but there are a lot of shades of gray everywhere you look.”
“And if you convince me, then what?”
“Let me put it this way: already you have proven to be very helpful to
my family, not because you had anything to gain, but because of your
compassion, which betrays your good heart. Your eyes tell a different
story, however. They have seen too much, and you see both the
good, and the bad; the truth and the hypocrisy, although your heart is
good, it is no longer pure. You walk a line as thin as the edge of a
razor between altruism and pragmatism. Too often, you chose to do
what you thought was right, and noble, and you have suffered for it.
You are too smart to be poor, but not ruthless enough to be rich.”
“How do you pretend to know such things about me, when you do not
know me?”
“I think we were cut from the same cloth a long time ago. I used to be
very much like you, and in my business, I have to be a very good
judge of character. I don’t need to know your history to know your
nature.”
“Suppose you are right?”
“Because of your kindness, compassion, and let us say, your
cooperation, we would be prepared to reciprocate your kindness with
generosity.”
“Company policy forbids us to accept tips.”
(This is only partially true in the air ambulance business, because
pilots are NOT enjoined from accepting gratuities, which they, in turn,
share with the rest of the crew.) In this case, the pilots and the aircraft
are leased, not a part of the flight medical team. Not to mention the
fact that in a decidedly “need to know” situation, they are definitely
“out of the loop”. For that matter, at this point, so is the rest of the
medical crew.
“We are obligated to you. Unless you accept it, our obligation would
be a source of embarrassment, and would bring shame to my family.
It is a part of our culture. Since we are in international airspace, I
think it would be a good idea for both of us to extend every courtesy
to each other in an effort to, let us say, transcend national and
cultural biases in a true spirit of international diplomacy.
It was becoming increasingly clear that they were dancing around a
subject neither of whom intended to be so indiscrete as to directly
address.
Besides, if a tree falls in the woods, and no one is around to hear it,
does it make a sound?”
“You would turn me into both a diplomat and a Buddhist?”
“Only in a manner of speaking. You can be whatever you choose to
be, so long as it serves our mutual best interests. I can hand you this
envelope that has some papers in it. Some of the pages are small,
and brightly colored, but they are in a smaller envelope that you can
place inside your jumpsuit without any real notice, while I speak with
your nurse long enough to distract her. Look at it this way. If you try to
betray our mutual interests once you are on the ground, you will
incriminate yourself, and if you cooperate, you can do a great deal to
help your family, as well as allowing my family to save face as
regards our obligation to you.”
“What else?”
“Well, for one thing, this whole event has been very well staged, and
many people are involved in ways I won’t bother to try to explain.
Your own military officers helped set my family up in our “business” a
long time ago. It was orchestrated, engineered, and even tacitly
tolerated with the cooperation of your CIA. If pressed, they would
disavow any knowledge of any of it, but if they had to, they would
eventually claim it was all part of the balance of power in an unstable
region.”
The truth is, that every one of them got stinking rich bringing poison
back into their own country. And that continued with the DEA and the
police. What happened in Chinatown stayed in Chinatown, or the
ghetto. None of them thought that their own sons and daughters
would ever get involved, and no one cared until they did…but today’s
operation will be very predictable, with a minimum of risk. Even those
who are not already in our pockets are so predictable, and rigid in
their methods, that we will use their own methods to our advantage.
We are businessmen. We are connected to other businessmen,
some of whom even claim to be legitimate, even though they would
not be very successful without us.
“And if I don’t cooperate?”
“Senior, I volunteered to go to Miami, just in case. If this aircraft
crashes into the sea, my family’s primary interest would still be
served. We both know that there are any number of ways to make
that happen, so why risk the lives of all of your fellow crewmembers,
as well as your own? To me, it does not matter, as I have recently
learned that I have terminal cancer. Do your know what it is like to be
willing to die for a cause, for something you believe in that is bigger
than yourself, like your own family?”
“I’d rather live for my family, but of course, I see your point.”
“Good, because I would hate to have to sound like I was bringing the
safety of your loved ones into the conversation just to make you
understand how kindly we regard cooperation with our family, or how
sternly we regard those who do not. Our sphere of influence extends
far beyond the mere boundary lines of one country or another. ”
“Just to, as you say, take out the trash?”
“This unfortunate gentleman was three times cursed; first by greed
and arrogance, and secondly, by stupidity.”
“And the third curse?”
“That he should look a great deal like my brother, especially after his
unfortunate ‘accident’ changed his face the way it did. As it is my
brother’s wish that our families should retire from the more, let us say,
hazardous or unseemly aspects of our business ventures, the
similarity between one’s enemies and oneself is a fortunate
coincidence. We are now a family of grocers in Miami, and New York.
We wish to be left alone and live in peace as legitimate businessmen.
My brother had become too well known for that. His official
declaration of death will afford him the opportunity to retire in
anonymity.”
“Why do I suspect that there is more to this than you are telling?”
“As I said, all is not always what it might appear to be, but sometimes
it is not wise to know too much.”
“I can respect that.”
“And in the process, you respect yourself.”
Are there any
Beliefs for which
You would Die?
More Transfer Details
Sonja meanwhile, has been driven by hunger to carefully scramble
out of the numerous layers of sheets to seek further nourishment.
What passes for food to a roach is beyond the ken of most people,
and driven by the hunger generated by her pregnancy “eating” not
“for two”, but for several hundred only intensifies her ravenous
desires. For every roach you have ever seen anywhere, there are
hundreds that you have not seen pass right beneath your nose. It is
one of the gifts bestowed upon Blattodea Periplaneta that helps
guarantee their survival. Now the fragments of food dropped within
the aircraft, as well as anything else the passes for nourishment are
Sonja’s for the taking. Blake’s discarded breakfast, with its foam
plastic lid still fastened, provides Sonja with easy access to the
treasures within, while at the same time providing the safety of cover
from discovery. A short time later, she scrambles into Jeff’s flight bag
to sleep.
Three Card Monty
Upon landing, the aircraft was immediately surrounded by MetroDade Sheriff’s Deputies, as well as Customs agents. Initially, all
attention was focused upon the patient, who had entered the country
dead, naked, and with no passport, or even so much as a driver’s
license to identify him, except upon the word of his brother, who had
not been listed on the manifest, as he was a last-minute substitution
for one of the sons.
Mysteriously, the digital photograph that was normally stored in the
Florida DMV computers, as it would have appeared on his driver’s
license was not on file, or at least, could not be located at this time.
Over three hundred persons with his same first and last name were
recorded as living in Miami. For now, nothing and no one will move
until they get some answers. They are methodical, thorough, and
amazingly slow-moving. No one even goes to the bathroom without
an escort. The investigators are stone-faced, as if suspicious of no
one in particular, and everyone in general. Jeff is a little worried about
Blake’s reaction, yet they suddenly let him go for no apparent reason.
The ambulance that was scheduled to meet the crew has been
cancelled. The engines and the batteries are shut down.
With no air conditioning, and parked in front of MIA Customs in the
hot Florida summer sun, any traces of recognizable features were
rapidly deteriorating. A morbidly obese male, weighing nearly four
hundred pounds, who has lived for between fifty and sixty years
engorging himself on Latin food who was a victim of Traumatic
Asphyxia, who has been dead for over eight hours, two of which have
now been at over one hundred twenty degrees does not invite a great
deal of time being spent lingering over details inside the aircraft. Jeff
and Tracey both realized that any possibility of refuting their account
of time of death, treatment rendered, etc. was long since passed. The
longer the detectives ruminated over the suspicious nature of the
details of the case, the greater the certainty that what they believed to
be the true facts would never reveal themselves, much less be
discovered.
Jeff had a lot of time to think as the each of the members of all the
agencies involved performed their assigned tasks. It became quite
clear that the entire process had been so well-anticipated, that all the
orchestrated events assured the success of the desired results.
Then the DEA brought in the dogs. By this point, the acrid vapors
from the cabin were so bad that even the dogs had been reluctant to
enter the cabin. It would have been pointless to expect them to find
what they were looking for, which turned out to be secreted up inside
the “Hell-hole”, a mysterious orifice strategically located beneath the
tail section where, had the aircraft been a bird, would have
corresponded to its anus. It is the home of many electrical breakers,
the fuel pumps for the jet engines, and sometimes a spare tire. It is
seldom opened, rarely thought of, and virtually never searched.
Except of course today. Although the agents had already been tipped
off, they did not know the location of the drugs, but as they circled
around the back of the aircraft, the dogs went on alert, and one of the
agents noticed the hatch.
Diversion
This was one of those examples of where a big fish feeds one of the
little fish to the agents to whom he is obligated, to appease quotas,
and keep up appearances. Not to mention the fact that, in so doing,
the attention was diverted well away from the prime objective.
Jeff and his fellow crew members were questioned briefly, then
released.
“Tell me what you know about this…”
“I don’t know what you mean.”
“Is there nothing you can think of to explain any of this?”
“Only one thought, although I don’t know if it will be any help to you.”
“Anything you can think of would be good.”
“Well, I would say that it just goes to show that although a real bird
would only have one asshole, this metal bird would seem to have
three…”
“I do not understand. Where are the other two?”
“Over there”, Jeff proclaimed, as he pointed to the Pilot and First
Officer.
By having used the “Hell-Hole” to attempt to secret the contraband,
the Pilot and First Officer had clearly implicated themselves alone,
since its location is neither accessible, nor generally known by
medical crewmembers. A short interrogation established that there
had been neither the time, nor the opportunity for the medical crew to
have been involved, and the fact that the aircraft and flight crew had
been leased on a last-minute basis further distanced Jeff and his
associates from complicity. Diego, the brother who accompanied the
body was likewise considered above reproach, since he had
accompanied the crew with the patient.
Also of course, the principals involved on both sides made sure that
was the way it went down. The agents in Miami immediately told Jake
and Ross that they already knew who they had bought the drugs
from, and then told them who they were, as a way of not only
protecting the Big Fish, but also giving them the nod and wink, so to
speak, so as to let them know they would be taken care of, which is
to say, make the problem disappear. A judge would later rule on a
minor technicality, and have the case thrown out, if all went well. If
not, then Jake and Ross would become the problem….
You always do
everything the hard
way
(Jeff once read this in a fortune cookie)
The Long Way Home
The one-hundred-mile drive back up the coast would seem
interminable. This “day” had begun something like thirty-six hours
ago, and several lifetimes had passed in the interim, in more ways
than one.
More time to think. He thought about Stella and the kids. He knew he
had a purpose; was it all in terms of them? One thing was certain; as
long as he guaranteed their safety and security, his wife’s recovery
would be neither certain, nor immanent. Ironically, he was usually too
busy to have the time to see that she had no feeling of purpose,
because she was not essential in the equations upon which we
usually balance the operations of our daily lives. It had become
increasingly obvious to him that things were going to get a lot worse
before they would get any better. He had often thought about the
concept of self-sabotage as regards Stella, but tonight, it suddenly
occurred to him that in its own way, his life had not been much
different.
There is a great deal of difference between self-sabotage, and selfdestruction. Many healthcare professionals are self-destructive. They
are usually self-destructive for many of the same reasons that they
became healthcare professionals. Addictive or obsessive-compulsive
personalities born out of massive insecurities and a need to feel
needed, to feel important, but most of all, to compensate for
overwhelming feelings of inadequacy, are usually the result of a
fucked-up childhood, abuse, or unrealistic expectations from
demanding parents trying to vicariously live the life they never quite
achieved. Is it any wonder they are so susceptible to the God
Complex of Paramedics, or the need for Hero Worship that many
EMS personnel are so addicted? Self-righteousness and an aura of
feigned superiority works for some, at least for a while, but selfsabotage is a distinctly unique character, not always as evident, or
easily identifiable.
Paramedics often have an uncanny ability to find fault with just about
everything. As regards emergency care and transportation of the sick
and injured, it can be usefully channeled into a “troubleshooting”
mode for re-assessment. Several years ago, JEMS (the Journal of
Emergency Medical Services) wrote an article entitled: “Why do
Paramedics Intimidate their Supervisors?” Jeff worked at a station
where it had been copied and posted onto the bulletin board.
Regardless of the reason, or whoever had posted it, someone had
written under the title: “It must be the boots”.
The problem is that most of us don’t really resemble our original
selves after a few years in this field. The stress is overwhelming. The
fatigue can be devastating. Shift work has been proven to be not as
conducive to as long and/or happy a life as similar individuals who
work “normal” schedules more in tune with the kind of circadian
rhythms that most folks follow. Add to all this the fact that a career in
Emergency Medical Services and a stable marriage are about as
likely to go together as polar bears and roller skates (although
Romance is a decidedly different matter….)
“You’re not a real
paramedic (or firefighter, or cop) until
after your first
divorce.”
(Ancient EMS Truism)
No matter how bad your personal life gets, the one thing you don’t
want to do is let it affect your career. At least that is what you keep
trying to convince yourself, no matter how much denial it takes. A
common form of this type of self-deception involves diverting
attention away from yourself by focusing on the shortcomings of
everybody and everything else around you. So-stated, this would
seem like a hopelessly flawed strategy that would never go unnoticed
for more than a day…maybe a week at best.
The reason this is not true for EMS personnel is because it is such a
prevalent aberrancy. Imagine a fire station, for instance, with, say
seven firefighters, including engineers, and drivers, two paramedics,
plus a lieutenant, and a captain. Per shift. One is having an affair, and
hasn’t been caught yet. One has a substance abuse problem, also as
yet unidentified (alcohol is a drug, too. Most everybody drinks too
much…we’re talking about more than everyone else. And there are
plenty of prescription drugs that initially appear to have legitimate
purposes…). One either is in the middle of a divorce, or has just
caught his or her significant other in some compromising tryst, usually
with someone else they both know in the business, or was just caught
themselves. Add to this the fact that you may have to face either your
ex-spouse, or his/her new “significant other” at shift change. Any of
the above-listed situations may be compounded with a sexual identity
crisis, or the crisis may exist all by itself, at least for a short while. By
sexual identity crisis, I would include performance problems, gender
identity, and the extreme isolation of those individuals who are for any
number of reasons, forced into long periods of celibacy, not by their
own choice. Then there are the ones who are suddenly forced to face
the fact that one or more of their favorite perversions, or fetishes are
so far outside of the mainstream that they face ostracism and ridicule
at the hands of their peers, now that the cat is out of the proverbial
bag.
Many have severe financial issues. Keep in mind, that most
emergency services personnel are more than a little obsessivecompulsive, and generally driven by ambition and unrealistic
expectations of all sorts. The salaries are in no way commensurate
with the education, training, long hours and emotionally demanding
circumstances required, compared to other lines of work, or
professions. Most of the ones who have kids eventually learn that this
is not necessarily a good profession for being the kind of parent we
all hoped we would be. If we work more than one job, there is yet
another factor to account for the fact that for twenty-four hours at a
time, you face a whole building full of people, who, as surrogate
family are constantly accusing and defending each other and
themselves, yet no one seems to notice. Irish, Italian, Greek, Jewish,
Arabic, African-American, and many other cultures with extended
families that remain close on a day-by-day basis usually understand
this phenomenon more easily than white-bread, middle-class WASPS
do. If you can imagine being held captive in anybody’s family reunion,
one-third of your life, for twenty-four hours at a stretch then you will
know what it is like.
How can you tell if a
paramedic or a firefighter
is an under-achiever?
(He only works two jobs.)
(More Memoires of a Dharma-Bum)
But Jeff’s realizations of self-sabotage went further than that. To him,
they seemed to stretch like a common thread, throughout his entire
life thus far. Some might maintain that it would explain exactly why he
found himself precisely where he now was. Eventually it all adds up
to this: you try very hard to achieve some hard-won goal, only to soon
find yourself incapable of being satisfied by your accomplishment.
This stems from a two-fold dilemma. Your low self-esteem provokes
you to demean any accomplishment that you should achieve. The
Mark Twain Dilemma of not desiring membership in any organization
that would consider you as a candidate.
Everything governmental, state-sponsored or municipally funded is
“Low-Bid”, and The Management convinces you that this is in fact the
case in regards to personnel as well. Of course, this is simply
endemic to standard policy for most Inhuman Resources
Departments, but if you are afflicted by the sickness, you personalize
it. Eventually, you will convince yourself that in order to respect
yourself you must leave for greener pastures.
You may change careers, seek more education, or pursue a lifetime
of endless self-improvement mirages, never really noticing that
nothing ever really changes. You can do that with relationships as
well. Not only do your problems remain, but at best, all you can hope
to do is change problems as you change significant others. As he
reflected upon the long and short of it, he realized that whether he
ruminated about what might have been…if only…he also recognized
that remaining in the circumstances he had chosen to escape would
have left him within the same dilemma…what might have been…if
only….
What remained unrealized was his acceptance of his present, albeit
temporary circumstances, to make peace with the ever-present,
never-present moment. The bigger picture. No escape. Accept your
present circumstances. They are temporary. If they are good, enjoy
them, as well as their impermanence. They are like cut flowers; they
remind us of how short-lived superficial beauty, or youth really is. If
they are unpleasant, they will eventually change. If you can break the
cycle of desire and suffering, the joy of acceptance far surpasses all
the endless suffering. To never know desire, lust, passion, or
suffering would be to deny the enigma of what it is to be alive. It is
possible however, to ride the winds of desire and suffering, revel in
both the tragedy as well as the comedy of life and celebrate the
paradox of life itself.
As much as Jeff had believed that there was some much more
personal, individual answer to the lesson each of us has to find,
endlessly repeating the cycle of birth, death, and rebirth, it was now
quite clear that it would reveal itself in due time. It’s hard to hear the
music over the screaming. Once you realize that the screams are a
part of the music, it is easy to hear it all. Just like this….
How many people does it take to
achieve world peace?
(Hint: there are over four billion people in the world)
One hundred one-hundred-dollar bills can be hidden away fairly
inconspicuously in any one of several cargo-style pockets on the
average flight suit. At least, to the casual observer, it could easily go
unnoticed. To Jeff, it seemed more uncomfortable than a bushel of
live blue-claw crabs in his pants. Ten thousand dollars. It wasn’t the
first tip he had ever accepted, but it was certainly the biggest. Ten
grand. At that particular moment, although it would solve a number of
very pressing problems in his life, it wouldn’t really change his life
very much at all. But then again, he knew that he would have done it
all over again, for nothing. The incrimination of the money had
allowed this thing to happen by allowing the “brother” to trust him
enough to do exactly what they both knew he would have done
anyway.
Would You Take
One Life to Save
The Life of
Another?…
How Many Lives
would it Take to
Justify One Taken?
In the end, everything we ever need, or need to be, is right at our
fingertips all along. We already possess perfection within us, even if
we don’t know it, or haven’t realized it yet. The Zen Master Jo-Ju was
once asked if a dog possessed Buddha-Nature, (since The Buddha
had once said that all things have Buddha-Nature). His reply (in
Chinese), which was “No!” was pronounced: “WU!” (Think about it for
a minute…it’s a phonetic pun….) The dog does not have to know that
he possesses Buddha-Nature in order to possess it.
Exhaustion was taking over. Any sensible person would have
stopped, and gotten a motel room, even if only for a few hours. Jeff
was not one of those folks. It was beginning to seem like he had been
on this same road for his entire life. In a way, indeed he had. He
found himself suspended completely in the moment. He could not
recall where he had just been, and was unable to anticipate the next
familiar sight until he was actually looking at it. Someplace between
Ft. Lauderdale and Ft. Pierce.
“Oh yeah…Turnpike toll booth…Lantana….”
More familiar places appear and disappear on the movie screen that
used to be a windshield. It did not bother him at all. He was no
stranger to road fatigue, or highway hypnosis. Over the years, he had
made friends with them, and they were in fact, his muses.
He thought of an image he had created many times for his children in
order to explain the ever-present-never-present moment. Imagine you
are riding on a three-hundred mile per hour train. The conductor
takes you to the front, where the engineer lets you look through the
windshield. That is the future. It is only an anticipation of what you
believe is coming. Then you walk to the caboose, stand on the
platform, and watch the past disappear. Memories. You go back to
your seat, and stare out the side window, very close to the edge of
the tracks. You try to focus on a single blade of grass. A threehundred-mile-per-hour blur. You look down at your feet. You hold
your hand, palm up, toward your face. You are traveling at three
hundred miles per hour, but within the car, all is stillness. Within the
present moment, even your mind does not move.
He could feel a great weight being lifted from within. It suddenly
occurred to him that The Fear that had consumed him for so long,
that had in fact been programmed into him since before he could
even recall, was just anticipation. If you live long enough, you will die
of old age. If you don’t, you may live long enough to die of some
disease. It could be a long, slow painful death, like cancer, or a quick
end from a sledgehammer cardiac arrest, or perhaps a ventricular
wall rupture, or maybe something in between. If you don’t, that means
that you will die from an accident…of course some asshole will say:
“He died prematurely from a tragic accident”…or…”His life was cut
short…”
(Nobody ever says: “His life was too long”.)
What about: “That old bastard was such an evil prick, it’s just a
shame he lived so long!”?…Ah! but I do digress…. How can you die
prematurely if it occurs precisely at the end of your life?
The point is that we spoil most of our lives living in fear, anticipating
the inevitable. It’s not as if we can prevent what is meant to be.
Stupid people die every day for good reasons, just like really good,
and smart people die for no good reason at all. It rains on the just and
the unjust alike. But smart people often avoid dying stupidly every
day as well. Just like greedy, evil, and lazy people get exactly what
they fucking deserve…just not often enough, and not properly
publicized. If the news media wants to do the public a real service,
they should try to do a better job of calling attention to the times
“When Cruel Douche-Bags Get Exactly What They Deserve”. Film at
eleven.
It’s just such a shame to spoil a perfectly good lifetime of present
moments with the shitty smell of fear.
There are many
things Much Worse
than Death
Jeff had seen most of them. We live most of our lives being afraid of
dying “too soon”. When you get older, you realize it is much worse to
live too long. To outlive your savings. To outlive your health. To
outlive your own memory. To outlive your own usefulness. To
become a semi-permanent resident of “Gomer Gardens”, which is to
say to become a human vegetable to be farmed like so much broccoli
in a garden of Lost Souls. The nursing homes keep the beds filled.
The medical directors get their thirty pieces of silver every time they
send one of their captives back to the hospital, usually by way of the
ER. And after each admission, Medicare will pay for another hundred
days stay. It’s an industry. Now imagine what will happen when all
those “Boomers” are in nursing homes, and there aren’t enough
personnel or money to care for them. Those changes in residence will
most likely have a similarly profound effect on the real estate market
as well.
All too often, we do
not extend life. We
just prolong Death
(EMS mantra, origin unknown)
The Boulevard of Lost Memories
As he continued his drive along the Highway of Present Moments, he
remembered when they had re-named the Florida Turnpike the
Ronald Reagan Highway. At a time not long after the ex-president
had been diagnosed with Alzheimer’s, Jeff had suggested to his coworkers that the DOT should therefore now remove all the entrance
and exit signs, as well as the mile markers. Few saw, or shared Jeff’s
sense of humor, and this time was no exception. He had also
suggested that the President’s claims as to not being able to
remember, or recall the events for which he was questioned during
the Iran/Contra Scandal hearings had forced his subconscious mind
to make it true, like a self-fulfilling prophesy.
Too much fatigue to either remember or anticipate a road he felt like
he had been on for his entire life. It occurred to him that, at least for
the moment, he, the ex-president, and this road had that one feature
in common. For the moment, it seemed very apropos, and he felt at
peace, and laughed out loud to himself. Desire is suffering, but we
can joyously embrace the suffering of Life, and in so doing, come to
know what it is to be alive. We spend far too much time and effort
either reminiscing, and wallowing in old memories, or eating
ourselves alive with fear anticipating an unknown future. Or instead,
this very moment, you can choose to be an active participant in
tomorrow’s memories. It’s your choice….
Perhaps Stella will liberate herself from the shackles of “being her
disease”. Jeff had believed that facilitating her enlightenment would
be his salvation. More likely, his enlightenment might end his
participation in her enslavement. He only wanted to be there for it if
his own presence wouldn’t prevent it.
One thing was certain, however; this was the end of the trail, as far as
working as a paramedic. The spell was broken. Twenty years was
long enough. He had paid back his debt. It was time to move on.
Perhaps the money would make a difference. It occurred to him that it
wasn’t enough money to really change his life, and just as quickly, he
realized that no amount of money ever really changes anybody’s life
the way they think it will. And in so doing, he came to a realization
that no amount of money could have ever bought.
Jeff finally realized that after all those years, he had betrayed himself.
He had betrayed the very essence of his being. This was one of the
big truths he had been glimpsing, only to turn his head away from in
fear…the truth he thought he craved so much, but feared so greatly.
He had turned his back on his art, his music, and his most cherished
talents because of fear, and loneliness, only to embrace even more
fear and loneliness that rushed in to fill the void that had been
created. He had been running from that realization ever since and
now it was upon him like hungry wolves running down a lost child in a
snowstorm. It made him gasp; the realization was so sudden, so
merciless, and so complete. He did not perceive it as especially cruel,
since cruelty implies some pleasure derived by its deliverance. This
was just simple unflinching truth. It was he who had turned his back
to his own muse. He had lost his way and had fallen from an almost
divine state of grace that few are ever lucky enough to even witness,
let alone possess for more than a moment at best.
After falling upon hard times and even worse company, he forgot
most of the best and most valuable things he had ever known, even
though it seemed he had known them from his earliest recollections.
When it seemed he couldn’t have gotten any more lost, or sadder, he
tried to make amends, or perhaps to do penance by devoting his life
to saving other people’s lives. On a very superficial level, it had
worked, but he had become a victim of desire and greed in the
process once again, simply because he could not recognize that what
he really desired could not be satisfied with the objects he unwittingly
tried to substitute. He suddenly remembered the many times that he
had been obsessed with the drive to create, and express himself.
There, at least, had been a cycle of desire and suffering with which
he felt comfortable. Always more, and yet never enough. Money had
almost no bearing upon the equation, at least not at first….
He visualized a rat chasing its own tail as it scrambled through a
maze in search of some piece of cheese he had never actually even
seen. There is pathos in comedy, and comedy in pathos.
For those who feel, life is a
tragedy. For those who
think, life is a comedy.
(More fortune-cookie wisdom)
He also realized that although his departure from what he had
perceived as his crafts had been necessary on a certain level, it did
not have to be permanent. He had continued to flounder because of
his lack of balance. We make errors of omission, as well as
commission, and that which we fail to acknowledge will eventually
force itself upon us in such a way as to either bring about our ruin or
our salvation.
A great calm settled upon him. In his realization, he saw not only
what needed to be done in terms of balancing his life, but he also
sensed a lack of urgency heretofore unknown to him. Finally, the
connection had been made between knowing and understanding. In
the process, the difference between what was important vs.
unimportant became exceedingly clear. A flood of images of his
follies followed. He felt neither shame, nor remorse, only the regrets
for the consequences he had brought upon others that he could not
change. And even that seemed to fit within the scheme of things.
Although we all bring a certain adversity into the lives of some of
those we encounter, those adversities are the key to not only their
enlightenment, but also our own as well. Although it is frequently not
done out of any desire to further any interests but our own, we hold
within us the ability to recognize those consequences as an
opportunity for self-realization.
Your conscience is like a
small voice inside your
head. If you ignore it long
enough, it will stop talking
to you.
(Old parable from the aboriginal and native tribes of what is now
called North America
Seeking enlightenment
through words created by
your mind is like trying to
hit the moon with a stick.
(Isn’t it?)
Next came the blinding flash of light, with a monstrous booming
concussion of sound, drawn out into a long groaning, grinding,
scraping, and screeching. Blackness. Emptiness. Gradually the
sounds began to return. First, voices, shouts and screams, then the
wailing of sirens, and the yelping of ambulances. Jeff suddenly finds
himself sitting on the hood of a police car. No one seems to notice
him, but eventually his attention is drawn to the sight of his truck,
smashed almost beyond even his own recognition. The next sight
would have taken his breath away, had he any to give. His shock
turned to horror to see firefighters dragging what appears for all the
world, to be his body from the wreckage. His mind races. Can this be
what he fears it is? The paramedics surround his body as he races to
where they have lain the body. He realizes that although he may
have raced, he hadn’t run, he just went to the body without a step.
This further unnerved him, at least, in a manner of speaking. One
medic was now listening for breathing as another attaches ECG
electrodes and searches for an identifiable rhythm. There is none,
save for an occasional agonal ventricular beat, unaccompanied by
any pulse. And Jeff recognizes his own face within the smashed
wreckage of this corpse he is viewing. He expects to pass out from
the sight of it, and realizes why he can’t.
“My God! This is it! My life is over, and yet…here I am…what next?”
He looks down. No feet. He wills his hands to raise to his face, the
way we all do, unconsciously, thousands of times a day. No hands.
He walks beside a fire engine, and looks into the mirror. No face. No
body. Yet he still possesses self-consciousness; an awareness of an
existence…but what?
He notices a mild commotion at the scene of his body. In searching
for his identification, the medics have found the envelope, and the
money. One of the medics hands it to a highway patrolman, amidst a
mix of subdued exclamations and irreverent speculations as to its
source. Of course, there is no good reason for a medic to be in
possession of that much cash this time of night….
Jeff fears that he knows all too well what to expect of this. Most likely,
the money will be “redistributed”, amid speculation and accusations to
be levied against his family. Then comes the IRS. Another nightmare
to haunt his family after his demise. Several county sheriffs’ deputies
are now standing beside a patrol car with the highway patrolman, and
they are actually laughing! This is just too much to bear, and Jeff
tries to scream to no one in particular, which is just as well, because
he now realizes that in addition to having no body, he has no
voice…he feels as if he is falling backwards, head over heels.
Spinning in a slow, flat spiral for what seems like an eternity, until he
realizes that time is an illusion, created by the mind, that does not
exist. Of course, once you are dead, this is much easier to grasp, as
philosophical premises go. Then again, once the illusions that the
mind creates are stripped away, there is no longer any need for
philosophical premises about anything; it just is, and before (or after)
words, it is self-evident.
If You Think Death, You Make Death
Eventually, Jeff stops screaming, stops attempting to control
everything, and finds himself standing in front of a house. He has no
idea why he is here, so he just goes through the door, which is to say,
he just goes through the door. Pure spirit. Pure being. And yet,
nothing special. The realm of magic is not self-conscious.
Jeff realizes that he is standing inside the entrance of an immense,
palatial mansion. Although the architecture is modern, the interior is
filled with objects and furniture from every conceivable period of time.
It is a beach house. He realizes that he has no idea what his name is,
or how he got here. As his panic subsides, he realizes that he really
doesn’t care, although he can’t explain why.
As he wanders from room to room, it becomes apparent that although
the occupants of each room are engaged in some activity that centers
around a sort of theme, each of the occupants seems largely
unaware of the occupants of the other rooms.
Within the main themes of Sex, Religion, Politics, Societal Protocols,
Etiquette for Their Own Sake, The Abundance of Wealth, and
Conspicuous Consumption, (or the lack thereof), Austerity and
Aestheticism are repeatedly explored according to the mores and
customs of every imaginable culture. Each room is distinctly different.
From Sacred Sex to every imaginable perversion known to Man…or
Woman. From capitalism to Communism to Tribalism. Body
Modification. From Catholicism to Wicca. Orgies, Ritualism, Music,
and Art of every variation.
It was there that Jeff first saw the Ultimate Post-Neo Survivalist. He
entered a room whose walls bore only the encryption, “What have
you done for yourself since you learned to dance (after the Music
stopped….)? Jeff had coined the term Post Neo which he defined as
a survivor of the Age of Magic. Jeff later began to refer to those of his
ilk as Post-Neo, since the real survivors are those who still possess
the ability to love, and laugh. Then he saw her… the Ultimate PostNeo Survivalist, something like Betty Boop on Acid. A lot more lewd,
and much more mysterious….
While others merely endure, she flourishes. A freelance dance
stylist/entrepreneur of The Apocalypso, a mad rumba, half Foxtrot,
half Tango, set to electric Flamenco guitars backed up by The
Hammers of Hell on Percussion. The only dance step permitted in
Dreamland; someday she will be the only instructor.
Created by accident during a highly secret experiment wherein
several rogue paramedics, a back-alley surgeon, and a psycho nurse
attempted to transplant the brain of a Mad Scientist into the body of
the Whore of Armageddon, (a hermaphrodite, and former
Valedictorian of the Miami Catholic Girl’s Academy). When the Dance
begins, she starts by blowing seven perfect crack-smoke rings out of
her pussy. The finale is so bizarre that few men who have witnessed
it have ever escaped with their sanity, in spite of the fact that the
women spectators instantly understand, and even smile...while some
eventually join in. Here, there is no danger, there is no fear, and
nothing is insane or forbidden.
Bands are performing in some rooms, while orchestras play in others.
String quartets, duets, solos, and ensembles of every genre. The
scenes change from day to night in what seems like a matter of
hours. On the beach, nude sunbathers and the modestly attired are in
attendance. As the scene changes rapidly from night to day, people
are surfing, swimming, sailing and fishing. For the most part, they
seem oblivious of each other, and their various differences, although
deep inside the house, down in the basement, groups of people are
endlessly criticizing some other group, or philosophy of which they
are aware, and take strong exception to each other’s differences.
They plot against each other, devising schemes to prevent those
others from the pursuit of their various perceptions of Happiness. It
occurs to Jeff that these people are magnifying miniscule differences
in outlook or opinion, and in so doing convince themselves that their
differences are mutually exclusive of each other.
From newborns to living fossils, as well as the recently deceased,
from room to room, numerous babies are being born, according to
every known social custom, while in other rooms, countless funeral
practices are being observed.
Foods and every sort of beverages are everywhere in abundance,
although some choose to ingest nothing. All sorts of drugs, too
numerous to list, many of which are unknown to Jeff are everywhere
he looks. While some people read, others are writing. Some watch
films together as others are engaged in making them. As he wanders
through the palatial surroundings, Jeff becomes increasingly lost, only
to turn a corner back upon some strangely familiar scene, only to
become lost again. As drawn as he is by curiosity, or even desire by
each of the scenes he observes, or even participates in, he can’t help
wondering what is going on in the next room, so he rarely stays
anywhere in particular for what might otherwise be a long time.
As confusing as the continual rapid passages of time have become,
Jeff’s perception of Time becomes increasingly distorted. He finds
himself constantly wondering how long the Party will last. How and
where is/are the host(s) and/or Hostess(es)? What Time is It? What is
time, anyway? What other rooms are there, as yet unseen? What am
I missing somewhere else, right Now? When is Now? What is Now?
Why is Now different from Then? Is it? Where did I come from? How
did I get Here? Where is Here, anyway? Jeff finds himself
increasingly more preoccupied with these thoughts and questions as
he wanders from room to room.
Brief glimpses of seemingly familiar faces come and go, but Jeff can
think of nothing to say to any of them.
As he enters yet another hallway, Jeff is met by a strangely beautiful,
nude pansexual being who somehow glows from within. It recognizes
Jeff, and calls him by a name that he can neither remember nor
pronounce although he nonetheless recognizes as his one true name
the moment he hears and simultaneously forgets it.
It says: “I know where you really need to go, come with me.” Although
he hears the voice clearly, as if it were being spoken within his own
head, there are no visual cues that the message was actually being
physically spoken by the Messenger.
He/She leads Jeff to a room that generally resembles a beautifully
paneled Library, full of books up to the ceilings, with rolling ladders,
and invitingly overstuffed leather chairs, and disappears as
mysteriously as he/she had appeared. A dreamily animated fireplace
pops and crackles by a long table, loaded with an abundance of
snacks and all sorts of drink. Candles and subdued lights were in
abundance everywhere. An ambience of serene lights and aromas
permeated the room, and hung in the air as heavily as the smog in
the San Fernando Valley. Although there is a gentle murmur of
conversation in addition to the sounds of the fire, Jeff notices that
within the room, it is otherwise silent, and no sounds of the outside
goings on are audible.
The other occupants are genuine and friendly, as well as disturbingly
familiar, albeit unrecognizable, and they immediately include Jeff into
their discussion, which centers around the following points:
 As they are all as bereft of their memories as Jeff was,
they tried to figure out who they really were.
 From where had they come?
 Who owns this property?
 What is it that is being celebrated?
 How long is the Party supposed to last?
 Where will they go after the Party is over?
In a sudden flash of insight, Jeff is overcome by the realization of
having been in this room before, in spite of the fact that he does not
remember having left it, or why?
He does not have the opportunity to share this with the others, as
they are becoming increasingly agitated by their insistence on
learning their individual identities, and arriving at a mutually agreedupon purpose. The discussion becomes increasingly heated, louder
and more oppressive. Some members are ranting so fanatically that
they cannot hear what the others are saying. As obsessed as each of
them is with each of their questions, none of them are willing to
consider the validity of anyone else’s answers. Their voices become
higher pitched and more shrill until Jeff is forced to cover his ears and
shut his eyes. He screams in frustration until every bit of his breath is
gone. Then there is only blackness and silence.
When Jeff finally opens his eyes again, he finds himself at the
entrance of the mansion, with no memory of having been there
before, and no clue as to his identity.
Gasp! Jeff sits bolt upright in his bed at home, surrounded by
darkness. He jumps up and races to the mirror to see himself again.
He runs outside, naked as the day he was born, to find his truck in
the driveway. He howls like a wolf at the moon, and races back to his
bedroom, to the arms of his wife, who looks quite alarmed, and in
fact, amazingly sober.
Closer examination showed that she was also sweating profusely,
and smelled ever so slightly of shit and vomit. She was sniffling and
shaking a little, more of a slight tremor, like she was suffering chills,
but her eyes were wide-open, and clearer than Jeff could remember
seeing them in years.
“Welcome home…I was a little hurt by the way you ignored me when
you came in, but you looked half-dead…like you were sleep-walking.
You didn’t even answer me, and I wanted to tell you that I got your
message…in more ways than one. We have a lot to talk about in the
morning, but for now, I am just so glad you’re back. It’s time we
started over again, from the beginning, but not from the beginning, if
you know what I mean.”
“Did you read my letter, or watch the video?”
Stella seemed amazingly calm, loving, and attentive. For the last few
years, these were not qualities that Jeff would have used to describe
her demeanor, whether she had read and watched or not. He held his
breath.
“Yes, I did. For a full day, I was livid with anger, and took enough
Xanax to put a normal person in a permanent coma, but since only
Death is permanent, eventually, I woke up, and your words were still
there, and I realized that it was just a day later…so I decided to get
sober. You should be glad you weren’t here for that!
The kids pretty much stayed on the other side of the house, and went
to school, and fixed their own dinner like usual, except that for once, I
was aware of how little they needed me to get through an average
day, and that hurt. It shook me up to realize that I didn’t need to tell
them to stay away, or leave me alone, because they already were,
and had been, for a long time. I resented feeling like they needed me
to be their maid, and forgot that they had also learned to live without
me as their Mom. I realized that I felt like I had to get sick, or be in
some sort of crisis to get your attention, but the more dysfunctional I
became, the less you paid any attention to me at all, unless there was
an even bigger crisis. I resented you for being so dependable and
steady, until I realized that I had forced so much responsibility on you
that you really didn’t have enough time or energy to spend on
somebody who was never going to get any better. I know it was partly
because of money, but I felt like you were shutting me out.
I wanted to feel like I was your equal again. That meant getting off of
the drugs. I’ve been sick pretty much ever since, but it has been
getting better over the last twelve hours or so. I really need to take a
shower, and brush my teeth, but can I get you anything before I do?
By the way, what was the running and howling all about?”
“God! I love you so much! I just had the weirdest fucking dream! It’s
like I know we are going to be OK, no matter what happens…It’s like
this weight was lifted from my soul…we already are OK, and I don’t
even have to worry about it. I know you already know it, too,
somehow….”
“And you don’t even have to die in the process…at least not yet, and
probably not any time soon…besides…it won’t do any good to worry
about any of it….”
“Wait a minute!…what did you just say?”
“I am saying that I had the same dream…or maybe you could say it
was a vision…or maybe you could say it was a spell, for two days
now. I kept calling you to join me, but you were too full of yourself to
listen…we can talk about that later…but first, I want to see the
money! I don’t know how much…I just know there was a lot of it…I
want to see it.”
“How do you know about that”?
“The money?…well most of my visions are in kind of general terms…I
knew you have been through some kind of ordeal that involved a
death, that wasn’t your own…you were in danger for awhile, and I
tried to send you protection, and I tried to summon your spirit guides,
and tell you to follow them.”
“All this was in the dream?”
“Baby, life is a dream. If you think of it as a movie, it should be pretty
clear that if you don’t like your movie, change the script. Edit the film.
You are the director, the writer, the cameraman, and the star. You
told me that a long time ago, but you usually forget your own best
advice. Time is an illusion. Heaven, Hell, and our so-called present
lives on Earth are connected, separated only by the illusions we
create in our minds. Everything we believe to be residing in either the
past, present, or future is actually occurring simultaneously. Not only
that, but it actually is possible for two objects to occupy the same
space if their densities are sufficiently different. Density appears to be
a product of velocity, at least according to some theories of relativity.
So what we perceive of as being past events could exist as an
infinitely slower series of progressions, and the future could exist in
an infinitely faster-occurring series, like water poured into a glass of
sand, for lack of a better analogy.
What we interpret as the present moment is merely a theoretical
concept to provide markers, or references, like X and Y axis’ as our
consciousness moves through what we believe to be our present
lives. Neither matter, nor energy can be created, or destroyed, but it
can be changed in form.
The life force of our souls is the most rarified form of energy there is,
and it passes from one body to another like renters moving from
house to house. That energy can be cohesive and focused, like some
beautiful hologram, or as incoherent and unfocused as a dusty fortywatt light bulb in a West Virginia shithouse. Not only that, but there is
no reason that two or more souls can’t occupy the same being at the
same time, although when they do so in harmony, it is regarded as a
gift, but without consensus, it is regarded as schizoid madness.
Most religions try to discourage that sort of thought process because
it doesn’t tend to produce large congregations of followers. The
scientific community is too busy trying to distract the general public
from noticing that their fundamental axioms are just as dependent on
faith as most religions.
Now here’s where it gets a little tricky: think of our present lives as
being real in the sense that we live in these bodies that have a finite
lifespan, even if virtually every aspect of our perceptions are built
upon a series of delusional fantasies programmed into us like some
giant series of self-sustaining hallucinations. Each of our lives traps
us in an essential enigma that represents the paradox of our
existence, like some riddle to be solved. We are so addicted to our
illusions that we can’t separate ourselves from them long enough to
actually experience the joy of the lives that are literally slipping
through our fingers. First there is a mountain, then there is no
mountain, then there is. Deconstruct the illusions, and then you can
see what really is. Getting sober isn’t easy, you know. I had to focus
on something completely outside myself. Between spells and visions,
it’s been a wild ride”.
“I am amazed…it must have been”.
For once, Jeff was speechless. Once again, two apparently separate
universes had collided in harmony, resulting in a momentary rapture
of pure bliss. They both knew that there were no guarantees of
anything, except impermanence, but what they did know, they both
knew together. One mind of no mind, or Mu-Shin: Mind like Water.
All he could say was: “I never knew that you even paid attention to
such things…that’s pretty deep stuff...I should have known better
than to underestimate you. Just when I thought I was ready to give up
on you because you had given up on yourself, you go and save
yourself. I should have stopped enabling you by thinking I could solve
your problems for you. I empowered your own victimization. ”
“So tell me…what would you like to do with your Goddess?”
As Jeff stood up to embrace her, he felt the room start to spin, and
his ears began to ring. Too many hours on the road, too few hours of
sleep, and poor nutrition or hydration had finally taken its toll, and
instead of embracing his wife, the floor rose up, and beat him to it. He
was aware of a loud bang, like someone striking a large cardboard
box that had been placed over his head. It was deafening, but
painless.
Next, he became aware of a knocking sound, like someone at the
door. He didn’t feel like he could move and he felt like every bone in
his body ached, and worse, yet, weighed several hundred pounds.
He felt like he could not even open his eyes. He called out to Stella:
“Who the fuck is that at this hour? Can you see who it is, Honey?”
“It’s ME! She cried out. “Let me in! Open the door for Christ’s sake!”
“What are you talking about?” He shouted, more than a little annoyed,
as he opened his eyes, only to discover he was still sitting in the cab
of his truck. The engine was still running, the headlights were on, and
the front bumper was firmly pressed against the house.
Stella opened the robe she was wearing, exposing her naked body as
she pressed her large, pendulous breasts against the window.
“Don’t you want to come inside? If you show me the money, you can
come any place you want, but you gotta unlock the door and get the
fuck inside the house unless you want to do it in the truck, and as
long as you’ve been gone, I’m not going to suck your cock until you
take a shower!”
Jeff began to laugh, and shake his head as he unlocked the door and
staggered out of the cab of the truck. His legs buckled slightly, and
she grabbed him, to try to keep him from falling to the ground.
“My God! You smell like ass and ball sack! I mean it! You REALLY
STINK!”
They both were laughing hysterically as they staggered toward the
house.
“Before you ask, the answer is yes…if the question is ‘Did I see the
video?’ or ‘Did I get the point?’, or Did I get sober?, or ‘Did I really
have the same visions?’, but most especially, ‘Do I really want you to
fuck my brains out on a big pile of money?’ All the other questions will
require answers that are just too complicated to be discussed until
after the swelling goes down and you can’t cum anymore, so don’t
bother asking until a lot later.”
In his delirium, Jeff did not notice Sonja jump out of his flight bag.
There was a very good chance that as long as she and her babies
stayed out in the woods that surrounded their house, peaceful
coexistence was a great deal more likely than in Belfast, Palestine, or
even Boston. Welcome to Florida. Viva La Estates Unidos.
One Big Family
Roaches. The transmogrificated soul of a despot and murderer. A
Dog, two Cats, three kids, an impaired Nurse turned Witch, a
licentious cousin and unemployed Witch, hell-bent on proving herself
to be Jeff’s incestuous half-sister and a Post-Neo Survivalist
Paramedic trying to wrestle with the concept of Life after 911 in a
house full of disembodied spirits. Squirrels in the trees and in the
attic. Snakes everywhere. Bugs galore. Plenty of room, as long as
neither camp encroaches upon the other.
If you say life is funny, it is. Considering some of the options, it just
might be no worse than the lesser of many, MANY MUCH greater
Evils. From a Zen standpoint, it’s not good, and it’s not bad. From a
Zen standpoint, you shouldn’t make good, or bad, or better, or
worse…In fact, it has been said (and the paradox is duly noted) that if
you even open your mouth to speak, already you are wrong.
However, for literary purposes, let’s agree that life is funny, if you
mean odd, peculiar, and even rancid, or tainted (as in “…does this
taste funny to you?”).
If the soul of a murdered murderer were to be transmogrificated into
the collective consciousness of an egg sack full of Blattodea
Periplaneta, the inherent Organic Justice Potential would, to many,
about equal the possibility that eventually the Kharma would be
resolved, even if it took five hundred lifetimes. We all have within us,
with each passing moment, the opportunity to rectify and resolve the
worst difficulties in our lives.
Of course, we cannot “take back” what we have done that we wish
we hadn’t, and we cannot prevent anything from happening that is
beyond our control, but we can make peace with ourselves, as we
are right now, and through acceptance of our present circumstances,
understand that everything we need, we already have, and everything
we need to be, we already are. Everything and everyone that comes
to us is here for a reason, and brings something to us that we need to
learn.
And if Jeff used the good fortune of all his previously miserable
momentary circumstances to inspire a story that could provide both
he and his Goddess the means to go their separate ways in peace,
they just might do exactly that…together.
Author’s Note:
The story you have read is true. Only the names, places, times and
events have been changed; but not to protect the innocent. Fuck the
innocent; it rains on the just and the unjust alike.
Most of the elements that were changed were done so because of
potential lawsuits, and investigations spawned by numerous local,
state, and federal agencies that are paid to punish people for
participating in many of the activities described herein. For that
reason, please be advised not to waste your time trying to solve
some crime that you think may have been committed. Better to use
this story as a new set of eyes to view the future, and be the wiser for
what you might learn.
Even guilt and innocence are highly subjective terms at best, and I
seriously doubt that any of you are in any kind of position to judge
anybody else’s behaviors. Self-righteousness is a highly suspect
character flaw. Jesus realized that a long time ago, although it didn’t
seem to do him much good as far as predicting the malice and
avarice of the crowd to which he was playing….
Never Underestimate the
Power of Large Groups of
Stupid People
and so it is now, as it ever has been….
Not all of this necessarily happened in the same place at the same
time, and there are more than a few embellishments, but no totally
unfounded Urban Legends. Some of the elements of this story never
actually happened to the author at all, having been described to him
by several of his associates and mentors, many of whom were also
notorious liars, smugglers, drug addicts, perverts, telemarketers, or
dangerous psychopaths. Some of them also used to be
paramedics…That however, does not change the fact that the story
is, in fact, nonetheless, true. It is true to human nature, and in some
form or another, either has, or will eventually happen just as it was
told, more or less.
There are those (either in or out of the medical field) who may believe
that this is just the sort of thing that will do grievous harm to the air
ambulance industry, or the reputation of paramedics in general.
Some may be younger paramedics who just weren’t there when the
industry was growing, and need some kind of mythology to bolster
their egos and identities. Unfortunately, there are way too many of
these weak-minded Pollyanna’s gravitating to this business in the first
place, just like the newbie (or wannabe) firefighters who got all tearyeyed watching Backdraft. First of all, get over yourselves, then stop
and think about it for a minute. There have been literally hundreds of
books and movies made about doctors or nurses who did all sorts of
unspeakable acts without having the public (or even other doctors
and nurses) generalize about the entire medical profession in the
process.
This is a story told by a medic who came of age, so to speak, in his
mid-thirties during the mid-eighties. The story itself is about events
from the first five years of the new millennium.
The ambulance business is even younger than professional law
enforcement. Years ago, before paramedics, they were all either
ambulance drivers or the town cop, (who was usually the town badass, a sot, a bigot, and a bully), and it was just easier to give him the
keys to the jail than it was to try to find someone else to lock him up.
First came Police Academies. Law enforcement came of age and got
respectable. It still took another decade to weed out the old guard,
and the nightmares that were associated with them. Some were
good, and some were not, but they were the only ones to get the job
done back then.
In much the same way, most of the first ambulance drivers actually
worked for the local funeral home, and yet no one ever stopped to
question any conflict of interest. Much later, EMT-Paramedic
certification programs began to lend some of the same air of
respectability to the ambulance business as academies and
certification programs had done for law enforcement.
We are still in the throes of that transition, but it is nearly over. Back
in the eighties, there were few applicants with no other previous life
experiences to draw upon. We all had been and done more than a
few other things in our lives, and hadn’t been programmed since we
were sperm to become EMT’s or Paramedics. The game was new
and all the rules hadn’t been written yet. Most of the few rules that did
exist have long since been rewritten by risk managers and legal
departments.
Now it’s all about playing safe, and being good little citizens. Yes,
back then, we were all cowboys, but it was a whole lot more
interesting. By the time this particular plot rolled around, we were a
few years into the New Millennium, over twenty years later. Most of
the Author’s colleagues have either risen to power in administrative or
managerial positions, or have dropped out of the industry completely.
Several of them may still be in jail. No one in their right mind would
choose to be a street-level Paramedic for the rest of their life, but shit
happens…People are people. Period. Paramedics, Doctors, Nurses,
Firefighters, Police Officers, Judges, Teachers…blah, blah, bah…ad
infinitum. At least we finally figured out (especially as far as priests
and Congressmen were concerned) to TRUST NO ONE. If we had
regarded them more like fallible human beings, they not only might
not have been able to get away with so much, and they might not
have been led to believe that they could have in the first place.
We have come upon Strange Days indeed, when you are safer
having Ozzie Osborne (or even a middle-aged Paramedic) baby-sit
your children than either a Catholic Priest or a Scoutmaster. Just
think of this as a very provocative true story, and don’t be so quick to
judge the characters, or the author, because if you do, the joke’s on
you.
(More Confessions
of a Mad
Philosopher)
(By the way, in case you were still wondering how
many people it takes to achieve world peace, the
answer is one…)
(Guess Who?)
The answer to the
question: “If all
things return to the
one, where does
the one return?…”
Zero.
And (inhale)
Five (exhale).
And (inhale)
Four (exhale)
And (inhale)
Three (exhale)
And (inhale)
Two (exhale)
And (inhale)
One (exhale)
And (inhale)
…
Zero.
The Crowning Glory of Man’s Inhumanity to Man
The Crown of Destruction
The War Babies lived in the shadow of The Bomb. My loss of
innocence, a chain reaction of reactions triggered by the images,
stark and surreal of rolling, boiling fire forming the ominous
mushroom of the Crown of Destruction:
of Dachau
of Auschwitz
of Treblinka
of Bataan
of London
of Dresden
of Berlin
of Nagasaki
of Hiroshima
No one is safe. No one is a civilian. Non-combatant victims. Corollary
damages. The cost of doing business when the business is War.
None of us would ever be the same. We lived in the shadows of
enough nuclear weapons to destroy the earth many times over with
the knowledge that there was no place to hide, nowhere to run.
Man had created Satan in his own image,
and God in his antithesis.
Ten years old
No God
No Satan
No Heaven
No Hell
Only Dreamland,
Where mannequins go to die, their eyes burned out by the fire of a
million suns.
A little village, made to look like Anytown, USA, where every living
room, bedroom, or kitchen is a department store display window in
Hell.
Home of the Ultimate Post-Neo Survivalist.
If you were a Post-Neo, you grew up believing that the Nuclear
Holocaust was inevitable, and only a question of time. To this day, it
seems miraculous that it hasn’t happened yet. It is not surprising that
so many War Babies can’t grasp a feeling of permanence in their
lives. Just as well, as Life is a study in Impermanence. The reflection
of the Crown of Destruction in the soon-to-be-shattered glass of a
department store display window in Hell.
In the distance, the drumbeat of the Ghost Dance echoes all the way
into Dreamland, where I alone am dancing.
Desire is said to equal suffering, but if you stop labeling, and making
differences between good and bad, one is left to wonder: “Is suffering
bad?”
If you say yes, you fall into a thousand Hells with no hope of escape.
If you say no, you only see part of the picture. Your head is a dragon,
but your body is a snake. You cannot split a diamond (or an atom)
with a hammer. Embrace the joys and accept the consequences.
You could ask a dog about the Moon, or simply howl for yourself.
The End
This is what we don’t want to face by ourselves. This is why people
invent and seek religions to tell us what to do, to figure it out for us.
We keep blocking our consciousness about this concept, because it
terrifies us, and as a result, we are never ready for the inevitable. It
has been said that it isn’t the fall that kills you, it’s that damn sudden
stop, but with life, it is that long fall that seems to fuck us up so bad.
It goes like this: We all know we are going to die, but we try not to
ever think about this fact any more than we are absolutely forced to
do. The really hard part isn’t the actual death. It’s the fear of it that
paralyzes our brains, and our souls. The fear of everything that leads
up to that last moment. Think about it. We start out like empty
vessels, then we prepare ourselves for what we think our lives will
become. That almost never happens, and then we try to keep
adjusting for the unanticipated events that keep happening instead of
what we planned.
Sometimes even that works out to some extent, but just about the
time that the chaos begins to subside, we suffer a stroke, or a heart
attack, or our beloved significant other dies, or we are faced with
burying our own children. Or we lose our life’s savings through no
real fault of our own, or we lose our minds. Eventually, we outlive our
usefulness, and even our own memories. We try to support this
fantasy that involves the perfect, happy ending to a life well lived,
when in our heart of hearts we know that in all likelihood, that will be
the farthest thing from what actually happens.
I’d rather drop dead in the middle of a dead run than to die slowly
sitting in a pile of my own shit.
Our culture worships youth, and fears death, so we keep people alive
artificially far beyond any humane purpose, save for commerce, and
we hide them away from our sight, so we don’t have to watch them
die so slowly.
We are born into ignorance and die in despair. In a moment of
unusually profound sorrow, I came to believe that throughout life, we
are in fact alone. We are born into this world naked and screaming.
And from that moment when we are separated from our mothers,
each of our lives becomes a singular experience, and no matter what
we do or where we go, we only really have ourselves and even that is
temporary.
To live is to suffer, and to feel sorrow for our condition. It was much
later that I came to see the connections that existed between myself
and my world, and the very temporal nature of life itself made those
shared experiences that much more treasured, and not to be taken
for granted. If we are very lucky, there may be some happy moments;
there may even be a lot of them, or we may be blessed beyond the
dreams of common men, but the inevitable is what it is, and there is
no escape.
You can spend your entire life complaining, and waiting for things to
get better, or you can start living tomorrow’s memories now, in the
present moment, knowing that things will eventually get much worse.
Best to not make good or bad in the first place. It is in our acceptance
of the essential sadness of what it is to live and die that we find the
sublime joy of realization of the truth of our impermanence, the
realization of the folly of the illusions created by our minds, and words
through thinking, and the clarity of seeing everything exactly as it is:
just this, only this. Stop making opposites, like good and bad, or even
better or worse. Stop judging everyone else’s actions, and
concentrate on your own, but don't be so judgmental about yourself
either.
Some days you will be disappointed, or embarrassed, but most of the
time, everyone else will be so preoccupied with their own imagined
shortcomings that they will never even notice, and all that
embarrassment will have been wasted…and if they do notice, too
fucking bad. You can’t be any better than you really are, no matter
how hard you try to fool everyone else, and especially if your try to
fool yourself.
Eventually, it comes down to this: You can spend your life worrying
about The Meaning of Life, or else just find some meaningful
moments in your life everyday. The big, overall meanings may come
as occasional epiphanies, or all at once, at the Very End (if you are
actually conscious at the time). Regardless, you can’t force
anything…
The Snake only Sheds Its
Skin
When It is Time To Shed
Its Skin
Mostly, we are faced with making constant choices about what we
are going to do with all that time before we die…
No matter what choices you make, you are just filling up time. Paint
the ceiling of the Sistine Chapel. If you do it for fame or fortune, big
deal. In the scheme of the Universe, it is just mindless doodling. Do it
because it fulfills a need within you to express yourself, and you
approach the Sublime, at least while you are in the act of doing. If you
find a way to share that joy of inspiration with others, then there is no
need to bask in your own glory.
It always beats watching TV.
I started with mundane, everyday chores that were necessary to
maintain a clean and relatively orderly life. Do it with purpose as a
conscious choice. If that doesn’t float your boat, try living in filth until
you are sick of it…. Being personally involved in maintaining your
everyday life reinforces the connections you share with the world.
If you are intent upon performing Great Works, never forget to enjoy
and nurture the little everyday joys of friends, co-workers, and your
family. It’s a pyrrhic and hollow victory to sacrifice your Life for Fame
and Fortune.
By embracing the eternally-questioning mind, you can get stuck in an
unsettling thought or state of mind that can leave you breathless,
cold, alone, and afraid, with no evidence of any way out. If you
question long enough, you will experience it eventually. It is different
for everyone, because it is the source of your one most essential
flaw, and deepest secret Fear. We are all enigmas, paradoxes, and
Koan of contradictions that form the basic nature of our character that
is somehow, in and of itself, incomplete, like a riddle. If you could see
yourself as the main character in a novel written by you, would you
possess the strength of character and insight to be able to see
yourself as you really are, complete with consistent inconsistencies,
lapses of judgment, and weaknesses, in all of your unselfconscious
ignorance? You would have to step completely outside yourself to do
it. When you do, ask yourself “Who am I Now?” You may not be able
to speak the words to describe your insight, but your understanding
will surpass any words.
One step follows the other. Never lose sight of your dreams, or your
everyday life. No one can pretend to be able to figure it out for you.
You have to find it and do it for yourself. Truth will present itself preeminently, as long as you don’t cloud your judgment with dogma,
prejudice, or assumptions from those who would make themselves
rich by promoting their doctrines, even mine…. Trust that you will get
everything you need to be whatever you are supposed to be, which is
actually what you already are, and you will know what that is as soon
as you get it. Just don’t ever look away….
Is There Enough
Heaven Tomorrow
to Make All This
Worthwhile Today?
Is There Life After Zen?
Zen is not the journey. Zen is not the way. Zen is not the map; it is not
even the compass. First, you have to decide where you want to go,
and what you want when you get there, or then again, you may
choose not to decide, and simply walk the face of the earth until you
decide where you do want to go. Or you can simply remain
motionless. Zen itself involves more a priori assumptions than many
devotees would care to admit. They say, “Desire equals suffering”,
and thereby imply that suffering is bad, and in the process, injure the
eternally questioning mind that would kill the Buddha to feed a hungry
dog. In many ways, Zen resembles Henry David Thoreau’s account
of life on Walden Pond insofar as it represents one’s personal attempt
to find a very personal accounting of what is essential, or what it
means to be alive. Who am I? What do I want? This is an account of
examining the values each of us may choose to find, or attach to the
elements within our lives to separate what we want from Life from
what we do not want. In any case, eventually we are lead back to the
Here and Now.
How do you distinguish between Eternity and Infinity? Intelligent
Design presupposes a Maker of All Things who usually promises
Eternal Life in Heaven in reward for Faith and Obedience. Eternity in
Heaven has a beginning (sometime later) with no end, and is based
on time. Infinity is not time dependent, because it has no beginning or
end, and does not require belief in the existence of a maker to explain
our existence, or any separation between Past, Present, or future.
“With Infinite Time, Monkeys, and Typewriters, eventually one of
them will produce Shakespeare.”…Or a universe.
Do you need the threat of Hellfire
and Damnation just to be a good
person?
Faith is what we believe in the absence of empirical proof. Faith in the
axioms of Science is no different from Faith in Religion. Whenever
possible, assume nothing. An open mind is sometimes referred to as
“Mu-Shin”, or “Mind like Water”.
Our desires are in effect, our motivation for all of our actions. There is
no free lunch. Our actions are all connected to consequences and
sequelae resulting from those choices. And they are also separate.
Although even the connection between actions and consequences
may be considered axiomatic, it may be true that they are random,
separate, and isolated events, devoid of any intrinsic purpose or
meaning. The truth is, we just Don’t Know. If you can differentiate
ideas from beliefs, it is much easier to maintain an open mind, as well
as a closed mouth. We all have an opportunity to differentiate those
choices from what we may have regarded as The Inevitable.
Is there Life after you lose your faith? By that I mean, can you live
your life without believing in fairy-tales and illusions? Can you step
away from those unfounded beliefs and accept the pain and
disappointment long enough to realize and implement the course of
your life in a way that assumes nothing more than what is absolutely
necessary, and recognize how precious and unique each of us is
living this one life we have here and now? Eventually, you even step
away from Buddhism, and Reincarnation. I was drawn into Zen by the
same forces and influences that led me out, or perhaps beyond. My
acceptance of No Form, No Emptiness provided me with a clean
slate upon which Majik wrote a story for me about The Secret Lives of
Everything around Me. The Occult Pleasures provided by the Life
Forces that flow so freely between all living things, as well as the
objects which I previously regarded as inanimate. Life’s energies are
everywhere. If God has spoken to me, I have not yet heard Him/Her.
For now, that is enough. I have no need of any Deity that is jealous
and angry and needs to be worshiped and feared, given sacrifice, or
told to kill in His/Her name. I already have a government that does
that now. I may be left with more questions than answers, but my
Quest energizes my existence and reminds me that even
unanswered questions provide me with a purpose that Lies cannot.
Since my destination is unsure, I am content to simply enjoy the
journey.
And if that is enough, then leave it alone, at least for now. The only
thing worse than inventing mysticism is accepting someone else’s
secondhand God. Fear of not having belief is more likely to prevent
you from truly experiencing it. It’s like orgasm; if you are afraid you
will come too soon, you will; if you are afraid you won’t come, and try
to fake it, you won’t, because you are too wrapped up in the Act. Just
let it all be, and then see what happens…If and When you actually
perceive and feel Majik, or sense the animation of objects, or hear
colors, (or voices), do not be afraid; but rather invite them into your
life, because they are yours and yours alone…
Some people hear Voices, others hear
Music. Listen to them both, but Dance to
the Music and don’t be afraid to
question the Voices.
Zen has been compared to a wheel. Form is Form, Emptiness is
Emptiness. (O degrees). Form is Emptiness, Emptiness is Form. (90
degrees). No Form, no Emptiness, or Nirvana (180 degrees). Magic,
Insanity, and Miracles, (270 degrees), eventually leading back to
Everything is Just like This, Only this, Just This. Form is Form,
Emptiness is Emptiness. (360 degrees). (The honorable Seung Sahn
said that in Dropping Ashes on the Buddha.) If the wheel is always
turning, then the Past, Present, and Future become one.
There is not only Life after Zen there is Life while practicing Zen, Life
outside of Zen, and also Life before Zen. Eventually, there is no
inside, or outside, or before or after. There you are, back on the three
hundred mile per hour train, staring at your hand. What that means
remains for you to discover for yourself.
Final Confessions, Rants, Lost
Rights, Last Rites and Wrongs
And so he witnesses Trauma,
as he heals their trauma,
and in so doing, suffers trauma,
and also inflicts trauma, all of which affect him
in different ways that are also the same;
and those effects resonate among themselves,
regenerating sums, and differences,
as well as products of their interface;
heterodynes and overtones alike.
Eventually, the effects become overwhelming
…a symphony of broadband noise
resonating and harmonizing within itself within our beings.
Perception is the Mother of Harmonization.
Recognition is the Father.
Their children are the players.
Improvisation is the Dirty Cousin with secrets to share,
(like the knowledge of Good and Evil
…and Jazz.)
Music is the Family that Plays Together.
Without humor, we are lost. Even gallows humor has a certain kind of
optimism within it, since it depends entirely upon an audience to
usher it into existence, even as we are ushered out, so as to
transform it into history and legend, if only for a moment...each of us
has within us, our own audience to our solitary experience of
Oneness with everything. Alone in our unity, we find singular
companionship.
Hope is what enables us to persevere, even into oblivion, fueled by
curiosity, inquisitive challenge and mischief; it is the perverse spark
that ignites the fire of everything aberrant, deviant, and rebellious,
provoking the Imp and the Id alike as they encircle each other like Yin
and Yang in a binary covalent orgy of fallacious cunnilatio.
Ambiguous, but hardly ambivalent…God is alive and sex is afoot.
Always, whether we choose to ignore it or not, zapping from pillar to
post, constantly discharging and recharging alike in an instant, and
an eternity, all at once. Feel the spark of the current that passes
between us, thereby confirming our existence, as well as our
animation. Tantric; tactile, palpable sensory sentience, the galvanic
awareness of both ourselves, as well as each other, thereby
confirming our ontological reciprocation. The comingling of the
vapors, the moistures, and the electrons between concentration
gradients and differences in potentials, always in flux as fission
evokes fusion. Convergence of matter yielding energy that empowers
convergence of Mind. Mutually interdependent confirmation of
Existence, Life, and Intelligence. Love seducing Logic as Romance
beguiles Reason. The Father, the Son, and the Holy Provocateur;
God and Goddess alike, We are One.