Silent Siren, page 23
Shit! Shit! Shit! Heat rises in my cheeks. How will I explain this to the boss?
To the stares of the decedent’s son and a skinny, gray-haired neighbor, I bail out of the van. There’s simply no way to make an elegant exit from this kind of situation—even with my crisp gray suit.
The skinny neighbor climbs into the ditch and he and I make a valiant attempt to defy the laws of physics as we throw our body weight at the rear of the removal van, struggling to right it. It doesn’t budge.
The van sits precariously half-on, half-off the driveway. I gaze dolefully at my mistake and notice that, through the tinted, Landau panel-less rear windows, the woman’s shrouded body is clearly visible to the gathering group of gawking neighbors.
I knew there was a reason we had those Landau panels!
The dead woman’s son seems barely fazed, even amused by my mishap. He makes conversation with neighbors and watches for a while before going back to the house. I wait for the tow truck, feeling silly and unprofessional.
The son reappears a few minutes later with a camera and begins to snap pictures from every conceivable angle as his mother reposes at a rather undignified angle in the tipped van.
The tow truck rumbles to a halt. The woman’s son sets his camera down on a mailbox. He wipes away a tear and cracks a smile.
“Mom would have thought this was hilarious,” he says.
All in the Family
I’m at home, enjoying a beautiful, sunny day in my yard when my brother calls me on my cell phone. Ben is a police officer, on duty that day, and on scene with a dead body in downtown Bainbridge. The dead woman’s family wants her taken to Catalano and Sons, but Ben has been unable to get a hold of the director, so he calls me.
I am once again reminded of the undertaker/mayor/proprietor small-town caricature. I can just imagine the conversation that might have taken place at the condo.
Ben: “I can’t get a hold of the funeral home but I can get a hold of my brother. He’ll take care of your mother.”
Family: “Well…Is he qualified?”
Ben: “Well, he does have a van.”
I tell Ben I’ll get my suit on, pick up the van, and meet him on scene. Ben doesn’t like dead bodies. Like most normal people, he prefers to spend as little time with them as possible, but it is part of his job to respond to unattended deaths on the island. I had once asked for his help moving somebody onto the preparation table at the funeral home. Dick Catalano was out of the area and I knew Ben was working the street. Though he obliged, he certainly didn’t stick around to chat. Another time, I asked for his help moving a three hundred-pound man into his casket. He had a sour expression on his face the entire time.
I arrive at the condo and Ben shouts down at me from a landing on an upper floor. “Just bring your gurney to the side of the building. There’s an elevator there. I’ll meet you at the door,” he says.
I pop the hatch release and remove my mortuary cot from the back of the van. Its burgundy zippered shroud sits atop a conspicuously flat mattress. No need for comfort in this case. Ben meets me as I come off the elevator.
The dead woman lies facedown on her rather filthy bedroom floor. The bed is unmade, and she is wearing underwear and a night shirt. It looks as though she had arisen from bed and fallen over dead.
“You remember this lady?” Ben asks.
“No.”
“This is the lady that had a stroke and wandered into traffic on Winslow Way.”
Now I remembered. She had been unresponsive with fixed and dilated pupils. I had intubated her and flown her off to Harborview. At the time, I didn’t think she would survive.
I leave my cot in the hallway and walk into the living room, where my brother introduces me to the deceased’s two daughters. They had discovered her body after having not heard from her in a couple of days. They are polite and appreciative. I prefer to speak to the family and determine the arrangements they want for burial versus cremation before I make the removal.
I move my cot into the room, unzip the bag, and spread the plastic sheet onto the floor beside the dead woman. Ben and I turn her over and the sulfuric stench of early decomposition mixed with the nostril-burning odor of ammonia causes us to turn in the opposite direction and pause for breath before continuing. Two to three days down time, I estimate. I feel moisture through my gloved hands—bloody purge fluid from her mouth and nose, a sign of putrefaction. Her facial features are badly distorted from lying facedown on the carpet for two days, her nose shifted off to the left, her cheeks blanched white from pressure. She looks very much like a small child who has squished her face against a window. The front of her body is stained purple from her blood settling in dependent areas. A small amount of bloody fluid bubbles from her mouth and she emits a groan as residual air escapes from her lungs.
We wrap her in plastic and place her on the cot, securing her tightly with two seat belt straps and zipping the burgundy bag around her. I’ll need to advise her family to replace the carpet before they sell her condo.
I set my cot at a sixty-degree angle to the horizontal, making it easier to slide into the elevator. I’m always taken aback by the lack of forethought that goes into elevator construction, especially at retirement homes. The elevators are just small enough to make it impossible to transport anyone, living or dead, fully supine.
The dead woman’s only son enters and sits with his sisters. “Can I see her?” he asks.
I put a hand on his shoulder. “I wouldn’t advise that. She passed away a couple of days ago. She isn’t the way you would want to remember her.”
He nods and turns away.
I take my leave and wheel the body into the elevator and down to my waiting van. The body has started to decompose, so I will bring her directly to refrigeration in Kent instead of storing her temporarily at the funeral home. I pull away from the curb and drive towards the ferry deck, bound for Seattle.
I roll down the driver’s side window, take a deep breath of fresh air, and then open up the van’s back vents to allow the odor of death to dissipate. The job isn’t pleasant or glamorous, but somebody has to do it, and it may as well be me.
I’ve left my Bee Gees CD in the van’s CD player and I can barely hear Barry Gibb begin to sing Staying Alive. I turn it up.
VI. Reflections
“I was naked and you clothed me. I was sick, and you took care of me. I was in prison, and you visited me.”
- Matthew 25:36
One of Our Own
Arnie Jackson died January 2, 2008. He had retired from Bainbridge Island Fire Department with the rank of Captain after over forty-five years of service to the department. He and his family knew the end was coming. He died peacefully at home, without pain, after a long battle with congestive heart failure. Arnie was seventy-two years old.
When I joined the Bainbridge Island Fire Department in 1989, Captain Jackson was one I looked up to. Known as “Growley” to his friends, Arnie was tough but kind. He belonged to an older generation of volunteer firefighters, the kind that would jump off their tractors to the sound of the station-mounted siren and head for the station to drive the engine to a fire. Not many of the old-timers exist anymore—replaced by highly educated urban professionals who have little time to volunteer. Arnie was always there.
He always dressed the same—blue jeans atop dirty work boots, a plaid shirt and suspenders, a well-worn Bainbridge Island Fire Department cap atop a head of thinning gray hair. The fish-hook at the brim of his hat was his trademark. His skin was ruddy and rough from years of working outside hauling nets for the Net Systems Company and running his own tractor company, Custom Tractor.
Arnie didn’t suffer fools gladly and was quite willing to offer his opinion of someone else’s ineptitude. On one occasion when a volunteer had slid a fire engine off the road in snow, he had roared, “I need to teach you guys how to drive a goddamn fire truck!” Another volunteer jackknifed the boat truck and trailer while driving in reverse. Arnie’s response was, “You guys do just fine when you’re driving forward!” He would admit his own mistakes though. He once told the story of becoming aggravated with a new volunteer’s attempt to back an engine into the station. Arnie had climbed into the driver’s seat, said something like, “I’ll show you how it’s done!” and backed right into an awning. He had gotten out, surveyed the damage and said, “See. That’s what you don’t want to do.”
His specialties in the department were water supply and marine rescue. On every major fire, Arnie was there, coordinating the comings and goings of the giant fire hydrants on wheels known as tenders, supplying water to engines for firefighting efforts. On marine rescues, he could be heard growling into the radio, “Boat 21, Utility 21 en route.” He performed more than his fair share of rescues.
Five years prior, he had suffered cardiac arrest at fire station 21, in the presence of his fellow volunteers. Because of the diuretic he took, his potassium level had plummeted, causing his heart to stop in the day room, where he sat working on plans for a new fire apparatus. His cohorts had rushed to his aid, starting CPR, intubating him, shocking him time and time again, and airlifting him to Harborview Hospital.
In time he recovered, but he was a changed man. There was a softness about him I had never noticed before. He would take time out of his day to ask people about themselves. He quit drinking for a time and lost weight. He looked good. His near-death experience had left him profoundly changed. This bear of a man would tear up slightly when he recalled his brush with death. “I damn near died,” he would say.
In time, both his daughter and his granddaughter became involved with emergency services. Vicky, his daughter, became an EMT with Bainbridge Island Ambulance and Alyssa, his granddaughter, became a volunteer firefighter and EMT with the department. Although Arnie was never interested in emergency medical services—fire was his thing—I was glad he could live to see the next generation carry on his legacy.
The memorial service was January 19 at Fire Station 21. Never a religious man, the fire department was his church and his family. We all dressed up in our class A uniforms, shoes polished, badges shining brightly. We lined up the fire engines and stood in parallel lines beside them as Arnie and his family made their way to their seats in the apparatus bay. We stood at attention as they passed by.
At least three hundred people attended, public and fire personnel alike, as Fire Chief Jim Walkowski eulogized Captain Jackson. Some long-time fire officers got up and spoke, telling the funny anecdotes we always tell at these occasions, and remembering the man who dedicated two thirds of his life to the service of the community.
At the conclusion of the service, the loudspeakers chirped to life and the CenCom dispatcher spoke: “Bainbridge Island Fire Department, stand by for tones.” The long, piercing alert tones went over the airways and the pagers on the belts of the firefighters, the same tones that alerted us to fires, accidents, and cardiac arrests.
The dispatcher began again: “This is final tones for Captain Arnie Jackson with forty-five years of service to Bainbridge Island Fire Department.”
Tears filled the eyes of many a tough old fireman as the final tones were sent—tones that represented a coming home, a sense of things coming full circle. The bell that had alerted Arnie to the accidents and fires and tragedies for so many years now tolled for him.
One of the old guard was gone. The words from Matthew 25:23 rang true: “Well done, good and faithful servant.” Well done…
Grandma
Street lights illuminate the dusk in the little town of Poulsbo. I’m riding in the passenger’s seat of Bainbridge Island Ambulance on the way back from Harrison Hospital in Bremerton when my dad calls me on my cell. “Hey, Matt. It’s Dad. Are you at home?” This is the way he begins every conversation.
“We’re just getting back from a call and we’re coming through Poulsbo.”
“Grandma’s not doing well,” he says. “According to the staff, she’s very pale and she’s fallen again. Mom and I are on our way.” Dad is always very slow and deliberate when he speaks. It reflects his thoughtful and cautious outlook on life.
I realize that just at that moment I am passing Grandma’s street. “I can check her out. I’m only two minutes away. I’ll give you a call when I know more.”
My driver flips a U-turn and we head up the hill to Montclair Park Retirement. It specializes in dementia care and Grandma has been slowly declining from “Alzheimer’s-type dementia” (whatever that means) for a number of years. She is what doctors refer to as “pleasantly demented,” a peculiar term that connotes a passivity and partial disconnection from everyday reality.
I might only work on Bainbridge Ambulance once every two months, so I can only assume that the little red bag I find on the passenger’s side of the ambulance contains all the supplies I need to evaluate Grandma. The rig is only a BLS unit, though, so I have no heart monitor or cardiac drugs.
Grandma is lying on her side in bed. A nurse’s aide is with her, dressing her.
“What happened?” I ask.
The aide replies in broken English, “She fall down on the way to bathroom. Look like maybe she faint.”
I approach Grandma and instinctively put two fingers on her radial pulse. It’s rapid and irregular—not normal for her. Her skin feels clammy and a little cool beneath my un-gloved fingers.
As I go through my usual paramedic questions, it occurs to me that I’m not sure what role I should be in—grandson or paramedic. She has had a slow mental and physical decline over the years and she isn’t the same energetic, funny sixty-five-year-old grandmother I remember from my childhood. Her words and her thoughts are slow. When she can’t understand a question, which is often, she simply smiles. It seems easier and less painful to detach somewhat and simply be a clinician to this ninety-two-year-old woman who rarely leaves her room, lives in the past, and sometimes mistakes me for my father.
I push on her belly. “Grandma, does this hurt?”
“No.”
Her answers to other questions are vague. Though she can’t articulate what is wrong, she knows something is. Her eyes plead with me for help.
The door opens and three Poulsbo firefighters enter, bearing equipment.
“Oh!” I say. “I wasn’t expecting you.”
The lead paramedic speaks up. “Yeah, we had another call in the facility and the nurse asked us to check on this patient.”
“The patient’s my grandmother,” I explain. “I’m working on Bainbridge Ambulance today. Let’s put her on the monitor. I think she’s in atrial fibrillation.”
The EKG confirms what I suspect—Grandma’s heart is running a marathon while she sits still. Her heart rate is 140 and completely irregular.
Since no medic unit is immediately available to transport Grandma, one is called from a nearby fire district and within ten minutes two paramedics arrive with their gurney. My parents arrive as well, along with an LPN from the facility.
Grandma looks so small and vulnerable, pale, and weak, lying on her bed. She smiles wanly at all the attention. It’s hard for me to watch.
I think of the vacations we enjoyed together so many years ago, the warm evenings at her house in Portland when I would lie in bed listening to the electric fan and the laughter of Mom and Dad and Grandma, drinking coffee on the porch, healthy and whole. Old age and its attendant infirmities had taken her quick step, her health, and her mind. I wished I could stop the passage of time.
The attending paramedic, a solid-looking man in his late thirties, picks up Grandma’s 110-pound body and places her gently on the gurney. She will be in good hands, I know, but I feel a need to attend to her on the way to the hospital, to comfort her and make sure everything goes according to plan.
Mom, Dad, and I ride to the hospital together in the family car. It had been many years and fewer gray hairs when we had piled into Dad’s 1984 Toyota Camry and made the two-hour journey from Bainbridge Island to Portland, to visit a much younger, much more aware grandmother. Now we made the journey again, this time to be with her in her time of need.
We stay in the emergency room until well after midnight and Grandma is admitted to the cardiac wing, her heart rate stabilized.
I don’t know how much longer we will have her in our lives, but at least she appears peaceful, at ease. The ride back to Bainbridge Island is mostly silent but Dad expresses his appreciation for the unique circumstances that put me only five minutes away from Grandma when her heart began to falter.
I turn off my ambulance pager and go to bed, grateful for the opportunity to be there for my family when they needed me most.
Success
The waterfront bar is packed to the gills, loud and a sultry seventy-eight degrees as I saunter in and greet a friend of mine, a former firefighter who now tends bar. Through the front door walks a thin, older man with striking features and thinning gray hair. He and his wife sit down at a table, exchange pleasantries with the bartender, and peruse the wine list.
Something about this man is familiar. Suddenly I realize when I had seen him last—four years ago, in the middle of Manzanita Drive, flat on his back, dead. Whilst on an early morning jog, he had apparently suffered an arrhythmia and gone into cardiac arrest in the middle of the street. Nobody had seen him collapse, but, fortunately, a man and his teenage son happened upon him very soon after his heart had stopped. They had begun CPR and dialed 911.
About a dozen EMTs and paramedics, including my brother and me, responded on that day. We’d shocked and intubated him, jabbed IVs into both arms, pushed epinephrine and atropine into his veins, worked valiantly to bring him back to life. We’d flown him off to a Seattle hospital, where, slowly he recovered, regained consciousness, and walked out a week later on his own power. Here in this bar was the same man, once drained of color and staring vacantly at the ceiling of the medic unit, now vertical, happy, and full of life.
