Years ago I picked up an overtime shift in Denton, TX.  It was a vacation station.  Our company decided to have a presence in Denton, but the presence came before the contracts and crews mostly sat around doing nothing while our competitor ran all the calls.  Consequently it was the most coveted overtime shift in the company.  Who wouldn’t want to get paid for sleeping and playing video games?

I had just gotten to work to find an abandoned station with three brand new trucks.  There was no equipment list, no stock room, no supervision, and no partner.  I called dispatch and said, “Hey, what’s up?  I’ve got nothing here.  Is this a station or a hibernation chamber?  Got no partner either.”

“Your partner just got off a day car in Dallas, he should be there shortly.”

My new partner soon filled the doorway.  At 6’4” his head grazed the top of the door frame as he walked into the bay.  “Are you the Buckman?” he asked with a quizzical look that told me he didn’t believe them when they told him my name.

“It is I, my new gigantic friend.  Your new duty is crowd control.  I will sit back and be the brains of this outfit.  You can rough people up and collect the money.”  He looked at me long and hard while he tried to figure out if I was joking with him or not.  “Come on, help me check out this truck.  I can’t find a freaking thing in this station.”

His eyes lit up immediately.  “You are checking out the truck?”

“Don’t get too excited Gigantor.  I think the need to find pillows for ourselves will be more important than the contents of this intubation kit.”  I looked down at the kit that I had completely disassembled on the cot.  I was currently checking bulbs.

“Yeah, but you are at least checking the truck out.  I haven’t seen anyone out here do that yet.  No one has even tried to train me to do anything.  Mostly they just disappear and talk to every chic they know on the phone trying to get them to come up to the station.”

“Ah…Denton…”

“Seriously, I think it’s unprofessional.  I just moved here from ____________.  I used to work as an EMT is a very rural setting.  Ya’ll’s protocols are nuts.  I have really wanted someone to show me around, and you are the first person I have seen give enough of a shit to break down the intubation roll.”

I looked at him with a new eye.  “Alright man, break out that suction stuff.  I’ll show you what’s up.”

We spent the next two hours checking out the truck.  No kidding.  He had a question about every single piece of equipment we carried.  For the first few minutes I thought he was a rookie.  But before long it became obvious that this was not the case.  He was a very experienced EMT.  He knew what he was doing.  He just didn’t know how to do it here.  He wanted someone to show him our way of doing things, our equipment, and our district.  To be honest, I found his eagerness surprising and refreshing and I found myself really wanting to help him.  After the truck check was done I grumbled something about turning in.

“Hey, we never checked the front.  Do we have good maps of this district?”

“You know what, I don’t know.  I know where the hospitals and the nursing homes are, but you’re right, we need to have a decent map.”

We couldn’t find one anywhere.

“Hey, let’s go to the 7-11 on the corner.  I’m gonna buy us both a slurpee and a map.  I need one anyway if I am going to be working in this town,” he said.

So we went to 7-11.  I think I ordered the pina colada slurpee.  And he spent over $20 on a Mapsco that covered our piece of Texas.  “Satisfied now?” I asked.

“Not really.  I know it’s getting late, but I am shit at reading these damn Mapscos.  Can you at least show me where the hospitals are?”

“Yeah, why not?  It’s going to take me a while till I get to the bottom of this cup.  Lets go.”

Then he got on the radio, and called us mobile in district.  There was a really long pause before dispatch came back, “Uh…okay…22:32.”

“What was that?” he asked.

“You are probably the only person who has seen fit to notify them of our movements.  They aren’t used to such things.  Keep it up though.  It’s the right thing to do.”

We then got mobile in district.  I showed him the two hospitals, but he wasn’t satisfied.  He wanted to see the highway access and follow along in the map while I drove.  Then he wanted to see the nursing homes.  Each time we rolled up on one he would ask about the quickest way to get to a hospital if we picked up something serious.  He asked if we could talk to the fire department with our radio.  He wanted to know their capabilities.  He asked what the quickest way to the trauma center in Dallas was and made me show him in the map.  He was a never-ending fountain of questions, and we weren’t done until it was 3am.

“Dude, we gotta wake up in four hours and go home.  You want to put an end to this and get some sleep?”

“Sure man.” He said, “Hey, thanks.  You are the first person who has showed me what to do in this town.  For the first time since I moved here I feel like I know what to do if someone needs our help.  Thanks.”

* * * * * *

A week later I was back in Dallas, toting GOMER in my usual district.  Things had been rough lately because I hadn’t had a permanent partner.  I was an FTO at that time, and they liked to keep me solo.  If I was assigned a partner for any length of time it was because it was a hard-luck case.  The Clinical Coordinator would bring me someone who was broken and tell me to fix him.  It was my job but it was getting old.  I heard through the grapevine that I was getting a new one, and to be honest I wasn’t looking forward to it.  But duty called and so I did my usual dirty trick, I showed up for work an hour early.  I was evil like that.  I liked to show up way before the new guy and have the truck spotless by the time he got to work.  I liked to make an impression that would last by having the cleanest truck in the fleet and throw them off by making it seem like they missed out on truck check by not beating the teacher to school.  I was surprised to hear that my new partner was already checking out the truck.

I got to my rig and opened the back door to find Gigantor huddled over an intubation kit that was dissected and laying out on the cot.  “Hey partner!” he said with a big grin on his face.

“Gigantor!  What the hell are you doing here?”

“I pulled a few strings.  I have been bugging the shit out of the scheduling lady to put me on your truck ever since I met you.  I hope you don’t mind.”

“Hell no, my friend.  I’m happy to see a professional for once.”

We instantly became the nerd-crew of the service.  We took pleasure in following the book.  Our truck was spotless.  Our care was flawless.  Our uniforms started to have starch build-up.  Before long we were given the best of all equipment by support because they knew that we would take care of it.  We were given a brand new truck because the supervisors knew that it would remain immaculate.  We were given the most resistant of trainees because the training office knew we would be the best example to follow and never let up.

The big man and I became close friends, and it wasn’t long before we became intolerant of other partners.  I once told him that I was going to take a week’s worth of vacation and he became concerned with who he would be made to work with.  When I got back he almost broke my hand while shaking it and said under his breath, “If you ever leave me alone with these unprofessional mother fuckers again I will have to hurt you.”

* * * * * *

As I grew to know him I quickly became amazed at his level of pharmacological knowledge.  I would often ask him about a drug if I saw it on a chart and did not recognize it.  I would point at the chart and say, “You heard of this one man?”

He would always look off somewhere else like he was busy and say, “Which one is it?”  I would tell him and he would say, “Oh yeah, that’s blah blah blah, and it does blah blah blah.”  I would then look at my trainee and say, “See, this man’s a fucking encyclopedia.  There is no reason why an EMT shouldn’t know his drugs!  The medic is asking him questions!”

It got to the point where I would make a game of it and try to stump him.  I never could.  He always had the answer.  His knowledge was so impressive that I began to question him about his background.  Why the hell was he still an EMT?

“It’s complicated,” he said, “I used to work way out in the wilderness, and I was a bit more than an EMT.  We had a ‘Community Practitioner Program’.  We were so remote that there wasn’t a doctor or a hospital for a couple hundred miles.  Our Medical Director put us through an internship program at the local clinic and we would drive our rig all over creation doing well-checks on old people.  I had to know their meds or I couldn’t help them.  When I moved to Texas there was no equivalent certification and all they could give me was an EMT cert.  I hated to leave, but my two kids had reached school age, and my wife was afraid they were not going to get a decent education.  I hated to give it up.  It was good money and I loved the job.  But we moved here, got a small apartment and put them in a real school.  Now I am stuck making $6.40 an hour, but its working.  Kinda.”

I knew that his relationship with his wife was strained.  I heard some of the phone conversations.  To make ends meet he had started picking up ridiculous amounts of overtime.  It made him tired and irritable.  She didn’t have a job yet and he was frustrated with it.  He had always supported her easily out in the country, but now that he was making so little things were getting tight.  He never ate out anymore.  I never wanted to embarrass him so I started bringing my lunch too.  We never talked about it, but I had his back.  Brown bagging it cut down on the uncomfortable conversations like, “Let me get you a drink.”  He was proud and it was better this way.

One day we caught a train wreck call at a nursing home.  We had a trainee on our truck, and this might have been a great call to get the trainee’s feet wet, but she froze.  My partner and I were annoyed with her, but the patient’s condition was more pressing.  We let her sit this one out and started working hard.

“Hey, man.  Look in that chart and tell me what meds this patient is on.”

“Uh…I’m busy.  Can you look?

I had a tube and a scope in my hand.  For the first time ever I was pissed at my partner.  “What the hell, man?  Can’t you see that I am busy.  Freakin’ tell me what she’s got going on while I get this airway!”

He crumbled.  He couldn’t do it.  He started setting up suction, an IV line, and the glucometer.  He set up everything but what I wanted.

“Damnit.  Trainee!  Look through this chart and start reading me the meds!”

We got through the run and I caught my partner outside away from the trainee.

“What the fuck man?  I thought you had my back.  What’s wrong with you lately?”

“Can you keep a secret?”  He moved in close after looking around.  His tone was conspiratorial.

“Yeah, man.”  I wasn’t mad anymore.  I was concerned.  “What’s up?”

“I can’t read.”

* * * * * *

My favorite partner ever, the man who always followed the book, couldn’t read the book.  He broke down later and told me the whole story.  He went through high school and passed, but it was out in the sticks.  He could read simple words of four or five letters or less, but he couldn’t make out anything past that.  The internship he had gone through was all on-the-job training.  He had memorized the name of every drug that could ever be prescribed to an older patient but couldn’t read any of them.  He had been faking it the whole time.  He had been an EMT since the earth cooled.  This was back when they would make accommodations in his state for not being able to read.  He had been grandfathered into everything and managed to get his cert in Texas before they were a National Registry state.  But to this day he could not read.

“Dude, I’m sorry.  I never knew.  What are you doing to fix it?”

“Well, my boy is in a good school now.  He is about where I am as far as reading.  I wait for him to go to bed, and I break out his books when he is asleep.  My wife makes fun of me for it, but I am getting by.”

It all came flooding back to me.  Having to point to everything on the map.  Always having to call out to him which drugs the patient was on.  The tense conversations with his wife.  It all made sense.

“I’m sorry.  How much do you trust me?”

“You’re my partner, man.  I’m here for a reason.  You know that.”

“Well, we work through the weekends.  I know your kid doesn’t need those books on Saturday and Sunday.  Bring them to work.  You’re going to learn how to read my friend.  I’m going to help you.”

* * * * * *

And so it started.  He was reluctant at first.  As I said, he was a proud man.  At first he pretended like our conversation had never taken place.  Things were tense on the truck for a couple of weeks.  But after a while I had just had enough and I stared to pester him about it.  He finally brought some of his son’s school books to work and he would try to read them when we didn’t have a trainee.  I would help him every chance I could.  I also started handing him the medication records for nursing home patients and he would try to sound out the names of the drugs between calls.  We started making flash cards, and he got better.  He would get excited when he could read me a whole list without stopping to sound it out.  After several months he was starting to feel better.  We were also grinding out trainees at an alarming rate.  It was hard to even keep track of who would be on our truck.

One day he was absent.  “Your partner called in, had some sort of family emergency.”  This was all the supervisor would tell me.  I called him a couple of times that day, but got no answer.  This was back before cell phones were prevalent and I had nothing to try but his home number.

The next day I got into work early because we had a new trainee.  I was up to my usual tricks, trying to beat the trainee to work and make a good impression.  Gigantor was sitting in the back of the truck.  But for some reason he wasn’t inside the cabinets.  He was just staring at the wall.

“What’s up, my man!”  I tried to sound up-beat, but I knew it was bad.

“She left me man.  She’s gone.”  He was proud, but he was about to cry.  I knew he didn’t want to do that in front of me, and out of respect I tried to get him to focus so that he wouldn’t.

“Tell me.  Just tell me what she did.”

“She didn’t leave me for another man.  I could have dealt with that, maybe.  She left me for a job.  She just called around and applied to a bunch of hospitals.  She has no training whatsoever.  She just has a high school diploma.  Baylor Hospital called her up the other day and offered her $13 an hour just to answer the fucking phones.  She works somewhere on the floor.  She just sits there, taking messages and typing shit into a computer.  She doesn’t know how to do anything.  She just sits at a desk and answers phones.”

“Well, that’s good isn’t it?  I mean, she’s probably just frustrated right now.  Give her some space and let her get used to things.”

“No, it’s not like that.  She told me that she just called around one day and found a job that pays twice what mine does, and she doesn’t need me anymore.  She told me she’s tired of my shit, and she’s taking the kids.”

It was hard to hear.  I didn’t know what to say.  I looked behind me just to make sure no one was coming.  But we had got there so early.  The sun hadn’t even come up yet.

“All I ever wanted to do was help people.”

* * * * * *

I was the beginning of the end.  We were close.  And some of the stuff we did on that ambulance was the tightest care we had ever given.  We could pluck someone out of a house or the seventh floor of a nursing home and have them fully packaged with ALS in place and be headed down the road in less than 10 minutes.  Sometimes five or six.  Our trainees were confused.  To be honest they got ignored a lot.  We worked so fast and so efficiently that there was really no room for training.  New employees would get the most awesome show they had ever seen and left bewildered because we never really spoke when we took care of patients.  In between runs my partner and I would be huddled quietly over a small book and would refuse to ask questions about what we were doing.

One day he came to work and announced that he had taken a job out in the country.  It was more money and fewer hours.  He would have time to come in and see his kids on the weekends, and that was important.  I understood.  On our last day together we bored our trainee to death by driving around all over town.  I bought him a slurpee.  We exchanged phone numbers and he left.  We never saw each other again.  Where ever he is, I know he is doing well.  His boots are polished.  His truck is clean.  His shirt is starched.  And he is helping someone.  I am sure of it.  His kids are probably in their teens by now, and I hope they know how smart their father is.

* * * * * *

Last night I attended a concert by the Louisville Youth Orchestra.  My niece is a cello player in their Concert Orchestra.  It was wonderful to see so many young people who are obviously clever and accomplished.  Unfortunately this is not the norm in Kentucky.

One of the pieces played by one of the youth orchestras (not my niece’s unfortunately) was the Nimrod movement of the Enigma Variations by Sir Edward Elgar.  This has always been one of my favorite pieces.  My old band director played this piece to me in his office one day because he thought I would appreciate it.  He told me that each movement in this piece was a musical portrait of someone Elgar knew in his personal life.  None of these people were famous.  Not much is known about them.  Elgar was an officer in the British army and Nimrod is the nickname of a fellow soldier named A.J. Jaeger.  Not much is known about this person, but while listening to the piece it is obvious how much respect he had for him.  It is the most beautiful movement in the whole piece.  Do not let the modern connotation of the word ‘nimrod’ color the feeling that is to be conveyed by the piece.

Blogging is not really much of an art form, but towards the end of my career in EMS I am sometimes struck by the memories of some of the people I have worked with.  Over the next few months I would like to write a portrait like this to remember some of them.  Some of these people may not want me to reveal personal things like this, so the identities will remain a mystery.

This is my Nimrod movement.  I wish you well my friend.