I asked why he was called Hollywood, and no one really knew.  He had quite a reputation for having a personality.  Those who hadn’t worked with him had at least heard a story about him and knew who he was.  His biggest claim to fame was something called the trauma dance, and he performed it every morning after his truck checkout.  He would spike a bag of ringers, and dance around the truck hopping from one foot to the other singing, “Hey-ya, hey-ya, hey-ya, hey-ya!”  He would anoint the truck on all sides with the electrolyte solution until the bag was empty.  He said this was to appease the trauma gods, so that they would favor him and give him a good gut-slinger.  When asked whether or not the dance was effective, he would look at you with disdain.  Apparently such things were not to be questioned.  Evidence based appeasement of the trauma gods had never crossed his mind.  This was simply a leap of faith not to be questioned.

I was driving into the parking lot and saw him dancing and splattering ringers on my truck.  He was still at it when I got out and met a co-worker at the door.

“Did my partner call in sick?”  I asked.

“Yep, you’re stuck with Hollywood.  He’s without a partner too.  He’ll be done with his ceremony in a second.  You’ve probably got time to get some coffee.”

When I returned he was hyper and ready to go.  He told me all about the Marilyn Manson concert he had been to the night before.  This was quite a few years ago when the song “Beautiful People” was climbing the charts.  Hollywood had done it up right with face paint and all.  According to him he was fighting a bit of a hangover, but was doing well despite the ringing in his ears.  And now the trauma gods had been appeased, so it was bound to be an awesome day.

But, true to form, we had an incredibly boring day.  One tote after another.  Dialysis, to wound care, to doctor’s appointment, and back again.

Mind numbing.

It had just gotten dark when our last run for the day was handed to us.  It was a woman complaining of hip pain.  Apparently another crew had been there earlier, was unable to complete the run, and we were to call dispatch before we started for the residence.

“This sounds like a big steaming pile of getting-off-late horseshit!” announced Hollywood as he dialed dispatch’s number on our truck phone.  After a short conversation, he gave me the scoop.  “Apparently there is a beached whale in the projects that needs toting.  She has hip pain.  The other truck said that their stairchair disappeared up her butt crack, so we are supposed to stop by support and get the big-dog stairchair.  This is a cluster that is just a-brewin’.”

I was unaware that we had a special stairchair for the gravity impaired.  It didn’t look like much when they gave it to us.  It did look sturdy, but not very big.  This was before the days of bariatric stretchers and lifts.  Everything we had was one-size-fits-all.

By the time we got to the projects, it was pitch black outside.  There was no moon out, and this set of apartments sprawled on forever.  The building numbers made no sense whatsoever and we found ourselves driving in circles.  Our trouble was compounded by the fact that the parking lot was so poorly lit.

“I’ve gotta fix this,” said Hollywood while he plugged our spotlight into the port for the cigarette lighter.

“Dude, put that away,” I quickly told him.  “That will make us look like cops.  They don’t like that shit in this neighborhood.  We’ll take a couple of stray rounds for sure.”

This did not slow Hollywood down in the least.  He got a big grin on his face and immediately stuck his body out the side window up to his waste.  He was hanging halfway out of the truck aiming the searchlight when he started shouting at the top of his lungs, “I am not the man!  Put your weapons down!  We mean you no harm!  We come in peace!  I am not the man!”

I just shook my head and continued to circle aimlessly.  Finally we caught a break when some young kids came out to see what all the commotion was about.  They gave us directions to “Big Mama’s house” and wished us luck before scampering off into the night.

“Big Mama” lived on the second floor.  Of course.  Isn’t that where all morbidly obese people live?  Our knock was met by the skinny husband of our patient.  I have nothing to offer on this subject but personal experience.  To my knowledge there has never been a study on the weight of the spouses of morbidly obese people.  But for some reason the following holds true: the weight and stature of the spouse will be inversely proportionate to that of the morbidly obese patient.  In layman’s terms, skinny guys seem to always get shackled to these giant patients.  Over compensation?  Maybe.

It was also immediately evident upon entering the house that the family was actively enabling the patient’s obesity.  In the hallway near the front door we encountered cardboard boxes filled with spam and twinkies.  They looked like they were purchased from a restraint supply company, and the quantity suggested they bought in enough bulk to justify their account.  This is common with these types of patients.  You will hear of glandular problems making a patient morbidly obese, but this is only true to a point.  The law of conservation of matter dictates that the bulk must come from something.  One doesn’t get to be over 500 pounds on a 2000 calorie a day diet. 

We were ushered into the back bedroom where we found her.  There was no bed, just a loveseat.  And her posterior took up every square inch of cushion.  She told us that the last time she was weighed put her at 700 pounds, and she looked every bit of it.  From what I could tell, our patient simply lived in this loveseat.  She sat there 24 hours a day.  Her foley caught her urine, and her dress caught what didn’t make it to her mouth.  She was filthy.  The question of how she moved her bowels occurred to me for a brief second, but I tried to push it back to the dark recesses of my mind.  Some things are better left a mystery.

“So what seems to be the trouble today ma’am?”  I asked.

“My right hip hurts.”

“Did you fall, or get injured in some way?”

“Nope.  I haven’t been out of this chair in over a year.”

She was serious.  Further questioning just got us no where.  I tried to examine her hip but I couldn’t even wedge my hand in between the arm of the loveseat and her hip.  It would remain a mystery until we moved her.

Hollywood was already calling for lift assistance.  Dispatch was calling the Dallas Fire Department, and we were told they would be responding with an engine company that had four people.  So we spent the rest of our time getting patient information and trying to come up with a plan to get down the stairs.

When they arrived they weren’t happy.  Our relationship with Dallas Fire was strained at best.  They hated helping us with lift assists.  Some engine companies flat out refused to do it and would take one look at the patient, clear up, and drive back to the station.  There was an ongoing argument with our management and theirs about whether or not they had an obligation to help us make runs.  To be honest, they were probably right.  But we always won the argument by saying to the patient, “Well, we asked the fire department for help, but they refused.  They said they didn’t do things like that.  They don’t want to help you.”  It was low.  But it worked.

They had never seen this patient, and they looked scared from the outset.

“Dude, she is freakin’ huge.  There is no way we are getting her down those stairs.  Did you see them?  That’s some rickety-ass shit.  We’re all gonna die if we try to get her down those stairs.”  His eyes were wide, and I understood his concerns.  I had them too.

“Man, she can’t live up here forever.  We can’t just say, ‘Oh well, you’re boned.  We gotta go.’  We have to do something.”

So, we came up with a plan.  It wasn’t much of a plan, but there was at least a concerted effort to get the patient out the door and I was running with it.  We asked the patient if she could stand up with assistance, and she told us that she does that about once every two days or so to be cleaned up.  I didn’t want any details past that, but at least she would be able to help us.  However, she said that she needed to ‘get rid of some things’ first.  I was unaware of what she could possibly be talking about until she started fishing around under her breasts and various folds in her upper body.  Over the next five minutes she produced half eaten sandwiches and other items in various stages of decay.  She explained that since she didn’t move very much that she liked to squirrel things away.  Storing a bologna sandwich in the warm smothered darkness under a breast the size of a thanksgiving turkey is not the wisest idea as far as cleanliness is concerned.  The smell was about to knock me backwards, but I held it together until the pile or rotting artifacts had been removed.

The stairchair was positioned.  We all had our assignments.  The truck was running and waiting.  She was working up to her attempt at standing.  We were at t-minus 5 seconds and counting for liftoff.  When the time finally came she pushed, we pulled, and we all were shocked to find the loveseat suspended in the air behind her.  She had stood up and the loveseat had come with her, currently suspended sideways in midair just perpendicular to her ass.

“Oh, crap!”  yelled a couple of fireman as they rushed to her aid and extracted the offending piece of furniture and set it down.

The stairchair was only two feet away from the loveseat, but it took all of 15 minutes for us to make the journey.  She could stand, but she could barely walk.  It took shouts of encouragement for several minutes just to get one leg to move a few inches.  We finally gave up, moved the loveseat, put the stairchair behind her, and helped her sit down again.

Then we realized that the straps for the chair weren’t long enough.  We had to tie cravats to the straps to extend them.  This seemed to humiliate her and she started to cry softly.  I tried to speak some words of encouragement to her, but to be honest, I was out of breath.  It’s hard to convince someone that they are not a burden when you are panting from the sheer effort of trying to help them stand.  It was like trying to get a Volkswagon to sit in a chair.  It just wasn’t feasible.  Both her hips hung off the sides of the stairchair by a good foot or so.  But it was all we had and we weren’t stopping.

The next few minutes were just sheer muscle and grunt work.  We leaned her back, and the six of us just shoved her down the hall and out the door.  It wasn’t pretty.  It wasn’t pleasant.  And we gave up trying to look as though we weren’t straining and grunted and groaned as we pushed and pulled.  There was just no way around it.

The stairs outside were a straight shot to the ground.  That was a lucky break.  Trying to navigate around a landing would have sunk us for sure.  Her crying turned into shouts of terror as we went over the first step.

“Oh Lord!  I’m gonna fall!  I’m gonna die right her!  Lord help me, Jesus!”  Her eyes were wide and her arms were flailing wildly.  I was struck in the side of the head with something I thought must be similar to a side of beef.  There was no room for recoil so the shock went straight to my brain pan and I was stunned for a moment.  All of us were telling her to put her arms down or we were going to die.

A crowd of onlookers were attracted by the noise and came to watch the show.  She screamed obscenities at them, but it was no use.  They weren’t going anywhere.  This was better than anything they had on cable at the moment and they were going to watch.

It took about 30 minutes for us to reach the bottom of the stairs.  No joke.  It took that long.  We would rest in stages at various points.  We soon found that if she was perched right on a step that she could be balanced by two or three of us while the others rested for a few minutes.  We rotated rest shifts like that about four or five times on the way down.

When we finally reached the bottom there was a round of applause while she screamed at her neighbors to go away.  One of us had slipped down and tried to make them disperse some time ago, but they weren’t having any of it.  We managed to clear them from the back of the truck while we transferred her to the cot.  Again, it was quite a show and took a few minutes.  She stood.  We moved the world around her.  She sat down again.

Once on the cot it was obvious that we could not buckle her in.  We didn’t even try.  We couldn’t even get the side rails up.  With the effort of all six responders we managed to get her loaded and locked in.  Although the firemen were exhausted, being done with the job gave them a second wind.  I distinctly remember hearing “fuck you guys” as they disappeared into the night.

I drove us in to Parkland hospital.  What ensued there was no more graceful.  But there was a never ending supply of hands and no onlookers, so it went a bit smoother.  Over two hours after our initial contact, the job was done.  She was safe in a reinforced bed in the hall of the ER.  The only thing left was to obtain a signature and go home.

“Well ma’am, I am sorry this was so difficult.  Thanks for your patience.”

“My hip still hurts.” She said.

“Well, that’s what we are here for.  I’m sure they will get to the bottom of it.”

“Can you just look down there a minute?  It burns like fire.”

To be honest, I didn’t want to.  I had seen the various sandwiches and deserts that had been extracted from that region earlier and was afraid of what I would find.  But I decided to try.  I grabbed a large fold of her hip and lifted.  Deep within the fold I saw something that glinted in the light.  I reached in and grasped a long thin object.  It felt like a knife, but smaller.  I had to give it a couple of tugs before it dislodged and came loose in my hand.  It was a nail file.

“Hey ma’am?  Are you missing a nail file?”

“Yeah.  How did you know?  That’s thing has been missing for a week.”

“Does your hip hurt any more?”

“No it doesn’t.  It feels better.  No pain at all.”

“Ma’am, very quickly now, press hard when you sign this…three copies.  We have to go!”

I grabbed my partner by the arm and dragged him down the hall.  “What gives?”  He asked.  “What’s the rush?”

“I cured her, and I don’t want to have to take her home.  Move your ass!”

We returned to base immediately afterwards and were over an hour late getting off work.  I cursed the trauma gods for impaling our patient with a nail file, and calling us to her aid.  I never allowed Hollywood to perform the trauma dance on my ambulance again.

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