Selected work-order problems and solutions

Below are the stated problems and solutions for several work orders filed on our ambulances and facility over the years.

Problem: [Ambulance] 56-B2 left inside rear tire almost needs replacement.
Solution: Almost replaced 56-B2 left inside rear tire.

P: Ambulance 3: Something loose in patient compartment.
S: A 3: Something tightened in patient compt.

P: Mouse in driver’s-side outside cabinet ([ambulance] 56-B2).
S: Cat installed.

P: [Ambulance] 56-B2's engine is missing.
S: 56B2 - engine found under hood after brief search.

P: Ambulance 2 (56B1): Lots of dead bugs on windshield.
S: Amb2: Ordered live bugs for windshield.

P: 56-B1: Evidence of brake fluid leak near front right wheel.
S: 56-B1: Evidence removed.

P: Building’s front door lock causes door to stick closed.
S: That's what it’s for.

P: Amb. 2 siren volume unbelievably loud.
S: Ambulance 2 siren volume set to more believable level.

P: Ambulance 2 handles funny.
S: Ambulance 2 warned to straighten up, drive right, and be serious.

P: Abnormal seepage near cylinder 3 glow plug (Ambulance 3)
S: Amb3 - seepage is normal. Cylinders 1,2,4,5,6,7 and 8 lack proper seepage.

P: Stairs to landing by rear building door rusted – I think they may fall.
S: I think you're right.

P: 56-B2 - Cat found in left outside compartment (behind driver’s door).
S: Dog installed.

P: Building lights hum.
S: Taught building lights the lyrics.

P: Ambulance 3: Noise coming from behind suction unit when on - sounds like a midget pounding on something with a hammer.
S: A3 - Took hammer away from midget.

Sneakers

Overheard, while I was building today:

Middle Schooler: Someone's backstage!

Teacher: Yes. That's Mr Badger. He's building the set.

Middle Schooler: He's wearing sneakers!

Never before has my wearing sneakers excited comment.

Top men

I've actually wondered why, at the end of Raiders of the Lost Ark, God allows the US to keep the Ark. You'll recall that earlier in the movie, while the Nazis have the Ark, it, or God, burn off the Nazi symbol on the packing crate. But nothing happens once the US gets their hands on it.

One explanation is that the US is Good, whereas the Nazis are Bad. These days, the distinction is less obvious, perhaps, but the movie is set back in the thirties.

But another explanation occurred to me today: God wants the US to have the Ark because of exactly what happens in the last scene. The US buries it so deep that no one will ever find it again.

I prefer the second explanation.

Two pieces of advice

When I was a kid, my father gave my brother and I two pieces of advice:

* To have a friend, you have to be a friend

* Never bring a knife to a gunfight

X-ray Chapter 7, part 12

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Back on the platform, Andy dragged Jeremy up the stairs to the daylight with an iron grip. Marcus sent One-nine Adam and Lieutenant Squadron, who had an inclination to vanish once extrication was complete, with Jeremy and Andy, then hopped in himself with Three-five Carlie and Ian. In the ride to the hospital Ian had Maria pull the ambulance to the side and he decompressed the patient's right chest: clean the site quickly by pouring iodine over it, find the second intercostal space midaxilary, sneak over the third rib with the IV catheter until a rush of air, remove the needle, recheck lung sounds and compliance, and attach a flutter valve.

At the hospital, they dropped their patient off and reconnoitered with Three-three Zebra, while Lieutenant Squadron caught a lift back to his car with Three-five Charlie, the Williamsburg Rocket. The other basic bus was immediately dispatched out for a twisted ankle. The four paramedics sat on the hoods of their ambulances and watched the rain fall together; there was nothing better to do.

[END CHAPTER]

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X-ray Chapter 7, part 11

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Twelve feet away Andy's patient was giving up on his side of the Mets-Yankees debate. Andy squeezed his patient's hand - Marc, it had turned out his name was. This was not the time Andy was interested in winning this debate. "Marc," he called, "Marc."

Halfway between the two patients Rescue Three had completed their cribbing and placed their air bags. You guys wanna pull out?" the fire lieutenant asked.

"Oh," Marcus indicated their patients, "we'll go when they go."

"I'm not leaving without my date." Andy said.

"It's cold." Marc replied.

The whoosh of air and the creak and groan as the car stirred, shifted, and rose. Rescue Three braced and cribbed the car at its new height, then Lieutenant Squadron, the two medic units, and the newly arrived Three-five Charlie and One-Nine Adam pulled both now-unresponsive patients free from the train.

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Sam Black

It was the usual bunch of photographs, the scene, the body, the wound, and even the weapon, still there in his hand. Several photos of each, from different angles, probably shot by Hoffmann, since Laretz doesn't work nights anymore. Too old for it, he says, and I guess I don't blame him. He is 72.

But it was the usual bunch of photographs, and as I sat there with them I wasn't feeling motivated. I had been woken up at about 3 AM by the phone, had been at the scene until 10, and had completed a few interviews after that, all over town. Everyone agreed that Eugene Waters would never have killed himself, but there was the gun in his right hand, spattered with blood, and there was the hole in what was left of his head. And for those of you thinking murder, no one could think of anyone who wanted him dead.

I certainly wasn't thinking of murder, not yet. All I could think of was my bed. I flipped through the photographs again, stopping at one that showed the whole scene. Waters lay there on the floor, face up, between his chair and his desk. But I couldn't see straight, couldn't even read the clock on the wall in the photo. I slid the photographs into the case folder, dropped the folder into the file cabinet, got my hat, and went home.

I guess I should introduce myself here. I won't give you my real name, 'cause if it got back to the department they'd have my badge, but I've always kind of liked the name Sam Black, so let's go with that instead. I've got about ten years on the job, the last three in homicide. That makes me not quite the most junior detective in our station house. My wife left me last year, too many hours on the job, I guess, so I moved out and now I live alone in a fifth floor walk-up. It's not a happy home, no pictures on the walls, rented furniture, but when I got home that night I didn't care. I fell right into bed, still dressed, and fell right asleep.

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X-ray Chapter 7, part 10

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Two minutes behind Louis came improved lighting and coffee, courtesy of the MTA engineers. Jeremy reappeared with another cylinder of oxygen and an umbilical cord of IV lies and extension sets that stretched 25 feet over and up to a Liter bag he had tied to a straphanger's pole. In the glare of the halogen light his face shone ashen and drawn. His breath came fast and hard and he fumbled with clumsy fingers. He was hyperventilating.

"Jeremy, you're hyperventilating," Marcus said.

"I'll, I'll be okay."

"Slow your breathing down, Jeremy. Deep breaths."

"I'll, be okay"

"Jeremy- sing, Jeremy," Marcus counseled.

"What?"

"Sing. You can't hyperventilate if you sing."

All Jeremy could come up with was to chant The Four Questions. He started in a low mumble.

"Sing, Jeremy," Marcus admonished him. "Let Andy hear you."

Drew and his patient heard the singing and broke off their baseball debate.

Up on the platform, Lieutenant Squadron looked up from his clipboard.

The MTA engineers crossed the platform and gazed down beneath the train. The train's two conductors followed them.

Jeremy's clear tenor interrupted Rescue Three in their cribbing construction.

The rookie policeman broke off his report to dispatch, then joined in for the last line. In the half silence that followed, Ian though he could make out the hiss of Andy's jazz cassette. Then Andy and his patient reiterated their arguments, Lieutenant Squadron bent over his clipboard, the engineers and conductors returned to their contemplation of lunch, Rescue Three redoubled their building speed, the cop recontacted his dispatcher.

"Rats," Ian said as Jeremy retreated.

"Ian," Marcus scolded.

"No, rats. Rodents. On the Lifepack."

No joke. Ian was closer to the monitor, but his hands were full with ventilating the patient; Marcus couldn't reach the bag valve. But Marcus could reach the prefilled syringes. Streams of lidocaine, then epinephrine shot at the interlopers. They retreated.

The monitor, which was waterproof, started showing PVC's again.

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X-ray Chapter 7, part 9

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Ian and Marcus had their hands full, too. PVC's had started to show up on the monitor. And although Ian had a line, it wasn't going to run because he couldn't raise the bag. Red blood had already started to streak back up the tubing. "Jeremy," he called.

Jeremy stuck his pale head down between the cars like an inverted jack-in-the-box, took in the situation with a quick glance, nodded, and disappeared again.

"Can you reach the lido?" Ian asked. "I think it's time."

"One hundred of lidocaine," Marcus pushed the prefilled syringe.

Ian squeezed the bag to flush the line. He reached for a pulse and wondered what he would do if he couldn't find one. "One hundred," he announced. "PVCs perfusing." Things could be worse.

Ian looked up when he heard the music. He had heard the exchange between Andy and the cop, but had already forgotten it. Louis Armstrong was drifting heartily beneath the train. "Thank you!" Andy shouted up to the unseen police officer. "I don't see why we can't be civilized just because we're under a subway train."

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X-ray Chapter 7, part 8

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Ian, another twelve feet further under the train with the second patient, grinned quietly as he struggled with the laryngoscope. "I'm in," he told Marcus, inflating the balloon and attatching the bag valve.

Marcus listened to the patient's lungs with his stethoscope. "Equal," he said a moment later.

Ian secured his tube, noted the lip line at 22, and slipped an OPA in beside it. Marcus tapped an ETCO2 detector across the patient's chest, but Ian shook his head. "I don't think I can fit it without kinking the tube. What's the oxygen at?"

Marcus glanced at the regulator. "About 900."

Ian glanced at the monitor, still sinus, then his watch. Ten minutes they'd been here already.

Andy was also facing problems with his patient, though of a different nature. He was alone with his patient because he had learned almost too late that Jeremy was claustrophobic. "Your knuckles are white, Jer," he told him, "Jer, you're crushing, Jer - Jer!"

"I'm fine. Fine, I'm fine."

"You're claustrophobic."

"No I'm not."

"What do you mean you aren't. Go away, away!" he pulled a liter of saline from his ALS bag and threw it at Jeremy, who retreated a few feet but sat there, looking uncertain.

"Go." Andy said. "Go." He chased Jeremy from under the train, "Go. And don't come back. Sorry about that," he said to his patient, "What were we talking about?"

The jaywalking laws. Which led to traffic, busses, back to the subway. Oops.

"I don't want to die." Andy's patient said. This was definitely a problem.

"I won't let you die," Andy said. "I will not let you die."

"I'm cold."

"We're lying on wet cement beneath a subway. It's normal to be cold. You think I'm not cold?" he smiled.

His patient smiled, too, then shivered once. Andy reached out to the one hand he could see and took it.

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X-ray Chapter 7, part 7

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* * *

The two days off passed in a blur. Ian returned to work with the feeling that if Sam hadn't been in there would have been open battle. He leaned his forehead against the glass of the driver's door and closed his eyes to block out his headache. Then he opened the door and climbed in.

Marcus had the paper spread open on the dashboard. Almost all of the dashboard - certainly more than just his half of it. Ian pulled his door shut and started the ambulance.

On the way down to coffee Ian opened his window for fresh air. Marcus would soon be after him to close it or shut of the A/C; Marcus would have to deal. Ian turned the stereo on, flipped through the presets, turned it off. He pulled back the wiper-washer lever and cleaned the windshield. He pushed in the cigarette lighter and power locked the doors. The clock on the dashboard was a minute slow; Ian reset it.

Traffic was at a near standstill due to utility work at the intersection. Ian fought off the urge to lean on the horn, and turned on the stereo instead, tuning in to a weather report. He drummed his hands on the steering wheel.

It would have taken a far less observant man than Marcus to not have picked up on Ian's mood. Marcus quietly reassembled and folded his newspaper, holding it in both hands and looking complacently out of the windshield.

Ian breathed in and out deeply a few times then shook his head as if clearing cobwebs. "Supposed to be nice all week," he commented on the weather broadcast.

"That's what they say," Marcus replied. Traffic inched forward. What Ian wouldn't give for a Diff Breather now. Anything to turn on the lights and siren and hop onto the sidewalk. The radio and MDT, however, remained stubbornly silent.

Overhead a pigeon circled, landing on the sidewalk beside the ambulance. Ian considered the bird, losing himself in the complexities of its shading, the way its feathers flashed pink and green in the sunlight, the fact that it absolutely had to bob its head to walk. How had they figured that out, he wondered, picturing a scientist squatting over a pigeon, holding its body and neck in rigid formation. No, that wouldn't work, he reasoned, the pigeon would peck at him. Perhaps a neck and body cast? Perhaps a Stiff-neck C-collar? He smiled.

Traffic had pulled up a car length or two, so Ian released the brake and let the bus roll forward. "Anything in the paper?" he asked Marcus.

"Oh, the usual. Now the mayor's cracking down on jaywalkers."

"Really? This is New Gotham. Who does he think he is?"

"He thinks he's the mayor."

Finally, the corner. Ian twisted the steering around until it hissed, slipping the bus onto the cross street and bumping one of the rear wheels over the curb. Somewhere he had read that some off road vehicles had artificial horizons on their dashboards. He wondered what it would cost to install one in the bus.

They took their time climbing out of the ambulance, but eventually made it into the deli. "Mister Marcus, your coffee," Abraham called as they walked in. "Fresh and hot, not milk."

"You look good, Abraham," Marcus replied.

"Not my time yet it was, not yet, but one of these days. Come to it we all do," he handed the coffee across the counter, "Every one, yes."

"I don't think it's your time yet, Abraham. And consider Elijah."

"A chariot of fire, yes, but only he proves the rule. With milk?" he asked Ian.

"Please," Ian answered, not wanting to be rude and still being in too much of a mood to be able to politely decline.

"Here, for you," Abraham handed the cup across.

They paid, they insisted, and Ian bought a newspaper off the rack, then they turned to go. "The Lord bless you and keep you," Marcus called from the door.

"The same may he do for you," Abraham called back. "The same may he do for you."

Outside, the earlier half mist had grown into a thin, drifting rain, the type Erin had called an Irish rain. "He looks good," Ian called across the bus's hood as they unlocked their doors.

Inside Marcus set his coffee on the console to buckle his seatbelt. "He does. The doctors told him very little damage. They t-PA'd him within five minutes of our arrival."

"Wow."

Ian found jazz comforting, as a general rule, and once they were parked again, he dialed up the jazz station on the stereo, flipped through the paper to the crossword, and leaned back into his seat. Andy found jazz comforting, too, and held to the philosophy that if he was going to be stuck somewhere he might as well have it to accompany him. "What do you mean, you can't get jazz down here?" he asked the pale-faced police officer who had climbed down below the R train to reach him and deliver his message. "Get me jazz."

The officer, a rookie, didn't know how to reply. "Get me a CD player, a tape player, I don't care. Jazz. Not blues," he cautioned as the officer crawled backwards from under the subway car, "jazz." He turned back to his patient in mock exasperation, "Some people."

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Smoke Assassin Customer Service Phone Number

Since I commented on the Smoke Assassin in a previous post, I've gotten several visitors looking for the phone number for their customer service. So, here it is:

Smoke Assassin Customer Service

1-800-604-9575

Unfortunately, the reports I read on the quality and caring of their customer service are uniformly bad. Be prepared for long waits, and expect to have to speak with a manager.

Good luck!

- B

X-ray Chapter 7, part 6

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Ian slept. He dreamed. He awoke. It was still raining. The radio was crackling: "Woman Acting Strange."

A note stuck to the steering wheel said that Erin had gone ahead with the Williamsburg Rocket, Three-five Charlie. Ian climbed over the console, catching his stethoscope on the radio mic., and slid into the driver's seat, fumbling for the ignition keys as he did so. The engine wouldn't start. He cranked, and cranked, and cranked until it caught, hesitated, and settled into a stumbling rumble. Ian shifted into gear and turned the wheel, shocked at the resistance he met. The power steering was on vacation. Once he had wrenched the wheel sufficiently around, he tried to pull out.

But the bus was stuck in the mud. Deep mud, Ian learned, promptly sinking to his ankles as he climbed down from the driver's seat. The rear wheels were buried to the rims, on both sides, it turned out. He threw his weight against the back of the bus and pushed.

All of the bags were still in the bus because Erin hadn't taken them. All she had was Three-five Charlie's oxygen and their HeartStart. "Ian," she called on the radio, "Ian, Ian."

Ian jumped as he felt a hand on his shoulder, and he opened his eyes. "Ian, the shift is over," Erin told him, "It's time to go home."

Ian had slept through the ride back to the station. Sara was waiting for him, leaning against the cab of her navy blue truck; Ian's car was in for an oil change and she had dropped him off to work. Ian pulled his bags from the bus and handed off his narcotics in the station office. In the locker room he changed quickly, then met Sara in the parking lot, tossed his bags in the back seat of her Yukon and climbed in shotgun. He reclined the seat, breathed in and out a few times, and settled down for the ride to the airport, where they were picking up Sam. "Never take it home," he told himself, shrinking from Sara's touch as she placed her hand over his.

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X-ray Chapter 7, part 5

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Ian drove while Erin sat in the back and completed her SAMPLE history. At the hospital she gave the report, then, "She has a full bottle of Prednisone filled two weeks ago next to a half full one filled a month and a half ago. Toast was buring in the toaster when we arrived, the smoke detector didn't go off, and it took her close to five minutes to find the coat closet when we went to leave. Lives alone, apparently a son drops by to deliver meds, including an OTC epi inhaler. I've had her three or four times since New Year's."

"I'll tell the social worker," Anne signed the run report

"That's all in the report. Thanks," she said as Anne handed back the report. Erin left behind the pink hospital copy and joined Ian in the Truck.

"I didn't offend you giving the report?"

"No. You knew her."

"Laura always flips if I get involved with patient care when its her day to tech. Ready for lunch?"

"Yeah." Ian punched up their numbers from the MDT and filled in the rest of the ACR, but his thoughts drifted back to the essence of the call. Erin had done a good job of trying to lay it all out in the report. A nursing home would just add to her confusion, but clearly she was no longer able to take care of herself. "You haven't seen any live in care around here, have you?" he asked Erin.

Erin paused to squeeze past a double parked 18-wheeler before answering. "Live in care? No. Not unless its a family member. Mrs Leonardowitz . . ." she trailed off. "They're closed."

Closed for good. The Top Hill Diner sat cold and empty with two new signs posted next to the advertised specials. "Death in Family," one read, "Closing our Doors." "For Rent," read the other, with a local phone number.

"Not even a thank you for years of customer support," Ian was suddenly very angry. He hadn't realised how much he had wanted his number two special until it was denied him. They crisped their bacon without shrivelling it. Done right every time. "Why can't one thing go right today? Why can't we just get a decent two egg special with toast, home fries, and bacon? For Chris' sake, it's not that complicated," he tossed the clipboard onto the dash. "Let's see what else is open," he said tiredly. Then he closed his eyes and fell asleep.

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To be a pet, or not.

I often wonder/worry about my cats' happiness as pets. I worry more about this with Christian, since he was a stray into his adult life and so has some perspective on this - he knows what he has lost, and what he has gained, in the transition from stray to pet. Shadow, of course, has been with me since she was three month old, and so never had a chance to experience the outside world on her own.

The tally, as I understand it, is this:

Pros of being a pet:
- food is provided twice a day
- clean water is always available
- no predators
- no bad weather, aside from occasional thunder (which may be scary but can't hurt them)
- no cars

I don't add things like veterinary care, since I doubt that they understand its significance.

Cons of being a pet:
- severely constrained roaming area, with
- little to chase
- only one other cat to interact with
- no sex (though they're both neutered/spayed/fixed)
- sometimes a little too much interaction with the resident human (I'm happy to pick them up, pet them, etc a bit more than they're happy to be picked up, petted, etc. But I'm learning to read them and there haven't been any altercations.)

I think there was one other thing, but I forget what it was for the moment. And in any case, the real point of this post is this: when I open the door to enter or exit the apartment, even though they often look out the door (which leads directly into the outside world), they never try to escape. I realized the significance of this only this week, when it occurred to me that that was their vote: to stay as a pet. Which makes me happy.