 So I wrote that It's funny to hear your words than somebody else's voice. It's I really couldn't figure out what he was gonna say for a while Crazy glue Thank You Michael Great introduction. Can we stop there? I'm just before I Give my introduction. I wanted us to thank Elizabeth Hastings Because I work with Elizabeth all year long. She's getting embarrassed because I'm talking about her Sorry, Elizabeth. I work with her all year long. We talked two or three times a week on the phone She does more for this program than all the rest of us put together. I just thought we should honor her Well, I feel badly that I won't be reading from my most recent book the other readers seem to be reading from recent stuff but I sent it to the publisher last Thursday the day before I drove down here and It was a commission book called learning at the speed of light About online learning in higher education. I just you know, I just couldn't decide which 10 to 15 pages of its 460 that you'd enjoy more So I'm not reading from that Next time Sonya and Rachel Bash And Karen Osborn and I will be on a panel this coming Thursday called managing the mess putting together a book of prose And so I thought tonight I would read from the book. I'm going to talk about in that panel. It's called saving Troy a year with firefighters and paramedics in a battered city and As the subtitle suggests this is a book with a chronological structure A sort of overwhelming immersion journalism project that I spent 18 months writing with these guys The first 12 I spent writing to make this book and the last six the Union hired me to write to do a video For them. So I made a training video and shot about 90 hours of video for the six months that I wrote it is To say the least a really really really gritty book. It's not just guts inside a wall It's pretty all the way through And I'm going to read an excerpt from it part of chapter five Which I've never read in public before and the reason I have not read it is that there's some racially offensive language Spoken by one of the characters And up to now I just I just didn't feel like I wanted to add something to the world that was hate filled And I just I don't know. I just didn't feel like doing that. I know it exists. It's out there We see it on the news every single day but it seemed like You know the events of the last year especially The racial situation has gotten so ugly that ignoring it's not going to help I think we have to look at it and we have to point it out all the time Even if it's just somebody you're having lunch with who says something divisive or hate filled like say don't say that You know the enemy is not the people as far as I'm concerned The enemy is the bigotry that exists and our writing can somehow expose the bigotry and get it to change You know, maybe if you will stop doing all this stuff heroin heroin okay The slight man about 20 with a neatly trimmed goatee Stops for a second to spit the words out at the nurse and then he resumes his pacing This room is small. Maybe only 8 feet square so we can just take a few short frantic steps Before he has to turn and go back It's hot too and he pulls his scarf free and unzips his jacket keeping his eye on the nurse the whole time Okay, okay, that's what we need to know. We have no idea the nurse is saying Holding her hands out in front of her to keep him at a safe distance Jeff Gordon the new lieutenant paramedic on the first platoon Knocks a couple of times and then opens the hospital examining room door They sent me in here to all right come on in the nurses. I need some men in here anyway an Older man still wearing a paint spattered car hard coat buttoned right up to his neck has been watching quietly from an empty corner of the room His face is ashen except around his eyes where the skin is pink and swollen Suddenly he takes a step into the center toward Jeff and he points at him. What happened to my son? Although Jeff at six feet tall and over 190 pounds is a head taller and probably 30 year About 30 pounds heavier than this clearly older Definitely a much smaller man Jeff jumps back in surprise against the closed exam room door Well, I don't know who was in the apartment Jeff answers quickly There were two other people in the apartment when we got there Josh and Abby the younger man says wait a minute Tim the older man tells him It was Josh and Abby dad they take heroin Tim says having to pace around his father now There was a girl and a guy in the apartment Jeff says the engine company was there We pulled in right behind them, but he was in full cardiac arrest when we got there. They shot him full of heroin dad Now I didn't do those things Tim mother said Tim's mother says Wrapped in her dark winter coat. She's been leaning against the examining table for support But now she grabs Tim's arm to steady herself in her words burst out and sobs. He didn't do them We did everything we could Jeff says frozen in place With his back still against the exam room door. We worked on him for are they here Tim interrupts He stops pacing shifts his feral brown eyes back and forth between the nurse and Jeff The police are at the scene though. Those kids are here. No, they're not here. They're not here the nurse says You're so upset. It's just not sinking in now. It's sinking in I told Robert Not to fuck around with that shit Tim says Tim is pacing again and his mother covers her face with her hands and moans loudly as she cries Are you all right the nurse asks Tim? Yeah, I'm all right. He says looks down at his mother. Don't worry about it. Mom. I'll get those bastards Suddenly Tim starts for the door. I'll be back soon. He says You're all we've got now his mother cries out and clutches in his coat and his father grabs Tim by the shoulder Stay here. His father says I'm gonna get those motherfuckers. You stay here. I need you here. Stop it the father pleads stop it Tim pulls away from them and the nurse steps in front of him. Look out. I'm gonna get those fuckers. He tells her Stop it. You're all I got left. I need you stop at the father shots and he throws his arms around his son from behind Tim slumps a little now and turns Reaching out for his mother bringing her in and then all three stand in the middle of the small room without moving For half a minute the only sounds of the muffled howls of the woman crying into her husband's coat Hang on to each other the nurse says hang on to each other. This is what you need. Hug your parents They need you right now, buddy. I Want to see my son the father says firmly looking up Tim pulls away from his parents and wheels around to face the nurse again his eyes glistening with rage Where is he? Can we see him? Just a minute just a minute. She says we have to The mother turns now and holds her hands out palms up to the nurse My son didn't do drugs. He told me he didn't do drugs. Was it drugs Tim wants to know? We can't tell you at the nurses We're not sure Jeff breaks and they'd have to do an investigation into the death You know to determine that we've called the coroner the nurse is saying overlapping Jeff's words the coroner is going to do an investigation Yeah, we had no way of telling at the scene. You know why why he died or anything Jeff says Well, I want those kids brought down. I know they're dealing drugs. I want the fucking police there I'm gonna rat those cock suckers out tonight Tim says The police were there before we left the house. They're there Jeff says Tim begins to pace again back and forth in the right corner behind his parents who are still holding each other in the corner of the room I'll take every one of those motherfuckers down Fucking scumbags and their nigger fucking drugs stop at his father says fucking nigger fucking drugs is what it is Will you stop it Tim? Don't worry about it. I'll take care of this tonight Let him get it out the nurse says let him get it out if that's what he needs to do Suddenly the mother shrieks Robert wanted to be a doctor and she collapses to the floor and lands sobbing against her husband's legs Didn't I tell you not to let him go with those fucking scumbags those fucking niggers didn't I didn't I? Tim demands of his parents now. We stopped spacing and stares at both of them. Didn't I? Jeff's knuckles gripping the brown clipboard with his half-finished pre-hospital care report on it are stretched white Today is New Year's Day It's Jeff Gordon's first day riding as a lieutenant and paramedic firefighter with a first platoon and he has been paired as Threatened with Don Kimmy on medic 2 All of which now means just the officer in charge on all advanced life support calls in the city of Troy When the first is working and that means Don isn't Apparently Don changed his mind about bidding off the shift when Jeff came on but he hasn't given anyone his reasons for staying Everybody on the shift is waiting for the fireworks to begin Earlier this morning huge slabs of ice and the Hudson River just beyond the low-income tailor apartments had been shoved into haphazard geometric stacks by a Coast Guard ice cutter and the slabs ragged angles were Shifting ominously in the Sun as the second call of the day came in over medic 2's radio Man down on 14th Street full arrest The first call had been at the tailor apartments one of Troy's infamous public housing projects for a woman with a broken jaw Walter Don said as you walked out of the building Referring to the woman's husband who towered over her in the unframed pictures tacked onto their living room wall We've been here before for the same thing. Walter's are regular Domestic abuse and a full arrest both before noon on the 1st of January. What a great way to usher in a new year Two police officers the crew of engine two and two kids and their late teens a boy and a girl We're in the 14th Street apartment when we got there Mark Fleming the captain on engine two was dragging another teenager by his ankles Into a cluttered filthy living room is Don and Jeff hurried into the apartment a Wide glaring line of blood and sputum Streaked across the olive wall to wall shag carpeting running from the boys face all the way back to the second room on the right off the hallway As Mark dropped the kids feet he backed into the round for Micah coffee table an Empty you who bottle tottered and then fell off under the rug The table as well as the ratty couch with no cushions next to it We're both littered with glasses half full of orange juice or dark soda Overflowing ashtrays opened in empty CD cases Crumpled napkins and paper plates with jelly smears and sandwich crusts on them Look at that shit coming out of his nose. That's all blood. See it. I don't know if he's got a head injury or what Don said Jeff knelt down next to the body and felt for a pulse. Yeah, he's cold too. He answered There was nothing there when you when you came in right mark. I mean he wasn't Don asked standing back surveying the whole scene What's that mark said you found him in the bedroom? Yeah, he was just lying on the bed. We pulled him out into the hall One of the cops was standing in the kitchen about 10 feet away with the two teenagers Jeff looked up at them and the kids looked away Nobody knows anything, huh? Jeff asked. Nope. Don answered shaking his head. I Don't know what he did last night. The boys suddenly offered. Were you with him last night? Don asked I was with him at the beginning of the night, but then we Okay, hold on for a second Peter Jeff said Pete Fleming Mark's brother and a hoseman on engine two had been performing cardiopulmonary resuscitation CPR since his brother dragged the kid into the living room But Jeff had some leads hooked up and needed the body to be still so we could read the heart monitor You got a sisterly or what Don asked? Oh, man? Very very flat Jeff answered and the green line moved horizontally across the heart monitor screen with no hint of a spike Remorseful remorselessly flat as the metal edge and a wooden ruler Okay, Don said pulling on his latex gloves kneeling down on the other side of the body opposite Jeff We don't know what's going on here. So let's do what we can. Let me take a look Even though Jeff was officially the paramedic in charge of this call He was still 32 years old with a baby face that fooled a lot of people in the thinking he was even a few years younger For a 22 year veteran like Don youth in this case didn't have to didn't add up to pragmatic knowledge As far as he was concerned his experience made him the one in charge Let's just run the thing Don said the thing Don was talking about was the full arrest algorithm an Algorithm is any particular procedure for solving a certain type of problem Remo the regional emergency metal medical organization the Hudson Mohawk Valleys Publishes a handbook of regional treatment protocols and procedures each year as a supplement to the statewide protocols published by the emergency medical services program of the New York State Department of Health These required handbooks established the baseline of standardized treatment protocols for EMTs and paramedics And are intended to establish a model or minimum standard by which all patients should be treated by emergency medical care workers in the state Remos cardiac arrest management algorithm for a patient with a systole or the absence of all cardiac electrical activity Begins with CPR Then moves through intubation and establishment of IV access and stops after administration of epinephrine and atropine Drugs which might get the patient's heart going again When paramedics finish all that they should transport the patient to the nearest hospital The remote does state the following in the fine print Some patients may require care not specified here in this algorithm should not be construed to prohibit such flexibility What Don and Jeff had this morning required flexibility? We don't need some suction. I think Don said and Pete Fleming ran out to the medic rig to get the suction kit I'm going to set up a lactated lactated ringer as Don Jeff said let me know when you're ready for drugs We'll put them down the tube This don worked to set up an intubation tube Jeff started in IV in the kids right arm with an 18 gauge needle The cop in the kitchen began to question the boy who had volunteered the information a minute before Did you see him this morning? Yeah, I woke him up. It took us a while to wake him up Then I told him bagged on yell or the hell is the bag Jesus. He's filled up with shit. Listen. Hold it. Listen Pete came back in with a suction kit. All right Pete. Thanks. Let me cure this clear this crap away and you can bag them All right, Don said I just wanted to make sure it was in it's got a ton of shit coming up A red and white froth has been running continuously from the kids mouth and nose And now it was oozing around the intubation tube Don just set up moving the way lava moves Jeff has two brothers in the Troy Police Department Peter and Paul Paul had been on the scene earlier, but he had gone outside to talk to neighbors and now he was back Full arrest Paul Jeff said to him. It's been down for a while. There's roommates here, but they're not saying much, you know Don was trying to suction off enough fluid to stabilize the intubation tube. I need that white tape Don said You got some of that heavy white stuff mark? Pete started to get it, but Don called his arm. Let mark get it. I need you to be bagging You ready for that epi yet? Jeff asked Hang on a second. Don't start the compressions yet. Don says still suctioning the fluid that was bubbling and frothing out of the kids nose and mouth He's all full of blood and oh come on. What is this shit? Paul motions to the boy in the kitchen Paul motions to the boy in the kitchen Hey, bud. You got a back door I can get through because I don't want to disrupt these guys I don't live here. The boy said he suddenly looked terrified Meet me out front. Paul said All of a sudden the dispatcher's voice blared from mark and jeff's portable radios Attention all units engine one and the rescue squad are responding to number seven seven zero third avenue Between 121st and 122nd streets for an EMS call Time is 12 0 4 Jesus turn that down. Will you jeff don said? Jeff lowered the volume on his portable radio The back doors nailed shut the boy said I don't live here. You don't live here. Paul said not to live here You know this guy. Yeah Well, who lives here? He lives here Who else? He's got two roommates, but they're home on school break How old is he? He's 19 You don't know anything about his history at all jeff asked I just know he's asthmatic What were you guys partying last night? What happened? Paul wants to know Yeah, the kids said we were partying with them last night and we came back here this morning We weren't with them all night though. So I don't know the boy said The speed continued to bag to pump air into the kid with a bag valve mask Some of it got trapped inside his torso And the skin on his stomach began to bulge tight with the strain Suddenly Pete stopped bagging and vomited off to the side Donnie I got that epinephrine here jeff said I'll set you up an atropine Did you find him on the floor? Paul asked the boy We were here We went to bed and then he was in the chair when we came out because I heard him like not breathing right It wasn't breathing right. So we woke him up It took a while and he woke up and then he was up for a while and then he went to bed And we went to bed in his friend's room and a while later I heard more of him breathing You know breathing wrong like he was And we tried to get him up and wake him up and he wouldn't so we stuck him under the cold shower But he still didn't wake up And then we called you guys Don let me know when you're ready for that epi jeff said all right. Let me see it now don said I just wanted to clear enough crap out of his mouth and throat Jeff handed the first dose over that's the epi. I'll give you the atropine when you're set with that What the hell are these on his arms don said all of a sudden and looked up at jeff I don't know what the fuck i'm dealing with here. This is all black and blue Don was pointing to red swollen spots on the kid's arm See this here See that this mark here that mark there. He's got marks all over him jeff got on the horn Is he breathing at all paul asked? The 16 gauge catheter don was using for the epinephrine fell apart in his hands What the hell happened give me another catheter. It just fell apart. No. No, he's not breathing Paul began to walk around to the other side of the dead kid and don pointed to the discarded needles on the floor Watch your feet there. Okay. I don't know what this guy's got or what you know Paul moved back to the front door and turned to jeff So when you got here, he wasn't full arrest when we got here. Yeah, jeff answered 201 send the supervisor up here. All right paul sent into his radio Two mohawk ambulance drivers come in the door and don motion again behind them. Watch the needles don't come near him Give me that give me that atropine now jeff All right, there's a clean sharp in the box that I've got another sharp in his other arm on this side jeff said You guys ready to go don ask the ambo workers. Yep all set whenever you are Let me just get this. I want to do this on another epi and then we're out of here Go ahead and wrap them up Another epi donnie. Where are your sharps jeff asked right behind me Two of them. Yeah, I see two. All right. I got another one makes three. This one here is four Jeff said and he collected the discarded needles Don pulled the clear lactated ringers bag up higher and made sure mark kept it taught so they could keep replacing some of the fluids the kid had lost Keep that right up there mark. I want the gravity to help take the fluid down keep pumping it as we go don said Showing him how hard he wanted the iv bag squeezed Jeff stood up and looked around as the mohawk drivers finished packaging the kid I'm just going to leave that sharp right in his arm don. You want another atropine before you move? All right, set it up and then we'll both be going St. Mary's or samaritan one of the ambo guys said Samaritan we already called him don answered. Yeah, let's get going. We'll be there in five minutes Somebody grab that oxygen Jeff held up a stethoscope and asked on if it was his and don nodded Then don stopped for a few seconds and wiped the sweat off his face with a towel Scrippy at heart along his skin and then wrapped the towel around his neck It's the two ambo drivers wheeled the kid on onto the stretcher Don stared blankly down at the mess of discarded catheter parts plastic caps occlusive bandage wrappers strips of bloody clothing and other junk scattered on the rug He kept his face expressionless as he looked over at jeff Did you talk to anybody yet don said? No, not yet. Jeff answered. I've got the apcor though. So whenever How old did they say this kid was? 19 In the trauma room at samaritan hospitals er the doctor on duty asked how long the boy had been down How much epinephrine atropine had been delivered at the apartment And enroute in the ambulance thought maybe two milligrams of narcan might be a good idea He looked somewhat resigned at the stage of the situation as he watched the flatline trudge relentlessly across the monitor Finally decided to give the kid one final effort I'd like to defibrillate him anyway once just to try it. He said We'll defibrillate him once we'll give him one round of drugs and that's it So one defib just go right ahead to 360 one after the epi one after the atropine If there's no response, I'm going to call it A few minutes later at the nurses station Jeff was explaining why the police were called to the apartment in the first place On an unattended death and that's considered an unattended death at the house, then we have to call the police Even though those people were there In this case because there was nobody else in an official capacity there It's considered an unattended death and the police have to go and investigate check for foul play Nine times out of ten it's routine where an older person dies or whatever, but in this case This is obviously not a routine type of death just because of his age or for no other reason But they may find any number of things at the house now drugs or who knows what they're going to find The cop who was with Jeff's brother at the scene came over and held up a driver's license for the nurse behind the desk He had a fake ID in his wallet the cop said because he's only 19. He's got his brother's ID He pointed to Jeff and said After you guys left the girl gave us his real name. It's Robert. The brother is Tim. This is his ID The kid we've got here over here is Robert Coates Then the cop handed a phone number to the nurse and walked back to the trauma room The nurse picked up the black phone that hung on the wall behind the desk and dialed the number Yes, is this the Coates residence? Yes. Yes. I'm looking for the parents of Robert Coates, please Who might I be speaking to? Yes, and your name is Well, um, we need to get in touch with them right away. This is Samaritan emergency calling Well, your brother's here in the emergency room and you need to come here and we'll explain calm calm down We're Samaritan hospital come to calm down Who is that Jeff asked? Brother the nurse answered Hang up on you Yeah screaming he didn't even find out why his brother's here. He was screaming just because he's here at all What's it gonna be like when he gets here? She wondered and looked up and down the hallway I feel like the cops to be here when he shows up Back in the exam room looking into Jeff's unfocused eyes It isn't hard to believe that he's remembering everything that led up to this moment The father is sprawled in an empty corner trying to cry quietly now His head jerking convulsively every time a loud sob escapes The mother is up on her feet pleading with the nurse I want to see him. All right. Can I go see him? She asks You can go see him the nurse says as soon as you calm down just a little bit She looks uncomfortably over at jeff The mother turns to jeff now too Just on the possibility on 14th street. Where was he found? 2236 jeff says is that where he lives? That's his home Okay, the mother answers he would have like three silver earrings Yeah, jeff says he did Now the mother turns and moves distractedly over toward her husband beginning to mumble He's an rpi student Okay, so so it is robert coats. It's the same robert coats. I just wanted to make sure I hope josh is happy He'll be happy tonight tim says Do you think you're calm enough now the nurse asks? None of the mantras are Listen, he doesn't Well, mrs. Coates. He's intubated. He has a tube down his throat. That's what looks bad. Okay. All right. Come on. Come on The nurse takes the mother by the arm and moves her slowly toward the door and jeff steps further into the room out of the way Come on. Why don't you and your son come on and see robert? She says let mr. Coates just sit there until he feels better. Don't get him up By the nurses desk don kimmy is watching the nurse lead the mother and brother toward the trauma room door As she opens it mrs. Coates falls against the jam and says That's not him under there. Is it? Jesus christ don says Now she starts into the room and says to the nurse just wake him up. Just get him up. Okay Don turns to the ER doctor who's filling out his own report now and says You remember that guy at christmas that young guy 25 or so? He had three kids. He got electrocuted where the wife comes in and she goes come on jerry get up We're going christmas shopping tonight Come on get up Boy, that was something He was operating one of those booms and he had a high tension wire with a boom and What he did he had the thing right against his chest and came back and got him went right through his heart Dead dead dead dead Never had a chance. We worked on him 45 minutes. Anyway Don motions toward the trauma room just like this guy. We worked on him a long time too