Many thanks! Yes, they are all real stories from my own experience. I cannot make this up; I’m not that creative!
Crime, Thrillers & Mystery / Found Wanting - Chapter 5 (Analysis)
Found Wanting
Chapter 5
As they pulled of the ramp, Brian exclaimed “Man, what a dirt bag! I never realized how many useless people there were in this world till I started this job. I wanted to work in the medical field because I always wanted to help people, but so many don’t want any help; they just want handouts and for everyone else to do everything for them!”
“Yep,” Marc agreed. “I was the same as you when I first started. But seeing all the scum of society every day all day makes you a little... jaded. I’ve gotten to the point where I don’t really care if these idiots live or die. It’s great when you can make a real difference in someone’s life, but those moments are few and far between.”
Brian thought for a minute. “I don’t think we’ve had a real patient in weeks! Other than that heart attack last week. And Sparrowhawk. Of course we didn’t really make any difference with him, seeing as he’s dead now.”
Marc turned to the front, staring out the windshield. Brian thought Marc appeared oddly distracted at that moment. Eventually Marc replied, “Yeah, he needed to go.”
‘That’s a weird way to put it,’ Brian thought. “I don’t think anyone will miss Sparrowhawk.”
“Let’s go get some coffee; I’m still tired” Marc suggested.
Just as they got their coffee, another call came out for “leg pain.”
“This is gonna be another bullshit call,” Marc commented flatly. He seemed to be doing a good job at deflating Brian’s enthusiasm for picking up any and every patient, as Brian let out a long, drawn-out sigh.
“I have a feeling you’re right,” Brian replied.
At the house, the two medics found a swirl of family members in the front room. Some appeared to be arguing, a couple sat and stared at the TV blaring “The Price is Right” at full volume. One woman finally acknowledged their presence and pointed down the hallway of the shotgun house. “He’s all the way in the back.”
Brian asked Marc quietly, “Why are they always ‘all the way in the back’?”
Marc muttered “I have no idea, other than to make it extra difficult for us to get them out. No one ever gets sick in the front room, or downstairs.”
They passed a bedroom with a couple mattresses lying on the floor, about a half-dozen children sleeping on them. “Why aren’t they in school? It’s Thursday!” Brian again whispered.
“What, and get an education and maybe get out from this hovel? Gain an opportunity for a better life off welfare? Can’t have that.”
Brian was still shaking his head as they entered the patient’s bedroom. There were three or four other female family members hovering around the bed. The man in the bed was dozing but woke up as Marc said “Hey, sir! How are you? What’s going on?”
Before the man could respond, one of the women spoke up, “It’s his foot; I think it’s infected.”
Marc hated when bystanders didn’t give the patient a chance to speak for themselves. He didn’t turn to the woman who had spoken but continued to address the man. “How do you feel? What’s wrong with your foot?”
The man began to say “I feel fi...”
“I TOLD YOU IT’S HIS FOOT THAT’S INFECTED!” the woman hollered at Marc.
“Ma’am, I heard you. But I have to ask the patient what’s going on. I know he’s having foot issues, but I need to know if he’s in his right mind and oriented and so on,” Marc replied with all the self-control he could muster.
The woman grunted and left the room. Marc began pulling the bedsheets off the man, saying “Okay, let’s have a look at this foot of yours.”
As he uncovered the man’s feet, Brian gasped. His left foot looked pretty normal, dry skin and horny nails, not unusual for an elderly diabetic. The right foot, though, was far from normal. The skin was blackened, far blacker than the rest of the man’s coffee complexion. It was not just dry, but dessicated, the shape of the bones of the foot clearly visible through the thin, beef-jerky skin. Marc touched it gently with a gloved hand to see if there was any pulse whatsoever. As his palm brushed against one of the dried toes, the remnants of the toenail simply fell off onto the bed. “Oh, my God.” Marc rarely was astonished at the condition of patients, but even he had never seen a completely dead, mummified appendage attached to a living person.
“How long has it been like this?” Marc asked anyone in the room willing to respond.
The disgruntled woman stomped back into the room. “It’s been like that for a while.”
“Why haven’t you brought him to the doctor? Why did you wait till it was like this to call the ambulance?”
“We just thought it would get better. We been praying for him to get better. We done had the minister out here a bunch of times to pray over him. And we been putting lotion on him.”
Marc blinked, at a loss for words. He looked at Brian, who was still staring at the zombie-like foot. It was like a train wreck; he couldn’t help but stare. Marc thought about what to say; a thousand different synonyms for “stupid,” “ignorant” and “hopeless” flooded his mind. Finally he decided that simple words would be best for this crowd - preferably one-syllable words. He turned to the patient who, after all, was the one who had to carry the dead foot around. “Sir, your foot isn’t infected. Your foot is dead. It’s going to have to be cut off at the hospital.”
The man wailed, “Oh Lord Jesus, no! My foot! I can’t lose my foot!” The family members also lost it, throwing their hands up in the air, asking for the Lord’s help, crying and shrieking. Marc glanced at Brian. Brian whispered “How can this be a surprise?”
Marc shrugged and said, “Let’s just get the stretcher in here.”
They trundled the old man out of the house, navigating past the multitude of family and friends in the bedroom, front room and on the porch. Besides the ones watching TV, still enraptured by “The Price is Right,” all seemed to be in varying states of panicky prayer at the announcement that the necrotic foot was dead. Brian wondered what the reaction would be when the rest of the old man eventually died.
At the hospital, Marc gave his report to the ER staff. All the nurses and doctors were as impressed at the foot as Brian and Marc had been. There was no question that it would have to be amputated. When Dr. Lovejoy asked why it had taken months, obviously, to do something about it, her jaw hung open when Marc informed her that prayer was probably not the best primary healthcare route to take.
“They just prayed? Did they think that he would just grow a new foot or something?” she asked, incredulous.
“Apparently so. Seeing as all six kids at the house weren’t even in school, I doubt that education or knowledge of such things is high on their priority list. I’m just amazed he hasn’t died of sepsis.”
After they left the patient, Brian asked Marc “Did you notice that other than the patient, there wasn’t a single male at the house? What’s up with that?”
“Yep. It’s a bizarre sub-culture. Male figures are never around. There were three pregnant women in that house. No baby-daddy anywhere to be seen. I don’t know where they are, but I do notice all the men that sit on milk crates on the neutral ground drinking beer all day. I guess that’s where they are. I don’t understand how a guy can father a child and have nothing to do with it, or sit and do nothing all day, but I quit wondering about it because you and I will never find an answer.”
“I just don’t get it,” Brian said in wonderment.
“Neither do I. But, welcome to New Orleans. Did you ever realize how deeply laizzez-faire went?” Marc replied, referring to the old New Orleans attitude that described the general apathy towards just about everything not involving food or music, translated “let things be.”
Brian thought for a second and said “I grew up my whole life here, but I had no idea what people were really like. Prayer is one thing, but that kind of ignorance and stupidity... that takes work to accomplish! You have to really want to stay ignorant to be like that family.”
“Yes, you do. Get used to it.”
Their next patient was a homeless man squatting in an abandoned house. He was lying on a discarded mattress, surrounded by empty styrofoam food boxes and liquor bottles. He smelled powerfully of urine and body odor, but oddly didn’t smell of feces. He was quite alert and oriented but appeared to be immobile, as the nearby boxes and bottles indicated. He had gotten another homeless friend to call 911 for “leg swelling.”
Marc examined his bare feet, they seemed slightly swollen and red, but reasonably healthy other than the apparent cellulitis. He noticed discolored Ace wraps around his lower legs. “What are your legs bandaged up for?”
He answered “I got those wrapped up when I went to the hospital for cuts on my legs after I got hit by a car. They gave me stitches”
“These bandages look pretty old,” Brian commented. “How long ago did you get stitches?”
“In January,” he said.
Brian raised his eyebrows. “January? This is September! You’ve had those bandages on for eight months?” Brian looked at Marc, who was clearly wondering about what they would find under the bandages.
The homeless man explained, “Well, I been putting iodine on them. You know, to keep ‘em from getting infected.” He produced a half empty bottle of Betadine from somewhere among the rubbish on the mattress. He also explained that since he couldn’t get around, he had his other homeless buddies bring him food from shelters and church handouts, and they would share their cheap liquor with him.
Marc asked “So you’ve just been pouring that on the bandages? When were you planning on taking them off?”
“I don’t know.”
“Oh, man.” Marc exclaimed, shaking his head. He rolled up the man’s jeans and began cutting away the Ace wraps with his trauma shears. Marc and Brian both expected the stench of rotten flesh to overwhelm them, but there was none. As Marc removed the last of the bandages, he looked closely at the discolored gauze dressing covering the wound where the sutures supposedly were. The gauze moved. It writhed on the man’s leg, powered by... something... underneath. Marc opted not to remove the dressing.
“Let’s just get him on the stretcher,” Marc recommended.
They retrieved the stretcher and donned their “space suits,” plastic gowns to protect their clothes and skin from whatever unseen entity was under the animated dressing and whatever other infectious processes were going on inside their patient. Back inside the house, Brian grasped the man under the shoulders and Marc held onto his pants legs to lift him up. Apparently the man was wearing the same pants he was wearing in January when he first was injured; as Marc tried to lift the man’s legs, he discovered that the trouser legs were already cut up to the hips. The force of Marc trying to lift an entire man but instead pulling at torn fabric caused him to fall back a step. A few objects flew out of the ripped pants toward the ceiling and scattered around the scene.
Brian studied one of the objects as Marc regained his balance. “Maggots,” they both said simultaneously.
“Gross,” again simultaneously. “Now we know why he doesn’t smell like shit; the maggots have been taking care of that,” Marc explained.
Wrapping the man in a sheet like a big burrito helped solve their lifting issues and helped prevent any errantly vectored larvae from landing on them. Marc chose not to start an IV or even check his vital signs. Neither medic even wanted to touch the man and his personal ecosystem. Brian just drove to University, Marc kept the exhaust fan on and the air conditioner on its maximum setting to keep the most ventilation going through the truck so as to lessen the ammonia smell of urine.
At the hospital, Dr. Lovejoy commented on Marc and Brian’s streak of patients with lower extremity issues as she examined the man’s legs and removed the brown gauze dressings. Exposed to the cool air of the emergency room, the maggots sought warmer climes and began wriggling vigorously. Several specimens a full inch long wriggled out of the wound in the man’s leg and dropped onto the stretcher. Brian retched at the sight of it and ran out the door onto the ramp, barely managing to contain the bile rising in his throat. Marc too felt ill at the sight and turned away, choosing instead to write his report at the nurses’ station.
Dr. Lovejoy, on the other hand, seemed positively captivated by the experience. She brushed maggots out of the way to study the wound, her face disturbingly close to the pile of worms. “Well, they’ve been doing a good job! The wound looks really clean, no infection. They probably saved his life.”
Brian had managed to compose himself once again and had come back into the ER as the doctor was commenting. He looked quizzically at her and asked “Saved his life?”
“Yes,” she responded, “maggots don’t eat living tissue, just the dead tissue along with the bacteria. Since they keep the wound clean, it doesn’t get infected. That other guy with the diabetic foot you brought in could have used some of these little buggers,” the doctor remarked, still mesmerized by the little white critters.
“Maggots, huh?” Brian replied, somewhere between amazement and nausea. “Learn something new every day. It’s still pretty gross.”
Later in the truck, Brian and Marc discussed their revulsion at the last two calls. Brian exclaimed “It’s just amazing how much nothing people are willing to do for themselves to the point that their limbs are literally rotting off their own bodies! The only reason that guy couldn’t get around was because his legs were rotten, and his legs were rotten because he wouldn’t get around! And the other guy - his foot was falling off because he and his family wouldn’t do anything about it! And that woman who called us to take her one block after she had just walked over two miles! How can people be so willfully ignorant and lazy? How can you exist that way? I’d rather die than live in that... that... stagnation!”
“Brian, I don’t know. But so many people for so many generations have been handed everything to them that they’ve lost the capacity for independence and self-reliance. That in itself is more disgusting to me than any number of maggots or putrefying flesh.”
“Why do we tolerate this? Even encourage it? These folks are just as much a parasite as the maggots. At least the maggots perform some useful function, like the doctor was saying.”
“I know, man. I’ve been seeing it for years, and it hasn’t changed,” Marc said. “If anything, it’s gotten worse. Those kids sleeping in the bed earlier? I wouldn’t be surprised if I had delivered some of them. Or if we’ll deliver one of those three welfare babies on the way in that house.”
Both medics contemplated that thought in silence and frustration. Their contemplation was broken when dispatch called them on the radio for another call, “shortness of breath,” uptown.
The patient was a thirty-five year old man with renal failure in need of dialysis. He sat silently in the chair, perfectly awake and in no visible distress. Like earlier, a female family member spoke for him. “He just got out the hospital.”
“For what? And when?” Marc asked.
“The same thing. He just got out two days ago.”
“When was your last dialysis?” Brian asked the patient.
“Tuesday,” the woman interjected.
“Where do you go for dialysis?” Brian pursued.
“He ain’t got no dialysis place here. That’s my cousin; he’s been stayin’ with us a couple weeks. He moved here from Houston and never got no dialysis doctor here.”
“So how have you been getting dialyzed?” Marc pursued, trying to direct the questions to the patient, rather than the “spokeswoman.”
She replied again for the man, “He gets his dialysis at the hospital. That’s why he was there. He’s my cousin and he just moved down here from Houston.”
“You didn’t plan for a doctor or a dialysis clinic here? You just go to the emergency room three times a week?” Marc inquired, trying to keep his impatience in check, for he knew what the answer would be.
“No, he just asks me to call the ambulance to take him to the hospital.”
Marc closed his eyes and exhaled slowly. “What hospital does he go to?”
“He went to Baptist last time, but he said he wants to go to Touro today. He was at University before that.”
“Okay,” Marc responded, at his patience’ end. Any further questions would simply serve to irritate him more. He went with Brian to retrieve the stretcher out of the ambulance.
At the back of the truck, Brian said “Weren’t we just now talking about this? Another one who does nothing for himself. And the family can’t be bothered either.”
“Yup,” Marc answered. “More of the same.”
Again back in the house, Brian asked the man to sit on the stretcher. The patient sat in the wheelchair, drooping like wilted lettuce. Marc was at the end of his rope and said in a commanding voice, “Dude, I just need you to stand up for one second and plop yourself onto my stretcher. I’m not asking you to do any gymnastics.”
The man lifted up his head, groaning, trying to give the impression that this simple movement was the heaviest burden since Atlas bore the world on his shoulders. Marc had had enough. Even Brian appeared exasperated, rolling his eyes and shaking his head. “Just pick him up and get this over with,” Marc ordered, grasping the man under the arms as Brian grabbed under his knees and planted him onto the stretcher.
In the back of the truck, Brian checked his vital signs and applied the EKG electrodes. The man’s EKG was a little slow and the complexes appeared wider than they should be, a typical sign of hyperkalemia, which is common in dialysis patients. Simply eating a banana has been known to send dialysis patients over the edge into a cardiac emergency with its extra potassium. In maneuvering himself in the seat in the ambulance, Marc’s clipboard slipped off his lap. As he picked it up and replaced it, his hand knocked against the purloined vial of potassium in his pocket, the one he had lifted from the hospital weeks earlier.
He stopped writing for a moment, staring at the clipboard, lost in thought. With an unemotional expression, he looked closely at the patient, then at Brian. “Go ahead and start an IV.”
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Bo reviewed Version 1 -
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Excellent portrayal of real life paramedics. I especially enjoy the sarcasm of Marc. It matches my own. I can identify with the “why” do people put themselves in these situations or rather why do they stay in them. No answers. Great dialogue between Marc and Brian. I can see why those in the medical field get the way they become overall. Start out gung ho, wanting to help others, end up twisted due to all of the “real life” they deal with daily.
The ongoing story of Marc and Brian and New Orleans as a setting is relaistic as I grew up in the south and lived in Southern Louisiana as a child. I know that attitude, “Cest La Vie”- Good work
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Allen_Grier reviewed Version 1 -
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Wow… This story never has its dull moments. It doesn’t seem like Brian’s going to last much longer either. I doubt I would. I can’t believe these are real stories. I don’t know whether to feel sorry for these people for their injuries, or for their lack of motivation. An altogether amazing piece.
oknapp reviewed Version 1 -
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every day.. Everyday. Put together, maybe?
stupid,” “ignorant” this looks wrong somehow. exclamation marks shouldn’t be together should they?
All the nurses and doctors were as impressed at the foot as Brian and Marc had been.” Would impressed be the right word? Disgusted, dumbfounded, might better describe seeing something like this. Or impressed or disgusted by the look or the “condition” of the foot
Is this omniscient narrator? i notice that a lot of the thoughts come from Marc’s head. There is nothing wrong with it’s narration. i am just currious.
Whew! dear God what condtions doth man get into. The maggots were his saving grace.
Good lord another one is fixing to get the shot. Now there are two killers in the midst. i think i will die quietly at home.
Your writing is stellar and the medical terminology is quiet interesting and done very well. You paint a picture that many never know exists. The trouble is that no one wants to know these types of folks. Perhaps that is where the problem lies. I suggested a few things. Good luck.
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