The Adventures of Mickey Machado and Bristol County EMS

NanowrimoThis was something I came up with as a side note to Twenty-Five at the Lip during Camp NaNoWriMo in April 2015. It’s a call that gets run far too many times in private EMS and often results in injury to providers, particularly in places like Fall River (Borden City) where the homes are often three-story walk-ups and the weight and size of the patient increases with each floor.

You’ll all be glad to see Calvin and Jeremy working together again in their usual dry-humored manner. This doesn’t offer much in the way of spoilers, but I can tell you that it takes place right after that awkward scene at Dave and Buster’s between Jeremy and Carley. You know the one I’m talking about 😉

“I’ll give you three guesses what floor Mickey lives on,” Calvin said handing Jeremy the paperwork on the patient they were taking off the floor at Union Hospital. Hargraves 5 was the floor best known for bariatric care, or the patients who exceeded the distinction of morbid obesity. Most of them were there for various infections relating to their condition, as well as the typical ailments such as difficulty breathing, congestive heart failure, and other classifications that deemed them unable to thrive. Many of them had simply given up on reversing the inevitability of their own health decline and ultimate mortality. Then there was Mickey Machado, famous on YouTube for uploading videos of himself dancing shirtless with his extraordinary amount of body fat hanging off of him. At his last weight he was reported to be closing in on nine hundred pounds. His rendition of Genie in a Bottle was said to be enough to make a weak stomach turn, but Mickey’s smell was guaranteed to do that if his videos didn’t. The smell is like a dank yeast. It lingers in the air, or can play hide and seek with your senses as the odor escapes the folds under the skin. Once it hits your nose though you’ll spend hours trying to get it out of there. It seems to bind itself to your nose hairs, clinging to you like a life raft until it eventually dissipates. The smell of death is sometimes preferable to the living funk of the over eight hundred pound crowd.

“First floor, with a wide wheelchair ramp and a crane to hoist him from our stretcher onto his bed or couch and then a full compliment of nurses to settle him in?” Jeremy asked sarcastically.

“Close,” Calvin said slapping the paperwork onto his aluminum clipboard. “Third floor, tenement walkup complete with narrow, winding staircase, rotten wood and as a bonus: German cockroaches.”

“Well if we get stuck in there cockroaches are chalk full of protein,” Jeremy suggested.

“True. See you’re thinking outside the box, that’s good.”

They wheeled the stretcher into the room and the odor of Mickey Machado hit them immediately. He was laying in his bariatric bed, complete with air support mattress working harder than any other piece of machinery in the hospital to keep him elevated. Jeremy caught a whiff of Mickey, a mere thirty-three years old, with purple legs covered in scabs and dripping with pustules. He was busy working on a dinner tray, scraping the remnants of his cardiac diet into his mouth form his plate. This might have been a good start for him if there were not half a dozen bottles of Mountain Dew lining the windowsill.

“He shouldn’t leave those out in direct sunlight,” Calvin muttered. “He might get cancer from the PVCs from the plastic.”

“I’m sure he would want to be as proactive about all that, if only he knew,” Jeremy said.

Mickey returned the empty plate to the table and pushed the tray table aside. He wiped his face with his hands and then flicked at the crumbs littering his blankets.

“I’m going to need you to move me,” Mickey said. “I can’t walk.”

“I see,” Calvin said. “So you’re not the guy who dances in all those videos on Youtube?”

Mickey’s face shook, jiggling his jowls and unshaven face. Jeremy coughed, the smell finally getting to him as he stepped outside the room. The nurse at the station smirked at him.

At the end of the hall two more crews showed up. For his part Calvin was relieved to see that Valerie wasn’t one of them.

“Short straw, huh Peirce?” one of them asked.

“You could say that…” Calvin replied. Jeremy was busying himself over by the isolation cart, fitting himself for a surgical mask to cut the smell of Mickey.

“How is it working with Shithead?” another asked.

“He’s really great, just so you know. You now how it is, Bobby Carreiro forgets he was new once too. You guys forget too?” Calvin asked. They shook their heads or looked away. “Didn’t think so.” He turned back to Jeremy and reached out for the surgical mask on his face, “Don’t bother it won’t do you any good. The smell cuts through everything. You just have to man up.”

The six of them entered the room and the smell hit them instantly. A few coughed, but Calvin could see Jeremy holding his composure, not wanting to let them see him flinch.

“Hey, aren’t you the guy who dances on YouTube?” one of the crews asked. Again Mickey shook his head. “Yea sure you are, I bet you can walk to the stretcher, right?”

Again Mickey denied who he was and the wide bariatric stretcher was brought up alongside his bed. With three to a side the three crews secured as much of the sheet beneath Mickey as they could, the nurse rushing in just as they were about to more him offering

“I’ll get the feet!” In other words, I want to look helpful and be part of the team, but want to do as little work as humanly possible. Sliding Mickey over the yellow stretcher groaned under his incredible weight. The stretcher creaked and groaned as they wheeled it down the hall, carefully and as low as they dared, still having to lift it up into the ambulance in the parking lot.

“We’ll take the stairs,” the other crews offered rather than travel down in a maxed out elevator. The door shutting before Jeremy and Calvin set the stage for instant claustrophobia.

They pushed the stretcher out of the elevator, Jeremy reenacting his own Israelite’s experience under the pharaohs of Egypt building pyramids. Outside in the parking lot the three crews assembled and together lifted the stretcher with the wheels into the ambulance, sliding it in with a deafening thud. There was actually a mechanical winch inside the truck that would have made it easier to load heavy stretchers with patients of this size. However, the mechanical winch, like many important pieces of equipment were perpetually non-functioning.

Jeremy found the truck to be particularly sluggish with the extra thousand pounds of weight. It wasn’t just Mickey on the stretcher, it was the stretcher itself. The truck listed down the road, Jeremy riding the breaks down Robeson Street past the Tio Joao’s and distinctly heard Mickey ask if they could stop and get him a coffee.

The pulled up to the house to find a gathering of typical Borden City’s finest citizens. Collectors of the state with more tattoos than teeth.

“Hey Mickey’s home!” they cried. Clapping as the back doors opened up, the three crews struggled to safely pull Mickey out and hot dropped the wheels, because well one couldn’t expect all their strength to be cut down to lower them gently.

The stair chair the sat in the side cabinet of their truck was rickety and even a little rusted. The lack of care that it had been shown was a combination of management not wanting to spend the money to replace it as much as it was crews disregarding their employers for ridiculously absurd rules such as no hat policies and no pay raises. It was a vicious cycle and often the equipment suffered.

“The stair chair we’ve got was the same one used to cart FDR around in his first election,” Calvin said euphemistically. Do any of you have a better one?”

“Who are you kidding?” the others asked.

“We’ve got a people mover…” Jeremy said.

A people mover was the polite term for what crews referred to as the Shamoo Shimmey, or the all else fails last resort to moving patients large enough to draw an orbit. It was a large tarp with handles that crews would lift their patient on and carry them across distances. It wasn’t exactly designed to take people up flights of stairs, but it had been used to taken them down from time to time. The other six EMTs groaned in unison, some already stretching their backs.

“Anybody have any other ideas?” Calvin asked. When none of them spoke up he was climbing back into the truck and opening the squad bench and fishing out the bright orange tarp pout and throwing it onto the sidewalk. The other EMTs looked down in disgust at what they were being forced to do.

“Look on the bright side,” Calvin said. “The civil service test is coming up again next year…”

Right or wrong the situation at hand hand not been appropriately dealt with. Mickey Machado, despite his utter lack of self-discipline, still needed to be brought up to his third floor residence. There was nothing in the world that could justify his place up on the third floor and it was very possible that he had grown to that size while residing there, not working and collecting state assistance due to his disability which only enabled him to continue on the path to self destruction. He had a victim mentality, and Calvin was not about to let the BLS crews shirk their own obligation to execute the function of their jobs and gratify Mickey with the sort of convoluted sob story that would surely be propagated by the liberal rag that was the Petitioner.

Mickey was gracious enough to roll form the stretcher onto the tarp, though the stretcher had to be lowered enough to meet the level of the sidewalk from the street. Laying flat on his back, the crews gathered around him, three men to a side and with Calvin and Jeremy at the head they began their daunting task.

The apartment house was three floors, but first they needed to negotiate the seven steps leading to the porch and the front door. On the porch was a doorway leading into the house, built as one might expect at the height on the Borden City industrial boom, the house was not appropriately sized to persons exceeding the weight and girth that nine hundred pounds demanded. They made the porch landing easily enough, though their arms strained under his weight. at one hundred and fifty pounds for each of them to lift, they were still dragging a small person each up the stairs.

“Do you want to call fire?” one of the EMTs asked. Calvin sighed and stretched his back. He looked at Jeremy who shook his head.

“The problem we have isn’t weight as much as it is logistics. We can call fire for the weight dispersal, but it doesn’t solve the problem of bringing him up the stairs.”

“What the fuck is he saying?” the EMT snapped. Calvin leered at the man.

“He’s saying that you can call another three guys, but weight isn’t the issue. Where the heck are you going to put them? The staircase is three feet side, we can only do three at the top and three at the bottom at best.”

“Fuck this!” the EMT snapped again. Mickey laid on the porch indignantly, a lump in the midst of his six handlers. Calvin pointed to one of the other four and waved him over.

“The three of us are getting the head and we are going to back him up the stairs. Mind the curve of the stairwell and watch where you step, there’s no telling how bad these stairs are. You three and going to push from the bottom, one on each side of the leg, the third in the middle. You can draw straws for who gets the foopa…”

The stairs creaked as they began their ascent. Despite the cool air outside the stairwell was a sauna and sweat was pouring from them before they reached the first landing. The sound of the vinyl tarp, nearly stuck inside the narrow stairwell with Mickey exploding around it, made a slow zipping sound as it made the difficult upward journey.

“OW!” Mickey screamed as they pulled him up onto the first landing. “I have a bad back you fucking idiots!”

Calvin resisted the urge to nudge the fatty corpuscle back down the stairs, mostly because of the EMTs still beneath Mickey, but also because there would be a lot of explaining to do about it. In hindsight though, his record was clean enough that he might have been able to pull it off and still get away with his job intact.

They took a breather on the first landing, Mickey wedged on the old, cracked linoleum floor. the six EMTs on the landing caught their breath and looked helplessly up to the next stairwell.

“Is your door unlocked?” Jeremy asked.

“My keys are in my belongings bag,” Mickey answered. An EMT near the first stairwell opened the bag, sifting through Mountain Dew bottles until he found a large keyring littered with obnoxious keychains and a single key. He handed it to Jeremy who went to the top of the stairs, finding a short landing with a slanted roof and a small door.

“This has to be a sick joke,” Jeremy said as he opened the door, finding only a single mattress in the middle of the living room. The apartment smelled musty with moldy pizza boxes and Chinese containers stacked up in various places in the apartment. Jeremy suddenly felt better about the condition of his own place.

“How’s it look?” Calvin asked as Jeremy came back down the steps.

“If you thought that last flight of stairs was fun…”

“Shit,” another EMT muttered.

With a there count the six men began pulling and lifting the 900 pound wonder up the tiny stairwell. It was a symphony of grunts and groans, broken only by the sudden chirping of Jeremy’s cell phone.

“Jesus, your phone has been blowing up lately,” Calvin remarked as they reached the landing. They ignored Mickey’s cries of pain and discomfort as they came up over the lip of the last staircase. His own discomfort was his own making, but Calvin kept that thought to himself as he entered the tiny, congested apartment.

Jeremy took the opportunity to look at his phone, the message he was expecting

Hi! How’s your day? from Carley.

Jeremy stuffed the phone back into his pocket, putting the ringer on vibrate. Almost immediately he felt another vibration and then another. He started turning red.

“You alright?” Calvin asked. as he came back to drag Mickey into his apartment.

“Yea my back is just killing me,” Jeremy replied.

Copyright © 2015, James Windale

cropped-25atthelip-4contrast-final-draft1.jpgJames Windale is the author of Twenty-Five at the Lip. It is is a year-long trip through the personal lives of three twenty-something paramedics struggling to navigate their relationships, sanity, and integrity. These young heroes come to find themselves struggling to maintain their sense of self and purpose in a quarter-life story written through the lens of EMS. It is available on Amazon in paperback and on Kindle, as well as any Kindle-enabled device.

Read Twenty-Five at the Lip by James Windale


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