Alexis is a Kickass Paramedic from Salisbury, MD. Watch her story!
Alexis is a Kickass Paramedic from Salisbury, MD. Watch her story!
All I saw was the gun and the hand holding the gun. It was coming out from behind the basement door. We were in a house searching for an assault victim, and this was the first guy we ran into.
All I could do was sputter, “Gun!” to the two sheriffs behind me. The guy-with-the-gun yelled, “It’s okay, I’m the one who called 911!” But in an instant, the sheriffs tackled him, slammed him to the floor, and cuffed him.
One of the officers looked at me and said, “You can’t trust anyone.”
I’ve always been intrigued by the argument that the best way to stop a shooter in a mass shooting incident is with a “good guy” with a gun. In our imagination, we see an individual — a civilian (or a posse of like-minded armed citizens) — calm, cool and collected taking out the shooter amidst the carnage and chaos of a mass casualty incident.
As a firefighter, I have never personally experienced a mass shooting (although sadly we now train for them annually). I have attended the aftermath of individuals being shot and I have been involved in a number of mass casualty situations. Thus, I have some questions about the reality of a good guy with a gun.
Question 1: Who’s the good guy? Who’s the bad guy?
Sophocles wrote, “Who is the victim, who is the slayer?” In an active-shooter situation —a crowd of screaming and running people — you probably won’t know victim or slayer. They aren’t wearing name tags. Who do you trust? How do you know, if you’re a “good guy with a gun,” who “the bad guy with a gun” is? What if it’s another good guy? Or, what if someone just yells — with gun in hand — he’s a good guy? Would you believe him or her? Wouldn’t that be the perfect way to get you to at least hesitate? Couldn’t that be a fatal mistake? Of course, if he is a good guy with a gun, and you’re also holding a gun, maybe you’ll get shot by mistake. Like our guy coming out of the basement, just holding a gun in a chaotic situation makes you suspect.
Question 2: Can you make the switch in time to help?
It takes training to be able to go from your daily routine and switch to becoming an emergency responder with a gun in seconds. Even as a volunteer firefighter, when the pager goes off we have time — driving to the station, throwing on bunker gear — to get mentally prepared. But if you were caught in a shooting situation, you would have to turn that switch on instantly; go from bystander, father, friend, mother to a shooter in seconds. On the fire department, we train every week (and regularly go on 911 calls) to be able to make that switch. It really is a switch in the brain, from civilian with lots of things on your mind to a single-mindedness based on training, training and more training.
Question #3: Situational Awareness: How do you even know what is going on?
The mass casualty situations I have been involved in are all car crashes with multiple fatalities. Most of these occurred at night.
Rolling up on those scenes, even when we are prepared, is unnerving in the beginning. The first few minutes are chaos. There are panicked people. There are wounded individuals crying for help. There are the dead. As a note, if you’ve not experienced the violent deaths of others you’ve no idea how wrenching an experience it can be. It will stop you in your tracks.
Coming into one of those scenes you don’t really know what is going on. There isn’t a TV narrator describing the scene in retrospect. You don’t know how many patients there are, or who is critically or mortally injured. You don’t know who the patients are, who are good Samaritans, and who is possibly the drunk driver hiding amongst the living. It can easily take minutes for us to sort out what happened and what we need to do as emergency responders. In a shooting situation, those are minutes you mostly likely do not have.
Then, think about when it’s dark, like the movie theater in Denver, the nightclub in Paris or the Pulse club in Orlando. When it’s dark you can’t see. Let me repeat: When it’s dark you cannot see what is going on. How then are you supposed to be an effective counter-shooter? (The shooter is most likely just spraying shots randomly. You have to pick a target.)
Question number #4: When was the last time you experienced true fear?
When was the last time you were paralyzed with fear? When was the last time you thought you were going to die? I would contend abject fear is not a frequent occurrence for most of us. Given that, let’s say you’re at the mall. Suddenly, you hear gunshots. Once you’ve figured out what they are, your amygdala will start yelling at you to run, get down or hide. Of course, human beings can overcome fear, but I would argue that it takes experience. And, because most have not experienced “I’m about to die” fear, it’s very difficult to know A) how you would respond and B) if you could gather your wits in time to figure out what is going on (see #3).
Question #5: How well are you trained?
Learning how to shoot a weapon is not that difficult. I grew up with guns. My grandfather taught me how to use a shotgun and a rifle when I was eleven. Catholic youth camps taught me to love target shooting. (Alas, I never pursued it.) But knowing how to handle a weapon is elementary compared to even thinking about pulling a weapon out of your holster or purse, aiming it in a crowd of panicked people and shooting at someone who “appears” to be the shooter.
In a crowd, what if you hit a kid by mistake? Could you live with that? Could you live with killing someone downrange of your target? What if you shoot and miss the shooter? (which, if you are the least bit terrified and shaking you probably will.) Now you have possibly a heavily armed shooter — who maybe is suicidal and thus willing to die — gunning for you.
If the trend continues, said shooter most likely will have a rapid-fire AR-15 while you most likely will have a concealed hand-gun. Hardly a fair match up. For a new shooter, a handgun is accurate up to 7-10 meters (30ish feet). An AR-15 is accurate up to 100-300 meters and as a semi-automatic (a round every trigger-pull) can easily fire 30 rounds in 5-10 seconds. The Las Vegas casino shooter was shooting from a distance of over 1000 feet with a bump stock that allowed him to fire at nearly 7 rounds a second.
The point here is that unless you train for mass shooting events and train regularly with a weapon in those scenarios you most likely are not going to be helpful. You may actually be a liability when law enforcement shows up. With you and your gun and the shooter, the scene becomes “multiple shooters” until proven otherwise (Go back to my sheriff compadres’ remarks: You can’t trust anyone”). Possibly you’re as likely to be shot by responding officers as is the actual shooter. (You are also not wearing a name tag that says “Good Guy With A Gun!”)
In sum, mass shootings are catastrophic and complex events. They don’t lend themselves to simple solutions, like “the good guy — a civilian — with a gun” theory.
It feels awkward to end this essay without proposing solutions. But solutions here are way above my pay grade. But here is one suggestion. If you’re in a crowd and chaos breaks out, maybe your first impulse shouldn’t be to draw a weapon. Maybe it should be what we now teach: run, hide and only then fight. Leave the armed response to the professionals.
“Roll Over, Old Las Vegas Highway Mile Marker 8. Timeout 2:30 AM.”
Every Fire department has its Old Las Vegas Highway, that stretch of road that has seen multiple crashes.
I got out of bed, got in my car and drove to the scene, thinking the bars had been closed for just an hour or so, so maybe another drunk trying to make it home. I rolled up on the scene, one ambulance and a couple of Deputy sheriff patrol cars were there, red lights and strobes lights bouncing off the trees and asphalt. The SUV was off the road in the weeds upside-down.The driver and the passengers were already out with only minor injuries.
The Med crew took care of the patients, and we did our regular work: 360 around the car, check for leaking fluids and see if we could cut the battery cables.
That done we hung out on the highway until we were released from the scene. A lucky, no serious injuries call. Dodged another bullet
But maybe because it was the middle of the night, and I was still half-asleep, or maybe because I’ve been doing this way too long, driving back to the station in our rescue truck the movies in my mind started. Every mile marker on Old Las Vegas highway has a story. The place where the horses in the overturned trailer were killed, the mile marker where the snow angel was thrown from the car on a winter’s night and died with us. There were the four crosses on the road up a little farther and then Angela’s marker. There was the call where I was in the car with two critically injured teenagers and a paramedic sticking her head in the window and asking if I needed help. I remember her calm tone of voice as if it were yesterday. There is a cross back from the road a bit where two little kids died. My sister, a medic brought one of the surviving kids a teddy bear in ICU only to learn that he too had passed away. Oh yea, the head-on that killed two kids and we had to wait for hours for OMI to show up before we could extricate the bodies. On and on, a dozen more calls on that fucking road.
You know what I mean? The unedited movie of all those calls on that same road plays in your mind.
Sometimes when people ask me why I seem so detached, I want to show them the movie, right? But that would be cruel. So we keep it to ourselves, share it with the brothers and sisters. Thank you, guys, for being there and understanding.
I planned to write a simple article on the benefits and risks of Cannabidiol, or as it is more commonly known, CBD and using it with dogs. As anyone would do, I called a veterinarian friend of mine for advice. My contact was hesitant. Finally, under the promise of anonymity she told me that for veterinarians to talk about you-know-what in public or with patients was FORBIDDEN! VERBOTEN! PROHIBIDO!
Why? Because apparently according to our beloved federal and state bureaucracy even the discussion between vet and pet owner about the benefits and risks of CBD and dogs might lead to a dog version of Reefer Madness!
So don’t ask your vet for CBD.
But this, dear reader, did not stop your humble correspondent because I have Google!
I immediately (researching from my couch) discovered a few things. First, if you have an older dog with arthritis or an anxious dog you need to think about CBD. It is the hottest new product on the market to treat a variety of conditions that may ail your dog. Full disclosure: we use CBD with both of our big dogs for joint issues. (please don’t tell the feds)
So here is a quick summary. First, CBD is a derivative of the hemp plant or marijuana. Therein lies the problem. If CBD was derived from sunflowers, we’d have a ton of research, and we’d have answers! But because it is derived from marijuana and hemp we are in a bureaucratic mess of who’s on first and what is legal. (And what can even be researched) Cloud Cuckoo Land.
Next, CBD is not psycho-active. In other words, it will not get you or your dog “high.” The high of marijuana is a function of the other derivative, THC. Medical uses of THC and dogs is an altogether different topic.
I super-apologize for throwing a technical term at you — but next, it is important to understand that dogs have essentially the same endocannabinoid system as humans complete with cannabinoid receptors. That system regulates appetite, pain sensation and mood. Thus it makes some sense that CBD might have some of the same effects on dogs as it does on humans.
But who knows?
The fact is that there is little actual scientific research— double blind, placebo-controlled research — on the efficacy of CBD on dogs. That means, other than the great stories we hear; we don’t know if it works, what doses are effective, what is too much and what is too little.
What is driving the interest is the massive number of anecdotal stories (anecdotal stories are not research!) reporting positive results in a couple of areas. First CBD seems to help with pain control, especially with older dogs and arthritis. Second, it’s reported to help with anxious dogs and dogs with separation anxiety. Finally, there have been reports of CBD helping with cancers including pain relief and possibly the shrinking of tumors.
Given all this, if you are interested in using CBD with your dog (or cat), it is best to think about it as a medical-scientific experiment. Here are a few recommendations:
1. Know what you are treating.
2. Buy your CBD from a reputable and knowledgeable source. We buy ours from “Fruit of the Earth” in Santa Fe. The formulation should be from hemp and contain no more than .3% THC. (Their hemp is grown in Colorado).
3. Since there are no dosage recommendations, it’s important to start with a low dosage and slowly work up to an effective dose. An overdose is possible, although rare. An unusually sleepily dog might be a dog with too much CBD in his system.
4. Keep a daily behavior journal so that you can track changes. Sometimes the changes can be subtle, so it’s important to observe if you are getting the result you want.
5. Although veterinarians cannot prescribe CBD, be sure to keep your vet in the loop! Come up with a code word! (Like “ice cream!” The feds will never catch on . . .)
Seriously, no one knows your dog better than you. If a dog is in pain, or highly anxious, we have an obligation to find help even if it is outside of bureaucracy of standard medicine. Use common sense and do your research. CBD might be part of a healthy solution for you and your pets. But don’t quote me!
An ectopic pregnancy is a pregnancy which is not in the normal place (the womb) . . . It occurs in about 11 in 1,000 pregnancies. . . A ruptured ectopic pregnancy is life-threatening, needing emergency surgery. (WebMED)
It was about 7:00 p.m., a spring evening. I drove up our driveway and got out of the car. I opened the front door, the dogs dashed out and there was my wife Laurie and then four-year-old daughter Brynne. Laurie was sitting on the floor, knees up, head resting on them, propped up against the wall. Brynne was playing with a doll next to her. As an EMT, I would have normally been instantly alert. As a weary dad I just asked, “What’s up?”
Laurie answered that her stomach really hurt, and she was so tired she couldn’t get up. Enormous flashing red signs: Woman. Abdominal pain. Too tired to move.
But I did not have my EMT brain in gear. I was mildly annoyed, thinking, “Hey, I had a hard day too . . .”
I asked, “Do you want me to call your doctor?”
Laurie comes from a long line of Scandinavian stoics. Like Monty Python’s Black Knight, she could lose a leg and her comment would be, “I don’t need your help, I can hop.”
So, she said, “No.”
But then she added, “Could you help me get into bed and then can you feed Brynne? Let me rest and I’ll be okay later.”
Neon signs painted on the walls: “This woman is seriously sick.”
I helped her slowly walk down the hallway and into bed. Then I scooped up our daughter, went back to the kitchen, made Mac and Cheese and turned on the TV. A few minutes passed. I heard Laurie weakly calling my name. I rolled my eyes at Brynne and went back to check. I said, “Look, either let me take you in now or I will call 911.”
It surprised me when she said, “Better go in.”
I paused. I thought.
Laurie said, “Hurry.”
That got my attention. I got on the phone and called Tahmina, our Medical Captain.
“Tahmina, I think Laurie needs to go in to the hospital. I don’t want to call 911, but could you come up in the Med Unit and we can take her in?”
Tahmina asked what was going on, and I minimized, “She’s too weak to get out of bed, her stomach hurts, she probably just has the flu. She’s okay when she’s lying down but standing up she gets pretty sick.”
There was urgency in Tahmina’s voice: “I’ll be right there.”
I was not connecting the dots. Our neighbor jogged over to watch Brynne. The Med Unit pulled into our driveway. Tahmina came in and we slowly walked Laurie, now dizzy and holding her stomach, out to the Med Unit.
“Tahmina, I’m so sorry we called you, we could have just driven.” Laurie said.
Tahmina replied, “Hush.”
We got her in the ambulance and Paul, our Assistant Chief, drove us away.
Laurie sat up on the gurney and tried her best to be a good sport, but she was pale and in pain.
Tahmina looked at Laurie, “I’ll get a set of vitals.”
As Tahmina wrapped the BP cuff around Laurie’s arm, she asked, “Have you been sick?”
Laurie just shook her head.
“Maybe food poisoning? When was your last meal?”
Laurie— also a Firefighter-EMT — looked at me. We both knew the algorithm that Tahmina was following. Laurie replied, “I had breakfast about 8:00. I worked until 2:00, and then I started getting sick. I came home. I couldn’t stand up.”
Tahmina looked at me. “Her pulse is 110. BP is 100 over 70. Is that normal for her?”
Laurie sighed. She was clearly tired. “No, I’m usually 120 over 80ish.”
“She’s pale, no fever. Pulse is high. BP low. Abdominal pain.”
“Laurie,” Tahmina asked, “Could you be pregnant?”
She shrugged. “Maybe.”
Tahmina looked at me and then turned to Paul, and said, “Let’s go lights and sirens.”
Paul hit the lights and accelerated.
My heart started pounding.
Laurie closed her eyes and nodded.
“Honey,” I said, “You gotta stay awake, Okay?”
I grabbed the IV kit from the shelf. I noticed my hands were shaking.
I put a tourniquet on her forearm and tied it. Tahmina handed me an alcohol swab. I cleaned Laurie’s wrist, searching for the telltale blue line of a good vein. I saw nothing, her veins had disappeared. I checked her other arm, nothing.
Then Paul yelled, “We’re here! Backing up.”
We got her out of the Med Unit and wheeled her into the Emergency Department on the gurney.Tahmina talked to the charge nurse. I was holding Laurie’s hand. The nurse took one look and was on the phone. Another RN took her blood pressure. It was now 90/60. Laurie’s OB-GYN just happened to be attending that night. He walked over, took one look at her, palpated her belly and said, “Prep her for surgery. Stat.”
He turned and walked to the surgical suites to scrub in.
The nurses hovered over Laurie like angels.They too had difficulty finding veins for an IV because Laurie’s blood pressure was crashing. But they finally got one and then wheeled her up to surgery. In the hallway the anesthesiologist gave her morphine through the IV line for pain.
Laurie perked up immediately and said, “Wow, now I know why people get addicted to this!”
Five minutes later, the surgical nurses came and rolled her into surgery. The doors swung shut behind them.
This was when the tables turned.
Now, I was the “husband,” powerless and just trying to keep it together. The nurses were being kind to me while I filled out forms; insurance, promising-not-to-sue-if-we-screw-up forms, and the big kicker: “Do you want a Priest, a Rabbi or a Minister if . . .”
Seeing the look on my face, the nurse just smiled that sad nurse smile.
Laurie was the center of my universe and there was nothing I could do to help her. I could feel my heart dropping out of my chest. I had no magic. It was in the hands of timing and a surgeon.
Sitting there, I thought of all the times as smalltown EMTs we sat with relatives of patients as they waited. During the waiting times, the pain and fear emanates in waves. There is little you can do except listen and get coffee. You can’t say it will all be fine, because in this particular room, sometimes you just don’t know.
Tahmina sat with me. My sister, also a firefighter-EMT, showed up and sat.
An hour later our OB-GYN came out and said Laurie was going to make it, but it had been a close thing.
“A close thing?” I thought, as the reality crashed down on me.
Reading my mind, the Doc clarified, “Another hour and she would have bled out. . .”
Had Laurie not said, “I need to go in,” had Tahmina not understood that it was an emergency, Laurie would’ve died.
When a loved one is wheeled off to emergency surgery, the illusion that we are somehow protected disappears like fog as the sun rises and we see reality.
The reality is that we are all vulnerable. But of course I knew that, years of being a firefighter had driven that lesson home.
But I didn’t believe that we were vulnerable.
I was pretty sure that we were protected. I believed that because we’d seen so much stuff, that stuff couldn’t happen to us. I thought, “I’m a firefighter, therefore my home will never burn down. I’m an EMT, therefore I’m too smart to be in crash with a drunk driver, and my wife will never have an ectopic pregnancy.”
But none of that is true. No one has special protection. Wealth, intelligence, your zip code — being a firefighter — doesn’t protect you.
Laurie spent the next few days in the hospital recovering from the surgery. When I finally brought her home, we were both quiet. She was tired, and I was guilty and furious with myself for missing the obvious signs of a burst ectopic pregnancy.
A few weeks went by and our lives, as lives do, returned to normal. We had a daughter, we had work and families. Life just flows forward, seemingly not impressed with the past.
The sharpness of that day faded but a thread had been pulled. It was one more testament to the fact that everything can turn on the proverbial dime. I became the husband/dad/brother who wanted to know where everyone was and that they were safe (Laurie called me neurotic). This lasted for a few years until it too faded. Then the fog settled in again: nothing can happen to us! We are protected!
Maybe we are after all, in the playwright Eugene O’Neill’s words, “fog people”. Reality is blinding, it will wear you down. The soft comfort of the fog calls us.
But we have to resist. Crisis and trauma, as terrifying and heart-wrenching as they can be, are also the shafts of light that cause us to see. They illuminate, they scour the fog from the shadows, and we are left with simple truths in plain sight: That our lives are fragile. That we are never promised tomorrow. That we must hold on to those we love.