Monday, June 22, 2020

Crush It!

As I noted in another post yesterday about Covid for some reason we think the worst is over, no its ongoing everyday.  Largely why? Because we have a Government indifferent to the reality of this, States and Municipalities trying to figure it out from Governors who are sure they have the right team, crew, input from the same afraid, ignorant or slightly more knowledgeable medical staff who for all ostensible purposes have actually never been in the field during a pandemic. And those that have been are relegated to the sidelines, not called to action, to devise a cohesive, comprehensive plan and more importantly find a clear messenger who can communicate with the public in a fashion that evokes both concern and hope that this will too come to an end.

For awhile here in the tri-state area we had the Three Amigos, Cuomo, DiBlasio and Murphy. After a week or two I realized that they were the Three Stooges, all of them grasping to be some type of leader with their messaging that emphasized fear and compliance and if you failed you would be relegated to restrictions, the irony was we already were so at some point what more can you do?  When I began to listen to their messages and the other crackpot Mike DeWine of Ohio I learned early on that none of them had a fucking clue.  Look to the West Coast and listen to Newsom and Inslee who actually ran for President, and no loss there clearly.  The most interesting was that while all of them had varying levels of tone and advocacy to ensure the public's cooperation you underneath realized that the message was the same - be afraid, be very afraid.  What they failed to do was actually have any real testing, tracking, tracing and treatment plan. They knew by shouting numbers, making threats and promises that it will get worse they seemed to think that being a bully was the way to somehow make Covid go away.  My favorite here was Murphy saying repeatedly, "Don't be a knucklehead" while constantly demonstrating what that was with his rambling bullshit that could never be clearly proven, numbers that mad little sense and just the clear copying of Cuomo as the leader of the tribe.  It was as if we are living on the island of lost boys - Neverland. And well that was no utopia and there is no Peter Pan.

When you look to the countries, largely those run by women, it was a much faster progress with regards to all the elements that manage a crisis, planning, communication, cooperation and of course clear established goals in which to meet them.   I knew from looking at the way the announcements were set that regardless we had only a 90 day window, it would be "over" by the 4th of July and that in the interim lives would be destroyed and the economy crushed versus the virus.   Men do that they crush it That is a man's way.  Never did I hear a voice from in the field sitting adjacent to these men to add resonance and personal experience.  I saw news reports that hysterical health workers fearing for their lives, crying and of course killing themselves over the stress of the failures of the same men crushing it trying to figure out how to have a well thought out plan to deliver supplies and in turn not crush them with patients.  Well they failed on that count as well.  If they believe this was a success then they also believe in fairies.   If any of these idiots are re-elected then I fear for us all.

Then the idiocy of the general public, sending food, the donation of supplies to supplement the ones they lacked, the flying of Blue Angels and let's not forget the nightly cacophony of clapping, banging pots and making noise to show support. I cannot believe that this will end but why it was in the first place also bothered me as this is a for profit industry and the public facilities where they dumped, yes dumped, most patients were so underfunded, so badly managed and so poorly prepared that I am not sure why we are clapping any of this instead also taking to the streets to demand that while defunding the Police, fund public health. For if we did some of this death may have been prevented.  Then again that would require intelligence and planning such as establishing testing protocols for the most at risk, quarantining them first and in turn having a staggered type of work schedule, to reduce commuting, allow business to function with the limits, the ones they have now only with clear guidelines in place. What is working now would have worked then it was just that they had no way to test the population and we know that the majority of people have not been tested who never showed symptoms nor were sick at all at any time during this lockdown.  So welcome to the doll house.

Today begins the next big phase and frankly what I saw this weekend was alarming, the lack of physical distancing, the lack of PPE and of course overall behavior that made me think the protests were safer to congregate among.  And at least their messaging was clear and concise.

This is from an EMT who I think says it all and reminds us that we are not in a second wave we are in the third wave, a wave comes and goes as all do, some are more powerful and each month the waves were smaller in nature but the water is not flat, it is not calm and it is still flowing every day.  Water does that until it dries out.  We ain't anywhere near shore yet.  Crush it? Fuck no we just dented it.

Voices from the Pandemic
‘Heroes, right?’
Anthony Almojera, on being a New York City paramedic and the injustices of covid-19
By Eli Saslow
The Washington Post
June 21, 2020

Nobody wants to know about what I do. People might pay us lip service and say we’re heroes, but our stories aren’t the kind anyone actually wants to hear about. Kids in this country grow up with toy firetrucks, or maybe playing cops and robbers, but who dreams of becoming a paramedic? That’s ambulances. That’s death and vulnerability — the scary stuff. We’re taught in this culture to shun illness like it’s something shameful. We’d rather pretend everything’s fine. We look the other way.

That’s what’s happening now in New York. We just had 20,000-some people die in this city, and already the crowds are lining back up outside restaurants and jamming into bars. This virus is still out there. We respond to 911 calls for covid every day. I’ve been on the scene at more than 200 of these deaths — trying to revive people, consoling their families — but you can’t even be bothered to stay six feet apart and wear a mask, because why? You’re a tough guy? It makes you look weak? You’d rather ignore the whole thing and pretend you’re invincible?

Some of us can’t stop thinking about it. I woke up this morning to about 60 new text messages from paramedics who are barely holding it together. Some are still sick with the virus. At one point we had 25 percent of EMTs in the city out sick. Others are living in their cars so they don’t risk bringing it home to their families. They’re depressed. They’re emotionally exhausted. They’re drinking too much. They’re lashing out at their kids. They’re having night terrors and panic attacks and all kinds of outbursts. I’ve got five paramedics in the ground from this virus already and a few more on ventilators. Another rookie EMT just committed suicide. He was having trouble coping with what he was seeing. He was a kid — 23 years old. He won’t be the last. I have medics who come to me every day and say, “Is this PTSD I’m feeling?” But technically PTSD comes after the event, and we’re not there yet. It’s ongoing stress and trauma, and we might have months to go.

Do you know how much EMTs make in New York City? We start at $35,000. We top out at $48,000 after five years. That’s nothing. That’s a middle finger. It’s about 40 percent less than fire, police and corrections — and those guys deserve what they get. But we have three times the call volume of fire. There are EMTs on my team who’ve been pulling double shifts in a pandemic and performing life support for 16 hours, and then they go home and they have to drive Uber to pay their rent. I’m more than 15 years on the job, and I still work two side gigs. One of my guys does part-time at a grocery store.

Heroes, right? The anger is blinding.

One thing this pandemic has made clear to me is that our country has become a joke in terms of how it disregards working people and poor people. The rampant inequality. The racism. Mistakes were made at the very top in terms of how we prepared for this virus, and we paid down here at the bottom.

It started around the middle of March when the call volume began to spike in the poorer neighborhoods. The stay-at-home order in New York hadn’t even gone into effect at that point. Trump was telling us he had everything under control. The mayor was saying we had great health care, and we wouldn’t get hit as bad as other countries, so we should keep on going to the movies. But for us, it was wheezing, trouble breathing, heart palpitations, cardiac arrest, cardiac arrest. This virus stresses out the heart in a bunch of different ways. I’d look at our dispatch screen sometimes and see 30 possible cardiac events happening at any one time across the city, mostly in the immigrant neighborhoods. It felt like watching a bomb go off in slow motion. You had time to see who was going to get hit and who had the ability to escape. I saw in Manhattan, on the East Side, people clearing out of the city to set up shop in the Hamptons or rent property upstate. The business class packed up their computers and went off to work elsewhere. Meanwhile, the rest of us were huddling with no ventilators, like fish in the barrel.

It got so quiet sometimes that all you could hear were our sirens. The most 911 calls we’d ever had was back on September 11th, and we broke that record every day for two weeks straight. My station is right in Brooklyn’s Chinatown, so it’s a lot of new Chinese immigrants, sometimes 10 or 12 people living in a small place. They tend not to call 911 unless its absolutely necessary, but they were calling. One woman was apologizing for bothering us while we were trying to get a pulse back on her uncle. The Dominicans and Puerto Ricans in Sunset Park got hit hard. Sometimes those families will pray over you while you’re doing CPR. The Middle Eastern neighborhoods in Bay Ridge got hit. The African American communities, where hypertension is a big thing. The nursing homes in Far Rockaway. The housing projects in East Flatbush. We weren’t carrying too many stretchers into the fancy brownstones.

I’m a lieutenant and vice president of the union, so I cover a big area, and I mostly go to the big traumas. I grew up in Brooklyn, and I know every street in this city. I can whip it. Doesn’t matter where the call is. I’m two minutes out. I had one guy with covid who was talking to me in his fifth-floor apartment. He was breathing heavy, so we loaded him on the stretcher, and by the time the elevator hit the lobby, he didn’t have a pulse. I went to another high-rise for an unresponsive elderly woman, and then I realize, two days before we were in the same place because her husband had dropped. Both of them died. We sometimes had 400 emergency calls sitting on hold. People were waiting hours for an ambulance on the more minor stuff. I pronounced more deaths in the first two weeks of April than I have in my career.

I got one call at the height of the madness, another cardiac arrest, and it was a Latin guy, young guy, unresponsive and passed out in a room with bunk beds. There wasn’t enough space to work, so we dragged him out into the living room to start giving him CPR. This guy had no pulse. That’s clinical death, but biological death doesn’t come until about six minutes later. That’s our window to bring you back. That’s why we do this job. Now this guy was 31. He was strong, healthy. His mother told us he’d just gone out. As a medic, you hear that and your eyes start to get big. It’s like, okay, maybe this is one we can save.

It was four guys and me. That’s the crew. The two EMTs were bagging him up to get oxygen in his lungs. The medics were starting to intubate and calculating the meds. Everything they can do for you in a hospital, EMS brings to you. We carry 60 medications. We hook up the heart monitor. It all happens so fast, and there’s barely time to talk. It’s scalpel, needle, put in the IV, pace it, shock it, check on the heart rhythms. It’s like a symphony, and you have to know your part.

The team kept working, and I went over to get information from the mother. There was a little girl standing behind her, 7 years old, and it turns out she’s the daughter. They told me he’d been sick four or five days, but he worked at a bodega and he couldn’t afford to take off. He’d come home from work and collapsed a few minutes later. Now I’m getting upset. Here we’re supposed to be this great society, and this guy can’t even miss one paycheck. There’s no safety net. The system we have is broken, and this 7-year-old is seeing her dad get CPR. We kept working. After a few minutes, we got a pulse back. I told the family: “He’s not out of the woods yet, but we might have a shot here.” We rushed him into the truck and over to the hospital, and then he died a while later.

I did 14 cardiac arrests that day. I didn’t save anybody.

The thing about being a paramedic is you need to have some reservoir of hope. This job is the ultimate backstage pass. It can make you believe in humanity, but it can also suck the humanity out of you. You see death, suffering — grief in its rawest forms. I’ve been shot at on this job. I’ve been beaten and cursed at. But then every year, we go to the Second Chance Brunch, and we get to meet some of the people we saved. There’s no drug on the planet like that. There’s no job that matters more. It keeps you going. But then we came into this virus, and we weren’t bringing people back. The virus kept winning. It always ended the same way.

I’d go park the truck at the beach after a double and try to calm myself down and gather my thoughts. I’ve gained weight during this pandemic. I don’t sleep well anymore. Emotionally, I’ve been feeling a little numb. They teach you as a Buddhist that life is suffering, and I believe that. You have to stay in the suffering. You can’t deny reality and turn the other way.

I’ve been in therapy for 17 years, and lately what keeps coming up is that reservoir of hope. It’s starting to feel more and more empty. Our call volume has been down for the last month, but I’m worried it won’t stay there. I don’t have that much faith in what we are anymore. America is supposed to be the best, right? So why aren’t we united at all? Why aren’t we taking care of each other? The virus is hanging around, waiting for us to make more mistakes, and I’m afraid that we will.

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