Full Moon. A healthcare provider’s worst nightmare.

Harley and I groaned as we looked up at the dark clear sky. On any other day the stars and the moon would have been beautiful, mesmerizing. But not at 6am, 28 degrees (Fahrenheit), and the start of our shift.

…

I lived two hours south of my station, but I justified my commute by only working two 24 hour shifts per week (sometimes longer if I picked up overtime). As I did before leaving every shift, I kissed Ty on the cheek at 3am, told him to have a good day, and made the drive up to the mountains. I’d peeked at the schedule and knew our crews would be running lean that day. It was going to be busy. And knowing that it was going to be that kind of day, once I parked in the station lot at around 5:15, I reclined my seat, set my alarm for 5:45, and fell asleep.

*Taptaptap* I jumped as I awoke to Harley tapping on my window – I’d slept through my alarm and the clock on my dash read 5:57. Harley chuckled and told me not to worry; he’d complete crew change for me while I got changed into my uniform.

That was my last chance of sleep for the next 24 hours.

…

Thankfully, Teeters, the medic I was relieving, was sympathetic and gave me a big bear hug when he saw me. He’d just returned from a transfer 4 hours south and was more than ready to go home.

Kara was back as a ‘new hire’ EMT. Although she’d worked at this company for a few years, she had left for a year to pursue other avenues. She was back in the nick of time, as we continued to face a staffing crisis. Harley was her Field Training Officer, tasked with signing her off on her ride to get her ready to jump on a truck and start running calls on her own. That meant I was the ‘trunk monkey’ – the third wheel that rides in the back of the truck. I didn’t mind though. I had a perfect little set up: my phone, kindle, notebook, and anything else I needed, neatly organized on the action area counter. Plus, leg room – a rare commodity when it came to ambulance life. Although I’d perfected the art of ‘EMS yoga’ (basically contorting yourself in the front seat to find a comfortable position to catch a small cat nap), it was nice to have the opportunity to stretch out my short legs.

Harley jumped in the back and sat on the bench seat. “Want to see my new socks?”

Of course, I did. “What kind of question even is that? Yes.” I leaned over as he rolled up his pant leg.

Imprinted on the white cotton were candy colored fruits and a large flourished “W”.

“The snozzberries taste like snozzberries.” He grinned. Willy Wonka socks. Maybe today was actually going to be a good day.

…

The morning flew by… then the afternoon. Call after call after call after call. Shortness of breath. Heart problems. Unconscious (but not really, the dispatch information relayed that the patient “felt faint” and was “conscious and breathing”). The whole quad city area seemed to blow up at the same time.

We grabbed lunch at Chipotle at 2pm (the first time we’d eaten all day, minus the very much required caffeine stop) and had just enough time to pay before we caught three more calls in a row. At 5pm I ravenously ate my cold burrito bowl faster than I should have and immediately regretted that decision, but I paid extra for guac, so I was going to eat it.

“This is why we stopped getting Chipotle,” Harley and I told ourselves. We were the definition of insanity: doing the same thing over and over while expecting different results.

At 9pm we happened to be driving downtown on our way to a posting when we caught a call for “unknown problem” at a popular bar. We backed up 50 feet and were on scene before the dispatcher finished relaying the information. Leonard was one of our new frequent fliers. Intoxicated and always requested to go to the hospital but refused detox treatment or psych help. My job wasn’t to convince people to make better choices – I provided them with the education and information, then let them carry on with their own poor decisions (much like my relationship with Chipotle). But Leonard was nice enough and didn’t try to fight me or make a scene. We evaluated him, made sure he didn’t have any immediate life-threatening injuries or illnesses, and took him to the hospital where he’d sat less than 24 hours ago for the same complaint. Then we were off to the next call.

I would take one hundred Leonards over one Jake.

We’d finally caught a break around midnight. A fresh crew had arrived, and the EMS Gods allowed us to sit in quarters for a brief 30 minutes.

“Medic 1, go available for unconscious person downtown. PD is on scene.” Downtown. At the bars. Police on scene…

We stretched and groaned and climbed back into the ambulance. Kara hit the sirens and I’m pretty sure I either blacked out or was so delirious from lack of sleep that I just don’t remember any part of the ride.

At the same row of bars that we’d picked Leonard up from just a couple of hours before, was Jake sitting on a bench with fire and PD. Jake was in his 20’s, roughly 120 pounds, with long, matted hair and somehow still had a bald spot on the top of his head. He was presumed intoxicated and had a laceration to his eyebrow. Jake was escorted over to the ambulance by the firefighters, and Harley and Kara loaded him on the gurney, out of the cold where we continued our evaluation. Muscles climbed in on the bench seat. His name was Muscles for obvious reasons. Big, intimidating, tattooed dude, who could probably throw down with the baddest MF’ers we came across in our field, but had the demeanor and bedside manner of the most caring providers I’d met.

Harley and Kara set to work attaching the blood pressure cuff, pulse ox, and cardiac monitor to Jake as he swatted their hands away. Jake was intoxicated and possibly on a substance he didn’t want to mention in front of the police. The police had issued a warning citation for trespassing and released him to our care, but Jake was too altered to recognize the difference between EMS and police officers.

But he took an immediate affection to Muscles.

“Hey, man, it’s going to be okay. Just cooperate,” Muscles said, and Jake relaxed a bit.

Jake nodded, but it was more like an involuntary flop of his head as if he couldn’t control his neck muscles. “Okay, I trussss youu,” he slurred. “I trusss you and I… I luuv youu..”

“Okay then.” Muscles went back to his tablet and charted the vitals while I took notes and instructed Kara to get me a blood sugar.

Kara looked at me like I was insane. “You want me to poke this guy with a needle?”

Muscles, having already established a good rapport with Jake, kindly took the glucometer from Kara and with a “Okay, one, two, three, poke!” obtained the drop of blood to test Jake’s blood sugar levels. “One-oh-five,” he read off the screen, “looks good.”

I told Harley and Kara we were ready to go, and they closed the doors with Muscles riding in the back with me. Jake continued to profess his love for Muscles, but I needed to look at the laceration on his eyebrow that he’d sustained at some point before police arrived. There were no bystanders who were able to report what happened and Jake was not a reliable historian at the moment.

I moved from the airway seat to the bench next to Muscles, and asked Jake if I could look at his cut to see if I needed to clean it. As I attempted to brush his almost-dreads back from his face, Jake swatted and leaned far away from me. “Donnn touch me!”

“Hey, Jake, this is Holly,” Muscles said evenly, “She’s a paramedic and she needs to look at your cut.”

“IT NEEDS THREE STICHES.” Jake exclaimed. I wasn’t sure how he came to that conclusion since he hadn’t seen his own face yet.

Muscles pleaded with Jake again to allow me to assess him. Jake did a quarter turn to face me, “I mean she’s gorgeous, but no.” Then after a second glance at me, changed his mind, “Well, okay.”

At least I know if Ty ever leaves me, I still got it going on – even at 1am with a mask on.

I inspected the laceration. “Partial thickness, about, what do you think? One inch?” Muscles nodded and put his phone to his ear to call the hospital.

Mid call, Jake, apparently overcome with emotion, threw off his chest straps and leaned into Muscles’ lap. He grabbed the pockets of Muscles’ jacket and pulled himself closer.

“Keep your hands to yourself!” I scolded, as if I was talking to my kids. I maneuvered to the opposite side of the gurney and pulled Jake off of Muscles who had finished his call. Muscles held jake down on the gurney as he flailed about, and I attempted to retrieve the soft restraints. Muscles let me know he had it under control and Jake relaxed as we pulled into the ambulance bay.

We rolled Jake into the ER, unsure how long he would continue to cooperate. The answer was… 30 seconds. Jake grew belligerent again and attempted to swing his legs over the side of the gurney to get down while the gurney was raised at its highest. Luckily, he forgot he was still wearing seatbelts and wasn’t able to go anywhere. The four of us pushed him into room 5 and removed the wires and blood pressure cuff from him. As he jumped off the gurney screaming obscenities, Kara caught a kick to the chest.

“I’ll get the Haldol and Ativan,” one of the nurses said, rolling her eyes. I knew the feeling. Another combative patient. It was our third or fourth tonight. I was sure the hospital had been overwhelmed.

Jake, all 120 pounds of him, squared up to the crowd of EMS, nurses, and techs swarming into the room. The nurse and Muscles attempted de-escalation first, without success. Six healthcare workers held down Jake’s limbs as they physically restrained him to the ER bed. Jake laughed in a way I can only describe as maniacal – like a Disney villain revealing their evil plan.

The nurse returned with the Sleepytime Cocktail and injected the needle into Jake’s arm. Jake apologized profusely between cursing, threats, and thrashing.

“Why aren’t you in there?” one of the techs asked me with an elbow nudge.

I shrugged. “It’s one in the morning. I’m not fighting anyone. That’s not my fight.” That was my policy. I would protect myself and my crew to the best of my ability, but once I was in the hospital – where they had armed security guards, more staff, and wayyyy better sedation drugs than I did – I was pretty much out.

“I have to PEE!” Jake yelled, restrained to the bed.

“Then pee!” one of the nurses called back, “But you’re not getting out of that bed until you chill out.”

I handed the nurse Jake’s ID and asked him to sign my chart for patient care. “I gotta say,” the nurse said as he signed my tablet, “If you ever feel bad about your own life, just come look around the ER.” I agreed and sleepily said the “see you later’s” to the staff. We knew we’d be back within the hour.

We walked outside and I finished my chart while Kara and Harley cleaned the gurney. I glared up at the moon just outside the ambulance doors.

The moon glowed back, tauntingly. Four more hours.