Everything in One

A little over a year ago I started working as a 911 paramedic in Camden, NJ. As a PA medic, I ventured into “the dark side” with an open mind and ready to see what it was all about. Camden has a reputation.

It is a place we hear rumors about but none can be confirmed. No one outside of Camden really knows anything about what happens on this side of the bridge. Camden looks across the river at Society Hill in Philadelphia. The ultra wealthy and poorer than dirt staring at each other on either sides of the Delaware.

What I found was bittersweet: a silent but exceptionally hard working EMS department, a city packed to the brim with addicts, some truly spectacular local food spots, a dying older generation who carried the city on their backs, excellent pay, the best paramedic partner anyone could ask for, a city without safety, a city caught in between political gains…where no one does checks and balances because, it is indeed, Camden and no one in power of value genuinely cares about this place. It is lawless.

My first call of my last day summed up my experience working in Camden.

37yoF at a bus station going through withdrawal. About 0800.

There were days this summer where all I took were overdoses. 9 dispatches in 12 hours all overdoses. Some go to the hospital. Some tell us to fuck ourselves and walk off. Some don’t wake up.

Pt walks to the truck and sits on the bench seat. It is a cool and dry, sunny morning. My partner and I wait for BLS and plan to kick it to them when they arrive. Pt is diaphoretic, pale, shaking. In disarray but alert and oriented. She has a trash bag of her things with her. All of this is normal for Camden, and for withdrawal. She wants medication for her withdrawal. She states she has a history of endocarditis and has chest pain. She last used around 7p, benzos and heroin.

My partner says “I got it”. We cancel BLS.

We ask for ID and go to start a 12 lead. She says she was drugged, robbed and raped last night.

I tell my partner “I got it” and switch spots with him.

Vitals are what we expect for withdrawal. Radials are strong/ equal/ fast/ regular. Pupils dilated (benzos). No adventitious breath sounds. RR shallow. She is tachy, 120-130. 12 lead is sinus tach. Blood pressure is 140/90 range. Sugar 131. Statting in 90s on room air Lungs clear all fields. Abdomen soft and non tender. Her extremities are covered in sores and bruises- also normal for Camden.

Pt says she has an infection in her genitals from shooting up she would like to have treated.

“At the ED, they will help you with that.”

EMS does not do genitalia unless you’re actively pushing out a baby. We will scream with you in that scenario.

She is cold. Withdrawal is a bitch. We cover her with blankets and strap her in to the stretcher.

We go in route to the hospital. She has no address but is from philly. I ask how she got here and she said:

“Some guys picked me up in a car last night. I didn’t know where they were taking me. Then they drugged, robbed and raped me.”

I looked away. She kept looking at me. She was gauging my reaction. I looked back at her.

She asked “Can I get a room at the hospital?”

I responded “I don’t control that but I will try. Is there a particular reason you want a room?”

She said “if they find me, I’m afraid they will kill me”

I looked away again. Im trying to figure out what to say next.

“I will help you get a room. Do you want to file a report? Do a rape kit? I can have the hospital help you with that.”

She said “No. they will kill me”

She is right. The justice system has failed her. Failed this city. Addiction is married to corruption here. The cops have hands off policies in Camden. They stand by as my co workers get assaulted, that is, if they even show up on scene. They are glorified sheep dogs. Herding the homeless out of camden’s waterfront to make it look safe. This is policy. The politicians policy. Not policing policy. She is right. They couldn’t and wouldn’t protect her. They probably wouldn’t even find the guys. She is another statistic lost in the system that has not yet figured out how to enforce laws in this new landscape of addiction while eliminating the Camden old ways of police brutality from decades prior of painful history. As my partner said “she would be another dead white girl in the river”.

Camden says the crime rate has been dropping.

It does that when citizens don’t report crime because it is safer to stay quiet.

“Do they know where you are now?”

She looked away “no, I don’t think so”

“If you change your mind, let someone know. I am sorry this happened to you”.

We arrive to the ED. I talk to the charge.

Side note- charge nurses are ice cold. They have been dealt every hand. They are the ring master for the circus. They never show emotion. They can put you in your place with a look or a few words. They know their people. They know their medics. Medics, we learn to use our cards wisely. Always respect The Charge.

I pulled my card on this charge. I told her I needed a room, please, a safety concern. The charge stops typing but doesn’t look up from her computer. I have 10 seconds to give report before she decides to make my life a living hell. The charge upon hearing half my report stands up from her throne and walks over to the pt.

“Honey, what hurts? Where did they hurt you?”

The patient looks at me, then back at the charge.

“My bottom”

Charge nurse walks back to her desk without looking at me: “Room 30”.

That in this part of the world, is a W.

She is transferred. Left in a bed. She isn’t my first and won’t be my last.

That wall you as the reader now feel, the “that’s it?” Feeling…

Yes. That is it. Welcome to the job. It is fragments of the full story.

Sit with that.

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Not long after we clear, a dispatch goes out for a retired police officer who shot himself in the head at his old station. He would go every morning and feed the stray cats.

The responding crew said it was a DOA.

“Went in and out.”

They shrugged and headed out to another call as I ate a stale day old bagel left out on the communal table.