Q&A with Kelly Grayson

Excerpt from En Route: A Paramedic's Stories of Life, Death, and Everything In Between

A paramedic in Louisiana and acclaimed writer and blogger, Steven "Kelly" Grayson is garnering strong reviews for his book En Route: A Paramedic's Stories of Life, Death, and Everything In Between, published earlier this year by Kaplan Publishing (www.kaplan.com). In an exclusive interview with EMSResponder, he shares the story behind his stories. Read more at www.kellygrayson.com and http://ambulancedriverfiles.blogspot.com.

How did your writing career get started?

 

I was working nights in a system status management system, and started writing as a way to keep myself from losing my mind. I'd sit in the ambulance when we were posting, and haul out my laptop and just start typing stories about old EMS calls. Pretty soon one story became another, then another, and those would remind me of more. Pretty soon I had 50 pages, and my partner started asking, "What are you writing over there?" I let him read some, and he suggested I should try to do a book. I'd already e-mailed a couple of the stories to a friend, and unbeknownst to me, she'd e-mailed them to Lou Jordan at EMS Books (www.emergencystuff.com). Lou sent me a publishing contract, and next thing you know, I was a published author.

That was the first book (Life, Death, and Everything in Between: A Paramedic's Memoirs). After it'd been out a couple of years, an editor from Kaplan was cruising the Internet and found my blog. He read some stories there, none of which were in the original book, and e-mailed and inquired whether I'd consider a publishing contract. I told him I had a book out, and sent him a copy. They asked if they could republish it, and that's where we are today.

What kind of reactions has it gotten around the EMS world?

 

Nothing but good feedback. People will call me or e-mail me or pull me aside at a conference and say, "You've been in my ambulance! Some of these people you deal with are the same people we deal with!" Everybody has their frequent flyers, their memorable calls. They're all memorable for unique reasons, but it's amazing how similar some people's experiences are.

The other feedback I get is that it's just as raw as an actual career in EMS. There's nothing sugarcoated in it. Lou once said there are so many "Look at me, I'm a hero!" books in the EMS genre, he couldn't stand 'em. And he said this one is anything but "Look at me, I'm a hero!" It paints the ugly part of EMS as well as the good parts, and I make some fun of my own foibles and failures. That's what he liked, and it turns out a lot of people who read it feel the same way.

How long have you been blogging?

 

I started the blog in December 2007, mainly as a way to publicize my book and serve as a trial balloon for new stories, and to kind of hone my writing skills. It's had the desired effect of bringing attention to the book and the book to the attention of a large publisher. And I think since I started the blog, my writing has improved a good deal. Hopefully we'll get enough stories for another book compiled.

What advice would you give others in EMS who feel they have something to say or experiences worth sharing?

 

People worry so much about patient confidentiality, and that is an important concern. But it doesn't take that much effort to obscure the identifying details of a case to satisfy your patient confidentiality laws.

People pay too much attention to the conventions of writing, I think, when what they should do is just tell the story. Telling the story in your own words and finding your own voice ? that was the hardest part for me. I didn't want to sound like every other writer who writes about EMS calls: "So there I was, with a box of 4x4s and a busload of hemophiliacs." I tried to find a style that was unique for me. And it has to be unique for everybody. Bottom line, you've got to tell the story in your own way. And if that means you flaunt some of the conventions of writing, and ignore things like run-on sentences or sentence fragments, or even make up your own words occasionally, if it adds to the story and helps you tell it better, that's what you should do.

 

Excerpt from En Route: A Paramedic's Stories of Life, Death, and Everything In Between

I'm Clear, You're Clear, the Chihuahua Is Clear...

Chapter 2 of En Route: A Paramedic's Stories of Life, Death, and Everything In Between, available from Kaplan Publishing

They say that the measure of a man's intelligence is the degree to which he agrees with you. By that standard, Dr. Mark Brothers and I regarded each other as certified geniuses. Not that we interacted a great deal in the clinical environment; as a lowly EMT-Basic, I simply dropped off my patients at the hospital, bowed respectfully, and backed slowly away from his presence.

But this day was a different story. The all-powerful physician and the lowly EMT were on an even footing, because when it comes to Trivial Pursuit, I bow to no man. I am the King of Obscure and Arcane Facts. Mark Brothers, if not my equal, is at least good enough to sit at my right hand. We had been paired off as partners in a game of Trivial Pursuit, and we were spanking some serious ass. We were humiliating people. For six games straight now, we had run the board, winning with nary a question missed. For the past two games, it had been everybody versus us.

We were hanging out at the Fort Sperry station, celebrating Chennault Ambulance's third month of business, and things were looking good. Call volume was increasing, we'd upgraded our capabilities, and rumor had it that we'd even be getting paychecks any day now. Life was sweet. Since I'd been getting paid in promises, I'd moved into the Fort Sperry station to save money. The only drawback to living there was that I was perpetually on duty. Every morning, I woke up and stumbled to Bob Graham's office and knocked on the door.

"Am I on duty today?" I'd ask, and wait patiently as Bob became lost in thought, shuffling through the duty roster he keeps in his head.

"Yep," he invariably said. "We can use you." I would then obediently trudge to the bathroom, shower, and put on a jumpsuit. But I didn't mind. This stuff was so much fun, I'd have done it for free. (Well, actually, I was doing it for free at the time.)

The emergency line rang, interrupting our game and sparing the rest of the crew further humiliation at the hands of my M.D. partner and me.

"Cardiac arrest at 137 Owl Creek Road," Bob called. "Let's go."

I was Bob's partner. After two months spent as the attendant on most of our calls, our upgrade to EMT-Intermediate service had seen me demoted back to driver. I didn't like it; I was going to start paramedic school in two months, and I needed the patient-care experience.

"I think I'll ride with you on this one," Dr. Brothers mused as we got up from the table.

Oh shit, just what I need.

I said nothing, just sprinted to the rig with Dr. Brothers in tow. On the way to the call, I could hear him curse softly from the back as I made a few hard turns.

"Hang on, Doc!" I called unnecessarily. "Rough road ahead!" In the rearview mirror, I could see him hanging on to the overhead bar for dear life. "Why don't you toss the suction, the jump bag, and the automated external defibrillator on the stretcher?" I called back to him, adding, "and spike a bag of saline, too!" Bob looked over at me and grinned, shaking his head.

At the house, there was a woman doing CPR on a fiftyish man lying on the living room floor. Several other relatives were standing around sobbing quietly, and a hyperactive little Chihuahua was bouncing from the couch to the chair to the floor, yapping excitedly. The woman doing CPR was crying, and there was snot running from her nose, which she absently wiped away as Bob placed the AED on the floor next to the man.

"Ma'am," he asked gently, "what happened?"

The woman didn't answer, but just stared vacantly and cried, wiping her nose with her sleeve. There was a smear of bloody vomit on her lip. Delicately, I moved her to one side and handed her off to Dr. Brothers, who was standing around looking lost.

"Hey, Doc," I suggested, "why don't you find out what happened, and have someone gather up his medications? Hand me the suction before you go." Dr. Brothers hurriedly handed me the suction unit and escorted the woman into the other room, talking quietly to her. The Chihuahua snapped at my hand as I suctioned the vomitus from the man's mouth and Bob attached the AED pads. I swatted impatiently at the dog, who returned the favor by snapping at me again and growling ferociously.

"Uh, can one of you corral the dog?" I asked pointedly at the group of relatives standing nearby. A young woman, perhaps the victim's daughter, snapped out of her reverie.

"Sweetie! Stop that! Stop it this instant!" she scolded, snapping her fingers. "He's really a sweet puppy," she apologized.

Sure, he is, lady. Why is it that every psychotic little ankle-biter has a name like Sweetie or Sugarpuss, instead of something that fits, like Tasmanian Devil or Charles Manson?

For his part, Sweetie ignored her, jumping from the couch to his master's chest and back. Irritated, I batted the dog off the man's chest as I began chest compressions. I hit him a little harder than I intended, sending him somersaulting across the rug all the way to the fireplace. Sweetie bounced back up like nothing had happened, and contented himself with jumping back and forth from the couch to my back, nipping at my hair and shirt collar with each circuit.

"Sweetie!" the woman cried, anguished. "Please leave the nice man alone!"

I ignored them both, moving up to the man's head to ventilate as Bob pressed the analyze button on the AED.

"Shock indicated!" the AED announced.

"Everybody clear!" Bob shouted, looking at the AED and pressing the shock button?just as Sweetie completed another pinball circuit, landing squarely on his master's chest, right between the AED pads.

"Pop!" went the AED, accompanied by an agonized yelp and the stench of burning dog hair. Sweetie ricocheted across the couch and retreated for safer parts, yelping piteously all the while.

"What was that?" Bob asked, turning back to the patient with a frightened expression.

"If the dog wasn't in V-fib, he probably is now," I commented drily. "Apparently, 'clear' is not a command in his vocabulary."

The AED interrupted any further conversation by reminding us in its telephone-operator voice that the patient was still in V-fib and one of us should press the shock button. Bob just shook his head wonderingly and, looking at the patient this time, pressed the button again.

"Kachunk!" The defibrillator discharged, causing the man to arch his back in a prolonged spasm. Within a few moments, the man coughed and started breathing raggedly. Bob and I shared a triumphant look.

"No shock advised," the AED told us unnecessarily. "It is safe to touch the patient. Check breathing. Check pulse. If no pulse?"

There was no need to check breathing or pulse, or begin CPR, as the AED politely suggested. Dead people do not vomit and roll their eyes wildly. I quickly stuck the suction catheter in his mouth to clear his airway. Soon, the man was breathing better, but still coughing and retching. I switched the oxygen tank to a non-rebreather mask and placed it over his face.

"What happened to the dog?" Dr. Brothers asked as he escorted the patient's wife back into the room. "He came through here like his tail was on fire or something..." He trailed off as he saw our patient.

"Ma'am?" He nudged the woman, who looked up, startled. He just smiled, gesturing toward her husband. She gasped and kneeled at his side, sobbing again, but in a different way than before. The man said nothing, just closed his eyes and squeezed her hand as he coughed and sucked deep, shuddering breaths of pure oxygen. I took a little time gathering up our equipment. The woman continued to hold her husband's hand all the way to the ambulance, disengaging only briefly as we loaded him onto the stretcher.

Since Dr. Brothers was with us, Bob let me ride in the back on the way to the hospital. Dr. Brothers had a bit of trouble getting an IV. "Goddamn! Can you ask Bob to take it easy for the next couple of minutes?" he asked, frustrated. There was sweat dripping from his nose as he made his second stick at a vein.

"He is taking it easy," I told him. The ambulance was barely moving forty miles an hour, and I could see Bob's eyes in the rearview mirror, watching Dr. Brothers as he made his second, successful attempt. "Besides, we'll be at the hospital in two minutes."

Dr. Brothers had his eyes closed, concentrating as he auscultated heart and breath sounds. "Shit," he muttered disgustedly. "I can barely hear. Lungs sound clear, I guess. He may have a systolic murmur."

"They call it 'diesel engine,' Doc," I told him wryly. "Now you know why we palpate so many blood pressures."

"This machine doesn't even have a printer or a screen!" Dr. Brothers complained. "We need a real cardiac monitor, and some lidocaine, and maybe some dopamine..." He looked around in frustration for a drug box that wasn't there.

"We're not a paramedic service yet," I reminded him. "But the AED does have some interesting features. For instance, it has a voice recorder that activates when you turn the unit on. Where do you think we get the tapes you review?"

"You mean that?" Dr. Brothers asked, looking suspiciously at the AED.

"Yep," I confirmed with an evil grin, "everything is recorded for posterity, including Sweetie's electrocution."

"Good Lord," he breathed. "Well, at least no one will hear it but me."

"Well, we could make copies of the tapes before you get them," I mused. "Purely for record-keeping purposes of course."

"You do that," he threatened with a grin, "and I'll withdraw my recommendation for paramedic school."

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