Win Some, Lose Some

South Beach is where the town started. The years went by, the wars, the inventions. Progress marched away to the north. Hotels became bigger and more lavish. Mansions were constructed. Islands were dredged out of Biscayne Bay. Causeways. Throughways. Motels. Traffic. The Fontainebleau. Eden Roc. Gradually, South Beach became old-fashioned, then marginal, and finally a slum.

Below Lincoln Road it is all stucco and tile roofs and Mediterranean styles. Or it is flat roofs and cubistic balconies in the style that couldn't possibly be called anything but "moderne." It is all lime green and sun-bleached pink and turquoise and washed-out blue, the apartment houses with names like Aloha, Parkedge, Elaine, Jem Arms, Avon House and Esplanade.

An old woman is in a wheelchair being pushed up the sidewalk by a young black girl. She holds a cigarette in her upraised fingers as though shushing for silence, her head turned at an angle, smiling and listening very carefully. But is it the wind rustling through the palms? Or is she listening to the blare of radios, the jets overhead, the neighbors sitting on the front porches fenced in by slats of jalousie windows? Or are they still other voices, inflected with hard accents, softened by the humid air and the shadows, by time and (continued on page 146)Win Some, Lose Some(continued from page 143) memory, still explaining how hard it; all is, how crooked it all is, how impossible to make sense, to make justice, to make a dollar?

Another woman is carrying a shopping bag emblazoned with the word—and with a map of—Florida. She is wearing a leopardskin-fabric jacket. She has a leopard-pattern scarf. Her feet shuffle on the sidewalk. She wears sunglasses. She has no hips at all and her stockings hang shapelessly on her thin, straight calves. As she passes a large hibiscus bush, a cat jumps out. She stops and turns and begins talking to it.

• • •

Between runs, you stood by at the station. Television sets were going. Telephones rang. Metal lockers opened and banged. Showers hissed. Industrious things were going on in the kitchen. Guys were coming upstairs from the volleyball court. The regular firemen were dressed in gray. Next to beds, lockers, desks or polished-brass poles were their boots with their empty bunker pants carefully rolled down over the tops. Standing guard, those boots were ready. All the men had to do was shove their feet inside, reach down, yank up their pants and run.

But the others were wearing sky-blue jump suits with short black-leather boots. On their backs it said Fire Rescue.

And it was between runs when I heard about the gory ones, the weird ones, those cases that went beyond the ordinary stroke and heart attack and pulmonary pneumonia and traffic injuries. Like the old man who had been hit by a car while crossing the street. He had been wiped over the asphalt, leaving a painted streak of gore and blood that ended in a tangled heap of scattered brain and smashed arms and legs. The car didn't even stop. Or the guy who went off the roof of a condominium and landed in a soft flower bed, half-burying himself in the ground. Or the old lady who had carefully climbed a ladder into a tree. It was late at night. Methodically, she broke away the twigs and small branches that got in her way. Then, very carefully, she hung herself. The caretaker found her in the morning, wearing pajamas and a full-length mink coat, her eyes open, her tongue swollen and protruding and coated with a swarm of flies. At first he thought it was a scarecrow of some kind.

The tanned, athletic young guy was slumped in a chair, his legs straight out, Ins eyes flickering back to the television set and away again as he told me about the man who did a dive off the roof of a two-story building to land square on his head on the sidewalk. It split open like a rotten fruit, splattering its juices. I asked whose job it was to clean up the mess. The question had never come up. His partner wandered in, picking his teeth. He didn't know, either. The sanitation department, maybe. The fire department gets called out to hose down the street after a bad car accident to wash away the gas and oil. But not blood. Any way. He shrugged. The ants would clean it up fast enough.

The doctor told me about one bizarre run they had recently made. They found an 85-year-old man dead on arrival. He had been married four months. His wife was 75. But a friend had made the call to Rescue and had cleaned things up by the time they got there. He told them what had happened. The old man was giving it to his wife with a vibrator. But the excitement was too much and his heart failed. He died with the dildo clutched in his hand, still turned on.

A very young, good-looking fireman didn't ride rescue anymore. He had become very depressed by the thousands of ailing, crippled, impoverished people who live in Zone One, the South Beach area where the average age is over 65. He had been shocked at the incidence of theft from the ill, the injured and the dead. As they would carry them off on stretchers, eager volunteers would always hobble up to "take care of" their rings and watches. But during one run, the good-looking kid discovered their $900 two-way radio was missing. Evidently thinking it was a portable transistor, an 80-year-old woman was running with it through the yard and into an alley. He chased her around the building, into and out of her apartment and through the hallway. The radio was still giving coded emergency messages as the wiry, stringy old lady tenaciously scurried away. By the time he caught up with her and pried the radio out of her fingers, he was cursing and screaming. After a year of it, he had to quit and go back to regular duty.

There was an old registered nurse who habitually called the emergency medical service and then demanded they take her blood pressure. Another regular with chronic pains in her chest finally admitted she liked to hear the sirens. They cured her by arriving silently when they next responded to her calls. One woman was so fat she had to use a walker to move around. Her daughter weighed about 200. She called the firemen to pick her mother up to put her on the toilet. When one of them made a remark about losing weight, she wrote a nasty letter to city hall. A woman fainted in front of McDonald's hamburger stand. Her pulse was 130. She was 74. The rescue men revived her and told her to go to a hospital right away. She refused. An hour later they made another run. It was the same woman. She was dead when they arrived. They call it a signal 45.

Another woman told the arriving rescue team that she needed an enema. But she had the wrong guy. His nickname was the Animal, a Neanderthal red-neck whose constant urge is to paint a Star of David on the side of the van every time they pick up a dead Jew. The Animal growled at her:

"The only way you'll get an enema out of me, lady, is if my toe squirts water when I kick you in the ass."

• • •

Eleventh Street and Jefferson. Station One. The team had already made 11 runs in the eight hours it had been on duty. I looked over the reports.

"Subject complained of being unable to move her bowels." She was 72. "Subject complained of being nauseated. Age 80." "Subject was sleeping. Roommate said she complained of colon trouble. Age 93." "Subject was lying on floor. Small cut on foot from broken glass tabletop. Belts tied together. Apparent suicide attempt. Moaning and screaming. Had apparently slipped out of noose. Age 74." "Blood pressure 210/100. Abdominal pain. Age 81." "Subject complained of pain in her chest. Age 78." "Subject took sleeping-pill and didn't know it. Couldn't stay awake. Had thimble still on her finger as sleeping."

Dr. Gasteazoro was from Honduras. He was intelligent and charming and liked to talk. He had a private practice in Miami Beach but was trying to cut down his number of patients. He wasn't getting enough sleep. Frank was a former lifeguard, tall and muscular, his hair long, his mustache in the same fierce, medieval style as his northern Italian ancestors. Ray was quiet and unflappable. He was 6'5", his hair and mustache both conservative. He was also a commercial fisherman and scuba diver. He and Frank went diving for crayfish together on their days off. As we stood around in the dayroom, the doctor smoked a small cigar and described a woman patient he once had who was worried about her ailment's interfering with her sex life. It turned out she had sex every day. She was 75. She wouldn't tell the doctor what her outlets were but insisted she got what she needed. Most women that age are incapable of sex. The vagina atrophies. The lubrication glands dry up. The reproductive organs shrivel and die.

7:01p.m. Buzzer and bell. Voice on the P. A. "350 Ocean Drive. Lord Balfour Hotel. Possible heart attack." Frank muttered as we went outside to the van:

"That's the second time today. Same address."

We arrived in a little over one minute. A small, thin Jewish man sat on a sofa in the lobby, a single crutch by his side. He was in pain, his breathing shallow. He was 72. Frank got the stretcher as Ray took his blood pressure. 120/70. Very good. But his neck veins were engorged. It still looked like a cardiac. The man moaned. He didn't want to go to the hospital.

(continued on page 158)Win Some, Lose Some(continued from page 146)

"I just came back from there."

Very quietly, the doctor spoke to him:

"It you don't go to the hospital, you're going to die. I can't tell you any plainer than that."

It took the help of another old man to finish the persuasion. With great reluctance, he got onto the stretcher and allowed himself to be strapped in with his crutch and covered with a blanket. With lights and siren, we went to the South Shore Hospital, arriving nine minutes after getting the call. The man moaned and gasped, struggling when the doctor tried to give him an injection.

As he was wheeled into the emergency room, he complained of sweating, although he wasn't. He was terrified and started to vomit, moaning as an I. V. needle was inserted, "You're breaking my arm." His clothes were removed. They prepared him for an E. K. G., took a blood sample and gave him five milligrams of morphine. He grew pale and suddenly calm, accepting the ministrations of the intern, a Cuban nurse and a Chinese doctor. His heartbeat was shown on the monitor. You could see the P. V. C. s, the premature ventricular contractions. If these misfires should happen to fall on top of a T wave, it could cause a fibrillation. This is a major backfiring of the heart. It becomes confused and disorganized. Instead of beating, it lies dormant, quivering. Unless it can be set in motion again, the patient dies.

Dr. Gasteazoro was still smoking his cigar, neat, dapper, one hand in the pocket of his long white coat. He told me that 70 percent of heart deaths occur in the first hour.

At 7:30, Rescue One left the E. R. They went upstairs to the intensive-care unit to visit a man they had picked up on their last shift, three days before. But he was sleeping under heavy sedation, wearing an oxygen mask. He was 75 and looked terrible. But Frank was very proud of him. When they got the call, he was already "dead" from a cardiac arrest and they had nearly given him up. They had even broken three ribs while giving him heart massage. At 7:35 we were 0-9, back in service.

But instead of returning to quarters, Rescue One stopped off at the Causeway Marina to visit with some old fishing buddies who sat at a table on the dock by the bay, drinking booze and telling stories. At 8:13, an amiable drunk was telling us about his World War Two flying days and the incident of the frozen parachute. The radio crackled. "Woman down." We arrived in a few minutes. A woman had stumbled on the sidewalk, had fallen into a hedge and couldn't get up. She had been there a half hour. People were watching from windows, from the patios of rooming houses and residential hotels, finally, someone called. The victim had heard a woman on the sidewalk saying:

"Morris. Leave her alone. Don't get involved."

There was no apparent problem. She was a little confused. She probably suffered from a vascular in sufficiency, the general debility and senility of old age. She wouldn't say how old she was but surely was well into her 70s. Rescue One gave her a lift. As soon as she sat in the van, she wiggled her hips, squirming against the doctor.

"Ohhhh. You like to play. I like to play, too. All these handsome men. They could give me just what I need."

It was an unusually quiet night. Melvyn Douglas was starring in Ghost Story on TV. He was a warlock who contrived the death of an old family domestic. The firemen, the doctor and the paramedics were all engrossed. Over the radio in the next room, you could hear a message to another unit, "Man passed out——" the rest of the words overwhelmed by the eerie, dramatic theme music. At ten o'clock we watched Banyon, a private eye in 1937 who attended a dance marathon with a girlfriend who was suddenly stricken with amazement. In the crowd she saw a friend who had died the year before.

At 10:30 we made a run to 1535 Jefferson. A 77-year-old man had a "pain in the stomach." We arrived in two minutes. The man was unable to get his own doctor, the telephone service not answering. The pain was in the gall-bladder area. He had had previous heart attacks and had already taken two nitroglycerins. Frank radioed for an ambulance on a three as Ray took the man's blood pressure. The doctor was irritated. It was difficult to determine whether or not the man had ever had gall-bladder trouble before. There was a collection of pills on the table. When Frank asked for his next of kin, he got a wise-guy answer and then "None." Then he tried to change it, but Frank refused to make a change. They began to exchange gentle threats and insults interrupted by Ray and Frank's admiration of a left-handed fishing reel on the kitchen table.

"You like it? Keep it."

"Are you serious?"

"Yeah. Sure."

The ambulance arrived. Very cheerfully, the man got onto the stretcher. They wheeled him out. At 10:45 we were watching the rest of Banyon and then the news.

It was quiet for nearly two hours. I talked with the fire lieutenant, a tough, scarred old-timer who was very proud of his engines and ladder, which included a beautiful 1943 Pirsch as well as newer pieces, such as a big, gleaming American La France. It was hot outside, with the mugginess of the tail end of the hurricane season. Station One was directly under the take-off pattern of the Miami airport, the jets thundering upward to pass over our heads and out to sea to make their turns and set their courses north. The streets were quiet. Nothing moved.

12:51. "Royal Hotel. 758 Washington Avenue. Woman with a broken arm." Rescue One was asleep. Within seconds, the men were out of their bunks, into their boots and in the van. In the lobby of the hotel, a drunken woman was sitting on the floor amid the scattered debris of an ashtray. One arm was in an Ace bandage, a loose, dirty sling dangling around her neck. She was crying in a slurred, maudlin manner:

"I'm a tough GI."

Another woman puffed nervously on a cigarette, her breath smelling of alcohol. She kept insisting the drunk's shoulder was "broken in two places." Helped to her feet, the subject refused to sit in a chair and submit to an examination. She staggered in a small, helpless circle, complaining that her arm hurt. Persuaded to sit down, she got up again, insisting on going upstairs. Ray and Frank took her up in the tiny elevator. The doctor remained in the lobby. Ray was quiet and patient. Frank argued and taunted her.

"I was in the Third Air Force and I'm pretty rough."

"Yeah. Sure. What are you? Irish?"

"I'm French and German. And I'm a nurse, too."

She staggered around in the hall, refusing to go into her room. Ray finally persuaded her. As she unlocked the door, she turned coy.

"Please excuse me. My room is a mess."

Ray got her to lie down as Frank stayed out in the hall and laughed at her. They closed the door and left. Down in the lobby, the other woman had been joined by a third. They smoked rapidly, muttering, "She won't stay." Frank growled on the way out:

"Next time, don't call us. Call the cops."

There were no more runs that night, but I couldn't sleep. I kept thinking of the passengers in those jets flying overhead and of how Ray and Frank once responded to a call "Car in the water." They had donned their scuba gear and gone into the water instantly, going down, finding no one inside, searching the nearby bottom. Then they found out the car had already been reported and checked earlier that morning.

• • •

The next team was quiet and talked very little. The doctor's name was Benco-rao. But one of the rescue men was a licensed practical nurse who worked at Mt. Sinai Hospital on his days off. He was always referred to as the Doctor.

My first run with them was at 3:26, "Woman limp and unresponsive." But it was really a signal 35. She was drunk. At 4:20 we went to 950 Pennsylvania Avenue, "Woman down on floor, people can't get in." As we parked, two old ladies walked by on the sidewalk. One of them was saying:

"She's gone with the wind. She's dead as a doornail. How they gonna get in?"

Inside the building, an old woman was crying. They hadn't seen her all day. We would have to break down die door. But the doors were double and although both were flimsy, there were no tools. A city policeman stood by. The maintenance man came up with a cheap screwdriver. He tried to pry open the outer door, but the screwdriver bent in the middle. With his pliers, he removed the pin from the top hinge but couldn't get the bottom one out. Several men took turns kicking at the doors. The locks finally gave.

The woman was in the kitchen, slumped down in a corner. She was still breathing. When they dragged her out into the middle of the floor, she moved, ever so slightly. The doctor said: "Stroke." They gave her oxygen and called an ambulance on a three. She breathed more deeply. Her face became bright red. She began to quiver, her left leg and foot shaking. The driver showed Dr. Bencomo a can of dietetic salmon. Perhaps she was a diabetic. Her blood pressure was 130/70. Pulse 76. She was breathing well, her life signs good. The driver found two pill bottles. They were for high blood pressure.

Someone went to find the manager to be a witness to the door damage. The old woman who had been crying then discovered she had a spare key to the room. She was upset she hadn't thought about it. The ambulance arrived with the same attendants who had made the last run. Rescue One went to a municipal garage and tanked up with gas. Dr. Bencomo said the woman might or might not recover. There was no way to predict when she would regain consciousness—if ever. And there was no way of predicting the extent of the permanent brain damage.

Back in quarters. The whole run took a half hour. I started reading a book in the dayroom. It was about the positive and negative impulses of the heart, about P waves and R waves and T waves, about Q. R. S. cycles, arrhythmia and atrial fibrillation.

"1051 Collins—a sick man." One of the beach-front hotels. Arrive in two minutes. Up the stairs. A mezuzah fastened to the door with electrician's tape. You could smell the Jewish cooking. The man was dizzy. He had seen a doctor that very day who had given him some pills. He had not eaten. But he had vomited. His wife was crying. He was fat and he was 90 years old. On a bureau was a recent photograph of a beautiful boy and girl. There were other pictures of children and grandchildren. The Doctor radioed for an ambulance on a four. Dr. Bencomo asked for all his pills and medications and then canceled the ambulance. Rescue One would transport the patient. His blood pressure was very low.

There were plastic flowers standing in vases on a bureau and on the window sill. There were some cornball reproductions of paintings on the wall, a Jewish calendar and a photo of a very young man with a handlebar mustache standing in an ancient uniform. It was the subject as an officer in the Romanian army ten years or so before World War One.

At 5:27 a woman lay on her couch with chest pains. Her husband had broken a leg a few weeks before. He had a cast and a cane. He was a little nervous but not much, saying nothing at all to his wife. Two women neighbors came in. awed and very worried. The subject was 70. She was given oxygen and an injection. She moaned that she felt much better. There were amateur paintings on the walls, plastic flowers, a TV set, gewgaws, pictures of young children, old photographs of the husband and wife. Again, the same ambulance team showed up. Rescue One disconnected its oxygen and packed up. The Doctor said:

"Momma. Next time you shouldn't wait so long."

Back to the station, the dayroom, the book. I read about wandering pacemakers, extra beats and skips, rates, infarctions, bradycardia, P. V. C. s. sinus arrest (The radio was saying: "Rescue Three—behind hotel—man in the water calling for help"), atrial flutter, Wencke-bach phenomenon——

5:49. The phone rang. We were cleared for a 12. We went to the Turf Pub for dinner. Everyone was depressed and quiet. There was no conversation. The radio stood between a soup bowl, a bread basket and a butter dish, hoarsely prattling something about Engine Three and about a boat in distress. We returned to the station and watched Zulu on TV.

7:36. "900 West Avenue. Apartment 833. Man having a heart attack." On the way over, the motor stalled. It took several tries to get it started again. High-rise apartment. Elevator. Man on sofa, mouth open, sweating, felt cold, age 74, white hair, listless, very dizzy, no longer had original pains in chest, had fallen down several times last week. Blood pressure 110/70. The furniture was Sears/fancy. "The subject was given oxygen."

"I don't want to go to the hospital."

"Sam—why take a chance? I don't think I could take it again, Sam. Please."

"I don't wanna go. I'm tired. I wanna go to bed."

"But that's what's wrong with you."

An ambulance was called. An E. K. G. was taken in an effort to convince the patient of the emergency. Outside in the bay, a large sight-seeing boat was going by. Group singing could be heard approaching over the water, the toot of a whistle, the ring of a bell, a cheerful tour-guide voice over a P. A. system, "Hello, dere!" Applause. Whistles. Cheers. A crowd of elderly people stood on the patio by the pool, laughing and yelling back at the boat. The Miami skyline was visible through the apartment window as Rescue One fastened the straps over the dabs of paste. The subject's wife called the answering service and asked to speak to their doctor. The E. K. G. was normal. But this could still be a case of serious insufficiency.

"Oh, gee. They never do anything at night. I've been there—so many times."

The subject moaned, tired, frustrated, hopeless. But when the ambulance men arrived, he agreed to go.

Back at the station, the British soldiers were still firing at the Zulu warriors.

8:08. False alarm. Headquarters pushed the wrong button. Rescue Three was wanted. A bus driver had been beaten up and robbed.

8:20. "825 Washington Avenue. Apartment 218. Clinton Hotel. Man fell down and couldn't get up." A crowd of old people were gathered around the TV in the lobby watching All in the Family. Archie Bunker was sounding off as we squeezed into the elevator. It was a cramped, ratty apartment. There were two narrow beds. The man was lying on his back on the bathroom floor. The woman was small, old, weak and nervous. The rescue men picked up the patient and put him back in bed. He was 82. He used a walker, but sometimes he could stand up by himself. He was completely bald, his voice very weak and hoarse. His wife didn't understand the question when the Doctor asked for the name until he said:

"Vas iz de Namen?"

8:32. The Zulus were making their final charge on the fort. Fire swept through the barracks. There were spears, rifles, war chants, death. The dayroom was crowded with watching firemen.

10:27. A Cuban woman called the police to report a burglary. When the detective arrived, the found her passed out and called Fire Rescue. Dr. Bencomo talked to her in Spanish. He patted her face. They took her blood pressure. A younger sister said she had a history of heart trouble. There was little response and then a moan. She woke up, crying and gasping, very short of breath and unable to talk. The detective began to dust various objects for fingerprints, using a very fine brush and powder, working with methodical, slow concentration. There was a Catholic icon on the wall, a statuette of the Madonna, the red/white flashier reflecting on its features through the open door.

"The woman gasped and choked and then suddenly rolled over in another dead faint. An ambulance was called on a three. Her brother came home from work, his face, hands and arms streaked with grime. He was cool. Earlier in the evening, he had seen three suspicious guys in front of the house and followed them up to 20th Street. He had their tag number and gave it to the cops. He had been suspicious because their apartment had been robbed three weeks earlier.

The woman recovered consciousness and began crying. The ambulance arrived. Rescue One went back to the station to watch the late news. Three black extremists had hijacked a jet and demanded $10,000,000 ransom for the return of their hostages. The FBI had shot out the plane's tires as it took off from Orlando. The plane was then circling Key Biscayne, just a few miles away from Miami Beach. The hijackers demanded to speak to President Nixon over the radio. He refused.

• • •

Monday. Ray and Frank and Dr. Gas-teazoro were back on duty. They got a call for a "woman sick." But her doctor had told her relative to get an ambulance and send her to Mt. Sinai. The relative thought you first had to call Fire Rescue to get an ambulance.

Back at Station One, I talked to the Philosopher, a well-read, thoughtful fireman who had ridden rescue in 1966 when it started. He told the story of the great showboat act he had once put on when he found a dead man on a bus right in front of city hall. He was good and dead. But the Philosopher went through the whole number, mouth-to-mouth resuscitation, heart massage, blood pressure, pulse. A doctor arrived from somewhere, took one look, gave the Philosopher a certain smile and joined the act. There was a large crowd. Rescue was a new concept then and everyone was conscious of the public image. It was true street theater. The doctor gave an I. M. injection, I. V. solutions and listened with his stethoscope. But there was nothing to hear except the moans and mutters of the sidewalk audience.

The Philosopher also told several stories of finding bodies in locked apartments; they had been dead for days. You could always recognize that smell even as you were going up the stairs. Once they had a new man. They had just finished a big spaghetti dinner. Catching that familiar odor, they talked him into going up to check out the problem, laughing hysterically when he threw up all over the hall.

Rescue One got restless and went for a ride. We went to the beach at the jetty and checked out the girls and then down to the chamber of commerce fishing docks. Ray carried the radio in the back pocket of his coveralls.

There was a call to treat an epileptic at the city jail. We went in through the back door, but no guards were around. Everyone was confused. It seemed the prisoner was a habitual drunk, one of those revolving-door cases. They only wanted an ambulance, but everybody thought it was necessary to call Rescue first. Ray and Frank went to the front desk to get the matter settled once and for all. But there was a hassle, a buck-passing contest, and finally we went to lunch at a sandwich shop.

At 4:58 there was a possible stroke. The man was 86, his mouth was quivering, he was unable to talk, there was a wet cloth on his forehead, his right facial muscles were twitching. It was motor aphasia. The man wanted to talk but couldn't. He had paresis of the right side. His wife was quite deaf. She fumbled through a pack of doctors' business cards. A neighbor was running the show, yelling at her, giving instructions, two other neighbors joining the chorus, trying to make the woman understand about getting his Medicare number. The radio was saying something about Engine One and a stuck elevator. There were porcelain gewgaws everywhere, cheap furniture, doilies on the arms and back of the sofa, plastic flowers and two very large framed portraits of the man and the woman in dignified poses, rendered in oils in 1929.

At 5:50 we were at the Causeway Marina. There was wine, jokes, laughter, fishing stories, handshakes. A call came in. "Lincoln Road and Pennsylvania. Alan down." We found him lying in a flower bed on the mall. A police car was there, a crowd of young Cubans. The man was hemorrhaging at the mouth. Witnesses said the had a cramp in his leg, sat down and started quivering. He wore a hearing aid. His mouth kept moving, but he was unconscious. Rescue One put him on a stretcher, gave him oxygen and transported him to South Shore Hospital. At the E. R. he was hooked up to the E. K. G. monitor, which showed some P. V. C. s and some arrhythmia. His pressure was good. His tongue had been bitten. This meant possible convulsions, perhaps epilepsy. The subject was cath-eterized. An I. V. was started. He was given several shots. Two doctors at once listened with stethoscopes. Nobody knew his name and they went through his wallet looking for I. D. The man started to struggle. He had to be held down to get a needle into his vein.

In the next bed, a man was calmly eating from a tray. Frank recognized him. They had made several runs for him in the past. He suffered from emphysema.

Two ambulance drivers came in and started joking around with Ray and Frank. We left at 6:10 and went back to the Causeway Marina.

6:25. 1000 West Avenue. It was a very fancy apartment house, the lobby floors of white marble, bas-reliefs on the walls. Inside the apartment, a woman was sitting on the sofa. There was a moment of confusion. The older woman at the door just looked at us.

"I didn't think there would be so many of you."

"Where's the patient? What's the trouble?"

"She's sick. You know what I mean?"

And then the woman on the sofa started screaming:

"No! No!"

"I called her doctor and he said to get an ambulance. Why are there so many? Four men? There used to be two. I know. My brother-in-law lives upstairs and he's a regular customer. Is this the usual thing to have so many? This will upset her. Oh, doctor. What do you think I should do?"

"Madam. I am not a psychiatrist. I can only suggest you do as her doctor ordered."

"Oh. What can I do? I'm all alone. There's nobody to tell me what to do."

The mother paced very rapidly and "very nervously, her fingers at her mouth twitching, folding and unfolding. Her daughter was 38, her face in a grimace of frustration and anxiety. She watched her mother. Curious but cringing, she looked at the four of us, three with mustaches and tans, hair and muscle, all six feet and over, the fourth one wearing a long white coat.

"No! No! Nooooooo!"

"Oh. I'm all alone. Look. Supper all ready. And she didn't eat a morsel."

"No!"

The mother clutched at her daughter's shoulder, yelling into her face:

"What's wrong with you? How do you feel?"

The daughter ran into the other room. Dr. Gasteazoro stayed, smoking his cigar. Ray radioed for an ambulance. Frank pleaded with them to let him handle it. He knew he was good at this. He had experience. He had the feel for it. We waited. Frank's voice was murmuring quietly in the other room, rapidly, comforting, soothing. The woman's mother kept trying to interfere. Ray kept trying to convince her to stay out.

"What's he doing to her? That's all I want to know. Is he giving her medicine or what? An injection? She was all right until so many of you came in. She's afraid of crowds. There used to be only two. Wasn't there only two? Oh. What shall I do? I'm all alone."

The ambulance men arrived with a stretcher. Frank brought the woman out, murmuring to her softly, his arm loosely and gently around her shoulders. She was sobbing and shaking, frightened of the six men who now surrounded her, one of them holding a black, secret radio, another writing things down on a big clipboard.

As Rescue One walked out of the lobby, an old woman approached, smiling with the assurance that it was obviously not her number that was up.

"What? You're leaving with no patient? That's good, huh?"

Just as we pulled away, we got another call. 1498 Jefferson, a cheaper but brand new building. The man was 54. He was half-bald, quite fat, with no muscles of any kind. He suffered from chronic emphysema, but this was his worst attack. He was clammy and cold and had already used his own oxygen twice that day. But then his foot turned blue and he got a pain around his heart. The television was on as he and his wife gave the doctor his medical history. The room was immaculate, thoroughly air conditioned, the furniture cheap/new and all neutral tans and whites. The wife noticed the TV and turned it off.

The elevator was too small for a stretcher. The patient sat on a chair with his arms crossed over his chest, trembling and weak and very frightened. Frank grabbed the legs and Ray held the back, carrying the man out. Outside the apartment, a woman of about 90 passed in the hall.

"What's going on in there?"

Dr. Gasteazoro replied:

"Lady, that's none of your business."

"Oh. So you're a nasty son of a bitch, hull?"

It was difficult getting everyone inside the elevator. And then the patient's face turned blue. The oxygen carrying case had to be opened, the mask pulled out and applied, the valve turned on. The elevator was stopped at another floor, the door opening, an old woman very upset at the scene inside. Getting out was even more complicated, the door opening and closing and banging against shoulders and legs. The stretcher was taken out of the van, the patient shifted, the chair returned. As the van pulled away with its light flashing and the siren yelping, a terrified cat ran in front of it and was almost killed.

At the emergency room, the man from the flower bed was stabilized and comfortable. He could talk, complaining of being cold even though he was under a thick blanket. The emphysema patient was given shots and oxygen and I. V. s. A needle was stuck into his groin to draw blood from the femoral vein to test for gas content.

Rescue One left at 7:05. In 20 minutes we made another run to 1500 Bay Road, the Morton Towers. There were trickling garden pools, a huge lobby, a milling crowd of people gawking and clucking. The apartment was quite large. Six elderly, well-dressed people had been spending the evening watching TV after dinner when suddenly one of them started to stare blankly. He was fully conscious but didn't talk or respond or move. He was 83. Blood pressure 190/105. "The doctor picked up the man's left arm and let it go. It fell slowly. The right arm fell hard. Occasionally, the man stopped breathing. In a moment, he resumed. It was the Cheyne-Stokes syndrome. The doctor muttered: "Right paresis."

Three more elderly people came in, cautious, quiet, in awe. The man's wife was dead. His sister was his nex of kin. The ambulance crew arrived, the same ones who had just returned from Jackson Memorial Hospital, where they had taken the psychotic woman. There were many jokes and wisecracks. Leisurely, they moved the stroke victim to the stretcher, pausing to talk with the rescue men, laughing about that kookie mother who had given them a bad time all the way to Miami. Besides. That girl didn't need a psychiatrist. All she needed was a hot beef injection.

At 8:57 we were eating dinner, a very special dinner, a paella made of chicken and rice that Rescue One had bought that afternoon at Publix, but also of clams and fish and lobsters that Ray and Frank had caught themselves while on a diving trip. We were eating it up, gingerly, waiting for it to cool, shooting the bull with a fire captain and a lieutenant and the Philosopher about the Russian bottled-gas deal and about Wankel rotary engines and about some of the famous rescue runs of the past. And then came the buzzer, the bell and the P. A. system. "1423 Collins. Woman fell out of bed. Fainted. Husband and manager put back in bed. Bleeding." We ran through the kitchen and down the hall, following each other down the brass sliding pole.

We arrived. The lobby was full of old people, all watching the same TV program. The elevator was tiny. The woman upstairs was in bed, moaning with small animal sounds of distress. Her face was a bright blue and she was given forced oxygen immediately. Her husband was a small man, very nervous, sweating, frightened. He kept asking if he should close the window until Dr. Gasteazoro said yes, sure. Go ahead and close the window. They would have to carry her down on a chair. Thrashing and yet limp, they laid her on the floor and then got a hard chair under her, keeping the oxygen on her face. But the elevator was so small everyone wouldn't fit in. The husband, the doctor and I ran down the stairs, carrying the oxygen. The woman was moaning: "Momma-Momma-Momma-Momma," as she was carried through the lobby, the old, wrinkled faces with the white hair and the suntans turning away from the TV set to stare with stunned expressions.

Rescue One moved very fast. She was strapped to the stretcher, lifted in and locked in place. Her husband got in the back with her. Ordinarily, relatives ride in front so they can't see what is happening and won't interfere. The red/white flashed. The siren yelped and wailed. The husband was very agitated, almost sobbing, trying to touch her arm, to stroke her face: "Rose. Rose. I'm here." He repeated the story of his wife's fall and nosebleed and the scratch on her leg. She was 68. Or 65. He wasn't sure. They had just come down from New York.

South Shore Hospital. Push through the double doors and roll down the corridor and into the E. R. The husband was told to stay outside. The woman moaned for her mother. Again she turned cyanotic blue. She was put in bed, her nightgown cut away with scissors. She was given oxygen. She had no pulse. The P. A. system called for the respiratory therapist. But he wasn't available. Neither were the emergency-room doctors. There were two cardiac arrests at the same time occurring somewhere upstairs. Dr. Gasteazoro lent a hand during the emergency.

In the next bed, the old man with the stroke, our previous run, was looking around, conscious but not moving, a neurologist poking his hand with a pair of scissors. He felt nothing. There was no reaction at all. But his eyes were busily watching the activity around the bed next to him.

The woman's heart stopped and then started. There was a frantic scurry of movement, the doctor, the nurse and an intern speaking rapidly, giving injections, heart massage, adjusting machines. The doctor tried to get an endotracheal tube down her throat, but the woman was fighting him and there was some sort of obstruction. He couldn't get it in. There was a desperate struggle. Dr. Gasteazoro bent down and blew on the end of the tube by mouth. There was a loud gurgle in her stomach. No good. He pulled the tube out and tried it again, stopping to put the oxygen mask over her face, although this wasn't really getting any air to her lungs. The E. K. G. monitor was showing one premature ventricular contraction after another. Her heart was misfiring badly. Another tube, another try, pry up the jaw, turn her head back, shove it into her mouth and down her throat. But again the air went into her stomach.

I stood at the end of the bed. Her toes were very deformed. She had horrible bunions and wore pink polish on her toe-nails. Staring down at her nude body, her fat stomach was very distended now by air, I wondered just how many dreary, hard and plodding miles those feet had traveled. The nurse, the paramedics and I exchanged looks. She was going. The doctor got the tube in and hooked up the oxygen breathing machine. But he wasn't sure if it was going into the stomach or the lungs. He put his stethoscope on her belly and listened. He disconnected the breathing machine and pulled the tube out. The woman vomited.

The intern gave it a try with another tube. The ambulance drivers came in, kidding around with giggles and jokes and fag routines. "Say. This reporter is kind of cute. What's he doing all that scribbling for?" The monitor was going crazy, the electronic ball bouncing every which way. But the rate itself was slowing. They were still struggling with the endotracheal tube. And then. Finally. Into the lung. Quickly, they connected the breathing machine. The doctor gave her heart massage—one-two-three. The rate on the monitor began to increase. But then it slowed. There were more P. V. C. s. Frank took over the heart massage. One-two-three. There was a gasp from the oxygen machine. One-two-three. Gasp. Everyone looked at the monitor and watched the patterns. Only then did the nurse pull the curtain part-way across to partially shield the view of the stroke victim, whose only response was with his eyes and with his good left hand, nervously fidgeting with the top of the sheet.

The woman's face was blue and purple. Her eyes were half open. Tubes were in her mouth and in her nose, her expression grotesque. There was some heart movement on the monitor. Someone said, "Hell. She might make it." Everyone smiled. It was a joke. Frank did it again. One-two-three. Gasp. A P. V. C. Another P. V. C. Pause and another P. V. C. Dr. Gasteazoro checked her pupils. Gasp. He pushed down on her stomach, which caused a tremendous burp. There were giggles, snickers and smiles around the room. A few people came into the E. R., technicians or intents. There was a total of 11 people around the bed. But she had no pulse. The nurse felt around the femoral vein and said she thought she felt something. One of the ambulance boys said:

"What you feel in there is a worm eating her from the inside."

"There's nothing. No cerebral. I guess we'll have to let her go."

The doctor pulled the tube away from the oxygen. He listened to her heart with a stethoscope.

"No pulse. But there's still a heart sound."

He put the oxygen back. Someone mentioned the husband outside. They said he was nervous and about to collapse. There were jokes about putting him in the next bed. They gave the woman a shot of sodium bicarbonate. Frank pumped on her chest—one-two-three. And then the doctor called out:

"Ventricular fibrillation. Get out the zapper."

Everyone stood back. The cream, the paddles—zap! They gave her one shot. And then they quit. Everything was turned off. She had gone over six minutes with no air. Three minutes is the maximum in order not to have brain damage. Even if she were saved now, she would be a vegetable. The air was stopped. The doctor listened with his stethoscope. Everyone watched the monitor. The rate decreased. The P. V. C. s were very slow.

There was something very shiny on the woman's left knee, something sparkling against the blue of her skin. It looked like a diamond. An ambulance guy reached down and picked at it. It was a sequin. Somehow it had come off a dress or a slipper or a purse. She must have knelt on it and it had become embedded in her skin, perhaps during her first fall in the hotel room.

"Listen. Did she breathe just then? This is ridiculous."

Snickers. Snorts. Quickly, the doctor hooked the air back on. Frank gave her more heart massage. One-two-three. Everyone gazed in silence at the electronic signal. And then again, they gave up.

There were jokes about orange juice and cheesecake. One ambulance guy goosed the other.

"Say, honey. Puh-leeze."

In semi-mock desperation, the Cuban nurse told me:

"You don't know what it means to be with these men here, twenty-four hours a day."

People left the E. R. Others stayed, watching the monitor. The pattern changed, slower and slower. The stroke victim's eyes were trying to see what was going on. No one noticed him. The electronic signal wobbled, wavered, jerked, forming a shapeless, spasmodic pattern. The woman was already dead, but the exact moment of legal death was very arbitrary. Her brain had gone a long time before. But her heart could possibly keep on beating for another hour, quivering, spastic, making meaningless motions. At 10:08 Rescue One left the E. R. as I turned for one last look at the monitor. The woman's husband was still outside in the corridor, pale, forlorn, pacing nervously back and forth, alone, waiting, still hoping—no one said anything to him. We put the stretcher back in the van and returned to quarters. On the way back, the doctor was quiet and thoughtful. The woman would have lived if he could have gotten that tube down her throat. Perhaps it was a congenital deformity. Perhaps a swollen larynx.

Both of the cardiac arrests upstairs also had stenosis problems. Both patients had also died.

The paella was ruined. It was stale and overcooked and sticky. We picked at it, then threw it away, washing the dishes.

10:50. Another run. 405 Espanola Way. "A sick man." It was a ratty hotel, an alcoholics' dive, everything brown, faded, stained. The manager led us upstairs to room 205, saying the maid could not get in that morning. We found the man naked, lying on his back, sprawled in an easy position. He had been dead at least five hours, perhaps 12. The doctor pointed to the discoloration on the underside of his limbs and body. He also pointed to the swelling in the man's groin about the size of a baseball.

"Not only is he dead. He also has a hernia."

There was an empty fifth on the floor, lying on its side. There was an empty pint of Old Taylor. There was another fifth, not quite empty. There was vomit in the bottom of the wastebasket. The man wasn't very old. He was lean and wore a neat mustache. We sat in wicker chairs on the sidewalk and waited until a policeman came. An old man came hobbling up to us and started to gossip. He said the dead man had worked at Wolfie's on Lincoln Road. The cop arrived at 11:05.

Rescue One drove to a Cuban restaurant, where Dr. Gasteazoro bought himself a cigar. He smoked it with little satisfaction, preoccupied and subdued, pondering, unsettled. As we passed Dipper Dan's, Ray stopped the van. The door was locked, but the guy inside opened it for us. We all ordered ice-cream cones. I had a double chocolate.

Back at the station, we watched football on TV. A jet plane flew overhead.