Firefighter-paramedic Dave Chavez, 42, grabs a blank incident report and marches toward his Rescue 9 ambulance with partner Juan Penuelas. At 11:20, they pull out of the station, and Chavez is taking in the devastation on San Julian Street in downtown Los Angeles.
We're on the scene at 11:22. The possible overdose is on her side, writhing on the grimy sidewalk. A few of her friends close in like a flock of ghosts, ulcerated skin ripped raw by needles.
The woman is 25 and says she shot up 10 hours ago. Right here in the open, where heroin is easier to buy than a quart of milk and crack pipes light the night like fireflies.
"I think it's syphilis or gonorrhea," says Sporty, a bony addict who calls the distressed woman his friend. "It's driven her mad."
No, says a female junkie. She got some bad heroin and the needle prick got infected. She was so desperately ill, they'd all been telling her to go to the hospital, but she wouldn't listen.
Chavez examines her with hands encased in white rubber gloves. She looks young and old at the same time, with broad cheekbones and haunted eyes. She squirms and wails, jerking too wildly for Chavez to get a blood pressure reading or a good EKG.
"What's your name?" he asks, trying to calm her.
The answer is mush. She tries again and again, rubber-mouthed.
It sounds like she's saying "Kristina," which Chavez writes down.
Her tongue is dry and caked, and she says her eyes are burning. It doesn't add up, says Chavez, who thinks she's "got some other things on board" besides heroin. He wants to tap a vein in case he needs to run an IV line, but she's got nothing left for Chavez to work with.
"You can see the track marks in her neck," he says, pointing out the chicken-footed etchings. Twenty-five, and she's destroyed herself, drugged out and curled up on wretched streets.
Chavez finally gets a blood pressure reading and a pulse rate of 75. She's stable, or so it seems. The siren parts traffic as the ambulance starts off on the well-worn route from skid row to County-USC Medical Center.
The firefighters call it the Big Screen. It's Station 9's gaping front door, through which they sometimes watch the show outside: the platoons of wounded vets, the mumbling hordes haunted by voices, the doe-eyed children of skull-faced addicts.
At night, crack-addled prostitutes trick in and out of Porta-Potties down the street. Amputees roll by in wheelchairs. Dealers brazenly peddle slow death. Chavez once watched an argument turn into a knife fight directly across the street from Station 9. The loser, his throat slashed, crossed the road for help, then collapsed and died in the firehouse driveway.
Skid row exists because we've created it — although until now, with the downtown renaissance approaching its borders, we've mostly been able to ignore it.
By shutting mental hospitals, adding thousands to the rolls of medically uninsured, skimping on rehab and keeping social services out of respectable neighborhoods, we've guaranteed this teeming human landfill.
Paramedics like Chavez are left to deal with the wreckage. He delivers babies on sidewalks and treats open sores crawling with maggots. He can tell you about Naked Man, who strolls about in the buff and carries on erudite conversations as if he were in coat and tie, and about the once-esteemed professor who wandered the streets in a death spiral after his family perished in a car crash.