A Hard Day’s Night for the Team in Rescue Ambulance 33

A makeshift apartment had been fashioned out of a few old couches in an alley behind a burnt-out apartment house in South-Central Los Angeles. A cheery fire crackled in a nearby garbage can.

For the five or six people who had called this place home since Tuesday, it had all the makings of a fine Sunday evening--until Verdell took ill.

Somebody called the paramedics. When Rescue Ambulance 33 pulled into the alley, Verdell started moaning.

“He all right,” Dorothy said as paramedic Michael Kwiatkowski felt for Verdell’s pulse.

“He doesn’t look all right, ma’am,” Kwiatkowski said, shining a light at the man’s pupils. “What’s his last name?”

“I dunno,” Dorothy shrugged. “He all right.”

“He’s not all right,” Kwiatkowski replied. “He is not all right.”

It was the kind of call that Kwiatkowski and Robert Fogelman, a paramedic team stationed in the heart of one of the poorest sections of Los Angeles, respond to by the half-dozen each night.

At a time of soaring private medical costs and long lines at county clinics, the 911 emergency number--for everything from a gunshot wound to a bout with the flu--has become an increasingly popular medical refuge for the city’s poor.

“Paramedics are the doctors that make house calls,” Los Angeles Fire Chief Donald O. Manning said in a recent interview. “We’re filling that void, and those types of things are probably being abused. That’s not what our system is designed to be able to handle.”

Routine medical aid calls are a major factor in the heavy workload of paramedics in downtown and South-Central Los Angeles.

On the Sunday night when Fogelman and Kwiatkowski were called to aid Verdell, only two of the calls that kept them rolling, off and on, between supper time and 5:40 a.m. were actual emergencies.

“We get a lot of calls down here; people want to use us as a taxi service,” Fogelman explained. “They say, ‘Take me to the hospital.’ Why? ‘Well, I’ve been sick.’ How long? ‘Three weeks.’ ”

The calls that night came in the waning hours of a workday that had begun at 6 a.m. It was a day that started near the Compton railroad tracks with a woman’s decaying body, sprawled next to the tracks and ringed by several carefully positioned baby carriages. Lunch had been an auto-pedestrian incident just off the freeway. Now it was dinner time. Except there would be no dinner.

5:04 p.m.: Rescue Ambulance 33, or “RA 33’ in dispatching parlance, is sent to a middle-class tract home where a worried father explains that his 32-year-old son, a diabetic, did not take his insulin on time.

As Fogelman and Kwiatkowski unpack their gear in the back bedroom and begin examining him, the man’s heart suddenly stops. His breathing ceases. “He’s gone into full arrest,” Kwiatkowski mutters, and the two men carry him quickly into the living room.

Fogelman begins administering cardiopulmonary resuscitation. Kwiatkowski radios back to the fire station for more help. The man needs immediate medication and a tube inserted into his airway to help carry air to his lungs, but until a nearby fire engine company arrives several minutes later, neither paramedic has a free hand.

At one point, Fogelman looks up anxiously at a Times reporter with no medical training who has accompanied the team.

“Do you know CPR?” he asks.

6:15 p.m.: En route back to the station from Daniel Freeman Memorial Hospital, where a team of emergency physicians and nurses is trying to help the stricken diabetic, RA 33 is called to the aid of Verdell.

Halfway to the hospital, Verdell begins trying to pull out the intravenous line they have inserted that is administering a drug that will counteract the effects of any narcotics he may have used. He pulls up his shirt to reveal a parade of needle marks across his thin stomach.

“Where am I? Are we flying?” he demands.

“You’re in an ambulance. You’re on the way to the hospital,” Kwiatkowski tells him.

“Lord, lord, lord, I’m in a world of trouble now,” he sighs.

A few minutes before 7, as Fogelman restocks the ambulance with supplies from Daniel Freeman’s emergency room, nurses wheel a gurney out of the treatment room where they had left the diabetic. A blanket covers the figure on the gurney.

“He circled and went down,” Fogelman says simply, then explains: “That’s what we call it, circling and going down the drain. He’s dead.”

7:22 p.m.: A woman has been struck by a speeding car on Gage Street. The car that hit her has disappeared. The paramedics apply splints and braces and take her to California Hospital.

8:47 p.m.: Back at the station, the two paramedics have downed three bites of reheated seafood pasta when they are called to a nearby residence. A man there says his ulcers began flaring up the other day. Back to Daniel Freeman. Before leaving the hospital, Fogelman checks in on Verdell, who is snoring comfortably in a back room.

9:35 p.m.: A man says his sister is having difficulty breathing. In fact, she is having difficulty sitting up as Fogelman and Kwiatkowski rush into the apartment. Gloria, 30, had never taken a drink until tonight. Now, she has had four large glasses of brandy since 6 p.m.

Because it was called in as a “difficult breathing” call, a potential emergency, there are also four uniformed firefighters in the cramped living room.

The two paramedics help Gloria to bed and head back to the station.

10:10 p.m.: The call comes in as they pull into the station house driveway: assault with a deadly weapon at 633 E. Imperial Highway. The address is quite distant, well outside RA 33’s normal service area. But because the closest ambulance is tied up on another call, Fogelman and Kwiatkowski are called to help.

“Pack a lunch,” Fogelman suggests as they pull onto the freeway. They arrive nine minutes later, but there is no sign of an assault.

11 p.m.: The two paramedics are just laying down their bedding at the station house when they are called to an assault six blocks away. A woman is sitting on the curb, cradled in her boyfriend’s arms, her head bleeding slightly.

“I’m gonna blow up that (expletive deleted),” she says of the man who hit her with a large board moments before. “You’re gonna hear about him. I’m gonna get a carton of gasoline. You’re gonna hear about it, and it’s gonna be me.”

12:05 a.m.: Ten minutes into the first sleep of the night, the bell goes off on a “person down” call. “We’re off like a herd of turtles,” Fogelman announces as he jumps bleary-eyed into the ambulance and engages the siren. They find only an empty parking lot.

1:56 a.m.: A woman is lying on the floor of her bedroom, the contents of her dresser drawers strewn wildly about and a lamp knocked over. Her blood pressure is normal. Her breathing is normal. Her daughter says this happens quite a lot.

“Patricia, what happened tonight? What are you upset about?” Kwiatkowski asks, bending over the woman. There is no response.

“Patricia, I can see you’re looking at me. Why won’t you talk to me?” The fatigue in his voice turns to irritation. He suggests she visit a doctor in the morning, says he can find nothing wrong with her. “There’s nothing the Fire Department can do for you,” he says.

Then she speaks: “Get the hell out of my house.”

2:50 a.m.: A woman living in the back of a van in a liquor store parking lot says she feels a tightness in her chest, like maybe her bronchitis is flaring up again. Maybe it’s her heart, she says. She has a fever. But she doesn’t want to go to the hospital.

“Why don’t you have your daughter take you to the hospital?” Kwiatkowski suggests.

She shrugs. Her daughter slips back into the van. Her husband pipes up: “I’m going to leave the bitch right here, and I hope she dies.”

3:05 a.m.: There is an apartment fire in northern Watts, and RA 33 responds to make sure there are no injuries. None are reported.

5:35 a.m.: A little less than two hours back in the silent station house dormitory, then the bell goes off on an auto-pedestrian call. There is no sign of a pedestrian when they arrive nor of an auto.

After 24 hours on the job, Fogelman and Kwiatkowski head back for morning coffee.