Letters from the front: Day 2

It could have been worse.

Day 1 was more or less uneventful aside from all the funeral home craziness. I had one dude jump off a 5-story parking garage (an unnervingly popular method of suicide) and an array of really uncomfortable phone calls… all of which kicked off with the previously blogged about situation wherein the funeral homes completely lost their shit in the face of crisis.

It’s fine.

On the one hand many of these phone calls weren’t anything unusual: mostly just folks asking questions about their loved one’s death. On the other hand, although these phone calls were “normal”, everyone that I spoke to had a panicky edge to their voice… more so than usual. The family of the suicidal jumper was downright hostile when I asked about the dead guy’s mental health history. And in another conversation in which a son was asking about the post-mortem changes he observed on his father’s body at the time of his funeral… well… the tone with which he asked these questions made me wonder if he suspected me of gleefully beating the shit out of his father’s corpse before we released him to a funeral home. I mean, decomposition isn’t pretty, but it certainly isn’t an intentional brutality that we medical examiners inflict on the deceased and their bereaved families. People die and then their bodies fall apart, it’s science, not a practical joke.

So what’s with the “HOW-DARE-YOU” tone?

I don’t know. It seemed to me like everyone I spoke to was significantly more on edge than usual- and seeing as how I regularly speak to people who are having the worst day of their lives- that’s really saying something.

Of course, in terms of being twitchy and unreasonable, one demographic definitely took the gold medal in the crazy olympics on day 2. They were so off-the-chain that they had me dropping the F-bomb all over the place.

That F-bomb being…

FIREMEN.

-DAY 2-

I awake at 0430 to the sound of the cell phone going off. Signaling someone has called our office number and the call went to voicemail. I pitch out of bed and drag myself out into the kitchen to call our voicemail. It’s a funeral home employee. He sounds confused and hesitant, like he’s not sure if he should be calling. I don’t blame him, I have something of a reputation for being a raging bitch when I’m woken up in the wee hours of the morning in order to deal with some inane problem that easily could have waited until I’m thoroughly caffeinated.

“Who daaares disuuuuurb my reeeeesssssst?!?!”

“Ummmm… Hi. This is Nate from *funeral home name omitted*. Can you tell me if Betsy Swanson (not her real name) is released from the scene? I just spoke to the family and they’re telling me that she’s been released and I need to come pick her up.”

I groan.

This is probably a hospice death and no one bothered to tell the funeral home. Hospice deaths don’t need to be reported to us as they don’t fall under medical examiner jurisdiction (except for a very few exceptions). But it should be pretty easy to deal with so I call Nate back and remind myself to be nice because if I raise my cortisol levels too high by bitching him out, I’ll never get back to sleep.

“Nate, this is the medical examiner,” I say, trying to clear the sludge of sleep from my brain. “What’s going on?”

“Hey, so I got a call from this family, asking me to come pick up a body… The name of the deceased is Betsy Swanson (not really) and I just need to know if she’s released.”

“Well,” I try to soften the edge from my voice, chances are Nate doesn’t want to be awake either and I don’t need to make it worse for both of us. “I don’t know anything about a Betsy Swanson (you get the idea) No one called me about any deaths tonight. Was she in hospice or something?”

“No. She wasn’t.”

“Are you sure?”

“Yes, I asked the family. She wasn’t in hospice.”

“Is she at a SNF or something?” (A SNF is a “skilled nursing facility” and sometimes they forget to call on deaths because someone, somewhere perpetuated the rumor that residential medical facilities don’t have to notify us when someone dies.)

“No. She’s at a residence. The family called me. They said a medical crew had been there…”

“A medical crew was there?”

“Yeah, and the medical crew told them to call the funeral home. It sounded like they’re from another country or something.”

“The medical crew said WHAT?”

I can hear Nate shrinking away from his phone as though it’s going to spring out of his hand and devour him. It’s clear my confusion has taken an abrupt left turn into outrage. Nate scrambles to explain.

“The family told me that she’s got cancer or something. I have their name and address. And, yeah, they said a medical crew came to the house and then told them to call a funeral home and left.”

I copy down the information. I feel sorry for Nate. He’s obviously as baffled as I am by this story and he absolutely did the right thing by calling me. But that doesn’t mean he wanted to. I assure Nate that if a medical crew was at the house, I will get to the bottom of it soon enough. I’ll call dispatch and figure out who went to that address this morning and what, exactly, happened there.

When I call dispatch, they’re apparently training a new employee, because when I identify myself as the M.E. she refuses to pony up any information regarding the address Nate gave me.

“Look,” I tell her, not bothering to couch my irritation, “This is the MEDICAL EXAMINER my call sign is ******* (no, I’m not going to tell you what it is) I need to know who was called to this address and what happened there.”

“I can’t provide you with that information,” she recites mechanically, her voice beginning to waver slightly. “I can page the fire crew involved and ask them to call you.”

“Ok, I need to speak to your supervisor.” I don’t like pulling a move like that, but for the life of me, I cannot begin to comprehend what the big secret might be.

When I get the supervisor on the phone, she isn’t much more help. “Well… understand. We have no way of verifying who you are over the phone. So we can’t give you any particulars about this call-“

“Do you have a lot of people who call you at 4:30 in the morning, claiming to be the medical examiner and giving my call sign?”

She stutters for a second.

“I’ll have the fire crew call you.”

I have no idea how long it takes to send that page, but the fire crew doesn’t call me back for approximately 45 minutes- maybe because they have to turn off their night-light and do a round of pushups before they can interact with the public. When he does call, the interaction is short. I ask him if he was called to the afore mentioned address, and when he replies in the affirmative, I ask him to describe what happened.

“Well,” he says. “We were called for ‘shortness of breath’. When we got there, the family was from Algeria or something. Only a couple of them spoke English and their elderly mother was there. She was incoherent and having a hard time breathing. I mean, she really looked like she had been sick for a long time and was dying. Super skinny, jaundiced… you know. They said she’d been diagnosed with cancer a couple of weeks back at St. Joseph’s. They asked us to put some oxygen on her but we told them that if we treated her in any way we would have to transport her. And they said they didn’t want that. So I just told them to call the funeral home when she was dead.”

“You told them to, ‘just call the funeral home when she was dead’.”

“Yes.”

“OK.” I do my best to keep my voice level and not begin oozing the profound level of blinding contempt and anger I’m feeling. “Did you call medical direction?” (Which is to say, did he discuss this whole situation with anyone further up his own professional food chain)

“No.”

I grit my teeth. “Was this woman on hospice?”

“No.”

Deep breath. “Did she have a ‘Do Not Resuscitate’ order?”

He hesitates. I can tell the reality of his faux pas is beginning to dawn on him. “… No.”

“Did anyone at the scene have medical power of attorney?”

He gulps. “No… I…” He stutters, he chokes and I give him a minute to blurt out whatever equivocation he’s brewing.

“So… here’s the deal,” I do my best to sound conciliatory, but I’m fucking pissed. Can I speak to the Lieutenant?”

“I am the Lieutenant.”

“OK, look. I’m not even going to address the whole patient care aspect of this situation, because that is not my area and I don’t know what your standards are for ‘patient abandonment’ or ‘professional negligence’ and so on. That’s not my wheelhouse. I DO, however, take serious issue with the fact that you released a person to a funeral home from a scene before they were even dead.”

“Well… I thought-“

“You do realize, Im assuming, that it’s AGAINST THE LAW for anyone to release a body from a scene except for the medical examiner. And that doesn’t even address the fact that this woman wasn’t even dead yet. And she had nothing resembling advanced directives that might explain or justify why you thought this was a reasonable thing to do.”

“I just thought-“

“I’d like the name and phone number of your Battalion Chief, please.”

He gives me the information and I get back on the phone with dispatch and tell them that we need to get a police officer to that house for a death investigation. I then call the officer who’s going to the scene and explain to him that he’s walking into a situation with a very confused family from Algeria that isn’t culturally familiar with American death investigation laws. Then I call the family at the scene and explain to them that no one is in trouble, but a uniformed officer is coming to their house to make a report because that’s how it’s done here. The family member who answers the phone at the scene tells me that he just got a call from the firefighter who was at his house earlier. Apparently, the Lieutenant got the family’s phone number from dispatch (who had no problem handing out information to him) and attempted to furiously back-pedal and re-engineer his earlier recommendations to the family.

Finally, I call the on-duty battalion chief. When he answers, I introduce myself and he tells me he’s already spoken to the Lieutenant who has explained the situation and mia-culpa-ed until he practically wet his turn-out gear. I tell the BC that, while I appreciate the fact that the Lieutenant appraised him of the situation, I don’t believe there is a thorough understanding of what went wrong here. I reiterate that several laws were broken and that the local heroes need to understand that they are not the goddamned authority in every circumstance. They need to respect their own scope of practice, stay in their lane and stop authoritatively winging it when they encounter an unfamiliar situation. More importantly, they need to understand that it was pretty fucking hazardous to just leave it to this family to know when their family member was dead. By the Lieutenant’s own report, most of them didn’t speak English… so what assurance did he have that these people were in any way qualified to pronounce their own family member dead? Contrary to popular belief, it’s not always as obvious as you’d think- especially not when someone has been chronically ill and has looked like a corpse for weeks. How does the fire department feel about opening themselves up to that kind of liability? Imagine if she had arrived at the funeral home and they realize she’s still alive? Or worse, imagine the funeral home rolls her into the cooler and finds her on the floor the next morning, because she awoke, attempted to get out, and died of hypothermia, alone is a steel refrigerator surrounded by corpses.

The Battalion Chief harrumphs a few times and is infuriatingly dismissive of my points. He admits that the Lieutenant was out of line, but then says that the Lieutenant admits he was wrong (which is nothing short of a miracle, because in the 9 years I’ve worked this job… as well as the years I worked EMS before that… I have NEVER known a firefighter to admit he was wrong about anything. ) But then the Chief brings it all to a head with the two comments that are, truly, the crux of my long-term beef with the fire department.

“Well,” he says with a condescending tone that implies this settles the matter, “the Lieutenant, he screwed up, but he’s a good guy.”

I’m too infuriated to go on… so he goes on:

“Besides, the Lieutenant just went through his mother’s death. She was in hospice and I think the situation was triggering to him. He was just emotional.”

And there it is.

You might think that I’m being too hard on the fire department, but the truth is, I’m hard on them because no one else is. I don’t know what it’s like in other jurisdictions, but around here, the fire department lives in this magical white tower of imagined infallibility. No one ever questions their judgement or gets in their faces when they fuck up. This results in the Fire Department consistently thinking that they can, literally, do no wrong. I can’t count the number of times that America’s heroes have blithely broken state laws and severely compromised death investigations by simply doing whatever the hell they wanted, and then refusing to accept the possibility that maybe, just maybe, what they did was FUCKING STUPID. And the problem isn’t so much the firefighters themselves, but rather the upper management. The problem is guys like this Battalion Chief who seem to think the excuses he’s offering for his Lieutenant’s gaffe somehow balance out the severity of his mistake.

First of all, I have officially HAD IT with a man’s shitty behavior being dismissed because, “he’s a good guy”. How good a guy he is or isn’t doesn’t change the fact that he broke the goddamned law and put people in danger. So he makes great chili and really knows how to tell a joke… he still needs to do his fucking job. I might bake cookies for my co-workers, but that doesn’t change the fact that I have to show up when someone dies and then write a report about it. And shielding someone from some much needed correction and discipline doesn’t do him, the fire department or the general public any favors. This “good guy” talk communicates to the department as a whole that such behavior is acceptable and you can get a free pass as long as you’re a, “good guy”.

Secondly, as a woman, I’m assuming I don’t have to emphasize to anybody the kind of hit MY professional credibility would take if I explained away impulsive, uninformed behavior by saying I was “emotional”. I would be setting back the progress and self respect of every woman who ever dared to learn to READ if I chalked up my lousy job performance to being emotional. So I cannot stomach the notion that a tulip-toed FIREFIGHTER was using THAT as an excuse. I’ve come to work when I had a fever of 103. I’ve come to work on a freshly sprained ankle. And yes, I came to work less than a week after my own beloved father’s completely unexpected death. I sobbed my brains out in between calls, but you know what? I held it together because that’s what a fucking boss-bitch does. And with the rest of the world in a swirling, panicky, infectious tailspin, I cannot emphasize the importance of emergency workers HOLDING IT TOGETHER. AND NOT ACTING LIKE A BUNCH OF IMPULSIVE SCHOOLGIRLS IN THE MIDST OF A GLOBAL PANDEMIC. If you’re too “emotional” to do your job, then you’re compromising all of us. GO THE FUCK HOME!

Oh, them? They don’t really want to vote… they’re just “emotional”

But back to the story at hand…

I glance at the clock. I could growl this out with the Battalion Chief but there’s no point. He’s already boxed up this incident in his mind and filed it away in the “not-that-big-of-a-deal” drawer in his head. I can tell I’m going to have to take this further up their hierarchy and put something in writing. So be it. If I go back to sleep now, I might manage a total of 5 hours before shift change at 0800.

Fine.

Great.

I stagger into the office and hand the pager to my co-worker. I suck down some coffee and take a quick detour into my supervisor’s office to impart the happenings of last night and this morning to her. She’s amazing. No matter how busy she is, she always has time to hear about what fresh-fuckery we encounter on our shifts.

Did I mention she’s the county epidemiologist and she’s got an iron-clad PhD in infectious disease? Did I also mention that she hasn’t eaten an actual meal in almost a month and hasn’t had a day off for 20 days and counting.

Yeah. Guess how she responds to the “emotional fireman” story…

Letters from the Front: Day 1

It’s a new reality.

Suddenly we’re all sitting in our homes, chewing on our fingernails as we watch the red dots spread out on the computer screen map like seeping bloodstains.

No one is attending school. No one is going to movies. No one is seeing concerts. No one is working out at the gym. No one is going to work…

…except for me.

(and the grocery store clerk at New Seasons)

I left for work today a luxurious 20 minutes later than usual because I knew there wouldn’t be any traffic. But as far as I can tell, it’s pretty much the only GOOD thing that’s happened as a result of this shit show.

That’s right, the medical examiner’s office is open with a vengeance. It is said that the only thing for certain in this life is death and taxes. And it’s entirely possible that taxes will be waived for the year as more and more clamor rises from the masses. No one can afford to pay their rent… let alone their taxes- so who knows. Taxes may be optional this year.

Power to the people!

The downside is, death is still a thing. As the panic surrounding the COVID pandemic really begins to pick up avalanche momentum, The medical examiner’s office is only one cubicle away from where the shit show is really on display- I’m not gonna lie, the Public Health people are having a much worse time than I am… so far. When I saw the county epidemiologist today, she told me that she’s been snorting No-Doze and it’s been 19 days since she had the time to take a shower.

The medical examiners office is doing ok, but we’re starting to feel the strain as well. It’s only a matter of time before the fatalities really start piling up. And I don’t just mean the folks who die of the virus. I’m talking about the people who freak out from the social isolation and anxiety and kill themselves. I’m talking about the families that are already hanging on by a very thin thread suddenly having to spend weeks quarantined together… all angry atoms vibrating together in an enclosed space, hovering on the edge of detonation. I’m talking about all those assholes who think it’s fucking anarchy out there and start driving around drunk- assuming the police have better things to do than pull them over. I’m talking about riots as people become more and more desperate, stupidly believing that the only thing standing between them and complete annihilation is a roll of fucking toilet paper.

It’s so maddening that all I can do is say the F-word…

Funeral homes

Day 1:

I arrive at work. I’m nervous. The magnitude of the corona virus hasn’t quite hit the ground yet, but we’re beginning to sense that it’s a much bigger problem than anyone thought. Businesses have started to close down. Most notably, my gym has closed down leaving me with an overabundance of nervous energy. I feel as edgy as a downed power-line, snapping and crackling on the pavement, daring anyone to come closer.

The first thing that happens is Henry tells me that a body arrived at a funeral home with “corona virus” written on it. I’m not altogether sure what he means.

“Was it like… a sticky note or something?” I ask him.

He doesn’t know, all he knows is that the funeral home employees are losing their minds with panic and don’t want to touch the body. Henry is talking about having to track down who the hell got the rumor started that the dead body was a COVID-19 victim. I shake my head in disbelief.

Then I get a call from the grandmother of one of my decedents from last shift. Specifically, it’s the grandmother of a dead baby. It was awful. This infant was found deceased in bed next to his mother. It’s a co-sleeping death- which is something I know no one wants to hear, but it’s true. Babies and parents shouldn’t sleep in the same beds and the repercussions of doing so are sometimes deadly.

But putting THAT debate aside for another day….

Then problem is, someone from the funeral home has called the family and told them that the baby tested positive for COVID-19. The funeral home is now refusing to let the devastated family come in and view their deceased child one last time. The funeral home is also refusing to touch the baby or proceed with any burial or cremation arrangements.

Then the grandmother tells me that the baby’s father (her son) had to tell his work that it is believed that his child died of COVID-19. His employer has freaked the fuck out and refused to let him come in to work until he can provide documentation verifying that he does NOT have COVID-19.

The grandmother is sobbing this whole story out and asking me why no one at our office told the family that the baby died of COVID. I do my best to tell the grandmother that no one mentioned this to them by virtue of the fact that it isn’t fucking true. The death had nothing to do with the corona virus and I have no clue where the funeral home got that idea. Nor can I imagine why they didn’t bother to confirm it with our office before they brutalized the family in this way. I tell her I will get to the bottom of it and I call the funeral home with the light of righteous indig-fucking-nation blazing in my eyes.

The funeral director tells me that he got the information from the transport crew that they hire to pick up bodies for them from the morgue. He claims that if there’s a problem, it’s not his fault, it’s the fault of the transport company. They’re the ones that said the baby had COVID. So I call the transport company… completely prepared to tear them limb from limb. However, the transport company swears they got the news from the morgue employee who released the body to them. So then I call the morgue, where the state morgue attendants claim that absolutely, under no circumstances did anyone tell anyone that this baby had COVID. In fact, the morgue folks are downright offended that I dare suggest such a thing.

Ultimately, I talk to the pathologist who did the autopsy. He informs me that recent guidelines mandate a COVID test for all pediatric deaths in the state. So the baby was tested for the corona virus and that test came back negative.

WTF?

I backtrack through the phone calls and graciously disperse this information to all involved parties, not one of whom is willing to admit that they’re the asshole that started the rumor that this kid had the corona virus. Ultimately I talk to the family and assure them that their home is not ground zero for the latest outbreak. The problem is, now there’s no help for the father who has been ordered to stay home from work. He can’t prove that he doesn’t have this illness because he can’t get a test. Right now, there aren’t enough tests available and the Health Authority isn’t willing to burn a test swab on someone who isn’t showing any symptoms and has no known contact with a verified Covid case.

So he’s screwed.

Then I get a call from the local hospital. It’s a nurse calling to report the death of a known COVID victim. It’s the first confirmed corona virus death in our county. It’s starting.

He doesn’t know what to do. But I can’t really help him. I tell him that the death isn’t reportable to our office since the decedent has been in the hospital for over 24 hours and the cause of death wasn’t a matter that required investigation. I tell him that the attending physician should have been briefed on which agencies to call and who to alert in this situation.

“Yeah,” he says. “The attending doc told me to call you.”

It’s not even 10 a.m. The day has barely started.

I’m still on shift for another 46 hours.

FUCK.