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…

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