Overdoses Keep ​“Emergency 2” Racing

For several minutes, the man stopped breathing. In a Beaver Hills apartment, he’d flooded his body with heroin.

The opioid molecules streaming through his blood created a high that his brain jumbled with sleep. Overwhelmed, his respiratory system had ceased functioning: his lungs slowed to one-sixth the normal rate, sucking in air just twice a minute, until they stopped working altogether.

Devoid of oxygen, the man keeled over, hitting the ground face down.

At that point, five minutes after noon this past Friday, the man was practically a corpse. His pupils had shrunk to the size of pinpricks; he didn’t hear the sirens approaching. When fire department paramedics Keith Kerr and Dan Brown arrived near Ellsworth Avenue, they stuck a tube down his throat and pumped his lungs full of air. Then they stuck a white tube into his nose and sprayed a dose of Narcan, an antidote that reverses overdoses.

A few minutes later, the man awoke to find police locking him in cuffs. Firemen wheeled him out on a stretcher and rushed him to the hospital.

Sick with withdrawal and still drunk from the morning’s whisky, the man wailed the whole ride over. He cried that he’d never been on dope, and he cursed the first responders for giving him Narcan, the brand name for naloxone.

The medics urged him to relax. One placed a gloved hand on the man’s shoulder, while the other methodically checked his heart rate, blood pressure, oxygen level. As they sped to Yale-New Haven Hospital, they knew they’d saved the man’s life. 

It was another call that has become routine for New Haven fire department paramedics, as they struggle to keep hundreds of people barely alive.

During a ten-hour shift that the Independent observed on Friday, a fire ambulance responded to two drug overdoses before lunchtime, including that close call by a heroin user. That’s an average day for the department, which dispatched its paramedics to 547 overdoses last year, about three-fifths of which are presumed to be for heroin, according to Rick Fontana, the city’s emergency services chief.

Those overdoses, plus any other urgent health problems, are all handled by just two ambulances within the Fire Department, making them the busiest vehicles in the Elm City.

That’s because only about a quarter of the calls to the Fire Department are actually for fires (or more often, their false alarms), to which hose-filled engines and ladder-carrying trucks usually answer. The rest of each year’s 25,000-odd calls are for medical emergencies. Engines and trucks take the routine issues; emergency units take the life-threatening ones. Picture it as the difference between who responds to a rear-ending collision and a rollover.

“We don’t fight fires every day. Every day, we go on medical calls. Every day, I get to help someone, where I get to hold your hand, console you, make you feel someone’s there for you,” said Kerr, one of Emergency 2’s paramedics. ​“Being a medic, you’re out there more with the public. They see you more, I’m able to help people more. It’s not just putting out a fire to save someone’s contents; I’m able to help you in other ways.”

On Friday, from 8 a.m. to 6 p.m., the ​“Emergency 2” team, based out of the Hill Station at 525 Howard Ave., raced across New Haven’s western half. Firefighter Brown, the emergency medical technician, took the ambulance’s wheel, while firefighter Kerr, the paramedic, readied to hop out and start treatment.

In addition to the overdoses, the two-person team showed up for a woman in Newhallville gasping for breath, a diabetic in Dixwell feeling chest pain, a blood donor in the Hill repeatedly fainting, and a 16-week pregnant mother in Edgewood dripping fluids.

Both paramedics called it an unusually slow day.

“I Don’t Want To Be Here”

The Emergency 2 team spent the first two hours of Friday morning jetting out to Newhallville. Lights flashing and sirens blaring, Brown pounded the horn as he sped down Dixwell Avenue. 

But each time, they turned around shortly after arriving on scene, seeing that American Medical Response (AMR) had the situation under control. Getting ​“cancelled,” the department calls it. It’s a regular occurrence that keeps the Fire Department’s paramedics freed up.

The pair got their first serious call at 10:09 a.m., when they were rerouted from helping a 30-year-old with shortness of breath in Westville to an attempted suicide in the Dwight neighborhood.

AMR was loading a woman into the back of an ambulance when Kerr started asking her questions.

“Do you know what you took?” he asked.

“I just told you,” she snapped. Eventually, she admitted she’d had the whole bottle of her ​“prenatal pills,” likely the vitamins supplements pregnant women take.

“You’re pregnant?” he checked.

“Fifteen weeks.”

“Okay, that changes everything,” he said, jumping in the back to check her blood pressure and glucose levels. He explained later, ​“Now, it’s not just her, but a poison that could affect the baby.”

The woman, wearing a pink Abercromie hoodie, whimpered into her right shoulder and wiped her nose.

“I don’t want to be here, period,” she said.

Kerr tried to ask as many questions as he could on the way over to the emergency room. She said she felt trapped: abandoned by her family, stuck with a drug-addicted boyfriend, unemployed and expecting. She puked up a few of the pills and held her belly as they wheeled her into the emergency room.

“She feels alone, and because of that, she basically, tried to kill herself. She feels that no one’s there,” Kerr explained. ​“I said, ​‘Listen, you’re not alone. You called 911, and I showed up to make sure you’re okay.’”

“Good luck to you,” he wished her, as he left.

The oddest part about riding on Emergency 2 was the day’s uneven energy, the abrupt shifts between a frantic response to a call and a placid return. On the way back to the station, Kerr and Brown talked about loans and cars, without the need to raise their voices over the sirens. They waited in traffic, stopping at streetlights they’d blown by just minutes earlier. Every time the ambulance was back in its parking spot, Brown ambled to the back of the station to grab the hose and spray the ambulance down with water.

Once a lifeguard at country clubs, Brown said he enjoys the pacing of his current job: the routines structuring a day in which he never knows what he’ll encounter.

“You can’t get complacent on this job,” he said, back at the station. Someone reporting chest pain could be experiencing a panic attack or a tear in the coronary artery; shortness of breath could be inflamed asthma or a pulmonary embolism. ​“You never know what you’re going to walk into.”

That’s why Brown studies up on the latest trends in drug use, watching documentaries and reading articles online. For instance, he’d just heard about smoking ​“wet,” a marijuana joint dipped in PCP, when he encountered a woman standing naked in her doorway in sub-zero temperatures. She seemed to fit the descriptions of the dissociative high, in which people report feeling so overheated they strip off their clothes.

And he tries to figure out what’s going on in New Haven, too, mentally making a note that crack use seems to predominate in the Hill, while dope’s more common in Fair Haven. That’s important when deciding what treatment to administer, because Narcan works only on opioids.

“I Didn’t Do Heroin!”

At 11:27 a.m., Emergency 2 got sent back out again on a series of calls. They ping-ponged from the Hill, where the blood donor had passed out, to Science Park for another call, to Fair Haven, where a pedestrian had been struck.

At 12:05 p.m., dispatch sent them to the other overdose in Beaver Hills. Kerr clocked up to 40 miles per hour on the cleared thoroughfares, taking the turns hard. ​“Move!” he yelled, as the crew got stuck on State Street. When they arrived on the other side of the city eight minutes later, the ambulance smelled like burnt rubber.

The AMR paramedics were just emerging from the apartment. Handcuffed and strapped to a stretcher, the man started to awaken from the heroin-induced stupor. After getting him in the back of an AMR ambulance, Kerr hopped in.

As the paramedics discussed what had happened, the 39-year-old man bellowed, ​“No dope, no Narcan!” When a cop appeared at the ambulance’s back door, he cried, ​“I didn’t do heroin!”

Kerr said he hears lies like that often. ​“That’s the thing that we have to deal with. When I first became an EMS, I would get really upset when they told the doctor a different story. I look like an idiot, because I repeated what you told me. It was frustrating, but I’ve gotten used to it,” he said. ​“They’re embarrassed about what they do from time to time, so they don’t really give up information right away.”

“That shows you what heroin can do,” Brown echoed. ​“It can take over your life.”

The man threw his head back violently; he smelled like booze. Even as he thrashed more violently, Kerr told the officer that he needed to un-cuff the man to remove his arm from his jacket sleeve and hook him up with monitors.

“I put everyone at risk,” Kerr explained later. ​“I put them all in danger, because I need to run the tests to make sure the patient is safe.”

Once they freed the guy’s hand, he tried to pull it away from them. Kerr tightened his grip, as they shouted at him to stop struggling. The AMR paramedic placed a nitrile-gloved hand on his shoulder. ​“Please relax,” he begged.

He relented, and Kerr started taking his tests. He pricked the guy’s finger and placed electrodes on his arms and legs. The man’s blood pressure was pushing 130/140, an elevated rate because of the drugs, he explained.

The man, who gave them seven different names, denied taking any drugs at all, saying all he’d had that morning was Irish whisky. He continued screaming as the ambulance drove to Yale-New Haven Hospital — until at one point he started sputtering like he was choking. The man kicked his legs. Kerr and the other paramedic paused, evaluating what was going on. The man hocked spit onto the glass shelves.

“Oh, please don’t do that,” Kerr said.

The other paramedic said the man’s oxygen levels were sinking. ​“Nobody’s going to hurt you,” Kerr said, as they strapped a mask hooked up to an oxygen tank across his face. He kept yelling, but the sound was muted through the mask.

“Saltine, Or Ritz?”

When they arrived in the emergency room, they pulled it off. Blood dribbled from his lip. He swung his legs out wide, hanging them from either the side of the stretcher. A black beanie and a cigarillo fell out of his pockets. He called the cops and nurses in the hallway racists, as they pushed him to his room.

But just before Kerr was just about to leave, the man changed his tune. ​“You’re a good dude, man,” he said. ​“Oh my god, the best cop. The oh-my-god cop.”

Then, he went back to cursing, calling the hospital security guard a ​“cracker.”

“Saltine or Ritz?” she asked back.

Brown and Kerr both had their lunch waiting in the ambulance, probably gone cold.

“I just want to eat,” Brown had been saying for close to two hours.

“You know that’s not going to happen,” Kerr said as they walked out of the hospital.

“We’ll Never Make A Dent”

Kerr said it’s tough to see overdoses every day. Like the blue-lipped opioid user in Fair Haven whom Narcan brought back on Thursday. Like the mother with a 4‑year-old son he’d revived from heroin multiple times in recent months. Like the user on carfentanil, an elephant tranquilizer, who took six milligrams of naloxone to revive. Like the many more who don’t make it.

“I’ve had more drug overdose deaths in the last six months than at any other time in my career” — including eight years with AMR and three with the Fire Department — ​“because of fentanyl and carfentanil,” Kerr said.

“To be honest, we’ll never make a dent; we’ll never make a change. The drug epidemic is on the uprise, and people try different drugs all the time.

“But I do think people are realizing how dangerous it is to mess around with those drugs, and it’s kind of slowing down a little bit. But when a new drug comes up, that’s when we start seeing more deaths.”

He added that Narcan has improved, saving ​“countless” lives. ​“Before Narcan, I wonder what they used to use,” he said. ​“If we didn’t have Narcan, we’d have to breathe for those patients until the drug wears off. Narcan is a miracle drug.”

Still, those horrific calls — the daily traumas Kerr compared to the sights in a war-zone — weigh on him. To keep the images out of his mind, he stays busy, working three jobs, with more paramedic shifts in neighboring towns.

“I don’t have time to think about it, to ponder,” he said. He doesn’t tell his wife, who’s studying to be a nurse, much about what he’s seen. He jokes around with his colleagues, with the gallows humor that’s common among emergency responders.

“You want to make it a job, but you can’t,” he said. ​“You can’t think, ​‘I can go home and be okay.’ You carry it on for the rest of your life.”

“Emergency 2,” Brown radioed back to dispatchers, once they’d slammed the ambulance doors. ​“We’re clear and available.”