A Thousand Naked Strangers

Praise for

A THOUSAND NAKED STRANGERS

“This insider's tale of what really happens in the back of an
emergency ambulance is as absorbing as it is revealing. Gifted with a reporter's
eye for detail and the wit and style of a bemused raconteur, Hazzard shows us what might
happen if the medicos from
M*A*S*H
were miraculously deposited
on the set of
Homicide: Life on the Street
.”

—Bob Drury,
New York Times
bestselling coauthor of
The Heart of Everything That Is
and
Last Men Out

“An unstoppable adrenaline rush with lyrical moments of truth and
beauty. Hazzard's unforgettable portraits of people in extremis, and the
swaggering, sardonic, and ultimately courageous medics who take care of them, will stay
with you long after you've turned the last page of this hell-for-leather
ride-along.”

—Theresa Brown, author of
Critical Care: A New Nurse Faces Death, Life, and Everything in
Between

“Take a terrific writer and put him in tragic, frantic, emotional,
heartbreaking and freaking situations for years—you get
A
Thousand Naked Strangers
. Reading this book is like watching
The Matrix
. Hazzard slows down the chaos and danger to allow
himself (and the reader) to experience it. A paramedic's life is the closest thing
to combat in the civilian world. To paraphrase a line in
The Bridge
at Toki Ri
, ‘Where do we get these guys?' This book is one long
rush.”

—Phillip Jennings, author of
Nam-a-Rama
and
Goodbye Mexico

“Get ready to feel the gunslinging, godlike
power of running calls in the back of an ambulance. Here, you'll learn what medics
already know: along with the vibrators, maggots, crackheads, homeless shelters, and
booby traps, it's the madness that both wrings you out and is the job's
biggest turn-on.”

—Julie Holland, MD, author of
Weekends at Bellevue: Nine Years on the Night Shift at the Psych
ER

“Open Kevin Hazzard's excellent book and you might die
laughing. You might also die of a broken heart. Or shock. Whatever, this writer will
jolt you back to life with his sensational inside account of the world of emergency
medical personnel.
A Thousand Naked Strangers
sends out a 911
call to readers . . . and those lucky enough to know these pages will
never hear an ambulance siren the same way again.”

—Charles McNair, author of
Land O'Goshen
and
Pickett's Charge

“
A Thousand Naked Strangers
is a
voyeuristic ride-along with a seasoned paramedic. Kevin Hazzard has an eye for
Atlanta's gritty detail—its true character and its true characters. Buckle
up and prepare for an eye-opening plunge into barely controlled chaos.”

—Judy Melinek, MD, coauthor (with T.J. Mitchell) of
the
New York Times
bestseller
Working Stiff: Two Years, 262 Bodies, and the Making of a Medical
Examiner

“A no-holds-barred look at what it's really like in the
trenches. A paramedic's story of life and death and personal growth told from the
back of an ambulance. Well worth the ride.”

—Robert D. Lesslie, MD, author of
Miracles in the ER: Extraordinary Stories from a Doctor's
Journal

Epigraph

Prologue

BOOK ONE:
A CHANGE OF PLANS

1. I've Made a Mistake

2. From Zero to Hero

3. Dead Mannequins

4. Living and Breathing Dead People

5. Failure Is an Option

6. A Job at Last

7. First Day

BOOK TWO:
FRESH MEAT

8. Pray for Carnage

9. Killers

10. Tourists

11. The True Believer

12. Death by Broccoli

13. The Seekers

14. Two Dead at Midnight

15. Nailed to the Wall

16. Accidental Veterinarians

17. (Un)Prepared for the Worst

18. Death Before Discharge

19. The Perfect Call

20. Rules to Live By

BOOK THREE:
TOP OF THE WORLD

21. Do No (Serious) Harm

22. The Private Life of a Public Hospital

23. There's Been a Prison Break

24. Courage Under Mustard

25. Dead Smurfs

26. Hearing Voices

27. Nobody Dies Tonight

28. Another Day in Paradise

29. A Long Answer to a Stupid Question

30. Faith Healers

31. Hubris

32. Dead on Arrival

BOOK FOUR:
THE FALL

33. Swirling the Drain

34. Grand Theft Auto

35. Mold Them in Your Image

36. The Stork Rides Again

37. The Summons

38. Full Circle

39. Long Way Gone

Epilogue

Acknowledgments

About the Author

You'll see some terrible stuff, I guess. That's how it goes. But try to look for the good things, too. They'll be there if you look.

—T
IM
O'B
RIEN

The Menace is loose again . . . running fast and loud on the early morning freeway, low in the saddle, nobody smiles, jamming crazy through traffic and ninety miles an hour down the center stripe, missing by inches.

—H
UNTER
S. T
HOMPSON

Au revoir, gophèr.

—C
ARL
S
PACKLER
,
C
ADDYSHACK

I
did nothing to save the first person who died in front of me. I simply stood watch and let her go. She was old and white and wasting away in a nursing home. Her death was unceremonious, but fast, and I was the only witness, earth's final sentry, there to do nothing but close the gates as she slipped through.

I was only twenty-six when she died, but already I'd squandered away two lives—the first as a failed salesman, the other as a reporter in exile. EMS was an accidental third act. It was early 2004, centuries ago. When I look back, I find it hard to believe this death and countless others happened, that at one time my sole purpose was to be present, as either anxious participant or indifferent witness. As with much of my EMS life, the memory is fuzzy: soft light filtered through gauze. It's only the details—the little ones that don't seem to matter at the time—that carry on. So really, what I have is more sensation than recollection, more feeling than anecdote.

This is how it all feels to me now.

It's my second night, and I'm partnered with a guy who never goes home. He's a firefighter in the next county, but he'll do anything for money and works a handful of part-time jobs. When he isn't here or at the fire station, he sweats over the fryer at
McDonald's. Just before ten, we're called to a nursing home for a sick woman. My partner is tired. He walks slowly, eyes to the floor, as we push the stretcher off the elevator and wander down the long corridor to the patient's room. We ease alongside her bed. A nurse hovers in the background, saying the woman didn't eat dinner, isn't acting like herself, and needs to be seen. I take her blood pressure, her pulse, count her breaths. Her eyes are closed; her skin—white and crinkled like parchment paper—is dry and hot. My partner asks for her papers. We don't ever leave a nursing home without papers. Most people in a nursing home can't talk, and those who can don't make sense, so even a question as straightforward as
Who are you?
doesn't yield usable results. So we get the papers, a thick manila envelope stuffed with everything from medical problems to next of kin. More important, it's in this packet that we'll find insurance information and whether or not there's a do-not-resuscitate order.

Ostensibly, we're here for the patient, but really all we care about is the DNR.

The DNR is the word of God Himself, written in triplicate and handed over not by Moses but by a big-boned woman in orthopedic nursing shoes. It's in these papers that we'll find answers to the uncomfortable questions that absolutely must be answered. What if she loses consciousness? What if she dies? Do I go all the way—CPR, electric shocks, slip a tube down her throat, drill a hole in her leg for medication? Or do I watch her swirl the drain until she disappears altogether? What does her family want? What would she want? The existence of this piece of paper, even its absence, means a lot. To everyone. At the hospital, the nurses will ask about it, and the doctors won't look at us until we've answered. At her age, in her condition, everyone will agree
resuscitation, even if it could be accomplished, would be cruel. So does she have a DNR? The nurse says she does, that it's atop her packet, the first page in the stack. She leaves to get it.

And that's when it happens. Before my partner—who's leaning against the wall—coaxes his mass into action. Before I pull back the sheet. Before anyone addresses her directly. She opens her eyes—milky and unfocused—and tilts her head forward. Her lips part and then, without ceremony, she relaxes. Her last breath escapes. A single tear runs down her cheek.

I know instantly what's happened. But is it really that simple? That easy? The nurse has just said the patient has a DNR, so that drilled-into-my-head-during-school compulsion to act doesn't kick in. Instead, I spend the first few seconds staring into her vacant eyes, tracing the arc of that single tear—her final corporeal act—and marvel at this woman. Moments ago she was something to pity, bedridden and in a diaper. Now, plucked from her stained nightgown, she is cloaked in the wisdom of the ages. She knows why we're here and, more important, what's next. And if it's not the black nothingness we've feared all along, then how small we must look to her now. In dying she has crossed over. Or hasn't.

My partner, unaware she's dead, has finally come to life. He motions for me to grab the other end of the sheet so we can move her onto our stretcher. I need to tell him, let him decide what comes next, but I don't trust my own instincts. I'm brand-new at this, I've never watched someone die. My experience with the dead—recent or otherwise—is limited. If my partner doesn't notice, then perhaps she's not dead. The woman was hardly moving when we arrived and now looks no different. With a yank, we slide her over. He covers her with a sheet, buckles
her in, starts pushing. I stare at her chest, her face, looking for signs of life that I know deep down I will not find. We grab her packet, and sure enough, the DNR is stapled to the top. We ride the elevator, step out into the cool night. With a sharp metallic click, the stretcher is snapped into the mount on the floor of the ambulance.

“I think she's dead,” I say.

My partner stops and looks not at her but at me.

I clear my throat, tell him I don't think she's breathing.

He climbs into the ambulance, looks, feels, deflates. In the absence of the DNR, he might do something, but it's not absent. It's right there, and this document, drafted and signed with the sole intention of clarifying this woman's final moments, instead obscures our next move. Had she died in the nursing home, we'd leave her, but she's here now. Dead on our stretcher. In our ambulance.