Tough Love


1 : strong or firm in texture but flexible and not brittle

2 : difficult to perform or understand; a tough assignment

3 : capable of great endurance; sturdy, hardy


1 : a feeling of intense desire and attraction toward a person with whom one is disposed to make a pair; the emotion of sex and romance


1 : when people intentionally do not show too much kindness to a person who has a problem so that the person will start to solve their own problem

My flashlight illuminates the graffiti covered walls of the parking garage as Scottie and I walk in to look for my patient. “Hello, Paramedics. Did anyone call 911?” Scottie has his light out and we’re doing our best CSI impression as we search the dark parking garage for any signs that something is wrong or someone is in need of help. But all we find are parked cars, dumpsters, graffiti and trash – typical for the hood.

We were sent here Code-2 – no lights, no siren, and no firefighters. The notes in the MDT (mobile data terminal) were sparse and just told me we were responding to a man who isn’t acting right and is in the parking garage. Most people in my mostly urban county don’t act right so this call could be anything or nothing at all. The founding fathers of the 911 system must roll over in their graves each time we bear witness to the daily abuse of the system that we encounter. People will call for an ambulance for just about anything. They consider it the same as calling a taxi – only better because it’s free to them. Either their insurance covers it or if they’re uninsured, the state covers it (or my company doesn’t get paid). In any case, it’s not money out of their pocket like a cab or bus would be.

As we walk up the stairs to the main courtyard of the crappy apartment building, we run into a woman. “Hey, I called you guys for Tyrell.” She’s in her mid thirties, a little out of breath, and just a bit worked up.

“So what’s going on with Tyrell?”

“Okay, so, well, I’m the building manager. I saw Tyrell walking around all agitated, well, just not acting right.” So far this woman is about as helpful as my MDT. “So I took his blood pressure. I’m a dialysis tech, and his pressure was 132/84. But he’s just acting strange and I think his potassium might be elevated.” Really… I’ve watched dialysis techs do some really appalling things over the years so she’s not scoring high marks on my informed witness scale.

“So, why would you think his potassium is high – is he a dialysis patient?” I really hope I’m masking my cynicism.

“Well, no, but people do strange things when their potassium is off, and his blood pressure is 132/84.” Okay, I’m done. Telling me his blood pressure twice doesn’t change the fact that IT’S PERFECT!

“Where is Tyrell?” I’m not going to get anything useful from this woman so I might as well go to the source.

“He’s in 301.”

As we walk up the next two flights of stairs I’m talking over my shoulder to Scottie. “Have you ever noticed that when a man carries a hammer everything looks like a nail?”  Scottie’s still laughing as I rap loudly on the door. “Paramedics, do you need an ambulance?”

The door opens and a cloud of marijuana smoke wafts out of the apartment, quickly followed by a young man in a dark hoodie; presumably this is Tyrell. He’s got the baggy pants that are the uniform of the hood and one hand is always in the process of preventing a wardrobe malfunction. He quickly walks right past me towards the stairs with the stiff leg walk I see in the hood all the time.

I’m talking to the back of his hoodie as he walks away from me. “Hey where you going?”

“The hospital!” Muffled by the hoodie I can barely hear him as he takes the stairs towards the street.

“Okay, so what’s wrong with you?” I’m actually having a hard time keeping up with this guy.

“I jus gots to go!”

At this point Scottie’s patience runs out, and I’m not far behind him. “Well, if you keep walking that direction you’ll be there in five minutes.” He just walks to the back of the rig and stands there waiting for me to let him in. Whatever…

I get Tyrell situated on the gurney and start my regular assessment questions as Scottie retrieves the laptop from the front of the rig. “Okay, Tyrell, tell me why I’m taking you to the hospital today.”

“Cuz I been stiff all day.”

“What do you mean by stiff?”

“Like hard, like down there.” He’s pointing to his baggy pants that are tented at the groin.

“You mean you’ve had an erection all day?” Seriously, that’s where this is going?

“Yeah, for like five hour!” He’s agitated and squirming on the gurney. I’ve been getting him hooked up to the monitor while talking to him and notice his heart is racing at 140 beats per minute.

“What did you take?” I know he has marijuana on board but it’s obvious he’s got other stuff working on his system right now.

“Libigrow.” Never heard of it. I look it up on my iPad and see that it’s one of these male enhancement over the counter drugs that you see advertised on late night TV. Basically it’s just asian herbs, B vitamins, and stimulants – the stupid man’s Viagra.

We’re driving to the hospital and Scottie is taking side streets that are riddled with pot holes and speed bumps. I’m getting bounced all over the back of the rig and I decide to give Tyrell some Benadryl in an IM injection. Our county has a protocol for “mild sedation” which allows us to administer this for anxiety. I’d say this counts.

Tyrell gets extremely nervous when I pull out the large needle for the injection. His eyes are big and round while I’m drawing up the drug into the syringe. He’s obviously terrified of needles. I decide to have some fun with him so I’m playing up the bumps in the back of the rig.

I’m looking at his tented pants and holding the syringe. “Okay Tyrell, I have to give you a shot.”

“Hell no! Not down there man. You not gonna stick me down there?”

“No man, it’s just a little shot in the arm.” Tyrell actual tries to climb into the cabinets on the other side of the gurney as I roll up his sleeve to expose his deltoid. He whimpers like a baby as I stab him in the shoulder.

When we arrive at the hospital I explain Tyrell’s situation to the triage nurse. “Hey, Tyrell, you said you’ve been hard since eleven o’clock this morning?”

“Yeah, but I ain’t hard no more.”

“When did that happen?”

“Before we got here.”

“About the same time you saw that needle?”


The triage nurse starts laughing. “Great! You fixed him! Now take him out to the lobby.”



~ by KC on January 16, 2011.

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