machado: when you call 911, someone should come
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our hospitals have sunk deeper into chaos with emergency departments that are overburdened by staffing shortages. getty
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“is she overdosing?”
“umm … i’m not sure? what am i looking for?”
“vomiting, distress, those things.”
this is how my conversation with a dispatcher for toronto’s paramedics went a few weeks ago.
i had been driving home around 6:30 p.m. on the very busy lakeshore boulevard when the cars in front of me starting swerving to the left to avoid something in the right lane. from far away, it looked like a small bundle of black clothes rolling back and forth in the rush of wind from the passing cars. a man walking on the sidewalk nearby briefly looked up from his phone at the lump — which by now laid tucked into the groove where the curb met the road. he kept walking.
as i got closer, a piece of metal on top of the fabric caught a glint of light from the sun — it was a necklace, and it laid around the neck of a woman who looked to be about 20. her eyes were closed.
i pulled into the next street and drove around the block into the loblaws parking lot that stretched over to the road where i first spotted the woman. grabbing a granola bar from my purse, i called the store as i walked toward her. i described the situation to the person who answered the phone and asked if there was security on duty or someone who had a first aid kit.
“you have a narcan kit?”
as i got closer to the woman, i could see that her eyes were still closed, but she was moaning and holding her head. a small ripped backpack lay nearby. the shredded laces of her too-big black high-top running shoes were hanging in the grate of a rusty sewer — the brown dust had rubbed off onto her black leggings. one of the thin straps of her leopard-print tank top had slid off of her shoulder, sitting just at the top of a long scar that ran all the way down a thin arm to her wrist.
“does she have a weapon?” said a man with a grey moustache in a loblaws uniform who had walked up behind me as i put the granola bar beside her. he said his name was steve, or maybe it was will.
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i hadn’t thought about a weapon, but she didn’t look like she was in any shape for a fight.
“you have a narcan kit?” asked the dispatcher on the phone, referring to naloxone, the medication that reverses an opioid overdose. i repeated the question and looked over at the loblaws guy — he looked confused and then shrugged.
“no,” i said.
“ok, we are on our way. we take this stuff very seriously, oh and don’t give her food,” the dispatcher said, at the same time as the woman reached for the granola bar, tore it open with her mouth, took a bite and then spit it out, hurling the rest of it angrily into the traffic.
for sure, it wasn’t the best granola bar — it was one of those protein concoctions that had the consistency of sawdust — but her sudden movement startled both me and the loblaws guy. she stood up and walked into the sea of cars, her arms outstretched as if she were flying. i described what i was seeing to the dispatcher, and she began to sound urgent, connecting me with one of the paramedics who was apparently in the ambulance that was heading our way.
“can you call her back to you?” the paramedic asked. i tried, but she didn’t seem to hear me. once safely across to the other side, she turned around and headed back, eyes closed, her movement steady and straight, as drivers honked and yelled. the paramedic asked me to describe what was happening.
“keep talking,” he said. “i am going to stay on the phone with you. if she starts vomiting, you need to get her to lie down on her side.”
“you know that i have no skills in this area,” i said, a little sarcastically, wondering out loud how much longer it would be before he arrived. he described heavy traffic coming in from the west. i thought about asking him to send someone from the east — it had been more than 30 minutes and i was feeling desperate. “just do what you can to keep her there,” he said.
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amazingly, the woman made it back across the lanes of traffic safely and, noticing me, sat down on the ground nearby, hugging her knees. she looked young and tired — just a kid, with uneven braids hanging over her ears. she was having trouble keeping her eyes open, and sometimes her head would fall back loosely, as if she couldn’t hold it up. after a few minutes she said she was sorry, that she had done a lot of terrible things, and began hitting her head with her fists — which were black with dirt — and crying, describing the “mean” voices in her head. on the phone, the paramedic said they were still stuck in traffic, and then the line went dead.
the loblaws guy cleared his throat and stepped back nervously.
“i’m … i’m …,” he stuttered, as he gestured with his arm toward the store. as he walked away quickly, i thought about calling the paramedics again, but then i worried the woman might hear me and get upset, or worse, leave.
we sat there for awhile, quiet. something about the way she was rocking back and forth reminded me of the anxiety attacks my son used to have when he was little. “distract if you can,” his therapist used to say, “and get him to breathe.”
i asked her what her name was. she stopped rocking for a moment: “beth,” then, “elizabeth.” “i’m lisa,” i said. “did you want to try some deep breathing, beth?” she moved a little closer, copying me as i sat cross-legged with my hands on my knees, and with every breath i took, she took a deep breath — “in through the nose, out through the mouth,” i repeated over and over for what seemed like forever.
the loblaws guy came back with a few bottles of water. “it’s been an hour,” he whispered, rolling his eyes.
the delay was frustrating, and could have been devastating had beth actually been experiencing an overdose. but as we sat there on the warm cement, underneath the pale yellow lights of the parking lot, i felt grateful that, even though she was obviously in distress, the situation wasn’t life or death — at least not in that moment. it was, though, yet another shocking example of how the system we depend on to take care of us is broken.
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the system is “in crisis”
while on some levels it may feel like we are finally crawling out from underneath the oppressive shadow of covid (we can go to the local pub without a mask, yay!), our hospitals in the meantime have sunk deeper into chaos with, among a whole other slew of complicated issues, emergency departments that are overburdened by staffing shortages. this is, in turn, creating a backlog that has ambulances often parked outside, monitoring patients in the back of their cabs until their care can be transferred to the hospital. during these “offload delays” — which can last hours — they aren’t taking 911 calls.
and we’re not just talking about ambulance services that take longer — sometimes they don’t come at all. it’s called “level zero” — also known as code zero, code critical, code black or code red, and it means that there are no ambulances available to respond to incoming 911 calls because they are either busy already or waiting at hospitals, according to the cbc. in fact, so far this year, there have been “more than double the number of code zero events than all of last year,” hamilton paramedic service chief mike sanderson told the cbc. ottawa paramedic service chief pierre poirier said the “system is in crisis.”
and so beth and i waited, sitting cross-legged on the ground, breathing loudly as people walked by, hauling their groceries and not paying much attention to us. with each breath, beth became more coherent and calm. she told me that she was from manitoba, that she had studied physiotherapy in university, but had met up with “bad people.” i asked her if she wanted help. i described friendly doctors, and a clean bed to sleep in, and help with the voice that said mean things. she smiled.
“i broke my cheekbone awhile ago and went to the hospital,” she said. “they weren’t very nice to me.”
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we talked about school and her family — she had three older brothers and a mom who she loved, but she wasn’t sure that her mom loved her. she didn’t have a home, but she said she was looking. deep breath in through the nose, out through the mouth. i told her about my kids, and she said she wanted to be a mother one day. deep breath in through the nose, out through the mouth. the loblaws guy had moved to the street, hoping to flag down the ambulance, i guessed. by then it was dark, and beth said it was time to go. i offered more breathing, but she just laughed as she shook her head. “i have to go get something,” she said, with a faraway look on her face.
i suggested that i take her to the hospital. i talked about all the possibilities if she got some help — school, a job, a roof over her head … children. but she stood up — it was clear she had decided to leave — threw her tattered backpack over her shoulder and asked quietly if she could give me a hug. we embraced, her spine feeling pointy under my arms. then i watched her tiny shadow walk into the night, her shoulders hunched, as she pulled the strap of her tank top up onto her shoulder.
the loblaws guy looked relieved as he left to go back into the store, and i checked my phone. it was after 9 p.m. my call list showed that i had requested an ambulance at 7:06.
i sat in my car for a bit feeling defeated, disappointed, and having a little less faith in humanity. the universe had provided so many chances to help beth — all of those people in all of those cars who swerved to avoid her body instead of stopping to protect it; the ambulance that never arrived; the doctors who should have fixed her broken cheekbone and offered a safe haven and an empathetic ear instead of sending her back to the street.
before heading home, i called the dispatcher’s number to cancel the ambulance. she told me that the paramedics had in fact come to the front of the loblaws — even though i had told them we were at the back, near the street — just a half-hour earlier and didn’t see anyone, so they left. so close, but yet, so far.
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and while i find it hard to believe that they would give up so easily, that they wouldn’t call me to check that things had resolved — even the dispatcher sounded surprised that they didn’t try to find us — perhaps that’s the cost of a buckling health system that’s no longer equipped to care for us the way we need it to.
we keep talking about all that needs to be fixed about health care, but it continues to be unclear as to how we’re going to do it. and until someone figures it out, it seems the only choice we have is to look out for each other as much as we can while crossing our fingers that, if we ever need emergency help, someone answers the call.
take-home naloxone kits are available throughout canada in most pharmacies, sometimes at no cost. click here to find a pharmacy near you.
lisa machado is the executive producer of healthing.ca
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