Mumbles was one of our dispatchers — earned the nickname honestly. We didn’t have MDCs in the rigs back then, so we relied on the dispatcher for any additional information. They had none. Just like that, we were on scene.

We grabbed the BLS bag and the burn sheets and ran into the house. Front door was open. I came through first and saw a very large woman sitting on the couch. Jim was right on my heels. We posted up on either side of her in the low light of the living room, both of us processing what we were looking at.

She was sitting there with her legs spread wide, no pants, holding a baby’s head.

We looked at each other and said it at the same time: “Childbirth — not Child Burnt.”

Fucking Mumbles.

We grabbed the OB kit and finished delivering the baby. She had no idea she was pregnant. Had to use the bathroom, thought she had to take a dump, pushed hard — then saw the blood and a baby’s head crowning.

Welcome to Tuesday night dinner duty.

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I monitored the pursuit until it ended the way those calls usually do — a high-speed T-bone MVC at 37th and Meridian, right at the main entrance to the mall. I put myself on the call and responded.

Figure 1

Figure 2

I arrived onscene at 37th and Meridian and linked up with Greg, one of the officers I knew from SWAT. We approached the vehicles and found a girl sitting on the sidewalk crying. We checked on her — she said she was fine. We moved to the car. The passenger side of the sedan had major intrusion into the passenger compartment. The driver of the stolen pickup had bailed on foot.

He sprinted through the parking lot and spotted Dave — also SWAT — running at him from one direction. He had enough distance that he figured he could outrun him and apparently decided to let Dave know it with a smirk as he poured on the speed. What he never did was look the other way. That’s where Zach was. Zach is the size of an NFL lineman — 250-plus pounds of solid — and he hit the guy so hard his feet touched the back of his head. Dave told me later the bad guy scorpioned. The two of them cuffed him where he landed.

Back at the car, Greg had crawled into the front seat from the open driver’s door. I opened the backside driver’s door. We both saw that the front-seat passenger was pinned. Greg expressed concern over the passenger’s copious blood from his head, but he was answering questions appropriately.

I palped his head and aside from the laceration it was intact. The standout problem: he was a big guy and filled the space. I continued my blood sweep leaning over from the back seat and discovered we had a bigger problem. At the moment of impact, he’d had his left leg crossed over his right, foot braced against the door. Now that foot was flipped in the wrong direction. When I felt around his lower leg it was like reaching into the door panel — the tips of his broken tib/fibs were in there.

Figure 3 red circle where broken tib/fib stuck in the door panel

As the interior firefighter in an auto-extrication or rescue you have numerous tasks which keep you busy. You are responsible for determining number of patients, conditions, entrapments, problems, and then preparing the interior space for the extrication. The extrication lead on the exterior will develop an extrication plan, 2-4 depending on extent of the problem.

The plan is then communicated with the interior firefighter, and he has the final say if that will work with what the entrapment and injuries are inside.

M66 arrived and Tim, also a FF/SWAT medic, relieved Greg and took his position in the front seat/ I gave him a fun down on what we had. Our patient asked us if he was going to die. I told him, based on what I had found he was doing well and we will do everything we can to get you out of here quickly.

I said, “I need you to do one thing for me”.

He said “OK”.

I said, “Your left foot is busted badly and not to look down, concentrate on staying strong and we will get you out.”

I told the first units on scene to have PD use one of their cars to pull the truck off the passenger side. We needed a B-post push-out before we could touch the door. A B-Post push out is a technique where a chain is wrapped around the roof through the windows.

Figure 4 B-Post Push Out

A high lift jack is hooked into the chain, and the foot of the jack is hooked on the B-post and jacked ‘pushing out’ the passenger side door. Once it was done, it confirmed everything — bone tips right where I thought they were.

Tim getting the patient prepped. Meanwhile we moved metal, a ‘maxi-door’ (see figure 5)— line started and gave him some medication for the pain and kept him calm. From that point the extrication went quickly.

Then someone outside started asking how she was doing.

I was in the back seat and didn’t have a clear view forward. I looked at Tim. He shrugged. I asked the patient their name. They said Raven. We both shrugged again. I told the person outside that Raven was doing fine and would be ready for extrication in a few minutes. Raven was a trooper — never complained once through the whole process.

Figure 5

I found out afterward that the woman sitting on the sidewalk — the driver — was actually a guy trying to be a girl. Raven was a guy trying to be a girl, and they were both lesbians. Which led to a reporter asking the police chief how the couple was doing. His answer: “It’s complicated.”

Raven made a full recovery and kept full use of their foot.

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Dispatch put it out: naked white male running in and out of traffic at 112th and Ainsworth. One deputy on scene, others responding priority. I was already moving toward the drug locker before the tones finished.

I pulled the ketamine and started drawing it up. The engine and M61 rolled out of the station together, lights and sirens, me finishing the prep in a moving truck on a road I’d driven a thousand times.

That was new. For years, ExDs calls meant arriving with benzodiazepines we already knew wouldn’t work and hoping for enough bodies to hold the patient down long enough to get him somewhere safer. Now we had the right tool and I had it ready before we hit the first intersection.

Two years. A bite on my wrist. Six months of shots.

Ready in sixty seconds.

Figure 14 Image Generated by Adobe Firefly

As we came down 112th we could see them from a block out. We had shut down our lights and sirens because they only serve to agitate a person in ExDs.

A cluster of deputies standing in a loose circle around a pickup truck. Naked man in the truck bed. They had him contained but were giving him room — the right instinct. You don’t crowd an ExDs patient. You don’t add stimulation. You hold the perimeter and wait for the people with the medication.

We pulled up and got the gurney out. Two of my guys set the restraints while the rest of us joined the circle.

I told the deputies we were ready.

They started to move in.

Figure 15 Image Generated by Adobe Firefly

He came out of that truck bed like something released. Cleared the tailgate and was into a residential yard before anyone could close the gap. Deputies and crew went after him and got him down in the grass.

He was growling. Drenched in sweat. Hot to the touch — the kind of heat that registers through a glove. His eyes had that look. Panic-stricken but not processing fear. Something else entirely.

He was fighting with the strength that comes with this syndrome — not adrenaline, not rage, but the specific terrible force of a body in full physiological revolt. The kind that breaks cravats and throws LifePaks across ambulances and doesn’t notice a knee on its throat.

I didn’t wait.

Figure 16 Image Generated by Adobe Firefly

I put the needle in his right deltoid and pushed all of it.

“Done.”

Everyone backed off.

We gave him room and watched. He sat up. Looked around like a man waking somewhere unfamiliar. Breathing hard, chest heaving, sweat running off him. His eyes were still wrong, but the fight was leaving them.

Then you could see the ketamine arrive.

It doesn’t announce itself the way the benzos do — or don’t, in an ExDs patient. It doesn’t creep in and maybe take hold or maybe not. It comes in like a door closing. His shoulders dropped. His head lowered. He laid back down in the grass.

We moved.

Gurney, restraints, loaded. The whole sequence in a time that would’ve made a rodeo proud. Ice packs in the groin and axillary. IV established. Temperature documented. Deputy in back, PCSO escort, rolling to the ER before the neighborhood had fully registered what had just happened in their yard.

Transport was unremarkable. Turnover was clean.

He survived his bad lifestyle choices that morning.

Figure 17 Image Generated by Adobe Firefly

I want to stay with that moment a little longer — watching the ketamine work — because it’s what all of it was actually about.

Not the complaint that went away. Not the meeting in Mike’s office where Ironfist sent his best friend to find an offense that wasn’t there. Not the six months of shots or the blood that got thrown out or the EMS Director’s paperwork requests or the Medical Program Director’s comfortable inertia or our EMS Assistant Chief’s parting comment.

All of that was the cost of getting to this yard, on this morning, with the right medication in a syringe.

An ExDs patient in full crisis has a narrow window. The physiological cascade — hyperthermia, metabolic acidosis, the catecholamine storm driving the heart toward arrest — doesn’t pause while you try the versed and wait to see if it works and try the valium and wait again. Every minute of struggle narrows the margin. Every failed sedation attempt is another lap around a track that ends badly.

Ketamine closes the window correctly. Fast enough to matter. Reliable enough to plan around.

Glenn and Byron built the framework. We built the joint training. We presented the evidence. We answered every question the EMS Director’s office generated and waited through every delay our EMS Assistant Chief didn’t push against. We watched the protocol sit in a pile while our county EMS system moved at the speed of bureaucracy rather than the speed of a man in cardiac crisis.

And then we got it approved, and we went to 112th and Ainsworth, and it worked exactly as designed.

That’s what it was for.

This series covered one thread of a much larger story — what it took to build something that didn’t exist, against people who were comfortable with things as they were. The ExDs protocol went on to serve as a model for other counties. The patients it helped don’t know any of this happened. They don’t know what it cost or who fought for it or who tried to slow it down.

They’re just alive.

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We were dispatched to assist a deputy for an unknown medical nearby. Quiet morning — which in Parkland means we’d only run four or five calls since shift change. We arrived to find Jeff standing with a very large man outside.

Jeff was a deputy we knew well. He didn’t call for assistance unless he needed it. He told us the man had been acting irrational — not safe to be on the streets. He was going to place him on an involuntary hold and asked if we would transport while he followed.

I talked to the patient. He was calm enough. Six-four, six-five, somewhere north of 275. He told me he’d been using and just didn’t feel right in his head. I asked if he’d be willing to let us restrain him for transport — for both our safety and his.

He said yes. Stuck his arms out.

We didn’t have commercial restraints at that point. We were still using cravats — triangular bandages tied around the wrists and ankles and secured to the cot frame. Less than ideal, but it was what we carried. I took a set of vitals, we loaded him up, and Todd pulled out toward the ER on 108th. Jeff fell in behind us.

We hadn’t gone five blocks.

Figure 9 Image Generated by Adobe Firefly

It started with growling.

I was in the captain’s seat writing my report when the noise started. Low. Animal. Then the sound of the cravats going taut.

Todd called back asking if everything was okay. I leaned around to answer him.

The patient had already broken the right wrist restraint.

His hand came up to the cabinet shelf and closed around the LifePak 12. It’s not a light piece of equipment. He flung it at me like it was an empty box.

I ducked. It caught me across the back as I was bent over him.

He grabbed my shirt with both hands and started pulling me toward his open mouth. Still growling.

Todd hit the brakes and keyed the radio. One word: fighting. Jeff heard it and stopped behind us. They both came around and got in the back.

I was trying to break his grip on my shirt when he got my wrist into his mouth and bit down.

Figure 10 Image Generated by Adobe Firefly

What followed was five people — myself, Todd, Jeff, and the crew from L61 who heard the radio traffic — trying to control a man who did not get tired, did not feel pain, and did not respond to anything we could do to him. Jeff had his knee on the man’s throat at one point. The patient kept fighting like Jeff wasn’t there.

The one thing that held was his leg restraints.

Our probie had just started that shift. She was riding L61 and came with the crew. She happened to pull open the side door of the medic unit at the exact moment the patient got hold of my shirt again. Instead of letting him pull me down on top of him I dropped my shoulders and straightened my arms.

My shirt came off just as she opened the door.

I looked at her and said not you and pointed at the two guys behind her.

We fought him all the way to the ER. I gave him everything we carried — all the valium, all the versed. It did not slow him down. Not one degree. We got him transferred to an ER bed and into commercial restraints with considerable difficulty. The ER staff gave him sedatives too.

Those didn’t work either.

I had been pushing for years to get ketamine added to our protocol. It was the only drug with documented efficacy for Excited Delirium. It was already being used in King and Kitsap counties. The research existed. The need was sitting right there in a bed in front of us, still growling, while the ER staff cycled through the same inadequate options we’d already exhausted.

The protocol was submitted. The approval was somewhere on someone’s desk.

Figure 11 Image Generated by Adobe Firefly

I asked Todd to call the MSO and report the exposure — I’d been bitten and protocol required it. He called. No answer. He called the EMS captain. No answer. He called up the chain to our EMS Assistant Chief.

No answer.

All three phones. Nobody picked up.

We called our BC and reported it.

I went to the doctor treating our patient and requested the exposure protocol for the bite. She told me she wasn’t going to do it. It was only a bite.

We argued. She walked away.

The district had lit up — three calls in our first due in the last ten minutes. We cleared the hospital with the understanding we’d return to get the exposure paperwork handled.

We ran the calls. On the way back to the ER, our EMS Assistant Chief finally called the duty phone. I told her what had happened. She told me to make sure I got the paperwork and the blood draw done.

We returned, found the doctor, and told her we weren’t leaving until she did her job. She gave me a tetanus shot and told me to go. I asked about blood draws. She told me they’d already drawn the patient’s blood and I didn’t need mine taken.

The first part was true. The second part wasn’t.

A case manager from state Labor and Industries finally called. She had my paperwork but no bloodwork on file — not mine, not the patient’s. I told her the ER had drawn the patient’s blood. She directed me to the Occupational Health clinic near Good Sam and told me to get my own labs started and begin the exposure series.

Six months of tests and shots.

I went. The doctor there was Archie Adams — a good physician and a genuine patient advocate. He called St. Clare’s directly while I was sitting in his office to track down the patient’s blood draw.

St. Clare’s told him the sample had been thrown out the day before.

Figure 12 Image Generated by Adobe Firefly

Standard procedure is to hold blood for seven to ten days. The sample had existed. It had been sitting in their storage the entire time. If our EMS Assistant Chief had done her job as infection control officer when I was still in that ER — if she had returned one of the three phone calls or made one call herself — they could have tested that blood and I would have known what I’d been exposed to.

Instead I got six months of shots and the uncertainty that goes with not knowing.

That same day I received a call from a chief. I was not to discuss this matter further. There would be a meeting with an unspecified chief. When I asked if I was being disciplined, he wouldn’t answer. He said if I felt it was discipline I was welcome to bring my union representative.

I notified the union. They recommended I file a safety complaint. This wasn’t isolated — there was a documented pattern of the department failing to follow its own infection control policies.

The reason all three supervisors had been unreachable turned out to be simple. They were in a seminar together. All three of them sat there and watched each other’s phones light up with calls working up the chain from M61 and not one of them picked up.

Because we don’t matter.

On my first shift back I was told to report to the BC’s office.

I brought Marc and Bill as my union reps. We arrived to find our BC Mike sitting there looking genuinely uncomfortable. The Deputy Chief — Ironfist, they called him — whose idea this meeting was, didn’t show up. He sent his best friend to do it.

Mike kept flipping through the table of offenses. Marc and Bill watched him quietly.

Figure 13 Image Generated by Adobe Firefly

Bill finally asked: Are you looking for an offense to charge him with?

Mike said he wasn’t finding anything that would constitute a violation.

Marc and Bill told him the meeting was over. They told him to let Ironfist know it was a dead issue.

That was the real beginning of being on the admin’s list. Not the call. Not the exposure. Not filing the safety complaint.

The crime was being right.

I saw our EMS Assistant Chief in passing sometime after that. She looked at me and said:

“I bet you wish you had ketamine.”

One more thing about that day.

We ran non-stop. Didn’t sit down to dinner until close to midnight. The whole crew around the table, food gone in about thirty seconds flat, and the conversation turned — as it always did at our station — to the EMS division’s handling of the exposure. The lack of response. The phones that didn’t get answered.

Then, because this is how stations work, it morphed.

Someone noticed the clock hitting midnight and pointed it out. Which meant it was time to watch for signs that Chris was turning into a zombie.

I was sitting next to our probie, Rebecca. She’d spent eight years in the Army as a Blackhawk pilot before coming to us. She knows what it means to work in a male-dominated environment and she wasn’t looking for anyone to adjust the temperature on her behalf.

The zombie talk was building. And out of nowhere Rebecca says, completely deadpan:

“Eat me first.”

Then she started laughing.

Mike, our BC, turned approximately eight shades of red.

Rebecca realized what she’d said and was trying very hard not to make it worse by laughing harder.

The whole room went up.

We got toned out to a house fire about thirty seconds later so the station emptied before anyone could fully recover. We made it back around 0600, sat down with our coffee at shift change, and her comment was still the only thing anyone wanted to talk about.

She owned it completely. Thick skin, earned over years of being the only woman in rooms full of people who tested everyone equally.

It was the best possible end to one of the worst days of the year.

Next: We got it approved. Here’s what it looks like when the protocol actually works.

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It just isn’t fast.

Glenn and Byron had been developing the Excited Delirium response framework for Pierce County with the goal of making it the model for the state. My role was to build out the Fire/EMS component and make it a true joint protocol — one document, one response plan, fire and law enforcement working from the same playbook. We trained together at departments across the county, Glenn and Byron handling the LE side, me handling the medical.

On the law enforcement side, it was well received almost immediately. Deputies who worked rough areas understood what we were describing. Most of them had been on scenes like the Blue Spruce Motel — wrestling a naked man through broken glass while our entire drug box did nothing. They didn’t need convincing.

The fire side was harder. Departments in more affluent areas, places that didn’t run the volume and type of calls we ran in Parkland/Spanaway, pushed back. Firefighters who had never wrestled an ExDs patient in a parking lot at two in the morning had a harder time feeling the urgency. That’s not a character flaw — it’s just the difference between reading about a problem and having it bite you on the wrist. We kept at it.

The protocol was solid. The training was solid. Glenn’s presentation to the ER board had already brought the hospital physicians on board. All that remained was formal approval and getting ketamine added to the county formulary.

That’s where it stalled.

Figure 5 Image Generated by Adobe Firefly

Pierce County’s EMS system is not structured the way most people assume.

In most states, EMS oversight flows from a state medical director down through individual fire departments, each with their own medical director. Washington State, in its infinite love of bureaucracy, layers it differently: a state medical director, then a county medical director, then individual department medical directors on top of that.

The county’s Medical Program Director — at the time of this writing, still in that role, having held it for decades — is a man whose name I will describe only as belonging to a breakfast menu. I am not making that up. You can’t.

He got the job back in the day because no physician of standing wanted it. The pay was poor, the politics were worse, and the workload mostly consisted of approving protocols for a system he rarely saw in the field. He settled into the position comfortably and showed no indication of ever leaving.

Running parallel to him — and equally consequential to anyone trying to get something approved — was the Pierce County EMS Director. She had been in that role for decades, having come up through Navy medical service. She carried herself accordingly: certain of her authority, thin-skinned about its limits, and long on institutional memory for anyone who had crossed her.

When Brett, Charlie, Tim, Kevin, and I had been teaching Tactical Combat Casualty Care — first for SWAT, then inside the department, then expanding out to schools, other fire departments, law enforcement, and state and federal agencies — the EMS Director caught wind of it. She attempted to shut the program down on the grounds that she was the only person in the county qualified to teach TCCC.

She never got traction on that. But she didn’t forget it either. The five of us found ourselves running into unexplained friction during recertifications for years afterward. Nothing you could point to directly. Just friction.

Now we were asking her office to approve ketamine for field use.

Figure 6 Image Generated by Adobe Firefly

She did what she did. Requests for additional documentation. Questions that had already been answered. Review timelines that extended without explanation. The kind of obstruction that never announces itself as obstruction — it just arrives as process.

Our EMS Assistant Chief could have pushed. Could have used her position to move the approval forward, to make clear to the county that this protocol had department backing and needed to advance. That was her lane.

She didn’t drive in it.

I want to be fair. Before this, I had gotten along with her. Other guys had warned me she wasn’t someone you wanted behind you when things got difficult. I gave her a clean slate anyway. Most people deserve one.

She cashed hers in by doing nothing.

From first submission to final approval, it took nearly two years. Two years of Glenn’s work, Byron’s work, the joint training sessions, the ER board presentation — all of it sitting in a file somewhere while the EMS Director’s office generated another question and our EMS Assistant Chief’s office waited for someone else to move first.

The protocol was right. The need was documented. Every piece was in place.

And while the paperwork circulated, we kept running calls.

Figure 7 Image Generated by Adobe Firefly

I want to be clear about what ketamine meant in this context — because the pushback on it was never really about the drug.

The sedatives we carried, the valium and versed, are benzodiazepines. They work on a cooperative nervous system. In a standard agitated patient — someone drunk, someone in a psychiatric crisis, someone who is scared — they do what they’re supposed to do. They slow things down.

An ExDs patient isn’t scared. They’re not processing fear. The neurological cascade that defines Excited Delirium has moved past the point where a sedative designed for a functional brain does anything useful. We had watched this firsthand. We had thrown everything we carried at patients and watched it bounce off. Jeff had put a knee on a man’s throat during a full fight and the man didn’t register it.

Ketamine works differently. It interrupts the cascade at a level the benzos can’t reach. It was already in use in King and Kitsap counties. It was being used intranasally by the Army under TCCC — the same program the EMS Director had tried to shut down. The evidence existed. The dosing was established. The need was documented in our own incident reports.

Figure 8 Image Generated by Adobe Firefly

What we were asking for wasn’t experimental. It was obvious.

It just had to survive the process first.

Next: What happens when the protocol isn’t approved yet and the call comes in anyway.

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Note: Some individuals are identified by role only.

This is the first in a series on Excited Delirium — what it is, what it does, and what it took to get the right tools to fight it. It starts with a call I didn’t know would change how the entire county responded to these patients.

We didn’t have a name for it yet.

We were coming back from a call when we spotted the B61’s suburban sitting in the Blue Spruce Motel parking lot, lights running. Nobody had heard him dispatched. We turned in.

Figure 1 Image Generated by Adobe Firefly

Garden was on the ground wrestling a naked man through a field of broken glass. The man had been smashing motel windows. Garden tried to stop him. The man charged.

By the time deputies arrived it was a full pile-on. It took everyone we had. Gough broke several of his fingers trying to pry the man’s grip loose. Nothing we carried in the drug box put a dent in him. We transported to the ER trailing a convoy of patrol cars and eventually handed him off.

We talked about it afterward — the strength, the noise, the fact that he didn’t seem to feel anything. In Parkland, a naked man destroying property isn’t a remarkable event. It’s a Tuesday. But this was different, and we knew it even if we couldn’t say why.

We didn’t have a framework for it. We filed it as a weird one and moved on.

That would change.

The call started as a routine assist.

Rush hour, morning. We were dispatched to meet county units in the grocery store parking lot just south of the freeway. When we arrived, it was a sea of law enforcement vehicles. I spotted a county lieutenant I knew and he waved me over.

Figure 2 Image Generated by Adobe Firefly

He laid it out. The suspect had been smashing car windows at an apartment complex near 176th and Canyon. When deputies responded, he was running through the lot swinging a hatchet. One deputy had left his patrol car door open and running. The suspect saw it and went.

He flew up Canyon Road in a stolen police car during morning rush hour and hit several dozen vehicles before they stopped him at 112th. It took multiple Taser deployments to get him down. He was cuffed and hobbled when we arrived.

We pulled the gurney, loaded him as-is, and a deputy climbed in back. I called ahead to the ER — five to ten minutes out. Then I started a line.

He never stopped talking. The whole ride in he told me exactly what he was going to do to my family when he got out. Every detail.

His airway was clearly intact.

Figure 3 Image Generated by Adobe Firefly

We got him transferred to the ER bed without incident. The deputy and I were at the nurse’s station working on our reports when a nurse came over and asked if we could remove the restraints.

The suspect had told her he would cooperate.

The deputy looked at me. I looked at the deputy.

He turned back to the nurse and walked her through it — the hatchet, the stolen patrol car, the two dozen vehicles on Canyon Road, the multiple Tasers. Calmly. The way you explain something to someone who wasn’t there.

She walked off unhappy. She came back with the ER doctor.

Who also happened to be our department’s medical director.

The doctor asked if I had transported the patient restrained and prone.

I said yes.

She told me that was against protocol. She said I had put the patient at risk for positional asphyxia.

I told her I was aware of the protocol and the reason behind it — the concern being respiratory compromise. I told her this patient had no such compromise.

She asked how I knew.

I said he never stopped threatening to kill me and my family for the entire transport.

She didn’t find that funny. She contacted our EMS Assistant Chief and requested I be disciplined.

Figure 4 Image Generated by Adobe Firefly

I called a friend.

Glenn had been on the SWAT team with me. He was one of the top state expert witnesses on use of force — the kind of man whose testimony ends arguments. I explained what was going on.

The timing, he said, could not have been better.

Glenn and Byron were already building a formal response protocol for Excited Delirium — developing it for the county with the goal of making it the model for the state. They’d been looking for fire department input. Glenn asked if I wanted to help build it into a true joint Fire/EMS and law enforcement protocol.

I said yes.

Glenn presented to the ER board. He walked the doctors through the pathophysiology of Excited Delirium, the actual science behind positional asphyxia, and what the evidence said these patients actually needed. He was exceptional — precise, credible, impossible to dismiss.

By the end of the meeting, every doctor in the room was on board.

The complaint against me went away.

The medical director glared at me every time she saw me after that. She took a few runs at me over the years for smaller things. But that particular fight was over.

The work, though, was just beginning.

Next: Building the protocol — and the people who spent two years making sure it didn’t get built.

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There are numerous buildings in the complex. We had to park and walk along the property line - a six-foot chain-link fence separating Eagle’s Landing from the Sandman Apartments next door. There was fairly thick brush and greenery on the Sandman side of the fence.

It was early morning. The sun was just coming up. Our tails were dragging.

Figure 1 Adobe Firefly Generated Image

Five of us walking: Noll, Hollstrom, Gough, Lieutenant Curnutt, and me.

Then we heard what sounded like a woman yell “Help!”

We looked around as we walked but didn’t see anything.

Then we heard it again.

This time we saw a woman’s hand rise above the brush on the other side of the fence.

We all yelled something - I don’t recall what - but when we did, a young male’s head popped up from the brush.

He was as surprised to see us as we were to see him.

Then he gave us a contemptuous smirk.

The smirk disappeared when he saw how fast four firefighters could clear a six-foot fence.

Noll, Hollstrom, Gough, and I hit the fence at the same time. Nobody said a word. Nobody initiated the action. We just went.

Figure 2 Adobe Firefly Generated Image

Curnutt - our Lieutenant - stayed on the aid call side. He got on the radio immediately and called for deputies priority for a rape in progress.

The suspect was fleeter of foot than we were. Gough is the fastest of us and made it into the Sandman parking lot before it became obvious this guy had some serious legs on him. Probably a bit of fear driving him too.

Figure 3 Adobe Firefly Generated Image

We lost him in the complex.

A Pierce County Sheriff’s deputy arrived. The woman had scrapes from the bushes and torn clothes, but she wasn’t seriously injured. The deputy took over her care.

Figure 4 Adobe Firefly Generated Image

We climbed back over the fence and went to our aid call.

Which, if I recall correctly, was probably BS.

The suspect had grabbed her and was about to rape her when we happened to walk by.

Four firefighters clearing a six-foot fence without a word between them. Just instinct and reaction. While Curnutt called for deputies priority.

We didn’t catch him. He was gone into the complex before we could close the distance. But we stopped what was about to happen.

We never heard if they caught the suspect. But this was Parkland. It was just another day.

Noll, Hollstrom, Gough, Curnutt, and I had worked together for over a decade. We didn’t need to say anything. We just acted. That’s what happens when you work together that long at a station like 61.

You fuck with one of us - and that includes cops and innocent people - you get all of us.

Sometimes the most important call of the day is the one you stumble into on the way to something else.

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As we arrived, we found a firefighter from his crew carrying a roof ladder toward the apartment complex. Two-story units with a common stairwell feeding two apartments below and two above.

Figure 1Adobe Firefly Generated Image

We didn’t give it much thought.

We approached the officer. He explained the situation: his friend thought he was going to be feeling bad real soon if he didn’t get his psych medications.

“Where are they?” I asked.

“In my room.”

The officer told us the patient’s upstairs apartment was locked and he’d sent his crew to make access through the balcony.

About that time, the firefighter - an experienced member of his crew - walked up with the ladder and the other firefighter.

“We can’t access the balcony,” they told the officer. “There’s a fence and a gate. It’s locked.”

The officer looked embarrassed and frustrated.

I looked at Gough.

“Let’s go.”

We walked around the complex to the “insurmountable” fence.

It was a rickety six-foot picket fence.

We both hopped over it.

Figure 2 Adobe Firefly Generated Image

We approached the balcony. Gough and I have worked together long enough so that we don’t need to say much. He runs faster. I climb better. We just make it happen.

“Boost me up,” I said.

Gough put his hands out. I stepped up and jumped, grabbed the balcony rails, and pulled myself up and over.

Figure 3 Adobe Firefly Generated Image

The slider popped open easily.

I walked through the apartment and opened the front door from the inside.

The officer was standing at the bottom of the stairs, looking up at me. He was grinning and shaking his head - equal parts amused and embarrassed.

“Need anything else?” I asked.

He just shook his head.

Total elapsed time: about one minute.

Meanwhile, his crew was still trying to gain access to the courtyard through the downstairs apartment - carrying the roof ladder through someone else’s living space.

Gough and I were already downstairs and walking away when we could still hear them banging into walls and furniture, knocking shit over as they tried to maneuver the ladder through the apartment.

We never saw those two firefighters again.

We left, trying not to laugh out loud.

The ultimate example of lower standards in the service.

The crew had turned a simple problem into a complex operation. Roof ladder. Bunker gear. Gaining access through a downstairs neighbor’s apartment. Navigating furniture with a ladder. All for a locked door on a second-floor balcony behind a six-foot fence.

Gough and I: one minute. Fence hop, balcony climb, door open.

The patient got his psych meds. The officer got to watch his experienced crew overthink a basic task while two firefighters showed them how it’s done.

This is what happens when you lower the bar.

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She was concerned her toddler had swallowed some coins. She’d left him alone in the living room for a few minutes. When she came back, her purse was on the floor with all the change spilled out. She said his breathing sounded different on the drive to the station.

Todd and I brought them into the bay and into the back of the medic unit. I listened to the child’s breathing. It sounded clear. I had Todd listen - younger ears in case mine missed something. He didn’t hear anything either.

The toddler was about two years old. Alert, moving around normally, no visible distress.

We started a full assessment and got vitals while talking to the mom.

Figure 1Adobe Firefly Generated Image

Then she asked: “Were you at my apartment a few years ago? My older boy climbed up on the dresser and it fell back on him?”

Now I remembered. That had been two or three years earlier. The dresser had nearly killed him - multi-system trauma. We’d transported him to the trauma center.

The older son was sitting right there in the back with us. He’d survived, recovered. He looked good.

We continued monitoring the toddler. After about ten minutes, we listened to his breathing again. Still clear.

The mother was really worried. I told her we could sit there for another twenty minutes and see how he does. We picked him up, moved him around. No change in breathing. No distress.

The mom was feeling better. I called Mary Bridge Children’s Hospital and explained what we had and what we’d done. They were comfortable with sending them home with instructions to follow up if anything changed.

I explained the plan to her. She was grateful we’d taken the extra time.

Todd and I helped her out to her car. I opened the back door to lay the child in his car seat.

The car seat was reclined almost flat.

As I laid the child down, you could clearly hear his breathing change. Stridor - that high-pitched sound of upper airway obstruction.

Figure 2 Adobe Firefly Generated Image

Todd and I looked at each other.

I picked the child back up. The stridor stopped immediately.

I laid him flat again. It started right back up.

Change of plans.

I called Mary Bridge back. Explained our new findings. We were on our way. They’d be ready when we arrived.

The child did fine as long as he was upright. So that’s how he went to the ER - sitting up in my arms the entire transport.

Figure 3 Adobe Firefly Generated Image

Mary Bridge was ready. The doctors found a penny lodged in his trachea. When the child was laid flat, the penny shifted position and partially obstructed his airway. When he sat up, it moved and the airway opened.

Figure 4 Adobe Firefly Generated Image

Position-dependent airway obstruction. Completely silent when upright. Potentially fatal when flat.

Had the car seat not been in that reclined position when I laid him in it, we would have sent them home.

The child would have been laid flat in that car seat on the drive. The penny would have shifted. His airway would have closed.

The mom had noticed something was off with his breathing at home - that’s why she brought him in. If she hadn’t been there to sit him up when the stridor started, the child would have died at home before anyone realized what was happening.

We almost sent them home to exactly that scenario.

Two saves with the same woman in two years. Two different kids. Two completely different emergencies.

The dresser fall - her older son with multi-system trauma, barely survived, months of recovery.

Now the penny in the trachea - caught at the last possible second before we sent them home.

That penny was sitting in his trachea the entire time we evaluated him. Thirty minutes of careful assessment. Clear breath sounds. Normal vitals. No distress.

All because he was sitting upright.

One detail changed everything: the angle of a car seat.

We almost missed it.

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Morning came and we were finally heading back to the station on A Street. We’re always cautious at intersections - nobody pays attention anymore. We had the right of way, but Todd slowed down as we approached. The intersection was a notorious T-bone generator.

[Photo 1: Cab view in rain - Firefly generated]

Right on cue, a car doing 60-70 mph blew the stop sign and missed us by inches.

Later that day, I was driving back from the ER. A jackass came flying out of a parking lot. I hit the brakes hard. If I hadn’t, we would have knocked him into next year.

It was turning out to be one of those days.

Then it started raining.

Rush hour. We were heading back to the station and got caught by the light at 112th. Waited to turn right onto Pacific Avenue.

Todd made the turn. As we rolled forward, we thought we saw a flash up ahead through the rain. We looked but saw nothing obvious.

We came up to 116th to turn left toward the station. A new pickup truck was stopped in the road with hazards on, window down.

We were in the center turn lane, both of us looking right, trying to figure out why the truck was stopped there.

The medic unit rocked hard.

A woman’s voice yelled in Todd’s ear: “DID YOU SEE THAT?!”

She’d jumped onto the step on the driver’s side, causing the whole rig to rock.

“See what?” we asked.

“A truck jumped the embankment!”

I told Todd to hang tight while I went to look. I played Frogger through rush hour traffic and got to the sidewalk.

Sure as shit, there was a Chevy S-10. Center-punched into a tree.

[Photo 2: Actual crash scene - S-10 wrapped around tree]

It had to have flown about eighty feet to end up where it did.

I requested additional resources and made my way to the truck. Found a woman unconscious in the driver’s seat.

[Photo 3: Extrication scene in rain - Firefly generated]

We extricated her with little difficulty. Once in the medic unit, she got the full meal deal on the way to the ER - airway management, IV access, full trauma workup.

[Photo 4: Inside medic unit treating patient - Firefly generated]

Witnesses said she’d started accelerating at A Street - about a quarter mile back - and floored it. Shot across Pacific Avenue at rush hour through multiple lanes of traffic without hitting anyone. Launched off the embankment at the intersection and went airborne.

Eighty feet through the air before the tree stopped her.

It turned out she’d had a seizure while driving.

Even more impressive: she only ended up with a broken foot.

Three near-misses in one shift - a car that almost T-boned us, a driver that nearly pulled out in front of us, and then this: a woman who flew eighty feet through the air, center-punched a tree at highway speed, and walked away with a broken foot.

The universe was trying to tell us something that day. We just weren’t sure what.

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The 142nd was one of the worst shitholes in our district - notorious for violence, drug deals, and massive brawls. The Sheriff’s Department was there constantly. It was only a matter of time before someone got killed.

This was technically Station 65’s first due, but they were out on another call. We were almost back at Station 61 when the call went out, so we caught it.

As we arrived, I could see one man down in the parking lot, yelling and rolling around. Blood everywhere.

“Where’s the other one?” I asked.

“Inside.”

I went in and found him on the floor. DOA. Multiple gunshot wounds to the chest. Nothing we could do.

I went back outside to the living victim.

I started a blood sweep - systematically checking his entire body for injuries. The only wound I could find was a bullet entry hole in his left butt cheek. No exit wound visible.

We loaded him up and got moving. Once we were in the medic unit, I did my secondary blood sweep. Stripped him completely and flipped him - that’s standard trauma protocol. Naked is how trauma patients go to the ER.

I visually inspected everything - including his cock and balls. No visible injuries. No swelling. No trauma. The only injury I could find was the single entrance wound on his left buttock.

I notified the trauma team we were en route. Started a couple IVs, reassessed vitals. He was stable - as stable as you could be with a bullet somewhere inside you.

We turned him over to the trauma team at the hospital and I finished my report.

We returned to the station and caught another trauma call early in the morning. Same hospital. The trauma doc who’d taken our shooting patient earlier pulled me aside after the turnover.

“I want to show you something,” she said.

Oh shit. My stomach dropped. Did I miss something?

No one wants to be That Guy.

She pulled up the x-ray from our shooting victim on the screen.

Figure 1https://www.researchgate.net/figure/Ray-Pelvis-Lateral-View_fig3_257709046

image for illustration only, not the patients xray.

“Do you see it?”

I stared at the image. The bullet had entered his left buttock, traveled through his pelvis, and came to rest in his scrotum.

I was shocked.

“That’s why you didn’t find an exit wound,” she said. “The bullet’s still in there - lodged in his scrotum. We’ll have to remove it surgically. It hadn’t swollen yet when you had him, so there was nothing to see or feel.”

I looked at her. “That’s why you’re the trauma doc and I’m a firefighter/medic. I did a complete exam - visually inspected everything. There was no injury visible and no swelling at that point.”

We both laughed. I hadn’t missed anything - the injury just hadn’t manifested yet.

The story came out later: The guy I’d treated and his buddy - the DOA - had started a fight with another patron inside the bar. Threatened to kill him. The third guy left and went to his car. The two aggressors followed him out to the parking lot, continuing the threats.

The third guy retrieved his handgun from his vehicle and was faster on the draw. Shot them both. The one I’d treated took a round in the ass. His buddy took multiple rounds to the chest and died.

The shooter was cleared on self-defense.

About a year later, I got a subpoena to testify.

This case went on forever. Mistrials, retrials, starting all over again. The lead detective and I became friends after five years of this legal nightmare. I don’t recall what the surviving aggressor was eventually convicted of, but they were determined to get him on something.

Finally, they got me on the stand.

The defense attorney started coming at me like I’d done something wrong. The usual intro - who you are, what you do.

Then he asked, “How are you employed?”

I wasn’t sure what he meant. “Full-time.”

He asked again.

“Gainfully.”

He asked again, getting pissy now.

I looked at the judge. “Your Honor, I’m not sure what he’s asking.”

The judge clearly felt the same way. “Counsel, clarify your question.”

The defense attorney sighed. “What is your job?”

If he’d only said that at the beginning.

“I’m a firefighter/SWAT medic with Central Pierce Fire and Rescue.”

“And what was your role in this incident?”

I explained treating the shooting victim in the parking lot and during transport.

“Do you see [such-and-such name] in this courtroom?”

There was only one man at the defense table who obviously wasn’t a lawyer - sitting right next to the defense attorney. I couldn’t recall what the victim’s name was or what he looked like. It had been five years and over well over 6000 calls ago.

So I pointed at him.

The defense attorney went full Perry Mason.

“Judge, let the record reflect that Mr. Lorenz just identified [such-and-such] as my client. [Such-and-such] was the man killed in the shooting. Therefore, my client was not involved in this incident.”

He looked at me with a smug smile.

I looked back at him.

“I don’t care what name a person gives me during treatment,” I said. “It has no bearing on my job. My job is to get patients from point A to point B in the same or better condition I found them in. So whatever name he gave me means nothing.”

The smile faded.

“Then how,” he asked, “can you be sure my client was involved in this incident?”

“If he has a bullet wound on his left butt cheek and a scar on his scrotum where they surgically removed the bullet that was lodged there, he’s your man.”

Silence.

“No further questions.”

I got a fist bump from the prosecutor on my way out.

The 142nd Street Pub was eventually shut down in December 2006 - declared a public nuisance after years of shootings, brawls, and drug activity. The site was cleared and redeveloped. One less shithole in Parkland.

The defense attorney thought he had me. Thought he’d caught me in a contradiction that would blow up the prosecution’s case. He went for the Perry Mason moment - the dramatic courtroom revelation that exonerates his client.

What he forgot is that I don’t care about names or faces or legal games. I care about injuries. I care about bullet wounds and treatment and keeping people alive long enough to get them to people who can fix them.

I did a complete trauma exam - stripped him naked, visually inspected every part of his body including his genitals. At the time of my exam, there was no visible injury to his scrotum and no swelling. The bullet was lodged internally but hadn’t caused any external signs yet. That came later, after the swelling started and they did the imaging.

The bullet entered his left buttock, traveled through his pelvis, and came to rest in his scrotum where it had to be surgically removed. That’s not something that happens to multiple people. If you have those scars, you were the guy I treated. Period.

The case ended in a conviction. Five years of mistrials finally over. The detective called me afterward to thank me. Said my testimony sealed it.

Sometimes the physical evidence speaks louder than any Perry Mason moment.

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A little background on Chris: He lived in the foothills of the Cascades and spent all his free time in the mountains. His natural habitat was away from people.

People skills were not his forte.

He was a phenomenal outdoorsman and great at his job. He just had some peculiar quirks.

The main quirk: he talked himself through procedures out loud. This isn’t necessarily bad - it helps patients understand what you’re doing. But there are times when narrating your every thought is a terrible idea.

He also had this habit of acknowledging everything you said to him by responding “Received” - like he was on a military radio net instead of having a normal conversation.

Our standard practice was to have one person do vitals and place the cardiac monitor. It keeps patients from feeling overwhelmed by a bunch of guys hovering over them. Critical calls were exceptions, but this was routine chest pain.

Chris explained to the patient that he needed to undo her button-up shirt and where he was going to place the cardiac leads.

The placement is standardized. Body type variations require some adjustments - females require their left breast to be lifted so the leads follow the same placement as on a male. The same applies to obese males.

As I asked the patient questions, we watched Chris place the leads.

He put V1 and V2 on either side of her belly button.

Then he started putting V3 through V6 almost below her waistline.

I looked at Ray and Todd.

“Chris, those are too low.”

“Received.”

He started to move them up. His second attempt, though in the right direction, wasn’t even close.

We looked at each other again.

“Higher, Chris.”

Chris saw the problem.

And in true Chris fashion, he said it out loud:

“The patient’s anatomy has fallen. Received!”

The patient looked at him like he’d just gotten off the short bus.

She was initially upset. But the 12-lead showed she was having an acute MI - a real heart attack - so the awkwardness was quickly forgotten as we went to work.

Chris didn’t get rattled. He just kept doing his job.

He finally got the leads placed correctly; we got the information we needed, and transported her emergently.

Later, back at the station, we found a picture of the old cartoon lady from Playboy magazine - the one they used for jokes in the back pages.

We made a 12-lead placement guide specifically for Chris. Put it on Station 61’s round table under the plexiglass.

The table was always full of stuff like that - jokes, screw-ups, newspaper clippings. They’d hang around like ghosts of the station for a while, then get moved to the drawer as other things took their place. Everyone eventually got a turn at being “That Guy.”

This was before the age of DEI and PC bullshit. These days, even a cartoon woman would get you in trouble with the new generation.

Chris’s comment was medically accurate - the patient’s anatomy had, in fact, fallen. That’s what happens with age and gravity. But you don’t say it out loud to the patient while you’re standing over her with your hands on her chest. You just adjust your lead placement accordingly and keep your observations to yourself.

The joke lived on at the station for years. Every time someone new asked about the Playboy placement guide, the whole story got retold.

Received.

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* * *

The Fire

I’ve always worked physical jobs, and the fire department was no exception. The job puts you on your knees constantly — on carpet, gravel, asphalt, concrete, or on a patient’s bed in their home where you tell yourself whatever you’re kneeling in is just a spilled cup of warm coffee. You learn not to think about it.

In 2013, we caught an apartment fire — 50-plus mph winds driving the fire hard and fast through the attic of a three-story occupied complex. Mid-day. Quitting wasn’t an option. We went in aggressive and stayed aggressive. In the process, the ceiling coming down knocked my helmet and mask forward and pulled my mask off my face. I got it back on and kept working. I assumed the burning pain I felt in my left shoulder blade was a pulled muscle.

It wasn’t.

After we knocked it down, the incoming crew did a face-to-face relief. The officer looked at me through my mask and said, ‘You look like shit. Go to rehab.’ I was bad enough that he could tell something was wrong through my facepiece. At rehab I couldn’t sit still. I was pacing, restless, couldn’t explain why. One of the battalion chiefs told me to go sit down. I grabbed some unused supply hose and started rolling it instead. I just needed to move.

Over the next six weeks I kept having this strange sensation — like being plunged into ice water, my breath completely taken away. I didn’t know what it was. I didn’t know what had happened to my heart at that fire.

* * *

The Wall

In August I was running a department-wide training evolution I’d spent nine months setting up. Pacific Lutheran University was expanding their campus and had purchased a full city block of old buildings. Through my work teaching community trauma care to their nursing students, I’d heard about it early. We negotiated access and ended up with five days to run the entire department through training. It was, as I described it to anyone who would listen, Disneyland for firefighters.

One of the evolutions required scaling a ten-foot cinderblock wall. I’d run crews through it for days. On the last day, I tried a different technique, got to the top, and a cinderblock broke under me. I fell backward in full bunker gear with my SCBA on and landed flat on my back. The biggest thing I hurt was my pride. I knocked the wind out of my lungs and called it good.

The next day was a Saturday. Our battalion chief had a crew that hadn’t made the training, and we ran them through the scenarios. On the last evolution, I climbed that same wall — for what had to be the fiftieth time that week. I made it to the top.

But I had never been so completely wiped out in my life. If my life had depended on climbing one more foot, I couldn’t have done it. Something was wrong and I knew it.

I didn’t want to alarm anyone, so I quietly excused myself — told my partner Todd I needed to take a leak — and slipped over to the medic unit. I pulled out the 12-lead, hooked myself up, took my blood pressure, and ran the strip.

My absence didn’t go unnoticed. The crew came looking for me and found me sitting on the bumper of the unit with electrodes on my bare chest. My medic Andy grabbed the printout before I could. He looked at it and said, ‘What the hell is going on. You’re going to the hospital.’

‘The hell I am.’

This went back and forth for a while. He called our battalion chief. I got overruled.

* * *

The Discovery

By the time I got to the ER I was feeling better. Most things checked out. But my troponin came back slightly elevated — just over the threshold that requires an overnight stay. Dr. Fink said he had a gut feeling and wanted to run a nuclear treadmill test in the morning. I called some of the guys on shift to bring me real food, because the cardiac diet menu was not going to cut it.

I nailed the treadmill test. The technicians were impressed. I went back to my room expecting to go home and was instead met by Dr. Fink and another physician who would become one of the most important people in my life — Dr. Kinney.

He told me the nuclear test had revealed a massive defect on the back of my heart. That’s why it hadn’t shown up on any 12-lead. He said I’d need a heart catheterization and should be back to work in a couple of weeks.

During the cath, he threaded up through my right wrist. I could hear him talking to his scribe: ‘I don’t understand this. Your vessels are clean as an eighteen-year-old’s.’ I said, ‘Well, that’s good, right?’ He said no — because he’d been expecting to find a clot or a blockage to explain what the test had shown.

Then he got to my heart and stopped.

‘Oh, damn.’

‘Doc, I can hear you.’

They pulled out, set up an echo, and told me I had a large aneurysm on the back of my heart. Open-heart surgery the next morning. When they reviewed the imaging more closely, they revised their assessment: the aneurysm was under an inch — smaller than they’d initially thought — but it had adhered to the pericardium. Any attempt to separate it would likely cause massive hemorrhaging. It would kill me.

They left it in place.

‘This is very interesting,’ said every doctor who reviewed my file from that point forward. It became the hallmark of my medical history.

* * *

The Price of Going Back

The aneurysm scarred over. My heart healed around it. The scar tissue is actually tougher than the surrounding cardiac muscle — which means it won’t rupture. But it also means my heart has never beaten free since that day. It is permanently adhered to the pericardium. They cannot separate them. I live with the chronic cardiac pain it causes, the pressure in the shoulder blade area when it gets irritated, and the runs of PVCs and occasional ventricular tachycardia that come with it. That is the permanent structural consequence of what happened at that apartment fire.

I worked my ass off for nine months and came back to full duty — but with conditions. Quarterly appointments with Dr. Kinney. Ongoing testing throughout the year. And the biggest concession: an implanted cardiac defibrillator. A subcutaneous ICD — essentially a hockey puck mounted to my left ribs. It was relatively new technology at the time, just starting to appear in the U.S. after use in Europe. It is not comfortable. It was the price to pay.

I went back to the line at Station 61, working as a Firefighter and SWAT Medic for two more years. My first call back, I ended up getting thrown into the IV cabinet at 55 miles an hour when my partner Todd hit the brakes to avoid a car that had spun out on the wet freeway directly in front of us. The battalion chief waiting for us back at the station looked at me and said: ‘Jesus Christ, can you go one fucking day without getting injured?’

After two more years on the line, I went to the police academy and moved into fire investigations. The county’s fire investigation unit was down to one commissioned investigator, and my years on SWAT made the transition natural. Through that work and the federal and regional law enforcement network I’d built, an ATF bomb tech I knew asked if I’d want to become a Task Force Officer for the ATF Seattle Field Office Arson Task Force — as a K9 handler. It took years to get approved. That’s how I became K9 Hansel’s handler.

It was the best work of my career. It was also a target on my back in a department where the new chief made clear he wanted nothing to do with law enforcement. Five years of that. I outlasted him, but the damage was done. When an offer came from another county, I took it. It looked like a way out of a dark place. It turned out to be a bait and switch.

* * *

The Floor

Seven months into that new job, in January 2024, I woke up on the floor with a dent in the wall and white paint on my forehead. I thought I’d had a strange dream until I looked around.

I had a cardiology appointment coming up in a few weeks, so I waited. Dr. Kinney said it was odd but everything checked out. He noted we hadn’t done an echocardiogram in three years and scheduled one. Months later, I had the test done around eleven in the morning. I was home less than two hours when the Heart Clinic called.

‘Dr. Kinney wants to see you first thing in the morning.’

I said, ‘That’s not good.’

They said, ‘No, it isn’t.’

My ejection fraction had dropped from 68% in 2021 — which is excellent; nothing goes above 70% — to 40%. Heart failure. My heart was visibly not contracting normally. Dr. Vora, who did the follow-up catheterization, said my heart looked like a white guy dancing on Soul Train. Nobody could explain why it had happened. Nothing had changed anatomically. I was fit. I didn’t have any of the usual risk factors — no obesity, no smoking, no poor lifestyle choices. My heart just decided to take a serious departure from the plan.

I was sent to a psychologist for evaluation. After a long and emotionally draining appointment, I was told I had PTSD. I don’t love that term, but I knew I had buried a lot over the years, and the last four had been getting progressively worse. The bad calls were coming faster and harder, and I thought I was managing. The psychiatrist told me that PTSD can cause heart failure in people with pre-existing cardiac injuries.

Who knew.

I was pulled from work. A second defibrillator — a traditional ICD implanted below my left clavicle, lead running through my subclavian into my heart — was added when the near-syncopal episodes became frequent enough to warrant it. That device was also the final nail in the coffin for any return to my previous career. You cannot work in my profession with a traditional ICD. Not even discounting the heart failure.

* * *

The Fall

By June of 2025 I felt like I had turned a corner. The near-syncopal episodes had stopped. I was improving. I had not gone down in months.

I was walking down the hallway when I woke up on the floor.

I didn’t fall forward or backward. I slid down the wall, and my left leg twisted underneath me while my right did its own origami. It took a minute to untangle myself. I stood up and immediately knew I had destroyed my knees and my left ankle. It was night, so I wasn’t going anywhere. I took some medication and had a fitful sleep.

In the morning I was in the urgent care parking lot waiting for them to open. Pro tip: if you want fast service at an ER or urgent care, tell them you’re in heart failure and passed out. They were very kind and very quick. Nothing broken, but significant soft tissue damage — which I already knew. I just needed confirmation.

The doctor asked why the fire department hadn’t taken me to the ER the night before. I said, ‘Fire department?’ She looked at me. ‘You did call 911, didn’t you?’ I said I’d crawl to the ER before I’d call 911. She stared at me the way you’d look at a display at the Natural History Museum — evolution of man, somewhere toward the right side of the exhibit. Then she said, ‘You’re either a cop or a firefighter, aren’t you.’

I just smiled.

Through a very good friend I got in with an orthopedic surgeon that same day. His assessment was quick: destroyed left knee, damaged ankle ligaments, turf toe on the left big toe. His words about the knee MRI: ‘Looks like a grenade went off in there. And your right knee isn’t much better — there’s massive wear and tear on top of the acute damage.’

Because I have an ICD and am a heart failure patient, getting any procedure approved is an act of Congress. On paper, my chart reads like a disaster — and every doctor or nurse who reviews it before meeting me arrives with a completely different impression of what I’ll look like or be like. I am the one-off who doesn’t fit any category or neat diagnosis. ‘Interesting, challenging, and unique’ are the words that follow me around.

* * *

The Preparation

I was put in a boot for three months while we addressed the ankle first. I used the time to prepare. The better condition you go into surgery, the better the outcome and the recovery — so I doubled down on whatever I could do. Core work, leg work, anything within the limits of the boot and my heart. I wasn’t going to waste the time.

Then came the argument about doing both knees at once. My surgeon wasn’t eager. We went back and forth for months. I made my case. I won.

Being who I am, I didn’t just agree and leave. I bought knee braces I could lock out and practiced every aspect of daily life I thought would be affected — including going up and down the stairs repeatedly. I installed grab handles on my bed and in the bathroom. I meal-prepped nearly three months of food, vacuum-sealed it, and put it in the freezer. I figured out transportation — mobility scooters run $350 a month and top out at four miles an hour, so I found an electric trike instead, and fabricated stirrups to support my feet until I could bend my knees enough to reach the pedals.

When my surgeon finished the procedure, he told me it had taken slightly longer than expected because the saw blade kept overheating. My bones are denser than average.

He said it like it was a complication. I took it as a compliment.

* * *

Six Weeks Out

I’m coming up on six weeks post-op. The pain during stretches and PT is significant. It peaks in the evenings and has cost me some sleep. But overall, it’s going well.

I got cleared to swim. Yesterday I did 800 meters — no leg kick yet, just arms, just moving through the water. It felt like something I hadn’t felt in a long time.

Eleven years from that apartment fire to bilateral knee replacements. One ceiling coming down, one cardiac injury that never fully resolved, one heart that doesn’t beat free, one syncope in a hallway, two knees that paid the price.

That’s how I got here. There’s more to the story —a lot more — and I’ll keep writing it.

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Jim and I arrived at the same time as Deputy Glen - I’d known him for years. We tried knocking. No response. We walked around the house, looking through windows, trying to find one we could open without forcing.

We met back at the front door and made the decision. We grabbed the irons - halligan bar and flathead axe - and popped the door. It opened easily with minimal damage.

We kept announcing our presence as we entered. The house was eerily quiet.

And spotlessly clean. Everything in its place. Tidy.

As we searched through the house, we saw religious items everywhere. Bibles on end tables. Crucifixes on walls. Icons, rosaries, prayer cards. Every room.

She was obviously a very pious woman.

We made our way to the bedroom.

The elderly woman was on her bed, supine. Her body and face were grotesquely twisted. Her nightgown and comforter were covered in blood. Part of her lung was hanging out of her mouth.

She’d been dead for a while - rigor mortis had already passed.

I called in the death and notified the appropriate agencies. The Medical Examiner wasn’t busy and called right back. He released the body to the family and funeral home.

There was a knock at the front door.

Glen answered. The next-door neighbor stood there. She’d called the family to tell them police and fire were at their mother’s house. They were on the way.

“They’ll be here in ten to fifteen minutes,” she said.

“Thank you,” Glen said, and shut the door.

We all came to the same conclusion at the same time.

We could not let them find their mother like this.

What we did next wasn’t protocol. It wasn’t in any standard operating procedure. But it was the right thing to do.

Jim and I took her off the bed and stripped her nightgown. I pulled out my Gerber multitool.

Figure 1 Yet one more task Gerber did not foresee their tool being used for.

I used it to cut the lung tissue that was hanging from her mouth. Then I stuffed the rest back down her throat.

Jim had gotten wet towels. Glen was stripping the bed. We worked like men possessed.

We cleaned her face, her arms, her hands. Got all the blood off. Jim found a clean nightgown in her dresser. We dressed her. Glen had remade the bed by the time we finished.

We placed her back in bed. Pulled the sheets up under her arms. Folded her hands over her chest. Closed her eyes. Closed her mouth.

A few more spots to wipe. We threw the bloody linens in a trash bag.

We had barely caught our breath when there was a knock at the door.

Glen opened it. Numerous family members came in - children, grandchildren.

We gave them our condolences. Tried not to look like we were sweating like whores in church.

They walked into her bedroom.

“Look,” one of them said. “Jesus took her in her sleep.”

We couldn’t look at each other. We bailed to the backyard as soon as we could.

Out there, away from the family, we finally let ourselves breathe.

Jesus most definitely did not take her in her sleep. Her death had been violent and grotesque and terrifying. But they didn’t need to see that. They didn’t need that image burned into their memories forever.

They needed to remember their mother the way they’d always known her - peaceful, faithful, taken gently by the God she’d devoted her life to.

Sometimes that’s the kindest lie you can tell.

She’d died from a severe asthma attack. Intense coughing can produce massive blood clots or bronchial casts - rigid formations of mucus, lymph, and blood that take the exact shape of the airway. They can look like actual lung tissue. That’s what was hanging from her mouth.

Back then, we didn’t have instant access to the medical information we have now. In the moment, it looked like part of her lung. What mattered was that it was grotesque and terrifying, and her family didn’t need to see it.

The Medical Examiner had already released the body to the family before we cleaned her up. We weren’t tampering with evidence or interfering with an investigation. The cause of death was clear. But what we did still wasn’t standard procedure.

We had ten minutes to give a family peace instead of nightmares.

We used every second.

We’ve never regretted what we did that day.

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Dispatch updated: two patients, one already extricated, crews working on extricating the driver.

It took about ten minutes to get there.

Just before we arrived, our officer asked command what he needed from L61.

Battalion Chief 71 replied: “Just bring your personnel.”

We pulled up facing the passenger side of a minivan in the ditch. All the crews were crowded around the open passenger door and sliding door, working inside the vehicle.

Figure 1 for visual only not actual scene picture

We walked up to command. BC 72 was visibly frustrated. The crews seemed to be struggling.

He looked at me. “Lorenz, get over there and find out what the problem is.”

“Yes sir.”

During this period in the county, common sense was still common. Egos were set aside and command utilized firefighters with specialized expertise. I was an extrication instructor with the Puyallup Extrication Team, taught Forcible Entry for the county, and as a SWAT medic taught tactical medical care.

I approached the driver’s side of the van.

No one was on this side.

Through the windows, I could see the crews had removed the passenger front seat and the second-row seats. The driver was a very large woman, pinned by the dash pushed down onto her lap. She was in obvious agony.

I tried the driver’s door. It opened.

I tried the driver’s side rear slider. It also opened.

I didn’t have to say anything. The look on the guys’ faces said it all.

Once the driver’s door was open, I had access to the electric seat controls. Standard procedure is to secure the battery after you’ve done everything you need power for - open doors, move seats, roll windows down.

I told the guys working inside: “I can move the seat back.”

They relayed this to the extrication lead, then gave me the thumbs up.

I explained to the woman that I was going to slowly move the seat back and to let us know if it increased her pain or caused new pain.

“Okay,” she said.

I started moving the seat back. Her body stayed mostly in the same position. She complained that her right leg hurt badly.

The guys inside felt around her leg. They thought they felt something stuck in her thigh.

“Hold tight,” I told them. “Let me update command.”

I was walking toward the BC when we heard a loud scream.

I turned and looked.

I couldn’t believe what I saw.

They’d grabbed her and ripped her out of the position she was in, yanking her onto the backboard.

That’s when it became apparent why she’d been complaining her right leg really hurt.

The transmission shift lever had been impaled in her thigh.

They’d just ripped her off it.

They had enough people at the gurney. I told command what I’d found and that I’d make sure the van was secured. I found the keys in the ignition, removed them, and disconnected the battery.

My officer said we were cut loose. We returned to our side of the county.

This is a classic example of what we teach - standard operating procedures are ultimately about patient care. All too often, especially in training, crews forget why we’re cutting the vehicle up. It’s not about the tools. It’s about the person inside.

Fast forward one year.

It was National Night Out - the event where law enforcement and fire departments participate in neighborhood crime prevention gatherings. Ladder 61 was assigned to an event at a church off 112th Street.

We’d been there for an hour or so when a woman with a cane walked up to me and thanked me for my service.

I always feel uncomfortable when people thank me for doing a job I signed up to do.

My canned response: “Thanks for paying your taxes.”

Most people laugh. Occasionally I get a disapproving look.

Not this time.

“You guys saved my life a year ago,” she said. “I was in a bad accident.”

She didn’t recognize me specifically. She was thanking the fire department.

She told me she’d broken her right leg, shattered her hips, and broken her right arm.

“You’re doing great being so mobile,” I said.

“Do you mind if I ask what happened?”

“I was driving my minivan,” she said. “My husband asked if I had any cash. I reached into my purse and pulled out a handful of money.”

“It was a nice August day. We had the windows down. When I went to hand it to my husband, he didn’t grab it fast enough. The wind blew it all over the van. A bill was going out the window and I reached to grab it.”

She paused.

“I was still holding the steering wheel. It turned as I reached. We went straight into the ditch and hit a tree.”

A dim bulb flickered in my head.

“Did this occur on South Hill Park Drive?”

She nodded. “Were you there?”

“I arrived shortly before they extricated you.”

I was waiting for the inevitable complaint: You guys hurt me getting me out of the van.

I wasn’t expecting what she said.

“The medic who rode in the back with me to the hospital was so nice. He made sure I felt safe and assured me I would survive the accident.”

Years before this, we’d had an EMS Chief who repeatedly told us: “Just be nice. You can fuck everything else up, and if you were nice, that’s what the patient will remember.”

She got a lot of things wrong during her tenure, but she got that right.

I called up the medic who’d been on that call and told him about my conversation with his patient.

He was expecting the same response I was - a complaint about the pain we’d caused.

Instead, she remembered kindness.

The woman had been impaled on her shifter - a four-to-five-inch laceration in her thigh. The crew, in their rush to get her out, ripped her off it - causing excruciating pain and additional trauma. They’d removed seats through the passenger side when the driver’s door opened just fine. They’d struggled with a complex extrication when the simple solution was right there.

Everything about that call was technically wrong.

But what she remembered - what mattered to her - was that someone held her hand in the ambulance and told her she’d be okay.

Just be nice. You can fuck everything else up, and if you were nice, that’s what the patient will remember.

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When dispatch sent us to a residential fire with entrapment, I felt it in my chest.

Additional information continued: smoke, fire, entrapment. At least one victim unconscious. Then: fire with entrapment of a man, his daughter, and several dogs.

Everyone responding was under the impression there were victims trapped in a structure fire, including children.

I was already on the road, not far from the address. As I approached, I couldn’t see any smoke or flames.

I turned north and saw the house number. A woman stood in the driveway holding a phone. A small child in a blanket stood next to her. The garage door was up. No visible fire. No smoke. The woman wasn’t reacting to my presence at all.

I contacted dispatch to confirm the address. They confirmed.

I backed up, rolled down my passenger window. “Did you call in a house fire?”

“Yes, it was this address.”

I could hear sirens from multiple directions. I asked dispatch to continue the closest two engines priority and slow the rest to routine - there was no apparent fire or imminent hazard. I didn’t want incoming units risking a collision when the emergency didn’t exist as dispatched.

I parked several houses west and walked to the residence.

The woman explained: the little girl’s father was unconscious in the garage. The little girl had found her dad “sleeping” on the floor and couldn’t wake him up. The woman was walking past when the little girl came out of the garage. The woman entered, tried to roll the man over - he started making snoring respirations. She exited and called 911.

I could see a man down on the west side of the garage, about fifteen feet inside. He was wedged between a vehicle on jacks with the hood up, next to a workbench, behind a large cabinet.

There was a slight chemical odor but no fire or other apparent hazards.

Since the woman and child had been inside and E67 and E68 were arriving, I held my breath, went in, and grabbed the unconscious man by his coat.

I was at the pinch point between the cabinet and the vehicle when I felt someone run into the back of me. I looked over my shoulder - a female deputy was standing there.

“Back up,” I told her.

I bent down to get another grip on the man’s coat and started dragging him out. His legs caught on the car blocks and his coat pulled over his head.

The deputy and I were both speechless.

This large, grease-covered man - obviously a mechanic - was wearing a lace bra.

It felt like we stared for a long time. It was probably only a few seconds.

I bent down, got a better grip, and dragged him toward the driveway. His bare torso was now in plain sight.

Two more deputies were running across the yard toward the house. They stopped dead in their tracks when I pulled him onto the driveway.

They looked at each other. Then at me.

I shrugged.

As this was happening, the first two engines turned the corner. Lieutenant Kamke hopped out, radio in hand, beginning his size-up report.

“Engine 67 at scene of a two-story...”

Then he saw the unconscious man lying in the driveway wearing a lace bra.

He looked at me.

I shrugged again. Beats the fuck out of me.

He never finished his size-up.

I bent down to check for pulse and breathing. The first thing I noticed was pinpoint pupils. He had a faint pulse. Purple from the neck up. Snoring respirations.

I looked at the crew of the second engine. “It’s an OD. Grab your airway bag and Narcan.”

Somehow this translated into the acting officer calling over the radio: “Trauma code.”

The patient was turned over to Medic 71.

Battalion Chief 72 arrived and asked what we had. He did a double take when he saw the man in the bra.

He looked at me. “It’s you. You always get these weird, screwed-up calls.”

It is a gift.

He called a huddle while the medics loaded the patient. He told Kamke he had to finish his size-up - there were two full alarm responses parked on the street thinking this was a fire with rescue, but there’d been no follow-up radio traffic.

Kamke replied that I’d said there was no fire, and then when he saw the guy in the bra, he had no words. No idea what to say.

Engine 73 checked the garage with the 4-gas monitor. Clear. Deputies checked inside the house - no other occupants.

There was drug paraphernalia on the ground where I’d pulled him out. The large cabinet turned out to be a cigarette rolling machine with numerous glass pipes inside.

The garage had paraphernalia spread all around the workbenches and cabinets. The car had the hood up and the intake manifold off. A can of WD-40 was lying on top of the engine block.

The little girl - five years old - was still outside with the neighbor.

Lieutenant Kamke and I asked her to show us where the fire was.

She took us to the garage shelving beside where I’d pulled the man out. There was a small glass “lamp” with a wick. No charring. No soot. No indication there’d ever been a fire.

The girl’s mother arrived from work. She stated he’d been transported two weeks prior for an overdose of fentanyl and meth.

The man survived. His wife was a stripper. He apparently had a garment fetish. The mother took the daughter home.

A month earlier, I’d worked a fatal fire that killed a family of five. I spent days at that scene, finding pieces of the children. When this call came out - fire with entrapment, unconscious victim, children involved - I was bracing for the worst.

A five-year-old girl found her father unconscious in the garage and thought he was sleeping. She couldn’t wake him up. She saw what she thought was a fire - probably the glass lamp used for heating drugs - and got help from a passing neighbor.

She called 911 reporting her father trapped in a house fire because that’s what it looked like to a kindergartener trying to save her dad.

What we found was a repeat overdose patient in a garage full of meth paraphernalia, wearing a lace bra for reasons that eventually made sense - his wife was a stripper, he had a garment fetish.

The absurdity of the bra - the deputy’s reaction standing behind me, the other deputies freezing mid-run, Kamke’s incomplete size-up, everyone’s confusion - that’s what we’ll remember and laugh about.

But underneath that is the relief I felt. It wasn’t another dead child. It wasn’t pieces I’d have to find and catalog. It was just an overdose with a weird detail. The man survived. The little girl went home with her mother.

After the family of five, I could handle a guy in a bra.

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Not long after we turned onto Pacific Highway, we heard the Ladder call out “Mechanical.”

We didn’t think much about it at the time. Dispatch had just told us a child was involved in the collision.

We arrived to find a couple in a small regular-cab pickup with a hole punched outward in the windshield. They’d been hit by a car that ran a stop sign.

They’d just picked up their niece - about two years old - and were driving a few blocks to their house. No car seat. No room in the little cab for one. She’d been sitting in her aunt’s lap.

We found her deceased in the grass lot across the street. Massive head injuries.

We turned the scene over to the Sheriff’s Department and headed back to the station.

When we pulled into the bay, we found the Ladder stuck halfway out the door. Two compartment doors had been ripped completely off.

We needed something funny to take our minds off the call we’d just cleared. We found it.

Both Ron and Danika are short - maybe 5’4” on a good day. Danika, driving, said she didn’t see the open compartment doors. Neither of them noticed the door alarms when she put the Ladder in drive.

The guys on the Engine were upstairs when it happened. They said it shook the whole station.

Figure 1 Not actual incident picture

Ron has what we call a giant “HOT button” - he’s easily wound up and goes from zero to explosion fast. Right now he was pacing, absolutely furious - partly at the situation, partly dreading what Lieutenant Duane was going to say when he got back.

Danika was just walking around sadly. As the driver, this was on her.

Jim gave me a nod. We walked up to her and put our arms around her shoulders.

“It’ll be okay,” Jim said.

She looked up at us, trying to smile. “You think so?”

As we said this, we walked her toward the big whiteboard in the apparatus bay.

“Of course it’ll get better,” Jim said. He pointed at the number on the board. “You get to reset that number to zero.”

Days Without Overhead Door Damage: 695

We both started laughing.

She cried again. And maybe called us dicks.

Ron and Danika had to swap into a reserve Ladder. When Duane got back and found out they were in the reserve, he was pissed.

It was a busy night. At some point during the wee hours of the morning – L61 was back in bed at the station - dispatch sent the Ladder to a car fire. The Engine was on another call, as was the next closest engine.

Jim and I were returning from a vehicle collision, already on the road, only a few blocks away. We attached ourselves to the call and arrived within a minute or two of dispatch.

We found fire in the dash and firewall of a car parked in a driveway. The owner met us.

“Where’s the engine?”

“They’re enroute.”

Jim and I found two garden hoses and started putting the fire out.

Time passed. A lot of time. So much time that the owner kept asking us where the engine was. We were wondering the same thing - they were coming from the station less than a mile away.

It took so long we had the fire completely out when the Ladder finally came rolling up.

Danika was first out. She looked like she’d rather be anywhere else.

Duane got out. He was visibly pissed.

“What do we have?” he asked.

We briefed him. He did a quick check, got owner information, and we headed back to the station.

Ron never got out of the Ladder at the scene.

When they got back, we got a bonus.

On the way to the car fire, Ron had turned the wrong direction on John’s Road. Duane had clearly said “right.” Ron turned left.

Ron got flustered - he was so mad about the entire day - and immediately turned into the first driveway on the left to correct his mistake.

It was a steep driveway. Turning in was fine.

Backing out was like fingernails on a chalkboard.

As Ron backed out with Danika as his spotter, he ground down both drop-down rear steps on the steep incline.

He’d thought Duane was mad before.

We saw Ron’s Big Red Hot Button and pounced.

“Can you put two accidents on one write-up,” Marc asked, “or does it have to be two separate forms since it’s technically two different days?”

“It’s the same shift though,” Jim added. “Does that make it one incident or two?”

“If it’s two separate disciplines,” I continued, “do they bump the second one up in the Table of Offenses?”

Ron was pacing back and forth.

“That’s it. They’re going to fire me.”

“I’m done. I’ll never get promoted. If I even keep my job.”

We were relentless. We kept pushing that Hot Button all the way until shift change.

Ron was positive he was getting fired.

He didn’t get fired.

They did what they always do when someone screws up. They promoted him.

We needed the dark humor after that first call. Finding a dead toddler in a grass lot - that stays with you. Coming back to discover Danika had ripped the doors off the Ladder gave us something else to focus on. The ribbing, the relentless questions about discipline procedures - that was us processing.

Ron and Danika understood. That’s how you survive this job. You find the absurd moments and you squeeze every bit of laughter out of them, because if you don’t, the other moments will crush you.

Ron eventually became a District Chief and the “695 Days Without Overhead Door Damage” sign got reset to zero.

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Paul and I were assigned to Charlie Division on the south side behind the large IKEA warehouse. We were told to report to an engine company from a neighboring jurisdiction and work under their command.

Figure 1 There were no buildings within the boundary at the time of the fire, all brush and trees

We arrived, geared up, and walked to the engine. They were flowing water from their deck gun into the greenbelt. A perimeter fence ran the length of the IKEA property between the engine and the fire.

We checked in with the officer - “passporting in,” in fire service terms, meaning we were now operating under his command and his responsibility.

Paul and I could both see immediately that the deck gun stream wasn’t getting anywhere close to the fire. The water was hitting the fence and brush well short of the thick stand of trees burning in the basin below.

“We’re assigned to your division,” I told the officer. “What do you need?”

“Just sit tight. We’re flowing from the deck gun because we can’t get close due to the fence.”

They had all the water pressure in the world - the IKEA fire pump was running and pressurizing the hydrants on the property.

“Your stream is completely ineffective,” Paul said.

“It’s the best we can do because of the fence.”

Paul and I looked at each other.

We walked over to their engine and found the circular saw. Checked that it had a metal-cutting blade. Fired it up.

We cut an opening in the chain-link fence large enough to get people and equipment through.

When we walked back to the engine, all three firefighters were staring at us like we’d performed magic.

“We’re going to extend all your two-and-a-half-inch hose down into the basin,” I told the officer. “Then wye off with your forestry bundles.”

They looked at us like we were speaking a foreign language.

We made the connection and shouldered all the 2½” hose we could carry. We made our way down through the fence opening toward the burning trees. Stretched everything they had, then came back up.

At no point did any of the three firefighters make an effort to assist. They just sat on the engine, flowing their ineffective stream into a fence.

We grabbed all their forestry lines - the smaller, flexible hose used for wildland firefighting - and went back down. Set up the wye connector, divided the water flow, and Paul and I worked out our plan for attacking this section of fire.

Maybe an hour in, a Battalion Chief from the neighboring department came down.

“How are things going?”

“Making good progress.”

“Need anything?”

“Water to drink and bodies to help would be great.”

“Okay.”

We never saw him again.

At some point after the BC left, we heard “Emergency Traffic” on the radio - the call that makes everyone shut up and listen. An engine in Bravo Division couldn’t get water from their hydrant.

We found out later from Marc - one of our guys working another division - what happened. The engine had made the hydrant connection. The officer called for water. The driver stood there looking like a monkey fucking a football, unable to figure out why no water was flowing.

The officer and driver had a meeting of the minds to troubleshoot this complex problem.

Marc, standing nearby, could clearly see the hose was flat. While they conducted their investigation, he walked to the hydrant and turned the operating nut until it was fully open, then backed it off a quarter turn.

Like a biblical miracle, water flowed.

Paul and I worked non-stop in that basin for close to five hours. Except for the BC’s brief check-in early on, we saw no other firefighters. We successfully extinguished the deep-seated fire in the trees and brush. Over the radio, it sounded like all other divisions were close to or had already knocked down their fires.

We were exhausted, starving, and thirsty.

We made our way back up through the fence opening to the IKEA parking lot.

Not only were the three original firefighters from our assigned engine still there - another engine company from the same jurisdiction was with them. All of them sitting down, finishing off several pizzas that had been delivered.

At no point had we heard any radio traffic about food being ordered or delivered.

The looks on their clean faces when Paul and I emerged from the basin - filthy from head to toe, covered in soot and ash - made it clear they’d forgotten about us.

There wasn’t a single piece of pizza left.

They knew they’d fucked up.

We were too tired to tell them what we were thinking.

I radioed command directly, bypassing our “division officer.” “Requesting to be relieved.”

“Check with your division boss.”

The officer just nodded.

Paul and I had cut through the fence, stretched all their hose, set up their attack lines, and worked a five-hour firefight while three - then six - firefighters sat in a parking lot and ate pizza.

Our BC gave us a pat on the back when we got back to the station. He knew what we’d dealt with.

The neighboring jurisdiction didn’t know how to problem-solve past a fence, but they knew how to order pizza and eat it while someone else did the work.

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“Some people are stuck on a ride.”

“Are the ride attendants aware?”

“Yeah, but they don’t know what to do.”

“Which ride?”

He turned and pointed.

The El Nino. Four riders per seat, spins horizontally at first, then the entire arm raises until the ride is spinning perpendicular to the ground - riders going vertical, upside down, vertical again. Over and over.

Right now it was stuck at about 45 degrees. I couldn’t hear the people on the ride over the Midway noise, but I could see them flailing in their seats.

I radioed dispatch: “We have a stuck ride. Notify Fair Safety, Fair Police, and all available Fair FD personnel.”

We made our way to the ride. The attendants looked like monkeys fucking a football - running around, accomplishing nothing.

“Where’s your supervisor?”

“He’s coming.”

“Don’t touch anything.”

A few moments later, the head ride maintenance mechanic and supervisor showed up.

“What do you need?” I asked.

“Give me a second. Let me see if I can fix it.”

We were located near the Orange Gate - a service entrance. I called dispatch and requested Ladder 71 to respond routine. The station was close.

The mechanic looked up from the control panel. “Something mechanical’s broken. The ride won’t operate under power.”

“What’s the contingency plan?”

“I can disconnect the gears. The system will freewheel - the heaviest car will settle to the bottom by gravity.”

I yelled up to the riders, explaining the plan and asking them to be patient. One special needs kid was losing her mind. We were going to try to catch her car first if the balance worked out.

That’s when the Engine Company officer for the fair arrived.

He’s a good guy. But he tends to overcomplicate things. He’d been on the SpecOps team.

He started yelling at everyone to get off the platform.

I went over to explain the plan. He wasn’t listening.

“Tell the mechanic to lock out, tag out the ride,” he said. Then he walked away, already on the radio calling for additional resources.

Fortunately, I’d already requested Ladder 71. They were pulling up to the Orange Gate.

The officer on L71 was Denny. We’d worked together for years - he’d been an officer since they used wooden fire plugs.

He checked in with the Fair Engine officer, who told him to find me because “I know what he wants you to do.”

I found Denny. “He wants us to lock out the gears and use SpecOps to lower all nineteen of these people with fancy rigging. Rope-a-dope rescue.”

Denny laughed. “What’s your plan?”

“Mechanic disengages the gears. We use two A-frame ladders and about ten of us to stabilize each car as it settles. Unload the passengers. Release the car, let it settle via gravity. Lather, rinse, repeat.”

Denny called everyone together and had me explain the plan. The other officer was off doing “officer stuff.”

We set up two A-frame ladders next to the ride. No car was level with the platform yet, so we’d have to let it settle once the mechanic pulled the gear release.

The mechanic made a safety speech before starting.

“Do NOT stand in the way of the cars until they’ve completely stopped,” he said. “They have more than enough force to knock you off this platform.”

Everyone nodded.

The mechanic pulled the release. The ride started to freewheel, eventually stopping with the heaviest car at the bottom. Everyone grabbed the car to keep it from moving. Luke and I positioned the ladders, released the harness, and helped the passengers down.

The operation went smoothly. Everyone got into a rhythm.

We were maybe ten minutes in, half the riders off, when we released another car.

For whatever reason, the mechanic - who had given the safety speech - did exactly what he’d told us not to do.

We got to watch him get knocked flat on his ass.

It was pretty funny. The only thing hurt was his pride. Everyone laughed, including him.

Twenty minutes total. All nineteen riders safely off the El Nino.

Had we done the pick-off rope rescue the other officer wanted, we’d have been there for hours.

I’d worked with Funtastic Carnival’s ride mechanics on several rescues over the years. I knew the two guys who actually understood the mechanical systems inside and out. The ride operators are just hired hands for the season - they can run the controls when everything works, but they don’t understand the systems. That’s why I told them not to touch anything.

The mechanics knew their equipment. They knew the contingency plan. Letting gravity do the work was the right call.

The Fair officials and Funtastic were happy with how smoothly the rescue went. The other officer never said a word about it afterward. Denny and I had a good laugh about the “rope-a-dope” conversation.

Twenty minutes. Simple solution. Everyone home safe.

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Sitting here with electrodes on my legs reminded me of an earlier experiment.

The Lifepak Incident - Early 2000s

The department was replacing our Lifepak 12 cardiac monitors with new Zoll units. Standard practice when introducing new equipment: overlap period to let crews get familiar before the old gear disappears.

Figure 1 LifePak 12

Figure 2 Zoll

Our crew had the new Zolls dialed in. The old Lifepak 12 sat upstairs in the dayroom, waiting to be collected.

We were sitting around shooting the breeze when someone - I don’t recall if it was Jim or me - brought up an idea: Could you use the Lifepak’s pacing function as a TENS unit?

Only one way to find out.

We put the pads on our arms and started cranking up the amperage to see how much we could take. The muscle contractions were intense but manageable.

“You could probably go higher on your leg,” one of the guys said. “Bigger muscle mass.”

Challenge accepted.

We put the pads on my thigh. Jim started dialing up the amperage. By the time he got up there, it was genuinely painful - I was gritting my teeth, trying not to tap out in front of the crew.

That’s when our Medical Services Officer, Dan, walked into the dayroom.

He looked at me with electrodes on my leg, Jim with his hand on the dial, and all the guys sitting in recliners watching like this was pay-per-view.

Dan didn’t say a word.

He turned around, walked back down the stairs, and left the station.

We had a good laugh, then got down to the important business of determining who could take the most amperage.

The experiment was interrupted by a call.

The S-ICD Test - A Decade Later

Fast forward ten years. I’d been injured at an apartment fire and ended up with an S-ICD - a subcutaneous implantable cardioverter-defibrillator. After months of recovery and stubbornness, I’d convinced the doctors to let me return to work with conditions.

I was given a list of things to avoid because of the S-ICD. All electrical: arc welders, MRI machines, TENS units, industrial magnets, certain power tools.

Most people would see this as a “do not do” list.

I saw it as “let’s see what happens.”

I systematically checked off most of the list. Then at FDIC in Indianapolis, we received instructor gift bags that included cheap TENS units.

The guys told me I should get rid of mine since I couldn’t use it with my S-ICD.

I’m not an electrician, but I’ve done enough electrical work to understand how electricity works. As long as you don’t put the leads across your heart, the electricity from a TENS unit will never affect your heart. Electricity travels the path of least resistance, lead to lead.

I had an appointment coming up with my electrophysiologist, Dr. Salam. I was going to bring him proof of my logic.

Marc was working at Station 63 that day. I called him.

“I’m coming by. I need you to hook me up to the monitor.”

Marc hooked me up to the cardiac monitor. We started with the TENS unit on my right calf, cranked the intensity to maximum, and ran a continuous printout. As expected: no change from baseline.

We did my right arm. No change.

Then we did my right pectoral - the closest to my S-ICD. This was the only placement that registered anything on the 12-lead, and it was just interference from the muscle contracting. Not actual cardiac activity.

We printed off the entire test and the 12-lead report.

At my next appointment, I handed Dr. Salam the printout and explained the systematic testing we’d done.

He looked at the data. Then he looked at me.

“This,” he said, “confirms that you are only separated from primates by the fact that you can walk fully upright.”

“I don’t want to know about it,” he said, handing the printout back.

Dr. Salam didn’t approve the use of TENS units. He just acknowledged that the data showed what I’d claimed it would show, and that we never had this conversation.

I systematically checked off everything on that “do not do” list. Nothing on it interfered with the S-ICD. But Dr. Salam maintained plausible deniability throughout.

Dan, our MSO who’d walked in on the original Lifepak experiment? He never brought it up. He knew better than to engage with knuckleheads.

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