It was a quiet night in the Middletown Division of Fire headquarters.
As reruns of “Blue Bloods” were shown on a television no one was watching, the scanner in the corner of the room was silent except for an occasional call for a resident who fell at one of the local nursing homes.
“Feast or famine,” is how Capt. David Von Bargen described a typical night in the firehouse.
Then, just like that, chaos broke out.
In the matter of a few minutes, all 17 emergency personnel working in the city Monday night were on calls and the fire department requested mutual aid from the Monroe Fire Department. At one time, there were four medical units and one fire truck parked outside the Atrium Medical Center emergency room.
Von Bargen and others had responded to a call for someone having difficulty breathing at a Middletown hotel. As the man was being transported to Atrium, another call was dispatched, an all too frequent call: A drug overdose.
Four paramedics and three police officers responded at 7:30 p.m. to the overdose behind the Midd-Town Carry Out on Central Avenue. Emergency personnel found an unconscious man lying between two vehicles across the alley. His breathing was shallow, Von Bargen said.
At first, paramedics tried to start an IV, the fastest and most effective way to push Narcan into the man’s system, and when that failed, Narcan was administered through the man’s nose. Then an IV was started. The entire time, paramedics bagged the gentleman until his oxygen level returned to normal. Two doses of Narcan, twice the normal amount, were used to revive the man, who was transported to Atrium, Von Bargen said.
In 15 minutes, the scene, once chaotic, was cleared.
Middletown paramedics and police officers have responded to nearly 600 overdoses this year, and 54 have resulted in deaths, fire officials said. Last year, there were 532 overdoses in the city that caused 74 deaths, fire officials said.
At the current rate, Middletown will use about $100,000 worth of Narcan this year, though the city budgeted about $10,000 to $15,000, said Fire Chief Paul Lolli. The city is hoping to receive a grant to offset the cost of Narcan, he said.
While dealing with an increased number of overdoses is easy to track, the toll taken on first-responders can’t be shown on a spreadsheet.
“You definitely are seeing fatigue,” said Deputy Chief David Adams. “Mental and physical.”
He said sometimes paramedics will respond to as many as 18 emergency runs in a 24-hour shift, and the turnaround for each is about one hour.
“That’s a long shift,” Adams said. “We send people home tired. There are times when we’re stretched thin. It is what it is.”
Each night, each call, he said, the department “plans for the worst.”
He called it “a balancing act sometimes.”
“You try not to judge them. But there are days when you get a little frustrated with it. I can go home and my wife can tell sometimes.”
- Middletown paramedic David Pittman
Adams, a paramedic with 24 years of experience, wonders when the city will see a decline in the number of overdoses. He said overdose calls are “labor intensive” and, depending on the circumstances, can be chaotic and dangerous for first-responders.
“It’s a problem we’re grappling with,” he said. “But we’re hoping there’s a light at the end of the tunnel. There is an answer somewhere to this problem that’s affecting families and it certainly affects our firefighters and paramedics. No one seems to have the ‘magic bullet’ right now.”
Middletown paramedic David Pittman said responding to large amounts of heroin overdoses can be frustrating, but, he said, it’s important to treat every patient with compassion and empathy.
“You feel sorry for the family members who are around,” Pittman said of overdose calls. “Is this gong to be a mom who did it in front of the kids? Or a dad who did it in front of the kids?”
He was asked about the toll overdose calls can take on first responders.
“The mental drain will turn into a physical drain,” he said. “There are people I have recognized who I gave it to a couple of times. You say, ‘What’s it going to take to get you to move forward on it?’ Sometimes you get angry with it. You try not to judge them. But there are days when you get a little frustrated with it. I can go home and my wife can tell sometimes.”
What’s a successful run?
Pittman mentioned bringing the patient “back from possible death” and through a conversation in the back of the medic unit, convincing them they may have “hit rock-bottom and it’s time to change.”
After someone overdoses, and they have been stabilized, the ride to the hospital is a good opportunity to address their addictions, said Von Bargen, EMT supervisor. He has instructed the paramedics to not judge those who overdose, but to treat them with respect.
“Something has led him to this position and we’d love to change that course of action,” Von Bargen said when asked about Monday night’s overdose run. “So many of them that you meet are actually good people. When they’re not using the drugs they’re good people, good hearts. They’re not all criminals. They’re stuck in a rut.”
Von Bargen remembers an overdose that occurred three years ago. He was in the back of the ambulance. It was a great opportunity to talk to the man who overdosed, he said.
He said the 26-year-old Marine, who got injured fighting for his country, became addicted to painkillers. When the medicine ran out, “he moved to heroin,” Von Bargen said.
Von Bargen asked the Marine if he wanted to live that way.
“I really want help,” the Marine said.
That’s exactly what Von Bargen wanted to hear.
“We have to show them the way,” he said. “If they’re ready and we miss that opportunity, we didn’t finish our job. Yes we saved a life or did we? We may have just delayed the inevitable.”