I’ve been a firefighter/paramedic for 16 years. In that time I’ve seen strange and unbelievable things. I’ve witnessed carnage and chaos, death and destruction, suffering and sorrow, and in all this time I have yet to become accustomed to it all…I’m not sure if you ever truly do. I still find it all surreal.
In my job, nothing is ever the same. Each call presents a unique set of challenges to be solved. This unpredictability creates an unsettling unknown and unease, one that begins to gnaw at your confidence. Traumatic events are hung inside an abattoir, patient’s and scenes dangling in some bloodied cold storage in the deepest recesses of my subconscious. They are useless memories, stories inappropriate to be recalled in casual conversation. These become my own personal specters that haunt, lingering in the fog of grey matter, waiting to appear at the most inopportune moments. These phantasms approach for remembrance, I having bore witness, only I knowing the truth of those final moments. But then there are those calls that really make you say “What the Fuck?,” those moments when your mouth is agape in disbelief as you are trying to comprehend what it is you are seeing.
When we arrived in the ambulance the pickup was off the road into a tree, the horn blared a drawn-out mechanical scream filling the air of that desolate space. We were on some dank, dark, wooded side road in Maine; the kind of road that has so much winter sand covering the asphalt you can’t tell if it is dirt or paved surface. The hood was up on the old beater Chevy pickup, and a set of legs hung over the grill from inside the engine compartment. I approached the kicking limbs, and at the same time I reached the vehicle, the rest of the body emerged from beneath the hood. The horn ceased with an abruptness that was both a relief and unsettling, leaving the only sound between us the tinnitus wailing in my ears. In his hands were wires wrapped around his fingers tightly, making his distal digits red and purple.
“Fucking noise maker,” he said in a weatherworn and phlegmatic rumbled voice. He had that trademark rattle, that coarse inflection of someone who ate his cigarettes for forty years rather than smoke them. His clothes were tattered and emanated a funk of musk and old whisky. He wore a red flannel shirt unbuttoned, revealing a sweat stained yellowed thermal henley, tucked into a pair of old Levis with tall muck waders on his feet.
Blood smeared across his face and flowed from his mouth with every curse that flung from his lips. Spatters of red spittle stuck to my uniform. Noticing this as he fumed at his misfortune, he apologized.
“Fuck of a time,” he said, “Goddamn mouth hurts.”
I did my paramedic thing; well as much as he would let me. Old stubborn fishermen take care of themselves. It is a different world on the water, and that transfers onto land for them as well. There is a level of self-sufficiency and survival when you are asea, the rollers and white caps bobbing your ship to and fro. He cooperated, but wanted none of my help.
He had scars to match his years on the water. Lacerations covered and maintained with stinking bait rags, crooked, broken fingers, yanked straight, and set on the ocean with bailing trap wire; he bore the signs of these wounds and so many more. I checked him over as much I could. My fingers palpated muscle, felt skin, caressed clothing, pressed on long bones. I left his face for last. At his mouth, I requested a smile. As his bloodied and cut lips curled up in an arc, there it was, the source of all the crimson ooze. A tooth shoved so far up into his gum-line, it looked like the smallest bit of shattered clam shell in a parking lot, after dropped by a seagull high overhead to reveal the meaty pulp.
I told him he needed to go to the hospital. That he needed treatment. He looked at me and guffawed. Yes, guffawed, like a thespian gesticulating humor for some invisible audience. He literally grabbed his stomach, as if I said something so comical he couldn’t contain himself. My response was to stare at him with that same, pleading look, the look I give all my stubborn and troublesome patient’s, the “Please don’t be difficult. Please just cooperate and come along. Be one of those patient’s that makes my job easy,” look. And he was one of those patient’s. He made my job so easy.
“I need some pliers,” he said walking away from me. Rummaging through the front seat of his pickup, he came back with a set of rusted needle nose pliers. Holding them up, he presented the tool as if showing a flashlight to some amazonian lost tribe at first contact with explorers. He smiled that cockeyed, crooked tooth smile, and said nothing, while his actions implied I bear witness to what he was to do; he came to me for witness.
Those grooved steel ends gripped a hold of that chiclet tooth, as he felt around blind for the malefactor which he would remove. Self-induced oral surgery on the side of the road was a first for me. Squeezing those handles tight, he pulled with both his gnarled and skin cracked hands and stopped to catch his breath. Blood oozed from the side of his mouth in a long viscous slimy stalagtite that hung from his lips. He leaned against the truck and panted, taking a break. Standing again, he gripped tight, finding the tooth instantly.
It did not come out on the first, or second, or third, or even the fourth try. His arms shook and hands were white knuckled as he continued with the extraction. I could do nothing but watch.
The police officers and other firefighters lingered at a distance, steeling themselves not to vomit. Some cringed and covered their eyes, peaking through slits in intertwined fingers. I was mesmerized, I couldn’t avert my eyes, compelled to observe. It took about ten minutes and multiple repositions of the instrument. When all was said and done, he was left with a bloodied mouth, and whole tooth, root and all, resting in his cupped palm.
I advised transport to the hospital but was waved off, dismissed as if what I asked was nonsensical timidity. He signed my release form, blood smearing all over the pages—I wonder how many documents at work have blood on them.
Hours later I brought in patient number nine. Weary from the day, I grabbed a cup of coffee at the counter, when I heard it, that rough, rumbling, sandpaper throated voice. I walked into his room, and there he was, his family around him, and he in a c-collar holding that damn tooth in his hand.
“Are you fucking kidding me?” I chided him, “What the fuck? You wouldn’t come with me, but here you are, just kicking back like you own the place.” We laughed. His wife expressed dismay on his refusal to go to the ER by ambulance and his self extraction. She lamented his stubbornness, which almost killed him. Cervical fracture of the spine. Almost paralyzed. And to think how he wrenched his neck around as he yanked at that tooth.
You can’t force someone to go to the hospital if they are alert and oriented, thats called kidnapping.
We bantered back and forth for a few minutes. I shook his hand, now washed of all the blood. We exchanged goodbyes and just as I entered the hallway he called to me, raising his hand, holding that yellowed ivory tooth between index finger and thumb.
“Don’t have to pay them to fix my tooth.”
“No, no you don’t.”