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Friday, December 12, 2008

Remembering Eric Rivera - EMT

By Steven P. Velasquez
December 12, 2008

EMT Eric Rivera - Rest In Peace Brother
When I first got my job at the MC, one of my regular partners was a guy named Eric Rivera. If the MC was a fraternity, Eric would be "legacy" as his older brother Eddie had gone before him. 

Eric had a shining personality that would naturally accent a room. He was charming beyond words; just ask any of the ladies! A handsome Latino somewhere in his early 20's, we used to tease him because he had a striking resemblance to Eric Estrada, the actor who played "Ponch" on the hit TV show "CHIPS." That used to drive him crazy, but I digress.

My first Christmas Eve, he and I worked together and there wasn't much going on. Without a place to aim our energy and attention, they turned inward, and so began the sad conversation of where we'd rather be than here. We talked of our families, our traditions, the things we used to do and how much we'd rather be doing that, than rolling through a quiet Journal Square in search of trouble. Long story short, we were bummed, but not for long.

The radio was no help either as one station to the next played sappy Christmas song after sappy Christmas song. We wanted to pull our hair out. Finally, we decided to be happy. That’s right, we made a conscious decision to be happy! We made a commitment to not let the drama of being away from our families ruin our night.

Journal Square had several Christmas trees lined and decorated by the taxi stand. I pulled the truck up close, pulled a branch close to me and clipped a small branch off with my shears. Eric whipped out the 2" surgical tape and we fastened our sad looking, Charlie Brown, Christmas tree to our dashboard. We then took some tinsel off the larger trees and began to decorate our little holiday shrub. A 5X9 was cut to shape a small blanket for our tree and so our night began. We decided that we would be each others family that night and so, it became a Christmas merry.

Our friendship grew stronger in the weeks and months that followed. We'd go drinking and dancing at Harpo's in North Bergen and he would tear up the dance floor. You know how those damn Latino's are with their swivel hips!! Women gravitated toward him, but so did the drama that comes with them. Eric was always getting yelled at by one or the other as he'd get caught with his hands in the proverbial cookie jar again and again.

About a year later, Eric left the MC. If memory serves me correctly, he took a position with Continental Airlines and away he went. I never saw him again but always remembered our Christmas merry, together – rolling through Journal Square.

Many years later, I had left the field to pursue a career in computers & technology. I was living in South Amboy with my (then) wife and children and would commute to my job with Empire Blue Cross Blue Shield on the 30th floor of Tower 1 in the World Trade Center. I lived directly across the street from the train station and would only have to shower, cross the street, board the train to Newark for 40 minutes, cross the platform to the waiting PATH train before getting whisked under the ground of my former call area of Jersey City.

"Journal Square," "Grove Street," "Exchange Place," they'd say over the intercom and my mind used to race wondering who above me was working, what was going on etc...? It's true that you can take a monkey out of the jungle but the inverse... well, it just doesn’t work.

The PATH train was always packed; so much so that I sometimes could go flaccid and be suspended in a standing position by the people around me. On one such morning, there was an attractive blonde scrunched up against me (notice I'm complaining) with really big --- eyes! Yeah eyes. We talked briefly, just chatter you know?

"Where ya' from" 
"Jersey City"
"Really, I used to work in Jersey City."
"Really, where?"
"Jersey City Medical Center; I used to work for EMS"
"No kidding? I knew someone that used to work on the ambulances too"

Can you see where this was going?

"Oh, what was his name?"
"Eric Rivera; we used to date for a while" Shocker! I thought silently.


I was beside myself with excitement. I was hoping she might have his phone number, email, something! 

"Do you know where he is or what he's doing? Do you know how I can get in touch with him?"

She suddenly became very somber and said that perhaps I hadn't heard what happened. My heart suddenly was wedged firmly in my larynx. No, please don't tell me.

"Eric died a while ago." The actual date escapes me but I wanted to say it was around 1998 or 1999 somewhere. She told me he was working out, bench pressing or something in a gym somewhere. She thinks he suffered sudden cardiac arrest from an undiagnosed, underlying cardiac condition.

The tears began to well up in my eyes as she delivered the unfortunate news while the PA system in the background droned “Journal Square,” “Grove Street,” and “Exchange Place.” She informed me of this at Christmas time 2000, while traveling beneath the very ground where Eric and I forged our friendship so long ago. She was only one of the tens of thousands of people who travel this same route every single day; what are the chances?? It was like living out some painful dream.

She concluded the story by apologizing for dropping such a bomb on me. Here’s the kicker. I asked if perhaps she knows where he was buried. She tells me some cemetery somewhere in the Amboys.

“Christ Cemetery in South Amboy?” I asked.
“That sounds right she replied.

My buddy and partner died without me knowing and was buried, literally in my backyard. Again, what are the chances?

A few nights ago at shift change in Monroe Township, I was talking to everyone about how great Facebook is and how many friends from the old school I’ve been re-introduced to. One of the EMT’s there named Josh is also JCMC alumni. He shared with me that Eric Rivera was his uncle and that what the woman on the PATH train told me was true.

To those of you who work there today. Take nothing and no one for granted. Work through your differences with your co-workers, embrace each other. You really just don't have any idea... sometimes until it's too late.

Rest in peace my brother.

Thursday, April 24, 2008

Common Threads & Awkward Circumstances

by Steven P. Velasquez
April 23, 2008

Once again the common thread that interconnects us all has revealed itself in a most surprising way. One can debate the existence of this "thread" but the next logical question would be for that person to explain life's coincidences that often manifest as more of a "perfect storm of events," than a benign set of circumstances that are easily explained away.

The Response

While working one of my jobs the other night, my partner and I were eager to hit the road and get a meal. As our luck would have it, we were dispatched to a local nursing home for a cardiac arrest with CPR in progress. These types of calls are often anti-climactic and severely lack the intensity and drama often found on your TV shows. It's often someone who has been quite ill, has not one but many disease processes working against him and his aging set of organs, and they have simply run out of gas – so to speak. They're dying. Many times, even with a rapid response and a bag full of medicine, they are too far gone; they're not candidates for resuscitation and they are pronounced dead in the field by Paramedics with a supervising physician via radio or phone. After answering enough of these types of calls, it often feels like more of the rule vs. the exception. This, of course, does not translate into delayed responses, lackluster care or absence of desire to assist the ailing victims.

Code Blue

As we arrived and were greeted by the nursing staff, we encountered a man in his 70's who has stopped breathing and had no pulses. The local EMS agency was already on scene performing CPR and using an AED (Automated External Defibrillator). "Were any shocks delivered?" I asked. "No, no shocks" they gasped as they compressed the patient's chest vigorously. A long litany of questions follows during this process as we setup our equipment to either confirm death or perform advanced resuscitative measures. The nurse stated that he had no DNR (Do Not Resuscitate order) indicating that all measures to sustain life should be attempted. A quick glance at the ECG revealed asystole or a "flat line" indicating the absence of any electrical activity in the heart (we all will have this rhythm sooner or later!). So far, the circumstances seemed to jibe with the description above. I expected to call the doc, report our findings and receive a time of death. Oh, and then dinner!

The patient lacked one or more of the qualifiers for pronouncement of death though. He had last been seen or spoken to within the past ½ hour, his body was still warm and pliable with no evidence or blood pooling due to lack of circulation. Our doctor instructed us to continue the resuscitation, give some life-saving drugs, and call back with any changes for further direction. Translation? Get busy and, uh, no dinner! My partner intubated (placed a breathing tube in his lungs) and I began an IV so we could administer fluids and medications. After only one round of drugs (1 Epi and 1 Atropine), the patient had a return of spontaneous circulation (ROSC). Initially I thought "Eh, it's just the meds doing their thing; it'll wear off!" Nope! We had nice heart sounds, strong pulses, his mottled (blotchy) skin color seemed to improve and his carbon dioxide levels were in the 40's (definite sign that the body is still producing energy). My partner and I exchanged a look of, how do I put this nicely? "Holy Shit!" Internally I thought "Jeez, this guy must really want to live." We began to move the patient to the stretcher and that's when my world was turned upside down.

The Helmet

As we moved the patient, I noticed a firefighter's helmet on the floor. I asked "where is he a firefighter?" The EMT's replied "he's a firefighter and an EMT from Union City." The words struck me like a giant's kick in the gut. Without seeing an ID bracelet, his chart or re-examining his face, I shouted his name and choked back my tears! "You know him?" they asked. Now, if this were a movie and I was the protagonist, this would be the scene where I grab the EMT by the lapels and shake him growling "You treat him like family – got it? Family!" But dramatics aside and with the absence of my camera crew, I gently told the crew (voice shaking and tears building) the following:

"I want you each to remember your very first time that you ever entered your EMS building. Who was the person that greeted you and introduced you to the place? Who was it that told you 'that's the driver's seat – you won't use it. That's the siren – you don't touch it. This is the radio – you never talk on it! I will?' Whomever that person was for you, this man is for me."

I'm currently in my 21st year of service. Two decades ago when I first joined Union City, this man was already in his twentieth year of service. He served in the US Navy during the Vietnam era, was a charter member of the Union City Volunteer Ambulance Corps. in 1972, was the gatekeeper of the place that would lead to my future career and now I, in a dramatic role reversal, was his gatekeeper between here and the ever-after.

The Location

My "routine" mentioned earlier was suddenly and dramatically turned upside down. The room seemed to elongate and the voices sounded slower than usual. I was caught in a vacuum of time and space. Where I was geographically was about 40 miles away from Union City. How did he wind up here? And, talk about a bunch of circumstances, how is it that he's here on my night to work, in my primary call area, I'm not on another call, I'm not at the furthest distance from where he is etc… etc… "God? Can you hear me? Why me? How?" All these questions and more raced through my aching head.

His Care

We covered him in blankets to preserve his body heat and moved to the ambulance. My partner and I double-checked all our IV's, tubes, machinery etc… This man who spent his life serving so many, caring for the sick, treating the injured, protecting life and property as a volunteer firefighter and until her passing – caring for his mother -- was now in my care. His last hours on this earth were under the care and supervision of one of his own. It was time for him to receive that which he gave so much of.


My partner and I stayed in the ER with him for the next few hours. His next of kin had arrived shortly after we did. She was his best friend and the only one who took care of him. I remembered her as a new EMT and cop wannabe. She now looked like the cast of NYPD Blue as she arrived in a business suit with a 9mm strapped to her hip and a gold badge? "Are you in the detective bureau" I asked? Humbly she replied that she was the new Lieutenant Commander of the night shift in that bureau. There was obviously much catching up to do.

We stayed, spoke to, reminisced with and comforted her. We stroked his hand gently and told funny stories of some of his antics from the past. We quipped that if he regained consciousness, he would probably kill me for not letting him go peacefully. Truth be told, his nurse told us there was no DNR order when in fact, there was. I shudder to think of how I'd feel had they produced a DNR and I had been forced to stand idly as my friend died before my eyes. I suppose I'd feel much worse than I do right now though that's hard to imagine.

My friend lasted through the night and was transferred to the ICU. I withhold his name so as not to betray medical confidentiality of one of my patients. I left work Tuesday at around seven. After running some errands, I called his next of kin to see how he was doing. She was just leaving the hospital and conveyed that he had passed on just a short while ago. She thanked me greatly for providing her with a window of time to wrap her head around these sudden and tragic events. She was afforded a chance to say goodbye. She stood by his side as his heart finally slowed one last time, as he crossed the gate from this life into the next.

And with that, another page of history gets woven into the fabric of life. Take nothing and no one for granted my friends.