Lawyers, Guns and Money

Had my preceptee back today after a couple week absence.

Started off with two COPDers with mild dsypnea.

Then we got called for a psych at the Y. The downtown Y is pretty much just a homeless/psych ward these days. We knock on the guy's door. Two ladies from mobile crisis, two medics, an EMT and three cops. The guy -- a large man -- sticks his head out of the door and starts harrassing the ladies, then he turns his head, sees us, and changes his tune. He is suddenly thrilled to be going to the hospital where he can then be transfered to the pscyh hospital. I guess his room is only paid through the next day. He gathers all his stuff, a couple bags, a boom box and big red electric guitar. "I'm happy to go, happy to go, coming right now. Let's go, let's all go." I have Haldol and Ativan in my pocket because we have heard he could be violent. But he is all smiles and babbles the usual psych babble about working for the CIA. "I'm an agent, that's right, that's me, but I'm ready. let's go, let's go get debrieved. I'm ready to come in from the cold."

We get to the hospital, and as we're wheeling him in, he starts changes his tune. "What's your name?" he demands. "What is your name?"

"Warren," I say.

"Warren what?"

"Warren Zevon."

"Bullshit! Give me my guitar. I have a summons for you. I have a summons, and when I am done, I will have all your money. Now give me my guitar. Don't you touch my guitar." He tries to grab the red guitar from me, but I keep it out of his grasp. I am worried he will try to EL Kabong me.

Now we are in sight of the triage nurse, and he really starts shouting. "I will destroy all of you. I have a summons in my bag and you will all be mine, motherfucker's!" He is now shouting at the top of his lungs and punching his fists together. I stand behind the stretcher. If he starts to tip it, I can grab it, other than that let him shout. The hospital security starts to gather and he is harrassing them now. "Com'on motherfuckers, comon sissy boys. You ain't tough. I have summones for all of you and I will own all of you!"

The nurse wants his jacket off and him searched. Securiy holds him down and we lower the stretcher so if he does fight, he won't tiopple the stretcher. He doesn't resist, but he continues to shout at them now. "Go on take my clothes! Go on rape me! Show your wives you like dick!"

A doctor comes to the front and orders Haldol and Ativan for him. She glances at us like why couldn't we have sedated him. I have the drugs in my pocket. "He was fine until he came in the door," I say.

"Rape me, rape me motherfuckers. I know you all like dick!"

We take him into the pscyh ward where the guards four point the man to the bed.

I stand outside the room holding his red guitar. I strum a few chords.

I sing:

Well, I went home with the waitress
The way I always do
How was I to know
She was with the Russians, too

I was gambling in Havana
I took a little risk
Send lawyers, guns and money
Dad, get me out of this

I'm the innocent bystander
Somehow I got stuck
Between the rock and the hard place
And I'm down on my luck
And I'm down on my luck
And I'm down on my luck

Now I'm hiding in Honduras
I'm a desperate man
Send lawyers, guns and money
The shit has hit the fan

Send lawyers, guns and money...

Lawyers, Guns and Money
-Warren Zevon

***

We take a lady with a head ache back to our most distant hospital. It seems this is her second ambulance trip today. She says they told her if her headache got worse she should come back. The firedaepratment has told us she is a frequent flyer. My preceptee says he remembers her from a couple weeks ago. I don't recall her. We get to the hospital and the doctor is perturbed to see her. A nurse says this is her 12th trip this week to the ER. She evidently has worn out her welcome at the nearer hospitals as well.

***

Last call is for a diabetic with a sugar of less than 20. She is very old and thin and pale and cold. My preceptee gives her 25 grams of D50. For a moment she looks like she is not breathing, like she dead.

She comes around slowly.

***

By the end of the night it is pouring rain again.

diabetic