Just because it’s a duck 99 times in a row, doesn’t mean it won’t be a Zebra for the 100th time.

(As always, to keep the HIPPA monster from coming after me, patient names, dates, and locations have been changed to protect the innocent. Partners names have been changed except for in cases where they gave me their okay to protect the not so innocent…)

The 20 of every month used to come with one guarentee; Ms. Amanda. No matter what day of the week it fell on that month, whomever worked the twenty-four hour shift for the 20th was guarenteed to pick Ms. Amanda up between the hours of 2 and 4 AM. Ms. Amanda would call without fail for the same reason, psychiatric emergency. What we all knew was that she knew how to use and abuse the system. Call 911, have the nice men and women in the big bright white box come and take her to the local ER, and she’d get a months worth of her medication for free. Wash, Rinse, repeat was her game. Sometimes, if she didn’t get what she wanted, she’d hospital shop for the next week until she found someone who wasn’t familiar with her and gave her what she wanted.

The crews became so familiar with her that most of the times the patient information was taken down before the crew arrived on scene. She called from the same place, saying she felt like killing herself, had no plan to, hadn’t talked to her social worker, and heard voices telling her that she’d be better off dead. Every month on the 20th, she’d go, get committed for 72 hours, then leave with free drugs to do it all again.

I know I began to lose my patience with her. One night, we took her over 20 miles away from our district, when a call came in for a possible shooting. The little slice of paradise I worked in only had one ambulance crew on at any given time, so we were running solo. The shooting was confirmed, and another company came in to take the patient while I was stuck taking Ms. Amanda, who had no “true” medical problems in my opinion at that time, to the hospital.

Almost 2 years of dealing with this woman angered many people in the service. Multiple crew members tried speaking to the ER physicians on duty about doing something with her. She was obviously in need of help, psychiatric and otherwise, but no matter what, within 72 hours, she’d be back on the streets.

I’ll admit my own part in this; I became complacent. I just didn’t want to deal with her. To me, she never gave me a challenge, a reason to take her to the hospital. She would just sit on the strecher and take up my precious sleep time. Even for a BLS trip, I’d still have to write a trip sheet on her, and because of the computer system at the station, a simple sheet could take an hour or more if the internet was acting up. If I was getting slammed that day, it was easily an hour or two taken away from my sleep.

The next month approached, and of course, I had the 20th again. This time, I told myself, I had enough. She was going to hear about how taking her was a waste of time; I could be out helping people who needed it instead of taking her to the hospital to just get drugs.

That night, I noticed the locals were out in force. It was a very hot night in the ghetto, and the natives were restless. We ran multiple assaults that day and into the night. Like clockwork, at 3 am, Ms. Amanda had gone out to the pay phone in front of her apartment and dialed 911.

As we pulled up, my partner and I both noticed she wasn’t waiting. Usually we’d see her standing in the wash of the street light giving us a pittiful wave. Odd, but what could I expect from her? In my mind, she did it in spite, something just to piss me off. I noticed movement out of the corner of my eye, and I saw a bunch of people tear off from behind one of the row houses. I locked the doors of the ambulance and asked Dispatch to send PD to the location. Only then did I noticed that Ms. Amandas’ front door was wide open, and the house looked ransacked. I rolled down the window and called out her name, but no one came to the open door.

I turned back to my partner, who was ready to get out of the truck, when I heard a noise. I turned around and jumped three feet out of my skin. Standing next to the truck was Ms. Amanda, covered from head to toe in blood, her clothes torn to shreads, and she was crying.

I jumped from the ambulance and took her into the truck. I began to bandage some of her wounds while trying to figure out what was going on.

“Ms. Amanda…what happened?”

“They beat me!”

She then broke into sobs. After some teeth pulling, she finally relented her story. Her family would take her psych meds from her, the minute she would get off her committment and sell them. Most of the time, they’d pick the drugs up from the pharmacy before she could get there, other times, they would wait until she was sleeping then nab them. In two years, the only time she would actually take her meds was when she would have to stay in hospital.

I felt like shit.

Because I somehow forgot that my own shit stank as much as the next person, I never asked the important question of why? I could ask all I wanted about the pathology of her complaint; What do the voices want? How long have you been feeling this way? Is this normal for you? but I never asked.

“How long has this been going on?”

“For years…”

“Why didn’t you ever tell anyone?” I crooned to her softly. What she said next blew me away.

“No one ever asked. Most people don’t even speak to me, no one, not even medical people care about me.”

My heart broke. I couldn’t believe what I had become. I was the helper; I was supposed to hold hands and help heal all wounds, but because I allowed the woman to become a bother to me, I didn’t do my best to help her. We got her to the hospital, and we relayed exactly what was going on to the nurse and doctor.

I never saw her again after that night, but I do hope that Ms. Amanda finally got the help she needed.

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