“Springfield Truck 10, respond to XXXX W. XXXXXX St. for a possible J4, with an unsecured domestic situation in progress”

“Truck 10 copies, en route. Truck 10 will stage upon arrival, Dispatch, please notify when scene secured by PD”

“Truck 10, update, there is no domestic, that was a child crying in the background, this will be for a possible overdose”

“Truck 10 copies, upgrading”

And like so many similar calls, the Engineer lights up the lights and I wind up the siren to respond to yet another drug overdose scenario. The above conversation may sound like gibberish to the outside world, but it is a common conversation between Dispatch and our end in the rig. A “J4” is a deceased individual in our lingo, and if there is a domestic violence situation, the fire department will “stage”, or wait near the scene until law enforcement secures the scene as a matter of protocol.

We arrive to a scene with a woman screaming at us to get into the house, that her brother in law is in the bathroom with a needle sticking out of his arm and “get your asses in there, he’s dying!”

True to her word, the individual is lying in the bathroom, his brother-in-law alternatively sobbing and screaming for him to wake up. The room is tight and time is as well, so with minimal conversation, and a murmur from my end, we haul him out to the kitchen floor and begin to unceremoniously cut away his clothing; we must hurriedly begin our chaotic ritual of rhythmic flogging of his heart and getting precious air and blood flowing again. The police rush in, followed by the medics who immediately commence the modern-day alchemy of trying to reverse the effects of heroin, to revive the dead and grab the patient away, once again, from the selfish clutches of addiction.

Performing CPR is labor-intensive, awkward and messy. The tangle of chords and machinery add to the cacophony and the lack of conversation is reflective of what we already know to be true: 30 minutes down (so we’re told) and asystole tells us that the spark of life is gone; this does not stop us from trying like hell for another several rounds to jump-start his heart, both chemically and through sheer physical force. All the while the brother-in-law is telling us the tale: he’s 36, been in a long-term rehab facility and just out on a weekend pass. He’s got family problems, as so many of us do, and here, among the half-eaten ham sandwiches on a kitchen table, kids toys scattered everywhere and cartoons blaring in the background, it’s all over. A phone call to medical control will be made, and all efforts to save his life will cease, for they are in vain.

I’ve been so caught up in the routine and rhythm of our crew pounding away at his chest and introducing air into his lungs that this is the first time I’m truly looking at him, noticing little things. Wondering what was going through his mind when he laced up those shoes this morning, not knowing it would be for the very last time. What torment must have been raging through him to give in to his hard-fought demons, telling his family he was just going out “to score a chew” and (probably) that needle full of liquid release. My cousin passed away from an overdose, and I think of him often in these scenarios….what were the firefighters thinking when they had to respond to his house, did they take the time to wonder about him, the sweet kid I knew who’s life was upended and ended by such savage addiction. I read over our victims info, his family sobbing and wailing in the background, the police holding them back so kids won’t see this strange vision in their kitchen, a half-naked man sprawled out and looking beat nine ways to hell.

Like so many communities around the country, the 417 has seen a surge in opioid addiction and overdose and it is usually in form of heroin. There are drugs to counter the immediate effects heroin has, and our patients will actually get angry with us when brought back from the brink of death, furiously asking why “liquid party pooper” has been used to ruin their rush. We help in the moment, knowing all the while that another score will be made shortly, and it’s just a matter of time before we see them for the last time.

I don’t have answers for any of this, and that is the most frustrating part as someone who responds to call after call after call. Addiction haunts like no other, and the chemical hell wreaked upon the body torments far more than the user. The pain chokes out family members, friends, everything that was once important. We’re left to stand over the bodies, wondering what could have been done differently for this son, that daughter, this cousin, gone far too soon, but released finally from the death-grip that has consumed them, entirely.

We pack up the large amounts of trash associated with this particular business, quietly, while the police and lead medic are left to have that gut-wrenching conversation with the family. His addiction has affected all of us as well, for each time we watch another person lost to the battle, it tears at our souls just a bit, even if we’ll never publicly own up to it. I selfishly admit to myself how lucky I am I’ve never slipped into a dance of addiction greater than coffee, and worry daily about the choices my own boys will face as they reach the age where such options abound.

Please don’t let them fall into that cycle.

Please don’t ever let firefighters have to stand over the body of my son, wondering what his story was that lead them there.

Please don’t let me be on the other end of that phone call.

The notion haunts me, as clearly as the face of that man will, for years to follow.