It's crazy in there, people screaming, confusion and chaos so contagious even the dog looks worried. The old lady islaying in her bed, struggling to breathe. Surrounding her are her well intentioned but completely useless family, sons, daughters, brothers and sisters, and a grandchild or two.
The old lady is sucking on her empty inhaler for all it is worth, her skin a pallid blue, eyes wide, jugular veins distended.
"Move it!" I say and the assembly ignores me.
"Get out of the way!" I say, and they move closer to the patient, suffocating her, She says something, the crowd roars, more pandemonium ensues and things begins to go downhill even faster than they already were.
"Who speaks English?" I ask, elbowing my way through the crowd,
Nobody. Not a one. Seven thousand people crammed into a 12 x 12 bedroom and a language barrier keeps us worlds apart. It doesn't matter, though, an Asthma attack looks the same in Spanish and English.
So does a medic on a mission.
The message to make room sinks in, and the seas part, and I'm able to get to Amaryllis, whose panic subsides a little. The stair chair arrives, I put a non-rebreather that had been deftly modified by my partner into a breathing treatment delivery system over her face, the airway clears, just a little, but a little is a lot for the patient and we begin to move.
Like the sun breaking through the clouds a little angel appears in the doorway. Everybody looks at her, dozens of eyes on a little seven year old girl, whose grandmother is masked, panicking, tied to a chair by men in uniforms and being wheeled out of her home.
"That's my Granmama," she says, nervously. "She has Asthma."
She hands me a bag of medications, and asks if she can come in the ambulance.
"Of course, you can. You are the most important person here right now," I tell her, and she leads the way, the nervousness gone. Her family stands to the side as we wheel the patient out, and follow the little girl, who in the Dominican Republic would be just a little kid, but here is the leader of the family.
She tells us all about Granmama as we treat her, switching from Spanish to English with ease.
Kids grow up fast when everybody is depending on them. Fast and well.