Dakota Ayers -An EMT's Perspective

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As an emergency medical technician, Dakota Ayers has seen a lot of pain and illness, much of it related to opioid addiction.  When he responds to calls, he's not there to judge.  

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Growing up I wanted to be a cardiologist. And after I graduated high school, I soon realized, Wow, med school takes a long time! What can I do to make an impact on society now? What can I do to matter?

I am an EMT, an emergency medical technician. We only run medical calls, so anything from the flu to chronic back pain to car accidents and people who suffer from drug addiction, because that is an illness.

I’d say the percentage of drug calls that we run into would be about 60-70% of every call. We will either get the call from the concerned citizen. They see somebody on the side of the road doing what we call ‘the nod,’ that heroin nod. They’ll call 911. Or you’ll have people who are getting high together, and they realize one of their friends took a little but too much and now they are unable to wake them up so they’ll call 911, maybe throw them in a cold shower, and then just leave. Which makes it much harder for us to do our jobs because how can we really help you if we don’t know how long you’ve been in this condition?

We’re medical professionals and it’s not we’re there to arrest anyone. We don’t have the ability nor do we have the want to arrest anybody. Honestly, the most important thing is getting the full story. That’s all we care about is rehabilitating them to the point of reviving them and helping them to get the medical care that they need.

If somebody is slumped over on the ground and they’re unable to pick themselves up, what we need to do is get them on to the stretcher. And what we do is we can either go under their arms and pick them up by their extremities, under their arms or legs. It takes a lot of strength and it takes a lot of effort and when you’re doing that nonstop for 12 hours every single day, it’s very easy to become numb. To forget that you’re not picking up a patient as a part of your job. You’re picking up a human. You’re picking up somebody’s brother, somebody’s child. You know, you’re picking up a person.

And, really, what I do sometimes is I like to think about people in my family that I know have suffered from opioid addiction, and I know – I’m so sure, I don’t know for a fact but I’m so sure -- someone has called 911 on them before. And when I’m with my patients, I like to remember that and think about that to bring that level of self-awareness and consciousness to the scene. And just to remind everybody that we’re around that, you know, let’s take a second look at what we’re doing. And let’s make sure that we go about this, not only by our safety protocol, but let’s make sure we are giving these patients the extra respect that they deserve for being humans.

Once we get the patients on the stretcher, we have to do what we call an assessment, checking their vitals, their blood pressure, the amount of oxygen in their blood, so on and so forth. We also have to document their story -- how they got to where they are -- because that’s a part of their medical care. There’s a large difference, there’s a huge difference between somebody who’s been an addict for five years, one year, or has been a chronic problem throughout their entire life, thirty-five years of abuse. We have to treat that differently, we see it differently, and we have to report that to the hospital differently.

Somebody who’s been an addict for thirty-five years is going to have much more trauma to their organs. You need to be able to assess how much tissue damage they may have, how much opioids or heroin they have injected into their system, or snorted or smoked into their system, in that moment because that depends how much medicine on our end that we need to give you. If I give you two shots of Narcan, intranasally, up through your nose, but you’ve been using heroin for thirty-five years, I’m probably going to have to up that dosage. I’m probably going to have to do it twice as much. That’s important to know because that’s the difference between allowing somebody to be able to breathe or not.

If somebody calls 911 on themselves. because they feel like they need help, the conversation will go completely different. You know, How did you get here? Why did we come here today? That’s what we say. And then they tell us, Because I felt short of breath. Because I was unconscious. Because I need help.

Sometimes people think they need to be committed for psychological issues or they think they need to be committed for recovery. For a lot of the cases that I’ve seen, a lot of addiction comes from mental illness, and the lack of stable doctors’ appointments that they are able to get, the lack of consistent medication that they are able to get , and the lack of family support that they have.

There’s two different types of calls that we get. We get the patient who is completely overdosed, and then we get the patient that is too high for their own good. A lot of times, we will see people who are high wandering throughout the street, bobbing in between traffic, knocking on car windows at red lights for money. Sometimes they are just so high out of their mind, they don’t realize the dangers of what they are doing. It’s not that they’re so hungry and so greedy for money. A lot of times they are just so far out of their own mind, they don’t recognize the dangers that they are putting themselves in and the dangers that they are putting other people in driving by.

When I’m on scene, when I go on calls, I try to make sure that I provide a level of tranquility to the scene that I know sometimes isn’t always there. I will go out of my way to make our patients feel like they aren’t being attacked because a lot of the times when 911 is called, they don’t want to go to the hospital. They don’t feel like they are doing anything wrong so it’s really our job, and something I try to do day in and day out, is just remain patient and cognizant of the way that you touch people, the words that you’re using, the tone of voice that you have, the way that you guide them into the ambulance.

A lot of these people – I’m only 23. Okay, I’ve been doing this for two years. And most of the people that I pick up are in their 50s, 60s, sometimes 70s, still addicts. It’s so hard to look at somebody who is so much older than you and when they’re looking back at you and they, they feel so small. You can just sense it. They feel small. They feel insignificant. And the vibe that they give off is, is I’m hurting.

Most people aren’t addicts because they think it is fun and glorious. There are some people who are like that but most of the patients that I encounter are-- they’re hurting. And it’s imperative that you look back into their eyes and really acknowledge, I see you as a human and I’m here to listen. It’s not my job to arrest you. It’s not my job to judge you. It’s not my job to tell you, Well, if maybe you did this, then you wouldn’t be in this situation and you know, Get yourself out of these streets, and dahdidahdidah. That’s not our job.

We’re there to save lives.

This is Dakota Ayers and this is my story.

Capt. Tyrone Collington -Alternatives to Incarceration

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Captain Tyrone Collington is the commander of Takoma Park, Maryland's patrol division. His #1 mission is to save lives. Sometimes that entails the use of a powerful tool called Narcan.

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Well, our number one priority from a police perspective is to save lives, and that’s what we want to do.

For our department, there are a number of us, including myself, that are trained to administer a counter drug treatment that you can give someone who you suspect to be overdosing, and what it does is it knocks off the drugs and revives the person, brings them back around. Even if it may not be an opiate, it’s harmless. It won’t cause any other type of medical effects.

Seeing people just strung out, unconscious, unresponsive, eyes may be rolled back in the head, shallow breathing, sometime they may be clammy, cold – it’s troubling because at this point you don’t know how long they’ve been unconscious, you don’t know what drug they are under. So you don’t really know how to begin administering any type of resuscitation or first aid. And you have to be careful that you don’t confuse that for some type of diabetic episode.

Sometime we get the calls from someone saying a friend has overdosed. And we have had anonymous calls where people have been left in bathtubs and it’s so sad. They don’t want to remain on the scene because they don’t want to be involved. So they’ll put the person in the cold water and left them which puts them in even more danger because they could drown.

So we have to get them out of the tub and then we’ll immediately administer the Narcan drug, two squirts, one in each nostril, and that will within there to five minutes start to revive the person.

To see them come back you feel like you’re helping this person live, you’ve just saved someone’s life. But I have been on scenes where I’ve seen the same person in the same state, unconscious, and you just ask yourself, you know, how many more times are you going to be able to come here to save this person before one time it’s too late.

I’ve encountered many different age groups, different colors, different race. You have a lot of professionals, students. Sometime when I see them I’m surprised, especially if it’s someone that I’ve dealt with within the community. And so I always say, You know, you never know what a person is going through, what demons they are dealing with within themselves. It’s a sickness. It’s an illness, and it’s important for us to educate ourselves, educate the community on, you know, how can we prevent this, what signs to looks for, and how to proceed with trying to get them treatment.

I’ve met a lot of good people who have had whatever setbacks and I’ve had conversations with them like, How did you get here?

One incident that really stick in my mind was an individual that told me he was using for 25 years. And I asked him, "How do you continue to look at your body just deteriorate?" And he said, "You know, sometime you just -- you need it. It’s a sickness that we’re dealing with. In our mind, we believe that we can’t function without it."

So when I see people on the street using, immediately I want to refer them to like some type of health and human services. I want to get them to talk to someone. There’s always alternatives to incarceration.

Not all the people that use drugs are bad people. You know, sometimes, you know, they have chronic pain, like back problems, you know, any kind of problem. They get medication, hard narcotics, and become addicted to them. That doesn’t make them a criminal.

So it’s more important for me to try to get them help, wean them off the drug, than put them in some kind of confinement.

You’re taking people away from their families, you’re taking them away from their jobs, you know, you’re taking them out of the community. If it had not been for this sickness, they would be productive citizens. These are someone’s, you know, wives, sisters, brothers, daughters -- loved ones.

Sometimes they just need treatment. You know, if you really want to get to the root problem, let’s get the person some help, especially if we’re not catching them breaking in the house or anything like that, we just find them using on the street.

I can come up and have that conversation, like, “What got you here?” That’s important to me. Let’s find out what really happened as opposed to “This is illegal, I need to take you to jail.” Because that’s not going to solve anything. You’ll go to jail, you’ll get back out, you’ll use again. But if I can help you to find some kind of medical treatment, I’m willing to do that, to save you, save your family, save your life!

Just saving one person means I’ve done my job but there are a lot more out there to be saved.

I’m Capt. Tyrone Collington and this is my story.