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On fire and emergency radio, dispatchers are stingy with details. When giving firefighters and medics the address of an emergency, they intentionally boil down all the panic and shouts to a single word or phrase, a tiny fragment of misery:

“Respond for assault…#”

“Respond for woman down…”

“Respond for sickness…”

At D.C.’s Engine 10, on Florida Avenue in Northeast, firefighters head out in search of these generic maladies about 7,000 times each year, or roughly once every hour—a frequency that’s made it one of the three busiest engine companies in America for the past decade. Operating at the nexus of three neighborhoods, the firefighters treat the worst medical cases each has to offer: the indigents and alcoholics of H Street in Stanton Park, the shooting and stabbing victims of Kingman Park, the drug users and ailing elderly of Trinidad.

Working in 24-hour shifts among four platoons, the firefighters at Engine 10 make up to 30 “runs” each tour, in a grueling and sometimes sleepless workday that they proudly call “the beatdown.” D.C. firefighters working in healthier neighborhoods enjoy a more leisurely workday: Foxhall’s Engine 29, the most idle in the city last year, made just 927 runs, while Engine 10 made 7,032. The vast majority of these runs at Engine 10 are known as “medical locals,” where a crew of four tends to everything from migraines to shootings until an ambulance arrives to haul the sick or wounded to the hospital.

The tour goes by with numbing repetition. Every so often a brief, high-pitched alarm sounds, no longer than a second, and the firehouse lights up in a crimson glow. Then, over the house speakers, the dispatcher gives her cool directive, always leaving plenty to the imagination: “Engine 10, respond for injury.”

The engine guys, most of them in from the Maryland ’burbs, move with varying energy, depending on the hour. Climbing onto the engine, they steal a look at the electronic ticker hanging between the two bay doors, where their destination shows in yellow.

Certain street corners indicate specific people, regardless of how the dispatcher bundles the emergency. A call for 12th and H Streets NE? Cat’s passed out across the street from the AutoZone. Mount Olivet Road and Montello Avenue? Fat Pat’s raising hell outside the North East Market. And even if it’s a new address with a new face, it’s sure to be an old affliction. “Seizures,” “injury,” “man down”—these are all just different ways of saying that somebody is terribly drunk somewhere, drunk enough to compel a sister or a store owner or a complete stranger with a cell phone to dial 911.

As first responders, the firefighters’ job is to get there quickly and leave as soon as possible. It makes for a strange window. They spend just enough time—usually between five and 10 minutes—stepping into a stranger’s home and problems, delivering whatever rudimentary care they can, and then watching all the players ride off in the back of an ambulance or a police cruiser, never knowing what happens next. Unless, of course, they find out in tomorrow’s paper—or make the same run the next week.

Between dispatches they’ll lounge in the break room or sit on the engine’s bumper, reliving last week’s fire—“The whole place was off, man”—or fondly bullshitting about how they were “burning ’em up” last month, back when it seemed they were running a blaze every other tour. What they rarely discuss, and never with anything resembling gratification, is the parade of diabetics, alcoholics, and schizophrenics they’ve been loading onto gurneys since 5 a.m. yesterday.

And who could expect them to? At least, through adrenaline, the fires manage to separate themselves. Snapshots of suffering, however, have a way of running together in the mind. Especially those that unfold with the same characters, on the same street corners, night after night, year after year. Seen in such volume, people’s ailments become unremarkable, like the stale ironies aired in the engine after routine calls: A “person with trouble breathing,” calmed into using her inhaler, is just a “troubled person breathing”; a sidewalk drunk, awakened from his harmless sleep with an ammonia capsule, goes down as “another life saved.” Nobody ever laughs, but somehow the cheesy one-liners make things more palatable.

It all adds up to one endless night. Ask three Engine 10 guys when something happened and you’ll probably get three different years. Ask for a story and you’ll get a composite. It’s hard to put the middle-of-the-night runs in order, because each one starts the same way. They’ll wake up and rub their eyes, slide down the bronze pole, and hoarsely ask the same question they asked 40 minutes ago: “What’s the run for?”

Respond for woman down, 12th and H Streets NE

“OK, does anybody here wanna go to the hospital?”

His fire engine idling in the dark, driver Danny McCoy has hit the most common snag on a midnight run to H Street: figuring out for whom the 911 call was intended. There are at least a half-dozen promising candidates huddled in store doorways and at bus stops, but they’re all deferring to one another. McCoy, who’s worked this neighborhood for five years, likes to call this intersection the “second sickest corner in the city”—behind only 8th and H, just blocks away, he says. But tonight, even the guy lying beside the Explorer takes a pass on the hospital.

Rather than come up empty-handed, the crew decides to try Cat. Carolene “Cat” McKinney is the engine’s most regular of regulars. As the wagon sidles up to the bench where McKinney looks to be sleeping, firefighter Brian Rudy, riding in the engine’s rear, leans out the window and hisses to her:

“Psss. Psss. Caaa-aaat.”

Just as Rudy starts to chuckle, McKinney’s grin widens beneath her matted black hair. She’s been playing possum.

Such games between McKinney and the firefighters play out on H Street on a near-nightly basis. Sometimes it’s just a coy charade, as it is tonight, aided by the goofy punch-drunkenness of firefighters working in their 20th hour. Other times, depending on where they catch her in her daylong bender, it can get violent. If she’s already run through a couple of the pint-sized wine bottles delivered by sympathetic H Streeters—McKinney’s been banned from all the liquor stores—she’ll kick and spit and spew obscenities at the arms that wrestle her onto the stretcher.

If she starts to swing her swollen fists and drop F-bombs, the firefighters have just one recourse: “Cat, sing us a song,” they tell her. She’ll break into an unintelligible tune, and they’ll load her into the ambulance as soon as it arrives. Then she’s off to the hospital. Sometimes she leaves the firefighters themselves harmonizing, as on one May night, to OutKast’s “Roses”:

“Caroline, Caroline….All the guys would say she’s mighty fine….”

McKinney has drunk and slept along H Street for so long that no one—not even she herself—can say exactly when Engine 10 started tending to her. Some place it 18 years ago. When asked to approximate how many times the engine has run McKinney, veterans work out averages in their heads and then do longhand multiplication on scrap paper. The figure invariably climbs into the thousands.

“There were years where she was responsible for at least 365 runs,” says driver Joe Myers, who’s been around for eight years. Greg Thompson, an 18-year veteran with the engine, remembers a late-’80s winter storm that shut down H Street, sending everyone to their homes or shelters—that is, everyone except for Cat, who stood alone outside the liquor store. “I was thinking, Man, now there’s a soldier,” recalls Thompson.

Every Engine 10 member has his own version of Cat’s worst call: the time she was beaten bloody, the time she was sexually assaulted, the time she was set on fire. “I’m just a sick lady,” she says.

But like everyone else on the block, McKinney turns down the hospital bed tonight.

“You have a good night,” Rudy tells her. McKinney smiles and waves at the engine as it starts to roll east on H Street, but no one inside is convinced by the farewell.

“We’ll be back,” says McCoy, nodding with certainty. “Cat’ll decide she wants to go, or one of those fuckers’ll get up drunk and take a fall.”

Respond for seizures, West Virginia Avenue NE

Connie Gaylor stands on the front steps of her Trinidad apartment, clutching the portable tank that runs oxygen into her nose throughout the day. Diagnosed with chronic heart failure, chronic lung failure, gout, and asthma, the 44-year-old looks to be the one in need of an ambulance ride. But as is often the case around here, the walking wounded you first see are just a diversion: It’s Gaylor’s grandmother who’s having the seizures.

Gaylor’s apartment is the firehouse’s first repeat run of the night. Once again, 82-year-old Constance Matthews, now in the first stage of Alzheimer’s, was sitting on the front porch when her arms began trembling and her eyes rolled back into her head. Once again, she’s come out of it.

“I ain’t goin’ to no hospital,” she snaps, pushing away the firefighters who try to lift her out of her chair.

“You got two choices,” Gaylor tells her surrogate mother. “You can go to the nursing home or you can go to the hospital.”

“You wish I was dead,” Matthews shoots back. Later, Gaylor will say that “Mom” was just talking crazy. Matthews, she says, is never so headstrong as when friends and family try to send her to the hospital for treatment. Anyone who tells the octogenarian to quit smoking gets the same defiant attitude: She’s smoked since she was 10, and she’s not about to stop now.

Hoisting herself up, not reaching 5 feet tall, Matthews takes unassisted baby steps to the ambulance, parked two doors up, waving off the stretcher. Neighbors eye one another and chuckle as she cusses out anyone who dares put a hand on her. She’s on her way to Greater Southeast Hospital, where Gaylor won’t visit her because of the expected emotional trauma.

“She’s feisty, man,” laughs Michael, a neighbor enjoying Matthews’ show. “She was tellin’ everybody to fuck off.”

Gaylor staggers back from the ambulance to get her cooler full of meds, her hands now shaking violently, her face wet with tears. The laughter in the yard dissipates.

“Hey, Connie,” someone calls out. “Y’all need a sedative?”

Respond for chest pains, Isherwood Street NE

Firefighters and EMTs like to think there’s a reason that stabbings, abdominal pain, and drug overdoses all seem to pick up on certain days. To inject some kind of order into the chaos, they like to propagate theories on when and why the call volume seems to peak.

Some say Thursdays are the busiest: Working folks, tired of the week and agitated, do whatever they can to get out at night and stir things up. Others think Fridays are worse: The whole neighborhood seems to hit the street with a pocketful of money, looking for all the wrong ways to spend it. But most firefighters agree that the first few days of the month are overall the busiest: That’s when people squander the social-services checks they’ve just received, or so the theory goes. There’s even an old saying at Engine 10, a bit of firehouse superstition: “First of the month, full moon, watch out.#”

Holding to theory, drug runs seem to have picked up tonight—a Thursday during the first week of the month. The call to Isherwood Street was for chest pains, but the guy’s passed out cold.

Two housemates stand over the man as he lies slumped against the hallway wall, his shoulder-length brown hair hanging in front of his pale face. They haven’t been able to wake him up, but they insist it couldn’t have been the booze. “He didn’t even finish his 24-ouncer,” says Debra, one of the housemates. Though he’s living in her apartment for the month, Debra doesn’t know the guy’s real name. She says he goes by Chief.

Debra sifts through the small pharmacy of prescription bottles lined up on his dresser in search of a last name. She jogs her memory in the process: Chief wolfed down six Percocets and five morphine tablets this morning, she says. Firefighter Derek Brachetti fishes through his medic bag for an ammonia capsule.

When someone is passed out, the ammonia capsule is the go-to item. But just about everything in the bag sees regular use: Insta-Glucose, to give to diabetics; oxygen masks, to help the “trouble breathing” cases; IV needle adhesives, to creatively plug the holes in stabbing and shooting victims; vomit bags, to save stomach contents for the doctor’s viewing; “trauma shears,” or scissors on steroids, to cut clothing off the wounded; plastic airways, in child and adult sizes, to open blocked breathing passages; gauze pads as large as letter-size paper, to staunch the worst bleeders; sterile burn sheets, for fire victims; obstetrical kits, for the most pressing OB cases; and a stethoscope and blood-pressure cuff, standard for just about every run.

Tonight, Brachetti’s ammonia does its job. Chief jolts his head and starts mumbling the same three words, each indecipherable, over and over and over. Eyes wide with terror, he sounds as though he might be trying to say, “I’m so sorry.” He repeats the phrase rhythmically for the five or so minutes it takes the firefighters to get him strapped into the chair, carried down the stairs, and loaded into the ambulance. When the doors shut, he’s still saying it.

Respond for man down, Bladensburg Road NE

Chief’s probably barely made it to the hospital when the crew responds to a call for a man down across the street from the CVS on Bladensburg Road. It’s actually two men, lying together on their backs like bedmates, sprawled across a set of concrete steps littered with potato chips and Mountain Dew bottles. Nicole Harper, 25, called 911. “I’ve never seen nobody passed out like that before,” she says.

Brachetti tries to work some ammonia magic on Andy, the more dire-looking of the two cases, but Andy’s only response is to wet his pants. Brachetti has better luck with Alan, who awakens and insists they’ve had nothing but crab chips tonight. But after the EMTs roll his buddy into the ambulance, Alan cops to having smoked some “dippers”—joints that have been doused in a PCP solution. He says they’re getting popular again.

Whenever they run into a dipper case, the crew members will start swapping their favorite PCP stories from recent years. Like the guy who wrecked his car on a tree and minutes later thought he was still driving, honking the horn and waving to firefighters as his tires spun in place. “We were doing five or six dipper runs a night,” McCoy says of last year, before a mammoth PCP bust ran most of it out of the neighborhood. “People were in the middle of the street, butt-naked. It wasn’t that violent, put-your-baby-in-the-microwave kind of stuff. People were just zoned out. They’d be naked, humping a telephone pole, all Who’s your daddy?” Like Alan, the dippers they run into are usually harmless. “They’re gigglin’, rolling around in the grass,” says Terry Robinson, a Truck 13 member who rode with Engine 10 throughout the ’90s. “The women get freaky.”

After vomiting twice, Alan is helped to his feet by a medic, his pants falling to the ground as he stands. It’s over 70 degrees, but he’s wearing long johns. He marches feebly to the back of the ambulance, grinning, with his khakis around his ankles.

Respond for injury,

Mount Olivet Road and Montello Avenue NE

The engine slows in front of North East Market, where firefighters Joe Myers and Mike Walker watch from the driver’s side as a woman screams and writhes before a crowd on the sidewalk below.

“I think that’s Fat Pat,” someone says.

“That can’t be Fat Pat,” says Walker. “That woman’s too big to be Fat Pat.”

Though he used to handle her each tour, Walker hasn’t run Pat—47-year-old Patricia Duncan—in about six months. Like other regulars, Duncan’s been known to come and go over the years, leaving the neighborhood for brief spells only to turn up at new street corners weeks or months later. “She’s been around for at least seven years,” says Myers. But her latest absence was so long that some firefighters, just days earlier, were musing that maybe she had passed away.

Once he steps off the engine and gets a closer look, Walker realizes that it is Duncan. As it turns out, she’d merely been visiting relatives in her native South Carolina for a few months. Duncan, who has lived in the area off and on since 1982, has returned to her room on Capitol Avenue—which means Engine 10’s average number of call responses each tour will probably increase. “That means five or six more fucking runs a day,” says Murphy.

Duncan is more than just a frequent call; she’s usually a high-maintenance call, as she is tonight. Wearing one of her signature large-brim hats and a long floral dress, Duncan rolls hysterically on the ground, cursing everyone within earshot and claiming she can’t breathe. Walker and Murphy give her an oxygen mask, but she tears it off. The crew tries to reason with her: “Pat, you’re talking. If you can call us ‘motherfuckers,’ you can breathe OK.”

One firefighter, two EMTs, and one of Duncan’s friends all take hold of her, lift her onto her feet, and brace themselves to be jostled. She swings her massive arms, bumping her handlers into one another as if in a Three Stooges skit, as the fray gradually moves to the back of the ambulance. By the time she’s inside, the caretakers are the ones breathing heavy.

Duncan is a bipolar schizophrenic, suffering from depression and what she describes as “bad nerves”—a common malady among the engine’s runs. She says she’s been hearing voices ever since she was 6 years old and saw her grandmother die in a fire in Lancaster, S.C. A lot of the engine’s customers, like Duncan, deal with their mental illnesses more or less alone, living in single rooms in boarding houses, prey to neighborhood forces. “This is their health care,” says firefighter Rob Heaney. “A big red firetruck and an ambulance.”

Duncan likes to hang out at a bus stop near the corner of Mount Olivet Road and West Virginia Avenue. If Joe Myers passes her with the engine during the day and sees her wave at him, he knows he’ll be running her later in the night. “I think she sees the engine and it gets in her head,” he says.

Duncan can’t go far from her room without finding trouble. Kids jump her and steal her purse, or the guys hanging out at the convenience store, sitting on plastic crates and drinking tall boys, try to swindle her out of her disability money. “I drink two beers and they start messing with me,” she says.

But often enough, Duncan just runs her mouth. “She talks a lot of shit,” says Lisa Jackson, a North East regular who’s tussled with Duncan before. Jackson says a neighborhood boy hit Duncan with a baseball bat in early May. According to both Jackson and Duncan, an ambulance denied her service, figuring it was just her usual hysterics. “Just because of who she is,” says Jackson.

Whenever Duncan’s sufficiently agitated, she’ll walk to the pay phone outside the market and place an emergency call. It’s hard for her to approximate how frequently she dials 911. “Every time I walk outside,” she guesses. Because her calls allege both criminal assault and medical injury, Duncan often brings cops as well as firefighters to the corner. When police officers show up, she says they give her an ultimatum: “You can go to jail or you can go to St. E’s,” referring to St. Elizabeths Hospital for the mentally ill in Southeast. Less stern, firefighters just want her to get in the ambulance.

“She was OK for a while when she stopped drinking,” says firefighter Roy Foster. “I wouldn’t say she was pleasant. But she was…pleasant, you know?”

The following evening, another platoon takes a call for the corner of Mount Olivet and Montello. Though these firefighters haven’t yet seen her, some have already caught wind from the previous shift that Duncan’s back in town.

“That’s her for sure,” says Richard Sheltra, plodding to the engine.

Respond for man down, 700 block of H Street NE

Engine 10 fields a call for the 700 block of H Street just about every night, anytime after 10 p.m. They’re all just variations on the same theme: an alcoholic with nothing but a VA card, pleading to use a bathroom; an alcoholic on dialysis who needs a lift to the hospital; an alcoholic who just wants to cuss somebody out.

Tonight, a middle-aged man in a torn undershirt lies on his back, spread-eagle, in front of the door of Major’s Carry-Out on H Street. Two young police officers stand by awkwardly as the foot traffic steps over and between the man’s legs to get inside the restaurant.

“Looks like [the police] found another one for us,” says fire Lt. Donnie Mayhew. Cops typically don’t arrest the sidewalk alcoholics on H Street; they have firefighters and an ambulance dispatched to the scene to haul them away.

“You awake now, buddy?” asks firefighter Mike Walker. The man’s eyes are open, staring vacantly into the sky, but he won’t respond. A woman in tattered clothes stumbles into the circle of cops and firefighters. “He dead,” she tells the crew. A gaggle of teenage girls start to laugh.

Walker breaks an ammonia tab. But whenever he places it beneath the man’s nose, the man’s heaving chest stops rising. The man is drunk but clever. Having been through this drill before, he knows to hold his breath to avoid a shock to the senses. He’s not in the mood for an ambulance ride.

Defeated, Walker shrugs and defers to an EMT. But the ambulance driver just nudges the man’s arm and pleads with him: “C’mon, bro. Wake up. Wake up.”

Respond for woman down in alley,

1600 block of E Street NE

The “woman down” is up and talking. At first glance, Rob Heaney thinks she looks like a perfectly composed Muslim lady. Only she’s not really wearing a maroon headdress. “It’s my head,” she says. The gash just above her neck has soaked the white rags with blood. When he sees how much skin is hanging from her scalp, Heaney’s shocked that she’s conscious, let alone coherent.

Mildred, 55, says she took a spill on the concrete steps behind her E Street apartment. Her daughter Rose isn’t buying it. “This man threatened her with a goddamn knife last week,” she says, pointing to her mother’s boyfriend. “You’re a motherfucking coward. You need to stay here until somebody locks your ass up.” Mildred’s upstairs neighbor, who called 911, tends to agree. “He be beatin’ the shit out of her all the time,” he says.

Heaney’s gauze wraps can hardly keep up with Mildred’s blood. It seems each new layer turns as red as the last. To make matters worse, Rose, not a small woman by any means, has started to shove her mother’s boyfriend. Short, gaunt, and weathered, he tries to back out of her reach; Rose takes a wild swing. The firefighters may be the only ones on the scene wearing uniforms, but Myers and Heaney aren’t about to play cops. If she lands a punch, they’ll just have to wrap more gauze.

By the time police officers step out of their cruiser, light rain is spattering the curious neighbors who’ve emerged from their houses. Heaney walks Mildred to the ambulance. “[The wound’s] gotta be this wide,” he tells the medic, spreading his fingers the length of a cigarette. “Not good, man. I wouldn’t take the bandage off.”

The cops put Mildred’s boyfriend up against her brick building and tell him to spread his arms and legs. Just as they cuff him, the winds start to scream down E Street, and a torrential downpour sends everyone scattering for their homes. Within minutes, the yard is empty, save for a heap of bloody rags.

Back at the firehouse, Heaney marvels at the dispatch. “Woman down,” he says, shaking his head. He was expecting a harmless drunk in an alley. “You run 7,000 calls a year, you’d think you’d get a handle on it.”

Respond for trouble breathing,

1200 block of Mount Olivet Road NE

“You call for an ambulance, you’d think that somebody would open the door.”

After Sgt. Rich Lehan raps the aluminum door a fourth time, out walks 43-year-old Rita Marie Royal from her one-bedroom apartment on Mount Olivet Road. Short and frumpy, wearing a pink top and bandanna, Royal leans on the stairway railing as if some neighbors had just dropped by for a chat.

Royal lays out the emergency: She was hanging out at a party down the street, some people were smoking some dope, and a guy kept hitting on her. She rebuffed him, and that was pretty much it.

“Ma’am, why are we here tonight?” asks firefighter Roy Foster.

“I might have a fever.”

Royal, who’s lived in Trinidad for most of her life, has been ringing up Engine 10 steadily for a little over three years now. She has a litany of conditions, any of which can put her in the mood for the hospital: seizures, stomach pains, arthritis, chest pains, “grandma feet,” gastritis, and schizophrenia. “As soon as I get to the hospital, it’s like I recover. When I get home, it’s the opposite,” she says. “Sometimes when I can’t sleep I call 911….And sometimes I call every week.”

“Ma’am, why are we here?” Foster asks again.

“I might be pregnant,” she says.

Royal is what’s known at Engine 10 as a “comfort call”—a routine run they’ll grouse about only if it causes them to miss a fire. “She’s pregnant every time,” firefighter Richard Sheltra says. “She’s been pregnant for years.”

Tonight, she’ll take a ride to the hospital for nothing in particular. Two nights later, she’ll call 911 and say she has a fever.

Respond for hemorrhage,

13th and H Streets NE

McKinney passes out at 12th and H with such consistency that Sheltra doesn’t think a call to 13th and H could be for her. “Not Cat,” he says. “She doesn’t stray.” But once the crew reaches H Street, Sheltra realizes somebody just called in the wrong coordinates: McKinney’s at her regular spot, illuminated on the ground by a police cruiser’s spotlight. “Cops,” says Sheltra. “They don’t even know where they are.”

McKinney used to have a small hut with her clothes and other belongings at this corner, piled against the brick wall across the street from the AutoZone, but somebody made off with her stuff one night. Tonight, she lies facedown on the sidewalk in front of a check-cashing operation. Police Officer Kemal Johnson, clearly out of ideas, says he offered her a banana if she could get up and walk. She told him to fuck off. “I mean, how much longer is she gonna last?” Johnson wonders aloud. Another showboating cop, short and stocky with a crew cut, looms over McKinney and barks at her: “Cat, get up!”

As Sheltra and a medic mummify her in white sheets and sling her onto a gurney, Johnson makes note of the five plastic hospital bands lined up along McKinney’s left wrist.

“She’s getting ready to have her sixth,” says Foster. CP

Art accompanying story in the printed newspaper is not available in this archive: Photographs by Darrow Montgomery.