You're not from here, I can tell

We have a unique issue in my district:  People not from here, come here, then call us and expect the same services they got at home.

They do try to fit in from time to time, using local language, slang, even phrases.  Mark Twain called it "local color."

Cut to an evening not long ago.


A man is having trouble breathing


Few people have trouble breathing on the train platform and in my brief 25 years of experience it is most often those found without tickets who have such a complaint.

On scene first I approach and see the PD prayer circle.

Don't be offended, this is how I describe a ring of law enforcement officers standing over someone.  They aren't talking to the patient, or assisting him in any way, simply forming a wall.  This happens for one of 2 reasons:  Either the patient is naked (yes, this is common enough to be expected) or he is filthy and they are shielding others on the train platform from something else.

Lucky for me*, it is something else.

The something else is visible infestation of jumping insects in his hair and clothing.  * Not so lucky after all.

The patient has a blanket and pillow and sees me approaching. "I have shortness of breath and 10 out of 10 chest pain." he rattles off like ordering an appetizer for the table.

"Hi, I'm HM and I've been told you have trouble breathing.  Was that what you told the paramedics back home to get a ride?" I ask seeing a regular pulse at his carotid as he realizes he isn't in Kansas anymore.

"Maybe you don't know the law, but I'm asking to see a Doctor and I need an ambulance."
"You're half right," I reply noticing the insects trying to jump off his hair towards my bags.  I push them farther back.

He goes on to mention every Delta and Echo code while I nod adding "You forgot stroke," to which he replies "I think I am having a stroke."
"You're not from here so let me tell you how it works," I start and he swings his dreadlocks around like my 13 year old does when she's upset.
"I was born and raised here," he adds, pretty much asking me to challenge him.  As he does the engine and medics arrive together.
"I'm from Downtown East Bay."

The cops laughed.
The Engine Company Laughed.
The Medics cried.

"Um...East Bay is a region, not a town. Try again."

He lowered his head and looked to the side, "Pennsylvania."

"Thank you. Now that we have that worked out, what do you say to a shower and some clean clothes, maybe some alcohol abuse treatment?" I ask as he sees the gurney and has already un-clicked the belts and climbed on.

"I have suicidal ideations," he says, crossing his arms over his chest in victory revealing no less than half a dozen hospital bands on each wrist.

"Does this work back home?" I ask clicking him in for the ride I know he doesn't need.

"I'll be back in my neighborhood in 10 minutes, sucker," He brags.

"You fell asleep on the train. We can't take you to your 'neighborhood.' You're going to the suburban hospital and," I check my watch, yup 0100," the buses stopped an hour ago."

The slow realization of his predicament was evident on his face as the medics slowly turned the cot and started towards the ambulance at the curb.
"Do you have any medical history we should know about?" I heard the medic ask as I gathered my things.
"Can you please just take me one town over? Please?" the patient asked.

How about 100 towns over?