morning, we aren’t merely punching in to work—we’re receiving communion. Out in the streets, just beyond Grady’s front doors, are ambulances, doctors, nurses, visitors, the homeless, half-medicated lunatics and patients who’ve dragged their IV poles outside to smoke. Huddled together on the sidewalks—which are dotted with chewing gum and droplets of blood and the occasional human turd—are anxious family circles praying for loved ones, and the local news reporter who’s camped out because something tragic has happened. Something tragic always happens.
There’s a McDonald’s beneath the parking deck. Hospital trash is taken out a few yards from the ramp where ambulances bring patients in. This ramp is new. The old one was smaller and faced a different direction and was bordered on one side by a wall. Regulars—vagrants and homeless and down-on-their-luck locals—would sit on the wall and smoke cigarettes. Every time an ambulance came in, they’d clap and cheer. That wall became known as the Rooter Wall, the people perched on its ledge Rooters. To this day, patients transported repeatedly to Grady are called Rooters, and everyone who works here walks a fine line between love and hate when it comes to Rooters.
All this before we get inside.
Grady was built in 1892, and the original building still stands. The main hospital is much newer and infinitely larger and was once segregated into two facilities: one for whites, the other for blacks. Jim Crow is gone but not by much, and poor blacks, ever mindful of their separate-but-equal past, still refer to the hospital—the place they were born, where they’re healed, and eventually, where they’ll die—as the Gradys.
There’s a main entrance with an atrium—marble floors and high ceilings, a receptionist, mounted plaques—but anyone sick, anyone coming by ambulance, enters through triage. Triage is a three-ring circus, and its main attraction is the human body gone suddenly, maybe irrevocably, wrong. Triage is run by two nurses, and at any given time it’s occupied by a couple dozen patients in various states of need. The main floor is home to the waiting room and its hundreds of souls in limbo. It’s also home to the ECC—what you’d call the ER. The Red Zone houses trauma; the Blue Zone houses medical. Both have a couple dozen rooms, plus twice as many informal hall spots where patients end up, despite having been shot, because someone has confirmed the wound isn’t life-threatening. The Red Zone includes the trauma bays where the most critically injured are treated. It’s also home to Red Obs, which is a cramped parking lot for violent psych patients too sedated or too in need of medical help to head upstairs.
The Blue Zone has no trauma bays, but it has the CPR room, four critical-care rooms, an asthma room, and the hospital’s detention area. Prisoners from the city or county jail, the men locked up in the federal penitentiary, all get handcuffed to a bed and brought to detention.
The ECC is a wild place overflowing with patients, competitive doctors, overworked nurses, and a ballooning coterie of support staff. It was built in the nineties, designed to replace an ER that took the worst the city had to offer, that functioned with a chaotic precision and whose tile walls sported a handful of bullet holes until it was demolished.
The cafeteria is on the second floor; labor and delivery is on the fourth. Every time a baby is born—a child known from that moment on as a Grady Baby—a lullaby is played over the hospital’s PA system so everyone knows another life has entered the world. This city has a lot of Grady Babies, thousands, and the song has announced the arrival of so many for so long that halfway through, it fades and hiccups only to gain strength toward the end.
The morgue is in the basement. The psych ward is on thirteen.
Grady is a strange place and very much a part of this city’s fabric. The EMS department is no different. Wearing a Grady uniform, driving a Grady ambulance, gets me into and (more important) out of countless dangerous situations. People walking down the street, all of them Rooters, many of them Grady Babies, stop and wave as we drive by. Hey there, Grady is yelled every day from every frayed corner of this city. But it’s not easy. The call volume is enormous—over a hundred thousand a year—and the patients (mostly homeless, many drunk) are a handful. Turnover’s so high that people who’ve been around a while won’t speak to me until I’ve