Philadelphia Fire Research Articles

Outcome of Travelers Who Refuse Transport after Emergency Medical Services Evaluation at an International Airport

Objective. To determine the short-term outcome of patients refusing transport after emergency medical services (EMS) evaluation at an international airport. Methods. This was a prospective, descriptive, observational study of patients who refused transport after evaluation by Philadelphia Fire Department paramedics at Philadelphia International Airport from July 2003 through March 2004. Paramedics contacted a medical command physician (MCP), who recorded the patient's contact information. Three days later, one investigator attempted to contact the patient to administer a survey of the medical course in the three days following the initial encounter. Results. Of 90 patients enrolled, 64 (71%) were reached in follow-up. Their average age was 45 years (range 10 months to 80 years); 41 (63%) were female. The most common presenting complaints were trauma-related (22 patients, 34%), neurologic (12, 19%), andgastrointestinal (7, 11%). The most common reasons for refusing transport were belief that their complaint was not serious (48, 75%) andfear they would miss a flight (34 patients, 53%). In the three days following the initial encounter, no patients recontacted 9-1-1, 16 patients (25%) had a recurrence of their initial complaints, and32 patients (50%) saw or talked to a physician. There was one hospitalization but no deaths. Among patients lost to follow-up, no deaths of U.S. citizens were detected. Conclusions. Most patients who refused transport after EMS evaluation at an international airport had good short-term outcomes. These results may assist paramedics andMCPs to manage refusals in this setting andto allow patients to make informed decisions. Key words: emergency medical services; treatment refusal; outcome assessment (healthcare).

Signs and Cities: Black Literary Postmodernism (review)

Reviewed by: Signs and Cities: Black Literary Postmodernism Aldon L Nielsen Madhu Dubey. Signs and Cities: Black Literary Postmodernism. Chicago: U of Chicago P, 2003. ix + 284 pp. Dubey begins by noting that while "we would expect African-American literature to form a vital resource for debates about postmodernism, it is conspicuously missing, even when these debates are launched in the name of racial difference" (2). Too often, when African-American literature is invoked in such discussions, it is in an effort to separate African-American writing from any association with the postmodern. Still, the gap Dubey offers to fill is not quite as wide as the publishers suggest on the book's cover, where they tout Signs and Cities as "the first book to consider what it means to speak of a post-modern moment in African-American literature." The fact that Dubey's own text makes reference to earlier books that undertake just such a consideration should serve to remind us that marketing departments are generally the final arbiters of jacket copy. Dubey's concentration on fiction brings about a further elision of preceding books on the subject, but Signs and Cities will be recognized, most particularly by its grateful predecessors, as a major statement on the subject as well as an invaluable addition to fiction studies, offering both broader and more acute comprehensions of postmodern moments. [End Page 767] Dubey follows Wahneema Lubiano in pointing out that the "decentering of Western cultural authority" should hardly be regarded as a crisis for African-American cultural studies (21), pointing to a long-standing black skepticism regarding Western metanarratives of the modern. Black critics raised telling questions about traditional views of agency and subjectivity in the West long before other black critics raised suspicions about the timing of poststructuralist critiques of subjectivity, and Dubey's acknowledgment of Toni Morrison's assertion that New World Africans faced the dilemmas of postmodern existence long before those dilemmas were named such by philosophers points in its turn to a long history of writings, most notably by W. E. B. Du Bois and C. L. R. James, asserting the modernity of African peoples and the contributions of New World Africans to emergent modernism. I find especially useful the ways in which Dubey addresses issues of the urban, anatomizing at the same time the curious turn toward the rural South and the past that has marked the growing popularity of a certain nostalgic reading of African-American culture in the years following the revolutionary 1960s. Dubey traces some of this to "the desire for a mystical encounter with the 'nonrepresentable' or 'naked' face of the other," which is but "the inverse side of claims about the decline of reality in postmodern times" (193). She effectively ties these phenomena to a mode of privileging of the voice that proceeds under the demonstrably false assumption that vocal signs are somehow less mediated, not in need of interpretation in the same way that is required by technologies of writing. Sutton E. Griggs, though he appears on few syllabi of postmodernity, cautioned as early as 1916 in Life's Demands that African Americans "must move up out of the age of the voice" into succeeding technologies, and succeeding generations of black technophiles have been not only "early adopters" but major innovators. This is part of what Dubey is getting at in her discussion of Colson Whitehead's The Intuitionist, a novel that "undertakes a critical excavation, revealing African Americans to be the hidden architects of modern cities" (238). The critical assertion that black culture is in so many ways the hidden architect of the modern is, of course, an assertion that can only be made from the standpoint of a post in the after-modern, and Dubey's book is a veritable blueprint of the contemporary racial spaces of the cityscape. There are occasional oversights due to the exclusive focus on fiction. Dubey's masterful discussion of John Edgar Wideman's Philadelphia Fire usefully locates a real-life model for the character of Richard Corey, but shows no awareness of the character's literary model. While it could be that readers of Wideman's generation may know the character...

"If the City Is a Man": Founders and Fathers, Cities and Sons in John Edgar Wideman's "Philadelphia Fire"

ohn Edgar Wideman's 1990 novel Philadelphia Fire assesses the contemporary implications and outcomes of black activism of the 1960s and 1970s-the promises of the civil rights and the demands of the Black Power movements generally, and the example of the radical African American communal group MOVE (short for The Movement) specifically. Wideman roots his assessment of the recent past in a detour through the nation's colonial history, returning to foundational American assumptions about power and creativity, race and gender. This recourse to history allows him to ground his main concern, the fractured dyad of the black father and son, in the raced and gendered spaces created by white founders. In Philadelphia Fire, Philadelphia stands as map and metaphor for the colonial past and (post)colonial present that position black men as dispossessed sons of white fathers rather than men in their own right. But Wideman also makes Philadelphia representative of alternative notions of history that challenge deeply held national ideals of what constitutes a man in his own right. Wideman chooses William Penn's founding vision of Philadelphia to serve as epigraph to his novel:

Where the Talented Tenth Meets the Model Minority: The Price of Privilege in Wideman's "Philadelphia Fire" and Lee's "Native Speaker"

Two years before the publication of Philadelphia Fire (1990), John Edgar Wideman was asked to comment on his oeuvre up to that point, more specifically to reflect on what had become his most well-known and acclaimed work, Brothers and Keepers (1984). This work of non-fiction, which earned him a National Book Critics Circle nomination, attempted, as Wideman put it, to make sense of the enormous gap between himself and his incarcerated brother, and more generally the breach between himself and the communities in which he was born and grew up. Very quickly, however, Wideman shifts from this personal reflection into a kind of cultural commentary, from his artistic successes to their societal consequences. The pathos, tinged with guilt, is palpable:

"Narratives of Self" and the Abdication of Authority in Wideman's Philadelphia Fire

Outside the confines of academia, John Edgar Wideman has achieved a celebrity few avant-garde or African American writers could claim. Although most of his novels are radically innovative and more or less inaccessible to readers lacking at least a college education, Wideman's persona exerts a strong appeal for journalists and literary scholars alike. Several popular magazines have run features focusing on the contrast between his extraordinary success and the troubles of his boyhood community or have published reviews of his novels. Klaus Schmidt lists seven published scholarly interviews in a 1995 bibliography, and Bonnie TuSmith's Conversations with John Edgar Wideman (1998) compiles nineteen interviews. Schmidt, however, bemoans the meager response to the writer's actual published work and presents his own article on Reuben as attempt to insert a missing page in literary history (81-82). In light of the accolades Wideman's fiction has garnered, reflected in laudatory reviews and significant awards, the virtual silence his work has registered from scholars of American literature stands in stark contrast to the scrutiny with which the work of African American women writers is habitually treated. Apparently Wideman, who has written provocatively about the psychic conflicts associated with being a Rhodes scholar and college professor whose son and brother are in prison, presents an irresistible subject for those interested in popularizing the work of African American while his novels and short stories are seen as too self-consciously experimental, apolitical, or disturbing. Only two book-length studies of his career, which is in its thirty-fourth year, exist in print, leaving James W. Coleman's 1989 monograph as the definitive study. (1) Coleman's analysis illuminates much about Wideman's concerns and technique and also makes a convincing argument about the evolution of the novelist's vision. But some of Wideman's most important work has appeared since Coleman's publication of Blackness and Modernism, including a collection of short stories, Fever (1989); the novel for which he won his second PEN/Faulkner Award in 1991, Philadelphia Fire; a meditation on race, Fatheralong (1995); and a semi-historical novel, The Cattle Killing (1996). Because of the relevance of its concerns, the urgency and distinctiveness of its voice, and its uniquely expressive narrative technique, Philadelphia Fire (1990) in particular deserves serious consideration. Philadelphia Fire represents the apex of the late modernist project Wideman initiated with the highly experimental Hurry Home (1969). (2) Keith E. Byerman, while drawing a definite distinction between Wideman's fiction and that of white postmodernist writers, notes that Wideman just as clearly sets himself apart from the orthodox critical realist tradition so often prescribed for writers with a social conscience (34, ix). Through a fragmented narrative and a modernist collage of voices, the novel treats the city of Philadelphia as a self-enclosed world of the artist's creating, a consciously textual world that contains, unifies, and imitates universalized themes within its structure. A troubling look at juvenile violence in the urban environment calls into question the seemingly insurmountable status quo that brutalizes socially marginal classes of people, as well as the significance of fictional narrative as a counter to the totalizing discourse of history. Structurally and thematically, Philadelphia Fire argues for a new form of narrative that transcends the typical modernist writer's alienated, authoritative vision. Wideman distinguishes between a kind of realism that cynically asserts the inevitability of social decay--the of the aloof politician who recognizes only changes for the worse in the living conditions of the poor--and a participatory, potentially liberating realism, defined as a linguistic construct. …

Short-term outcome of seizure patients who refuse transport after out-of-hospital evaluation.

To determine the short-term outcome of patients with a known seizure disorder who have a seizure, are evaluated by out-of-hospital care providers, and refuse transport. This was a prospective study conducted over a 15-month period. Philadelphia Fire Department paramedics contacted a medical command physician whenever they encountered a patient with a known seizure disorder who had had another seizure and was refusing transport. After confirming that the patient had the mental capacity to refuse care and understood the associated risks, the physician recorded the patient's name, address, and telephone number. Beginning three days later, a registered nurse attempted to reach the patient by telephone and administer a brief questionnaire about his or her medical outcome. Patients not reached by telephone were sent a certified letter. The names of patients lost to follow-up were compared with medical examiner records to confirm that they had not died during the follow-up period. Of 63 patients enrolled in the study, 52 (82.5%) were reached in follow-up. Of these, three (5.8%) had another seizure within 72 hours and recontacted 911. One of these patients (1.9%) was hospitalized. Twenty (38.5%) patients contacted their primary care physicians. There were no deaths, including patients lost to follow-up. Most patients (94.2%) who were evaluated by out-of-hospital care providers for a seizure and refused transport had no further seizure activity in the subsequent 72 hours. However, because there is a risk of recurrence, out-of-hospital care providers and medical command physicians should ensure that patients understand the risks of refusal.

Race and urban space in contemporary American culture

This innovative book looks at representations of ethnic and racial identities in relation to the development of urban culture in postindustrialised American cities. The concept of 'urban space' organises the detailed illustration of a series of themes which structure chapters on white paranoia and urban decline; memories of urban passage; the racialised underclass; urban crime and justice; and globalisation and citizenship. The book focuses on a range of literary and visual forms including novels, journalism, films (narrative and documentary) and photography to examine the relationship between race and representation in the production of urban space. Texts analysed include writings by Tom Wolfe (The Bonfire of the Vanities), Toni Morrison (Jazz), John Edgar Wildeman (Philadelphia Fire) and Walter Mosley (Devil in a Blue Dress). Films covered include Falling Down, Strange Days, Hoop Dreams and Clockers. Provocative and absorbing, this interdisciplinary treatment of urban representations engages contemporary theoretical and sociological debates about race and the city. Issues of space and spatiality in representations of the city are explored and the author shows how expressive forms of literary and visual representation interact with broader productions of urban space.

“Woven of Many Strands”: Multiple Subjectivity in John Edgar Wideman's Philadelphia Fire

Many of John Edgar Wideman's rich fictions scout the borderlands of African American collective identity, those places where blacks question and confute the hateful stereotypes that hegemonic white culture has written for them. At the same time, Wideman's residence for all of his adult life in the interracial middle-ground—the “goddamned middle” as it is called in Philadelphia Fire—has obviously made him sensitive to many issues that go beyond race, even if questions of race first triggered his awareness (71).1 In this essay, I examine how, in Philadelphia Fire, Wideman places African American subjectivity in the context of a broad field of social relations that are determined quite as often by gender, class, or intergenerational or professional interests and antagonisms as by race.

Storytelling and Democracy (in the Radical Sense): A Conversation with John Edgar Wideman

In his introduction to Best American Short Stories 1996, John Edgar Wideman wrote that that mount a challenge to our everyday conventions and assumptions stir my blood. Not only because they are exciting formally and philosophically, but because they retain for fiction its special subversive, radically democratic Wideman's own writing assumes this role. The muscular energy of his prose and his nonlinear style, which segues in and out of multiple narrations, formally challenge a mainstream sense of pace and structure. His unsparing focus on African Americans rattles a white cultural framework. Through its attempts to answer ultimate questions about individual identity, Wideman's writing self-consciously acknowledges the power that stories have to seek out the unfamiliar and to herald difference. Wideman's fiction most frequently returns to the landscape of his childhood--Homewood, an African American community in Pittsburgh--and to the well-publicized tragedies of his own life, which have resulted in a brother and a son in jail, to write the complex, varied experiences of blacks in America. Homewood is the physical and psychological setting of his latest novel Two Cities: A Love Story (1998), and the voices that intersect in this work are no less dynamic or raw. The three narrators of the novel speak from the wounds of their lives: The young woman Kassima has lost her husband to AIDS and her sons to gang violence; Robert Jones, scarred by a lifetime of racism, longs to break through the emotional walls Kassima has erected to ease his loneliness; and Mr. Mallory, Kassima's elderly tenant, who served in World War I, repeatedly resurrects his relationship with John Africa, the founder of MOVE, the black separatist group whose Philadelphia settlement was bombed by police. Mallory roams Homewood's street s with his camera documenting the black, urban experience he witnesses. In the explosive climax of Mallory's funeral, Kassima and Robert must confront the youth violence around them as they decide what to do with Mallory's brutally honest photographs. Wideman is the first writer to win the PEN/Faulkner Award twice--in 1984 for Sent for You Yesterday and in 1990 for Philadelphia Fire. His nonfiction book Brothers and Keepers received a National Book Critics Circle Award nomination, and his memoir Fatheralong was a finalist for the National Book Award. He won the Lannan Literary Fellowship in 1991, the MacArthur Award in 1996, and, most recently, the 1998 Rea Award for the Short Story. Wideman resides in Amherst, where he teaches writing in the graduate writing program at the University of Massachusetts. Baker: Mr. Mallory, the photographer in Two Cities, is scared, worried that the picture on the film won't be the picture in my mind. Could you talk about the role of the artist of black, urban American: as witness, as recorder, as someone responsible for accurately representing what people feel? Wideman: Mr. Mallory is a guy who would be very familiar to anyone who's lived in an African American community, I think--any big-city, African community, and probably some small-town communities--because Mr. Mallory is the man possessed of artistic instinct, artistic power, sensibility, intelligence, who never gets an opportunity to develop and exploit these qualities, these gifts. And so in some ways they turn in on him. And sometimes this ubiquitous character in African American communities--an old man, sometimes an old woman--is a very silent and bitter person, but sometimes these persons are also connecting points, and rallying points, and nodes of knowledge for the community. The person that I am talking about is usually an eccentric of one sort or another. He might be a janitor, in a building. But every now and again, when you speak to him, you hear something you couldn't imagine this person knew. You find out that he or she has been all over the world. You find out that he has a shadow life that's jus t incredibly varied and interesting. …

Philadelphia Fire, or the Shape of a City

Philadelphia Fire, or the Shape of a City

Of Balloons in John Wideman's Fiction

Of Balloons in John Wideman’s Fiction Françoise Palleau-Papin (bio) Reading John Wideman’s books is as dangerous as letting a balloon explode in your face when you are least aware of it. As a matter of fact, so many balloons explode in his books that, as readers, we must beware the blasts that unsettle us every now and then. I would like to go through a number of passages in which balloons appear and try to see what it is all about. The excerpts are taken from Sent for You Yesterday, Reuben, Philadelphia Fire, The Cattle Killing, and some short stories. The balloon images that can be found in these works generally express the vulnerability of the human condition very vividly. In Sent for You Yesterday, a balloon is the metaphor for one character duplicating himself and viewing himself in two parts when he is high on drugs: He could see one part of Brother Tate anchored to the busted sidewalk of Finance Street but he could also see the sun-dimpled bubble of his bald head floating miles up in the sky, so high the string attaching it to his feet disappeared before it reached the pale balloon. Brother Tate wondered what it would feel like to cut the string, to snip the cord and watch the balloon jet away. Would the sun pop it, would the air rush out and the balloon zigzag, crazy as a chicken with its head cut off, across the sky? Would he be able to hear it sputter and hiss and squeal? Would it finally fall back to earth, land somewhere on Finance Street and some little kid pick it out of the gutter and stretch it and poke it and maybe put his mouth on the dirty rubber and blow it up again? (172) Although the character Brother Tate is the focalizer, his name is used as an external reference. The sentence goes: “He could see one part of Brother Tate . . .”; instead of using the expected reflexive: “Brother Tate could see one part of himself. . . .” This emphasizes the dissociation between the character and the image he has of himself as a balloon. What begins as a mild case of schizophrenia, in which the balloon-like head is separated from the rest of the body while the character gets an overview of himself, ends up as a playful meditation on the versatility of life and chance. Beware, beware, seems to say the balloon, I am not just an odd metaphor in John Wideman’s fiction, but a warning that something is at stake. Once this balloon metaphor has been used, it comes up again as a reference in the book, about a hundred pages further along, as “Brother” urinates on the sidewalk: [End Page 645] Brother remembers the time on the corner of Finance and Dunfermline when he felt like a balloon, when he held the string in his hand and a balloon with his funny face bobbed closer and closer to the sun. He wondered if it would pop. Wondered as he made a little river along the curb why the air didn’t rush out when the water rushed out. You pulled the plug and the water drained, and why didn’t the air leak out too? (178) Here the memory of a balloon gets entangled with the situation of the character who is urinating, and the phrase “he held the string in his hand” takes on a humorous double meaning. In the sentence “He wondered if it would pop,” the pronoun “it” is ambiguous, referring to the balloon but also to the body of the man, as the next sentence makes clear when Brother is wondering “why the air didn’t rush out when the water rushed out.” A metamorphosis takes place gradually, as the abstract challenge to the laws of physics takes on a reality of its own. Liquid and air follow the same outward movement so that a man urinating and a balloon’s deflation participate in the same annihilation, the same shrinking and shriveling into nonentity for either the balloon or the man: He feels his body going limp. All the air hissing away...

The Silent Man's Voice in "The Statue of Liberty"

The Silent Man’s Voice in “The Statue of Liberty” Claude Julien (bio) “Stories are like onions. You peel one skin and another grins up at you.” John Edgar Wideman, Fatheralong (61) “The Statue of Liberty” is a programmatic title. Give the reader only that to go by and an icon of America’s self-congratulation may offer itself. Add the author’s name or, if you are first approaching his work, his picture on the back cover and that initial program may be redirected into the consciousness that the statue’s torch also casts shadows onto this ideal world, perhaps, to some extent, points them out. But such a program is only in the mind, and a different strain rises from the page as the story creates its own path away from prefabricated guesses. Put in a few words, “The Statue of Liberty” deals with American fantasies of interracial sex. John Wideman does not treat this theme in the hilarious manner of Cecil D. Brown’s The Life and Loves of Mr. Jiveass Nigger. Nor is there any sardonic signifying such as in Hal Bennett’s Lord of the Dark Places or Melvin Van Peebles’ film Sweet Sweetback’s Baadasssss Song. Those fictions bear the stamp of the Blaxploitation era. “The Statue of Liberty” is more intemporal. There is humor in it but contained by the grave and sedate tone it assumes to present its concern for the black man’s status. This essay will try to delve into the textual strategy of a story that opens like a bland narration and builds its way to an unwritten question, yet one repeated three times (perhaps once for each shadow of a character) in the shape of the “Y” pattern the three chairs have been disposed in on the unfinished patio. The Statue of Liberty is an infrequent visitor in John Wideman’s fiction. However, it does come up in Philadelphia Fire as “the bitch wit the torch” (80) and much more signally in a passage of Hurry Home 1 that must be brought up here if only because it happens to associate the statue with sex. Cecil Braithwaite’s departure for Europe tests the reader’s need to cast anchor in the referential world while a merciless poetic logic sweeps his mind out to sea, the way Cecil is put afloat when the land leaves the ship. The young traveler’s qualms (“do all journeys commence with such questioning, such tumult and confusion”), the text’s teeming “formless profusion” and the taunting “significance to be deciphered” come together in a passage that globally offers itself as a trope for Cecil’s existential anguish. The text erases punctuation, plays upon the signified and the signifier, jumbles the metaphorical and the metonymic, blurs the [End Page 740] realistic bearings that stabilize reading such as when “Handle with care, with fragility. Made in Japan. Maid in Germany. Union maid” leads, through an allusion to Wallace Stevens twenty lines or so further down, to “the tall lady with an upraised ice cream cone toasting the emperor.” Hurry Home’s derision of the symbolic torch lighting the way to the gate of freedom happens to be ushered in by the embrace, the passionate-sex-on-the-deck-before-departure (but who knows, as the liner already is on its way to the open sea?) of an anonymous couple. Cecil is confused, out of place, whatever he may think to the contrary. He is an educated young man whose head has been crammed full of literary knowledge (even some Old English) not necessarily relevant to the life opening before him as a black lawyer. T.S. Eliot’s foggy dangerous world of “The Dry Salvages” is present through the tolling harbor buoys defining the navigable channel. But so is Langston Hughes’ “The Negro Speaks of Rivers” through the allusion to geological times. As Jacqueline Berben suggests in her unpublished dissertation (221–23), there are other leads to grasp at to reconstruct the racial overtones Cecil’s existential anguish carries. The rusty knell of the buoys doubles into bell boys, and the horn’s shriek “Bee Ohh” suggests B.O., the 1950s body odor advertisement for...

Self reflection(s): Subjectivity and racial subordination in the contemporary African‐American writer

Abstract Shelby Steele's The Content of our Character, and John Wideman's Philadelphia Fire are contrasted for what they reveal about the two authors’ confrontation with self‐expression and self‐definition in a society that denies African‐American individuality. I argue that Steele's and Wideman's distinctive solutions to personal expression as demonstrated in these works constitute the discursive boundaries, the poles between which black male subjectivity oscillates in this racialist society. To explicate these particular positions, I draw on psychoanalytic concepts of narcissism, masculinity, and subjectivity. Thomas Mann's Death in Venice is invoked to articulate, albeit in a different society and context, the subjective crisis of the intellectual, the linkage between one's inner world and outer society, and the relation between personal identity and national self‐understanding. While Steele opts for an isolated, transcendent individualism, Wideman embraces a conception of self inextricably connected t...

Psychological distress in survivors of residential fires

This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors over time. The sample ( N=69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.