Simple Gifts

It is the day after Christmas. Our house is decorated with enthusiasm if not style, the living room cluttered with wrapping paper. We came home from Christmas with the in-laws to find a large package on our porch, and after quick work with a pocketknife on the many layers of tape, we opened more gifts.

Its quiet. Just the hiss and swish of iron on fabric.

Getting the pleats just right takes skill. First, I take off the badge, take off the nametag, take off the tack pin that came from that first aviation assist, a shiny unexpected gift from the BDU pocket of a pilot that afforded that instant of sheer childlike delight; a tiny enameled helicopter. I take off the Hazmat certification and follow the creases that came in the shirt, iron around the patches. Promise myself I will sew them down better, another time. The pins go back on; the tiny silver angel from my mother goes back on my shoulder. The badge wrapped in black ribbon. I eye it all critically, making sure all is straight and even.

It is the day after Christmas.

The pants are easy; lint roller and a razor sharp pleat front and back. I hang it all together on the outside of the closet door, ready for the morning.

In the morning we will present ourselves in our best, out of respect. We will present ourselves to confront the unimaginable, to say to a family, he was one of us and we loved him too. To say, we cannot know your pain, but in this place where there are no words, and only tears between heartbeats, we will stand with you. We will always stand with you.


Chief Timothy R. Martin
Goodyear Hose Company
October 4, 1976- December 21, 2008

Quiescat in Pace

Not just a job, but an adventure

Ah, the station. I probably spend more time here than I should. In fact, I'm writing this here. Mostly because we have a big flatscreen monitor on the computer and the keyboard isn't full of crumbs like the one at home. (I'm not to blame. I'll leave it at that.)
Anyway, the station is a little like college. You sometimes share close quarters with other people of whom you have a certain fondness. A certain camaraderie. Okay, you tolerate them. Sometimes.

We don't have a live-in program or anything, so there isn't a full kitchen, though we do have a bunkroom that has been used now and again. I camp here myself in inclement weather, since I have a car that isn't the best handler in snow and ice. I'd rather be here already if its really bad out.

Some time ago it was decided that someone should be cleaning this place on a regular basis. I won't get into why. Just trust me. It was necessary. A price was negotiated, and the job fell to myself. I don't really mind it. Twice a week I chase away the cobwebs, wipe up the smudges, and clean the bathroom. This is a pretty uneventful experience about 98% of the time. Today was a two-percenter. I performed an intervention. Then left this note.

Some Thoughts to Ponder


1. The throne on which
you are sitting delivers water at the rate of 1.6 gallons per flush.
2. Despite the impressive WHOOSH it makes when you pull the handle, it
is a LOW FLOW TOILET.
3. If you, in the course of business here,
believe that the payload you are delivering will not be sufficiently moved into
the sewage system of Our Fine Borough by 1.6 gallons of water, a mid-transaction
courtesy flush is in order.
4. The average human anus is approximately
the size of a dime. It does not require FIFTEEN YARDS OF PAPER to clean.
5. Should you experience a plumbing emergency worthy of intervention,
a plunger can be found across the street (in the firehouse) in the ladies
room. Knock first; it’s a one-seater.
6. Should I ever have to clear a
plumbing emergency like the one I found tonight, and the perpetrator does not
make an effort to solve the problem, and leaves it to me, and said perpetrator
can be positively identified, they might find what they left behind in the
pockets of their turnouts.

Brothers and sisters, this holiday season, if you stop at the station for a little 'You Time'....just make sure all systems are clear before you go about your day. That's all I'm sayin'.

Physics is Not Your Friend

I have no kids. Some might say I have no business dispensing advice to kids. I'm going to anyway. Its not particularly loving or kind. Too bad.


List of Realities For A Seventeen Year Old Male

1. You are too young to drink.
2. Anywhere. Anytime. Four more years to go. Wait.
3. Drinking anyway makes you a lawbreaker.
4. Drinking and driving makes you a selfish dickhead lawbreaker.
5. Such decisions are expensive. No one is impressed, least of all your parents, or the person whose rather new sportscar you totalled.
6. See #4 re: selfish dickhead
7. That body you are walking around in is essentially an animated bag of meat. It is fairly easy to break and poke holes in, particularly when you are too stupid to wear a seatbelt.
8. We all know that you know better. Since you aren't dead you get a chance to prove it. Don't screw it up.

Training

I'm sure that at some point you've knelt on the floor in some firehouse annex or church basement learning the fundamentals of rescue breathing with one of these.



And when you take EMT class, you are invariably faced with the Bag 'o Babies:


If you are especially lucky, you have the model for 'emergency childbirth' demos, complete with a rubberized vagina and a palpable fetus and a removable placenta that looks just like a grape fruit roll-up. I had the good fortune of sitting directly in front of the training pelvis for one whole evening while it was parked on the table in front of my regular seat. You'll just have to take my word for it; it was creepy. I can't find a picture and to be honest I am scared to try harder.

All I can say is, if Pennsylvania EMS protocols ever necessitate the use of THIS training item, I quit.

LIfting Assistance

Friday night I took a four hour piece of the duty section for a couple who were on their way back from somewhere. I was folding laundry and making some sort of point about something or other when my pager went off. Difficulty breathing call. I went to the station and arrived pretty much at the same time as the rest of the pinch-hitting crew and we responded quickly. The driver asks me as I go to jump out whether the patient is a man or a woman.

"A woman. Why?"

He cuts his eyes sideways. "You'll see. Just go inside."

I go inside and it doesn't take too awful long to figure out what he was talking about. Before I can even say it the call goes out for lifting assistance and pickups start pulling into the driveway.

I'm not good at eyeballing such things but I'd say my patient is somewhere in the region of 400-500 pounds and all day she has felt like she hasn't been able to catch her breath. We help her stand, turn, and sit on the stretcher, and when we try to pull her up the blanket rips in half. I suddenly feel very grateful I've been spending five days a week at the gym because lifting one of her legs onto the stretcher takes pretty much all I've got.

Anyone who knows me is probably wondering why I'm even writing about this; I'm not a small person. I guess that's the point. This lady scared the holy hell out of me. She couldn't move. Her body wasn't just betraying her; it was suffocating her. It made me think of what it means to live in a prison of your own making, and how much further I still need to go to break out.

You hear a lot of still, small voices in the ambulance. One of the most chilling and persistent is 'This can happen to you'.

Binge

Fourth of July weekend, I volunteered to cover an extra duty section. The husband and wife who faithfully cover our Friday nights went on vacation and since I wasn't going anywhere, I figured, what the heck. I imagined all sorts of holiday emergencies to which I might fly, ready to render comfort and aid to citizenry impaled by bottle rockets or pinned in spectacularly mangled vehicles. I sat reading a book on my couch, listening to the distant pop of firecrackers, waiting for the inevitable page, the feverish search in tall grass with a powerful flashlight for missing digits.

It didn't happen. In fact, nothing happened at all. So when one of the Saturday night crew called me Saturday morning to ask if I could cover for her so she could have an evening off, I gladly agreed. She's a dispatcher as well and, in my view at least, deserves a break.

It was a busy night; one minor car accident with two transported, a syncopal episode that resulted in an orbital fracture because the person landed on their face on a hard floor, a kid who rolled a new dirt bike and ended up being transferred to another hospital to get his splintery bits screwed back together. I got to bed late. I thought I was done.

02 45. Dispatch for a woman behind a local establishment 'semi-conscious'. I check the time and reflect on what this is going to be. I decide its going to suck. I am not wrong.

We back in behind the bar and the bright lights flash across a knot of patrons standing a cautious distance from the 5-0. Something about their vacant gawping sort of pisses me off, so I give them a peevish once-over as I pull the doors open and grab the stretcher. Our patient is sitting on the ground unable to support the apparent terrible weight of her head. She's not a small girl, and with no gravitational cooperation coming from her side it takes a couple of guys to hoist her up onto the stretcher. We strap her in and lever her into the ambulance. As I close the doors I see her lurch to her left. I briefly consider simply running.

I need to pause here and mention what I left the house in. An unseasonable chill had settled in our valley and I grabbed a sweatshirt on the way out the door. Two layers up top: check.
I'm a deep sleeper. I've often joked that on most calls I am fully awake right around the time we are at the far end of the ER putting new sheets on the stretcher. This is the excuse I will have to use for the fact that I was wearing shorts and Birkenstocks. No layers down bottom: check.

So I guess you know where this is going.

I pull myself up into the back of the rig just in time to witness a rather violently projected wave of something in the margarita family which lands mostly on the floor, partly on the stretcher, and, because she's spittin' for distance when she gets to the chunky bits, all over the bench. She has enough power behind it that I figure suction is a waste of time and I position myself on the opposite side and swab off anything with a towel that looks like it might go back in. She wetly gurgles "I'm soooooorry!" during her brief periods of not-vomiting.

The good news: Since she apparently didn't eat all day its mostly alcohol.
The bad news: Its all over my (my!) horribly bare legs and feet.

Our friend is sliding off the stretcher so I grab her by the front of her hoodie and pull her back to center as best I can. Its good, sensible activity that is not only protecting the well being of the patient but its keeping me from screaming. We get her to the ER and I step out of the stall when it comes time to transfer her to the bed, because if I'm going to get up under this girl and lift her, I'm going for the feet. The nurse can take the head. We manage this transaction without incident but just as I step out of the curtain I hear the unmistakable sound of someone else catching a juicy wave.

It takes a good twenty minutes to render the bus inhabitable again. I go on a chunk-search on the bench seat with a couple of paper towels, fully expecting to recover cherry stems, swizzle sticks, a cocktail napkin or two. We're told the boyfriend is en route, which is good because we don't even know this girl's name. He doesn't show, but the paramedic gets the info from the police and we find her in the computer. Mystery solved, we can leave, only to return half an hour later with a fall victim. As we are wheeling her into the ER, we see the boyfriend pushing his besotted love down the hallway in a wheelchair, destination unknown, though I am encouraged to see her holding up her own head. I want to say to him: "Were you looking out for her tonight? EPIC FAIL, dude." I settle for a hard look that I hope conveys annoyance with a soupcon of disgust and go home to scrub my legs again.

Better Living Through Chemistry

I don't want this third cup of coffee. But I'm going to drink it anyway.

Besides, I need something to take the pill with. I hold it in my fingers, wondering whether my feeling better has more to do with feeling like I'm doing something than the actual medical action of this particular drug. I decide it doesn't really matter, that improvement is improvement and whatever dispels the dark is welcome.

I see skinny, tanned, shirtless country boys everywhere, ones like the one we loaded to fly a few weeks ago. The first crew onscene found him standing uncertainly next to a wrecked car, cradling his arm, his shoulder not so much dislocated as relocated. They had to ask him if he was in the wreck. "Which car were you in, sweetheart?" she asked. He pointed to the one wheels up in the middle of the road. He'd been asleep in the back seat, ejected somehow without a scratch on him, except for the shoulder. Twenty years old and terrified of needles. All I could do is stroke the five square inches of velvety crewcut that was not encircled with c-spine stabilizing plastic and vinyl and say over and over, "Its going to be okay, it'll only take a second, you have a great vein there, just relax." I wondered at the sinewy length of him and just how he was ejected without more damage. A perfect jacknife dive out of a broken window. The car was small. With every MVA my grasp of physics becomes less science, more mystery and chance, possibly miracle. Possibly. That accident put my skills in perspective. The damage was done. We cleaned up the mess. Maybe, maybe, we prevented more damage.

You walk out of EMT class with your certificate and your patch and think (secretly) that you are going to save the world. You stare hard at strangers whose perfusion seems questionable, watch them make their tentative way up sidewalks, down steps that never seemed so precarious. You shake your head at bikers gliding bareheaded through intersections. It doesn't take long to learn that your ceremonial duties are limited to cleaning up the aftermath of someone else's choices, or asking questions and bearing witness to forces of time and disease beyond all control, particularly yours.

Later on, after my third cup of coffee, I step to the front of the church and receive the cup, the throaty rumble of motorcycles behind me, headed to their destinations. Perhaps I am headed the same way in a hail of sound and flashing lights, though with a swallow of sacred wine and the knowledge that I do not save anyone, not even myself.

Contempt

It was bound to happen eventually.

Saturday, the latest in a string of early risings, only this time for no reason. Last year I watched dozens of racing bikes hum down an ill-advised hill at an even more ill-advised speed. There were no crashes. But we were there. This time there were no crashes (as far as I know), but we were not there since the rest of the crew didn't show. My powers of invisibility were great yesterday, my questions met with shrugs and blank stares, turning away to more interesting conversation, punctuated by the occasional unreturned phone call. I completed some other tasks as the darkness descended. I was angry, but not because of this. It was time to go home. I had to walk a few blocks through merriment I wanted no part of just to find the person who had parked me in.

I hate people, I thought.

I tasted that thought, contemplative, settling into it like an ominous easy chair, pressing my shoulder blades into its sumptuous upholstery, my elbows resting on its portentous girth.

I don't know what other people do when they feel this way. Actually, I take that back. I do know what they do. They drink and fight and fall down and take things they shouldn't or buy things they shouldn't or otherwise do what they shouldn't to avoid the feeling, push back the sucking dark. Sometimes we have to go after them, get them out, wrap them up and strap them down, feeling for damage while they search our faces with anxious eyes, attempting hope and excuses for trying and failing to ride the tide. I opted to hide in the house. Hating people pretty much means you should avoid them for a little while. It definitely implies that, at least in the short term, you should probably not attempt to render quality emergency medical service. I ignored a text for a transfer, knowing no drivers were available anyway. I pulled my pager out of my waistband and shoved it in my purse, thumbing it off as it went. Off went the phone. 1R-259 is OOS, I wanted to write on the whiteboard in the garage. Only I have to do my own warranty work.

Today may be better only because I'm still in the house. But its better. One by one necessary chores get done. I'm at least willing to look out the window, and I may even go out there, soon. I know this sabbatical is short, no more than a day. There are things to do, you see. Obligations to the family I adopted and persuaded to set a place for me, the brothers, the sisters (maybe), the God who watches over us, shaking His head, protecting what we do not treasure.

Overheard on the Bus

Its only May, and my collection of DUI humans grows by the week. I had considered waiting until the end of the summer and doing a wrap up of all of the fun conversations I've had with alcohol-fueled drivers but I can't wait until August or I will forget them all.

First, I'm glad they had a mock DUI at the high school. They should have made parental attendance a condition of graduation. So far this summer every single one of my drunk-wrecked has been between 45-55 years old. Post-boomers: Get your crap together. Seriously.

Exhibit One: Love the One You're With, if in fact you are with her.

Patient: "Did I cause an accident?" (He rammed his car into a tree. There was a large bottle of vodka rolling around on the floor of the car.)

Me: "You had an accident, sir." (I'm holding his head while others are coming in from the other side to get him in a KED.)

Patient: "How is my truck? Did I have an accident?"

Paramedic: "You ARE the accident, partner. Just hang on and we'll get you out."

Later, in the ambulance: "Did I wreck my truck? Is Amanda* okay?"

Paramedic: "We aren't the police, so we don't care, but how much have you had to drink tonight, partner?"

Patient: "6 or 7 shots. Why?"

Paramedic: "Because you were driving a Dodge Neon and Amanda's not with you."

Patient: "OH MY GOD! I WRECKED MY MOTHER'S CAR!!"
__________________________________________________

Exhibit Two: In which its more important to look good than to feel good.

The patient failed to negotiate a 'T', rolled through the stop sign, and rolled his truck several times. When we got there, he'd self-extricated and the truck was on its roof.

Patient: "Oh, shit. My truck."

Paramedic: "We aren't the cops, so we don't care....but how much have you had to drink tonight, partner?" (See a theme? We get to say this a lot.)

Patient: mutters something about just a couple of beers, then turns to me earnestly and says
"Oh man, is my face all messed up?"

Me: "No sir, you are just fine, just a little cut on your head."

Patient. "Oh, good." I guess his modeling career is safe. "Man, that ditch, man. It just...." (Just what, jumped up and grabbed you?)

Later on...as we're bringing him out of the ambulance.....

Patient: "Well, that's the rodeo."
____________________________________________________

Exhibit three: Getting your story straight isn't always enough

We arrive to find a large motorcycle leaning carefully on the embankment with two guys sitting beside it looking for all the world like two kids who got caught stealing in a candy store. Neither of them will look at us directly. Not much debris other than a broken amber turn signal lens, a wristwatch, and a pair of glasses. Both refuse treatment, which seems fine for the one guy but the other one's forehead is busted pretty good and he's trying to nonchalantly swab the blood off with a headwrap. I'm thinking five stitches minimum. We start filling out the refusal paperwork. (Translation: we start killing time until the state police arrive.)

One guy starts to tell us how they were coming up the road and jeez, there was a deer. Just come out of nowhere & ran right into the back of the bike. Ran off that way. And so we called someone to come and get us and while we were waiting, we had a couple beers. Four beers. Apiece.

Now. This scene was about a five minute ride from town. We were enroute probably no more than four minutes after the call went out. So in nine minutes, these gentlemen did the deer tango, got the bike off the road, called a friend, hopped a squat, and had four beers apiece. Because nothing says Miller Time like a close encounter with wildlife. I suppose they were careful to stash the empties back in the saddlebags for recycling because I didn't see eight empty cans anywhere around. Gentlemen: Do not piss on my leg and tell me its raining.

I hand my guy a handful of 2 X 2s for his head. I take a walk in the direction of travel and see a thirty foot long scrape on the blacktop that extends from the apex of the curve and starts just over a rough spot and I get an idea that's where things went tits up for these two and no deer were harmed in the making of this film.

Refusal forms complete, we wait. Oddly, the ride they called does not arrive. But the staties do.
I can honestly say I've never been in the kind of trouble that involves the state police; once a very kind Delaware State Trooper gave me a ride to my office when my car broke down on a busy and dangerous stretch of highway. So I can't say what it is about that slow saunter across the road from the black and white car that changes things for a patient/victim/defendant, but suddenly, the deer story was abandoned in favor of a finger-pointing meltdown over who was actually driving. I had walked away but I overheard one of the troopers saying something like "Okay. So I'm gonna ask you ONE MORE TIME...."

State troopers have the magic touch when it comes to getting impaired folks to get in the ambulance. Its called the "You can come with us" speech. As in: "You have two choices: You can go with them or you can COME WITH US." Its downright miraculous how people have a sudden awareness of pain they had not noticed to that point and elect an ambulance transport. Our busted head guy did us one or two better.

As soon as he was immobilzed he started shaking. It wasn't so much an involuntary tremble as it looked like he was reprising Tom Cruise's role in Cocktail. Then it started:

"Oh man. I'm gonna go back to prison. I don't wanna go back there. Please don't send me back to the Gulf. (the hell?) I don't wanna go back. Three times was enough."

"Sir, we're just taking you to the hospital to get you taken care of."

This refrain is repeated all the way to the hospital. In between he manages to tell us he has PTSD, he broke his back in the exact same place three times, and suddenly his back hurts an awful lot. Despite my very best efforts with a handlight I cannot get his pupils any smaller than dimes. All the way to the hospital we have to assure him many times we are not shipping him back to the Gulf. I get his arm out of his leather coat without complaint so I can get a BP but as soon as the ED nurses touch him he shrieks like they set him on fire.

He ends up being released with a couple of stitches in his head.

Its only May.

Department of Vehicular Awesomeness

I'm too lazy to cross-post. So I will just give you the link to my new post over here, wherein we talk of ambulance-related happiness.

Riding Season

All EMS professionals must face death. The need for coming to terms with death is universal; death is part of an EMT's everyday duties. These professionals must not only learn how to respond to death, but also how to react to it and integrate it into everyday life. EMS professionals employ several strategies to control the stressful effects of death. The most frequently used defense mechanisms are educational desensitization, humor, language alteration, scientific fragmentation, escape into work, and rationalization.-- Emergency Medical Technicians Forum, Encyclopedia of Death and Dying

Monday wasn't a duty night for me, I was hanging out at the station waiting for a meeting to start. I went to a quick NH call because I happened to be there, thought that was going to be it. Then we heard it.

Alert tones and two beeps.

Two beeps is a car accident, usually. It is also an invitation for our entire department to LOSE OUR FREAKING MINDS.
In twenty seconds every piece of equipment we have was screaming down the road at 80 miles an hour toward what we were told was a motorcycle accident. Helicopter was in the air, we're lurching all over the back of the ambulance pulling equipment out on the stretcher. I guess some of us were excited about the possibility of saving someone's life. I'm still new enough that I was hoping I'd be useful and not in the way. I don't know.

The first thing that I saw was a little cluster of young guys. Guys that looked like they'd been working on cars or something. Guys of the normally "I'm invincible" variety suddenly looked very young, and a little lost. They were standing a little way away from our patient/the body. Amazing how quickly he went from one to the other. We got there in time to help turn him over and watch as the paramedic attached leads to him, in time for the bright green line. We got sheets and covered him. He looked so small.

A lot of time passed, that was spent standing around waiting for the 'stuff that happens when this happens'. Painting lines. Lighting flares. Measuring. Taking pictures. People that have to come and give the official imprimatur to what we already know to be so very finally and permanently true.

I read a lot, see a lot of movies, and probably think about stuff like this more often than is any good for anyone, but standing there with someone who probably got up that morning and looked forward to riding his bike and enjoying the hell out of a beautiful day waiting for the go-ahead to put him in a bag kinda rams it home for you like nothing else does: every day we get through is a miracle and not a single one of them is guaranteed. I don't think I had real faith until I stuck my hands into how it all breaks down. Damage. Loss. Disappointments. Fatal errors in judgement. Things that happen that aren't fair. At the end of the day it comes back to a verse that just sounds better in the old King Jimmy translation: "Whatsoever ye do for the least of these my brethren: you have done it unto Me."

And that's why I'll be back tomorrow.

Nineteen Months

Wednesday I got a call right at the end of the work day for an ambulance transfer to Geissinger. I said I could be there in twenty minutes and headed out of the office.

When I got there I questioned, just for a minute, my "Say yes and ask questions later" methodology.

The transfer coordinator was still on the phone trying to secure a driver. He mentioned, as he deftly punched buttons on his cellphone with one thumb while spraying down a truck that had just come back from a fire call, that it was a 'pediatric patient'. I had visions of entertaining a 9 or 10 year old on the way down the road, letting them mess around with all the 'cool stuff' in the back of the ambulance.

Driver secured, we went to the hospital. He and I quickly threw together two cups of coffee which he took back to the bus while I went upstairs. All the way down the hallway I'm following a man of about 25 carrying a carseat in one hand. Odd, I think. If his kid is getting out of the hospital why don't they just carry him downstairs and put him in the car? I lose him in the bank of elevators.

The nurse points me to the children's ward, and as I roll down the hallway an insistent wailing is getting closer and louder. I wait. I shuffle my papers. A nurse appears and I point hopefully at the door across the hall from the banshee-ing and ask, "Is this where we are?"
"Nope," she replies. "In here." I turn around and my young father is standing there. Another nurse comes out and plunks the carseat in the middle of the stretcher. We all look at it for a moment like apes contemplating the monolith. I break the silence.
"Look, I have to be honest...I don't have kids, so I don't know how to work one of these." The nurse smiles, we grab the straps on the stretcher, and figure out how to thread them in the back. So ends the very easiest part of this process.

According to the 10th Edition of Emergency Care (Limmer & O'Keefe), toddlers:
-Do not like to be touched or separated from their parents
-Do not like having their clothing removed
-Have a fear of needles and pain
-Understand more than they communicate
-Don't like oxygen masks

In short, this experience could not really suck more for this kid than it already did. Except that she had pneumonia that wouldn't go away, she was exhibiting a lot of accessory breathing, her sats were crap, and her respiratory rate was tanking.

When kids are too young to understand certain things, you try to coax them to comply. Sometimes you trick them a little. In the hospital, you have to force them to comply. You can imagine how happy this makes them. Her arm was splinted and wrapped so she couldn't bend it or touch the IV port. Her nasal cannula was held in place with two large pieces of tape on her face. It took three people to disentangle her from the tubes and machines so she could be placed on the stretcher. Her eyes were two standing puddles of tears, as she kicked at the straps and looked at her mother in disbelief. She was still wailing but it was obvious she was wearing out. It was time to go.

Do you know how, in movies, people are on airplanes, but you can't actually hear any noise? Just quietness, and their conversations? If you've flown, you know it isn't like that. Its noisy. Ambulances are the same way. You have to speak loudly to be heard. Every pothole feels like you are riding the mechanical bull at the fair. It didn't seem like a place where an already agitated child would fall asleep. But weariness took over and little by little, as her mother sat stroking her hair, her eyes grew heavy, and soon her long dark lashes were resting on her cheeks and she was out. We all looked at each other and smiled a little.

A tiny comet-shaped bruise where an IV had been marked the back of her small hand. Monitor wires trailed out from under her doll-sized hospital gown to a machine that told us how she was doing. (Not horrible, not great.) Once she awoke with a jerk and turned toward me, the sun catching her golden brown eyes. She was in an instant very young and ancient, an unbreakable soul in a very breakable vessel.

The wailing started up again when we got to the hospital; she didn't like the noise of the stretcher or being brought out the back doors. It was a long walk to the PICU and we tried to go as fast as possible, though we were only bringing her to another whole group of strangers to do those things she didn't want done. I was, admittedly, happy to be out of earshot once all of our equipment was removed and it was time to go. Sometimes there is not a lot you can do to make a patient feel better. That is someone else's job. I wished I could have left her with a lullaby. This will have to do. You can sing along too, if you like.

Once there was a way to get back homeward

Once there was a way to get back home

Sleep pretty darling do not cry

And I will sing a lullaby

Golden slumbers fill your eyes

Smiles awake you when you rise

Sleep pretty darling do not cry

And I will sing a lullaby

Sonrisa

"Our birth is but a sleep and a forgetting: The Soul that rises with us, our
life's Star, Hath had elsewhere its setting, And cometh from afar: Not in entire
forgetfulness, And not in utter nakedness, But trailing clouds of glory do we
come From God, who is our home…"
--William Wordsworth

12:30am. My gut fills with the familiar shot of nausea inducing adrenaline that comes from a sudden loud noise piercing the silent dark of the bedroom. When will I ever get used to that? I swing my feet out from under the flannel sheets and search for my sweatshirt, fumbling my feet into shoes and feeling blindly for glasses. I leave the house as quietly as possible and slip into the frozen night, saying a quick prayer as my sleepy, growling ignition catches and my car rumbles to life. I drive the empty streets to the station and take my pick of parking spaces.

Our patient is a 92 year old woman at an assisted living facility with difficulty breathing. She had a coughing spell and then got very dizzy, could not catch her breath. Someone who was with her decided she'd better go to the ER and get checked out. No bronchitis or recent colds, surprisingly few chronic meds, and she is able to get on the stretcher with very little assistance. We swaddle her against the punishing cold.

"Will I come back here?"

"Yes ma'am, I'm sure you will, we just want to make sure you are okay."

"I'd better take my glasses. Do you have my glasses? I don't have my glasses. Maybe I should leave them here. Where are my glasses?"

"Why don't we leave them here, so we know where they are and you can get them when you get back."

"Okay. Just don't forget my glasses."

We wheel out of her room and toward the exit while an honor guard of sleepy looking nurses holds all the doors for us. Frigid air eddies through the stairwell as we negotiate doorsills, ramps.

"Will I come back here?"

"Yes ma’am."

I walk around the side as she is being loaded so I can take my seat alongside the stretcher. I try my best to be there when they slide in so they don’t feel alone. As I join her and reach for the blood pressure cuff she turns to me with wide blue eyes and a brilliant smile.

"I’m sorry, do I know you?"

"Yes ma’am, I’m an EMT with Wellsboro and my name is Kimberly. We’re taking you to the hospital now."

"Okay."

We swing onto the main road, back into town, toward the hospital. I put my hand on her arm, to reassure her over the bumps. Her eyes open and I am again treated to the smile, like watching sunrise over and over.

"I’m sorry, do I know you?"

"Yes ma’am."

We trundle into the hospital driveway and she grimaces briefly against the cold when the doors are opened, squinting against the bright busyness of the emergency room. The nurses help transfer her into a bed. I gather our paperwork and give her hand a pat as I leave. She beams with the merry eyes of a sister who has just shared a secret.

Snow Storm

I present for your consideration a guest post from one of my fellow
EMTs. My friend here came through EMT class with me (with one of the
highest grades and best recommendations, I might add) and in his short tenure of
certification has had some pretty intense experiences. He's one of
those teens that reminds you that this generation is really pretty okay.
More than okay.

Hello everyone! I’d like to start out by thanking the lovely blog host for letting me add a guest story here and there. I hope to interest some of you out there to join your local fire department or ambulance service. Just a little about me, I joined the fire department and ambulance as soon as I was of age and have been loving it ever since, but enough about me, onto the stories that you’ve been waiting for…

Snow Storm
The local weather service had been predicting a heavy snow storm for that night, and for once they got it right, except it all came as ice…The ice and sleet pellets were inches thick. I awoke to my pager’s annoying sound at 2am after being in a deep sleep. Dispatch reported a full arrest at our local apartment building. I didn’t bother getting dressed. I have a firm rule that after 1am if anyone needs my help that badly, they won’t mind me in my pajamas. I carefully made my way to the car attempting not to ice skate down the sidewalk. In the heat of the moment, taking the time to clean off my car didn’t seem like good idea. It did shortly thereafter. It is amazing what adrenaline and a sleepy mind will do to your common sense.

While driving down our main highway to the station I soon figured out that driving on a ice covered road with only a paper-sized port hole to look out of was not a good thing. Fortunately the general public has enough smarts and doesn’t drive too much at 2am on icy roads so it was deserted. I arrived at the ambulance building where a crew who didn’t have to drive was already there, one had decided to stay the night while the other lived next door. I jumped on board and away we went, with the bus occasionally sliding a bit. That experience will open your eyes very quickly.

We arrived onscene with the hospital’s paramedic beating us to the scene. We quickly found out that the building was locked down after a certain time and we were never given a key. The special emergency entrance had been locked as well. Somehow the paramedic had gotten in but we could not, so we radioed the communications center to have the police officer on duty come let us in. Just as he arrived a good citizen inside heard our knocking and let us in. We quickly boarded the tiny elevator and headed upstairs. We navigated the hallways looking for the room until we found it. Once inside we knew there was no help for this poor soul. The paramedic had determined that he could not be resuscitated, and we would have to remain on scene for the funeral home. The man’s wife was inconsolable, as anybody in her situation would have been.

She needed to notify family but was in no state to do so. Being the jacks-of-all-trades that EMT’s are, we began calling her family. We then called her friends who lived in a nearby town to come be with her. This was not a time for her to be alone. Of course, this was during an ice storm, so everything took a bit longer. We kept the woman company while waiting for the funeral home and friends, which would take at least an hour. She began to tell us about her life when she lived in New York City and how things were so much different here. It was actually quite interesting and got her mind off the situation.

After an hour of small talk and thinking to myself, what do I say…what can I possibly say to this woman that holds any significance and will help her cheer up? Unfortunately nothing came to mind. At last the funeral home arrived with Barney Fife and friend. These two were a pair to say the least, but they were there, and I was ready to be going. We quickly placed the body in the bag lifted him onto their stretcher. The friends arrived as we were leaving. After the funeral home completed everything they needed, we were on our way as well, carefully negotiating the slippery curves of town back to the station.

Once home, I hopped into bed and found that I could not get to sleep. The thought of death was on my mind. After dealing with so much death, it finally gets to you and you begin to realize we are all human and death is possible at any minute so we must cherish every moment.

Policy

Another double-transfer week.
Tuesday night, we went south to Williamsport. Wednesday was another visit to the fine folks at Robert Packer Hospital. Our patient was stable, the trip was uneventful, we got her tucked into bed, met up with another crew to grab some equipment to take back to our hospital, and we were on our way.

We only had one problem. Sayre, apparently, has a curfew. And we were past it.


Need a cup of coffee after 9pm ANYWHERE in a five mile radius? Tough. Because everything is closed. Everything. Our driver just wanted coffee. The rest of us were a mite peckish, but the driver having coffee is kind of important. We drive around and no luck. We finally find a Wendy's, which is open, but only the drive through. Surely, we reason, we'll be able to get coffee here.

Now. An ambulance is higher than a pickup, has a noisy diesel engine, and enormous side-vew mirrors so we can see past the patient compartment. Which means if we pulled up to the ordering thing, we couldn't get close enough and they would never be able to hear us. Never mind that we could never successfully complete the transaction on the other side of the building, between the height difference and the mirrors, without getting out. So we park the ambulance ON THE LEFT SIDE OF THE BUILDING WHERE THEY CAN SEE IT and walk up to the window. This is the retardation that ensues.

Our driver: Are you open?

Window Idiot: The drive through is open, but the dining room is closed.

Driver: Can we just order here?

WI: No, you have to be in a vehicle. I can't take your order at the window.

The driver and I part and gesture to the AMBULANCE which is parked IN FRONT OF HER STUPID HEAD.

Me: We can't drive around the building in that, you'd never be able to hear the order over the engine.


Driver: I can't even just get a cup of coffee and pay cash?

WI: No. That's the rule.

Me: But we're in an ambulance.

WI: Sorry, that's the policy. We can't serve people on bicycles either.

I am so close to pulling her through the window I'm experiencing involuntary muscle twitch. Because, you know, four people on an ambulance transfer from an hour and a half away who are just trying to not FALL ASLEEP AND WRECK on the way home are just exactly like some douchebag on a bicycle. We all freeze for an instant and let the pointlessness sink in, then get in the rig and go home.