Wednesday, July 9, 2008


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.

Tuesday, July 1, 2008

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.