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Thursday, January 14, 2010

The Angel and My Ghosts

I walked out of the locker room, buttoning up my uniform shirt. I'd clocked in for a three or four hour fill-in while a couple of the FT career guys were running a patient transfer to the Very Big City hospital. It's just me and Jeff, the career medic that stayed behind.

It had only been a year or so since I got my badge, and I still felt pretty good when I got to clock in and back up the career guys.

It's pretty late. Jeff is futzing in the kitchen and I've got the TV on. Just settling in, might even get some Z's before the other guys get back.

The lights came on. The speakers in the ceiling hummed, but no dispatcher voice yet. That didn't take long. I'm the driver.... let's go! Jeff muttered and put down the bowl he was holding.

Medic 61, Engine 61, Rescue 61, Ladder 61, traffic accident on the state highway.

Not a gomer call. Sweet. The ladder is not usually on MVC's though. Wonder what the dispatcher knows that we don't.

In this agency, the Medic goes first, other units to follow when the volunteers make it in.

Jeff and I go. Driving code at night was still a kick for me, watching the lights flash on all the downtown buildings as we went through town. I ask Jeff what he wants me to do, eager to show I am heads up, but he tells me to relax, he'll figure it out when we get there.

Out on the highway. as we come around a bend, I see cars pulled over, flashers on. There's crap all over the road, but I don't see any damage on these cars. Then I notice people down the embankment. Not a gomer call. Jeff keys up.

Medic 61 arrived, two-car head-on collision on the southbound side, heavy damage, both vehicles down the embankment, multiple patients, other units expedite.

One guy is laying in the grass, lacerated all to crap. Someone is clearly pinned in the front of one of the cars, as the hood and front left tire look to be under the windshield. I see long blonde hair and an arm.

Expletive.

Bystanders report no other occupants, just the two patients. Jeff goes to the pin and directs me to assess the guy in the grass.

I lean over to identify myself and get permission to.... ugh... phew. The alcohol smell took my breath away. He doesn't really acknowledge me, so I just go to work. Lots of blood. As soon as I touch his head his eyes snap open with rage. I'm going to f'ing kill you, you f'ing blankety blank blank. He doesn't look like he's up to it, but I pause. His attention wanders. I reposition myself defensively and start in again. This time he swings at my face and nearly connects. He's sure got some fight for being so cut up.

I back off as a deputy arrives and I wave him over. Together we go in, and the deputy verbally asserts reality with lacerated man, with his flashlight out and in a skull-smacking grip. This works, and I finish my assessment, though the hate-filled eyes are on me. The guy is cut all to hell on his face and head, some cuts to his arms. No breaks anywhere that I detect. There's the blood loss from scalp lacerations, but he'll clearly survive if he doesn't have any hidden internal bleeds, but that will get sorted out at the ER. I put some 4x4s on the appropriate places. A bystander asks if he can help. He's a big guy, and looks ready to defend himself if drunk asshat takes a swing, so I warn him of the patient's frame of mind and have him take c-spine.

Jeff calls for me. I'm in a tight spot. No one else has arrived yet, and leaving the asshat is abandonment. Jeff calls again. Screw it. Jeff's in charge, so it's on him anyway. I ask the deputy if he's OK with me helping the medic. Yeah, he says, he'll call if something changes. More blue lights are arriving, and Engine 61 also draws into sight.

It's bad. The girl is moaning and trying to move her head. Jeff is trying to start a heavy gauge line and needs me to hold a light. He calls for Engine 61 to take command and prepare for an extrication.

Stuff happens fast. Six guys pile off the engine ready to work. Thank God the cavalry has arrived. I've never felt so alone, and I wasn't even alone.

While they're setting up, the department's numbnutz (everyone has one) throws the hydraulic manifold into the pressure position before everything is hooked up. The pressure now prevents hooking anything else up, and we're screwed. Expletive expletive....... we drilled on this specific problem over and over again when we got this thing. Engine Captain is pissed and directs the guys to get hand tools and the sawzall. Numbnutz is trying to blame someone else.

Rescue arrives and we have more help, but everything quickly goes downhill. We end up doing a rapid yank-and-go extrication without c-spine considerations, because her BP is almost nonexistent, she is bleeding out and we don't have 15-20 minutes to waste on doing it "right" with the limited tools. On the cot, and we're loading up. Four guys climb into the back, and I pull out for the hospital. I don't even know who took over for the drunk asshat. I turn the box around and pass Medic 63 arriving. Good call, the guys heard Jeff's initial size up and deferred the ladder to bring another medic.

Of course I get a guy who won't pull to the right lane as I am on his bumper, with very light traffic. I finally pull into the left oncoming lane and he moves over.  I am beyond annoyed that anyone would consider being in the way tonight of all nights, but to the driver who moved I am just another thing with flashing lights of the type he will see a few hundred times in his life without this one being especially noteworthy.

We arrive without incident and take the girl in. In the light I can see better. She's no more than 17 years old, and stripped of all modesty except for her underpants. The monitor is hooked up and although I have no cardiac training to this point, even I can see that it is bad.

She is quickly moved off the cot to the ER bed, and CPR starts. She has virtually no obvious external injuries. A bruise on her forehead, but otherwise she is angelically clean and white.  Pale.  I'm ready to help, but feeling useless as the ER staff and medics do their thing. Then I notice she is too low on the bed, because her feet are off the end. Mainly I notice because her right fib/tib are broken just below the knee and the ankle and foot hang straight down.

Dumbly, I grab the foot and try to straighten it to normal, and wait for a lull so I can ask that we move her up the bed. No lull. I am holding her pale foot.

The blur is interrupted when I hear OK, get clear now. Everyone has backed off and a couple of sets of eyes are on me. Oh. I try to let the foot down gently, but the bone pokes through, marring the purity of her pale skin. Her body jerks. They move in again, and after a short internal debate I decide to leave the foot be.

Nothing works. Fifteen minutes or so later, they call it.

I stand there, but I cannot emotionally resolve the lack of outwardly obvious severe trauma with the death of this girl. Why did they give up? She was moaning for help when we arrived, and here less than 45 minutes later she lays unattended, still not covered. So, this is denial, I guess.

Jeff takes me out of the room, but we don't talk.

We clean up and return. The guys out on transfer get back not too long after, and tales will be told but I want no part of it. I go home and my young wife is sound asleep. I don't wake her, just kiss her on the forehead.

------------------

The girl was just going home from work when drunk asshat crossed the median on the curve. He was treated for cuts and released. Sentenced to a few years, but comparatively a slap on the wrist. He's sorry and remorseful and all that.

I'd seen death before, and a whole lot more and a whole lot worse than this one since. But this is the one that sticks.

I hope writing about it helps me stop thinking about it so much. After all, it's been 15 years. Just proofreading it has choked me up a bit. I should be so over this by now, but I'm not.

As the good Captain Schmoe says, Thanks for reading.


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