Wednesday, October 28, 2009

Blast from the past...

Some stories on my old hard drive, from high school and that failed first college semester. They're between 3 or 4 years old now. Since I haven't been writing I figured I'd out them up. Enjoy!

Popped My Code Cherry

Most 16 year olds would spend their Wednesday nights doing homework, or out with friends if their parents were lenient. I on the other hand, found myself sitting in the back of an ambulance checking its supplies. My shift had started at about 7 PM. I don’t think I was sitting in that rig very long before the tones rang out.
It was an ominous feeling, because I sort of sensed it before it happened. Almost like my brain could see it coming before the radio picked it up. It startled me nonetheless and I snapped to attention in the seat of the rig, already hastily replacing the cervical collars into the long blue bag. The sharp, two-tone alarm rang hung in the air. I don’t think there was a longer pause between the tones and the dispatch then normal, but looking back, it felt like an eternity. I knew something hard was about to hit us.
“WNXN-527 on the air, request for Stony Point Ambulance and Medic 1. Please respond to number 123 Fake Street for a 41-year-old female, not breathing. Time now is 1914.” I stifled a curse and hopped from the back of the rig to open the bay doors. I climbed back in, grabbing the giant blue first-in bag, equipped with everything from oxygen and airways to a BVM, and trauma pads. I dropped the handheld suction in the top of the bag as well. I didn’t want to bring too much in since we would have to move fast, but suction would likely be important.
Eddie Conklin, our driver, slammed his door shut. He turned back to me sitting in the captains chair and tossed a big binder back towards me. “Hey, Junior!” he yelled. “Fake Street, and make it fast!” The binder was an alphabetical listing of each street in Stony Point, with directions on how to get there. I wasted no time in locating the street and relayed the direction up front as the EMT Tom Peterson reached his seat. The rig pulled out of the bay and I was out the back, closing the doors, and back in the rig in a matter of seconds. Seconds counted.
I’m not entirely clear on how fast we were moving, or how long it took us to get there. My thoughts were moving way faster then an ambulance ever could. This was my test as a First Responder. Could I really do this? Would I remember my training? Would I fail? Would I choke? All the while I made sure that the supplies we needed were there, that the crew had gloves. As the rig stopped, Tom made sure I got right out and did not wait.
There was snow and ice still on the ground. The moon was high up and it’s light caused the snow to glitter. The beauty of it was offset by the on and off strobe of red flashing emergency lights. I ran through the door of the house where a police officer was waving us. All beauty disappeared.
It wasn’t a large house, and it was a mess because furniture had been hastily pushed aside. My eyes moved to the floor. Lying on a light brown carpet, lit from the dim glow of a dying light bulb was our patient. A police officer was doing CPR, with one hand. A man to my left was breathing with a bag-I don’t remember if this was another cop, or her husband.
The first thing that caught my eye was her stomach. It was large and bloated. “Is she pregnant?” I asked, more to the officer then anybody else. Tommy was there as I knelt on the floor next to the officer on compressions. Turning to Tom, the man bagging her said with frustration, “Her jaw’s held shut, I can’t get any air in!” Tommy pried with his hand and I handed him a measured oral airway but to no avail. They couldn’t get her mouth open.
“Let’s try a nasal,” I suggested. I dug in the bag for a few moments. A pang of fear hit me when I didn’t come up with it right away. I cursed myself. I’d just checked it myself, dammit! But there it was a moment later, under another OPA bag, a little orange tube. I measured that and lubed it, then handed it to my EMT. The medics arrived through the door as Tom was midway in getting it in.
The dialogue is a bit sketchy for a big part of this, mostly because it was curt and quick, and we all knew what needed to be done anyway. The paramedic team asked the normal cardiac arrest questions-how long she’d been down, what had happened. She was without pulse for about 10 minutes before they walked through the door. He husband had left her watching TV to take a shower. When he came back she was down. He’d started CPR and rescue breathing himself-but had not extended her airway properly, hence the stomach bloating. She was not pregnant, and each of us breathed a sigh of relief.
Though her jaw was locked before, it opened on contact for the paramedics. One of them spread-eagle on the floor pushed a tube down her throat. Now we no longer needed a nasal airway. They pushed an IV into her arm, and gave me the bag to make sure it kept dripping. Suddenly I found myself with everything, and nothing, to do all at once. It was am important job. But I found myself wishing that I could be doing more-giving this woman CPR or on the bag. I didn’t feel as if I was using my skills properly. So I became a bystander and a player all at once. I saw the medic perform accelerated CPR to circulate the drugs faster, and I saw them hook her to an AED. Asystole, no shock-able rhythm. They put her on a chain of light shocks-called pacing-to try and stimulate her heart to beat.
Eddie Conklin had grabbed a backboard and the stretcher. They rolled her, and lifted her onto the stretcher with the board beneath her. We made our way quickly to the ambulance, careful of the ice and snow. One of the police brought our equipment out.
There was music in the rig, which died down when Eddie got in. It seemed so fitting-and yet discourteous. In the movies, everything has a theme song. Here it was not the time. The husband rode up front. I sat in the captain chair, Tom to the side in the CPR chair. The medic that rode along with us, Neil, was on the bench. We quickly put a cervical collar on, a job that fell to me being at the head. It would keep her from getting whipped around and keep an open airway. I began to bag, while Tom compressed and the paramedic did his thing.
The thing about it was, everything was so different. It wasn’t at all how I imagined, to rush in and be the knight on his white horse to save the day. Not at all. This was sad, and harsh. This wasn’t like the books. This was not a mannequin. This was a wife, and a mother. And my patient.
Our ride to the hospital was a longer one then most corps. It still couldn’t have taken long. But it felt like we were driving through the next millennium. At some point, Neil leaned towards the two of us. “At this point, she is dead. But because she’s so young, and because her husband is with us, we’re going to keep working.” He looked down at her face. There was a yellow-green fluid leaking from her mouth and nose. “Do me a favor, grab some 4X4’s and clean her up a bit.” I nodded soberly. I was still holding out on a miracle for this woman, as resigned as I was that this would likely be the first patient I would ever lose.
Though I was at the head, and bagging the whole time, cleaning her up was the first time that I ever had really looked at her face. The gunk I was wiping up never gave me the willies or anything-but it saddened me. It killed the idea that we would save this woman. When I finished, however, I looked at Tom Peterson; mouth cocked half open, red in the face, pressing down on her chest over and over. CRP was no easy task, and this woman had a chest harder than most, although I‘ve since forgotten why. “Switch with him,” the medic gestured towards me. Tom insisted he was fine, but Neil stayed firm, and I slid past Tom into the CPR chair, benchmarked her chest, and pushed. I continued the next few minutes until we arrived at the hospital. Before we got there Neil gave a bit of a pep talk. “Keep working hard, put on your game faces. To her husband, it’s not over yet.”
Stone-faced we unloaded the stretcher, entered the code into the doors, and wheeled her into Cardiac 1. Doctors and nurses kept working for another few minutes. When they called it, and went outside to tell her husband, he burst into tears.

It took awhile for the full effect of everything that had just taken place to hit me. It was a bittersweet moment returning to the building, and returning home. Everyone was so proud-myself included. Tommy even wrote on my evaluation that I handled the call “like a seasoned veteran.” But I wasn’t sure there was anything about losing a patient to feel proud about. Weak, grim smiles accompanied the news for anybody who had asked about it.

It had to be two days when it took maximum effect. The day I had read her obituary in the paper. I saw it and went out for a walk. It was dark, and cold. I was walking fast, franticly. I lit up a cigar and puffed on it as if my life depended on it-ironic in that I was killing myself in the process. I broke into a run, my brain swimming with emotions and images that wouldn’t leave. The idea that she would die didn’t occur to me before. I knew the statistics on CPR, but of course I never thought that *I* would loose a patient. The idea that perhaps, she was watching me now from above was a little eerie. Voices echoed in my head. As we had left, her daughter had given her dad a hug, and through tears, said “I love you daddy.” “I love you too sweetheart,” he replied.
Before I reached home again, coyotes were howling on the hill. I listened to them for awhile trying to take my mind off it all. I sobbed relentlessly in my room later that night-that became the release, the turning point. That night I came to terms with what had happened. She changed my life. I later found out that she had suffered a major brain bleed. Even if it had happened to her on the table, she probably could not have been saved.

1 comment:

  1. Jim you captured the emotions and frustrations so perfectly, I felt like I was in the rig with you, Tom & Ed. Beautiful writing job.