Wednesday, November 11, 2009

Horror and hindsight

I am disoriented and groggy when the high pitched, two-toned call pierces the air. It is dark and I roll over once groaning, then sit up. "WNXX-527, Stony Point Ambulance and Medic One respond to an Motor Vehicle Accident, Palisades Parkway Southbound, between exit 16 and 17. 3 month old infant involved. Time now 0230."

That woke me right up. I cursed under my breath and laced my boots up a little faster, then ran for the ambulance bay doors and cranked them open. We rolled out a moment later. We were right around Exit 15, so the ambulance had to go North past the scene and turn around where there was a spot for it. We would have crossed the median, but there were too many trees in the way. No sense causing another accident on our way. Luckily there were very few cars on the road at such an early hour.

After what felt like an eternity, but was probably less than ten minutes, we arrived on the scene. There was a blue minivan on the shoulder, perched up on a tall rock, and the front end in a small tree, maybe a foot in diameter. Shining my flashlight I can see two adults in the van, huddled over a small, crying baby. That's a good sign.

To a medic, a crying baby is a good baby. Kids cry when they are hurt or upset. It's their way of telling you that something is not right, when many times they are unable to say what. It also tells you that they have a patent airway, and they are breathing, with adequate air-flow to scream. A quiet child who has just undergone major trauma makes me nervous. He may be brave, and perfectly OK, or he may be silently slipping off the cliff that is a child shock profile.

I take the baby from Mom, who is crying and hyperventilating herself, and a quick assessment show's no injuries except a fairly deep, clean laceration on the left side of her chest by the pectoral muscle. Bleeding is mostly controlled. It looked to have been caused by one of the plastic adjusters on the car-seat that she was strapped into. I put her back into the car seat and take it with me. We don't have any C-spine materials that small, and with all her thrashing with the crying, and her parents having moved her, I didn't see a need to stress her more.

Both parents are patients as well, and Tommy is with me so they both climb in the back. They are insistent that we only treat their baby. Mom is hyperventilating and complaining of a severe headache, but refuses to let us look. Dad claims he is sore but nothing else. Neither one will allow us to board and collar. Dad is like a helicopter. As I hold pressure on his baby's wound, he leans in as if in a panic, and says " They baby is dying! The baby is dying, do something!" I am a calm individual and simply told him that nobody would die in my ambulance today. When he continued, Tommy, and our ALS for the night(at least 450 pounds between the two of them) told him that he needed to calm down, or go with the nice police officers that wished to speak with him.

I was actually shocked that he wasn't arrested on scene. The police pulled him out of the ambulance, I believe he had already signed an RMA. He was not carrying a license and driving his fathers car. He claimed that a deer had jumped out and that he swerved, and ended up on top of the low, sloping rock that we found the car on, but there was something off there. When the police took him away from the back, Mom went nuts. Her hyperventilation increased severely, she cried and screamed worse than the child laying on my cot, in a total panic. We let him come back aboard mostly for that reason.

It was an easy ride to the hospital. I made repeated offers to check out Mom, and her head- she refused, though it seemed to be giving her severe discomfort, and she kept rubbing one particular spot. Dad continued to panic, asking me once when the baby finally relaxed, "Is she still alive?? Does she still have a pulse?" I told him that she did. I told him that I didn't even need to feel for it. I could see her heartbeat causing her skin to pulse around the fontanels, and her color was fine. He tried to then grab her head, as if he couldn't see and wanted to feel the pulse I had mentioned. I stopped him and told him that touching a baby's head like that could be harmful, and not to do it again. He leaned back against the bench and calmed down a little longer until we reached the hospital. I gave my report, wished them luck, and said goodbye.

A few days later I was told that a police officer needed to speak with me about a call that I'd worked the previous week. Earlier that evening Tom and I had done an obvious domestic violence case. A woman's boyfriend had pushed her down some stairs and thrown dirty cat litter on her. She claimed to the police that she had tripped over a cat, but it was easy to see her black eyes through the makeup and I don't think the police officer bought it. She told us the truth in the truck, and swore us to secrecy but I wrote up the wounds as I found them, and wrote the Chief Complaint as I'd found it. I figured that he would want to talk about that call, but I was very wrong.

Three days later, dad had spent the day with Mom and her child. Before he returned home for the evening, he asked to hold his child one last time for the night. He then took his beautiful, new, lively daughter, and swung her by her ankles, hitting her head repeatedly against an iron railing. She had died instantly, an he was tackled by a horrified neighbor before he could run. Police were looking to see if there was any kind of precursor or warning to this. They'd found a Leatherman tool in the car, with brown hair that looked like it was from mom's head on the floor of the car. Apparently it had been wrapped up in her hair with the knife blade to her throat. The skid marks show that the car was traveling in excess of 90MPH, on a slight uphill grade. It started to click. Her headache, and her reluctance to allow examination. His panic, not because he was scared for his daughter, but because he had wanted her dead, he had hoped she would die. The crash was attempted murder. He wanted to kill everyone in the car. I felt like I had missed something. Alarm bells were ringing in my head the whole time, but nothing I could place, nothing I could act on. And now a child was dead. I held no sympathy for Mom. To me, she was almost just as responsible for her daughters death. She could have told us, while he was gone. She could have let us examine her, find out for ourselves. She could have let the police arrest him. She could have gone to somebody when she realized what a freaking psycho he was. But she did not.If only he'd gotten a bit more aggressive and I'd hit him, and THEN he'd been arrested, But I wasn't given that opportunity. And I am still left feeling like I missed something.

Neither one of us was ever called into court to testify. There either was no provable connection between the crash, and the savage murder, or they had such an open-and-shut case we weren't needed. I never found out what happened to him, or his enabling girlfriend. A google search showed plenty of stories if the incident but no sentencing info. I hope he rots in Hell. Maybe he's already dead. Even most inmates have a conscience when it comes to children.

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