I never thought I would respond to a motor vehicle accident ever again. It’s been five years since I worked in the back end of an ambulance– five peaceful, nightmare-free years.
Most people in my life today don’t know that I used to be an Advanced Life Support Emergency Medical Technician– in NYS that is an AEMT-Critical Care. Most people who did know me then have long forgotten how close I came to a life-long career in Emergency Medicine. It was almost as if it was another lifetime ago…
Most people who knew me then probably also didnt know about the nightmares, or the strain on my marriage. Delivering a baby to a 15 year old girl who is lying naked in a pile of garbage while her schizophrenic mother wails in the background that the baby isn’t really her grandchild isn’t the sort of thing you just go home and forget about when the shift ends. It’s not the kind of thing your spouse can help you talk through over dinner. It’s not the kind of thing you can even fully process your own feelings about until months, in my case years, later. So when we moved to New York City, it was with great relief that I left EMS behind me. New city, new life, new start. My certifications lagged and then expired…I’ve never been sorry.
But certified or not, when we drove up I-270 this afternoon, on our way home from the fair, and we saw the SUV upside down on the other side of the road– passengers still inside, hanging from their seatbelts– I couldn’t stop myself. A split second of hesitation and observation told me no one on scene at the time was a professional. The cops hadn’t come. The ambulance wasnt there. About 25 bystanders milled around helplessly. “I’m going, ” I told the Auditor as I pulled the car over. He didnt say a word.
In about ten seconds I was out of the car, and across the four lanes of traffic. Shrapnel littered the road. Two men had succeded in prying open the hatch and were coaxing one of the passengers– a young woman with a blonde ponytail hanging down over her face, to escape the vehicle that way.
The other passenger was larger and would not be able to crawl out through the back hatch–from the angle I couldn’t tell right away if she was a man or a woman. All I could see of her through the shattered window was her upper arm, badly scratched and bleeding. Three other men were trying to remove the whole car door to get her out, but the door itself was buckled like corrugated cardboard. Not an easy task.
When the young woman finally emerged from the hatch, at least 10 people converged on her, all talking at once, asking her what happened, was she ok. They were like a well-meaning, but extremely unhelpful, swarm of bees. This poor girl was trembling so violently she could barely walk, looking around blankly at all the faces in front of her. I took her arm and steered her away from the crown. Her name was Hailey. She looked back at the car and told me the passenger in the car was her mother. She was 17.
Hailey and I went to sit by the guardrail. Broken glass and shredded metal littered the ground for about 30 feet in every direction. Someone produced a small blanket for her to sit on. I checked her over quickly and then we talked– she couldnt breath she was shaking so badly. Somebody kept shouting over and over that she must be in shock. (Why is it that people in a panic are so LOUD? A person is smart, but sometimes people are dumb. If they’re in a crowd, they automatically feel like they need to shout. sigh.) Her ankle was in a cast, so I asked her how she hurt it– playing rugby. She began to take some deep breaths and calm down. A horrendous crunching noise told me the men had finally pried the door off the frame, and a few moments later her mother emerged from the car and came to sit beside us.
Her mom’s name was Jane, and she was a CHAMP!
Jane, from what I can tell, is a good mother. She didn’t care about her own (minor) injuries. All she wanted to do was be an emotional support for her child. Standing in shrapnel, wearing only one flipflop, after having been suspended upside down for at least ten minutes, and having climbed out of said vehicle, she was utterly and completely calm. If a rollover accident at the hands of her 17 year old daughter didn’t phase her, I dont think there’s much that could!
Hailey fluctuated between deep, calming breathes, and moderate fits of hyperventilation and trembling. We just sat and talked– me and Hailey and Jane– until a first responder from the fire department showed up to help prepare them for backboarding.
That was always my role on the rig– calming people down. They tell us in training that Calm Is Contagious, and it is. “Calm” is either a trait you have, or a trait you do not have– it’s a very hard skill to acquire. It’s been five years since I ran my last 911 call. I doubt I could tell you the proper dose of ANY injection. Neither could I recite to you any of my old protocols or standing orders. But I can still do this. I can still watch, listen, assess, and soothe. (And, if I do say so myself, I am excellent at gaining IV access– I could cannulate a vein from across the room :)). Hailey and her mother didn’t have any obvious physical injuries– some scratches here and that at worst will require stitches. No broken bones, no obvious bruising, no change in level of consciousness, no medical history, nothing. To be honest, once all of this had been determined, there wasnt much to do but soothe and ensure they stayed as still as possible until the rig arrived to backboard.
The medics eventually arrived and the firefighter and I transferred care to them. At this point, seeing myself as redundant, I wished Hailey well and checked out with the state trooper directing the scene. As I picked my way back across the four lanes of traffic, I felt my head spin and my stomach turn over. Those women should be dead. Their car is crushed. They hung upside down for upwards of ten minutes waiting for rescue. Had the roof collapsed another 3 inches, they would most certain be critically– possibly fatally– injured.
I don’t do this anymore. I don’t play at heroism. I don’t wait in the station for the tones to drop and hope that it’s “something good” and not just another ankle injury. Only outside the culture can I see how sick the culture can sometimes be. There’s even a book written on the subject, entitled “The Magic of 3 am”, which primarily discusses the ‘rush’ people get when the tones drop and the call comes in. It’s a high that addicts many people– and also skews their perceptions a little bit, in my experience. It makes you see a motor vehicle accident as an adventure of sorts. On the drive in, you wonder if you’ll get to use any of your really GOOD skills, like intubation, or needle crich. Maybe that’s a coping mechanism for the people who run EMS– talk in terms of injuries, of calls, of faceless, nameless patients. Disassociate from what you’re really doing. Swap war stories in a way that seems callous to the outsider, but is crucial to the paramedic’s ability to clock in to work every day.
I never got the high. I never felt the rush. Even as a student, when the calls came in and we scrambled out to the rig, I held my breath, praying to God to help me not screw up– to give me the clearness of mind to know exactly what to do, and more importantly, to be able to do it when the time came.
I’m not squeamish about blood, or feces or vomit. I’ve been covered in afterbirth, and I’ve been puked on in a moving ambulance. I’ve assessed elderly patients who have been deceased for three days, their absence noticed only when the odor reaches the hallway of the apartment building. I remain calm when others panic. I make good eye contact and I speak softly but firmly. I knew my stuff and I was a good medic. More importantly, I felt some kind of obligation to be a medic BECAUSE God blessed me with the ability to do so.
But I couldn’t do it. Days later, I was still remembering the elderly woman who died alone in her apartment. I still think about the 15 year old who gave birth in the filth– her name was Tiffani. The first person to hold her infant daughter was me– I held her in my arms from her birth all the way to the hospital, and then for another 30 minutes until a nurse was finally able to admit her to the nursery.
It was too personal. I was never able to disassociate, and see a patient as a patient and nothing more. These women today, in the rolled SUV are people. Hailey was 17. When she and Jane left their house this morning, they were heading up to the Frederick Fair, for a silly little afternoon. Hailey’s inexperience behind the wheel led to an overcompensated evasive maneuver that caused her mothers SUV to roll. She’s had the scare of her young life and is badly, badly shaken. On top of all of that, she will very likely lose her driver’s license– she mentioned to me that she had a fender bender last week and she’s still driving on a conditional license anyway.
I wonder how long these two women will stay with me, in my thoughts and in my prayers. I’ve been replaying the scene in my head all afternoon– over and over. The extrication. The shaking. The blanket. The shouting woman in the crowd. The image of bloody carnage I had in my head when we first drove by. (I fully expected to find them horribly mangled– images of other accident scenes are replaying themselves over and over in my head right now). If you have a moment, say a prayer for them, and prayer of thanksgiving that they survived– and only minorly injured! It is but for the grace of God that they are in as good shape as they’re in right now!
God puts us in each other’s paths sometimes– we can’t know how or why. I’m very thankful to have the knowledge and skillset I have– but equally thankful that I so rarely have cause to use it…I’ve been looking at the incident this afternoon as some sort of test or self assessment. I’ll never work in EMS again, but it’s nice to know that when push comes to shove, I’ve still got it. It makes me useful.