Rescue 12 Responding, page 9
“Yes,” David knew that somehow Tim would see him among the crowd that would be there. “Yes, you will.”
Chapter Five
Thursday:
Some Days Are Just Too Long
Thursday morning, David drove slowly to the fire station. The sun seemed to force its way into the morning sky. Darkness fought it but lost. The colors swirled across the sky. Light had broken through. Watching the sunrise over the interstate, David’s mind raced as it tried again to sort all the different emotions. The last two days had been full, and his emotions had been taken from one extreme to another. How could so much happen so fast?
Lennie, the paramedic from the previous shift, was in the ambulance replacing the items they had used. Her hands were full of IV equipment and bandages. “Nothing major is missing. We did have a backboard go with the helicopter to Tampa General, so if you get by there, you might want to look for it. But we still have two, so you’re ok.” Lennie continued with her morning report.
David slipped in beside her on the bench in the back of the unit and began his morning evaluation of the equipment and supplies. “Is the unit’s a/c still not working well?” David asked. “They checked it out last shift but didn’t find a cause.”
“Yes, it still is kind of hot in the back with the patients. The mechanics said that it would have to wait until they could schedule it to look again. Hopefully, you’ll get it fixed today.”
Jonathan arrived to work a few minutes late and joined the crew at the ambulance. He spoke with anger as he came around the back of the unit and kicked the rear tire, “Well, I know what kind of day this is going to be.”
“So, did you wake up on the wrong side of the bed this morning?” David tried to jest with his partner, even though he knew it wouldn’t work to improve his attitude this morning.
“Wrong side. Ha! It’s Robert, that bastard! He threw my clothes out of our bedroom. He’s such a baby.” Jonathan was not going to cool off quickly. Anger was just masking the depression in Jonathan’s voice.
David stopped checking out the unit and turned to face his friend. Everyone knew that Robert and Jonathan weren’t ‘right’ for each other but, that was for Jonathan to decide. Until then, David could only offer his friendship. “Boys will be boys.” David again tried jesting. “So, what did you do this time?”
Jonathan sat on the back bumper of the unit and tried to calm down and control his emotions. “I didn’t take out the trash. He threw my clothes out, because of the trash.”
David chuckled. “That’s gotten me in trouble before, too.” He began again to check out the truck.
“Well, he said the only reason I keep him around is to be my woman. He says that I expect him to pick up after me. He can really nag and nag and nag. He’s worse than my ex-wife!”
“No one is that bad!” Lennie joked as she came around the front of the unit.
Jonathan laughed, “You’re right, no one is that bad.”
“So, do you think you’ll have a place to go home to tomorrow?” David asked.
“I don’t know. He’s so temperamental. I’ll call tonight. Probably. I know he really cares. But, he gets so angry sometimes. Sometimes I don’t know if it’s safe to be around him when he’s in one of his moods. He really scares me.” Jonathan hushed, remembering how forcefully Robert had pushed him against the wall during their argument last night and the fleeting fear he had felt. Not wanting to continue that thought out loud, he tried to lighten the mood, “The truth is that he is the one who expects me to clean up after him. It will be ok. I have put up with him for five years - and he has put up with me, trash and all.” Jonathan jested, “Boys will be boys… baby boys,” he laughed as he turned around and opened one of the outside compartments. “I see we are missing a backboard. Do you know where it was left?”
Two tones put an end to this morning’s equipment inspection, “Rescue 12 respond to a possible cardiac arrest at 10349 Highway 41.” David immediately answered the call as Jonathan threw their personal medical bags onto the unit. The day was to begin early and go late, very late.
The two paramedics rapidly walked up to the door with their equipment in hand. Just as David began to knock, a little, eighty-year-old lady opened the front door, but only by few inches. She would speak to these men from behind the chain.
David looked at her curiously, searching for clues. “Did you call for an ambulance?”
“Oh, yes, I called.” She spoke with hesitation and bewilderment. That answer didn’t help.
He tried again, “Do you need an ambulance?”
“I guess so. Do you think I need an ambulance?”
David looked again through the small opening in the door. He couldn’t see another person.
“Ma’am, could you try to tell me what is going on? We would like to help,” he added gently. He could see nothing odd inside. He spoke to her with a warm smile, trying to win her confidence. “Is there someone else inside?”
“Oh no, I live alone. I called for me.” she sounded surprised that David didn’t know that.
“Could we come inside?”
“I don’t know. Do you think you need to?”
“It depends. What’s wrong?” David recognized the attitude. She wasn’t comfortable with people inside her house. He put his equipment down on her front porch. He would take it as slowly as she needed.
“I called this morning when I woke up, and I didn’t have a pulse.”
“You didn’t have a pulse? How did you know you didn’t have a pulse?”
“I take my pulse every morning. With me living alone, I’m so afraid that I will wake up dead. I take my own pulse, so I know that I will be ok. Every morning I do this. But this morning, I didn’t have one.” She was so serious and slightly afraid.
Jonathan tried not to laugh and forced the mask of professionalism to cover his face that so wanted to smile. “If you didn’t have a pulse, do you think you would have known to call for help?”
“I thought if you didn’t have a pulse it meant you were dead. I didn’t want to die alone.” Her voice cracked as she honestly tried to answer their questions.
David and Jonathan looked at each other. They knew this was just another call for a lonely lady who just wanted some companionship and reassurance. Now they smiled; another crisis resolved. David looked at the woman. “Could I come in and talk to you? I would be glad to check you out, take your blood pressure and recheck your pulse.”
She reached up and pulled the chain off the door. “Could I put some coffee on for you two?”
“That would be nice.” Jonathan walked in behind David and adjusted the volume to the portable radio he was wearing. He would monitor the radio, and if he heard that another emergency call came in near them, he and David would take it. But, if it were quiet, they would give this patient the treatment she needed - someone to talk to.
A few minutes later, she returned to the front room with small china coffee cups and a small rose covered pot with steam rising from the spout. She sat with her guests.
David looked to his patient, “Could we take your blood pressure and other vital signs? It would help me a lot.”
She seemed a bit surprised by this request. “Do you think it’s necessary?”
Jonathan rose and walked over to her. Slowly he reached for her hand, her wrist. As he spoke to her, he held her pulse under his fingers. “It would help.” Jonathan looked at David. The look told David that her pulse was fine. He began to examine his patient. David administered the cure; he had her just talk.
After they finished their coffee, David began the process of having their patient listen to him. “Do you understand that if you don’t have any pulse, that you wouldn’t know to call us? That if you are afraid of being alone, you should find someone to stay with you at night?”
“Yes, but I don’t have anyone. I’m all alone.” Her eyes filled with tears as she began talking about her late husband. For eight years he had been gone, but the pain was fresh as she faced each day alone. Jonathan again reached over and took her hand. She squeezed it tight; she drew strength from the touch of another person. Their patient was cured. She simpered, suddenly realizing they might need to go. “Could I give you some coffee to take with you?”
David stood and walked over to the front door. “No, but we do need to go. I’m surprised that we were able to stay this long. We need to get back to the station. Call us back, if you have any pain or other medical reason to call.” David accented the “medical reason,” hoping that she understood that today didn’t offer an appropriate reason, but only time would tell. They walked out of the house burdened down with all the equipment they had carried in.
“Sure am glad we didn’t need all this stuff.”
“Yes, I can’t stand a code first thing in the morning.” Jonathan reached up and felt for his pulse. “Help me, David, I think I am dead.”
“I am sure you are dead. I have known that for a long time - brain dead.” Dispatch heard the background noise of laughter as David notified them that they were back in service.
“Rescue 12 return to your station,” the dispatch voice calmly replied. A few minutes later, the unit turned into the station. Before they took their seat belts off, the next call came in. “Rescue 12 respond to a possible cardiac arrest.”
“Rescue 12 responding,” David answered.
“Well, maybe we will be lucky – twice,” Jonathan said as he brought up the map for the new address. The ambulance responded immediately.
The crew ran inside the next house with all their equipment in hand. This house had no one at the front door, so they just entered. Cries were heard from the back bedroom. Jonathan reached the bedroom doorway first. He found an older man standing near his bed, looking down toward the floor. His voice was pleading to his wife. “Please, get up! Agnes, please get up…” His voice disappeared into the void that filled the room. Sobs were hushed as the two strangers entered.
Jonathan knew what he would find. He wasn’t surprised. The code began…
David pushed past the husband. Quickly, the man left the side of his wife of forty-eight years and stood silently against the far wall watching and praying. David grabbed the pink silk nightshirt of this elderly female and with a single motion ripped the shirt, exposing her bare chest. Her pale warm body remained still. The EKG machine wires were quickly placed on her chest.
Three more firemen entered the small bedroom. The husband was pushed even farther away from his wife. Tears revealed the sorrow of this man’s heart as he watched his wife exposed and manipulated by these strangers, knowing there was nothing he could do to help them. He could only watch.
One fireman knelt beside her small body and placed his hands on her chest bone. David grimaced as he looked at the straight line running across the small green screen of the EKG machine. He nodded his head at the youngest fireman. At that signal, the fireman compressed the rib cage about one and a half inches. The force of the compression broke a rib and the sensation of the snapped bone shot up his forearms. The fireman grimaced. He gritted his teeth and began the count. “One – one thousand, two – one thousand, three – one thousand, four – one thousand…” The cycle of compressions began. Bones continued to snap under the weight of his compressions. He hid the inner struggle of breaking this woman’s ribs, keeping his face emotionless, focused on providing the blood circulation that might save her life. A life for a few broken bones, maybe. He concentrated harder, nor wanting to go any deeper than necessary. Another broken bone, and then another. The sweat from his brow dripped onto his hands as they worked on this woman’s chest. Sweat was allowed. There was no time for tears. The compressions continued. “One –one thousand, two – one thousand, three – one thousand, four – one thousand…” All the while, he could feel the stares of the husband searching his expression for any sign of hope.
Jonathan opened the airway box and pulled out a hard-plastic curved shaped tool and an ET tube. He opened her mouth and found the airway passage. He inserted the ET tube, and with one motion he dropped the curved instrument he had used to find the air passage and grabbed the stethoscope. He inserted the ear pieces into his ears and then placed its metal end against her chest. His other hand grabbed the airway bag and attached it to the ET tube. He pressed the bag, forcing oxygen into the woman’s lungs. He listened to the air exchange. It was equal in loudness on both sides of her chest. He checked the sounds over her belly. It was quiet. He smiled at the confirming evidence that the tube was placed in her airway and not her esophagus. It would be her lungs, not her belly that would receive the oxygen. His hand immediately went for the tape to secure the ET tube in place.
She didn’t respond to their treatment; drugs, oxygen, chest compressions, there was no change. Her color remained pink, but her heart remained still. Ten minutes, fifteen minutes, and there was no change. The pace was fast. The time seemed like seconds to the ever-watching husband. Did he dare ask? Suddenly, before he even knew he had spoken, he asked the question that every paramedic dreads to answer. His eyes were dazed, like a dream, Did the question come from him? Again, he asked, “Is she going to be alright?” His voice broke, and the question ended more like a whisper than a request for information. David heard. He looked up at the frightened husband. The man’s eyes begged for the right answer. Begged for his wife. “Please.”
David stood up, walked to him, then looked him in the eyes. “Sir, it doesn’t look good. She’s not breathing, and she doesn’t have a pulse.” Instantly the man’s eyes filled with tears. His silence had been broken only to discover what he feared. Not another word was spoken. He simply watched through dazed and tear-filled eyes. David knew the man understood. Now he needed to return his attention back to the patient. There was little left they could do that couldn’t be done en route to the hospital. Quickly, they placed the woman on the stretcher and began transport to the hospital. They all knew it was too late, but all effort was given. David watched as the ambulance backed up to the Emergency Department entrance. He looked down at his patient. In the ambulance, the mechanical chest compressor provided perfect chest compressions and ventilations causing noise and rhythm without rhyme or reason. Why does one respond to treatment and medications and another remain untouched by the power of men and medicine? There was nothing left to do but the paperwork.
The exchange of patient and treatment were given to the Emergency Department staff. The husband was taken to a small waiting room nearby. He nodded at David and mumbled something about the doctors doing what the paramedics could not. There was no reason to remove the last layer of hope this man had, but David knew the only thing left for the doctor to do was stop “the code” and sign the death certificate. Quietly, David walked outside to his ambulance. The cries were hushed for a while, but David knew they would return and did not want to be there then.
Death stood silently near the door and watched. All must come through him. This woman passed through the door of death and entered a new life. She left her sickness behind. She saw her husband as she passed through this life and into the next. She kissed his cheek and said goodbye. He could not see her. He felt nothing but loneliness and began to softly cry. She continued to follow the path of life. She knew he would join her soon and she would be waiting for him. Her love for him began to grow, until all she could feel was love. Yes, she would be waiting for him, and he will like it here. With joy, she went into the light.
“Agnes, you can’t leave me. Please, Agnes, come back.” He sobbed, but she could not hear. Death turned and walked out of the waiting room. He had no control of the destiny of those who passed through his doors. His task was complete. His victory was hollow for he could not claim those who passed from death into eternal life. The sting of death could only touch the living for a moment. He left the task of suffering to Loneliness who stood and began to speak into the ear of the crying man. Death’s appetite had been satisfied, but only for a moment.
David walked out into the sun. Jonathan had begun the process of cleaning the unit. Paper boxes, tubes, and wires covered the floor. David said, “So much for not starting the morning out with a code.”
“At least, we got our coffee,” Jonathan replied as he bent over and picked up the empty drug boxes. He dropped them slowly into the trash. “Do you need to count these boxes?”
“No, I have them all recorded. But I do need to finish the paperwork. I’ll be in the nurses’ lounge, if you need me.” David returned inside, carrying a long trail of EKG paper. It stretched out for several feet and had a single, straight line running through the middle of it. The straight line recorded the stilled heart within the body of the man’s wife. This paperwork would be quick.
The ambulance pulled out of the ER parking lot. Dispatch advised them to return to their station. David turned the unit down a small side street. Its tree-lined avenue was a beautiful reminder that life went on. Jonathan ran his hand through his hair, “Let’s stop at the convenience store, I need a drink.”
“Sure. Where did you get that scratch from?” David saw a large cut across the top of Jonathan’s right hand. His curiosity was not only out of concern; it meant more paperwork, as well.
“I cut it on the screen door as we were carrying the lady out of the house. She was so light that I didn’t say anything when it happened. We needed to get her to the stretcher,” Jonathan reexamined the cut on his hand. It had only bled for a moment, and that blood had been trapped below the gloves he had been wearing. “Did you notice the broken screen on the way out?” Jonathan asked.
“Yes, I saw it on the way into the house. I thought you did, too. Sorry I didn’t mention it to you.” David knew that they both were on guard for dangers. Sometimes they saw them, sometimes they didn’t. Paramedics all wear scars from the dangers not seen.
