Silent Siren, page 3
Paramedic Howie Cannon has kept us in stitches this shift, and the aid crew joins him in hearty laughter at his latest off-color joke when the pager fires again.
“Bainbridge Fire, respond for a full arrest. Elderly female collapsed in the shower. CPR in progress.”
Bainbridge Island has a dense geriatric population within about a three-block radius, and the Winslow Green Apartments falls, more or less, into this category. Often I think it would almost be worthwhile to have a BLS unit staged downtown just for the retirement homes.
Upon our arrival, the patient, seventy-four-year-old Eunice Evans, is fully dressed and fully conscious. The caregiver must have hastily put the woman’s pants and shirt on before calling 911. She sits on an overstuffed couch in the front room of her apartment, and appears to be in no distress at all. The air is thick with steam and the scent of Ivory soap. Sweat beads on my forehead and leeches under my latex gloves. I check my own pulse, noting that I am still in “resuscitation mode.” I take a few deep breaths and adjust to the changed circumstances.
Paramedic Howie Cannon attaches the monitor leads to the woman while Lt. Mark Crowthers takes vitals and administers oxygen to the woman through a nasal cannula. Meanwhile, I’m doing a darn fine job of standing in the corner of the room and looking very sixteen years old with my oversized blue uniform shirt and white tennis shoes. Well, at least it’s a good vantage point from which to learn the trade, and if anybody needs equipment from the rig, I can always run out, open every drawer, and look panicked with the best of them.
A perfectly normal sinus rhythm reads out on the green screen of the Lifepak 5. Howie decides the woman is stable but should probably be seen by her physician. He decides to transport her a few blocks to Dr. Keyes’s office.
Sequoia Jones and I pack the drug box with all our cardiac drugs and IV supplies, as well as the ventilation kit with our oxygen and bag-valve mask out to Medic 21, leaving our patient attached to the Lifepak 5 for the time being. In retrospect, our decision to bring all equipment back out to the rig was a mistake—one that I will never make again.
Howie is on the phone with the Medic One doctor in Seattle, with whom he consults on most all cases, when Sequoia and I saunter back in with the stretcher. Sequoia and Mark ease the elderly woman onto the stretcher as Howie continues his phone consultation.
Suddenly Eunice’s eyes roll back in her head and she begins to snore loudly, her tongue falling back in her throat and obstructing her airway. The jagged peaks and valleys of ventricular tachycardia, the precursor to ventricular fibrillation, read out on the heart monitor. Alarms sound. She’s gone into cardiac arrest. “Stand by, Doc. She’s attacking on us!” shouts Howie. With the phone still cradled between his shoulder and ear, he grabs the defibrillator paddles, gels them up, and presses them hard onto Eunice’s chest.
Two hundred joules of electricity course through her thoracic cavity and she twitches, arm flailing in the air. “Unnnngggghhhh!” she moans.
“What happened?” she asks. The ventricular tachycardia has been converted to a ragged sinus rhythm.
“You just died,” Howie replies.
I’m so fascinated with the drama unfolding in front of me that I almost forget that we will need all the equipment I had just packed back to the rig five minutes ago. I sprint out to grab the vent kit and drug box.
When I return, Eunice moans slightly but is still conscious. It must hurt like hell to be defibrillated. Her shirt has been pulled rudely open for lifesaving efforts. Blue defibrillator gel dries above and below her sagging breasts.
Mark grabs a pair of trauma shears and begins cutting up both Eunice’s sleeves in preparation for an IV.
She looks forlornly at Mark’s handiwork and says, “That was my favorite shirt.”
Daddy’s Sick
We have been called to the home of an eighty-six-year-old man in congestive heart failure. George’s heart, weakened by age and a previous heart attack, has begun to falter, causing fluid to back up in his lungs. The aid crew and I pile into the man’s small house at the end of a long rural driveway. Like an urban medical Sherpa, I carry with me all the kits, defibrillator/monitor, med box, and ventilation kit. Explorers are good for that. The little house smells as though nobody has opened a door or window in a very long time. Dated wallpaper lines the walls. An ancient cast-iron stove claims a considerable space in the kitchen.
George struggles for air, leaning forward on his overstuffed couch, hands on his thighs. A non-rebreather oxygen mask is placed on his face and he sucks the clear plastic oxygen reservoir dry with every breath.
The paramedic pulls up George’s shirt, damp with cardiac sweat, and listens to the wet gurgling through his stethoscope. His lungs are almost half-full of fluid.
A firefighter places electrodes on George’s chest, and I make ready an IV as EMT-IV Greg Borgen applies a tourniquet and searches for a suitable vein.
As our crew fights to, if not save this man’s life, then at least make him comfortable and relieve his anxiety, I catch the eye of a tiny, distraught elderly woman watching the entire scene from the kitchen. Slowly and with tears in her eyes she walks over to George and puts her hand on his shoulder. “Oh, Daddy,” she says tearfully. George puts his free hand on top of hers and the two look at each other. She turns to the cluster of strangers so abruptly invited into her living room, searching for some reassurance. “Poor Daddy’s so sick,” she sobs. She turns from her husband and companion of sixty years and walks towards me, seeking comfort. I put my arm around her shoulder and she leans her head against my chest.
Of all the responders in the room, she chose me. Maybe I seemed approachable. Maybe it’s just that I have one free arm, the other holding an IV bag.
My eyes mist over for a few seconds, then clear. I must remain objective.
It is this day that I realize the unique privilege I was given as an emergency responder. We are strangers invited to the home of someone we had never met, trusted to take care of their most precious possessions: their family. In this there is a sacred trust. George’s wife was able to say goodbye to him as we loaded him into the medic unit for the short ride to the waiting medical helicopter for transfer to Virginia Mason Hospital. She was able to visit him one last time before he passed away in a Seattle nursing home.
Station Rats
Throughout high school, I volunteered my time at the fire station, along with my fellow “station rats.” I spent much of my time sitting in the day room of Fire Station 21, dressed in multiple layers of sweaters and turtlenecks, even if it was 75 degrees outside. I was addicted to coffee and there was always a pot on. The Explorer program was one of the primary ways new department volunteers were recruited. Many went on to paramedic careers and firefighter jobs with other departments. One became an emergency physician.
Many of the former Explorers knew us by our other informal name—“coons.” The legend was that some years ago, before a limit was imposed on how many Explorers could ride on a truck together, the medic unit received a 911 call at night and about six Explorers jumped in the back. Turning around to see who was joining him on the call, the duty officer looked from his seat at the wheel to see six pairs of wide and eager “raccoon eyes” faintly illuminated by the lights of the apparatus bay.
My brother, Ben, was also starting his public service career about this time. Three years my junior, he expressed an interest early in law enforcement and joined the Bainbridge Island Police Department Cadets—Winslow Police back then. We often saw each other on emergency calls at all hours of the day and night. In time, he joined the fire department also, becoming a volunteer firefighter and EMT. Ben dedicated several years to the fire department and is now a full-time police officer for Bainbridge Island Police Department.
My father, Mark, had recently retired from a career in law enforcement and wanted to get experience for a possible second career in medicine or allied health. He got involved as a driver for Bainbridge Ambulance Service, working his way up to EMT and IV technician. He served eleven years there before hanging up the stethoscope.
Once I can recall that Ben, Dad, and I all showed up at a car accident together, each performing our individually assigned roles. I felt proud that we were able to be at the heart of public service in our community. We all had our ears to the ground. If anything major happened on Bainbridge Island, most knew to ask a Sias. We each had a slightly different perspective.
Mom was the mortar that kept the family together. As a social worker, she was used to “working in the trenches” and I always thought her job much more difficult than mine. At least her job had regular hours and she became used to, if not utterly pleased with, beeping pagers and radios interrupting Thanksgiving and Christmas Dinners, husbands and sons coming and going at odd hours of the night. She knew better than to hope for any holidays with the entire family together, in civilian clothing, without beepers, radios, or firearms.
The Dukes of Bainbridge
The radio crackles to life: “High-speed motor vehicle collision, result of a police pursuit, Fletcher Bay Road and High School Road.” My adrenaline is pumping more than usual since a police officer is involved. We don’t yet have any details as to who is hurt—a police officer or an escaping suspect. The duty resident and I board Rescue 215, our medium-duty rescue unit, and head to the scene, Dick at the helm.
It’s early evening and we can see blue and red police beacons swirling in the area, but it is difficult to tell exactly where they are coming from because of the density of trees and the approaching darkness. We eventually get to a point on the dirt portion of High School Road where we can go no further. A police cruiser blocks our ingress. The duty resident hits the generator button and the powerful spotlights come to life on the sides of the rig. Artificial daylight shines through dense foliage. So far, no mangled vehicles are in sight.
The last place we had thought to look was up. On a steep hillside to our left, a spotlight catches the metal glint of a vehicle overturned in what appears to be somebody’s yard. “How in the hell did it get up there?” I wonder out loud. We don our helmets and our bunker coats and make our way through the darkness and up the hillside to access the vehicle.
The paramedic unit, its red strobe lights creating a light show against the night sky, has located the driveway leading to the house, though it is clear this is not the way the overturned vehicle had entered. From first glance, it appears the vehicle’s driver had circumvented the driveway entirely, choosing instead a shortcut up a hill and into a Koi goldfish pond, where the car now reposes, silent and slightly steaming, in a foot of shallow murky water.
The paramedic, in his typical attire of blue uniform pants and short-sleeve paramedic smock despite the frigid weather, inserts a crowbar into the vehicle’s passenger side and attempts to pry it open. It’s the Cro-Magnon approach to extrication. To heck with hydraulics and safety gear. After a couple of minutes, his attempts prove futile. The door doesn’t budge.
The pursuing officer contacts us on scene. Apparently he was giving chase at very high speeds westbound on High School Road when the vehicle he was pursuing struck a berm. It flew through the air a la “Dukes of Hazzard” and splashed down into the pond.
Since the pry-bar approach is not working, out comes firefighter Sequoia Jones with the Hurst Tool, also known as the Jaws of Life. Using the spreader application, Sequoia, a towering man known to his friends as “Tree,” pops the door open with hydraulic force, and encounters the vehicle’s driver, hanging upside down, still suspended by his seatbelt.
The water level is nearly to the top of his head. If the vehicle had landed a foot or so in either direction, he likely would have drowned. A lone and hapless Koi goldfish, its environment rudely disrupted, flaps its tail against the man’s face as he hangs upside down.
“Get the backboard,” the paramedic commands.
With one quick movement, Sequoia hacks through the seat belt and lowers the driver onto the board. Haphazardly, we secure the man for his trip back to the medic unit. It’s a difficult task to slog through uneven, slippery terrain with a 180-pound backboarded patient. Sequoia slips on a slime-covered rock. He falls backwards into the pond and the backboard dips into the muddy water, its cargo with it.
“Shit!” he says.
“Jesus Christ!” slurs the helpless backboarded man. Sequoia struggles to his feet and continues his carry through the mud to the waiting medic unit.
The man, clearly drunk, seems almost amused by the whole debacle as he is being helped out of his self-caused predicament.
“Thank you, guys, for helping me,” he mutters.
Suffering more from embarrassment than injury, the hapless dipso earns himself a ride to Harborview Medical Center via helicopter and thus ends his evening rather differently than he had expected, in a different city, smelling of algae blooms and beer, being prodded by strangers in white coats and blue scrubs. Next week he may have a great story to tell his drinking buddies. Tonight he is just lucky to be alive.
Pieces of a Man
The early morning fog is just beginning to lift as we are toned to a residence only about a mile away. I’m finishing up the night as a resident firefighter at Station 22, Bainbridge Island’s south end volunteer station.
“Aid 22, Medic 21, respond for a gunshot wound. Stage in the area.”
The term “stage” refers to dispatch’s request for us to stay a distance away from the scene until the police department is able to assure our safety. Any time weapons are involved or if there are other safety concerns, we arrive a safe distance away, turn off all our red lights, and wait for law enforcement to give us the go-ahead to proceed to the scene.
I am with two other responders in Aid 22 when we arrive at the staging area about a block away. Medic 21, the advanced life support unit, arrives on scene shortly thereafter, and we wait for Bainbridge Island Police to make the scene safe for us to enter.
I hear screams from the basement as my team and I enter, gear in hand, and clamber down the rickety stairs. Mike, the paramedic on shift, follows closely behind. I feel my pulse in my throat as I near what I am pretty sure I don’t want to see.
The door to the supply room is ajar. A woman, dark hair tangled and falling in front of her tear-streaked face, kneels over an inert man splayed out on the filthy floor next to an overturned chair.
“He’s still breathing!” she screams.
The man twitches spasmodically—a spinal reflex with no involvement of consciousness. His finger still rests in the trigger guard of the 12 gauge lying against his chest, the barrel smoking slightly. Above the lower jaw, his skull is obliterated. Flaps of his scalp are splayed apart like bloody wings surrounded by chunks of skull and beige brain matter. Apart from his lower jaw, the only part of his face that remains is a single eyeball, still attached to its optic nerve and lolling from a mass of unidentifiable meat. The smell of gunpowder hangs heavy in the air. High-velocity blood spatter mixed with tiny particles of gelatinous brain matter dot the ceiling, the walls, and the old mattresses. Semi-coagulated blood drips slowly from a bare light bulb.
Wordlessly, Mike removes the shotgun from the clutches of the dead man and secures it in the corner. He wants to take no chances that the dead man’s reflexes would cause the weapon to fire again.
Somehow, this scene is less disturbing to me than I thought it should be. It is so grotesque as to be ridiculous and it seems easier to frame it as a scene out of a horror movie or a pathology textbook than a recently destroyed human being.
Out of curiosity, I stay behind after the medic unit leaves to help the coroner with the investigation and body removal. Detective Scott Anderson from Bainbridge Island Police Department arrives, photographs the scene, and interviews the victim’s distraught widow.
After at least two hours, the van from Kitsap County Coroner’s Office arrives. One body is already in the back of the wagon; they had been tied up on a homicide in Bremerton, forty minutes away. Deputy Coroner Ricardo Lopez and I spend hours photo-documenting the scene, including the holes in the wall and ceiling and the body from multiple different angles. We conclude with the gruesome task of retrieving the large chunks of tissue and skull from behind mattresses, in corners, and on top of furniture. It’s like some macabre game of hide and seek in which you are never pleased to find what you are looking for. Like clumps of washed-up jellyfish, brain matter jiggles in and threatens to strain through my latex-clad fingers. One bag we label “tissue”; the other we label “bone.” All needs to go with the body for examination at the morgue and, later, for burial. Behind a mattress I find the man’s disembodied nose, mustache, and upper lip. A Biohazard Clean-up team will be needed to sanitize this scene.
Still, I doubt the new widow will be able to live in the house after what has transpired.
I feel the disembodied presence of the dead man as he imbues the whole of the disheveled storeroom with his dark countenance. Was he horrified at what he had done? Was he finally at peace? The story we get later is that the man, a fifty-three-year-old drug addict, has been having marital problems and is threatening to kill himself. He attempts to take a 12-gauge shotgun with a slug down to the basement, at which point he gets into a struggle with his wife, who attempts to pry the weapon from his hands. In the ensuing fray, the shotgun fires into the sheetrock on the wall. The slug bounces off a stud and into the ceiling. He gets free, runs to the basement, and shuts the door to a supply room, filled with old mattresses and furniture. He sits in a straight-backed chair, puts the shotgun under his chin, and fires.
