May 11: An EMS story, on an anniversary
Anyone who has spent time in emergency services will tell you that some things stick with you more than others. Sometimes it's obvious why, sometimes not so much. Over the years you become hardened to the 'standard' things--the blood, guts and gore that are a given in that line of work. It has to be something really remarkable to make an impression on you after a while, and even more so for something to be remembered after many years. It's been a surprise to me how few of the big, dramatic calls I remember anymore. What sticks with me out of the thousands of responses I had over a 25 year career are the emotions, mine as well as others.
The emotions that you encounter in EMS are different than anywhere else. Because they are so powerful: raw, unfiltered, primal. From the patient: fear, pain, numbness, anger. From the family: concern, terror, tenderness, anger at you or the patient. From bystanders: helpfulness, morbid curiosity, drunkenness. And you, the 'ambulance person', are not allowed to show any emotion. Not shock, not disgust, not anger, not sorrow. And, when you're one of only a tiny number of female paramedics in the county, certainly not weakness.
Deneen was there, on one of the crews that responded to help. Kevan may remember: he came to the ER on another call and supported me--literally--in the aftermath.
It was May 11, 1992. And this year the date falls on a Monday, same as that year. And every year I think of this call, pull out the run sheet. I debriefed myself by writing several pages about what happened, my thoughts, emotions and prayers. The basics are this: a 5 year old boy, playing 'chicken' with the garage door (this was the time of Indiana Jones films....). Somehow, got his head caught under the heavy garage door, which didn't go up (despite it doing so every time when tested afterwards). And he suffocated, under that door, trapped, helpless. His mother was yards away, washing dishes in the house. A neighbor saw him, pulled him out. Called 911.
The entire call was, quite honestly, perfectly executed. House down the street from the police station at change of shift, so all the cops immediately responded. The Fire Chief was in the area, a rescue crew instantly materialized. A couple street responders from the Squad as well as a couple of our transport crews. I arrived six minutes after dispatch. Intubated, longboarded, packaged and enroute in nine minutes. The most incredible police escort--the entire lower end of the county was involved: police blockades at every intersection, six police cars around me with the Fire Chief in his vehicle with the mother; Eric didn't touch the brakes the eight minutes to the hospital. Only 23 minutes for the entire call, into a trauma team with a pediatrician. I'd gotten a rhythm back enroute, they got pulses, BP and respirations back in the ER. Flew him to CHOP. It was the most incredible response and teamwork you could ever have hoped for. It was the call that went perfectly.
Except the patient died.
He was brain dead. They took him off life support in the early hours of the morning. It was the days before I went back to school, the days of 24 hour shifts. CHOP called me at 1 am with the update, the date of death was officially May 12th. But, in my mind, it was the 11th.
This child's death started a week of hell for me: the first of six critical pediatric calls where I was the lone paramedic over the next seven days. Maybe all the expended emotion on this one enabled me to handle the next four really sick kids even before the three year old cardiac arrest that following Sunday, by which point I was pretty numb. And yet this is the one that has stuck in my mind for the last 17 years. He wasn't the only child I couldn't save, not the only call that went well, not the only parents who I watched deal with the horror of a child's trauma. Not even the only call where I documented my feelings. It didn't change anything for me, cause any real impact in my life. Why this one?
This one was shared with the greatest number of people. This one my writing was the most revealing. This one was the example that no matter how well things can go the patient can and will still die. I don't really know why. But, for whatever reason, this is the one which sticks out, the one I remember the most about. The one which, for just this one day, year after year, I still remember and grieve.
His parents surely have no idea that someone who had contact with their son for only a few minutes still thinks about him. I never tried to find where he was buried, never wanted to intrude or become that involved. But every year I send out a prayer for his parents, hope that they have some peace, let them know--somehow--that someone else remembers the tragedy of this day.
David, you are not forgotten.
Laurie
The emotions that you encounter in EMS are different than anywhere else. Because they are so powerful: raw, unfiltered, primal. From the patient: fear, pain, numbness, anger. From the family: concern, terror, tenderness, anger at you or the patient. From bystanders: helpfulness, morbid curiosity, drunkenness. And you, the 'ambulance person', are not allowed to show any emotion. Not shock, not disgust, not anger, not sorrow. And, when you're one of only a tiny number of female paramedics in the county, certainly not weakness.
Deneen was there, on one of the crews that responded to help. Kevan may remember: he came to the ER on another call and supported me--literally--in the aftermath.
It was May 11, 1992. And this year the date falls on a Monday, same as that year. And every year I think of this call, pull out the run sheet. I debriefed myself by writing several pages about what happened, my thoughts, emotions and prayers. The basics are this: a 5 year old boy, playing 'chicken' with the garage door (this was the time of Indiana Jones films....). Somehow, got his head caught under the heavy garage door, which didn't go up (despite it doing so every time when tested afterwards). And he suffocated, under that door, trapped, helpless. His mother was yards away, washing dishes in the house. A neighbor saw him, pulled him out. Called 911.
The entire call was, quite honestly, perfectly executed. House down the street from the police station at change of shift, so all the cops immediately responded. The Fire Chief was in the area, a rescue crew instantly materialized. A couple street responders from the Squad as well as a couple of our transport crews. I arrived six minutes after dispatch. Intubated, longboarded, packaged and enroute in nine minutes. The most incredible police escort--the entire lower end of the county was involved: police blockades at every intersection, six police cars around me with the Fire Chief in his vehicle with the mother; Eric didn't touch the brakes the eight minutes to the hospital. Only 23 minutes for the entire call, into a trauma team with a pediatrician. I'd gotten a rhythm back enroute, they got pulses, BP and respirations back in the ER. Flew him to CHOP. It was the most incredible response and teamwork you could ever have hoped for. It was the call that went perfectly.
Except the patient died.
He was brain dead. They took him off life support in the early hours of the morning. It was the days before I went back to school, the days of 24 hour shifts. CHOP called me at 1 am with the update, the date of death was officially May 12th. But, in my mind, it was the 11th.
This child's death started a week of hell for me: the first of six critical pediatric calls where I was the lone paramedic over the next seven days. Maybe all the expended emotion on this one enabled me to handle the next four really sick kids even before the three year old cardiac arrest that following Sunday, by which point I was pretty numb. And yet this is the one that has stuck in my mind for the last 17 years. He wasn't the only child I couldn't save, not the only call that went well, not the only parents who I watched deal with the horror of a child's trauma. Not even the only call where I documented my feelings. It didn't change anything for me, cause any real impact in my life. Why this one?
This one was shared with the greatest number of people. This one my writing was the most revealing. This one was the example that no matter how well things can go the patient can and will still die. I don't really know why. But, for whatever reason, this is the one which sticks out, the one I remember the most about. The one which, for just this one day, year after year, I still remember and grieve.
His parents surely have no idea that someone who had contact with their son for only a few minutes still thinks about him. I never tried to find where he was buried, never wanted to intrude or become that involved. But every year I send out a prayer for his parents, hope that they have some peace, let them know--somehow--that someone else remembers the tragedy of this day.
David, you are not forgotten.
Laurie
posted by Laurie @ 11:00 PM
3 Comments:
At 10:21 PM,
J.T. said…
Emotions..... O how true your statement is about EMS and their emotions. It always seems I'm engrossed w/ dealing w/ everyone elses emotions and never my own. It seems I never have to the time to figure out my own emotions when running a odd call or one that could strike a nerve like working a kid that is close to my own. I had a 9yr. With my son being 10 it was very tough not to think of my own son but the crew that I assisted was having a tough time w/ their emotions resulting in failed IV's and airway management. As I watched a second failed I.O. I stuck in an 18G-EJ. As I finished that someone got the OETT. Some sticking w/ the emotions I saw everything from friends, family and EMS suffering from this horrible event. It got worse at the ER. I kept my emotions in check but thought so many times.... I could not handle if that was my child. I totally agree only a few calls stick w/ you after a certain period of time. This year makes my 20yrs in fire and EMS. One does become numb so you can be ready for the tones to drop for the next family that needs you. Not only are we medical providers but after a period of time you begin to relaize your also a social worker that rides in an ambulance.
At 10:25 PM,
J.T. said…
I should have check over my post before posting.. O well that's what happens when your half a sleep... Good night.
At 12:21 AM,
Anonymous said…
Laurie,
You helped a lot of people, and one will never know why certain things stick. Sometimes its just the innocents of a child doing what he was suppose to - at home, good kid, playing, not on the streets not causing trouble. and just a plain freak accident. One will never know.
You always did have way wacked calls, but always know you helped more people then you will ever even remember coming in contact with.!
Deneen
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