One of the goals of this blog, if it has any apart from giving me a place to deposit my brain droppings, (apologies to George Carlin) is to try to cast some light on the day-to-day realities of work in fire and EMS. You may have seen us passing by in the ambulance, gathering food in the grocery store, or speaking to your church group or your child's class. When you were a kid, you may have gone to a fire station to see the big red trucks. Perhaps a good-natured fire fighter let you sound the siren. And certainly, you've seen us portrayed in a thousand TV shows and movies.
But none of that really gives you an idea of who we really are. Who are those people, who, when you pass by an accident on a rainy night, are climbing into the crumpled remains of a car? Who are the people in bunker gear crawling into a burning building? And why the hell do they do it?
Let's start with the obvious answer to the latter question: we don't do it for the money. Firefighters on large municipal departments are paid and compensated well. The rest of us have to work mulitple jobs just to get by. And volunteers, of which there are many, do it for no money at all. So, why? When the public asks, we'll tell you that it has something to do with public service, and with making a difference in people's lives. And those things are true. But there's more to it than that. There are any number of ways to serve one's fellow man that don't involve the stresses and dangers of emergency services. But we've chosen this life. The reasons why are probably as myriad as the people who chose to do it, and many of those people can't give you a very good answer. For a lot of us, it just seems right.
Answering the second question isn't much easier. Who are we? The shortest and most direct answer is probably, "We're people." And that's true. We're family men and women, perpetual bachelors, aspiring intellectuals and lovers of reality TV who've never picked up a book we weren't assigned. We're risk takers and risk averse. We're pious and profane. As a group, we contradict ourselves and contain multitudes.
There you are then-a wordy answer that is no answer at all. But the truth is that our reasons for choosing this line of work are as we are. Ask a thousand insurance salesmen why they do what they do, and the answers will probably be fairly similar: it's something that pays reasonably well and that they can tolerate doing from day to day. I suspect that for first responders, the answers, while varying wildly, might fall into a few categories.
Some of us are keeping up a family tradition. Fire and police departments are thick with tradition, so it's perhaps appropriate that joining them is often a tradition within families. Some are thrill-seekers and glory hounds. Thankfully, they don't usually last very long. Others are truly motivated by the desire to help. Yet others want to be challenged. Most of us take some from column A, some from column b, etc.
It's also true that many of us just aren't suited for whatever it is that goes on in normal offices and workplaces. I tend refer to us as the island of misfit toys. It's hardly original, but it fits.
Thursday, March 6, 2014
Monday, January 27, 2014
Of Lighted Streets and Quiet Nights
It's been a while since I've posted. While I doubt that many people (anyone?) have missed me, I apologize to anyone who did.
I don't have any good stories to share, or at least any that would be all that interesting to anyone not in Fire/EMS, so I thought I'd say a bit about the town I live in and the department I'm part of.
Riverton (not the town's real name) is like a lot of small towns in that it seems to be slowly emptying out. About 5,000 people live here, and most of those were born and raised within the county, if not the town.
Often, the most promising kids graduating high school are the first ones out the door. It's hard to blame them for that. Opportunities in small towns can be limited. The regional hospital and the presence of the county seat ensure that we have more than our share of lawyers, doctors, and RNs. The low cost of living here means that teachers, often among the least prosperous of professionals, can live solidly middle-class lives. But to enter that class, one has to leave town, at least for a while.
For those who stay, opportunities are limited. There simply aren't that many places to work here, and the jobs that are in town don't usually pay well. The plum jobs for kids without a college degree are mostly in the large city 30 miles to our west. There, a military ammunition plant and two large auto factories pay blue collar workers well enough to make the sort of middle class life that has ceased to be an option for many people in the manufacturing sector possible. People who spend years at those plants do quite well by local standards.
For all the lack of opportunity, the town has its charms. It's small enough that the odds are good you will see a familiar face at the grocery store, but not so small that everyone knows the minutiae of everyone else's life. Many of the homes in town date back to the Civil War and before, and most of those are still in good shape. Although the town is anything but booming economically, a drive down some of our streets leads through neighborhoods as nice as can be found in any wealthy enclave.
There's a bookstore downtown that offers a good selection of reading material and coffee. It's run by a woman who retired from a specialized construction engineering job. She's extremely intelligent and helpful, but has thrown at least one person out of her store for making stupid political comments. Pam came to town about the same time I did, and I was among the first customers through her door. I like knowing that her shop is there. I seriously doubt that I could live anywhere without a good bookstore and coffee shop. Pam's place combines the two.
I live in a small house with a large front porch at the end of a residential street. Although the house is near the center of town, geography, in the form of a deep, wooded ravine that hooks around two sides of the house and an old, sunken railroad right of way on a third side make the half-block of street that makes up my immediate neighborhood isolated and quiet. I like that. I live there, in something just under 1000 square feet, with my daughter. While it's certainly not the opulent house in the suburbs other people who grew up in my chronological and economic cohort have, I like it there. I don't have the land or the money to create the Japanese water garden I always dreamed of, but the vegetable garden I put in last year produced prodigious amounts of vibrantly colored tomatoes, peppers and okra. The marigolds I planted on one side of the porch grew thick and bushy, as did the herb garden I planted on the other. The porch itself has room for an outdoor dining table, a grill, and several chairs, which make it a perfect place to cook, eat, or read when the weather is not terrible.
Across the railroad right of way from me is a large cemetery, plots in which date back to before the Civil War. A walk through that graveyard can easily become a lesson in the history of this part of the world. Here, under a 20 foot tall stone plinth, lies the body of one of the founders of the Pony Express. And here, under these four identical small rounded stones, lie the bodies of four Union soldiers. They were pulled from a train by the notorious (and celebrated by some) Confederate Guerilla William Quantrill, forced to kneel down, and executed. About 100 uphill yards away, in a more central and sunny part of the cemetery, is a memorial to several fallen Confederate soldiers. Not far from that is the grave of an area Congressman who occupied a powerful position involving oversight of the military. On the day of his funeral, the sound of his 21-gun salute crashed and echoed against the front of my house, startling me and causing me to send my daughter inside before I realized what was happening.
Riverton is not the kind of place people often move to, unless they are buying a retirement home or attempting to set up a bed and breakfast. Yet it's a place I've come to and established a home, nearly 10 years ago. I never intended for that to happen. Upon arriving in Lexington, I planned to stay no more than a few years. But opportunities to leave have come and gone, and I am still here. While I wasn't looking, I became part of the community, and began to view the town not as a waypoint, but as a place to live.
For me, the heart of the community, and the center of my life outside the home, is the fire department. I joined the department almost as accidentally as I came to call Riverton home. I moved to town to take a job as a reporter, and that job put me in frequent contact with the Fire Chief. Chief Jones looks just how you want a fire chief to look: neatly trimmed moustache, short grey hair brushed straight back from his forehead, uniform always neat, and badge always shiny. Over the course of several meetings, Jones found out that I had been in the Marine Corps, and that thanks to my job as an Air Force reservist, I had some familiarity with hazardous materials and working in IDLH (Immediate Danger to Life and Health) environments. It wasn't long before he suggested that I come out and volunteer. I initially demurred. As a reporter, that could create a conflict of interest. And as a human being with nerve endings, I suspected that burning to death would suck.
On the other hand, working with the department would probably lead me to some great stories. And, the more time I spent around the fire department, the more I realized that I liked the people there. A few months later, I found myself at the weekly training, learning how to lock my legs around the rungs of a ladder and I handled heavy equipment.
I don't have any good stories to share, or at least any that would be all that interesting to anyone not in Fire/EMS, so I thought I'd say a bit about the town I live in and the department I'm part of.
Riverton (not the town's real name) is like a lot of small towns in that it seems to be slowly emptying out. About 5,000 people live here, and most of those were born and raised within the county, if not the town.
Often, the most promising kids graduating high school are the first ones out the door. It's hard to blame them for that. Opportunities in small towns can be limited. The regional hospital and the presence of the county seat ensure that we have more than our share of lawyers, doctors, and RNs. The low cost of living here means that teachers, often among the least prosperous of professionals, can live solidly middle-class lives. But to enter that class, one has to leave town, at least for a while.
For those who stay, opportunities are limited. There simply aren't that many places to work here, and the jobs that are in town don't usually pay well. The plum jobs for kids without a college degree are mostly in the large city 30 miles to our west. There, a military ammunition plant and two large auto factories pay blue collar workers well enough to make the sort of middle class life that has ceased to be an option for many people in the manufacturing sector possible. People who spend years at those plants do quite well by local standards.
For all the lack of opportunity, the town has its charms. It's small enough that the odds are good you will see a familiar face at the grocery store, but not so small that everyone knows the minutiae of everyone else's life. Many of the homes in town date back to the Civil War and before, and most of those are still in good shape. Although the town is anything but booming economically, a drive down some of our streets leads through neighborhoods as nice as can be found in any wealthy enclave.
There's a bookstore downtown that offers a good selection of reading material and coffee. It's run by a woman who retired from a specialized construction engineering job. She's extremely intelligent and helpful, but has thrown at least one person out of her store for making stupid political comments. Pam came to town about the same time I did, and I was among the first customers through her door. I like knowing that her shop is there. I seriously doubt that I could live anywhere without a good bookstore and coffee shop. Pam's place combines the two.
I live in a small house with a large front porch at the end of a residential street. Although the house is near the center of town, geography, in the form of a deep, wooded ravine that hooks around two sides of the house and an old, sunken railroad right of way on a third side make the half-block of street that makes up my immediate neighborhood isolated and quiet. I like that. I live there, in something just under 1000 square feet, with my daughter. While it's certainly not the opulent house in the suburbs other people who grew up in my chronological and economic cohort have, I like it there. I don't have the land or the money to create the Japanese water garden I always dreamed of, but the vegetable garden I put in last year produced prodigious amounts of vibrantly colored tomatoes, peppers and okra. The marigolds I planted on one side of the porch grew thick and bushy, as did the herb garden I planted on the other. The porch itself has room for an outdoor dining table, a grill, and several chairs, which make it a perfect place to cook, eat, or read when the weather is not terrible.
Across the railroad right of way from me is a large cemetery, plots in which date back to before the Civil War. A walk through that graveyard can easily become a lesson in the history of this part of the world. Here, under a 20 foot tall stone plinth, lies the body of one of the founders of the Pony Express. And here, under these four identical small rounded stones, lie the bodies of four Union soldiers. They were pulled from a train by the notorious (and celebrated by some) Confederate Guerilla William Quantrill, forced to kneel down, and executed. About 100 uphill yards away, in a more central and sunny part of the cemetery, is a memorial to several fallen Confederate soldiers. Not far from that is the grave of an area Congressman who occupied a powerful position involving oversight of the military. On the day of his funeral, the sound of his 21-gun salute crashed and echoed against the front of my house, startling me and causing me to send my daughter inside before I realized what was happening.
Riverton is not the kind of place people often move to, unless they are buying a retirement home or attempting to set up a bed and breakfast. Yet it's a place I've come to and established a home, nearly 10 years ago. I never intended for that to happen. Upon arriving in Lexington, I planned to stay no more than a few years. But opportunities to leave have come and gone, and I am still here. While I wasn't looking, I became part of the community, and began to view the town not as a waypoint, but as a place to live.
For me, the heart of the community, and the center of my life outside the home, is the fire department. I joined the department almost as accidentally as I came to call Riverton home. I moved to town to take a job as a reporter, and that job put me in frequent contact with the Fire Chief. Chief Jones looks just how you want a fire chief to look: neatly trimmed moustache, short grey hair brushed straight back from his forehead, uniform always neat, and badge always shiny. Over the course of several meetings, Jones found out that I had been in the Marine Corps, and that thanks to my job as an Air Force reservist, I had some familiarity with hazardous materials and working in IDLH (Immediate Danger to Life and Health) environments. It wasn't long before he suggested that I come out and volunteer. I initially demurred. As a reporter, that could create a conflict of interest. And as a human being with nerve endings, I suspected that burning to death would suck.
On the other hand, working with the department would probably lead me to some great stories. And, the more time I spent around the fire department, the more I realized that I liked the people there. A few months later, I found myself at the weekly training, learning how to lock my legs around the rungs of a ladder and I handled heavy equipment.
Friday, January 17, 2014
On Punk Rock and Anger
I used to be a punk rocker. I don't know what I am now. But here are some thoughts on who, and what, I used to be.
When I was about 12, a friend of mine gave me a dubbed tape of several songs, one of which was Black Flag's "TV Party." It probably wasn't the most auspicious start to life as a young punker; the song was basically a joke. Certainly, it lacked the rage of Black Flag's other stuff. But that other stuff wasn't far in the future.
Like a lot of kids who got into punk rock in the 80s, my first real punk album was Black Flag's Damaged. If you've seen the cover, you probably remember it. A bald young man is pictured smashing his fist into a mirror. Along the top of the cover were the words Black Flag and the band's four-bar logo. If you looked carefully, you could see blood dripping from the man's fist. The picture is not faked. Someone (I believe it was Henry Rollins) smashed his fist into a mirror to get that shot.
The music was just as brutal as the album cover. The album opened with "Rise Above." Greg Ginn, the band's guitarist, was able to capture in a few bars the hurt, anger, and defiance-always and forever defiance- that I felt so strongly at that age. The lyrics were the sort of thing I wanted to scream in the face of any authority figure I could find. Parents, teachers, whoever-none were to be trusted, and all were part of a system dedicated to extinguishing whatever sparks of creativity, free thought, or individualism might arise in their arid world. "We are tired/ of your abuse/ try to stop us!/ It's no use!" To my furiously Manichian pre-adolescent mind, that said it all.
In retrospect, I'm not sure where all that anger came from. My parents were anything but stifling or abusive. They were quite the opposite. Both my mother and father encouraged creativity and intellectual independence. My father could be authoritarian at home (as fathers sometimes must be), but his attitude towards power and authority in general was highly skeptical, and he never hid that from me. During one conference with some school authority figure I'd managed to offend, I demanded, "Don't I have the right to ask why?" The authority figure hemmed and hawed for a moment, obviously searching for a way to tell me that I ought to just shut up and obey. My father, who had been silently sitting to the side spoke up, using the fullness of his courtroom voice. "Always. You always have the right to ask why." When I was older, it was my father who introduced me to libertarian politics.
My mother was a graphic artist and tended to be more creative and free spirited than my strictly intellectual and hyper-rational father, but she too encouraged me to think for myself.
So, it wasn't my parents who were the source of the anger I felt towards a society I was convinced was trying to crush me. Of course, that didn't stop them from becoming targets of my anger.
My school no doubt had something to do with the early onset of adolescent rage and rebellion. There are plenty of stories to be told there, but none of them are really within the scope of this narrative. Suffice it to say that my it was a private k-8 school run by the Episcopal church. It was and is a good school, but I suspect that as a young person, I was not tempermentally suited to the classroom environment. I did and do live almost entirely inside my head, and had little interest in 'socializing' with my classmates. By the time I did develop that interest, I was already well established as an outsider.
Most of it, though, had to do with me. I was congenitally rebellious and suspicious. I remember resenting being told to sing, "I am calm/ I am still/I am doing God's will." Although I probably didn't have the vocabulary to put a name to my feelings, I was quite sure that the song was just a way to get us to do the teacher's will. I was probably seven or eight at the time.
A less flattering, and more honest account would probably be that I have always been a bit of an asshole.
Enough navel gazing. Back to punk rock. Damaged was only the start. I couldn't get enough punk rock. Within less than a year, I had acquired close to a hundred punk albums, and I listened to them obsessively. I wasn't enough to have the music playing while I did something else. I would spend hours laying in front of my stereo with the volume cranked up, listening to the songs and reading the lyric sheets or contemplating the album art. If the album was on one of the dubbed tapes I had, I would read through the catalogs that now came to the house: Alternative Tentacles, SST, and whatever else I could get my hands on. I was unaware of zines, but had I known about them, I would have acquired all I could find.
Some kids get religion around that age, and in a way, so did I. The lyric sheets of Black Flag or Dead Kennedys albums were my scripture, and I studied them as closely, and uncritically, as some read the Bible or Quoran. What I learned was what I already believed: society was another word for a conglomeration of powerful people who valued conformity and the status quo above all and the less powerful people subject to their rule. Our 'leaders' were power-hungry madmen whose machinations threatened the very existence of the human race. The best we could hope for was a few decades of drudgery, followed by a long wait for death. There were a few who saw the truth, and who tried to resist. They were almost always crushed by the system, which had a mechanistically efficient system of enforcing its rules. Kids who stood up or stood out were fed into a system that started in the schools and ended either in jails or in psychiatric institutions. A few years later, I found this idea expressed much more elegantly in Ken Kessey's discussion of the Combine in One Flew Over the Cuckoo's Nest. The kids were big, but the machine made them small.
I knew the system was out there, and evil. And I saw it everywhere I looked. I picked a fights with it every chance I could. And I invariably lost. This isn't meant to be a detailed memoir (and surely those of you who have made it this far are bored enough already), so I won't recount any details here. I will say that things eventually came to a head, as they had to, and I lost, as I had to.
What followed was a long period of confusion. While I never really quit believing in the punk ethos, I had had enough of the fight. Listening to those albums began to feel dangerous, like feeding air to the embers left in a half-burned building. I gave away most of my collection. And I tried to keep my mind right.
Of course, it didn't work. Although I was certainly passionate, especially after discovering libertarianism, I never felt the sort of constant fury that I did at twelve, and that was probably a saving grace. The kind of anger I felt at that age was not controllable, and would have burned me out.
Leap forward a few decades. My passions and my politics have moderated. This story ends like almost every other one about youthful rebellion. I still like to blast Black Flag, Minor Threat, and a few newer punk bands. I still tell myself that I am a rebel at heart, and that the angry punk kid that was willing to go to war against perceived injustice is still a part of me. And maybe that's true.
Or maybe I'm just a middling guy hurtling towards middle age mediocrity and clinging to memories of a younger, better self.
When I was about 12, a friend of mine gave me a dubbed tape of several songs, one of which was Black Flag's "TV Party." It probably wasn't the most auspicious start to life as a young punker; the song was basically a joke. Certainly, it lacked the rage of Black Flag's other stuff. But that other stuff wasn't far in the future.
Like a lot of kids who got into punk rock in the 80s, my first real punk album was Black Flag's Damaged. If you've seen the cover, you probably remember it. A bald young man is pictured smashing his fist into a mirror. Along the top of the cover were the words Black Flag and the band's four-bar logo. If you looked carefully, you could see blood dripping from the man's fist. The picture is not faked. Someone (I believe it was Henry Rollins) smashed his fist into a mirror to get that shot.
The music was just as brutal as the album cover. The album opened with "Rise Above." Greg Ginn, the band's guitarist, was able to capture in a few bars the hurt, anger, and defiance-always and forever defiance- that I felt so strongly at that age. The lyrics were the sort of thing I wanted to scream in the face of any authority figure I could find. Parents, teachers, whoever-none were to be trusted, and all were part of a system dedicated to extinguishing whatever sparks of creativity, free thought, or individualism might arise in their arid world. "We are tired/ of your abuse/ try to stop us!/ It's no use!" To my furiously Manichian pre-adolescent mind, that said it all.
In retrospect, I'm not sure where all that anger came from. My parents were anything but stifling or abusive. They were quite the opposite. Both my mother and father encouraged creativity and intellectual independence. My father could be authoritarian at home (as fathers sometimes must be), but his attitude towards power and authority in general was highly skeptical, and he never hid that from me. During one conference with some school authority figure I'd managed to offend, I demanded, "Don't I have the right to ask why?" The authority figure hemmed and hawed for a moment, obviously searching for a way to tell me that I ought to just shut up and obey. My father, who had been silently sitting to the side spoke up, using the fullness of his courtroom voice. "Always. You always have the right to ask why." When I was older, it was my father who introduced me to libertarian politics.
My mother was a graphic artist and tended to be more creative and free spirited than my strictly intellectual and hyper-rational father, but she too encouraged me to think for myself.
So, it wasn't my parents who were the source of the anger I felt towards a society I was convinced was trying to crush me. Of course, that didn't stop them from becoming targets of my anger.
My school no doubt had something to do with the early onset of adolescent rage and rebellion. There are plenty of stories to be told there, but none of them are really within the scope of this narrative. Suffice it to say that my it was a private k-8 school run by the Episcopal church. It was and is a good school, but I suspect that as a young person, I was not tempermentally suited to the classroom environment. I did and do live almost entirely inside my head, and had little interest in 'socializing' with my classmates. By the time I did develop that interest, I was already well established as an outsider.
Most of it, though, had to do with me. I was congenitally rebellious and suspicious. I remember resenting being told to sing, "I am calm/ I am still/I am doing God's will." Although I probably didn't have the vocabulary to put a name to my feelings, I was quite sure that the song was just a way to get us to do the teacher's will. I was probably seven or eight at the time.
A less flattering, and more honest account would probably be that I have always been a bit of an asshole.
Enough navel gazing. Back to punk rock. Damaged was only the start. I couldn't get enough punk rock. Within less than a year, I had acquired close to a hundred punk albums, and I listened to them obsessively. I wasn't enough to have the music playing while I did something else. I would spend hours laying in front of my stereo with the volume cranked up, listening to the songs and reading the lyric sheets or contemplating the album art. If the album was on one of the dubbed tapes I had, I would read through the catalogs that now came to the house: Alternative Tentacles, SST, and whatever else I could get my hands on. I was unaware of zines, but had I known about them, I would have acquired all I could find.
Some kids get religion around that age, and in a way, so did I. The lyric sheets of Black Flag or Dead Kennedys albums were my scripture, and I studied them as closely, and uncritically, as some read the Bible or Quoran. What I learned was what I already believed: society was another word for a conglomeration of powerful people who valued conformity and the status quo above all and the less powerful people subject to their rule. Our 'leaders' were power-hungry madmen whose machinations threatened the very existence of the human race. The best we could hope for was a few decades of drudgery, followed by a long wait for death. There were a few who saw the truth, and who tried to resist. They were almost always crushed by the system, which had a mechanistically efficient system of enforcing its rules. Kids who stood up or stood out were fed into a system that started in the schools and ended either in jails or in psychiatric institutions. A few years later, I found this idea expressed much more elegantly in Ken Kessey's discussion of the Combine in One Flew Over the Cuckoo's Nest. The kids were big, but the machine made them small.
I knew the system was out there, and evil. And I saw it everywhere I looked. I picked a fights with it every chance I could. And I invariably lost. This isn't meant to be a detailed memoir (and surely those of you who have made it this far are bored enough already), so I won't recount any details here. I will say that things eventually came to a head, as they had to, and I lost, as I had to.
What followed was a long period of confusion. While I never really quit believing in the punk ethos, I had had enough of the fight. Listening to those albums began to feel dangerous, like feeding air to the embers left in a half-burned building. I gave away most of my collection. And I tried to keep my mind right.
Of course, it didn't work. Although I was certainly passionate, especially after discovering libertarianism, I never felt the sort of constant fury that I did at twelve, and that was probably a saving grace. The kind of anger I felt at that age was not controllable, and would have burned me out.
Leap forward a few decades. My passions and my politics have moderated. This story ends like almost every other one about youthful rebellion. I still like to blast Black Flag, Minor Threat, and a few newer punk bands. I still tell myself that I am a rebel at heart, and that the angry punk kid that was willing to go to war against perceived injustice is still a part of me. And maybe that's true.
Or maybe I'm just a middling guy hurtling towards middle age mediocrity and clinging to memories of a younger, better self.
Saturday, July 6, 2013
It Ain't Ozzy and Harriet..
Television shows would have you believe that ambulance crews spend
their days pulling one life after another back from the maw of death,
rushing from rescue to rescue in between bouts of supply-room sex with
hollywood-gorgeous members of the opposite sex. The reality is sadly
less interesting. Most of our calls are little more than expensive taxi
rides. Few of our patients need anything more than a lift. Few of us
are hollywood-gorgeous, and the supply room contains an abundance of
spiders and a lack of places suitable for love-making.
Still, we sometimes get to do things that approximate life saving. A month or two ago, we were called for a man down at a local factory. It was early summer, just starting to get really warm, and factories tend to be hot and poorly ventilated. As we went en route, I reviewed treatments for heat exhaustion and dehydration. Of course, diabetes was another possibility, and I reminded myself to grab the glucometer and some dextrose.
We were met at the gate by a manager, who explained that the patient, a man in his 60s, had suddenly collapsed. "What was he doing before that?" I asked.
"He was just cleaning up when he grabbed his chest and fell down," the manager replied.
"He grabbed his chest? Does he have heart problems?" The manager says none that he's aware of, but I'm already shifting to double-time movements. I snatch the cardiac monitor out of the truck and speed walk inside. There, I find the patient laying on the ground. He's awake, but pale and diaphoretic (sweaty.) It's not all that hot in the factory, but his chest is so sweaty that I have trouble getting the monitor leads to stick. When I finally do, I'm initially confused by what I see on the monitor. Heart attacks usually show up on an EKG in the form of ST segment elevation. Essentially one part of the QRS complex, that squiggly line that represents the heart's electrical activity, is higher than the rest. This man's ST segment is so elevated that I initially have trouble figuring out which part of the complex is which. After a few seconds, my brain engages, and the readout resolves into a complex that screams 'heart attack.'
Several EMTs and firefighters have arrived, and my partner asks what I need. "Load and go. Let's get him in the truck now. I'll do the 12-lead there." If we were moving at double-time before, we're now in a full sprint. We scoop the patient up, put him on the cot, and move him to the ambulance. On the truck, we move even faster. My partner hooks up the 12-lead (a more detailed EKG), and I start an IV and give nitro and aspirin, followed by Fentanyl. The 12-lead prints, and I examine the tracings before looking at the machine's diagnosis. For once, the machine and I agree. It's a STEMI, medical speak for heart attack. Kevin jumps out, speed walks to the driver's seat, and we pull out with the sirens screaming. In back, I recheck vitals and prepare another round of medications. I grab the phone, hit the speed dial for the local hospital, and clamp the phone between my ear and shoulder as the ambulance rocks side to side, speeds up and slows down. I tell the nurse on duty what I'm bringing in. My usual laconic phone manner is gone, and I'm rattling off vital signs and medications in the same way I used to call out fire mission information in my days as a Marine artilleryman.
Moments later, we pull in to the hospital. We wheel the cot in, and the hospital staff quickly sets up their own EKG, and draws blood. The local hospital doesn't have a cath lab, and I step out and visit the bathroom, knowing we're going to be taking the patient down the road to a bigger facility. By the time I come back, the doctor has confirmed my diagnosis. The patient has never even left our cot, and we wheel him back out to our truck.
Over the next forty minutes, I'm busy with medications and monitoring. I contact Midtown hospital and call a Code STEMI, alerting them that the cath lab needs to be up on running on our arrival. When we arrive at Midtown, the cardiologist and cath lab nurses are waiting for us at the ER door. We don't break stride, and I hand the EKG print outs to the doctor and give my report as we speed walk to the cath lab. Moments later, our patient is on the table, and Kevin and I are making up the cot and getting ready to return to the station.
A few hours later, I call the hospital for an update. Our patient is doing well, and expected to go home in the next several days. At the beginning of my next shift, I find an image of the patient's heart and the cath lab report on the day room table. The left anterior descending artery had been totally blocked-not only had the patient had an MI, he had one of the worst ones possible. But he survived. Sometimes you get a good save. But there's still no sex in the supply room.
Still, we sometimes get to do things that approximate life saving. A month or two ago, we were called for a man down at a local factory. It was early summer, just starting to get really warm, and factories tend to be hot and poorly ventilated. As we went en route, I reviewed treatments for heat exhaustion and dehydration. Of course, diabetes was another possibility, and I reminded myself to grab the glucometer and some dextrose.
We were met at the gate by a manager, who explained that the patient, a man in his 60s, had suddenly collapsed. "What was he doing before that?" I asked.
"He was just cleaning up when he grabbed his chest and fell down," the manager replied.
"He grabbed his chest? Does he have heart problems?" The manager says none that he's aware of, but I'm already shifting to double-time movements. I snatch the cardiac monitor out of the truck and speed walk inside. There, I find the patient laying on the ground. He's awake, but pale and diaphoretic (sweaty.) It's not all that hot in the factory, but his chest is so sweaty that I have trouble getting the monitor leads to stick. When I finally do, I'm initially confused by what I see on the monitor. Heart attacks usually show up on an EKG in the form of ST segment elevation. Essentially one part of the QRS complex, that squiggly line that represents the heart's electrical activity, is higher than the rest. This man's ST segment is so elevated that I initially have trouble figuring out which part of the complex is which. After a few seconds, my brain engages, and the readout resolves into a complex that screams 'heart attack.'
Several EMTs and firefighters have arrived, and my partner asks what I need. "Load and go. Let's get him in the truck now. I'll do the 12-lead there." If we were moving at double-time before, we're now in a full sprint. We scoop the patient up, put him on the cot, and move him to the ambulance. On the truck, we move even faster. My partner hooks up the 12-lead (a more detailed EKG), and I start an IV and give nitro and aspirin, followed by Fentanyl. The 12-lead prints, and I examine the tracings before looking at the machine's diagnosis. For once, the machine and I agree. It's a STEMI, medical speak for heart attack. Kevin jumps out, speed walks to the driver's seat, and we pull out with the sirens screaming. In back, I recheck vitals and prepare another round of medications. I grab the phone, hit the speed dial for the local hospital, and clamp the phone between my ear and shoulder as the ambulance rocks side to side, speeds up and slows down. I tell the nurse on duty what I'm bringing in. My usual laconic phone manner is gone, and I'm rattling off vital signs and medications in the same way I used to call out fire mission information in my days as a Marine artilleryman.
Moments later, we pull in to the hospital. We wheel the cot in, and the hospital staff quickly sets up their own EKG, and draws blood. The local hospital doesn't have a cath lab, and I step out and visit the bathroom, knowing we're going to be taking the patient down the road to a bigger facility. By the time I come back, the doctor has confirmed my diagnosis. The patient has never even left our cot, and we wheel him back out to our truck.
Over the next forty minutes, I'm busy with medications and monitoring. I contact Midtown hospital and call a Code STEMI, alerting them that the cath lab needs to be up on running on our arrival. When we arrive at Midtown, the cardiologist and cath lab nurses are waiting for us at the ER door. We don't break stride, and I hand the EKG print outs to the doctor and give my report as we speed walk to the cath lab. Moments later, our patient is on the table, and Kevin and I are making up the cot and getting ready to return to the station.
A few hours later, I call the hospital for an update. Our patient is doing well, and expected to go home in the next several days. At the beginning of my next shift, I find an image of the patient's heart and the cath lab report on the day room table. The left anterior descending artery had been totally blocked-not only had the patient had an MI, he had one of the worst ones possible. But he survived. Sometimes you get a good save. But there's still no sex in the supply room.
Wednesday, May 15, 2013
Let me tell you about my morning...
Let me tell you about my morning. It started at 4 AM, when we were toned for a patient at the jail having a breathing problem. It was a simple call with an easy fix (Albuterol and Atrovent work wonders for asthmatics), but the timing was just right to ensure that after finishing my report, there was no point in going back to bed. And, as soon as I was off at Riverton, I had to drive to the next town over for another 24 hour shift. Such are the joys of making a living in EMS.
By the time I finished writing my report, taking a shower, doing station duties, and making a small breakfast, I had about an hour and a half to kill before shift change. I took a cup of coffee from the thermos I always keep full of tungten-strong french roast and carried the novel I was reading to the picnic table out back. The weather forecasters were threatening us with a hot, sticky day, but for now the weather was pleasant. The sun had come up, but not so long ago that it had completely chased away the tendrils of dawn pink from the sky. I reflected that although getting hauled out of bed at 0 dark stupid always sucks, now that I was up, there were worse ways to spend the morning.
That, of course, is when the tones dropped. Before the cacophony of high pitched sqeals and whoops that call us to work had stopped, I was mentally figuring times. If the call was close, and if the patient wanted the local hospital, I calculated, I might just make it to my next job on time.
"Attention Riverton EMS, response is needed to 17 Highway one mile South of 28 for a one-vehicle MVA." Crap. These calls often turn out to be nothing-the patient was out of the vehicle before we got there, and didn't want to go to the hospital, or the car has driven off before we arrive. But when they're something, even if it's a minor something, they're time consuming.
I chugged the rest of my coffee down, and, on the way to the ambulance, stopped by my locker to pick up my bunker gear. Our fire gear provides pretty good protection against the broken glass and sharp bits of metal that tend to litter accident scenes. Climbing into the passenger seat of the ambulance, I glanced in the mirror to make sure my partner was on the way out. He was, and I reached across to get the clattering diesel that powers our truck started. A moment later, he climbed in, and we pulled out of the bay. Kevin pushed the button that activates our LED light show, and I turned the knob that cranks up the noise makers. I grab the radio handset "Rescue 1, Central, we're en route, miles zero."
About a mile down the road, dispatch calls to tell us that a civilian on scene was reporting that the driver was still in the vehicle. So much for getting to the next job on time.
The accident scene is on one of the main two-lane highways through the county where it intersects a gravel road. A combination of highway department engineering and weird topography mean that the gravel road sits atop high, steep embankments on both sides. The car, a Ford hatchback, is at the bottom of a ravine on one side of the gravel road. It's about 60 yards from the road surface, and I'll be damned if I can see how the driver got there. Usually, when a car leaves the road, the path it takes will be marked by churned up dirt and broken plants. If the vehicle rolled on the way, bits of broken car, along with papers, purses, CDs, cell phones, and the other junk people carry in their cars will mark the path of travel like breadcrumbs. As we get close, I can see some churned up dirt, but, while that trail leads to the car, it starts about 30 yards from the road. Kevin says what I'm thinking. "What the fuck did this guy do?" A bystander is frantically waving at us and pointing to the vehicle. He bounces up and down as he points, a gray haired gentleman looking like a toddler doing the pee-pee dance. "We see it, jackass," I mutter. "Calm the fuck down."
We pull up, and I hop out as the ambulance rolls to a stop. There's some water at the bottom of the ravine, and the ticks are said to be bad this year, so I take a moment to pull on my bunker pants as I survey the scene. A civilian, probably the one who had been talking to dispatch was squatting next to the passenger side of the car. Of the driver, I see no sign. Leaving Kevin to carry down the backboard and C-collar, I make my way down the embankment. The civilian starts talking as I walk up. "I've been trying to keep his head still, but he keeps moving it. He was unresponsive when I got here, but he's talking now."
The patient himself is laying face-down, with his head slightly out of the open passenger door, his torso in the passenger footwell, and his legs draped across the driver's seat. Both airbags have deployed, and the windshield is broken on the passenger side. There's a small puddle of blood on the ground under the patient's head, and he has several abrasions on his face and forehead.
So. He left the road moving fast. He wasn't wearing his seatbelt. When the steep angle of the embankment caused the car's nose to plow into the ground, he went flying across the passenger compartment. The broken windshield and abrasions suggest that his head hit the windshield. Since the airbags deployed, there may have been two impacts, one that set the bags off, and another that tossed the guy into the glass. His airway is open, and his breathing is regular. There's blood dripping from his face, but not enough to be concerned about. But I can only see the patient's back and face. I can't tell what's going on in front.
Kevin walks up with the backboard. Although he's the shift captain, and therefore the boss most of the time, I have a higher medical license, and on medical calls, I run the show. "Have dispatch get a bird on air standby" I say. In other words, have a medevac helicopter start flying our way. I turn back to the patient. "Hey, buddy, where do you hurt?" He says something but I can't make it out. "Do you know where you are right now?"
"At work." he says. Not good. At all. He's almost certainly suffered a head injury, and his level of consciousness is altered. By ground, we're at least 40 minutes from the nearest level 1 trauma center. And this guy needs a level 1 trauma center. I turn back to Kevin. "Go ahead and have the helicopter come to the scene. We're going to fly him from here." By now, I can hear the engine coming, and after calling for the bird, Kevin radios the engine crew to set up a landing zone. The best option is to shut down the highway and land the bird right there. We're about to piss off a lot of commuters.
I pass off c-spine (control of the patient's head to protect his spine) to Kevin and jog back up to the truck. I need more stuff. I grab the trauma bag from the shelf and yank down the IV start kit I keep taped to the wall of the ambulance. I mentally chastise myself for not grabbing this stuff in the first place. Blame it on a lack of caffeine in my system. On the way back down, I yell to the engine crew. "Hey, we're going to need some help here!"
Back at the car, the first order of business is to get the patient onto a spine board. Given the mechanism of injury, there's a good chance he's got a spine injury, and I need to see his front. As firefighters and EMTs arrive, I climb over the patient and into the back of the car, where I perch with my boots on the seat. That position will give me the best access to the patient once he's rolled over. Climbing in, I hear dispatch advise us that the bird is 20 minutes out. Too damn long, but I'll think about that once I get a look at the rest of my patient.
The board in place, we roll him over. At first, I don't see any other serious injuries. Both sides of his chest are rising and falling equally. His pelvis looks intact. No jugular vein distention, and his trachea is midline. His face is scraped and bruised, but I don't see double black eyes or the shadowy bruises behind the hear that can indicate a skull fracture. Then I notice his right arm. The hand is pointed at a 90-degree angle away from his forearm, but the bend is several inches down from the wrist. The skin of the wrist is pulled tight across what looks like the distal (far) end of the radius. "He's got a broken arm!" I call out as I grab ahold of his forearm. For a moment, I'm baffled. I need to splint it, but the hand is in such a weird position that I'm not sure how. I turn to Kevin. "How in the hell should I splint this?" Kevin's not a medic, but he's a damn good EMT and has been at it for a long time. As he has many times in the past, Kevin demonstrates the truth of the saying, "Medics may save lives, but EMTs save medics." Kevin suggests using a flexible splint rolled and bent to match the distorted shape of the forearm. It works.
But there's a problem. I'm manipulating the patient's arm. The patient's obviously and colossally broken arm. He should be screaming. I shouldn't be able to do this without dosing him with high-octane narcotics. But, although he's awake and talking, he's not showing much reaction to the pain.
Dispatch advises us that the helicopter is making better time than expected. Good. The other crew members slide the patient out of the car and began carrying him up to the ambulance. I take a moment to look more closely at the car. It hasn't rolled over. The damage to the front is minimal. The roof has no dents, even at the top of the windshield. The broken glass has to have been caused by his head.
In the ambulance, Kevin and I get to work. Carl, the Assistant Chief, jumps in too. We continue the oxygen the patient has been on since shortly after we reached him. Kevin hooks up the monitor, which will provide an EKG reading as well as basic vital signs. One problem: I need to get an IV started, and Kevin needs a place to put the blood pressure cuff. But the patient has only one we can use for those things. I yank off the patient's shoes and examine his foot for a possible IV site while Kevin gets a blood pressure. There's nothing in the foot, but Kevin tells me he feels a good vein in the patient's left arm. I look. I can't see it, but I can feel it. To get to that arm, I have to straddle the patient. I hate starting IVs that way, but this time I get lucky, and I hit the vein immediately. We run warm fluids wide open.
As we've been poking and prodding at the patient, I've been talking to him. He's becoming more coherent. He knows where he is. He understands that he's there because he crashed his car. He was in the hospital two days ago for extremely high blood pressure, but he doesn't remember how high. I perform a quick stroke exam, and find nothing to suggest that that's what's going on. The cardiac monitor looks good. Kevin points out a small bruise on the patient's abdomen. A bruised abdomen can be a very bad sign, but this one looks old, and when I felt the patient's belly, I didn't notice anything untoward. Still, I make a mental note to tell the helicopter crew about that.
By now, I can hear the bird overhead. Carl steps out of the back of the ambulance and drives us 100 yards or so to the landing zone. The helicopter crew arrives, and I brief them as we transfer the patient to the bird. A moment or so later, it lifts off and roars away towards the trauma center. Everyone on the crew has seen the bird take before, but we all stop to watch. I turn to Kevin and say the same thing I always do after a medevac, "No matter how many times you've seen it, or how many times you've ridden in one, helicopters are freaking cool." And they are.
The highway patrolman on scene has examined the accident scene, and tells us what he thinks happened. The guy drove off the highway, crossed several hundred yards of grass, then shot up the embankment with enough speed that he launched all the way over the gravel road before hitting the ground halfway down the opposite embankment. The trooper, Kevin, and I look back down the road, mentally tracing the car's path. After a moment, I turn to the the trooper. "So, he did a Clark Griswold," I say. I do my best Chevy Chase impression, hands on hips and staring at the horizon. "Fifty yards...." It's not often you can make a state trooper chuckle.
The back of the ambulance looks like a toddler has had a particularly destructive temper tantrum in it. Bandage wrappers, saline flushes, needle caps and other detritus are scattered on the seat, on the cabinets and on the floor. "Let's just get back and fix it at the station" Kevin says.
We get in front, and I pull out my phone. I've got to call the next job and let them know I'll be late.
By the time I finished writing my report, taking a shower, doing station duties, and making a small breakfast, I had about an hour and a half to kill before shift change. I took a cup of coffee from the thermos I always keep full of tungten-strong french roast and carried the novel I was reading to the picnic table out back. The weather forecasters were threatening us with a hot, sticky day, but for now the weather was pleasant. The sun had come up, but not so long ago that it had completely chased away the tendrils of dawn pink from the sky. I reflected that although getting hauled out of bed at 0 dark stupid always sucks, now that I was up, there were worse ways to spend the morning.
That, of course, is when the tones dropped. Before the cacophony of high pitched sqeals and whoops that call us to work had stopped, I was mentally figuring times. If the call was close, and if the patient wanted the local hospital, I calculated, I might just make it to my next job on time.
"Attention Riverton EMS, response is needed to 17 Highway one mile South of 28 for a one-vehicle MVA." Crap. These calls often turn out to be nothing-the patient was out of the vehicle before we got there, and didn't want to go to the hospital, or the car has driven off before we arrive. But when they're something, even if it's a minor something, they're time consuming.
I chugged the rest of my coffee down, and, on the way to the ambulance, stopped by my locker to pick up my bunker gear. Our fire gear provides pretty good protection against the broken glass and sharp bits of metal that tend to litter accident scenes. Climbing into the passenger seat of the ambulance, I glanced in the mirror to make sure my partner was on the way out. He was, and I reached across to get the clattering diesel that powers our truck started. A moment later, he climbed in, and we pulled out of the bay. Kevin pushed the button that activates our LED light show, and I turned the knob that cranks up the noise makers. I grab the radio handset "Rescue 1, Central, we're en route, miles zero."
About a mile down the road, dispatch calls to tell us that a civilian on scene was reporting that the driver was still in the vehicle. So much for getting to the next job on time.
The accident scene is on one of the main two-lane highways through the county where it intersects a gravel road. A combination of highway department engineering and weird topography mean that the gravel road sits atop high, steep embankments on both sides. The car, a Ford hatchback, is at the bottom of a ravine on one side of the gravel road. It's about 60 yards from the road surface, and I'll be damned if I can see how the driver got there. Usually, when a car leaves the road, the path it takes will be marked by churned up dirt and broken plants. If the vehicle rolled on the way, bits of broken car, along with papers, purses, CDs, cell phones, and the other junk people carry in their cars will mark the path of travel like breadcrumbs. As we get close, I can see some churned up dirt, but, while that trail leads to the car, it starts about 30 yards from the road. Kevin says what I'm thinking. "What the fuck did this guy do?" A bystander is frantically waving at us and pointing to the vehicle. He bounces up and down as he points, a gray haired gentleman looking like a toddler doing the pee-pee dance. "We see it, jackass," I mutter. "Calm the fuck down."
We pull up, and I hop out as the ambulance rolls to a stop. There's some water at the bottom of the ravine, and the ticks are said to be bad this year, so I take a moment to pull on my bunker pants as I survey the scene. A civilian, probably the one who had been talking to dispatch was squatting next to the passenger side of the car. Of the driver, I see no sign. Leaving Kevin to carry down the backboard and C-collar, I make my way down the embankment. The civilian starts talking as I walk up. "I've been trying to keep his head still, but he keeps moving it. He was unresponsive when I got here, but he's talking now."
The patient himself is laying face-down, with his head slightly out of the open passenger door, his torso in the passenger footwell, and his legs draped across the driver's seat. Both airbags have deployed, and the windshield is broken on the passenger side. There's a small puddle of blood on the ground under the patient's head, and he has several abrasions on his face and forehead.
So. He left the road moving fast. He wasn't wearing his seatbelt. When the steep angle of the embankment caused the car's nose to plow into the ground, he went flying across the passenger compartment. The broken windshield and abrasions suggest that his head hit the windshield. Since the airbags deployed, there may have been two impacts, one that set the bags off, and another that tossed the guy into the glass. His airway is open, and his breathing is regular. There's blood dripping from his face, but not enough to be concerned about. But I can only see the patient's back and face. I can't tell what's going on in front.
Kevin walks up with the backboard. Although he's the shift captain, and therefore the boss most of the time, I have a higher medical license, and on medical calls, I run the show. "Have dispatch get a bird on air standby" I say. In other words, have a medevac helicopter start flying our way. I turn back to the patient. "Hey, buddy, where do you hurt?" He says something but I can't make it out. "Do you know where you are right now?"
"At work." he says. Not good. At all. He's almost certainly suffered a head injury, and his level of consciousness is altered. By ground, we're at least 40 minutes from the nearest level 1 trauma center. And this guy needs a level 1 trauma center. I turn back to Kevin. "Go ahead and have the helicopter come to the scene. We're going to fly him from here." By now, I can hear the engine coming, and after calling for the bird, Kevin radios the engine crew to set up a landing zone. The best option is to shut down the highway and land the bird right there. We're about to piss off a lot of commuters.
I pass off c-spine (control of the patient's head to protect his spine) to Kevin and jog back up to the truck. I need more stuff. I grab the trauma bag from the shelf and yank down the IV start kit I keep taped to the wall of the ambulance. I mentally chastise myself for not grabbing this stuff in the first place. Blame it on a lack of caffeine in my system. On the way back down, I yell to the engine crew. "Hey, we're going to need some help here!"
Back at the car, the first order of business is to get the patient onto a spine board. Given the mechanism of injury, there's a good chance he's got a spine injury, and I need to see his front. As firefighters and EMTs arrive, I climb over the patient and into the back of the car, where I perch with my boots on the seat. That position will give me the best access to the patient once he's rolled over. Climbing in, I hear dispatch advise us that the bird is 20 minutes out. Too damn long, but I'll think about that once I get a look at the rest of my patient.
The board in place, we roll him over. At first, I don't see any other serious injuries. Both sides of his chest are rising and falling equally. His pelvis looks intact. No jugular vein distention, and his trachea is midline. His face is scraped and bruised, but I don't see double black eyes or the shadowy bruises behind the hear that can indicate a skull fracture. Then I notice his right arm. The hand is pointed at a 90-degree angle away from his forearm, but the bend is several inches down from the wrist. The skin of the wrist is pulled tight across what looks like the distal (far) end of the radius. "He's got a broken arm!" I call out as I grab ahold of his forearm. For a moment, I'm baffled. I need to splint it, but the hand is in such a weird position that I'm not sure how. I turn to Kevin. "How in the hell should I splint this?" Kevin's not a medic, but he's a damn good EMT and has been at it for a long time. As he has many times in the past, Kevin demonstrates the truth of the saying, "Medics may save lives, but EMTs save medics." Kevin suggests using a flexible splint rolled and bent to match the distorted shape of the forearm. It works.
But there's a problem. I'm manipulating the patient's arm. The patient's obviously and colossally broken arm. He should be screaming. I shouldn't be able to do this without dosing him with high-octane narcotics. But, although he's awake and talking, he's not showing much reaction to the pain.
Dispatch advises us that the helicopter is making better time than expected. Good. The other crew members slide the patient out of the car and began carrying him up to the ambulance. I take a moment to look more closely at the car. It hasn't rolled over. The damage to the front is minimal. The roof has no dents, even at the top of the windshield. The broken glass has to have been caused by his head.
In the ambulance, Kevin and I get to work. Carl, the Assistant Chief, jumps in too. We continue the oxygen the patient has been on since shortly after we reached him. Kevin hooks up the monitor, which will provide an EKG reading as well as basic vital signs. One problem: I need to get an IV started, and Kevin needs a place to put the blood pressure cuff. But the patient has only one we can use for those things. I yank off the patient's shoes and examine his foot for a possible IV site while Kevin gets a blood pressure. There's nothing in the foot, but Kevin tells me he feels a good vein in the patient's left arm. I look. I can't see it, but I can feel it. To get to that arm, I have to straddle the patient. I hate starting IVs that way, but this time I get lucky, and I hit the vein immediately. We run warm fluids wide open.
As we've been poking and prodding at the patient, I've been talking to him. He's becoming more coherent. He knows where he is. He understands that he's there because he crashed his car. He was in the hospital two days ago for extremely high blood pressure, but he doesn't remember how high. I perform a quick stroke exam, and find nothing to suggest that that's what's going on. The cardiac monitor looks good. Kevin points out a small bruise on the patient's abdomen. A bruised abdomen can be a very bad sign, but this one looks old, and when I felt the patient's belly, I didn't notice anything untoward. Still, I make a mental note to tell the helicopter crew about that.
By now, I can hear the bird overhead. Carl steps out of the back of the ambulance and drives us 100 yards or so to the landing zone. The helicopter crew arrives, and I brief them as we transfer the patient to the bird. A moment or so later, it lifts off and roars away towards the trauma center. Everyone on the crew has seen the bird take before, but we all stop to watch. I turn to Kevin and say the same thing I always do after a medevac, "No matter how many times you've seen it, or how many times you've ridden in one, helicopters are freaking cool." And they are.
The highway patrolman on scene has examined the accident scene, and tells us what he thinks happened. The guy drove off the highway, crossed several hundred yards of grass, then shot up the embankment with enough speed that he launched all the way over the gravel road before hitting the ground halfway down the opposite embankment. The trooper, Kevin, and I look back down the road, mentally tracing the car's path. After a moment, I turn to the the trooper. "So, he did a Clark Griswold," I say. I do my best Chevy Chase impression, hands on hips and staring at the horizon. "Fifty yards...." It's not often you can make a state trooper chuckle.
The back of the ambulance looks like a toddler has had a particularly destructive temper tantrum in it. Bandage wrappers, saline flushes, needle caps and other detritus are scattered on the seat, on the cabinets and on the floor. "Let's just get back and fix it at the station" Kevin says.
We get in front, and I pull out my phone. I've got to call the next job and let them know I'll be late.
Tuesday, April 30, 2013
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