16 February 2006

When a Stranger Comes

16 February 2006

"When a Stranger Comes"

Have you ever walked down the street and look at people that you have never met or have no clue as to the values of thier lives and try to figure out who they are?  I mean, c'mon, I know that some of us had made fun of someone for the clothes they wear or the way they sound when they talk or laugh.  Everyone has done it. I have done it.

But have you ever really looked at that person and asked yourself "Will I ever get to know that person?"  Even if it for a brief moment in your life. 

Is that person going to lend me a quarter when I am that much short at the register?  Will that person jump my car when it is dead in the parking lot?  Does that person need a hand carrying all those bags that they are fumbling with?

I know, this is a pretty deep issue to ponder there and for some, if you haven't had your coffee, it is a hopeless and uphill battle.

Here is even a deeper issue to ponder.  Not so much as to who that person is and what they can do for you, but rather, what can you do for them? 

If you really look at it, the most suttle gesture can open the hearts of many.  Hold a door open for someone, pick up an item that they dropped, even making eye contact and saying "hello" can really open up a wealth of emotion not only for you, but it cold end up making thier day.

Besides, you never know...you might need a stanger someday.

1630 Hours.

It was slowly starting to get gray outside as I knew we were scheduled for some rain and even some thunder within the next few hours.  I had just finished getting my sweatshirt sewn from my aunt's house. She is wonderful and does all my patches for my job uniforms.  All I wanted to do was get home knowing that I had some projects to accomplish.  The new house that I am in has some rather old wiring and all the outlets are still those old two prong jobbie. I had a box of new three prong ones that I wanted to put in and I wanted to conquer that before it got too dark.

Traffic was a little heavier than normal coming down the highway as the turnpike seemed to empty into the regular interstate.  My exit was coming up so I merged over  and began to make my desent down the off ramp.

Getting a peak down the road, I could see cars making a full stop which I found normal seeing it was a weird merging area. You know, one of those ones where the off traffic and the on traffic have like 50 feet combined to wedge themselves in.  As I approached a little further, I noticed people fleeing their cars.  Not normal.  I didn't think we were supposed to get an alien invasion for at least another seven weeks.  Good thing I bought some bottled water.

Moving even closer, I saw skid marks, which led to a guard rail, which had a hole it it, that wasn't supposed to be there.  Beyond that I could see where everyone was off to....The over turned car that laid there on its roof.

Being a paramedic, I guess it is second nature to see something like that and even more of an instinct to get out, evaluate the situation, and lend support to the best of your abilities.  So...that is what I did.

Turning the hazards on, I pulled to the right and parked strategically so that anyone not paying attention would go flying off the road and into the accident site. Last thing I need is multiple vehicles with multiple patients. We already know that I am still reeling from my last mass casulty incident. 

Getting closer to the car, I noticed that through the driver's window, a hand laid dormant and motionless.  A voice came from inside the car as bystanders began converging in to see what they could do. 

From my right, I could hear someone ask the victim how many are in the vehicle.  His answer made me sick to my stomach, I went in anyways.


Five is what he told the person who was on the phone with 9-1-1. Five is the number of bodies that I was prepared to find in this flipped twist of metal. Five was the number programmed in my mind to help.  Five...was not accurate.

Coming around to the passenger side of the car, I found the only point of entry that I could which was a rear passenger door that was unlocked but stuck in the wet and very soft mud.  Trying to pull it open seemed counterproductive as the more myself and a gentleman helped me, the more the water began to get in from the ditch that the car had landed in.

Now, I am not talking about white water rapids here. There really wasn't enough water that I had to be overly concerned with and consider calling the coast guard for (no, I wasn't going to call them anyways), but it was enough to make a difference and the extrication a bit more difficult. 

Giving the window a few swift kicks, Entry was gained with a price paid...I ripped my Indians coat.  Sigh....

Looking around in the car, I noticed something of great importance to me and the rescuers outside.  There was only one person in the car.


Four less than five.

I had to ponder the thought, was there really ever five in the vehicle.

"Sir, are you alright?" I asked.

"Yeah, I think so>" He replied.

Now was the million dollar question.

"Was there anyone else in the vehicle with you?" I gulped out.

"No, I am by myself." He told me relieving all tension I had in my heart.

Now, I DID hear him say five when asked by the lady on the cell phone.  I am just glad we were wrong.

Telling him I was a paramedic and that I was going to help him and get him out posed more of a challenge than they ever could teach you in school.

While learning about extrication in class, the fundamentals are taught with a pretty cut and dry knowledge of what to do in a motor vehicle accident.  How to support the cervical spine, Note hazards that you may encounter, The safest way to evaluate a patient.

All of this was good and wise and rules to live by.

But no one ever taught us how to hold c-spine on a person who was upside down in a car that was filling slowly with water.   Good thing I watched Third Watch.

 Hey guys...s'up.

Now, training tells us not to move a patient until the scene is safe and the vehicle is secure.  Your gut tells you to get them out while you can and worry about the rest later.

"Do you remember what happened?" I asked.

"I think I hit a patch of black ice." He said.

Strike one.

The temperature at the time of the accident was 46 degrees and all ice had melted the day before with the same mild temperatures. Plus I could see no ice when I cam over.

"Did you black out at all?" Asking him that,

"I don't think I did." He replied.

Strike two.

This is called a pertinent negative. If a patient can't remember if he/she did or did not lose consciousness, then it is in the best interest to assume that he or she had.

"Are you hurting anywhere?" Again I posed a question.

"I don't think so, but it is a little hard to breathe." He told me.

Strike Three.

Any compromise to the patient's airway, breathing, or circulation superceedes anything and that patient needs to come out.

Doing a quick check of the patient, I found that it posed little threat to extricate him before the fire department got there.

Having one of the bystanders unbuckle his safety belt (which saved his life by-the-way..had he not had it, he would have been tossed from the vehicle and most likely under the car.) I instructed the people outside as to how to assist the patient to the solid ground.

Getting him out, I wiggled my way out of the car and came around to assess the patient better.  No sooner than I unstuck my shoe from the mud, the squad came and I relayed the patient info to a couple of guys on the squad that I used to work with.

Seeing that there was nothing more for me to do, I went back to my car and took off, just a quietly as I came in.

I am almost certain that the driver of that car will be released after a quick check-up at the local hospital but I am certain that he is going to need a ride home.

It was the efforts of a group of complete strangers that came to the aid of a person in whom none of us had ever met, nor may ever cross paths again, but for those few brief moments, those strangers had one common goal, and that was to help another stranger...whom needed the help of others.

People come and people go in our lives. Some may be for a moment, some may be for eternity, and some may be when you need them....the most.

Rounding Third and Heading Home,


11 February 2006

The Hatfield's and the McCoy's

11 February 2006

"The Hatfield's and the McCoy's"

Folks, I have to tell you. I have been doing this job for many, many years now and I have seen my share of life. I have been beat up, thrown down, shot at, burnt to a crisp, frozen over, and just plain old left out to pasture.  Many of the patients that I have encountered have graced me with these less than adequate giftsleaving me with a bad taste in my mouth on more than one occasion, yet, beyond all rationality, I tend to get over it rather quickly.  Sure, they may be an asshole by nature, but I blame it on genetics or just a plain old lack of not getting any.  The fortunate part of the meetings that I have with these people is that a very high percentage of the time, our paths cross only once.  Of course, I will get the frequent flyer every so often who really tend to push my buttons to the point that I want to install an ejection seat on the cot so I can launch them into the next county and let someone else worry about them. But, in reality, that is part of the necessary evil when dealing with the public. It is a way of life, whether we want to accept it or not. Tough. Deal with it. It isn't going to stop until you are laying in an oak casket deep below the Earth's surface. Then, most likely, it will continue.You just can't fight back.

So, with this, I have learned to grow a certain tolerance to the ignorant and asinine. But there is one thing that really, REALLY frost my ass beyond all feeling coming back. And that is good old fashioned arrogance.  It is one thing to be stupid, but it is quite another to think that you are way better than someone else that is out there....

Especially when it is your rival EMS company.  Crossing the line once is angersome, yet waived to indiscresion. Doing it twice is an invitation to throw the gloves off.

Some body ring the bell....it's go time.

0930 Hours.

Today was one of those days where you know what is going to happen and you lose sleep the night before obsessing over the overall outcome of the impending task at hand.  Dragging ass, I got to work almost two hours ago, on half hour earlier than I needed to be, in order to preparate for what was, for sure, an extremely long day that was in store for me.

Doped up on coffee, I grabbed Dar (my partner for those who didn't know) and slowly headed out for our destination.  Making sure the garage door closedbehind me, I took the immediate right and started our long, stroll down death row.  I remember taking a huge sigh and in the corner of my eye, I saw Dar looking at me, giving me a sympathetic smile, patting my shoulder, telling me it "won't be that bad."  For her sake, I was optimistic as to her being right. In reality, I knew what was in store.

Today was the mock Mass Casulty Incident at the local high school put on my the county sherriff with observation by the state EMA (Emergency Management Agency for those of you who totally ignored the news about Katrina and are absent as to what it stood for) representitive.

The scenerio was this:

A teenage student got into some sort of trouble in the school. His parents were called to come and speak with the authoritative figures as to his conduct.  The parent, being his father, arrived on scene at the school only to become irate, pull a weapon, and start holding hostages. Now, to add a little more flavor to the pot, a struggle for power ended up in a chemisrty lab where some sort of acid was spilled, causing several burns to students and creating a fire in the process.  The scene was not secured at the time of initial arrival and we have been called to render medical care.


There are two ways that these exercises turn out.  Either they run like a finely tuned machine not having any glitches with a result so impressive that it makes the text books look shameful.

Or, they are a total clusterf***.  The left hand doesn't know what the right hand is doing and usually there are too many chiefs and not enough indians.

Today was one of the latter.

To simualte an actual response, we were to take route from our station so that times from the initial call to the time that we arrived on scene.  The idea was to simulate the entire incident to the letter of the law.   This lasted 5 minutes.

Here is what SHOULD have happened:

The school was in our response area so EMS was our responsibility.  Once arriving on scene, me, being the medic in charge, would have made my way to the incident commander, identified who I was and what company I was with.  Being the first ones there, our squad would have been medical incident command.  This job entails intial triage of patients, tagging them, sending them to the proper area, coodrdinating with IC (Incident Command) in reference to getting additional help, establishing a staging area, and assigning the proper personnel to where I needed them at.  Any medical questions or concerns were to be filtered up to me and I would ultimately confer with the IC to alieviate the problem.  Other than initial triage, there was not to be any patient care until relieved by an EMS supervisor or someone he designates.  As the other squads come in, I would designate when to come in, where to come in from, and where to go with their patient.   A job that is less than gratifying and with the slightest mistake, could throw off the whole incident.  Pretty cut and dry if you come to look at it.  No worries.

Here is what REALLY happened.  Pulling up on scene,  I scanned ahead to see where we should go.  In the distance, I could see a green light indicating the location of the IC. Scanning back, I saw an ambulance sitting at the edge of the driveway. It was not one of ours. It wasn't supposed to be there.  Getting closer, I noticed that it was from the private company that runs the EMS for the adjacent county sitting  there staring us down as if we violated their turf. 

This company (I won't mention names) is similar to the last that I worked for in the essence that it is privately owned yet, has the contracts to run 9-1-1 service.  Unlike the previous company I worked for, this "rival" company is a whole lot less organized, technilogically behind, and really think that after God and Jesus, comes them.  When I worked for LifeCare, they WERE our biggest rivals.  To relate to the competition, it was a lot like the Yankees-Red Sox rivalry that millions had come to love with LifeCare ultimately winning the season series time and time again.  Now, it was the David and Goliath of EMS. Rural vs. Urban. High volume vs. country treat and street.  Even the odds makers in Vegas wouldn't put numbers on this.  But we have something they want. Two hundred and fifty-five square miles of area.  This would give them the boost that they need to return to "elite" status and the only thing standing in their way is a little ambulance service who is on the verge of breaking out and becoming a dark horse.

Anyways, I pulled the squad right in front of theirs  feeling the cold, icy stares they were tossing our way run down my back.  Hey, screw them, this was our briar patch. Going up to the IC, we did what we needed to do when instantly, we were met by the tactical IC. Holding his hand to his ear emmulating a secret service agent, he told us that there was one injury and for us to get our equipment. Well, that was fast.  I told Dar to go and get the truck and bring it up here after getting cleared by the IC that this is where he wanted us to stage.  Three steps into the motion for our equipment. I could hear Dar yelling "Hey" at the top of her lungs.  Turning around, I started to walk toward her only to be cut off...by the other squad.  Not swerving to avoid me, I slammed my hands into the side of their truck as they drove by with their blatent disregard of our safety.  Getting out of their truck, they scurryed to get their equipment. 

Rememeber my two and out rule?   I threw that out the window.

"Hey!!!" I yelled at him from across the parking lot.

"Problem?!?!" He yelled back with a sarcastic undertone.

"Did you forget what color your truck is?" I hollared at him.

The closer I got, the faster they worked until they ran (yes ran) into the school.

At this point, I am beyond the boiling point. If you would have lit me, I would have launched into space.

Trying to regain my composure, I was met by my supervisor who was there as an observer.

"What's going on?" He asked already knowing the answer.

"Those son of a bitches cut us off!" I relayed to him.

You thought I was mad?!?!?

"Yeah, that's twice in 24 hours. They snaked one of our calls early this morning too KNOWING it wasn't in their district." He explained.

Not really hoping to escalate this into something that it wasn't, it had appeared that the pissing contest had started well before I got to work that morning. ANd from the sound of things, it seemed to be the beginning of an all out bar fight.

Fast-forwarding to the end of the drill....

I was met in the debriefing by the swat medic who came up to ask what had happened. 

"Hey, where were you guys at?" he asked.

"Outside, where we were supposed to be until your guys hosed us." I told him.

You see, the swat medic worked part time for this rival company.

"I didn't know you guys were coming so I called for them to come in." He tried feeding me.

By this time, my blood is back to needing Prestone to control the boil over.

"How could you NOT know? Our supervisor was one who helped get this together." Catching him in his bull shit answer that he fed us.

"I didn't know you were sending a squad" he tried to cover up.

"Even if that WAS the case, this is not YOUR response area so I found it rather convienent that you just HAPPENED to be staging at the scene of an incident." I was beginning to open the flood gates.

Just then, the lever turned off. My supervisor stepped in.

"You know, that is twice in 24 hours your guys did that. You and I NEED to sit down and discuss that" he came around me to defuse the situation.

Turning to walk away, I could sense that his tell was discovered and he knew he was caught.

Trying not to erupt, I went back to the squad and said very little on the way back. Dar knew I was pissed but it wasn't her fault and it wasn't fair to her to take it out on her.  She let me be.

24 hours have passed and with no other calls, it seemed that the calm before the storm will be put off for at least one more day.

You know, there is a thing called professional courtesy that people in our field tend to offer the other.  There is no room for error when the shit hits the fan and when the cards are down, you are hoping that there is someone there to get your back...no matter what the trouble is.  My question is why try to be better, you are only fighting yourself.

Rounding Third and Heading Home,