Helpless.

“Ugh!”  I threw my gear bag into the back of the ambulance with an angry grunt. Just that last Saturday, I was supposed to sit for my turnover board; the thing that would make me a ‘Real Medic’, but instead, almost six hours before I was supposed to go, my insides thought differently and decided to play havoc on me. Going pale, sweaty, and doubling over in pain in a house full of Nurses and Paramedics does not make for the decision to, “play through the pain”, considering I couldn’t even speak because I was in so much pain. Once in the emergency room, pumped full of Fentanyl, a gift from God I might add, I wanted to still go to my boards. When I couldn’t even form a coherant sentence, much less remember the dosage for Zofran, another command decision was made; I couldn’t go.

 

This shift was going to suck.

 

I sat in the crew room brooding. People passed before me, excited to get into the ambulance to find out if we were Paramedic ready; we weren’t. The tools of my craft sat wantonly in the closet no more than fourty feet away from me.  I was working with one of my favorite EMT’s, Jake.

“Hey, babe.”  He sat next to me, pulling out his laptop.

“Hey…”

“I heard.”

“Good, don’t want to talk about it.”

Immediately we began figuring out the plan for the night, The Princess Bride followed by Blazing Saddles, History of The World: Part 1, SpaceBalls, and then finishing the shift with Young Frankenstein. It was set to be a good, easy night.  Making it through The Princess Bride and halfway through Blazing Saddles, with the entire crew acting out their favorite parts as we went, our tones dropped.

“Responding to an unknown age female, unknown medical problem, unknown if breathing, cannot understand caller.”

I threw my stethoscope around my neck and ran the address through my mental address book; it didn’t click with any address I had been to before. It was barely two miles away from the station. As we got on our way, I was asking the crew in back to get things ready for me; getting the portable suction set up, grabbing the oxygen tank, and BVM. With having an ALS SUV on their way to us, I had found, through experience, that the less bags we as BLS had sitting around, it made it just that much easier to get out when we needed to get back to the ambulance carrying the patient and all the ALS gear while the Medic got into the ambulance, unburdoned, yet screaming at us to hurry up.  For some Medics in our county, ALS also stood for ‘Ain’t liftin’ shit’.

We turned into the complex when another set of tones went off and the radio squaked at me.

“Ambulance 890?”

“Go ahead.”  I stared at the mic, holding it loosely in my hand.

“Police on scene stating it’s a 4 month old male, unresponsive, not breathing.”

“Received.”

I whipped my head around as our driver hit the afterburners.

“Grab the peds BVM and the Frenches out, we’ll meet the Medic enroute!”

As we neared the building, our driver stopped, “Get out, I’ll turn the unit around.”  I hopped out the truck and sprinted for the crowd of people growing near a particular door. Some people were screaming and wailing, others just stood there, smoke curls from their cigarettes wafting lazily in the air. I ran through the crowd like a linebacker after the man with the football.  As I entered the house, I saw a young cop, his flashlight on a lifeless form on the couch.  The mother hovered over her child, screaming, “Oh God! Oh God!” I gently moved her out of the way.

“What happened?”

“I don’t know!”  My hands flew over the child. I could feel no pulse, no breathing.  Around his mouth was spit up formula. I picked the child up, giving it a good whack on the back. Just be choking, just be choking…please God, just let him be choking.  I felt my shirt get very warm.  I looked down to see my shirt covered in vomit.  I took my sleeve and wiped off the rest of the vomit around the mouth and I gave two quick breaths.  I cradled the child and began compressions as I went to the door.  My crew and the fire department were just walking into the small room.

“Make a hole!” I screamed. “Get back in the truck, NOW!” I ran past everyone, pushing past bystanders.  “Open that door! Get it open NOW!” I yelled at a firefighter standing by the back doors of my truck. He flung them open with a quickness.  I jumped in as the rest of the crew was climbing in the truck.

“Let’s go! Cat 1, CPR in progress!”

The truck lurched into action.  Jake looked at me from the airway seat.

“What do you want or need?”

“Suction him, get my tube kit, put my leads on, and set me up for a line and IO.”  He looked at me as I continued with compressions. Aimee, another crewmember next to me, took over ventillations.

“Shao.” He said it very gently, “You don’t have that stuff.”

In that moment, I felt the blood drain from my face. I looked down at the lifeless child on the stretcher. I felt helpless. My eyes darted to the tube kit sitting in the cabinet. Each BLS ambulance had a tube kit in it in case the ALS gear set failed. The words of my Medical Command Doc went through my head, something he told me almost two years prior, ‘Only use ALS gear if there is no ALS available or they cannot get to you before you get to the hospital and ALS is needed, like an arrest or something like that. Until you are turned over, I can protect you only under those circumstances.’

I took a deep breath; I needed to calm down, to think. I had never had an arrest as just a basic; I always had a Paramedic with me. ALS can only work with good BLS first. My mouth was moving before I knew what I was saying, “Suction, get an oral in there if you can and continue with compressions.”  I looked into the rear view mirror. Lynn was darting her eyes from the road to the mirror, watching all that was unfolding.

“Find my medic!”

Her hand flew to the radio as I wrapped my hands back around the childs’ chest. My thumbs met in the middle and I began compressions again. Lynns’ voice floated to the back of the rig.

“We’re gonna meet ’em up here! Less than two!”

I played musical chairs in the back of the ambulance. I moved from the bench seat to the stretcher and Jake moved from the airway seat to the bench seat. As the truck slowed, it never seemed to stop as two Medics jumped on and we began moving again.  The two weren’t exactly my two favorite Paramedics in the world, but they had the tools…my tools.  I let Aimee continue with compressions as I unzipped the monitor, rattling off what I knew. I snapped the leads on their cords and they were taken away from me.

“Just do basic stuff, we have everything else.” One of the Medics looked at me and jutted her head to the side. I moved from the stretcher, standing between the wall and the stretcher as she moved over to do the IO.  I felt my hands ball into fists at my side. As tools were called for, I could orchastrate my crew around me to find what was needed, yet not having any hands on was just killing me; how could I say I did all I could do if I couldn’t do what I was trained to do?  I knew everything was being done to the extreme; tube was in and good, lines were in, drugs were being pushed, Aimee was doing her thing with compressions, switching off with Jake, and they were being done well, yet I felt like I had done nothing, like I had let the child down.

As we pulled into the hospital, I was given the dubious honor of bagging while we picked the child up and just ran inside. The other Medic and I couldn’t get a good rhythm moving with one another. He was well over six feet tall and I was reaching up to bag and trying to run sideways at the same time while he was using huge strides to propel himself into the emergency room. As we got through the doors, one of the nurses took over and as I was turning around a woman walked shaklily through the doors. It was his mother.  She looked damn near ready to fall over, so I went to her, holding her up.  Wordlessly, I walked her around the ER, avoiding the room her child was in, taking her to the Quiet Room just off to the side of the waiting room.  As I walked her in, she spoke to me for the first time.

“They only take you in here if they’re dead…like on TV.”

I turned on the small table lamps and gestured to one of the chairs.  When her back was turned, I flipped the switch on the wall that turned a small green light on outside the door.  It showed that there was someone in there.

“I figured you would need to call people, so I didn’t think you wanted to do it out in the general waiting room. You can sit out there if you’d like…if you’d feel more comfortable.”  I didn’t want to tell her that, yes, her child had been asystolic for a twenty-five minute ambulance ride and we weren’t exactly driving just ten over the speed limit, so the chances were slim to none and slim was on vacation, away from this nightmare.

“Can I smoke in here?”

“No…and please, try not to go outside unless you absolutely have to.  If you do, let the nurse at the desk know exactly where you are going. Is there anything I can do for you? Before I leave, I mean.”

The young woman shook her head and I saw a set of Rosary Beads in her hands, “Would you like me to get a Priest…to pray with you?”  She looked at her hands and nodded.  I bowed my head slightly and I turned to walk out the door.

“Hey…”  She called behind me. “Can you throw one out there as well…a prayer? I’m sure He’d listen to you before He’d listen to me.”

I nodded, “We are all the same. I’m sure I don’t get any extra credit just because of this.”

Walking out, I felt the adrenalin fall away from my body as if it finally pitched over a waterfall. I went into the Medic room, sat down at a table, put my head down, and cried for all I was worth.  I was helpless, once again. My body shook with every sob. I was alone and helpless. As I was walking to the Medic room, I saw the curtains drawn, but no activity behind them. A nurse asked for the number for the coroner; the one that was on the list was wrong. I knew it was over.  I felt like it was my fault; because I hadn’t started pushing drugs or getting a definitive airway, or doing anything more than what I did, that my inaction caused the death of that child.  What good was I when I could do nothing more than what amounted to a bandaid?

I heard the door open behind me and I sat up and wiped my eyes and nose with a 4×4.  I fumbled around, acting like I was trying to clean off the stains on my shirt.  A shaky voice called to me.

“S…Shao?”

I turned in the chair. It was Aimee.

“Please tell me he made it.”  I stood up.  She had never worked an arrest before this, I knew that much.  She had a little one at home as well, probably not much older than the one we just worked.  I stood next to her.

“No, he died.”

Her face scrunched up and the tears began to flow.  I pulled her to me, resting my chin on the top of her head.

“Why?!” Came the muffled cry.  I let her bawl it out on my chest for a few more minutes before I spoke to her.

“Listen to me. Here it is medically. Peds are hard.  They compensate for so long, then they just fall off the edge. Who knows what was wrong, medically.  Who knows how long he had been down before mom found him.  We were well behind the eight ball before we even got there.  Non-medically…” I took a deep breath, “because it happens. There’s no logic behind it, it just does. Babies are born, babies die.  It happens.”

She looked at me and I began to feel uncomfortable. “You don’t believe a word you just said, do you?”

“I have my own demons to fight in this one. If nothing else, you did everything you could. Your compressions were great and you didn’t get flustered when the shit hit the fan.”

“I thought you could fix anything, Shao. You’re a Paramedic, right? You were taught how to fix this. Why didn’t you?”

“Aimee…”

“No! You didn’t do what you were supposed to do! What kind of Medic are you, that you can’t save a child?!”

Ouch.

“You did nothing to fix it! You…”

“I can’t fix dead, hon. I can’t.”  I then remembered where she got the idea. Her father had collapsed due to sudden cardiac arrest, but the planets were aligned that day and he survived. In her eyes, Paramedics could fix dead.  It was why she became an EMT. She saw a Paramedic save the day and she wanted to do the same.

“You can, but you didn’t.” She turned on her heels and walked out.  I stood in the silence for a moment.  I thought back to Medic class, when we were going through PALS, how the instructor said, at the end of everything, ‘It’s calls like this that make even the most level headed Medic contemplate going home and eating their own gun. Everyone has a hand in it when it goes right, but when it doesn’t, you will be blamed for something that you had no control over. It’ll be your fault, in their eyes, and yours alone.’

I fired off a quick text to our Cheif, telling him that it was a Peds arrest and that the crew needed to talk it out. He replied he had heard the call and was already waiting. The ride back to the station was a quiet one.  Jake popped his head through the birth canal and touched my shoulder.

“Can I ask you something?”

“Sure.”

“Would…could you have saved the day if you had your stuff?”

I shrugged, “Probably not, but that’s water under the bridge now, hon.”

We were going back out of service. It was a rule. Any bad call bought the crew an hour out of service to breathe, talk, smoke, or to do whatever would made them feel better.  We could get longer if we needed, but no less than that.  As we pulled into the station, on the side of the building was a big, red fire engine and more cars than there were before we left. A horde of people stood by the ambulance bay.  We got out of the truck and the mob decended on us.  Each one of us were pulled a different way, to be able to let whatever we felt out without our partners overhearing.  I kept my head down.  There were fire fighters from my home station; guys who wouldn’t be caught dead in an ambulance station any other day.

“What are you guys doing here?”

Brian, one of the lieutennants, stepped up, “We heard our little sister was having a bad day, so we came to help her.”  They all hugged me, telling me I had done everything that I could, yet hearing it didn’t make me feel any better. It was amazing how deeply Aimee’s words cut into me.  Not being a ‘Real Medic’ had already left its own wounds, but this was even worse.  I nodded and smiled, even laughed, in all the right places, but my heart wasn’t in it.  As the crowd began to thin, we were left with ourselves, our Cheif, and the company CISD person.  Aimee still wouldn’t look at me, doing her best to stay as far away as humanly possible.  I cited ‘womanly issues’ and excused myself inside.  I locked myself in the bathroom and just sat on the floor, letting my mind wander through the call.

When I finally came out, Aimee was packing her things; she was leaving early.

“Aimee. Wait.”

She glared daggers at me and I held up my hands, “Look. Your family got lucky. You don’t realize how lucky, but you did. That was pure luck your dad survived. It doesn’t work like that in this job all the time. If you would go and ask those Medics now, just how many saves they’ve gotten since then, I would put down a hundred dollars on them saying any number less than two.  So far, I’ve had two cardiac arrest saves in almost ten years. Do you know how many I’ve had die on me around that? A lot more than two.  I’m sorry this one didn’t survive, but you can’t blame me for it.”

Wordlessly, she picked up her bags and left.  I stood in the empty room, alone.

*************************

A few months later, I’m washing the ambulance. As I sweep the soapy brush over the windows, I hear a small voice behind me.

“Excuse me, miss?”

I turn around. It was the mother from the arrest.

“Yes, how can I help you?”

“I saw you out here as I was walking past. I just wanted to say thank you, for everything you tried to do.  You guys really are angels. Thank you.”  With that, she turned and walked away.

“Your welcome.” I called after her. She never again looked back.

Comments

  1. Shonda Scott says:

    Thank you!
    I say thank you because I am an EMT-B getting ready to go back to Paramedic school. One of the main reasons behind me getting my paramedic is becuase I don’t like being on a bad call like that and not being able to use the tools nessasary to help my pt. I have been a medic 1yr now and had 1 cardiac arrest that we saved and 1 cardiac arrest that we couldnt save. The code save afterwards I felt awesome like wow this is why I got into this field. And then on the one we lost, I knew we did the best of our ability but I still felt horrible.
    It will take time but Amiee will come around.
    Thank you for being an awesome medic and doing your best every day that you can!!!!!!!

  2. I’m sure you know the difference between God and Paramedics right??? God doesn’t play Paramedic. I think we are here for a reason, and that we have a chance to try to make the difference for the patient, but sometimes the patient can’t be saved, so we can still be the positive difference for the family and bystanders. Sounds like if as much else didn’t feel right, you did right by the mother. Take care, be safe, and don’t do anything different next time.

  3. Sounds like Aimee needs a new career. Everyone gets upset after bad outcome codes, especially pedi codes; but attacking a crew member like that is way out of line.

    I’m sure that you already know (if not feel) that you did everything possible; even the patient’s mother recognized that there was noing more that could have been done. Thank you for sharing this. It helps many of us by reminding us (as I hope others have reminded you), that we’re not alone after something like this.

    Stay safe.

  4. I just read the blog post ‘Okay’ where the medic has a properly mad night gets in and tells his Mrs his night was ‘okay’. I was going to comment on it, but sometimes we have shifts like that. Then I read your post and had to comment. This job is bad news. Most of our calls are ‘routine’ and we get into the rhythm of it. We remind ourselves to stay on top of our game. But its not the same as doing these high demand calls all the time. Your rational and and emotional minds are separate, yet the same. You know what I mean, “do you really believe…?”.

    Everyone who’s been in emergency care on the streets for any amount of time knows this, you and other bloggers share it with those that aren’t.

  5. My monitor here at work must be broken. It kept getting fuzzy when I read this.

    Good job, Shao.

    ~Kev

  6. You really caught my complete attention with this story. Very well written.
    Hard, hard stuff.
    I’m glad your firefighters were there for you.

  7. Dinosaour Medic says:

    I have worked LOTS of adult codes and know that we save very few, as far as kiddos well thats a tough call to take and remaining thick skinned becomes very hard. Sorry that your friend and Co worker was effected in such a manner.. you can only teach so much in EMT school, experiance is the unforgiving instructor.

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