Bear with me this is a bit long
……1, 2 , 3 , 4 , 5…This poor girl. 6, 7, 8, 9, 10…Her poor mother. More compressions and 2 breaths. I look at my crew that I’m on. Why the hell did they put me in charge of EMS today. More compressions and 2 breaths. Shit I can see the marks from where the chain was on her neck. More compressions and 2 breaths. She really is a beautiful girl. If I ever have children I want to have a girl this beautiful.
More compressions 2 breaths. I love her freckles. She has a lot for a 5 year old. More compressions 2 breaths. How did this happen? How the fuck did she do this. More compressions 2 breaths. I hear something louder than the screaming from the mom. It’s silence. The silence is what is really deafening, It’s louder than any scream. WE are silent WE know. More compressions and 2 breaths. ALS finally arrives. They know I just graduated medic class and am going to start precepting soon.
They let me continue to run the code but I run it as an ALS call now. The they support me when I need it. We did everything right per protocol and then some employing every piece of shared knowledge. She still didn’t make it. She is to this day the only patient whose name I remember without difficulty.
It was an innocent enough call. An accident. Her mom was washing dishes and watching her 2 girls play outside. Jessica had slipped the dog’s choker collar off and put it around her own neck. She wanted to play pretend. Mom answered the phone right as she went down the slide on her play set. The chain hung on the knotted wood.
Fast forward. Welfare check turns into smoke alarm. My crew pairs up with another and we force entry. I’m on rescue. There’s a heaviness to the air like fog. It’s smoke from several burnt out candles. We find a body while the attack team tries to locate a source. We try to remove the woman and get her to safety. She’s so limp and heavy. Our damn grip keeps slipping.
I remove my gloves as does the firefighter across from me and we bear hug her and lace our fingers for a better grip. Out the door we go. No pulse. I try CPR but I keep sliding across her chest. The other firefighter asks to take a turn but then we both realize what’s wrong. We realize the same time everyone else does. Her skin is sloughing off. Not from burns but from death. She had died in her sleep and the candles just finally got low enough and “smokey” enough to set off the alarm and let everyone else know. There is still skin hanging off of us and our gear.
More memories. The numerous car accidents with mangled bodies. The guy that went head first from his motorcycle into a Volvo. I still can’t believe I found him. He was in a ditch with muddy water and rotting leaves. He has no idea how lucky he was. Only his nose and mouth were above the water line.
A STEMI, a 27 year old male when I just turned 27. He was only worried about his mum. He died.
The mother with obvious internal bleeding pleading for me to save her children and grandmother (who thankfully happened to be fine) while I listen to Life Evac debate if she will make it the 5 extra minutes to another Level 1 Trauma Center because the closest one just got shut out due to a change in movement from a random thunderstorm.
The silence of acceptance as I watched an elderly woman greet death during a critical care run for a dissecting AAA. I held her hand.
Another Critical Care run for a father of 4. He had so many issues. The doc looked at me and asked if I could do Pericardiocentesis because he didn’t know how. That was one of the longest 20 minute rides I ever made. The sending hospital refused to take him back or provide extra help when he couldn’t tolerate the vent 5 minutes in and had burned through all his sedation and paralytics. I breathed for him the entire way. I got a pat on the back from the Trauma Center but it didn’t feel right. Never did find out how he did.
Oh and let’s not forget the time when half the engine and wagon crew I was with fell through the floor to the basement that was fully involved. That one was a mixed bag. Fear and then relief when we realized they were OK. They landed on a pool table instead of the concrete floor. I retrieved an attic ladder fast as I could and used the webbing I kept in my bunker pocket to help everyone out of the massive hole. The chief who had also gone through the floor shared in the pride and relief from the crew and congratulated me for the fast thinking but I still remember the silence afterwards when we all realized everything is OK but it could have been worse. The rest of that fire was fought defensively.
I took a moment of silence for each one of those events. My way of acknowledging they happened. Then I neatly set them aside and carried on. At least I thought I did until this past month. I like to call my self the extroverted introvert. I can go out have fun and if in the right group I can actually feel energized from it. Otherwise I’m like every other introvert in the world and prefer my alone time with a favorite activity to recharge.
I hadn’t got much of that time lately due to keeping my family together because they needed me as usual. I had a day off. It was mine. I just so happened to be shopping by myself for ingredients to make my favorite pumpkin pie. OH fuck! Not now! Not again! What are the chances. I can stop this. I start to run but something has changed and I stop. She leaves with her mother. WTF just happened? I just saw a girl like Jessica.
She had wrapped a chain from the pen on the counter around her neck. I was going to stop it this time so she would be safe. But it wasn’t a gorgeous 5 year old with a ton of freckles and marks on her neck from a chain. It was a random girl playing while her mom was talking to customer service.
I surprised myself with my reaction. I’m lucky. I have been in EMS 15 years now. I started in a small local fire department and now am in a high call volume city. I even worked in a couple ED’s to get experience and picked up quite a bit. I have loved almost every minute of it. I really mean that too. Even the not so good minutes. It sounds so cliche but it does make the good minutes that much better. I never thought I was immune. I knew I had seen some of the best and worst moments of humanity. I knew that some of these moments would bother me on several levels. I knew they may even come back to haunt me. I was aware of the risks. I knew like every other provider or first responder out there each call could be the last. It could be from an injury, an illness, or even death depending on the circumstances. I was aware.
I felt like and still feel like I had not entered this field with ignorance or naivety. I set up my work and home to stay separate. Took mini-vacations to blow off steam. Kept healthy habits. But it still happened and I still got blindsided. I’m Lucky. I’m lucky because I managed to have some self awareness and felt comfortable enough to say something before it got too bad. I have an awesome chief who listened when I shared what had happened in the store. He filled me in and told me what to expect for the next couple weeks. I told my partner what was going on so he would not be blindsided if I was short tempered or “off” for the next week.
I still believe you are only as good as your team. I waited for Jessica to come back and visit. She did. So did the others. I wasn’t ready for them but not too surprised either. Then the worst one came back. It did catch me by surprise. It is the one I buried. Buried so deep I thought I would never have to face it again. Panic. Absolute Panic. I have never panicked in my life. Is this what its supposed to feel like? The world is going to end if I can’t wake up. I can’t breathe. There is a hand moving over my face. I can’t think straight. Another hand. It’s moving over my body and my legs. I feel so heavy. I can’t move. I can’t scream. I’m out.
I wake up several hours later. There is snow outside. The snow is still falling. It’s beautiful but I can’t enjoy it. I feel hungover and gross. I woke up in the oncall room where it was dark and quiet. I remember having a migraine and asked to go home a couple hours early because there were no scheduled calls left. Somebody offered me a BC powder. I took it and laid down for a bit too take the edge off before I drove. Was it a dream? Why are my pants falling off did I toss and turn while I slept? Why did I sleep here again? Then it comes in a flood. Everything is wrong. I was headed home.
I wasn’t going to leave until the Aspirin kicked in but now I don’t think it was Aspirin. My belt is 2 holes away from where I normally fasten it. I remember a hand caressing my face then heard several voices. The hand quickly moved to cover my mouth and I could not breathe. I know who’s hand that was. I also recall a face. I trusted that person because of their position. They were my supervisor. How, Why? I almost destroyed my self over that incident.
I never told anyone about it until now. I never told anyone I had a plan and almost carried it out. At the last minute a thought came to me like a sliver of light in a dark black room. Why am I letting the other person win. Why am I letting someone shape me, who I am, or what I do. I should control that. I set all those memories aside, pulled myself together and never looked back. I refused to be a product of my environment. I didn’t let it happen before why should I now. At least that’s what I thought when that incident had occurred but now it too was back for a visit.
I’m lucky. I spoke with my chief again. He listened and guided me towards the right steps without pushing or making me feel pushed. I’m lucky. I have an awesome partner who also listened and did not push. He is great and was a sounding board when I needed to rationalize out loud and gave me sound advice (ie practice what I preach). I’m lucky. I have a best friend who listened and didn’t push. She also gave me hope and made me feel like I could share or do whatever whenever. I’m lucky. I have wonderful caring and understanding husband who’s also been in this field a long time and knows what we see and do. In fact he let his medic certification lapse long before we met because of it. He has listened and been very supportive.
I’m doing better this week but the thoughts and anxiety still creep in when I least expect it. I swear before this month I had never been anxious. I have never felt such fear. Not even my fear of heights compared to this. I could control that other fear but this this is new. I haven’t slept more than 4-5 hours but it is better than 1 or 2 I was getting. I’ve lost 15 pounds in 2 weeks because I can’t handle the idea of food. It’s going to take awhile to get back on track and I’m OK with that. I’m OK because I’m lucky. I’m lucky because I had friends when I needed them.
Advise for all, be a friend who listens. Maybe you can help someone when they need it or maybe it will come back to you when you need it. I took a much needed mini-vacation recently. I spent time at the ocean which always centers me. I got to kayak, play with the dogs, and just spend uninterrupted time with my husband. I also got to save a shark. It was awesome returning it to the ocean. I had 2 realizations while I was there. The shark was only 2 foot but handling that shark was exhilarating. It still had teeth though and could have turned on me at any moment just like my memories but I wouldn’t trade that experience for the world. I also found some sea glass while combing the beach. It is very much a product of its environment and it takes a hell of a beating before it becomes a frosted gem. I’m made of glass. Maybe I can take that same beating and let it turn me into a something awesome. I’m Lucky…
– Story written by Christa Rector, paramedic with Richmond Ambulance Authority. 15 years in EMS.