Some Stories Can't Be Told

Some stories cant be told right away. They need time to ferment and to brew. As time goes on terrible things that I experience become a part of me. The grotesque images do not go away they always seem to lurk in the shadows of consciousness. They become like a dependable friend, always there when you need them.
This story is from almost a year ago but the memories are as crisp as if it happened today.
I spent the day in a pediatric advanced life support class. We spent eight hours practicing the seldom used interventions that would be needed in the case of a critically ill infant. After class I went to work. The shift started as most do, checking of equipment, a laugh in the dirty garage, the smoke from a casual cigarette twisted upward in the waning light. My partner and I turned up our collars against the cold fall night, snow was in the air. After a few routine calls we dug in on the couches at the base. It was Saturday night and there was no supervisor on duty so we could turn off the lights and try to doze between runs.
A few minutes after two am the alert tones went off and a harried sounding dispatcher put out a call for a baby who was unconscious. My partner and I rolled off the recliners and loaded into the ambulance. The snow was falling in earnest now. The red strobe lights reflected on the individual flakes making a fireworks display in front of the bus. My partner and I joked that the baby was probably sleeping but the tension was already in the air. Children tend to remain stable much longer than adults, there bodies are much better at adapting, but when there bad they are really bad. The other crew that was on duty was alerted too, just as a precaution.
Both ambulances glided up to the front of the housing project at the same time. I was first out and made my way up the steps. Hurried only slightly by the screams for help emanating from the open door. Once this business has become a part of you, you do not rush for anything. Walking into the small apartment the signs of poverty surrounded me. The single room was lit by a bare bulb dangling from the ceiling. I made my way over piles of dirty diapers and empty beer cans to a shit stained mattress were a young woman groveled. I fully expected to find a teenage mother overreacting about a deep sleeping baby. I could not have been more wrong. She cowered over a gray bundle, screaming unintelligibly. I jostled her out of the way and picked it up. It was like picking up a plastic doll. It was a baby boy, naked. His skin was grey, his arms and legs were stiff and he was cold to the touch. Something was obviously wrong but it wasn't until I took a good look at his open eyes that I realized that the three month old baby was dead. Once you have been around the dead and the nearly dead for a time you begin to be able to tell just by looking at a patient whether or not there is anything left to save. Looking into this baby's glassy black eyes I was immediately convinced that there was no chance. That thing, that some call the spirit, which animates us and makes us all unique was long gone from the young body.
At that moment training kicked in and we worked in a mechanical non-thinking way. I see the rest of the call as if I was watching from a distance. The necessity of immediate and decisive action does not leave room for emotion. The mothers moans were drowned out by my own heart beating in my ears as I rushed to the truck. We didn't do anything on scene. I sat in the middle compressing the baby's cold chest while the ambulance skidded toward the hospital. My hands encircled his entire stiff body. To my left one medic attempted to open his mouth to intubate but rigor mortis had set in and his jaw was clenched shut. To my right the third medic drove a large needle deep into the thick leg bone and began to force medication in. No matter what we did the line across the screen of the cardiac monitor staid as flat as if it wasn't connected to anything at all. It took only a few minutes to get to the hospital but it felt like seconds. We didnt say much other than a confirmation of agreement that we were just going through the motions.
As we weeled the gurney into the crowed emergency room that nurses and doctors could tell by our grim expressions what they were dealing with. After a short explanation and a few more minutes of futile CPR, time was called. The baby had died hours before but officialy he was not dead until the doctor said so. It eases my conscience to know that I didnt have to make that call. I was in another room when they must have told his mother. The bloodcurdling shriek was like no human sound I have ever heard and my hiar is standind on end as I right this months after the fact. I'm glad I didnt have to do that too. We cleaned up and headed back to the station ready for the next call but with heavy hearts. I can't remeber his name.

The News 8/20/08

I watched the news last night. The usual chaos and tragedy unfolded on the screen and I found myself wishing that some of it was mine. I do not care to be on TV but I longed for the rush and the excitement that is only brought on by catastrophe. It was a relatively busy day but it was filled with the frustrating and the mundane. As paramedics we think of ourselves as highly trained medical professionals. Our customers, in general, seem to think that we are a better way to get to the doctor than a taxi because we do not ask for money on the spot. True emergencies occur, but on days like yesterday it seems like it only happens on the news. A paramedic somewhere took care of a young man who accidentally choked to death on his headphone cord. The young woman who crashed her car on the highway was rushed to the hospital by people who do my job somewhere else. I gave the guy with chronic back pain, who ran out of vicodin, a ride to the hospital.
Someone who does not work in the emergency medical service might say that a day without tragedy is a good day. I go to work hoping for two things. The first is to take care of patients who really need an ambulance and the second is to experience the rush, challenge, and intensity of a true emergency. In this business these desires are inextricably intertwined with tragedy, death, and chaos. I am like a soldier who is excited to go to war. Are we born with this infatuation with the suffering of others or is created by the environment in which we work? This question deserves consideration, for the sake of a paramedics humanity.

The diaries of a street medic 8/18/08

The shift crept along at the pace of a mountains moving. My partner and I spent the the first twelve hours lounging at the base, watching the endless babble on television, and hitting golf balls into the wind. At first the silence on the radio felt like a blessing, a welcome change from the usual chaos of our busy urban EMS system, but by the time the dark evening rolled around we paced through the small station like animals looking for an escape. A moment like this is one of the worst in an EMS station. When you haven't been busy during the day an ominous feeling of foreboding creeps in at the edges of rationality. "If nothing has happened all day then something insane is bound to happen". We wish for tragedy if only to brake the boredom and get the stagnant blood pumping throughout our thrill seeking bodies.
At night the streets seem to pulse with their own vitality. When most people go to bed the city comes alive in its own absurdity. The street light illuminates a small oasis in the unknown inkiness,. The blackness is broken by the flick flick of the strobes as the ambulance cruises silently through the heavy night. There is no traffic on the street so the siren stays off. People sit on their porches quietly watching at we throttle through the lingering August humidity Its just the rush my partner and I have been looking for it rushes through my veins like a drug. Dispatch crackled on the radio saying that she was unconscious and she might have overdosed. We arrived and found her slumped over on the shit stained toilet snoring loudly. Her boyfriend said she might have been trying to kill herself. For the first time all day blood flowed and we lived. Suddenly, it all came to a crashing halt with the soft innocent sigh of a sleeping child wrapped in a blanket curled in a corner of the dirty bed.