I am driving south on a major highway. An interstate, in fact.
There are smells leaking in to the confines of the vehicle I drive. They are smells like any other.
It all comes down to context.
There is a smell I call "vaporized rubber." Its the smell of locked wheels sliding across tar pavement. Some of that black tire material becomes a vapor and gets into my nose. I have smelled the remnants of this as I pull up and survey the scene of someone's bad decisions
"Diesel urgency" is a smell that exists in many areas. Chemically, it's the smell of insufficiently burned diesel fuel. This can happen when a diesel engine is accelerating excessively (Go faster! She's fading fast!)or when one is desperately trying do decelerate(Oh Crap! Oh Crap! Oh Crap! *BANG*). It is also the smell equated with spilt diesel fuel hitting a hot surface (Get 'em out now!!).
This, too, is a smell I equate with highway calamity.
I, however, am not driving an ambulance tonight. I'm merely driving home from work. These smells leach into my nose and brain via the ventilation system of my car.
Around me, the day to day catastrophe of an interstate occurs. I am just another commuter.
The smells remind me.
I'm dead asleep and it's the address coming over the dispatch radio that wakes me before the bell rings. Somehow I'm attuned to the addresses and street names in my home town.
"One not breathing" is an ominous call for early in the morning.
During our run to the scene, dispatch updates us that CPR is in progress. I've got 2 trainees, Babygirl and Fireplug. They wear stern faces and follow my instructions with immediacy and exactitude. Babygirl is about to go into the military and Fireplug has been active duty army for about 12 years.
We roll into the house to see the daughter doing chest compressions on her father in a hospital bed in the living room. Grizzly is my partner on this one and, in his 30 years at the firehouse, he's seen enough of this. We work without speaking. No pulse, no breathing, nothing.
We grab the top and bottom of the sheet and move the patient to the floor. Stiff.
"Cot and backboard, into the house." I say. Without looking, I know that Babygirl and Fireplug are on it.
Grizzly gets the monitor ready as I try to secure the airway. I can't even open the jaw to get a oral airway in. The chest is crunched in from the CPR and the stomach is distended. We slap the pads on his chest as the Medic unit arrives.
"When did you last see your dad?" I ask the daughter.
"Last night, when I gave him his morphine."
We logroll her dad and see the dark purple blotches of pooled blood on his back. This is called "dependent lividity." He also moves like a board. I can't unbend his arm to look for a vein, nor can I move his head at all. Rigor Mortis. The Stiffness of Death.
The two other medics bustle in the front door, just ahead of the cot and backboard. I give the lead medic "the eyebrow" and say,
"Lividity and rigor."
The medic hands me the leads for the EKG and plugs my pads into his monitor. We see a flat line (asystole) on all leads.
Dad is cold.
"He's dead, isn't he?" says the daughter. She works for the recreation department and is CPR certified. She's been all business since we walked in the door but this is the first time I've heard a quaver in her voice.
"I'll call it." says the medic.
"I'll talk to her." I tell him.
"You sure?" he asks. He's looking me in the eye. I look him back.
"Yeah, She's a neighbor." He nods and pats my shoulder and calls in for the police and coroner.
She's already on the phone with her sister in California.
"He's dead, isn't he?" She's got her hand over the phone receiver.
"Yes he is. He seems to have been for a while." I look right at her. I will not shy away from this. Her eyes now start to fill up.
"Here, tell my sister, will you?" She hands me the phone and sobs.
"Hello? This is "maddog", I'm with the Fire department."
"Is my father dead?" says a scared voice from 2800 miles away.
"Yes he is. He died last night, it seems. I'm sorry." This is the point where it hits me. I was expecting this but it always hits hard. My face is getting hot and I feel the welling of tears in my eyes. "Your father is dead."
"Thank you so much for being there. Thank you so much for what you do" She says. That's the hammer-blow. My cheeks are now wet. "May I speak to my sister now?"
"Sure." I croak as I hand the phone back. The daughter sees my tears as she takes the phone. I will not shy away from this. This is what I do. She mourns with her sister on the phone.
As we put away our gear and my eyes dry up I see the leering face of the full moon as it dips behind the trees to the West. It looks like the skull of death to me this night. I can imagine it nodding at me as if I've done my job and been in the place I'm meant to be for this one life.
This is what I do.
Posted by --maddog at 05:38
I'm now a Sergeant at my volunteer Firehouse and, this particular duty night, I'm in charge.
1900, Assign housework, apparatus checks and get dinner ordered. We eat, run some training and then get ready for a long night.
You see, the moon is full and the night is one of the warmer ones as spring starts to seep its way into our area. I'm ready for stabbings, shootings, fights, drunken silliness and more.
First call: car vs. car at an intersection. I have the most cooperative and mellow patient in the world. She's in the driver's seat and got t-boned (side impact) she's got no complaints other than a painful hand and head. The arriving crew before us has already put a collar on her and we arrive in time to extricate her.
Both cars are sitting where they stopped and I have to crawl over the hood of one car to get into the passenger door of the one my patient is in. The plan is to pull her out, feet first, from the driver's side door onto a long backboard. My job is to guide her head and shoulders down into the passenger seat and to keep her head in line with the rest of her spine. It's not as elegant as it would seem. Cars these days are built in a way that they seem to wrap around a person and make it difficult to just turn them 90 degrees and lay them down. I have to negotiate the parking brake, gearshift, armrest/console and the bucket seats. All the while we're bouncing this girl around a bit. She's not complaining, wincing, or crying at all.
This is not normal.
We get her onto the backboard, into the ambulance and YoungJim and I work her up. Rapid trauma assessment reveals no obvious injuries or pain other than her left hand. Ok. I ask her if she hurts anywhere other than her hand (NO) and if she feels different or funny.
"I can't feel anything." She says calmly.
UH OH! I'm thinking she can't FEEL anything!!! Quickly, I check that she has motor, sensory and a pulse in each of her legs and hands. I pinch the top of each foot, "Wiggle the toes of this foot."
"Ow! Ok." she says.
Same with the other foot and both hands. Good. Apparently she meant that she didn't feel ANYTHING as in she wasn't hurting anywhere. YoungJim and I take the tension down a few notches and calm down.
Grandma's going to ride with us.
"Do you mind if I take your grandma for a drive?" I ask the patient.
"Please do." She replies. "She needs to get out more." I install Grandma in the front passenger seat and drive easy and smooth to the hospital.
Posted by --maddog at 05:23