Billy Graham once said, "I've never seen the wind; but I've seen the effects of the wind."
In the spring of 1973, I was working out of a remote fire station north of Coalinga, California. I was training under an older captain who'd worked in this desolate place most of his life. We rolled up to a motor vehicle accident on an overcrossing to the brand new stretch of Interstate 5 that had just opened on the west side of the San Joaquin valley. The captain had some first aid training from his Navy days; I had some from my time on the fire department at the college. We didn't need it. It was hard to tell where the damage from the other vehicle stopped and the efforts of the locals pulling the vehicle apart with their four wheel drives and winches started. No matter; there was a young lady with broken bones and a baby with a shattered skull.
"Not much for us to do here, Dan. We just wait for the ambulance to take them into town..." "When the kid's heads feel mushy like that, they don't live too long."
That's how life was back then. No oxygen on the rigs; EMTs were still on the horizon; paramedics were a TV show. Mortuaries ran the ambulances; it was just easier economically.
Another call, from my last shift before I reported to paramedic school not quite two years later: Again on I-5, in an area where the road rises and passes through hills. ...and where vehicles that roll down the ravine between the lanes won't be seen until the morning sun rises enough to glint off some metal. ...or broken glass. Three people this time. One dead; a young lady still alive, but barely breathing; and a young man who was almost conscious, laying in a pool of gasoline.
The next Monday, I started medic school. That afternoon, I saw the young lady again. ...in the ICU. She made it another day or two. I saw the young man when we toured the burn unit. It seems that gasoline had been in close contact with his skin for a long time. I think he made it a week...
...and that's the nature of devastating critical injuries.
As a medic I became much more interactive with patients and their care. My group was the first turned loose in our county. ...and we were on the radio with the docs who trained us. One team...
...and you'd start to notice things. Like how an entire family was wiped out by a drunken driver. ...and how much you sometimes drank after some of those shifts.
...and how sometimes nothing would go right on a call. Like that impossible to get IV line getting kicked loose by someone during a cardiac arrest call...
...or the times when some random set of circumstances kept family or friends from notifying you in time to do any good. ...and all you could say was, "I'm sorry."
Then you learned that sometimes it wasn't such a good thing to attempt a resuscitation, especially when the body you brought back didn't have a person within it anymore. ...and those 'random sets of circumstances' maybe became a blessing.
...and then there was the day the elderly lady across the street from the firehouse collapsed. No pulse, no respirations. ...and you went for it anyway. ...because that's all you could do. You do your job. ...and she makes it to CCU. ...and lasts long enough for her sons and daughters to make it in from out of state. And when they send her home to die and she calls you over and says, "Okay boys, I've seen all my kids; next time, please do nothing..."
...and life goes on and you win some and you lose more. ...and you just deal with it.
...until one of those 'random sets of circumstances' puts a flight nurse on your rig one Saturday morning. You've worked together on the bird and she wants to see what it's like out on the streets.
...and the call comes in for a patient with a "heart attack". It's in an area covered by fire service medics, so normally a Basic Life Support unit with EMTs would roll for transport. But today, the BLS coverage is eating lunch and the boss sends you, "just to let them eat". ...and you roll in to find a patient in frank pulmonary edema, likely secondary to his congestive heart failure. The first-in medics are ready to transport, but they want a line in him first. You may even use their rig as it would cut some time off the call. ...and the lady runs over from around the corner.
"Come quick, he's fallen and can't get up!" ...and it's decision time. You're not essential to the first patient's care. ...and it's okay with the charge medic to go check this guy out. So you grab some gear 'cause you'd rather lug stuff you don't need than need stuff you didn't lug. ...and head over with your nurse and the Fire Captain.
...to find a man in full cardiac arrest.
With Kathy along, you can suspend some rules and work from standing orders. Which is a good thing, as this guy is throwing all sorts of rhythms at you. The Captain is doing CPR as you and the nurse ventilate, defibrillate and medicate. ...and the neighbors gather round. You send one as a runner to get your partner and ambulance and to let the crew on the other call know you're tied up.
After a very interesting resuscitation, you get the patient to the emergency room. ...and you clean up. ...and head back. ...and get some lunch yourself.
...and you think how lucky you are that Kathy was along; things were moving faster than radio orders could have followed. ...and how you're glad Larry sent a medic unit on the call.
Later that afternoon, you do something you never do: you follow-up on a patient. Hey,he's made it to the floor! "May I speak to the nursing station handling Mr. Jones, please?"
"Hello, this is Ed Jones; who did you say you were again?"