Take care, Henry.

It was hot. Not just hot, but that oppressive kinda hot where your uniform sticks to you. Your hair sticks to you. The heat radiates off the road making the local Taco bell ahead of you look like a mirage. Even doing that simple breathing thing takes a little extra effort.

You know, hot.

I pull into the parking lot of The Closet station and park next to Pseudo Dad's truck. He's got the light bar, the Fire Chief license plate, and the Lifeflight sticker on his back window.

I bet he never gets pulled over.

My car isn't nearly as impressive. No EMS stickers. No light bar. No special license plate. I don't have a FOP sticker. I do have a powder blue Littmann draped over my rear-view mirror. If I don't leave it there after every shift I'll forget it somewhere along the way.

Pseudo Dad and I were always early arrivals when it came to work. Our relief was the same way in the morning, and it’s mutually appreciated. Tonight is no different. We were sitting in the air conditioned station talking about what it's like to work as a Volunteer in EMS versus working for a Private service on a night car.

We talked about doing CPR on an actual human. Something that at that point, I had never done. We talked about what it felt like to actually make a difference in someones life, what it felt like to save someones life, literally. He told me it was a feeling he's only experienced a handful of times in 15 years.

*sigh* If someone would just have the decency to drop in front of me...

I wanted to know that feeling, even if it was just one time. To know that by my being there, someones life was saved.

Bless my sparky little heart.

I didn't know any better at the time. I believed that because I wasn't out there doing the more exciting runs, that I wasn't making an impact on anyone's life. And that's what had initially attracted me to the job. Like I said, I didn't know any better at the time.

Pseudo Dad understood what I was talking about. He reminisced about being new and being excited, and “Just hoping to see… Something... Anything.”

It's 6:55pm. Shift starts at 7.

As I’m about to pick up the phone to clock in at The Closet, it rings, startling me. "Uhm, The Closet," I stammer.

Cool Dispatcher, who is ending his long day in five minutes, laughs. "Forget what station you're at?"

I grab a pen and the pad of paper nearby, "Actually I have it written on my hand. I just forgot which hand. What's up?"

"Is your partner in?"

I look at Pseudo Dad who’s mouthing the words “No” while shaking his head. He's not nearly as sparky as I am, poor guy. I stick my tongue out at him. "He’s here, whatcha got?"

Cool dispatcher is on another phone, confirming the run, it takes him a few seconds to respond, "County Run, Code 3, at the Local Nursing Home."

I scribble down the nursing home name and hand the pad to Pseudo Dad, "We're clear and heading out."

I hang up the phone, grab the portable radio and say goodbye to the day crew. On county runs (911 runs) we have a mandatory "chute time" of two minutes. That means we have two minutes from accepting the run to get our butts out to the truck, contact our dispatch as well as County dispatch, and put ourselves enroute. At The Closet it's not difficult to make it to the truck in two minutes. Just a quick walk down the hallway and out the doors to our waiting truck.

Pseudo Dad, of course jumps behind the wheel. I glare at him and mumble under my breath as I climb into the truck. "I never get to drive." I key up the mic and wait for the beep telling me that I can talk. "Unit X to dispatch, we're en route."

"Clear Unit X, be advised Lifesquad is on the scene."

"We're clear." I put us en route with the County next, while Pseudo Dad turns the lights on and pulls us out of the parking lot.

I check each intersection as we approach them, making sure that our intended path is clear before we proceed through. The drive to the ECF is only four minutes. I can't help but notice had we gone code 2 it would have taken us maybe thirty seconds longer. Even with one of the safest drivers I've ever had the pleasure of riding with, the risk doesn't seem worth thirty seconds.

We arrive at the Alzheimer's Unit of the ECF and unload the cot. Lifesquad is still there, which is unusual. Typically they're gone before we arrive.

One of the TFD Medics meet us at the door and explains the situation as we work our way through the building. "The Patient was eating, aspirated some food and started choking. He has a DNR. His sat is at 68, up from the low 50's. They're suctioning him."

Pseudo Dad looks at the empty cot we're dragging toward the patient's room and exhales. "Damn... Okay, I'm going to run out and get the portable suction and the airway bag. I'll be right back."

I nod and continue to play Follow The Medic. I find myself turned around. Haven't we gone down this hallway twice now? "Do you think they design these Alzheimer units as a maze of hallways on purpose. I'm not sure I can find my way out on my own." I'm not kidding.

No, that wasn't my half-assed attempt at flirting. He was cute though. I love a man with a southern accent.

The red headed Medic laughs, "Hell it took me five years to figure this place out. No worries, we'll getcha out. Have ya'll been busy tonight?"

"No, Sir... We haven't had a busy night in a coon's age." Okay, I didn't say that. "We just came on, actually... We work overnights out of The Closet ER."

"How do you like it so far?"

Holy cow, the TFD Medic is talking to me. "I like it well enough. It's not TFD, but I work with some excellent people."

"Have you thought about TFD? We need more Ladies on, yanno."

Sign me up for the next test. Sign me up now. I respond by blushing and telling him that I'd be sure to get an interest card sent in.

We round one last corner and are instantly greeted by a wall of navy blue. Seven from Toledo Fire. They get to wear shorts to work while I sweat my ass off in BDU pants thick enough to stop bullets. I'm not bitter. Really.

Oh my goodness. Here we go. Where in the hell is Pseudo Dad?

I'm pushed forward by some of the FF's into the patients room. He is BLUE from the knees down. his hands are blue as well, although not as dark. His lips are a sick purple.

Now, I know what cyanosis is. I've studied it, I've seen pictures. I have never seen a blue person before. My three months on the job had been limited to some very uninteresting County runs and a couple of hundred Dialysis transfers. A nurse is working on suctioning the patient while everyone else watches. They have oxygen on him by cannula and a pulse ox that they seem to be especially interested in. You don't need a pulse oximeter to tell you the guy looks like shit.

Pseudo Dad enters the room seconds behind me. I turn to him instantly. "YOUR Patient," I blurt out. I'm immediately ashamed of myself. I stick my shaky hands into my pockets in a pathetic attempt to hide my nervousness.

Pseudo Dad being Pseudo Dad shakes his head. He whispers in my ear, "You wanted to make a difference? Here ya go. You'll do fine."

Another nurse shows up with the signed DNR, thrusting it at my chest. "Suctioning and O2 only," She stresses. "The family wants him to go to Inner City Hospital." Since The Closet was closed to EMS when we left, Inner City Hospital would be an appropriate alternative. I shove the DNR paperwork and the patients file under the head of the cot.

"He's as clear as I can get him," the nurse sighs. She backs away from the patient so we can move him.

With some assistance from TFD we move our patient from his chair over to the cot and begin to wheel him out. His name is Henry, according to his paperwork. The same as my Grandfather.

The suctioning nurse stops me at the door. "Honey, if he dies on the way to the hospital, it's okay." She pats me on the back.

Well, thanks so much. I'll keep that in mind.

Red-Headed Medic escorts us out. I walk at the head end of the cot.

"Henry, my name is Epi. We're going to take you to Inner City Hospital. Your family will meet us there, I'm going to take good care of you." I don't know if he can hear me, but I talk anyway. If he can hear me maybe I'm calming him, if he can't, at least I'm calming myself. He still looks like crap, eyes closed, and not talking. I have him on a NRB on 15L. He's breathing is shallow, but at least he's moving some air.

We reach the truck and load Henry in. I climb in next to him. I catch Pseudo Dad's eye as he's about to close the doors and shake my head.

"You know what you're doing, Epi." He closes the doors and leaves. Now it's just me and Henry.

I realize he's a terminal patient. I realize he has a DNR. It just didn't seem right to me that he should die from choking on dinner. "Just keep breathing, Henry, Please."

Pseudo Dad yells from the front of the truck, "You ready, Grasshopper?"

“Drive fast,” I yell. I push feeling of hopelessness and panic out of my head and flip the switch on the trucks onboard suction unit. It roars to life and I use the suction for all it’s worth. I’m getting all kinds of nastiness out. I suction for another ten seconds and put the O2 back on him and check his pulse.

60-ish. It wasn't regular, it wasn't particularly strong, but it was there, I could feel it. I held his hand. "Henry, if you can hear me, I'd be really grateful if you could try coughing."

Nothing. I leave him on the oxygen for another minute and remove it to try to suction him again. I'm rewarded with more food. I slip a little with the suction tip and get my second reward of the day. Henry coughs. I pull it out and give Henry a chance to clear his own airway.

"How's he doing?" Pseudo Dad yells. I throw the oxygen back on him. He's coughing weakly.

"He's coughing," I yell. "I'll take a patch."

Pseudo Dad gets the receiving hospital online and hands me the mic. I give what can only be described as the worst radio report ever. PD would later tell me all he heard was "Six minutes out... DNR... Suctioning... Non-verbal..." and something about blue feet before I tossed the mic back up at him. The patient would have given a better report.

I decided to try to suction him one more time as it sounded like Henry wasn't going to be able to clear what he was coughing up. One more time, I was rewarded with a hunk of what I can only assume was once roast beef. Almost instantly he started pinking up.

I stroked the back of his hand and took his pulse again. 80-ish, still irregular. He was breathing at a rate of 20 or so. He still wouldn't open his eyes. We were pulling into the hospital when I allowed myself to exhale. I checked the pulse ox that I had all but forgotten about. He was at 86. Still hypoxic, but a hell of a lot better than when we climbed into the back of the truck.

I handed him over to the ER/ED/EC Nurse and gave my verbal report before retreating to the quiet EMS room. I tried to fill out my paperwork but couldn't do much other than shake. So much for the adrenaline junky I thought I was. On one hand I was happy that he was doing better. On the other hand I had to wonder what kind of life I had just prolonged. A Diet Pepsi can appeared next to my shaky hand.

Pseudo Dad put a hand on my shoulder and squeezed. "You did good, Kiddo. You handled yourself well."

"Shush. I think maybe I suck at this."

"Henry's daughter wants to talk to you."

She was standing outside of the EMS room wiping tears from her eyes. She thanked me repeatedly and hugged me. Her father was completely alert and speaking.

"What? Really?"

She nodded and I followed her back to his room where I saw the most beautiful green eyes I had ever laid eyes on.

I couldn't do much other than smile. "Henry, you scared the heck out of me. How are you feeling?" I was choking on my words. I could feel tears forming, I just wanted to get out of that room before my eyes betrayed me.

"Thank you, Young Lady. Thank you." His voice was raspy. He outstretched his hand and I grabbed it. He pulled me into a long hug.

"You're welcome," I whispered. "You take care, Henry."

As we were leaving the ER and heading toward the truck I heard someone yell to us.

"Hey, Little Private Service! How'd our guy turn out?" It was the red-head medic.

Pseudo Dad yelled back, "She saved his life. She's a rockstar!"

"Right on!" He winked at me.

I just smiled and climbed into the truck.

10 comments:

Medix311 said...

Way to go! You really made a difference! Way to be an allstar!

Epijunky said...

That was quite awhile ago, and I still don't know how I feel about it to be completely honest, but thank you. :)

northflrn said...

Coming from a nurse let me say this. You did everything you were allowed to do within the DNR, and it made a difference. Be proud of a job well done. As someone one who has had it go both ways, I think that the outcome you had was great. For you and for him.

Keep it up Epi and never lose sight of your dream. You might not be able to get to it right now, but you can still use it as a inspiration.

You keep writing and I will keep reading

MDC708 said...

I have to agree - that's a rock star call!

Living proof that BLS is what saves lives.

Greybeard said...

Enjoyed that.
Thanks.

Anonymous said...

What an inspirational post....it's just what this student nurse needed to read today...that we do make a difference.

Thank you for that.

Laura said...

Excellent post, Epi! Sounds like that was a memorable day! And you expressed it VERY well.

(But I wanna know how things turned out with the red-headed medic...)

:o) Laura

Epijunky said...

Thanks everyone for the kind comments... It was one of those runs that I'll never forget. It was just three months after I got my basic card.

Oh, and Laura, I do have a picture of the red head :)

John said...
This comment has been removed by a blog administrator.
cj said...

What an amazing story. Thanks for sharing it.

I've wandered over from Greybeard's blog and am glad I did.

Thank you for the work you do.

cjh