I am one very tired TransportMonkey. It’s been… well, it’s been a week.

 

Some very good calls, and one that left me with a horrible feeling afterwards. And several transfers that really had no business being sent up to the City Medical Center. All in all, not a bad week, really. Even with that one call hitting home in a bad way.

 

One thing I’m finding out about working in this rural area… For the most part, the 911 calls are usually legitimate calls. I’ve seen more people actually drive themselves to the ED for minor things than have called us to take them to the ED. I have run one call that would usually be considered BS. Compared to when I pulled medic internship in NM I could run a twelve hour shift with 8 or 9 calls and they’d all be BS.

 

Our transfers on the other hand… If Rural County Hospital even think it might be a patient they can’t handle, they will transfer them out. Some high acuity, legitimate transfers get flown out on either fixed or rotors. But they will usually turf some calls to us that leave us scratching out heads. For example, these are some of the type of calls I’ve seen, personally, come out of that hospital:

Finger that needs sutures

Chest pain, non-cardiac in origin

Pt needing a lapcholy

Any cardiac chest pain.

Abcessed tooth.

 

In fact one of the medics I ran with joked that the criteria for transferring chest pain patients to Big City Medical Center is… Chest pain. They have yet to keep a single CP patient in the last 9 months.

 

One of our transfers runs an average of 3 hours of time from start to finish. That is if we run into no delays picking up or dropping off the patient, run into bad weather, or stop to eat while we’re there. When you wind up doing three of them back to back with patients that a Lvl4 trauma center should be able to handle, it gets old quick. Especially when the patient gets back to Small Town before my bus does cause the ED in Big City discharges them right away.

 

Add onto this that my department now thinks I’m a gigantic black cloud. In the last two weeks I’ve seen… 5 dead bodies, plus the two I’m gonna tell you about later. Only one of them was a viable code. That’s more DOAs than the agency has seen in the last two months put together. Between that and the fact that we ran a 5 pt rollover along with 7 other calls last night on the 1800 to 0600 shift (that I wasn’t even on duty, just on call for… although I was on duty for 10 of those 12 hours), it just seems like the call volume has gone up steadily as I’m there.

 

Now… onto the call that made me just question even if I want to do this job forever. Don’t get me wrong, I love my job and couldn’t imagine doing anything else, but when I see things like this I question things.

“Son of a…!” I curse quietly to myself as I shocked myself on the battery terminal on my car. One of the advantages of this job is I can try to get my car fixed once station chores are done and no calls are dispatched for us. And since I have gotten stuck at the station during my oncall shift cause it wouldn’t start, I wanna get it fixed so I can got to my apartment and sleep.

 

“DEEEEEEEEEEEEEEEEEE-BOOOOOOOOOOOOP!” I hear the radio on my belt signal the EMS tones. “All EMS Personnel, please respond to neighboring county, rural route highway, marker 20, for reports of several patients with GSW.”

I quickly sprint from the driveway back into the station to slip on my uniform shirt and grab my stethoscope from where it was hanging by our little closet. My partner passes me as I head out to the rescue we’re taking out there. He hops in the driver seat while I pull out our map book.

 

“Rescue 1, leaving quarters, en route code three to call location,” I say quickly into the radio, letting dispatch know that the station was empty. We flip on our beacons and siren to clear the road so we can get out.

 

“How far out are we?” I ask my partner, since I’m not familiar with the area we’re headed to.

 

“Not too far, about 8 miles out.” He replies as he scans the intersections to his side.

 

I return the favor and scan mine. There are only a few intersections before we’re out onto the rural route and don’t have to worry about cross traffic. “You’re clear on this side. Glad to hear it’s not too far out.”

 

“Rescue 1, Dispatch. New update from deputy on scene. Looks like two codes. LEOs are investigating looking for shooter.” Our radio squawks at us, I pick up the mic and answer in return. “Copy dispatch. Advise of any further updates.”

 

We spend the rest of the time running out to the scene in almost silence, punctuated only by conversation when we need to clear intersections or my partner is telling me what he wants me to haul into the scene. As we get closer we can clearly see the area of the shooting, since there are many emergency lights strobing the air. We turn into the street and just see a deputy shake his head at us.

 

I keep my head on a swivel as we pull onto the scene, trying to take everything in at once. I see what looks like two bodies in a heap beside a vehicle. There appears to be family all around the bodies, and PD is doing next to nothing to control the scene. I think to myself that this is not a good looking scene.

 

I hop out as soon as we stop and reach into the cabinet on the outside of the box behind the cab to get the first in bag. I’ve already gloved up just prior to us getting on scene, so that’s one less thing I need to worry about. I walk over to the patients and just from looking from 10 feet away I can tell this is not going to be a workable situation.

 

I look over the patients as I get close. The male patient is lying on top of our other patient, blood spilling out of his mouth with gray matter in a pattern behind his head. Yep, that’s an injury that definitely is not compatible with life.

 

I turn my attentions to our other patient. She is lying in a pool of blood. I get in quick to check a pulse and feel nothing. When I look for where the injury is, it looks like a grouping of 4 rounds right in the area of the heart. I turn the patient slightly looking for exit wounds and see three. My medic makes the call not to work the patient, and I have to agree, since it looks like the rounds most likely took out the heart and pretty much her entire blood volume is in a puddle under her.

 

We get up without opening our bags, being careful not to contaminate what is now a crime scene more than we have already. When the family sees this they let out that sound. That god-awful sound that I have only heard a time or two in the past. A sound that I could go the rest of my life without hearing again it it would still be the worst sound I’ve ever heard. It’s the sound of realizing that someone they love isn’t going to be getting up off the ground. I’ve heard it most commonly called by other EMS providers as ‘The Wail’. It’s probably the most disturbing sound that you can hear while doing this job.

As we get up the family that is surrounding the scene starts to surge in towards us. They are upset that we aren’t doing anything. They feel like we’re not doing our job. Then I see something that just breaks my heart. The victims two small children (both elementary age) kneel down in front of their parent and just cry. It’s not a sight I don’t think I’ll ever get out of my mind.

 

There are some days that this job really sucks

 

 

So… yea. It’s been one hell of a week. The last two weeks I’ve racked up over 100 hours of time on duty, plus 80 or so of on call hours. And tomorrow I have to head up to the city to turn in my application for medic school that starts in January. I need to find something to do to distract myself from work. That’s the only downside to working in a small town.

 

Ya’ll stay safe out there.

 

 

 

 

  • http://fakingpatience.blogspot.com/ Fakingpatience

    holy cow, you do sound like a black cloud!
    I’ve ran a code w/ the pt’s young kids watching before, and heard their response at the er when the doc called it. It sucks. I have always said that codes or DOAs don’t bother me, it is the family’s grief that we have to hear that gets to me. At least you are writing about it, and not just holding that scene to yourself.
    Good luck with the medic school app!

  • http://www.twitter.com/JonEMTP Jon B

    Nathan,

    Sounds like you’ve been keeping busy. I’m glad you are adapting to the change.

    I find that working as a medic with a 5-minute transport time is much different than working with a 15-20 minute transport time… and even more so when you get to drive an hour.

    It’s also funny when one describes an 8-mile response as “close”.

    Sorry to hear about your call – I know exactly what you mean when you refer to “the wail”. Last I heard it was a 7-year-old in cardiac arrest. That was pretty aweful. I was in the resusitation suite at the ED when they called it – and even though I knew it was coming, I wasn’t really prepared for it.

    Then again, the fact that these calls get to us is a good thing, I guess. It proves we still care and have a heart. I think the medic that can’t hear the anguish is actually hurt more.