Quiet

The quiet after accidents is what often strikes me the most. It seems that a very chaotic scene should be really loud, but they always seem very quiet to me. We were alerted for a pedestrian struck on Route 1, in front of a bar. This section of route 1 has a bar on each side and people often run between them. They sometimes get hit. I went to the station and took the ambulance out by myself since no one else showed up. I could see the woman in the middle of the road as I approached. She was lying face up, like she just decided to lay down and take a nap. I pulled past her and parked the ambulance across the lane, to protect me from oncoming traffic, got out and walked back to the body. A small crowd had gathered, but I didn’t hear anything. The world was narrowed to just me and this lady. A man approached. “I am an EMT and she is dead. She was thrown at least 100 feet. I saw the whole thing.” “Ok” I knelt down beside this woman and felt for a pulse. There was none. She looked perfectly normal except for her grey color. There wasn’t any obvious deformity, but as I did a quick initial assessment I could feel that her skull was crushed through her long blond hair. She was a bag of goo. It felt like her body had no internal support left. I wanted to work her. She was so young, maybe 20, and beautiful. But I knew she was dead. “EMS lieutenant 73 dispatch. Priority 4” It was hard to pronounce her. Priority 4 is a designator that technically means no patient, but in my region it means the patient is dead prior to EMS arrival. There was nothing I or anyone else could do for this young woman. I knelt in the middle of route 1 with this dead young woman, and the world around me was silent. It was just the two of us, even though a group was gathered. “What is that lady doing out driving at 2 am anyway?” one of them said about the woman driving the car. Really? You are blaming the driver who struck this woman, who was out running between bars My patient now became the driver of the vehicle, and my concern became the crowd. I really don’t remember the driver much. I know she was upset, but she didn’t do anything wrong. Law enforcement arrived and helped secure the scene. I put a sheet over the body. The forensic investigator arrived. I didn’t have to, but I stuck around to assist with the forensic investigation. I felt I needed to for some reason. I had some kind of connection to this person I had only met in death. Maybe because I was the one to decide she was dead. Six years later, I met her husband. He had no idea I was on that call. He had no idea I was in EMS. As he described the scene, I knew instantly who he was talking about, and 6 years later he still blames himself for his wife’s death.

Naked Guy in Trailer Bathroom

Marty and I left the station for a person fallen call. Marty is a truck driver and EMT. He is an avid hunter and is always laughing and joking. He is a solid guy and I enjoy running with him. The call was to an age restricted community of double wide mobile homes. We were met by a concerned neighbor at the end of the driveway. “He is in the back bathroom. I think he is dead. He has been there a few days.” The neighbor tells us. Marty and I prepared ourselves for what we were about to see and smell. A body in a hot trailer decomposes rapidly. We cautiously entered the trailer, and saw a shotgun on the sofa of the living room. I didn’t smell the distinct odor of a decomposing body. We called out with no response, and slowly walked through the kitchen to the back hallway. The trailer was dark. There weren’t any lights on except for the light coming from the back bathroom. I could see a hand sticking out of the doorway. An elderly man laid on the floor of the bathroom next to a tipped over potty chair, and motorized wheelchair. He was covered in urine and feces and it looked like he was there for a while. He was large, tall, bald and naked, and he was an amputee with his left leg removed above the knee. His skin looked normal, not grey or purple like I expected. “Sir, can you hear me”? I shouted, afraid to get close to the mess on him and the floor. His eyes opened. “Help me!” he grunted. We were shocked. We expected this man to be dead. “Sir, what happened?” I asked as I squatted next to him to feel a pulse and start my assessment. He answered in unintelligible words. Marty started to get a bp as I checked pupils. “Can you tell me where you hurt?” “Help me” “We are trying but you need to tell me what is going on.” “What happened? Where do you hurt?” “My leg! my leg! Marty got a normal blood pressure and moved on to check a blood sugar. I went through a list of possibilities of what was wrong with this patient in my mind as I tried again to ask what happened. “My leg!” The blood sugar was normal. Bp normal. Rules out two likely reasons for this guy to be rolling around in his own feces. I stepped into the tiny bathroom to continue my assessment. The floor was slick with shit, and both Marty and I almost wiped out. “Go get a bunch of sheets we can lay down on the floor to give us some traction.” I couldn’t figure out what was wrong with this patient. He really wasn’t able to communicate, or follow commands, so I couldn’t rule out stroke. He had a good airway he was able to support, was breathing adequate and his pulse was strong and regular. I didn’t see any obvious life threats, but he did have an altered mental status. It didn’t look like anything was going to kill him in the next few minutes but we needed to start moving to the hospital now. Tracy arrived just as we were finishing our assessment. There wasn’t any room to work in the bathroom so we decided to slide the patient out into the hallway. There wasn’t anywhere to grab the patient; he was as slippery as the floor. Marty and I both got one hand under each arm and inched him out through the door and tried not to have our feet slide out from beneath us. Neither of us wanted to end up on this floor. He screamed with each move, but we really didn’t have any choice. Our physical exam didn’t reveal any injury, he couldn’t tell us what was causing his pain and we needed to get going. We placed a backboard next to the patient and rolled him onto it, mostly to get the patient from the floor to the stretcher. We wiped him off as much as we could. It was good his neighbor stopped by, but we weren’t sure why he described his neighbor as “dead by a few days” when we arrived. This patient was very much alive and was home the next day. Marty and I joked about with friends like that who needs enemies? But the truth was that man owed his life to a concerned neighbor. His potty chair tipped over when he was transferring to his motorized chair after using the bathroom. He fell to the floor and tried to pull himself back up into his chair. No one could hear his cries for help. He was there in his feces for two days before a neighbor came by to check on him. He was exhausted and dehydrated by the time we found him. We need to look out for each other. If his neighbor didn’t stop by to check on him, he probably would have died.