Blood, Sweat, and Tears (Part 2 of 2)

… I approached the car from the front, as I was always taught to do.  The intent is to get the patients attention without causing them any surprise that would cause them to jump or turn their head.  Things were already not going like the book says it should; all I could see from the front of the car was a wall of torn metal.  The bumper was about waist high, and the remains of the hood were pushed back over the windshield opening.  Even on my tiptoes, I could not get a glimpse of my patient, so I made my way around to the driver’s-side window.  The intrusion had deformed the car tremendously, but I could see that he was still sitting straight forward, with the steering wheel against his face.  I noticed no signs of life, but realized that the opposite side of the car had not caved in as far and my best access would be from the passenger’s side door.  I tried the handle, but knew by looking at the creases behind the hinge that this door would not be opening any time soon.  My visual assessment through the window was not pretty, but I did see that his eyes were open and moving around in bewilderment, like a newborn examining the world for the first time.  I found a place to perch my supplies and managed to wiggle my ass through the window opening.   Yes, I was a bit more svelte and agile in my younger years.  I introduced myself, and began methodically running through my trauma assessment checklist.  

      

This poor guy was in bad shape.  The impact of the collision left his frail body entombed in plastic and metal.  The four-inch gash on his forehead was spilling blood down his face, and the only extremity he had free was his right arm. Other than a few cuts on his hand, his arm seemed fine.  He alternated between wiping his eyes of the crimson river that kept blinding him, and trying to push the dash and steering wheel from in front of him.  I threw a trauma dressing and “kling” snugly on his head to plug that leak, and helped him wipe his eyes and face.  I was honestly thinking about making him as comfortable as possible…there was little else I could do at the moment.  I engaged him in some small talk to distract him, as well as assess his mental state.  He clearly had no idea where he was, who I was, or what had happened.  I tried my best to explain the answers he sought, while I assessed his situation.  I was looking at the dash, floorboards, steering column and door that had him pinned in to see what we would need to free him, and he was looking at the same things trying to understand what they were.  I remember being able to touch the radiator cap, it was that close to me.  No doubt that directly behind the flooring was the hot engine block pressing tightly against his legs. In the steamy atmosphere, I could smell the coppery taste of his blood, the sweetness of the antifreeze, the stench of burned motor oil.  The five or ten minutes I spent with George in our demolished little “world” seemed like a life-time.  I learned that he was 70 years old, worked on the railroad his entire life, and was only a few weeks from retirement.  

As I was clearing debris to create some wiggle room, he spotted a lunch kettle of the floor and asked me if that was his!  I remember it was a well-worn, dark gray plastic hinged-top Thermos brand lunch pail.  I remember because he asked me to look inside of it.  Not sure what he was after, I obliged his request and gave him a verbal inventory of what was inside.  This is also when I discovered his name was George; it was in red Dymo label on the front of his lunch pail.  Once we determined he had already eaten, he immediately made the connection that he must have been on his way home from work.  “My wife will be worried”, he sadly whispered to me, as a wilting frown fell from his face.  “I have never been late coming home from work in 48 years.”  He didn’t say much more after that, and I was at a loss for words myself.  I kept talking, but I may never know if he kept listening.

I watched as his color drained, and his eyelids grew heavier.  His breathing became shallow and more labored, despite the oxygen I was pumping through the non-rebreather mask.  I heard determined voices surrounding the car, and the familiar clunking of wood cribbing as the rescue squad started stabilizing the car.  Before long, I felt the door behind me shifting from the strength of the Hurst spreaders.  “Hang in there, George; we will have you out of here in no time!”  There was no response…  “George?”  Still nothing ...  Even his right hand that was gripping me a few short minutes ago was limp and listless.  

I remember a simultaneous sense of frustration and relief, as I gave up my position for a medic that had arrived to take over patient care.  By now there were responders everywhere, so I grabbed the opportunity to catch a breath and take in the scene from a wider perspective.  I immediately began my self-critique and mental debriefing.  The adrenaline kept me from crying, at least until I got home later that afternoon.  As I left the car, I told George I would see him later, but I knew that was a lie.  I hope he forgives me…

I Will Always Remember…

It is one of those moments that I will always remember… 

People always talk about these moments because they capture our hearts with such shock and sadness that they burn an indelible snapshot of time into our souls.  The end of World War II, the Kennedy assassination, the Space Shuttle Challenger explosion, the attack on the World Trade Center and Pentagon are a few examples that many people will always remember.  They can tell you where they were, and how they felt, with chilling accuracy, when they heard the news.  We share these moments because they affected all of us, and we can all relate to the emotions expressed by others.  They united us because of their global impact.

Then there are very personal and private moments we each hold quietly in our memories; the death of a family member or pet, the moment of birth of our children, a marriage proposal, getting our driver’s license.  These moments bond us together in a different way.  We each experienced these moments at some point in our lives, but in our own personal space, in our own personal time.  They are similar stories with similar emotions, but vastly different details, locations, and characters.

Then there are the events in between global and private.  The concentric circles of impact reaching levels of notice globally, levels of sadness regionally, and levels of grief and devastation at the personal level.  I am referencing the tragic assassination of Kyle D. Pagerly.  Kyle was gunned down by a cowardly fugitive whose blatant disregard for human life took from our world, an amazing young man.

It is one of those moments that I will always remember… 

I took the phone call from my department chief that evening with no expectation of the news that would buckle my knees and temporarily drain my face of its blood supply.  This was followed by a wave of changing emotions that overlapped so frequently I lost track of my senses.  I was in denial.  I was in shock.  I was angry.  I was sick to my stomach.  That news derailed my understanding of mankind, and I suspect I will be forever changed by Kyle’s sudden passing. 

Though I was 20 years his senior, I watched Kyle live like few others ever dared.  I admired his energy, his up-beat, can-do attitude.  I watched him grow as a determined fire lieutenant, a loving young husband, a proud patriot, a dedicated public servant, and a friend.  He would have been an amazing father to Savannah Kylie, his daughter that he will never get to hold in his arms.  It doesn’t seem fair that a man with so much love of life was taken from us at such a young age.  The loss of Kyle will sadly be one of those moments we all will remember, but most importantly, his LIFE will be something that will be remembered as well.  Despite his age, and even without his knowledge, Kyle taught me many things about life.  I never had the opportunity to tell him, and I will always regret that.  Perhaps I didn’t realize just how much he taught us all until after he left.  Now, almost 10 months after his tragic death, I still hear his voice, picture his smile, and mourn the fact that he is gone.

I was proud to be on the fringes of his life.  I can only imagine the sadness felt by those even closer to him.  His loving wife, Alecia, is an amazing woman.  I am awed by the strength she shows as she fights through the tears of life without Kyle, always standing proud at the events honoring Kyle’s life. 

Thank you Kyle, for all you have given to your family, friends, associates, co-workers, and comrades. 

Loved my many, forgotten by none!

Please honor Kyle, by rewarding his K-9 partner, Jynx with the honor he earned as well.  Jynx’s actions saved many lives that warm summer evening.  Vote every day at THIS LINK .  Thanks.

Strong Enough to Ask for Help?

Yesterday, I began writing a post about firefighter “mayday” calls.  Sadly there is a tendency to delay making a “Mayday” call, assuming that a call for assistance is a sign of weakness or failure.  The truth is…sometimes delaying the call for aide is the difference between living and dying.  I suspect I will have more commentary about “Mayday” signaling in the future, but as usual, current events steer my thinking toward another concern. 

I was fortunate enough to be in another state on Friday, while my comrades were dealing with a horrific crash on the main thoroughfare through our first due.  The Tractor Trailer vs. car vs. SUV with fire and entrapment had the expected fatal results, and the lives of the responders will forever be altered.  It was a long, agonizing event that involved 8 hours of activities, including; response, extinguishment, patient care, investigation and clean up.

These are the calls that worry me.  Not the strategy and tactics…we all train to deal with the emergencies we respond to. I worry for the responders who now need to deal with the emotions that will be altering their character for the next hours, days, weeks, or perhaps longer.  Sadly, the machismo developed by people in the emergency services prevents us from understanding the impact of these stressful responses.  Helplessness can erode the soul, witnessed death can haunt the mind, and the sights, sounds and smells of scenes like these can rot your gut.  Sometimes these effects are immediate and sometimes they manifest over time. 

We don’t ever think about calling “Mayday” for our feelings, but truthfully, it is the perfect word.  It comes from the French phrase “m’aidez”, which means “help me”.  As brothers, we need to be aware of the signs of someone needing our help, and reach out to offer that help.  If we are not comfortable with the role of “shoulder to cry on”, we have the duty to report our concerns to a company officer, or trusted friend.  This problem may not be an immediate case of “life or death”, but it certainly has an affect on the quality of life. 

I have personally been involved in Critical Incident Stress Debriefing 4 times.  In all four cases, I swore I did not feel any ill effects from the incident I was exposed to, and refused additional intervention.  Much to my surprise, I found myself telling these stories to a therapist 15 years later, after several personal life-altering events occurred in my life.  I have to wonder what damage was really done by all that grief that I chose to bury deep inside me.  

So, brothers and sisters, when you find yourself exposed to the horrors of your job…speak up.  Seek a sympathetic ear from a trusted colleague, or if you prefer, consider professional help.  Keep an eye and ear open for signs and symptoms of stress in yourself and your peers.  Changes in personality, attentiveness, sleep patterns, mood, and spirit are just a few of the signs that may be present.  Consider these symptoms as a Mayday call, and respond accordingly.  It may not be quite as flashy as a grab by a RIT team, but is every bit heroic!

All I Want For Christmas

The Christmas holiday is right around the corner.  Along with the joy of the season comes the tension of tragedy that is likely to occur.  Every emergency responder remembers that one call that rots at their gut, not only because of the circumstances, but because the time of the year makes it extraordinarily memorable. 

As a kid, I remember my father’s haunting was a double fatal house fire, while the parents were away and the kids were left in the care of a babysitter.  He never really talked about the emotions that plagued him and his colleagues.  Perhaps he thought I was too young. As the years wore on, and the stories continued, I began to understand the impact that call had on all the people who responded that tragic night.

The EMS veterans certainly have memories of the cardiac arrest call at a holiday dinner party, or the dreadful “unresponsive person” calls on Christmas morning that end up with a call for a coroner.  Surely, every cop remembers taking mommy or daddy away from crying kids during the holiday season, as well.  Bless them all for dealing so closely with the humanity of the holiday.   

One of my first bad memories was a crash with entrapment a week after Christmas.  Imagine my horror when I discovered the girl we were extricating was a friend of mine.  I think of her every year around this time when I hear a crash along that road, or whenever I see one of her friends during the holidays.  We really don’t talk about her any more, and I wonder if they remember her the way I do…battered and struggling for her life.  No matter how hard I try to remember her smiling face and her endless giggle, I can’t shake the image of her on that cold icy highway.

It seems like every year, there is some memorable fire in the days leading up to Christmas; fires that route people from their homes or apartments, destroying gifts, and memories and replacing them with nightmares that will last for decades.  In 32 years, I have seen more scorched Christmas decorations, and burned up Christmas trees than I care to see.  

So PLEASE, everybody, blow out your candles, check those old holiday lights, don’t overload your circuits, watch what you are cooking, be careful with your fireplace ashes, keep your tree watered daily.  Furthermore, celebrate wisely, and don’t drive if you have been drinking.  Keep your head cool, even if you don’t get the gift you wanted from Santa. 

All I want for Christmas is for every law enforcement officer, firefighter, and EMS provider to have a pleasant, quiet holiday.  I am hoping Christmas 2011 is the season that is remembered for having nothing notable happen.  A little snow would be nice, as well.