Paramedic Story 1

Fathers Day, 2016.  Round Rock, Texas.  Just north of Austin.

Returning from dinner tonight, we drive through Round Rock.  30 years ago, I was a paramedic there.  At that point in my life and career, I lacked interpersonal or communication skills. Completely. But I had amassed exceptional psychomotor prowess.  I could stick a needle or tube into just about any part of your body and probably cure what ails you.

I worked hard on that; I took extra jobs drawing blood and giving shots, working in the ER and ICU to improve my assessment skills and understanding of pathophysiology.  Clinically, I was very good.  I got into more fist fights than just about anyone else, and typically, although the patient was medically better off after I took care of them, everyone involved was pretty dissatisfied with the whole experience when I was involved.

I didn’t get that part.  “Patient is better, screw all the rest of you”, was my theory.

As we drive by the scene, I remember one of those calls.

****

Summer, 1989.

It’s the middle of the night.  Tones light us up for an “unknown medical; officer requests EMS”.  Everybody stumbles to their vehicles. We assume our usual position, our medic unit in tow behind the fire engine.  We find the scene; it’s a traffic stop; cop car behind a civilian vehicle.  The officer is at the back door of a station wagon, peering in.  When he sees us, he waves fervently.

Great. I always love these.  The more frantically the cop waves, the worst my day is.

The firefighters go to the car while we gather our gear. By the time we arrive at the car door, everyone’s faces are set in a grim pose. I see a very small boy, maybe 18 months old, sprawled across the grimy back seat of a station wagon, his young mom rubbing his chest. The child is unconscious, and twitching.

The firefighters focus their flashlights on the baby. I crouch down and begin physically assessing him, while my partner, Erin, starts asking questions of mom.  The boy is laid out long ways on the back seat, head at the door, one arm pointing straight, in the air, out the door, and past my face as I kneel on the summer-hot pavement to check him out.

He’s having a seizure, I realize.  Erin’s questioning reveals that he has been twitching like this for about an hour. He has extensive medical problems, and has been stuck in seizures for a dangerously long time on prior occasions.

After 45 minutes of convulsions at home, Mom finally decided to go to the hospital.  She was rushing down the road, quite a bit over the speed limit, when she passed the cop. He pulled her over, and asked the age-old cop question “is there an emergency?”.  Much to everyone’s surprise, in this case, yes….yes there was.  So, now, here we are.

We need to turn off these convulsions as soon as possible. They are burning up his brain cells and hurting his heart.  In 1989, we only had one way to do that; we had to give him Valium through an IV.

So, I’ve got to start an IV on a twitching, sick baby in the backseat of a station wagon, by flashlight, at 0200 am.  While kneeling on molten hot pavement.

This job is awesome.

Everybody knows what we need to do, and they start setting up the IV and medication stuff

Erin and a couple of the firefighters do all the talking. Thankfully.

I scrub the kid’s arm with antiseptic, and start looking for an IV site.  The Mom says “oh God….they can’t get IV’s on him”. I don’t say anything; just keep looking and feeling for a vein.

And then a firefighter, David, paid me one of the greatest compliments I’ve ever had.

At this point, I’m sitting on the road, criss-cross-apple-sauce. I’ve got the twitching baby’s arm captured in my hands.

Flashlights are illuminating his little extremity.  His color is worsening; he’s grayish-blue.

Mom restates her concern: “the nurses and doctors can’t get IVs on him; they have to call a specialist”.  David the firefighter points to me and says: “He can. He’s the best I’ve ever seen”.  David puts his arm around the Mom, and tells her “it’ll be fine”.

I’m thinking: shut the f— up.  This is not helping. I don’t need stage fright now.

All eyes and flashlights are on me.  I’m 23 years old. I’ve been doing IVs for about a year.

And this baby…..might….die.

I see something.  I think it’s a vein, but it might be a bunch of other stuff. I am intensely focused now; the voices around me become buzzes in the background. I pull the cap off the IV needle with my teeth, and nervously chew the plastic as I start to stick the baby.  That noise…me chewing on the plastic cap….is now all I hear.

As I push the needle into the baby’s skin, blood flashes into the chamber.  I slowly advance the catheter off the needle, into the vein. Blood flows easily.  Erin turns to the crowd: “he got it.  Gimme the IV”. As a firefighter moves forward to hand me the end of the IV line to connect it to the catheter, the Mom asks incredulously, to the crowd of firefighters and cops, “He got it?  The IV?  He got the IV?”

David nods and says:  “told you”.

Erin squirts the Valium into the IV, and within seconds the baby stops twitching. His color improves.  We carefully move him to the unit and load him up.

David belts Mom into the medic unit with us, then jumps up front to drive us to the hospital.  He turns and asks “Code 3?”   I tell him “no, non-emergency.  We’re fine now”. Those are literally the first words I’ve spoken through the entire call.  As Erin and I continue to work on the baby….checking his sugar and oxygen levels, cooling him down, listening to his lungs….I say maybe 10 more words, all to Erin.  Erin finally turns and talks with Mom for a while, telling her what’s going on, what we plan to do and what will happen at the ER.

I never do talk to to the Mom.  In my mind, I don’t need to. That’s Erin’s job.  I just get IVs when no one else can.

After we get the baby to the ER and turned over to them, I see the Mom go up to Erin and thank her, and hug her.  But nothing for me.

Erin and I pile into our truck and start heading back to the station.  After a few minutes of silence, I mumble “she didn’t tell me ‘thank you'”.  Erin turns and looks at me for a moment, then says “No.  Because you were an asshole”.

I’m shocked, and more than a little hurt.  “I saved that baby’s life”.  Erin snorts, and shrugs her shoulders.  “You helped him, but I could have too”, looking directly at me now. “But his mom was really scared, and you didn’t do shit for her.”

We sit in silence for a while, me fuming.  Finally Erin says “look; you’re really good at this job. Better than me…I know that.  But you gotta talk to people.  Me, the firemen, the family….you gotta talk. You suck at that”.

Angrily, I swing the nose of the truck around as we arrive at the station, and back us in. “Just try talking” she says, glancing at me one more time as she gets out.

She heads into the station, and goes to bed.

I sit, in the diver’s seat, for a long time.  Listening to other crews going out on calls.

And think.