the healing muse

Volume 13, 2013

Road Trip

Karen Donley-Hayes

      Decades ago, when I trained to become a paramedic, I had a passion to come to the rescue, to step in and make a difference, take control of chaos, save lives. I discovered the first time I performed CPR that it was just like we’d practice on Annie-the-manikin, except for the airway and the ribs. In a dead or dying person, the airway is flaccid, much harder to manage than Annie’s. And with a dead or dying person, when you do chest compressions, you feel the patient’s ribs and cartilage snap and crack under your palms. Your first impulse is to pull back. But you don’t. You push through it to the heart of the matter, because you must. It’s the only way.

      I don’t know, really, if the accident happened before or after I’d stopped counting how many times I’d done CPR, or how many fatal wrecks I’d worked. Regardless, I wasn’t thinking about heart attacks or trauma arrests that morning. I was thinking about the long road trip my EMT partner and I had, taking a patient from Cleveland to a rehabilitation facility in West Virginia. It was the best kind of road trip—a beautiful, sunny September day, and only one patient—a stable patient at that—in my care for my entire shift.
      Several hours into our trip, we happened upon an accident which had just occurred. With most accidents, EMS personnel have time to prepare while responding. Not so here, the wreck so fresh dust still swirled as I stepped from the squad. This was a bad accident—perhaps not the worst I’d seen—though plenty bad enough, enough to make your adrenaline surge and your mouth turn cottony. But even without the normal response time to brace for the task, I walked into the rubble knowing I was a paramedic doing what I’d been trained to do—save lives in crisis—and knowing my competence gave me confidence that helped temper the anxiety and adrenaline surge.
      But the baby changed everything.
      I didn’t even know she was there at first. I was preoccupied trying to take care of the three people I did know were there: one critical; one serious but stable; one in remarkably good condition, considering there was nothing left of the car. The semiconscious driver—she was the critical one—was lying on her back on the pavement, the shoulder strap of her seatbelt still around her. That’s how demolished the car was.
      I was working on her, starting an IV, getting vital signs, when someone standing next to me said, “There’s a baby in the back.”
      I looked at the man who had spoken, at his face, pinched, how he pointed off to the right. A baby in the back? In the median? A baby? How had I missed that, a punch in the stomach, but already I was getting up from my squat by the driver, even as I looked past the man pointing toward what had been the back of the car. There was a baby ejected? And good God, how had I not assessed the scene well enough to miss a baby in the median? I stepped around the back of the car, each step weighted, the median coming more into view with each step, step, step, but there was no baby in the median. All this stepping and looking took maybe four or five seconds.
      Just to the left of my leg, the car’s back half sat, smashed and crumpled. I looked there, just a glance down, and here’s how time works, how another three or four seconds in time, what that time carries, years and years and years and eternity, forever, get seared into the brain:
      I saw her leg. Her little calf, baby pudgy, there in the crumpled wreckage. By her knee, her leg opened up, a neat wedge chunked out. There was no blood. Paramedic assessment clicking. No blood. So, probably detached. I shifted to my right, looked closer into the wreckage, trying to process what I saw, fit it into triage, mechanism of injury, assessment, extrication, treatment protocol, everything I’d learned. Bits of material, shirt, maybe, or perhaps belly or arm or other leg, I don’t remember how my brain parsed that because I was trying to figure out the hair. The blonde curls, gentle tendrils, soft, but parted and divided, headed all which way, and I think I blinked once or twice before I knew her tousled hair was jumbled with her brain matter, spread on the scraps of wreckage.
      A baby’s leg that doesn’t bleed. Blonde curls and brains.
      I stood up then, and turned to my left and stepped back to my patients, step, step, step. Back to my living patients who still needed me, whom I could still help, and I remember feeling my heart beat, the air sucking out of my lungs, and saying to myself, Keep it together. You have people to take care of. Keep it together.
      So I kept it together, and retraced my steps back to the driver, who was only conscious enough to ask, again and again and again, “How’s my tot? How’s my tot?”
      Every time she asked, again and again and again, I said, “Everyone’s being taken care of.”
      I know we were stellar paramedics that day, I tell myself we took control of chaos and saved three of four lives in that wreck. I always have the urge to add for what it’s worth.

      I think about her often. She was only a year old. I don’t know anything else about her. It’s been over twenty years, and I still see and smell and hear those seconds, looking at her wisps of hair, at her leg that didn’t bleed, and feel my heart hammer against the inside of my ribs. She could be graduating college about now, if she hadn’t been in that car, or if her mother hadn’t lost control, or if the truck hadn’t been right where it was, traveling on the other side of the median in the other direction.
      I wonder if she was frightened, or just startled at the sudden buck of the car as it careened across the median. Did she hear her mother and her aunt and her grandmother scream before the truck hit them? Sometimes, I think I see her, sitting in her car seat, baffled, but not quite scared yet, before the truck smashed the car and ripped her leg off and smashed her head and smeared her brains through her hair.
      Sometimes, I like to think she laughed, a child’s delight at the bumping thrill in her tummy, laughed, laughed before she was snuffed out.

      When I was first a paramedic, I believed I’d never lose the passion. In the middle of the night when I was on call, I could be out of bed, dressed, and running to my car before my pager had finished delivering the dispatch. I remember the first rescue call I ever went on. I don’t remember the last one, though, and I don’t remember most that came between the first and last call. I wasn’t aware of my passion’s dissolution. I wonder if it gradually diluted with all those calls, was already thin and friable by the time I couldn’t any longer tell you how many runs I’d gone on, or how many dead bodies I’d seen, or how many car wrecks or farm accidents I’d responded to, or how many heart attacks I’d worked.
      Maybe my passion didn’t dissolve gradually, but spilled out at calls with dead babies. Or when snowstorms slowed our response times until we were inconsequential. Or when another sober person was dead at the scene but the drunk who caused the accident was only walking wounded. I don’t remember my early passion dying, although I do remember a late surge of that passion—maybe the last surge of it. I had finished a shift—the details of which are lost to me—and someone asked how my day was.
      “I had a great day,” I said, and I remember smiling broadly, feeling that smile all through me. “I had a great day, saving lives.”
      I wonder when that stopped being enough.

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