Friday, October 9, 2009

Man, I'm tired

Spending nights awake on a medic truck in Columbus can beat on a person.

I was tt’d to Medic 24 on the city’s north end. TT meaning assigned to work a shift at a different station than the one I call home. Now the following scenario isn’t unique to 24’s, as I’ve experienced it plenty at my regular house of 22’s, but this particular night, it happened while I was working at 24’s.

First, you have to understand that a typical run at 24’s, from the time the call is dispatched to the time we drop a patient off at the ER and return back to quarters, is about 45 minutes to an hour depending on traffic.

With that in mind, some of the runs can be as short as 15 minutes if, for example, no one is injured in an auto accident or something along those lines. That day we had 12 runs in the first twelve hours. Pretty busy, huh? Well that’s where my story starts.

From 8 PM until midnight, I didn’t bother lying down. It wouldn’t have done any good if I had. At 10 o’clock we were called to an injured person.

We pulled out of the bay and into a fresh rain. The dispatch was to an apartment building but when we arrived something in the darkened front yard caught my eye. I grabbed my partner, Warren’s, attention before he could head into the apartments.
As we came closer, we could see a woman lying in the wet grass, crying. We approached. I asked her what had happened. She sobbed that she fell getting off of the bus and then crawled into the grass. She cried that no one would stop to help her as traffic continued to whiz by unfazed.

I asked her what hurt and she said her ankle. She said that it felt wet inside of her knee-high boot. She didn’t say knee-high, I added that. I looked down as the rain poured onto my head, down my brow and off of my nose like the downspouts of a gutter. Her toes pointed behind her.

Ah, shit!

Warren saw what I saw at the same time and he had pretty much the same reaction. I wondered what we could do for her out in the dark rain, deciding the best course of action would be getting her into the truck. But that wasn’t going to be easy.

Or painless.

Warren went for the cot while calling for an engine on his radio. I did a quick evaluation of her neck and a rapid secondary exam which made me comfortable that she hadn’t any other injuries. I told her we had to move her because we needed to get her boot off and make sure she wasn’t bleeding too badly. I also told her that we didn’t have time to give her an IV and morphine and that I was sorry.

As Warren lowered the cot next to her, I said, “Honey, you’re going to have to help us. I’m afraid that it’s going to hurt.” She cried.

Warren braced her foot and leg so her foot wouldn’t be left behind. I lifted her under her arms as we had her scoot onto the cot. It must have been excruciating; the grinding of her lower leg bones assured of that.

The engine arrived as we loaded her into the medic.

“What do you need?” the Lieutenant asked.

I said, “Someone to drive and someone to hold her foot on.”
He ordered someone behind the wheel and hopped into the back with us. Another EMT followed him. We had him hold her foot.

I said, “We gotta get her boot off,” and he agreed. Warren started searching for an IV site while the lieutenant and I started cutting her boot. Once we reached her ankle, we were stuck. The scissors couldn’t squeeze past the tight boot.

“We’re going to have to wiggle it off,” the lieutenant said, though I already knew.

With the boot mostly cut, we could see that her bleeding wasn’t severe and decided to wait for Warren to finish the IV and let the morphine have a chance to kick in. It did. But morphine in the amount we are allowed to give doesn’t stop the pain, it only dulls it a bit. With some screaming (her, not me), we slid her boot off. I told her not to look. She asked if her foot was still there. I wanted to say, “barely,” but simply told her that it was.

Her shinbone was sticking through her skin like a spear. Luckily for her, she still had a pulse and blood flow into her foot. But that could quickly change with the wrong movement or a bump in the road. Her foot hung from her leg by little more than skin and ligaments.

We raced with lights and sirens to the hospital. By the time I had finished with the report, the nurse told us that our patient was already going into surgery and that she was going to keep her foot. We dried off and got back in service.

I was already tired and this unbelievable night had only just begun.

Stay tuned for the next part of my crazy night in the coming weeks…

That’s called a tease by the way.


  1. Two things come to mind. Oh, and please understand that I feel like a douche for dishing out the criticism, but you told me it's what you wanted.

    First, I think that the description of the water dripping from your face was a nice bit of figurative lanuage, but it's in the wrong place. You stopped the story dead in it's tracks. If you were to use the same sentence back when you approaced her in the wet grass, it wouldn't change the pace a bit.

    This is the linear continuity I'm always on about. Make it flow like a river. If you talk about the rain up front, establish the details there, and only mention it again if the rain changes, or complicates what you're trying to do. You could say something like, "I looked down and saw her toes pointing the wrong way. As if on cue, the sky opened up and pummeled us with a torrential downpour, letting us know that a bad situation had just gotten worse." You can use your environment to punctuate the action, but you want to put it where it will support the action, not detract from it.

    Second, you have a huge time warp between running lights and sirens, and you finishing the report while she was in surgery. What did you do with her dangling foot on the way? Did you let it flop about? Were you able to control or stop the bleeding? Did you attempt to splint it? Did she see it? How did she react? What did you do to distract her for the 15 minute ride? What was the reaction of the ER staff when you wheeled her in? What did she say to you? Was she grateful? Dismissive? In too much pain to interact on a personal level?

    I simply LOVE the stories about your runs, but need and enjoy the details that you gloss over because they're routine to you. It's not at all routine to me.

  2. Matthew, I definitely understand where you are coming from as we've discussed some of your criticisms previously. I'm not glossing over details that I find mundane as much as trying to focus on certain elements of certain runs. I understand how your mind works (a little) and how you need all of the details. However, what I'm attempting to accomplish in this blog is to give a short (1000 or so word) glimpse of calls that I take. I need to pick a few interesting details and focus on them. Whereas one run may have descriptions of responding in the medic (if something happened that I feel is out of the ordinary), another call may include a particularly difficult IV attempt or intubation. Therefore, I have to gloss over some of the details. If you take my entire blog as a whole, instead of per run, my stories would become boring if I told you about every IV, or every driver who cut us off. This run, I felt, the excitement was better served telling about the woman's injury and the difficulties with her boots. Also, if you read back through, you'll see that I touched on having an EMT hold her foot throughout the transport though I didn't specify how he did it. This story is part one of a 3-part story about one incredible night that I had a couple months ago. My next post should have more back-of-the-medic description as the interesting part of that run takes place during our treatment.
    Do I make any sense or am I out to lunch?