What I Learned
Copyright 2006 by Joni Bour
It is an unusual breed that lives to serve others. I always felt that I had not been the one who chose the work so much as it was God's will. It is the kind of work that gets into your heart and sooner or later a particular case will dig really deep into your heart, threatening to destroy you if you cannot find a way to make your peace. I credit my faith in God and the following lesson I learned on my 23rd birthday with keeping my spirit and heart from breaking.
My heart nearly jumps out of my chest when my pager vibrates at my side. I’m happy to put the hot pink bowling ball back where I found it, because it is obvious to even the kind-hearted that my best sport must be something other than bowling. I listen to the dispatcher’s voice while I step out of the two-tone rented bowling shoes, it is a code-99(cardiac arrest in progress) in a 14 year-old girl. I toss the shoes on the counter and begin to run, forgetting my own sneakers. The fire station is right next door and in the darkness I am halfway there before I realize it is raining and I have no shoes. I laugh as I continue to jog, because if I hadn’t stepped on a rock, I might not have even noticed I had left my shoes behind in a bowling alley full of strangers. Some of the guys will get a laugh out of this -probie, newbie, recruit, dummy- Being new and female, I have heard them all before. I reach the doorway with feet splatting on the cold dry cement and I leave a wet footprint trail all the way to my turnouts on the shelf. I hear 91-11 already being started up, so I grab my turnouts and am in them pulling up the suspenders as I jump in the back and away we go. We ride without speaking, cramped together inside that old EMS van purchased from the phone company. The air tanks rattle in the back in a strange little tune accompanied by the rain pounding on windshield and the mud flaps flapping away against the tires. Actually the whole van makes all sorts of noise as flares roll in their trays, tow chains slide from one area to another and there are creaking noises from everywhere.
One of the firefighters sitting next to me
announces (ignoring my attempts to stifle him) that it is my birthday
and begins to sing an off-key and flat version of Happy Birthday but
is abruptly cut short by a frustrated voice on the radio, ”Where
is 91-11, we need QRT assistance now”. We glance at each
other, even though we can’t see clearly in the darkness.
Anxiety has taken a seat behind us and is sitting there, breathing,
and playing with our secret fears. We are unused to hearing the
senior paramedics seem flustered and we are each thinking our own
thoughts about mayhem, chaos or untold emergencies.
Instinctively each of us searches in our pockets for gloves, tape or
other things we might need. The engineer tries to find the unmarked
road in the gloom and rain, muttering frustrated curses because he
knows we are near, but we may as well be in the next county if we
can’t find the turn. With relief and now some trepidation we
see a small sign and the van turns down the correct road. We are
banged around inside as one firefighter grabs a helmet that slides
his way and another one stops a flashlight with his boot. Someone
lets out an awkward chuckle as his helmeted head clanks hard against
mine and he jokes that he needs a medic, but the joke falls flat. We
are all practicing in our minds what we will do and how we will do
it. I am going through motions I have been through many times before,
but I still methodically practice each step in my mind. Everyone has
without cue buttoned up jackets, steadied helmets and put on double
With a lurch the van and my thoughts are abruptly thrown forward as we stop and pile out of the rig. There are many people milling or standing around, sobbing or just staring at us. I worry about what is in store for us as I try to make my way through the crowd. I can’t see the ambulance or the crew until the crowd slowly parts to let us through. There is so much emotion in the air I can feel it touching me as the three of us pass by. I can hear people whispering, praying and just breathing. It is so loud and so quiet at the very same time I have trouble separating the sound from the heavy tension and emotion clinging to air.
Finally we are there and the paramedic closest to me mutters something about us taking too long, grabs my arm and pulls me to the ground where he has been kneeling in the rain. I can’t see because the deck’s floodlights are in my eyes and my helmet is getting in my way so I take it off and toss it aside, knowing I will get in trouble later for my lack of care of our equipment. Instinct takes over as I listen and act almost in synchronicity taking only a few seconds though it seems like forever. I feel as if I am on autopilot as I stare down at my patient. I am shocked in a time in my life when I think I am shock proof. I feel almost as if I am here and yet I am far above us looking down at me and the others who are trying so hard to accomplish a futile task. Her eyes are staring up at me as I kneel down at her shoulders. The raindrops are pooling in her eyes and they drip down the side of her face as if the angels themselves are crying. I want to look away, but I know we have to help her, I have to focus. The senior paramedic that grabbed my arm before shoves the AMBU bag in my hands and yells at me, “Now get it together, hyperventilate her, do it now”. I stare into his and he whispers,” Do your best, for them” as he points over his shoulder with a movement of his head. He says it so quietly that no one else notices and later when I go over the events in my mind, I wonder if it had actually been God who had spoken. I no longer hesitate and I squeeze the bag as fast as I can. There is a man to my right, who is so close to me our knees touch and I almost jump out of my skin with his closeness feeling like an electrical shock. His eyes are wild with fear and I wonder who he is, I know he is not one of us. He is getting in my way and I want to ask him to step aside, but I can tell by the resolve on his face he will not go and we do not have time to argue. I want to feel sad for him whoever he is, but I cannot spare the distraction. There is chaos all around us in the form of tubes, discarded plastic, tape, bright colored canvas bags and black boxes. An IV has failed three times and another medic tries to find a new location. There is shouting of medications in and stop or continue compressions and even though these voices are just inches and feet away, I feel as if I am hearing them through a filter or a tunnel far away. The man next to me leans forward and whispers, “Don’t stop”. I am desperate now for him to leave as his words and presence are tearing at my heart and I think of shouting to someone to get this man out of here, but my heart is in my throat and I cannot speak. I can feel him looking at me and I try to avoid his eyes because I feel as if he is looking into my very soul. One, two, three, someone is counting their compressions, but me, I am squeezing just as fast as the bag will fill and as my hand begins to shake, I try to switch hands but it doesn’t work.
I hear someone say that it is time to go and on the count of three we lift the girl on a backboard and strap her down as fast as we can and then place her on a gurney. We push the gurney down the gravel road through people who respond by gasping, crying or looking away because things are falling and rolling everywhere and there are just not enough hands to hold and push and squeeze. I feel badly for everyone, but mostly for our patient and I try to shield her from the crowd, but I know I have to keep pumping. Breath I say in my mind, please breath, why won‘t you try?
We are finally in the ambulance and are going at a death defying pace down a road with potholes that bang us from one side of the ambulance to the other and I fall over a couple of times because I am trying to pump the ambu bag and maintain her airway as well and there are no other hands to keep my balance. The other medic reminds me that if I fall I cannot pull her intubation tube loose or we are in big trouble so I try even harder. My brain feels like it will explode. I lean forward and sweat begins to drip into my eyes causing them to sting so I try to use my shoulder and arm to wipe it away without breaking my rhythm. I am tired but I won’t stop, I swear I won‘t stop. I keep willing her to breath but I think she must not hear me. I see someone adding something to an IV after getting orders on the radio and then begin compressions again with one hand while he tries to steady himself with the other. I worry we are causing her more pain but there is no way for us to know. I realize for the first time that the man is in the ambulance with us and as my eyes meet his, he begins breathing very hard. I fear he is having a heart attack too and I try to think of what we should do next as the other medic and I exchange glances. But the man reaches into his pocket, pulls out an inhaler and breaths in deep. I see his chest begin to relax and when he is able to speak, he reaches out to touch my arm and it is odd that I can see his hand resting on my arm, but I can’t feel a thing. I am relieved that it stopped hurting about 5 minutes ago and now it is just numb. He says,” Please don’t let her die, this is my kid”. I feel as if he has hit me with a sledgehammer and is pounding me into the ground. I want to tell him I will not stop, that I won’t let him down, but instead I put my head down to try and drown out the common pain we now share. As we drive through the streets, heading for the hospital, I remember my own child’s death and the tubes, needles and the paramedics pounding on her chest and I understand his pain. I haven’t thought about that horrible night for a long time, but I know it is why I am here and I beg God to let me not fail this time, and I pray for strength. I want to sit with him and cry our heartbreak and shame away but I know this is a line that I cannot cross.
Finally we are here and we pull her gurney out and head into the hospital. The sweat and rain drenched hair are dripping into my eyes and I am out of breath but I am committed. We wheel her into a room with curtains and someone gets me a chair to stand on as they raise her bed to it’s highest level. A man walks in and by his strides, I know he is a Doctor. He looks at us and then down to the muddy footprints on the floor we have created. He chuckles, saying we are quite a sight- all dripping wet and tired. He walks around the gurney a few times, rubbing his chin as if he is pondering what to do next, but he isn’t really wondering, I can see on his face that he has made a decision already. He pauses a moment, looks at the clock then the girl and says in a tone I shall never forget,” Time of death is 7:58”. I stare at him as if he has lost his mind and I want to scream at him and I wonder what has gotten into me, maybe I have lost my mind! He sees me as I continue to work the bag and he says,” I said, you can stop now” crossing his arms across his chest as if he is in charge of me. I look at the senior paramedic in disbelief, “ This isn’t over” is what I want to say. But he touches my arm and says to go. I look down at my hand and I stop squeezing, but it is cramped and I can’t let go, so I use my other hand to release the bag and I set it down awkwardly nearby. As quickly as the world is told to stop, it is told it must start again and I catch myself as my knees feel weak. I am at a loss for what to do next until the senior medic reminds me that I can take off my gloves and wash up nearby.
I take a second to collect myself and realize the call is over and I have to move on. I was just one of many who tried their best. As I leave the tiny space to return to a world that won’t understand the way I feel tonight, I look down and avoid the eyes of those who are watching. It is like running a gauntlet as there are people all around again, waiting, wondering, some perhaps already knowing. If I look up they will see the night’s results written on my face and I know that the reality of a new different life, one without a loved one must be revealed by someone else. But I know as I look down and stare at my boots that they will begin to guess what the news will be and I feel so bad for them and selfishly for me too. I walk back through the doors we just came flying through and with my back turned I step into the pouring rain and finally let a tear fall. I am in a quandary about how I should feel right now, for there is a code all emergency workers must keep. There is no written rule, but we all know what it is. We are to be tough, we are to be courageous and we are not to get involved and yet I feel involved. I stand here a moment trying to keep my thoughts together when I hear a tap on the glass door behind me. I turn, thinking it is a medic or a nurse trying to get my attention, but it is not. It is the father and as my gaze met his, My eyes plead for forgiveness, understanding or perhaps comfort. He smiles at me as his tears begin to fall and he presses his hand against the glass and mouths, ”Thank you” and slowly turns away to the arms of his family. As a firefighter I don’t always get the chance to hear thank yous so I should be happy or relieved, but I‘m not. I wonder if this is what a person dying of thirst and lost at sea must feel when surrounded by so much water and unable to take a single sip. I look up to God and I beg him to please help me see what I did wrong. I want to be mad, but there is no one to be mad at. I know God is not punishing me, but still my heart feels broken. Logic tells me that many times we arrive and dress a wound or splint a fracture and things work out well. Other times we arrive too late to help or things just go too far wrong, but I don’t really feel up to logic right now. I slump against the wall and as I slide to the ground I can hear my turnout coat scratch like sand paper all the way down to the ground where I rest on my helmet.
My head weighs too much to hold up so I let it hang between my shoulders until I hear a tiny sound behind me and I look up to see Chrissy. She is my dearest friend and she was one of the other medics tonight. Neither of us speaks for a long while because we know sometimes there really isn’t anything to say and the only thing that fits into the void is nothing at all. Finally she breaks the silence and says that sometimes things just are what they are and that is all there is to it so why try to figure it out? We smack hands and agree to this solution, but agree on the one thing we have learned on this day that I turned 23 . Which is that everything we can and we can’t do are in some way acts of God. We can only do our best and sometimes we will win but the only time we will really lose is when we don’t try at all. Even now when we are heartbroken we know we will fight other fights and win.
Joni has lived on the Oregon coast all her life.
She enjoys writing, working on the Veterans History project and
reading. She was a firefighter/EMT for seven years and considers
those years some of the most important times of her life, life
altering in many ways, none of which she would want to change,
because all events have led to the person she is today.
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