The Dutiful Nevada Wife

She Drove Him to the ER

Henry Lansing Woodward

 Winner in the 2023 General Nonfiction Contest
© Copyright 2023 by Henry Lansing Woodward

Photo by Mikhail Nilov at Pexels.
Photo by Mikhail Nilov at Pexels.

We had just discharged our last patient, the man with the shotgun wound, and were still parked in the ambulance parking area in front of the double doors leading into the emergency room.  After each transport (not all dispatches result in a patient or a transport of a patient), there is always some cleaning and restocking.  The four things always needing to be done, besides re-stocking, were to wipe down the gurney, change the linens, wipe all surfaces and mop the floor.  Always.

On most calls, it was usually as minimal as that.  On others, it could be a major cleaning involving the walls, floors, gurney, equipment, ceiling, cabinet doors, and passenger bench.  In other words, everything.  After the call we had just completed, the floor needed some special attention, or specifically, the corners where the floor met the walls.

Our patient had injured himself critically by shooting himself with his shotgun.  Despite two tourniquets, pressure dressings, and tight wrappings, a lot of venous and arterial blood was still escaping.  There was also leakage of intracellular fluids from all the individual cells which had been blown apart or open.  This wound was too large to stop all the bleeding.  It involved the loss of the entire front or top part of the left leg, from the groin to the knee.

The man no longer had the top front part of his left upper leg.  Most of it was still back in his house on the linoleum.  That is, of course, except for all the fragments and the remaining twenty percent of his liquids which were now on our patient compartment floor.

The patient's condition required a CODE THREE, lights and sirens transport from the scene of the incident to the emergency room.  There was no time to spare.  This man needed many infusions of whole blood.  Because of our emergency transport, the rocking and tilting of the ambulance spread all that seepage, and the small pieces of tissue and bone included within it, all over the floor where it collected in the wall/floor corner junctions.

These areas were difficult to clean correctly, but there was no other option.  It had to be done to sterilize the junction area. The removal of the solid materials prevented any bacteria from growing, thus preventing the unwanted smells of rotting human tissue.

I was applying the “toothbrush method” with alcohol to clean the corners when a car pulled up right behind the open double rear doors of the patient compartment.  The gurney was still outside and was now between those doors and the car.  We hadn’t yet slid it back into the patient compartment because I was still cleaning the corners.  A woman was driving the car, and an older man was slumped forward in the front passenger seat.  Slumping is not a good sign, especially for an older man.  But we’ll get back to that.

When we pulled up to the house, the front door was closed, and no one was in sight.  No one at all.  Paramedics know it is not good to be the first to arrive at a call that involves a gun.  The police must first secure the scene and then allow us to enter.  That is the standard operating procedure, and there were no police.

We contacted dispatch and were told they would arrive in about five minutes.  We were also told the caller was currently talking with them and that it was safe to enter.  The emergency was an accidentally self-inflicted wound, and the gun was empty.  The guy was alone in the house, and the front door, although closed, was unlocked. 

It’s not that I didn’t trust the dispatchers in the Emergency Call Center.  They could only act on the information they received.  However, there were many times when there was a big difference between their information and what we found upon arrival.   Anyway, the Police rolled up as my partner, and I discussed entering the house.  With their hands on their weapons, they slowly opened the front door, looked in, stepped in, then looked back out at us and waved toward us to enter.  

The house was a small older house built many years ago and still had the original linoleum on the floor.  The room was furnished as any small living room probably would have been, with one exception.  In the middle of the room, covered with gun cleaning supplies, was a card table, the folding kind.  There was also one folding metal chair.  It was tipped over backward and resting in a large pool of blood.  A huge pool of blood.

As I stepped into the front room, I saw a broad streak of smeared blood on that original linoleum floor.  It was a straight line trailing away from the huge pool of blood.  It almost looked like someone had done a long, wide, red finger painting.  Mixed into that finger painting-like smeared blood were small pieces of fabric and chunks of tissue.  The tissue chunks included red muscle pieces, white skin, yellow fat, and ivory-white bone.  Not big pieces, all of them were shavings and small chips.  At the same time came the smell of gunpowder hanging in the air.  

The finger painting-like smear of blood stretched to and through a door on the far side of the room about ten feet from the table.  It went directly into the kitchen another eight to ten feet and ended at a guy sitting on the floor and talking on the phone.  He had somehow managed to drag himself almost twenty feet to the nearest phone.

There was so much blood on the linoleum between the pool and the streak he should not have been alive, let alone conscious and talking intelligently.  He was sitting upright on the floor with his back against some drawers to the left of the sink, and he had the phone in his hand.

It was one of those old-style wall phones designed so the handset could rest in the cradle over the dialing wheel when it wasn’t in use.  It had one of those long curly cords from the handpiece to the phone and was mounted on the wall about five feet above the linoleum floor.  How this guy reached it is a mystery I’ll carry forever.

It must have been the closest, if not the only phone in the house, and to say this guy needed a phone would be one of the greatest understatements of the year.  He had been cleaning his “unloaded” shotgun, and then “Bang!” He was missing the top part of his upper left leg.  The little pieces of bone in the blood had come from the top of the Femur.  It sustained a lot of damage.  He had not immediately bled to death due primarily to the incredible engineering of the arterial circulatory system of the human body.

When arteries are severed by a blast like the one from this guy’s shotgun or by a crushing injury, they automatically pucker and constrict to close themselves.  Automatically.  It’s an ingenious and sophisticated method of stopping blood from squirting out of high-pressure arteries.  Only the arteries do it.  Blood escaping from the low-pressure veins flows much slower and is, therefore, less life-threatening to a point.  I have no doubt it was designed by the Master Medical Engineer.

After rapidly applying a tourniquet and some pressure dressings, we moved the patient quickly to the ambulance.  He had lost so much blood he was in critical condition, perhaps extremely critical.  Because of this, we did our additional treatments, including two fluid-replacing IVs, some more pressure dressings, and applying high flow Oxygen in the ambulance on the way to the hospital CODE THREE, lights, and sirens.  This saved time, and this man’s time was running out, just like his blood.  We arrived at the emergency room in time for him to survive his blood loss.

So there we were at the emergency room doors. I was on my hands and knees using that toothbrush method to clean the corners of our patient’s tissues and blood.  My partner was inside getting replacements for the supplies we used to treat our patient when that car pulled up with the slumping man in the right front passenger seat. I stopped what I was doing, got out of the ambulance, walked to the car, and looked in.

The man’s face was blue, and he was not breathing.  I turned and ran to the emergency room doors, pushed one of them open, and yelled, “Cardiac arrest in the parking lot!”  All the right things began to happen.  In an instant, the Cardiac Team came out with a gurney and pulled the man out of the car.

As they laid him onto it, two members of the team, one on each side of the gurney, stood on the bottom rails, so they were riding along with the gurney.  One began CPR.  The other began mouth-to-mouth rescue breathing.  At the same time, two other people, one at the head and the other at the foot began rolling him and the two riders on each side of the gurney into the emergency room.  It was all done very quickly and efficiently.

The man’s wife remained outside with me.  She was telling me what happened, and it seemed important to tell her story and that I should listen to her.  She even delayed going inside to be with her husband to talk with me.  This seemed very strange.  Usually, you can’t pry the family away from their loved one(s) in an emergency.  But here she was, talking to me.

Her husband had admitted he wasn’t feeling well.  She said this was a big admission for this self-reliant, read stubborn, Nevada pioneer.  “He never complained,” she said.  “Never.  His whole life, he just did what he felt needed to be done when I could see he should not be doing it.”

He would say,” she continued, “It has to get done, Ma.  Who else is going to do it?”  “There was no use arguing with him,” she added.  “For over fifty-five years, he would never give in.  He would never let me or any of the kids have our ways.  It was always his way.  He surprised me by admitting he wasn’t feeling well.  He just didn’t ever do something like that.

She had suggested calling 911 to send an ambulance, but he would have none of it, and that was it.  He had made his decision.  Once again, things were going to be done his way.  “Drive me in the car, Ma,” he had told her, and that was what she did.  They then walked to the car, got in, and she started driving.

She said, “He told me to drive him, and all our lives, we always had to do things his way.  I didn’t want to cause him any discomfort, so I drove real slow.  Real slow.”  It seemed to me there was a double meaning in her tone.

The hospital was about ten minutes from their house.  Not too far.  I knew this because she had told me where they lived.  On the way, there were several traffic lights, and it was just about dinner time, so the traffic was somewhat heavy.  She drove slowly and carefully, watching the traffic and managing to stop at each light along the way.  It had taken her about twenty minutes to make that ten-minute drive to the hospital.  She said, “At the third stoplight, he fell asleep.  I knew he was probably gone.”

After a long life of doing things his way and keeping her vows of loyalty to her husband, she had once again faithfully completed the last task he had told her to do.  She slowly and dutifully drove “that stubborn bastard” (her words) to his death.

After talking with her, I felt confident she knew what she was doing and what was happening with her husband.  I was also pretty sure she knew I knew what she was implying.  It was as if she wanted me to know.  While she was still talking, a nurse came out and asked her to come in.  They needed her to register her husband.

My partner and I finished cleaning and restocking the ambulance and began our drive back to the station.  I didn’t say anything to him about the conversation with the wife.  I considered it private and was perfectly content to keep it between us.  I felt honored she chose me to hear her story.

The patient with the shotgun blast to his leg needed a lot of blood and had his leg amputated just below the hip.  The man in the right front seat of the car could not be saved.

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