On The Clock

As I’m climbing off the medic after a call, we get toned out again and I see Drew and Eric headed to another unit.
“Come on Sam, let’s go,” Drew says grabbing my hand as I step off the medic, “dislocated hip.”
I sit in the back of the medic envisioning a frail old man that slipped down the stairs, dislocating his hip. I envision his pie-baking wife dialing 911 and greeting us with, “thank you so much for coming; I know it’s late.” When we arrive, what I find is very different.
In the pouring rain, there lies a very inebriated man on his lawn with his equally inebriated wife standing over him. There are about six firefighters on scene already, and the first thing I hear is, “have fun with this one, Sam.” I sigh and put some gloves on.
The firefighters use a scoop stretcher to put him on our bed, and off we go. Eric looks at me and nods, “I’ll precept you.” I lean over to take a blood pressure and immediately recoil, gagging. He smells of liquor and a mix of dirt, body odor, and unbrushed teeth.
“Oh my God,” I mouth to Drew through the rear-view mirror. He nods his head in the direction of the wife sitting next to him in the passenger’s seat. I crane my head to listen, and I can make out “good for nothing uneducated medics.” I’m unappreciated. Priceless.
I run through the vitals, and take a blood glucose. I start my SAMPLE history and try to decipher what our wasted patient is trying to say. I look over at Eric who is sitting on the bench, head reclined, hands folded in his lap.
Trying to engage him, I say “what do you think about oxygen?” He looks up at me sleepily.
“What about it?”
“His sats are great, but due to a traumatic event, he might go into shock.” He shrugs and puts his head back against the seat. Great.
“We ain’t going any faster with them si-reens because we’s black, ain’t that right,” I can hear from the front.
“Yes ma’am, the emergency medical system reserves the use of lights and sirens for white patients only. It is with that ridiculous bias that we are able to stay in business.” I shake my head as I hear Drew explain that it is a non-emergency, blah, blah, blah. “Damn, he’s good at dealing with stupidity,” I think to myself as I take a second pulse.
“I haff to frow uhp.”
“What’s that?”
“I haff to frow uhp.”
“One more time.”
“I HAFF TO FROW UHP!”
“Eric, get me an emesis basin!” He lazily reaches over his head and hands me a basin as I make my way to our patient’s head.
“Eric, I need you to help me turn him since he’s still on the scoop stretcher.”
“He’s fine, he can turn his head.”
“Eric, he’s throwing up on himself, help me out here!”
“Fine,” he sighs as he tilts the stretcher with one hand. Too little too late; I wipe the vomit off of his face and shoot Eric a look that could kill.
As we arrive at the hospital, Drew and I unload our patient as Eric watches. Drew, the hospital staff and I help move him to the bed as Eric watches. I tell our patient and his wife goodnight and that I hope he gets to feeling better soon. I hear something about a “cracka,” and I head for the door. I’m unappreciated. Priceless.
I write my PPCR report as Eric stands in the hallway talking to other providers.
I’m getting really angry, really fast. I get no input, no help, and no feedback from him; this call did not go the way I thought it would at all.
As I hand my report to Eric to sign, he reads my narrative.
“What the hell, Sam, you didn’t mention that he had no head or neck pain!”
“Oh man, I knew I forgot something. It’s just that the other preceptors usually help me write the report.”
“Yeah, well now you’ve messed it up.” I’m unappreciated. Priceless.
I look at Drew with frustration and he winks at me, “come here Sam, help me with this stretcher.”
As we put a new sheet over it, I hear Eric grumbling about how he would have just had our patient walk rather than use a scoop stretcher. “What the hell,” I mutter to Drew, “I don’t understand.” He nods and says, “Eric’s…well, he’s a different kind of provider. I just let him talk a big game, and then disregard everything he says You did a great job. You’re an awesome EMT; don’t let him make you think any different.” He gives me a hug, and I smile. I’m appreciated. Priceless.

“Station 2, unresponsive patient.”
The tones drop for another county, interrupting my dream. Frustrated, I roll over in the bed as I hear station 2 and central dispatch corresponding.
“Medic 2 is en route.”
“10-4.”
“Medic 2 has arrived on scene.”
“10-4.”
“Central, show that we have a working code.”
“10-4.”
In my dream, I wonder about how little central dispatch ever seems to say. I hear the door creak open as light streams in the room. Someone pushes my foot over and sits down on the bed.
“Sam. Sam, wake up.” Chris pokes me, and I close my eyes tighter; I am not getting up for him, no way, no how.
“Sam, get the hell up!”
“What do you waaaant,” I moan as I pull the covers over my head.
“There’s a code.” I’m up like a shot, tying my boots as I run awkwardly down the hall. I push the hair out of my face, tying it in an unkempt bun as I climb into the medic.
“Why are we going to this,” I ask, “it’s not our call.”
“If this is truly a working code, they’ll need manpower,” he answers as I attempt to fix my hair once more. We’re screaming down the road, going faster than I ever recall; I buckle my seatbelt as I wrestle a pair of gloves on my hands.
We nearly pass the house, but pull in behind another medic and two police cars. I jump out and walk towards the door; I’m not sure if I’m supposed to run in, or if that’s reserved for the movies.
I can’t even get in the door. She’s right there, in the foyer. I shimmy to the side, and stand oddly, looking on. I have no idea if I should offer to help or stay out of the way.
And there it is. There’s the bright yellow oral airway jutting out from her mouth. There’s the Bag-Valve Mask and someone to squeeze it. There’s the heart monitor, showing a flat line running across the screen mockingly. There is the technician doing chest compressions as she wipes her forehead with her upper arm.
I push myself further into the wall, hoping to blend in, hoping no one notices my anxiety. I feel the color draining out of my cheeks, but I know I’m keeping my composure, keeping my face flat and unchanging. The woman lying on the ground is in her forties, and she’s wearing a terribly leopard-print dress. I can see the velvet of the garment sticking in different directions after the technician’s hands interrupted its fluidity. I see her clunky black heels, and her formerly coiffed hair.
There’s a tech showing another how rigor has set in, how it’s useless. There’s a police officer asking me questions, but I have no idea what they are; I just grasp the wall tighter.
It’s done, she’s dead. The technician stops compressions, and I notice how she takes special care to modestly arrange that awful dress so that she looks put together. I see one of our medics go to the family member and break the news. All I hear is a scream, and I head out the door. I can’t take this.
I have a brief flashback to when they told me about so many of my loved ones. I remember the guttural noise I screamed, and the way the sobs choked their way up my throat. I take a moment to breathe, and Chris is heading out the door.
“Alright kid, let’s go. You okay?”
“Yep,” I say as I manage a rather convincing smile.
As we drive back, I hear the medics talking about the call, and as I sit alone in the back, I realize I need to talk to someone too. I open my cell phone and call my dad, the only person I know will understand.
“Hey dad, I just got done with a code.”
“Oh wow, how was it?”
“Really…real.”
“Are you okay, Sam?” I hear his voice falter, and I steady my own.
“Yeah. Yeah, I’m okay. It was just so real, you know Dad?”
“Yeah, I know.”
“I mean, she was wearing this disgusting leopard-print dress, and there was this woman like…like pushing on her chest, you know? It wasn’t glamorous or anything like that. There was a woman lying next to a stain of her own emesis as an EMT pushed on her chest!”
“Yeah, I know kiddo.” The tears well up behind my eyes, and I make up an excuse.
“Well I’ve got to go; we’re pulling into the station. Just thought I’d let you know.”
“Thanks. Take care, okay? Love you.”
“Love you too.”
I bolt out of the back as soon as the truck is in the bay, and I mumble something about needing to use the bathroom. I slide down the cold cinder block wall and put my head in between my knees. I let myself cry for a few minutes, and then I’m back with everyone, laughing and eating breakfast.
“Station 1, shortness of breath.”
“Medic 1 is en route,” and we’re off again.

“Sam, this is your call,” says my favorite paramedic with a wink. “C-Spine,” I say more to myself than anyone else as I wrap my hands around our patient’s neck. It’s my first call ever as a precepting EMT, and it has to be an unrestrained passenger in a two-car motor vehicle collision. Our driver slides a collar under my fingers and secures it in place. As we carefully backboard our patient, I ask him about his pain, run the gamut of SAMPLE questions, and once we have him in our medic, I start my detailed physical exam. Shining a pen light in every orifice, and palpating him up and down, he sighs and says, “I’m such a fucking idiot, driving without a seatbelt.”
“Yeah that’s true,” I think to myself, but instead I ask him if it hurts when I do “this.”
We drive to the hospital without incident while I do all the other things I can possibly remember. We get him into the hospital and he starts shaking, and the next thing I hear is “Oh Christ,” as my partner grabs an emesis basin from the table, moving back as he thrusts it in our patient’s face. I grab the board to help my partner turn our patient as he vomits. Faster than I can say “that’s disgusting,” the doctor’s rounding the corner. She starts listing off the tests she wants done and shoves me aside. “Give the report,” urges the paramedic, and I swallow hard.
“Twenty-five year old male…motor vehicle accident…unrestrained,” I literally wipe sweat off of my forehead. What if I forget something? “No prior medical history, vitals WNL,” I falter, and the paramedic puts his hand on my shoulder. “He didn’t complain of nausea until a few seconds ago,” my partner continues. I hear our patient mumbling about how stupid he is, when the paramedic says, “good job Sam, let’s do the paperwork.”
The Pre-hospital Patient Care Report (PPCR) scares the hell out of me. It’s got boxes to be checked, blanks to be filled, and a narrative to be written. He guides me through it one step at a time and then points to the “attendant-in-charge” line for me to sign.
“Oh, no, I’m just an attendant; that’s your blank,” I mutter. He smiles. “Nope. Sign here.” I sign, and he pats me on the back. “I know it was scary,” he says, “but you did a great job. Congrats on the first call.”
On the way back to the station, I lie down on the bench in our medic and close my eyes.
I’m so glad that it’s over; it was possibly the most nerve-racking thing I’ve ever done.