On The Clock

“We got a pediatric BVM?”
“Yeah.”
“Alright…what about the IV boxes; all sealed?”
“Yep, both sealed.”
“OB kits?”
“Two of ‘em, not like we ever need them,” I say with a wink. I hear the pre-alert go out, and we stop checking off the rig to listen.
“Station 1, active labor.” My partner glares at me.
“Really, Sam? Didja have to go ahead and jinx us like that?” I jump out of the back and look for the medic.
“John, I’m going on this.” As the daughter of an OB/GYN, long-time volunteer in the birth center, and employee at an OB/GYN’s practice, I feel confident that I could deliver a baby.
“Oh thank God,” he says, “I really didn’t want to take another guy.”
As we climb back into the ambulance, I text my dad.
“Might deliver a baby!” I receive a prompt “Holy S,” in reply, and I chuckle to myself, double-gloving in anticipation.
We arrive to the local meat packing plant to find a woman who is 28 weeks pregnant and has contractions five minutes apart. I hold my breath, wondering what I got myself into. Me? Deliver a baby? I must turn a bit pale, because John leans over and asks if I’m alright.
“Oh, yeah, doing great!”
En route, John starts an IV and I time contractions. 5 minutes. 3 minutes. A minute and a half. 20 seconds.
I check to see how dilated she is as John bashfully pretends he’s talking to the driver. She’s not. She’s not dilated. Beautiful.
My hand goes numb every twenty seconds as she squeezes the life out of it.
“Just keep breathing, you’re doing great.”
“She’s not due for another three months,” she groans as she attacks my hand once more. Through her contractions, I try to figure out her Gravida/Para numbers, but give up each time she screams. As we roll into the delivery suite, the nurse starts asking questions I don’t have time for.
“Who is she?”
“Melinda Saunders, John gave that in report.”
“Well what are her G/P numbers?” I groan as I try to help our patient into her gown.
“She’s only ever delivered here. They should be on file.”
“But what are her numbers?” Melinda drops her jewelry on the floor, and I see her diamond ring slide under the toilet.
“I. Don’t. Know.” I do not have time for this, and neither does she, I think as crawl around on my knees trying to recover the escapee ring.
“She’s only 28 weeks?”
“Yes, I know.”
“Well this is too early.”
“Yes. I know.”
“How dilated is she?” With my patient grabbing the bathroom railings as another contraction happens, and my ass sticking straight up in the air indecently, I sigh. Did this woman pay any attention to the report?
“She’s not dilated.”
“What?”
“She’s. Not. Dilated,” I repeat as I stand back up, handing Melinda her ring. Attempting to help her move the IV through her clothes and back through the hospital gown, I hear the nurse open her mouth again.
“Here,” John says as he presses the PPCR to her chest, “it’s all here.” Thank God for helpful partners, I think as I help Melinda into her bed.
“Well, I just have to go talk to the doctor about this,” says the nurse as she leaves the room, having obvious difficultly moving, what with the stick lodged firmly up her backside.
“Need anything, Melinda,” I ask, letting her squeeze my hand again.
“A new nurse,” she says through a smile. “What’s your name again?”
“Sam. Samantha.”
“Did you know it means name of God?”
“Oh wow, no, I didn’t.”
“Yeah, my mom was named Samantha; she never let us forget its meaning.” I smile, and she lets go of my hand.
“Thanks, Samantha.”
“Of course.”
“You’re really good at this stuff.” I laugh and thank her as we head for the door.
“She wants ice chips,” I say to the nurse as she comes back in the room, “and a softer pillow.” She smiles at me through another contraction, and I can’t help but giggle and I see the nurse put her hands on her hips and blow the bangs out of her face.

I’m barely awakened from my 10:30am nap when an EMT student taps my shoulder.
“Um, Sam,” he says quietly, “I think you need to get up; there’s a call, and I think it’s a code.”
Up like a shot, I grab my boots and head towards the rig.
“78 year old male, unconscious, not breathing. Sam, I need you to unhook the monitor, grab the drug box and the IV box and put them all on the stretcher. Can you do this while I drive?”
“Yep,” I say regrettably as I hit the wall, “not a problem.”
“Sam, if this is a real working code, you will either be bagging or doing compressions. Are you up for this?”
“Yep,” I say once more, wondering if I really am.
As we scream down the main street, I take off my sweatshirt and tie my hair back. I’m ready for this call, I think to myself, remembering my first code. As we arrive, I grab the backboard and clumsily take out a bush as I try to carry both the board and the strap bag into the house. The hallway could not be any narrower, but I manage to slide into the living room relatively quickly, without destroying any walls, furniture or artwork along the way.
“Sam, get down here and bag.”
I make my way towards the man’s head and take over for the paramedic.
“Every five seconds, okay? Christ, the guy’s in PEA, 40 bpm. Somebody get a line in!” The paramedic doing compressions looks flustered, but I keep my eyes on the mask.
Breathe. beat. beat. beat. beat. beat. Breathe.
I see the man’s glassy eyes looking into my own, but I keep on bagging, trying to push all thoughts from my mind.
“Sam, when I say ‘go’, I want you to move out of the way, and I’ll intubate. Then you’re going to take off the mask part and put it back on the tube as we secure it. Okay?”
“Got it.”
“Go.”
I let him work, and I take a second to breathe. Before I know it, I’m bagging through an ET tube as he listens to lung sounds. Everything sounds good so they secure it in place.
“Sam, do you see how I’m doing compressions?”
“Yeah.”
“In just a few seconds, we’re going to switch because I’m getting tired, okay?”
“Alright, tell me when.”
“Now.”
I step over the patient, apologizing silently as I do, and start compressions.
“Sam, a little more to the left. Deep compressions, Sam, deep.”
I push harder and feel the furniture shaking. I feel an odd cracking beneath my hands and think back to CPR class; good compressions break bones. I don’t have time to marvel at how terrible it feels, so I focus on compressing to a beat. I can’t seem to find one, so I start to imagine that I am doing compressions to the beat of a song. I pick the one that best matches the tempo I already have.

If you’re listening.
Sing it back.
String from your tether unwinds.

Jimmy Eat World? Are you serious?

Up and outward to bind.
I was spinning free with a little sweet and simple numbing me.
Are you listening?
Sing it back.

Oh my god. I realize I’m singing Jimmy Eat World under my breath, and in my head I apologize to the man whose bones I’m breaking.
“Great compressions, Sam, you’re doing a really good job.”

So tell me what do I need when the words lose their meaning.
I was spinning free with a little sweet and simple numbing me.

Before I realize it, the paramedic is telling me to stop.
“Guys…guys, look at this. Holy shit, he’s converted…80 beats, normal sinus!”
I stop and push the hair out of my eyes with my forearm, managing to slide my glasses back up my nose. They got two rounds of epi and atropine in him while I was busy singing Sweetness, and he’s actually converted. I switch back to bagging, and look at the monitor; I can’t believe what I’m seeing.
As I go to bag again, I feel a strange pressure. Trying not to think much of it, I try again. Once more, I’m met with resistance. I look down and realize he’s actually trying to breathe on his own. I watch him intently and bag when he breathes.
By the time we get to the hospital, I can even see his hands moving, and I feel so encouraged. This guy could actually make it.
After turning over care, I stretch and find it funny how I’m just now realizing how badly I ache. We start to clean up, and I realize just how long this is going to take. About forty minutes later, I hear someone come up behind me as I’m cleaning.
“Hey Sam?”
“Hey Liv, what’s up?”
My roommate has been doing clinicals at the hospital all day for her EMT class, and I can tell she’s worn out.
“Your code patient died. I’m sorry.”
I can see she has tears in her eyes, and all I can manage to say is, “oh.”
She leaves, and I’m left alone in the EMS room, a can of half-empty fresca sitting in front of me.
“Oh.”
While I make sure no one is looking, I start to cry. I told myself I was stronger than this. Who is this guy to me anyway? He’s no one! I’ve never met him or his family before in my life, but still I can’t help but be completely devastated. I put my head on the desk and cry into my shirt.
My mind wanders, and I push thoughts of his empty eyes staring up at me out of my head. I try to finish my soda, but all I can think of is his wife’s distressed look as she opened the door.

This sweetness will not be concerned with me.
No the sweetness will not be concerned with me.

Oh.