On The Clock

The rain always seems to fall harder when you’re in the ambulance than when you’re outside. Maybe it’s just because there’s little noise when it hits your skin, compared to when it hits the hood. It’s falling harder now. The heavy stacatto of the rain beats in time with my heart, which is going crazy.

“Assault, possible rape,” the radio had murmured in the dark. I swear my pulse spiked before I even awoke.

“Sam, we need you.” Drew’s face is only barely visible through the fog in my mind and the darkness of the room.
“I don’t want to go.”
“We need you. You’re the only woman on duty in a 20 mile radius. Let’s go.”
“I’m scared,” I had whispered in the dark.
“Me too.”

But here we were now, waiting for the police to clear us to go on scene. It’s the first thing you learn; if the scene isn’t safe, neither are you. If you aren’t safe, what can you possibly do for your patient? The scene isn’t safe. There’s a criminal somewhere in Clearview, and he might still be around. I shudder as I think of a girl huddling in the corner of this dark alley, wondering why the ambulance hasn’t come for her.

After what feels like an eternity, we get the go-ahead to approach. What I had pictured is almost the exact reality.

She’s tiny. Five-foot-four with sopping wet hair, she holds her knees in close to her chest, shaking from the cold. Her sobs shake her, too, and as I come closer, she raises her head. Big blue eyes stare up at me, horrified and confused. I want to cry right then, but I push it away.

I am stoic, I am calm. I cannot let emotion overcome me when this girl needs me the most.

Handprint bruises are forming on her arms. I see marks on her face, and her clothing is torn. Her lip is bleeding onto the knee of her jeans, and the water is running out of her blond hair onto the shoulders of her green shirt.

Her name is Vicki, the police tell me as I get nearer. The rain falls softly on my arms, and I shiver from the cold, or so I tell myself.

“Vicki? Hi, Vicki, my name is Sam, I’m with the rescue squad.”
“Hi Sam,” she says as she manages a little smile. She’s trying to be brave, and this display grabs my heart a little tighter, wrenching it a little more.
“Vicki, can you tell me what happened? I know it’s difficult, but I need to know if he–er, how he hurt you.” I catch myself, feeling stupid. Obviously, he hurt her. Obviously she isn’t the same girl she was earlier.

She tells me what happened, and I nod and say stupid things like “uh huh,” and “okay.” I don’t quite know what I feel. I’m angry, nauseated, sad, and hurt. I see Drew standing a few feet back, his eyes lowered to the ground. I feel so stupid and insignificant when I ask her more questions. She’s going to have to answer questions for a lot of people soon, and I hate being one of them.

“How old are you, Vicki?”
“I’m sixteen,” she says as she fiddles with her high school class ring. In big, bold numbers it proudly proclaims “2010.” I fight the nausea a little harder as I look at my own ring.
“Sam?”
“Yeah, Vicki?”
“How old are you?”
“I’m nineteen,” I say.
“Can I see your ring?”
“Of course.”

She takes it from me gingerly and examines it.
“2006,” she says softly, “I was in eighth grade.”
Innocence flashes in her eyes, followed quickly by maturity. I don’t know which makes me feel better. She hands me my ring back, and I slip it on my finger quickly.

I don’t realize it’s happening, but she’s crawled into my lap. I don’t stop her, I don’t make any noise, I just let her find her fit in my arms. We sit there for a while under the dim light in the alley. The officers have turned their backs on us, not wanting to interfere in this. Drew and Eric face away as well, and answer the radio when dispatch checks to see if we’re okay.

I hold her as she cries, her tears mixing with rain on my shoulder. Her fingers grip me tightly and I rock her softly as I hold her head with my hand.

After a little while of this, I pick her up and carry her to the ambulance. Drew wraps us in a blanket and squeezes some water out of my hair.

“Do you want me up front with Eric,” he asks.
“That’d be fine.”

Together as one, immovable, we ride to the hospital. I have strapped myself onto the stretcher with her, and asked Drew to call in the report. Her breathing slows, and her heart beats in synch with mine.

“Vicki,” I whisper to her.
“Yeah, Sam?”
“I have to go now.” I’ve placed her on the cold exam table in our SANE room. The forensic nurse is standing next to me, ready to go.
“Okay, it’s okay.” She forces that little smile again. I feel awkard saying goodbye. What do you say? “Feel better,” or maybe “take care?” She speaks instead.
“Thank you, Sam.”
“You’re welcome.”
“I mean, thank you for like…you know, just being there.”
“I’m glad I could help some.”
“I think you’re the most helpful person I’ve ever met.” She squeezes my hand as the forensic nurse pushes me out of the way. I take the hint and leave, my heart sinking.

We drive back in silence, save the rain falling heavy on our ambulance.
“So what happened?”
“He beat her, raped her, and left.” I’m a little short with them, but if I go into any detail, I’ll break down.
“Oh. Wow.”
“Yeah.”

—–

The sound of the rain is replaced by the shower water. Steam rises up, disappearing as it makes its way further into the bathroom.
“I’m going to take a shower,” I announce to no one in particular.
“10-4,” is the generic response I get.

I make my way into the humid room and carefully take off my clothes, folding them neatly in the corner. I step into the hot water and slide the curtain closed behind me. The hot water replaces the cold water that had made its way into my bones, and I seem to melt right onto the floor of the shower. The teal tiles wash my already-pale skin out even further, making me look like some sort of living ghost. I remind myself of Vicki.

I’m not sure how much time has passed. I’m not sure if they could hear my sobs or feel my pain from the other room. I’m not sure if they could picture the way my teeth were bared tragically in some sort of twisted smile as I bawled. All I know is that the water has become tepid, and I am shivering. I think I’ve stopped crying, but I can’t be too sure.

The water stops running, and I raise my eyes to see why. Drew is standing over me with a towel. He covers me, and gently picks me up off of the shower floor. My fetal position remains the same as he carries me to my bunk. He wraps another towel around my body, and puts one in my hair.

“I…” My attempts at verbal expression fail, and I don’t try again.
“Sam, I don’t know what she said to you. I don’t know what happened in the SANE room. I don’t know anything, really. But what I do know is that you’re hurting, and I want to do whatever I can to help ease that pain. You don’t have to explain anything or tell me what happened. All you have to do is tell me how I can help.”

And staring into those big, blue eyes of his, I put my head in his lap as the rain falls softly at the window.

I’m trying to be nice. His constant stream of expletives makes it hard, but I’m trying. Calmly, I ask him what’s wrong. The deputy standing at the foot of the stretcher answers for him, since he won’t answer for himself.
“He’s hearing voices again, but that’s no surprise since he hasn’t taken his meds in a few weeks.”
“Oh. Any idea what the voices want him to do?”
“Unsure, but they’re certainly causing him distress.”
“Violent?”
“Not as of now. Just…angry.” She pauses, staring down at our patient, looking as if she’s trying to predict the future.
“I don’t think he’ll be any trouble for you, just loud,” she says nodding towards him, “but I’ll be more than happy to ride with if you want.”
Drew lifts his head up from taking our patient’s pulse.
“I think we’re good, Deputy,” he says with that ridiculous smile of his that causes most everyone to forget their train of thought.
“Y…yeah, okay,” she stammers. I giggle to myself as she leaves, obviously still thinking about that smile. I’m immune now, but boy I remember when…

“FUCK YOU!” interrupts my train of thought and–SMACK!
I don’t really know what’s going on, but Drew is on him in an instant, and I follow his lead. My eyes are stinging, and my nose is throbbing, but I haven’t put it together yet.
Eric is in the back in seconds flat, and he sits on a shoulder as he calls for ALS. We need something to put this guy out, but we can’t do it.
The deputy runs back to the medic, jumping in with handcuffs ready in hand. She restrains him somehow, but I’m not really paying attention.
I look down at our patient. He’s bleeding. I don’t know where from, but there’s blood on his face.
“Drew, he’s bleeding.”
“What?”
“Look at his face, he’s bleeding.”
“Sam,” he pauses, “Sam, that’s your blood.” His eyes flash with intense hatred as he pushes his elbow harder into our patient. It looks like he could spit, he’s so angry.
“What?” I touch my hand to my face and it feels warm. I pull it away and my hand is covered in deep red. My lips start to taste like metal, and the smell of iron makes me dizzy.
“Who the hell do you think you are, hitting a woman, hitting my partner!?” Drew’s voice cracks from anger.
“Fuck you,” is all the response he gets.
Eric is off the radio now, joining the party more fully.
“ALS is in route,” he says as he gently pushes our patient’s head to the side.

Suddenly he goes limp beneath us. He’s unconscious, but he’s…not. I look at him a little puzzled, and tell Eric to move. My bloodied hand picks up his arm, holds it in front of his face, and lets it go. It falls down awkwardly, avoiding the inevitable smack to the face. Drew catches on.
“Oh, wow, he’s unconscious,” he says heavily.
“Yeah, I wonder what happened,” Eric echoes.
“Wow, poor thing, we should really get going. At least he’s not dangerous anymore.” It’s a little muffled through the gauze I’ve got coddling my nose, but I chime in as well.
I think I see a self satisfied smirk flash across his face as 500 collective pounds of human rise off of him, only to be replaced by some new silver bracelets.

The deputy rides with us all the way to the hospital, asking me every few seconds if I’m okay, and if I want to press charges. I’m too tired to think about legality, so instead I just tell her that I’ll think about it.

When we leave the patient’s room, Drew and Eric turn around simultaneously. They tell the deputy thanks and goodnight, and then shoot a look that could kill at the man in the bed. He spits their way, and Drew puts a protective arm around my shoulder.

“Asshole,” he says as he squeezes my arm.

We did a transfer from a hospital to nursing home rehab. This is a hospital with nuns, for context. Each room has a picture of Jesus mounted on the wall right next to the “Good Morning, today is _________. Your nurse is _________.” sign.

While we were in our patient’s room, waiting for the nurse, I could hear the conversation taking place in the room across the hall.

Nurse: “Mr. Smith?”
Mr. Smith: “Hrmmm?”
Nurse: “I need to check your pupils.”
Mr. Smith: “Hrmmm.”
Nurse: “Can you look at Jesus for me? Come on, look at Jesus.”

In my line of work, if my patients start seeing Jesus, I tend to discourage it. Just sayin’

Take care out there,
Sam

She died. Right there on the floor, no warning, she just fell over, dead. That was her final act, really–falling. Maybe she clutched her chest, and maybe she made a noise, but her last act was falling.

Those around her panicked, calling 911 as they screamed for help, their sobs sticking in their throats desperately.

And then we showed up. And very calmly, we did our job.
“Hey Matt, could you pass me that epi over there?”
“Sure thing.”
“Could someone take over compressions?”
“I’ve got you.”
We smiled at one another with compassion, taking time to say “please,” and “thank you.” And I hummed “Sweetness” in my head as I pushed on her chest again and again, the sweat forming on my brow, the glasses slipping down my nose. I thought of the beat of the song matching the beating of her heart that my hands were creating as I watched the flat line on the monitor move with me.

“Well-oiled machine” is what I hear a lot, but that’s not really it. We’re just a few people who know what to do, and act. We’re just a few people who don’t let our emotions get in the way of our jobs.

And when we’re done, away from patient and family, that’s when I think. That’s when the emotions hit me, the thoughts of my parents and my friends. That’s when I sigh deeply and get a little misty eyed and I’m silent; that’s when it hits me, fully sinking in.

And all of that? That’s how I know. That’s how I know I’m an EMS provider–and a good one at that. That’s how I know I’m meant for this job. That’s how I know that I’m still human, still normal, even though throngs of people would beg to disagree; any person who willingly signs up for a stressful, taxing, vomit and death-filled job must be certifiable, or cold and unfeeling, right?

So I go home from another call both questioning and confirming my desire to do this again. And that’s how I know.

I used to walk through nursing homes with a smile on my face. I’d look all the residents in the eyes, grin a little wider and say hello cheerfully. I’d flirt with the old men playfully and chat up the nurses while getting some signatures.

“Help me, please, somebody help me,” I heard from room 23. I imagine a little old lady who has fallen and hurt herself, or perhaps needs help getting to the bathroom. A nurse stands outside the door, looking at a chart as she picks her nails. I hear the woman again, begging for someone to help her.

“What can I do for you,” I ask as I peek my head in the room. She’s straining to reach her cup of water that’s just out of her reach.
“Oh, I just want some of that water from the cup right there.” I step outside and ask the nurse if she’s allowed to have the water–I just want to make sure she’s not NPO. I get the go ahead, so I step back inside.
“Let me get that for you,” I say as I fill it up a bit before giving it to her.
“Oh thank you so much,” she says, “thank you, thank you.”

I walk back out of the room and stare at the CNA with disgust.
“She just wanted water,” I say as I leave, although I’m not sure she cares.

My partner finds me and we start to head out. A man in a walker approaches me and reaches his hand out for my face.
“Molly? Molly I’ve missed you so much.”
“Oh, I’m…”
“Oh Molly, I’m so glad you’re here.”

I evade his touch as I try to keep up with the gurney, my stomach twisting in knots. My partner makes a joke about what just happen, but I don’t laugh–I just keep walking.

We get in the ambulance and he asks me what’s bugging me.
“Water,” I say curtly.
“What?”
“Water. All she wanted was a fucking cup of water.”
“Oh. Well I’m sure her nurse was getting to it.”
“You don’t understand. She just wanted some fucking water.” I spit the words out with disgust, the t’s and f’s hitting harshly as they escape my mouth.
“Yeah. I hate nursing homes.”

I don’t smile anymore. I don’t look at the patients, their mouths hanging open and their eyes staring at nothing. I don’t talk to the nurses except to get a signature or two. I just stare at my feet as I walk by. I breathe through my mouth to escape the smell and I think about the books I want to read or the movies I want to see.

I don’t think about my mom or my dad in one of those beds in a room occupied by a vacant stranger. I don’t think about the families that never visit. I don’t think about my children saying, “Mom, we just can’t take care of you anymore. We want to put you in a home.”

I think about writing my book, about where I’d like to go on a date, about my junior year in college. I think young thoughts and it hurts me inside.

“I could never do it,” I say to my partner the next day.
“Do what?”
“Be in a home.”
“Well, you probably won’t have much say in it if you lose your mind.”
“Nope. I’m offing myself. If I’m ever enough of a burden to someone that they would put me in a home, I just want someone to put a gun in my hand, point it at my temple and say, ’shoot.’”
“I made my wife promise me that a long time ago.”
“Are we sick?”
“No. We just see it every day and we know it a little bit,” he pauses, “differently.”
“I guess.”

My first patient in the ER is groaning as the nurse keeps him on his side.
“That’s the biggest decube I’ve ever seen,” my preceptor whispers to me.
“Where did that come from?” She looks at the chart and nods.
“Nursing home neglect. They left the temporary foley in for two-ish weeks.”
“And the decube…they didn’t turn him?”
“Lazy.”

I want to vomit. I want to cry. I want to scream. I want to drive to the nursing home, find his “nurse,” and beat the shit out of her. I want her to feel the pain that he feels every day, but I know it won’t be the same. She can take care of herself, even beaten all to hell. He can’t even turn himself in bed, let alone tend to his wounds.

And so I swallow back another set of feelings as I go off to find my next patient.