A Lesson Learned

“What do we have?” I asked as I ran from my car toward the ambulance barn.

Jeff was at the barn opening the overhead door. He looked over his shoulder and yelled, “Car wreck, one victim, six year old Caucasian male.”

He opened the door and ran to the driver’s side of the ambulance. I quickly entered and went straight to the back.

We had done this so many times it was like clockwork. He started the van, turned on the lights and siren, radioed the police and we were on our way. I started running through my mind what we would need for a trauma such at this. Six-year-old boy, I thought, quickly I grabbed the child’s cervical collar. Oxygen, non-rebreather, check, all ready. What else? Back board, I grabbed it and threw it on the stretcher. Trauma kit, it went on too.

Jeff, my partner was on the radio. He yelled back at me, “Only the one victim, trapped in the back seat, grossly deformed leg. Bleeding from the right arm, no apparent other injuries. Fire department is on the scene with the jaws.”

Ok then, I thought, we probably need the
traction splint, maybe the seatbelt cutters and extrication equipment. Quickly I gathered up the remaining items I thought we would need. Timing, as usual, was perfect.

I looked up as we were just topping the hill. We could see the vehicle about half way down the other side. It was apparent what had happened. The vehicle had slid on the ice and collided with a tree. The front was destroyed beyond recognition on the passenger’s side, with the tree still standing in the middle of the tangled mess. I looked around as we drove up. Snow was still lightly falling and a slight image of the sun could be seen through the clouds. The trees around the scene were white and had a lonely, barren look to them with the snow covered field in the background.

I saw a highway patrol car with its lights flashing, the fire truck and several other vehicles parked around the scene. People were rushing back and forth from the wrecked vehicle to the fire truck. A highway patrol was standing in the road with his spotlight, ready to direct traffic. I could hear the voices as they yelled instructions to each other. I recognized one of them as a fellow EMT.

As we pulled up he ran to the back of the ambulance. He was a short, but stout man with brown wavy hair. “We need something to cover the patient while they use the jaws,” he said as he opened the back door and grabbed a blanket. “They are going to cut the back door off.” I could tell by his voice that he was out of breath. His faced was flushed, as it always was when his adrenalin was pumping fast.

I jumped out of the back and grabbed the handle to pull out the stretcher. “Did you get vitals?”

“No, I don’t have my equipment, just heard the call on the scanner and came on.”

I should have known. We all knew if there was an accident everyone would be there to help. We took pride in our crew and the efficient way we all worked together and could handle just about anything. Somehow we had all divided up the different jobs to be done and we spontaneously carried them out as the professionals we knew we were.

As I headed for the car the sound of the fire truck revving up stopped me. I knew what was happening. I went to the back of the fire truck and parked the stretcher in a safe place. The loud roar of the generator starting overtook the scene. I couldn't see the car for the group of firemen between it and me. But I knew what was happening when I heard the loud screeching of metal being cut. I covered my ears to help drown out the sound. But, there was no drowning it out. The high-pitched screeching became unbearable,like fingernails on a chalkboard but a thousand times worse, as it cut through the metal. Suddenly, there was a loud crash as the glass broke; I knew from the sound it was shattering. Without seeing I could picture them peeling the door off like the top of a sardine can. I could see the shower of sparks as they flew in every direction and I the smell of burnt metal hung in the air and refused to leave.

As always, I was relieved when the jaws were shut off. I would never get use to the ripping and shredding of a vehicle, the sounds, smells or sight.

As soon as they gave the all clear, I started for the car. The tree that was entangled with it prevented me from taking the stretcher. I could tell from looking that the driver had hit the tree hard. The passenger's side was destroyed beyond recognition. As I rounded the corner on the driver's side, I could see it was in better shape. A lady had beaten me to the car and had door open. She had obviously removed the blanket from the victim's head and was bent over looking in the car. Apparently a family member, probably the mother, I thought.

“Excuse me.” I simply said, “We need to get to the victim.” She leaned over once more, gave the victim a kiss and whispered something to him. Good, I thought, the victim is conscious. She then backed quietly out of our way.

The victim was half sitting/half lying in the back seat. The blanket they had covered him with while they cut the door off was still on his lap. I removed it and the few chips of glass it contained. I could see we had a good airway and the victim was breathing. I immediately started my neuro evaluation as I took the victim's head in my hands to stabilize it for the cervical collar. “What is your name?” He answered me. My partner was at the other side of the car with the collar. He slipped it around the victim’s neck. Very carefully we slipped the half backboard behind him and secured him to it to minimize movement. “Do you know where you are?” I asked him while we did this. His answer was correct. “The victim is coherent.” I hollered at another EMT who had arrived and stood outside the car with a clipboard.

“Good.” He yelled back, “Do you have vitals?”

“Not yet.” I answered.

Jeff assessed and bandaged the bleeding arm and announced it wasn’t serious. “Just needed a few stitches.” While he did this, I took the vitals. It was difficult for me to hear the blood pressure with all the noise and confusion, but listening very closely I was able to get it. All vitals were stable. While I evaluated his head and upper torso Jeff was checking his leg. Two men started taking out the front seat. The third EMT had meanwhile entered the car with oxygen and a mask, which he started to apply to the victim's face.

Somewhere in the middle of the loud screeching of metal as the saw cut through the metal of the seat, the medical communications going on between three EMTs as they conveyed messages of assessment and treatment going on and the chaos of the scene, a small weak voice, very quietly said, “I’m scared.”

I looked at Jeff and he looked at me. I knew we were thinking the same thing. I felt like I had just been hit with a brick. Somehow that small precious little boy taught us a valuable lesson with his statement.

Suddenly, that victim, that deformed leg fracture with stable vitals, possible neck injury, laceration to his left arm, became a person. We looked at him for the first time. And what we saw was a frightened, little, six-year-old boy.

I had looked at his pupils, but not his eyes. I had assessed his face, his body and condition, but I hadn’t looked at him. I did then as he looked at me.

He was a cute blonde headed boy. He had chubby cheeks and a cute little chin. His nose was small and upturned just enough to be adorable, and his eyes were as blue as a summer sky.

When his eyes met mine I saw fear. I saw deep, “don’t scare me anymore” fear. I suddenly wanted to grab him and hold him close. I wanted to take back everything we had done. His eyes told me what this experience had been like for him.

Jeff motioned to the men to stop the saw. Quiet overtook the scene and Jeff sat down on the edge of the seat next to this scared, brave, sweet little boy. And they talked.

They talked about all kinds of things. The little boy was Johnny, he told Jeff about the wreck and how scary it was. He told him about his puppy and his sister at home. He told him he had never been in a wreck before or seen an ambulance. And Jeff told him about the ambulance and all the cool things it could do. He told him that it was ok to be scared and Jeff wouldn’t leave him. He would stay with him and make sure no one hurt him anymore.

They talked and talked. Soon they were telling jokes and laughing. The bystanders started joining in. The whole scene changed. No one was hurrying around, the chaos was gone, all the effort that had been put into treatment a few minutes before went into entertainment now.

As I watched and listened tears filled my eyes. I wasn’t sad because of Johnny. I knew he would be just fine. I was sad because of me. The realization that what I had become was setting in. Somehow in the training, the traumatic events that I had been to and the day-to-day routine of patient after patient, I had lost the person. There was no person in the patients anymore. It took an innocent six year old to teach me what I had been so naïve as not to realize it myself. I wiped my eyes and looked outside.

There was that lady, but now she wasn’t a lady, an obstacle, something I was trained to handle, she was a mom. She was an upset mom with a little hurt boy. She was standing by herself in the cold with one hand holding her coat tightly shut and the other tightly clenched at her mouth. I saw her face for the first time. Worry lines were etched deep in it and fear filled her eyes as she anxiously waited to hear something.

I backed out of the car and approached her. The look she gave me tore my heart in two. I quietly reached out and touched her arm. “I’m so sorry,” I said, “I shouldn’t have rushed you away while ago. Please, go be with your son.”

Eventually, we took care of Johnny. We took our time, with his feelings as well as his mother’s in mind every step of the way.

Johnny turned out just fine. He mended beautifully and was soon playing and running like any other six-year-old boy.

But, for three EMTs things changed that day. We went on many ambulance runs after that; still had traumas; still saw patients. One major thing was different, however, the patients were people too. Thanks to that one special little boy.

Thanks to Johnny, we took care of people.