Chapter 6

There are patients who stick out in your mind, something about them or their circumstances just sticks in your mind, and you can never forget them. There are ones you'd prefer to forget, and there are those who are so common that they slip from your mind entirely. Often I'll run into someone who will walk up to me and start talking as if they've known me all their life, and I will have not a clue as to who they are, or where I met them initially.

One will always remember the first "Good" trauma patient they had, or their first Code, the first one that died on you, etc. But you also remember those who were just a bit weird as well.

We get dispatched to some unusual calls, toothaches, nosebleeds, are run of the mill, but then there are the bizarre ones.

In the middle of the night, as you try desperately to catch a few hours of sleep, then tones will smash into your dreams and send you scuttling to your clothes and into the ambulance, flying away thru the darkness and fog to someone's perceived emergency.

"COUNTY EMS COUNTY EMS, RESPOND TO 435 BLUEBELL LANE, REFERENCE TO A ALLERGIC REACTION. PER THE CALLER, HE WAS BITTEN BY FLEAS TWO WEEKS AGO AND IS NOW HAVING AN ALLERGIC REACTION, SLIPPING IN AND OUT OF A COMA. TIME OUT 0234 HOURS."

What the Hell? Fleas? Two weeks? Coma???

You arrive at the house and a bewildered woman comes to the door, asking confusedly, "What are you doing here?"

You explain you were called out for the "Coma" and she begins to curse and start looking for her mentally impaired son. After a brief conversation with her, you check on him and find him asleep in bed. Back to the station for an hour of paperwork before you can go back to bed.

Or on one of those days when you've been slammed, running all day and night, you finally get a break and try to catch a quick nap, only to be awakened again.

"COUNTY EMS COUNTY EMS, RESPOND TO 183 DUNRENTIN TRAIL, REFERENCE TO A 49 YEAR OLD FEMALE, PER THE CALLER, SHE FELL ASLEEP WITH HER MOUTH OPEN AND HER HEAD IS FULL OF AIR CAUSING A MIAGRAINE HEADACE."

You roll out to a ramshackle house belonging a local family of idiots, who stare slack jawed at you as you explain to them that what they claim is a physical impossibility. All the while "mama" complains loudly that she wants you to let the air out of her head.

Then there's the 18 year old who was diagnosed with Gastric Reflux, and now calls repeatedly telling dispatch that his Gastric Reflush has gotten into his blood stream and went into his brain causing him to have headaches. When you arrive, he demands transport to the ER, and no amount of explaining will change his or his family's mind. So you load him up and he tells you that he can't breathe unless you run lights and sirens. You explain that his "emergency" doesn't warrant them, and he threatens to have you arrested.

One frequent flyer we've had, called 911 late on night, complaining of chest pain, we arrived on scene, and her long suffering husband met us at the door. He explained that nothing was wrong with her, except she had ran out of her medications and wanted more. She was in the back of the house screaming for us to "quit talking to that mofugga and get our ass back here", we begin to assess her, and she tells us he had beaten her twice today, but she had someone taking care of that. She explained that all she needed us to do was give her a shot of morphine and some valium, and she would see her doctor tomorrow. We explained to her, not the first time either, that we couldn't do what she was requesting, but we would be glad to put her on the cardiac monitor and to transport her to the Emergency Dept. She in turn explained that her doctor had told her that when we got there for us to just give her morphine and valium and leave. After a long and pointless discussion, we were soundly cussed out and told to leave, and that we would lose our jobs in the morning. She called us back two hours later and was surprised that the next crew told her the same thing.

Then there was the woman who kept a large wooden coffee table with the top not bolted down in her living room. When she ran low on her pain medications, which was almost weekly, she would push the top over and lay down beside it and call 911. When we arrived, she would moan and groan loudly saying she'd fallen and thought she'd broken her hip.

The first time I ran on her, my partner who'd been to her several times, stood back and let me handle the call. I carefully immobilized her pelvis, boarded and collared her, and we moved her to the ambulance. I ran through the rapid trauma assessment, and as every question I asked that might possibly indicate a need for pain meds was answered with a yes, the light began to dawn. "Does this hurt?" "AWWWW YES, OH MY LORD YES!" "Does this hurt?" Same answer, but louder. We went down the assessment, each time it was more painful than the last.

"FOR THE LOVE OF GOD, WHEN ARE YOU GOING TO GIVE ME A SHOT?" "Ma'am, I can't give you any pain medication, you'll have to wait till we get to the hospital."

"YOU SON OF A BITCH, I NEED SOMETHING NOW. THOSE DOCTORS WON'T GIVE ME ANYTHING. GIVE ME SOMETHING NOW." I explain that I can't give her medications without doctors orders, and she decides her hip isn't broken after all, rips off the collar, unsnaps the straps and cussing like a sailor, jumps out of the ambulance, shoots my partner a bird and disappears into her house.

"Radio, we are going to cancel this call, patient refused transport."

Some patients make you want to laugh, some make you want to cry. The circumstances people allow themselves to get into can range from comic to horrific, and anywhere between. Each call requires you to make snap decisions, often without any background information to go on except your instincts.

Two AM, all is quiet until the klaxon notes of the Rescue Tones burst out of the overhead speakers.

"COUNTY EMS, COUNTY EMS, RESPOND TO MOSQUITO CREEK ROAD, REFERENCE TO A MVC, WITH EJECTION"

There is a quick scramble of boots being pulled on, toilets flushing, and we rush to the trucks, as the radio blares out additional information. We hop into the ambulance, dodging past the front of the Rescue truck as it rolls out the bay, lights flashing and engine roaring.

"PER LAW ENFORCEMENT ON SCENE YOU HAVE ONE PATIENT EJECTED, ALERT AND BREATHING, ONE PATIENT ENTRAPPED NOT BREATHING."

You push even harder on the accelerator hoping to gain a little bit more speed from the already straining engine. Over the channel you hear first responders calling in to Dispatch. As you round a curve, a deputy blazes by you blinding you with his lights, you feel the ambulance sway with the effort of staying on the road. Your mind races as you try to decide what you might find on scene, assets you'll need. Your partner radios to have Air Med put on standby, a quick flight will give the patient a better chance of survival; after all, you are 45 minutes by ambulance to any decent trauma center.

After what seems an eternity, you round a curve and see blue and red lights everywhere, a fireman with a flashlight is directing you forward towards the center of everything and you twist around patrol cars, pickups and fire trucks watching to keep from running over anyone. As you brake to a stop, you can see a pickup on its side, torn earth and twisted fence wire scattered around. In the field about 100 yards away, a sedan sits at an odd angle, steam rising from its shattered front, a crowd of firefighters surrounds it, strangely doing nothing, not a good sign. A deputy with a strained look on his face runs up to the truck.