Unexpected

I pulled my old pickup into the drive. Today was one of the first days of fall where the weather was neither hot nor cold. I paused as I opened my door to inhale the sweet smell of aging corn stalks and falling leaves. I knew today was a good day. I cheerfully pulled my bags of groceries from the back seat and headed up the stairs to my apartment. My tiny kitchen was warm and welcoming as I laid out the ingredients for dinner. Before I could even set a pan on the stove, my heart jumped into my chest as the now-familiar tones broke the silence. My heart immediately started racing. After all, I was the sparky newbie. Actually, to say I was sparky was an understatement. I was full on blazing for this job. I was truly enjoying my new responsibilities as a baby EMT. Of course, my service was nothing like what people described in class. Rarely did I go to the station. When we were paged, my vehicle was transformed into a first responder vehicle with a willing and mostly capable EMT inside.

Down the stairs I went, ignoring the fact that I was still in heels and a skirt, a byproduct of my full time job. As I pulled on scene, I was relieved to see AC's truck on scene. As I swapped heels for steel toes, I heard a voice over my shoulder.

"Here. You are going to need this." It was Jay, the AC's son handing me the big, scary orange defibrillator.

I peeked around the front of my truck and sure enough, there is a crowd around the patient... and a cop doing CPR. My heart dropped to my feet to the beat of a million a minute. Cold sweat stung my forehead and the pinch of anxiety knotted my stomach. I grabbed my coat and the d-fib and jogged to the ever-growing crowd.

I knelt to the right side of the patient, hid my shaking fingers in purple latex and lowered my ear to the patient's face. Nothing. My heart raced faster. I placed my two fingers on the neck of the patient and counted... and waited... and realized I was holding my breath. With the exhale I grabbed the BVM and placed it on the burly man's face. A shiver of discomfort and reluctance vibrated up my arms as the mask failed to seal to the shattered structures coated in broken, bleeding skin. I looked up to the faces staring expectantly back at me. The deputy to my left fumbled with the pads, bystanders randomly fussed with the patient's limbs and circled like vultures casting doom down on my head. I wasn't thinking, I was only reacting. It was almost like those dreams where you are floating somewhere above your body watching your own actions, unable to reason with your own muscles. Then, a face. A face I didn't know, but a face that topped black turn out gear that boasted my department's name. Never in my life have I been so happy to hear, "I'll take care of the airway." With renewed vision and strength, I pulled the pads from the trembling hands of the deputy and placed them neatly on the patient's chest. With an authority to my voice I didn't know I had, I demanded all hands be off the patient.

*No shock advised.*

Hand over hand, my palm met the sternum. I hesitated, expecting the crack of bone to reverberate up my forearms. Instead the chest caved to the left with no resistance. Fire rose up my throat. I gulped it back breathing in the scent of blood and soil. As if we were a well oiled machine, we gave the best CPR we could. All the while I prayed for the sound of a siren to signal my relief. It may have been 5 minutes but it felt like 5 years. The rest blurred by. I spit out a report of what happened and watched as the crew wheeled the patient to the ambulance. I stood there unsure of what my role had turned into. I tip-toed through the debris to the engine that had arrived and peeled off my gloves. Someone sat me down on the front bumper, revealing a perfect view of the flurry of activity inside the ambulance. I was shocked. I wasn't sad. I wasn't angry. I was optimistic. And happy. Surely survival would occur. It had to. We were EMT's, and damn good ones. We save lives and I just put on one hell of a show.

It was in that moment that I realized I loved this job. Until that point it was basic transports on which I was pushed into the corner and told to watch. I had made decisions. Heck, I had remembered what to do and I did it. In the right order even. I wondered if I should have felt worse, even if the patient lived, it wouldn't be any sort of quality of life one would hope for. Would I be this uncaring about all my patients? Would I ever feel badly about poor outcomes? My mind was in warp speed with no signs of slowing. Little did I know that this patient was the first of three I would see pronounced on scene in the next four weeks.

Looking back and knowing better how I respond to patients and their outcomes, I am surprised that I was so numb to the events that occurred. I don't know if it was the shock of it being my first call I was "in charge of" or my first patient to be called on scene. I can't really tell you. What I can tell you though, that the years and stories can and do change us. Sometimes it is positive, and sometimes it is negative and cause us to pause and wonder why we do what we do.