Sunday, August 12, 2007

Never forget....

I woke the other night choking down a scream, sweating and trying not to wake my Wife. I couldn't really remember what the dream was about at first. I just knew that it seemed familiar, like I'd had it before.

I sat up and went to the bathroom and splashed the sweat from my brow with some chilly water. As I looked up into my face in the dim light of the small nightlight by the sink, the dream came back to me with a vengeance. For just a second, I wasn't looking into my own eyes, but that of another man. A man screaming with rage, terror and grief. I gripped the edge of the sink and stared back into the reflection that didn't seem like a reflection as I remembered something that I thought I had long forgotten. But we never forget do we? I don't think so, even though we try, we never forget.

Just about anyone who has spent time on the streets as a cop, firefighter, or paramedic can tell you stories of their nightmares, if you can get close enough to them to get it to come out that is, this is one of mine....

Awhile back I was riding around in my truck, not doing much of nothing when my fire department/ rescue squad got a dispatch: Pedestrian struck. I flipped on the blinkers and motored over that way.

I was the third person on scene. The first was a fireman who didn't have much in the way of medical training, but eager to help. The other was a classmate of mine from early medic school. The scene was thus: A large sedan parked at the end of 10-15 feet of black marks on a curvy residential street, 10-15 bystanders that had come from out of their homes to gawk and one 5 year old child laying in a spreading pool of his own blood.

At this point I went into my "EMT Mode"- no emotions, just get the job done. I walked up and asked the fellow classmate what he had. I'll never forget his answer, "It ain't good BRM". As I was walking up, surveying the scene, I couldn't see the child in his entirety. I trusted the classmate for the hands-on stuff for the moment, and I was the only one at the time with any supplies whatsoever. So I started pulling stuff out of my bag and asking questions at the same time.

"Is he conscious?" I ask.

"No" he replies.

"Airway, Breathing, Pulse?"

"No, no, maybe."

"Maybe?"

"I can't seem to feel one" he says shakily.

I kind of nudge him aside to check for myself. This is my first, unobstructed view of the patient. It's a site I don't think I'll ever forget. His head is a mess of blood, hair and torn flesh. His shirt is torn in several places and blood is oozing out of many of them. One of his little arms is bent at an distorted angle back and behind him. His legs are mashed and bleeding and he has only socks on his small feet. This all took place in about 2 seconds, although it felt a lot longer at the time. I had the fireman hold what he could for c-spine while I inspected the child's airway and assessed for breathing. He wasn't, not good. His airway was full of blood and I asked for the hand-held suction in my bag. I got most of it suctioned and remarkably it stayed clear as far as I could tell.

In goes the tiny oral airway and I ask for the BVM to start breathing for him. Classmate hands me an adult one and I remember that is all we carry. Due to budget restraints we were never issued the pediatric or infant ones. I fit the mask to his face the best I can and give a squeeze feeling for compliance and watching for chest rise. It doesn't. I try to get a better seal and I am looking at his head this time when I squeeze. As I put pressure on the plastic bag I notice bubbles popping out of the top left side of the child's head where most of the damage seems to have occurred.

I can't believe what I am seeing. I try again and see the same results. I realize that the entire inner anatomy of the child's head is pretty much gone. The air I am trying to put into his lungs is coming out the side of his head. What the hell do I do now? I feel for a pulse and there is a weak one in his neck.

I can hear the sirens of the fast moving ambulance by now. It's almost here, but in my focused state of mind I didn't hear it. There are others on scene now, other EMT's and rescue personnel but they are just standing there looking at me. One asks me what I need and I say a surgeon. I'm thinking that is the only thing that can help at this point.

I continue bagging with the Classmate holding as good of a seal as he can with the over sized mask. Knowing that the effort is pretty much futile with all the bubbling coming out of the skull, but hoping that at least some of it is getting where it's supposed to go. I had also applied all the gauze pads I had to try to staunch the blood coming from his head, also futile, but I didn't know what else to do.

The ambulance arrived and 2 medics that I knew jumped out. You could smell the brakes cooking. We loaded him up and by that time the weak pulse I had earlier felt was gone. CPR and down the road we go. They tried to intubate, then tried to cric him. Neither worked, there was just too much trauma. They worked him for a long time at the ED, being a kid and all, no one wanted to give up. Eventually they did and we made our way back to the truck. Other fireman/ first responders from my department had followed us and cleaned up the truck so I rode with them back to the scene.

They had moved my truck down the road a little, to make room for the yellow tape the state cops had put up for their investigation. That's when I got the story. That's when I found out the rest of the horror.

The child was playing in and around the road. Neighbors said that he lived about a quarter mile away in a trailer park. He was always playing near the road. Most thought of him as a nuisance. He would throw rocks and such at cars and other devious things. A few had spoken to his mother, but being the alcoholic that she was, she just got defensive and cursed the neighbor out.

The child also had an older sister, 11 years old. She saw it all happen from the side of the road, about 6 feet away and was the one to run and ask someone to call 911. I can't imagine the thoughts of that little girl as she tries to grow up and find her place in the world.

The driver of the car was cleared from all charges. It was determined that he was driving within the posted limit and that he would not have been able to see the child in the road because of the curves. I never even saw the man. I don't know if he even got out of his car, I'm sure he did, but I didn't know it. Even though he has no criminal charges, I can imagine that if he ever got behind the wheel again, he would see that little boy crashing into the front of his car. If it were me, I'm not sure I could ever turn the key to another vehicle again.

He is a grandfather. He had his 2 young grandchildren in the car with him, ages 6 and 8. No one but God knows what kind of emotional scaring occurred to them that day.

After the investigation was over, we had to do the clean-up. We poured sand on the blood and tried to wash it off the road. It had poured from under the boy and ran all the way to the other side of the road and pooled in the dirt shoulder. I've drove through there many times since and I don't think it ever washed away completely, but that could be just my imagination.

We found the child's shoes. One was right behind the spray-painted marks where the car had been sitting, the other was about 15 feet farther up the road where the initial contact was made. This was the first and only time I had ever seen anyone actually knocked out of their shoes.

About this time we heard an engine growling its way toward us. A small pick-up came over the hill and several fireman had to jump out of its way. It skidded to a stop in the grass just beyond the yellow tape that was still up. The vehicle had barely come to a halt when a young man wearing mechanic's overalls jumped out. He was screaming before the door was open. He was screaming his son's name.

Someone had eventually called him at work and he came here instead of the hospital. He and the boy's mother were separated and initially no one knew how to reach him. One of the EMS supervisors was still on scene and apparently knew the guy but had not made the connection between him and the child. I was about 5 feet away when they stopped him. I could see the strain of the tendons in his neck as he pulled against those that had ahold of him.

I could see into his eyes as they told him that his only son was gone. I stood, unable to move, frozen by that mask of terror, grief and rage as I realized that the eyes that I was looking into were my own.

At this point I woke up.

At this point I always wake up.

It had been a long time since I'd had this dream. Up until now, it wasn't my own eyes that I was looking into as I awoke. But my wife is pregnant with our first child and now the dream has taken on a new form. I couldn't sleep afterwards. Instead I lay awake, cradling my wife, my arm protectively around her pregnant belly.

My wife also works in EMS as a Paramedic. But she doesn't have any of the experiences that I have had. So she can't really understand, even though my best attempts at trying to articulate my thoughts to her. She is my rock, but this time it seems that I break my waves around her, instead of on her. Even though she wants to help and understand, she is unable to stop the torrent that floods my mind.

So I am trying this, other than my wife, no one has heard this story in its entirety. I guess that I am hoping that by writing this out, I can somehow free the rat that is trapped in my mind.


BRM

41 comments:

RevMedic said...

Powerful story, well told, and one that most medics can relate to. Your feelings are yours alone, and very appropriate. I hope they fade over the years as you watch your family grow. Take Care.

Divemedic said...

I have been there. Every time you cradle a dead child, a part of your soul departs with his. It is the curse of EMS, your ghosts come back to visit.

Just remember that what happened is not your fault. What happened, happened before you arrived.

Joeymom said...

God bles ou for doing all you could do for that child- including remembering him. Sending lots of hugs your way.

Old NFO said...

BRM, you have to make peace with yourself. You know you did all you could, and it almost sounds like you separate the Father's actions from the scene with the child- Know they are one in the same. I still have memories of two scenes from the 1970's that still wake me up on occasion, one was actually a young girl that visited the fire house on occasion who was also hit by a car- She was literally unrecognized by any of the fire rescue who responded, although we ALL knew her. Her Mom was a nurse in the ER that we took her to, and only recognized her own daughter after about 10 minutes, when she was cutting the jeans off an recognized the embroidery as hers. That image of Mother and Daughter sticks with me to this day, but I have made peace with myself over it as I know we did everything we could at the scene and in transit. It was just that little girls time to go...

Just hang in and hang on- Remember, YOU WERE NOT THE CAUSE OF THE INCIDENT!

Detail Medic said...

Hon...I don't even know how to console you. I know that every time your child accuses you of being overprotective and says "Hey Dad! Relax!" you'll be thinking of this. No matter how many deaths we see, the children are the hardest for all of us.

RT/Medic said...

I hate to say i been in your shoes too and it never gets easier losing kids sucks big time and the ghost do come back I still have nightmares from the 9 year old i did who hung himself after a fight with mom. Kids dieing is a good medics worse fear and i hope you find the strength to make it thru my email address is nettech13@gmail.com if you need someone to talk to.

BCFD36 said...

It was 14 years ago. We were paged to a 4 day old little boy, pulseless and not breathing. He had been minutes before. We worked him for 30 minutes on the ride in. My son was 1 at the time. I could see his face on the face of the little guy we were working on.

I've been lucky. I've seen plenty of bad stuff. But I don't dream about it. So far. Hang in there. The wounds will heal.

D. Scruggs

SpeakerTweaker said...

Bear in mind, as you read this, that all the medical training I have came from Boy Scouts.

BRM, it's hard for me to articulate just how I feel about this. What happened that day is just terrible, and I feel horrible for folks like you for having to keep that with you for so long.

I find comfort knowing that there are still people out there in the world that try so hard to do so much for people they don't even know, even at the risk of having these awful memories or worse.

I don't know if what I've said helps at all. If we ever belly up to the same bar, though, your drinks are on me.



tweaker

knitalot3 said...

Thanks so much for the work you do. I know it doesn't help, but the child is now in God's hands.

I hope you can find some peace.

Ben said...

Quite a sad story, the death of a kid is always a tragedy. I assume that seeing the dad learning the news didn't helped.

I hope for you one day this bad memory will fade away.

armed_and_christian said...

My prayers are with you, BRM. Love your wife, cherish her and that little life growing in her, and be grateful that there are some things she can't comprehend.




FWIW, I was knocked out of my shoes once; crossing the street in Phoenix, AZ in 1985. When the light changed, I was in front of a big pickup truck. The driver just started accelerating while I kept one hand against the grill, tried to run, and screamed like a little girl.

Aunt Murry said...

The one thing that I have learned is that we can only do our best with what we have. I have no words only prayers. I am sure that you will be a good father and do your best with what you have. It is never enough. Thank you for sharing your heart.

Beaker said...

I wish I could say something to make you feel better.

Just know that you and everyone did their best and will continue doing your best for future kids. It's not your fault he didn't live.

Kat said...

(((hugs)))) and prayers coming from here in GA.

Reminds me of a little boy who could have been at most 3, who was allowed to roam the neighborhood we USED to live in, with no supervision at all. He is just the same as the little boy you described here... oftentimes people have rescued him out of the busy highway just up the road a ways... when we lived next door to his so-called parents, often times he ended up playing in our living room all day and into the evening. He'd just walk in unannounced... and we much preferred that, to having what you described here happen to him.

Now that we've moved, I don't know whatever became of the little fella.... Hopefully he's still OK.

((more hugs & prayers to you & your family))

Scott said...

I'm sorry you have to bear that memory. God bless you and your family!

Doctor Bee said...

I'm a pediatrics resident and had a patient of mine unexpectedly pass away while I was on night float two weeks ago. It's the first code I've ever called and ran myself. I've grieved, been consoled, and attended meetings to help change the system.

I still feel numb. I'm not sure when I'll stop feeling numb and start feeling again.

My best to you and yours.

Anonymous said...

I too have seen the aftermath of bad parenting, had to try to clean a small child's blood from my hands.

This kid's in a better place now, with people who love him and care -- he had neither here, although Dad probably tried.

You did all you could. Just remember he's better off, now.

DD

Blue Ridge Medic said...

Thanks to all commentors, I appreciate all the thoughts and prayers.

BRM

PJ Geraghty said...

I'm kind of lucky; I rarely see the raw scene or even the ED treatment of cases like this. Instead, I see them if/when they make it to the ICU. Before I had kids, it didn't bother me too much. Now I have four, and I see at least one of them in every dying child I see in the ICU. All I can do is offer what comfort I can to the family, go home, and hug my own kids. And that's all you can do.

Believe it or not, you were part of the solution. Imagine the trauma of the family and bystanders had no one known what to do before the ambulance arrived. Instead, you got there quickly and did what you could to try to save this kid. Whether they realize it or not, the parents will know, somewhere in their minds, that someone (you) tried like hell to save their kid, as if it were your own.

Be safe, brother.

Epijunky said...

I wish I had some sage advice to bring you some peace. I haven't gone through anything like this, and I don't want to imagine what it must be like.

You're in my thoughts, take care.

Amanda said...

I can't add much. All I can say is that, as a former volunteer police officer and wife of a man who's trying to join our volunteer firefighters...

I'll pray. For both of you.

Emt's Do It For Life said...

My prayers are with you Blue that you find peace and are able to unload your burden.

northflrn said...

What you have to keep in mind, and it is impossible to do sometimes, is the ones who make because YOU were there. Yes, it doesn't make these nights any better, but it is a comfort. A while back I was a hospice nurse, and I had a thirteen year old with desmoplastic round cell carcinoma. One of the hardest things I have ever had to do was tell this young lady that I was there for her no matter what. Knowing that she was going to leave her family and me behind. But, you know I think that by being there in some small way I made her life a little better place. Find some solace in knowing that if it was possible that you WOULD have saved him, and be thankful for all those that you have saved.
I sir thank you,

Anonymous said...

I've seen alot of death in my life, young and old. The young ones are the worst.

I had trouble with dreams for a while until an old timer told me how to make them stop. It worked for me and I hope it works for you.

I made the mistake of trying to put the memory out of my mind everytime I thought of it. I never gave my mind the chanceto work it all out. My friend told me to do exactly the opposite. He told me to remember everything. Everyhing I saw, felt, heard and smelled.

I sat down and ran through the memory in my mind moment by moment. Everything about it, pulling up in the car, what the house looked like on the outside, going inside, the smell of the house, the slipping of my boots on the floor all of it.


I did it and I don't have those dreams anymore. I still see faces and scenes in my mind sometimes when I lie down and close my eyes but I'm at peace with that now.

Hang in there, you'll make it through.

Anonymous said...

The previous post is great advice. I learned from a grief counselor to put the call in a box and place it on a shelf in your mind. Make time to take the box down off the shelf, open it up and look the whole thing, feel it, relive it; then close the box and put it back on the shelf. Do it often until you don't need to look at it or stop dreaming about it. This imagery or something like it can help you have control over when you think about it instead of it controlling you (in your dreams) or worse yet, freaking on a call. Writing about it should help too. Good luck to you.

Captain America said...

Dude I can relate. There are a few things I can tell you if you want, I hope they help. Your very articulate. You told that story well. That should help get it out of your head. Writing things down can be like therapy. If you become too disrupted by your memories you should get counseling through your EAP if available. You have to take control of your emotions or you will end up in the scrap heap. You have a new baby on the way and there will be even more stress on your plate. It's natural to be bothered by trauma. The fact that you feel sorrow, loss, empathy even fear shows that your having normal reactions. Now that you know that, take control of them. Try working out. Stay physically fit. Your body takes a pounding from the stress. Try to get regular sleep (Yeah I know it 12:30)You will sleep better after you work out and that may put the nightmares to bed. Personally I forget every call as fast as I can. I remember it long enough to do the paper and then it goes in the sh*tcan.
If all else fails, then you have to suck it up. There are days that nothing will do it for you. Like the time I had a family of five burned to death. Grandmother & four kids. No amount of running, swimming, counseling, hypnotism, booze, or prayer takes that one away. Sometimes you have to suck it up. Peace.

Anonymous said...

take comfort in the fact that you have helped all the commenters tonight.
Avenues for expression are few and far between for those who may have to live through these experiences every day. I have 2 human experiences.
(I spent several years in large animal medicine and have more experiences than I care to mention.They are mammals too) One of my experiences was during childhood one as an adult. One worse than the other. I won't bore you with details, but I see the instances clearly to this day from time to time. One was 40 years ago. I did the relive rethink thing and it was helpful. Nothing I did not do would have changed the outcome.Everything I did would not have changed the outcome. I have never reduced the first thought to paper, until today. Thank-you

Anonymous said...

I'll tell you something else that helps get images out of my mind. Photo albums. I worked a child murder a while back and I had to go the autopsy. The victim was the same age and sex as my kid. Everytime I closed my eyes for about a week I saw that kid lying on the coroners table. One night I came home and just got out the photo albums and spent about an hour looking at pictures with the wife and my daughter. When I closed my eyes that night I saw the pictures in the photo album instead. The mind does some crazy shit.

prairie mary said...

I'm convinced that these super-intense memories are somehow physiological -- actual chemical molecules in the body that record the incident. They may need to be processed through memory and sharing, as the two anonymouses suggest, in order to be finally re-categorized into something that is finished and doesn't need more attention.

Such a terrible death is hard to look at, but it means that the child felt nothing -- was simply gone. No long days of suffering.

Prairie Mary

Anonymous said...

This is a powerful story. Not to sound callous, but you have to make a choice. Either build an emotional wall between your life and your work, or find another career. The only other possibility is eventual emotional collapse from which you may never fully recover.

Bill CST B.S.

erarein63 said...

I'm an ER RN and have been one for the last 11 years. It's never, ever easy when it's a child. Ever. You just do your job, go home and hug your own kids a little tighter and a little longer, and thank God for their health and safety each and every day. Hope you feel better. De ;)

phlegmfatale said...

Blessings to you and all the good people who pick up the pieces when things go wrong. As did everyone who ready your post, I thought of all the little ones in my life, and how precious and fragile they are. There but for the grace of God...

Moth said...

Thank you for what you've done and what you continue to do. If there were a way to take these dreams from you...

You are in my thoughts and prayers.

Judy said...

I think that the hardest thing is that this could have been prevented. If only the mom didn't drink. If only the dad knew how that little one was being raised - and could have done something about it.

You have no reason to feel guilt. The neighbors who didn't call CPS? They're the ones who should feel bad about this. You, and that poor man who hit him, and his sister, and everyone else involved have no reason to regret anything you did.

I hope telling this story helps you. It was worth telling in any case, because it may help someone else.

L Darnall said...

BTDT. You did the best you could; that's all you can do. I know it doesn't make it any easier. Talk like you're doing. Time will heal.

I'm sorry.

LD,
EMT-P

Adoro te Devote said...

I don't think I have anything to offer, really, other than my prayers.

My first Code 3 call was for a child on a bike hit by a car at a major mall, near a major highway. IMHO he should never have been there. I still remember going through rush hour traffic to get to him, but another squad got there first...and thankfully, he was ok. On all the kid calls I responded to, they were fine.

But my heart breaks whenver someone loses a child, whenver something like this happens...and the effects it has on those who try to damn hard to help.

God bless you. Keep at it, and keep caring.

When you don't care anyomore, it's time to hang it up. Keep that in mind...the only reason you can do your job well is because you care.

If you're not affected, then something is really wrong.

Jaime said...

I don't really know what to say but the story is a powerful one and written so well.

I couldn't imagine how it must be to experience that. This is the one reason I'm nervous about perusing a career in L&D nursing.

Thanks for sharing your story. I hope the bad dreams go away.

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