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