Reuniting with Duane

Friday night (or maybe I should say Saturday morning) was a very long night.  I think the high point had to have been taking an unmarked, minimum maintenance government road ten miles through the desolate swamp of a park preserve around 0330 to reach a patient at the very farthest edge of our service area.  We felt like we were driving through Deliverance, and if it weren't for our dispatch making wise use of our truck's AVL system, I'm not exactly sure we would have found the patient or our way back to civilization.

As we were restocking, the other truck got a PI which turned out to be a fatal.  It's common in this line of work, at that hour of the night, having run back-to-back calls, to feel relief at not having to work up a trauma, clean up that kind of mess, fill out that kind of paperwork.  I'm guilty of it myself, and to admit that shames me.  Yet even when I forget in the moment from whence I came, I am heartbroken with empathy.  I don't know how many of my coworkers feel this sorrow while coming to understand the stark realities of life and death and perhaps simply don't talk about it, but I always feel it. I don't even think about the patient who lost their life.  I think about the parents, siblings, spouses, and children.  I think about how hard we fight, how frustrated we get, how engaged we become in the battle to save someone's life on that rare call where that is what we are called to do.  I think about how none of us is promised so much as the remainder of this day, the pain of those who go on living, and of what a truly baffling shock it is to realize how deeply we can be wounded and keep breathing.  The world shouldn't go on when it hurts that bad, when nothing makes sense, and yet it does.

By the time my shift was over, I'd had about 2 divided hours of sleep in the past 27.  I could have cancelled my plans and gone home to sleep, but decided to push through instead.  As I drove through my service area, I passed the field where the snowmobile drags used to be held.  I remembered the man from years ago with a floating midface after his four-wheeler landed on it.  Seriously creepy stuff to watch someone talk to you while their teeth, nose, and cheekbones grind and ooze around.

I took a back route since I desperately needed Starbucks, passing the intersection where once upon a time, a Culligan van pulled out in front of a woman driving down the highway.  That was the most massively broken femur I've seen to this day, when you pull someone out of a car and their leg is nothing but a collapsed bag of bone fragments.

I made my last turn into town and passed a street down which we worked a cardiac arrest, years past again. Because of an inaccurate numbering system and a mismarked map page, we were delayed about 4 minutes in finding that address.  That still bothers me.  I remember so acutely the relative youth of this patient, the absolute shock of her spouse, how the firefighters hesitated to stop CPR even after our med bag was empty, and after our second call to medical control.

Ten years of calls began to flood over me and my exhausted, disorganized mind.  My eyes were on fire.  My whole body hurt. I couldn't feel my feet, they were so swollen inside my boots.  All I wanted was to eat carb after sugary carb and to wash it down with four espressos.   It's moments and memories like these that make me ask myself, again and again:

How do any of us keep doing this?

The reason I chose not to go home and sleep was because a good friend (and partner-in-EMS-crime for nine years) and I were traveling north to surprise a former patient.  I don't know what it is about certain calls or certain patients, what it is about them that gets inside us or vice versa. This patient had an curious and unfortunate clinical story, and was extraordinarily grateful as we transferred him from one hospital to the next.  As we watched his procedure, despite his sedation he kept craning his neck back toward the control room, asking, "Are my girls still here?"  Eventually we did need to leave, and sadly it was with the uncertainty that he would survive.  Per his request we had left him with our address, and we were pretty happy when a card arrived at our quarters a couple months later, informing us that he was doing very well. 

During transport, he had talked at length and with great enthusiasm about his antique tractors, and his concern that he may not be able to continue his work with them.  It was a joke that he carried forward in the several cards we received, including the formal invitation we received last month to come see "the old duffer and his tractors" at his annual threshing show.  We knew immediately that we would go, and we knew we would make it a surprise.

We were surely not prepared for the size of this rural event, and we sure didn't expect to be celebrities!  The ladies at the gate could only be convinced to let us pay for one admission, and they warned us that we'd be lucky to find him as he was probably climbing the tower, leading up sawmill operations, or leading the tractor parade - this, and he turns 79 next week.  We found him doing the latter, and when he recognized us, he got so excited he almost drove his 1944 John Deere into the side of the barn.  An entire family and community of strangers could not stop hugging and thanking us for being part of giving them back their "social butterfly" of a father/grandpa/great-grandpa and friend.  Our patient insisted on treating us to not one but two massive ice cream cones and introduced us as "his ambulance girls" to anyone who would listen.  We watched him operate his father's massive ancient sawmill, toured his 130 beautifully restored tractors, and got invitations (orders, actually) to come back and drive a few in next year's parade. 

Maybe I'll do some checking and see if I can post our picture here on my blog.  Silly HIPPA.

My friend and I talked on the way home about how all we did was come to work that day.  We aren't heroes.  We just did our job, but we did it with all we had.  If anything, it was the cardiologist who did the open-heart surgery who performed the truly life-saving work.  Numerous others contributed far more to his recovery than did we.  We agreed that perhaps the heroic part is that we weren't afraid to go beyond the uniform and connect with another human being, to humbly allow him to offer the depth of his gratitude for a life he got to keep.  It wouldn't be appropriate or even possible to do that with every person we encounter, but when invited, we walked in and welcomed the opportunity to make his day a second time.  It's hard to do: to remember, to care, to let people and their circumstances inside your heart.  If you did it consistently, it would break you.  But sometimes, it's good to be reminded that what you do matters, even if only to one patient out of thousands, and a whole lot of people who love him. 

We walked around this man's farm yesterday and the question of my morning drive changed its form, and becomes so especially relevant on this 9/11 day:

How do we NOT keep doing this?

I was sore.  I was beyond tired.  I was overwhelmed with other thoughts and responsibilities.

It was worth it.