The Pink Cross

I anxiously watched the clocks second hand slowly ticking off the seconds until this shift was over. My ears strained to hear the sound of my replacement driving up the gravel driveway as I stared blindly out the window of the shift bedroom. “To hell with the call gods,” I thought and I packed up my duffel bag. Stuffing the pieces of my life that I carried back and forth to work with me into my old duffel bag I defiantly dared the tones to drop. I glanced at the clock again and thought of how ironic it is that the last 30 minutes of any shift last the longest. With another ten minutes to wait, I rolled up my sleeping bag and tossed it into the locker. I tensed a little, thinking I had heard the slight static the speaker system puked out before the tones dropped and stopped what I was doing to listen for the staccato beeps. But not this time. This time the beeps didn’t come and the speaker remained silent. This time the call gods must have sensed that I was teetering on the edge. They must have known what I did not know. Whatever it was, they waited until eleven minutes after I punched out to drop the tones and page the rig out to an assault on the other side of the reservation.

As EMS5 lumbered out of the driveway with lights and sirens blaring I tossed my heavy duffel bag into the backseat of my car and slid exhaustedly into the driver’s seat. It had been a tough shift and this time there was no pang of guilt for not even offering to assist the EMT on call. She was new here, and still had grandiose idea’s about changing the world, one person at a time. She hadn’t come to the realization yet, that no matter how much we cared, or how much we did, the abused will return to their abusers, the alcoholic will return to his alcohol that makes the ugliness of how he sees the world a little less ugly. She doesn’t know yet that sometimes, the only thing we can do is listen to the pain in their voice as we tend to their outer wounds. To be someone with a gentle hand and a caring heart as we fix what we can see, and pray about the things we cannot see or change.

Shifting the car into gear I followed the rigs tracks out of the snow covered driveway and turned in the opposite direction it had taken and began the long journey home. Four hours of traveling time to clear my mind of the events of my shift. Four hours of solitude to think about what I wanted to think about and rehash the tough calls in my mind, time to put my work life in a box and tuck it safely away until my next shift.

As I left town everything glittered with the sun’s reflection on the pure snow. The trash and thrown out garbage littering the sides of the road was covered with sparkling white snow diamonds in the suns early morning light. Like a band aid covering a healing wound, it covered the historical and intergenerational trauma that was felt here and for a brief moment in time, the snow bridged the cultural and financial gap between the reservation and the rest of the world. Not wanting to ruin the morning beauty I left the radio off and driving in the silence I admired what a beautiful job God had done creating this land. Listening to the muffled sound my tires made as they hummed along on the freshly fallen snow I was slowly decompressing and transitioning myself from EMT to mom. I was closing all the doors and lowering all the walls that kept my EMS life, and all the depression and tragedy that I see in it, away from my real life. I caught a glimpse of a bald eagle soaring through the crisp spring air over the pastures and rolling hills and I could feel the tension leaving my shoulders as I tossed a cigarette fresh from my pack out the window as an offering to the spirit of the eagle. I whispered a quick prayer and began to feel a peaceful blanket cover me in warmth and chase away the pain and depression of the last 48 hours. I decided that if I got home early enough this afternoon I would pick my son up from daycare and take him to Wylie Park for the day instead of going home to sleep. I smiled thinking about how he loved going there and seeing all the animals and playing in the fairy tale worlds they had so skillfully created. Today was going to be a wonderful day.

And then I came to the curve. The curve where 22 hours ago there had been a tragic accident. The curve where we had scooped up the tiny body of a three year old girl thrown from the window of the car her drunk mother had rolled while trying to negotiate the curve at a high rate of speed. I tried not to look at it. I tried not to let my anger at the mother and the pain of losing the child fill me with sorrow. I tried to keep those feelings on the other side of the wall I had built in my soul, to keep them where they belonged, packed tightly away into the box. But then I saw it. A tiny little pink cross with white flowers on it standing there, like a brave little soldier surrounded by busted car pieces, empty beer cans and random contents from inside the car. Silently standing guard in the middle of the ditch and daring me not to care. Daring me to drive by without letting the walls come down and reliving the entire call. Daring me to not shed a tear, to not to feel the anger I had felt towards the mother. And the wall in my soul crumpled and buckled under the weight of the memory of those beautiful brown eyes of the child glazing over as the life drained from her body beneath my hands. The box that contained the part of me that wasn’t supposed to seen blew apart into a million pieces of tears.

I pulled the car over to the side of the road and dissolved into a ball of sobbing tears and gasping breaths for air. The sadness and the futility of the fight to save the little girl’s life filled my entire being and touched me to the core. I let the tears flow and the emotions take over as I sat in my parked car and stared at that tiny little cross so bravely marking the spot where a beautiful little girl had lain just hours before all crumpled and broken. I ran the entire call through my mind again and again, critiquing everything I had done, everything I hadn’t done. I questioned myself if there was anything I missed, anything I could have done differently. Deep down I knew that I had done everything I could and had given her every medically possible chance to live, but I still couldn’t make a difference. I cried as I remembered seeing the mother’s expressionless face as she lay on the long spine board secured to the bench seat beside her dying little girl. Uncaring, unaware, or maybe just unable to feel the pain of knowing that she had just killed her baby. Maybe her life was so miserable that she didn’t expect anything less than to lose a precious little girl that she had given life to. My mind replayed how she had screamed at me to give her something for the pain in her leg while I was trying to intubate her little girl. How she had called me a “white bitch who didn’t give a damn about her” when I was doing compressions on a tiny little chest that was crumpled and broken inside. I shivered as I recalled the cold grip of her hand on my arm while her daughter took her last breath and demanded that I call her ex-boyfriend and tell him his baby girl was dead. I remembered looking into her drug and alcohol glazed eyes and seeing a small glint of understanding in them. A quick flash of realization of what was happening and what she had done to her baby before they glazed over again. A glimpse of knowledge that was too great for her to bear at the time. It was easier for her to be hard hearted and uncaring and she silently stared at me I as continued to try and bring some life back to the crushed soul beneath my hands.

I felt the empty hollowness in the pit of my stomach that I had when my partner and I had walked past the trauma room that held that tiny little body on the cold metal steel bed, covered with a white blanket and lying all alone while her mother cursed out the hospital staff across the hallway from her. Each of us turning our eyes away from the lost little life in that room. Each of us stuffing it into the box to be tucked away in our minds and kept from the world.

I stared at that little pink cross and worried about my partner. I recalled the hollowness in her voice when I asked her in the rig on the way home if she was okay and she shrugged her shoulders and said “yeah.” I told her I was going to call a critical stress team in for everyone involved on the call and she shrugged her shoulders again and said “I won’t come anyway.” During the trip home I had tried to talk to her knowing full well that she wouldn’t talk about it until she was ready. I knew she would just go home and call up her buddies and they’d go out and get drunk and there wasn’t anything I could do about. After staring out my window for a bit I looked over at her and I told her, “You know you’re like a little sister to me right?” and she shrugged and nodded her head. I knew she would be calling in “sick” for our shift next weekend and I probably wouldn’t see her again until she had dealt with this in her own way. “You know I love you right?” another nod, but this time without the shrug to her shoulders. A small victory. A small acknowledgment that she knew how much I cared about her and wanted to help whenever she was ready. And we rode the rest of the trip back to the bay in silence, both of us lost in our own thoughts as the headlights of the rig guided us through the dark cold night back home.

I wiped the tears from my eyes and began to tuck the memories and feelings back into the box and place them behind the wall in my soul. Quietly I stared at that little pink cross in the middle of the glittering snow and prayed that whoever had placed it there had shown the little girl some measure of love. I prayed that in her short life there had been someone there to give her some measure of happiness. I wiped away the last of my tears and I told her that I was sorry and that she will always be loved by me and I will forever carry her in my heart. As I put my car into gear and slowly drove away, I asked her to forgive me and wished her a safe journey to a place where I knew she would be happy and feel a glorious love.

The cross is probably gone by now, but I have carried her memory in my heart since that day. Several years and many calls later, I have finally become friends with her spirit. That tiny little spirit that came in the dead of the night, or when I felt like I was all alone. I’d see her standing there, staring at me when I was so depressed I didn’t think I could do this job anymore and it would fill me full of sadness and make me question why I kept putting the uniform on. Make me ask myself why I was going out to do this job over and over again only to have more people die, more broken bodies and lost spirits locked away in that box. Until finally one day it dawned on me, this is where I was meant to be. This job, with all the things we see and do in the field, the calls that can take us from pure elation at the birth of a newborn baby to the anguished cries of a trapped teenager in the space of a 48 hour shift is the job for me. I think about the new EMT who replaced me on the reservation and I hope she kept her grand ideas of saving the world, one life at a time. I hope she never lost sight of trying to help one person at a time and I realize that although I thought it was silly at the time, I still had that hope inside of me as well. I still go on every call hoping that I can say or do something to make one person feel better about themselves or the situation they’re in. Hoping that I can make a difference to at least one person with whom I come into contact with. Whether it be a calming voice and gentle hands as I help a patient through an asthma attack, or the feel of my hands as I carefully splint and wrap a broken arm, I am still trying to change the world one person at a time. I hope I never stop doing that.

And now, when my little spirit visits me after a tough call or in the middle of the night, she comforts me instead of haunts me. She pushes me to be a better provider and reminds me that this is the job I love, this is where I was meant to be. She is a piece of me, she comforts me, and I no longer try to keep her in a box. I carry her spirit and the spirits of many others along with me through this life and they will remain forever in my heart. They will continue to remind me that sometimes, the only thing I can do is just be there for my patient and let them know that someone does care.

Tami

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If I could talk to me……..

Dear Tami,

The first time a really sick or hurt person’s life is placed in your hands, you will panic. You will briefly forget everything you have studied for the past six months, including your name.

You will put the blood pressure cuff on upside down at least half a dozen times or more before you become comfortable doing it.

When a pregnant lady is on your cot and she tells you she has to push, believe her.

When someone looks really sick or hurt and tells you they are going to die, believe them.

When your gut is telling you to get moving, listen to it.

You will meet asshole doctors who treat you like a moron. Learn from them. Show them respect and expect them to respect you in return. Don’t be afraid to ask them if you could have done something differently. If they are not willing to assist you become a better provider, get over them and realize the problem lies within their attitude. Never succumb to becoming a half-assed provider because you feel the doctor or hospital staff doesn’t recognize it anyway. Your patients will.

You will meet asshole paramedics who treat you like an idiot. Get past it. Never let a first impression cloud your judgment. Look at things from their perspective before getting your panties in a bunch. Maybe you could have done more than you did, or maybe you panicked and did too much. Cut them some slack until you get to know them. Always keep communication open regardless of the reception. They may need you someday just as you have needed them. Strive to become a team with everyone in the back of the ambulance, it’s not about egos, it’s about the patient.

When the pregnant lady does push and you see a head crowning, take a breath. Even though your brain just flew out the back window, get ready to catch a baby. Babies are slipperier then a wet bar of soap in the shower. Don’t drop it. When you see the white lights, breath. You can’t help the baby if you are flopping around on the floor from oxygen deprivation.

People will die before you get them to the hospital. People will die before you get on scene. Learn from it.

Pediatric calls will be no easier in fifteen years than they are now. They are always hard.

You will make mistakes. Own up to them. Learn from them. Don’t make them again. Ever.

You will never stop learning. Something new will always come around. Be receptive to new treatments and new practices. Don’t do something just because that’s how you’ve always done it, only do it if it that is the right thing to do. Know what the right thing to do is.

If you ever blame yourself for something happening that really was out of your hands, forgive yourself. No matter what the call, no matter what the outcome, you are the one that has to face yourself in the mirror. Always conduct yourself so that you are proud of the person looking back at you from the mirror.

Enjoy your career and your patients. If there comes a day when you dread going to work, take a break. Your patients’ lives depend on you.

They All Live On~

As the ambulance pulls up on scene my gut drops to the bottom of my stomach. It’s not going to be a “good” call and it’s already started out wrong. People are standing around the front door, some are crying hysterically, others are just standing there with glazed looks on their faces. Picnic tables are covered in an assortment of food and children are playing quietly but watchfully around the eges of the campsite.

The frantic mother runs out from the crowd of people carrying her baby in her arms with tears streaming down her face and big black gobs of eye makeup smudging under her eyes. (It’s funny the things we notice in a moment of stress isn’t it?) She hysterically tells me that the baby was fine this morning when she laid him down for his nap and she’s babbling a bunch of stuff I don’t really hear. 

I look down into the blanket she has wrapped around the baby, it’s one of those soft fuzzy blankets that everyone loves to run their hands across and feel the smoothness of, and I see the beautiful face of an infant. Such a beautiful little baby I think to myself. Then I focus on his eyes and see the blank, gazed stare and the blue around his lips and my heart does a flip in my chest. She hands me the baby and turns around and collapses into the arms of someone who looks like they might be her mother. She’s turned her back on the pain, trying to find some kind of escape from all that she knows will come next and my heart aches for her.

We run to the rig with the baby, get out the pediatric kit and do all the right things. The next couple of hours go by in a blur as we get to the hospital and assist in the attempts to resuscitate the beautiful little boy who will never hear his mommy say I love you again, never go to school on that first day and feel the fear in his heart of beginning a new stage in life. 

And then we stand there and talk quietly with the doctor and nurses who just minutes ago we were standing side by side with, desperately trying to bring back a little heart that had quit beating. We console each other with talk of other things. Each of us mourn the life of the little boy that was lost in our own private way, trying hard not to let on how deeply it affects us. The nurses and doctor go back to their patients and my partner and I restock the ambulance and head back to the bay.

The rest of the day has a quietness to it. There is no silly banter and no goofy jokes. We deal with what has happened in our own little ways. My partner calls his wife and asks to speak to his children. I call my babysitter and ask how my sons day at daycare went and ask her to give him a hug for me but I don’t talk to him because I know I’ll break down and cry. We take the rest of the calls that come in and maybe get a little angry sometimes when we attend to someone who really doesn’t need us, and work a little harder on the ones who do, but we try not to show it.

The next morning when we get off our shift, my partner and I say the usual good-bye to each other and we each walk away with a little piece of Tobias James in our heart…………