A Firefighter's Christmas

'Twas the night before Christmas, and all through station

All was quiet except for our snoring dalmation.

Our boots had been placed by the bunksides with care

In hopes that the shift change would finally be here.

The lights were turned down and the TV was off

The rigs had been washed and the floors had been  mopped.

Firemen and Medics lie nestled in bed

While visions of homelife danced through their heads.

When out of the darkness, arose ringing and light

The Plectron brought tidings of something not right.

The Firemen and Medics were dressed in an instant

Aboard their trucks and racing into the distance.

The moon on the breast of the newfallen snow

Reflected the lights in a hellish, red glow.

The sirens, they wailed while the federal screamed

Moving too slowly, as if in a dream.

The wreckage was there and came slowly in sight

Lending fear, pain, and loss to our silent night.

Each of us thought of our own Wife, Daughter or Son

Each prayed in silence, "Let me save at least one."

We leaped to the task without further a thought

And for more than two hours we worked and we fought...

To free the two drivers who hadn't been thinking

their driving would suffer after a full night of  drinking.

The smoke of the flares, and the stench of the blood

The screaming of metal as we rolled back the hood.

The cry of one driver, the whine of the Jaws

Putting fear aside, we never gave pause.

With one driver out, and the other prounounced dead

We focused our efforts on keeping our heads.

C-spine and backboard and IV in place

We loaded him up and we started the race.

The monitor showed a heart rate to slow 

BP revealed a systolic too low.

Level of consciousness rapidly dying

Despite all of this...the Medics kept trying.

Atropine, Dopamine, Epi and more...

to keep our reason for being from opening death's  door.

We fought and we prayed and tried all that was known

While trying to believe fault wasn't our own.

The sun, she was rising as we reached the ER

We'd given all that we know, and all that we are.

The Doctors pronounced with barely more than a glance.

And gone in a blink, was the patient's last chance.

The ride back to the station was quiet, and then....

Despite what we'd been through, the singing began.

At first it was one and then all followed suit

This effort together was merely the fruit...

Of a labor that however needlessly beared

Was one of a million we knew we had shared.

As we sang out the words of the song, "Silent Night"

We acknowledged to ourselves that we put up a good  fight.

The punch of the clock, the start of a car

we all realized and loved who we are.

And on Christmas morning, as we all drive away...

We know we'll all try in a couple of days...

To give someone back their one chance to live

Now matter how hard or how much we must give.

So please, when you pray on this new Christmas morn

Add something for us, and for all that we've borne.

    -Anonymous

With my family celebrating Christmas on the 26th due to conflicting schedules, I swapped shifts with another sleeper so he could have the 25th off and I the 26th.

And surprisingly, I found I LOVE working the holidays, for several reasons. 1) If it's a national holiday, aside from our daily duties (rig checks, cleaning and such), we don't do a blessed thing. It was just the three of us on the duty crew at the station. So quiet. So calm. I almost fell asleep. 2) It gives me a way to give to my community on the day most celebrated for giving. 3) Patients and their families or friends are much more likely to express thanks and gratitude, and folks, that means a LOT to us. We transported an elderly lady who was feeling weak and had been vomiting all morning. There wasn't much I could do for her, except give her supplemental oxygen, monitor vitals and try to reassure her. I felt a little useless. But when I found her son and daughter-in-law in the waiting room and walked them back to her room in the ER I got the biggest hug from the son and a sincere thank you--and it absolutely made my day!

Some citizens of our little town donated food items to the station--which I believe they do every year. We were overflowing with potatoes, onions, carrots, celery and other food items. We were even given a turkey, which one of our crewmembers took upon himself to cook.

And he did it fabulously! We dined sumptuously that afternoon.

We wound our Christmas day down with chocolate brownie thunder ice cream, running on the treadmill, watching movies and doing absolutely nothing.

And then the calls came down.

Ah, what a way to spend Christmas! 

I breathe in the odors of cigarette smoke, vomit and stale, cheap liquor. Hot air is streaming from the vents, perfusing the smell throughout the tight, stuffy space of the back of the ambulance.

Sweat begins to trickle down my back. I painstakingly work my jacket off, but I have to be quick and I don't take my eyes off the patient. With one hand I am holding the Bio-hoop bag beneath her chin. The vomiting has subsided for the moment, but there's no telling when it will begin again. The monitor honks at me irately because the pulse oximetry keeps slipping off and one of the 12-lead electrodes doesn't want to stick. I mash on the button to silence it. The patient's veins are elusive--the paramedic can't get an IV, and she can't take the oral ondansetron tabs.

Thus, it is no surprise when the vomiting erupts once again.

One thing I love most about my job is the camaraderie people from completely different districts, departments, stations, counties, even different states, share. That seemed to be even more true on Christmas. EMS is such a tight, everybody-knows-everybody community, and we exchanged many a "Merry Christmas" with every crew we met up with that night.

 He's in the postictal phase now, characterized by the smacking lips, the dazed expression, confusion and fatigue. Our patient, in his mid-forties, that came down as a "sick person" had apparently had a seizure before we arrived on scene, and his caregiver found him just as he was becoming conscious. He has schizophrenia...or autism...or both. The information we received was confusing. There's a definite barrier to patient care. He can understand us pretty well, but he can't talk with us. He wanders the house agitatedly and it takes us some time to convince him to sit down, take his coat off and let us assess his vitals. Throughout the transport he remains quiet and compliant. I get ready to hold his arm still in case he tries to pull back when the paramedic starts the IV, but he doesn't flinch. He smiles at me frequently with those strange, somehow vacant eyes and crooked teeth, but that's it. He's content to watch the waveforms of the EKG trace across the screen of the monitor. We're about five minutes away from the hospital when the next seizure hits . It was so fast! I try to gently hold his arms still and keep him on the gurney, while his fist clench tight, his head is thrust back and his arm and facial muscles contract in a spasmodic, disorganized, jerking fashion. For a few short moments that felt much longer he doesn't take a breath, and then he relaxes. The whole seizure last about a minute and a half.

It isn't until we're wheeling him down the long hallway of the ER that the next one hits. 

 Part of the closeness of EMS and Fire personnel is covering each others' backs. We took a call in Mac when all of their medics were out, and I was reminded of the time we spent about half of one shift in Mac running calls for them because they were so swamped.
And then I think about all the times they've covered for us...

I fumble with the nebulizer. I haven't had to put one together for a long time. I pour the clear liquid medications into the reservoir, connect the oxygen tubing to the bottle and the vaporized medication starts puffing from the plastic mouth piece. I try to get the patient to hold it in front of his face, reasoning with him that it will help his shortness of breath. He finally consents to put it in his mouth, but it doesn't last long. He lets it slip out and I sit at his head, holding it so he can get some blow by" oxygen. 

Once again, the back of the ambulance is uncomfortably hot and smells of alcoholic beverages. I don't know if the patient was intoxicated or not. It is not my judgement to make.

The patient doesn't want to be seatbelted, but he has to be. He doesn't want to lie on his back or be covered with a blanket. The blood pressure cuff and pulse oximeter are close to jerked off. After a few minutes, he gets irritated and abruptly shoves the nebulizer away. His hand swings out and I pull back.

Okay, we're done with that I guess.

It was a good shift, and I'm glad I got to work it. 

How was your Christmas?