I wrote this story to help myself cope with a pretty bad ambulance call I was on. I had to change some details due to patient privacy laws and changed some characters and towns around, but all of these things are things that I have experienced at some point.
The girl in the pink jacket
It’s times like this when I love the decision I made to become a paramedic, and I mean that in the most sarcastic tone I can muster. Don’t get me wrong, I really do love my job, but the 24 to 48 hour shifts are exhausting and waking up at all hours of the night to the screaming high-pitch tones of the pager and the frantic and unsure voices of the overnight dispatchers leaves something to be desired-like a full night’s sleep in my own bed.
Right now I am sitting in the passenger seat of truck 440, our first out rig, fighting the intense urge to lean my head against the cool window and go back to sleep. I’ve been awake for 36 hours. Well actually that’s a lie, I got about 20 minutes of sleep before this last page came yowling over the pager.
It’s 2:30 a.m.
I just want to sleep.
Instead, I am hurtling down a back country highway with my partner, Tina, who, by the way, is way too energetic and awake for me right now. Tina is a short woman bright green eyes and a saucy attitude. I marvel at her ability to always seem extremely awake-it must be a skill she acquired when raising her 5 children. I pick up the radio off of its silver perch on the dash and say,
“440 to dispatch, we are en route to the scene. Can you repeat the nature of the call please?”
“10-4, 440, you are heading to County Road 18, north of Brandon about 7 miles. The call came in from a third party; the gentleman heard a car crash in his farmyard. He has no more information, but the county patrols should be arriving any minute now. We have the fire department headed out as well.”
We barrel down back county roads, winding around curves, passing road kill and black skid marks that seem to accumulate easily on these roads in the early fall. We seem to hit every bump in the road as the siren continues to howl its warning to the empty ranges of plowed fields and groves of trees. Somehow, I still find myself blissfully dozing off in the passenger seat.
Tina woke me up by blaring the radio to the local pop-music station and told me we were about 2 miles from the scene. As we approached I could see the vibrant blue and red lights gleaming off the frost covered road and through the thin fog that was starting to appear. It seems like there are more lights than usual.
Tina gracefully backs the truck into the driveway next to a fire truck and two patrol cars. A county sheriff rushes up to the truck and opens the door before I get a chance to unbuckle my seat belt. “There’s someone trapped in the car. They’re not moving and not responding. The fire department is getting ready to start stabilizing so we can cut the doors off,” he says urgently, and then he is off talking with the fire chief.
I look around. I don’t see any decimated cars in the road, just a flock of fire trucks with a herd of men in red hats bustling around. I get out of the truck and walk to the end of the fire truck. My lungs freeze mid-breath. Past an electric fence and down the hill an older model red car lies on its roof. I can see firemen trying to open doors, breaking out glass, looking for the victims; passengers that may be trapped inside the car.
The firemen begin to stabilize the car as we start to grab our equipment out of the back. A large fireman in an even larger dusty yellow jacket and tall, muddy, black rubber boots meets us and grabs some of our equipment. Tina and I exchanged concerned glances and make our way over the still-electrified fence carefully sliding down the frosty hill to the car.
I stand back, taking in the scene. Tina starts laying out our equipment, a backboard, a collar to protect the patient’s neck, the heart monitor and bandages. I turn around and look across the field, trying to visualize the path the car took to get where it now lies, upside down in this ditch. There are tracks leaving the road off the sharp curve that cut a path through some shrubs and small trees that lead up to the top of a small hill. Then nothing. No tracks. It has to be fifty yards or more from where the tracks end on that hill to where the car lays now.
A horrible feeling washes over me. The car must have flown through the air, landing upside down. I am wide awake now, adrenaline pumping through my veins, coursing down my limbs. My gut is telling me that this is going to be a long night.
I turn back to the car. I see a hand sticking out from under what used to be the passenger side window. A pink sleeve starts at the wrist and disappears under the door.
Firemen bring over a saw and start cutting out the passenger door. We are out in the open, but the sound of the saw is screaming in my ears. I want it to stop. I don’t want any of this to be happening. I wish I could go back in time to the minute before my pager went off, then I would still be in bed and no one would be trapped in this car.
The large fireman that we spoke with earlier clamors down the hill with the Jaws of Life and slowly the door is being removed from the car. Tina and I gather behind the line of firemen working on the car. The first responders gather behind us forming a large half circle. We wait for the door to be pulled off, wait to see what horrors could be laying on the other side. For a moment I think that if we were put on a stage we would look like we were performing a small concert, about to break into song. It’s thoughts like these that make me wonder if I am losing my mind. Tina seems to be vibrating with what I am guessing is a combination of excitement and nerves.
This is the part I hate the most-the waiting game. Someone is inches from me-possibly not breathing, possibly bleeding severely. I can’t reach them, I can’t help them. The thick metal of the door is like a prison locking them in and me out.
Someone yells out,
The door is pulled off the car.
My heart drops into my stomach.
For a fraction of a second no one moves, frozen in place as we look at the scene splayed out before us. There is a young girl in the car, her body lying across the roof, her head by the passenger door. Her body is contorted in a position that isn’t conducive with life. She wasn’t wearing a seat belt. Her right eye is swollen and bruised; there are cuts on her face and neck from flying glass.
Oddly, none of her wounds are bleeding.
Her long brown hair surrounds her face, attempting to protect her. Suddenly everyone is moving. It’s like a morbid synchronized dance.
I reach into the newly cut hole and stabilize the girl’s head as two firemen grab under her arms and we pull her out onto the backboard, straightening her crooked spine. I look down to her ribs, she isn’t breathing. I reach to her throat feeling for a pulse that isn’t there.
Her neck is broken.
Someone starts CPR. Tina slaps on the patches of the cardiac monitor and I put on the collar to hold her neck straight and still. Millions of thoughts fly through my mind, clouding it up. I can’t think straight.
Why did this happen? This girl can’t be more than 17, young and beautiful. Even laying here at this gruesome scene with a bruised and swollen eye, she is pretty. Her pale face is accented by her long dark hair. Her hands free of cuts from the glass around the car. The pink jacket she is wearing brings out the slight color left in her cheeks, the flashing lights glint off the broken glass tangled in her hair.
The monitor shows that her heart isn’t beating. It can’t be right. There has to be a patch off, a malfunction with the monitor. Her life was not meant to end this way, on the uneven ground in this ditch with the crisp fall wind biting through her pink jacket.
I grab a bag valve mask and start forcing air into her lungs. My mind snaps out of the fog and I start barking orders at people. Tina starts an IV in the girl’s arm, firemen start cutting her pants off, looking for injuries to her legs, looking for blood. I call out for a round of Epinephrine to help her heart start to beat again.
My own heart is beating hard enough for the both of us. She can’t die. I can’t let it happen.
The first responders stand in a line waiting to perform CPR, relieving each other when they become tired. We push all sorts of medications into her IV. I keep breathing for her with the bag valve mask and prepare to put a tube into her lungs so we can help her
Nothing seems to be helping. Her heart still isn’t beating, she still isn’t breathing on her own.
Has it been too long?
I move down to take my turn at performing chest compressions. Tina looks at me; we both know that nothing we do is going start her heart again. Too much damage has been done to her frail body. My head starts spinning again. I continue compressions to try and block out all the thoughts flooding back into my brain but my attempts are futile.
How can this happen to this beautiful girl? She is so young. Kids this young aren’t supposed to die. They aren’t supposed to get hurt like this, body busted up in a car accident, contorted into the horrifying shapes of broken limbs. They aren’t supposed to die on the side of the road in the cold October air with no family or friends around to say a last goodbye, to brush the lock of hair away that has fallen across her face.
We don’t even know her name.
I was warned about this in paramedic school; warned that people will die. But no one ever told me it would be like this; in a dirty, dusty ditch in the middle of the night.
Suddenly, I become aware that Tina is pushing on my shoulder. She is telling me to stop, that we have done all we can. I realize that I am crying. The tears running down my face are starting to freeze in the stinging air. I continue CPR, pump after pump on her chest. I have to save her.
I am unable to move myself away, to do anything else. My brain tells me to keep going, that she is young, she can live.
Young people aren’t supposed to die.
I stop and check the heart monitor one last time. It shows a thin, flat, final line. I feel for a pulse once more. The skin at her neck is smooth and cold. There is not pulse to be found.
I look at my watch and hear myself saying, “Time of death; 3:16 a.m.”
Tina walks over with a sheet and covers the girl’s body. I stay, unable to move, looking at the girl’s face, the bruise surrounding her eye, the glass in her hair. I wonder what the last thing she said was, wonder who she spoke it to, and why she was driving on this desolate county road so late at night all alone.
I walk back over the electric fence to the truck. Glancing down the hill I see the car is still upside down. Our equipment is scattered on the ground, paper wrappers blowing across the field in the wind; the evidence of our failed efforts easily blowing away as if they were never there.
The door of the car is lying behind it, out of the way and out of place. Most haunting, though, is the white sheet that flutters in the cold breeze, attempting to hide the outline of a young girl whose life ended far too soon.