Tuesday, July 24, 2007

Seeking Words of Balm

Summer, 2000

The man's face is waxy and pale. His cheeks and eyes are sunken, the lips drawn in a
wrinkled circle outlining his gums. His dentures sit in a glass on the night stand. I take
my time attaching monitor electrodes while Pardner attaches a bag-mask device to the
oxygen cylinder. If I thought there was any hope at all, I'd have started off with the
hands-free defibrillation electrodes. Pardner would have been doing CPR.

I knew he was dead when I walked in the room. Attaching the monitor and watching the
flat line march across the screen merely confirmed it. I check his hands and his back.
The fingers and wrists are stiff, and his back is mottled with lividity. Pardner and I trade
a look.

I straighten and turn to the woman standing behind me in the doorway, supporting
herself on a walker with tennis balls on the legs.

"Is there anything that can be done?" the woman asks, her voice every bit as frail as the
rest of her.

"I'm afraid not," I tell her gently. "Nothing we'd try would work. He died sometime
during the night, in his sleep."

She nods silently as she looks at the body in the bed, her husband of fifty years. Behind
her stands the staffer of the assisted living home who called us. She looks more
emotional than the old woman.

The old woman lets out a ragged sigh and turns back to the living room, pausing to give
the aide a gentle, sympathetic pat on the arm as she goes. She putters around the small
kitchenette, arranging mail, placing her breakfast dishes in the sink, emptying coffee
grounds and her husband's uneaten breakfast into the trash.

I watch her as she moves about the kitchen as if no one else is there, as if her husband
weren't lying dead in the next room. She pours a cup of coffee, turns around and offers it
to me.

"I suppose I need to call the funeral home," she muses, speaking to no one in particular.
I take the cup from her and pass it to Pardner, and steer the woman to the couch.

"I need to tidy this place up before the funeral home boys get here," she mutters. "So
much to do..."
"Ma'am." I lay my hand gently on her arm. "Why don't you let us do that for you? You
shouldn't have to worry with all this," I tell her softly, gesturing to the nearly
immaculate apartment behind me.

"If not me, then who?" she asks hollowly, looking me in the eyes. Pardner clears his
throat.

"Ain't there somebody we can call, hon?" he asks. "Family, maybe? A preacher?"

"No, there was nobody but us. He was all I had left."

And then the tears come.

We sit there with her and wait for the coroner to arrive, me next to her on the couch and
Pardner sitting in a chair, for the better part of an hour.

Not a word is spoken. But we stay anyway.

**********

Late Spring, 2005

Her face is misshapen, the blonde hair plastered to her skull, still wet with blood. Her tongue is
bloated, her face purplish. She had run straight through the stop sign, striking a pine tree head-
on. She lay slumped over the steering wheel, pinned between it and the seat, her blood pooling
on the deflated air bag. Her shoulder restraint is still in place.

I play my flashlight around the wreckage of the car while Part-Time Partner rants and
bangs on the roof of the car behind me. There is a formal dress still in its cellophane
wrapper lying in the floorboard behind the front seats, and a garter hanging on the rear
view mirror mount, still stuck to the shattered windshield.

This is how PTP deals with the senselessness of it all - he gets angry. He has daughters
this age, and I know what he is thinking. There is no one here but me and the deputy to
see him vent his fear and frustration. PTP keeps it in and seethes silently when we have
an audience.

"Goddamned prom parties!" he shouts, gesturing to the pinkening sky behind us. "Why
the fuck else would she be out at this time of the morning?"

I say nothing, walking around the wreckage, playing my flashlight over the ground.

"Probably drunk off her ass," he continues, veins bulging in his neck, "seventeen
Goddamn years old and now her life is over before it even started!"

"No alcohol evident in the vehicle," the deputy points out quietly. "You smell anything?"
"No," I answer.

Did you know you can smell the alcohol in someone's blood? You can.

"No skid marks, either," the deputy sighs, pointing his flashlight back up the road. "She
never even hit the brakes. Besides, she was a responsible kid. I'm thinking she fell asleep
at the wheel."

"You knew her? I asked.

"Yeah," he says sadly, his shoulders sagging. "My daughter's the same age. We go to
church with her family." He clicks off his flashlight and places it back in the holder on
his duty belt, looks absently back up the road. "Wrecker oughta be here in a few
minutes, then I'm gonna have to go tell her Daddy. Damn."

PTP looks at him for a moment, hands still clenching and unclenching, veins still
bulging in his neck. Then he marches purposefully to the ambulance, opens the rear
doors and climbs in. A moment later, he emerges carrying a folded sheet and carries it
over to the wrecked Honda Accord. He unfolds the sheet and carefully, gently covers her
body with it.

"Sun's coming up," he grunts in explanation and I nod my understanding. "I don't want
people driving by and gawking at her."

As if on cue, a pair of headlights appears over the crest of a hill and grows steadily
closer. The deputy removes the flashlight from his belt and signals the truck to go
around us. As the pickup pulls abreast of the scene, passing just feet from the deputy, he
freezes. The truck continues on for a few feet, and then skids to a stop with a screech of
brakes.

A man and a woman bail out of the truck and run back toward the wreck. The deputy
intercepts the man, and PTP and I are left to deal with the woman. I step in front of her
and catch her before she reaches the car.

"That's my baby!" she screams frantically as I try, and fail, to wrap my arms around
hers. "Let me GO! Let me see my baby!" she screams as she flails at me impotently.
There is nothing I can say to her, so I lower my head and let the blows rain down. None
of them do any damage anyway. She's not trying to hurt anyone. PTP moves behind her
and tries to grab her hands.

I look over her shoulder and see the deputy with his hands on the father's shoulders,
forehead to forehead, saying something I can't hear.

PTP and I manage to walk the mother over to the front of our rig, and she collapses in a
heap, still crying and screaming "my baby!" hysterically. PTP's eyes are moist and his
jaw muscles bunch as he kneels next to her, one hand laid gently on her shoulder as she
wraps her arms around her chest, trembling violently.
I walk to the side door of my rig, open it and pull the drug box across the floor to me. I
withdraw a 5 cc syringe, fish the Valium out of the narcotics pouch on my belt, and draw
up a full ten milligrams.

By the time I walk back around to the front of the rig, the father was there, sitting with
his back against the front bumper of my rig, cradling his sobbing wife in his arms. His
eyes run with tears as he holds his wife's head to his shoulder, but he says nothing. The
deputy and PTP stand there, watching mutely as I kneel next to her, lift the hem of her
khaki shorts, and plunge the needle in her thigh. She doesn't even flinch.

The husband meets my eyes as I stand up. I say nothing to him. I don't have to. I just stand there
quietly until the woman's sobs start to wane. It takes longer than I thought it would.

The sun is shining and the wrecker has arrived by the time I can help the husband to his feet. His
wife just sits limply against the bumper of my rig, eyes vacant and moaning tonelessly. We try to
help her to her feet, but her legs are too unsteady. Her husband picks her up and cradles her to his
chest and walks to the back of the rig. He doesn't even wait for us to unload the stretcher, just
climbs into the rig and gently deposits her on the cot.

I wipe the tears and snot from her face and brush back the wet hair plastered to her cheek, and
spread a blanket over her as her husband sits on the bench seat and holds her hand, staring
blankly at his reflection in the plexiglass cabinet doors.

"Where will you take her?" he asks, breaking the silence, his voice low, harsh and strained.

"She'll go to Bossier for an autopsy," I say softly. "It's required by law. After that,
whatever funeral home you specify."

"I meant my wife."

I blush in shame and mentally kick myself.

"I'm sorry, Sir. We'll take her to Podunk, if that's all right with you. They'll keep her overnight,
keep her sedated. I'll get you some contact info for some grief counselors, if you'd like."

He doesn't answer right away, just stares down at his wife. After an uncomfortable silence, he
speaks again, still processing information from five minutes ago.

"An autopsy? Why do...I mean she's still in her...how do they get her..."

"We'll take you and your wife to the hospital, and another crew will get your daughter out of the
car. The fire department will come, and they'll extricate her. Afterwards, one of our ambulances
will take her to Bossier."

He nods silently, and I watch as his lips start to quiver. He squeezes his eyes shut, and huge tears
roll down his cheeks in single file, and drop onto his knees one by one.
"I don't want strangers seeing her," he says pleadingly. "Will you ask Danny to stay with her?"

So that was the deputy's name. I can never remember.

"She won't be gawked at," I promise him. "The men that will get her out all have families,
daughters of their own. They'll be gentle, I promise. And I'm sure Danny will supervise things."

"Insurance cards."

"Excuse me?"

"My insurance cards are in my wife's purse in the truck. You'll need those, right?"

"No, Sir."

You will never see a scrap of paper from our ambulance service to remind you of this day. I'll
lose the run report entirely, if it comes to that. But it won't. The Boss understands things like this.

"Who is going to take my little girl to...Bossier, you said? Do you know who it will be?"

"If you'd like, I'll take her there once we get your wife settled in at the hospital," I offer. "I'll do it
myself."

"Yeah," he sighs, wiping his eyes with his forearm, "I'd appreciate that."

And so I did, even though my shift had officially ended an hour before.

**********
Thanksgiving Day, 2001

"Can you think of anything else?" I look around at each face surrounding the man's body.
Everyone shakes their head.

"Four epi, three atropine, fluid bolus, tube placement is good even though end-tidal CO2 never
got better than 10," Paramedic Student Partner summarizes as she does compressions. "Blood
sugar is okay, bicarb did nothing, and she's got a purple face and shoulders. I'm thinking
pulmonary embolus."

PSP is showing promise, and she's starting to put it all together.

"And still asystolic after twenty minutes of working it," I finish. "Okay, I'm making the call."

I flip open my personal cell phone and call Dispatch for a patch to Podunk ER. We always do
things like this over a recorded line. I walk to the far side of the living room and turn my back to
the family.

"Hey Doc, this is AD on Medic Four. We're on scene with an asystolic arrest, been working it
twenty minutes now. Down time prior to our arrival was over ten minutes, with no CPR. Got a
tube, got two good lines, four epinephrine, three atropine, and one bicarb on board. Rhythm
never changed from asystole. I'm thinking she threw a clot. Requesting permission to terminate
efforts."

"What's her history?" Doc wants to know.

"Non-insulin dependent diabetic, hypertensive, smoker, age fifty-four. Not much else, according
to the family."

"Helluva a way to celebrate Thanksgiving," Doc grunts. "All right, call it. Family taking it
okay?"

"We'll see," I answer. "We may be calling you back."

"Just put me on the phone if you have any problems," Doc offers, then Dispatch breaks in on the
conversation.

"Coroner's been notified, Medic Four," she offers helpfully. "They're en-route to your location."

"Thanks, Dispatch." Not all dispatchers are like Satan.

I tuck my phone into my pocket and walk over to the woman's daughter, standing there in the
doorway between the dining room and the den, the food still on the table in the room behind her.
She has stood there and watched the entire scene without changing her expression; eyes red-
rimmed and tearful, hands clasped over her mouth, she has leaned against the door frame and
watched in mute horror as we tried to resuscitate her mother. Her son-in-law had taken the
woman's hysterical granddaughter to another room shortly after we arrived.

I place my hand on the daughter's arm and can feel her trembling. She tears her eyes away from
the EMTs and firefighters doing CPR and looks at me questioningly.

"I'm sorry, Ma'am," I tell her gently, "but there's nothing else we can do. Anything else we could
try would be fruitless."

She looks from me to her mother's body, and back. "That...that's it?"

"Her heart had stopped beating before we got here," I explain. "By the time we started CPR,
there was no electrical activity in your mother's heart. If there had been, maybe we could have
revived her. Maybe not. But when there is no electrical activity, there's not much medicine can
do to fix that. We've tried all the drugs we can, the same ones used in the hospital. Nothing has
worked. At this point, we're just abusing her body."

"No...no chance at all?"

"No Ma'am," I say softly, and then I say The Words. "I'm afraid she's dead."
At that, she walks back into the dining room and collapses into a chair, folding her arms on the
table and burying her head. Her shoulders shake with sobs. I motion for PSP and the firefighters
to stop what they're doing, and walk down the hallway in the direction taken by the son-in-law. I
find him in a room at the end of the hall, sitting on a brass daybed, stroking his daughter's hair.
She is almost asleep, her cries slowed to the occasional snubbing of a heartbroken child.

"I'm sorry," I whisper, answering the question in the man's eyes. He nods sadly, looking tenderly
at his daughter. He sighs and gingerly gets off the bed, successfully avoiding waking his
daughter. It's a little girl's room, but not this little girl's. From the looks of the photos, stuffed
animals and 80's vintage posters on the walls, this was once her mother's bedroom.

"I figured she was gone," he tells me quietly as he shuts the door behind him, "but thank you for
trying."

"I wish the ending could be different," I offer. "Sometimes it is, but most of the time we can't get
them back."

We pause at the entrance to the living room, and he watches as PSP and the firefighters gather up
the assorted detritus of a resuscitation and rearrange the furniture we moved.

"We have to leave the breathing tube and the IVs in place," I explain, "until the coroner gets
here."

He nods absently and looks at his wife, still with her head down on the table. "What happens
now?" he wants to know.

"The coroner comes and does his investigation, and then he'll call whatever funeral home you
request. We have to stay here until he arrives. We can call a family member or your minister if
you'd like."

"Okay," he nods.

"We'll wait outside," I offer. "Give you some time alone with your family."

"Thanks," he sighs, looking at his mother-in-law's body lying on the living room floor under a
sheet, "but I think we'll wait outside instead."

**********

August, 1998

"He's gone, isn't he?"

"Yes, Mrs. Dodge. I'm afraid he is." I knelt next to the frail body on the bed and gently tucked his
hand back under the covers. It was a hand I knew well.

Jeremy Dodge was close to my age, just twenty seven. He had suffered a devastating brain injury
in a motorcycle accident when he was sixteen. The strain of caring for Jeremy had taken its toll
on JoAnne Dodge. It very nearly ruined her financially and broke her marriage. Through it all,
JoAnne cared for her son with an unwavering faith.

We first met him when the home health agency had called us to transport him to the hospital.

"What for?" we had asked.

"He needs an IV access," the nurse had explained, "and I can't find a vein."

"He's going to the ER just to get an IV line? What if we can get one right here? Can he stay
home?"

"Well sure, if you think you can get one," the nurse had said dubiously.

One stick later by my partner, Vascular Access Wizard, and we had made a new friend. Even the
home health nurse had been grateful.

We cared for Jeremy Dodge for five years. On duty or off, day or night, one of us would run over
to the Dodge house when they called. We only transported him when we had to, and we got to
know JoAnne and her other children, Jeremy's half-sisters.

The official medical opinion was that Jeremy Dodge was profoundly brain-damaged, and only
minimally aware of his surroundings.

We knew better. We could tell when he was happy or sad, and all of the pretty nurses had learned
never to lean over Jeremy too closely. Even contracted as he was, he could grope a boob with
unerring accuracy.

Eventually sepsis took him, as it does so many bedridden patients. JoAnne had called,
desperation in her voice.

"He can't breathe!" she had blurted desperately. The home health nurse had taken the phone from
her and told us what was going on. So Pardner had swung by my house and picked me up, and
we had beaten the ambulance there by ten minutes. Even then, we weren't quick enough.

Heather, the home health nurse, had cleaned Jeremy up by the time we arrived, and the look in
her eyes told me all I needed to know. JoAnne and her daughters had composed themselves, and
Jeremy was no longer breathing. A quick pulse check of my own confirmed what Heather's eyes
had told me, and I tucked the kid's arm back under the covers.

"I'm sorry, JoAnne," I said as I knelt next to her rocker and hugged her. "I wish I knew something
more to say."

"Sorry for what?" she asked, a warm smile breaking through her tears. "This is a time to rejoice,
not grieve. I've grieved for my son for eleven years. Now he's sixteen again, healthy and whole."
"I believe that," I tell her honestly.

"Are you a Christian, AD?" she asks. "All this time, and I've never asked."

"Yes, Ma'am," I answered. "I am. Not as good a Christian as I should be, but I believe, yes."

"The doctors all say that Jeremy wasn't aware of anything. He had never been Baptised before
the accident. I didn't find my faith until after it happened. He was born out of wedlock, you
know."

"Yes Ma'am, you told me."

"Do you believe people can go to Heaven if they've never accepted Jesus as their personal Lord
and Savior? My religion says no."

"I believe in a loving and merciful God," I tell her, "one who wouldn't condemn Jeremy as he
was. So yes, I believe he's in Heaven."

"So do I," she smiled with utter conviction. "So do I."

"Tell ya' what I believe," Pardner broke in laconically. "I figger Jeremy wouldn't be sittin' here
gettin' all weepy like this, wonderin' if he's with Jesus or not. He'd be up, actin' up and bein' a
sixteen-year-old kid. Then he'd grab Heather's boob."

And we all laughed uproariously and listened to funny stories of Jeremy's childhood, many of
which we had heard before. When the coroner arrived, he thought we were all nuts.

**********

September, 1994

Simple human touch is next to impossible through a PPE kit. You want to touch someone, the
gloves, eye shield, gown and face mask thwart you at very turn. Even feeling a pulse is tough
through double gloves.

More importantly, they can't feel you.

Not that I wanted to touch her. She was smeared from head to waist with AIDS infected blood. In
1994, during the height of AIDS hysteria, death lurked behind every exposed needle, every
splash of blood or bodily fluids. People believed you could get HIV from a toilet seat or an
infected mosquito back then. I wasn't taking chances, not at first.

She had contracted the virus from a boy she met in college. Her parents, highly religious people,
had shunned her when they found out she had AIDS. Her first inkling she had the disease was
when she got sick for the first time. That cough and the weight loss...well, it wasn't just HIV, it
was full-blown AIDS.

So she sought solace from her family, and her parents cast her out like so much garbage. Not
only did their daughter have that homosexual disease, she had fornicated with a man outside the
bonds of matrimony. She was dead to them.

And they were probably right, if a few years premature. The cocktail wasn't widely used back
then, or at least I hadn't heard of it. So she had tried to speed things along in their front yard, by
taking a knife to her wrists. For a first-timer, she did a pretty fair job.

I'll never forget the coldness of her father as he had stood there behind that screen door and
watched his daughter lie bleeding on the lawn.

"Get her out of here," were the only words he had said, a curt directive before closing the door in
our faces.

I learned all of these things about her on the thirty minute trip to the Big City, in between her
broken sobs and her whispered conviction that she was going to Hell. I don't remember saying a
word. What was I going to do, tell her she was wrong? Her entire religious upbringing told her
otherwise.

Her own father had told her she was damned.

So she sobbed and she talked, and she begged me to understand, and I tried to smile
comfortingly and answer with my eyes.

Kind of hard to do that behind a mask, though.

Somewhere along the way, she grabbed my hand and held it, and I resisted the urge to pull away.
So I put away my forms and my clipboard, and I sat there next to the cot and I held her hand all
the way into the ER.

Held her hand all the way through the hand-off report, too. I had to pry her fingers away from
mine. I wished the gloves hadn't been so thick.

The nurse I handed her off to was one of those stern old battle axes who had known Florence
Nightingale personally and been working the ER since Hippocrates was an intern. Frankly, she
scared me a little.

But when she leaned over that stretcher, there was no judgment in her eyes, and she was as
soothing and motherly as the girl's own mother should have been. An angel, if a stern one. She
took her vital signs and cleaned the dried blood off her face and arms and disposed of her bloody
clothes and put her in a gown.

I stopped in the EMT lounge before I left and grabbed a couple of Cokes from the ice chest. I
ducked into her room, opened one of the Cokes and sat it on the procedure tray next to her bed. I
still don't think I said anything.

But she was able to see my face and eyes, and I clasped her hand again before I left.

Without the gloves.

**********

These little recollections were brought to mind by an e-mail I received from one of my readers, a
medical student who seeks the proper words to ease the grief of a loved ones' passing, or the
proper approach to the family of a dying patient. Seeking words of balm, in other words.

There are no proper words, Rav. Medical school will teach you how to improve and extend life,
how to ease physical pain and suffering, perhaps even how to save a life if the situation presents.
Where the training, and advice like mine, always falls short is in what to do when there is
nothing left to be done.

You'll read the words of Elizabeth Kubler Ross, if you haven't already, and you'll be taught how
to recognize and deal with the five stages of grief. You'll be taught to use words like "death" and
"dead" and to avoid platitudes and euphemisms like "passed on" or "in a better place."

And all of that will fail if you do not feel compassion. If you do feel compassion, most of that
knowledge will be rendered irrelevant. Don't let the grind of your education beat the compassion
out of you.

Compassion is the one thing that traverses all cultural and religious boundaries. It is universally
understood, be you atheist, Christian, Muslim, Hindu, Buddhist or Pagan.

And it need not always be expressed in words.

Hope that answers your question.

Radioed by Ambulance Driver at 3:00 AM

52 pithy observation(s).:

dylthedog (EMT) said...

Powerful words AD and very well put.

July 24, 2007 3:39 AM

Bob@thenest said...

Had to make two death notifications when I was a first sergeant. I agree with you -- no
training in the world prepares one for that. Compassion and sensitivity are what make it
happen in the right way. Without those qualities it's all just a factual rendition.
 After reading the series in this post I took something else from it, though of course I may
be wrong.

I think there is a part of you that knows you're good at handling those situations and it
maybe misses being on the rig where you can provide that comfort and support in the
most trying of times.

July 24, 2007 4:25 AM

Jay G said...

Dammit, AD, now you've gone and made it rain all over my keyboard.

Again.

There are many reasons I deviated from my path to medical school. Making calls like
these was one of them.

Now I'm in sales and as such have no soul... ;)

July 24, 2007 7:44 AM

Loving Annie said...

Ambulance Driver,
Those stories each brought tears to my eyes.
Your compassion was evident, side by side with your professionalism. You are a good
role model, for your words of widsom and kindess are backed up by action.
Happy Tuesday to you.
Blessings,
Loving Annie

July 24, 2007 9:25 AM

Sarah said...

The meteorological phenomenon that affected Jay has traveled to my computer too. Well
told. Well done and just...wow.

July 24, 2007 9:39 AM

Anonymous said...

yeah, what they said.

July 24, 2007 9:43 AM

Fyremandoug said...

Wow AD you brought up old memories and a few tears, great writing,
 July 24, 2007 9:44 AM
SpeakerTweaker said...

It would be systematically damning for me to shed tears at work, as the men I work with
would annihilate me. So I'll read this again with The Wifey when I get home.

I think that Compassion, while profoundly important, is merely a step. Prerequisite, if

you will, to Honor.

And you have Honor, sir. More than most.

tweaker

July 24, 2007 10:16 AM

Digital Falcon said...

I am speechless. Thank you for sharing those powerful stories. Well done.

July 24, 2007 10:40 AM

HollyB said...

AD, your compassion is one of your most attractive features. That is what makes you
such a manly man.

July 24, 2007 11:12 AM

Yenner said...

Those the most touching and incredible stories I have read. I tried not to sob at my desk.
It is so nice to know that there are still people in the world like you. Too many people are
unwilling to show compassion any more for one reason or another and it saddens me.
Thank you for sharing with us.

July 24, 2007 11:53 AM

Queen of Dysfunction said...

This has to be one of the best posts I have read on this blog or any blog ever. Very
powerful stuff here. It also reminds me of why I have chosen to pursue the profession I
am. Thank you so much for sharing.

July 24, 2007 12:45 PM

bigdaddyb said...

These have left me as close to speechless as I get.

 Our most trusted and needed (AD's, police, fire, teachers, etc.) are often our least
appreciated. Those who perform these duties while still preserving their own humanity
and the dignity of those they serve fit a category that I am at a loss to name.

You all have my undying respect and my gratitude.

July 24, 2007 12:45 PM

curmudgeon said...

"The nurse I handed her off to was one of those stern old battle axes who had known
Florence Nightingale personally and been working the ER since Hippocrates was an
intern."

Simply brilliant!

Great post.

July 24, 2007 1:47 PM

WR Olsen said...

I hope the next book you write will be one of ethics and philosophy since you are brilliant
when you discuss the human side of public protection.

July 24, 2007 3:51 PM

knitalot3 said...

Geez, AD! Couldn't you have put out a tissue alert at the beginning?

Thanks for sharing. I never know what to say to someone about a death. It always sounds
so cheap and plastic.

Going to go hug my family now.

July 24, 2007 4:20 PM

Hammer said...

Very moving as always.

Thanks, it makes me appreciate things even more.

July 24, 2007 4:42 PM

Scott said...

Wow! Very sad stories. And very well-written. I just wrote a post about death on my blog
yesterday. It's not nearly as good as yours, though.
 July 24, 2007 5:02 PM
Ambulance Driver said...

"I just wrote a post about death on my blog yesterday. It's not nearly as good as yours,
though."

I read it, and a good post it was, Scott.

July 24, 2007 5:05 PM

Judy said...

AD,
You made me cry and you made me laugh -- but most of all, you made me hope that
someone like you will be there if ever I need them.

I know we have AD's like you around here. I've met a few. They may not be so eloquent,
but words aren't always necessary.

July 24, 2007 5:26 PM

skywriter said...

powerful stuff. This is the reason I put you on my blog today with a "blog award". I didn't
do you justice.

scully

July 24, 2007 6:47 PM

Kate said...

It's raining at my keyboard, too. Thanks, AD.

July 24, 2007 8:27 PM

Squeaky Wheel said...

These are the kinds of stories that result when someone with a heart works where they're
needed. Sometimes the simplest things are all that are required.

Great stories. And you tell them very well.

July 24, 2007 8:34 PM

Brandon said...

Those are very moving stories, thank you for going above and beyond what you had to do
with the families. The world would be better off if there were more people like that.

July 24, 2007 9:42 PM

KG2V said...

Thanks AD,
My Mom is expected to die sometime in the 7-14 day span. Just a bit too long for in
patient Hospice around here, so she will have to go to accute care tomorrow. Lung cancer,
and she is only awake a few minutes at a time. It's good to know there are caring folks
out there

July 24, 2007 9:48 PM

outside_of_apex said...

Powerful stories AD. And I like how you don't get words in the way of the telling.

The summer after my first year of college I worked at a hospital taking EKGs
(electrocardiograms). Let's just say that you might have recently graduated out of diapers
at the time. Minimum wage, no experience necessary.

Most of the EKGs were routine. Dr puts in an order on Tuesday, we performed it on

Wednesday, and they got the results on Thursday. The good ol' days.

However, if it was your turn to carry the pager, you could be called on a code blue. I went
to about two dozen of them that summer. I don't know if they have code blues any more
but this was when a patient either had a respiratory or cardiac arrest. One always seemed
to follow the other so there wasn't much difference in my uneducated mind.

My job was to get a rhythm strip. That meant attaching wires to each wrist and a leg
(forget which, maybe both and one was a ground). Woe be unto me if I did not have one
when the Dr asked for it.

However the entire initial episode was utter chaos. There'd be a nurse straddling the
patient doing CPR. The respiratory folk would be sticking stuff down his/her throat.
Other nurses would be sticking IVs in. I would be fighting for limbs to stick my wires on.
I hope today the team is as choreograped as a Nascar pit crew.

Anyways, the point is, every time but once the patient died. But by being there, working,
with a bunch of professionals, not knowing the person I was working on, and so on, their
deaths did not affect me as I thought they would (I had never seen someone die).

Of course it wasn't up to me to tell someone that their loved one had died.

July 24, 2007 9:50 PM

Ambulance Driver said...

Prayers to you and your family, kg2v.

My old man was a HAM operator for years, call sign K5QAS.
 July 24, 2007 9:57 PM
AZBanjo said...

Raining here too ....

July 24, 2007 10:03 PM

BuckeyeEMT said...

Compasssion...Caring.....Understanding. Just a few words that come to mind when I read

these posts. You are the total package AD. You have the knowledge but you also have that
other aspect that is so sorely needed in this field....you have a tender heart. From the little
time I have been in this field, I have seen more than once where that has not been the
case. It's refreshing to hear that someone still does. I think it makes all the difference in
the world.

In my opinion, that might make more of an impression on the family than

anything....knowing that the person who came to help them at their greatest time of need
CARED and treated them with the kindness, compassion, dignity and respect they so
deserved.

My hat is off to you AD.

July 24, 2007 10:15 PM

vipin said...

As Rav's roommate and as an EMT - those were powerful words that were well put in
ways that I probably will never be able to describe.

The emotions and feelings that you describe are real enough to be felt by your readers as
if they were their own - amazing work.

July 24, 2007 10:18 PM

pixie.dust said...

I'm glad you were there for those people, and also for all the others whose stories we
have yet to hear. Your compassion is inspirational. Two thumbs way up from the Pagan
corner! ;)

July 24, 2007 10:20 PM

Lea said...

Thank you, and Blessed Be you and yours.

July 24, 2007 10:34 PM

PierreLegrand said...
 Oh my...came over from PJ media...what a tremendously moving blog. We just lost two
folks in my family, my wifes father and my uncle who was like a father. Thank you for
sharing its good to know folks like you exist.

July 24, 2007 10:40 PM

Pseudo_Doctor said...

AD,

Seriously an email would have sufficed =). This has to be one of the best posts I've ever
read from you because in every one of your stories you answer my question with a
different platform from a gesture, to silence to whatever else felt right at that moment.
Thats probably the best advice I could have received and its something that I doubt I will
forget.

Thank you....

July 24, 2007 10:54 PM

Jean said...

Soul salve.

July 25, 2007 12:18 AM

John said...

"Do you believe people can go to Heaven if they've never accepted Jesus as their personal
Lord and Savior? My religion says no."

I don't care how much the Bible says about Salvation through Acceptance & Confession
of Jesus---(I know that to be true)--BUT--- WHO ARE WE TO EVEN BEGIN TO SAY
WHEN OR IF A PERSON ACCEPTS JESUS?

Somehow & at sometime- I believe God makes HIMSELF known to the Jeremy Dodds
of this world!!! I can't PROVE it- but I too believe it!

You Ministered and Gave His Mom what Jesus would have given her. Compassion, Love
and Unconditional Acceptance!! You gave her exactly what she needed-- The Truth as
you saw it, and with it, confirmation of her own belief that Jeremy made it!.

"Are you a Christian, AD?" she asks. "All this time, and I've never asked."

AD: "Yes, Ma'am," I answered. "I am. Not as good a Christian as I should be, but I
believe, yes."
 You sir are as fine an example of a Christian working in this World System as I've met
(read)- never ever sell yourself short on that!!! God is using you just as much as any
Preacher on any given Sunday throug this Blog!

GREAT CALL!

John

July 25, 2007 1:00 AM

T said...

wow - what an amazing heartfelt read - I hope all that are involved in tragic events come
across someone as compassionate as you.

July 25, 2007 1:46 AM

Kiki B. said...

June 19, 1990...The day after Father's Day. Twenty minutes outside of St. Louis, MO. A
husband and wife both 48 years old on a trip to MI and then OH. The husband is driving
a van pulling a 29 ft. travel trailer for them to stay in on their trip. They hit construction
traffic in this area outside of St. Louis. The husband says, "Aren't you glad I'm...", and
then gasped.

The wife thinks they just had a blow out, especially as the husband isn't steering. In the
process, he takes out one of the extremely large digital construction signs that hits the
front of the van, and flies over the trailer. The wife realizes something is seriously wrong
with her husband when the van and trailer scrape the underside of an overpass. She can't
get to the steering wheel because it's one of those nice vans with the Captain's seats, and
the armrest is down. She finally gets her seatbelt off, and goes for the steering wheel. She
can't reach the brake because his foot is blocking it, but she throws the car into park, and
it stops at the edge of the road, as though they pulled over to the side of the road to park.

There are construction workers all around who come to help. All they see is the accident,
so they won't help move the husband or do anything, but call the police and ambulance
on their radios. By the grace of God, there just happens to be an ALS ambulance 2
minutes away that diverts from their call and comes to the scene.

They take the husband out. He's in V-Fib. on the side of the road. They work him for 20
minutes into the hospital, and 10 minutes more there before calling the code. A kind
police officer at the scene has called his home and asked his wife if this man's wife could
stay with them until their family in Houston could come pick her up, and she said that she
could. As it turned out, the family had some friends in the area who came and got the
wife, and took them to their home to stay until the oldest son could pick her up.

The youngest daughter, who was in nursing school at the time, wasn't home, so the wife
 got ahold of her oldest daughter who remembered that the husband had written out
everything he wanted done with his body before he left on that trip. He had never done
that before.

A few hours later, youngest daughter is at work at Houston NW Medical Center. She sees
a pastor friend of the family and her younger brother coming through the glass that
surrounds the Newborn Nursery where she is working that day. They take her into the
nurse's lounge where she is told that her father just died of a heart attack that day. It
seemed like the end of her world, and yet, so bizarre and surreal because she had just
been taking care of newborn babies.

You see, this is the story of my father's death. I wasn't there when he died, but I am
eternally grateful for the Paramedics, EMT's and police officers, as well as hospital
personnel who took care of my dad and my mom during this time. Thank you. I wish I
could say more, but I don't know what words can express anything more than THANK
YOU.

July 25, 2007 2:00 AM

Kiki B. said...

If you don't know exactly what to say to a grieving family member, wrap your two
loving, gentle arms around them, and say, "I'm sorry". That's generally all that's needed at
the time, because what they usually want is for someone to acknowledge their loved one's
death, as they are in shock, and a shoulder to cry on.

July 25, 2007 2:02 AM

cardiogirl said...

As everyone has said, wonderful post. I don't know how you can deal with this on a daily
basis and not fall apart.

Having said that, do you think it's your audience or the fact that you are writing about
strangers that evokes comments? I find when I write about my mother and brother's
failing health (Mom is Stage 6 Alzheimer's and brother has progressive MS, bedridden,
essentially paralyzed) I receive no comments. Just crickets chirping in the night.

I actually wrote about that recently, saying I think people in general do not know how to
deal with sadness and vulnerability. They shy away from it, but any other emotion is
readily accepted. Maybe they just feel helpless and do not know what to say to comfort
me.

Regardless, I just find it curious.

July 25, 2007 4:56 AM

Guilty Secret said...
 Wow, what sad, sad stories so beautifully written. It is clear how much you care from the
level of detail you remember from such a long time ago. Thanks for sharing.

July 25, 2007 5:41 AM

Kyle J. said...

As a green EMT and a Paramedic Student i haven't yet had to inform someone that their
family member is gone. I am dreading the day, not because i can't handle the upset
family, that is part of my job and i will just have to do it. It's just that i don't know how to
word it. This post is something that Brady 5th edition just can't teach. Thank you AD.

July 25, 2007 12:08 PM

PunkRockHillbilly said...

This is the first time I have read your blog and I was truly touched. You have compassion
and understanding that some of us will never get. Reading your words constricted my
heart and brought tears to my eyes.

July 25, 2007 1:08 PM

Ambulance Driver said...

"Having said that, do you think it's your audience or the fact that you are writing about
strangers that evokes comments?"

Cardiogirl, if I knew why people leave comments, I'd be famous like Glenn Reynolds.

Mostly, I just write and people like it. It my be that enough people haven't discovered
your blog yet, and the ones that have may already know the story.

July 25, 2007 2:18 PM

Jeff said...

Most people expect that people who take care of their health will all be like you.

The problem is, there aren't nearly enough people like you to fill all those jobs. And even
people like you, with the best will in the world make goofs, sometimes bloomers.

It can't be helped! People are people. And we are not all compassionate geniuses 100% of
the time. If you have the balls to take on a job with such high stakes, you have to have the
balls to live with the fact that your bloomers will have outsize repercussions.

Hard to understand for most of us. But I think one thing I take away from your blog is
that I hope if I am ever in a medical disaster, I will have compassion for the people
treating and transporting me, KNOWING that they cannot completely make me other
than a part of their work routine. Even with the best will in the world.
 And to be really GRATEFUL for those who heroically manage to do so much more. Like
yourself.

Goodness benefits everyone in the world. So I believe. That's part of the Spiritual
Economy. So, thank you, too, from me. God bless.

July 25, 2007 3:35 PM

Matt G said...

I've found that the smallest comments are heard.

Things that sounded trite to my own ears were recalled months later with thanks by
widows and daughters.

If your thing is to into a shell (it is, for many, and that's okay), it's acceptable to say
without really feeling anything "I'm so sorry for your loss." You would be, if your
emotions weren't putting on a suit of armor much thicker than those Nytrol rubber gloves.

Also, if your thing is to feel too much, don't find yourself getting into a shouting match
with an angry, unreasoned family member. I've seen that, too. No, they don't realize that
it's hurting you, too. But this was somebody's fault, by-Gawd, and they're gonna pay. And
there you are.

July 26, 2007 3:35 AM

Amy said...

I took my first ACLS class about a year after I finished nursing school. It was a 2-day
event at the time, and was taught by several different people, one of whom was a
paramedic from my hometown. His topic was airways, and he told a gut-wrenching story
about a 16 year-old kid who had lost control of his car while crossing a drawbridge in a
torrential downpour. His car had crashed partway through the guardrail and was hanging
about 200 feet above the water. The passenger in the car had been fully ejected and was
clearly DOA. So, they got to work on the driver, who had been partially ejected. He had
multiple facial fractures, but was still alive when they got to him. The medic talked about
the challenge of trying to intubate a kid in a downpour, in the dark, in a precarious
location. He said he knew right away that the kid was a goner, but he and his partner
worked for 20 minutes to try to establish an airway, but in the process they lost his pulse
and discovered a massive skull fracture. The medic said something about that particular
kid on that particular night in that particular situation had affected him more than any of
the other horrors he had seen over his career, and that even after 12 years he still thought
about that kid and felt like a failure for not being able to do more for him. I just sat and
listened, brushed away my tears, and said a silent prayer of thanks that this man had tried
so hard to save my little brother's life.

July 26, 2007 3:27 PM

TC said...

Well, at least no one's around this early in the morning to see me cry. I'm going to save
this one.

July 27, 2007 3:39 AM

Pangloss said...

This is what I wrote about this site at my site.

This blog is a remarkably clear-eyed, gracious, and courageous look at the very end of
ordinary human lives from the viewpoint of the men who come to pick up the pieces.

When I read an extract from this blog on The Belmont Club, my eyes grew misty and I
thought intellectually about the end of life and what it means. When I clicked through and
read the whole entry I teared up, then wept, then sobbed. And then I laughed, but not in
relief. It didn’t let up. The cycle continued. What I did may be cliched, but it is not false.
That is what amazingly talented storytellers and writers do with their words when they
tell the right story. The characters in these autobiographical short-short-stories have first
names, or they have titles like Pardner, Part-Time Temporary Partner, Trooper, and the
girl with the prom dress. But they are no less real, no less true, for that. The writer, who
calls himself Ambulance Driver, is so technically proficient, his style so natural and
unaffected, and he is so sure of his subject matter that the reader is immediately drawn
into the stories, even the short ones. He is ready to be widely published in hardback and I
expect his books to be best-sellers.

Read the comments. The Ambulance Driver’s stories are so good, so powerful, that the
comments draw personal stories out of readers of his site of the ends of other lives, their
relatives, friends, some strangers. Some of the comments are as powerful and affecting as
the stories they respond to.

I added him to my blogroll under Moral Clarity. I expect many others will add him to
theirs as well.

July 28, 2007 12:06 PM

Aunt Murry said...

Wow. First time reader. I have always believed that I would always know the right thing
to say and or do in any of those situations, guided by the hand of God. But more often
than not, I just dumbfounded and end up with a cliche. Thanks for the lesson.

August 1, 2007 4:07 PM

CountyRat said...

Thank you, AD. You said more then most could in so few words, which is why there are
over fifty responses to this post.
 For those who missed AD's point, and want or need some more formal information, here
is what I offer. The answer to the question, "what are you supposed to say," is simple:
nothing. There is nothing to say. Don't try to be smart. You aren't smart enough, so don't
try. Don't try to be compassionate. Its in you or it isn't. Don't try to work it up. And don't
offer any answers, because you don't have any.

What you do, what matters, all the answers to the "what do you do or say questions," is
this: you don't DO anything, you just stay there. If they're standing, you stand next to
them. if there sitting, you sit next to them. If they're crying, you can do that too, if you are
cool with that (if you're not, then don't. It doesn't matter).

You are a bit player in the story of the worst moment of someone's life. That's all you are.
All your "what do I say" questions arrise from an erroneous belief that you matter. You do
not matter. So stop trying to figure out how to matter.

What matters, the thing they will remember (if they remember you at all, which also does
not matter) is that when they where suffering, someone stayed with them and let them
suffer without adding words to their grief.

Rav, all that matters is that you stay. And while you stay, that you suffer with them. Do
that, and you have done it all. Do anything else, and you have done nothing.

Then, give yourself three minutes to clear your mind, wipe your eyes, and move on to the
next patient.

January 15, 2008 12:26 PM

Alexander said...

Speaking both as a student Funeral Director and a man who has recently lost his father
we could all use the compashion that you have shown AD and one day I hope I can show
it as well as you do

December 2, 2008 9:10 PM

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The Sunday Roast

She's A Heart-Starter. No, Seriously. This week's interview is with Epijunky, who writes
the blog Pink Warm and Dry. Here's the first of the standard questions. Why do you blog?
To answer that question I have to give you a little bit of ...
Radioed by david mcmahon at April 25, 2009 8:30 AM
linkage
 pictures from last year’s pensic. sigh. about the five second rule. the words of balm: an
ambulance driver recalls the moments when he had to tell survivors the dread news. in
the category of seriously weird; a philippine prison camp ...
Radioed by Lorenzo at July 31, 2007 8:22 AM
blogspotting: a day in the life of an ambulance driver
this blog is a remarkably clear-eyed, gracious, and courageous look at the very end of
ordinary human lives from the viewpoint of the men who come to pick up the pieces.
when i read an extract from this blog on the belmont club, ...
Radioed by Pangloss at July 28, 2007 11:50 AM
i even like the chicken if the sauce is not too blue
ambulance driver: "seeking the words of balm"; brian doherty: "generation dobler";
eidelblog: "those who fear wal-mart and call for "separation of commerce and bank"";
free exchange: "facebook, dating, and sexual income inequality" ...
Radioed by Ilkka at July 27, 2007 7:45 AM
change of shift
monkey girl has done an outstanding job at musings of a highly trained monkey. check it
out. ps be sure to check out this one, it's a keeper. seeking words of balm by ambulance
driver.
Radioed by TC at July 26, 2007 8:28 PM
Change of Shift: Volume Two, Number Three
What Color Crayola Crayon Are You? Nurse Secrets Vol. 1 is Vivid Violet. You'll see
why. I Am That Person is Mauvelous. Because any nurse that does what she does is just
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Radioed by MonkeyGirl at July 26, 2007 3:43 AM
great advice on how to deal with death....
i recently found out that a friend of mine had passed away about two weeks ago. so in
having talked to my friend's whom were all grieving (rest in peace jaron), i asked ad for
some advice on how to deal with these situations. ...
Radioed by Pseudo_Doctor at July 25, 2007 5:59 PM
when words are not enough.
sometimes it is the small things that count more than any eloquent speech or dramatic
action. humamity is not a lost cause as long as there are fine people in this world. a day in
the life of an ambulance driver: seeking words of balm.
Radioed by StarfuryZeta at July 25, 2007 6:22 AM
the last rites
the ambulance driver recalls the moments, over seven years, when he had to tell anxious
loved ones the person he was crouched over was dead; beyond his help. there were men
gone from old age, young blond accident victims, ...
Radioed by at July 24, 2007 8:32 PM
go. read. now.
ambulance driver has a very powerful post up today. if you read nothing else today, read
this. you'll alternately cry, laugh, and shake your head in amazement at the human
condition displayed therein. that is all.
Radioed by Jay G at July 24, 2007 7:44 AM

http://ambulancedriverfiles.blogspot.com/2007/07/seeking-words-of-balm.html