As I slowly crept down the ramp and into the main line of traffic I could see some type of emergency activity ahead. Several State Troopers were directing traffic down to one lane. I could see someone out in the center of the highway crouched over a person. I thought to myself, whoever this first responder is, he's all alone and could probably use a hand in providing care. I quickly pulled to the shoulder, grabbed the medical bag I kept behind my seat and walked towards the scene. Seeing that I was there to provide assistance the Troopers let me pass without question. I approached the man who was giving aid to the patient. He was kneeling over a young man who from the contorted nature of his limbs, had obviously been subjected to some type of severe trauma. There wasn't time or need for introductions. I simply asked if I could help and he looked up at me for only a moment as he prepared a bag valve mask to reply most emphatically "Yes." It was his expressions and demeanor more than his single word response that related his great need and desire for someone, anyone to be his partner at that moment. His eyes were as wide as dish pans. He was anxious but all business. Being first on scene he had already assessed the patient and having found no breathing and no pulse, he went right into CPR mode. He asked if I would take chest compressions and I replied in the affirmative.
I had just several months ago been certified as an EMT. I did so only because I thought the knowledge and skills might be useful as volunteer firefighter. It wasn't something that was required for the job. I hadn't yet even had the opportunity to use any of the skills in any real situation. Now out of nowhere I went from my daily drive to work to kneeling over a unresponsive patient who was obviously the victim of some type of severe trauma. As I slipped on my latex gloves my partner related to me that this young man had leapt from the highway's pedestrian overpass and by design or chance had done so at just the right timing to be struck by a passing dump truck. The picture and the patient's condition was becoming ever clearer. All of the training I had received began to kick in as I went into CPR autopilot. I palpated the appropriate location for hand placement. I formed the fingers of my hands together and placed the heel of my hand on the sternum just slightly higher than the ziphoid process. I began compressions and my partner began ventilations and we both counted the rhythm to ourselves.
After several moments of intense focus on my technique I looked up from my clenched hands and into the face of our young patient. His eyes were wide open with pupils dilated. His skin was ashen. Without being able to speak a word, his face alone was able to tell volumes about his condition. My partner and I continued CPR. A set of five compressions, two ventilations, five compressions, two ventilations, five compressions, two ventilations. Even though I was getting somewhat lost in that simple, almost mindless rhythm, my brain was still able to work through all I had learned in EMT training. The patient's chest didn't feel right. It was very unstable and seemed to be floating under my compressions. I presumed that he had suffered a flailed chest. In other words both sides of the ribs were broken to the extent that his sternum was disconnected from the rest of his rib cage. Massive chest trauma. Worse than that was the fact that every time I compressed his chest, cerebral fluid would expel from his ears. Massive head trauma. The young man's life was literally draining from his body in front of us and even though he had given up on himself, we weren't yet ready to give up on him. My partner and I continued.
I was pulled from my detachment when I momentarily looked up from the patient to survey the overall scene. Cars were passing by just slow enough for the occupants to have a good look. Their expressions related the horror in which we were entrenched but from which they could continue past into their morning. I saw the driver of the dump truck on the shoulder of the highway. He was frantically pacing the tarmac in front of his massive, lime green machine. The fingers of both his hands were digging into the top of his head. He wasn't injured but was obviously suffering from critical incident stress. I could almost read his mind. He was feeling guilt and placing blame on himself for the young man's fate. I could almost hear his thoughts. "What if I had braked harder?" "What if I had swerved more?" "Oh, God, why is this happening?" I wanted to speak with him and comfort him but the young man needed my attention more. I then glanced to the part of the shoulder where two troopers were standing. There was a thin, middle-aged man standing with them. He too was in obvious distress and had to be restrained from attempting to rush towards us. I wasn't sure who he was or how he fit into the scene. We continued.
We anxiously awaited the arrival of an ambulance. One of the troopers came over to inform us that an ambulance had been requested but that none from the local jurisdiction had yet to respond. Paramedics from the nearest hospital were also notified. The trooper then related to us who the man was that was standing with them who needed to be restrained. It was the young man's father who came from the family's nearby home in search of his son. The trooper offered more information and why he felt it was necessary to share it. The patient's blood was potentially a hazardous material. I paused for a moment to look at my hands and think about my own health and safety. The young man had apparently been struggling with a drug addiction. His life was in turmoil over it. He was failing to succeed in his young ambitions and more and more resorted to the escape of heroine. The escape became the rule. His father, like any loving parent, anguished over his son's pain and addiction and tried to help him overcome it. On that morning loving help turned to conflict between father and son. The son bolted from his father, determined to end both their suffering. I looked again to the father. I saw and felt the pain in his face. His life would never be the same. He would forever endure the self doubt, guilt, and pain of his son's fate. We continued.
We had been conducting CPR for what seemed like hours but in reality was probably no more than 30 minutes. It seemed as if the ambulance was never coming. My knees were aching from the blacktop and my hands were cramping from being clinched so long. Then a passing, private ambulance service rig pulled up. The two on board EMT's came over to offer assistance. We requested oxygen and relief, which they quickly provided. We never gained an upper hand in the struggle for the young man's life but weren't willing to discontinue care.
The paramedics arrived soon after. I gave them the details. Patient unconscious, unresponsive, no vitals, CPR 30 minutes plus. They took one look at the young man's deformed, lifeless body and told us to continue just long enough for them to run a tape and then we could go. In a second, it all became that simple. A straight line on a piece of paper. He was gone and we could go. In reality that young man was gone the second he decided to step off that overpass, and we did need to get on with our day and our lives. I realized that most of what we did may have been more for our sake than his. The tape soon confirmed what we already knew. I picked up my bag and shook my partner's hand. We shared a brief conversation and then went our separate ways never to see each other again. I saw the young man's obituary in the paper a few days later. I thought of attending his wake but then thought better of it. I often wonder how his family is doing and what kind of man he might have become.
This story was first published on 1/07/02
You can e-mail John Klim at firstname.lastname@example.org
Copyright 2001 by John D. Klim. All rights reserved. No part of this publication may be reproduced in whole or in part without written permission of the author.