My First Trauma

I know this is long overdue... it happened about a month ago on an ambulance ride-along.

The day had been busy with fairly routine calls. Take Mr. Jones from hospital A to hospital B. Take Little Susy from the urgent care facility to the real hospital because she has appendicitis. Yada yada yada.

After all of that stuff, I was relaxing on their ridiculously comfy couch watching some stupid movie when we overheard on the radio the local fire department getting called out to a 2 car, 2 motorcycle MVA about 2 miles from the station we were at. The EMT told me to prepare to go on the call. The company I was riding with is private and does a lot of non-emergent transport, but they have a contract with the local fire department to essentially take all the 911 shit that they don't want or can't handle alone.

Within a few minutes, we're called out to the crash. I'm elated. This was the last hour of my last ride-along I had yet to see any MVAs or real trauma. On the short drive over I glove up and slip eye protection into my pocket. My heart is pounding. As we're pulling up I can't see anything because I'm in the captain's chair in the back. The paramedic hands me a traffic vest so large that at least 4 of me could fit into it.

We come to a stop, the back doors open to reveal sunshine and road, and I scurry out. The scene is the typical well-organized chaos... police and firefighters and cones and flashy lights abound, but they're all in order. There's 2 motorcycles laid out in the road... one of them is barely recognizable as a bike.

It's a fairly busy and large intersection but now it's almost completely shut down. Bystanders are gathering in the grass and on the sidewalk, talking loudly and bonding with strangers over their communal witnessing of someone else's tragedy. As the medic, EMT and I walk up they all fall silent and stare. I try to pull the humongous traffic vest back onto my shoulders, but it keeps trying to fall off of me.

My eyes finally locate our patient. The firefighters are all standing around him... one is holding c-spine. By his clothing it is clear to me that he was on a motorcycle, and I'm happy to see that there is a helmet lying next to him and that he has gnarly helmet hair. From a distance I can tell that he is not bleeding, grossly deformed or screaming in pain. Based on the mood and activity of the firefighters I can tell that he is probably not critical.

A firefighter gives us a rundown of what happened. 2 buddies were out riding motorcycles. A car pulled out in front of them and they each hit her. Biker #1 was not wearing a helmet, hit her first at full speed - about 45 MPH -, is in bad shape, and has already been transported by the fire department. Biker #2, our patient, was right behind Biker #1, was wearing a helmet, had time to react and slow down a bit. According to the firefighter he's pretty much okay... just has some crepitus over the clavicle with shoulder/clavicular pain.

The EMT calls me over to help with packaging as the medic and firefighter continue to chat. He hands me a c-collar as I look over the pt. He is middle-aged and looks great for his age... strong features, clean-cut, in good shape. He is exposed from the waist up and I can tell that he is shaking from a distance. A wave of... what it is... mercy? pity? sympathy? Well, whatever it is, it socks me in the stomach and resonates throughout my body. I cannot know exactly how he is feeling, but I do know that he has experienced something awful.

That image... of an injured, trembling half-naked man lying in the grass with firefighters and bystanders gathered around... will never leave me. It's amazing how quickly a moment of impact can steal someone's dignity. It's hard to explain, but that image captures so many reasons why I want to go into this field.

The EMT introduces me.

"This is Lucid. She's a student but she knows what she's doing. She's going to put this uncomfortable collar around your neck to remind you not to move it, okay?"

Moving only his eyes he glances over at me.

"Okay." He half-smiles at me, but I can tell he's in pain.

I size up the collar and place it on him. The firefighters roll him onto the board and strap him down. I secure his head down and they move him into the ambulance.

The hospital is only about a mile away. I ride in the back with the medic and talk to the patient, let's call him Jim, as the medic starts an IV. I ask a few questions about his pain and the accident and his history... I decide not to palpate his clavicle because he says it hurts and it's clearly deformed.

Out of the blue he says... "Rick is in pretty bad shape, isn't he?" It's more of a statement than a question. He knows. He watched his friend crash.

"I didn't get to see Rick. I know he's hurt, but I don't know how bad. He's at the same hospital we're going to, so we'll probably find out more when we get there," I tell him.

Jim registers my answer and stares silently at the ceiling, through his eyes I can see his mind tugging around thoughts. We pull into the ambulance bay and roll him out of the ambulance into a trauma room. The trauma room 2 doors down where I assume Rick is, is buzzing with activity and humming with noise.

The customary information swap amongst the medic and the doctor and the nurses and the registrar and the patient begins as I switch Jim to the hospital's oxygen and make sure he's comfortable. After the doctor does his own assessment, begins his orders and has Jim log-rolled off of the backboard, Jim finally receives some information after giving so much. The doctor tells him that it looks like he simply broke his collarbone so they're going to get x-rays of that and his spine just to make sure everything's okay. Jim doesn't seem to care much. He just asks about his friend.

"Jim, your friend has a pretty bad head injury. We're doing some tests to look at his brain right now and we're doing everything we can, but at this point we don't know what his condition is going to be. Do you have any questions?"

"No."

The doctor and nurses leave the room. I ask Jim if he wants anything.

"Yeah... my cellphone... it's in my pocket. Can you get it out for me and help me call someone?"

I slip the phone out of his pocket. He has me look for a man's name in the cell's phonebook so I scroll through all these people to find it... dial it... and hold the phone to his ear for him because it hurts too much to raise his arm up. They don't pick up so he leaves a message... who was it? His son? Brother? Then we call a woman... I think it was his sister... she picks up and starts heading for the hospital once he tells her what's going on. We call one last person who doesn't pick up. Based on the somber message he left, I think it was someone from Rick's family.

The EMT calls me out of the room, it's time to go. I wish Jim the best for his recovery and Rick's. It's really hard to find the right words. I squeeze his hand as I leave.

As the medic finishes up paperwork in the EMS lounge he tells me what he learned about Rick's condition from the fire medics who transported him and the nurses.

"It doesn't look good... he didn't know his name or anything and apparently he was very combative in the back of the bus. Now he's unresponsive. His pupils were normal on scene but now one of them is blown."



I don't know what happened with Rick or Jim. I'd like to imagine that they both recovered just fine and right now they're back on their bikes, this time both wearing helmets.