138 South Main

I could smell him from seven feet away. Seven feet is the distance in the ER from the trauma room to the bathroom, and he sat in a wheelchair in front of the door to the latter. He had been ready to go for about thirty minutes, but just as we were getting ready to transfer him to our squad the service that borders us to the south brought in a ninety year-old man in full arrest. The ER went on hold as we all tried to stabilize him, which meant our seven hundred pound frequent flier would have to wait for his return trip home.

He had been to the ER three times in the preceding 24-hour period, each time for the same thing. And each time a lights and sirens squad trip and we push the drug that restarts his heart and you can see the panic on his face as it first takes hold, that freeze when for a split second everything resets itself. And three times thus in a 24-hour period and you begin to wonder what some people live for. To make no change in the positive direction, to know there is another squad trip in the very near future and that clinging desperation that the next trip could be the one in which the heart gives up.

Our full arrest gets transferred to a trauma center in Cleveland via helicopter and we make our trip back south, seven hundred pounds heavier. It is a basic life support trip and I am in the back with him. The industrial air conditioning blasting through the myriad vents in our truck is not near enough to overpower the stench of unwashed flesh. He is too big to wear shoes and his naked feet look like something from science fiction with their long and curled toe nails and elephant hide roughness. I breathe in shallow and erratic breaths to stave off the creeping nausea. He speaks and I bury my face into my t-shirt, the need to not vomit overtaking the normal social proprieties. The eyes roll around in his head as he complains about how the system has failed him and we leave him in the doorway of an apartment littered with cigarette butts, pizza boxes, empty mountain dew two-liters. It is the closest I have come to just not caring. We don't talk on the ride back to the hospital and spend twenty minutes disinfecting the squad when we get there. I punch in the door code to the ER and Freddy turns to me before the door slides all the way open. "We don't even talk to him anymore. At least you still have your niceness." It's a small victory. You can't save them all.

Necrotizing Faciitis

I think it's good that I chose to be in the trenches. I can't even see those books on the bookshelf without thinking of the life I would have chosen before, the lofty ideals I had in my youth. You never put together that the awful people who are your peers in college turn into awful adults and so your task becomes to figure out what you love. And fuck all to the things (people) that would put that love asunder. Life is hard no matter what, but it's easier to fight for and justify your existence when it's something you can believe in. And barrelling down a busy street in a college town in the big white and red box sirens blaring and life clining desperately to its target in the back is the something for me. I hope it doesn't get muddied up.

I used to say a prayer, for the EMTs and the patient, everytime I heard an ambulance siren. It's funny and endearing that the girl who would have been content to make her world academia acknowledged what was going on inside there. Or perhaps like in a Kurt Vonnegut novel my future self was able to visit her and tell her, whisper quietly in sleep, your elbows gotta get dirty, this ain't the life for you, pea under your mattress. I wonder sometimes why it has taken so long. Or that perhaps my sisters got the Irish blood with their stout opinions and strength and backbone, levity and determination. And so I was left with the Russian part, the brooding and mania and staunch belief that my suffering will somehow be deposited into a bank that loved ones can borrow from at a future date. I will stay the same, there is no getting over that part. The goal becomes to find strength in that.

I still say the prayer, but the words have changed a little. I want to drive there but be in the back on the return trip. I want to be calm. I want to hear my patient's heart beat through my stethoscope instead of my own pumping wildly. To be the best at it. To fix a life! How can it have taken me so long to come to this. And a thank-you, that finally I did.