Quite Shocking (literally)

As a firefighter/EMT, even with all the blood, guts & gore we see, there are the "routine" ambulance calls, false fire alarms and other less "exciting calls" But even those can change in a hurry and without warning.
It was Thanksgiving Day, about 7 years ago or so and after finishing my annual Thanksgiving running around, I decided to spend the night at the fire house to help with staffing. You see, at a fire house that has live in members, most of them are not from the area and go home to spend time with family and friends. These same guys run a vast majority of the calls because most of their free time away from work & college is spent at the firehouse, so on holidays, staffing gets light & us "home responders" pick up the slack.
I got there around 20:00 hrs (that's 8 pm in civilian time) and it had a fairly uneventful day so the few guys there were watching a movie. I settled in, watched the rest of it with them then decided to call it a night.
At just before 0700 (7 am) we get tapped (dispatched) for a Delta 2, a 70 some year old male, unresponsive & not breathing. We spring from our bunks, and head to work. I responded in the ambulance, only we were BLS (basic life support) and since it's an ALS (advanced life support) call, we requested a medic.
We receive confirmation that one of our Medics would be in rout but a bit delayed because he was just leaving work (at the dispatch center)
We arrive on scene & we run up to the house with a frantic women screaming "He's in the bed room, hurry, please save him"
So to the bed room we went. I walk in and there's our patient laying face down across the bed in his gutchies. I make my way around to his head & upper body and roll him over to check for an airway & as I'm rolling him he groans. "He's breathing" I yell to my partner/driver Chad as he comes through the door with the first in bag followed by the engine crew.
I give the guy a sternum rub (rub his sternum hard with my knuckles...it's definitely an attention getter) and he kinda swats at me & mumbles "stop it" and opens his eyes. I tell him I'm with the ambulance, then he shoots back, kinda confused "so, what in the hell are you doing in my bed room?" I explain that his wife found him all unconscious so she called 911. He denies anythings wrong, and swears he was just sleeping. He looks at me kinda funny and asks again who I am and why I'm there, only this time, a little more coherently. His wife then chimes in and explains how she found him, and pleads with him to let us check him out. It was obvious something had happened & he knew it, but it was obviously an awkward situation for the man, after all he came to on his bed, in his underwear, surrounded by a bunch of fireman.
I ask him what's wrong & how he's feeling but he still kinda denies anythings wrong, but you could tell he was now rethinking everything. So I politely ask him to let us check him real quick to make sure he's ok if for anything, to calm his wife down and he agrees. Chad starts taking vitals (pulse,blood pressure, O2 levels & lung sounds) Then Jim, the wagon driver, comes in with the heart monitor, we start hooking him up & Jim tells me the medic is about 2-3 minuets out. I nod and continue putting the stickers & wires on the patient. Once he's all hooked up Jim turns the monitor on and I start organizing the "retreat" of the guys in the bedroom & removal of some equipment we won't need. Then I start back with the patient, telling him he should let us take him to the hospital just to be safe when I here Jim say "Uuuh, Stan!...
I look over to Jim and he's holding the monitor so I can see the screen & I immediately notice what has him so concerned. On the screen his heart rhythm is showing what are called "Tomb Stones"
Now, most of you have some what of an idea of what a normal heart rhythm looks like. It's the line with the sharp high and low points followed by a short flat line, then repeat. Tomb stones look just like the name says, it's a flat line followed by a "hump" that looks like an old tomb stone or one from a cartoon, and also, as the name suggests, they are really REALLY bad! To put it in more convenient terms, we were basically watching this guy have a heart attack.
Now it's real, we need to go and we need to go right now. I call for the reeves stretcher (a long stretcher about the size ofva back board with carry handles) then sternly but polity tell our patient like it or not, he's going to the hospital. Now, by law, we cannot make anyone go to the hospital, you have the right to refuse, but I wanted to get across the seriousness of the situation with out frightening him or his wife anymore than he probably already was.
As one of the guys brings in the reeves stretcher, he's followed by our medic, Fred, who asks "What's up guys?"
Jim shows him the monitor, and Fred says "OK then, get him out to the bus (ambulance) I'm gonna go get a line ready (iv drip) and what ever you do, make sure you print that rhythm.
We get him onto the reeves then carry him out to the regular stretcher that's waiting in the living room. As simple as it sounds, 6 guys, in gear, carrying someone on a reeves stretcher, out of a bed room, around the corner and down the stairs, is anything but simple. (look at the hallway & stairs in your home and imagine it)
So after we carefully but expediently, carry sim down stairs, managing not to fall, or drop the poor guy, we place him onto the regular Ambulance Stretcher then make a B line out to the bus.
Fred starts a line (iv) and pushes a few drugs while I monitor vital signs. We give the nod to Chad who's our Chauffeur for the trip, tell him to run it "lights" (emergency) and off to Forbes we go.
We pull in, get the patient out of the back & wheel him in. It's kind of a slow morning so the Drs are waiting for us and lead us to a room. We switch him onto the ER bed, then start giving the report the Drs are looking at the monitor strip & one says to the unit clerk to start making arrangements for a helicopter to transfer the patient to West Penn hospital because he needs to be in a Cath Lab ASA (heart catheterization lab/procedure room).
I make exit from the room and head out to get new sheets for the stretcher & put the ambulance back together.
Chad and I step outside and notice that it had started snowing & it was coming down pretty good. I turn around and head back in to tell Fred do that we can get back to the station before the roads get bad. As I approach the patients room, Fred pops out from behind the curtain and with concern and a bit of confusion says, "They can't fly....they said the weathers to bad...?"
I tell him "Yea it is, it's snowing like crazy, we should probably get back soon."
Fred says, "Yea....That's probably not going to happen, their ground transport service can't be here for one to two hours, so they asked if we would transport."
"OK then, let's get it done, I'll go tell Chad & get the stretcher." I replied.
So i go inform Chad that our job here isn't finished and we get everything together & wheel it back into the ER and on the way I pass a Dr on the phone with West Penn so they can be ready when we get there.
Now I'm starting to get a feeling of urgency and out side the room Fred pops out again and I ask "This dude's pretty bad off, huh?"
He simply replies "Bad off would be an improvement."
Then I say, "Well, with the roads & the weather the way they are, I don't think this is going to be a quick trip."
He nervously replies "I know."
At this point the seriousness of the situation hits us. This guy doesn't need to be in a cath lab now, he needed to be in one yesterday.
We all kinda take a quick quiet deep breath & Fred asks "Ready"
"Yup....let's do this." I answered.
Chad nods & gives us a "Lets roll." then heads out to get the ambulance warmed up and ready while Fred and I wheel the stretcher into the room, to again, make the switch. This time, the patient has 2 more IV's that we have to maneuver as we lift him over to our stretcher, get him settled in for the ride then wheel him out to the ambulance.
Now by this time the patient has become more comfortable with us and is cracking jokes like "Oh great, you too again.....can I get a meal on the trip this time?" we nervously chuckle and load him into the stretcher with Drs in tow giving Fred instructions.
Fred acknowledges and tells them if needs be, we'll be back. And our journey begins.
Now as fast as weather would safely allow, we head towards the parkway, lights & siren, and as we approach the parkway the patient slips into unconsciousness. Fred starts to holler his name.
Chad questions from the front "Head back (to forbes)?"
Just then, the patient comes to.
"No Chad, we're good" Fred answers.
Then as we're on the parkway on ramp, the Pt slips out again & shows a goofy rhythm for a split second.
Chad asks again "Do you want me to head back?....tell me now while I can still turn and go down the next on ramp (the wrong way)."
The patient again comes to and Fred says "Nah, i think we're ok"
"Are you sure, we're almost to the point of no return....." Chad shoots back.
"We're good, just keep going and watch the road (condition)"
Fred yells back.
"Don't worry," Chad says "the road (on the parkway) is just wet.
Which makes us fell just a tad bit at ease.
We make it a few more minuets down the road, and as soon as we get to what could be considered a "half way point" the Pt straight up crashes
Fred yells "Stan!, bag him" (use the bag valve mask to breath for the patient)
"Got it!" I say as we each switch seats.
I kinda stand over the patient and start bagging him with one hand while I'm doing chest compressions with the other.
Fred says "I know you gotta do it one handed but these compressions gotta count " as he starts pushing (administer via IV) certain cardiac drugs charging the monitor/defibrillator. Then we here the distinctive "snap crackle and pop" as a few of his ribs break from me doing compressions. (it's normal during good quality CPR)
"Never mind" he says, then "Ready?!" he asks
I give him a nod then he shouts "CLEAR!!"
I yell back "GOOD!" to let him know I'm safe and clear of the patient & stretcher then "Whack!" Fred delivers the shock...and the patient has a good heart beat again.
We continue on to West Penn, constantly check his vitals...he's kinda in and out and barely responding to his name.
Fred, tells me to move so he can intubate the patient to secure an airway (insert a tube in through the mouth down to/near the opening of the lungs) and hands me the mic & says I'm calling (medical) command, you just hold the mic.
So as he's intubating he's on the radio telling the Doc at Forbes what's going on & the doctor tells him to just follow protocol (preauthorized plan of care) and keep doing what we're doing and that he would update West Penn so they're ready.
I hang the mic back up as Fred gets the tube (successful intubation) and we hook the bag valve mask straight up to the tube and start helping him breath and bang, he crashes again. So again I go into the dual role of pumpin & blowin. (EMS slang for CPR)
Fred pushes more drugs and then "CLEAR" Fred hits him again, then looks at the monitor..."Nope!...CLEAR!"
he hits him again....looks....."We got it."
"Shit!....CLEAR!"
He drops out so Fred zaps him a third time.
This time the heart beat stays, but only for a minuet or two then down he goes again.
We would continue like this for what seemed like hours. A continuous hectic ballet of CPR, IV drugs and defibrillation. We started out following the general rule of 3 shocks followed by cardiac IV drugs and CPR but eventually it wasn't enough and we reached the end of Fred's paramedic protocol for a cardiac arrest, meaning we have performed every emergency medical intervention that we're authorized to do. So Fred says "let's just keep going" and the ballet continued, even managing to almost shock each other once or twice during the chaos and using up all of the cardiac drugs on the ambulance which only meant more CPR for us, and my arms were starting to feel like jello.
After what seemed like a few long hours, we pull into the ER at West Penn and we're still in the back pumpin, blowin & shockin.
Chad gets out and comes around back to help us get him out and as soon as he opens the door we tell him to tell security to get us help, then get in and help with CPR.
Chad screams over to the guard, climbs in & starts compressions to give Fred & I a break.
Caught up in our work, about 15 minuets goes by and we notice we still have no help from the ER. This guys feet from the door to the ER (and the rest of his life) and was in such condition that we couldn't stop even for a second to get him out of the bus. We were keeping him alive.
I switch with Chad and again start chest compressions stoping only to administer shocks, and send him to find our help.
He returns later with a nurse, she was a little thing, maybe 5'4" & 100 lbs soaking wet. She looks in the back and says "Oh My God" in utter disbelief of us administering more shocks and perform CPR amidst the absolute mess we've made in the back of the ambulance.
Fred calmly says, "Sorry hun, but I think your going to need more help" and the nurse takes off back into the ER for reinforcements.
The adequate help arrived, and we get the guy out & on the way into the ER. I'm standing on the side of the stretcher doing compressions, Fred's bagging explaining how we were originally supposed to go straight to the cath lab but he crashed & it's been chaos ever since.
We get him into an ER Room, then off the stretcher & onto the bed, and a nurse kindly relieves me of chest compressions so I switch up with Fred and started bagging again whole he continues with the report.
After about 5 minuets in the ER we get an acceptable rhythm and as soon as we go to move him to the cath lab, he crashes again.
We continued working him for another 40 minuets untill we got him stable enough to send him to the cath lab.
As they wheel him away, all that's left in the room is Fred and I. We just stand there, sort of collecting out thoughts as we begin to mentally process what had just just transpired. I notice the ER room is now trashed, with a small island of clean floor where the ER bed sat. I look at Fred, a seasoned medic, and he too kinda has the blank stare that I'm feeling. We look at each other and kinda nod, as If to say "Good job" He looks totally whooped and I'm sure I look no better. I'm sweating, my arms feel like rubber and I'm just plain exhausted. Then he breaks the silence and says "We should probably go clean up."
I quietly answer "yup...."
So we head out to the ambulance.
When we get there, to our surprise, we find the Chad had pretty much had it cleaned up. We helped him finish what little was left, then Fred suggested we head up to the cath lab to see if he in fact made it up for the procedure. so we had back in. We find our way and step into the control room to see them finishing preparations on our patient when the Dr walks in and asks "Can I help you."
"Fred tells him we brought him in how we had one hell of a fight to get him there. The Dr pats us on the shoulder and says "Good job guys, I got it from here." and then steps into the procedure room.
We stayed to watch for a little bit then decided it was time to go.
On the ride home, we light heartedly talk about the ordeal we had just went through, Fred, taking notes the whole time do that he can be sure to get everything documented on the state (ambulance) trip sheet (call report) And it wasn't until we "relived" it in conversation and looked at the printed strip (report) from the heart monitor that recoded to memory ever heart rhythm and every shock. As it turned out, we had defibrillated this guy 37 times (yes, thirty-seven) which is practically unheard of, we had done, re-done and done again every possible thing we could to get this guy where we needed to be.
Finally, at around 11:30 we arrive back at the station and we peel ourselves out of the ambulance so we can clean it and finish putting it back together to get it back in service. Then shower & head back to bed.
Later in the day we would receive a call from the Dr in the Cath Lab. As it turns out it was a curtsy call to let us know that our patient did intact make it through the procedure and would be just fine.
We had done it....We fought long and hard, faced practically ever challenge we possibly could and used every skill we had, and we came out on top, and had we not been so damn tired, probably went for a beer.
To this day, I don't think I have ever had to work that hard on any ambulance call......it was physically, mentally and emotionally exhausting, but it's the reason we do the job.

Thick Skinned

"For those who protect it, life has a meaning the sheltered will never know." - unknown


If you were to ask my wife what she thinks about me being a firefighter/EMT, one of the things she'd probably tell you, because theres no easy way to explain it, is "He's fucked up" or "cold hearted" Now some who know me may agree with that for different reasons, what she is referring to is my psyche, more specifically the "cavalier" additude I have towards the uglier parts of the job. More specifically, how after seeing blood, guts, death and dismemberment, I can come home and eat, or go back to sleep, or just carry on with my day like nothing happened.
You see, people always ask the same few questions..."Have you ever saved anybody?"....."Is it hot?"....and "What's it like?" All of them inquiring about the exciting and dangerous parts of the job, but never give two thoughts about the ugly side of the job. The dark and grim events in life for which we have a front row seat.
I honestly don't think I could even begin to tell you how many dead people I've seen, or even how many I've watched die, and by that I literally mean watching a persons life slip away and cease right in front of my eyes. As horrible as it may sound, it's all part of a any given day on the job. It could be weeks or months before your faced with a call where you can't make the save. Then there are the times when the grim reaper stows away on one of the rigs so he can ride around with you to get caught up on his quota.
Truth is, you never know what your going to find on scene. Sure, there's the more obvious patients. Usually it's something like a cardiac arrest call. Where you expect to run in & see the person lifeless & kinda pale laying on the floor. Or, if you get called for an MVA (motor vehicle accident) your going to find at least one wrecked vehicle, maybe more and you can almost always count on someone having at least some "lawyer pain" (the "agonizing" pain that changes in severity & location from the time you get on scene to the time you hand them off at the ER) Or say a traumatic injury call where you expect a lot of blood, or a bone sticking through the skin. You almost always have an idea of what you'll find, but your never 100% sure, and to really keep you on your toes, there are even times when you arrive on scene and find something totally different than what you were called for.
For example, a call for a "severe" nose bleed only to arrive on scene to find your patient had tripped and face planted onto a set of concrete stairs. So, yes his nose is in fact bleeding, what someone failed to mention was that it's also smashed. Along with his broken jaw, missing teeth, gash on the forehead and so on.
Then there are the calls that seem as if they'll be nothing more than an expensive taxi ride to the hospital but skips turning bad and goes straight to worse. I remember taking an call for a nose bleed, it was an Alpha response, meaning no lights or siren, the lowest priority call. I shoulda known nothing good was gonna come out of it either, I was driving & my tech (the person handling patient care) was a total idiot....but its a nose bleed so how bad can it be, right?
We arrived on scene to find an elderly female with an obvious nose bleed. She wanted to be transported, so we did, and wouldn't you know it, 5 min into the trip to the hospital, "SURPRISE" she go's into cardiac arrest. So just because a call seems like it will be routine doesn't mean it will be.
If you haven't figured it out yet, death is undoubtably part of the job, and it pretty safe to say that people in this field probably see more dead people and death in one year than most people do in a lifetime....literally. Sure it may sound a little harsh, but that's the truth of it. We are trained as firefighters, EMTs and Paramedics to save lives but we also understand that sometimes they're just too far gone and its just out of our hands.
There are the calls that always seemed to kinda piss me off. Those are the ones where you are able to keep the patient alive or even bring back to life, in the back of the ambulance, and usually your bustin your ass doing everything you can to save them. Then you get to the hospital and roll them in side with a heart beat, only to see the Dr. call it (pronounce them dead) not even 5 min after you get there. You want to grab him by his stethoscope and yell "Hey Doc!! What the Fuck!?"
You bust your ass and put in all that hard work to get some poor bastards heart beating again and then poof, its all for nothing. And you really do bust your ass. Ask any medic or EMT, after a good call where you have to seriously work the patient and time is of the essence, you are whooped. It's like this physically tiring emotional high, thinking that all your work will pay off this time only to find out it won't. It's a bit disheartening, but pisses you off more than anything, well at least me anyway.
Then there's the calls that stand out for different reasons. One example was an accident with rollover and ejection. (person thrown from vehicle) this poor guy, in his 30's lost control & rolled his pick up truck & was ejected. When he was thrown from the vehicle, he landed on top of the Jersey barrier, then plopped down onto the road. As we arrived on scene, we found two nurses performing CPR. Because patient care was started, we're obligated to continue. But we could tell it was a lost cause. By the way his head was positioned, it was fairly obvious his neck was broken. I happened to be in the fire side of things for this call, do we helped the ambulance crew load him up & get going, he was pronounced (dead) almost immediately upon arrival at the trauma center.
Back on scene, while cleaning up debris & looking for some patient identification, we came across A Military helmet. We then found his wallet in the cab of the truck, right next to a airline ticket stub that was paper clipped to some photos and discharge papers. Turns out he had just flown into the states after a tour of duty in Iraq. Here was an American soldier who had seen combat & couldn't have been back in the states for more than 12 hours, and now he was dead.
And somewhere, was his family, patiently waiting to hug him because he had made it home safe from War, only to find out they would never get the chance.
And then there are calls you get where you know it's just gonna be plain ugly, but you still aren't sure what to expect. Persons hit by a train fall into this category. I responded to a few of these over the years, and they're all different, gruesome as hell, but different.
One I went on turned into a lighting detail and a body (parts) recovery. According to the train engineer, he was tooling along at about 40 mph when he noticed something between the tracks but couldn't tell what it was, then, at the last second, "it"sat up.
We spent about 2 1/2 hours looking for pieces, parts & guts, chasing away the raccoons & other critters that were eating said pieces, and marking what we found with lite flags so the coroner could collect & identify (as best he could) what it was we found (you never realize how long the intestines are until they're laid out in the dirt) After everything was marked & documented, we placed everything into red biohazard bags, the placed those in a body bag. The largest "hunk" we found was a section of upper leg. It was still attached (sorta) to half the pelvis and lopped off just below the knee. We also spend a good 30 minuets explaining to the State Trooper why we couldn't find the head. Imagine taking a watermelon and throwing it in front of a speeding train. POOF! Instant disintegration. Except for the chunk of his scalp and a few teeth that we're stuck to the front of the train, the rest of the head had pretty much vaporized.
Over the years, I've seen just death from about every "common" way you can think of. I think the easiest way to explain the different ways I've seen death come would be to say the only "common" way I have NOT witnessed death is by stabbing. You also notice certain things, things you kinda wish you hadn't, for example, brains smell horrible, burt flesh is even worse, bone is actually off white tanish grayish kinda color and 98% of the time when they die, they shit themselves. I would guess its safe to say you really cant appreciate any of that unless you've seen or smelt it in person. And the smells are such that they practically stick with you all day and leave a taste in your mouth.
And with all of that and then some,we wake up the next day, strap our boots on and do it again. Not because we're sick in the head, but simply because someone has to do it, yea it's a bit cliché, but it's the truth. Your probably never truly going to understand why we do it, or what it's like unless you experience it, and even still you may not. It's just simply not for everyone.
As you can imagine based simply on what you've just read, we really do see truly horrible things. Dealing with what you come across as different for any given first responder. Some handle it pretty good & take it in stride, others, not so much. Each individual is different. Me, I deal with it by being thankful I can go home and hug my family, and, remembering that the dying die, the dead stay dead and I am not God. And even sometimes, once the stress of what I seen have built up inside me, a good hard cry is enough to reset the system.
So how does one continue to step into the horrors of life day after day? Simply put, once you've spent so much time around death, you simply just get used to it, but, in the process, you definitely learn to appreciate life a little more.

The Pin Stripe

I remember one specific call for an vehicle accident about 12 years ago. It was early in the morning and we were out on a fire alarm call across town when we get hit out for a wreck & they report one patient still in the vehicle, unconscious & breathing not verified, a Delta 2 response. (a delta 2 is the highest priority call indicating an immediate life threat)
Now it was still early in the morning and it had snowed about 4 or 5 inches of heavy wet snow, and most of the roads were still covered. We're released from the fire alarm and high tail it back across town in the engine, stoping at the end of the road the firehouse is on so one of the new guys can hope out and literally run to the station and get the ambulance. We had a medical "jump kit" on the engine and the guy driving was a medic so we had enough training & equipment to get us started on Pt care until the ambulance got there. So one of the guys, Mike, hops out and begins his 40 yard dash for the station to grab the ambulance and we continue about a quarter mile down the road to the scene.
As we pull up, I notice a gold 4 door Toyota that has wrecked into a garage where the side of garage door meets the wall. The driver is a 23 year old female, kind of slumped forward a little. (i distinctively remember her age & birthdate, turns out I was exactly 3 days older than her) There is some damage to the corner of the building, not to bad but still bad enough to consider the building unstable making the patient extraction a little more challenging, because now one wrong move of the vehicle, and part of the building can come down. So we add a rescue truck to the assignment and get to work. As "luck" would have it, aside from the medic, the rest of the crew was fairly new to the station, none of them having their EMT training. I had the training,but was just waiting to hear if I had passed the state exams. Bill, our Medic on the call, and also an Asst. Chief looks at me and says, "Your the closest thing i have to an actual EMT so glove up, hop in the back seat & hold C-spine (stabilization)." the rest of the guys started prepping for the extrication. So I glove up, take out the rear passenger door window and crawl in the back seat as the guys begin stabilizing the car to take off the doors. I make my way over behind the driver, looking around the car at the windshield & steering wheel trying to see if there's any evidence that the drive impacted any parts of the vehicles interior. Imidiately I notice some blood and hair on both the "A" post and the "B" post. (the part of the car body that supports the roof of the vehicle, from front to back they go in alphabetical order) I also notice some on the block wall that's directly outside of the drivers window. I relay the info to Bill and get situated inside to grab C-spine. (I'm 6'6" in full gear, in the back seat of a Toyota, needless to say its a bit cramped) I reach over the back seat and gently place my hands on the sides of her head so i can lift it into the normal upright position and as I begin to apply slight pressure to lift her head and I feel this "squish" with my left hand. Wondering WTF it was I pull my hand away and look to see my hand covered in blood and a piece of skull bone about the size of a silver dollar stuck to my palm with long bloody brown hair hanging from it.
I yell "ahhh, Bill.....we've got a serious problem!...."
Bill replies "what's that?" then looks in through the back window. I calmly show him my hand with the her pieces and parts still stuck to it.
"OH SHIT.....ok, we need to get her the fuck outta hear now.....rapid extract......and don't loose that!"
He lets the guys know there will be no car cutting, we're doing this quick & dirty. (to "properly" perform the extrication would have eaten up time this girl didn't have)
Luckily, they managed to get the front passenger door open just before my gruesome discovery, making the rapid extrication a little easier, and, the ambulance had just pulled up, it was time to go.
I grab C-spine, we quickly get a collar on her, wrap her head wond with gauze and bandages & begin the extrication. We get her out into the stretcher & into the back of the ambulance to start working on her. At some point a medic from another station, Rich, shows up & hops in the ambulance to help. We give him a quick run down then start cutting her cloths off to look for other injuries, start IVs and hook her up to the heart monitor. Rich, tries intubation, but there's teeth & blood in the way...he tries a few times then turns & says "here, you try"
I said "Dude!....I'm not a medic..."
He replied, "Don't worry about it, you can't do any worse than me" "Are you fuckin serious?!" I shot back.
"Yea god damn it, now come on!" basicaly this poor girl was in such bad shape that there weren't enough Medics to do everything that needed done, and "trying" was better than "not doing" at all. So we switch places and he starts talking me through it while beginning another task.
"Look for the (vocal) cords, do this, do that, ok try and place the tube" all of this while he's using suction to remove blood and help guid the Tube.
"Did you get it?" he asks
"I don't know!? I think it's in but I don't know!" I replied
Rich then says "Hook up the bag valve and give some breaths, I'll listen"
So I do, and sure as shit he looks at me and says "You Got It!!"
Bill looks up at me with a smirk and says "Beginners luck." (and it was) But before I can even catch a breath and take a second to soak in what i had just accomplished, the driver of the ambulance yells back "Give me some towels, I need a dam!" I turn and look at the floor and all this blood was running across the floor towards the front of the ambulance and into the step well for the side door. We throw a bunch of towels down, then Bill tells the kid driving "Lets Go!.....Presby,now!" and off we go.
I'm baggin her, and I cant help but notice the blank stare in her eyes, Rich & Bill are starting a central IV (into the jugular vein just below the neck) and pushing drugs to keep her alive. As we reach the tunnels the heart monitor goes into alarm.....she's starting to "crash."
Rich grabs the paddles, charges them up, places them on her and yells "CLEAR" Bill and I get clear and reply "CLEAR" to let Rich know we are in fact clear of the stretcher, then he whacks her. Her body kinda twitches a little bit (it's not the big lunge you see on tv) and her heart rhythm returns to something not quite normal, but acceptable considering the condition, but it lasts only for about 30 seconds, then she crashes again. We ended up shocking her about 3 or 4 more times and that's when I notice the blood gushing from the now solid red bandage, is starting to look clear,the damn of towels on the floor is also soaked, holding back a puddle of blood and the step well also has about an inch deep puddle of blood, and every time I squeeze the bag to give her a breath, a clear/redfish blood bubble inflates from the location of the head wound then pops. Basically what has happened is most of her blood, which is all over the floor of the ambulance, has been "replaced" with saline from the IV.
"ummm, Guys!?....her blood is turning clear..."
Bill & Rich look at each other as if to say "oh shit" then Bill asks the driver where we're at.
Mike the driver tells back "Bates St. About 2 minuets out"
Bill turns to me and says "you just keep bagging" then starts chest compressions. Then no sooner do we make our last turn towards Presbys ER, she flat lines. And as the monitor starts to make the infamous long "beep" tone to indicate flat line (no heart beat) I look down at her & I rember watch both pupils in her pretty blue eyes slowly dilate to about the size of a dime.
We pull into the ER & the trauma team is waiting. We get her out & right into a trauma room. I'm still bagging as the trauma team gathers around to start there job.
They push a few drugs then shock her a few times to no avail....then the Dr calls it, "OK people, Time of death 8:41" and then that's it. All the work we had done during the longest 10 min ride ever, is now null & void. We did what we could, but it was out of our hands.
Before leaving, we go over the ordeal with the trauma team again & they compliment us on the work we did, assuring us that we did everything we could and we did it right but today it just simply wasn't enough.
we head back to the ambulance. In side, it looks like a massacre & is totally trashed with gauze wrappers & empty IV bags & heart monitor cable just thrown about in a blood covered ambulance.
I walk around to the side door and open it to see coagulated blood kinda slide out onto the ground & go splat. Then I noticed blood down the side of the ambulance in a perfectly straight 3" wide pin stripe. The blood in the side step well was leaking out through a bad door seal and as we drove to the hospital, and worked its way down the side of the ambulance perfectly parallel to the red reflective strip thats supposed to be there.
It took about an hour just to clean up the ambulance enough to drive back and would take another 2 hours of scrubbing at the station to get it in service. But on the way back we swing by the scene to let the police know she didn't make it and just to take a look at what happened & how she wrecked. As it turns out she was on her way home from work driving on the snow covered roads when she lost control & hit the garage. When she hit the garage and the car stopped, she kept moving forward striking her head off off the "A" post then coming back and striking the "B" post and finally hitting the block wall just outside the drivers window. Hence the severe head trauma.
The car itself wasn't that bad, needed a bumper, fender and hood, that's all. The police also told us to look at the speedometer, it was stuck at 23 mph, the speed at wich she was traveling on impact.
As it would turn out, relatively low speed crash and no seat belt equaled out to a dead 23 year old girl.
It's a shame, but in this business you see a lot of death that could have been prevented. You just learn to accept it.

Big fire, cold night

At just about every firehouse there is one night a week or month set aside for training. Usually it's nothing more than training on techniques, tools & equipment we use on a fairly regular basis, or, on a rarer occasion,  for the guys to familiarize theirselves with something new.  One night while at drill as a member of 13 Engine Co, we were doing search training. This is the task of entering a burning building and methodically searching every room for victims. It more or less boils down to two firefighters working as a team, crawling around and sweeping the floor with their arms and legs in hopes of feeling any victim laying on the floor, only in a real fire, you usually can't see anything & it's hard to hear anything over the Darth Vader like sound as you breath into your air mask mixed with the sounds of fire trucks, chain saws, breaking glass and of course, the roar and crackle of the fire. So, as "simple" as it may seem, in the real world,  it's a little more challenging than you think. .  Now as you can imagine, it's a bit difficult to mimic those conditions for training, after all, lighting off the firehouse isnt exactly good for business or PR, so you crank up some tunes for background noise and pull your nomex hood over your mask so you can't see. Then, you search the firehouse for victims. In our case, he was a dummy made out of fire hose & stuffed into a set of bunker gear.  We were about 30 minuets into drill and i was patiently waiting ny turn when we hear a first alarm assignment go out in station 21's first due (their fire district) for a working structure fire at an old glass manufacturing plant. Shortly after dispatch, chief 21 calls for a second alarm. You can tell by the tone of his voice this was a good fire,  so we turn up the radio a little and listen a little more carefully as the call unfold.  As we continue to listen we notice the anxiety in the voices of those on scene....and practically everyone with a radio reporting heavy fire conditions...and in almost no time at all, the attempt at an interior fire attack is nixed and the decision is made to go defensive....or as its know in the service, a "Surround and Drowned." By this time, drill has come to a standstill as everyone at the fire house huddles around the radio & listens. Debating exactly where the building is located & what the best place to set up elevated master streams (ladder trucks with the big nozzles at the tip of the ladder)  Its not too long into the call that we begin hearing pump operators starting to get a little frantic as they do everything they can to get as much water out of the hydrant as they can.  We begin to realize, as I'm sure they already had, they're running out of water. The small water main that feeds the area in which the fire is located simply isn't big enough to supply the needed amount of water to fight a fire of this size. Compile that with multiple engines in a 2 block radius sitting on hydrants that are all on the same water line, and you've got water issues, and that in itself is a huge problem. You see,  water supply is key in the firefighting operation. Obviously you need water to actually put the fire out, but it's more than that. Water supply is the building block of the entire operation. Any fireman with some experience will tell you, if you have problems with the water supply, the rest of the call turns to shit in a hurry.   By now a third alarm has been transmitted plus a few "special calls" for ladder trucks and first and second alarm companies are putting in for standbys. These are engines and trucks that are dispatched to fill in at fire stations who are on scene. It was obvious that this was turning into a block party ("invite" a bunch of fire companies to squirt water and watch the block burn) so we were wondering not so much if but when and where we would end up on stand-by. Then we here the familiar "clunk!" and the fire whistle behinds to wind up and scream. At first we're all sorta confused, after all we never heard the alert tones over the radio, so we're not quite sure where we're going.  "911, station 13 respond, assist station 21 with a working commercial fire"   Well, I guess No stand-by for this house, we're going to the scene of my first "big fire." Already half dressed from drill, me and 7 others grab the rest of our stuff, hope on the wagon and away we go. We pull out, make the left out of they bays and Scott, our chauffeur puts the hammer down.  13 has a pretty good wagon with some real get up and go, and Scott, one of if not the best driver we have and one of the best I've ever seen, knows how to squeeze every last bit of power out of the motor.  The 5 mile or so drive seems to take for ever, even at what seemed like Mach 2. The whole way, the radios going not stop with alert tones, stand- by companies marking up (acknowledging the call) firefighters and pump operators all over the air (talking on the radio) and poor chief 21 who for the most part can't get a word in edge wise, is trying to run a large scene and give orders,. I know, you have to wonder how the guy in charge is unable to talk on the radio. At the time, the county radio system wasn't exactly the best thing goin and the fire service in general had the radio etiquette of a toddler. Basically it boiled down to one simple phrase "Have radio, will talk" 

 We continue through the neighboring towns on the way, and at about 3 miles away you can see the large orange glow in the sky. As we wind through some of the tight streets we start haveing to weave in and out of traffic that has either gathered to watch or has been turned away from the scene by police.  As we get a few blocks away, we somehow,  amongst all the radio chatter, manage to call approaching and get instructions to reverse lay (lay hose from the fire to the hydrant.)  from an engine positioned about 100 yards from the fire building to a hydrant a couple blocks away that we're told should have sufficient water because it's on a different water grid.  We pull up to an engine at in intersection, and stop. The officer yells back "Let's Go!" and we peal off the rig.  As I step out and look up the street toward the scene, trying to make sense of the many fire trucks just beached all over what looked like miles of hose....and this orange glow that practically lit up the entire neighbor hood, and that smell.....   As one of the guys bumps me & breaks my thoughts...."Got your face piece?" he asks.  I check and give him a nod. "Well then lets go"  And up the street we went, up hill, a steep ass hill I might add. Up past the still parade of fire trucks all the while stepping over and around the miles of hose. As we crest the hill, the excitement of seeing my first big fire up close were dashed with disbelief as I see that the building is still about 200 yards down the street.  So we continue the long hike.   After what seemed like forever, we make it to the front of the building. The entire scene is lit with a bright orange glow, a glow so bright it was next to impossible to even look at the building. And the heat was intense. You couldn't get within 40 ft of the building itself without risking minor burns to yourself.  I imagine it would be  like standing next to the sun.  

We're instructed to stretch a few hand lines and a portable deck gun, (that's the big "water cannon" on top of a fire engine)  and officially set up for surround and drowned, for this was definitely well beyond an interior attack and had been for some time.    We sat on our hand lines, aiming water at the inferno in what seemed like a pointless effort, occasionally knocking down the fire in a nearby tree that had lit off from the heat, wich added a little flavor to the monotony of sitting in one place babysitting hose lines.  After a while we decided to just strap the hose lines to nearby trees & fences so we could go get warm. We walked down a small driveway that led to the building and about 150' down was what looked like a small building burning with a bunch of firemen huddled around. As it would turn out, it was an old guard shack that command elected to let free burn so that it could be used as a source of heat for the guys as the night went on.   It was a damn good idea too. You see, when the call came in, the temperature outside was in the upper 50's but had been forecast to drop drastically....and boy did it. We warmed up and drank some luke warm brown water (we were told it was hot chocolate) and after about 45 min stepped away from the "Bon fire" and went back to our hose lines.   Immediately we notice a thin layer of ice starting to build up on a chain link fence, that by morning would be a solid 3 inch thick wall of ice. It got bitterly cold and fast and we did everything to keep warm, but in soaking wet gear, it was next to impossible. At one point we did 15 minuet shifts taking turn huddled around the exhaust of a nearby ladder truck. It was horrible.

  Eventually we were relieved but asked to remain on scene to relieve another crew in about an hour or so.  We headed to our squad truck, climbed out of our we gear and wrapped ourselves in blankets. We tried to get some sleep but you just couldn't get warm, and just about the time I fell asleep, it was our turn back on the lines. It continued that way the rest of the night & by the time we returned to station the following morning we had been on  scene for 18 very long, cold hours.  The first due company would remain on scene for another 2 days and even felt kind enough to call us back the next evening to relieve some of the crews on scene and help pick up some of the miles and miles of hose. As it would turn out  my first major (abandoned) commercial structure  would become and still stands as the single biggest fire I have ever gone to battle with.

Like a scene from a movie

  Just about every fireman at some point early in their career wonders what it would be like to make a save, as in save someone from a burning building. What kind of building will it be....were would I find them, will I have to grab them and run down the stairs, or will I climb a ladder through a second floor window and find them unconscious in bed. Fact is, that aside from your really busy fire departments that catch a lot of fire, a huge number of firefighters never get the chance to make a save.
     Now as a live in firefighter, the fire house is your home. You wake up, go to work, and come home to the fire house. You physically live there. At the time I lived there, there were a total of 11 live in members. All who either had full time jobs or were attending college or even both. And at any given time, any combination of the guys (and at the time, one girl) would be at the station. On this one particular night, there were 9 of us. The house officer of the night was the girl. She was in fact a lieutenant, now I could tell you that she was there for the job and was worth of a colored helmet, but that, in my opinion (and that of many others) would be a lie. I won't get into the hows and whys because it's not important. Anyway, every evening the house officer would find out who was or wasn't going to be at the station over night and then make riding assignments for those sleeping up. These were pre-assigned riding positions so that in the middle of the night when a call came in, everyone knew what rig they were riding, in what riding position for any type of call, structure, non structure and vehicle accident/rescue. This eliminated the confusion of who's riding what and where and help speed up response time. I was assigned Chauffeur on the truck. In civilian terms, the chauffeur is the driver/operator of the rig and a "truck" is a ladder truck. I was just fine with this, you see the truck was our pride and joy, it was a 135 ft ladder, or "straight stick" (meaning it didn't have the bucket at the end of the ladder to stand in) Not only that, but on about only 1 in every 4 or 5 fires is the aerial ladder used, which means as the chauffeur, the odds were I wouldn't have to operate the aerial and could go "play" with the rest of my crew performing any one of a multitude of  tasks that the truck company is responsible for. So all in all, to me, it was a good assignment to have.
  As the night went on, we ran a minor accident, and a smells & bells call or two (smell of smoke/something burning & automatic fire alarm) but then it was time to hit the bunk and call it a night. Now sleeping at a fire station takes some getting used too because the dispatch radio is piped through out the firehouse including the bunk room. So you hear ever word said on the air 24 hours a day, 7 days a week. Some people adjust pretty easy, others, not so much, but eventually you learn to sleep through it all but at the same time never miss a beat. You hear every pre-alert, every address, every call that other stations run and every word spoken on the radio. And its nothing in the morning for the guys to discuss in detail the things they listened too while they slept. Its weird, I know, but that's how it is. Well at sometime around 0200 hrs (2 am) in a dead sleep, I hear 2 pre-alerts, this doesn't wake me up, but it kinda brings you into a "lighter" stage of sleep. After all, 2 beeps is a structure call, and chances are, we're going. As I lay there asleep, I hear the dispatcher start his cadence. "At 3930, Building J, for a reported structure fire, with entrapment, companies 1,3,6,Truck 4, Truck 5 due to respond"   Now before he could finish the initial dispatch, just about every one in the bunk room was up and moving if not already sliding down the pool to the apparatus bay. My bunk was closes to the door, so I was the first one down, I climb into my boots, pull up my bunker pants, grab my coat and my leather(helmet) and head for the truck. Before my ass hits the seat I'm reaching for the start buttons and get that big diesel motor hummin. I close the door cab, click the garage door opener and switch on the emergency lighting and wait for my crew. I anxiously wait for the guys to get on and the officer (our "favorite" female) is the last one on and asks..."where is it?" I repeat the address and she starts flipping through the the map book for the fire pre-plans for the apartment complex, I give two honks of the air horn, release the breaks put the pedal to the floor and away we go.
As I'm pulling out, the dispatcher gets on the radio with a supplemental (a report with more information from the 911 caller) and says they're receiving multiple calls and that one caller had stated the building is full of smoke and can hear some one calling for help but cant get to them because of the fire.  It's at this point it hits me....this ain't no bull shit burnt food run...this is the real deal in a multi residential building and some one's in a bad spot....big time.  I feel a quick rush of adrenalin flow threw my body as my foot becomes heavier on the gas pedal. As I make the first turn, I'm thinking about the crew assignment, and remember thinking that I have a good truck crew, an aggressive group of guys who aren't afraid to work & get into the thick of it...they the only exception being the officer in charge of the rig, but if she was going to prove herself, this was time to do it. After about a mile of straight road I reach my second turn, and notice there isn't a car on the road, which is good, cause this 65 thousand pound hunk of aluminum and steel is hauling ass....big time. I wasn't driving it, I was flying it cause I swear that fuckin ladder truck had wings. As I approach the right turn I take it into the left turning lane to give my self as much room to make a right turn as possible as to not lose any speed when I notice the 6 lane road I'm turning onto is empty, so I use every inch of the road taking my foot off the gas if only for a second, then once I make the turn it's back to the floor. The big diesel V-8 is screamin and I'm running it into the governor at around 68 mph. I know the general area where the apartment complex is, but I also knew it's right next to another one, I just wasn't sure which was which, and this wasn't the time to mess it up because it would in fact be a monumental fuck up and I wasn't about to do that to my crew or my station. So, as we approach the 3rd turn I ask the officer, "Is it the first or second left? In return I get a frantic "I don't know!!! It's not in the book"
 "BULLSHIT" I shot back....."Find me that fuckin building!!!"
By this time I've made the 3rd turn, and I'm approaching the 4th turn that leads onto the road in which the driveway to the apartment complex(s) were, and that's only about 100 yards after I make the turn. As I approach the 4th intersection, I ask again... "WELL??!!"
Again I get "Its not in here!"  By this time, I'm at the 4th turn, and hesitate to go because I don't want to make the turn into the wrong complex. I look to my left and Truck 4 is approaching the intersection and they have the green light, so even though I can make the turn and beat them in,  I impatiently wait for them to pass and figure I'll follow them in. Only now I'm pissed, big time.  Being the only 2 truck companies in town, there's a bit of a rivalry and beating them into a fire means bragging rights. But due to incompetence on the part of the person in the seat (officers seat),  we wont get them this time.  Truck 4 passes and I pull out right behind them...go about a hundred yards and we both slow down to let Engine 1 turn into the complex.... Now I'm really pissed because  we were the last due unit and would have been first into the scene had the dumb broad in the officers seat known what the hell she was doing. But...No time to dwell on it because as we turn in you can smell the smoke and just see it over the buildings in front. I scream over the motor to the guys in the back "We got smoke showing" This  for them is sorta like first hand confirmation that this is a real job.
 We make a right and go down the hill and around a bend to the fire building and all I can see is smoke pouring out of every floor of this building and people, at least a dozen of them, hanging out of windows and off of balconies. Some of them half naked, covering their mouths with a shirt to breath, every one of the screaming  for help....it was unreal..... It looked like a scene from a movie.
   As we pull up to the building I turn to our "officer" and ask "What do you want? (us to do)   She looks at me with a look I can only describe as amazement and eyes the size of dinner plates and says.."I....I....I don't know..."
  I let out a "Jesus Christ your useless, stay in the truck so you don't get some one killed" then I slap the parking break, flip the PTO to power the aerial and scream back at the guys "Ladder that fucking building!"
 We bail out of the truck, the smoke heavy in the air and the screams of trapped people becoming more louder and frantic, The guys run to the back and start stripping the ground ladders from the truck and getting them to the building. I throw my wheel chocks and set the ground plates (metal plates the out riggers or stabilizing jacks sit on when deployed) then head to the back where the controls are. I set all four out riggers which fall perfectly on their ground plates, and the whole time I'm engaged in a kind of ballet, stepping around the guys as they pull ladder after ladder from the truck. I flip the power switch from the jacks to the ladder and climb up to the turn table and ladder controls. As I start bringing the ladder from the cradle and rotating towards the building I spot one of my Asst. Chiefs, "Lurch"   He had come from home straight to the scene and had not yet been assigned a task yet so I ask him to "fly me in" (be my eyes and guide the tip of the ladder close to the building so that I don't ram the building with the ladder) I position the ladder for roof access as ordered and hope from the turn table....all of this taking only 4 or 5 very short minutes. Buy this time the guys are still throwing ladders and pulling people out of the building, I head for the cab to grab my coat and my helmet when some lady comes running from the back of the building screaming, "There's people in the back and they can't get out!" Lurch yells "Let's go!" and we grab 2 roof ladders from the truck and head straight for side 3 (back of the building)
We make our way around to find a slew of people gathered to watch and to aid those who were able to make it out on their own, still coughing and hacking from the smoke they had inhaled on their way out. Adding to the already borderline chaotic scene, those not aiding others were yelling and pointing to upper floors, Some even stepping up to us to be sure they told us face to face. I remember having to stop my forward momentum 2 or 3 times because of it, I remember one lady actually grabbed my face and positioned it towards the upper floors. "LOOK" she screamed, "Do you see them?!"  "YES!...I SEE THEM, NOW GET THE HELL OUT OF MY WAY!" I shot back as I pushed her hand from my face.  You see, it's not that I was pissed at her, well  OK, maybe a little, but it was the repetitive interruptions we face while trying to do what they were so adamantly making sure needed done. In a situation like this seconds count, and they were wasting them, and we just wanted to do our job.
   Now free of civilians, Lurch, radios command to advise them about the dozen or so patients located in the back of the building, and I'm screaming to people on the upper balconies trying to talk them out of jumping. Once I get them talked off the railing and back onto their balconies I have the task of telling them not to touch the ladder. You see, in panic situations like this, civilians have been known to start climbing down the ladder before it's set and stable, even at times, jumping to the ladder while its still feet from the window, or in this case, the balcony. Both instances usually don't fair well for the civilian and sometimes a firefighter down below. . I finally set my ladder to the balcony and  begin my assent, the whole time trying to keep the people calm. I make it up to the balcony and there is a boy standing there, probably about 16 or 17 and he frantically begins to tell me his mom went back in to the apartment. My first thought is "Are you fucking kidding me?!" but I ask where. He tells me "Through the dinning room and to the right.." as he points into the dark smokey abyss.  Now I can't even see the room just inside the door, let alone be able to tell if it's a dinning room or not, and I'm thinking that I'm gonna get my ass chewed off for this one because all I have on is my boots pants and helmet, no SCBA or even my coat, so technically I shouldn't be any where near the building let alone on a balcony. But...I get low and go in anyway.  I crawl through the door and the smoke is kinda thick and nasty, I yell for the woman then try and get close to the floor for fresh air, but there is only about 4 inches of "fresh air space" at floor level making it kind of difficult.  I take in some smoke and start coughing a little bit and holler for the woman again, still making my way deeper into the room. Take another breath, and this time gag a little bit....I'm not quite sure why, but for some reason, compared to other fires, this smoke tasted like shit, it was just absolutely horrible. I finally lay flat on the floor to try and catch my breath from that valuable 4 inches of air. I call again, and finally I get a reply.
 "Hello....Mam....it's the fire department, where are you?"
 She shouts back... "I'm looking for my cat, but I cant find him... please help"  
 "Mam, you need to get out of here it's not safe, lets get you out then worry about the cat,.... where are you?"
"I'm in the Kitchen" she replies.
By now I am able to realize that I am in fact in the Dinning room just inside from the balcony, so she's got to be close, but the voice is coming from my left, not my right, the direction I was told she went.
I start along the wall to my left towards the voice make it about 5 feet and find the kitchen, I call for her again, this time when she answers I realize she's only a few feet from me so i sweep the floor with my hand, and just as I bump what I think was part of her leg she grabs my hand. I pull her towards me and begin to make my way back to the door with the woman in tow. Both of us coughing pretty good, but we finally reach the balcony.
She gives a hug to her son then I help her onto the ladder and climb down just ahead of her to make sure she doesn't fall. Then I head back up for the son. On the ground, Lurch asks..."Hey dude...where the fuck'd you disappear too"
I reply..."The dumb broad went back in to look for her god damn cat."
  Now, this has always baffled me... I understand pets are like family...but putting your self in jeopardy by going back into a burning building for your cat or dog or what ever...that's just plain dumb.  Many civilians die every year doing that. But anyway...
 Lurch and I kinda give each other a look as if to say "good job", then he says lets get back to it....but go put the rest of your gear on.
"ME?!" I exclaim.... "your the one in he nomex PJ's!
 In simple terms, "Nomex PJ's" are what we call it when some one shows up to a call at night in regular clothes...in his case, a t-shirt, soccer shorts and flip flops with socks.
"Yea...I'll probably hear about it too"  he replied.
We both chuckled and made our way back to the front of the building.
I head back to the ladder truck and ask one of the guys how it's going.....he tells me the fires now out and they have some over hall to do. I figure that by this time the fire floor is probably nothing but ass holes and elbows....a bunch of fireman standing around watching 4 or 5 do all the work, so I decided to stay at my post on the turn table and watch.
 About 10 min go by and I notice my guys coming out of the building... I hop down and greet them and ask how they're doing...is every one OK and things of that sort. They start telling me about what they did inside and the ladders they threw and the saves they made. Even the useless lieutenant would get credit for a grab, She climbed a ladder as it was being thrown by another firefighter.
  When it was all said and done, the crew from #5 made six saves that night, plus 3 pets...one of them being the cat that led me in after that lady, and Lurch and I did get a piece of our asses bite off by the chief for what we were wearing that night, or more importantly, what we weren't wearing. We took our lumps then went back out to the apparatus bay. We knew we were in the wrong, but the job still needed to be done, and if it happens like that again....we'd probably do the same thing.
   I walked a little taller for the following day or two. Granted, I didn't pull a life from the bowls of the fire, but it was still a save non-the less. As I look back on it now, I still get filled with a sense of pride, but, when it comes down to it, I was just doing my job.

"We Got This"

Over the past few weeks I have been mourning a great personal loss. On Friday, June 10th 2011, I lost a dear close personal friend, Ryan Patrick Douthit. (he happens to be the person next to me in the background picture) As the hours without him turned to days, and days into weeks, I have reflected greatly on the impression he has made, and the void that is left on me, my family and the fire service. I wont get into the personal side of things, after all this is a blog about one mans accounts of the fire service. And in the fire service Ryan exemplified a rare breed of firefighters.
    I met Ryan at the Fire company picnic in July 2005. It happened to be the day he was moving into the fire house as a live in.  As with most live ins, He had been down to visit with his mom & dad a few months before. Took a tour of the station,  and filled out his application. The next meeting he was voted in as a member on a kind of "delayed entry"  meaning his membership & probation period would not begin until he moved in. At first impression, he seemed like a good kid, athletic, good personality and an good looking kid. As one of the senior firefighters I made way over to him and introduced myself to him and his parents and started talking. Not long after he ran off to grab a bite to eat or something & i stayed to talk with his parents. It was obvious to me that they had some concerns so i spoke with them and answered any questions they had about the department and what their "little boy" was getting into. Their concerns were that of any parent, How would he adjust and how would he do in school (ryan moved here to take fire science classes as ccac) but as discussion went on I was able to pick up that they were not new to the fire service, just from some terminology they had used. As I come to find out his Dad was a past fire chief of the City of DuBois Fire department. This means one of two things, as history has shown, a new member who's father is a fire chief some where, the kid will either be a stick in the ass "fire snob" who thinks they know everything because daddy was a fire chief, or he's going to have his head screwed on straight and really understand the job for what it is and what it truly means to be a firefighter.  As I continued to talk to his dad, i was beginning to believe that this was the latter of the two and that he would be just fine.
     As his career at #5 began, he was doing everything he could to learn as much as he could. Not to mention jumping in to help out with whatever around the station or simply finding stuff to do.  It wasn't more than a few days, maybe a week at most until Ryan passed his first "probie test" and was able to start responding to calls on the rigs. You see, at #5 every probie has two tests they have to take in the first 6 months. The first test, commonly called "the riding test" tests basic knowledge needed to be of any use on the fire ground. Using the map books, talking on the radio, using our SCBA's (self contained breathing apparatus...our air packs and masks) and understanding what rigs roll on what type of call and in what order. Ryan was now riding, he was on top of the world, a fireman in what he called, "The Big City"
   As his probation carried on, he found his nich and fit right into the department. Coming from a small single engine company in DuBois to a busy "big city" firehouse with 2 engines a ladder truck and a tanker is a big step and a world of difference. But he made the transition flawlessly, and he began taking a liking to the ladder truck. He would ask me all the time about truck company operations....how to do this and how to do that, and as fast as I could tell him, he'd soak it in and have another question. Every time I was at the station, he was a shadow, but I didn't mind, I was taking a liking to the kid. He reminded me of myself a bit, and i could tell he was here to not only do the job, but to do the job as best as he could.
   Ryan would grow to be one of the best damn firefighters I have had the privilege to work with, and thats no bull shit. He was one of the smartest and aggressive firefighters I had seen in some time. From time to time, you could see his adolescence kick in and he might pull a bone head move. But as soon as he did, he knew it, and you could bet your ass he wouldn't make that mistake again.  He grew as a firefighter with every fire alarm, car accident, structure fire and ambulance call he took.
  One night we got a call to the local low income apartment complex for a reported working structure fire that immediately went to a second alarm after the initial dispatch. We pulled up and this place was OFF!!! Huge amounts of fire and a broken hydrant.... not a good combination. Ryan was with the first bunch of guys through the door. He quickly and methodically began performing searches. More hand lines were stretched into the building with hopes of keeping the fire in check, and about the time they got a water supply outside, 2 of the hand lines inside, burnt through. It was at this time they decided to pull the plug on an interior operation and get the guys the hell out. As Ryan moved from a back bedroom to exit the structure, the roof collapsed. Knocking him down and pinning him to the floor, only 10 ft from the door. As he wiggled to free himself a firefighter from #4 saw him and helped pull him to safety. We did a quick accountability check of all our guys to be sure everyone was accounted for. Then gathered in front of the ladder truck to discuss our plan of attack. During discussion, Ryan is seen standing kind of behind the huddle, waving his hand like a first grader that has to go to the bathroom. Our Assistant Chief Mike, (aka Lurch) asks "what do you need"  And ryan calmly asks, "Is it OK if I go throw up?"  Lurch kindly replied "Sure dude, go ahead, you don't need to ask, just go do it by their (another companies) engine."  And off he went. Now as funny as it sounds, there is profound meaning to that story.... Ryan was lucky, 20+ guys were injured in that collapse, 16 of which were transported to the hospital, (luckily none life threatening) yet he stayed to keep fighting and actually asked permission to puke, not because he wasn't allowed, but because he was afraid it might make himself and his company, look weak.  I later explained to him that I as well as some of the other guys had been there....in that we had also had our close calls... and the sick feeling you get in your stomach you get after your outside and begin to wrap your mind around what just happened and how close it really was. There's really nothing more  you can do but thank the man upstairs, take a big breath in a sigh of relief and sometimes, you puke.
    That fire would be the one I think that calmed the adolescence in him down. He constantly played that over in his head trying to figure out what he could have done differently, as did many of us. But he realized that in this jobs there are some things you just cant control, so he didn't beat himself up about it...he learned from it.
   Another fire I remember was in #4's area. While working on an old car in the garage, the home owner dropped and ruptured a full gas tank on the car & in the frantic moments that followed, knocked over a work light. The light hit the ground, the bulb popped and the gas lit off and it lit off big. As we approached we could see the column of thick black smoke. We pulled in as the second engine we could see smoke from every window and flames beginning to peak over the roof of the house. Ryan jumped off the engine and gave his ever famous "Oh yea....We got this" and away he went, with his air bottle on his back, and no air mask. He ran down the driveway following a 2 1/2" hand line on side 2 (the left side looking at the house) as he came to the back he noticed a kid from the first in engine kneeling on the ground 30 ft from the house with the nozzle only opened half way in a sort of "spray and pray" mode. (spray water at the fire an pray it go's out) Ryan, still running full steam, began yelling at him "Get the fuck in there!" but the kid didn't budge. With our missing a beat Ryan (still running) lowered his shoulder and 3-pointed this kid clean off his feet from a kneeling position.
Ryan rolls once then hops up and begins screaming again "Get the fuck in there you pussy....or give me the line and get the fuck outta my way!" Still dazed from the truck that just ran him over, the kid hands over the knob (nozzle).  Ryan grabs it moves into position, and with flames literally shooting 12 to 15 ft out of a 2 car garage door and rolling up the back of the house higher than the roof, he begins his attack. Using a hand line that normally takes 2 to 4 guys,  He wrestled that 2 1/2 inch line like it was nothing, and put a big knock on the fire, and with out an air mask, made entry into the garage putting out more and more fire with every step until one of our other guys, realizing not having a mask in such and environment isn't exactly a good Idea, went in after him and yanked him out to put a mask on and let someone else mop up the rest of the fire.
 We fought that fire for about another 15 to 20 minuets, chasing hotspots throughout the upstairs. Ryan would eventually join me inside on the first floor and again become a victim of a collapse, only this time it would be nothing more than the wall board & plaster off the ceiling. Just enough to give you a head ache and piss you off. Once the fire was over we cleaned up and went back to the fire house to "hotwash" or critique the fire. This is where we discuss everything that happened. We point out flaws to learn from and thins we could have done differently.  Throughout the entire hot wash it all kept going back to Ryan, or "Rip" as he was called, and the great knock he put on the fire....and of course his James Harrison approach to getting the nozzle. But I can say that with as much fire as there was, The knockdown he put on the fire was one for the books. He alone put that fire out....the rest of us just mopped up the little stuff after the fact.
  Throughout his time here at #5, he was always apologizing to me for making mistakes....or as he would say... "I fucked up"  He would eventually learn that it's OK to make mistakes and that he wasn't expected to be perfect on the job, but to simply learn from the mistakes you made. This would help advance him with in the department and  Ryan would move on to become a Lieutenant in the department. And altho he was a stickler for making sure all the small equipment was operational at all times, the guys looked up to him. He was a natural leader and firefighter and through all this, he never forgot his roots from a small single engine firehouse in DuBois. As it would turn out, he wasn't the snot nosed punk who's daddy was chief, He was your traditional, no bullshit, go get em kinda firefighter and a damn good one at that. Aggressive but humble, proud but quiet. He wasn't there to impress anyone or to be "that guy" who makes some miraculous save. He was there to do the job and he did it well. He was a Firefighter.
   The fire service has lost one of a rare breed. But as I remember my friend Ryan and his place in the fire service, I have no doubt that he has gone on to become a member of that big truck company company in the sky. And If I know him, he's standing on the roof over hell (without a mask of course) cutting a huge vent hole and screaming down at the devil "What now Mother Fucker"
That was just how he did it....all out, 100%, every time, and I am honored to be able to tell you that I was able to breath some of the same smoke as him and call him my friend.

"We Got This"
Lt. Ryan "Rip" Douthit
1985 - 2011

The one I'll never forget.

As you follow along, you will realize that Im not going in any chronological order in regards to my career as a firefighter/EMT.  Today, Im going to fast forward a few years in to my career.  After I began to establish myself as a "real" firefighter, I wanted more action...so I began looking for a busier company to join.  My search led me about 8 miles away, just across the county line to a station I'll refer to as "Number 5". No. 5 is one of a hand full of volunteer fire departments that also provides EMS services. In most other towns you have the fire dept. and then separate from them you have the Ambulance Corps. Sure they work together on a multitude of emergencies, but aside from that they are totally separate. Up until now, that was the extent of the relationship I had with any ambulance corp. so this was going to be a big step.
  I joined early in 1998 and began learning their ways. (every station has a different way of doing things) and I slowly began riding as an "observer" on the ambulance...or as we call them, the "gut bucket" or "the bus." I wouldn't do much except help carry equipment and help get the patient on the stretcher, but eventually I would have to get my EMT and start doing more. So, I signed up for the first class I could.  From that point on I would be "learning on the call",  doing everything on scene that I was learning in class, from taking blood pressures, assessing respiration's and pulse, and as I would later find out, CPR.
   I was a little over half way into my EMT class and had a few calls under my belt, all of them "routine", things like difficulty breathing, minor vehicle accidents and some minor traumas like twisted or broken arms. On night while I was "sleeping up", this is when you actualy sleep at the station, #5 was a busy enough company that they allowed this and actually had live ins, guys that lived at the fire house. Anyway, I was sleeping up this particular night and had gone to bed at around 23:30 (thats 11:30 PM civilian time)  I couldn't have been asleep for more than an hour when the house bells went off (the loud ass bells that ring for a call) and someone screamed over the intercom "LETS GO LETS GO LETS GO"  Half asleep and sort of confused I stager out of my bunk and head for the slide pole and slide down into the apparatus bays. As I hit the bay floor I hear the ambulance starting up and one of the guys, Rick, yell..."You'll have to do, get your fuckin shit and lets go!"
 I rush to my gear and step into my boots, pull up my bunker pants and head for the bus and hop in the back as it starts to pull away. Before I can sit down in the back, the Ambulance makes the right off the aprons (the "drive way" in front of the apparatus bays) and Im thrown onto the stretcher. I begin to pick myself up and we make the turn at the end of the road and I'm thrown onto the bench seat opposite the stretcher. As I finaly get my bearing and get into my seat I notice that we are hauling ass...I mean this fuckin ambulance has wings.  I lean forward into the front cab to see Bill driving, which is comforting, He was an excellent wheel man (driver) and to this day he remains one of the best emergency vehicle drivers I have ever ridden with.
 He calmly says, "You may wanna put your seatbelt on there slick"
And I ask where the hell are we going and for what.
Rick says, "Mutual aid into the next town and it aint good"
Before I can say anything else, the dispatcher calls us on the radio to inform us that they're giving "pre-arrivals." Pre-arrivals are the instructions on giving CPR. They are given by the dispatcher to the person who called 911.
  I ask again whats going on but Im ignored as Rick reads directions from the map book for Bill. By now I can feel the intensity in the air....what ever it is cant be good.
  I sit quietly in the back, my mind racing as to what could possibly await us when we arrive on scene. My hear beats so hard I swear I could hear it over the siren and the roar of the motor. My thoughts are finally broken when I hear Rick tell Bill that after he makes the next turn, the house will be the second one on the right.
  I again lean forward into the front cab..."Will someone please tell me what the Hell is going on?!!"
  Briefly ignored again, Rick explains to Bill the fastest way to get out of were we're going is to bust a "U-ey" but to drop us off before hand. Rick then looks at me and says "Look, this aint no bull shit, its a 7 month old baby in cardiac arrest, we don't have time to fuck around, He's (Bill) gonna drop us off in front of the house, hall ass, grab the kid and get back out here so Bill and I can switch." Bill, was also a Paramedic, with far more training than me as an EMT..
 We rounded the last bend, still going what seemed like mach 2 and we pulled up noticing that the local cops had also just arrived and were running into the house with such hast that he didn't even shut his siren off. Bill slows down enough for Rick and I to hop out, and I hit the ground moving.  Now I don't know how far it was from the street to the house, but it seemed like i made it in only 2 steps...only Im sure it was farther than that. I  burst in the front door with a level of focus I had never experienced to see a young mother, in her 30's holding  a lifeless baby girl in her arms, attempting to do CPR, fighting back tears and feelings I cant even begin to fathom.
  As the police officer reaches to grab the baby from the woman's arms, he looks at me, I simply says "ambulance" and the lady looks up and turns to hand me the child....."Please.....save my baby..."
 Almost as if it were instinct, I quickly but gently grab the child, laying her on on my forearm with her little head in the palm of my hand and I head for the door. At this point Rick was making his way in, saw me coming and held the door open...."Pump and blow man, pump and blow" (ems slang for administering CPR) We head for the bus which Bill already  had turned around with the drivers door open, ready and waiting. He was in the back getting the pediatric bag opened and ready (bad full of medical supplies designed specifically for "wee ones")  I hear Rick yell up to the officer the name of the hospital we would be going to and hop on the ambulance, sit on the bench seat and continue CPR as bill shuts the back doors and Rich throws it in drive...we're off.
   I can remember stopping for a second to catch a quick breath from all the running combined with CPR. I hesitated for a split second more than I wanted because for the first time I actually looked at the child. She was a cute little thing, with a little swirl of hair on top of her head, and beautiful blue eyes that I could barely make out threw her half closed eye lids.
 Bill asks me "What the hell are you doing?" referring to my lack of CPR....trying to keep my composure, I simply tell him "checking for a pulse"....but I couldn't feel it....so he reached over....."Yea....its there....but barely...keep doing what your doing, I'll set up the (heart) monitor"
  I again place my mouth over the tiny little face and gently blow, watching the chest on this little body slowly rise and fall then follow with chest compressions using only 2 fingers.  I swear I repeated this for what seemed like hours. As I look back, the ride to the hospital doesn't seem like it took all that long, and faintly remember Bill calling a report into the hospital, and periodically checking for a pulse, but never really telling me what or if he felt anything. Then before I knew it Rick hollers into the back "We're here" (at the hospital)
  The ambulance comes to a stop, the back doors open and in jumps a guy in scrubs who announces himself as Dr. so and so.  He politely asks me to stop CPR and begins checking for a pulse....the look on his face tells me that he cant feel anything...so he takes his stethoscope and listens...and with a disappointed look, softly shakes his head "no" followed with, "Lets get her inside"
  He takes the baby, steps out and head for the ER doors and I'm right on his heals....they get her into the room a few more Dr's take a look and bill gives them his report.
"How long has she been without a pulse?" they ask
Bill softly answers, "5, maybe 10 minuets, and before that it was very weak"
One of the Dr's lets out a big sigh and says..."thats it....call it"......"time of death, 12:53"
My heart dropped like a stone...and I could feel my eyes starting to well up so i turned and left the room....walked out of the ER.  As if what I had just been through wasn't bad enough, as I'm walking out I notice a police car pull up to the ambulance entrance and a woman frantically jump out and run in. She Recognizes me and the person she handed her child off to and trusted to save her daughters life....
"Where is my baby?"
"Room 11" I reply
"How is she?" she then asked...still fighting back an onslaught of tears.
Now I ask you....how do you answer that?.... After having someone hand you their child trusting you will save them and knowing you didn't.....what do you say?  To this day I still don't think I know how to answer that, and I sure didn't that night....I just looked at her, and the tears running down my face said enough.
She let out a scream with a feeling of agony I wouldn't wish on anybody, then collapsed to the floor right there inside the ER doors, completely hysterical. The police officer began to comfort her as did the nurses who responded to her scream. I just stood there and began to ball with my face in my hands...and for the split I could muster simply said "I'm sorry" then turned and walked out to the ambulance.
  Now as you can probably imagine...I didn't sleep that night, neither did Rick or Bill. As the luck of that night would have it, about a day or two later in EMT class we had the hands on portion of our Mid term....and what did i have to do?....you guessed it....infant CPR....and I couldn't. As I held that mannequin and tried to complete the task I couldn't stop thinking about the feel of a real lifeless child in my arms, and the smell of what  I would assume was the little girls baby lotion......so I walked out.  Sitting on the curb outside the school my instructor came out and sat next to me...he had heard what happened, a lot of people had.  He told me I didn't have to do it...I had already done enough. He than began to tell me of a child he had lost once...It's not easy.....and it is by far the shittiest part of the job...but you gotta keep at it.
 I had done everything we could of that night...but the final decision wasn't ours to make...but I decided to do this for a reason...and I have to accept the bad with the good.
It wasn't until about 3 or 4 days later that I was actually able to sleep, and that was only out of pure physical and emotional exhaustion. It bothered all 3 of us for some time....it was probably about 2 weeks until I started feeling some what normal, and that was only after the Chief ordered us to take some time off from the station to regroup.
   Believe it or not, some good did come out of that horrific night. A policy was put into place that stated anytime there would be a loss of life involving children, the hospital would send over staff and every person involved would attend "Critical incident stress debriefing" to help us to work through it....and after experiencing what I had, I can say thats a good thing. But still....all these years later....this is the one that still, from time to time, wakes me up at night.