A few days I had my first patients that I couldn’t save.
On Monday I was driving home from San Diego on Highway 72 and traffic came to a stop in a place it normally doesn’t. I was behind a big rig but couldn’t see much, so I grabbed my phone and checked my messages. After a few moments I heard someone say “accident”. I peered out, didn’t see any flashing lights, and got that EMS feeling.
Most of the time, things aren’t an emergency. Even “emergencies” usually unfold slowly and you have a minutes if not hours to correct things. Actual no-kidding emergencies where the stuff hits the fan are, fortunately, rare. The EMS feeling is my stomach dropping an inch or two, thinking “oh shit, is this for real?”
I pulled off to the side and saw multiple vehicles ahead. Some on the shoulders, some flipped over on their backs, some so smashed to pieces I couldn’t tell what they were or in what position.
Someone started yelling at me to stay back. Instantly my training kicked in: scene size up. Is it safe for me? How many patients? How many rescuers? I looked at the guy yelling at me to not go in: he was a civilian, there were no red and blue lights anywhere, and if there was anyone in there that I could help, fuck you, I’m rolling in.
Is it safe for me? Hard to tell. I had my exam gloves which offers me razor thin protection, but it was a debris field of gasoline and gear old, car parts, walking wounded mulling about like zombies from a horror flick. How the hell do you determine what “safe” is in something like that? One step at a time, I told myself.
How many rescuers? One, counting me.
How many patients? Again, hard to tell. If they’re walking, I’m not interested in them at the moment. Take me to the worst and most terrible: I was pointed towards two vehicles that looked like soda cans crushed for recycling.
I didn’t even know how to access them. In one vehicle, if I crouched down, I could see a body part hanging down with bones sticking out. The “safe” part kicked in and I realized that I wasn’t a firefighter anymore with extrication tools, a team, and turnout gear. I pounded on the vehicle and listened: nothing.
I moved to the second vehicle. Air bags had been deployed: lots of them. Curtain air bags, steering wheel air bag, side air bags, the works. The un-moving person was in their seat belt.
I yelled that I was here to help. No response. I reached into the mangled metal cage and squeezed tight for a carotid pulse. Did I feel one, or was that my own adrenaline? For a moment I felt the faintest movement, deep inside the neck. I probed around more. I check a lot of pulses and the carotid is by far the easiest and most pronounced: even on a baby you can find it within a second.
As a I kept probing all I felt was warm soft skin.
A few minutes later, I couldn’t really tell you how many, a CHP car raced in. I explained who I was, my level of training, and what I was up to. He nodded and thanked me for stopping and asked me to keep working the scene. There wasn’t much to do as all signs pointed towards death. The kind of death you don’t come back from. The physics required to bend metal and send cars flying airborne is simply more than ample to cause massive hemorrhaging in nearly every part of the human body. Brain and heart, in particular.
Ten minutes after the police arrived a fire rescue team rolled in. I gave my assessment and findings, and got out of their way. I read the news this morning and saw that both drivers were pronounced dead at the scene.
I spent the rest of my drive home calling my wife, and then two of my friends: one cop and one fellow sar. The next day I went snowboarding by myself for a while. I’m still not “okay” with seeing and feeling so much death and carnage. But everyone, including you and me, will die. If you’re an EMT you’ll see it more often than a librarian.
Be good to each other out there. Leave lots of follow distance when driving. If you care about someone let them know. And don’t think the safety features in your car have made Newtonian physics obsolete.
The location and date have been changed.