My First Real Medical Emergency

Submitted by sven on Wed, 08/24/2016 - 08:16

I'm writing this story because I need to process my feelings on paper so this exercise is more for me than it is for you in a fashion not unlike El_Mono_Rojo's /r/TalesFromTheSquadCar stories. So understand that I just need to get this out.

WARNING: This is a graphic story. Discretion is advised. Names have been changed.

It was Sunday afternoon this past weekend. We arrived home from church and, deciding last minute to check out the latest Star Trek movie, headed out after a quick bite. It was on approach to the nearest set of traffic lights that we saw him; a "John Doe" laying on his back in the grass across the intersection convulsing and clutching his chest with a few bystanders gathered round. One of them was on the phone.

"They seem to have things under control." concluded Andrea.

I wasn't so sure. Both Andrea and I are first responder certified, having updated our training every year for the last three years. In addition, and because I find emergency medical fascinating, I've taken classes in resuscitation science, hypothermia and I sleep with a copy of the first responder manual on my night stand (yeah, I'm like that). So it's no surprise that I'd already made my decision.

"We're first responders. I'm stopping."

I tore across the intersection when the light turned green and pulled into an adjacent parking lot. The scene that greeted me as I ran up was exactly what the training had prepared me for, but something inside me went horribly wrong as I tried to render aid...

John Doe looked to be in his 50s; he had dark messy hair sticking out from beneath a ball cap, was clad in ruddy jeans with some kind of band tour t-shirt, a jacket, deep circles under his eyes and hadn't shaved in a few days. He lay on his back, clutching his right hand across his chest, appeared semi-conscious, convulsed and was sucking air in sharply and irregularly. His left arm lay straight out and his eyes - when they weren't rolling in and out of the back of his head - revealed constricted pupils. He looked confused and scared. Surrounding him were bystanders keen on helping as one of them was already on the phone with 911. I approached, Andrea followed.

"My name is Sven. I'm first responder certified. Does anyone know what happened?"
"I don't know." responded a woman who appeared agitated and a little pale, but she seemed to be holding together. "We were stopped at the lights a moment ago and I saw him walking. Then he suddenly grabbed his chest and collapsed. When the light turned green we found him like this. I think he's having a heart attack."

I know exactly what a heart attack is and this didn't seem right, but for some reason my brain couldn't offer up anything more conclusive as I'd never actually been in an emergency medical situation before. My internal monitoring processes found this interesting, but this was not the time for reflection.

I overheard the 911 operator through the earpiece of the caller behind me, "...dispatching an ambulance to your location now..." Having read a research paper on ambulance response times in the Canadian Prairies (you'd be amazed at the weird stuff I read) I knew that I'd only need to tend John for the next 7 or so minutes given the conditions and our proximity to the hospital. Nevertheless, shit happens, so I knew I needed... something.

But the thought went unfinished.

It felt stuck, as though it were struggling through molasses as key data points missed their appointments to connect with it and thus, no conclusion. Observations flitted about unhinged in my consciousness and decisions were uncharacteristically slow in coming. This unsettled me as those of you who know me personally can attest that indecisiveness is not a quality of mine. It seemed to take forever for the next thought to touch down.

"How long ago was that?" I asked the woman once I managed to grab a hold of it.
"About 2 minutes I guess?"
"Okay. Thanks."

I turned my attention to John Doe who had good Samaritans kneeling next to him on either side, encouraging him to stay with us. He was barely holding on and attempting to say something in between convulsive gasps for air. "Kyle. Call Kyle." Assessing the scene I knew what I was looking at, but something obvious wasn't connecting for me.

Why can't I figure this out? I've role played exactly this scenario for years and suddenly I can't put a name to this condition? Cardiac... something.

The half-answer arrived randomly and disjointed from any of the other threads I was processing. Somehow I knew intuitively that John Doe needed an AED and so it was at this point I chided myself for not trusting my gut during last year's refresher course and following through on buying an AED to keep in the car. The words "We need a defib!" came out of me before any of my normal filters could process it.

What's happening to me, why is my brain so slow? Why is everything happening in slow motion? Cardiac what?

I looked up. "Can someone run across to the gas station to see if they have an AED?" The woman who answered my questions earlier acknowledged and took off running. I turned my attention back to John Doe and-


The thought exploded into my consciousness with the force of airbag deploying and in response I nearly bulldozed over the fellow next to me, but the next thought arrived in time to save him.

But he's still conscious and breathing! Check his pulse instead.

Pulse. That was a good idea. Somewhere in the fog of my mind I knew that a missing pulse meant something specific given the symptoms, something serious.

It starts with an "F" I think, and why can't I remember what CAB stands for?

(The answer is Ventricular Fibrilation, and "CAB" stands for Chest Compressions, Airway, Breathing - the three things to do when performing CPR. CAB is sometimes taught as "ABC" but updates to the CPR curriculum in 2010 have different companies teaching different things.)

"Check his pulse." I instructed the two fellows next to him. One placed a gentle finger against John Doe's throat and I took a wrist. Nothing. I took a finger and squeezed the nail a little. Minimal response. "You feel anything?"
"No." replied both men.
"Me neither, which means he's in cardiac arrest so there's not much we can do until he either stops breathing or we get that defib kit."

Cardiac Arrest!! THAT'S what it's called! Okay. Now what? When's that "F" word I'm missing going to occur to me?

The two men acknowledged as John Doe and I made brief eye contact. I got the sense that he grasped that last bit, but the effort cost him and his breathing worsened immediately after. He stopped convulsing and it was obvious we were losing him. "Talk to him. Get him to focus on breathing, the longer he's breathing the longer he lives." I instructed the fellow next to me.

Another disjointed thought slammed through the fog... Identification.

I turned to the other gentleman, "Does he have ID on him? Is that his phone on the ground?" I asked, pointing to a phone in the grass.
"Yes, I think so."
"May I see it? Maybe it has some information that could help us."

The fellow handed me John Doe's phone. I unlocked it with his finger and gained access to his call logs, contacts, texts, everything. Now, you'd think that as a career technologist I'd know what to do but it was in this moment that the next thought unhinged my world...

This man is dying at my feet.

Suddenly all thought processes fizzled and I was left standing in the fog with John Doe's call log staring me in the face; unable to recognize the fact that he had already called 911 around 9:07am that morning. It was all I could do to just stand there, cradle the phone in my hands and contemplate the demise of a man whose physical and digital lives now lay in my hands.

An incoming text message momentarily brought me out of it. I loaded up the conversation and skimmed. The history indicated that he was "messed up" and "depressed", and at some point there was mention of the loss of a child. All of this was tangentially relevant, but more importantly it was personal information I should keep to myself, but my brain fizzled again and it dawned on me that I'd reached the end of my usefulness in this emergency. I stared off into space and it hardly registered that I was watching the woman return empty-handed from the gas station. Off in the distance I chided myself again for not owning a portable AED when I know I can't rely on businesses to have proper first aid equipment.

I felt ashamed and angry with myself. I'm here to save this man's life and I'm too spaced to be of any use. What THE FUCK is wrong with me? Why now? There's SO MUCH I know to do, SO MUCH I can do to help this man and provide leadership to these people and I can't remember any of it.

Moments later the ambulance pulled up - a good two minutes ahead of my estimated timeline - but I was too far gone to feel anything but relief. I watched from inside my fog prison as the EMTs calmly assessed and loaded up John. "Is that his phone?" the EMT asked me, pointing to the phone in my hand.
"Oh! Uh... yeah. He called 911 already this morning and he's asking us to contact someone named 'Kyle'. Check his contacts. He does have a couple of doctors listed as frequent contacts and there's no mention of medication or drugs in the few moments I had with his texting history, but I suspect he's on something." I handed over the phone, making sure to touch the screen one more time to keep it awake for the EMT.
"Thanks, that's helpful." he replied, giving me a look that I'm still not sure wasn't a mix of confusion or amazement. Then he switched gears and called to his partner, "Okay! Let's roll."

And that was it.

With John Doe in the hands of professionals our little gathering of good Samaritans disbanded without a word and Andrea and I headed to the movie. It wasn't until later that I sat in the theater [trying to ignore the stupid pre-show advertising that - somehow - I had paid to see], that I looked up all the information my brain had jettisoned when I needed it most.


Three years I've known and studied this stuff and in the moment of truth my brain ran for the nearest escape hatch. Even without an adrenaline surge (thank GOD that didn't happen!), the fog lasted the rest of the day. And now, as I write this, I feel a tinge of shame for spacing out in spite of recognizing that my performance was adequate for a first timer.

The good news for me in all this?

It was just like my first ever sparring match in the dojo. I knew exactly what to do, had practiced for hours upon hours, but when that first moment of truth came I reacted in exactly the same manner as I did on Sunday. The stuff that had worked its way into muscle memory performed beautifully while the rest got dumped in the face of trauma. Now, with sparring just a regular part of my training in Ninjutsu, I know that my ability to serve others well when the shit hits the fan will only get better with time.

I just need more shit to fly. :)

Anyway, there you have it. As we say in BJJ, "There's no substitute for time on the mats."

~ Sven

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