10.06.2009

watershed

Two years ago today, everything changed for me.

Two years ago this week, I had just dropped out of graduate school. I had spent the first weeks of fall cooped up in a classroom with twenty eight fifth graders and an increasing sense of panic. I had spent the last year and a half taking graduate courses in education, but was realizing with growing certainty that the US educational system was not where I wanted to spend my life.

The first Saturday of October, Peter arrived home from a shift at the mental health group home where he worked. We went for a walk around our little neighborhood of cabins, relishing the fresh snow - first of the season - and crisp mid-20's weather. There were two puppies at the pound we were considering adopting - two little husky-mutt sisters that I was fantasizing about turning into pulling dogs and the start of a small recreational team. Instead of heading indoors at the end of our walk, we stood in the driveway chatting about fencing and pacing out a possible layout for an outdoor dog run.

A blue truck drove by at top speed, and a few seconds later I heard yelling.

"Somebody call 911. There's a car flipped over in the pond."

I ran out to the road and looked in the direction of the truck. There was a children's party going on two doors down, with cars parked all up and down the street and people milling the yard and porch. Two men were walking quickly towards the driver of the truck, one whipping out a cell phone.

I thought, "If the car is in the water, there isn't much time."

I was pretty sure I knew where the car was. There is a little drainage pond about a hundred yards down the road from our cabin, right where another street Ts into ours. It was frozen over when we had walked past it just a few minutes before.

I yelled for Peter to call 911 and then bring the car, not thinking in that moment that he hadn't heard anything and had no idea why I was suddenly running down the road. As I was running, my mind was spinning through the Wilderness First Responder course I had taken in 2005, and the refresher I'd finished in June. Scene Safety. BSI. Airway, Breathing, Circulation. Spinal Precautions. In that first course, we did a simulation of a Jeep rollover in a creek. All the fake victims had been thrown, one ending up in a tree, one in the shallow water, the other two in the deep grass on the bank. It had been deep winter in Texas, sixty degrees and sunny with green grass and college students playing Frisbee on the other side of the road. I had dealt with a few minor emergencies working for Wilderness Quest in Utah, but most of my in-the-woods training had been in blister care and forced hydration. I was thinking, "This is it. Now I'll find out how I handle something serious."

I heard screaming before I got to the little drainage pond. Although it had snowed, the weeds and brush growth from the summer obscured my view. The screaming continued, followed by a hollow banging. I finally cleared the weeds. In the pond was the underbelly of a large sedan, sunk to its axles. Serving-plate sized chunks of ice bobbed on the wakes of black tannin water. A girl was on the other side of the car, screaming and slamming the undercarriage with her fists. She was up to her shoulders, soaking wet and clearly hysterical.

When she took a breath, I heard pounding from the inside of the car, more muffled screaming and the sound of water pouring into the space. I looked around. The street was empty, and the sun had dipped below the trees.

Scene Safety. Keep yourself safe, first. This is the first lesson of every CPR, first aid & EMT class. I tried to ignore the screaming from the car and coax the girl in the water towards me. At first she wouldn't even look at me. I looked around. The street was still empty. I was not about to get in the water, or get close enough to the girl to get pulled in, at this point. I told the girl that help was on the way and she needed to get away from the car and onto the road. Still screaming, she started to wade towards me, chunks of ice bumping away from her as she made her way around the exposed tail pipe. I coaxed her on as she repeatedly turned back towards the screaming victims still in the car. Out of the corner of my eye, I saw Peter pull up in our little Ford wagon. He got out and helped me pull the girl up the steep bank. In the process, I slid down past my knees into the water. Peter bundled the soaking, crying girl into the back seat of our car with the heaters on full blast. I asked how many people were in the car.

“Four."

“Shit.”

I saw three men come around the bend in the road towards us, one of them carrying a crow bar. Already sliding down the steep side into the pond, I decided with Pete & a warm car in the road, three more big men headed our way and 911 called, it was as safe as it was going to get. I slid the rest of the way in and struggled past chunks of ice towards the far side of the car. The screaming and banging was louder, and I could still hear water pouring in. Yelling when the screaming stopped for breath, I asked if they could open or unlock the doors. The screaming continued, and I groped under water with quickly numbing fingers to find the handle. It clicked back easily, clearly locked from the inside. Suddenly Pete and the three men from the party were next to me in the water. We tried to break the windows, but deep under water the crowbar and the hammer Pete dug out of the back of our car couldn’t get enough momentum to crack the glass. We tried to rock the car onto its side, feet groping for purchase on the slippery sludge at the bottom of the pond, but the vehicle was wedged into the bank on the road side and heavy with water and wouldn’t budge more than a foot or so.

The sound of water pouring into the car had long since stopped, and the banging from the inside was weaker although the screaming continued. We were all getting cold, and didn’t know what else to do. I remember slamming my fists on the undercarriage in frustration, screaming “Jesus” as a curse and not a prayer for the first time. I knew if we could get the windows broken, we might be able to go from there. Things were getting fuzzy with cold. I looked up and there was a crowd on the street, some holding blankets, watching us flounder, listening to the now faint cries from the car.

We went for the windows again, and suddenly a back side window gave. I had gotten Pete to bring a heavy winter glove with the hammer, thinking of glass, and it was still sitting dry and warm on the frame of the car. I reached for it, but my hands were too stiff and cold to slide it on. I threw it into the water and took a breath, sinking under and groping through the window for the lock. I couldn’t find the back lock, so I went further until I felt the front door and threw the catch. I never felt the glass slicing my fingers.

The five of us rolled the car back up a few inches and popped the front door open. When the car rolled back down to rest on the open door, I reached in and pulled out a little boy, probably ten or eleven, blue with cold and eyes wide with terror but breathing and looking at me. I passed him to the man behind me, and he was handed off to the shore.

I reached back into the black recess of the car as a McDonald’s cup and French fries floated out through the now-open front door. I saw a pale arm in the gloom. I pulled it and met no resistance at first. Then the body it was attached to wedged between the two front seats and stayed there. Back passenger. I struggled to free her and yelled to nobody and everybody on the street, “this one’s unconscious” hoping for direction. From someone. With a little gentle prodding, she floated free and came face down through the door. I rolled her gently onto her back. Blue. Not breathing. I said this out loud, hoping for some help. There was still no ambulance in sight. I slid my arms under hers and started walking backwards towards the road. Somehow we got her up the steep edge and onto the gravel. I looked up, and Peter was kneeling on her other side. I looked down and saw her tennis shoes, the wet laces forming ice crystals. I tilted her head, looked in her mouth. Black water and dirt. Still no breath. I felt for a pulse, but my hands were totally numb and now, alarmingly, I saw that they were also bleeding. I think I remember screaming for someone with warm hands to feel for a pulse. Nobody came forward. I wasn’t prepared for this eventuality. What do you do when you can’t assess for a pulse because your hands are too cold? They didn’t go over this in class. I looked up and saw the crowd watching us, saw Peter looking at me, saw the other rescuers coming out of the water into the waiting blankets of those on the shore. I tried to rip her shirt, to get to her skin. CPR has to be skin-to-skin, I remembered. I looked up at Peter.

“Are you sure you’re OK with doing breaths?”

“Yes.”

“I love you.”

And we started doing CPR on a real person for the first time in our lives. I felt her ribs cracking like sticks under my frozen hands, felt her chest destabilize as I pushed down. I had read that this meant you were doing good compressions, but what skin I could still feel was crawling with the feeling of it. After several cycles of compressions, I looked up while Peter gave her breaths, and realized that there was still yelling and banging coming from the inside of the car. I looked up, and saw a trooper and another bystanders struggling to break open the door wedged into the mud on the road-side of the pond. I looked behind me at the group of people watching. The other rescuers from the water were gone.

“Does anyone know CPR?”

A raven haired high-school girl looked left and right, and then stepped forward. “I do.”

“Can you do this?” She came and knelt beside me and I placed her hands where they needed to go.

“Right here, OK?” Her hands were warm.

I walked back to the pond, and slid into the water. “There’s a door open already,” I yelled to the trooper.

“He won’t come out that way.”

I waded back into the water and yelled into the open door.

“Hey, what’s your name?”


He told me.

“Can you get the door unlocked on that side.”

“No.”

“Can you come towards my voice?”

“... no.”

“Are you trapped? Tangle up in something in there?”

“I don’t ... know...” His voice trailed off.

“Can you reach towards me? Just reach towards my voice so I can get ahold of you.” I groped in the dark water bracing against the side of the car in case he made a grab for me. I didn’t want my head to go under again. Finally I felt, through my numb clubs of hands, the seam of his jacket. I grabbed it tight and pulled. I felt him brace against me.

“You need to come out of the car.”

He didn’t answer.

“Are you still with me?”

“Yeah. I’m cold.”

“I know you’re cold. We’re trying to get you out. The ambulance is on the way. I’m just going to hold your jacket for now, OK?”

I struggled to keep my grip and keep him talking. His voice was fading, leaving the ends of sentences off. I looked up and suddenly there was an ambulance and a fire truck and a swarm of people in uniforms hovering around the unconscious woman on the road and a woman in a red dive-suit looking thing jumping into the water and moving in next to me.

I introduced the person in the car, and told her he wouldn’t come out but I didn’t think he was trapped – just cold and scared. She reached along my arm and gripped his jacket. I let go and backed away. Suddenly I was very, very cold. She coaxed him through ducking into the water to get to our side of the car, and then suddenly he was free and she was guiding him towards the shore. There was a blanket waiting, and he was bundled off to another ambulance. I stumbled out of the water, and there were hands pulling me up the slope onto the road. Now I could barely move. I knew I needed to get my wet clothes off, but my arms and elbows wouldn’t bend. Someone passed me towards an empty ambulance, and I struggled to step up and inside and nearly fell when I dropped to sit on the cot. I heard someone say “we need this for the code” and after a few long seconds my mind processed that I needed to get out. I started to get up, but found my legs weren’t responding. I looked at the medic in the rig and said “I’m really sorry, but my legs won’t work. Can you help me get up?” She hauled me to a standing position and I waddled back out onto the nearly-dark street. I was hustled towards another ambulance, but when I stuck my head inside there was the little boy being passed into the back, and the older boy on the cot and three firefighters filling up the extra space and I backed out.

Then I saw Peter in our car, backing towards me. I stumbled to the other side and carefully folded my stiff limbs into the seat. The heater was on full-blast. I could barely feel it. I lifted my hand up. It was still bleeding. We drove around the block and into our driveway, shuffled up the stairs and into the house, stripped off our stiff, wet clothes and turned on the heater as high as it would go. We huddled there, shivering violently, for an hour, wrapped in sleeping bags and blankets, unable to think of anything except how cold we were and how the heat wasn’t blowing out hot enough or fast enough to make up the difference.

But eventually, it did. Later that night we went across the street to return the coat someone had thrown over my shoulders between the ambulances. It was a neighbor I had only met once before. She invited us in and drew a steaming bath that I lay in while Peter drank hot tea and chatted with her.

We found out later that the unconscious woman had died on impact, and the two boys and girl had gotten away with only a few scratches. Nobody knows how the girl got out of the car, or if anyone would have noticed the dark undercarriage in the tannin-black water of a drainage pond after dark on a quite rural road on a Saturday night in October if it weren’t for her being there in the water screaming loud enough for a passing truck to hear and look.

Peter took a beer down and split it with Georgina’s spirit at the pond a week after the accident. I went to her pot-latch, held at a local bar down the road, and stood against the back wall as adults cried and children played and slipped out after half an hour. I did not stop to look at the pictures of her life, posted on a table by the door. My neighbor made a cross of flowers and hung it in the branches of the willow tree on the other side of the pond once it froze back over.

I had nightmares for a year, seeing her face or the face of the little boy gasping for breath next to my bed in the half-way place between dreams and waking. Within a month, I was enrolled in an EMT course at the volunteer fire department for the area where we live. By January I was riding the ambulance, learning to take blood pressures and pulses and cut people out of cars with the jaws of life. By the first anniversary of the accident, I was enrolled in the local Paramedic Academy with not nearly enough experience but more sure than I’ve ever been that I was finally on the right path.

It has been two years since that cold October dusk, and I still never drive past that little drainage pond without thinking of Georgina and the three kids whose names I never learned.

10.02.2009

job

A week down, and work looks to be palatable and possibly something to look forward to. My coworkers are down-to-earth and happy, but not in the high-pitched sappy way I was worried I would find with so many women occupying not much desk space. The actual tasks are going to be a little repetitive ("Hello, your prescription is ready ... hello, you can't have more vicoden, atavan, percocet, methadone, _fillinnarcotichere__ you just refilled a month's worth two days ago ... hello, you missed your appointment ... hello, I can't diagnose over the phone you'll have to come in and see one of our clinicians") although checking in patients should break it up nicely. They, at least, are a varied and interesting crowd.

There are several providers, as different from one another as the patients, from the fast-moving-fast-talking PA who finishes charting on the way to the next room to the slow-talking southern Physician who is an hour behind by ten am, to the thorough Internist who arrives two hours before anyone else to review the day's charts, scribbling handwritten notes to himself and his assistant to make sure no test or question or possibility falls through the cracks of a busy city clinic serving the un-and-under-insured.

I am home now. Peter is cooking tacos and the dogs have gathered at his heels hoping for scraps. We are going to watch Toy Story, a welcome relief after this season of endless John Carpenter movies on Friday and Saturday nights. Two days in a weekend, and there is a lot of laundry to find time for.