Kevin navigates the residential streets to St. Closest while I’m in the back with the sergeant tracking respirations and the fire medic helping me by taking vitals. My new patient, who was dead just a few minutes ago, is actually doing pretty well. He’s got a decent blood pressure, reactive pupils, 12-lead is clear, and he’s got some spontaneous movement in the extremities. I decide not to put him on ice (therapeutic hypothermia) based on his increasing level of consciousness and the knowledge that the ED at St. Closest wouldn’t continue with the procedure over the next 24 hours.
We move him over to the bed at the ED and I give a report to the MD and nurses who are going to continue treatment. They seem a little crestfallen as they are surprised by the level of consciousness of the patient. It’s not like anyone is sad to see a resuscitation but it’s so uncommon for someone to go from asystole to having perfect vitals and be sitting upright in a bed and staring at you that they are at little bit of a loss. Unlike in the movies, where they seem to bring people back from asystole all the time, in real life a flatline most often means game over.
I’ll check back in a few minutes but right now I have a mountain of paperwork to do in documenting all of the things we did and how the patient responded. I walk out of the ED towards the rig so I can start typing on my computer.
Two EMTs from the Inter-Facility Transport division are walking in and one of them catches my eye. “Hey, did you have Brian’s dad?”
“No, I had a code-blue with a resuscitation.” I’m just a little proud of myself for pulling off an improbable field save. They look a little bit confused but continue into the ED. I’m walking to the rig when it finally hits me. Fuck ME! The son was Brian!
I didn’t recognize him out of uniform. He’s been working as an EMT in the county forever, long before I got here. He’s a career EMT in the Inter-Facility Transport division so I seldom see him on the streets or at the ED. I’ve only talked to him a few times and I knew he looked familiar – but I just couldn’t place him.
I’m actually shaking as I tap away at the computer to document the call. I’ve never worked up the family member of someone I know, much less pulled them back from the dead. And having pulled off a minor miracle I took him to the one hospital in the county that none of my co-workers would ever want to go to – much less send their recently dead father to. I feel like I let him down, however paradoxical that feeling may be. I just can’t shake the torment in my mind.
Having finished my paperwork I drop it off in the room and see that Brian’s father is sitting up, talking to staff and family, and upon glancing at the monitors I see that every vital sign in well within normal limits. The other son and his wife thank me as I try to get out of the ED. I’m starting to feel like I need to vomit. I need to move on to the next call and shake this out.
Kevin’s waiting for me and he’s also trying to digest the news as I jump in the driver’s seat and put my hand on the key. I look up through the windshield to see Brian sitting on a bench being comforted by his girlfriend, crying tears of grief with his face buried in his hands. Try as I might, I physically can’t start the engine. I have to bring this full circle and talk to Brian even in his grief stricken state. I’m not sure if he’s going to take my head off or thank me but I have to see this to the end and do it right now. I have never felt so bad after saving someone’s life before and I can’t really come to terms with the emotional upheaval that’s ripping me apart.
Brian stands up as he sees me walking towards him and his girlfriend backs off to give us some room. I’m seriously expecting him to punch me in the throat and I know that if he does I’m just going to stand there and take it – I might actually deserve it.
“Brian, man, I’m so sorry, I had to come here, you know I did…” We’re both crying now standing just a foot apart.
“Thank you! You saved him. Thank you so much.” His huge arms envelop me in a tearful hug. Oh, thank god! I don’t need an ambulance…
“No, you saved him. You kept his heart going until we got there. It was all you!”
The emotional turmoil that I attempt to convey in this retelling may be difficult for those outside of EMS to fathom. It may seem strange but even on a successful field save we try to get out of the hospital before the family members arrive. I don’t want praise for a life saved and I definitely don’t want blame for a life lost. Speaking for myself, though I think other first responders feel the same, I must preserve my emotional detachment so I can make the right decision at critical times without hesitation. I know I did the right thing in my transport decision. But in retrospect I’m glad that I didn’t recognize Brian while on-scene. I may have hesitated longer or possibly even gone against my training. I’ll never know what I would have done but I know I’m now better prepared if the situation ever comes up again – and I have no doubt it will.
That night Brian’s father was transferred to his hospital of choice with no deficits. After being surrounded by family members for two days he coded on the nursing floor and was pronounced dead. Our resuscitation bought him and the family some time together. Sometimes that’s enough – but in this case I wish the outcome was different.