other people's emergencies: random thoughts of an urban paramedic

For more than twenty years I've worked as a paramedic for the city of Boston, Massachusetts. The opinions expressed in this diary are mine alone, and do not represent the views of Boston EMS. Names, dates, locations, and physical characteristics have been changed to ensure patient confidentiality.

Friday, February 08, 2008

Collision With A Twist

Whenever a car rolls over, there is a risk of serious injury. Occupants get tossed around, smashing their heads against windshields, and their chests against steering wheels and dashboards. For this reason, in Boston, paramedics are dispatched along with EMTs to all rollovers.

This one happened on Storrow Drive, the parkway that runs along the Charles River. Wreckage blocked both lanes, backing up traffic for more than a mile. It took us a while to weave through the stopped vehicles. We arrived to find two cars smashed, with two drivers standing in the breakdown lane.

Climbing down from the cab, I surveyed the damage. One car had a dent in its right rear corner. The other had been damaged on all four sides. The dents were not deep, which would have suggested severe impact, but all of the windows had blown out and the roof was dented inward. Skid marks on the asphalt led to skid marks on a concrete retaining wall. Obviously, one of the vehicles had both rolled and spun, hitting the wall and the other vehicle in the process.

Troopers were interviewing the drivers. The owner of the car with little damage denied being injured. He didn’t even want us to look at him.

The other man said his shoulder hurt.

“Your car’s pretty banged up,” I said. “How fast were you going?”

“I’m not sure,” he replied. “I stopped looking at the speedometer when it went over a hundred.”

“I’ll get the immobilization stuff,” I said to my partner. Anybody going that fast must be presumed injured until x-rays and a CT scan prove otherwise.

Soon we had him strapped to the board in the back of the ambulance. Incredibly, he didn’t have a scratch on his face. “He’s bleeding from someplace,” one of the EMTs said. “There’s blood on his pants.”

The man was cooperative but extremely hyperactive. He kept trying to sit up. As I gently pulled him back down, I saw blood on his hand. Turning it over, I saw a series of parallel slice marks on his wrist. His other wrist had similar cuts.

“Did you cut your wrists on purpose?” I asked.

“Why, yes,” he said, smiling the way some people do when they’re drunk.

“Is that why you were going so fast? Were you trying to kill yourself?”

“Yes, I was. I want to die. Will you please stick a needle in me and give me some poison?”

I shook my head and tried not to laugh. I don’t believe suicide is a funny matter, of course. But the man was acting so happy that it was hard to take him seriously.

“I’m sorry,” I finally told him. “You know, I’d really like to help you with that, but I can’t.”

“Please? I think it would be a good idea. You can do it. Just give me a needle.”

It was the strangest situation. I’ve had conversations like this with people who were weeping, but never with people who were grinning.

“When did you cut your wrists?” I asked.

“An hour ago. I’ve been very sad lately. So I smoked some marijuana, and drank some beer, and cut myself.”

“And then you drove fast.”

“Yes. And then I drove fast.”

We started toward the hospital. On the way, I started an IV. He remained strangely cooperative, not even flinching as the needle punctured his skin. There was none of the drama of the usual suicide attempt.

He remained in the hospital’s trauma room just long enough for a cursory examination. Then it was off to the CT machine for a head-to-toe internal exam.

I was just about to leave when a trooper walked in. He gathered the usual information—the name of the patient, the name of the doctor, the names of my partner and me. Then he smiled. “I feel sorry for the poor bastard in the other car,” he said.

I asked why.

“The guy was driving along, and he saw the flash of headlights in his mirror. He looked back, and there was this car, rolling end over end, catching up to him. He’s doing sixty miles an hour, and the car actually smashes into him from behind as it rolls along. Scared the shit out of him.”

I laughed. What had begun as an ordinary collision had turned into something quite bizarre.

One of the emergency department nurses made a very astute observation, though.

“This would never happen to any of us,” she said. “Only somebody trying to kill himself could hit a wall and another car at a hundred miles an hour—then walk away without even getting hurt.”

13 Comments:

Anonymous Anonymous said...

After reading this last blog about the doctor riding along I became curious if Boston has an observation program open to the public. I am currently in Boston as a student. Prior to coming here I was an EMT in another state. I just thought it would be quite the experience to see how busy the city can be compared to where I am from.

11:53 PM  
Blogger Mick T. said...

100mph on Storrow, that's pretty amazing, and the fact he survived.

12:10 AM  
Blogger Jenna said...

Wow! Just goes to show you that when it's not your time, it's really not your time. He's lucky that he didn't kill someone else in his pursuit of self destruction.

1:07 AM  
Blogger TS said...

ANONYMOUS: Observers accompany Boston EMS ambulances frequently, but generally this occurs as part of a formal training program. Physicians training with the Boston University Medical School's Emerergency Medicine Residency, for example, must go out on a specificed number of observation rides.

Nurses, too, must complete field observation time to qualify for some kinds of specialized certification.

Actually, I posted the story about the doctor by mistake. That's why it doesn't appear on the blog right now. I wrote two stories in one evening on Word, and I meant to cut and paste only one of them to the blog. By accident, I cut both of them. That story will appear some time in the future.

The doctor was one of several physicians who came to America as part of an exchange program through the Beth Israel Deaconess Medical Center. At some point, American doctors will go to Europe to observe.

As for the public observing, I'll say that it's possible, because it has been done before. I certainly don't have the authority to arrange it, however. I'd recommend contacting Deputy Felicia Robinson, head of community affairs, at Boston EMS headquarters. The central number is 617-343-2367. Play up the fact that you are (or were) an out-of-state EMT interested in comparing systems, and don't mention that you got the idea from this blog.

Good luck.

8:55 AM  
Blogger TS said...

Mick:

It really is. Sadly, the more intoxicated people seem to be, the better they seem to survive crashes. It happens too often to be a coincidence. Some EMS and ED people have theorized that it has something to do with being more relaxed when intoxicated, that this creates some kind of protective mechanism. That's not much consolation for the loved ones of the people often killed in other vehicles that collide with these idiots.

Keep in mind that this incident might not have happened on Storrow Drive. It might have happened on the Massachusetts Turnpike, or I-93, or even on the Fenway. Note the disclaimer in the upper left corner of this blog's home page, where it says that certain details have been changed. This is necessary to comply with federal patient privacy laws. The thing is, you never know which facts have been changed, and I can't tell you, so maybe this happened on Storrow, or maybe it happened someplace else. I have to do this because, unlike most medical bloggers, I don't blog anonymously. I've divulged the city in which these incidents occur, and which EMS agency I work for.

And in case you or anyone else is wondering, I don't change anything except for identifying characteristics. The stories happen just as I describe them.

Thanks.

9:05 AM  
Blogger TS said...

Jenna:
Yeah--like the guy he caught up with, while his car tumbled and rolled!

9:07 AM  
Blogger TS said...

To the person who might know this patient:

I'm sorry but I had to delete your comment, because I don't want to run any risk of betraying patient confidentiality. Federal law is very strict about this.

As the disclaimer on this blog's home page says, certain details have been changed to ensure the privacy of the patient.

That's true here. I did not divulge the patient's name, age, physical description, national origin, address, or even the location of incident, the date or time it happened, or the hospital that treated him. In fact, I can't wondering how you could possibly be certain that you know the subject of this story, since so many details have been changed.

In any event, I have to ask all readers to PLEASE not make any attempt to guess the identity of anyone described in this blog. No good will come of that. And it might cause a lot of harm.

Thanks for understanding.

4:01 PM  
Blogger TS said...

To the person who might know this patient:

I'm sorry, but I had to delete your comment, because I don't want to run any risk of betraying patient confidentiality. Federal law is very strict about this.

As the disclaimer on this blog's home page says, certain details have been changed to ensure the privacy of the patient.

That's true here. I did not divulge the patient's name, age, physical description, national origin, address, or even the location of incident, the date or time it happened, or the hospital that treated him. In fact, I can't help wondering how you could possibly be certain that you know the subject of this story, since so many details have been changed.

In any event, I have to ask all readers to PLEASE not make any attempt to guess the identity of anyone described in this blog. No good will come of that. And it might cause a lot of harm.

Thanks for understanding.

4:02 PM  
Anonymous Anonymous said...

sounds like a pile of bs to me.a friend of my famliy was injured in an accident that sounds exactly like the one you wrote about.without giving the whole world all the details, his injuries jibe with what you wrote.we all thought th story he is telling his family was rather strange.then i log on and see your version and everything clicked.you should have more respect for your patients privacy.i also did not like the way you said you laughed at him while you were treating
him.is that your normal bedside manner? who do you write this stuff for? is it to make you feel smart? do your job and leave the writing to writers.

12:51 PM  
Anonymous Navyfire said...

To the Anonymous commenter above,

How many car accidents happen every day? Just because a friend was in a similar accident does not make it the same. TS has -always- taken great care not to take any chances when it comes to possibly identifying paitients. Regardless, there is no proof either way. As to the joking, humor is a means by which many in the emergency services field cope with the horrors that they encounter in everyday life. Before critizing so harshly...you should spend a day in our boots...

8:29 AM  
Blogger TS said...

I've only just now come across the inflammatory comment left by "anonymous." I'm sure he or she will never see this reply, but I'll write it anyway. (Even though Navyfire did an admirable job of defending me.)

To Anonymous:

First, it's important to note that certain details have been changed. Not the way the accident happened; just the details that would allow the patient to be identified. Obviously, you failed to read the note that explains this, which appears right at the beginning of the site's home page.

Second, you can believe what you want, but the story happened as I told it--except for the identifying details.

As for the laughing, well, I'm just being honest. In theory, we should take every call seriously, all day every day. We should never find anything amusing, and we should never show any emotion. But that's just not possible. We're human beings, and we're not perfect. I could cover up the parts of our behavior that some people might consider "wrong," but instead, I'd prefer to describe the job as it happens--the good parts, bad parts, and everything in between. That's been discussed in detail elsewhere in this blog. Try reading those parts before tossing out accusations.

And finally, leave the writing to writers? What's that supposed to mean, exactly? I'm not allowed to express my opinion on my own website?

Nobody's forcing you to read, Anonymous. I welcome all opinions, negative as well as positive, but if you don't like what I write, then stop reading. It's as simple as that.

10:10 PM  
Anonymous MichiganEMT said...

About a month ago my partner and I responded to one of the local hospitals for a psych transfer. Upon arrival one of the ER nurse's pointed out a young Indian male. This was to be our patient. When we asked the nurse how the guy had attemped suicide, she told us that he hit a freeway overpass head on at over 100 miles per hour. This guy did not have any injuries, nor did he have a mark on him. The nurse told us that he had his seatbelt on when he hit the bridge support. Kinda defeats the purpose, doesn't it?

11:34 PM  
Blogger TS said...

It does indeed. That's pretty funny, actually.

Thanks for sharing.

12:22 AM  

Post a Comment

<< Home

[ View Guestbook ] [ Sign Guestbook ]
Get a FREE guestbook here!
Blogger Talk Blog Community
« ? EmergiBlogs # »
Medicine Blogs - Blog Catalog Blog Directory