Welcome to the pointy end

It’s cold and dark, mid-March and barely 6 am as we hit the streets to start shift. I am the consulting head shrink on for a ridelong in the ambulance.  The crew is upfront, I am strapped into the jumpseat as we chat and head to our assigned station... a parking lot behind a mall.  We sat in the dark and wait, monitoring the chatter. Back across the harbour bridge to our next spot and wait again, not long this time …. The radio squawks and calls our number “320, proceed to vehicle reported stopped in 4-way intersection with driver unresponsive.”  My adrenaline surges, heart pounding as I watch them shift into gear… “Proceeding Code 3”… lights and sirens.  They are already getting ready for a suspected MI …. Their day has started.  Looping around tiny dead-end streets we finally whip up to the scene. I could stay inside or get out. I decided the latter, one of them hands me a jacket with ‘Supervisor’ stenciled brightly across the back. Now that was irony if there ever was…. I did not even know my way round the bus.  I would monitor and keep the gawkers back as they removed the unresponsive 80 year-old fellow from his car seat and followed their protocols to revive him, jolting him several times.... 5…. 6… 10 minutes, nothing.  Compressions are still going but no words are spoken as we pack him up inside and off to Emerg to be officially pronounced.  Family is already there, the devastation on their faces. I was with the Paramedics, and like them I was somehow also separated from feeling the pain of death for someone loved.  You see their faces and tears but are somehow immune to it, you notice but don’t look at them directly; we were still occupied with the technical aspects of the call.  Once he is in Emerg with the ERP, everyone knows this is a bad ending… off we go for a next call.  Short stop at base for batteries for one of the 2-ways and on the road again.  Almost immediately, next call, 911 from a 10-year old … her mother has fallen in the shower and does not answer to her.  Off at high speed again, weaving through the morning rush, we arrive to find a woman in her late 40s in the most contorted shape I have ever seen. Her neck is crooked back like a crane staring blankly towards the sky. Amazed, I watch as the lead Paramedic does his thing, gently grasping her head and moving it slightly forward… She has vitals... We are on… Backboard! I help by clearing a path from the bathroom and bedroom ... everything is pushed roughly and quickly out of the way.  They are busy as I catch the big eyes of the bewildered young girl looking up the stairs squarely at me. I still have the Supervisor’s jacket on… I have a responsibility.  Down the stairs, I sit on the third step and tell her calmly that her mom’s back may be really hurt so we are going to take her down the stairs and into the ambulance and we will take her to the hospital.  I watch as the big eyes relax slightly as her mother is carried down the stairs and maneuvered to the ambulance.  The Paramedics are busy and don’t need to know that I switched back into therapist mode … It allowed me to feel useful.  They are busy enough, they don’t need to know, I figure. I ask the little girl if she can call someone to come over or if there is somewhere she can go to be with people.  She points to her neighbour’s house and heads out the door with me and disappears into the house.  Barely 10 am and back on the road to Emerg, the guys tell me this is a slow morning …

How do you know when things may be going off the rails when this is the norm?    

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