Showing posts with label fire. Show all posts
Showing posts with label fire. Show all posts

Thursday, September 17, 2009

Memories

I hear the sirens and air horns now, especially the air horns. Not every time I hear them, but sometimes. Suddenly I am back on the trucks. Pulling on my bunker gear. Looking up a street on the map. Shouldering the straps to my air tank. Pulling up my three quarter boots. Putting on my gloves. I am back in it. I am back on the street. I can almost hear the radio traffic.

“Engine 1, Engine 51, Tower 1, Rescue 1, District 1 house fire….”

“Engine 7, Rescue 7 shooting. OPD is not on the scene….”

“Rescue 1, Rescue Boat 1 respond to assist Engine 7 and Rescue 7 with a drowning….”

“Engine 6, Engine 4,Crash 6, Rescue 6, Tower 1, District 1 plane down…”

“Engine 3, Rescue 3 person not breathing…”

“Engine 10, Tower 10, Rescue 7 District 2 accident with injuries involving entrapment…”

I can almost feel the adrenaline rush. See the red lights of the trucks. Hear the roar of the diesel. Then dispatch would give the report that always meant you had something serious.

“We are receiving multiple calls.”

“We have reports of people trapped.”

“CPR is being performed.”

Then I find myself listening for the reports from the first units to arrive.

“Engine 1 to dispatch we have heavy fire showing from a single story wood frame structure. We are pulling an inch and three quarter line.”

“Engine 6 to Orlando we have a single engine plane down in a tree. No fire. But we do have a fuel leak. Be advised the passenger and the pilot are trapped.”

I am back on the street. That mystical place I named so long ago, the other reality that exists just outside most people’s everyday work a day lives. It is a place that seems to exist in parallel to daily existence. Yet it is only a car accident or cardiac away for everyone.

The street was more than a physical place. It was a place where all of the safe guards end, and my job begin. It is a place filled with excitement, fear, tragedy, horror, sadness, despair, joy, and laughter. It was a place where everyday decisions had terrible consequences. I am going to the grocery store, or I will fix the wiring fixed next month. Where people died or were horribly injured because of these simple daily decisions. It was terrible place, or maybe it is reality. It was where I worked.

The street existed in the poorest homes in Orlando, and in the richest. It existed in back alleys and the main streets. It existed in brush fires, house fires, shooting, stabbings, hangings, cardiac’s, codes, drowning’s, and a thousand other emergencies. It was everywhere. I have houses or intersections that had been scenes and now were signposts in my life. That house is where I pulled the woman out of the fire that afternoon. I pass the intersection where all those people died on that Thanksgiving night when I go to the YMCA. I can see where I had the double shooting from the East/West Expressway. I can see where we tried to save a mother and three children that night in that fire, each time I get on the interstate. Across the street from those apartments is where we found that body that had been undiscovered for three days in the Florida heat. The reminders of the street and the years I spent on it are everywhere around me, like some kind of map of my life. A map that marks life-changing event for me and those I tried to help. Even now, thirty years later, the memories they produce are as strong as ever.


Friday, April 25, 2008

Keeping Your Balance

The day after we had pulled the baby from the house fire (see Smoking Baby post) and before I learned the outcome, I was at a party with friends. The television was on and the local news was running footage of the fire. I stood there watching myself with the emotions still fresh from the day before. There I was with Donny working fractically on the baby. In the background the house still burned furiously. It was such a startling perspective.  I was now looking over my own shoulder. Firefighters were pulling hose lines and police officers were trying to hold back neighbors. It seemed even more dramatic now that it was on TV.  

My friends began to kid me that about being a media star. They said I needed an agent. I tried to join in the kidding but I could not take my eyes off the screen. There I was in bunker gear kneeling over the child working with Donny. I did not remember the news crew being there. 
 It was as if someone had plucked the whole scene out of my memories and thrown it on the screen. It brought the reality back in a rush of emotions. I felt the pressure of getting everything done right as quickly as possible, all the while fighting back the emotions of working on a baby. My friends tried a few more jokes then realized I did not know any jokes about this one. 
It was one of the first times I realized just how different the world I worked in was from theirs. When they went to work nobody died. They did not have to risk their health or their lives when they were at their jobs. It was one of the first time I began to feel distance between myself and those who did not do the job. The job was beginning to separate me from people who did not experience what I did each day. That separation would grow over the years until I was leading two separate and parallel existences. One filled with poverty, dying, illness and violence and the other filled with family and friends. My friends and family were not in the business. So there was no bridge between the two worlds, no one on the family side to talk to about the job and to help keep the balance. That proved to be a problem with no bridge there was no balance. There were times when the scales were weighted much more one way than the other. The intensity of the job would tip the balance of the scale. The job would color everything in my life.  
The job would weigh me down at home with left over images or fatigue and no easy way to get rid of them. This was long before today's understanding of what that type of stress can do to relationships.  It was one of my biggest mistakes over the years, never to have found a way to balance the job and home. It lead to some difficult years in my marriage. We hung on somehow but I have colleagues with three and four marriages to their credit. I have a friend who dropped dead one day off duty in his forties. I had another friend who after 19 1/2 years on the job called up and said he could not do it anymore and  he quit. The department was able to get him a medical retirement so he did not lose his retirement but the street claimed another victim. He was one of the strongest and most respected of us. We had a saying that we would follow him into hell with a booster line if he asked because we believed and trusted his courage and judgement.  
Out of the twenty something members of my paramedic class 2 of us lasted as paramedics until retirement. Some quit the department abruptly, a number simply gave up being paramedics and went back to firefighting, and a couple were pensioned out with medically. In the early days there was no safety net. The hidden dangers of the job were not understood either by the department or those of us out on the trucks.  The job can demand a high price.  If you understand that and are prepared to fight for the balance you need, then you stand a good chance of surviving it's pitfalls. If you ignore them you do so at your own peril. 

Tuesday, March 25, 2008

Mostly at Night

You finally get back to the station sweaty and exhausted. You just came back from a shooting, stabbing, accident with injuries, take you pick. All you can think of laying down before you get another run. You fall on you bunk not even bothering to take off you clothes. You just luxuriate in the in the wonderful feeling of being in bed.

As soon as you close your eyes your right back in it, a series of black and white close ups of the scene fill your head. Always closes ups. Other times it is a slow motion reply, again and again rolling through your head. A running commentary goes as the scene gets played back in your head. “What did I miss?”. Could I have started the IV faster? Put the tube down faster? Should I have scooped and run instead of getting the IV first? Should I have checked the breath sounds sooner? But it is always the pictures. Blood matted eyelashes. The man with no face after he put a shotgun under his chin. Two bunker coated arms thrusting out of a smoke filled window a still smoking baby cradled in the hands. The house blowing fire out of all the windows. The half open eyes of someone you know is dead but who you still have to work. The images never go away. Sometimes they won’t let you sleep. You get up and wander into the ready room and stare at the TV but not really watching, people are laughing at some joke on the Tonight show. You stare the TV not really watching it until 3am when no matter what you finally might be able to go to sleep. So you stumble over to your bunk and fall into a semi sleep. Hopefully those images don’t follow you home but some do. Some stay fresh for years. And now for decades. They crawl out from behind the wall you construct. It is mostly at night. 

Sunday, March 16, 2008

Four Codes

            I did something that night that I had never done before or since. It started like any other shift. We were busy with the normal man down, accidents with injuries and cardiacs. But I felt something coming; something big. We were standing in dispatch after one of our calls getting our times for our report when I could not get over the feeling and I said.

            “We going to have something big tonight. I can feel it.”

            It’s funny because I remember that instead of laughing at me, there was kind of a moment where everyone just kind of looked at me. Then we all just moved on with our jobs. I did not know how right I was. I still don’t understand where the feeling came from. I was very new and everything was very intense. Maybe that intensity somehow provided the instinct to sense the thing that was waiting for us. The thing that we would have to deal with. The thing that changed my life and many of those who responded that night.

 The call had come in as smoke in an apartment building. We arrived with the full first alarm assignment arrived at the apartment building. Nothing was showing, nor was there anyone to meet us. It looked like another false alarm or a pot on the stove.

So at three in the morning I am dressing out slow and walking to the two story concrete structure with the other firefighters. I listened to the radio as the various units walked around the small apartment building trying to find the origin of the smoke. It was a small two story concrete block apartment complex with a sand parking lot. Nobody was finding the origin of the smoke order.

I was just behind Lieutenant Baker when he stopped in front of a window.

“Here it is.”

The window was completely obscured by smoke and condensation. We pulled on our masks. Lt. Baker crawled through the window first.

When Baker crawled through the window he looked right. When I crawled through the window I looked left. That’s when I saw the young woman lying on the floor just short of the door.

“I got a victim!” I yelled through my mask. I crawled over an overstuffed chair and bent down to pick up the woman. The door flew off the hinges. The guys off the Tower had heard me and had forced the door. Gary Woodward off Engine 2 grabbed the woman’s legs while I picked up her upper body and we moved her out onto the bare concrete outside the door. Tower and Engine firefighters rushed past us into the apartment as we laid the woman down.

            I pulled off my mask and helmet and put my ear next to her nose and mouth and felt for a carotid pulse in her neck. Gary had his hands poised above her chest waiting. She was not breathing and she did not have a pulse. I leaned down and gave her two quick breaths, still nothing.

            “OK, start.” I said and Gary began compression’s on her chest. No bag valve mask this time, it was skin to skin. Each time I gave her a breath I felt her cheeks expand against my own. I could feel the coolness of her skin against my own. She wasn’t that old, very close to my age.

            “One-one thousand, two-one thousand, three-one thousand, four-one thousand, five-one thousand,” Gary counted as he gave compression’s. I gave a breath.

            Suddenly I had time to think as I waited for each fifth breath. Until now everything had happened too fast, now there were seconds when a whole world of impact could sneak in and it came in from all sides. I was smelling her. It was the unique dirty, greasy smell of a house fire, that clung to her now as I waited my mouth an inch from her own.

            “Five one thousand.” I gave a breath. Her cheeks expanded against my own as her chest rose. The house fire smell filled my nostrils. She was covered in the greasy sooty ash a fire leaves on people, but the smell is what I remember.

            “Somebody get my gear.” I yelled. I need all of our ALS equipment from the truck.

            “Your partner’s gone for it.” someone yelled.            

            I gave another breath.

            “Will someone get my gear” I yelled again. I felt so helpless. I was railing at the situation more that just yelling for equipment. It had happened so fast, with none of the usual-flame-showing-get-in-there-and-find-a-victim buildup. No it was as if I climbed through a window and fell off the edge of something into the middle of this.

            I could hear glass breaking and furniture being turned over as the crews searched the rest of the apartment. My partner showed up carrying the equipment. I moved away from the woman so he could put an endotracheal tube down to control her airway.

            “We got another one.” someone yelled.

            I looked up to see another firefighter coming out of the apartment with the small limp body of a child. He was doing CPC with the child cradled in one arm.

            “I got another one.” Another child was handed out to one of the Lieutenants standing outside. He immediately began CPR.

            Somebody had brought Circle D lights off one of the trucks and the area was suddenly brightly lit by glaring lights. It was as if someone had turned the world into a black and white photo essay. Suddenly all the color had been washed out of the world, because I remember the next minutes in a series of black and white still images.

            The firefighters bent over the small still bodies. The baby’s arms hanging limply as one of the guys cradled the limp body close, pressing its chest with two fingers and blowing gently into its mouth. A police trainee in his tan uniform accompanying one of the cops looked on with stunned horror on his face. He seemed lost, as if he were wondering how in the world he had ended up here. I knew how he felt, I wondered if I looked the same.

            As I continued CPR it was as if someone had connected my emotions to the cable then started to slide through the channels. Each channel brought up a different, completely separate set of emotions, and each new emotion created a different impact.

One moment I had to fight the urge to turn my head and vomit. The body odor of the woman mixed with the stench of the smoke created a totally unique smell I would never forget. Then the unseen hand changed the channel on me. Tears this time, it was all such a goddamn waste, a nothing fire and all this death. Panic surfaced next, what in the hell were we going to do with three codes.

            “The ambulance is here.” someone yelled.

            It brought me out of my reverie. I gave a last breath then turned over my place doing CPR on the mother to another firefighter. I jumped up and ran to the unit.

            “We’ve got three codes working.” I told the paramedic off the ambulance, ”Two of them ped’s. We’ll work the woman here and transport the ped’s to the hospital.”

            The paramedic off the ambulance jumped out with his equipment and ran for the apartment house. I was close behind. I would stay behind with my partner and the paramedic off the ambulance.  We would work on the woman I pulled out of the apartment. The ped’s codes are best worked at the hospital, and it was only five minutes from the scene. We could work the mother through another hospital on the radio. Three pediatric codes were going to stress that one hospital enough, without working the mother too.

            When I got back to the scene. The Assistant Chief for the shift looked at me and said.

            “What do you want to do?”

            “We’ll work the woman here and transport the codes.”

            “Sounds good.”

            I do not know how I decided to take kids to one hospital, and leave the woman for the three of us to work. It was as if some computer somewhere separated from my emotional turmoil had been fed this information and spit out the answer. I did not know where it came from or how I arrived at the answer, but it was the right answer. By the time enough rescues and ambulances could be summoned to the scene to work all the codes, we would have the patients in the hospital.

            Just as I ran up to the scene behind the ambulance paramedic a rookie fireman stepped out of the apartment with another child cradled in his arms. He was not doing CPR, he stood there with a completely stunned and horrified look on his face.

            “Give her to me.” I said.

            He handed the small limp body to me, she was less than a year old, I cradled her in my arms as I started CPR. Small breaths from my cheeks, two fingers on the little chest.  I felt that ever so soft baby skin against my own as I blew into her nose and mouth. The smell of baby and smoke all mixed together, the taste of smoke on her skin, the sounds breaking glass, radios blaring, firefighters moving past into the apartment, all combined into an overwhelming whole. I had to again fight through it all and keep working CPR. We needed to get out of there and get the kids to the hospital.

            “We taking the kids to ORMC. Let load up.” I said between breaths.

 The two other firefighters working codes on the other two children walked out to the waiting ambulance with me, all of us continuing to work on the children. The feel of that little limp body in my arms, I had never felt a body so limp before. I struggled to keep my composure.

She was limp in a way that only a dead child can be. It was the first time I felt that weight. It would not be the last time, but it was the time that took me across the line that separates us from those that have not felt that weight. Those that do not carry that weight for years the rest of your life after you have picked it up for the first time.

 We all climbed in the back of the unit. It was a very silent, no sounds except for the occasional hushed words of someone counting to himself under his breath, counting chest compression’s . No sirens needed this time of night, the street were deserted. Again the kaleidoscope of emotions, washed over me as I worked the little girl. I fought back tears as I stopped to wipe some of her burnt skin from around my mouth. Her half-open eyes stared up, the stare that said what made that person who and what she was no longer there. Those half-open dead eyes, that somehow reached deeper into me that eyes of living person. 

            It was a short quick ride to the hospital. A security guard opened the back doors and the three of us with our small still burdens piled out. We ran into the ER where three teams of physicians and nurses waited for the children. I laid my little girl down on the gurney and backed away. She looked so small on the large stretcher. So alone on that big white streatcher. Soon she was lost behind a wall of hospital personnel as they worked frantically over her. Another doctor rushed in to help. He asked one of the nurse’s what happened.

            “It was a fire. They found them after.”

            “No, we didn’t.” I exploded. How someone could say we found them after the fire infuriated me, it was as if she were saying we were waiting until it were safe to go in and look for victims. “I never saw the fire. We had them out before we even put water on the fire.”

            Somehow this was important as if would have made a difference. When I knew it would not have really.

            The doctors and nurses worked frantically as the three of us stood staring. Three guys in bunker gear smelling like a fire. Part of the real world smelling up their professional environment. We said nothing to one another or to the doctors or nurses. We just stood there watching. What was there to say? We all knew somewhere what the outcome would be. I don’t think we could say anything. Then one by one they stopped. It had been too late. No responses from any of them. They were all gone.

            We remained silent as the ambulance driver rounded us up and said he would take us back to the scene. We rode back with just the creaking of the rig breaking the silence. For the next twenty years I would see one of those men and that night would come back strong. We would just look at each other, sometimes we would say.

            “Remember?”

            “Yeah. Yeah I do.”

            That would be it.

The units were still on the scene as we crawled out of the back of the ambulance. My partner had gone with the woman to another hospital by a second ambulance. Everyone was standing around with little to do. It had been a tiny fire, some clothes left on an ironing board. But the fire had slowly produced enough toxic gases to kill everyone. Apparently the mother had awakened and tried to get to the front door where I found her. The three children were in the back, the room of the fire’s origin, they never had a chance. So much tragedy rolled up into a small apartment.

            Larry came back and we were standing with the other firefighters trying to get some control over all that had just happened, when the radio blared.

            “Rescue 1 can you go available for a call?”

            I reached for my radio to reply.

            “Check.” Incredulous I looked over at the Chief you had just answered for us.

            “We got it you go ahead and go available.”

            I felt no more capable of handling another run than I did of running a marathon. If you shook me then I would have rattled, there was nothing left in my tank emotionally or physically, I was running on empty. Back then the stress of these types of runs was not recognized. There was no Critical Incident Stress team to help you sort your way through these tragedies that effected you, almost as much as it effected the victims, you were on your own.

            “Rescue 1 respond to a cardiac....” the dispatcher droned.

            It was a short run and we made it in a couple of minutes. We found a man in his sixties experiencing chest pain and shortness of breath. We both were fumbling with equipment and having a hard time doing the simple physical tasks necessary to take the blood pressure and begin to start an IV. We had accomplished little by the time the ambulance arrived. I was never so glad to see someone in my entire life, we let them take the lead with the cardiac.

            We got back to the station and found everyone up, and sitting around drinking coffee. We did the same, no one was talking, there wasn’t anything to talk about. There really wasn’t a fire to speak of just this bizarre turn of events that lead to the deaths of four people. There was none of the usual talk after a fire there was only this emptiness. We had a new role, where our actions could not have made a difference. Our only role in this tragedy was to experienced it’s consequences, without any of the satisfaction that can come from trying to make a difference.

            There is a cleanness, a straight forwardness, to firefighting, that is pure and satisfying. There is a fire and it is destroying something, your crawl into it with a hose line and you do battle, you put it out. This had none of that, there was nothing clean about this, this thing had so many twists and turns it looked like a maze. One that I might never find my way out of. No one told me about these, no one said there were going to runs that would change your life. We were going to save them all, we had the equipment, we had the training, and we had the system. What was the point, why were we out there if I could not help one of those four people. Why climb on the truck everyday and stumble home exhausted if you could not help three babies and their mother when it counted the most? What was the point in this anyway? I began to ask questions that we all eventually had to answer for ourselves if you were to stay on the Street.

            I was burnt out and up after this one, I felt empty, flat no affect, as if someone had poured my emotions out and left nothing to react to life with. The Street had been exacting it’s toll on me. It was as if a bucket had been lowered into my emotional well and drawn out the last of what it takes to do the job. Each run had taken a little more out of that well, until it began to run low. This one took the last of my reserves, left a dry well. I felt as if I had no emotional reserves left, nothing to get you through even the next shift, nothing to draw on.

Burnout, had an emotional and physical feel to it.  It dulled everything, as if some sort of filter was straining out the joy and laughter and left only the sadness. It was a filter that would change my life and how I viewed it. It would take years and a lot of work to regain my perspective.

This wasn’t what I had signed up for. I was supposed to save their lives. Instead I seemed to be some highly trained witness, who was along for the ride.  Nobody had told me about this. Nobody warned us as we went through fire school. Nobody told us anything during paramedic training. We were supposed to make a difference. We were supposed to save people.

I felt lost after that. I had come to love what I was doing. Love in a way that made it a calling and not just a job. But it was tearing me apart. I was having to face the realities of the street and I had no tools to fight it.

One morning not long after the fire as I was getting ready for work, shaving and showering. The Today Show was on as I was getting my uniform ready.  They were interviewing some actor or actress who was plugging their latest “growth experience/lousy movie”.

I am putting my uniform on. Sticking my tourniquet, stained with blood from the shooting last shift, in my back pocket. Slipping my paramedic pouch on my belt with my scissors, hemostats, and penlight in it. Nothing different or unique about the morning but suddenly it hit me. When these people go to work nobody dies. That’s right, they go to work and make believe people die. But whey they say cut everybody gets up and heads for the coffee truck.

I changed the channel and they were talking to one of the new mavens of Wall Street. They would go to work and sell stocks or bonds and make a lot more than I will during my whole career. The Masters of the Universe as they were being celebrated throughout the media, leading this merger or that buy out.  And not once will they have to make a life and death decision.

Not once will they go over a scene in their head for the umpteenth time wondering if they had done all they could for a stranger. They won’t have to be a part of the little tragedies that make up so much of life for so many people. They won’t have to risk their lives treating some drunk on the highway. No, they will just to the office, make some phone calls, play some office politics and head for home around six or seven. By then I won’t have even hit the down side of the shift. I will still have fifteen hours left. While they made money I treated a cardiac or a code. While they had lunch I will probably be on an accident with injuries. While they sell off their holdings in a stock, I will be cleaning the blood off a backboard from the accident. 

            So that morning when I drove into the station, I noticed the men and women in the other cars. They are dressed in nice suits. They are all heading off to an office. Looking at them and imagining their world I feel as if I live on another planet. All of these people are somehow different from me. Sheltered from all of the shit the street produces. Protected by me and the others like me in stations across the county. Safe in the knowledge that if they call we will come, while completely unaware what that safety feeling demands of those of us who provide it.   While I am out there hanging my ass out in the wind, they sit safe, sound and unaware.

Some mornings that feels good because I knew that there is nothing else I would want to be doing. What I do means something. When I go to work I help people. No nine to five for me. No, I am living life to fullest. I deal with life as it really is; no hiding for the kid.

            But there are other mornings when I would give everything I had for a quite nine to five job, safe and secure from all the pain and suffering out in those streets. Nothing to worry about but how much money I can make. No working Christmas, Thanksgiving and the 4th of July in the same year. Suddenly all of those neatly dressed people in all those cars are to be envied. Maybe playing the money game is the real world. Maybe playing in the streets is for the suckers, who don’t know money is the reality of the world not helping people.

            But I pull into the parking lot at the station and I hear the radio blaring, the men laughing in the kitchen as  yesterday’s shift is relieved. I walk into the station put my gear on the truck and do it again. 

 

            

Thursday, December 13, 2007

The Smoking Baby

I still think about her. Even though it has been close to thirty years, I still think about her. When I am off guard, the question tries to slip past the walls I’ve built, a question that has no answer. A question that I struggled with over the course of my twenty-six year career through hundreds of runs like hers.

            It happened in the early years. When I had not learned the harsh math of the street, the math that sometimes multiplies the outcome. When I thought I was going to save them all, and did not know how many shades of misery could be crammed into a single call. As I said it was in the early years, and I did not know the realities of the profession. It was a late afternoon in February. We were in the station when the call came in.

            “Engine 1, Engine 51, Tower 1, Rescue 1, District 1 house fire 2212 E. Livingston. Engine 1, Engine 51, Tower 1, Rescue 1, District 1 house fire 2212 E. Livingston.”

            Everyone in the station headed for their trucks. The apparatus bay was filled with noise as the flaps on the fire poles slammed open when men slid from the second story, truck doors slammed as each driver climbed into the cab of his truck, and diesel engines were started with a roar. It was the fire station din of a house fire. Red lights for each truck snapped on. Then to the sound of five sets of sirens the trucks pulled out of the station and into the street. Engine 1 lead out followed by Engine 51, then Tower 1, I was in Rescue 1 and we pulled in behind the Tower with the District behind us. The trucks formed a conga line of fire apparatus as we weaved our way through rush hour traffic. Close to fifty red lights flashings and multiple sirens blaring, a full alarm assignment out of one station bursting with building fire adrenaline. No sooner had we left the station than the radio blared.

            “Engine 2, Engine 7, Rescue 7, Snorkel 2, District 2 house fire 2212 W. Livingston. Engine 2, Engine 7, Rescue 7, Snorkel 2, District 2 house fire 2212 W. Livingston.”

            The Dispatchers were sending another full assignment to the same address on the west end of the street. There must be some mix up with the address. We worked our way through traffic to the address. When we arrived we found nothing, just a row of houses with no sign of a fire.  The District got on the radio and said.

            “District 1 to Orlando. Nothing showing. Investigating.”

            “Orlando check. Be advised we are receiving multiple calls on this. It is apparently at the west address you can cancel.”

            “District 1 check.”

            “Orlando to Rescue 1 respond with units to the west address. Rescue 7 you are cancelled.”

            We were still closer than Rescue 7, who would have to come from the west side of town. We flipped the lights and sirens back on and headed west on Livingston. As we worked our way through traffic the radio blared over the sirens.

            “Engine 2 to Orlando we have heavy smoke in the area.”

We had something and the adrenaline goes up another notch. Then Engine 2 arrived on the scene.

            “Engine 2 to Orlando. We have heavy fire showing from a single story wood frame structure. Taking in one pre-connect.”

            “District 2 on the scene. Engine 7 bring in a line.”

            Engine 2 would be attacking the fire off the five hundred gallon water tank on their engine and would need a supply line from a hydrant as soon as possible. Using a pre-connect they would only have a few minutes of water to fight the fire.

            “Engine 7 check.”

            We still had blocks to go. We worked our way through the dense afternoon traffic. As we neared the scene, both sides of the street were lined with parked cars and the center of the street was filled with fire equipment. We parked at the end of the line of fire apparatus. My partner and I jumped out and scrabbled into the back to the truck to put on our bunker gear and tanks. As we were donning our tanks another report blared over our radios.

            “Dispatcher to all units we have reports of children trapped inside.”

             It was my first fire with victims trapped. It was the first time that I felt the real responsibility of being a firefighter. Because I rode the rescue, it would be my responsibility to find anyone trapped. If I did not do it then it would not get done. The responsibility was mine. This type of responsibility was why I had joined the department. I had wanted this. Now it was here. I had felt it on medical calls, but now I felt it for the first time on a fire call. This responsibility meant I would push myself to the limit someone else’s life would depend on it. If I did not then I would not live up to the oath I had taken when I came on the department. It would be up to me now. It would include risking my own life if necessary. It was my duty. I wore the badge. It was what this job was about, the risking of your own life for others. It is why I signed up. It was the time to do the deed. To see if I was up to the real thing.

Not waiting to completely dress out, we both grabbed our tanks and ran for the house, frantically donning our tanks on the run. The house was small white wood frame structure, the entire front of the house blowing smoke and flame out all of the doors and windows. The only part of the house that wasn’t blowing smoke and fire was a single window in back of the house. Suddenly out of that window two bunker coated arms appeared. They cradled a baby who could not have been much more that six months old. The baby was smoking. Smoke rose from the baby’s skin and clothes.

            A firefighter off the Tower grabbed the baby from those bunker-coated arms and started running toward us. He handed the very still body to my partner. Donny immediately began CPR. I turned and ran for the truck and the medical gear we would need.

            I remember what a long run it was in boots, bunker gear and an air tank. The image of that smoking baby kept fighting it’s way through the adrenaline, and the thousand and one things I had to organize in my mind. I kept seeing the dirty smoke smudged skin. The babies half open eyes.

I reached the truck and threw off my gear. I started pulling the various medical boxes and equipment we would need. The airway box. The oxygen box. The drug box. The trauma box to bandage her burns.  Before I left the truck I called and received a medical channel so we could communicate with the doctor as soon as possible. I also had them notify the hospital we would be bringing them a pediatric code even before we contacted them on the medical radio.

            As I ran back carrying the equipment I could see Donny sitting with the baby cradled in his arms calmly doing picture perfect CPR. A small group of people surrounded him. When I reached Donny he gently laid her on the ground as I threw open the boxes so we could begin to work on her. When Donny laid her down she started to breath on her own.

            “That’s it girl breathe.” I said as I attached the EKG dots to her chest.

            Donny attached her to the O2. I put the stethoscope to her chest and listened to her lungs. Surprisingly they were clear. I put the dots on her chest. Her EKG was normal. She was continuing to breathe on her own.

She was sloughing skin badly around her face and upper chest. It was coming off in sheets as we worked on her. That meant those areas were in probability third degree burns. Those third degree burns on her face and chest meant we had to suspect she had breathed super heated air from the fire. That super heated air would damage her trachea and lungs. We still had to suspect the damage even though her lungs sounded clear. The ambulance arrived. We covered her burns put her on the stretcher and loaded her into the ambulance.

            Donny and I climbed into the back of the ambulance. She looked so tiny on the adult sized stretcher. Her dirty smoke smudged body was so very still.  But she continued to breathe on her own. Her heart beat was regular and strong.

The smell of her burnt skin and house fire filled the back of the ambulance. We could do little more than had already done. We monitored the oxygen and listened to her chest. Bandaged her burns. It was a short ride to the hospital, with sirens blaring, and the ambulance swaying.

We pulled under the portico and unloaded the stretcher. They were waiting and had the doors open for us. We pushed the stretcher into the trauma room. I gently lifted her limp body and placed her on the hospital stretcher and backed away.  Again she appeared even smaller on the hospital gurney. She was so helpless and dependent. She disappeared behind a wall of doctors, nurses and technicians as they began their examination and treatment. I turned and walked out of the trauma room.

Since we both had ridden in the ambulance with her we were going to need a ride back to the scene to pick up our truck. The departments Chaplin gave us a ride back. It was hard to remember when I felt so much pride in my newfound profession. The system had worked. We had lost so many, but this time the system worked. I can’t remember feeling as good about my job, or the young system that we were all trying to so hard to develop. The exhaustion and how badly she was hurt would hit me later, right now all I could think of was the simple fact that she was alive. It was a great ride back. We had saved her. She would have been given up for dead just a few years before but we saved her with our new skills. It felt great.

            I waited for a week before I checked on her at the hospital. I wanted to find out she was doing. On TV it was always all smiles and congratulations on a great job by the hospital staff. I needed a little of that kind of reinforcement at that point. Successes were rare.

            “Yeah, I wanted to check on the little girl we brought in about a week ago with burns.” I told the burn unit nurse.

            “Sure we sent her to the Shiners Burn Hospital.”

            “Great then she is going to make it.”

            “Yes, but she going to be badly disfigured…blind and deaf.”

            “What!”

            “Yes. Her brain was without oxygen just too long when she coded.”

            I thought I was having a nightmare. What was the point of it all? James English risking his life to rescue her in that tinderbox of a house. The EMS system that worked so hard to save her and for what. What kind of life did we give her? I wasn’t sure we had not done her more harm than good.

It was as if someone had reached in and pulled out my professional life. I felt as if someone had literally kicked me in the stomach. What was the point of all the training and technology if we could not only save this girl; but give her a life worth living. I had saved drunks with their throats cut, but when it counted I couldn’t give a little girl a life. Every shift we helped the people who did not take care of themselves, who had given up and were drinking themselves or drugging themselves to death, but we could not give this little girl a decent life.

            I remember walking back out to the truck in a daze. Neither Donny nor I said anything. In fact I don’t we ever talked about her again and we worked together on and off for twenty more years. What was there to say? We had twenty-two more hours on duty. If we thought about it, if we thought that might be another one like her waiting for us today, I think I might have just gotten out of the truck and gone home. There were no good answers to this one. There were only bad feelings and confusion. Confusion over what my job really was about. Why were we out here? What was the point?

How could her fate so affect me? Where did this come from? It is not like I had not seen death and dismemberment before. I had. It is what I had become a paramedic to do. I wanted to go to the bad ones. I wanted the responsibility. So where was this coming from and why? Why did I care so much about her? Was it my own naiveté being crushed, with the thought that I was not going to save them all? That I was not going to be some kind of hero. Was it more about my own loss than of hers? I do know I was never the same after her. Something began to break that day and would eventually break completely, some part of me that cared too much for my own survival.  The part of me that made me want to become a paramedic. It had to die in order to continue to do the job. At least it did for me. It would be the only way I could survive.             

I thought a lot about quitting for a while. I didn’t and I not sure I can give a specific reason why I did not or how I held on, but things were never the same after her.  I would realize eventually how to manage these types of tragedies that seem to make up the street. The twists and turns of the street left few outcomes clean and neat. They always seemed to have this little nasty twist at the end, especially on the ones where you wanted so badly to make a difference. It was as if there is just no way you can get a clean win. The street always had to win either through blunt force or trickery. The math just never did add up. There was always some sort of subtraction going on, or if you were unlucky like this one, some real multiplication.  But she was my first. She was my first multiplier. There would be many others but she was the first and therefore the biggest. Her math had too many zeros behind it to count. The street had played her first trick on me.

            I could not think about her for a long time, without feeling as if I were walking along the edge of a very deep drop off and if I was not careful I would loose my balance slip and fall. I was not sure where I would land. I had to find an answer to or I would end up slipping and falling.

            So what is a success on the street? How could I measure when I made a difference? If I were going to last on the street I would have to have an answer, maybe not the answer, but my own answer.  An answer that would allow me to go to work and climb on a truck everyday. Without an answer the job would become impossible, shifts were filled with the kind of calls that left no clear-cut outcomes, the math was always off somehow. It would break me if I didn’t have a way to understand them. I saw others who were not able to come up with their own answers and they did not last.

The answer did not come in a day or a week but in years. Years, in which I saw other paramedic’s burnout, quit the program, quit the department, abuse alcohol and drugs to forget. The answer came when I finally lifted my head up and looked at the passage of time and the long string of patients, some of whom I helped and many who I had not. Only by looking back did the perspective of distance begin to give me an answer. And the answer was not one that gave me immediate peace of mind. Instead it only gave me understanding. The answer was a simple one; there is only the doing, the satisfaction that comes with doing the job, not with the outcomes. Do the best you can, and you stop caring about the outcome.

It was the only way I could continue. Others may have been stronger but for me it was the only way. Some may call it professionalism; maybe it is I don’t know. But I do know when you work with people who desperately need your help, it takes some real work not to judge your success or failures by through their living or dying. There is a price to pay for this distance. To loose the distance is to loose the caring piece of you. You loose a piece of yourself. It was the piece that got me into the profession in the first place. This distance you keep can creep like a cancer into other parts of your life to affect the people you love. You become hard in a way that is not always good for you or your family.

The only satisfaction I could find was knowledge that I did try and I had enough of what it takes to climb back on the truck, week after week, month after month and year after year. Trying each shift and every shift to keep getting it done. Knowing full well that there were going to be other smoking babies out there waiting for me. Who no matter how hard I tried, would close the professional distance I worked so had to keep, but who will crawl up close and make me feel the impact again. That old kicked in the stomach, hollowed out feeling. If there is courage in this job, it is the knowing what you will face more smoking babies and still keep showing up and doing the job. She taught me the biggest and most difficult lesson there was to learn out there, one that you can only understand if you can hold on long enough to learn it.

The price you pay for continuing is a large one, because you end up with a long string of smoking baby’s waking you up at and night. Slamming intrusive images into your off duty life. Is it worth it? That is real question each of us must answer, and the answer can change from shift to shift. That would be my struggle through out my career. Was the price worth the service? It was a steep price that at times that did not seem worth it. Each of us had to choose where to draw our lines, when would the price become too much. When was there nothing left to pay the bill the street demands.

The street and those that occupy it, continues no matter how many you times you leave the station, it is a war without end or truce talks, without an armistice or peace. It will always be there. My direct participation has ended, but the profession I helped create continues after I had worn out. Others have stepped forward to take on the fight in that profession. It will extract a high price from each of them. Some will last and some will not. Some will be pensioned out through injuries Others will die in the line of duty.. Yet they continue to step forward to do the job me and those like me helped invent back in those fast hot, exciting, frightening days and nights on the street.

 

In all the years I spent on the department I never called to find out the out come of another patient.