A car skidded into hers, tapping her bumper. She drove home, sat in her driveway and then called 9-1-1. She gave us the license plate number of the car that hit her, and then said the pain in her neck and back was too much to bear and she couldn't walk. We brought the stretcher over to her, put a collar around her neck, put a backboard under her and extricated her from her vehicle. She grunted and groaned and put on quite a show. It didn't bother me too much; I was numb, and this call was business as usual in the city. If I let things get to me I'll be in the nuthouse before long. This is the meat and potatoes of EMS... the kind of thing we do day after day.
We brought her to the ER. She told the triage nurse she was now having severe abdominal pain. That bought her a trauma room and a full work-up. I'm not being cynical, just honest by telling you there was nothing whatsoever wrong with this woman; she was simply padding her case. In a few years, maybe less, she will get a check from her insurance company or the hit-and-run driver for a few thousand dollars, if she gets lucky. Not bad for an afternoon's work.
I wheeled her into Trauma Room 5, left my report on the desk and walked out. I figured it was a fairly simple thing, nothing new; the same thing happens dozens of times per week. Stable vitals, no sign of trauma, no visible damage to the vehicle...just people following protocol and not a damn thing we can do about it. My autopilot was at full throttle. It had to be.
A few minutes went by; somebody told me that the trauma team in Room 5 was asking for more information. Apparently my written report was sparse on detail. I walked in and a roomful of grim-faced doctors and nurses waited. I told them the details; they listened politely and got to work. I watched for a few minutes as they did their thing, asked all the right questions, ordered all the right tests, cleared her from the board and moved back to the girl in the room that adjoined. The girl that an hour ago I had brought into Room 6.
The patient in Room 6 lay on her bed, bandaged, IV’s running, not moving. The trauma team had done their thing, ordered the right tests, administered the right medications and notified the right people. She was unconscious, intubated and had no feeling in the lower half of her body after smashing into a jackknifed tractor-trailer on Route 95 and being crushed in half, her spine broken and her cord irreparably damaged. She was nineteen years old and the back seat of her car was full of nursing books, and she had a nursing school sticker on her back window—the only one that wasn't shattered.
My autopilot was stuck in neutral. I tried to get into drive but failed, and stood there at the foot of her bed, and couldn’t move.
In an out-of-body experience I saw myself rip my other patient off her backboard, drag her across the hall and plant her in front of the kid who will never be a nurse, and tell her that this is what a trauma room is for; I tell her to appreciate the life she was given, her health and the hope of a future that doesn't include a wheelchair; and I tell her that her puny little lawsuit and the puny little people who go along with it—the ones who look the other way or “follow protocol”— should be ashamed of themselves.
Then I returned to my body, responded to an MVA in a parking lot and put a guy in his twenties complaining of neck and back pain following a minor collision onto a backboard. I put a collar around his neck, took his vital signs and brought him to the ER where he will be treated like a real patient.
I don't know how they do it. Come to think of it, I don't know how I do it.
Michael Morse, EMT-C, is captain of Rescue 5 in Providence, RI, and has served on the city's busiest engine, ladder and rescue squads as a firefighter, rescue technician and lieutenant during his 21-year career. He is the author of the books Rescuing Providence and Responding.