Book excerpt: ‘Ambulance man’
The minister is acting weird
The night Reverend Lindstrom collapsed, the appellant only said, “The minister is acting strangely. Witnessing a sudden stop in speaking, a puzzled expression, a tightness in the chest and falling face first to the ground, was actually strange behavior. He may have had an attack of hypoxia when he took on an ashy color. It would become increasingly clear that one should vaguely hold onto the stated nature of an appeal.
I had presented myself to the service in the diffused light of the late afternoon. As I walked out of the ambulance quarters, I was disappointed to find that it was now dark. I thought the heat of the sun would keep me from shaking; I felt weak and cold, but not from the cold.
I always worked as an extra person and attended calls while sitting in the patient compartment of the ambulance. As the platform exited the garage, a familiar chill started in my arms and pulled my elbows spasmodically against my sides. The wave of apprehension swept through my bowels and legs. The muscles in my inner thighs were contracting and my knees were bumping. My clenched teeth ached in my jaw muscles.
I endured that same wave of anxiety on every trip to an emergency call, but knew that once I got out of the ambulance and on the move, I would be able to function. I didn’t understand at the time that the adverse reaction was neurological, or chemical and not character, with my adrenal glands hijacking my body for fight or flight. Instead, I assumed it was a mental flaw, another deficit to hide and endure. At the time, I didn’t imagine a future self free from this discomfort, but I understood that my future self was being formed, formed by a kind of fire, a fire that hardened steel, hoping nerves of steel.
We arrived at the Lutheran Ascension Church and entered the building. People moved around as lost in the very church where they had been baptized or married. Some made their way to the exit, others staggered as if the minister himself had exploded and had been hit by human debris. We have moved against the grain.
The Reverend was lying on the floor of the chapel. Having moved too quickly, I got to his side before the rest of the crew. In front of me there was not only a dead man awaiting resuscitation, but someone I recognized. I had met him months earlier on my graduation ceremony. He was the father of a classmate. Standing close to his head, I found myself enveloped in void-like silence as I fell into a sudden trance. I had no filter to protect me from full reality, and I lacked the experience to see it other than from a civilian or pedestrian point of view. A circular mist surrounded the small scene as if I was looking down a tunnel. I could only see his deep blue-gray head surrounded by shoes. I even recognized my own uniform boots.
Cropp barked an order, and suddenly I was again a paramedic, responsible for mechanical ventilation with the oxygen resuscitator. I became completely engrossed in the task of ventilating it once every five seconds. My concentration was absolute, like deep meditation. I was engaged in supreme concentration on rhythmic breathing, except I was breathing for another. The force of this determination was so great that we arrived at the hotel without my recognizing the trip.
In the hyper-lit ER, his treatment turned into a medical exercise of electric shocks and drug administration. It was nice to be out of reach of the congregation. The doctor had asked me to take care of the chest compressions. I applied the same intense concentration to the compressions as to the ventilations. I figured that just one lack of speed or depth would throw out a handful of human brain cells. To precisely time the sequence, I tried using a clock on the wall in front of me. But the hands of the clock, as if they were personified and waiting for me to look, suddenly turned cartoonishly clockwise and then counterclockwise. I was calmed by a nurse’s questioning gaze when I regretted commenting on it. Fortunately, my crazy speech got lost in the mix of gossip and organized chaos.
A final electric shock made his heart beat, and soon after he was revived. He started to struggle on the narrow stretcher and vomit more than I thought possible. Every time he did, the vomit would come out with a gigantic roar. It was as if villagers in white coats had captured a wild beast and were trying to hold it on a table; Despite its large size, fierce sound, and vomiting, they managed to prevent the creature from escaping. He only became manageable again with the loss of his pulse. Cropp tapped me on the shoulder and just said, “Let’s go.” I walked out knowing I now had cardiac arrest, the crown jewel of paramedic work, in my small but precious stash.
The adrenaline rush that almost made me twitch, the altered perception of time, the crazy clock hands spinning, were all part of the mad rush my body had taken me. The clock had acted like a clock; I had been the one with internal rotating parts. I kept the experience of the shoe ring around the minister’s blue face and the cartoon clock a secret, a bit of shame and a bit of a miracle. I had decided years earlier to keep my collection of these things to myself.
The call had taught me many things, and for the next cardiac arrest, I would be more adept with the essentials of the trade. Even though the lingering smells, sights and sounds were at hand, what was most present in my mind was not the victim herself, but the memory of the atmosphere of crisis and death and death. the reaction of others.
Most importantly, my knees had banged, but I hadn’t fallen, I had tunnel vision but saw my way through. There were holes and crooked lines in my memory, and things had happened that I couldn’t explain, but no one saw me falter. No one knew what was going on inside me. Without thinking of an alternative, I would continue as I had always done.
Extracted with permission from, “Paramedic,” by Brian Casey
Published by Alley Light Press (January 15, 2022)
About the Author
Brian Casey is a sergeant with the Saint-Paul Police Department and Director of their Employee Assistance Program. He has a degree in Health Education from the University of Minnesota and over 35 years of experience as a paramedic, EMS educator, and police officer. His personal experience of critical incidents and his work as a health educator has given him a better understanding of the health and well-being of public safety personnel. Casey is also the author of “Good cop, good cop: a guide for law enforcement, be healthy and stay healthy.” “