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The Christmas Call

Willa Cather once wrote, "Some memories are realities and are better than anything that can ever happen to one again." I'm often asked what I would consider my most memorable EMS call. There have really been numerous memorable calls.

There was the call where we transported a famous entertainer. There was the call where I got shot in the arm and didn't realize it until we got to the hospital with our patient. There was the call where my partner drove all the way to the hospital before realizing that he had left me at the scene. Then there were the bad ones. In my memory there is a montage of calls with multiple gruesome deaths; they all run together. There was a call where I transported my mother-in-law-to-be to the ED with major burns-never realizing who she was. These images used to haunt me-not so much today. However, sometimes when I least expect it, something will remind me of a call and a patient.

Every Christmas I remember a particular call. It was Christmas Day 1977. I was one of the first four paramedics in Fort Worth, and we would respond to numerous calls. It was almost midnight and Christmas was winding down. We were dispatched to a house fire some distance from our territory. It seemed the engine companies on scene were requesting a paramedic. It took us 10 minutes to drive from the south side of Fort Worth to an area near the historic Fort Worth Stockyards on the north side. We turned onto the street to see numerous engines, ladders, and Fort Worth's famed Squad 2.

From a distance, we knew something was different. There was an anxious tone to the dispatcher's words. We rolled on the scene and found three people, all females, on the lawn with firefighters administering CPR. They had been occupants of the house-now smoldering. Smoke had overcome them, and the firefighters had pulled them out and begun care. I first glanced at the mother. She was coughing and trying to push the BVM away from her face. I thought, "She looks OK for now. The firefighters can handle her." The other two victims were young girls-one age seven and the other age nine. As I walked toward the victims, firefighters from both patients said, "Bryan, come here."

I sent my partner, a paramedic student at the time, to the older girl, and I went to the younger. The firefighters were doing effective CPR. The child looked hopeless and was covered with soot. I intubated her-amazingly easily as I recall. We gave her a dose of epinephrine, and she began to stir. She started to move and reached for the tube. We continued to ventilate her, and she pinked up. About that time, the second ambulance arrived-an EMT unit with a paramedic student. I yelled, "Ya'll get the young girl and take her on to the hospital." The firefighters scooped her up, and she was moved to the ambulance.

Then I turned my attention to the second girl. My partner, the paramedic student, had started an IV and had gotten the endotracheal tube ready. I immediately intubated the girl-amazingly easy I thought. We ventilated her and she pinked up. By this time, she had a strong bounding pulse. We transported the nine-year-old and the mother. The mother watched and quietly wept as I squeezed the ventilation bag all the way to the hospital. She asked, "Are my daughters going to be OK? I lost my husband two years ago and could not live without my girls." I mumbled something that sounded positive and kept up my work. We delivered the girls and their mother to the hospital.

I was beat-both physically and emotionally. I sat on the back of the ambulance, drinking a Diet Dr. Pepper and staring into the darkness. I was a young paramedic, and I kept running through the call in my mind. Did I do OK? Could I have done anything better? Did I miss something? My partner came out with the stretcher. He looked at me and said, "Man, what a call. Here I brought you a Diet Dr. Pepper." About this time the fire chiefs and media started arriving. They walked past us and into the ED. I walked down the trauma hall. The seven-year-old was in Trauma 1 and on a ventilator. The nine-year-old was in Trauma 2, also on a ventilator. The mother was in Trauma 4 and being treated for burns. I thought, "Burns? I never checked the mother for burns. Damn, I can't believe I didn't check the mother."

After the call we went back to the station. By now it was 4 a.m. I lay down and tried to sleep. I kept replaying the call in my mind. Soon, the sun came up. I called the ED and learned that all three were doing well and were expected to survive. Next shift we visited the family. The mother had been sent to the burn center-but the girls had been extubated and were sharing a room. They both recognized us and thanked us.

The next week we got a thank you card. The card, although simple, meant a lot to me. It told me that I had made the right decision in becoming a paramedic. It made me proud of what we had done-but humbled at the magnitude of the event. What makes this case different is not the call, but the girls. For the next 10 or so years, I faithfully received a Christmas card from the girls. One went to nursing school, and the other became a lawyer. They often wrote that they were thankful we made a positive impact on their lives. Then I went to medical school, moved several times and lost track of them. I hope and pray they are well. They never knew they, too, had made a positive impact on mine.

I am not a religious guy. But I like Christmas. It is a time of family, fellowship and friends. Soon after the winter solstice comes the New Year with a hope for a better world and new beginnings.

So that is my Christmas story. I am sure each of you has one equally etched in your memory. Now is the time to remember it and reflect on your work. Remember that EMS is a profession that makes a difference. May each and every one of you-no matter what your belief or religion-have a great holiday season and a wonderful 2006. Please join me in hoping for a world where EMTs and paramedics are never needed.


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