Columns, Patient Care

Don’t Forget The Hat

For the past couple of years, I had run the C-shift, four to midnight truck. Kim and I were on Medic 310, Mike and Dave on 305. We had just come on duty one afternoon and were watching the Indians game. I hadn’t even had the chance to finish my first cup of coffee and catch up on the day’s gossip, when we were toned out for a “woman in labor” call.

At that point, I had been in EMS for about 10 years, but still no stork pin. I had been on dozens of “woman in labor,” “water broke,” “woman giving birth at the police station” calls, but none had ever resulted in a stork pin not even close. I had even been stuck for 20 minutes at a railroad crossing with a woman whose contractions were two minutes apart and then stopped as soon as the crossing gates opened. And there were a couple not even close to term who didn’t make it. Needless to say, I had given up hope, and my reaction to this dispatch was a “yeah, right.”

My partner Kim and I arrived at the apartment complex. The apartment was on the ground floor, first door on the right. When we entered the tidy first-floor apartment, our hands in our pockets and only the jump kit with us and no OB kit, our patient was lying on the couch surrounded by concerned relatives, who also had their hands in their pockets. The mother was moaning and clutching the couch cushions.

“How many minutes apart are her contractions?” I received no answer from the family. That was because they spoke no English. And as for my Spanish, well, I can ask “Donde te duele” and hope that the patient points to what hurts in reply. Because if they answer beyond “cabeza” or “pecho,” my anatomical vocabulary is pretty much used up.

At this point, the mother-to-be managed to grunt “coming now, coming now.”

With practiced nonchalance, I peeked under her housedress, and, just like in a cartoon, did a double take at the crown of matted black hair that was definitely not a part of the mother’s anatomy. Immediately, I devolved from moderately competent professional to bumbling neophyte. “Get the, the, the, stuff!” I yelled to my partner, my voice a couple of octaves higher and decibels louder than I would have liked.

Kim ran out to the truck and got the OB kit. Opening the plastic wrapper was like trying to get the shrink-wrap off of a new CD. When I finally got it off, the kit sprang open like a jack-in-a-box, and obstetrical paraphernalia went bouncing around the room. I had just managed to get my gloves on; Kim was doing the breathing coaching thing at the mother’s head and here, ready-or-not, came another head.

Out it slipped, one wet, gooey, wrinkled little head. I just knew I was supposed to do something at this point, but I couldn’t for the life of me remember what that was supposed to be. Immobilized by shock for what seemed like an eternity, but was in fact probably only a couple of seconds, it dawned on me like a lightning-flash. Suction! I was supposed to suction. Where’s that bulb syringe? Luckily, when the kit popped open the bulb syringe had landed on the coffee table within easy reach.

OK. I can do this. Squeeze. Suck. Squeeze. Suck. Squeeze. Suck. Out slides the rest of baby. Rub. Dry. Rub. Dry. Come on you little bugger. Cry. Breathe. Something.

OK. There he goes. Cry. That’s it. Good. Cry now. OK. Let’s see. What now. Oh yeah, cut cord. How was that? How many inches above what? Anybody got a textbook handy? Oh well, clamp, cut, wrap in blanket, place on the mother’s chest. OK, something else. Something’s missing; this doesn’t look right.

Oh Yeah! The hat! Gotta have the hat! Kim, where’s the hat? Thanks Kim. Cute hat. OK, the hat’s on baby. Yeah, it’s a cute baby now with the hat, more like baby, less like lizard. The mother and her family are looking at me kind of funny, though. I can’t imagine why.

I didn’t have to wait another 10 years for the next one, but that’s another story …