Many people know three things about me:
- I “bleed purple.” Fire and EMS need one another, and are stronger together than they are apart;
- I have a nagging but admitted “medic envy,” because my military medicine career was shorter than expected; and
- I am involved with the development of America’s first registry of children with special health needs, for real-time access by Mobile Medical Professionals.
Fewer know that as a child, I watched a man get run over by his own car in the driveway across from my parents’ home. I recall almost everything about the scene: where we stood as he lay dying; the moment my mother (a former oncology nurse) explained there would be nothing for us to do besides make him comfortable as we waited for an ambulance. His face in shock—was it “life flashing before his eyes,” or “what just happened?” Brain matter leeched from his ears. He died en route to UCLA Medical Center.
From time to time, I have wondered what I would have done, if I could have done something to help this poor neighbor. This past weekend, life provided an answer.
More from Jonathon S. Feit
I took my wife and kids camping for the first time, opting for the weekend before the holiday crush. I was standing at the front desk of a campground about an hour west of Yosemite when a woman rushed in, saying there was a problem at the pool. Clearly that took precedence—whatever the problem was—so I began walking back to my site. About a minute later I passed the pool and heard, “He’s at the bottom!” Several onlookers stood around but no one rushed in—I learned later that apparently none of the adults knew how to swim, and the pool was eight feet deep. There was a shape down there…I couldn’t tell anything else…so I pulled off my shirt and hoodie (swimming in a hoodie is a surefire way to be unable to see) and dove in. I found a young boy motionless, neither flailing nor breathing. He had likely been there a while when I raised him off the bottom.
- Mobile Medicine and the Mysterious Case of the Invisible (But Ubiquitous) Healthcare Provider
- The Silence of the Sirens
- Why Mobile Medicine Matters, Part 1: Ethics & Evidence
He was unconscious, bleeding from the mouth and nose (we figured later that he either bit his tongue or else his brother hit him while trying to escape the deep end). How he ended up in this predicament is distressing on its own: despite being just twelve years old, Mark is a large child—taller than me and at least 150 lbs—with a brother close in size. They had been roughhousing in the shallows where their heads were comfortably above water, but the drop off happened more suddenly than expected. They panicked. As we resuscitated Mark, his brother kept saying, “I’m so sorry.” The trauma to this second child should go neither unnoticed nor unaddressed. It could scar the rest of his life—then again, the fact that there’s a happy ending might inspire him.
I am in the Mobile Medical (Fire & EMS) technology business, and I have written about how my journalist’s heart is trained and “willing to don fresh eyes, to ask any question, and infinitely more important, to listen to the answers.” Turns out that one can learn a great deal by osmosis when paying attention: Mark may owe his life to the fact that my friends on the line across the country taught me what “ABC” stands for. The man who helped me get this large boy out of the pool began chest compressions; but besides that he was doing them incorrectly, he also had not bothered to check for either a pulse or a clear airway. I did.
When I poked Mark’s carotid, he jerked. I told the man to stop what he was doing, lest we break his ribs and exacerbate the problem. My biggest concern as that Mark would aspirate; we needed to ensure that he could breathe. We didn’t have a way to immobilize his neck, but when we rolled him onto his side—careful to use a smooth motion—blood and water poured out. He heaved. His eyes then rolled back in his head as he began to pass out again. I smacked his face, yelled “Come back!” and he did. Mark opened his eyes and breathed. I instructed everyone within earshot to grab warm towels and cover him because this entire scene was taking place at night in the mountains, where it was around forty degrees Fahrenheit. Some folks cleared bloody towels while others brought fresh ones. At last, we heard sirens getting closer.
First on-scene were a Mariposa County Sheriff’s deputy and a paramedic from Mariposa County Fire, followed closely by an engine from the California Fire Department (CalFire). An emergency department physician with rural health experience happened to be staying at the campground, so he assisted as well. Almost immediately the game of “Telephone” began—someone who works in data interoperability and ePCRs is more attuned to this than most—so I clarified what had happened. Now the boy’s parents were on-scene, reacting as expected. They had been in the lobby area while their kids played in the shallow end of the pool. Apparently, no one anticipated that they would venture deeper.
Paramedic supervisor Jonathan Knauf of Mariposa’s Mercy Medical Transportation diverted a call to the scene—they already had a lower-acuity patient in the ambulance, but no one else in the vicinity, so his partner stayed in the rig—and he took charge of the scene with a deft touch. (I couldn’t help noticing that Knauf wrote pertinent detail in a spiral notebook, broken out by the sections of a patient care record. We absolutely have to get this workflow digitized. The receiving hospital will have so little to go on, because research shows that ~50% of critical data are lost at each node of handoff in a prehospital context. I was already seeing drift, firsthand, as I stood there.)
The inclination was to fly Mark to Merced or Fresno, but weather made it impossible to land an aircraft. By this point, he was responsive. His O2 was low but his systolic BP had recovered into the 100s, and he was talking quietly. Looked like he would make it (and he did, I found out! Mercy Medical Transportation had to drive the boy out of town, a roundtrip of at least a few hours). I returned to the campsite and found that my wife (who was wondering, from a distance, “Why is Jonathon shirtless by the pool in this cold?”) had wisely decided to keep the children calm and start on dinner.
These were the facts, and I get a chill when I consider the timing of these events.
An hour or so later I sat by the fire with bourbon in hand, letting the adrenaline run its course. Thought-provoking questions kicked in, accompanied by a feeling I confess I have never experienced in forty years (including surprised delight that there are still emotions I have not yet experienced). I expect that the sensation is one that Responders feel regularly: “Happy” isn’t visceral enough. “Relieved” is insufficiently loaded. Of course I was thrilled that Mark will recover. But the most accurate description of the feeling may simply be “weight.” It felt heavy. Existential. Spiritual. Ineffable even for one with no lack of words.
I posted a quick note about the incident on social media, and some of the reflections only raised more questions. One friend said, “You know I am not a very religious person but you were there for a reason. That feeling is one that you can never describe to people.” Another encouraged me to “allow yourself the good feelings. Not everyone is wired to act…The “what ifs” are much worse when the outcome is not positive.” Agreed. But why was I in just the right place, at just the right moment, with just the right skills?
Scott Topiol, an Orthodox Jew who works with the Los Angeles County Fire Department, cited the Talmud, the canon of rabbinical teachings: “Whoever saves a single life is considered by scripture to have saved the whole world.” If so, then what impact will Mark have on the world, now that he has more time in it? What will be this boy’s purpose? Who is he meant to become? Does he become a watchful sentinel—a medic, firefighter or sheriff—and pay it forward? Does he become reverent, or fearful of life’s fragility? Or callous and nihilistic about how close he got? Will he earn his second chance, making a lasting impact on the world; or will it take him down a path of hedonism…cognizant firsthand that it can end in a minute?
And what of me: If my purpose was to save him, then what’s my next purpose? It’s a more complex question than it sounds. After all, according to that inimitable bastion of psychospiritual truth, Morpheus from “The Matrix”: “What happened, happened—and couldn’t have happened any other way [because] we are still alive.” Put another way: Everything I have done in my life to date—every question I have asked, every answer I have heard, the decision to take our children to Autocamp the week before Thanksgiving instead of during Thanksgiving, even being at the front desk when that woman brought that news down the stairs, literally everything—had to go just right to ensure that I would be at that precise spot and time.
I’m still here, so this, too, was a necessary step on the way to some future future. Like rings spreading outward from a pebble tossed in a lake, as futures are often described, what ripples will reverberate from the fact that Mark’s death was averted? For that matter, what will come of the fact that you are reading about Mark’s death having been averted? The meta-mystery of it all is where I find faith. It is also why and how I encourage friends—in this industry and elsewhere—to pick themselves up when they are feeling low (and we know that happens often in Mobile Medicine). Something will come of every action; our impact is incontrovertible but often difficult to prove (hence my “day job” in the data business).
That which we can see but not prove is very interesting indeed. It is also the cornerstone of religion.
Saving a life—as Topiol alluded—is a “boundary situation,” and among the most religious of act. Boundary situations are “anomalous experiences and events that bring people face to face with the limits of their worlds, that is, with birth, death, inexplicable suffering, or challenges to the moral code of a culture.”1 Crossing a “boundary” means nothing after is ever quite the same.
Indeed, the link between religion and Mobile Medicine has always been obvious to me (it helps to have a Master’s degree in the subject): there is much religiosity in our industry—not just faith, but faithful action, both inside and outside of churches. It takes a special faith to run toward crises, to believe that sacrificing oneself is acceptable. But Topiol recalled for me the words of a family friend who happens to be one of America’s most powerful clergy (and, I would argue, its most compelling orator): Rabbi David Wolpe of Sinai Temple in Los Angeles once told me that it takes a “special kind of empathy” to internalize the experience of another when it differs from one’s own—to see through another’s eyes while abandoning bias and judgment. For a decade-plus I have passionately fought for Mobile Medicine’s seat at Healthcare’s Table of the Future, by linking the ecosystem, clarifying paths for economic advancement, even bolstering Responders’ wellness and mental health.
My reward came on the Saturday before Thanksgiving 2021. I received a gift—a special kind of empathy—raw, intimate, and lasting. Mark’s mother stepped toward me and said, “Thank you for saving my son.” I barely managed a reply; there was no verbosity left. I merely stammered: “I’m just glad I could be there, ma’am, and able to help.” And now I understood: That feeling is why Mobile Medical professionals always show up.
- Little, David and Twiss, Sumner. “Basic Terms in the Study of Religious Ethics” in Religion and Morality: A Collection of Essays (eds. Gene Outka and John P. Reeder, Jr.). Garden City, NY: Anchor, 1973.