The year after college I was an ambulance EMT. I started in July, and it wasn’t until September that I was assigned a steady shift with a partner. Before that I just bounced around between paramedics, snoozing, reading, and writing this blog on my cellphone between inventory and 911 calls.
My first code blue was an OD, on my first day of work. We arrived on scene before fire to find a supine fat kid unresponsive on a back driveway, with a gaggle of bleary-eyed teenagers who’d obviously waited too long to call, and were real quiet and vague about what happened to their friend.
I attached the EKG nodes and started bagging while my paramedic trainer pounded on his chest. No cardio activity. Fire arrived and they started banging on his chest in a rotation. Still no activity. Then someone offered to bag while I pumped, and I went to town so hard on this kid that I cracked his sternum. The snapping sound was horrific, but the moment it happened the heart monitor gave a beep and started going.
The thing about it was, everything happened in under ten minutes, and although he died later that day, when we dropped him in the ER the kid was still alive—unconscious and intubated, but alive. It wasn’t until November that year that I actually witnessed a death.
Now, I’m an omega, a contrarian loner who hates rules and rarely strikes up a lasting friendship. I’m also fairly tall and large-framed. My first paramedic partner, Tommy Gonzales, was a medic second lieutenant in the National Guard, the kind of beta-simp who joins the service to compensate. He looked like Eugene Levy—gaunt, about 5’6″, and very uptight, but highly intelligent, which necessitated bending the rules as often as they got in the way of logic. I respected him for that.
One night just about dusk as I was driving Tommy around the Sonic drive-thru, we got coded to a trailer park. Again, we got there before fire. Again, the patient was supine, this time on a shabby carpet. It was a double-wide with fake wood paneling and a bunch of taxidermied elk heads on the walls. The guy must’ve been in his mid-sixties. He was shirtless and barefoot in a pair of jeans that hadn’t been washed in a coon’s age, skinny-fat like alcoholics often are, and covered in a half-inch layer of wooly grey body hair that went all the way up his neck to an untrimmed beard. The place was strewn with empty pint bottles and crushed-up Coors cans.
The family was all assembled—son, daughter, daughter-in-law, adult grandkid. They said they’d found him the way he appeared, unresponsive, not breathing. They thought he’d choked on a turkey sandwich he’d been eating lying down, and that he must’ve rolled off the couch onto the floor. That was what it looked like. I had to shave him to place the EKG nodes, then Tommy and I started doing our thing.
It was a long night. The monitor gave just enough activity after a minute of CPR that we had to keep going even though the guy’s chances were very slim. Fire got on scene and Tommy started trying to intubate, but the laryngoscope kept bringing up turkey sandwich. The firefighters and I rotated doing CPR while Tommy smeared gob after gob of partly digested food like pâté onto the inner lining of a red haz bag. Eventually we got the guy tubed. His cardio kept flopping and starting back up with just enough activity for hope.
At one point I stood up to stretch my legs. Across the room, the family was piled around a card table in the corner, faces downcast, their arms draped around one another, watching their patriarch recede into eternity past indifferent, knee-jerk bureaucracy—past us, with two forms of state-issued ID over his eyes. We were the boatmen.
Above the family on the wall was a framed and faded portrait of a proud and fearsome Marine with a flag half-draped across the background. That was the guy we were trying to save. The two of them couldn’t have looked more different. He wasn’t in his body anyway, yet he might not’ve been further away than that portrait. I felt this sudden sense of reverent foreboding in the pit of my stomach, that this man lying dead at my feet was witnessing his family’s despair, and screaming desperately from just out of reach of them.
After three hours, Tommy advised the family that things weren’t going to turn around. They nodded stoically. We called up to the hospital and signed the necessary forms. Then we packed up our equipment in haz bags and debriefed with the firefighters before leaving them to wait for the coroner.
That shift went long. We went back to base, cleaned up, and tried to get a nap, but the calls just kept coming. The 24-hour shift that had begun just before that code in the Sonic drive-thru turned into 35, 36, then 40, and topped out at 51.
At one point we dropped someone at the ER. It was about 9 in the morning. I was sitting in the driver’s seat of the ambulance waiting for Tommy to snag Graham crackers and juice boxes from inside at the nurse’s station, when all of a sudden I started sobbing maniacally, just huge choking sobs without any kind of buildup or anticipation whatsoever. It was so primal. There was no reflection, no social pressure (I was completely alone) and no reason to feel anything. I hadn’t known the guy, the Marine—I hadn’t known him. I’d run plenty of codes, seen lots of pitiable people in sorry states and felt bad for them, and I’d gone hours by then without it occurring to me that I’d been impacted at all. It was just a job, I was just exhausted, I just wanted to go home to my family, I just wanted a burrito. This is America—nobody has real feelings. I remember that I’ve had them, back when I was a kid, but I don’t even remember what real feelings feel like. It’s been six years since that 911 call and in all that time I haven’t experienced a comparably spontaneous and authentic emotion. And yet it happened, in spite of every social pressure militating against it.
It’s strange how things incubate in us when we thought they didn’t matter, or that we’d forgotten them. Sometimes when I discipline our kids, my wife gets on me and says, “This isn’t the army, you know!” On the one hand, when I hear this it sounds odd, because the army is the furthest thing from my memory and my motivations. On the other hand, my first reaction is to feel she’s being unreasonable, because life is rough, and it’s better they learn it first from their dad. But what she sees me doing that I can’t see myself is sublimating an experience that’s constantly with me in ways I’m almost never aware of. Sublimating the untold humiliations and death by a thousand cuts of being a king, and a piece of shit, all at the same time.