This morning I woke up tired.
My entire body hurt. My back felt strained, my neck ached, my arms were on fire, my core tingled, even my thighs and glutes were sore from being bent over another human being desperately doing chest compressions for almost an hour yesterday.
I was driving out to the coast for a friend’s birthday with two of our mutual friends. The roads in Northern California that lead to the coast are usually precarious and windy, so accidents happen. When I was 16 I saw what was left a motorcyclist peeled off one of these roads while a woman screamed “God, no, please no” over and over as if God was going to magically appear and give us a miracle. One rule of working in medicine/EMS: Miracles happen, but not because you beg for them.
We were driving along when all of a sudden the cars in front of us came screeching to a halt. I told my friend to throw on our flashers and rolled down my window, expecting it to be a deer in the road or something. Actually, that isn’t true. Like I said, accidents are to be expected on these roads, but I guess I was hoping for a deer, something mundane and easily dealt with. We were stopped just before a sharp bend so we couldn’t see what was now several car lengths ahead of us, but when I heard screaming my heart sank. “DOCTOR! MEDIC! SOMEBODY HELP!”
The military taught me to be reactive. You don’t think, you just do. If you stop and think too long you’ll second guess yourself. If you think about what gore might be waiting for you on the other side of the bend, you’ll feel anxiety and anxiety clouds your judgment. I threw the trunk open and grabbed the (sparse) basic first aid kit I keep with me. “Please, a man isn’t breathing.” The woman is nearly hysterical as she leads me to the scene, and I can see why. It’s a bad scene, not even near the worst I’ve ever seen, but if you aren’t desensitized to this stuff it would be jarring.
I shout for someone to call 911, but there’s no cell service. There is no east bound traffic-yet-only west bound, and the accident is blocking the road completely with a drop off on one side and a wall of mountain on the other. Someone volunteers to turn around and drive the 20+ miles back to where we all last had cell service and call 911. A nurse appears too and starts dealing with the other victims, who are also in critical condition, but leaves me with the man who isn’t breathing.
I don’t think about the fact that if I don’t start CPR within a few minutes he’ll be dead. I don’t think about the irreversible damage already done. I don’t think that there are other people in need of immediate attention. I just react. I follow the steps I’ve been taught. I check to make sure he’s unconscious. I move him onto the road as gently as I can with the help of my friend because I can’t get the door open. No pulse, no breathing. I start chest compressions. I do a rescue breath. I do chest compressions. Somewhere in the back of my mind I’m wishing it wasn’t so hot, so maybe we could put him on ice. I’m trying to calculate how long it’ll take EMS to get to the scene even once 911 is called. But mostly I’m just counting, over and over. CPR isn’t like it is in movies. You do CPR to keep the blood flowing, organs need the oxygenated blood to keep pumping otherwise they’ll die without it. You don’t do CPR to restart the heart. Short of a miracle, you need an AED to attempt to restart the heart.
I lose track of time. My arms hurt but only in a way so that I’m vaguely aware of it. Someone coming from the coast has turned around to try to call EMS but by the time they arrive to an area with cell service EMS has already been contacted. It’s hot even beneath the shade of the tall trees around us and I’m covered in sweat but I hardly notice. The noise around me becomes a buzz. A doctor eventually shows up, from one of the backed up cars, but a few minutes later Cal Fire arrives. And then an ambulance. And then a REACH helicopter. They’ve taken my patient away and are racing down the road to the helicopter, but I don’t hear it take off. It’s only when they come back for another victim and go back several miles to the helicopter that I hear it take off. So I know my patient is dead, and I know I did everything I could to save him, but I still stand there in a daze with numb arms.
I am profoundly tired. I’m not sad. I’m not angry. I may be a little disappointed but mostly I’m just tired. Traffic doesn’t move until nearly three hours after the accident occurred. My friends offer to take me to the house we’re staying at and let me rest but I shrug; I’m a mute. So we go to the famous glass beach and look at glass, and I collapse onto the sand and second guess myself. Now I think. Now that it’s all over I think. I wonder who he was. I wonder if his family knows yet. I wonder if I’d started sooner if he could have been saved. I play the what-if game and lie to people, telling them I’m not doing that. I think about the randomness of it all. I think about the fact that even when we intervene, we can’t save people. I close my eyes and lean back, letting the sand conform to my spine and fill in the gaps between my limbs and torso. The others start to trickle in, and then my brain is being flooded with images of all the ones I couldn’t save, because those are the ones you remember. I think about gore and it doesn’t bother me, it doesn’t make me nauseous and it doesn’t make my skin crawl, and I wonder if a wire in my brain has short circuited. And I think about my mother telling me I should talk to someone again, a professional, but all I have to say is that I’m just tired. How many times can I repeat that over and over before somebody hears me?
I think, I want to lie in the sand and be alone, and have waves wash over me until I’m a tiny, shiny, smooth piece of glass too.
A sound cuts through the near silence. My friends yell my name, and my eyes shoot open. It’s time to rejoin the world of the living. It’s time to celebrate life rather than mourn death. And as I pull myself up, I repeat this phrase over again in my mind: I am profoundly tired.
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