LITMIR.BIZ

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impact. Sadly, it often wrapped itself with unyielding ferocity around not only other cars, tree trunks, and the like, but human flesh. It was all well and good to have ambulance people and equipment at a car accident, but we needed to get the people out of the cars. Preferably in one piece, if they were still alive.

      The police and fire departments were experts at cutting up cars. Those guys from the FD are truly a credit to their profession—at least, they looked impressive and had great tools to work with. They had helmets, gloves, boots, goggles and the finest power tools available. Sporting all this safety gear, the fire department personnel would cut a small hole in a smashed-up car in an effort to gain access to a patient. Still wearing all of this heavy safety equipment, they would then turn to me in my short-sleeved shirt and say, “Go on in.”

      So, with no safety equipment, I would crawl into the twisted wreck to tend to my patient. While it may sound crazy to enter a wrecked car this way, it was necessary because bulky equipment would prevent access. It could also make a quick exit from the car impossible in an emergency.

      Picture, if you will, two people in a space the size of about half a refrigerator: one trapped there and frantic to get out, and the other wriggling into this mess for the sake of the first. As I climbed into these cramped and dangerous spaces, I had no idea who the other person was—all I knew was that both our lives were on the line inside that metal tomb. We had to work together with trust and confidence, but did not have the luxury of time to bond with each other. I usually broke the ice with a little small talk.

      “Hi, my name is Joe. How are you doing?”

      “OK.”

      I would want to say, “If you are really OK, then can I go?” But usually I said something like, “That’s good.”

      Now the formalities commenced.

      “I’m with the ambulance and you have been in a car accident. We’re here to get you out and take care of you.”

      “What happened?” was often the victim’s first question. (It was also the insurance company’s first question.)

      “You were in an accident,” I would inform them again. It was often necessary to repeat this, as peoples’ awareness would wax and wane.

      “Who are you?” The patient would say with trepidation.

      “I’m Joe, from the ambulance.” Just once I would have loved to respond with, “I’m the car accident groupie who travels around the country following only the best accidents. You’re very lucky, this is a 9.5. You don’t get above that number without loss of life, but in your case there is still hope of making it to 9.9.” “Am I OK?”

      “Yes, we are doing everything we can for you.”

      One time we were at the scene of a single-car, singlepatient accident. The sole male patient was named Ron Dieble, and he was about 40 years old and very scared.

      “How am I going to get out of here?”

      “Let me help you.”

      We were hope brokers. We were in a caring profession. Other caring professions include nurses, doctors, allied health professionals and social workers. People who pursue professions such as these usually say they want to help people. I always wanted to help people too, so I began training in first aid at the age of 13 and completed numerous first aid courses as a youth. I took an EMT class at 17 and became an emergency medical technician less than a year later. I immediately started working on the ambulance, with a view to becoming a paramedic and making a career on the ambulance. My chosen pathway for helping people was to provide care and comfort to the sick and injured when they called an ambulance. This is what I lived for, and that’s what I was doing for Ron. If you were in our ambulance there was still hope. No one ever died in my ambulance. No one dies in an ambulance because we did not pronounce people dead in the ambulance. People would be pronounced dead in the wreck at the scene or when they got to the hospital. But no one ever died in the ambulance. My patient did not know this, though. He was just beginning to come out of the fog and understand that we were there to help him.

      From the darkness outside, a voice boomed. “What you got in there?” “A big 6-incher.” “What?”

      “A 6-inch laceration across his forehead, broken nose, OK on airway and bleeding, broken arm, chest is fine. Below that I can’t see.” I gave this summary quickly and professionally. I would have to assess the chest and abdomen when we got Ron out of the car. Right now I would focus on head, neck and breathing.

      Our extrication of Ron Dieble was relatively simple up until the point where he said, “I can’t see,” with just the right amount of panic in his voice to make me take him seriously. Loss of vision can mean brain damage or other hidden head injuries, so I was quite concerned.

      “OK, Ron, you took a good hit on the head. We can take care of you. Sit tight and don’t move. I need to get your head and neck immobilized.” I said while searching through the trauma kit for the cervical collar. The collar would prevent him from further neck injuries. As I placed it around his head and neck, I got a good look at the laceration running horizontally across his forehead. I was familiar with the dermatomes that surgeons follow on a person’s skin to minimize scarring. These are regions where the skin has a grain to it, and some lacerations can cut along the dermatomes. Ron’s cut looked like it was running along one of these lines because it was so straight. Too straight.

      “Ron,” I shouted, “Open your eyes and look at me.”

      His eyes slowly opened to expose a blank stare. But he was staring at me nonetheless.

      “Ron,” I asked, “do you wear glasses?” My common sense said to me that the laceration might be caused by glasses hitting his forehead as his face hit the windshield. So I wanted to find out if he was wearing glasses at the time of the accident. Glasses or frames could also be imbedded in his eyes or face.

      He blinked, brought the hand of his unbroken arm to his face and said, “I’ve lost my glasses! You have to find them—I can’t see without them!”

      He stared at me with terror at having lost his glasses while I tried to hide a smile as I realized that he had not lost his sight.

      “Ron,” I asked, “is your vision like it would be without your glasses?”

      “Yes,” he replied tersely. “I need my glasses to see.” Accident victims can become very emotionally dependent upon personal effects like watches, glasses, stuffed animals and keys in the first shock-filled minutes after an accident. So I did feel for him, but my first priority was to get him stabilized and out of the car. I had formed a strategy for this by scanning the wreck for routes out. The doors were smashed, the roof was crushed and the side windows were no good. The front windshield was also smashed on the driver’s side, but it did look like a possible escape route. We could peel the broken windshield out and both exit from there. The safety glass of the windshield had formed a little basket bubbling out in the shape of Ron’s head. Sticking back into the car from this basket were Ron’s glasses.

      “Ron,” I said, “I found your glasses.”

      Ron was very happy to get his glasses back, and I was happy that he wasn’t blind. I was also glad that the glasses appeared to be intact, so they most likely did not leave pieces in his face or eyes. They were however the cause of his lacerated forehead and most likely the broken nose as well. I will never forget how Ron looked sitting in that wrecked car, with his Frankenstein forehead and broken nose, sporting those eyeglasses that matched his injuries perfectly. All topped with a big smile.

      “Ron,” I asked, “do you normally have a front tooth missing?” Ron had lost one of his front teeth in the accident too, and I found it sitting on the dashboard right below where his glasses were. A front tooth loose on the floor would have been easy to miss amid the shards of broken glass around. The good news for Ron was that the root was intact, so there was a good chance the tooth could be reimplanted.

      We bandaged up Ron, packed him into the ambulance and shipped him off to the hospital. I must admit that although I often

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