Working with Death Wednesday: A Writer and an EMT

Today I am so excited to post an essay written by Mike Cyra right here on my blog.  Mike found this blog when I posted an interview with my friend Katie, who is also an EMT.  Mike has written a book called Emergency Laughter and it's available right here on Amazon You can also check out Mike's website here.
Grab a Kleenex and be sure to let Mike know you were here by commenting or clicking one of the boxes below.  Or buy his book.

Two Little Angels

It was a beautiful sunny day in a perfect neighborhood, at a perfect house, with perfect parents and two perfect children.
The six-year-old twin girls ran across the manicured lawn toward their mother who was drinking iced tea and talking with her neighbor.
“Mommy can we go to the kitchen and get something to drink”? In a stern voice their mother said, “Yes, but only to the kitchen and then come right back here.” The girls raced each other to the front door of the house yelling, “OK, We will.”
They didn’t even slow down at the kitchen. In seconds they were in the backyard kicking their shoes off and climbing the ladder.
Mothers have an internal alarm that sounds when things are not as they should be. It was too quiet. She called out her daughter’s names loudly. When they didn’t answer she began walking toward the house. She yelled their first and middle names. No sound. Red flags of fear and panic flashed in her brain. She dropped her glass of iced tea and raced around the side of the house into the back yard.
Her scream pierced the air. “Oh God noooo!” The neighbor lady’s hands shook uncontrollably as she flipped open her phone and pressed 911.

My partner, and me were in our ambulance when the sound of a call being dispatched brought our radio to life. The dispatcher’s monotone voice said, “Aid 3, medic 71, CPR in progress,” and she gave the address.
By habit my partner, Tim, picked up the map book and started plotting the address, even though it wasn’t our call. This was before GPS and laptops were standard equipment in ambulances.
Only a few moments passed when the dispatcher radioed, “All units responding to this call be advised this is a pediatric CPR in progress.” 
Without realizing it my right foot pressed down on the accelerator and I asked Tim, “Where was that address again?”
Ten seconds later the stress-filled voice of the dispatcher said, “All units be advised this is a double pediatric CPR in progress. Repeat, double pediatric CPR in progress!”
My right foot slammed down on the accelerator as I turned on our emergency lights and siren.  Tim tightened his seat belt and grabbed the map book again. I yelled, “Where do I go?”
He began a rapid succession of instructions, reading the map, scanning the traffic around us and visually clearing his side of the intersections we were speeding through, yelling, “Clear right, GO!”
We were going to our worst nightmare, two children in cardiac arrest. I grabbed the microphone and radioed our dispatcher, “Central, medic 6. We’re rolling on that. ETA four minutes!”
We hadn’t been officially told to respond to this call; but there was nothing she could or would do to stop us. She simply said, “10-4, medic six responding.”
I remember trying to push the accelerator pedal through the floorboard and the voice of my partner, constantly shouting to me about the traffic around us.
“Clear left, clear right, watch that guy! Ok he sees us. Go for it! Easy man, watch him, watch him, OK clear right. GO, GO, GO!”
If our ambulance had wings, we would have flown.

I heard the first two ambulances radio, “On scene.” We were still two minutes out and only slowing down for intersections and when absolutely necessary. It’s hard to describe the anxiety we feel when responding to certain types of emergency calls. When you know what’s waiting for you and that every second counts. “Kid calls” are the worst.
An eternity passed before we came to a stop behind the other ambulances. We grabbed our equipment and ran across the lawn to where dark uniformed EMS personnel were kneeling over two very small patients and performing the unmistakable task of CPR.
Adrenaline is a strange drug. Time either slows down or speeds up. You have hyper-sensations. You see, hear and absorb enormous detail of your surroundings, or you become so focused, that the brain blocks out what isn’t needed and you have acute concentration on what is vital. For me, on that day, I was focused.
I knelt down beside one of the girls. One medic was doing chest compressions; another was at the head breathing for the girl. I started setting up an I.V. line as another medic prepared to intubate her.
Short, rapid conversation passed between the teams. “They were both found floating face down in that above ground swimming pool.”
“How long were they in the water?”  “We don’t know, the mother says they were out of her sight no more than five to ten minutes.” 
Instantly I thought, “The mother, oh shit, where’s the mother?” It was then that her screaming started filtering into my brain. I looked up and she was kneeling on the grass not ten feet away crying, “My Baby’s, my baby’s!” Her girlfriend was trying to hold her back, away from us. They were both soaking wet.
I listened to her anguished cries for a millisecond and then my brain turned down the volume on her and drew my attention back to the fact that I had already stuck an I.V. needle into a vein on the girls’ tiny arm.
It’s all about communication and teamwork. Everything happens very fast.
“I need epi here!”
“Ok, tubes in, listen to the lungs.”
“How much do they weigh?” 
“Hurry up with the bicarb.”
“I need another O2 tank.”
“We’re still asystole here.”
“Charging defibrillator. How many joules?”
And so on, as we tried to reverse the time that ticked away on two small lives. We got our girls’ heart beating again and started getting ready to move her to the ambulance.
Gently lifting the small weightless body onto the gurney, it struck me how tiny she was on this adult sized stretcher. I jumped into the back of someone else’s ambulance with one girl and I saw the other girl being loaded into another unit.
I watched my partner gently put the mother into the passenger seat of our ambulance. It would be hell for both of them following us to the hospital.
The doors were closed and the ambulance began to move. I sat at the girl’s head ventilating her lungs while the other medic pushed more drugs. To no one in particular he said, “My two girls are just about their age and I have an above ground pool in my back yard too.”
He paused, looking down at one of his daughter’s laying on the gurney with tubes sticking out of her body. Then he said, “I’m going to take it down tomorrow.” I offered to help him.

We continued the litany of things to do. Rechecking the lungs, I.V.’s, medications and EKG. It was when we checked the pupils that our hearts dropped. Both of her pupils were fixed and dilated. We knew our little girl was brain dead and that she was gone.
I stared down at that pretty little face, at the eyes and the big black pupils that didn’t stare back. I silently asked God, any God, to please let this little innocent child into heaven, or any place where she could sing and laugh and play. “You wanted her, for whatever reason, so now you take care of her!”
I felt the ambulance stop. Doctor’s and nurse’s flung the doors open and the relative quiet of our office was turned into voice’s everywhere: Questions, orders, movement and teamwork. We wheeled the gurney into the trauma room and lifted the little body over to the hospital gurney as a report was given to the doctor. I said another silent prayer and headed outside for a smoke.
My ambulance pulled up and the mother was helped out and guided into the Emergency Room’s sound proofed Quiet room.  That’s where she would sit, waiting to hear that she could go home with her daughters; that everything was Ok and the mere seconds it took to turn perfection into unthinkable pain…never happened. Wake-up, you were having a nightmare.
The ambulance with the second girl arrived. As she was wheeled inside, one of the medics’s looked at me and gave a slight shake of the head. Not good.
I wandered into the trauma room every few minutes until I heard the doctor say, “Ok folks, that’s it, thank you everyone, are the parents here?”
A nurse said something about the father being away on a camping trip but the mother was waiting. Nurses quietly cleaned up the child’s body and the doctor headed toward the quiet room.
Everyone else scattered. No one wanted to hear the cry of anguish that we knew was coming-the cry that couldn’t be contained by soundproof walls.
We were getting into our ambulance to leave when a lady hurriedly walked up to me and asked, “The little girls, the girls you just brought in, how are they?”
I must have looked down at the ground to avoid eye contact because she stiffened and put her hands over her mouth.
I said, “She’s inside Ma’m. Why don’t you…”?
She cut me off saying, “They’re dead aren’t they”. 
It was a statement not a question. She was looking at our eyes and she knew. What the hell can you say but “Yes Ma’m.”
Her eyes filled with tears. She reached out and touched my arm and looked deeper into my eyes than I wanted her to. I felt her squeeze my arm slightly, and then she disappeared into the Emergency Room.
When she touched my arm and looked at me, it was as if she was telling me that she was sorry for us. It was too much emotion for me. I was letting myself think about what just happened too much for having twelve hours to go before the end of my shift. I took a huge hit on my cigarette, threw it on the ground and got into the ambulance.
I went home that night and casually mentioned to my dad and brother that we had lost two girls that day. They shook their heads and gave a “that’s too bad” look. It’s hard to explain to people who haven’t experienced a lot of death, many times on a daily basis, just what your day was like. How did it go at the office honey? So usually you just keep it to yourself.
Four days later the phone at my house rang. When I answered it my heart stopped. It was the father of the two little girls. He started the conversation by telling me point blank, “Mike, I just want you to know that there was nothing more you could have done to try and save my girls, not gotten there faster, not tried harder. God wanted them and that’s that.”
“You and everyone else did all you could do. Don’t ever doubt that.”
He had been camping that week and told me about the last time he saw his two daughters. He said the reason he was telling me this was because he needed to know about the last few moments of his daughters’ lives. 
“I want to know mike, I need to know.  Please, tell me.”  I put myself in his shoes for a moment, desperately needing to make sense of the senseless.
So, I sat down and for the next hour we relived that day together. It was one of the toughest hours of my life.
I didn’t know it but throughout the phone call my father was standing behind me, listening. As I hung up the phone I began crying like I’ve only done a few times in my life. I sat hunched over with my head in my hands. My dad came over to me and put his arms around me. He knew. He lost a daughter, my sister, when she was five years old. He had carried the small white coffin down the church isle himself. He knew.
I never heard anything else from, or about, the man and woman who lost their two girls’ that day. I’m not sure I wanted to. I was a veteran of death but those two or three hours took something out of me.
I can only imagine what it was like for them. I hope that it didn’t tear them apart. I hope they have both found happiness. I hope they have been able to cope with the loss-the loss of two little angels.   

Copyright Mike Cyra 2011