Things you don't forget in EMS(Motions)

Going through the motions

It was the middle of the night when we were dispatched to a pedestrian struck in the middle of a four-lane road downtown. While we were en route, we were told the person struck had been in a wheelchair. When we arrived, the scene told the story immediately. The person was lying in the roadway, not moving. There was no pulse, no respirations, and the injuries were catastrophic. Parts of the body were positioned in ways they simply aren’t meant to be. It was clear to everyone on scene that this person was not alive. We covered them with a sheet and waited for law enforcement.

A second unit arrived shortly after to see if anything else was needed. Around the same time, a local late-night news cameraman arrived and positioned himself along the edge of the scene, his light cutting through the darkness. He was a familiar face on late-night calls — professional, respectful, and always willing to help. That night, as he did for many others, he provided extra light on the scene and even grabbed equipment from our units so we could stay focused on our work. He knew when to stay back and when to quietly step in without ever getting in the way. The younger medic on the second unit asked if a cardiac monitor had been placed on the patient. It hadn’t been. In cases like this, it isn’t needed to determine death. The injuries alone made that decision unmistakable. Still, the medic insisted. The monitor was brought out and applied. The screen showed pulseless electrical activity — electrical activity without a heartbeat. Technically, something was still firing. Practically, nothing was happening. The medic contacted the hospital, explaining the apparent injuries, the lack of signs of life, and asking for orders to terminate any resuscitative effort. We were told to work the patient. 

There was no arguing it. With a camera light still cutting through the darkness nearby, we removed the sheet and began resuscitation efforts that everyone on scene knew would be futile. Nothing changed. At the hospital, the patient was formally pronounced deceased.

That call stayed with me, not because of what we did, but because of what it showed me early on. Sometimes in EMS, everyone already knows the outcome. The scene is clear. The injuries are apparent. The answer is right in front of you. But the system still makes you ask the question. And sometimes, even when the answer is already written, you still have to go through the motions — not for the patient, but for the process.

Years later, that same cameraman would lose his life after being struck by a vehicle while working an accident scene. He was a good man to have beside you in the dark.