Growing Up EMT

Cynthia was a person to me for two hours. She was a story for many months. She was a memory for the rest of my lifetime.

One day, years from now, my sister’s kids will ask me to get down the bin of stuffed animals in the guest room closet where I keep all of their toys for visits like this. Of course, I will oblige because they are my nieces and nephew and they are very persistent, actually, they must have got that from their mother. So I will hand the eldest of the three this very big bin of stuffed animals that I haven’t touched since I moved out of my parents’ house. My nieces and nephew will tear through their bounty with the grace of a pack of wolves. I’ll probably be amused. I’ll probably make for the door because I have some things to do around the house. A question will stop me in my tracks.

“Who’s Cynthia?”

I will turn, the smile dissolving from my lips. I will see the eldest girl and the crimson heart she’s holding in her hands. The heart’s two Velcro arms are still tied behind its back, presenting her name in white script without shame: Cynthia 7-26-18. It’s not a toy, but it must have gotten mixed up with them when I moved out. I will think, With today’s schools, thank God this girl’s literate. I will think, Do I have time to answer honestly?

I will sigh, not because my sister’s kids are irritating like every other kid I know, but because it’s a long history to recount. I will sit on the edge of the guest bed. Fold my hands in my lap and check the clock on the wall. I’d better get this out of the way before their dad comes back and accuses me of scaring them with my “unorthodox” stories. So I will have them gather around, in my arms, at my feet, by my sides, and this is what I will tell them:

Cynthia is a funny story, actually, because I never wrote her down. She wasn’t like Steven, Harry, Betty, Jane, Dennis, or Allen. Cynthia was different. She was the first life I saved.

EMS is a superstitious lot, so I should have known it was coming from the moment my shift started and I saw my crew was CJ and Lindsey. I should have known it was coming from the moment we drove to Biggby’s for our free coffee, and they were playing my favorite band over the speakers. I should have known that Life is ironic—it doesn’t always give you the dead, dying, and want-to-die. It was hard to know this, though, as my coworkers nicknamed me Death Magnet, Grim Reaper, and Angel of Death after so many suicides and cardiac arrests blighted my record. At the time, I was only two months into the job. I didn’t have a proper uniform, only the white polo that had the embroidered WAEMS Training wrapped around the Star of Life over my heart. I didn’t have a proper uniform, but I had a proper reputation. And of course, for a while, Cynthia changed this, too.

When CJ, Lindsey, and I walked through Cynthia’s front door, and the first-responders led us down a narrow staircase to the basement where she was located, my first thought was, I am not getting the stair chair out for this. Which is really a very good thought for an EMT to have—it means I was problem-solving, as stair chairs are like trying to make an origami crane: it takes too much time to set up. So while CJ was asking—well, more like shouting because Cynthia was half-asleep—questions like, “How many pills did you take?” and “What pills did you take, Cynthia? Cynthia?” I was searching for an alternate exit that had nothing to do with the flight of stairs we had just come from. And I found one. It was called the back door.

Lindsey and I followed a trail from the back door to the ambulance. We unloaded the stretcher. We dragged it through mounds of dirt and overgrown grass back to our new entry point. I asked the officer to hold the door open for us, which is probably one of the only times an eighteen-year-old can tell a police officer what to do without negative consequences.

Lindsey and I lowered the stretcher. We unbuckled the straps, and we unfolded the pink sheet in preparation for Cynthia. We held the stretcher in place while CJ and the first-responders carried Cynthia’s half-asleep body to our ready-made stretcher. We bundled and buckled her up, rolled and pushed out the back door, locked the stretcher in place on the ambulance, and we left for Bronson.

It’s ironic: just before we got the call, CJ said, “I don’t want anything that will get my heart rate up,” and Lindsey said, “I don’t want anything that takes us to Kalamazoo,” and I wanted to say, “I don’t want anything that requires a medical examiner.” Only one of our wishes came true.

As an EMT, my job is to take basic vitals, such as blood pressure, heart rate, oxygen saturation, lung sounds, temperature, and blood glucose. After that, my job is to do whatever my paramedic says. I don’t remember doing these things on Cynthia, but because it’s protocol, I know I must’ve. I remember Lindsey was frustrated because the GPS was taking her through all the dirt backroads. I remember CJ was asking Cynthia a lot of questions to keep her awake. “Do you know where you are? Who’s the president? What year is it? Can you tell me your name? What kind of pills did you take again? Why did you take these pills? Cynthia, Cynthia, keep your eyes open for me.”

I remember Lindsey found paved main roads, so she wouldn’t be as frustrated anymore. I remember CJ was laughing, and I was thinking about his mom, Marilyn, and his dad, Bob, and how he must have wanted to be a paramedic because both of his parents were. I remember Cynthia was stable—her vitals weren’t terrible, her EKG wasn’t alarming. But then something shifted. CJ was sitting directly across from the monitor displaying all her vital signs, so he noticed first. To be honest, I probably wouldn’t have noticed the monitor at all because, though I read a lot of things, EKGs are not one of them.

CJ leaned forward, eyes squinting. “Wait a minute…”

Cynthia squirmed in the cot. When I looked down at her, her eyes were fixed on mine. They were terrified. And I thought, Shit, she’s going to have a seizure or something.

Except CJ was yelling and yanking the AED pads from the monitor pocket, and I was proved wrong.

“Lindsey, she’s coding!” And Lindsey was flicking the lights and sirens on, and CJ was unbuckling the strap across Cynthia’s chest. He was telling me, “Lift up her shirt,” and I was obeying, flinging that thing up so high and so hard, I’m surprised the thin fabric didn’t tear. CJ was placing the AED pads on bare skin, and my spine was straightening, arms were twitching into position because I was going to have to do CPR on someone who wasn’t made out of plastic and oh my god, I wasn’t going to let Cynthia down, even if she tried killing herself in the first place. I didn’t hear the sirens or how hard CJ and I were breathing. All I heard was the mechanical, female voice of the AED.

“Analyzing heart rhythm.”

I held my breath, as if my own exhalation would alter the AED’s reading of Cynthia’s pulse.

“Shock advised.”

And I exhaled because that was the first time I heard an AED say this in real life.

CJ yelled loud enough for even Lindsey to hear, “Clear!” And I was backing away from Cynthia’s arm, hanging over the edge of the stretcher near my knee, because I remembered Don telling me that one time, he didn’t say “Clear!” loud enough, and accidentally shocked his paramedic, Orland, too.

And CJ pressed Shock on the monitor.

Cynthia screamed like you do when you stick your hand under scorching hot water, thinking it’s actually going to be cold. Her body jolted against the remaining straps. I’d never seen the dead do this in real life either.

CJ must have told me to bag her because the next thing I remember doing was grabbing the emergency BVM from the counter and fixing it over Cynthia’s mouth and nose. I clasped my hand on her jawline. I tilted her head back a degree to open her airway. And I heard Marilyn’s voice, “Ventilate every five to six seconds.” And I saw the line in my EMT textbook, “Ventilate every 5-6 seconds.” So I did.

Under my breath I counted, “One, two, three, four, five.”

Squeeze. Repeat.

“One, two, three, four, five.”

Squeeze. Repeat.

And then she breathed. I lifted the mask from her face.

“Cynthia, do you know where you are?”

I was very still, watching her, marveling at her, thinking, I really needed this, waiting for her to respond to my question, and hoping we wouldn’t have to shock her again.

Her eyes kind of rolled in her head, and she was actually probably very pissed because we just electrocuted her heart and she felt it.

“Ambu…lance.” And she tugged her shirt down, saying something like how she was fat, why couldn’t we respect that? I wanted to laugh—I wanted to laugh because a minute ago, she was dead.

Afterwards, CJ examined the EKG reading and declared, “Yup, her heart stopped right here,” like he was trying to convince himself or me or even Lindsey. I believed CJ, but I wasn’t sure Cynthia “counted” as a save because we never did compressions—CJ was just that quick, all we had to do was one shock. I can’t say how often that happens, but I’m pretty sure “not often” is accurate enough.

When I came home that evening, my dad was more excited than my mom. I don’t know exactly why. For a long time, he would call me from across the room at family gatherings and say, “Tell so-and-so what you did at work.” So I would, even though I was tired of telling the story. I don’t think my dad was tired of listening to it. And on December 7^th, when I came home from the Christmas party with a stuffed crimson heart in my hand, my dad was more excited than my mom. For the rest of the holiday season, he would call me from across the room at family gatherings and say, “Go get that thing you got at your work’s Christmas party.” So I would, even though it meant telling the story all over again. This time, I didn’t mind. I traced the letters of her name, and I let myself remember what it felt like to watch her breathe again.

Cynthia is a funny story, actually, because she wouldn’t have meant so much without the line-up of bodies that came before her. I won’t go into detail because recalling those scenes is actually really, very difficult. Like reliving your worst failures. But they went something like this:

When Steven died, I was still a senior in high school going through my EMT training course. Logging hours in the field was part of this training, though, if I’m being honest, I didn’t think I’d encounter Death on my very first shift. For five days, I didn’t cry. For five days, all I could think about were Steven’s eyes: blue and crystalline like the sea glass my sisters and I found on the shore of Lake Huron. For a long time, they were the most intriguing eyes I had ever seen. Because Bob is a caring boss, and because I was having a difficult time adjusting, I was given the medical report Orland wrote about our patient Steven. I keep a PDF of this report on my phone for those days when I forget it wasn’t me who killed him but the twenty-six fractures and internal damage he endured from walking in front of a semi.

When Harry died, I was late for two things that evening: 1) my meeting with Bob for my official interview to get the EMT job (just because you can run calls, doesn’t mean you get hired), and 2) registering for my first round of classes at Kalamazoo College. I was late because Harry died in the back of our ambulance, which automatically meant it was a crime scene. My partners and I waited a long time for the medical examiner to arrive and take pictures for “the record.” In my head, Panic at the Disco’s line from “Roaring Twenties” was on repeat: “Roll me like a blunt, ‘cause I wanna go home.” I really couldn’t explain why that lyric was there, but it existed, right alongside the image of the boxcutter Harry used to slit his wrists.

When Betty died, she was probably alone in the hospital room where we left her. We picked her up from a nursing home. She had a DNR order, so I couldn’t help her if I wanted to. She also had a family too far away to make it in time to say their final goodbyes. On the drive to Metro Hospital, I wanted to hold her hand, but I thought maybe that was breaking some kind of rule. I wish I had said, “Rules be damned!” and held her hand anyway. I couldn’t find her carotid pulse, but she had a blood pressure, so I know she had one, it was just very faint. Her skin was clammy and leather-like; she wasn’t very responsive at all, eyes fixed elsewhere. On the drive back from Metro, Don asked, “Did that bother you?” And of course I lied, shook my head. And of course Don knew I was lying because he’s Don, and he said, “You know, if something does bother you, talk about it.” He said a lot of other things I will never forget, but in the end, all I said was, “Okay.” I didn’t want to be serious anymore; I wanted Don to tell a funny story instead.

Without the tragedies, the triumphs wouldn’t be as profound. Cynthia’s heart was a lot of things to me. It was a victory, and it was a promise that “they don’t always die.” It was a rush of adrenaline that lasted for days. It was a story I didn’t have to hide from my family and friends. It was something I could be proud of.

But if I said all of that, my sister’s kids would probably never ask me a question again. And their dad would actually have a reason to accuse me of scaring them with my “unorthodox” stories. Their mother probably would too. So I will take Cynthia’s heart from the eldest girl’s hand. I will hold the youngest child to my chest, tuck his head under my chin, and purse my lips. I will trace those letters and remember what it was like to watch Cynthia breathe again. I will take a deep breath and say something like this instead:

Growing up is learning, loving, and losing. Growing up EMT isn’t much different. It’s wishing every paramedic were as patient as Bob. It’s comparing Caleb’s laugh to fentanyl. It’s thinking, If I get into an accident down in Kalamazoo, I hope it’s CJ’s truck who responds to it. It’s composing letters to Don when things get bad. It’s drinking Jack and Coke with Lindsey in Holland. It’s committing Faith’s spontaneous speeches to memory. It’s watching hours of Tanked with Karreena between calls. It’s being afraid to let Orland down.

It’s passing the Martin exit and smiling at the billboard on the southbound side because it’s not the same one from the day Steven walked in front of a semi. It’s grabbing coffee with a firefighter named Eric and laughing about all the times you almost got lost going to the Grand Rapids hospitals. It’s singing to yourself when driving with a patient in the back because you’re actually very nervous you will crash the ambulance on the winter roads.

It’s only feeling your “true self” in plain white T-shirts because that’s what you always wear underneath your uniform. It’s hearing people screaming through your dorm walls and wondering if there’s been a domestic assault or if these screaming people are just being college students. It’s walking to your afternoon classes, hearing sirens, and longing to be on that ambulance. It’s seeing blue and red flashing lights and remembering all the times the policemen made sure your scene was safe before you entered.

It’s your youngest sister telling everyone you’re a doctor because she doesn’t understand the major difference. It’s your aunt hugging you when she finds out you never saw that dead man on the side of US131, and it’s you thinking, But I have seen other dead men on the side of US131. It’s looking at your male professors and seeing those dead men in their faces because, really, they all look the same. It’s not being able to read The Things They Carried without remembering your own Ted Lavender, and it’s getting upset when things like that happen because it’s out of your control.

It’s laughing at the time Lindsey hit a construction cone with the ambulance. It’s sitting down and researching how to donate a kidney because no thirty-four-year-old mother-of-three deserves to be on dialysis because of pre- and post-eclampsia. It’s not losing your shit when dispatch says, “CPR has been started.” It’s wearing your tragedies on your sleeve but tucking them away when you go home or to school. It’s feeling like Bruce Wayne when you’re not at the station, and it’s feeling like Batman when you are. It’s writing your way out of trauma, and when that doesn’t work, it’s having imaginary conversations with Marilyn, or having real conversations with Lindsey, or just watching a lot of Netflix.

I will hold my nephew to my chest, that crimson heart glowing with something ethereal in the sunlight coming through the thin curtains, and I will say to my sister’s kids, “Growing up is a lot of things. Saving Cynthia’s life was just one of them.”