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“Rescue 3 and Engine 11, Respond to 673 Carter Street for a woman not breathing.”

“Looks like the doctor’s going to have to wait,” I said to Ryan as I keyed the mike.

Rescue 1, clear of the detail, responding to Carter.”

“Roger Rescue 1, at 0945.”

First day back after three days off, third call in a little over two hours. That’s just the way it goes. An emergency medicine resident from Rhode Island Hospital was scheduled to ride along with Rescue 1 for the shift, we had been trying to connect all morning.

“Engine 11 to Fire Alarm, code 99.”

“Received, Engine 11, Rescue 1?”

“Message received.”

It was Ryan’s second week on the rescue after six months in the acadamy and another six at Atwells Ave, training with Engine 14 and Ladder 6. This would be his first code.

“Rescue 1, on scene.”

“Engine 11 to fire alarm, send a ladder company for assistance.”

Ryan and I exchanged glances. A ladder company at a code 99 meant only one thing.

A large woman was preparing to get on a handicap equipped bus when she went into cardiac arrest. She only made it to her doorway. She fell from her wheelchair blocking entrance to her home. Her daughter and the driver of the bus stood by, waiting for help. She had been down for about five minutes before we arrived. I checked for a pulse, knowing there would be none. She wasn’t breathing. Her daughter screamed, the bus driver waited.

“Start CPR.” I said, as I knelt at the doorway. One of the guys from Engine 11 jumped over my back, and over the four-hundred pound patient and into the hallway. He started compressions after Ryan had assembled the bag-valve device and began bagging. I tried to reposition the patient as her daughter tired of screaming and began to sob. Somebody handed me the monitor, I applied the pads in position.

“Stop CPR.”

The sporadic fluctuations in the ekg stopped, and a flat line appeared. In a dull monotone the machine told us what we already knew.

“No shock advised, continue CPR.”

The officer of Engine 11 brought a backboard from the rescue and we attempted to maneuver it under the patient. A lift here, a tug there, some pulling and pushing and we finally were successful. We strapped her down. Ladder 5 arrived. The Army, Navy, Air Force and Marines could have shown up but the same situation remained, a big lady was stuck in a doorway. We had her on a board, of which there are only two ends, and no room in between. I was at the head.

“On three. One, Two, Three.”

We got her up. I backed out of the doorway, three people on either side helped carry her to the Rescue while two others continued CPR. Air flow was terrible, but the best we could do. Three IV attempts in the doorway failed. The bigger the patient the more difficult to treat, I’ve learned.

I wish I could say the adrenaline masked the pain in my back, but after nearly twenty years, adrenaline is in short supply. Every bump in the road toward Rhode Island Hospital felt like the Grand Canyon.

I gave Ryan my seat, feeling bad that his first intubation attempt was doomed to failure, but wanting to give him the experience in a difficult situation. If he was nervous, it didn’t show, he tried, and tried some more but ultimately failed. Somebody got an IV, Renato I think, as we pulled into the hospital lot. I hobbled out of the truck, the crew did their thing, I gave the report to the medical team that had assembled and stood back and watched. Eventually I had to sit.

I left the trauma room ten minutes later. The patient was breathing on her own, heart beating steadily.

“Are you alright?” asked Kim, the RN in charge of triage.

“I think not,” I said and began the long road to recovery.

The MRI showed five crushed discs in my lumbar spine. They are gone, and are not coming back. The back specialist that treated me, on orthopedic surgeon, reportedly the best there is advised my doctor to not release me to full duty. Ever. My doctor agreed. They neglected to consult the real expert before ending my career.

Me.

A month after the “final” diagnosis I returned to the specialist, Arthur, my Physical Therapist’s report in hand. “Full flexibility without pain, improved strength, overall  prognosis good…”

I feel great, all things considered. I’m forty-seven, been lifting heavy things and people for a long time.

“I’m the one who’s going to die when it’s time for me to die . So let me live my life, the way I want to.”  Jimi Hendrix, If Six was Nine

Never quit, because you never know when the heart will stop beating. Or begin again.

I’ll be back to full duty in two weeks.