A Distraction From The Day’s Pain

Just a gentle reminder that the world has good happenings in it, dear readers. In between mourning the dead and listening to commentators, politicians and pundits dishonor them, remind yourself that happy endings are not extinct. You just have to look for them.

“You know, it does no good to get only halfway to the scene really fast,” I remind Pardner as our wheels lose traction yet again. “They’ll have to send somebody to come get us. It is considered bad form for the paramedics to need an ambulance for themselves, remember?”

“Shit!” Pardner snarls in frustration, steering into the skid. “By the time we get there, the kid will be born, weaned and potty-trained!”

It’s mid-December, and we’re in the middle of an ice storm. Podunk Parish has come to a standstill. We normally get a bad ice storm every couple of years, but they usually happen in February, not December. Hell, two weeks ago I was still wearing shorts.

The entire parish is without power, and quite a few people are without phone service. Our station in Quaint Little Hamlet is dark and freezing cold, and since the town’s water system requires power, we have no water, either. Pardner and I have spent the last eighteen hours evacuating one wing of Decubitus Manor Nursing Home, and distributing blankets to the rest of the residents. There are tree limbs and power lines down everywhere we look.

The only wreck we’ve worked is a woman who slid her minivan off the road into a deep ditch. She and her two children were uninjured, but I got wet all the way to my crotch while standing there in the ditch and handing the kids up to Pardner. To add to my discomfort, I’ve been unable to dry my pants because the power is out all over town. My nuts are only now beginning to defrost.

We’re going to a call for a woman in labor in the Hooterville community, up near the state line. For the past thirty minutes we’ve been picking our way north through the ice and fallen pine trees at a hot five miles an hour.

“Look at it this way,” I say. “Women have delivered babies for millennia without the help of an EMT. She’ll probably be fine.”

Pardner just snorts and rolls his eyes. “Transport is gonna be a bitch,” he points out. “We have less than half a tank of fuel, and at the rate we’re going, the trip to Big City will take two hours. We’ll be lucky to make it on the fuel we have.”

I hadn’t thought of that. The gas stations are all without power, as is the bulk fuel plant. The only gas stations likely to be open are forty miles away, which might as well be four hundred miles with the current road conditions. This could indeed be a problem.

“Oh shit,” Pardner groans. “This is a problem.” He’s looking at a large pine limb lying across the road, it’s needles encased in a thick crust of ice.

“Maybe we could move it,” I suggest. “It might not be as heavy as it looks.” Pardner rolls his eyes at that assessment, but puts the rig in park and gets out.

Me and my big mouth. Damn, it’s cold out here! That limb looks a helluva lot bigger now that I’m out of the rig, too.

“Well, it’s not going to move itself,” he shrugs. “You get that end, and let’s see if we can pull it off to one side.” Predictably, I’m on the heavy end. Sighing, I grab a couple of sturdy branches and struggle to pivot the limb far enough that we can squeeze the rig past. By the time we’re through, my back is aching and my hands are scraped raw, and I’ve managed to slip down and bang my left knee. We manage to move the limb about three feet however, and Pardner wants to try squeezing past.

“Spot for me while I try it,” he says, heading for the rig. I grab his arm, stopping him. “Uh uh, Pardner. You EMT, me paramedic. Plus, I’m still soaking wet. You spot while I drive.” He gives me a look that would curdle milk, but moves around to the passenger side of the rig.

“Ready when you are, asshole!” he yells. “I’m freezing out here!” Grinning, I inch the rig forward. I can hear the branches scraping against the passenger side, and the wheels bump over something big, but I make it past. Before Pardner can climb in the passenger side, I hit the door locks.

“Hey Goddamnit!” he yells, banging on the window. “Quit kidding around! It’s twelve degrees out here!”

I give him an evil grin and pretend I can’t hear him. “What was that?” I yell back, cupping my hand next to my ear. “I can’t hear you with the heater going full blast like this!”

Pardner just continues beating on the door. “Open up, asshole! This ain’t funny any more!”

Nonsense. It’s fucking hilarious. And you stood up on the road shoulder while I froze my nuts in that ditch, remember?

“Excuse me?” I ask. “What did you say? All I heard was ‘asshole’ over the heater…”

“Okay, please let me in,” he pleads. Chuckling, I unlock the doors and he scrambles into the rig, glaring at me and holding his hands in front of the heater vents.

Five minutes later, we pull up in front of the house. I try to pull the rig up the steep dirt driveway, and nearly wind up sliding into the ditch. “How about we leave the rig parked on the road?” I ask Pardner sheepishly.

“Yeah, why don’t we,” he retorts. “Unless you want to hike all the way back to town.” We gather our gear and carefully make our way up the driveway, slipping and sliding on the frozen ground. The house is dark, but there is smoke coming from the chimney. Pardner knocks on the door with his flashlight. “Podunk Ambulance!” he calls, then opens the door.

A woman is sitting in a recliner near the fireplace, telephone pressed to her ear. Her face is glistening with sweat, despite the chill in the house. The only illumination in the room comes from the fireplace and a few candles.

“They’re here,” she groans gratefully into the phone, then hangs up. She manages a tired smile. “That was your dispatcher. We were beginning to think you weren’t going to be able to make it up here.”

“The roads are really bad,” Pardner says apologetically. “Plus, once we get north of town, our communications get real spotty. One of the towers must be down. How far along are you, ma’am?”

“Eight months,” the woman answers. “I’m not due until January fourth. Oooooohhh crap, here comes another one!” she groans, gritting her teeth.

I check my watch. “Has your water broken?” I ask. “About an hour ago,” she nods, panting through her contraction. “At first I thought I had wet myself. I called right after that.” She visibly relaxes as the contraction eases. I check my watch again.

“You didn’t realize it was your water breaking?” I ask, curious. “And where is your husband?”

“He works on an offshore rig,” she tells us. “He comes back in on the seventeenth. And this is my first pregnancy,” she explains.

Well, that’s a relief. She may be in labor for quite some time. Her contractions are only fifteen seconds in duration.

“Any complications with your pregnancy?” I ask as Pardner checks her blood pressure. She shakes her head. “My blood pressure was a little high at my last visit, but my doctor wasn’t too worried. I was working until two weeks ago. He said to just take it easy for a while, that it woul
d be better if I didn’t work.”

“Her pressure is 150/84,” Pardner tells me. “Pulse is 116.”

“Still high,” the woman says, shaking her head. “Do you think this will hurt my baby?”

“It shouldn’t,” I smile reassuringly. “All the same though, a dark, cold house is no place to have a baby a month early, so why don’t we get on our way to the hospital?”

“I hope Big City Memorial is your hospital,” Pardner grins, “because anywhere else is probably going to add another hour to the trip.”

“Actually, it’s St. Sanctimonious, but right now the closest place that has lights and heat is fine with me,” the woman says as we help her out of the recliner. “I think my doctor goes to Big City Memorial as well, anyway.”

“Normally, we wouldn’t ask the pregnant lady to walk to the rig,” Pardner chuckles as we walk her to the door, “but considering the conditions, a stretcher ride down your driveway may be more excitement than you bargained for.” The woman laughs and walks gingerly between us, holding onto our arms.

It is bitterly cold outside, and the lawn and driveway are coated in ice, but we make it to the rig without any embarrassing slips. I climb into the back and help her aboard, and Pardner closes the door behind us. I apply oxygen and wrap a tourniquet around the woman’s arm. “Ma’am, I’m going to start an IV on you and give you some fluid,” I inform her as I spike a bag of saline.

“My name is Kate,” she grunts, then doubles over and grabs my knee. “Here comes another one!” she announces as she unconsciously digs her nails into my thigh. I check my watch yet again.

Just under ten minutes since the last contraction. Not too bad. We may even make it to the hospital before she squirts this kid out on the cot. Of course, if she doesn’t let go of my leg soon, I’m going to have a baby.

I wait until she’s through panting and gently detach her fingers from my leg. “Sorry about that,” she apologizes. “That was a hard one.”

“No problem Kate,” I lie as I insert a 16-gauge catheter. She’s got those great veins common in pregnant women. They stand out like ropes. “So what are you having? Boy or girl?”

“It’s a boy,” she announces proudly. “My husband carries the ultrasound picture in his wallet.”

“Well, if you haven’t decided on a name,” I grin at her as I open up the line, “Ambulance Driver is a good name. It means ‘warrior’ in Gaelic.”

“Sorry AD,” she laughs, “but we’re looking for something less generic. We’ve already decided to name him Bryce Daniel. Listen, with my pressure as high as it is, should I be getting all this fluid?”

“Well, your pressure is high, but it’s not high, if you know what I mean,” I assure her. “The amount I’m giving you shouldn’t make that much of a difference. I’m trying to slow down your contractions.”

“How does it do that?” she wants to know.

“I trick your body into thinking it has too much fluid, and it stops producing certain hormones,” I explain. “One of them is a twin sister to the hormone that stimulates uterine contractions. They come from the same gland. Sometimes this works.”

She nods and leans back on the stretcher, closing her eyes. I have nothing else to do, so I amuse myself by trying to hear fetal heart tones. It takes some listening, but I eventually hear a heartbeat over the sound of the engine. The rate is fine, about 140 or so. I sit back and watch the road pass slowly beneath us as Pardner creeps back toward town.

Kate has several more contractions, and I encourage her to breathe but to avoid pushing. I feel the ambulance make a slow left turn and look up to see the darkened windows of the shops along Main Street in Quaint Little Hamlet. Thirty minutes have passed, and Kate’s contractions are now six minutes apart. I’ve given her a 500 milliliter bolus, and I’m not comfortable giving her any more.

“Hey Pardner, can we step it up a little?” I ask hopefully, sticking my head through the window into the cab.

He shakes his head ruefully. “No way, man. The tire chains aren’t giving us that much traction. Any faster than this, and I start sliding around.”

“We may wind up delivering this baby before we get there,” I tell him quietly. “The trip to Big City may take an hour and a half.”

“Want me to divert to Podunk General?” he asks. “I got through on the radio a little while ago. They’ve got road crews out spreading salt and clearing trees off the road between here and Podunk.”

“What are they going to do that we can’t?” I point out. “Go through Podunk just the same, though. Don’t take any of your shortcuts. Those back roads will be the last to get cleared.”

Pardner nods and says hopefully, “Maybe the main highways will be in better shape than this. I might be able to make up some time.”

I pull my head back through the window and check my watch again. We’ve made ten miles in slightly less than forty minutes, and we have another 45 miles to go. I’m starting to get a bad feeling. There is nothing to do but sit in frustration and check vital signs. Kate’s labor seems to be progressing normally, but I’m not thrilled about delivering a 36- week preemie in the back of my rig in the middle of nowhere.

Thirty-five minutes later, we’re entering the outskirts of Podunk. The roads are clearer here, and Pardner takes the opportunity to put the hammer down, accelerating us to a whopping thirty miles an hour. We’ve passed a number of utility company and highway crews, busy trying to clear the roads of fallen trees and restore power. With the exception of the hospital and Podunk Ambulance headquarters, most of the town is still in the dark.

“Uh, how much longer is it going to take?” Kate asks, grunting as another contraction hits. They’re four minutes apart now.

“Just passing through podunk, and the roads are getting better,” I say brightly, trying to be reassuring. I am not very convincing.

Thirty more miles, and another hour at this speed. We’re not going to make it.

“We’re not going to make it,” Kate echoes my thoughts. Tears form in her eyes as she asks me fearfully, “I’m gonna deliver before we get there, aren’t I?”

“Probably,” I answer honestly. “But every mile we go is another mile closer to the hospital. Try not to worry.”

“Please tell me you know what you’re doing!” Kate pants, grabbing my hand.

“Lawdy Miss Scahlett, I don’t know nuthin ’bout birthin‘ no babies!” I say in my best imitation of Butterfly McQueen.

“That’s not fuuunnnneeeee!” she half-cries, half-laughs as the contraction peaks and begins to subside.

Damn. That was forty seconds by my watch. Not good.

I get the obstetrical kit from the shelf and open it, spreading its contents out on the bench seat. “Okay Kate,” I direct, “let’s get ready, just in case. Lift up your hips.”

She elevates her hips and I quickly pull down her underwear and slide an absorbent pad and a pillow under her buttocks. There is no crowning yet, thank God. I quickly drape her legs and abdomen and lay the receiving blanket and stocking cap on the seat. I’m ready to go, except for the sterile gloves. There is nothing to do now but wait. I occasionally peek under the drapes to look for crowning.

I look up to see Pardner’s eyes in the rearview mirror
. He’s been watching. He says nothing, but I can hear the engine change pitch and feel the acceleration as the rig picks up speed. “Good roads south of town,” he calls out reassuringly. “They’re practically clear.” I nod my thanks.

Thirty minutes later, Kate’s contractions are less than two minutes apart, and close to a minute in duration. I lift up the drape to look, and immediately wish I hadn’t. I see baby hair.

Well, at least it’s not a baby’s butt. Look on the bright side.

I look out the windows to see that we’re entering the outskirts of Big City. The Medical Center is less than ten miles away, but right now it might as well be ten thousand. I sigh.

“Pardner, find a good place to pull it over!” I call out. “We’re not gonna make it!” I can hear him cursing to himself, but I can’t quite make out the words. Another minute passes, and I feel the truck turn to the right and come to a stop. Presently, the rear doors spring open and he clambers into the back. We’re parked at a convenience store just outside town. It doesn’t have power, either.

“What do you need?” Pardner asks uncertainly.

“First, squeeze past me and get into the jump seat,” I order. “Switch her oxygen to a non-rebreather mask, and get the Pitocin out of the drug box. Other than that, just hand me stuff when I need it.”

I scoot down to the end of the bench seat and kneel on the floor next to the cot. “You ready, Kate?” I call out. “When the next contraction starts, you can push, okay?” She just nods her head and grunts. I don’t have to wait long.

“Aaaaaaahhhhhhh shit!” Kate screams, grabbing Pardner’s hand in a vice grip. His face goes pale and he shoots me a dirty look. Kate screams through her contraction as I encourage her to keep pushing. The baby’s head comes tantalizingly close to delivering, then recedes like a turtle withdrawing into its shell.

“Next contraction, Kate, and we’ll be in good shape. Now puuuuuuuuusssh!” I find myself unconsciously pushing with her, and a tiny little fart slips out. Nothing horrendous, mind you, but just enough to make its presence known. I pray that nobody will notice.

“Ooooooohhhhhhhh God!” Kate screams, and all at once, the baby’s head pops out. He looks like a little blue Shar Pei with a cone-shaped head.

“Bulb syringe,” I order curtly, and Pardner smacks it into my palm. I suction the baby’s mouth and nose, noting that his airway is agreeably clear of fluid.

“Okay Kate, there’s the head! You’re doing great! One more big push and we’re done, okay?” She complies, grunting and swearing like a sailor, and the baby turns slightly and the upper shoulder delivers. Kate relaxes, sobbing in relief.

“Uh, Kate?” I say. “I lied. Make that one more big push, and we’re done!”

“That’s what you fucking said the last time!” she snaps. “And what’s with this ‘we’ shit?” Nevertheless, she strains mightily and the baby immediately pops out into my hands.

“Towel,” I tell Pardner, then look up at Kate, grinning. “You did it, sister! One big, baby boy! Congratulations!” I take the towel from Pardner and vigorously dry the little boy off, and am immediately rewarded by an irritated wail. His color improves rapidly, like someone swiped him with a pink paintbrush.

I jerk my head at Pardner. “Slide down here for a minute.” Once he does, I nod my head at the umbilical cord clamps and sterile scissors lying on the seat. “Clamp and cut the cord,” I direct, pointing at where the clamps should go.

He grins and clamps the cord while I hold the baby. A few spatters of blood hit me on the neck as he cuts the cord, but I don’t mind. I finish wrapping the baby in the receiving blanket, and put a stocking cap on his head. “Hey Kate,” I say quietly. She is lying back on the stretcher, exhausted, but she opens her eyes when I call her name. “I present to you Bryce Daniel…what is your last name anyway?”

“McMillan,” she laughs, taking him from me. “Bryce Daniel McMillan. We named him Bryce after my grandfather, and Daniel after my husband’s grandfather.” Glowing, she looks quietly at her son as he squirms and wails.

“Uh, that all you need me for?” Pardner asks gruffly. If I didn’t know better, I’d say those were tears in his eyes.

“Yeah sure, tough guy.” I tell him wryly. “Get us back on the road. We still have a ways to go.”