Sunday, April 18, 2010

his name

A fifty year old man has died after a fire at a sheltered housing block.

The man sustained serious burns when the fire broke out in his fourth floor flat in the early hours of yesterday morning. He was pulled from the flat by fire crews, treated at the scene by paramedics and taken to the local hospital, but died from his injuries a few hours later.

Police and fire investigation teams are working at the scene to determine the cause of the blaze.


***

The long and narrow car park of the block is crowded with fire trucks and police cars, the blue flashes of all the lighting racks skimming around the steep sides of the scene, making the building windows seem to flicker and move.

We park as near as possible on the street.
‘I think I’ll put the old yellow jacket on,’ says Frank.
I grab the resus and obs bags out of the back, but for some reason I don’t go all the way inside and get my jacket.

We’re half way to the heart of the scene when we see a firefighter high up on a cherry picker put in a window with an axe and then lean back as a great coil of black smoke rushes past him out through the jagged hole and away up the face of the building. Despite being perched high up on the white metal platform, every detail of his breathing apparatus, the heavy jacket and boots, the grip of his gloves on the shaft of the axe – the smallest detail is caught in sharp relief by the emergency scene lighting.

I have a change of heart.
‘This looks bad,’ I say to Frank. ‘I gonna nip back for my jacket and some more stuff. Won’t be a minute.’

Back at the truck I hurriedly put my jacket on and then grab the burns kit, carry chair and a couple of blankets.

I pick my way across a maze of swollen hoses that run out across the tarmac. A torrent of water gushes from underneath one fire truck. Fire crews are tightening up breathing gear and passing ahead of me into the lobby and on into the upper reaches of the building. Police officers talk urgently into radios, or lead residents hunched over and coughing through the melee and out onto the patio on the other side of the building.

A fire officer in a chequered tabard waves to me.

‘In the lobby, mate.’
‘How many patients so far?’
‘One coming down. Nothing else so far.’
‘We’ve got more ambulances en route.’
‘Excellent.’

I hurry into the lobby.

The last time I was here I was picking up a resident who’d fallen down drunk in front of the inner set of doors. Apart from the drunk and the warden kneeling alongside him, the lobby had been deserted. Rows of brand new, pressed-wood chairs quietly arranged along the walls, magazines of local interest lined up on the table tops, even the clay bead dressing of the potted plants seemed counted out and perfect. The warden had been so clipped he could have been shaken from the pages of a brochure.

But now the lobby is utterly transformed. Water slops around the laminate flooring. The air smells cool but tainted, drawn down low in a mist of grey and black, like something caught on the stove in a flooded kitchen. Back outside, the roar of the diesel engines rises and falls as the demand constantly changes for water pressure. Then I see Frank. He is standing over the blackened figure of a man on the floor supported from behind in a seating position by a fireman who holds an oxygen mask to his face. Another fireman stands in front of them, dousing the man with a fine spray.
‘Hey guys,’ I say, unzipping the burns kit. My hands shake as I pull some shears out of my pocket and rip open a large burns blanket. Frank has already cut away what he can of the man’s clothes; what’s left are pendant strips of scorched cloth and flesh. His burns are so extensive it’s hard to know where to begin. His abdomen seems to have split vertically above and below the navel, a mottled layer of fat extruding along the line. The man is conscious, but his only response is to follow us with his eyes. Around his nose and mouth the skin is blackened by the smoke he has breathed in, but other than that his face seems untouched by the fire.
I tuck the burns blanket the length of his body and up round his neck, then immediately fish around for any other burns dressings I can find. I use a couple of face dressings on each thigh. Frank has the chair open and ready to go.
‘On three … ‘
We lift him onto the chair with the firemen.
Another crew arrive in the lobby.
‘Any others?’
‘Just this one so far. Can you take the equipment?’
‘Yep.’
They carry the bags as we hurry outside. It’s an obstacle course of hoses and trucks. In our haste to get back to the vehicle we roughly manhandle the chair, but the patient stays strapped in position, utterly passive. He doesn’t appear to be in any pain, though. He breathes regularly through the oxygen mask and his eyes follow his own progress with ominous detachment.

At the vehicle Frank puts the lift down and we load up. We transfer him onto the trolley. He seems fixed in a seated position, his legs crooked at ninety degrees and his arms held stiffly along by his side. We don’t even bother to fold the chair away; we kick it to one side into the stairwell.
‘Good to go?’
‘Yep.’
As Frank climbs out to take us off, and I give the man a nebuliser. When he’s breathing that, I tip a bottle of saline over the areas of his lower legs that I couldn’t cover with burns sheets. I look for some cling film but can’t find any. The ambulance is filled with a cloying mixture of tea tree oil and burned flesh. As it rocks violently from side to side I put my face near to the man’s ear.
‘What’s your name?’ I shout.
He tries to speak.
I pull the mask a little away from his mouth.
‘What?’
He looks up into my eyes and his voice when it comes is rasping and faint.
‘Pe-ter.’
I replace the mask.
‘Peter – my name’s Spence. We’ll be at the hospital before you know it, okay? Just hang in there, mate.’
I touch him gently on the shoulder as we scream away along the road. I try to estimate the burn area. It has to be in the nineties. His eyes stare out over the mouthpiece of the mask, grey and glistening.
The hospital is just two minutes from here.
‘Almost there,’ I say into his ear. ‘Almost there.’

At the resus room a team of medics is there to meet us. The shock on their faces as we bring him alongside their bed is unmistakeable. As we slide him across on the sheet I shout out what I know, his name, what we’ve done. It isn’t much.
‘I used as many burns sheets as we had,’ I tell the consultant.
‘Good boy,’ he says. ‘Well done.’

The team closes around him as we withdraw with our filthy trolley.

He lives another two hours.

23 comments:

rheumablog said...

What a nightmare, Spence. That poor man.

I once rode along in the back of a U.S. military ambulance with a young man who'd been horribly burned in an accident during an Army exercise. He was being taken to a hospital plane for transfer back to the U.S. from Germany, where he'd be receiving treatment and rehab for his burns. As a writer/editor for Army public affairs, I'd been assigned to interview him on the way, and then write up the interview for publication in the post newspaper.

He'd suffered burns over 60 percent of his body. 22 years old. He'd joined the Army after marrying his pregnant girlfriend so he'd have a way to support her and his baby; they'd remained in the U.S. He'd been in Germany less than six months when the accident happened. He had no idea what he'd do once he was well; the doctor I'd spoken to told me that his survival was not assured, but they were doing all they could for him.

I honestly didn't know what to say to this terribly injured young man as we rode along toward the airport. I felt as if I was intruding, badly, into the most private part of his life. He had little to say. In the end, I wished him luck and watched as they trundled him off to the plane. Took some photos, not showing his face.

When I went back to the Army post, I found I couldn't write much about him, so ended up mainly writing about his care and the burn center he would be treated at, and how the Army would take care of him. His personal feelings ... no. I hadn't been able to bring myself to ask the usual questions: How did it happen? What was it like? How do you feel? What will you do?

My boss decided it would be best not to publish the story at all. I was glad. And I've often wondered in the years since if he survived, and if so, how his life turned out. It seemed to me like a stunningly unfair tragedy.

I'm sure that this incident you wrote about so beautiful has affected you deeply. You must have felt so helpless, faced with such terrible wounds. My heart goes out to you.
-Wren

Rach said...

Wow!! Spence, how very sad!! x

terrierandy7.com said...

"My hands shake..." >>> I love your honesty, Spence.

Many people have asked me about all the 'exciting' jobs I did as a medic. If only they knew that we always dread the 'exciting', crave only the mundane.

Thanks for sharing, Spence.

Baglady said...

That's just awful. God, what a way to go.

Thanks for sharing Spence.

Spence Kennedy said...

Wren - That sounds a tough assignment you were given there. The fact that he was so young, too. Horrible. I think burns are particularly nightmarish - difficult to treat, difficult to recover from.

I was very affected by Peter's injuries. Even though I've had very limited experience of serious burns, I knew that he couldn't possibly survive them. Frankly I was amazed he could speak at all. The fact that he was able to tell me his name was incredible. I knew that when he got to A&E he'd get the best care possible, that they'd take care of any pain he was in. All in all an awful job (in fact that particular shift had it's fair share of difficult cases...) x

Rach & Baglady - Thanks for that :)

TerrierAndy7 - I'm with you on that! We've got our fair share of trauma queens on base, and I'm glad to say I'm not one of them!

By the way - I really meant to dedicate that piece to the fire crews. What a brilliant job they did that night! We're just kicking around in the lobby, whilst they're striding into the building, into the smoke and flames, pulling people out. Amazing!

ViatorT said...

'contrary describes something that contradicts a proposition, converse is used when the elements of a proposition are reversed, opposite pertains to that which is diametrically opposed to a proposition, and reverse can mean each of those'

Alive while well and truly dead ...a tough one spence!

VT

Spence Kennedy said...

VT - Hmm!

Well - I've been to lots of fatal illnesses and a few suicides, but nothing like that. It shook me up.

Henry said...

Spence, yet another cracking post. It's really odd reading your stuff sometimes. We're there with you as readers - pearched on your shoulder, watching. It's really vivid in my head!

What a tough case. What a way to go.

(And I've all this to look forward to... or perhaps not in this situation.)

Silje said...

Beautiful, honest writing. I really don’t know how you guys do your job, and I really admire and thank you for it.

Spence Kennedy said...

Henry - Cheers mate!

Yeah - pretty dreadful circumstances for the guy. The only comfort is that the whole event would have overwhelmed his senses, so I'm sure that even though his injuries were grievous, he wouldn't have felt much.

Luckily, these big trauma jobs don't come along that often (although I've probably jinxed my next shift by saying that) :/

Thanks Silje!

Sometimes I wonder about the job, too. But I suppose it's like anything else, you take the good with the bad.

Wayne Conrad said...

Spence, When you relive the moment in the writing, I live it in the reading. Your writing is always interesting, sometimes exciting, sometimes melancholy. Here it tightens my throat and makes it hard to speak. I can't imagine what it takes to do your job at those times, and I marvel that you have the courage and strength to relate it to us so honestly. Thank you.

lulu's missives said...

Hello Spence,
Well that sort of puts my problem into perspective.
Burns are so brutal. Painful in every way.
I would be affected too.
It takes a strong person to be able to aid someone in that situation.
How do you unwind and let go?
x jo

Spence Kennedy said...

Thanks a lot, Wayne.

It is a strange job in many ways. You go from job to job to job, and though you quickly learn to have low expectations - so many are given as screaming Cat A emergencies but turn out to be nothing of the kind - now and again a job turns into something awful (but thankfully not that often). A bit like fishing - if you keep putting your rod in the water, eventually you'll come up with something other than a boot. :/

I do try to be as honest as I can, whilst respecting privacy. I've been writing the blog for 3 years now, and it feels as if for 3 years I've been getting away with it. I don't doubt that if management ever read it I'd be out on my ear. But maybe that would be fate intervening and telling me it was time to go, anyway - whilst I'm still sane...

Hey Jo

Are you home yet?
Got, what an ash-up this has been.
I hope you're okay and bearing up under the strain. The Navy have set sail, so don't worry.

Still - Miami, eh? Nice :) xx

Spence Kennedy said...

Oh - sorry Jo. I didn't answer your question! (That's what comes of replying to comments with the music on too loud)

I must admit I don't feel strong (emotionally). But I do feel like I want to help out when something's happened. I like the fact that if someone's stuck in the bath or stuffed down in a cellar me and my leetle friends can get them out.

How do I unwind?
Family & Friends
Dogs
Music - listening & playing
Alcohol
Films
Swimming
Art
Alcohol (did I say that already?)
Sleeeeeeep xx

Sam said...

Spence, beautifully and sensitively written as always. I hope I never have a job similar to this.

Sam

(Formerly Ambulance Nut, Louise. Had to close the site due to issues on station. Concentrating on R&R blog now.)

lulu's missives said...

Hey Spence,
Funny man....so alcohol helps, eh?
I'm sure it does.
Sadly not stuck in miami, but stuck in Chicago with friends/family.
Not too bad considering. Was really hoping to be able to fly out tomorrow, but that is looking very unlikely.
Need to do homework still.
Everything else has been rescheduled.
xx

Spence Kennedy said...

Thanks v much Sam

Sorry to hear you had to close your site. When you say 'station issues' - I hope it wasn't anything too serious / diff for you.

As you know, I'm absolutely crap at visiting other sites / leaving comments, despite all my resolutions. But I had a look at your Scottish Adventures site just now, and I have to say your photos are breathtaking! I'm so jealous - wish I could go walking / climbing there... ;)

Jo - hope you make it back soon (with all your homework done) :/ x

Chimera said...

Bloody hell Spence! What a situation and how wonderfully you have written about it. I caught a bit of 'Trauma' the big new US TV drama series and the screen writers could well do with having a look at your work! They make it all transient, sexy, momentous and yet in reality, when seen through your eyes, the paramedics job is tough, sad, frustrating, odd, sometimes funny and always very moving. I am so sorry you had to go through that and as your first commentator says - it reminds him of seeing the war-wounded. You have really been through it. Hope all ok.
T x

Spence Kennedy said...

hey T!
I love it on shows like ER when the ambulance crew comes busting through the doors with a trolley and a team of medics hurry alongside, everyone speaking a whole bunch of acronyms really quickly. The last time I used an acronym - PPH (ante-natal thing...), the nurse asked me what the hell that was, which spoiled the effect!

That burns job was unusually bad, and the scene did have something of a war zone about it. As it turned out, there were only 2 casualties - the resident of the flat where the fire started and one other with smoke inhalation. Imagine if they'd been a number of casualties. Doesn't bear thinking about :/ x

Terri said...

A breathtaking yet heartbreaking post Mr Kennedy. I am glad that modern technology gives guys like you an outlet. I have no idea how you (and your family) would cope if you weren't able to have this cathartic avenue to wander down.
A truly sad and sorry tale, with no happy ending :(
Thankyou for your writing, there are many days when you manage to remind me just how much I have, not how little.

Spence Kennedy said...

Thanks Terri
It is fantastic that Blogger exists! An amazing tool - and free, too.
I'm typing this on a laptop in the sitting room, on a (rough) old regency table we bought from a flea market. The table dates about 1820 - I really like the idea that something from the 19th century is part of a little 21st century domestic set-up. Who'd have thought...

I wonder how things will look when my two girls are grown up. Probably some kind of virtual environment. I can't wait! (But will I be fit enough to wear the headset / take the implant?) :0) x

Crazy Nurse said...

I don't know how you guys manage to go out and deal with these kInd of situations on a regular basis. I have huge respect to ambulance crews, think they are not acknowledged enough by society.. May Peter rest in peace
xXx

Spence Kennedy said...

Thanks Crazy N - but straight back atcha! I don't know how you cope with your caseload! Respect to you times ten for that. At least with us, difficult as those psych cases often are, it's always a limited contact. But to make a productive intervention over a period of time - I don't know how you manage it!