We’re rolling past some police vehicles now. As we screech to a stop at a large, four-lane street, we’re greeted by deputies moving cones for us to pass. One of the sheriff’s SUVs has been disabled. It lies by the roadside, front pushed in. The ambulance rides into a cul-de-sac, and the driver silences our sirens as we pull towards another intersection. More officers. They wave us deeper through a small battalion of police vehicles.
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“1501, you are the second response for a GSW. You are clear to enter. Confirm response.”
The driver pauses with the radio mic in his hand and looks at me. “Did you get that?”
GSW. Gun-shot wound. More experienced responders easily cut through the static for their radio traffic. Not me. It’s my second day of training. I finish frantically scribbling response numerics into my notepad.
“Got it.” Seated behind us, the training officer looks over my shoulder to confirm. He nods his approval.
“1501 responding code three. Copy – clear to enter.” The driver finishes transmitting and locks the mic back into its slot on the center console.
I give the driver his directions. Our ambulance screams to life with its sirens howling. As we roll through concrete suburbia, my mind flits through the possibilities. Does that street cut through all the way? Is it actually safe to enter? What happened? What if it’s a mass casualty? How are we going to get them on the gurney? Can they walk? What if it’s a nothing call?
Meanwhile, the driver scans the road ahead of us. Vehicles scramble in and out of our path.
“Keep your eyes up, we’re approaching an intersection,” the training officer reminds me, not unkindly.
My head is buried in the too-small map book I have in my lap. I look up to clear my side of the intersection, before barking over the yelp of our sirens, “Clear right!”
“Thank you!” The driver takes it in stride.
Back down to the map book. Head on a swivel. Check route options and alternatives. Look up – another five hundred feet to the next intersection. What supplies would we need on the gurney for this one? I’ve never applied occlusive bandages on an actual patient. I grab two pairs of nitrile gloves. One for me, one for our driver. He’s got his hands full, manipulating the switchboard for the lights and sirens with one hand on the wheel.
As I wrestle with contingencies, the training officer breaks in. “I’ll toss some trauma bandages and 4x4s on the gurney. Get another pair of gloves, it might get messy.”
We’re rolling past some police vehicles now. As we screech to a stop at a large, four-lane street, we’re greeted by deputies moving cones for us to pass. One of the sheriff’s SUVs has been disabled. It lies by the roadside, front pushed in. The ambulance rides into a cul-de-sac, and the driver silences our sirens as we pull towards another intersection. More officers. They wave us deeper through a small battalion of police vehicles.
We see them at the end of the street. Another ambulance crew is already on site, but police are racing the crew and gurney towards us. The training officer opens the bay doors and pulls out our gurney, ready for another patient. As we approach the other crew, the paramedic looks over at us and shouts for us to load the patient into our ambulance.
I grab one of the side rails to help stabilize the gurney. I look down, and I see a young man. No, a boy in his late teens. He’s wearing a T-shirt and jeans, with his shirt ripped open. Small dime-sized holes pocket his lower abdomen and thighs. It doesn’t look like he’s conscious. Then we’re on the move again.
There’s a brief pause as the driver locks the gurney into the loader and pushes him into the ambulance. I hook him up to the monitor: four patches for the 4-lead electrocardiogram. Another six for the 12-lead. A blood pressure cuff, pulse oximeter. We pull up the bottom of the gurney to raise his legs. Shock positioning will help pool his remaining fluids in his head and torso, with the organs that keep him alive. He’s already got one IV started, the medic is working on getting another one going. I fumble to get the blood pressure cuff around his upper arm but his hand is caught on something. I look down. He’s been handcuffed to the gurney. I realize then that we’re accompanied by two police officers. Their faces are made of stone.
He’s been quiet through most of this – the patient, that is. Now, he makes some guttural noises as we work. He groans, then violently contorts his entire body in an unconscious spasm. The handcuffs strain against the rails of the gurney, digging into the flesh around his wrists. Nobody reacts. Once he’s done, the medic ties off a band around the patient’s upper arm and digs through his box. My training officer is standing by me, also busy at work on the patient. The medic finds a 20-gauge needle with a saline bolus, eyes the patient’s forearm. A couple flicks of the finger, a deft hand movement, and a second bag of saline is on its way to refill the blood tank. I pass the medic some adhesive and gauze to secure his work. The medic leans back, pulls his tablet over, and begins documenting the call.
I stand over the patient, holding the safety bar running along the ceiling of the patient compartment. I look him up and down, only pausing to realize that I’m holding my breath. Exhale. A cold sweat creeps down the nape of my neck. There’s a slow drip of something on the floor. A trickle of blood creeps down his forearm and pools in small, dark puddles below. That, and the humming of tires on asphalt, are all that fill the silence.
At some point I notice that we’ve picked up speed, and the sirens are off. The front window opens, and wind blasts throughout the ambulance. Someone outside barks orders, and our driver yells back. The window closes, and now we’re rolling with lights and sirens down a busy freeway at 50 miles an hour.
He’s doing okay. His blood pressure is tanked, but he’s stable. “Hey, should we put an occlusive on that?” The paramedic looks up briefly at the training officer before answering in the affirmative. The two police officers look at each other. The training officer passes me the bandage and I tape the corners around a hole on the youth’s torso. The medic looks back down to his tablet.
All of us sit silently. The patient is, if not stable, more stable than when we found him. He’s receiving fluids to maintain his blood pressure; his entry and exit wounds have been stabilized and documented. An artificial homeostasis dedicated to keeping this man alive. There we all sit, bouncing in a metal box, as we roll the rest of the way to the nearest receiving trauma hospital.
Nelson Wu obtained a Bachelor of Science in Biomedical Engineering from the University of Southern California in 2016. He went on to work as a 911 emergency medical technician, responding to calls throughout the Greater Los Angeles area. He obtained a Master’s of Public Health in Epidemiology & Biostatistics from Boston University in 2021. Nelson lives in San Francisco. He works now as a researcher studying socioeconomic disparity and cancer at the University of California, San Francisco. He enjoys reading and rock climbing in his free time.