Ever since Damar Hamlin was injured and subsequently went into cardiac arrest the other night on the field, I’ve been replaying some of my own experiences over and over again. Some of those experiences are of calls I’ve run as a paramedic where I did what they did and more, not even making $15/hr, and I’ve also been reflecting on my earliest memories of being on a ventilator after my own near-death accident; scared, aware, and unable to communicate. I scroll through Facebook, seeing all of my healthcare friends talking about the trauma of resuscitation and desperately trying to shine a light on a significantly underpaid and underfunded profession (EMS) and wonder if there’s a way I can somehow lend my voice in this fight. Then at night, I remember my own internal panic I felt when I was extubated (had my breathing tube removed) and saw all the black goo in that tube that was just in my trachea. I remember having questions and things I desperately wanted to say but couldn’t ask them or couldn’t relay that I was in pain, or I had an itch, or just that I was very, very scared. I wonder how Damar feels. I wonder if he felt scared too. I wonder if the work of EMS, now blasted all over the media, will lead to any real change. Probably not.
I’ve had one. One call in my career where I can say that the patient was dead and would’ve stayed that way had it not been for the direct efforts of myself and my partner (wassup, Matt?). I’ve been on others and helped that had good outcomes, but I didn’t do the paperwork on those, so I’m not counting those as ‘mine’. My partner, Matt, and I were on a double medic truck when we got dispatched to a brush fire with a male patient that was not breathing. We had about a fifteen-minute response to what wasn’t a brush fire, but a trailer hauling hay had caught on fire, and while trying to put it out, the patient collapsed and died. CPR was started immediately, it was a witnessed cardiac arrest, but when I got him on the cardiac monitor, I saw that he was already in asystole (flat-lined. D E A D. No heart activity), but best I remember, we had a good capnography reading while doing compressions once he was intubated, and I knew he had a chance. Then, just like that, I saw the end tidal CO2 go from like 16 to 40-something, and sure enough, he had a pulse.
For the non healthcare professionals, capnography/end tidal CO2 is a tool that we use to measure the carbion dioxide exhaled into a breathing tube during working resuscitations. (Can be used for many other things, but for the purposes of the story, this is what it was used for.) It's a byproduct of metabolism, thus, helping us to determine if our tube is good, if our compressions are adequate, or if someone is too far gone for us to continue with resuscitation. If you can't tell already... I'm a big fan of capnography.
Once I confirmed he had a pulse, I was able to get a 12 lead ECG, and sure enough, he was having a massive heart attack. The problem was that the closest hospital didn’t have a cath lab, and the closest hospital after that was a good 30 minutes away, so I had to make a decision. Hope like hell he doesn’t arrest again before we get to the hospital with a cath lab that’s further away? Or continue on to the closest hospital? He was in his 40’s or 50’s. Young. Too young. Protocol states that all patients in cardiac arrest must be transported to the closest hospital. If I go to the closest hospital, we may as well sign a death certificate now because there’s nothing they could do that we weren’t already doing, so I made the decision to hope like hell he could hold on a little longer. I made about $13.50/hr by the way. I feel like that’s pertinent right here… These are the kinds of decisions that I made for $13.50/hr- crazy, right?
Thankfully, he maintained a pulse for the rest of the transport and was even opening and tracking with his eyes as we arrived on the ER ramp. I was able to notify the staff on the way that we had an incoming STEMI, post-cardiac arrest and intubated. We handed our patient off to the ER staff and went back in service to run the next call, but knowing we did a really good job that day. His family was going to get to see him and talk to him again, and it meant a lot to me personally that we had such a direct role in that- we don’t see that often. I found out a few days later that he made it out of the cath lab and was in ICU and able to communicate with his family, and I was ECSTATIC! I felt like I had won the lottery, and in a way, I had because that is so, so rare to get that outcome so far out in a rural setting.
A day or two later, I got a text on my way home from running errands. I pulled into the driveway, put the car in park, and looked at my phone. It was my husband telling me that my patient had another heart attack and died in the ICU. That was one of the very few times in eleven years that I sobbed over a call. $13.50/hr. I was physically and emotionally wrecked. I was so hopeful for him and so excited that I finally got my ONE person where I could legitimately feel like I saved a life, but in the end, it just didn’t work out that way. I had to reconcile the fact that he at least did get to see his family again; even if it was just for a short time.
I’m so, so happy for Damar Hamlin and his family that I could cry, and I don’t even know them. I do, however, know what it took to save his life, and I also know exactly what he probably felt like when he woke up. Scared. Hopeful. Frustrated. Grateful. My sincerest hope is that he recovers mentally as well (I have no doubt he will), and I hope somewhere, someway, this sheds light on what paramedics and EMTs go through daily, and I hope the rest of the world agrees that they deserve better than the status quo.