3311 - Paramedic Excerpt


San Bruno, California (near San Francisco), 1975


            “Thirty-three eleven, code-three injury accident on 280 at Eastmore exit.”

Translation: ambulance 3311, go in service, lights and siren…

            “Ten-four, thirty-three eleven’s ten-eight.”

Got it, rolling.

            Mike, the dispatcher, wall-eyed manager, and son of the ex-motorcycle-cop owner, is, as usual, trying to tough-up his high-pitched voice. Jim and I give each other a look.

            “Thirty-three eleven.”

His usual clever acknowledgement.


            Thankfully, there isn’t much traffic on this Sunday morning, meaning I can concentrate a little bit more on doing my job instead of watching my ass. It’s easy to spot the two crushed cars next to the whirling cop car lights on the otherwise empty five-lane freeway. Jim jerks the van over into the left lane, downstream of the crushed cars. Protection. The cops are directing traffic, waiting for us. They’re always happy to hand off the injury stuff. I notice a woman cop leaning over a little girl on the pavement, and I’m guessing this time they wished they’d paid a little more attention in first aid class.

            I grab my plastic fishing tackle case full of the tools of the trade from behind the passenger’s seat, van still rolling. Jim, my driver, grabs the microphone and says, “Thirty-three-eleven, ten-twenty-three,” meaning we’ve arrived at the scene. He slams the mic back into it’s cradle, then jerks the shift handle into park, causing the van to lurch—his familiar signature—and leaps out his door, leaving the motor running and lights flashing. He takes one step, sees the little girl, eyes wide, sitting cross-legged and staring at us, turns on his heel and reaches back into the van. The lights blink off. He’s got his grim smirk on. He always does on these jobs. That’s as opposed to his arrogant smirk, which he wears at all other times. The male cop’s face, also grim mouthed but without the smirk, turns his mirrored sunglasses towards me. My twenty-one hours a day of sitting around bored to death, feeling like a jackal waiting for something to die or get hurt is over.

            I scan the scene. Remember to breathe. A crumpled, bloody young woman tilts crazily out the wrecked driver’s door, arm dangling. Her nice blue dress is splotched black from the blood. Ruined.

            Nearby on the vast gray landscape of pavement is the little girl, choking back tears, hair a wild mess, her eyes fixed on the woman. Okay. Stay detached. I hear her voice. “Mommy? Mommy?” She’s wearing a pretty little pink dress, white socks, one shiny black shoe, a blanket over her shoulders. The woman cop is crouching over her, whispering into her ear. The girl looks strangely grown-up. My chest hurts all of a sudden. Stop it.

            Whoooosh. Two feet away, a car speeds past at seventy miles an hour, punctuating the weekend silence, the lonely wails. Pay attention.

            The wails emanate from a casually dressed guy near the far, overturned car. Matted hair. Blood on his face, dripping off his chin. He’s sitting on his heels on the pavement, about twenty feet away. Might as well be in another galaxy. The car next to him is crumpled in the front, lying easily on its roof, as if this was perfectly normal. His hands cup his head, red and sticky. His pants don’t look too soggy from here, no spreading red pool below him. He’s rocking back and forth, staring at the indifferent sky, moaning and sobbing and crying out, “I’m sorry, I’m sorry, I didn’t mean it. Oh God, nohohohoooo!

            Experience and instinct lead me away from the two talkers and towards the other. Focused, in no rush. Two feet away and still coming in, I switch from scene assessment and triage to individuals. Choices have been made.

            “Ma’am? Ma’am, can you hear me?” Nothing.

            “Ma’am, my name is Jeff. I’m a paramedic. I’m here to help.” I pause a fraction of a moment as I reach her, then gently but firmly grasp her bare arm, initiating my routine. Partly hi-I-mean-you-no-harm, partly diagnostics—skin temp, consciousness level, reaction to touch. “Honey, can you hear me?” The unconscious ones are always so much easier. Sometimes, though, I wish they’d respond. Like now.

            Cool. Not cold, but, well…cool. Too solid, thick. Shit. Not the rigor mortis feel of synthetic rubber over ice-cold steel that always makes me cringe, but...

            Life and death feel different. I can always tell right off. It’s the difference between grabbing lightning and a rock. Shit.

            I feel for a pulse, going through the motions. Eyes open and dead, pupils dilated, hair matted in back. The matted part draws my free hand. I touch stagnant, thickening blood. A massive head wound like this should be pouring blood. If her heart were beating, that is. My hand expects solid, round skull but it’s like a broken windshield… crumply bits and pieces, like ice in a bag. My other hand stays on her carotid. No pulse. Shitshitshit.

I ask the male cop over my shoulder, “How long since you got here?” He growls, “Fifteen minutes, maybe more. Been like that since we got here.” His voice sounds kinda funny to me. I glance up. Arms folded, typical aggressive cop stance—legs spread, feet splayed, the usual mirrored sunglasses. But the voice, the pursed lips, the exaggerated frown give him away. Not the usual boredom. Human, after all.

            “Didja try for a pulse when you got here?”

            “Yep” he says. “Nothin’.” I don’t push it.


            All the while, cars whizzing by fast—white noise—and that fucker kneeling over there crying and screaming, “Ohhh, I’m so sorry, oh my God….help me!

            I would really like to stride over there and kick the shit out of that fuckin’ bastard. The cop’s jowl muscles bulge. Him too, I guess.

            I leave the mom. She’s nice looking, well dressed. Church, maybe, or a party. I wonder if she had time…

            I shake my head clear. My trajectory is now towards the child. I glance up at the billowy clouds giving weight to the sky above.

            New disguise. Teacher mask. Bus driver, maybe. Uncle. She rocks and whimpers, eyes locked on the blue dress. My bones ache.

            The woman cop’s face meets mine. Again the mirrored sunglasses. Now I get it. She steps back, gives me room, attentive. Mother wolf, cub in a trap. Whew.

            She’ll fall apart later, alone. For now, she is solid fucking ground.

            I lean over the girl. Get the tone right, now. “Hi, darlin’. My name’s Jeff. What’s yours?”

            “Sarah.” Her answer is almost a question. Her eyes are green and beautiful. She’s seven, maybe eight.

            “I’m here to help, Sarah. Can you tell me where it hurts?” My mask smiles.

            “My arm.” Pouting, she offers it up. As I reach, her look pierces clean through my camouflage. “Take care of mommy first.” A command. Then, right back to a little girl again, “Is she okay?”

            I can’t lie to her. I’ve tried that so many times, but it just never works. They see right through me and a bond is broken. “There’s a nice policeman over there with Mommy, Sarah. Can I take a look at your arm, Sweetheart?”

            This will be easy, medically anyway. Broken forearm—radius, and ulna. Nothing through the skin, no deformity. Good pulse in the wrist. A quick check, and its clear all she’s going to need is a splint and transport to the hospital. What comes after is not my job.

            I glance at Jim, who’s waiting for me to tell him what to do. He hasn’t said a word, as usual, and is chewing gum, as usual, since he can’t smoke when we’ve got patients. He can’t be thirty, but already he’s got diabetes, smokes too much, drinks too much, eats doughnuts too much, and has a potbelly. Real attitude. He refuses to do mouth-to-mouth under any circumstances, which always leaves me in a fix. As the senior medical staff, I should be doing the compressions in CPR. I’m better at it. But I also need to be near the defibrillator and medical kit and the radio to the ER doc. Doesn’t matter. If I don’t do the breathing, it won’t get done. We don’t like each other, but we share a certain professional respect. He recognizes I know my stuff, I accept he knows these streets and is a great driver. We spend forty-eight hours together at a time, day and night, every single minute. Separate beds. Like a fucked-up marriage.

            “Jim, can you get out the inflatable arm splint and splint-up Sarah’s arm for me?” He moves towards the ambulance. I turn to the screamer. The woman cop returns to her pup.

            Brace yourself. Be professional.

            “Sir, my name’s Jeff. I’m a paramedic. Does anything hurt? Are you hurt anywhere?” Curt, maybe, but within the limits. I smell liquor.

            “Oh God Oh God Oh God help me help me help me I didn’t mean it I didn’t mean it Oh God Oh God!”

            Too late now, you fuck.

            “Sir, can I please check for injuries?”

            “Oh God Oh God I’m sorry I’m sorry help me help me ohhhhhh!”

            Why the hell is it the drunks are always the least hurt. Back at the ambulance shack, we muse that they get hurt less because they’re so loose. Too bad. I cringe, like I’m touching something dirty, check his hands, now glued to his knees by congealing blood.  Some cuts, but not too bad. I check his head, a little too hastily. More blood, not much, a small cut on the scalp. Obviously his heart’s beating, and he’s breathing. He ignores me and wails while I do a perfunctory physical.

            “He won’t give me permission to do a medical. Not much I can do.” I shrug to the male cop. He says, “Go ahead and take the little girl to the hospital. We’ll take care of the guy and the bod…. the woman.”

            Jim and I are glad to drop off the girl at Saint Mary’s ER. Her dad’s not there yet, which I’m grateful for. I couldn’t look him in the eye. Let somebody else do it. We sneak away. Cowards.


            The rest of the day is uneventful. Transfers, minor injuries, nothing. Jim and I communicate just enough to get the job done, as always. We arrive back at the ’50s-era, dilapidated stucco home base, all depressing peeling paint and broken ceiling tiles and trashy green linoleum. Whoever is on night shift sleeps in the lumpy bunk beds in the back room. Several guys lounge on the ratty old couch and a couple of cheap folding chairs. The day shift is finished. They’re drinking beer and watching a porn video, not wanting to go home to whatever it is that’s waiting for them there. Some are silent, absorbed; some cheer. They know what happened. They all, like myself, listen eagerly to the radio in their own vehicles, for entertainment. We can tell not only what the call was for, but can read between the lines, get the nuance from the words and subtleties in the crackly voices. I glance at the screen long enough to notice a fat old guy who reminds me of an insurance salesman sodomizing a tiny, young, dark-haired girl. They always try to make them look young, and by their youngness, innocent. She may or may not really be eighteen, but I bet some of the guys love imagining she’s not, either way. They steal a quick glance at me, then back at the screen. They know me by now, and don’t invite me over or interrogate me. I walk past them into the dark abyss and crawl into my second-tier coffin. I have to try to get that little girl’s eyes out of my brain, the feel of the cold, wet, broken glass off my hands.


            Well after midnight, I drift off, wondering how this all started. Why am I living in a city instead of the mountains where I belong? Somebody’s made a huge mistake…

            Maybe I should have continued on to Alaska instead of selling the school bus. Maybe moving into Dad and Mom’s house and getting a job as an EMT wasn’t exactly a good career move. Or maybe it was an okay career move, just bad in every other way.