A Thousand Naked Strangers (26 page)

It happened on a normal day. We were dispatched to the far end of town for a woman with abdominal pain. She was pregnant and bleeding in her apartment. When we walked through the door, she didn't speak. Her mother was there and said she was twenty-three weeks pregnant. When we reached the back of the
ambulance, she yelled that something was coming. In went the stretcher with us behind it. I yanked her pants off. The doors were open. There was no time. There, in full view of the world, she delivered a tiny, lifeless child onto the stretcher. She was panting and nervous, asking how he was doing. The words
uh, well, not good
shouldn't have to be the first thing a new parent hears. We clamped the cord and cut it, wrapped him in a blanket, and placed him on his back. He wasn't breathing, had no heartbeat. We suctioned his mouth and tried to stimulate him. Nothing. I began chest compressions, using a single finger on his tiny chest. We tried to ventilate him, but our equipment was too big. We were twenty minutes from nowhere, an eternity when you have something too small for any of your equipment. Never had a situation felt so hopeless.

We arrived at the hospital with a nervous mother and a child that never was. Then, as we pulled the stretcher out of the ambulance, a change. His heart started to beat, big and bounding, each beat visible through his translucent skin. It continued—the outsize thumping of his awakened heart—through the parking lot, down the hall, into the elevator, and beyond that to the neonatal intensive-care unit. An anxious pack of nurses and a single doctor awaited our arrival. They instantly washed over both mother and child like a crashing wave.

It's difficult, if not impossible, to track the progress of one among thousands, so what happened to the kid after that, I don't know. He disappeared into the health-care ocean without leaving so much as a ripple. What I know is what I knew that day: that a tiny child no bigger than a soda bottle, born in a parking lot, whose life began among the dead, had a chance. I know, too, that it was our last call of the day. We went back to the hospital,
turned in our equipment, and went home. I stripped off my clothes, showered, put on jeans and a T-shirt. I poured a drink, cooked dinner, ate, watched television, and went to bed, all the while thinking,
What a strange, strange job.
The next morning I awoke and went back to work.

At thirty-seven weeks, the whole world changes. Time has sneaked up on us—Sabrina is full-term—and that very
large
swell in her belly is no longer a possibility, or a fetus, really, but a child.

It's around this time that conversation among our friends turns to the possibility of an accidental home delivery and how, unlike the thousands of unfortunate Americans who unexpectedly find themselves delivering an infant in the backseat of a car, I, at least, will be prepared. Someone suggests that I steal an OB kit from work and keep it at home in case of the unthinkable. Sabrina makes it clear that she doesn't want me to even
see
what's happening at the moment of delivery, let alone participate. I don't consider home delivery an option. Again the curse of experience. I've seen mattresses destroyed and car seats, comforters, couches—entire carpets—rendered unusable. I've witnessed the horrified fathers and the confused dogs and the pain of a natural childbirth. I know the unmentionable reason why expectant mothers are given enemas in the hospital.

Near the end I fret over every detail, the biggest of which is
where
. We're lucky in Atlanta to have Northside Hospital, a baby factory known for churning out more children than any
facility in the country. Many expectant mothers plan out every detail of what's to come. But sometimes nature writes a different script, and the child is welcomed into the world by two medics crouched on the dining room carpet. We come dressed in goggles, gloves, and a gown and offer nothing but an OB kit containing a blue bulb syringe, cord clamps, a disposable scalpel, sterile gauze, a foil blanket, and a pink and blue skullcap. Often the pain gets to be too much, and when that happens, two firemen whom the woman doesn't know will throw her legs over their shoulders as I yell for her to push and the husband, pale white and withering, leans against the wall.

Sometimes a home birth was the plan all along.

One night I walk into a barely furnished apartment vibrating with the thud of tribal drums, slow and rhythmic like giants marching. In the back bedroom, I find a woman standing in an inflatable pool filled knee-high with water. In the corner, a naked woman stands with her legs spread, umbilical cord trailing down to an infant lying on the floor between her feet. They have attempted a water birth—some strange claim to a tradition and ancestry they clearly didn't understand. They got the date right but screwed up the execution, so the child has spent six minutes underwater. Nobody seems to fully grasp the significance of what they've done except us and perhaps the child, but it's too late for him.

•  •  •

Sabrina's water breaks at two
A.M.
She went to see her doctor earlier in the day, and they agreed that if nothing happened by Friday, she'd be induced. All those plans are out the window. She calls to me from the bathroom, and despite being in a deep sleep, I recognize the tone of her voice and jump out of bed. We've
already packed a bag, so there's nothing to do but get dressed and head out the door. I desperately want to leave, to start driving, to get out of the house and into the hospital. Baby number one typically takes the longest to deliver, with subsequent deliveries getting easier and faster. But it's all so subjective, so dependent on factors beyond our control, that I just want to
get there
. Sabrina insists on covering the car seat with a bath towel, and once it's down, I drive like hell.

Even though her water has broken, there are no contractions, no urge to push, and we're able to enjoy the moment. Something big is happening—a forever kind of thing—and this moment, the two of us in the car with a bath towel, is the beginning. It's hard not to smile. There's nothing to do but wait.

And that's what we do.
Wait
. Without end, without progress. It takes hours for the contractions to kick in and hours more for everything to get real. Finally, there's a spinal tap, an epidural, more exams, more waiting. The frequency of contractions, like a slow burn, picks up little by little until we almost don't notice the moment has arrived. Suddenly, there are nurses and a doctor, and for the first time everyone is wearing a gown. All I can think is
I'm not ready for this, I'm not ready for this.
The doctor asks if I want to help, and even as I say yes, my hands are trembling.

When the doctor tells me to step around to the end of the bed, Sabrina is deep into what will be the final push. As I get close, the head appears. I reach down, cradle it, and guide it out. Nothing dramatic, nothing to report. No disaster. Merely a child, a son. Healthy and here and ours.

By technicality, his delivery is number fourteen.

I
was told
years ago that if I stuck with this job long enough, three things would happen: First, I'd burn out and need to find my own way back. Second, with time, I'd run every call I ever hoped to run. And third, I'd end up in court. The first two have already happened, though I never expected the third. Until I got sued.

When news of the lawsuit arrives—alleging that I'm a poor provider who irreparably harmed someone with my negligence—I'm not surprised. I remember the patient. I knew this was coming. Though it was a few years ago now, the details of that day are clear and simple. Basically, it unfolded like this.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                      
¹

So I've
known this day was coming. I've known—at least
suspected
—that a lawyer has been creeping around the doors of my past, looking for a way in. There's been nothing to do but wait for him to pick the lock and steal inside. Now it has happened. It's early spring, and I walk into work to find a letter shoved in my mailbox. It's from the hospital's lawyers, and they're asking, almost apologetically, if I can set aside some time to speak—when it's convenient, of course. I schedule a meeting, arrive at their offices, shake hands, sit down, and am stripped to the bone.

Every detail of the call is dissected until its parts no longer look like they belong to the same whole. My recollection is put on trial and sentenced to death prior to its conviction. After several hours, I explain that I have to leave, that I have a child back home who's a few weeks old, and my wife works in the morning.
This inquisition is over. The attorneys look at each other and, because I've left them without a choice, say I can leave. I stand.

“Do you have any questions for us?” one of the attorneys asks. She's bone-thin, and her jacket hangs limp from her shoulders. Her partner is powerfully built but says almost nothing.

“Am I being sued?”

“No.”

Relief. Because the hospital has bigger pockets, I'll merely serve as witness at my own trial.

A month later, we meet again. This time with less cross-examination. More questions.

“Give shorter answers,” the attorney says, shrugging off her jacket to reveal a set of skinny arms. “No unsolicited explanation. Make them work for it.”

The whole thing is a sucker punch. It's unnerving to be drilled and doubted and accused of the worst while never having a chance to explain. The facts are an afterthought; what matters is how each side can manipulate and present them. I develop a nagging nausea, like the faint echo of food poisoning that lingers for days after the purging. I'm embarrassed and isolated from everything, even my own confidence. Imagine being exiled from your mind.

But I'm not alone. My old partner, the one who was there that day, is going through the same thing. We're kept separate, never interviewed together, discouraged from speaking to each other about what happened that day and how, years later, it's all playing out. I suppose, from the outside, this seems perfectly acceptable, but in EMS, where your partner is not merely your lifeline but the entirety of your world for the forty minutes you're
running a call, to be split up is completely unnatural. Especially when you're friends. We ran God knows how many calls together. For years we laughed, sweated, and drifted off to sleep in the back of an ambulance. We shared our dreams and insecurities, our dinner. We did CPR on a woman in her own kitchen as her indifferent family watched television. He's from South Georgia and huge, a giant in EMS blue who, through sheer physical intimidation, once got us out of a very dangerous situation.

The waiting lasts forever.

The deposition does not. If you provide a common complaint and a set of patient data to every medic in the world, they'll all tell you the same thing. How the patient presents, how it looks and feels to run that call, which protocol to follow. Once treatment begins, what happens and why can be understood only by the two people crouching over the patient, because each call occupies its own unique space and time. Often the tiniest of details makes the biggest difference. Subtleties are difficult to explain in short answers to pointed questions. Anyway, nobody wants them. The plaintiff's lawyer wants an admission of guilt. The hospital's lawyer wants me to testify that on this call and all the thousands I ran before and the thousands I'll run after, I'm mindlessly following the unimpeachable guidance of a distant, unseen, but all-knowing physician.

I can't satisfy either.

And then, just like that, it's over. Another letter arrives. This one says there's no more case. What happened to it, I don't know. It's dissolved, and nothing further will be required of me. I'm
both relieved and frustrated. True, I've slipped the grip of forces beyond my control, but I've also been left without the opportunity to explain myself or defend myself, to speak to the accusations made against us. My old partner and I are abandoned in a battlefield that suddenly isn't.

And there's nothing positive I can take from the experience.

1
  The terms of the suit, at least the very few shared with me, stipulate that I'm not to speak about the details of the call.

A
man falls from a tree. There's nothing dramatic or poetic in the fall, just a jerk as his harness fails and he drops to the ground forty feet below. It's late afternoon, midsummer, hell-hot and Deep South–humid. A second ago he was cutting a dead tree on a forgotten hillside in a land thousands of miles and several countries removed from his own, and now he's broken on the ground. He has no insurance or legal standing, no comprehension of English. The ground below him slopes steeply—a pitiful, weed-choked ravine—which probably saves him but will make rescue no easier. Though his harness fails, his chain saw doesn't, and when he lands, the saw meets his face, cutting a jagged smile from one ear to the next. Skin, meat, sinewy jaw muscles, teeth, tongue, the bones of the jaw itself are all churned up and left to dangle in a horrible and horrifying slurry of mouth parts.

We arrive, park, and tumble down the hill. My partner and the four-man fire crew, fearful of snakes, pick through the weeds with the deliberate caution of soldiers in a minefield. But me? For a moment I'm not there; the weeds, the hill, the almost certain proximity to nervous copperheads, none of it exists. Instead I'm back in July 1997—or, rather, its shadow—and I'm floating in fifty feet of water off a small island not far from Charleston as
a member of my tour group coughs his face into the bay. Then my thoughts shift, and I'm sitting in a chair on my first night of tech school. I'm staring at graphic depictions in the back of my brand-new EMT book and wondering if I can do this—
really
do it.