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Editorial: On Day Off, A Crisis

By Eugenia Klopsis
The New York Sun
Copyright 2007 The New York Sun, One SL, LLC
All Rights Reserved

Editor’s note: Klopsis is an EMT on an ambulance in Brooklyn. This column details her observations and experiences. Some names and identifying details have been changed to protect the privacy of patients.

It’s a cold, sunny winter day, and, happily, I’m not at work. I switched to a part-time schedule a long time ago because life is too short and I wanted to be a stay-at-home mother.

I’m walking with my son, who is now a year and a half old, to a music class a few blocks from where we live.

I push his stroller around the corner and see a woman of about 65 stumble from a crookedly parked sedan. “Am-boo-lance!” she shouts. “Pliz, somebody call an am-boo-lance!” Marine Park is a residential Brooklyn neighborhood, and it’s 9:30 a.m. on a weekday, but luckily there’s a pedestrian across the street, and I see that he has his cell phone out. The woman gets back into her car, and I push my son’s stroller to the open passenger-side door.

The woman is panic-stricken. “O Dios mio!” she shouts, shaking her husband, who is slumped to one side. She’s pinching his nose, breathing into his mouth, and rubbing his chest above his heart. He’s wearing a plaid flannel shirt under his coat, and his chest hair is gray. When she releases his mouth and nose, a wisp of white vapor rises, and the man lets out an agonal gasp. Technically, the term is “agonal respiration,” and its groaning sound is characteristic of the last breath of a person in cardiac arrest.

I call my husband, an ex-police captain who is now a paramedic. He also has the day off. “Somebody is in cardiac arrest around the corner in a maroon sedan,” I say. He soon pulls up in his car, takes out his oxygen, and approaches the slumped man.

My husband and the passerby struggle to get the man out of the car. As they lift him, an ambulance arrives, and the EMTs and my husband move him directly onto a stretcher and roll him into the ambulance. They shut the doors.

I notice one of the man’s shoes in the middle of the street. It’s old and scuffed, with a tiny brass buckle on the side for decoration. I pick it up and spend a long time thinking about what to do with it. Give it to the woman? Place it inside the ambulance? The man might be dying. Of what importance is a shoe? I place it on the sidewalk next to a telephone pole. Without my uniform on, I feel frozen, unable to act. I’m a mother here, not an EMT.

The woman, still panicked, comes out of the car to where the ambulance is. Seeing the shoe, she picks it up. Her hands are red and cold. I offer her my mittens, but she says she has her own, though she’s too distraught to find them. I ask her what happened. She tells me in broken English that her husband had chest pains early this morning while sweeping a light dusting of snow off their stoop. She told him to lie down, but he said no, he wanted to drive to their daughter’s house as planned. In the car, he had severe chest pain, pulled over, and slumped forward. “How many minutes before you came out of the car?” I asked.

She tries to think, but can’t. “A few minutes,” she says.

Paramedics arrive. I tell them, “Man in cardiac arrest, about five minutes.” It’s a long time for the brain not to receive oxygen. The senior medic does not glance at me. “Yeah, yeah,” he says, walking to the EMTs’ ambulance. “We know.” He disappears inside the ambulance and slams the doors.

At first, I’m shocked. EMTs and medics are trained to get a history from anyone who’s witnessed the scene. This guy doesn’t seem to think it’s important. In a way, he’s right: What matters is the heart arrhythmia. What matters is whether he can intubate and start a line to push drugs.

They’re not going to let the woman be privy to brutal resuscitation attempts. She is led back to her car by the passerby. I stand on the street corner with my baby son. “Come on, sweetheart,” I say, shivering. “Let’s go home.”

Later, my husband walks in. “We shocked him,” he says, and shakes his head. “But he went asystole.”

Flatline. I think about this, and after a few minutes say, “I wonder if he made it,” more of a statement of hope than anything else. Maybe because I wasn’t in uniform, this patient wasn’t just “a cardiac job” for me but a man, a husband, someone who died unexpectedly one morning on the way to see his daughter.