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Book Excerpt: Responding EMS: it happens now

The thought of a young woman becoming an organ donor was pushed aside at the time but never left EMT Michael Morse


Editor’s Note: Responding EMS is the second book by EMS1 columnist Michael Morse. This powerful introduction opens the book. Twelve years after this incident Morse had an encounter that affirmed his decision to keep her heart pumping and ensuring a young woman’s viability as an organ donor.

It’s staying light later now, as winter loosens its icy grasp on Rhode Island. Loosens, but doesn’t let go.

I like to drive. I find the routine, mechanical movements relaxing. I know the road to work so well the car could drive itself. It gives me time to think. An incident from last week comes to mind, though I try to push it away.

It had been quiet for about an hour, the only sounds I could hear came from the open window of my office as the late night bar crowd straggled past the station on their way home. A few drunken shouts, tires squealing, bottles breaking on the pavement as people cleared out their pre-club empties before heading home. I turned the portable off, hoping to sneak a few hours sleep in before the next run. It had been a long shift, thirty or so calls so far with six hours to go. At one time most of my time was spent being on call, now, it seems all of my time is spent on calls. Almost, but not all. I hit the bunk and was out cold before my head touched the pillow.

Responding at 0230 hrs (2:30 a.m.)

“Rescue 5 and Ladder 4, Respond to 1 Providence Place for a woman who has fallen.”

Ladder 4 was out of the building before I made it to the rescue. Tim waited for me, the engine running. He saw me from the rear view mirrors and turned the engine over. The piercing wail from the truck’s siren scattered the people lingering in front of the station as we rolled past them, closing the overhead door behind us. As we passed Water Place Park, the officer of Ladder 4 gave his report.

“Ladder 4 to Rescue 5, twenty-five year old female, fell approximately forty feet, massive head injury.”

“Rescue 5, received.”

I hung the mic back in its cradle and put on some gloves. One Providence Place is an enormous shopping mall located in Downtown Providence. The building takes up four blocks of real estate, big enough to warrant its own zip code. Tim made his approach, stopping behind the ladder truck in front of the north entryway. Most of the stores were closed at this hour. A movie theater and restaurant occupied the upper levels and stayed open late. We loaded the stretcher with a long spine board and med bag and made our way into the mall. A lone security guard stood outside the entrance. I asked if he knew anything about the incident.

“Somebody fell.”

We walked past him, up the ramp toward the elevators. The mall is a confusing place when shopping, worse when seconds count. Overlooking the balcony next to the elevators I saw the guys from Ladder 4 two floors below me, working on a young woman. A dark shadow outlined her head. We walked into the elevator car, stopped and looked at the buttons.

“LL, 1, 1M, GF, 2, 2M, 3L, 3, 4.”

“Which floor?” I asked Tim.


I hit the 1 button and slammed my fist into the panel when the elevator started going up. I was a little more tense than I thought. The elevator wouldn’t stop until it made it to the first floor no matter how many times I pushed the LL button. After an eternity it did stop, then reverse direction. At 1M the elevator stopped again, the doors opening to an empty floor. Gaining control of my emotions I pushed LL and felt the box begin its descent, agonizingly slow. Finally, the doors opened on the proper floor.

John Morgan, a truck mate of mine from another part of my career held the girl’s head in his hands while I tried to apply a cervical collar.

“It’s soft,” he said, cradling the back of her head while I wrapped the hard plastic around her neck. I reached around back and felt the crushed skull, like jelly where there should have been bone. I checked her pupils, shining light into her eyes hoping to see a reaction. There was a reaction, though not in her eyes. A sick feeling started in the middle of my chest and worked its way through my body. “She’s my daughter’s age,” I said out loud.

“Fixed and dilated.” I stood and stepped back while the crew from Ladder 4 and Tim immobilized her, assisted ventilations and put her on the stretcher. They had all been around long enough to know the girl’s chances for survival were none and none. Off to the side a young couple and a solitary young man stood watching, ashen faced.

“Will she be all right?” asked the young guy who stood alone.

“We’re doing everything we can,” I replied, again, knowing that all we could do would never be enough. The girl was gone; the best we could do was keep her heart pumping and hope for a miracle. Somewhere, somebody waiting for a kidney or a liver just hit the lottery. The thought made me sick so I pushed it aside.

“What happened?” I asked.

He pointed up to an area of escalators, three stories above us.

“She fell.”

The stretcher was moving now, a group of firefighters pushing the stretcher toward the elevator, bagging and picking up the mess we made with our equipment. We all fit into the elevator. As the doors closed the only thing that remained was a little Spider Man doll, tossed to the side of the floor, and a dark red stain on the mall’s new carpet.

What could have been

I found out a few days later that the girl had planned on being married next month. She was a single mother and was about to get a degree from a local community college. She was out celebrating her birthday. She won the Spider Man doll at the nightclub where she spent her last night on this earth and planned on giving it to her four-year old son in the morning. I hope somebody picked the doll up from the mall floor and gave it to its rightful owner.

Reading the obituary is worse than living through the experience, there is nothing to do but read about the person who died on your watch, and think about what could have been.


Responding EMS: it happens now
Copyright © 2011 by Michael Morse
Available on Amazon and wherever books are sold.

Captain Michael Morse (ret.),, is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.