Thursday, April 24, 2014

A CHAPTER FOR THE BOOK

As most of you know, I do plan to write a book about my EMS journey one day.  Tonight while posting photos to the jocofire.com site, I thought about a particular call and wanted to blog about it.  This could possibly be a chapter in that book.  This incident occurred before HIPAA and besides, I know the family and they would not mind the story being told.

Her name was Jerdana.  She was 7 years old and waiting for her school bus on Norris Road not too far off of Barber Mill Road early in the morning on January 20, 1998.  She had crossed the road to get the mail for her mother, who was waiting inside her van at the bus stop.  While handing the mail to her mother, she was struck by an oncoming car.

It was a cold morning and I was at home where I stayed with my mom and dad.  I was a full-time 911 dispatcher and volunteer EMS member of Clayton Area Rescue.  Our first duty unit was on another call that morning and I was at home sleeping in when the pager went off "Johnston Central EMS Station 4 Second Duty Crew, Cleveland Fire Department, 10-50 PI Pedestrian, Norris Road just off Barber Mill Road."  I got up from bed and went to the station.  Since I lived one block from the station, I was generally the first one there and that was the case this morning.  I pulled out unit 44 (1987 Ford Type III Braun).  I checked on the radio that I was "10-12 for additional."  Volunteer MeMe Dunford arrived at the station in a few minutes and we checked enroute.  Stefan and Deidra Fehr called on the radio (I believe he was our chief at the time) and let us know they were meeting us on the scene.  They were paramedics and I was an EMT-Intermediate at the time and I was thankful they were going to be there.

The rest of the events seem like a blur - they all happened so quickly.  I remember arriving to find Cleveland Fire Chief Jeff House performing CPR on the small child along with Deidra and Stefan.  We quickly immobilized the child and loaded her into the ambulance to begin transport to Wake Medical Center as it was known back then.  I remember calling and having Clayton Police to hold the stop lights for us on US 70 as we passed through town on the way to Raleigh in the early morning traffic.  We arrived at the hospital and shortly thereafter this fragile child was declared dead in room one of the hospital after a valiant effort to save her life.

The days and weeks afterward yielded quite a few unusual events.  First of all, Deidra and Stefan were questioned about the treatment of the child.  What were they questioned about??  They had placed an IO in her.  She was years old and back in 1998, OEMS guidelines said interosseous lines could only be put in a child up to 60 months.  It's amazing that today we place IO's first line in everyone who is in cardiac arrest.  We were just ahead of our time.  Deidra and Stefan did what they felt was best for the patient and by today's standards provided PERFECT patient care.  Back then they were just about run out of town because of it by our "medical control" at "JMH" who audited all of our charts at the time.  My havn't we come a long ways.

I think about Jerdana often.  I went to her funeral along with the rest of our crew.  I run into her aunt quite often as she worked at our Smithfield Barbecue for years.  So many people don't do EMS in the town they grew up in nor do they generally transport people they know.  I was blessed and privileged to to do EMS for 20 years in the town I grew up in.  I continue to face the patients I have saved through the years.  I also continue to face the families of the patients I was unable to save through the years.  It's a humbling feeling and at times it makes you feel terrible.  At times, those family members still tell me thank you, even though I wasn't able to save their loved one.  I smile and I always tell them that I remember working on their family member and I tried everything I knew to do, but I'm very sorry it didn't work that day.  I think they need to know that yes, I am human and yes, I'm well aware that they relied on me at one of the worst times of their lives and I wasn't able to do what they wanted.  I want them to know I'm aware of that and I wish it could have gone differently and our lack of success was NOT for lack of compassion, love, care and concern.

There are many patients - countless patients that I do not remember.  There are serious calls - BAD calls that for some reason I've forgotten about or pushed aside in my mind.  I get told all the time about calls I've been on and I really do not remember them.  I can tell you though, there are times they do come back.  I pass an intersection where something happened, run into a family member who jogs my memory, or they simply flood back late at night - like right now - and I see their faces.

Her name was Jerdana.  I never, ever pass Norris Road when I don't think about her.  I never see her mother or aunt when I'm not reminded that on that cold morning, we tried very hard to save a life but it just didn't work.  I thank God for the opportunity to interact with that family.  I thank God that on that cold morning and in the following days, they saw rescue squad members cry, hug, visit and pray with their family for comfort and guidance.  You see, for many, many years whenever I would lose a patient - I would face that family not only on the day of the loss - but at the funeral home and at the funeral.  It gave me closure and I feel like it showed the families that we are human, and even if we couldn't save them, we cared about them, loved them and respected them.


Monday, October 7, 2013

Updates and Stuff

It's been a while since I've updated my blog, but tonight I feel like it's time to put some thoughts down.  As most of you know, my eventual goal is to write a book about my journey in emergency services.  That said, I need to put some thoughts down tonight.

For the first several years of my EMS career, I put on a very tough exterior and tried to be that "rock" that held everyone else together.  I remember back in the 90's I had one month where I had 6 or 7 pediatric patients who died, all for different reasons.  I remember that I got a card from some friends in my EMS family that encouraged me to stay strong and keep my chin up.  At the time, I thought, "Well I'm ok, but this sure is sweet."  Now, almost 20 years later, I find myself haunted by so many of the bad calls of years past.  There has been much discussion about PTSD and EMS in recent years.  Anyone who stays in this job for any significant length of time (over 10  years) is certain to have faced many events that would just incapacitate an ordinary citizen if they saw it.  I have always accepted this as a part of the job and have always remained tough.  I have had many lifeless children thrown in my arms through the years, and I have rushed them to the truck doing mouth to mouth without ever thinking twice about it.  After the calls were over, I accepted that we did everything we could and that as unfortunate as it was, they died. 

That being said, I've started to notice some things over the last couple of years.  I am becoming more tenderhearted for one.  I cried about 2 patients in my first 17 or 18 years in EMS- just two!  Now, in the last 3 or 4 years, I find myself thinking much more about my patients and their outcomes.  I think about their families.  I think about the expression on their faces.  I think about what parts of life they will miss now that they've died (prom, drivers license, graduation, college, boyfriends/girlfriends, etc.) None of this has affected how I do my job or anything like that, but I have noticed the trend of being a little more caring than I've ever been.  Now, here's the kicker and the part that is strange to me.  I feel like in recent months I'm being somewhat haunted by those from the past.  No, not as in the ghostly form, but in the form of curiosity.  For example, I'll drive up a road and pass an intersection where I went to a fatal wreck 10 years ago.  Suddenly, I start thinking about it and it bothers me that I can't remember the details.  I remember it was fatal, I remember the time of day, the season of the year and what firefighters were there along with who my partner was.  What I can't remember is the patient.  That's a blur.  I don't remember their faces for the most part.  I don't remember what they were wearing, etc.  It's like somewhere in my mind I have blocked the "worst" details about what happened.  So then I go on a quest.  I google it, I search the News and Observer, WRAL, WTVD, etc. and I try to learn everything I can about the incident.  I try to remember those details.  Then, with the help of the media, some of those images come back.  It's almost like I needed that closure.  I needed to know those details for some crazy reason. 

I've sat here tonight, racking my brain about two particular calls.  One was a fatal wreck out on Cleveland Road in the early 2000's.  It had to be around 2003, 2004ish.  It was late at night and 2 friends of mine who were in fire/rescue and me were coming back from the RockOla in Garner when the call went out.  Immediately, the telecommunicator (Danny Morgan) had me call him on the phone.  He said, "A fireman came up on it, said everybody is dead and he got scared and left and went to the fire station." I immediately turned on my lights and we rushed to the scene.  I arrived just behind Cleveland firefighter Charles Kneeshaw and Chief Matthews.  We found a Jeep Cherokee in the middle of the road with front-end damage and we found a passenger car in a field that was destroyed.  One side of the car was pushed to the other.  We had only 1 flashlight (no apparatus had arrived yet) so we started counting victims.  The people in the jeep (2 adult men) were walking around and said they were fine.  We look in the car and there are bodies on top of bodies and I counted 3 people.  Charles then said, "No Jason, look there are 4 heads, it's 4 people."  He was exactly right, 4 people.  I remember it looked as if someone flipped a light switch.  One of them still had their lighter in one hand and a cigarette in the other.  Just that quick, literally in the blink of an eye, those four people were killed.  They were all upper teens, maybe early 20's at the most.  I remember how we got them out.  I remember Joan Vause was on one of the ambulances.  I think Mick Stewart may have been on another.  I remember those details.  What I don't remember are the faces.  I think it was 2 girls and 2 boys.  I don't remember what they were wearing.  I don't remember their faces.  They have somehow been blocked.  I think deep down inside me I want to know who they were, I want to know about their families.  I want to know who was left behind and do I know these people.  Do I work alongside some of them and not even know it.  For the sake of being "tough" I guess I just blocked all of those things out back then and never bothered to even want to know.  Now, more than ever, I do want to know.  I want to know all about them.  I want to know what happened to the guys that hit them.  I want to know what date it was, what year it was.  I carried these four lifeless teenagers to the morgue but I can't tell you what they looked like or what they were wearing or what their injuries were.  Something blocked that out. 

I had another incident in the late 90's where a little boy was playing in a sand pile.  It was a new development and construction workers had piled up a load of sandy dirt in the yard.  A little boy climbed up on that mound of sand and it caved in on him.  A family member, as best I can remember, found him buried and pulled him out.  When we arrived, I remember vividly one of my heroes, Becky Denning was on the ground doing CPR on this lifeless child.  She was spitting out sand after giving ventilations.  Becky was yelling at us to bring the suction as soon as we got there.  I remember suctioning out sand, lots of sand.  Then, just as all the others, it's a blur.  I don't remember whether I drove or rode in the back.  I was an EMT-I then.  I don't remember the child's name.  I don't remember the year or the date.  Those details again haunt me.  I want to know all about it now.  I want to know who the parents were and if they're still around.  I want to know if they felt like we did everything we could or if they were mad at us.  I want to know were there other brothers or sisters or was this their only child.  I have so many questions.

Why weren't these details important to me then?  Did I not care?  Am I that different a person now or have I just matured over the years and refocused on the important things in life.  I have many, many more scenarios very similar to the above.  They generally involve fatalities.  If you see me in the library going through newspapers or see me pause at an intersection and just look around, I'm trying to go back to unblock some of the details.  Maybe it's good that I blocked them. That may be why I'm still working in EMS.

To the younger people in this line of work - don't be afraid to care.  Don't be afraid to follow-up.  I used to didn't follow-up on any of my patients, because deep down, I didn't want to know.  My job was done, move forward.  That's not the case anymore.  I think it's a crying shame that it has taken me over 20 years in this line of work to mature and develop a heart.  I'm glad I finally did and I think it makes me a better paramedic than I have ever been. 

Sunday, April 28, 2013

Hello everyone! 

It's been a little while since I updated the site, so I thought I would give everyone an update.

First of all, I've been working really hard lately to update the jocofire.com website.  I've worked on the history page, getting some photos added, etc. and also have been working on the appearance of the site.  Here are a few of the most significant changes:

- I have changed to a new site for photos.  I am now using Flickr and everything after April 1st, 2013 is now on Flickr.  At some point, I hope to go back and move all photos over.  Flickr is so much easier to use. 

-  I have added photos to the history page.  This is a work in progress and I am in BIG need of Johnston County Fire Department historical photos.  This can be of incidents, apparatus, personnel or stations. 

-  I have created a jocofire.com Facebook page.  This has proven to be really popular.  You should be able to get to it, but if not I will gladly send you an invite.

-  I have created a Youtube page so I can post videos.  This page is "JOCOFIRENEWS" and can be found at the following link:  www.youtube.com/jocofirenews.  It is a work in progress but I hope to add many videos to the site for you.

As some of you may have noticed I am responding to more scenes than usual.  I have recently incorporated my own business, "Thompson Media Group, LLC" because I do sell my photos from time to time.  A couple of local media outlets have expressed interest in my photos and I am thrilled to be able to help them out.  From an emergency responder prospective, I can't contribute any photos to the media when I am working, and I am avoiding anything related to Town of Clayton business as well.  If you see me on scene, please act natural and continue your good work.  I am not there to get in the way; and I will check in with command to let them know I am there and find a good place for me to set up.  Anything that goes to the media from me is from a "public" point of view and will be from behind the scene tape.  Anything I take inside the tape and "up close and personal" is for YOU the responder.  I want each of you to be able to use these photos for training or personal use.  My intent is that you have a photographic history of your journey in emergency services that you can be really proud of one day when you look back.  Having worked on both sides of the scene tape through the years, I understand the importance and integrity of not releasing some photos and will not post anything that even remotely crosses that line. 

Please check out all of the new updated sites, and be safe out there!!

Saturday, July 28, 2012

Ran into an old EMS friend

Yesterday, I worked a shift at Four Oaks EMS.  As usual we ate breakfast at King's Restaurant.  While eating I was shocked to see an old EMS friend come in the door with his wife.  It was Larry Hobbs.  Larry was a member of Elevation Fire Department for over 21 years, a charter member of 50-210 Rescue Squad and a former Assistant Chief of both!  Larry was always known as a down-to-earth country fella who had a heart of gold and always went above and beyond to help others.  Larry was one of the two first full-time employees at 50-210 EMS along with Sharon Roberts - both were EMT-I's at the time.  Larry worked in the ER at JMH (Now JMC-Smithfield) for many years, and also worked with MidSouth Ambulance Service. 

Larry is doing GREAT!  He works as the draw bridge operator at Surf City, is happily married and is loving life.  He returns to his homeplace in the Elevation community regularly to take care of yardwork, etc.  He says he hopes to retire in April of next year!  He loves life at the beach, loves his Lord and his wife. 

What a pleasant surprise to run into someone who I consider a big influence in how EMS evolved in Johnston County in the 1990's.  Larry was present for the transition of 50-210 from EMT-Basic Level through EMT-I Level and got out of EMS just prior to the squad becoming paramedic level.

Friday, July 27, 2012

New Website! www.jocofire.com

I hope this blog post finds everyone doing well.  I wanted to take some time today to let you know about my new website.  I have been working very hard over the last few weeks to develop a comprehensive website that covers Emergency Services in Johnston County.  The site is www.jocofire.com and I developed it with the hopes that it is somewhere that all Police, Fire and EMS folks in Johnston County want to visit EVERYDAY to get updates and see new photos of their departments in action and not in action. 

I have my camera with me at all times now and intend to take as many photos as possible with the focus being on personnel and apparatus.  One of my biggest regrets in the last 20 years of my career in 911 and EMS is that I have very few photos.  I especially lack photos from the 90's.  I wish I had a picture of EVERY ambulance I ever rode on, every police officer that worked with us, every partner I ever had on the EMS unit and every Fire Engine that responded with us.  I have had the honor of riding on some awesome and not-so-awesome pieces of apparatus and wish I had a photo of the extierior and interior of each.  I also wish I had photos of some of our equipment as well. 

I hope you all will visit my site, and visit it regularly!  I also hope each of you will dig through your old files, records and drawers and find me photos!! No matter how insignificant the photos are, I would love to have them if they involve any type of emergency service in Johnston County or one of our mutual aid departments.  I especially would love to have photos of JAS, Midsouth, Metro and the Lion's Club Ambulance Service of Smithfield.  I also want to collect histories and apparatus rosters from each department that currently operates in Johnston County.  I have a brand new vest with "Photographer" on the back and I hope to see you at your incident scene soon!!

Sunday, January 22, 2012

Updated Ramblings...

Well, as most of you know, it's about time for an update!! I've not blogged in a while - and honestly, I've not had time. That's finally changing and you'll see updates from me more often now.

So, what's new? I left the 911 Center in late August to go to work for a local hospital in the cardiac catheterization lab. Wow, whan an experience. I learned more in just a few months than I have in YEARS about cardiology and worked with some top notch cardiologists and met some great people. Y'all know there is a "but" in here somewhere, so here it goes. But, I just didn't like it. In the particular cath lab I went to work in, I was the only paramedic employed there. There were a couple of former EMS people, but they have since long been out of the field and I just didn't fit in. I didn't spin nor get excited when patients coded or became worse - I responded like I do in the field - calmly - and well let's just say that my calm demeanor didn't fit in with the rest of the crowd. My primary motivation for leaving Johnston County was the money and for a change in pace. Of course, hindsight is 20/20 and I should have stayed and explored options within the county government.

So, effective this month, I am returning to Johnston County to work in the field again as a paramedic. I know the county well geographically, from my years of 911 and EMS time. I love shift work, especially night shift, because that's what I have primarily worked most of my career in the 911 industry. I think it was definitely time for me to make a change, but in hindsight I should have made it within JoCo instead of leaving completely. I am thrilled to returning to the field and most appreciative to Selma and Four Oaks EMS for giving me the hours and ability to work.  I love this County, the citizens, and my coworkers and look forward to each day at work now serving the citizens.

Now for the next biggie! I ran a successful campaign this fall to win a seat on the Clayton Town Council! Serving on the town council has been a life-long dream of mine. I used to joke with my schoolmates about being the mayor one day - well I'm not the mayor, but I have joined him in serving our wonderful town. For the last 20 years I've responded to calls from citizens and entered the homes of those who often times could not help themselves. I've responded to the elderly who can't afford to run their air conditioner in the summer because of high electricity rates and I've responded to the poor who cannot afford medications. I've delivered babies in houses with no electricity at all. Now, I feel like I am in a position to do something about it! My primary motivation in filing for town council was to put myself in a position to help those people out who can't help themselves. I want to be a voice and advocate for the elderly who are on fixed incomes. I also want to be a voice for the minorities who often have nobody willing to speak up for them. EMS has given me a unique perspective, as it is a profession that CANNOT descriminate. Whether you have insurance or not, are rich or poor, foreign, minority or American, EMS will respond to your call and provide assistance. Working in EMS has afforded me the chance to serve EVERYONE and see their needs. Now I want to be a voice for those people who have never had a loud voice before. I am super excited to begin this new adventure and be a part of the management of the best town in the United States.

Anyway, that's enough of an update for now. Thank you for listening and look for frequent updates from this point forward.

Friday, April 1, 2011

Serving Since Tuesday!

A veteran firefighter in a neighboring "big city" recently referred to some of the EMS providers as having nameplates that say, "Serving Since Tuesday." In a metropolitan EMS system, that somtimes isn't a bad thing because the ambulance Paramedics and EMT's have backup from Advance Placement Paramedics (APPs), System Supervisors, Administrative Staff and they have the best, most experienced firefighters around on their worst calls. That approach works great in a large system - but in a smaller suburban EMS system, we cannot afford to have "Serving Since Tuesday" on our front-line ambulances responding to calls alone with a partner who has been "Serving Since Last Tuesday." Consolidation of EMS resources coupled with the demise of many of the traditional "Rescue Squad" EMS providers has led to the rapid growth of County-run EMS systems in our region of the state. Government-run EMS systems are initially very attractive to many EMS recruits. They have decent benefits, retirement, nice equipment and flashy uniforms. Often the County providers tout themselves as "the best" and often times contracted EMS agencies (the former Rescue Squads) are looked down upon because they don't have the funding or resources to have "the bling" and the "flashy" trucks. The government-run systems attract many new EMTs and Paramedics and often have mass-hirings to "put butts in seats" to ensure units stay in service. Thus, "Serving Since Tuesday" may be the front-line response to many EMS emergencies in a large system. I'm "ok" with that because they do have contingincies in place and veteran providers available just a radio call away. I do not agree with smaller, suburban government-run EMS systems hiring with the same philosophy. Often in our area, a single paramedic ambulance is the ONLY responding unit to some really bad calls (no first responders in some areas, no APPs or abundance of system supevisors). Thus, "Serving Since Tuesday" isn't the best that we can do. Our contracted EMS agencies recognize this and hire accordingly. The government-run system MUST adhere to the same standard. When a member of my family becomes ill, a "driver" and a "Serving Since Tuesday" are NOT who I want to come to my family member. You heard it correct - "Driver." It seems there is a trend lately to hire new EMT's who work as firefighters to fill the role of ambulance EMT. I have NO problem with this if they are proficient in ambulance operation. Often times, they are not. They have never filled out a PCR, never driven an ambulance (the operate differently from fire apparatus), and don't know what to say on "the call-in" or even what to do in the back of the truck by themselves. Folks, we need to be hiring CLINICIANS not TECHNICIANS. A technician can fill the seat, but a CLINICIAN can perform patient care adequately, complete the report and operate the unit with little help. Now, as for the government-run agencies touting themselves as "better" than contracted agencies, I agree and disagree. They may be better in that they have more employees, and often better benefits and retirement. I disagree with the notion that patient care is better provided by government-run providers. The contracted agencies in our system have the most experienced providers. If my dear friend Lisa and I work on an ambulance together - our patient receives 40 years of EMS experience caring for them. This is the "norm" for a lot of contracted providers rather than not. There are VERY few times that contracted agencies have less than 5 years of combined experience on a truck. Often it's 10+ years on almost every unit. "Serving Since Tuesday" and "Serving Since Last Tuesday" on a truck together have NO place in a suburban or rural EMS system that does not have the back-up contingency that our big cities have. Many days I see 20+ years of EMS experience on our contracted trucks and then see a 1 month paramedic and a 1 year EMT on a County-run EMS unit. Who would you rather have come to your mother? Contracted agencies may not have the size or the administrative overhead of a government-run system but they do have a lot to offer: 1. Excellent clinical care with years of experience on most units 2. Nice equipment (I work for an agency with 2 nice, new Horton ambulances). 3. Compassionate care - Contracted providers often interact with the same people/geographical area every day. They learn the area, know the people and become attached to the patients. I LOVE riding with new providers. I've been a preceptor in our county since the very first "preceptor class" was ever taught here by guest instructor Steve Gardner from Wake EMS. I enjoy riding with new people because I know my years of "street smarts" and their new "book smarts" even each other out. I can depend on them for quick drug calculations and they can depend on me to "figure out how it works" or how to get a person disentangled from a situation. In conclusion - -"Serving Since Tuesday" should be coupled with a veteran provider, not left alone with a new EMT. It's the right thing for the patient. -Hire Clinicians not TECHNICIANS. I want an EMT who can perform all of the EMT functions assisting the paramedic helping my family member - I don't want a steering wheel holder or clip-board holder coming to our aid. -Don't put down the contracted agencies. Often they have the most experienced clinicians that can be found, nice equipment and SPOTLESS units that you could eat off the floor of. Another thing they have is their customer service which generally far exceeds that of a government run organization that doesn't have to rely on those customers when it comes time for fundraising or making a capital purchase. I have NO problem with any government-run EMS provider in our area. I work for the government myself. I applaud Wake County's initiatives and the dilligence that has been given to their special programs, the APPs and keeping system supervisors responding to calls. Unfortunately, in a rural/suburban system that doesn't have the funding for "extra hands" we must place the most experienced providers available on every unit. We should support our contracted agencies and applaud their efforts serve their communities at a lesser cost.