We need to watch things die

I remember watching a bird drown in a river last year. There was nothing I could do to help it. Its wing was broken and it floated helplessly in the water. I couldn't reach. I couldn't even move. I stood, paralyzed, watching its final heartbeats, its last helpless movements making circles in the water. The ripples almost made it to my feet.

This was not some perverse pleasure that made me stay, it was a need to witness something pure, something animal, something denied to us in polite society. This was the closest I have come to death in a long time. For me, a funeral is not death. It is merely the completion of life, a boxed-up body hiding from mortality. No wonder people gawk at car accidents; they need to whether they admit it or not.

Death is an essential part of life, no matter how hard we try to avoid it. We put our old in nursing homes, our sick in hospitals, our dead in cold, isolated morgues away from anything we might have to look at, hoping that the icy cleanliness of strangers will turn death into something we can stomach. Sterility is not the right kind of death.

I needed to watch that bird die. It was pure, it was final, it was complete. As the carcass floated away I felt like I had witnessed something beautiful.

No matter where I end up, at least I will have this. I will watch each sunrise with the knowledge that I am a part of it, not watching from the outside.

I was in a similar situation about a year ago, on my way to high school in the morning. I saw a cat die - a set of twitchy furry legs sticking out from underneath the rear bumper of a Mercedes Benz.

Well, I didn't really see it die, the car turned a corner shortly after. But I couldn't eat anything for the rest of the day.

Death under natural circumstances is one of the most beautiful things in the world. I recall watching a documentary on Discovery a few months ago, and there was a clip of a dead fox being overrun with decomposers, fast-forwarded. Watching the fur rot away and the bones reveal themselves gave great catharsis to the moment - a life is taken, and new life is created.

Roadkill, on the other hand, is far from pretty. Not when it lies perfectly still in the middle of a cross-junction with crows picking the entrails out. Not when it is surrounded by little boys poking dried branches at it.

A dried moth or dehydrated frog is one of the prettiest sights anyone is likely to find in the city. In a small city like mine, anyway.

I first joined the Fire Department when I was 18. My family was mostly medical, and I was going to follow in the footsteps and become a nurse. Before investing the money in school I decided to volunteer for a while to see if I could handle all the things I heard about around the dinner table.

Once I started, I found that I enjoyed the helping of people. We are the people who come when no one else does. We are the ones who go into the burning buildings, who look at twisted pieces of metal that used to be cars and figure out how to get the people still inside out. We are the ones who rescue cats from inside walls (true), people from muddy fields (true), and who stand out in the rain and help shovel dirt into sandbags for people whose houses will soon be flooded.

We are also the people who hold the ones you love as they die.

I don't remember the first dead person I saw, or the first person I did CPR on, or the first person who died right in front of me. I know that in seven years I have seen a lot of deaths. There is only one way that I am able to come home at night, able to look myself in the mirror and not want to just scream. It is my treating these people as patients - pseudo-people who are there but you are completely detached from.

The leg I carry across the highway when someone has been hit by a car is a completely inanimate object with no association to a living being. The body crushed in a car is no more than a task to be completed so we can then move on to the next thing, the next call to help someone else. The person bleeding in front of me screaming in pain is a patient - and that is how I survive.

Four years ago I was driving near Fort Benning, Georgia on my way somewhere or another. It was a beauitful Sunday afternoon and I was enjoying the day. I happened to look over and noticed a traffic accident. This is not uncommon for me - my fiancee swears I see more accidents then should be normal, while I remind her that I am trained to look for them. It looked like a moderate accident, worthy of stopping, so I did.

Stepping out of my truck with my medical bag, I took quick note of the scene. Two vehicles, t-bone type accident. Moderate damage to one vehicle. One patient ejected from the car. Three patients with one vehicle, at least four with the other. As I approached the patient who had been ejected she began screaming at me to help her baby that was still in the car.

I got to the car at the same time as a trauma doctor from a local hospital. We pulled the boy out of the car. He looked to be about three years old, and appeared to have a crushed trachea. His pulse was way up - around 180 - but he wasn't breathing. He was scared. I could see it in his eyes, could feel his body shuddering in my arms. All he wanted was to breathe again. All I wanted was to make that happen.

We tried to intubate him using the equipment I had, but just could not get an airway started. After about two minutes the first ambulance pulled up. I gave them a quick summary of what we had and we turned the kid over to them.

As I turned away from the vehicle the Fire Department pulled up and I briefed them on the situation. They went to the ejected patient, and I began triage on the others. I took note of the following patients:

• The three-year-old, who had been in the backseat of the car unrestrained.
• A eleven-year-old girl, backseat passenger in the car, who was wearing lap belt. Complaining of slight discomfort to her abdomen, fine otherwise.
• The driver of the car, approximately forty-five years old, who was wearing her seatbelt. Complaining of neck and back pain.
• The passenger of the car, approximately forty years old, who was not wearing her seatbelt and was ejected.
• The driver of the truck that hit the car, no injuries.
• The driver's daughter, approximately twelve years old, no injuries.
• The driver's son, approximately ten years old, minor laceration to face.

I began an assesment on the eleven-year old girl. Slight tenderness to her stomach, but Ok otherwise. She was upset about possibly missing school the next day. I turned around and put a band-aid on the ten-year old boy, and when I turned back, the eleven-year old collapsed and went into shock.

I grabbed the nearest paramedic, and we threw her into the ambulance. They rushed her to the ER along with her brother. Both were dead within an hour, he of a crushed trachea, her of a liver laceration from the lap belt when the car was impacted.

Our station runs around 1300 calls a year - fairly busy for a single station. Not the busiest in Hillsborough County (the busiest is Station 14 - they average 40-60 calls per shift between two fire engines and a ladder truck), but still a fair amount. While I have not run every single one of those calls, I have run my share of traffic accidents, and non-breathers, and drownings, and shootings, and stabbings, etc. I have helped a lot of people, I have watched people die, and I have seen a lot of dead people.

Somehow, day in and day out, I can make it through. I can have compassion for people. I can cry when I see a bird hit, or a dog die. And I pray that for most people that is all they see. Death is a most amazing thing. But if I never have to be amazed again, to look into the eyes of a three-year old boy who just wants to live, just wants to breathe, to cry - if I never have to see that again, I will consider myself blessed beyond belief.

Until that time I will continue to do my duty, to do what I have been called to do. I and my crews and our brothers will be the ones that come. We will be the ones that show up no matter what may be going on. We will do everything we can. We will be a stong shoulder. And when it is finished, we will go home and put it all aside to live a normal life.