Fog

In the strict sense of the word, I’m not a killer.  But there are different levels of understanding, and sometimes I awake in the pitch black of night after some homicidal dream and think, of course.  I’ve known all along.  The relief of reality takes some time to sink in as I check and double check my memory, searching for screams and violence.

 On occasion, the more ebullient type of individual will ask about it.  What’s the worst thing you’ve seen, they’ll want to know.  But there’s no way.  There’s no way for them to see, even if seeing was the way to experience it in the first place.  Sure, the imagery is part of it, but some things are more to be felt and smelled than they are to be seen and described.  Bones cracking beneath the weight, the thick, metallic stench of blood.  And even more than that, there’s the feeling.  The deafening roar of silence, the hot tears welling up from some inconvenient place inside, unbidden and unwanted.

  That night, though, the feeling was more than just that.  Somehow, Sarah knew things were amiss.  As we departed the hospital to make the long journey home, she mentioned that something just didn’t feel right.  It had been a difficult call to be sure, but there was something more than that, otherwise it would’ve passed by without commentary.  Part of the job.
She was uneasy, and if I had been wiser, that would’ve been my first clue.  But I didn’t have any experience with these things.  Every call before had been the same: panic, terror, excitement, and then finally letdown.  We’d been called to an apartment complex the previous day, ready for anything.  As we parted the crowd to reach the patient, something seemed off, he looked too well to have called, too calm.  And it turned out that he was; a large cut to the thumb, yes, but hardly anything life-threatening.  So, we bandaged him, dispensed some common-sense medical advice and departed.  I want the real thing, I thought to myself.
We called the first one half way to the hospital.  It had been a pitiful attempt really, all of our equipment was oversized for the tiny human.  Even the neonatal bag-valve mask was too large, the pediatric IO needle had popped into—and then immediately through and out of—the little tibia, almost a joke.  
919 Charlie had been cobbled together with an eye towards cost.  In some strange world of second-hand ambulance parts, it was cheaper to buy a chassis and a box separately, connecting them later with a mixture of gumption and spare parts.  There was a story circulating around that the box had actually popped off of the rig on one particular night when the driver, due to inexperience and a lack of sleep, had driven under a low-hanging feature.  The way that the back shook and rattled on the way to a call certainly lent the story some credence.
“Is that supposed to happen?”
“Shit,” I muttered under my breath, looking at the rear door, open and flapping while we rattled down the freeway at seventy-five.  Careful not to fall out, I stopped working her child to shut it.  I tried to offer some sort of reassurance as I stepped past her, I think, but things were going badly and I’m sure my face showed it. 
Up in the cab, Smokey Joe sat with dad, both silent, ashen faced.  The box was connected to the cab through an open portal and there was nothing to insulate them from the direct reality of what was occurring behind them.  If they had any emotional reaction, they didn’t show it.  I’d like to think that it was sad for the dad, listening to his newly-born child die behind him, but no tears were shed.
At the hospital, a certain kind of hush greeted us.  Not exactly a silence as much as a muffling, reminiscent of stepping outside when it’s snowing and windless.  Certainly they were all aware of the details of our ordeal and, as happens with the saddest of calls, there’s just not much to say that doesn’t seem trite.  
Once the hand-off was complete, it was hard to tell what to feel.  Objectivity was key during the call, but afterward, what?  Treating emotions like a simple machine with an on-off switch had obfuscated what should have been a normal human sadness.    
It’s hard to piece together now, the exact sequence of events.  Even at the time, it seemed deeply unfair that Sarah had to actually compile everything into an official report: exact times, interventions, medication doses.  So it is that I’m not sure when in the exact sequence of events it happened.
Likely I had fallen into the trap of tunnel-vision.  With so much chaos and such heavy consequences all around me, I had focused in too closely on one patient, missing the finer details that would have clued me in to the true gravity of the situation.  The bleeding was heavy and among the tangled flesh I had missed it: twins.
The thing is, it’s unlikely that anything could have been done.  Similarly, it was hard to place blame.  The mother hadn’t seen a doctor in years, young with belly swollen and wallet empty, she had left it to fate.  And though fate is a weighty term, there are no great lessons to be learned.  There was simply a shared experience of death and suffering with which we all now must live.