13 April 2014
In the early 1970s I was working at a small town forty bed hospital as the ambulance director and moonlighting part time as an Emergency Medical Technician (EMT) regional trainer for the Minnesota Department of Health and Vocational/Technical School System. I received my training and all of my work experience in Minneapolis so working in a facility this size was something very new to me.
Minnesota weather can be tricky, especially if you work as a paramedic in densely forested rural areas as I did. Winds you cannot see or feel at ground level can whip the tops of trees with the frenzy of a wolf tearing into a coyote, thrashing them in a hundred directions ripping old nests, broken branches, acorns, and pinecones into shrapnel. In the winter months, nature adds ice, heavy snow, and slush to the mix making driving in a car an adventure and running down a poorly maintained country road in an ambulance a major challenge.
On a quiet Friday afternoon in late November I began a weekend of emergency standby which usually meant I either sat around home all weekend or was busy with emergency calls – there was rarely a happy median. However, this weekend soon proved to be different.
When I checked in with the dispatcher to sign in for my shift and pick up a new two-way radio, she told me to expect some “weather” moving in tonight. For those of you who didn’t see the movie “Fargo”, “weather” is a Minnesota euphemism for stock up on food, beer, firewood, and warm clothes – there is a major snow storm coming our way and we are going to shovel white stuff! This also meant as lead driver it was my responsibility to keep the ambulance garage doors free of snow and ice.
The early evening saw light flurries of snow but no winds or major accumulation but we were ready for snow, or so I thought.
We received our first call at 10:40 pm to pick up an elderly patient at a nursing home and bring her into the hospital for admission. Immediately following that, they dispatched us to an auto accident on the interstate where we patched up and transported up two teenagers to the hospital for treatment and overnight observation. Our last call was at 2:30 am when a drunk driver tried to move a giant pine tree.
As the evening progresses the snow fall increased in flake size, consistency and amount so before garaging the ambulance for the night we made sure it was adequately stocked with extra supplies and blankets, and had a fuel tank of gas. We also cleared the snow away from the garage doors and driveway before going home to bed.
Saturday morning came with a 6:30 am call from the dispatcher telling me we had to pick up the on call physician and bring him to the hospital. Apparently his snow driving skills were far less perfected than his medical arts for he ended up in the ditch along his gravel drive trying to get into town.
Personally, I would like to have left Dr. Daytona to wait for a tow but he was needed at the hospital so my partner, Norm and I drove out in the ambulance through substantially more snow than we did coming home at 3:00 am that morning to get him. The winds had also picked up causing drifting across the road making for slow progress, but we made it and Dr. Daytona was so happy he excited yelled; “Turn the goddamn heat on back here!” You’re right, we didn’t allow him to ride in the comfy front seats. How he became a doctor I will never know – he thought everyone was incompetent and worthless. He was God’s gift to mankind and I was always willing to return him.
By the time we got back to the hospital the weather had starting to degrade dramatically. The snowfall had increased and wind speeds were in excess of thirty miles per hour. Visibility in town was about half a mile or less and the weather service reports said to expect a minimum of twenty inches of snow by midnight with wind gusts in the sixties. This meant that Dr. Daytona I’m in charge here has to stay at the hospital for the night. Imagine, an overweight physician in his mid-sixties having to sleep on a cot in the lounge, excuse me, he did put up a handmade sign: “Doctors Lounge – Private”. We could have taken him home in the Sno-Cat the Department of Natural Resources brought us but he refused to go. I guess he was working on his “image.”
By noon the weather had deteriorated to the point that nothing but snow-cats and snowmobiles were moving outside.
Except for the sounds of the storm outside and windows rattling inside, the remainder of my night was quiet. I was able to spend a little time with my wife and sleep.
At six fifteen Sunday morning I received a call from the dispatcher – “Woman in labor – possible breech. State road crews assisting.” Now the adrenalin is going!
I dressed as fast as I could and headed for my garage where my snowmobile was parked. One turn of the key on the snowmobile, one push of a button for the garage door and I’m facing a wall of snow. Drifting snow had accumulated against the garage door from ground to eave – not cool. Suddenly there is a hole at the top of the snow and the ugly face of partner appears.
“Let’s go boss, state crew has us dug out.”
I literally had to get a step ladder to exit my garage.
Once outside the snow had stopped, there were no cars on the street and a snowmobile was partially parked on my garage roof. As I hopped onto the back of his snowmobile I wondered where my wife’s car was – she usually parked it on the street in front of the house. Found that strange because my wife had a big 1969 Chevy Impala sedan which she loved to show off by parking under the street light when she came home from work. As we raced out of the driveway I saw my wife’s car, or at least a part of it. Only the antenna stood out above the snow.
Arriving at the ambulance garage, I noted the state road crew had dug out the driveway and was clearing a path down the center of the street towards the center of town. As we climbed off the snowmobile and down the mountain of snow to enter the garage, my partner gave me more details on our call.
“It’s a twenty year old pregnant woman, first pregnancy, minimal pre-natal care and claims to be in full labor. She’s located about thirteen miles out of town at a farm on county road five. Husband is with her. He states ‘she’s fully dilated and contractions are less than four minutes apart. No known allergies or medications.” Norm says.
“What’s the road condition?” I ask.
“We got forty six inches of snow since Friday, so I’m going to say, we’ll have to find them before we can say.” He replies
“Police and the dispatcher coordinated with state road crews who are waiting for us. We follow the plow and salt trucks to edge of town where two road graders have started clearing a path down State Five for us.” Norm answers.
“Ok, let’s turn on the lights and head on out.”
“Unit EMS-1 is 10-8 (en route)” I radioed to the dispatcher as we pulled out of the driveway to join the state vehicles.
It took us a little over two and one half hours to go the thirteen miles. Had to be the slowest emergency response time on record. We even lost one of the road graders on a tight turn when it slid off the road into a drainage canal. Thankfully the driver was not hurt.
“Unit EMS-1 is 10-7 (on scene) I radio to the dispatcher.
“Hold for the Doctor.” Is her reply.
“No heroics, I suspect patient aborted. Just bring her in.”
“10-4 Doc” (understood). Asshole! I mumble as we grab our med bags and head into the house.
“She’s in the bedroom.” The husband says.
On entering the bedroom we find a very young looking twenty year old obviously very pregnant female laying on a large bed.
“She’s having the baby now.” The husband exclaims.
“How often are your contractions?” I ask her.
“Constantly!” She cries.
“Slow your breathing down. That’s it, now pant. Do not bear down yet. I need to check how dilated you are. Stay on your back, bring your knees up and spread your legs please.”
“I’ll try.” She responds.
“We’re doing well – appears you’re dilated about nine. One more to. Now I’m going to listen to the baby’s heart so I need every one to remain quiet.”
Taking my stethoscope I check the mother’s abdomen for a fetal heart tone. I can barely hear it but it’s there. That’s both good and bad. I have to decide whether to deliver her here at home or risk the trip into town.
I decide to call the charge nurse the hospital for her help so I go out to the ambulance and use the radio. Raising the dispatcher, I tell her I need to talk to the charge nurse stat.
“Dr. Smyth (not real name) is standing here. He wants to talk to you.” Dispatcher responds.
“What’s going on out there?”
“We just got here doc. I’ve done an initial exam. Mom’s vitals are good. She’s dilated about nine and having contractions every 1-1/2 minutes. I can hear a faint fetal heart tone.”
“Can you deliver there?”
“Could if I had to but think we better get her in.”
“Baby is probably going to be still born.” he says.
“Will check again but I’m sure I hear a fetal heart.”
“You don’t have enough experience and training to diagnose that. Deliver there then bring remains in.”
“10-4 doc.” But thinking “Fuck you doc, you just don’t want to deal with this.
Back in the house, the mother has slowed her breathing is a little more relaxed. Contractions are remaining at about 1-5 per minute and she’s not shocky so I decide to check for the fetal hear again.
“Roads are pretty bad and I want to check you again before we decide to take you in to the hospital.” I tell her.
Immediately following a contraction I listen to her belly again.
There it is dammit, I’ve got a decent fetal beat.
“OK, here’s the deal. I want you to deliver in the hospital so we’re going to load you up and head for town. Roads a rough and bumpy right now so there’s a chance we won’t make it all the way without having to deliver. We can do that in the ambulance if needed but I prefer to get you to town.”
“Please hurry.” is all she said.
Between the father, my partner, the highway crew, local fire/rescue people and some cops we formed a real parade to town. It took us a little over forty-five minutes to get back to the hospital. Guess who was waiting at the door looking like I married his son, yep, good old Dr. I know more than you, himself.
“Take her into the ER”, he says to my partner then turned to me and said, I want to talk to you.
Oh shit, here it comes. The old don’t you ever contradict my instructions lecture. I was wrong, he just said “I’ll have your license revoked and see to it you never work in medicine again. Get out of my sight.
What he did not know is that the patient’s husband, a nurse and two police officers heard him say it.
We watched as the doctor and head nurse rushed the mother to the elevator and up to the delivery room. About an hour later I was told she had delivered a 6.5 lb. healthy boy. I smiled a lot that week.
As for Dr. Dumbass, well when his contract with the hospital and clinic came due, it wasn’t renewed.