Be well. Practice big medicine.

Newman | The Positive Paramedic Project #75 Tethers

Richard Hertzog, one of the tether keepers at CSL EMS. Photo courtesy of Michel A. Di Iorio.

A nugget of Big Medicine every day. #75 Tethers

We were working a road traffic crash up on the Jacques Cartier Bridge in Montreal. It’s an unforgiving bridge because it features three curves including a big one in the middle where the deck passes over Saint Helen’s Island. The view from the bridge is spectacular at night and I remember seeing the cloud of mist surrounding Molson’s brewery as we climbed out of our rig at the scene of the crash.

There was a Harbours Board Police crew already on-scene and because the wreckage was right in the middle of the curve and pretty much blocking a bit of each available lane, they had shut down the bridge until a towtruck could get up there. We had the entire bridge to ourselves. A surreal calm descended on us as we worked-up our patient. He was incredibly lucky. Blowing a tire at speed is never a good thing. Blowing a tire at speed in a curve on a busy bridge 160 feet above the waterline where the only thing keeping you from going down there from up here are guardrails and the superstructure itself is not something I’d recommend for the faint of heart.

He was relatively unscathed with only a shoulder injury after multiple rolls that began on one side of the bridge and ended in the far opposite lane of traffic. All the other motorists had managed to avoid becoming part of his nightmare.  His car was destroyed in the way NASCAR cars are destroyed after a bad wreck. There wasn’t a whole lot left other than the passenger compartment which, I guess, it just the way you want it to turn out.

We got him settled into the rig and one of the Harbours Board cops climbed aboard to complete paperwork. I had just stepped out of the side door when we all heard the sound of an engine screaming and growing louder by the second. I managed to squeeze out the thought, “That doesn’t sound like a towtruck” but the thought didn’t have time to make it to my lips before impact.

Having stolen a pickup truck on the South Shore, the perp then decided his best chance of escape would be to run across the Jacques Cartier Bridge and disappear into downtown Montreal. A police pursuit ensued. The perp ran the police roadblock on the south side of the bridge and before anyone had a chance to warn us he was coming, he had already arrived.

The pickup truck hit our rig almost perfectly deadcenter – with the emphasis on dead. The police estimated his speed at the moment of impact was 80 miles an hour and accelerating. There were no skid marks.

The impact was wild and dramatic and bizarre. I was slammed in the back by the side of our rig as it was propelled sideways along the deck of bridge. Somehow I managed to stay on my feet. I ran back and looked into the back of the ambulance. Our patient was now a major trauma case still strapped into the stretcher which had broken out of the rails holding it to the floor. My partner was down with a serious head injury. The cop was down with a serious arm fracture.

I ran around the impact side of the truck to get to the cab and the radio. Pickup truck guy was quite clearly dead having inhaled most of the firewall and a good chunk of the engine itself. DSAF. I picked up the radio and made the call for assistance. All radio communications were in french in Montreal and despite my heavily accented french I had always done quite well in getting my point across.

Not so much this time. I started with my rig’s ID number which included three 3’s – notoriously difficult for me to pronounce and always a source of great amusement by my peers, the communications crew and anyone else listening in via scanner. “Twahhh, Twahhh, Twahhh…” and then proceeded with our location and tried to explain that we needed at least three more ambulances and a fire crew on location.

I struggled to make myself understood in french but the impact seemed to have messed with my ability to process thoughts in one language never mind two.

The radio was damaged by the impact and the microphone kept cutting in and out so they were only hearing every second or third word with lots of background noise – which were the sounds of my partner and the other injured moaning and the sound of our rig’s engine which had kicked into high throttle and wouldn’t shut down and the sound of the pickup truck horn which was locked in the noisy position.

And then through the cloud of confusion came this calm voice speaking to me in english. “Hal, are you still on the Jacques Cartier Bridge? Answer Yes or No. Just repeat Yes or No four times.”

Before I had time to think about how weird that moment was I answered on the microphone, “Yes…Yes…Yes…Yes.”

“Okay Hal, we are sending you help. How many injured are there? Answer with the number and repeat four times.”

I included my partner, myself, the original patient, cop number one, cop number two – because I couldn’t see him anywhere, and the dead guy in the pickup truck. “Six…Six…Six…Six.”

“Okay Hal, we are sending ambulances. Do you need the fire department? Answer Yes or No. Just repeat Yes or No four times.”

And so it went.. “Yes…Yes…Yes…” until the cavalry came riding up onto the bridge. As it turned out, I had a mild concussion, my partner had a skull frac, cop number one an arm frac, cop number two a heart attack [he was in his cruiser slumped in the front seat], our original patient went from minor trauma to major trauma and the guy in the pickup truck remained dead.

That voice, that quietly calm voice that cut through the chaos and chatted with me as if we were just a couple of friends making conversation belonged to an emergency dispatcher named Jean-Pierre. I heard from a colleague that before he had cleared the air on that frequency he had told units that were closest to the location to be specified in the following conversation to begin their response immediately while he sweated the details with me – in english – on the air.

When my world had descended into a very dark and dangerous place, when life and death were all around, and when I needed it most Jean-Pierre provided a tether to a saner world where help would be on the way just as soon as he could get it to us.

There weren’t any protocols for what he did. He made it up right there on the spot. He knew instinctively that by talking to me in english and in a calmly conversational tone, he would be able to draw the required information out of me.

I don’t know that I’d have been able to do the same thing were the roles reversed.

I’d like to dedicate this episode of The Positive Paramedic Project to all of the emergency communications specialists who  maintain those tethers to a safer place.

Be well. Practice big medicine.



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