Some things we can't fix.

“Your patient died.” my partner announced as I entered the room.
“What?!”
“Yeah, she died.” it was strangely casual. It made me more sad.

As I looked back I shouldn’t have been as surprised as I was. When we arrived an EMT was crammed into the back of the twisted car, the front of it barely recognizable. He was making his best efforts to protect the patients’ spine from further injury. But the patient was so altered that she was not even able to rationalize her actions, pulling off the collar and oxygen, and kicking her free leg. One look at the pale, sweaty, tachypnic patient and I said “This one goes first.” The fire department continued to carefully cut the mangled car away from the patient.

I didn’t even get a blood pressure before the receiving helicopter crew arrived. We intubated her on the street while the helicopter blades droned, waiting in the background. I watched as they took off, satisfied at the speed of the call, barely ten minutes had past since I arrived. The combined efforts of the fire department and EMS had given this patient the best chance she had. I am not a surgeon, and the back of an ambulance is not an operating suite. Still, I didn't expect her to die.

It’s one of those calls I’ve reevaluated many times. But with no access, and no time, there wasn’t much I could have changed.
That doesn’t stop me from wishing I could have.

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