Repeat After Me
The confidence of effective emergency medical response comes with repetition and practice. When you first encounter this advice, you are 23, still young enough to believe everything you read. You tab your EMT manual for easy reference. You cling to it like an infant.
But like all who have once listened, you will eventually realize how this job imprints itself on your memory. How even the most mundane of activities will trigger your past: bending down to pick up your keys from underneath your car; the smell of asphalt in June; the way that boy at the park placed that coin in the palm of your hand, probably because he felt sorry for you.
The past for you hasn’t happened; it will always be happening. The car will continue to smolder. The victim will eventually bleed out.
No one will ever straight-out die in your memory, but the process will always be familiar. This is one thing you will learn from repetition.
When you first arrive on scene, you go through standard emergency procedure. You survey the scene for safety; you determine the scene is safe enough. To your left, a red SUV stalled in the middle of the street. To your right: a mangled green tricycle on someone’s front lawn. Moving past you: a police officer carrying a woman away from the scene. The words that linger: You are needed at the scene. The woman’s lipstick is smeared on her face. She won’t stop crying.
You take your place down next to the SUV, readjust your gloves. Beside you, another medic—someone you don’t recognize, a new guy—has his crash kit open.
No one is moving, and yet the car engine still whirrs. No one is moving, and yet the hazard lights still flicker on and off. At this level, the heat from the asphalt rises; the smell of tar is unbearable.
The medic next to you begins to reach his hand underneath the car, only to pull back at the last second.
I can’t do this, the medic next to you says, removing his gloves. I just can’t.
You arrive on scene like you always do: blankly. The dispatch had been made on the MVC on Gardner Avenue while you were coping with work traffic on the Long Island Expressway; your adrenaline revs in time with your engine. You acknowledge the MVC, and tell the dispatcher you will meet the ambulance there. You make good time in the Corsica by riding the grassy shoulder to the exit. A few drivers give you the finger as you drive by, but you don’t have time to respond. The emergency sirens are going off so loudly in your head. You can only handle so much detail at a time.
If you were a psychologist, you would question this medic’s—this kid’s—impulse further. What is it that you cannot do? Is this hesitation coming from a physical or psychological place?If you were a teacher, you would evaluate the response, and then ask what he has learned from the exercise. If you were a screenwriter, you would write yourself a monologue in which, through your empathy and life experience, you move this young man to act, and, in turn discover some greater truth about himself.
It is winter. You are twenty and home from school for winter break. The house is too quiet for you; you are restless in your own home. The area had been hit by a bitter ice storm the previous week. The streets are a mess. The town is a mess.
You go outside. The night before, you had worked on the driveway just enough to be able to move the cars the next morning. The driveway looks even worse now, with all the cars gone. You decide to make yourself useful. Grabbing the metal shovel you used the night before, you start at the bottom of the driveway, working in vain to expose the black pavement buried below. The rock salt doesn’t do much to help. It takes a good half hour to clear five yards; you are tired, and don’t feel like shoveling anymore.
Using the handle of your shovel for support, you find yourself looking at your next door neighbor’s house. She’s been dead for a month now. The spruce on her front lawn looks so pretty in December, the snow filling in the gaps in its branches. It upsets you that her house is the only one that doesn’t look lived in. Her driveway is the only one on the block that hasn’t been shoveled. You had always shoveled her driveway when she was alive; why stop now?
You scan the block to make sure you’re the only one around. You don’t want to be seen shoveling your dead neighbor’s driveway; you have never been the one to perform for an audience. You start with the walkway to her porch first, scraping what you can off the cement and piling it underneath the spruce. The ice is too thick and has bonded itself to the stone. You clear just enough so the mailman can deliver her letters. You wonder if he knows she is dead. Frustrated, you move to her driveway by the entrance to the side door. You’re digging into the ice—more like chipping—and your shovel’s getting beat. You find yourself getting angry, and now you’re just driving your shovel into the ground, you’re furious, you just keep slamming the metal to ice again and again and again.
But you are not a psychologist. You are not a teacher. You are not a screenwriter. You are a medic. You respond to things. When you get the call, you go. When you find the victim, you act. You put on gloves. You blot bleeding things. You take gloves off. You collect your instruments and move on.
This occupation is a series of repetitive motions. Survey the scene. Conduct an initial assessment. Give two rescue breaths. See if they go in. Readjust the resuscitation mask if needed.
Voices in these sorts of situations rarely inhabit bodies. They exist as a sort of vapor that condenses on your face. One voice that you feel: What about my boy? What about my boy? What about my boy?
You reanalyze the scene. You start from the beginning.
You look up.
If you ever get somewhere and every responder is looking up, don’t look up. You first learn this against your will on a visit to MOMA in New York to study Andy Warhol. You believe in biology, not the arts, but your school still believes you will become a more balanced individual if you experience art and are forced to write about it.
Walking through the sterile hallways, you find multiple causes of concern for the artists whose works litter the walls. To you, the museum is an accumulation of crap: soiled bedspreads, dangling phallic representations, emaciated faceless men walking towards someplace, something. You pass by a beach lifeguard chair amongst jars of preserved brains and roll your eyes. If anything, these artists lack serious balance, hence the physical manifestations of their insanity.
When you finally get to Warhol, you notice that everyone’s looking up.
You are standing in front of a large green canvass—a screen print, you later read—of an overturned car on fire in a suburban neighborhood. At first, you think that the multiple screenshots are a progression of sorts—you almost expect the car to combust right in front you—but you soon realize that it is the same image duplicated next to one another. In this world, the car perpetually smolders. The smoke obscures the frames in layers.
“Green Car Crash, 1963,” says an old guy in the turtleneck next to you. He smells like iodine. “I personally like Orange Disasterbetter, but, nonetheless, quite moving, don’t you think?”
You’re not sure if he is talking to you, but you answer anyway.
“Not really.” You pause, then clarify your answer. “It makes me feel blank.”
The man in the turtleneck makes a sophisticated sound in the back of his throat. “That’s probably what Warhol intended: witnessing cruxification through a green filter.”
It is only after he leaves that you realize what he meant. In the far left corner, just above the car fire, a man has skewered himself on the hook of a telephone pole. His shoulders are slumped; his head, cock-eyed. In the background, a man continues to walk. He continues to look up. The ash collects at his feet.
You take a step back.
You look up. You see no one.
You look again to be safe. You still see no one.
Process of elimination: if the victim is not with the voice or with the bike or on the grass or in the streets or in the trees or in your mind, there is only one place in which he must exist.
If you think Green Car Crash is grisly, you should check out Warhol’s Orange Disaster. That poor kid trapped under that car. I still can’t get her eyes out of my head. I just can’t.
I can’t do this, the medic next to you says, removing his gloves. I just can’t.
This occupation is a series of repetitive motions. The screen imprints itself again and again.
Step back, you tell the new guy. He looks at you blankly.
You respond by shoving him. He crashes into his crash kit.
Don’t make me repeat myself, you tell him.
Then you replace your gloves.
After that long winter, you are forced to replace the shovel. There is nothing wrong with the shovel, except that it is blanketed in your grief, the type of dirt that never comes clean.
You open your eyes. You take a deep breath. You squat down farther. You are right up next to the SUV. You are careful to avoid the sharp edges. You extend your arm as far as you can extend such a thing.
On your first attempt, you feel nothing. When you pull your hand back, your arm is covered in blood.
An experience that can’t be replicated: reaching your hand into the top shelf of the first apartment you rent out of college, and then hearing the snap. You cry out and stick your middle finger in your mouth. You taste blood.
Your roommate later warns you about the mousetraps. You are the first animal it catches.
You put your right hand in, you put your right hand out, you put your right hand in, and you shake it all about. You do the hokey-pokey and you turn yourself around. That’s what it’s all about. That’s what it’s all about. That’s what it’s all—
You respond to things. You absorb bleeding things.
Why isn’t anyone doing anything?
The woman with the smeared lipstick sees your bloody arm, then throws up on herself.
Give yourself two rescue breaths. Readjust your brave face if necessary.
You always shoveled the victim’s driveway when (s)he was alive; why stop now?
This occupation is a series of repetitive motions.
No one is moving, and yet the people still whirr. No one is moving, and yet your heart still flickers on and off. At this level, the heat from the crash rises; the smell of iron is unbearable.
You put your right hand in. You extend your arm through.
And someone, something grabs your wrist.
You open your eyes.
He opens his eyes.
You whirr together.
Illustrations By Meghan Murphy