text: **This is a true story. Names and details adjusted to maintain confidentiality. It has themes of death and trauma which some readers my find distressing. If you struggle with mental health please know there are always people to help. I am always happy for comments on ways to improve my writing, I have fairly thick skin at this point.** This is a sad story. A difficult situation and a horrible outcome. It was shortly after being qualified as an Intensive Care Paramedic, my partner the same. I am working with a friend, John, competent and capable. I always enjoy working with people that just know what to do, too know they’ll stop you from fucking up. We are relaxing, on a soon to be interrupted meal break. “Motor vehicle accident” Rings out across the station with the associated alarm. I always find that funny. Calling it an accident just doens't make sense!? An accident implies no one is at fault. Anyway. The car dislplay tells a short story. “Female 40s run over by car. CPR in progress.” The address is some suburban street. Weird. My partner is driving, we head off lights and sirens. Now I say weird because you don’t expect any serious injuries in a low speed area with minimal traffic. The forces just aren’t usually there. We are thinking our patient was a pedestrian and stepped out unexpectedly. MDT Update “Pt run over by her own car. Dragged across pavement before going under and car rolling over.” Well there’s the answer. A second car is attached, AFP on scene. I get nervous and start to do some planning with my partner. I hate this. You know your turning up to shit scene. In the simplest sense I always wonder if I’m going to get this right or will I be caught out as a fake. It’s horrible. We talk through our roles and priorities. I will lead, my partner will be on the airway. We drive, siren blaring. John checking the MDT for directions. I clear him through intersections. I’m losing the joviality in my voice. “Clear, clear, clear”. We roll through the intersection. I put my gloves on. I’m nervous I always do that when I’m nervous. I try and get them on before my hands sweat too much. Gloves are impossible to get on when that happens. We turn into the suburb. I’m silent. I’m nervous. It a weird feeling, things are happening, lights flashing, siren blasting. But you just don’t hear it. It’s quiet in my head. Not calm, just fear being held at bay. As we drive into the scene it’s controlled chaos. There are police and the fire brigade evidently just arrived. To our left a small crowd of bystander’s huddle in concern near a new model Jeep. Some are turned away with heads nestled into consoling hugs. Police are nearby trying to gather information, performing crowd control for the small group. It’s not needed. Everyone is staying back, staring. Their attention is on the dead lady across the road. I look over and see where she lay, a young man performing CPR. We pull up close get out and grab our gear. We’re quickly informed the patient had pulled into her driveway when she got out and walked behind the car to go inside. No handbrake, it then rolled over her and dragged her a short distance before hitting the gutter where she stopped, and the car rolled across the road to where we can see it now. Everyone had only arrived moments before, not much has been done. In the time it takes us to get out, grab our equipment and wlak the 2m to the patient the firefighters have fallen into their position, doing CPR. She looks in her early forties. There’s no blood, no scratches. It looks like the car has run over her chest and abdomen. She looks dead. We start taking control and ask the firefighters to continue CPR. My partner goes to the airway as planned. Well haven’t frozen yet, we just get on with the job. I expose the patient cutting away her top and bra with shears. I apply the pads and we find she is in a non-shockable rhythm. We continue with our guideline and our back up arrives. We quickly brief them, and they take over certain tasks. I get to step back and take stock. I note the young man from earlier, he’s only a kid really, maybe 14. He’s squatting maybe 2 meters away. “Do you know what happened?”. Nothing, he just stares, no recognition I spoke. I dismiss him and move on; I see the husband distraught and talking with police nearby. I try and focus back on the patient. Again, no shockable rhythm. I discuss our next steps with John and our back-up. Something to understand in chest trauma like this is the lung likely detaches from the inside of the chest wall creating a space that shouldn’t be there. That space fills with either blood or air and you have a pneumothorax, or what would be called a ‘collapsed lung’. If it is big enough and affects your blood pressure, we call it a tension pneumothorax. This lady probably has one. To fix this we place a large needle through her chest until it reaches that new space. We then leave a tube in place and it allows the air (or blood) to escape and releases pressure. So I set up for the procedure and mark my place. But I can’t get the needle through the chest wall. That’s when I realise, she’s ruptured an implant. The silicone has ridden up and I can’t get my needle through. I quickly tell my partner who just reached over and pushes the silicone down and out of the way. I insert the needle successfully and step back out. The job continues for another twenty or thirty minutes but there is no change. She’s dead. We talk it through, and I go over to inform the husband of what we’ve done. There is understanding, he knows we will soon stop. We will clean up finish our paperwork and leave. He will stand there next to his dead wife who only moments ago was fine. We stop. He goes over to the boy and consoles him. It’s his son. I guess that explains why he was acting weird. As we pack up, I hear commotion. Police are holding back a young girl that just drove up to the scene. It’s the daughter. I go over and start talking to her. I retell the story, that her mum suffered severe chest injuries from the accident, that we’ve stopped CPR and her mum is deceased. She turns away and paces for bit. Calmer than before. I always thought it strange that. How quickly people calm down once the worst news is confirmed. I tell her she can see her mother, that its ok and we walk over together. We kneel down next to the body; we have a blanket over her. I pull it back to reveal her face, unmarked. You can sense the daughter is getting more emotional, more distressed. I watch her as she glances at her mother, then down her blanket covered body. Back and forth, back and forth. Her hands reach out and hover over the blanket. In conflict whether to peak underneath. It clicks, she thinks her mum is mutilated under that blanket. All she knows is her mum got run over by the car causing ‘severe chest injuries’. It just felt right so I rest my hand on her shoulder and gesture over her mum as I explain. I reassure her there is no gory wounds or deformity under there. The blanket is for modesty. The distress dissipates. The sadness remains, overwhelms. She cries as she strokes her mothers face. I leave her to her grief. We finish our paperwork and leave. Controlled chaos, a distraught family, a dead mother. We go back to station and finish our lunch, having a laugh and making jokes. The dead body soon to be poorly remembered as just another job.