Wednesday, July 8, 2009

Wounded Warrior

The call came in for chest pain, at a factory that we go to on a regular basis. They are pretty dialed is as far as businesses go. They have their own response team, which includes an EMT. They are pretty good about sending someone out to the gate to guide us in, usually someone in a golf cart.

We meet the golf cart at the gate and follow him into the facility, stopping at an assembly building. I grab my H.T. (handy-talkie), my clipboard, my EMS bag and step off of the engine. I ask the guy how far into the building we are going and if the patient is talking. He tells me that the patient is only in a few hundred feet and that the patient was conscious when they found him. The crew grabs the airway bag, drug box and monitor and we all follow our guide.

We walk into the building, make a few turns and find our patient. He is lying on the floor, with his head resting against the knees of a co-worker. The co-worker is kneeling on the cement floor at the head of the patient. Various supervisors are present, but standing out of the way at a respectful distance. The plant EMT is tending to the patient, administering 02 via mask and trying to get vitals for us.

The patient is a 35 yr. male. He has a shaved head, a goatee and has numerous tattoos. The patient is shaking heavily and initially isn’t responding to our questions. He is breathing at a rapid rate, respirations cranking along at about 60 per minute. A look at his hands reveals that they are cramped up into a claw like position.

Our patient mutters something about needing to see Sgt. Gomez and some other statements which I can’t make out.

We shut off the 02 and continue our assessment, leaving the mask in place. No obvious signs of trauma, no evidence of a fall. Witnesses said that they found him leaning against a pallet of aircraft parts and that they had assisted him to the floor. My medic is telling our pt. to slow his breathing down in calm, soothing voice.

About this time, one of the supervisors walks up and tells us that our pt. had a similar episode about a year ago and was diagnosed with an anxiety disorder, depression and a few other issues. Our patient is answering more of our questions now and tells us that he takes five medications. He doesn’t remember what they are, but tells us that they are for anxiety, depression, anger management and mood stabilization. He denies any other medical problems.

I have to be honest; sometimes it is hard to tell what the deal is with these types of calls. Sometimes we “get gamed” by people for any number of reasons. Other times it is just someone who is having difficulty dealing with life or someone who is juggling so many issues that any additional stress pushes them over the edge. Frankly, some people just handle stress or emotional trauma better than others. Then, there are all kinds of people that have legitimate mental / emotional issues which require medication and therapy to get it sorted out. As we are not E.M.P.s, (Emergency Medical Psychologists), we have no way of telling who is what.

The solution to this quandary is to assume they all fit into the latter category, treat whatever symptom that they are presenting to us and act like the professionals that we are. It’s best for the patient, best for the public and it keeps us out of trouble.

As I watched my crew continue their assessment, I wondered what the deal was with this guy and how he got this way. I also noticed that one of the many tattoos on his arm was an elaborate design incorporating the term “U.S. Army”. Another was designed around a unit insignia and had a Latin term attached to it.

A few more co-workers show up and one approaches me. He tells me that he is a friend of our patient and that our patient had served in Afghanistan. He adds that our patient had been a “designated marksman” in his unit and has been struggling with a lot of “issues” since coming home and leaving the army. The friend adds that our patient was shot while in Afghanistan but he doesn’t think that are any remaining problems from the wound. He also tells us that his friend learned recently he is eligible for VA benefits as he has become partially disabled as a result of his service.

A designated marksman is a specially trained soldier who is attached to a small infantry unit known as a squad. His job is to support the squad by taking out targets that are farther away than regular infantry can accurately hit, yet closer than those company snipers usually engage. Designated marksmen use a rifle with a telescopic sight on it. This “scope” gives them a good view of their target before the round is sent down range and often as the round hits the target. I imagine that some of those visual images are disturbing to say the least.

I don’t know what kind of shape our patient was in before his stint as a designated marksman. I can tell he isn’t doing so well right now.

Our assessment is complete and we turn him over to the ambulance crew for transport. As he is being wheeled out to the “box”, I think about how he appears to have recovered from his physical wounds, but how he continues to be ravaged by his emotional ones.

I hope that somehow, through treatment and counseling, our patient can conquer the demons that he battles with on a regular basis. Although his enlistment in the army is over, his war rages on.


  1. I really enjoy your writing. You tell a compelling story each time. Just gotta get over here more often is all. Keep blogging!

  2. Cap, as a Vet myself, I thank you and your crew for caring for my Brother in a kind, compassionate and professional manner.

    Some people trivialize these type of patients, saying that the guys from WW2 and Korea didn't have these problems. If you look back, even at the movies post war(some of which specifically dealt with these guys troubles mentally postwar), there are plenty of examples of PTSD displayed by Vets from those times too. It just wasn't as recognized and treated as such.

    I just hope that he will find some peace. The VA can help. I should know, I am a 20% Wartime serving Disabled Vet myself. The Docs and Nurses at VA are first rate.

  3. Yeah, It would have been easy to not take this guy seriously in the beginning of the call. But, the reality is we never know for sure what our customers are bringing to the table. It turned out that this guy was carrying a far heavier load than we even imagined.

    I just hope this guy can get it together enough to keep his gig, have someone in his life that he cares about and that cares for him. Isn't that what we all crave?

    Thanks for reading and the comments fellas.


  4. We've had a few vets we've bent over backwards for, including one of the Doolittle Raiders. But we had a guy couple of years ago, retired paratrooper, had his Class As with all his ribbons (Gulf War 1, Panama)hanging on the wall in his trailer. Chest pain, SOB, back pain so bad he couldn't walk due to breaking his back on jump #106. My crew and I bent over backwards (I'm a Marine Reservist)and were disgusted that this guy who had given so much was living like a bum and in pain. We carried this guy to the ambo 3 times in one week. The third time the ambo crew watched him sign out AMA and walk out to a car because the ER wouldn't give him Vicodin immediately. The ER let us know he was an addict and did not have a broken back. Thankfully he moved out of our district the next week, or we might have beat the snot out of him.

  5. Great post! Please don't stop writing as the men and women who are still having troubles, are a a very large group, and people need to understand and recognize these issues! With the heat on again in the mid east, more trauma victims are heading home! My adopt a soldier is a Cav.Scout and he tells me his job is to try to get in and look around and get out, not to fight, but if he is engaged, his life expectancy is 15 SECONDS ! Imagine living with that statistic over your head and continuing to do your job. Kudos to your team for being men enough to show compassion to another human!!

  6. Thank you for showing me a part of Life I forget too often, don't think about...
    Much reflections needed for sure thoughout those moments.
    Be well...