Not Your Average Christmas Story

Not Your Average Christmas Story

-----August morning, daybreak, already 79 degrees.

About 7:05 am, Peggy P,* the dispatcher from City Hospital calls the little ambulance company.

Crew coordination 8:00

Stage: 9:30, at the JF parking lot about two miles from the traffic of the big city.

Report to ambulance bay, City Hospital 10:30.

Destination: HOME (central North Carolina, somewhere between Fayetteville and South Carolina.)

(no location filled in)  Directions are challenging at best. This is the time before GPS.

Surgery: Successful placement of neuphronic tubing.

Recovery: Likely, barring possible complications.

PT NON AMBULATORY

Approx weight: 340 lbs.

Ramp at residence (?)

O2 not required for Pt. during transport

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Ambulance crew arrival to ambulance bay at City Hospital 10:25.

Staff and nurses at City Hospital are always professional.

The ambulance crew was provided all necessary required forms for legal transport of Mr. Kringle (not his real name).

The Pt. name has a Scandinavian suffix.

His name is too similar to Kris Kringle to release his actual name.

That would be a violation of federal Patient Health Information (PHI) regulations.

The ambulance transport company (crew of three) went through the normal proceedures of completion of paperwork on the forms necessary for authorization to transport. We read and meet around the Ferno A-35 stretcher to understand

Pt Hx, which is the chronology of recent and previous surgeries, meds, stage of recovery and more.

When the timing seems right, we stick our heads around the edge of the door.

Just to get our GI (General Impression) and LOC (Level of Consciousness) of the patient.

The crew of the little ambulance company laughed quietly in the hall because they realized the patient REALLY is a "big boy".

And, his name is too close to Kris Kringle, and he looks just like Santa Claus.

The run leader instructs the crew:

"Protect the patient. Let's do our job. Distance run.

Home run. Let's make it happen."

According to the dispatch orders, Wife is with Pt. at City Hospital. Wife will ride. She looks more like Mrs. Claus than anyone could imagine. She has a smile and a glow that hangs on her like supernatural honey.

Outside the room, in the hall of the hospital Pt. wife repeats an ongoing litany of: "I just want to make sure Kris is alright."

Also: "There is so much for Kris to do, NOW." (This is August).

As a team, the little ambulance company crew does the knock three times, and go in.

General Impression, LOC, sound of voice.

Knock knock knock, "Good Afternoon "

"Good morning, Mister Kringle",

"My name is Charley."

(Mark and Catherine introduce themselves).

(Speaking slowly)

"We are Emergency Medical Technicians."

"We have a nice ambulance.

We are going to transport you to your home with Tender Loving Care.

We have a good air conditioner, so we can keep you cool.

And we will protect you". 

The wife smiled and nodded.

I asked the patient :

"Are you from Norway?"

"NOOOO, HO, HO I am of Scandanavian dissent."

Mutual nod from the crew. (Everybody is too professional to LOL.)

In the room, we did the standard check for patient personals floor to ceiling and the ceiling to floor. (Eyeglasses, dentures, hearing aids, personal things, anything more??)

Good.

Transfer of a 340 pound patient from hospital bed to an ambulance cot is always challenging.

A standard hospital bed is about 48 to 60 inches wide, and a Ferno ambulance cot is exactly 24 and 1/4 inches wide.

It's like lifting, moving, and landing a Boeing 757 jet onto a 5 by 7 index card.

After setting up the strategy to protect his nemphronic tubing, Our team brought Mr. Kringle (not his real name) across with a smooth and safe transfer.

And yes!

His belly DID shake like a bowl full of jelly!

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As an ambulance company transporting a semi-critical patient long distance to home-assisted care, we have our normal procedures and a clearance sequence that allows us to get Mr. Kringle (not his real name) up and into the ambulance.

I've pushed and pulled a lot of patients through many miles of hallways in hundreds of hospitals. It is rare to see the patient "light up" the staff walking in the hall.

To every single person we rolled by.

Mr Kringle said: "Woo, ho".

He never actually said "Ho Ho Ho." Even with the meds he was on, he was speaking clearly, in total control.

It is notable that Mr. Kringle spoke to people in the future tense.

As we rolled down another hallway, he smiled and said directly to a group of snobby white-coated doctors: "You're going to do better."

Pt vitals remained stable prior to load into the ambulance.

Vitals: P 90, R 20, BP 140/80, O2Sat 96, skin dry, pupils normal.

Thanks to "traveling meds" admistered at City Hospital, Mr. Kringle (not his real name) remained restful.

Vitals are stable.

Afternoons in August on Interstate 85 and Interstate 40 are always challenging for an ambulance crew. You have to deal with insane traffic. You have to keep your patient stable and cool, and outside, it is sauna humidity and hot as a hundred hells.

From I-40, we went on to a state semi-paved road, through what was explained on a sign as a "work in progress".

Mapquest, Expedia, and True Maps instructions went to: "Take local roads."

Magellan GPS reported: Acquiring satellites.

We are now transporting a semi-critical patient and his wife, with crew of three, and a temp gauge way past H, wandering through nowhere in the scorching heat.

(And the crew has verified, there's no cell phone towers, and we are out of radio range for our grid of hospitals.) Hmm.

After what seemed to be a maze of turns on challenging, unnamed country roads, (this is August down South) we stopped long enough to pop the hood on the big diesel engine and notice our own radiator really swollen, spitting, and  ready to explode.

Attitude check.   

Sooooo, while completely good and lost, Mr. Kringle sat up with his nephronic tubing attached and said: "Turn left there."

Quite honestly, by this time, many were completely unhappy with the idea of trying to drive an ambulance in 100+ degree August heat down another gravel road, then 4 by 4, for about two miles, then goat trail, then there really really "ain't no more road."

There was a lot of mutiny. The little ambulance company crew made it clear that they might be working somewhere else starting tomorrow.

Phones don't work. Radio doesn't reach any tower.

And our patient Mr. Kringle, (not his real name) is laying on his back, looking out at a charcoal tinted window insisting: "Turn left there, turn left here."

Sooo, I cut the wheel of ambulance Unit 4 hard left and the power steering of the trustworthy Beth O Ford Econoline screamed resistance as we plowed through a small field of tall weeds that have been there for a while.

I was looking for solid road, because every ambulance is notably heavy, and driving across somebody's fallow field is a huge risk. Also, it destroys the suspension system of the ambulance, and does a lot of damage to the universal and the transmission.

I shouted to the crew:

"If we get stuck up to the axels in the mud in the middle of some field in the middle of nowhere, with a critical patient and his wife," I said, "We are going to find a way out."

(Actually, I was just keeping the team thinking positive.)

About half a minute later, Mrs. Kringle smiled and clapped her hands.

Without looking, Kris said: "Now turn left again".

Three left turns means you're going in a circle!

The crew is now REALLY calling BS. This is too much. They wanted to turn it around and find a road.

Again, Kris said "Now turn left again."

Again, I cut the wheel hard left and the ambulance went through another bunch of weeds about four feet tall and forty feet deep.

Then another 40 yards to a completely unmarked bridge across a stream with a twenty foot drop. All of the rafters of the bridge were bumpy tree trunks, Indiana Jones style, not two by eights planks, which would have been flat.

When the ambulance made it across the bumpy bridge, the patient and Mrs. Kringle smiled.

The little ambulance company company was relieved that they themselves didn't die by way of heavy ambulance with crew, critical patient and wife falling through a flimsy bridge into a creek.

Then there was another quarter-mile of goat trails, which later turned into marginal Jeep trails that were not cleared since last Spring and not fit for any motor vehicle without truck-type clearance. 

Pt vitals remained stable.

Vitals: P 90, R 20, BP 140/80, O2Sat 96, skin dry, pupils normal.

For the ambulance crew, that is a big What?

When transport gets challenging, Pt vitals don't stay stable. We are looking for variations to the norm, (called trends).

Only a man with sincere focus (like Ghandhi) can keep cool like that.

This Kris Kringle is a good patient with a great wife who provides a lot of support and love.

We finally, finally got the little ambulance company and patient to the residence.

There was a circular driveway in front of a red and green doublewide trailer-home.

In the middle of the circular drive was the equivalent of an oversized cattle feeding trough. Twenty feet by five feet, in a rounded rectangle, four feet tall, with rounded corners. This huge trough was not filled with cattle feed.

It was actually filled with cow manure and hundreds of pot plants that stood six feet tall in the August sun.   

When questioned, Mr. Kringle laughed and refused to answer. Mrs. Kringle said, "that's just for the deer," and later added: "that's how we keep the deer."

Hmmm.

As always, on a home run, the little ambulance company has to figure out how to get the patient into the residence, then usually into his or her bed.

The Kringle family (not their real name) has a brand new ramp on the west side of the property. The ramp is well-built. The wood is clean, light color, fresh cut, untreated, and not from a Home Depot.

And there were five and six nails on every connection in every beam. Small nails, similar to finishing nails.

(I have worked my share of construction jobs. I have done more than my share of framing work and building decks with a pneumatic gun that shoots two nails in two seconds and keep moving. Nobody ever puts lots of small nails into every part of any project.)

Both Mr. and Mrs. Kringle have been at City Hospital for the last two weeks. The ramp and deck on the west side of their residence are brand new, with uneven, untreated wood. As if some kids (?) did their best with small nails to piece it together.

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Prior to transfer to bed, (actually a recliner) Patient vitals are noted as stable. P 90, R 20, BP 140/80, O2Sat 96, skin dry, pupils normal. Again, this is unusual. The vitals don't stay rock solid, unless he is some kind of olympic athlete.

The place has a notable amount of Coca-Cola classic trays and plates on the walls. They are not dusty.

ALL of them are with Santa Claus holding a Coke. From 1954, 1961, 1971, 1987 (with Madonna), 1992, 2001, and more.

Every single one has Santa Claus holding a Coke.

And the wife, now glad to be home, said. "Thank you so much. Would you like a Coke?"

On the rectangular table next to the couch, there is a stack of catalogues. On the couch, there is another huge stack of catalogues. They have been worked through. There are a lot of pages with corners turned down.

These are catalogues for wholesale buyers of

(you guessed it) children's toys.

Again, I can't make this up. And there are witnesses.

The little ambulance crew shut up and drank their (10-ounce vintage bottle) Cokes.

We noticed there was no evidence of kids, and asked.

Kris responded: "We have lots of them."

"Ho, Ho." (We never could get three Hos, but he did two.)

Now, as an Ambulance Guy, when we do a home run and take the patient (and wife) to their residence,

there is always an abundance of pictures of kids on the wall.

And everything on every vertical surface is either family oriented, an inspiration, or a prayer. 

In the Kringle residence, the place is covered with pictures of our patient from many years ago. And he looks exactly the same age in every picture. Hmmm.

The catalogues are from every country Magellan could imagine.

Why (and how) would anybody buy toys from Sudan, Paraguay, Thailand, Nigeria, Haiti, Poland, Malaysia, Patagonia (Argentina), Michigan USA, and Switzerland?

And the patient is on Medicaid, (which means he is church-mouse poor.)

Even after the professional paperwork transfer of care to the wife, she continues to offer us small bottles of Coca Cola.

Mr. Kringle (with nephronic tubing recently implanted) waved goodbye while drinking a small bottle of Coke.

The crew of the little ambulance company rechecked their paperwork, locked it in, and dressed the Ferno A-35 stretcher in the blazing August sun.

While leaving the residence, there was a notable fog. (This never happens on a sunny afternoon, 95 degrees in the middle of the August.)

About 300 yards from the residence, we pulled right, onto a dirt road, another quarter mile, and then turned left onto a paved road.

No rickety bridge. No fields of weeds? Just fog.  HMM.

And two minutes later, it was still a thick fog (this never happens in the afternoon in August.)

We came out on another no-name country road somewhere between I 40 and US 421.

Everyone on the crew wondered how we somehow missed the field of weeds, the scary bridge and the long drop over the creek.

I yelled to the crew sitting in the back of ambulance unit 4: "Where were we?"

The answer was: "Lost in the fog!" Until it lifted like a gigantic curtain.

Now the sky is clear and Carolina blue.

Lots of silence from a normally talkative crew. Cold chills up the spine (in August.) 

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Nobody said a word (this type of silence never happens) for the next two hours until we got back to the staging area outside of City Hospital.

Even then, it was the mandatory handshake, and head nods instead of chatter.

I wonder if any of us will ever be the same.

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Sooooooooo, if there was a time that anyone perhaps transported Santa Claus, in an ambulance........

Just do me a favor, and remember.

It never happened.