Not a Scratch on Her

The call is for a rollover, no injuries. Non-priority dispatch. When we arrive we see the car off the road into the bushes. The officer tells us the driver, who is claiming no injuries, is sitting in the police car. As the officer is talking to us, a bystander approaches and interrupts. “When I got her out of the car she wasn’t right,” he says. “She wasn’t acting like she is now.”

I nod and say thank you and go back to hearing the officer describe the accident. She lost control on the curve, jumped the curb, rolled and went into the bushes. She told him she thinks she hit the accelerator, instead of the brake.

I go over and check the car while my preceptee talks to the patient. The car is in good condition, considering it rolled. There is no internal invasion. All airbags deployed, including the side air bags. The bushes slowed and caught the car like a giant safety net. There was no sudden deceleration.

When I walk back over to my preceptee and the patient, I can see she is a young woman in her early twenties, who is wiping tears from her eyes. She says she was on the way to pick her daughter up from day care. She says she is okay and thinks she doesn’t need to go to the hospital. It’s a little chilly out, so we ask her if she minds if we get her into the back of the ambulance where it is warmer and more space so we can check her out a little more thoroughly.

We do a full head-to-toe assessment. Good vitals, not a scratch on her. Good thing she was wearing her seat belt. We all agree on that. She tells us her husband is out of town, but her father is coming down to get her. He should be there in about fifteen minutes. We tell her we’ll wait with her until he gets there and then we can all discuss our transport options.

While waiting, we ask her to describe again how the accident happened. She says she was driving and she had a little episode where she was aware of things, but couldn’t really respond to them. She thinks that’s why she lost control. We ask her to elaborate.

“It started a few months ago,” she says. “I just froze for a few seconds. It was very odd. It’s happened a few times since. I saw the doctor. He doesn’t know what is causing it. I’m scheduled to have an MRI next week.”

I tell her it sounds to me almost like an absence seizure. An absence seizure while driving would cause you to lose control for a moment, cause you to mistake the accelerator for the brake. That’s probably what happened, we speculate. I remember what the bystander said now about her not being right. Something medical definitely happened.

Her father arrives and he hugs his daughter and asks if she is okay. She says, she’s fine and thankfully Tammy wasn’t in the car.

“We never should have allowed you to drive with what’s going on — until we know what it is. I think about what could have happened.”

“I’m all right, Daddy,” she says.

We talk about the options with them. We can take her to the hospital and get her checked out, which is what we recommend or he can take her to the doctor or call us back if anything happens. He doesn’t know what to do. She just wants to get her daughter and go home. We suggest that maybe we should call her doctor and discuss it with him since he has been treating her. We could call him and she what he would like us to do.

They both agree that is a good idea.

We call the doctor and repeat that there is not a scratch on her and that we think the crash was likely caused by another one of her episodes. We can take her in to be evaluated if he’d like. He hesitates a minute and then says, maybe we should bring her in and get her MRI today instead of next week. We agree that is a good decision and I hand the phone back to the father can hear the doctor’s recommendation directly. The father thanks the doctor and then tells the daughter he will go get Tammy at the day care and then meet us at the hospital.

On the way into the hospital, as I watch my preceptee interact with the patient, I think what a sweet young woman she is. Very pretty in an unassuming way that she probably doesn’t realize how pretty she is. She shows us pictures of her daughter and I show her some of mine.

We leave her at the hospital and wish her well after giving the nurse the report. I’m thinking lucky young woman to have her seat belts on and to be in such a protected car, lucky to have gone off the road where she did, where the land would catch her and ease her car to a halt. Someone was looking out for her.

***

Later in the shift, when we are back at the hospital, I see the nurse and ask how that young woman made out. I see something terrible in his face. He gestures for me to follow and then I see the woman on a bed in the hallway, her back to us, just a few feet away. She smiles on seeing me. She wears a hospital gown, her daughter playing in her lap, her Mom and Dad standing by the foot of the bed, looking on. “Is it all right if I tell the paramedic about what we found,” the nurse asks.

“Sure,” she says. “He’s one of the men who helped me,” she tells her mother.

The nurse says, “The MRI found a glimona — a mass.”

I know what a glioma is.

“Oh,” the young woman says brightly, “That’s good — they have a name for it.”

Her mother and father nod, but there is no brightness in their eyes.

8 Comments

  • FireResQGuru says:

    Sometimes life is too cruel. I all too often question my faith and wonder how God can allow such thiings to happen.

  • AlisonH says:

    Her car was caught and cushioned and she was unharmed–it was not her time yet. She had the even greater blessing of having good and kind souls looking out for her, from the bystander to you to everybody else; it helps SO much not to be alone. Everybody’s caring about her was why she was able to be cheerful.Looking at the experimental therapies in that link, and having had my own life saved five years ago by an experimental drug when all else had failed, I offer up my prayer for her and her family. Having her little girl to live for will be powerful in strengthening her will to live and to get through whatever she has to go through. The experiences ahead will teach her a depth of compassion beyond what she knew she had.Fireresqguru, for whatever it’s worth, I would not trade what I went through for anything–it changed everything, and I’m a better person for it. (And I don’t want to go through it again, thankyouverymuchjustthesame.)

  • chrys says:

    Your initial thought of the seizure somehow did not hit me. It made sense though, but I just felt reading this, that this would be the outcome. I’m glad that there are people still doing this job that have your care. Keep up the good work that you do and never forget the zebra’s.

  • PDXEMT says:

    One of the worst calls I’ve had, in a very subtle way, was a late-20s mother of two who presented with a new-onset grand mal seizure. Her only history was a week of increasingly worse headaches.I didn’t follow up on that one; couldn’t bear to. These are tough calls, in a way totally different from bad traumas or peds codes.

  • Lauren says:

    Oh jeez… that’s harsh. Gliomas are bad news. Poor thing. It makes my heart sink. Good thinking catching the absence seizure, though.

  • MichelleD says:

    I have been a medic for almost a year and have actually seen more than one MVC caused by a seizure. But they were often epileptic.When I was going through school I read both of your books a number of times and I just recently found this blog.Reading this post today I just had to say hi. My job, my patients mean the world to me, but it is often thankless and I am still new and learning every lesson the hardest way; so reading your words keeps me strong, wanting to learn and help that much more.So thank you, can’t wait for the next publication!

  • jeepgirl says:

    Here via Nocturnal RN’s place. Loving the blog!Worked in neuro for a bit and glioma’s happen to the nicest people. Too bad.

  • Anonymous says:

    Well just because i know a little bit about it… this Glioma was removed and treatment is under way… Hope all goes well.

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