Twisted 1/3

twist·ed

1:  to combine, as two or more strands or threads, by winding together; intertwine

2 :  bent so that the original shape is change or destroyed

3 to distort the meaning or form of; pervert: He twisted my comment about to suit his own purpose

4 :  a sudden, unanticipated change of course, as in events or story – a plot twist

We pull up in front of the accident so the rig is less likely to get rear-ended. We’re at the corner of Really Bad Street and Even Worse Street which is deep in the hood of the large city in my mostly urban county. I saw the car as we passed – a compact two door that was wrapped around the large light pole in the center divide of a busy inner-city arterial. The car somehow turned perpendicular to the direction of traffic and made contact with the pole on the passenger side. It looks like a fortune cookie wrapped around a straw.

There was some confusion as to the actual location of the accident – probably due to multiple calls from cell phones and people getting their locations wrong. So I want to check with City PD, who are already on scene, to see if there are any other accidents around here. That way I can cancel the other unit and save them a trip if I can handle the patients here. There’s no reason to take up extra resources if I don’t need them.

Checking with the officer on scene I find out that this is the only working accident in this area. Then I check with the fire medic and find that there are only two patients, both with just minor injuries. I can take both so I call to cancel the other rig.

Now that that’s taken care of I take in the damage to the car as Louis helps the fire medic to put a cervical collar on the passenger from the car and get her onto a back board. There are at least 24 inches of passenger space intrusion and the air bags didn’t deploy (or maybe there weren’t any). Fortunately, there are no star shaped patterns on the windshield, which would indicate impact by the occupants’ heads. But because of the extent of the passenger space intrusion I’ll have to trauma activate and go to a trauma center. County protocols require an activation based on the mechanism of injury and I’m obligated to follow protocols when it’s this clear cut – even if the injuries to the patient don’t warrant a full trauma activation.

Louis and the fire medic are almost done with the passenger so I try to find out if anything is wrong with the driver. I’ve been kind of ignoring her since I got on scene – or possibly it’s more that she’s ignoring me. She’s been frantically pacing up and down the scene of the accident hysterically crying into her cell phone and occasionally answering a question from PD when they can get her to focus.

I took a quick glance at her as I was checking out the car – no blood or obvious signs of trauma, moving all extremities, able to focus on the officer when he asks her questions. The lack of proper phone etiquette – especially in young people – really astounds me sometimes. I’m constantly asking people to put down their cell phone so I can finish an assessment.

The fire medic and Louis are loading the passenger into the rig. Louis jumps in to get a set of vitals – he’s a great partner and I trust him to do the initial work up and give me good information once I get ready for transport. I’m still trying to get the driver to focus on me as I follow her up and down the street. Finally I get her to hang up the cell phone.

A quick assessment shows that she has no signs of injury, no complaints, and no neurological deficits. I run a State of Maine neuro exam on her just to make sure. It’s a really effective way of finding any deficits that would warrant taking spinal precautions. As I find nothing noteworthy I walk her to the ambulance and have her take a seat in the “captain’s chair” at the head of the gurney.

Louis gives me his findings and I re-check a few things just to make sure everything is okay. Right before we pull out into traffic the officer hands me an incident report number for the driver so she can track her car as it’s getting towed to the city lot.

Now that we’re driving to the hospital and in the controlled environment of the ambulance I can focus on the patients a little better. They are both 17 year old girls, from the more affluent city on the other side of the county, and dressed like they are going out to club or party. Both of them have high heels, perfect lipstick, tight fitting clothing, and hair that’s done up with highlights.

I’ve said it before and I’m sticking to my guns on this one: Paramedics profile their patients – and these two girls don’t match the situation. They’re too dressed up for early afternoon, this is not the right neighborhood for them, and they’ve been acting just a little evasive when I question them. There’s more going on here and I’m having a boring day so I decide I’m going to see if I can figure it out.

I have to tell cell phone girl to hang up again as she’s trying to call people. I ask her to tell me how the accident happened. I need to know so I can give the MD a decent description, but I also need her to focus as she’s on the verge of hyperventilation – very emotional.

“This car came up behind us and was driving all crazy. It cut me off and I swerved into the pole.” She’s breathing fast and waving her hands around for emphasis.

“So there was no impact with the other car and the only damage was your car hitting the pole?” She nods her head. “Okay, then what happened, were you able to get out of the car yourself or did the fire department have to help you get out?”

She’s waving her arms around again. “No, this guy opens the door, and I like think he’s helping us get out when he grabs my purse. I’m pulling on it when he opens it up and takes my cell phone and money. He takes off down the street and I chase him, I fought him for my cell phone but he took off with the money.” Seriously? Robbed by a bystander after an accident?

“Were you hurt when you fought him for your cell phone?” She tells me no. “What were you doing in this neighborhood when you live twenty miles away?” She thinks about it for a while and tells me they were visiting a friend. “Okay, so how much money did he steal, was it like thirty dollars or three hundred dollars?” She says she doesn’t know. “You told the police all this right?” Yes.

Okay, I’m done. It’s obvious they are both hiding something and not answering questions with complete honesty. I have no doubt that she was robbed. But it’s the circumstances that bug me.

First, she’s not being straight with me about being in this neighborhood and “visiting a friend.” They are both dressed wrong for the situation. And if a guy is going to rob them he’s just going to take the purse and run. He’s not going to take the time to open it up while she’s hitting him and rifle through it to find her cash and cell phone.

Think of the audacity the thief would need to have to be fighting with a girl in a car in the middle of a busy street just after the accident. They are actually within sight of the police sub station and he’s got to know that PD/FD/EMS will be there any second. Then the improbable act of chasing him down the street in high heels, actually fighting him for the cell phone and having no marks on her. And finally, every seventeen year old knows exactly how much money is in their purse. It’s just not adding up for me.

I’m reminded of Dr. House from the television show, “Why should I talk to patients? They just lie to me.” That sentiment has rung true for me more often than not. It’s a lot simpler to just treat what I find and move on. In this case I’ve actually got nothing to treat so I do my paperwork on the way to the hospital.

After dropping them off at the ED Louis and I are talking about the call and pointing out all of the inconsistencies. We decide it went down like this: two girls from the affluent neighborhood go to the hood with a lot of money, possibly looking for drugs. The wrong people find out they have money and one of them uses a car to run them off the road into a light pole. He then jumps out and threatens her until she gives him the money. Then he drives off. She then has to make up a story that will explain all of this to her parents who are going to be pissed that she’s in the wrong neighborhood and totaled the car.

Our version of the story is much more credible, but the fact is that I’ll never know the real one. That’s often the case in EMS – we get partial truths, misinformation, and misdirection. It’s an exercise in filtering to weed through the things that really don’t matter and treat what is necessary. It’s the wrong career for people who are dedicated to absolutes. If you’re comfortable playing in the gray area of reality then everything works out pretty well.

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~ by KC on October 12, 2010.

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