Reverting Back to Training
As I approached an elevated section on the divided highway, I noticed flashing blue and red lights on the opposite elevation. I pulled over and opened the hatch on the rear of my Cherokee. Still in it's spot was my black leather nursing bag. I grabbed it, pulled on some gloves, and went to see if I could help.
I passed several officers who surrounded a cursing and barefooted man, handcuffed prone at four points to a backboard on the ground. His feet were bloodied by broken glass. They were ignoring his profanity. I sprinted past a bloodied matronly woman in hysterics with an officer holding her away from the scene. Two conjoined vehicles were surrounded by firefighters, paramedics and policemen. The jaws of life was humming among the shouts. A paramedic saw me running forward in my green surgical scrubs carrying my nursing bag. He tapped the responder beside him on the shoulder. She looked around, and they all began to part like the Red Sea. This is not good, I thought.
"She's pregnant Doc," they said as I entered the fray.
"I'm not a doctor, but I'll try," I replied.
"Her water broke," I heard someone say.
Inside the crushed sedan was a woman with her knees pinned to the dashboard. She was in labor. Her mother had been transporting her to the local hospital where I worked. She was in labor.
Apparently, the handcuffed man had stolen a pick-up truck from a automobile dealership. In trying to evade the law, he had driven the wrong way onto the overpass. At the crest, he had smashed into the sedan at high speed. The smell of gasoline and antifreeze hung over the scene.
"She's going to have the baby before we can get her out Doc!"
"The hell she is! Ma'am, stop pushing. Keep that child inside you."
"I can't, it's twins......" she cried.
Sometimes when things just can't get worse, they do. I stretched my stethoscope forward to try to hear fetal heart tones above the rumble of the jaws of life. It was a futile effort, but it did have the effect of calming the trapped woman. "You will keep your babies inside," I told her. That's when her eyes rolled back and her body began to tremble. She was seizing.
"Get her valium," I heard somebody say.
"No! Get mag sulfate!" I commanded. As I drew up an intramuscular bolus of the stuff, a wave of trepidation washed over me. I was responding on labor and delivery instruction I had received a decade previously. I leaned into the vehicle, pulled the woman's butt cheek laterally, and slammed the 18 gauge needle I was given home.
I was pulled back as several firemen clambered onto the automobiles and began peeling the roof back like a sardine can. I watched as the woman's trembling subsided. "Just keep those babies inside....." I whispered.
I could do nothing further, so I went to check on the bloodied grandmother to be who had been driving her daughter to the hospital. She had superficial wounds and I pulled Kerlix from my bag to dress them. When I looked back to the wreck, the woman was being lifted to a stretcher. "Start a mag drip," I called out, as I went back to assist. The woman was loaded into the back of the waiting ambulance, and her mother into a police cruiser to follow her to the hospital. I was left at the scene of carnage with the police officers and firefighters. I looked over at the cursing man, still handcuffed prone to his backboard. An officer saw me looking at him.
"The son of a bitch tried to run away," he said.
"Am I needed for anything else?" I asked.
"Just your name. You work at the hospital?"
As I drove home in my greasy bloody green scrubs, I marveled at the human mind. I had delivered two babies previously. I had dealt with seizures. I had never done both simultaneously. The knowledge of magnesium sulfate had been stored away in some pigeon hole of my mind until it was needed. It had been passed on only in lecture, and perhaps, it had shown up on a test in nursing school. I no doubt studied it. I filed it away in my mind and forgot about it. Yet, when I needed it, it was there.
It has been said that in times of uncertain crisis, a man will not rise to the occasion, but will instead revert back to his level of training. Nursing students often feel overwhelmed with information during their training. At one time, I doubted that I could ever retain all that was shoved into my head in nursing school. After I saw two twins in the nursery the next day, I never doubted it again. You do what you can. You try.