We talked about thread quills, woolly buggers, fire starters and how it’s best to wait until spring for a new line, since cold water can crack the casing.
We talked about dry flies and gink, casting at eleven downstream, waiting for the kick, the dead stop, the strip set.
You taught me the basics of fly fishing on that float trip a full day, a birthday gift.
You gave me flies and a wealth of knowledge, and in between, I watched you move through heartbreak toward self-discovery.
Now you’re moving to another state, and I feel the small sadness of loss.
But I’ll see you again in Montana, when we both find the time.
We’ve all gone out. To the bar, a restaurant, game night with friends and heard someone say, “I had a bad day at work.”
We can all relate. A bad day is just a day where things didn’t go right. That truth doesn’t change no matter the career. The feeling is the same across the board. It’s comforting to realize how normal that is, how universal. My career doesn’t make my bad day worse than anyone else’s. It’s all relative, tied to the same simple experience: the feeling of “bad.”
We found her lying under her car at a warehouse.
Before an ambulance responds, dispatch usually sends over a few notes from the RP or the requesting party. This one just read: “I ran over my mom.” and a checkbox: patient unresponsive. We were close, so it didn’t feel like we got the full picture.
We flipped the switchboard, lights and sirens. I can’t remember exactly when the adrenaline hits, usually somewhere around here.
A police officer was waiting out front, waving us in. I’ve started to believe when co-responders look uneasy, something’s wrong. We run so many calls that what the public calls an “emergency” isn’t always what it feels like to us. This one… I still don’t know if it was an emergency. Death is so stable in the end.
I thought about other Auto-Ped calls. Sometimes they’re straightforward, not much problem-solving. This wasn’t one of those.
Behind the front driver’s wheel, I saw a gray bush of hair sticking out. A head under the vehicle, maybe a minivan. The body lay perpendicular, torso pinned near the axle.
We got out. My partner checked for a pulse. Nothing. I did the same. Nothing.
I kneeled to look again, looking for anything. I couldn’t even tell if she was on her stomach or her back. Her position was so tangled it was hard to orient her body. Later, I learned both arms were dislocated.
The week before, I’d worked another traumatic arrest. A man crushed when his car dropped on his head. Neither scene had as much blood as you’d expect. People imagine gore, but sometimes there isn’t any.
Fire arrived, then another engine. They started prepping to lift the car safely.
Three thoughts circled in my head:
What equipment do I need?
How do I create privacy?
Blunt Traumatic Arrest protocol.
I pulled the stretcher from the rig, set it on the sidewalk, and unloaded our bags. Medical, airway, monitor. I arranged them in a half-circle to block the growing crowd. Twenty people, maybe more. Then I pulled a blanket from the back, tore off the plastic. Waiting.
Protocols guided my thinking: this was a blunt trauma arrest, greater than a 10-minute delay to a trauma center. Chances were gone before we began.
Fire secured the car and lifted it away. Out she came. She went on the monitor: a rate of 30, but PEA. Electrical activity without a pulse. The heart sending signals but not pumping. Cardiac arrest.
Her body told the rest: torso blue, eyelids swollen to the size of a baseball, open fracture at the ankle, torn pants, pubic hair exposed where her underwear shifted, arms bent wrong. Not bleeding. A ragdoll. I had a passing thought about the indignity of dying indecent. Then another thought: maybe it only matters for the living.
We covered her with the blanket. The call was over.
It was a bad day at work.
There’s peer support in place here, and I used it. If you want to know more, look up Critical Incident Stress Management.
Later, at a haircut, the stylist told me, “I couldn’t do that job.” I think most people could. The real challenge isn’t the call. It’s what comes after.
This call sucked. So did the one before it. Writing only captures part of it.
I’m grateful for family, for friends, for the ones who help me move forward. I don’t know if there’s a reason for any of it. But writing it out helps.
It paused, the sadness. Therapy, renewal. The fall from confusion into curiosity. Memories of my grandfather surface. Acceptance that physical time together has ended, traded now for small glimpses and scattered traces of connection woven through the work we do.
Fly forward. She was ninety-four. She was watching Everybody Hates Raymond. Her daughter asked her, “Why are we here? Why did we call?”
And now, in the back of the meat wagon, I find myself in the mother’s shoes, connecting to my own grandfather, as this wise old owl asks me the same question. “Why are we here?” “What’s the point of it all?” Is she coming to terms with her own mortality? I’ll never know.
I answered, “To help each other out.” And once again, I was back with him, embraced by his love and stewardship, living out my own role.
My function is no greater or lesser than the one who hands me coffee at the counter, or the one who provides food for me to eat. We all serve a function, one for the other. Mine is only slightly more morose.
The seed of my grandfather’s love is why I love this work. I am still just a small boy who misses the touch of his grandfather’s hands.
The first call, on the first day, in the first hours of a cool summer morning began in death and ended in death.
The first man walked away from the hospital, barefoot but for the hospital socks with their non-slip chevrons across a city that never sleeps. His friend didn’t know where he’d come from, but it was clearly a hospital. The night before, he’d made a quiet knock-and-entry at his friend’s apartment. He was given a blanket to sleep on the floor. Wrapped in fleece and catecholamine release.
We call it an AMA: Against Medical Advice. It’s almost always against medical advice to leave a hospital when your heart history is written in ischemic tissue. We got his name off the wristband, peeled back his rigored hand, and cut off the plastic printed with his demographics.
I watched in silence as my partner consoled the man’s acquaintance. I still don’t have my first cup of coffee. Death already in the air. I’ll never know how he died, but I keep wondering why it’s always us who respond.
Earlier that morning, we’d entered the garage, our supply room, our staging area. Air thick with gasoline. Unit 19. I was born on the 19th. My mother broke her finger on the 19th. My little brother almost died on the 19th and recovered in the trauma ICU, room 19. Today, I’m assigned Unit 19.
I don’t usually place importance on symbols, but I’m human, and these connections make life more vivid. We check the rig: the airway bag, the BVM, the oxygen tanks, the meds. I pull my narcs and place them in a Plano fly-fishing tackle box that sits permanently in my right ankle pocket. One sticker marks it, a design from Hailey’s company. YEE Hotdog: a sentient hot dog with a lasso against a desert sunset of reds and purples. It’s my last reminder before I push narcs, screaming that I too am ready.
We check the CAD, computer-aided dispatch, but the Wi-Fi won’t connect. An Ethernet cable juts from the tablet like an IV line, its clip broken like most things on the meat wagons. If I press it up and tape it just right, it connects for half a second. That’s still a victory.
We switch to Rig 47. The first call, the first day, the first hours of a warm summer morning.
The second call of the first day takes us to the edge of the county. A breather not breathing well, but breathing all the same. We light up the sirens and take the highway. My preceptor in the back asks to turn them off, the Doppler scream rattles the cabin and out to the void. I keep playing. The siren dial has three tones. On the hands-free mode, I tap out “Jingle Bells” as we speed toward someone else’s emergency. She rolls her eyes. I’m sure she enjoys it anyway.
A large fire engine waits in the lot, and as always, a bystander waves us over as if we might not see the flashing lights.
On this second call, of the first day, in the first hours of summer, I’m met with my second dead body, but this one still has a chance. We step out, never run, and walk our gear to the fire crew performing CPR.
I take command. We start our work.
Quick spoiler: he dies too. Most of them do.
Does it matter? We get ROSC. Lose it. Get it again. I can still see his eyes, bloodshot deeper each time we drag him back. He bites the tube, still neurologically intact, to some degree. We load him, drive just fast enough. We start to pace him. Little sparks telling his heart not to quit. We say his name. He dies. He comes back. Dies again. Returns.
The pacing works. He has a pulse. The end-tidal is high. We start a pressor. We have him back. We roll through the ER doors. Before we break that threshold into his tomb, we lose him again. I do compressions while handing off report. You already know how this ends.
The first day. The second call. The warm summer morning beginning again.
The last call is in Room 119. He’s been dead for weeks. We know it not by sight, but by smell. Thick, sweet, unmistakable. You’d be surprised how common it is for neighbors to ignore that smell, living their normal lives while someone decomposes a wall away.
We know the smell. We know the fear when breaching a locked door. The fire department forces it open. We double our masks, smear Vicks between layers, hoping to blunt the stench. It never does.
Inside, he’s supine, surrounded by empty bottles like grave offerings, pizza boxes stacked in this pyramid . His skin is yellowed, blackened, mottled. His eyes are white, and from them black tar streaks like tears.
There’s more I could say, more thoughts, more small rituals, more ways of moving on. But these are my death maps. And my death maps are my own.
Death Maps 