The Worst

Some people, in their macabre sense of curiosity, will ask me "What's the nastiest call you've ever had?" I assume their expecting a tale of a motorcycle dragged under a semi or something like that. Something they can imagine and something they can handle. I've seen plenty of dead bodies, bones sticking out where they shouldn't, suicides, car accidents, people run over by BART trains, etc. However, I wouldn't say I've had a truly gory call (though my perspective towards what is truly gory is probably a bit skewed). What comes to my mind when asked that question are the calls that are just plain disgusting. I've only had a handful of calls in my career that caused me to dry heave (I distinctly remember each one) and I've never actually thrown up on a scene. This call was the closest I've come (stop reading now if you have a weak stomach):

We were called out on a medical aid for an elderly woman down-unknown medical, no other information. Apparently the police department had been called out to do a welfare check on this woman because she had been out of contact with family/friends for a couple days. When my crew arrived on scene we were greeted by grim faced police officers out on the lawn. As we entered the house an officer told me my patient was in the kitchen and that she was, "covered in shit". This would prove to be an understatement.

I knew it was going to be bad before I even got around the corner into the kitchen (smell) but I couldn't have predicted what I was about to find. What I saw was an elderly woman face down on the kitchen floor lying in a small lake (about 3 feet wide by 4 feet long) of vomit; or so I thought at first. As we got closer I discovered it was actually feces. The puddle stretched from above the woman's head to about her waist, which didn't make any sense. At least not until I realized that she had actually been vomiting feces (also known as copremesis caused by a bowel obstruction and also, I've learned, the name of a band I won't be listening to). Now, I can handle vomit and I can handle feces (I have kids and pets), but vomiting feces...that got me.

The quick thinking firefighter on my crew ran to the woman's linen closet and grabbed every towel he could find and threw them down around the woman giving us something to at least step on. I must admit, I hesitated, but he jumped right in and held the woman's head while we rolled her over. I later nominated this firefighter for EMT of the year. When we rolled her over her wet, soiled, impregnated hair whipped around his forearm and stuck there. It was at this point that his dry heaves started. All I could do was stare at him and plead, "Don't." And then of course, mine kicked in. Our patient had apparently been down on the floor for quite some time, she was cool to the touch but conscious enough to talk to us...well, berate us actually because the police officers broke her window to gain entry. Okay, priorities people, seriously. You've been lying on the kitchen floor for over 24 hours vomiting fecal matter and you're pissed at your rescuers for forcing entry into your home?

We set about cleaning her up enough to do even a cursory examination. At this point the patient's home health care nurse showed up. This woman did us the biggest favor of the day by finding a scented candle on the kitchen table and holding it out for us. The firefighter and I would alternately lean out and 'take a hit' from the candle, hold our breath and dive back in.

The woman's vitals were surprisingly decent so thankfully there wasn't much to treat right away. When the ambulance arrived we basically had to burrito wrap her in chux and highway blankets for transport to the hospital. I do not envy the rest of the ambulance crew's shift, I can't imagine that smell came out easily. As for us, we set about decontaminating ourselves and all of our equipment and trying in vain not to relive that call for the rest of our shift.

This kind of call serves, to me, as a good example of the things we in EMS and the fire service are expected to do. People say no one in their right mind would run into a burning building when others are running out. But, who wades into a lake of shit to take care of a stranger who spends her time chastising you for something you didn't even do? We are called out for every type of thing imaginable. Whatever situation a person finds themselves in that they can't handle we are expected to mitigate somehow. We'll go on doing our best to do so, but I can honestly say that I'd gladly run into a dozen burning buildings before I ran that call again.