I have treated countless patients over my 20-plus-year career as an EMT and then paramedic. Some days, the cycle of dispatch, arriving on scene, assessing the patient, moving the patient to the ambulance, transporting to the hospital, transferring care to the ED staff and the PCR to follow is rhythmic … some might say monotonous.
I think that at some point, clinicians forget that they too could be patients, requiring the assistance of their peers to be assessed, treated and transported to an appropriate facility.
That afternoon came for me on February 8, 2024, when my jurisdictional medical director and I were involved in a crash returning to our office.
Aviation requested
Just after 1 p.m., the St. Mary’s County Department of Emergency Services Communication Center began receiving calls reporting a vehicle crash on Hollywood Road in Leonardtown, Maryland. Callers reported the vehicle was on fire. As units from Hollywood and Leonardtown fire departments arrived, command confirmed that a Department of Emergency Services vehicle had struck a tree and was on fire. EMS units staffed with DES personnel arrived on the scene and – with fire department assistance – began providing patient care.
My medical director and I were both deemed trauma patients and aviation was requested. Maryland State Police Aviation Command was dispatched, adding Trooper 2 (Washington) and Trooper 7 (Southern Maryland) to the incident.
We were transported to the R Adams Cowley Shock Trauma Center, Maryland’s only primary adult resource center, in serious condition, by MSP helicopters.
I have no recollection of these events.
Bright lights and voices
“Todd, open your eyes … Todd,” a male voice said. As I slowly became more alert, what seemed like a spotlight blinded me from above. The light drowned out anything surrounding it. As I laid there, Dr. Thomas Scalea, physician-in-chief at the University of Maryland R Adams Cowley Shock Trauma Center and my mom slowly came into focus.
I couldn’t speak. I attempted to mouth questions with no success. My arms and legs felt like they were being weighed down. Dr. Scalea and my parents went on to explain that I had been involved in a serious vehicle crash while at work nearly 6 weeks prior and I was a patient at the Shock Trauma Center in Baltimore.
I was confused. I felt like I had just gone to sleep the night before. My body couldn’t rationalize that I had been a patient of Dr. Scalea and his team for such an extended period.
The beeping of the IV pumps, the wound VAC and the sounds from other patient rooms – the noises of the hospital – kept me awake.
My confusion, coupled with the inability to speak because of the tracheostomy, kept me in a state of frustration and aggravation. I couldn’t grasp why the team and my family couldn’t understand me. They wanted me to try and write my questions, but my arms were so heavy. They tried to have me use a communication board, where I would point to words or things that I needed.
As the days turned to months, I hadn’t been out of the bed and atrophy began. The physical therapist attempted to get me to sit at the edge of the bed, stand and walk. Each time, I felt like I was going to hurt myself or them if I fell.
I spent many days disgusted with myself. I knew I had to force and push myself if I wanted to get stronger. That was easier said than done.
After I was medically cleared to be discharged, I was sent to a rehabilitation hospital, where I spent over 100 days building strength, learning to do daily tasks and to walk again. Before all this, I would have taken many of these tasks for granted. The dedicated staff worked with me each day.
With their compassion, empathy and support, I stood for the first time. Within a few days, I was taking one or two steps. It didn’t seem like it was happening fast enough, but within weeks, they had me walking down the hall.
Part of being the patient was letting my guard down and trusting these experts with their job. Again, this is easier said than done.
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Timely definitive care
When responding to our crash, the highly skilled and educated clinicians within St. Mary’s County DES and fire departments immediately identified that a higher level of care was going to be needed. Driving critically ill trauma patients to an appropriate center isn’t appropriate. These clinicians used resources that they had available to them to get me and my passenger to the most appropriate facility, in the most appropriate timeframe. I truly believe that their quick action, assessment and treatment saved our lives.
Reflecting over the last 8 months, transitioning from the treating clinician to the patient was challenging. I have the utmost respect for my coworkers with the St. Mary’s County Department of Emergency Services, Hollywood and Leonardtown fire departments, the Maryland State Police, MSP Aviation Command, the St. Mary’s County Sheriff’s Department, the Shock Trauma Center staff and PAM Rehabilitation Hospital of Dover staff.
To say that I am proud to be from Maryland is an understatement. As a patient, I am so thankful to experience the EMS system firsthand. Many clinicians are not able to relate to their patients in these types of situations. Having gone through this, it gives me a new perspective.
