Knot in My Stomach

A postscript to “Blood in my Mouth”

It’s the following day and I have walked around with a knot in my stomach, been flippant at work and not very productive in general.  Sorry. In the past I have done a reasonable job of keeping my emotions in check but in this case I have decided to let them wash over me. It makes for some unexpected moments especially when I conjure up the sensation of his little head cupped in my hand, feel his cool skin, and see in front of me his frightened and trusting eyes.  What a burden of responsibility we have for those who can’t help themselves.  He was not talking but he told me all he needed to tell me with those luminous eyes of his and, with the experience of the way my memory works its going to be those eyes framed by his brown curls that stay with me a very long time.

But a few other impressions are clear as well.  When I arrived on the scene I was not the first. But that helped since after a quick survey of all the wrecks I figured the one on which I should focus was the blue car in the middle. It seemed to be getting a lot of attention from people trying to break into it. I started to run, only to have some clown attempt to cruise through the whole mess and drive me down. I was vaguely aware of barking in my best parade ground voice at this idiot to stop but don’t know if he did.  Once I got to the car I realized there was a kid in a restrainer seat in there somewhere. The smell of fuel was overpowering. I let the guys continue with their tools for a moment. Another turned up with a sledgehammer as I walked around the car – quick survey to see if there were other options. Strange, the driver’s door was undamaged and open and gave me good access. There was no need to pry anything apart at all. It’s hard to recall exactly what I said then but as I climbed in it was to the effect that no one needed to be attacking the car and that with all the fuel around it wasn’t a wise move anyway. It took a few moments but they eventually fell back, and for the rest of the time I was in there I was vaguely aware of the cordon of care and concern that they formed as they stood around and watched.  I get what they were doing – desperate to help, they are Good Samaritans all.  But a quick recce is always a good idea before settling on a course of attack.

Once the enthusiastic lads had stopped trying to bash into a car that was already open things settled down in that wreck. There was an older chap who had gotten there before hand, lying across the front seats and reaching back to the passenger, but I think he was deterred by the blood and had no idea what to do other than pat the boy’s leg.  I am vaguely aware of something he muttered to me about blood as I scrambled across him. Poor chap, I was paying him next to no attention at all. I clambered over him, heading for the boy in the back corner, my mind running through that checklist mentioned earlier. But I can say now that my very first impression was that the little boy’s neck was broken – “that head is at such a strange angle”. Your ear cannot usually touch your shoulder. Then suddenly he lifted his gaze and coughed blood into my face. If it was not so serious I would have laughed, I was so relieved. He was breathing! But I knew he could still have a broken neck despite the movement so I got my left hand snugged in there between his seat and his neck and head and he nestled into it. I didn’t want him flopping  his head around any more than he had to.  When I first looked in and scrambled over to him I had checked his ears and nose for fluid. Nothing. But I keep checking for blood or clear fluid, just in case. Nothing. Then Graeme appeared.

“You right in there?”

“Yup, all good”.

The other chap asked who I was and Graeme responded with “a first aider” to which he responded with something like “Phew, I’m out of here”. Which was convenient for it allowed me to get closer to the boy and properly support his head and have a quick look for any other trouble. And to get as close as I could to talk to him.  There is always something very intimate about these situations.  Hard to put my finger on but its about sharing the madness together.  His bloody, broken little face told me I needed to be careful about how I handled him. Caresses were out so getting as close as decently possible was the next best thing.  I wanted my proximity to tell him I was not going anywhere.  That he was not on his own. That he could be scared but we would be scared together. Impossible to verbalise such concepts to a three year old in normal circumstances, so it seemed getting close was the natural and next best thing to do.

I was also relieved at the departure of the other guy for another reason – the smell of petrol was very strong. I am sure it was this smell that had galvanized the guys trying to pry open doors that were well and truly bent shut.  I wanted the boy to stay in that capsule until the ambos arrived (some of the initial attendees at the site were keen to get him out of the capsule but I had firmly disavowed them of that idea. What would we do with him once he was out? And if he had a broken neck we would not be doing him any favours) but I was ready to grab him and bolt if the car ignited. I thought through where and how I would grab him and where I would put my own feet and hands (quick look around to make sure I wouldn’t get tangled in seat belts or any other loose  stuff) as I reversed out of the car if things suddenly got hot. Another body in there would have only complicated a hasty exit.

With the “get out of here quickly” plan sorted, and no emergency services yet on  site I got focused on the boy. Strangely, things seemed to cocoon. It’s hard to say how long I was in there with no distractions and no awareness of anything else except this little man’s distress, his spraying and clotting blood, his luminous eyes and the sound of my own talking to him. Five minutes? No more than ten. My left hand stayed locked around his head the whole time and he mostly stayed rested in it. There were numerous, very intense moments when he stopped to listen and we locked eyes before whatever was hurting him had him look down and whimper.  Beautiful hazel brown eyes. And then suddenly they closed and he slipped away.

“Please God, he can’t die in here, that would make for a very crappy day.” Conscious that there could have been all sorts of unseen damage, that it looked like his jaw was broken and worried about his skull there were few other points of contact where I might avoid exacerbating an injury. So I gently rolled the corner of his eyelid with my free thumb and he groggily remarshaled himself, coughed more blood and cried. He grabbed my hand as he came to and I grabbed it back. His cry was a relief to hear but now he was functioning more slowly and was less responsive. “Don’t let him die, don’t let him die” became a mental mantra even as I talked. Told him what a great job he was doing. All those trite lines that spill out but it was less the content and more the tone I was making an effort with.

The cocoon curtain seemed to drop away as I glanced through the tangled and crunched latticework of metal where the passenger window should have been and I saw the first police car arrive.  I watched a uniform approach and a face peer in at me.  I told the face I had no idea what the other passengers were like but felt this was a serious situation and needed the first ambo on site to have a look at him. The face nodded and vanished.  My charge went silent again and he slipped away a second time. A roll of the eyelid and he was back with a cry and a cough. He seemed to sparkle up a little and his cry was a little more strident. Then suddenly an ambulance filled the view through the metal and a couple of very relaxed looking characters peered in. The first ambo heard the cry and his response was perfectly understandable – “He’s crying, he’ll be okay”. I felt like shouting at him but that would not have helped, so kept my counsel and turned back to the boy and kept talking. Sure, crying is an excellent sign but by now I realized there was something potentially very wrong with the left side of his head. Quite apart from the huge egg that had grown up on his forehead that is.

In the quiet lull we had together before the police arrived the boy had wanted to flick his head away from my hand a couple of times so I reached over to gently cup the other side of his head with my other hand. It was then I realized that something did not feel quite right and I pulled my hand away.  If a pin had dropped I am sure I would have heard it and for a few moments I went back some decades to another accident with another head injury and thought of Joanna. Same side of the head I mused.  “Not another one God, not another one”. That blow to the head had killed my sister. It was a strange thought but I wasn’t interested in having a blow kill this kid. As if I had any say in the matter! But I stayed with Joanna for a few minutes in there. It was a quiet little sanctuary and hallowed in its own perverse sort of way.  Just he with his beautiful eyes and Joanna and myself. No sounds intruded. I lost any awareness of what was happening outside the car. Just the three of us floating in our own crazy little world.

Another head appeared.

“Hi, I’m an ICU doctor. Fluid from ears?”

“No.”

“Breathing?”

“Yes.”

“No airway blockages?

“No.”

And a few other checklist points. “Goodo, stay where you are, looks like you have that sorted – I’ll check the other cars.” Someone had earlier wanted to knock in the passenger window but I had simply leaned over and wound it down. I recall thinking the last thing I needed was an out of control sledgehammer coming through the window at me. Or him. A short time later a woman appeared at the open window and introduced herself as an ICU doctor. Really?  Surreal. A flash of a thought that my leg was being pulled but she rattled off the same checklist the other doctor had mentioned, at the same time reaching in and feeling the top of his head. “Good, the fontenelle is closed” she quipped.  She stepped away and an ambo reached in with a pair of shears and started into the boy’s clothes. He had conked out again and had gone completely limp, dropping his hand out of mine but I concentrated on helping the ambo. Up the left sleeve first. I help lift and tension the material. Up the centre. Down the next  sleeve and a brief moment of levity as the ambo and I agreed we would not try and shear off my finger holding the material away from his body. Bit of a struggle to get the last snip. Shorn of clothes the little fellow stirred himself under another roll of the thumb and the doc was now back in and doing a quick check. Body colour fine. Bruising around his neck and shoulder, probably from the restraint.  Looks okay. She steps back and the ambo is leaning in with a neck brace.

He clips it together and between the pair of us we tried to wrap it around the boy’s neck. But it was too large so he vanishes for a moment and returns with something smaller. After a bit of fiddling we get it fitted.  The ambo steps back and the doc reaches for the boy’s feet and I cradle his head and support his torso as we lift him towards the window through which he vanishes into the hands of the ambo and onto a stretcher.

And suddenly its over. Over more quickly than it had begun. I look down and see the driver’s wallet and glasses and loose change and tissues and all the ordinary things of life that mark a quick drive to the shops. Except my hand is resting in a pool of sticky blood which he must have coughed up at some point and I had not previously noticed. Then I realize my glasses are covered in a fine mist and spatter of blood and so I stop  in the door way of the car to compose myself and clean them off. Must have been in there a while I figure, since the blood was now dried hard.   I step around the front of the car to the stretcher – the doc is checking unresponsive eyes. He was falling unconscious as I handed him through the window. My last impression of him is of one rolled back eye, only the sclera visible, the other unresponsive and of a pale little torso on a stretcher about to vanish under a blanket.  There is nothing else I can do so I walk away, back to the ordinariness of a meeting and taking minutes. As I do so the taste of blood fills my mouth and only then do I appreciate the intimacy of our contact. Someone on the sidewalk tells me my face is spattered with blood. Best get cleaned up. Which I do.  Change gears. Take a deep breath.  And start thinking about him later.

(photo courtesy of the Manly Daily)

Previous Post Blood in my Mouth

Additional Thoughts Cheek by Jowl

Also Aftermath – reflections three weeks after the accident

And meeting Ryan in hospital