15 month old not breathing. You rush out to the ambulance, buckle yourself in, and as you flip through your field guide to read the recommended ET tube size for the age and the epi dose, you wait for them to update you. Child is breathing. Child choked on some milk, but is alert and crying. Child had a seizure, but is now breathing. Nearly every time they call you back and tell you this. Like clockwork. After you hit the lights and sirens -- forty-five seconds, maybe sixty seconds later, you get the update -- It's okay. Take it easy. False alarm.
This morning, they update you with these words: "Starting rescue breathing. Continue code three."
A woman is screaming and two police officers are on all fours like giants over a doll. I have already told my partner to set up in the back of the ambulance, my plan is to snatch the kid, and do walking CPR out to the ambulance where we can work it.
I pick the baby up. It is cold, its skin white mottled in places with livitity, its limbs stiff. It feels just like a mannequin, except it is much smaller. The baby isn't fifteen months, it's fifteen days.
I ask the woman, when she last saw the baby moving, while I raise it's mouth to my lips, and press my fingers against it's chest. All I can hear from the woman is noise. I don't know what she is saying, but there is no answer for my question. I turn and begin the hurried CPR walk out to the rig, out of that too small house.
"The baby is dead," I tell the officers and my partner on our way out. I give it another breath. "We're going to the hospital, but the baby is gone."
In the back of the ambulance, I lay the baby on the half board and we put in an oral airway and bag the child while we do CPR. An officer drives. We go lights and sirens. I tell him to drive slower. Drive like you are in a funeral procession, I say.
I radio ahead. I say "15 month old found not breathing. I mean fifteen week old, no -- day old. It's got some rigor and livitity. Aystole. We're doing BLS CPR."
When I get to the hospital, I am expecting a quiet room with doctor and clock on the wall that he can look at and call the time, but they have heard baby not breathing and they have paged soome sort of code Blue. I have never seen so many faces standing around expectantly.
"The baby's dead," I say. I hold the baby up and show them the stiff legs and arms, the lividity.
The doctor understands now. He examines the baby briefly, then asks for the time. The word is passed to all the people crowding around trying to get into the small room. The baby is not workable. There are still questions asked. When was the baby last seen? What happened? What is the history?
I don't know. All I know is the baby was dead, and we had to get it out of the house. I couldn't just say. "Time of Presumption: 8:02. Here's my name, license number, date of birth, car number. You can call the ME now."
I suppose I could have called medical control on the way in and said the baby's dead, may I presume it here, call the time, shut down the sirens, pull a sheet over its head.
I don't mind calling the time on someone whose time has come, but for a baby, you sort of have to go through the steps. How can you ask a doctor to presume a 15 day old he hasn't seen? Isn't it better to say. We did what we could. I don't know. I may be callus, but I have a hard time calling the time on a fifteen day old. Let the family know we did what we could -- CPR, transportation to the hospital -- while at the same time not violating the corpse with IV and bone needles. But everyone has their own limits on what they feel they should do.
This is the third stiff baby I have brought to a hospital. The first one was ten years ago. When we got there the fire department was there. I remember them swearing at me with tears in their eyes, big grown men crying. "Where the fuck have you been? What took you so fucking long? The baby's fucking not breathing!" That child was ice cold. The other was a baby expected to die. The mother crying to the child, "No, no, not yet, I'm not ready yet. Don't go. Don't go!" We transported him, with the mother in the back, wailing in grief the whole way to the hospital. She wouldn't let go of the baby's cold hand.
Today I don't remember what the mother or grandmother or anyone else in the house looked like. I could see them in the supermarket later and not recognize them. The same with the other parents, I could sit next to them on a bus and talk for hours and have no idea who they were. I remember each of the babies though, exactly how they looked -- like cold lifeless dolls.
On my way out of the hospital, I hear the howls coming from the family room down the hall.
