85 year old male, broken leg. That’s what the pager said and I didn’t have much reason to doubt it. Some pages are more vague, such as Male lying in ditch or Unresponsive child. I’ve driven a gazillion miles an hour to Elderly female, no pulse to find her, eyes wide open, chatting like a parakeet. So you never know. Rural Emergency Medical Responders (EMRs) are the last in a little game of telephone. We see everything from car accidents to overdoses. Our scenes can be on the road, beside a toilet or in the woods. My squad once got a call to a “chest pain” and found a hunter slumped next to the deer he’d been trying to drag out of a state forest. They helped him down a trail for half a mile to the waiting ambulance. Afterwards, one of the EMRs – a firefighter – said “Hey, we gotta go get his deer!” They hiked back down the trail in the dark, dragged the deer out and their patient lived to dine on venison that winter, presumably with a side of statins and low-dose aspirin. Full-service medical response at your service! As a volunteer medic, I’m not always available for every call, but when I am, I need to make a calculation or two before heading out:

  1. Can I get there before the ambulance crew? If it’s a broken arm and I know they’re going to beat me by a few minutes, then my presence will be redundant.
  2. Do I have a couple of drinks under my belt? If yes, then no Rescue Robert today.
  3. Is it a nasty call? The ambulance may beat me there but if it’s a bad collision, for example, they are going to need all the help they can get. Let’s go!

The address was nearby so I closed the laptop, grabbed my bag and hopped into the Pilot. I was definitely going to beat the ambulance and since it was ten in the morning, the only thing I’d had to drink was a double-shot machiatto from which I’d taken exactly two sips. When I worked in ambulance, I never relaxed until I was at least three quarters through a meal. Then, the pages could come. In fact, I hoped they would. Any call was better than watching my partners watch some Godforsaken reality show or, worse, the Vikings get the snot beat out of them by [fill in the blank].

At the end of our driveway, I double-checked the address, turned right and sped down County Road 9. Two minutes later, I turned up a gravel road and into a farmyard with a picturesque red barn and one-story yellow house. The farm buildings sat at the top of a grassy slope like something from a Norman Rockwell painting and I had admired them for years as I drove on by. I had no idea who lived there.

I parked next to the deputy squad car. Of course he had beat me there. EMRs don’t have emergency lights and even if we did, we still need to drive with “due regard.” Deputies can drive as fast as they damn well want and they never miss an opportunity fly down the road faster than the Millennium Fucking Falcon. These guys would drive 90 to a hangnail. They would break the speed barrier for a low blood sugar. I’m glad for it because law enforcement can be helpful with patients and good at managing scenes. The first thing they teach you in EMT class is this: if the scene is not safe, we are not on the scene.

Two women, probably a mother and daughter, stood in the yard, pointing towards the paddock where a man lay on the ground. I pulled out my medical bag and headed towards my patient but the older woman stopped me with a raised hand. “Don’t bring your bag!” I stared at her, not knowing what to say. I’d heard a lot of strange things at calls, but “Don’t bring your bag” was never one of them.

She pointed to a holstein in the paddock nearby. “Cow might react to the bright colors on your bag. She head-butted my husband when he was climbing into the paddock.” I looked past the old farmer and, sure enough, the cow was stomping and pacing back and forth as if she wanted nothing more than to blast through the gate and finish the job. Her forehead looked like a fur-covered anvil and her victim was no more than three feet away. A man in brown coveralls stood nearby, holding a cattle prod, and a few steps behind him was the Deputy, hand hovering near his gun, looking like Clint Eastwood. Add a half-chewed cigar and some cheesy music and The Good, the Bad and The Ugly was alive and well in Bemidji, Minnesota! I’m the Good, by the way.

My patient lay on his back, his hands crossed over his belly, like he was laying down to a summer nap – except he was in cow manure. With one eye on the black and white hulk, I knelt in the muck and said “Hi, I’m Robert, your Friendly Neighborhood Medical Responder.”

“Hello,” he said clearly.

“Cow break your leg?”

“Yep.”

“Mind if I feel it?”

“Nope.”

A nasty bulge swelled from his thigh. Broken femurs are rare and can be dangerous if they are bleeding. The ambulance would carry a traction splint which stretches the leg back out, allowing the bone ends to meet and the blood to circulate. I had practiced with traction splints for a long time and had looked forward to using one. This was my first femur fracture. “Feels broken to me,” I said.

“Yep.”

The cow punched the gate with a jut of her nose, causing it to shudder. I imagined a speech bubble above her head: “I’m going to kick your little white ass!”

“Let’s hurry up!” said the guy with the cattle prod, “She rams this thing, she’s coming through!” Cervical spine or bone injuries usually require EMTs to stabilize the injury before moving the patient. The exception to this rule is when the scene is not safe, such as a burning car. I wasn’t sure I wanted to drag him over to the yard and was just considering how to move him when I heard the ambulance approaching. Good. They’d have a backboard and if Bessie would sit still another minute, we’d have him out of the way. “You know,” I stalled, “I always wondered who lived here. I love your barn.”

The younger of the two women leaned over my patient and spoke loudly: “Dad, this is Dr. Human’s husband.” It was then I remembered that she was a nurse in the clinic where my wife worked.

The older woman said “we love Dr. Human. Honey did you hear that?”

“Yep.”

Cow: “I am going to break your other leg, then pound your Goddamn head into that shit field!!”

I met the Paramedic as he hopped out of the ambulance wearing a Packers hat. Gutsy move in Vikings country and even though I’m a hockey guy the attire required a riposte: “Nice hat, loser.”

“Yeah, yeah, what’s going on?” He was joined by his partner and they whisked past me towards our patient – each carrying a bright, shiny ditch bag.

“Whoa there fellas!” I said, in my best farmer’s wife voice. “This here would be what you call ‘scene not safe.” They gave me the same look I’d undoubtedly given her. I pointed at Bessie and explained the situation. A minute later we were at our patient’s side with the backboard.

“So,” said the paramedic, “you broke a leg, huh?”

“Yep.”

Cattle Prod Man: “Let’s pick up the pace, alright?”

Clint Eastwood: “We done here?”

Cow: “FUCK ALL OF YOU PEOPLE, I’M GOING TO KICK YOUR MOTHERFUCKING ASSES!!!”

We rolled our patient to his side, slid the board under him and buckled the straps. Clint Eastwood came over and helped us carry him to the ambulance where the medics began to prepare the traction splint. I filled out my paperwork, said goodbye to everyone and headed back home, wondering what calls were like in Detroit or New York.

Believe it or not, three minutes before I was ready to post this essay, the pager went off and I responded to this

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Back home now and back at it. Now…where’s my machiatto?

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