About 2:00 am on a Saturday night my pager went off. It was always on alert, charged, by the side of my bed. “Man down. Main Street; in front of the Baptist Church. Police on scene.” Holy cow, this was a mere fifty yards from my parsonage, tucked in behind the United Methodist Church on the opposite corner. 

I put on my coveralls and shoes, grabbed the pager, and headed for my truck parked around back. Too close to drive, I fetched my medic kit, oxygen tank, automated external defibrillator (AED), and radio. In the self-made medic kit were a stethoscope, blood pressure cuff, gloves, trauma dressings, forceps, a flashlight, glucose in squeeze tubes, and other assorted supplies.

“Palmyra 1415,” I called dispatch, “I’m on the scene,” even as I rounded the corner. I was close, but still had not laid eyes on what was going down. I was prepared for anything.

Or, so I thought.

I rounded the church to find a police cruiser with lights flashing, driver side door open, radio blaring, parked half in the street and half in the driveway next to the Baptist Church. On the sidewalk laid a man, face down. No cop to be found. Where was the perpetrator? Where is the village cop?

I thought to myself. Is the scene safe? This is one of the foundational lessons of Emergency Medical Services. One does not need to become a second victim.

I carefully approached, finding no one around. The man had no pulse and wasn’t breathing. I rolled him over on his back and noticed a blood stain growing on the left side of his chest. “Palmyra 1415,” I called again, “expedite the rig, start Advanced Life Support, and hit our pagers again for more help. CPR in progress.”

Then I started one person CPR.

What is taught in class is far different than the real thing. I’ve probably done CPR more than two hundred times. Never is it sanitary, especially in the elderly. Ribs get broken. People spew. The patient before me had been drinking beer all day, I later learned, and he responded like Vesuvius. Fifteen and two, was the standard of the day for one person CPR; fifteen compressions, followed by two breaths. Two mouth-to-mouth breaths. No, I did not have a CPR mask.  

Just hurl and get it out of your system, I learned early on. So I wretched to the side without breaking stride. Fifteen compressions, followed by two more breaths. What is also neglected in training is how exhausting CPR can be. Relief is necessary to maintain effective, uninterrupted compressions and breath. I was quickly losing steam. 

Then, a pair of shoes appeared next to me. “Jump in,” I asserted quite forcefully, “take over compressions.” No need for someone else to be covered in bile and vomit. “Palmyra AM-24 on the scene,” I heard on the radio. The scene was bathed in halogen headlights. Help had arrived. I didn’t even hear them calling dispatch that the ambulance and crew was responding.

Sirens, police cars, cars driven by my crew with flashing blue lights descended on the scene. It was like the cavalry was arriving. My crew took over CPR. Trauma scissors removed the patient’s shirt and pants, exposing one entry wound on the left side, between ribs. The open wound was oozing blood. The AED pads were applied and the machine was turned on. “Halt CPR,” I ordered. Asystole appeared on the screen, or, as everyone else knows it, flatline. Asystole is not a shockable cardiac rhythm. His heart had stopped beating and no amount of electrical charge could get it started again. 

With every compression, he continued to spew. The Endo-Tracheal tube slid between his vocal chords and was firmly placed, exactly as advertised. Thank you, Lord, for bright headlights and near perfect anatomy. The Bag-Valve-Mask (B.V.M.) was attached, making reparations much easier.  

As he was being packaged on a backboard and lifted onto the gurney, I got an I.V. established. There was no flash of blood, telling me his blood pressure was non-existent. Yet, the D5W dripped into his collapsing veins. Off we went in the ambulance. No Advanced Life Support was available, hence, the cardiac drugs would have to wait until the emergency room. My certification allowed me to start I.V.s and sink E.T. tubes, not pass pain relieving or cardiac medications. My crew did the thump and pump all the way to Newark Wayne, the closest hospital. We were all covered in spew. 

Windows open, exhaust fans on high, the AC cranked to 10; nothing could mask the smell. I made the radio call to the hospital and it must have sounded on the other end like I was in an open cockpit airplane. In the age before cell phones, we called in our patient reports to the emergency department over the open radio. Everyone with a scanner was privy to identity and health care information.

The backup alarm pulsed as my driver backed us into the ER bay. The doctor opened the back doors as soon as the rig came to a stop. His mouth was agape, surveying the organized chaos before him. He, too, turned shades of green, but refused to wretch. Wheeled into the trauma bay, the backboard and patient slid to the table under the bright lights of broken biology. 

Experience taught me to make the verbal report, then bow out and head to the janitors sink to fully immerse myself under pouring water, washing the offending fluid down the drain. The crew followed my example. We became like showered rats. 

Burned forever in my memory is the sight I witnessed while under the blessed stream of cleansing water. The patient was on the table, his left ribcage was lifted, and the doctor was up to his elbows reaching into the victims chest to message the heart. Rural EDs are often staffed with general practitioners, not specialists or surgeons. My doctor this evening literally had more than a handful. 

“Call it,” he told his code team. “The left ventricle is cut in two.” His gloved hand withdrew from the cavity. Without a left ventricle, blood can’t be pumped into the circulatory system. Life isn’t possible. He was dead before I got to him. 

A few weeks later, I’m gathered with my clergy colleagues around the breakfast table at a local diner. Bacon. Scrambled eggs, covered in Tabasco. Wheat toast. The same order for the past fifty years. We talked of church, parishioners, town gossip, the state of the country. Love was our common language, Jesus was our common redeemer. 

The door was awkwardly pushed open. In walked an elderly woman, assisted by a walker. She scanned the dining room. She set eyes on us and began to shuffle our way. “Don’t look now, but, I think we have a visitor.” We all tried to look innocent, uncertain what was to unfold. 

The woman stopped at the end of our table and asked, “Are you the group of ministers from town?” “Yep,” we all shook our head in agreement. “Is one of you Reverend Goddard from the Methodist Church?” She asked. Others sighed in relieve while I looked up and squirmed. “What can I do for you,” I asked, trying to force a smile. 

“You’re a medic on the ambulance, aren’t you?” 

“That would be me.”

“Were you on duty the night my son was killed?” She asked. Pause, then silence.

“Yes. Yes, I was,” I whispered.

He and his girlfriend had been drinking beer all day and had a fight late at night. The domestic dispute came out the back door and into the front yard. Neighbors called 911. She pulled a steak knife and sunk it into his chest. As he collapsed, she threw the knife into the bushes and ran. The police officer pulled in, and commenced to pursue, leaving just the victim for me to find. 

“Did he suffer?” she whispered.

It was like the Oxygen was sucked from the room and everything moved in slow motion. Carefully, gently, I responded, “No ma’am. Your son did not suffer.”

“Oh, thank you,” she surprise me. I rose to her embrace. “I’m so glad he didn’t suffer and that you were with him when he died.” Thank you, she repeated, wiping away the tears. Thank you.

You are welcome. 

—   

The pool felt good this morning. Lap after lap slid by, the silent count drummed by in my brain. Water walkers were in the lane to my left, swimmers churning water, passed me on my right. 

Slow is how I like to go. Deliberate. Disciplined. Holding back my full potential. 

Lent is a season of discipline, I remind myself.

Speed and strength are but memories of my youth. Wisdom keeps me in my place, protecting my geriatric frame and muscles from injury or harm. Head up. Eyes up, straining to look forward. Reaching, pulling, flying my hand over the surface back to the water before me. 

My hand skimming over the water, like the breath of God in the Creation. Ruach. 

The wind blows where it will. We neither know from where it came, or where it goes. That’s what Jesus said, so scripture informs us. 

Reach. Breathe. Pull. 

Where is it that I am going? Do we pull, or, are we pulled?

—-

Life settled down the eight years I served the parish in Palmyra. Church attendance hovered around ninety every Sunday. We were an active congregation, engaged in numerous local and distant missions. Church leadership liked to complain a lot, but we held it together for the common good.

We hosted twice a year chicken BBQs to bolster income, directing cars though the parking lot to a place where packaged dinners can be run out to the car. We cooked 625-750 chickens each round, halved, and flipped on huge home made wracks. Members of the parish were generous with donations of their time, pies, and all the makings for coleslaw. Our parsonage smelled like BBQ chicken for two weeks after each event.

My wife, Cynthia, was making the commute to her labor and delivery job in Geneva. Our son was taken to and from daycare in Canandaigua. There were church meetings a couple of times a week, senior citizens Bible study down at the high rise apartment complex in town, hospital and shut-in calls, worship planning, and sermon writing. I leveraged my math and computer science undergraduate to build a church web page right after Al Gore invented the internet. We were one of the first church web pages in existence. Email was delivered to my computer; too bad, in the early years, few were online to send it. There was no time for slowing down. In my early 30’s I felt invincible, professionally on an upward trajectory. The sky held no limits.

Except, I felt like I wanted more.

So, I did my medic thing and answered fire calls. I answered more than three hundred ambulance calls and over a hundred fire calls a year. House fires, car wrecks, heart attacks, strokes, childbirth, flooded basements, brush fires, mutual aid, homicides, suicides, you name it. Code 2479 meant “calling hours are from 2 to 4 pm, and 7 to 9.” The adrenaline rush was addictive.

I was the chairperson for the district Board of Ordained Ministry, the first committee beyond a local church were a person begins to explore a potential call to ordained ministry. This was a responsible volunteer job, balancing the reports and responsibilities for about thirty people at a time. The bishop placed me on the Conference Board of Ordained Ministry, a front row seat where all the sausage is made. Who gets in? Who’s in trouble? Who gets their ministerial status changed?

And yet, I wanted more. What about my seminary training and experience at Eastway Community Mental Health (Dayton, Ohio) conducting crisis interventions and psychiatric assessments? Though there was plenty of mental health concerns in the parish, I was wondering what kind of opportunities existed in the community.

A newspaper ad caught my attention. Clifton Springs Hospital and Clinic (CSHC) was looking for part-time Psychiatric Assessment Officers (PAOs). It felt like the heavens opened and the voice of God spoke. It wasn’t about the money; the church was fairly compensating me. My empathy for people suffering mental health crisis ran deep, especially those who faced the challenges of chronic disease. It was more about the thrill of busting into somebody’s mess and being the one to make everything better.

I applied and was hired. After a period of orientation in the day clinic, I was signed up on the rotating call schedule. Every third night between 7:00 pm and 7:00 am, I was the PAO on call for the emergency department. Everyone in psychiatric crisis from a three county area were brought into our ED for assessment. They came by police, ambulance, or they just walked in. Because of my role on the volunteer ambulance, I already knew and liked the ED doctors and nurses, and they liked me. In time, the psychiatrist I worked for grew to know and trust my work. If it was my opinion that a person was in need of involuntary treatment, with the power of a physician’s signature, they were taken away, most often never to be seen by me again. I was in and out of a persons mess in one hour or less; and that was the way I liked it.

Some nights on call, the pager was silent as a stone, and I’d get a good night sleep. Other nights, I’d get called in five or six times. Often, I’d be assessing one patient, or writing up my notes, when another person came in to the ED. In good weather, I loved to zoom in on my Honda CB-750, dressed in leather and helmet. The doctors called it a “donor cycle.” That always made me smile. I didn’t care; I looked and felt bad-assed.

Major depression was probably the most common complaint. A lot of people will have a major depressive episode in their lives, where they might lose weight, inability to sleep, feel long periods of depressed mood, or might have pervasive homicidal or suicidal thoughts. If untreated, depression can become chronic. Note to self: if overwhelmed by depression, get help. Get treated before an episode of depression changes brain chemistry and you’re left with a life-long, chronic disease. Assessment is straight forward. Treatment is effective. Medication and counseling works wonders. And medication is improving all the time.

Five or six major depression assessments in a row tended to make me feel a little depressed myself, so I loved to have the occasional bipolar or schizophrenic patient come along to mix things up. You know, to keep things interesting. Our team and I conducted assessments on children and youth, and elders and the frail. Drugs and alcohol, oh, my, led to substance abuse disorders, self-medicating, and additional poor life choices. The hospital was blessed with an out-patient mental health program, in-patient, a drug and alcohol floor, and even provided electro convulsive therapy (E.C.T.s), an effective and modern treatment for depression. The only mode we had lacking was an in-patient adolescence unit, but then, at that time, few hospitals provided psychiatric care for kids.

My plate was full. In fact, I was juggling a lot of plates. But, for the time being, I was able to keep them all spinning.