CODE BLOOD

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Chapter Eleven

On Tuesday morning, the squad was toned out for a car that had gone over the side of Malibu Canyon Road, an eight-mile asphalt ribbon winding up and down through deep gorges between Pacific Coast Highway and the 101 Freeway. Brian and Colt were on a quick run to the supermarket when the call came in. Instead of stopping to pick up food for dinner, Brian hit the lights and siren, and sped through the traffic up PCH.

A Code 3—lights and siren, immediate response—was the next report they heard through their headsets: “Car over. Vehicle entrapment. Dispatching 88’s engine and Sheriff’s Search and Rescue.”

“What is it out here with people and their cars?” Brian said. “Last year a guy in a Ferrari hit a phone pole doing 110.”

“Dead?” Colt asked.

Brian nodded. “It was really ugly. Driver and passenger ripped apart. PCH was covered with body parts and pieces of carbon fiber.” He sounded the air horn, rolled through a red light and turned right onto Malibu Canyon Road.

Before he came to Los Angeles, Colt imagined that Southern California was flat. He didn’t expect to see steep mountains running down to strips of white sand along the ocean. As they climbed up through Malibu Canyon, he watched the blind curves. Speeding vehicles often missed a bend, shot off the road and plunged hundreds of feet into the canyons below. “They need more guardrails out here,” he said.

“Tell me about it,” Brian said.

Command and Control now requested an engine from 125’s.

“We’re gonna be sliding into the canyon on our asses,” Brian said.

Colt glanced at the speedometer. The squad was only doing 25.Malibu Canyon was a two-lane highway with no room for traffic to move to the right and it was impossible to pass. “Someone might be out there dying and we’re just creeping along,” he said, chewing on his lip. The trip to the scene of an incident was always the worst part for Colt. After five weeks in the field, his initial panic had dropped to mere anxiety, but he still rode along thinking of all the possible injuries he might see and all the procedures and treatments he might be called on to utilize. He’d had a year of instruction and hands-on training, taken dozens of written exams and was certified by both the State of California and the County Fire Department. He was now a paramedic and was supposed to be able to take care of any injury situation. He had learned so much, but worried that he might only have seconds to make an assessment and decide on a course of action. What if he made the wrong decision when someone was lying injured at the scene of an accident, relying on him for help? Sometimes when he thought about the responsibility, it almost overwhelmed him. Fortunately Brian had years of experience and was there to back him up.

Brian looked at him and seemed to read his mind. “It’s OK. You never get over the apprehension. When you get to the scene, your training kicks in and you’ll know exactly what to do.”

Colt nodded and hoped Brian was right. A car over the edge usually meant trapped bodies and a difficult rescue. Sometimes there was no rescue at all. A month earlier, a surveyor counting fish for the Department of Agriculture discovered two skeletons in a car at the bottom of a deep canyon near Malibu. The husband and wife were still strapped into their seatbelts. The couple had disappeared three years earlier and Search and Rescue never found them.

The squad ascended the second hill in the canyon. On the way down the backside, they saw the flashing red and blue lights.

“Here we go,” Brian said. He slowed and pulled onto a dirt turnout, stopping next to the empty Sheriff’s car with the driver’s side door still open.

Colt jumped out and ran to the edge of the embankment. Four hundred feet below, he saw a deputy standing on a ledge of rock looking into the side window of a red sports car. From above, the vehicle looked like a crushed Coke can. Colt thought it must have rolled several times before coming to a rest, right side up, next to a boulder jutting out from the side of the canyon.

Brian joined him and looked over the edge. “Oh baby, look at that car,” he said.

“Hey,” Colt shouted and waved. His voice echoed in the silent canyon. The deputy looked up and waved back. “How the hell did he get down there without a rope?” Colt said.

They ran back to the squad. “I hope the driver was wearing a seatbelt,” Brian said. “This isn’t gonna be pleasant.” There were no trees or guardrail on the turnout to use as an anchor point for the descent lines. Brian moved the squad up to the edge of the canyon, set the emergency brake and placed chocks under the rear wheels.

Colt uncoiled the nylon ropes and secured them to the front bumper. He pulled at each to make sure they were secure, and then tossed them over the side directly above the car. Colt tried to imagine what they would find below.

Brian took out the over-the-side medical bag and clipped on a small fire extinguisher.

Colt buckled a descent harness across his chest and around his waist. He pulled on his gloves.

“Go easy, don’t rush it,” Brian warned. “We don’t want to have to rescue a rescuer.” He buckled his own harness. “And try to avoid the poison oak.” He slung the medical bag over his shoulder, clipped onto one of the descent ropes and backed over the edge.

Colt was right behind him with the KED – the Kendrick Extraction Device—used for spinal immobilization in place of a backboard. It was less than three feet long and lightweight, but felt like a surfboard hanging from the webbing on the back of his harness. Colt began to rappel down, looking over his shoulder as he hung onto his descent line. Most of the ground was exposed bedrock covered in places with decomposed granite, gravel and small stones. Clumps of vegetation and chaparral dotted the slope, but were brittle and useless for a handhold.

Colt dislodged a rock and slipped backward. “Damn it,” he cursed. “I hate doing this.” He tightened his grip on the line and regained his balance. His all-purpose firefighter boots were useful for everything but this.

Brian was already 10 feet ahead of him. As they made their way down, small stones and pebbles dislodged from the canyon’s wall, cascaded past them and bounced off the damaged car below. The deputy, struck by some of the debris, moved aside and watched them descend. It took several minutes for Colt and Brian to reach the car.

The deputy recognized Brian. “Hey Brian,” he said. “Glad you guys are here. We’ve got a trapped kid, and a dash bow.”

Colt looked at the red Corvette. It was a disaster. What wasn’t crushed, was shattered. The parts of the body made from carbon fiber were split and broken, and red pieces littered the side of the mountain. It looked as though the car had gone over nose first and the front of the vehicle took the first impact before it rolled down sideways. “How’d you get down here without a rope?” he asked the deputy.

“Wasn’t easy. I traversed on all fours.” He held up his forearm to show a torn shirtsleeve and a bloody patch of skin. “Nearly lost it.”

Brian dropped his pack and tried to open the driver’s side door, but the frame of the car was twisted. He bent to look in through the space that had once been the side window. “Sir, can you hear me?” he said. “I’m a paramedic. I’m here to help you.”

“Yeah, I’m fine,” the kid inside said in a normal tone of voice. “I’m OK, just get me out.”

“What’s your name?” Brian asked.

“Tyler.”

“Do you know what day it is?”

“It’s Tuesday. I told you, I’m OK.” He sounded calm.

Colt joined Brian at the window and saw Tyler, who looked like a teenager, pressed back against the expensive black leather seat with the seatbelt still around him. A deflated airbag hung over the steering wheel. The dashboard was pushed down and inward against his legs, obscuring his body from the waist down. He was bleeding from a large cut on his forehead, but Colt thought his upper body looked remarkably good.

“What happened, Tyler?” Brian asked.

“I guess I lost control.”

The deputy interrupted. “Hey guys, we’ve got a gas leak.” He pointed to the rear of the car.

Colt detached the fire extinguisher from Brian’s pack and tossed it to the deputy. “Keep an eye on it. Our engine should be here in a minute.”

“I’m OK,” Tyler repeated. “I just need to get out.”

Colt doubted if Tyler was “OK,” although he probably wasn’t feeling any pain yet.

“It’s gonna take some time,” Brian said. He reached inside the car and put his fingers on the boy’s wrist, then turned to Colt. “Steady pulse, 110. He’s got a strong heartbeat.”

Colt’s training did kick in. There were so many things to do, all at once. First, they had to stabilize their patient. He opened Brian’s pack and pulled out the IV’s. When he leaned into the car, he said, “You a football player?”

“Basketball,” Tyler said. “Can I use a cell phone? I have to tell my folks I’ll be late.”

“Just take it easy,” Colt said. It was important to talk to the patient and reassure him. “We’re going to insert an IV in your arm.” He reached in and tied a rubber strap around the boy’s bicep. Colt patted, then slapped the boy’s arm, found a vein and inserted the needle. Colt looked for an indication of desanguination—massive blood loss—on the floor of the Corvette, but the crushed dashboard obstructed his view.

Brian attached the IV tube to the saline bag and managed to suspend it from the bent doorframe.

Colt heard 88’s engine above him. In the midst of everything, he realized he had learned to discern the different siren sounds of the engines, squads, ambulances and police cruisers. Colt pulled out his radio and called Captain Ames. “Cap, it’s a high angle descent and we need the extrication equipment. We’ve got a trapped driver down here. We have to do a dash push. We’re gonna need the AirSquad and an ambulance.”

“My dad’ll be pissed,” Tyler said. “This is a new car.”

Brian checked the saline line to make sure it was flowing. “Please don’t talk now,” he said. “Try to relax and save your strength.”

Colt looked at Brian. For the first time since Colt had been working with him, he saw an expression he had never seen before.

“Get the C-collar on him,” Brian said. “I’ll start a BiCarb IV. He’s gonna have crush syndrome.”

Colt took the collar out of the pack. He was able to reach in, slip it around Tyler’s neck and secure it under his chin. Colt had learned about the severity of crush syndrome, but had never seen it. During an extrication, once the compression on a part of the body was released, acid and other metabolic waste from damaged cells flooded the bloodstream, causing heart fibrillation and possible death. Colt wondered again about Tyler’s condition under the dashboard and how much blood he might have lost. He looked stable, but that might be because he was an athlete and in good physical condition. An adult body had five quarts of blood. One quart could be on the floor of the Corvette and Tyler could still look normal. A loss of any more would be a major problem—three quarts of blood was the minimum amount for the IV fluid to maintain blood pressure and allow the heart to pump to vital organs. Sometimes the legs were amputated on impact but the dashboard acted like a tourniquet until it was pushed back. Colt had heard stories about situations when arms and legs were finally freed and were found attached to the body only by pieces of skin. Colt wondered if Tyler would play basketball again.

Colt took Tyler’s pulse again. “His heart rate’s up to 127,” said Brian.

“Search and Rescue just arrived,” the deputy announced. “Equipment’s coming down in the Stokes.”

Colt was thankful for S and R. They were pros at high angle repelling with heavy equipment. Without them, the paramedics would need a helicopter to lower the ram, the Jaws of Life and the gas powered hydraulic generator. Bringing the AirSquad into the narrow canyons was difficult and dangerous.

Brian finished inserting the Bicarb IV in Tyler’s arm. He stepped back from the Corvette, looked at Colt and shook his head. “I’m sure he’s bleeding,” he said. “I don’t know if he’s gonna have a Golden Hour.”

Colt tried to reconcile Tyler’s matter-of-fact attitude with the severity of his situation. He heard another siren echo through the canyon and thought it must be the engine from 125’s. When he looked up toward the road again, he saw four S and R members on the side of the canyon. They were attached to steel cables, walking face forward, two on each side of a Stokes Basket held by a larger cable. When Tyler was freed, they would wrap the KED around him, load him into the Stokes and winch him back up. Then he would get his Golden Hour—and a chance for survival. The ambulance would take him the short distance back to the helicopter pad at Pepperdine University and the AirSquad could pick him up and rush him to CU’s hospital.

As Colt watched, he saw Captain Ames and Moose, in harnesses, come over the side and start down on the ropes he and Brian had used.

“Do we need to crib the car?” Brian asked Colt.

Colt went to the side of the Corvette and tried to rock it. It was solid against the boulder and didn’t move. “We’re good,” he said, and looked up again at the S and R men. They were moving fast, already halfway down the side of the canyon. Captain Ames and Moose were above them, coming more slowly. Higher up, above the edge of the turnout, Colt saw the last vestiges of the coastal fog disappearing from the tops of the Santa Monica Mountains. The late-morning sun would soon burn through and begin to bake the landscape. In another hour, the canyon would be like an oven. There was not a breath of wind. A flock of boisterous wild parrots flew by overhead.

Brian put a patch on Tyler’s forehead to stop the bleeding.

Tyler still wanted to call his father about the damage to the car.

Brian told him again to relax and keep quiet.

Colt checked Tyler’s pulse again. It had climbed to 136.

S and R arrived, unhooked from their descent cables and began to unload the Stokes. They looked like military commandos in gray form-fitting body suits and black helmets. One of the team members carried the Jaws compressor over to the Corvette and uncoiled the hydraulic hoses. He glanced inside the damaged car, looked at Tyler, then at Colt. He said nothing.

A familiar sick feeling began to well up inside Colt. He thought of his father lying in the corral looking up at him. He thought of Bibi, unable to speak, staring straight ahead with unfocused eyes. He saw paramedics wheeling injured patients with glazed eyes into the ER at CU. Colt knew Death was on the side of the mountain with them, waiting to take charge. He wondered if he was the only one who thought Tyler might not survive. No, Colt decided, Brian knew. The deputy probably knew as well. If the S and R men didn’t know now, they would soon.

The three remaining S and R men dragged the basket filled with the tools over to the car. One of them set up the compressor and started it while another hooked up the hydraulic hoses to the cutter.

Brian told Colt, “When the cutting starts, be sure to cover the kid.”

By the time Moose and Captain Ames arrived, the compressor had built up maximum hydraulic pressure. Moose went to work. He surveyed the damage to the front and sides of the car and looked inside. “Hello, sir,” he said to Tyler. “We’re gonna start this piece of equipment. It’ll make some noise and take a while, but we’ll work as fast as we can to get you out of here.”

Tyler’s eyes were open. “Hurry.” His voice sounded weaker andmore urgent.

Colt checked his pulse again. “145,” he announced. Tyler’s heart was pumping faster to compensate for a loss of blood. He put his hand on Tyler’s forehead. It was cool and damp. Colt told Brian in a low voice, “He’s losing blood and he’s going into shock. What if we have to give him CPR?”

Brian shook his head. “We can’t do it while he’s trapped in the car.” He turned to Moose and said, “Make it quick.”

Moose nodded.

Colt looked at his watch. It was 10:55 a.m. They were toned out at 10:15 a.m. Tyler had been trapped in the car for almost an hour.

A second deputy came down on one of the S and R cables. Colt listened to him tell the first officer, “Looks like he came through the canyon too fast. Tire marks show his rear end started to come out. He steered into the skid like a big deal race-car driver, regained traction and the over-steer took him across the turnout and over the side.”

The first deputy had his pad out and was already writing parts of his report.

“We ready to go?” Moose asked. “I’ll spread the front quarter panel first and cut through the door hinge.”

Yeah, Colt thought, Dad’s definitely going to be unhappy about the damage to the Vette.

“Once I cut the A Post,” Moose continued, “I think we can lift the dash without peeling the roof.”

Colt took a blanket out of the Stokes basket, reached into the car and did his best to cover Tyler’s upper body, leaving only his head exposed.

“The minute you get the door off, we have to try to get tourniquets on him,” Brian said to Moose. “I don’t know what’s going on under the dash, but it can’t be good.”

Moose picked up the spreader tool and signaled to the S and R man, who throttled up the generator. It sounded like a lawnmower engine, but generated enough hydraulic pressure to cut and tear the structural steel parts of an automobile.

Another noise mixed with the sound of the generator. Colt recognized the distinctive clatter of the AirSquad and looked up to see the Blackhawk pass over the canyon, heading to the landing pad at Pepperdine University.

Colt prayed Tyler had enough strength to survive the next part of his rescue. The incident seemed like it had been dragging on for hours. He checked Tyler’s pulse again. “165,” he shouted to Brian. Now Tyler looked pale. Colt pulled the blanket away from his upper body and watched Tyler’s chest rising and falling. His respiration and heart rate were accelerating. He was in shock.

Moose worked at fast as he could to pry the metal away from the front wheel well and gain access to the doorframe, but automobiles were not made to be taken apart quickly.

Colt tried to will Moose to work even faster. He tugged the blanket back up over Tyler’s chest and saw him close his eyes. Colt let go of the blanket and searched for Tyler’s pulse. “His heartbeat’s down to 120,” he called out to Brian over the sound of the compressor.

Colt watched Moose methodically work at the side of the Corvette, change the tool head from the spreader to a cutter and wait for the pressure to build up again. Thank God for Moose. He handled the heavy tools as if they were toys. Colt wondered how anyone did extrication before the invention of the Jaws of Life.

Captain Ames talked on the radio with the captain from 125’s, waiting above.

Brian pointed up the slope, describing to the S and R team where the car had come down.

The first deputy wrote more of his report.

The second deputy talked on his radio.

Colt stayed at the window of the car, holding the blanket in place. Tyler’s eyes remained closed. Colt was certain he would be the last to see the kid alive.

Moose started on the toughest cut, the A Post that held the door in place. He was an expert, but it was taking too long.

Colt looked at his watch again. Now it was 11:20 a.m. Twenty-five minutes had passed since he last checked the time. Tyler had been trapped in the Corvette for almost 90 minutes.

Suddenly, Tyler opened his eyes and stared at Colt, inches away on the other side of the window frame. Colt’s heart sank. He knew the look. The light in Tyler’s eyes was dying out.

“We’re losing him,” Colt shouted. “Cut faster Moose.” Tyler’s head was immobile in the C-collar and couldn’t fall forward. Colt saw the muscles in his face go slack. He searched for a heartbeat, but there was nothing. He tried again. “He’s in full arrest,” Colt said to Brian, and began pressing Tyler’s chest as best he could through the window.

Brian pushed Colt aside and gave Tyler shots of epinephrine and atropine, then stepped back. Tyler’s face was white.

Colt leaned in and again tried CPR. “Don’t die,” he whispered. Colt pumped Tyler’s chest. Nothing happened, the stimulants had no effect.

“Again?” Colt asked.

“Yeah,” Brian said, and administered another round.

Colt began CPR again, but after a minute, Brian stopped him and shook his head. “He’s bled out. It won’t help. It’s over.”

Colt stepped back. He clenched his fists and looked up—as though he were looking for Tyler’s soul rising from his body. A tear ran from Colt’s eye. He shook his head, walked a few steps away and stood looking down into the canyon, his back to the others. He took a couple of deep breaths and swallowed the urge to scream.

Brian leaned into the car and checked Tyler’s pulse one last time. “He’s gone,” he confirmed and looked at his watch. He pulled out his radio and contacted the MICN—the mobile intensive care nurse—their base connection at the hospital at CU. When he reached her, Brian identified himself and said, “We have a vehicle entrapment and cardiopulmonary failure. Two rounds of epi and atropine were unsuccessful. Another round would have no effect. Patient is still trapped in his vehicle and has bled out.” Brian looked at his watch. “I determine the time of death to be 11:23 a.m.” He listened while the nurse repeated the information back to him, then said, “That’s correct, thank you.”

The first deputy stopped writing his report.

The second deputy stopped talking on his radio.

Captain Ames stood next to Brian. Neither of them said anything.

The S and R men stood around the Stokes basket. One made a quick sign of the cross on his chest.

Only Moose continued to work. He licked a drop of sweat off his upper lip, glanced toward the motionless body covered with the rescue blanket and kept cutting.

Colt stood looking down into the canyon and felt empty. There was no Golden Hour. There was no miracle. No angels descended from heaven to save Tyler’s life. The look in Tyler’s eyes had sent Colt the goodbye message. Tyler was alive and then he was dead—that was it. Colt wondered if Tyler knew he was about to die. Was he thinking about his family? The damage to his car? His basketball team? Did Tyler see anything? Did he disappear into a tunnel of light? A circle of darkness?

Colt kicked at the loose shale and sent a rock bouncing down into the canyon, starting a small rockslide. As a teenager, his time at Sheridan Fire and Rescue had stoked his desire to help people. The first five weeks of his service as a paramedic weren’t working out as he expected.

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