Station 88, squad and engine respond to vehicle accident on Pacific Coast Highway at the Surfrider Restaurant.
When the tone sounded, Colt Lewis was replacing the IV bags in the drug box. A surge of adrenaline pulsed through him. He ran to the engine bay, stowed the box in the side-panel of the squad—the paramedic truck—and pulled on his gear. Brian, his partner and preceptor during his eight-week internship in the field, slid behind the wheel and grabbed his headset. Colt punched the red button on the wall and jumped into the passenger seat as the heavy metal garage door rumbled up.
“You good?” Brian asked. He hit the lights and siren.
Colt nodded and heard the deafening wail before he put his headset on. They rolled down the driveway onto Pacific Coast Highway and turned right. It was an early Sunday afternoon in mid September and PCH was crowded with people coming to the beaches. Colt was living his dream. He had just become a Los Angeles County Fire paramedic stationed in Malibu. He was part of the firefighter brotherhood. The men on his shift replaced the family he no longer had.
Vehicles moved aside to let the squad pass. Brian wove through the sea of traffic to the center divider lane and picked up speed. “Squad 88 responding,” he called in. “What have we got?”
“Single vehicle accident,” dispatch radioed back.
Colt’s adrenaline spike subsided. He shook his head. You never knew what you might find when you were toned out. People drove at high speeds on PCH and collisions were common. The worst were the devastating MVA’s—multiple vehicle accidents. During his two years as a firefighter before becoming a paramedic, Colt saw several MVA’s with torn flesh and metal spread across the pavement. A one-car accident at the Surfrider sounded harmless. An old woman with blue hair probably bumped her head when her husband touched the brakes in the parking lot.
In his side view mirror, Colt watched the LifeLine ambulance fall in behind them. Farther back, he glimpsed the red lights on top of 88’s engine, caught in the traffic. The squad screamed past Ferraris and Porsches, SUV’s, motor homes with satellite dishes, Jeeps with surfboards, Harleys and sport bikes—all trying to squeeze over into the right hand lane. A black and white from the Sheriff’s Department made a sudden U-turn and preceded them for the short trip down the coast. After five years in California, Colt was still amazed at the congestion. In Wyoming, where he grew up, the land was empty. The entire population could be on the highway and no one would notice.
A mile from the Surfrider, traffic was backed up to a standstill. Sheriff’s deputies had placed their cars diagonally across the highway in front of the restaurant, stopping traffic in both directions. Brian swung out into the center lane again. As the squad approached the Surfrider, Colt saw a metal light pole lying on the ground, one jagged end in the parking lot and the other, with a smashed streetlight still attached, sticking out into the right hand lane of PCH. A silver pickup rested on the cement pad where the pole had been anchored. The impact had driven the front bumper, grill and hood halfway to the windshield. Colt looked for the telltale circle of smashed glass and blood and hair on the inside of the windshield, but saw nothing.
Brian pulled into the parking lot and stopped. Several feet away, a crowd from the beach wearing bathing suits, restaurant customers wearing shorts and tank tops, and the Surfrider staff dressed in black pants, white shirts, red suspenders and bow ties, had collected. A surge of excitement pulsed through the throng. People shaded their eyes to get a better look, pointed and spoke to their companions. Several took photos with their cell phones.
Brian was out of the squad before Colt had his hand on the door handle. “Let’s go,” Brian said. “Glove up.”
Colt grabbed the orange drug box and followed Brian.
The ambulance arrived seconds later and the LifeLine EMT’s trailed after them across the parking lot. The crowd parted as they approached. Colt saw a deputy kneeling next to a girl wearing a blue T-shirt, lying on her back. The next thing he saw was what remained of her right leg—a stump with shreds of muscle and tendons in place of her foot and ankle. Blood from a severed artery formed a puddle on the ground next to the deputy. Colt felt a new rush of adrenaline.
The deputy turned toward them. “Glad you guys are here,” he said. He had pulled everything off his belt and was using it as a tourniquet. His flashlight, radio, mace, gun and holster, two sets of cuffs and bullet clips lay in a pile at his side. He held the thick brown belt tight around the girl’s right calf, but blood continued to leak from her severed limb. Nervous sweat ran off his face, dripped onto the blacktop and mixed with the blood. His tan shirt had dark rings of perspiration under the arms.
Colt couldn’t take his eyes off the stump of the girl’s leg. His job was to help those who needed it. Although he would never admit it, sometimes when he knew the victim had done something stupid, Colt was a little less concerned. The person lying in front of him wasn’t one of those reckless jerks injured in a motorcycle crash, or some lunatic who raced down Pacific Coast Highway weaving through traffic. This victim was a girl, badly injured and bleeding out from a severed foot. Although surrounded by Sheriff’s deputies and curious strangers, she seemed alone. Colt didn’t see anyone trying to comfort her.
Brian pulled a tourniquet from the drug box and tightened it around the girl’s leg above the deputy’s belt. “How long have you been here?” he asked the deputy.
The deputy loosened his belt and slipped it off the girl’s leg. He wiped his face on the shoulder of his shirt and looked at his watch. “It happened about fifteen minutes ago, say around 1420. The dispatch was a Code 3. They should’ve said it was a Code Blood.”
Brian wrote the time on the tourniquet with a black marking pen. The medics in the ER would want to know how much time had elapsed since the accident.
Colt realized the girl was wearing a blue CALIFORNIA T-shirt. He paused and stared at the vivid blue color with the white letters.
“Colt, damnit,” Brian said. “Get her vitals.”
Colt knelt down. “Miss, can you give me your name?”
Her eyes were open and she turned her head slightly toward him. Her lips barely moved. Her voice was inaudible. Colt had seen the glazed look of shock before. It was not a good sign.
“Do you know your name?” he repeated, and leaned toward her. He thought he smelled scented soap on her skin.
“Bibi,” she whispered.
“Bibi,” Colt said to Brian. “She says her name’s Bibi.” He turned back to the girl. “Do you know where you are?” She looked at Colt but said nothing. He read the response in her eyes: help me.
He touched her palm. She had a delicate hand and white skin, but her nails were dirty and ragged. “Can you squeeze my finger?”
She could not.
“A-O times one,” Colt said, giving the paramedic shorthand assessment of her alert and oriented condition.
“You writing this down, Colt?” Brian didn’t ask, he ordered.
“Uh…yeah,” Colt said, looking away from the girl’s face. He pulled out his pad and began to make notes. The LifeLine EMT’s stood by, listening and making their own notes on the girl’s condition.
The deputy stood up, dangling his belt like a dead snake between his gloved thumb and forefinger. He looked at the spots where blood had stained the leather and shook his head. While his partner picked up his gun and equipment and took everything to their patrol car, the deputy coiled up the bloody belt, held it in one hand and pulled the latex glove inside out over it. He pulled the second glove off over the first, creating a casing of latex around the belt.
“Get a C-collar on her,” Brian told Colt. When Brian was in action, there was no idle chatter. He spewed out staccato commands and expected immediate execution.
Colt took out the collar, gently wrapped it around the girl’s neck and immobilized her head. Trying to stay ahead of Brian, he yanked two saline bags and IV kits out of the drug box, bent over the girl, found a vein and inserted the first needle into her arm. As he hooked up the saline, Colt glanced at her face again. Ocean blue eyes looked back at him. Colt had never seen such a beautiful color. She appeared to be in her early twenties, had short blond hair and a California tan. She could have been a cheerleader from nearby Pepperdine University. Her white shorts, probably spotless when she put them on that morning, were spattered with blood and soiled from the dirt on the parking lot. The blue CALIFORNIA T-shirt matched her eyes and reminded Colt of a picture of his mother wearing a similar blue T-shirt.
Colt leaned toward her and held her hand. “Don’t worry,” he said, “we’re here to help you.” He squeezed her hand gently, then moved to her other side, held her arm and searched for another vein. He worried they might be collapsing from lack of blood pressure. He watched the blue T-shirt rise and fall as she took quick, shallow breaths. Colt pressed his fingers against the radial artery above her wrist and felt her pounding pulse. It only took a few seconds to count the beats. “One-thirty-two, she’s going tachy,” he said to Brian. Colt pressed his wrist against her forehead. In the warm afternoon sunlight, her skin felt cool and damp. Her body was shutting down and shunting what blood remained to her main organs. She was going into hemorrhagic shock from loss of blood. It was a standard case study from his training.
He found a vein and started the second IV.
“Cold,” she whispered. “Cold.”
For a split second, he thought she had uttered his name, Colt, and that she knew him. He took her hand again and held it in his own for a few seconds, trying to give her a sense of reassurance. “We’ll take care of you, Bibi.” He looked at her. “Don’t worry. It’ll be OK, I promise.” He wasn’t so sure it would be OK, but that’s what he was trained to say. “Get us some blankets,” he called to one of the LifeLine EMT’s. “She needs blankets.”
As he bent over the girl, Colt’s peripheral vision registered the bare feet, sandals, tennis and running shoes and the shined Sheriff’s boots surrounding the girl. Where was her foot?
An EMT returned with a gray blanket. Brian took it and spread it over the middle of the girl’s body. He stood up, stretched his back, and turned to one of the deputies. “What happened?”
The deputy lowered his voice and looked at the silver pickup. “That asshole was texting when he veered off onto the shoulder. He had to be doing close to 50 because that’s what it takes to bring down a metal pole.” The deputy shook his head in disgust. “He’s lucky he had his seat belt on or he’d have gone through the windshield and ended up on the other side of the restaurant. He passed a breathalyzer test, but he’s definitely on something. This poor gal was standing out here and the pole sheared off her foot when it came down. It happened so fast she couldn’t get out of the way. We were parked in the lot and saw the whole thing.
“You saved her life,” Brian said.
So far, Colt thought.
Brian radioed a size-up to Captain Ames, still caught in traffic a minute away. “We’ve got a trauma case, severed foot and we need the AirSquad.”
Colt looked at Bibi’s face again. He looked out at the white sand and the water beyond. It was a beautiful afternoon. The sun was warm and the sky was blue, sprinkled with the thin cirrus clouds that hover over the Southern California coast during the late summer. The surf crashed onto the beach throwing up a fine mist. The smell of saltwater hung in the air. Gulls circled and fought for scraps of food from the restaurant’s trash bins. Two lifeguards with deep tans and wearing red shorts had run up from the beach to check out the situation, one of them carrying another drug box. How terrible is this, Colt thought. This beautiful girl is lying here on the blacktop bleeding out when she should be down on the sand enjoying the last hours of the weekend. Instead, some moron had taken her down.
Colt wiped the sweat off his face and motioned to the other EMT. “Hang on to these,” and handed him the saline bags with the drip lines inserted in the girl’s arms. Colt began a quick assessment. He didn’t have to pull her jaw open to make sure her throat was clear, she had already uttered a couple of words, but he ran his hands along her body to check for broken bones and further injuries. He remembered the half-joking words of one of his instructors: “Trauma calls look dramatic, but just splint the twisted stuff, plug the holes, start an IV, immobilize the back and get the patient to the trauma center.” Right now, it didn’t seem so simple. How do you plug this hole, Colt wanted to know.
Brian finished briefing Captain Ames, put his radio away and called out to the crowd, “Is anyone here with her? Does anyone know this person?” No one responded. Brian lifted her arm, placing his fingers above her wrist. He tried to find a heartbeat, then dropped the arm and stuck his fingers on her carotid artery. “Her pulse is dropping,” he said to Colt. “It’s down to 60.” Brian frowned.
Engine 88 finally rolled into the parking lot and Colt waved them over. Moose jumped out, took one look at the situation and ran to the squad to get the backboard. Captain Ames joined them clutching his radio. Colt heard him talking to the AirSquad stationed in the hills above Malibu.
“We’ve got a trauma run,” Captain Ames said. “A female patient, foot amputation. She’s going into shock. We’re at the Surfrider Restaurant. The SD’s clearing a landing zone on PCH. This is ALS, repeat, advanced life support.”
Colt heard a small chopper. It sounded like a lawnmower. He knew it couldn’t be the AirSquad and looked up. A news helicopter circled overhead. He saw another coming up the coast from Los Angeles. In minutes, news crews in vans would arrive, extend their satellite transmission poles, broadcast pictures of the accident and fan out to find people to interview. In the process, several spectators would have a moment of fame on Los Angeles network television. The accident would be a good lead-in on the 11:00 p.m. Sunday night news, but the anchors would be disappointed that a Malibu celebrity wasn’t involved.
Moose joined them with the backboard and laid it down next to the girl’s body.
Brian checked the C-spine. “Ready guys? On my count.”
The men prepared to roll the girl on her side.
“Be careful,” Colt said.
Brian gave Colt a quick look and said, “One, two, three.”
In unison, they rolled her onto her side, Moose pushed the board in toward her and the men laid her back onto it.
Colt thought he heard her utter a faint moan. While Brian secured the head brace and straps across her body and prepared her for transport across the beach, he looked at her bloodied leg again. “Where’s the foot?” he shouted. “Does someone have her foot?” She still wore one delicate leather sandal.
“We can’t find the sucker,” one of the deputies told Colt.
“Can’t find it? How’s that possible?” Colt said. The girl needed her foot. They had to ice it down before the tissue started to die. It might be reattached. “It has to be here somewhere.” He went over to the damaged pickup.
The driver of the truck sat with his head down, behind the metal screen in the back seat of a black and white. A sheriff’s deputy stood outside, questioning him through the window and writing on his notepad. Colt interrupted. “Where’s the foot?” He was met with a shrug and a blank stare from the deputy. Colt looked at the driver of the pickup, a man about his own age, and hated him.
Colt walked around the pickup. Glass shards from a headlight and pieces of plastic lay on the ground. He knelt in a pool of green coolant dripping from the smashed radiator and looked under the front of the truck. The foot wasn’t there. He stood up and looked around. Thirty or forty people stood in the parking lot watching the activity.
Colt grabbed the arm of the deputy who was questioning the driver. “Help me out. We have to find her foot.” The crowd backed away as Colt and the deputy walked a circle around the truck and the cement base of the pole, scanning the ground. Colt shouted to the crowd, “We have to locate this girl’s foot. Has anyone seen it?” A few heads shook as a buzz went through the crowd: a foot was missing. A severed human foot was somewhere in the parking lot.
Colt scanned the crowd of spectators, hoping for a response. He noticed a short man holding a take-home food bag, wearing a black hat, dark sunglasses, tight black pants and a long sleeve black shirt, buttoned at the neck and wrists. Standing among the people wearing shorts, swimsuits and T-shirts on a beautiful hot day at the beach, the guy looked like someone from a Goth horror movie. Next to him was a girl wearing a skimpy tank top with tattoos covering her neck, shoulders and bare arms. Colt did a double take and ran his eyes over her body before he resumed looking for the foot. While the deputy continued to circle the area, his eyes glued to the blacktop, Colt searched the area around the end of the light pole and saw the blood on the sharp, ragged metal.
Colt looked over at the deputy, who shrugged his shoulders and said, “Nothing.”
The deep whack, whack, whack of one of the AirSquad Blackhawks echoed as it flew in over the hills. It stopped overhead, hovered and began to descend slowly onto PCH, tail and nose bobbing up and down, threading its way between power lines and telephone wires. Bystanders near the road turned their backs on the sandstorm and debris kicked up by the rotors. The backwash sandblasted a few cars and sent blue and green plastic trash containers flying.
In a well-rehearsed rescue ballet, the rotors had barely come to a stop before the AirSquad crew in dark blue flight uniforms and white flight helmets opened the side door and jumped to the ground. The EMT’s and the men from 88’s, trailed by Brian holding the IV bags, carried the girl on the backboard across the parking lot, up along the shoulder of the highway and across the pavement to the waiting helicopter. As the aircrew took charge and loaded her inside, the engines gave off a high-pitched whistle and the rotors began to turn again.
One of the AirSquad medics shouted from the door, “Where’s the foot?”
Brian shook his head.
Everyone backed away as the departing Blackhawk churned up another sandstorm. When it lifted off, Colt was still searching the parking lot. He looked up at the belly of the yellow and black bird as it headed for the California University Hospital. “I hope you make it Bibi.”
When Brian returned from the beach, Colt told him, “We looked everywhere. Her foot isn’t here.”
“It has to be,” Brian said. “Let’s check again. It didn’t just walk away.” He gave Colt a small smile.
Colt was still unaccustomed to the paramedic “crispy critter” jokes. He understood humor was a way of coping with the terrible things they saw, but to him the jokes made everything seem worse. They walked the area again and came up empty. Reluctantly, they returned to the squad.
It was time to write reports. While the girl in the AirSquad was fighting for her life, everyone on the ground had a form to fill out. The Sheriff’s deputies had to record the details of the accident and the people involved. They were already measuring the distances between the base of the light pole, the spot where it fell and the place where the girl was injured. One deputy had to submit a request for a new belt. The driver of the pickup was already on his way to the Lost Hills Sheriff’s Station for booking and a drug test. The LifeLine EMT’s sat in their ambulance and prepared their own run sheet, even though they had not transported a patient. In the squad, Colt grabbed the metal clipboard with the patient assessment sheets. He looked at the list of questions. He knew so little about the girl and had so little to report:
Name – Bibi?
Address – unknown.
Age – 23? Colt made a guess, and then crossed it out.
M/F – F. At least he knew that.
Assessment – Severed Right Foot. Not Found.
Colt went on to fill in some of the vital signs they had recorded earlier and to write a brief description of the accident. He wanted to add, life of a beautiful girl ruined by speeding idiot on drugs.
The entire incident had taken less than an hour, but the expenditure of nervous energy was enormous. Now that the girl was someone else’s responsibility, Colt could relax and begin to decompress. He felt exhausted. Activity in the parking lot returned to normal. The news crews finished their interviews. The spectators dispersed—some departing, others returning to their meals at the Surfrider. A tow truck prepared to haul the pickup away. The crew from 88’s helped direct traffic while they waited for CalTrans to arrive and drag the pole off the highway.
Colt finished the assessment sheet and decided to circle the area around the cement base of the pole one last time.
The deputy who interviewed the truck driver joined him. “Did you find her foot?” he asked.
“Someone probably picked it up.”
“Picked it up? Colt was incredulous. “Who would do that? Not possible.”
The deputy shrugged. “You never know. This is Los Angeles. Plenty of nut cases running around.”
On the way back to the station, Colt said to Brian, “’Bibi.’ I wonder what kind of name that is.” He couldn’t stop thinking about the foot and wondered if it could have even been reattached. They were trained to retrieve any severed body part—fingers, toes, hands, feet, even a penis—put it on ice and get it to the trauma center in a cooler as fast as possible. From that point, it was up to the surgeons to do their best. Colt refused to accept the fact that the foot was gone. A body part didn’t just disappear from the scene of an accident. He was disappointed. It was his first real life and death situation as a paramedic and he felt he had failed. He promised Bibi with the ocean blue eyes that he would take care of her. She had been his responsibility while she lay injured on the blacktop. Now someone would have to tell her that her left foot had disappeared from the parking lot at the Surfrider Restaurant.