Helping and Being Helped

By Karen Najarian

            “Shut the fuck up and go sit across the street!” That’s what I should have told his blabbering, drunk buddies who were only distracting me and making things worse: “He’s fine. He’s been a lot worse than this. We’ve got it. We’re calling 911. Look at me. I got banged up earlier today! Here, buddy, have some water. You’re fine.”

                He was not fine. As I helped him across the highway, a two-lane road in the mountains near Huntington Lake east of Fresno, I noticed the sweat beads on his forehead, his gray face, and the arm I held to guide him was cold in my hand. There were abrasions on his legs and arms but most unnerving was his right hand dangling like a hinged trap door from a deformed wrist. Bones protruded from a bloody opening in the skin. He kept trying to hold up the dangling hand with his left hand as if it might click back together. Placing my index finger on the radial pulse point at his left wrist, I found his heart rate too fast to count. I’d never seen anyone this close to death from shock except maybe the gunshot victim with a hole in his chest I once saw in the ER. His two motorcycling buddies definitely did not “have this” and calling 911 was impossible on this twisty mountain road out of cell range. The tall talkative buddy had ripped pants and a shirt with bloody abrasions showing through but, after checking them, his only impairment was probably from the beers he admitted to and the pot I smelled. And you don’t give water to a shock victim! Shock withdraws the blood to your core and to organs essential for life. The body does not sense the stomach as an essential organ. He could vomit. No, he was not fine. And he needed more help than just my friend, Val, and I could provide.

                I had just spent a lovely, long, relaxing, weekend with my long-time friend, Val. On Thursday that week, I drove to her home on the east side of Fresno. While sipping wine with Val and her husband, Barry, before dinner my phone rings. It’s my daughter’s partner: “Lisa’s been in a motorcycle accident and is in the ER. She’s ok, just banged up.” Good God. She’s only had the motorcycle a week and not with her mother’s approval. Kripes.

            I had arrived to 105 degree afternoon heat passing, in disbelief, the natives out on the golf course. The AC was a blessing and unlike here in Martinez, where it cools off as the sun sets, my hosts graciously kept it on all night.

            On Friday morning, we loaded up Val’s sweet Chesapeake dog, Maggie, our hammocks, and camping gear. Two kayaks were strapped on top of her 4Runner. On the way to her cabin above Huntington Lake, she stopped at a very small corner grocery store, way out among the dry grassy fields of the Sunnyside District, and got two beautiful Harris Ranch fillets and a package of cookies. I’d packed some fancy cheeses from Trader Joes, some rustic crackers, and a couple bottles of red. We were set.

            The drive was empty of traffic and serene through the passing golden hills and ancient dusty-green oaks dotting the parched summer landscape on either side of the rolling ribbon of asphalt. It was beautiful, that is, just until we were a few miles from her cabin. Soon, there were burnt patches and singed trees that gave way to a stark floor of white ash peppered with charred, black spires. These were the remains from last summer’s Creek Fire, at one time the largest single fire in the state not part of a larger complex. For weeks, I would daily check Inciweb to see if the boundaries of the fire had consumed their sweet little hide-away. At one point I was certain it had. My screen showed the fire boundary surrounding their street by a wide margin. Then I zoomed in closer to see a green bubble around their tract of forty seven homes. I called Val to see what she knew. A fireman lived within the bubble and they were using the few streets of the tract as a staging area for earth movers and firefighting equipment. So far, their place had been saved and, as the flames incinerated the forest around them, their cabin stood.

            Driving through it, the devastation felt final, the ground sterile, the charred spires a symbol of all the losses in my life endured since my cancer diagnosis and, quickly on its heels, Covid. Usually, after a fire, with the nutrients returned to the earth, the wildflowers bloom brightest. Perhaps this area would have to wait for a winter without drought to spring back. We’ve all been waiting way too long for life to spring back as it was before Covid and, as for me and the cancer, it will never spring back to what it was but we’ll both endure. I’d always felt comfort in this quote by John Muir: “Earth has no sorrow that Earth cannot heal.” Perhaps the forest would just take a bit more time.

            Rolling into the driveway of their little A-frame cabin, a sigh exited my chest and I felt my shoulders drop. It was surrounded in all directions by about fifty feet of lush untouched forest. It belied the devastation just beyond the bubble. We partially unloaded the car and proceeded to plop down in the deck chairs with a glass of wine and my cheese and crackers. I smiled. “You’re so lucky they saved your place.” “I buried my face in Barry’s chest and sobbed when I saw it for the first time after the fire.” Shortly, we threw together the rest of the evening meal into an ice chest and drove up to White Bark Vista Point, where a dirt road off of Kaiser Pass Road deposits you at 9,600 feet.

            From its promontory, White Bark Point overlooks the Sierra from Lake Edison in the west to Mt. Abbot twenty miles away on the eastern crest. I followed with my eyes where Val and I had hiked the Sierra High Route in 2014 for 200 miles mostly off-trail. Imagining my tiny figure out there among such immensity simultaneously elicited the strange combination of a full chest of pride followed by a deep exhale of humility. Against a darkening sky and with the sun setting behind us toward the west, the peaks glistened with that same silver sparkle that’s drawn me to them for half a century. We hung our hammocks and found a flat slab of granite the size of two dining tables to stage dinner on. Val made a salad in our plastic bowls and I sizzled the filets in a frying pan over the tiny backpacking stove. Val’s good whiskey was passed back and forth and sipped gratefully. The warmth of the golden hour, magnified by the warmth of our decades-long friendship, could probably be sensed by heat seeking infrared technology as easily as we’d later see campfires dotted on the landscape before us.

Val making salad
Maggie and Val

            Val brought these fancy camping chairs appropriately called Stargazers. We leaned back, as the chairs are made to do, and put our feet up on the “kitchen table”. As we waited for the show to begin, the haze of moisture in the sky came and went a few times to finally reveal an ink-black moonless bowl over our whole domain. Val had phoned a few weeks before. Without even saying hi, she blurted out, “Wanna go camp up on Kaiser Ridge to watch the peak of the Perseid?” Without thinking, I replied an immediate yes. Such are the offers of My Tribe.

            The Perseid meteor shower is the result of debris ejected off the Swift-Tuttle Comet as it travels its 133-year elliptical orbit around the sun. If the debris enters our atmosphere, it burns up creating a shooting star, a different kind of fire. An annual event, the peak usually occurs sometime around the second week of August. It gets its name from the Perseid Constellation, from where its meteors seem to emanate in the northeastern sky.

            With Val’s husband, we had shared THE BEST METEOR SHOWER OF OUR LIVES back in August 1991 while leaning up against a snow bank off-trail at 11,000 feet on the longest cross-country hike I’d ever undertaken without my mentor, Rolland Carlson. (Fearing I’d get lost, I’d brought pounds of maps.) We were snug in our sleeping bags, our pads insulating us from the packed, cold snow, passing a flask, and ooh-ing and aah-ing like it was the fourth of July. I intimately came to know what John Denver sang about in Rocky Mountain High: ‘I’ve seen it raining fire in the sky…” Just like this night.

            In 1991 the shower became visible early, like 8:30 in the evening. We were just cleaning up from dinner, which means we were swishing and tossing our cups and bowls leaving them “mountain clean,” when fiery bombs started streaking across the whole width of the heavens. Tonight the show was scheduled to peak around 1 am. I hoped I could stay awake.

            This time the show proved to be just as spectacular. As we kept our gaze skyward, the temperature dropped and we wrapped our sleeping bags around us. Oblivious, Maggie laid on her pad and snuggled at Val’s feet. I turned to Val. “This is the good life,” I finally looked at my watch. Midnight!!! Val had been up since 4 or 5 tending to her mom’s horses. It was way past my bedtime but we would not have missed the gods playfully tossing fireballs at each other for anything.

I didn’t catch a meteor but I did catch the Milky Way

            We crawled into our hammocks, strung as we like, using a common tree so that we’re rocked by each other’s movements all night long. We were perched at the very edge of a steep cliff to the valley below, the 13,000-foot peaks beyond. The Universe held us warm and cozy under that celestial playing field.

            Friday morning we awoke to High Sierra sunshine and high altitude stumbles. The oxygen in the air at 9,600 feet is 70% of that at sea level. Rocks on the uneven ground seemed to jump into my path and a headache threatened. While walking around the previous night, I would have to stop from dizziness after three steps if there was the slightest incline. The drug I’m on, Xeloda, does not decrease my red blood cells but they are enlarged (macrocytic) and, from my own bioassay, I can tell you that they don’t function like usual. Walking up my front steps at home can leave me short of breath. I hadn’t been this high in altitude since I’d started the drug last Oct. I knew that drinking water to increase blood volume can help altitude sickness in general and I’d been doing that since the day before, so it could have been worse.

            Instead of packing up quickly and heading back to the cabin, I said, “I’m in no hurry,” and we dallied over hot cocoa and oatmeal with fruity yogurt. Instead of setting behind our backs, our star was now a hot spotlight dead ahead coaxing our domain, spread out below, back to life. I imagined John Muir Trail hikers already five miles into their day’s hike after a big breakfast at Vermillion Valley Resort on Lake Edison, bears curling up in the shade to avoid the day’s heat, and the flowers rotating to turn their faces toward the Sun.

            After our descent to the cabin, we enjoyed a giant-sized hamburger and cold beer at the Lakeshore Resort Restaurant on Huntington Lake before unloading the kayaks and paddling on the cool, wavy water. Back in the parking lot with one kayak loaded up on the roof, a man in a truck drove slowly past us. Out his window he offered his teenage sons for assistance. Val declined but I, getting more used to accepting help, said “Sure, come on over.” They lifted the thing like a feather and Yes, Ma’amed us when we thanked them. What a great lesson on gallantry this father seized for his sons.

Huntington Lake
Val

            The day came to completion with a mountain thunderstorm enjoyed on the covered back deck sipping Chardonnay and savoring the heady perfume of wet pines from the first rain of the season. The contentment of that moment will carry me until I’m back in the mountains again.

            I have a handful of good friends that are like mini-me’s. We love the same simple natural phenomena, we talk, we listen, and we can sit, or hike, in a companionable silence. Val is one of them.

            Sunday morning brought us to the last day of our respite. We lazed over a huge breakfast of barbequed sausages, slabs of French toast with real maple syrup, big black cups of coffee, and slices of fragrant cantaloupe.

            After breakfast Val insisted we hike to a seep spring meadow surrounded by charred snags and ash at the edge of the green bubble. “I think the spring saved this from the fire,” I remarked. Even in late season there were green, thigh-high grasses and we named the flowers: Black Eyed Susans, Yampah, Yarrow, Monkey Flowers. Before leaving, we stood back silently taking in this patch of life in the middle of so such destruction. “Hope,” I said. “This means hope to me.” In the midst of my own slash and burn cancer treatment program, I needed to see this. Val probably knew that.

            We quickly packed up and moved out, waving to Val’s neighbors working on a new front deck. Unfinished with no railing, there was already a barbeque and a rocking chair gracing its platform. The plan was to drive back to Val’s house in Fresno where I would pick up my car and drive home.

            But, the Universe had other plans. Less than a quarter mile from her driveway, we arrive at the T-intersection where Val’s street meets the 2-lane highway. We stop at the stop sign and are struck by an odd scene. There are three black motorcycles parked off the road on our left. Three guys stand there, two in motorcycle garb and one in a dark blue polo shirt with an EMT logo over the left chest. Out the open driver-side window Val calls out, “Is everything all right?” With a phone pressed against his ear, the tall one called out, “We got it,” literally waving us on. The guy in the EMT shirt stood there, proud as a three year old who’d just learned to hop, and says, “And I’m an EMT!” Not immediately seeing anything wrong, I’m dumbfounded as to why they are calling 911 or why, if there is a need to call 911, the EMT is just standing there. Then I noticed the third motorcyclist alone across the road stumbling around in the highway. “That doesn’t look right.” I jump out the car door and, to Val’s multiple screams of, “Careful!” and the guys, confident calls of, “We got this,” I run across the highway. He is standing, bent over cradling his right hand with his left. When he moves his left hand away, the right hand uncontrollably dangles at the wrist like a dead fish held by its tail. He looks confused as to why it won’t stay horizontal. That’s when I see the white bone sticking out of his deformed wrist. Still cradling his limp hand, I take him by his good arm and lead him back across the highway to where the guys and motorcycles are. His arm feels strikingly cold in this eighty-five degree heat. His face is gray and beads of sweat glisten on his forehead. “I’m Karen. I know first aid. Can I help you?” A nod of the head. “What’s your name?”

            “Francisco.”

            I had no idea what happened, didn’t understand his buddies’ confidence, and what the bloody hell was this EMT doing standing there proudly doing nothing!?

            To, “It’s ok. We got it. I’m calling 911,” Val yells back, “No, you’re not! You have no reception up here.”

             “Well, I’m going to try, anyway.”

            I sit Francisco down on a mound of dirt on the side of the road. I feel as bad as I did when a fellow SAR team member had a heart attack on Mt. Diablo and I set him down in the dirt. I turned to Val, “Go back to the cabin. Call 911 on the land-line and bring a chair.”

            In the meantime, we get his helmet and jacket off to reveal a hard shell vest called a spine protector. Considering his injuries, his buddies are pretty rough pulling the helmet and jacket off, as if to prove they are right that he is fine. “Gentle. Gentle.” I admonish. I’m checking for major bleeding, getting the gist of the accident, and doing a SAMPLE patient history (Signs & Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading up to present injury.) That’s when I learn about the beers consumed at lunch, the details of the accident, and why the EMT, however useless, is there: There were three cars ahead of the three motorcyclists. As the first car came to the intersection, he jumped on his brakes. Maybe looking at the street sign. I don’t know. In response, the second and third cars did the same. Francisco was riding behind the third car and couldn’t brake in time. He swerved to the left and rolled his bike. The first two cars sped on and the third car with the EMT in it stopped.

            OK. Now I’m getting an idea of the situation: the mode of injury, the forces involved, getting schooled on dumb-ass twenty-four year old male beer drinking, and their names, all of which I’ve forgotten except for Francisco, who his friends call Frankie.

            Soon Val shows up with a chair, a blanket, and a First Aid Kit. We sit Frankie in the chair by the edge of the forest on the side of the road. Suddenly the EMT places a zippered First Aid Kit on the ground in front of us and continues to stand there, as if providing a First Aid Kit was the only thing he’d learned at EMT school. All the while, in my mind, I’m deferring to him since he has higher credentials than my expired Wilderness First Responder Certificate but he does NOTHING! Finally, I realize that I am the only one, besides Val, a Wilderness First Aider, that is going to help Frankie. So, I kick into gear. I open the First Aid Kits to see what’s in there. I see an orange SAM Splint, a lightweight rigid splint built from a thin, light core of aluminum alloy which is then sandwiched between two thin layers of closed-cell foam. Perfect. Nobody has sterile 4 X 4 gauze so I run to Val’s car knowing I have some in my net bag that goes everywhere with me. Wrappers start flying everywhere as I rip the supplies open and toss them without thought. My focus is on Frankie. Attempting to be helpful, the EMT drapes a triangle bandage over the whole mess. I can’t see what I’m doing and move it away. Val brought some Vet Wrap (four-inch wide chartreuse green Coban). I place a gauze roller bandage under Frankie’s curved palm on the SAM Splint, place the deformed wrist in the most normal looking position I can manage, and wrap the whole mess from fingers to elbow with the Vet Wrap. A properly wrapped triangle bandage stabilizes the whole injury. ”Ah. That’s feels better.” Next, I clean and bandage a big abrasion on his knee.

            All this time, while I’m sitting in the dirt tending to Frankie and reeling from my own revulsion over the appearance of his dead fish wrist, the severity of his shock, and my sense of responsibility for the human in my care, his drunk buddies are in our faces reassuring Frankie, but mostly themselves,  that he’s alright, “You’ve been through worse, buddy.  Hell, remember the time… And look at me. I did this this morning!” as he shows the wound through a rip in his pants. I’m focused on Frankie who is now slumped over leaning on Val. I realize that Frankie doesn’t need to hear that he’s ok. He damn well knows he is not ok.

            I’m trained to say only, “We’re doing all we can. I’m here and I won’t leave you.” When you’re hurt and need help and someone tells you that you are ok, it’s an act of emotional abandonment and can lead the patient to take the mental leap that if his caretakers think he’s ok, there’s no help coming. I wanted to shush his buddies. I wanted to say how severe Frankie’s injuries were so they understood the severity of the situation and would stop acting like it wasn’t. But I didn’t want to say it in front of Frankie to make his shock worse. I had a client in Yosemite who burst a few hemorrhoid stitches. (He neglected to tell us beforehand that he’d just had surgery.) While not life-threatening, the sight of blood in his stool turned him gray. As he recovered I said,” Yeah, you’re still a little green around the gills,” which again dropped his blood pressure and put his skin signs back into the gray zone. So I knew that the emotional component can be significant and Frankie didn’t need any more complications. “I’m here and I will not leave you,” I reassured him over and over to which the guys kept responding with, “You got this. You’re fine.”

            While waiting for definitive care, I’m learning that the guys are all twenty-four, live in podunk towns in the Central Valley below, and that Frankie, himself, is an EMT. I start thinking ahead: “Ok, we’ve got three bikes here, how are we getting them home?”

            “My dad has a truck. He’ll pick them up. I’ll drive to Huntington Lake and make a call on the resort’s wifi.”

            “Who’s going to tell Frankie’s mom about this?”

            “I will,” says the less drunk one. “Who’s going to take Frankie home from the hospital?”

            “His mom.”

            At this point, Val is standing behind Frankie with her hands on his shoulders and says, “One shoulder feels different than the other.” Oh, crap, I think.

            Years ago I reduced my husband’s dislocated shoulder while he lay in a bush off-trail on a steep slope ten miles in on the penultimate day of a backpack trip just west of the Minarets. Before satellite communicators and with no other real choice, it was only after his screams filled Dike Creek Canyon and I plied him with two Vicodin that I applied traction and successfully popped it back in. I’m still traumatized.

            I moved over to Frankie’s right side and gently pulled his upper arm out to apply traction to his shoulder joint. “Oh, that feels better.” Double crap. His relief with traction indicates it IS a dislocated shoulder. Reducing a dislocated shoulder is a medical procedure and out of a first responder’s scope of practice. I ignored that with my husband in the hopes that he wouldn’t sue me if things went wrong and he had permanent nerve damage. With Frankie and medical help hopefully on the way, I didn’t chance it. But I did stand there holding his arm in traction to reduce his pain until he was back-boarded by paramedics.

            After about an hour of waiting by the side of the road and waving on a few stopped cars conveying that we actually did have this under control, a fire truck pulls up. I knew I needed to relay to the fireman all the information I had about Frankie. “I need everyone quiet!” I yell over the guys’ continued babbling. A fireman approaches us and I tell him about the compound fracture, dislocated shoulder, and shock. “Do you think he could use some oxygen?” “YES!!!” Val and I both yell.

            In about another fifteen minutes fire trucks and ambulances started arriving from everywhere. I counted eleven. Traffic was stopped in both directions. Soon a helicopter was circling to land on the highway a hundred feet from the intersection. “Val, what on earth did you say on the phone?!”

            “I told my neighbor working on the deck about the accident and he called it in. He’s with SWAT.”

            A paramedic team strolls over to check out Frankie. I again relay all the information. Unable to see Frankie’s wrist through the Vet Wrap, I get the feeling they thought I was being dramatic and exaggerating about the compound fracture. “Did anyone take any pictures?’ Ha, I thought. Lesson learned. Looking at my splint, “Well, we don’t need to do anything here,” he approves. I reiterated about the dislocated shoulder. “Presumed dislocated shoulder,” he replied. Whatever, I think. “Just keep traction on it.”

            While the paramedic was checking out Frankie, the blue-shirt EMT was standing there talking with one of the paramedics. I thought, You are NOT going to take credit for Frankie’s care are you? No, he was explaining that he had Aspergers Syndrome and only deals with epileptics. More craziness. Why epileptics? I’m thinking. Why anybody?

Backboarding
Paramedics finally arrive

            Soon they are back-boarding Frankie and attempting to wrap the straps over his injured wrist. “NO!” I scream, “that’s a compound fracture!” I look over to my right and a highway patrolman is putting the tall blabbermouth into the back seat of his squad car: DUI and suspended license I learn later.

            “My wallet and my backpack. Where are they?”

            “I put your wallet in your backpack and handed it to the shaved-head pilot who loaded it on the copter. I put my name and contact information in the outside pocket. I’m going to stay right here with you until they load you in the copter.”

            “Thank you.”

            They slide Frankie in and with a whirl of rotor wash, the copter levitates and swooshes off over the forest tree tops. Suddenly, my face is wet with tears and I’m sobbing into Val’s arms. And then she into mine. One of the firemen ask, “Did you know him? You kept saying, ‘I’m going to stay with you.’”

            “No. I was just deeply invested in his care and I know emotional support can make a huge difference in managing an incident and the outcome. That’s what I was taught. This,” pointing to my tears, “is adrenaline crash.”

            Soon a big navy blue pick-up pulls up and a grizzled old guy, with wild gray hair wearing a T-shirt extolling the virtues of weed, steps out. He’s the dad that will transport the motorcycles back to town. The CHP now questions him as to whether he’s in possession of any. “You’re on National Forest Land, you know.”

            Officials take notes. “Do you know his last name? His address? Phone number?”

            “Only that he’s twenty-four.” And then I got offered a position on Fresno Search and Rescue.

Copyright: Karen Najarian, October 28, 2021