Overtime Onslaught (Warning Graphic content)

I am currently working 70+ hours a week for the month of November at the 2nd busiest station in Riyadh as the sole ALS provider for one of the worst neighborhoods in the city. I also cover a huge surrounding area. Overtime is mandatory and it is currently Hajj Holiday (an annual pilgrimage to Mecca) so most of the doctors and flight medics have been transfered to Mecca and Jeddah leaving a shortage here in Riyadh.

The rays of sun painfully pierced my eyes as I stepped outside. Bags under my eyes, hair a mess, i struggled to peer through my eye lashes whilst I stumbled towards the fly car. My partner yelled at me to hurry up while I struggled to pull my boots on. I had not shaved or slept well in days. My face could be read like map indicating the lack of sleep, pure chaos and destruction I had witnessed this week. I was a train wreck and it showed, but I wouldn't have had it any other way. I rubbed the water from my eyes and stepped into camery.

I am called for an early morning motor vehicle accident. I am close to the accident and arrive within 2 minutes after our dispatch. As I step out of our car my eyes open wide, pupils dilate, and I can feel my heart rate increase as my mind takes in the pure carnage that has been bestowed in front of me. I see a trail of twisted wreckage 100 meters long that ends where I am standing. In front of me are the remains of a car that is missing most of the engine compartment. I focus my eyes on the inside of the car where the driver is, but I do not rush to help him. I just stand there staring in amazement. My partner rushes over quickly yelling something and then suddenly stops mid sentence and is now staring in unison with me. Its so quite you could hear a pin drop as we both stair in disbelief at the driver. He's body is in surprisingly good shape considering the accident, but our attention is focused on his head. The top of his skull is missing and the contents inside are missing. He's head had exploded and his skull now resembled an empty fruit bowl. You don't have to be a doctor to realize there is suppose to be a brain inside, but what happened to it? I would soon solve this mystery as I looked up at the ceiling of the vehicle and the inside of the door.... The patient was obviously dead on arrival so I turned my attention now to the wreckage and also searched for other patients. I followed the trail of devastation to try and recreate what had happened. As I followed the wreckage I found another large piece of the patients brain laying on the road. I soon found the culprate near by. The driver had been traveling at a high rate of speed when he drove off the road and took out about 100 meters of a heavy galvanized steel fence. Somewhere along the way one of the fence post impaled his head, passing completely through it causing the end result of what we had seen. The fire department arrives and uses the "jaws of life" to pry apart drivers side door and recover the body. We assist in pulling the driver out and placing a blanket over the body.

A short time later I receive another call...

Upon our arrival to the scene I step out of the car and fight my way through a crowd of ruffly 50 people in the middle of the road. I finally reach the middle of the crowed and find a 7 year old boy laying in the road breathing erratically, blood gurgling up from his mouth, unresponsive. We are told he was walking home from school when a car struck him at a high rate of speed. We quickly get him stabilized, and packaged for transport, taking care in protecting his airway and spine.We are only 3 minutes from the hospital so I make the decision to defer any ALS procedures that could waste precious time on the scene. We call this a "load and go." The boy needs definitive care at the hospital as soon as possible and we are very close. I jump into the ambulance to ride in to the hospital and have my camery partner follow us.

 Like a comet in the night we fly down the road. Its difficult for me to hang on in the back of the ambulance as we travel at warp speeds, wheels screeching around every turn. Equipment starts to fall out of compartments and onto my head and the ambulance starts to shake we are going so fast. I do my best to suction the boys airway and start to assist respirations with a bag valve mask and supplemental oxygen while in the ambulance, which has now turned into an earthquake simulator. We arrive at the hospital in under 3 minutes and the boy is taken to the pediatric wing of the ER where they find he has a huge closed skull fracture and bleeding on the brain, amongst other injury's.

Just another day at the office....