My Ambulance Education. Joseph F. Clark

along the railroad tracks. The call came in as “man trapped.” A PO was already on the scene when we arrived. A plump, elderly gentleman in a security guard uniform was lying on the ground with his left leg trapped under a railroad rail. The ankle was bent in such a way that it was clearly broken. A young couple was standing beside him and comforting him. Rick broke out the trauma kit and I started getting the patient’s vitals. There was a normal pulse in the foot, called a distal pulse, and the foot was warm, with good color. This was a good sign, because it meant the blood supply was intact. The patient’s name was William Robinson, but he wanted to be called “Hobo Bill.” The young woman came up to me and implored us to take good care of Hobo Bill. “Don’t worry, we’ll take good care of your friend.”

      “We’re not friends,” she said. “Gareth and I just met him tonight. But it’s our fault that he got hurt.” She looked ruefully at Hobo Bill. “Sorry,” she said.

      “It’s OK, Sweetie. Don’t worry about it,” said Hobo Bill.

      Hobo Bill was a semi-retired employee of the railroad who was working part-time at night as a security guard. The railroad was repairing this stretch of the track and had dropped off a bunch of railroad ties and long metal rails. Apparently the couple had been walking along the pile of rails when Hobo Bill spotted them and advised them to get down, since the rails were not secured and could roll, especially on the uneven ground at the sides of the tracks. The warning was right and timely, because the moment he uttered this warning, the weight of Gareth and his girlfriend, Wendy, caused one of the big rails to roll onto Hobo Bill’s ankle. The rail was much too heavy for us to move safely.

      We had to wait for the FD to come with some jacks to get the rail off our patient’s ankle. Rick and I stabilized Hobo Bill as he consoled the couple for unintentionally getting him hurt. He regaled us with stories of his life on the rails as a conductor. He would often sleep on his trains and this earned him his nickname. In his younger days he would go with the real hobos on overnight trips. He was sad that the railroad company had forced him to retire, and it was only due to some old friends that he was allowed to still work the lines as a security guard. Hobo Bill seemed to swell with pride when talking about his life on the rails and I could see that his ankle was swelling, too. Wendy and Gareth obviously felt bad about the accident and seemed quite relieved when the FD arrived.

      Hobo Bill was a pleasant patient and he was gracious to Wendy and Gareth throughout their numerous apologies. We brought Hobo Bill in without incident, and although this was highly irregular, Wendy and Gareth accompanied him all the way. Rick drove while I rode in back with them all. Hobo Bill’s major concern was how soon he would be able to get back to work. The rails were his life. I promised to convey that concern to the ER staff. He seemed comforted by this and Hobo Bill thanked us, which I appreciated greatly. We saw Wendy and Gareth as they were leaving the hospital a few hours later. They said that Hobo Bill’s family had arrived and were going to take him home. They also said that they would be keeping in touch with him. I hoped they remembered to do this, because Bill would surely appreciate two new friends.

      The rest of the night was relatively calm until 5:13 a.m., when we were dispatched to an accident on the interstate. The first police officer had requested ambulance, police and fire backup for three cars and multiple injuries. Despite the hour there was a long line of traffic behind the accident, so the PD told us to enter on the exit ramp and come up the highway the wrong way. Traffic was going to be stopped for a while, so we would not be running into any oncoming cars. On the scene we saw the three cars; one was seriously damaged in the back end, another had a crushed front end and the third was on its side in a gulley on the side of the road. We went to the car with the damage to the front end and the other ambulance went to the car on its side. The PD informed us that the car with rear end damage had had four people in it, and they were all under arrest in the squad cars. None were injured and they were under arrest for drug violations.