by Rachael Yukey
“Nettie, do you have anything to add?”
Every fiber of my being silently screamed no. The people occupying the circle of chairs in the big conference room swam in and out of my vision, transmogrified into bizarre little fat frog people, then snapped back into focus.
A handful of cops, a veritable horde of firefighters, and the crew of the rig that had transported the dump truck driver, one of whom was Terry Wilder. I’d spent the entire meeting avoiding his eyes.
The four meeting facilitators were seated together, wearing dark polos with Crisis Incident Stress Management logos on the left breast. Other than Terry and the facilitators, most of those present were people I’ve known for as long as I could remember.
Robbie Wachinsky and Jessie Kramer flanked me on either side. Had the three of us really made the mad dash to Johnstown only two days before, the wreckage of Jason Bixley laid out before us? It seemed like a lifetime.
I hadn’t slept since fleeing Terry’s house that morning. The day had passed in a hazy cloud of booze, with a soundtrack provided by a litany of heavy metal albums, mostly recorded before I was born. Around noon I’d taken a bath, whiskey bottle in hand and the bathroom door open so Judas Priest could filter through, Rob Halford calling out to me, warning that “In the dead of night, love bites.” You bet your ass it does. I’d masturbated to a joyless orgasm in the tub, not even trying to block out images of Halee, dissolving into tears as it subsided.
Returning to the living room naked and dripping, I’d checked my phone. There was a text message from Terry. He’s the only person I know that texts in full sentences.
It seems you must have remembered a VERY early appointment at the last minute. I would ask you if everything’s OK, but I guess I know better than that. I hope you’re still thinking about the debrief tonight. It really would help a lot of people out if you were there, and dare I suggest that it might not be so bad for you as well? Take care.
It had taken a few minutes for the subtext of it to seep into my exhausted, booze-addled brain. This was the last straw; Terry had been flaked on one too many times.
The tears came once more, this time with shocking force. My legs had buckled, and I’d huddled naked in a ball on the floor, shaken by great braying sobs that threatened to tear me apart.
Now there I was, seated amongst this circle of humanity, completely hollowed out. My head ached, I was still carrying a light buzz from the last-minute drink I’d tossed down just before leaving my apartment, and I was so exhausted it was almost impossible to think.
We’d been here for well over an hour, talking through the horrendous events of two days prior. The discussion flowed easily around the room as people shared their thoughts, feelings, and recollections. Grown men wept. Jessie, seated to my right, had been running the waterworks the entire time and seemed in no hurry to turn them off.
I contributed little, speaking only when spoken to. A nod here, a word of affirmation there. And now, the facilitator, who happened to be somebody I worked with on occasion at Thormleton, wanted to know if I had something to add.
Sure, I’ve got something to add, you fat fuck. I’ll add garlic and barbecue sauce to your nuts when I roast them over an open fire, how about that?
I straightened, ignoring the wave of pain, and forced a transformation. When I spoke, it wasn’t the drunk, tired bitch who’d spent most of the day drowning in a puddle of booze mixed with a generous dollop of her own tears. It was Antoinette Hastings, critical care paramedic, and I spoke in a voice both strong and authoritative. At least that’s what I tried for.
“If you’re asking for my clinical assessment,” I said, “we were presented with a hopeless case. He bled out before the extrication was completed. Probably before the rescue crews even made it to the scene.”
My eyes circled the room, making eye contact with each man or woman in turn. “I was very impressed with the extrication crew,” I went on. “I work all the time with bigger, better equipped services than this one, and I don’t think anybody could have gotten him out of there any faster. Especially considering that the car was on fire. You guys did a fantastic job.”
I paused, drawing in a deep breath. Every word seemed a tremendous undertaking.
“I guess that’s all I really want to say. The firefighters got the car cracked open as quick as it could have been done, and once we had him I doubt it even took forty-five seconds to get him into the rig. Robbie and Jessie did… hell, I’d go as far as to say a perfect job assisting me during the resuscitation effort.”
I looked to the right, my eyes falling upon Jessie. The girl looked as if she hadn’t slept in two days.
“You really did,” I said. “We lost a young man on Thursday, and nothing anybody can say will make that any easier. But everybody in this room did work they can be proud of trying to save him.”
I settled back, exhausted.
The meeting wrapped up, and people began trickling out of the room. Hands were shaken, hugs were shared. More tears were shed. Stuck in the epicenter, I did my best to be gracious. Almost everyone approached me before leaving the room, thanking me for coming with tears in their eyes, sometimes drawing me into a hug.
I felt husked out, incapable of emotion. Finally, I was able to leave. As I stepped through the conference room door and into the ambulance garage, I saw Terry Wilder standing next to one of the rigs, speaking with a small group of firemen. He shook their hands as they passed on. Jessie Kramer approached him hesitantly, and he swept her into a hug. She buried her face in his chest, her shoulders heaving. Terry said something to her that I couldn’t hear, squeezing her tightly in his arms.
He’s good at this, I thought. I wish to God I was.
I got my brain in gear, and my feet followed with alacrity. I strode towards the exit door. Terry caught my eye, and held up a finger. Damn it; what the hell does he want? I considered making a run for it, then decided I’d done enough of that for one weekend. Moving to the side, I leaned against the wall of the garage. The hangover was beginning to take shape, and it was going to be a bruiser.
Terry let Jessie go, shook the hand of a Sheriff’s deputy who was passing by, and beckoned me to follow him. We crossed to the other side of the garage, and Terry punched in the combination code that opened the door to the office.
It was a good-sized room, with walls of old cinderblock and office furniture that looked as if it hailed from the Woodstock era. The flatscreen monitor and the big, modern fax printer seemed out of place. Terry settled into one of the two old office chairs, and I took the other.
He fixed his gaze upon me in the harsh light of the office fluorescents, eyes widening. “Jesus, Nettie.”
“What?”
“How shall I put this? You look like hell.”
“You’re not exactly Brad Pitt yourself,” I said, trying to sound flippant. Even to my own ears, it came out flat and dull.
He peered at me intently. “First I thought you must have been crying, then I thought you must have been drinking, but my unparalleled powers of deduction are now suggesting that it’s both.”
“What do you care? We’re just fuck-buddies now, right?”
Terry’s face hardened. The chair creaked as he put all his weight against the back.
“Fine,” he said. “The reason I snagged you is that you forgot about the labs that were being faxed over from our call last night. I got to thinking about it around noon, strolled on over here to get a look, and lo and behold – there upon the fax machine lay the besainted object of your forgotten desires.”
He handed me a small stack of papers from the desk.
“Labs and tox screen both. I thought you might still want to see it. Besides, I’m kind of curious myself, and most of what’s in there might as well be pig latin to me.”
Leaning forward, I took the papers from him without a word, but in my mind humiliation and self-loathing chased one another across the neural pathways. You forgot about Jason Bixley’s labs and autopsy too, you idiot.
Terry seemed to be reading my mind.
“Did you get the Bixley info?” he asked.
I shook my head, not trusting myself to speak, and forced my bleary eyes to focus on the lab reports in my hand. I could feel my eyes narrowing as I sifted through the sheaf of paper. My mind shifted to a higher gear, and the clouds faded a little.
“Something interesting?” Terry asked.
“A lot of things.”
I flipped from the labs to the tox screen, then back again. “How much of this kind of thing do you actually understand?”
“Just barely enough to be dangerous,” he said. “Didn’t you know EMTs are like monkeys? You can teach us to use tools to a limited extent, but expecting us to comprehend things? Dat just be crazy talk.”
“Then I’ll spare you the details,” I said. “The labs are… all over the place. Some stuff is elevated as hell, other stuff is a lot lower than it should be. The LFT… that’s liver function test… is particularly screwy. It’s what you’d expect from a fifty-year-old alcoholic, not a seventeen-year-old volleyball player. I sure hope there’s no long-term damage. The tox screen is negative, and there’s no way that can possibly be right. Sam Jensen was on something. The ED staff apparently thinks so too. There’s a note from Doctor Benson on the bottom that he’s going to talk to the state poison control center and see if they can get an answer.”
Terry sat forward and rubbed his chin with the palm of his hand. “So what does it all mean? Remember: monkey. Primitive tool usage, not deep understanding.”
“It means that wherever Sam was before she wandered home at 2 AM, they were messing around with something a standard tox screen won’t pick up on. We might be looking at something new.”
Skepticism was written all over Terry’s face. “You’re seriously going to tell me that there’s something floating around Franklin County that hasn’t already made its way through the major population centers? Perhaps my primitive monkey brain is preventing me from grasping the larger picture with ultimate clarity, however – oh, never mind. I call bullshit.”
I leaned back in the chair and closed my eyes. The last of the buzz had faded, and all that remained was the rotten throbbing in my temples.
“I’m not trying to tell you anything, Terry. I don’t have a single fucking clue what it is. I’ll call about Jason Bixley’s stuff tomorrow, I guess.”
“Nettie…” My eyes flew open at his tone. “I’m going to say it,” he said at last. “You need to get some help, or do something. You’re not well. This is not a new problem; I’ve seen you sleeping. It was worse than I let on Thursday night, and it’s hardly the first time.”
“Just… just stop.” I got up, and a wave of nausea assailed me. I stood still for a moment while it passed, leaving a vague queasy feeling in the pit of my stomach. I turned to leave, but Terry was by my side, a gentle but firm hand on my arm.
“Hear me out, Nettie,” he said. “You owe me that much. This isn’t the first time I’ve had cause to worry about you, but it is the scariest thing I’ve seen so far. Forgetting to follow up on a patient of interest isn’t like you at all – as in I can’t believe it’s actually happening. How far does this go before you’re not even capable of doing your damn job anymore?”
I looked away. “Leave it alone, Terry. I’m fine, it’s just… I’m fine.”
My stomach heaved. Knowing that I’d never make the bathrooms, I fumbled the door open and ran for the big garbage cans at the far end of the garage. Somewhere in the back of my mind it registered that the place had emptied of people during the few minutes we’d spent in the office. Thank god for small favors.
I batted a lid aside, and leaned over the can. My hair fell forward, and I felt it being pulled back a split second before the contents of my ill-used stomach came up in a hot, loose rush. I vomited for what felt like forever, until nothing was left but wretched, aching dry heaves. I was crying again, weary tears falling straight into the can to mingle with the smelly mess inside.
I straightened, casting a glance over my shoulder. It was Terry holding my hair back; of course it was. Now he was guiding me towards the worktable near the exit door, taking some tissues from a nearby Kleenex box, and gently wiping my eyes and mouth. He tried to draw me into an embrace. I almost surrendered to it, I wanted to, but instead I placed my hands on his chest, holding him at bay.
“I have to go.” It came out as a strangled whisper.
“Bullshit,” he said. “Come back to my place. We’ll set you up in the guest bedroom if that’s how you want to do it, but the last thing you need is to go home alone right now.”
I wavered, and nearly succumbed. His long, slim hands gripped my upper arms. It would be so easy to let those hands pull me close, to collapse into his embrace. But what would become of me then?
I screwed up the last vestiges of my resolve. “No, Terry,” I said. The tears were flowing freely. I realized this was the first time he’d ever seen me cry, and the shame ran deep. “I’ll — I’ll see you on the ambulance.”
A cold, steady drizzle had set in during the debriefing. Pulling the hood of my sweatshirt up, I set off.
“Did you walk, Nettie? At least let me give you a ride,” Terry’s voice called out from behind me. I kept on moving. Looking over my shoulder from two blocks away, I could see him still standing under the eaves of the ancient building, his hands shoved into the pockets of his reflective coat, watching me go. Resolutely facing forward again, I forced myself to pick up the pace.
***
I stumbled into the lobby of my apartment building, fumbling in my jeans for the keys. Looking up, I started at the sight of a figure leaning against my door, arms folded across her chest.
“Halee,” I said. “What…” My voice caught in my throat. Halee was the pinnacle of gorgeous young gothiness in a knee-length black denim skirt, ankle boots, and a leather jacket. Just a touch of dark coloration adorned her lips, and I wondered if she’d dare to wear that lipstick in her dad’s presence. She peeled herself languorously off the doorjamb and took a step towards me. Then she stopped, her eyebrows nearly disappearing into her hairline.
“You look awful,” she observed.
I got my keys out of my pocket, awkwardly separated out the one to my apartment and shoved it into the lock. “What are you doing here?” I got out, ushering her ahead of me into the entryway.
“I had to see you,” she said. “I was kind of a bitch this morning, and I didn’t want you to be mad at me.”
“Forget about it,” I said, dropping to the couch like a rag doll. I rested my aching head on a throw pillow and closed my eyes. “Halee, does your father know you’re here?”
She scoffed. “God, no. I told him I was going to a friend’s house.” She was standing over me, concern written all over her face. “Nettie, you look sick. Is there any way I can help?”
I stared up at her. Halee had always struck me as being about five years older than she really was, but never so much as right now. I reached up, caught hold of a hand, and squeezed.
“I just need to down a big glass of water and sleep,” I told her. “That’s all. I’ll be okay by morning.”
“Then come on,” she said, tugging at my hand. “Let’s get you to bed, and I’ll bring some water.”
I let Halee pull me to my feet, groaning as a wave of pain washed over me. Halee was casting her eyes around the room, trying to figure out what was where, and it dawned on me that she’d never been in my apartment before.
I gently pulled my hand away. “I can find my own way to bed,” I assured her. “I have to use the bathroom, anyway.”
“Then I’ll bring you something to drink,” she insisted. “Where’s your bedroom?”
“End of the hall,” I informed her as I hauled my tired ass towards the bathroom. Even tired and hungover, the idea of Halee entering my bedroom made my stomach tighten.
I peed, cleaned up a little, and with a final effort of will, got my teeth brushed. When I made it to the bedroom, Halee had just placed a steaming mug on the nightstand.
“I found teabags and some honey,” she said. “I thought if you’re not feeling good, maybe this would go down better. Where do you keep your pajamas?”
I groaned. I didn’t give a wretched rat’s ass about pajamas at that particular moment in time. “Who needs ‘em?” I said.
She looked me up and down. “What, you’re going to sleep in your jeans and sweatshirt?”
I sat down heavily on the bed. “Wouldn’t be the first time,” I mumbled, lifting the steaming hot mug to my lips. Halee was right; the hot, honey-sweet beverage soothed both my mouth and my stomach.
“C’mon, where?”
I gestured towards the dresser. “Middle drawer. But I don’t need a mommy to dress me.”
Halee crossed the room, opened the drawer in question, and selected a fuzzy blue top-and-bottom set. She smiled a little as she returned to the bed. “I kind of like the idea of being your mommy,” she said primly. I gaped at her.
“Here, put ‘em on,” she said.
“You gonna just stand there while I undress?” I replied.
“Yup.”
I pulled the hoodie over my head, followed by my t-shirt. Halee’s eyes were fixated on my chest, and I debated about the bra for a moment. Of course I wasn’t going to sleep in it, but it might be… well… safer to not take it off in front of her. The only problem with that was I liked the way she was looking at me. Fucked up as I was, I was still getting turned on by her scrutiny.
I reached behind my back and slowly, deliberately, unclasped the bra, pulled it free of my chest and tossed it to the floor. Halee’s lips were parted, just a little. Her eyes looked a little glassy.
“Like what you see?” I taunted in a low voice.
“Yeah.” It came out as a croak. I tugged the pajama shirt over my head and down. It’s one of my favorites, soft and comfortable. Then I stood, unzipped, and pushed my jeans to the floor. Stepping out of them and kicking them away, I reached for the pajama bottoms. I took a little longer than I needed getting into them, but not too long. There was something incredibly erotic about all this, but I really was at the end of my endurance.
I sat on the bed again, this time positioning a couple of pillows so I could prop myself into a sitting position against the headboard. Lifting the mug, I took another sip of tea.
“Thanks, Halee,” I said, meaning it. “I think I’m just going to read for awhile while I drink this, then sleep. You should get home before your dad decides to check up on you. And I’m sorry about the way things went this morning. I really am.”
“Can we talk about it sometime?” Her voice broke as she said it. Her eyes were desperate, pleading.
“Soon,” I promised her. I knew it was a bad idea, something that could lead us down all the wrong roads, but I was just too tired, too fucking beat to care. “Halee?”
“Yeah?”
“I need something to keep me awake while I drink this. There’s a book on the big shelf in my living room called Mechanical Ventilation. Could you bring it to me?”
Halee left without a word, returning moments later with a large hardcover book that’s nothing less than the bible on management of a ventilated patient. Handing it to me, she made a face. “This is your idea of a relaxing bedtime story?”
I smiled. “It’ll force me to stay awake while I get hydrated.”
“Okay.” She leaned over and kissed my forehead. Weary though I was, hurting though I was, dehydrated though I was, I had to fight the urge to meet her lips with mine.
“Thanks, Halee,” I said again. She smiled shyly at me and slipped out the door.
***
“Don’t be afraid to dig into the rib cage and find those spaces,” I said to the head full of fiery red hair. “When you’re working with me, putting the twelve-lead on will mostly be your job, and if you don’t get the ECG electrodes placed correctly I won’t be able to trust anything the monitor is telling me.”
Dana Fraser didn’t look up. She merely nodded and pushed down harder with her fingertips.
“Sure,” said the shirtless young man lying on the cot in the conference room. “It’s easy to say that when it’s not your chest she’s poking.”
“Sorry,” Dana said in a plaintive tone.
Darren Tanner grinned. “No problem. I’m just giving your boss-lady there a hard time. Do what you gotta do.”
It was Dana’s first day at Thormleton Ambulance, and I was making a valiant effort to curb my annoyance. My problem wasn’t with her; she was eager to learn and an apt enough pupil. But dammit, new EMT hires were supposed to spend about two weeks training and going on calls with an experienced team before they were sent out as half of a two-person crew.
That’s how it worked in theory, but we’re short personnel as is, and two crew members had called in sick. We had to just stick Dana on a truck and hope for the best. It’s not as bad as it sounds; an EMT on an Advanced Life Support crew acts mostly as driver and assistant to the paramedic. Of course, I’m the clinical director at Thormleton, which puts me in charge of training. So guess who got stuck with the newbie?
Dana straightened, turning to glance up at me. Roughly 102,324 freckles, by my calculation. I inspected the placement of the electrodes, wishing this was something that was taught in EMT school.
“Looks good,” I said, turning my eyes to the monitor and inspecting the readout. “Now pull a snapshot.”
Dana pressed a button on the monitor, then paused for a moment when a prompt came up.
“How old are you?” she said, looking down at her ‘patient’.
“Twenty-six,” said Darren, looking amused. “You might wanna watch how you phrase that question when it’s a little old lady you’re doing this to.”
Dana smiled, punched in the information, and then sat back. A long strip of paper issued from the top of the machine, which she tore off and handed to me.
“I have no idea what it means,” she admitted.
“Me, either,” Darren assured her. “I’ve been doing this long enough that I know what normal looks like, but I can’t look at a twelve-lead and tell you what’s up with somebody’s heart.”
“Are you going to get your medic?” Dana asked him.
“Nope. I’m starting nursing school this fall.”
Noticing the way they were looking at each other, I suppressed a smile.
“It’s not your job to know how to read it,” I told Dana. “So long as you can properly place the electrodes and get me a snapshot, I’m happy. It’s harder with a female patient, by the way. I’ll have you put one on me later if you’re comfortable with that.”
Dana fixed me with an appraising sidelong look. She’s checking me out, I realized. I’ve been bi long enough to be able to read the signs. Yeah, she’s obviously attracted to Darren, but I’ll bet my next paycheck she works both sides of the street.
“Okay,” she said after a long pause.
“You done with me?” asked Darren. I nodded. He sat up, swung his legs off of the cot, and began ripping the electrodes from his chest, wincing a little with each one.
“At least chicks don’t have to worry about their chest hair getting pulled out,” he muttered.
“If you think that, you’ve never put a twelve-lead on Barfing Bonnie,” I said with a snort of laughter.
Dana seemed to be mulling something over. “Is medic school very hard?” she asked.
“Depends,” I said. “I took a certificate course that runs thirteen months, and it’s a hell of a lot of information packed into that timeframe. It wasn’t too bad for me, but I was eighteen and still living with my mom. Some of the others had kids and full-time jobs.”
Dana’s eyes widened. “You went to medic school when you were eighteen? You must have just got your EMT.”
I settled into a chair. “Pretty close, yeah. I was rolling with the volunteer service in Bronning and working part-time here. It wasn’t too bad. Critical care school wasn’t as long, but it was a lot harder.”
“When did you do that?”
“About six months after I got my medic.”
“Jeez,” said the young woman, clearly impressed. “I was wondering how you got to be the clinical director so young – oh, I’m sorry.” She put her hand over her mouth, and the blush on her pale, freckled face was truly spectacular. “That didn’t come out quite right.”
I laughed. “It’s okay.”
Darren, who was pulling his shirt back on, favored Dana with an endearing lopsided grin. “That’s the least of the things we wonder about her.”
Dana smiled back at him. Good Lord, I thought. Stop undressing each other with your eyes and get a room already.
“I kind of got the job by accident,” I said. “When Amy Perkins retired, I was the only critical care medic left in this dump. A lot of the transfers we do technically fall under the category of critical care, and the owners like to have someone with that certification in charge of training. So they made me clinical director.”
“So regular medics are allowed to do critical transfers?”
“In this state, yes,” I told her. “It depends on where you’re at. We have a low population density, along with a lot of rural hospitals that aren’t very capable. So a lot of stuff gets transferred out to bigger facilities. They fly out most of the really severe cases, but if flight no-gos because of weather or whatever, they send it by ground. Other places like the coasts, you don’t have that kind of situation, so the rules are stricter. In some states you have to have a critical care certification to take a vented patient, or someone on an infusion of blood products.”
The radio squawked, and I held up a finger.
“Franklin County to Bronning Ambulance, please respond to 13242 State Highway 225 for a twenty-year-old male with an altered level of consciousness, your time is 1333.”
Darren swatted me on the shoulder. “Hey, there’s your Bronning people going out,” he said.
“Yep,” I said, getting to my feet. “And that part of 225 is in our intercept zone, so if they need ALS they’ll be calling us.” I beckoned towards Dana. “You and I are up for the next call, so let’s get the monitor wrapped up and back in the truck.”
Dana began coiling the ECG cables, her face flushed with excitement.
“Bronning Ambulance, Franklin.” Jessie Kramer’s voice on the radio. At least she’s getting back in the saddle.
“Go ahead, Bronning.”
“You can show us en route.”
Darren’s eyebrows shot up. “They’re not usually that fast.”
“Jessie lives a block from the station,” I said. “I don’t know who her partner is today, but we have a couple of other people who are almost that close.”
Darren rolled his eyes. “It’s Bronning,” he said. “Everyone is almost that close.”
“Do you think they’ll need us?” Dana sounded breathless with excitement.
“Hard to say,” I said. “If it’s something simple like hypoglycemia, they can probably handle it themselves. If it’s a stroke, an overdose, or they just don’t know, they’ll yell for help.”
“Aren’t they ALS sometimes?”
“Only when I’m around.”
Dana picked up the monitor, and the three of us headed out to the garage. Three orange-on-white ambulances were parked in the bay. As we approached the one against the far wall, a familiar male voice burst forth from the overhead speakers. I winced; the radio feed is ridiculously loud in there.
“Bronning Ambulance to Franklin – on scene.”
Dale cocked an eyebrow. “That’s Terry Wilder, right?”
I nodded, keeping my face impassive. I made sure my frighteningly inexperienced partner had the monitor plugged in, then headed back into the quarters area. I was just coming out of the bathroom when I heard Terry’s voice again.
“Bronning Ambulance, Franklin. We need to get an intercept coming from Thormleton.”
By the time dispatch paged us, Thormelton Ambulance number 3520 was already easing out of the garage and onto the apron. I was behind the wheel, with Dana Fraser in the shotgun seat, opening a new incident in the computer. Ordinarily the EMT on an ALS crew would drive to the call, but we were going to be running lights and sirens, and thus far Dana had spent all of two hours in orientation learning to handle an ambulance. The flashing lights came on; the siren sounded. The big door trundled closed as the ambulance pulled out into the street.
We’d just turned onto the highway when we heard Jessie Kramer announce over the radio that Bronning Ambulance was clear of the scene and transporting to Pinewood. That meant Terry was in the back, which was probably for the best.
As we barreled up the road at just under eighty miles an hour, the howling siren sending other vehicles scattering for the gravel shoulders, I gave my rookie partner a rapid-fire rundown on the ins and outs of running emergent. After about ten minutes, I switched the radio over to the private channel dispatch had assigned to the call.
“Thormleton 3520 to Bronning Ambulance on FC2.”
“Go for Bronning,” said Jessie.
“I’d like a patient update when you get a chance.”
“Thormleton, stand by,” Terry’s voice broke in. It was a little over a minute before he spoke again.
“Thormleton, this is Bronning. The patient is experiencing periods of alertness accompanied by convulsions alternating with a semi-comatose state. At no time is the patient oriented or responding appropriately to questions. Pupils are pinpoint. Patient is tachycardic with a pulse of one thirty-six, and hypotensive with a pressure of seventy-four over forty-six. I have a pulse ox of ninety-five percent on room air, blood sugar is ninety-six. I have an eighteen-gauge IV with saline lock established in the left forearm.”
Uh-oh. “Copy that,” I said. “What’s your twenty?”
Jessie’s voice. “About two miles outside of Radcliff.”
“So are we. Pull into the Amoco station and we’ll meet you there.” I hung up the mic. “Okay,” I said to my partner. “when we pull in, I’m going to grab a pump and the narcs out of the back. You get the ALS bag – it’s the big green one – and follow me. The Bronning truck carries a lot of the same supplies, but we mostly use our own stuff on intercepts. I probably won’t have you do much because there hasn’t been time to train you on anything, but no big deal. Terry Wilder’s there, and he’s got his shit together.”
The ambulance slowed. Hauling the wheel over, I killed the siren as we pulled smoothly into the parking lot of the Amoco gas station on the edge of Radcliffe. I got out, turning my face up to the sunshine. Finally, a nice day.
Rounding the front of the rig and ducking into the box through the side door, I extracted an infusion pump from a rack of five that was clamped to a rail, then got the narcotics out of the safe. As I hurried back out I caught the wail of an approaching siren, which cut off a moment later as the Bronning rig pulled into the lot.
I entered through the side door, Dana right behind me with the ALS bag. The overweight young man on the cot was lying on his left side and convulsing. No, that’s not quite right; Terry was holding him on his side, his left hand on the meaty shoulder to prevent the large body from flopping back like an eel, his right attempting to capture a stream of vomit in an emesis bag with only partial success.
I moved quickly, getting behind the patient’s head and leaning in to help support his writhing bulk. I glanced down at Dana, who was more or less stuck on the first step for the moment. She was staring at the mess, wide-eyed.
“I think he’s done puking,” said Terry.
“Okay, I need your seat.”
I stuffed myself into the space alongside the rear-facing chair, enough room for Terry to squeeze by. He parked himself in the jump seat next to the monitor, and I took his former place on the bench seat.
“Get up here,” I instructed Dana. “Help Terry get this guy propped up on his side.”
Dana moved to where I’d been standing by the rear-facing chair, and the two of them stuffed some pillows behind the fat kid to keep him from flopping onto his back. I sized him up at a glance. Three days stubble, oily brown hair, dirty jeans and a t-shirt. Probably weighed two-eighty or so.
Extracting supplies from the narc box, I glanced at Dana. “What I’m drawing up right now,” I said, “is called Versed. It’s a sedative in the same drug class as Valium, and one of our favorite things to do with it is make seizures go away. Terry, this is Dana.”
“Hi, Dana,” said Terry, flashing that damned grin of his that always seems to make ladies’ limbs loosen a little.
I pushed the Versed, drawing up another med as the convulsions slowed.
“This is Zofran,” I said, “and it’s for the nausea. You’re going to want to start learning this stuff, because all the medics you work with will expect you to get things for them.”
After pushing the drug I inspected the monitor, then pored over the ECG printout Terry had left on the seat for me.
“Okay, Dana,” I said. “You can go on back to our truck and follow us to Pinewood, but we’re going to be running hot so do not try to keep up. Just go routine and we’ll see you there.”
Dana nodded. “Nice to meet you,” she said to Terry as she left.
“We can go, Jessie,” I called out. “Run emergent, please.”
The siren sounded, and the ambulance pulled out. Terry caught my eye.
“This looks just a tad bit familiar,” he observed.
“Yeah,” I said. I rummaged in the green bag that Dana had left on the rear-facing seat.
“You want me to get the patches out in case you have to zap this guy?” Terry asked.
“Nope,” I said. “because this time I’ve got my work bag, and I have some stuff in here that’ll boost his blood pressure without messing with his heart rate. He’s tachy, but not so much that I’m going to fuck with it unless it gets worse.”
I tossed a fluid bag at him. “Do me a favor and spike this, but don’t use one of the usual drip sets; use this.” I gestured towards a line I’d taken from the green bag; one designed to be used with a pump.
By the time I’d drawn up the medication, Terry had a bag spiked and ready to go. I hooked it to the pump, squirted the med into the fluid bag, and set the pump’s infusion rate.
“Give it a few minutes, then get another pressure,” I said.
Terry hung the bag from the collapsible pole on the side of the cot. “What is this stuff?”
“Levophed. It’s kind of like Epi, but more specific as to which receptors it acts on. It constricts the vasculature, but it won’t speed up his heart like Epi will.”
“Neato. Anything else you wanna do with this guy?”
“If this gets his blood pressure out of the ditch, I’m gonna call it good.”
Terry pressed the blood pressure button on the monitor. The cuff on the right arm began to inflate.
“This looks suspiciously like what we saw a couple of nights ago,” he observed. “How much you wanna bet we also get a negative tox screen?”
“Yeah,” I said, “and I found out more just yesterday. Sam Jensen’s samples got sent down to a toxicology center in the twin cities for more detailed analysis. They found some kind of weird stuff in her blood that the tox screen didn’t catch, and they can’t identify.”
“No shit?”
“No shit, but there’s more. I got Jason Bixley’s autopsy information this morning. He had the same crap in him. I’m guessing he was cruising back home, high as fuck, and then one of these seizures hit.”
Terry leaned back, a thoughtful look on his lean face. “Interesting. You might have told me.”
“I meant to text you this morning, but I got stuck with a trainee.” The blood pressure came up on the monitor. 102/76; I’d take it. I forced my muscles to relax.
“By trainee, you mean that frail slip of a girl following us in? She’s cute, in a… freckly sort of way.”
I snorted. “Forget it, cowboy. She’s got big eyes for Darren Tanner. If they’re not screwing by Friday, I’ll eat my duty boots. Hey, you’re right by the radio; wanna call this in? Tell the hospital he’s had five milligrams of Versed, four of Zofran, and I’ve got him on a Levophed drip currently at ten mics per minute, which I am now titrating down to four.”
Terry reached for the mic.
***
The four of us stood in the ambulance garage at Pinewood Memorial Hospital in Johnstown. Dana had helped Jessie clean up the Bronning rig, and the two women appeared to have hit it right off. I was addressing my trainee.
“When the first thing you see on your first call is puke, it’s a sign that you’re destined to be an EMS lifer. Didn’t they tell you that in EMT school?” I said.
“Tis an omen sent down from the gods themselves,” Terry agreed.
Dana snickered, then changed the subject. “Do we know what was wrong with him?” she asked. I met Terry’s eyes. I saw no reason not to relate the weird chain of events to the two younger women, but some odd impulse held me back.
“No clue,” I said. “Narcotic of some kind, but damned if I know what. Anyway… Terry, Jessie, nicely done. I’m going to take my protege here back to the station and try to teach her a few more things.”
“Teach her well,” Terry agreed. “After all, we’ve just established that she’s going to be in this line of work for the next thirty years or so. We need to head north and get this rig back in service, anyway. Pleasure to meet you, Dana.”
As I settled into the passenger’s seat, I drummed my fingers on my thigh, furrowing my brow as I compared what I’d just seen to Sam Jensen’s presentation the previous weekend. What the hell?
On to Chapter Six!