Just Here Trying to Save a Few Lives: Tales of Life and Death from the ER (18 page)

The security guard put his arm in front of Dino's chest nearly cradling him with it. “Dino, what the hell do you think you're going to do? Shoot him again? You need to cool it. Let these guys do their job.”

I put my hand out as well, my palm resting up against his bulletproof vest. “Dino, don't make me have to throw you out of here.”

Dino stopped shouting and looked beyond me distractedly. What he saw now in trauma bay one was his partner supine on the gurney, his chest wall split open, his heart pulled up and visible to all while the Doberman rooted around in the inner recesses of the thoracic cavity. Dino swayed as if he was about to go down.

That's when I turned my back on him and walked away. I had to; I had to work on the second trauma.

“Hey, buddy, what's your name? What's your name, guy? I know you're awake. Don't try to pull the possum stuff on me. Tell me your name.” That was Carol shaking the shooter's arm. I walked over and looked down. He was a skinny white guy, with a face pockmarked with acne, who somehow through all the recent events managed to still be wearing his baseball cap. He seemed very much alive. I caught his right wrist in my hand. Good strong pulse.

“Do we have anything on this guy? A name, anything?” 1 asked EMS.

“He's got his license in his wallet,” the paramedic said. “We got he's Jay Stryczek.”

“Could you spell that?” Carol said. She unfolded the trauma form before her and began filling it out.

I grabbed at the sheet to help EMS transfer the patient from the gurney to the hospital cart. “What's the report?”

“Triple gunshot wound to the abdomen. Three entrance wounds, it looks like, no exits. Pressure of eighty when we got there. We started two IVs normal saline, last pressure of one twenty over sixty-four.”

“Good work,” I said mechanically.

The paramedic beamed. He had saved this guy's life.

I leaned over the patient. “Jay,” I said loudly, “do you take any medicines?”

Slowly, almost imperceptibly, he shook his head.

Carol was the professional one. She put him on the monitor, fixed the IVs, labeled the blood. At this point my hands were shaking so badly that the only thing I could trust myself with were the trauma shears. I scissored open his pants, pulled his belt off, then sliced through his blood-soaked Tecate beer T-shirt.

The automated blood pressure cuff pumped up and I stopped, gazing up to watch the numbers dial through on the monitor. I felt as if I were watching a slot machine. And the winning numbers were: 84/30. This guy was hurtin'.

“He's going to need more fluids,” Carol said.

“We need another IV for starters. I'll put in a central line.”

I began my survey. Airway, good; breathing, yes; circulation—well, he was hypotensive but he wasn't going to die in the next twenty minutes. I ran my hand over his chest, which was bloody but otherwise unscathed, and then let both hands travel down to his belly. There were three bullet holes. One in the right upper quadrant, dead center of the liver, one in the epigastrium that had probably nailed his stomach and one just above the symphysis pubis. The part of me that was a doctor took over. I thought of the gunshot wounds in terms of anatomy and the bullet's potential pathway. Three bullet holes to the belly. No exits, EMS had said, although I needed to roll him to make sure. If the patient was standing erect and the bullets hit him straight on, most of the damage would be to the abdominal organs, the liver, the bowel, the spleen (which bleeds like crazy). If he was falling backward when he was hit, the bullets would have pierced the diaphragm, dropped a lung or even hit a ventricle of the heart. If he was falling forward when he was shot, the bullets would have traveled down into the pelvis, hit the bladder, the prostate. The trump card, of course, was the spine. The rest of it, bellywise, was pretty fixable. If the bullet had hit the spine, however, that could mean a lifetime of paralysis—wheelchairs, indwelling urine bags, crater-like bedsores—all at best.

I surveyed the patient's now naked body.

“Wiggle your toes,” I demanded of him.

After a moment's thought he wiggled the toes on both feet vigorously.

I shook my head. Something inside of me was disappointed.

I abandoned him as Carol bent down to start another IV and went back over to where Sheldon lay. The surgery resident had finished the central line, and two units of blood plus several liters of normal saline were washing into Sheldon's circulatory system. The resident stood on Sheldon's left side now, both hands wrapped around Sheldon's heart, squeezing gently as he gave open heart massage. Underneath him, working in the narrow hole between the ribs, the Doberman had both forearms half buried in the chest cavity. He had his face down there as well, nose practically inside the chest as he tried to see. He had put on a face mask, but now one of the straps had come loose from around his ear, and the mask flapped uselessly against his cheek and jaw. There was blood in his hair. He looked up at me, and I could see his lips were pressed tightly shut, forming one thin line of concentration.

“I've got it,” he said finally. “I've got it clamped.” He eased his hands out of the chest and looked up at me. “How's the other guy doing?”

“He's currently alive.”

“Which is more than I can say for your cop friend here.” The Doberman looked around. “Have we got maximum fluids going, team? That's the only chance this dude has.”

“Should I keep up with heart massage?” the resident asked while, simultaneously, Tracy said: “Oh, no, no, no. Oh, no. Do you see?”

“What?” We all looked around and then down at Tracy's hand. She was pointing at the bullet hole in Sheldon's neck. Blood had been oozing from the neck wound before but now it poured out, a wide stream of blood that swelled wider every time the resident squeezed the heart.

The Doberman threw the needle driver he had in his hand down on the floor. “Aw, jeez,” he said, “for crying out loud. That bullet nailed the carotid, man. This guy was a goner before we even started.” He yanked off his face mask.

“Okay,” Carol said. She was standing pumping up a pressure bag on one of the units of blood. She had been silently crying throughout the code, and now she was trying to snuffle herself back together. “So what now?”

“Nothing now. This guy is dead.”

“So you want to call the code?”

“Yeah, code called. Okay?”

Everyone just stopped what they were doing, mid-gesture. The Doberman turned away, peeling off his gloves. The resident, still giving open cardiac massage, looking around nervously, not sure if he, too, should just stop. Finally he pushed the heart back down through the rib cage into the chest cavity and reached in to give it a nervous pat before he, too, turned away.

“What about the other guy?” the Doberman asked. We both looked over to the other trauma bay, where Carol was taping a second IV into place. Except for Carol, the guy was lying there alone. “Do we have more to work with?”

“Yeah, if the cops don't tear him limb from limb.”

So the Doberman went over to save the life of the guy in trauma bay two. I couldn't follow him. Not just yet. I walked up to the head of the cart and looked down on Sheldon's neck wound, still oozing blood. I remembered that I was sure the bullet had gone too lateral to have hit the carotid. When I looked down now, though, it was clear that the entrance wound was right over the carotid; there was no way the bullet could have missed it. I thought of the blood in the car, all that blood on Dino, the stillness of Sheldon's face. Why had I lied to myself? Clearly Sheldon had bled out from a carotid injury before he had ever arrived at the ER, but just as clearly, I hadn't been able to face it. That's why we cracked his chest. I wanted to believe that he still had a chance. But he never did.

Tracy, standing next to me, was staring down at her bloody gloves. She looked gray and unsteady. “Sheldon's dead,” she said miserably. She looked so young to me at that moment, like someone who still believed that just because we tried with all our might to save someone, he would be saved. “I can't believe it. What did we do wrong?”

“We didn't do anything wrong. He was dead at the scene.”

Tracy leaned back so that her back was against the wall behind her. Slowly, limply, she slid to a seated position on the floor.

“Are you going to faint?” I asked, a ridiculous question.

“No,” she said. “I think I'm going to cry.”

The evening supervisor came up and looked down at where Tracy was sitting.

“Are you all right?” she asked Tracy.

“No,” Tracy said.

“The wife is here,” the supervisor announced. “Someone needs to talk to her.”

There was a moment of silence. Finally I said, “I will.”

The supervisor quizzed me as we walked away.

“How's the guy who did the shooting?”

“He's doing terrific,” I told her glumly.

Outside the trauma room there were at least twenty police officers, ranging in rank from the foot soldiers to the brass-bedecked big guys. Dino came forward out of the pack, his head down. “How is he?” he asked my shoes.

“He's dead, Dino.”

Dino stood there for a moment still looking at my shoes. Finally he said, “How's the assailant?”

“He's going to surgery. I don't know any more than that.”

Dino turned away, shaking his head. “I meant to kill him,” he said.

I reached a hand out to comfort him, but all I could feel was the bulletproof vest as I patted him on the back. “We did everything we could.”

Dino stopped. He turned back around to look at me for the first time. That's when I saw that he was not grieving; he was furious. “What do you mean you did everything you could? My partner is dead and the guy that shot him is still alive.”

“Dino,” I said, “Sheldon died at the scene. The guy got him in the carotid. He bled out in the car.”

Dino turned away again.

“Don't do this, Dino.”

With his back to me, he said, “So you let the fucking shooter live. Well, fuck this hospital and fuck you.”

Now I was angry. I came after him, grabbed his arm and turned him around. “I can't help that,” I yelled at him. “1 was just doing my job. People come here; I try to save their lives.
It doesn't work any other way.”

I looked around at the other cops standing around us. Most of them I knew. I saw them every day; I gave them penicillin for their sore throats, physicals for their kids, back-to-work excuses for their wives, a dozen little courtesies. But I saw none of this reflected in their eyes as I looked around at them now. All I could see was suspicion and blame. One of theirs was shot and I did not save him. It was my fault. I didn't perform the expected medical miracle and save Sheldon. It was everyone's fault.

I just walked away. I couldn't take the way they looked at me. They all moved silently to let me through. When I passed by the district commander, though, he held my shoulder for a moment. “Okay,” the commander said. “I know you did your best.”

“I've got to go talk with his wife,” I mumbled.

“Do you want me to go with you?”

“No,” I said. “Just let me go alone.”

It was that same long, dark corridor. At the end was a single door. I slipped into the room. A woman wearing a flowered sweatshirt was sitting alone on the couch, crying. When she heard me come in, she tried to pull herself together. She wiped her face with a wad of shredded tissue, sniffling, but it was impossible, so she just went back to crying again.

I sat for a while on the chair opposite her, hands steepled, elbows on my knees, trying to think what to say. Where had I done this before? Bosnia, Nigeria, the South Side of Chicago. A death is always the same.

Finally she looked up at me. “He did not have to do this,” she said. “He's got a couple of businesses with his dad. I don't know if you knew that. We don't need the money.” She paused. “He just liked being a cop.”

I stared back down at my hands.

“Why did he do it?” she asked me.

I looked up.

“Why did he shoot? Why did that man shoot my husband?”

I thought of what Dino had said when he first jumped out of the car. “It was a routine traffic stop,” he shouted. It had never occurred to me to ask more.

“I dunno,” I told her. I wanted to tell her that the last time I saw her husband alive he was singing Cole Porter for a patient he had brought in, singing for all of us, really, but I was distracted by another thought. Imagine ten thousand deaths just like this. That's what Bosnia was. That was Nigeria.

“He died on the scene,” I told her in a flat voice that did not sound like my own. “The shooter nailed his carotid. He bled out before he got here.”

Why was I telling her this? I wondered to myself.

Sheldon's wife reached out and took my hand.

“I knew your husband well,” I continued. “He was the nicest guy…I just can't believe this.”

“I know,” the wife said, crying. She patted my hand to comfort me. “Everybody knows.”

The headline in the paper the next day read:

“Policeman Killed, Motorist Injured in Roadside Shootout.” Below it, in smaller type, it read: “Mother of victim states son was a victim of harassment.”

“Oh, give me a break,” Bill said. “Give me a fucking break.”

It was the next afternoon shift, a quiet one. We all sat there glumly listening as Bill scanned the newspaper article. “'Jay Stryczek, twenty-eight, convicted of armed robbery times two, wanted for parole violation'…I see he is a topnotch citizen…‘critical condition from abdominal injuries.…Sheldon Tennant, thirty-seven, thirteen years on the force, pronounced dead on arrival’ at this hospital. Was he really dead on arrival?”

“Close enough,” Donna said.

“…'leaves behind a wife and three children.' It doesn't say anywhere in here about why the guy shot him, though.”

“Yeah, well the big question,” Donna said, “is whether the guy is gonna live or not.” She turned to me. “Have you heard?”

I shrugged. “No, but then dirt never dies.”

“We could have saved the county a whole lot of time, trouble and money if we had just accidentally let that guy go to ground.”

“Listen to this,” Bill went on. “The mother, Stryczek's mother, said: ‘They stopped my son for no reason. He was observing the speed limit. They had no reason to stop him like they did.’”