“Because,” Tigger chimed in, “it’s all property damage—you’ll see.”
When we got there, the driver of one car spoke to the responding officer, gesticulating wildly as he tried to explain himself, while the other driver sat in his seat, hands fixed firmly to the wheel. He knew who he was, making him oriented to person—he was Guy Carlotti; he knew where he was, so he was oriented to place—he said he was up shit creek because this was his wife’s new car; and time—he knew the date. This made him “Ay and Oh times three,” which was what I wrote on the PCR.
Tigger took tension on his head, meaning he held it between his fingers and lifted slightly—just enough pull to lift a six pack of soda is what we were taught—which was enough to relieve pressure from the head to the spine in case of a neck injury.
Trevor had me fit him for a cervical collar, which I slipped into place around his neck, and on a three count, we shifted the patient as a single unit so we could place the short backboard behind him, then fastened him to it, at which point it was safe for Tigger to let go of his head. We had to maneuver a bit to get him onto the stretcher, and the cops helped us, because Mr. Carlotti was no lightweight.
Once inside the ambulance, and at Trevor’s subtle insistence, I got to perform the entire examination drill: A, B, C, D, E. Although the patient’s blood pressure was slightly elevated, the rest of his vitals were within normal ranges, and except for his statement that he felt “a pain in the neck” that he said would turn into “a pain in his wallet,” the examination revealed no bruises, no bleeding, no broken bones, no signs of internal damage, and he was able to wiggle his fingers and toes.
Again, the guys had me present the patient in the hospital: we had a forty-year-old male who’d been in an MVA. He had a slightly elevated blood pressure, or BP, and was complaining of neck pain. He was A&O x 3; his eyes were PEARL: pupils equally active and responsive to light; positive bilaterally for clear lung sounds; positive all four quads for nerve response, which meant he could wiggle his fingers and toes; and had no medical history to speak of. I may not have presented the information in the right order to the attending doctor, but at least I presented all my findings and left absolutely nothing out.
After we transferred him from the stretcher to a bed and Trevor got someone to sign off on the paperwork, we set up the stretcher and picked up a new short board on the way out.
There was another MVA. The driver RMAed—refused medical assistance.
Two asthma attacks. Check vitals, check lung sounds, administer O
2
, monitor en route, then present paperwork and set the stretcher.
A fifty-six-year-old male with chest pain, a history of CHF—congestive heart failure—with visible jugular venous distension bilaterally. A check of his vitals revealed a rapid pulse and elevated BP.
We administered oxygen, and for the first time, when I listened for lung sounds, I heard rales: the distinct sound of cellophane paper crinkling that meant fluid in the lungs. The patient also had pitting edema, which meant that his extremities were so swollen that when I pressed a fingertip to the skin, an indentation stayed there for several seconds or longer.
Needless to say, we took him rather quickly to the emergency room.
After that call, things quieted down, and the guys drove to a Chinese food place off Bay Street where we picked up some food to go.
It was getting very close to the end of the shift. Tigger parked the rig on Edgewater, a large lot that faced the bay, and it was neat listening to them talk while we ate fried rice and smelled the salt of the ocean as we leaned against the front of the vehicle.
The radio crackled. “Five-five Eddy, come in.”
Trevor grabbed the mic as he hopped in the front, and I clambered through the side door and settled into the jump seat.
“Oh, man!” Tigger groused from the driver’s seat as Trevor wrote down the address and we pulled out of the lot. “It’s Danny again. The skell probably ODed to avoid getting busted.”
“Can they do that?” I asked.
“Sure,” Trevor chimed in, “while we can override on the scene to declare the medical emergency and go to the hospital, the cop can choose between continuing the arrest afterward or letting it go as a medical.”
“Saves ’em a lot of paperwork if they let it go,” Tigger added.
When we got there, I had a feeling they were wrong about this being a medical override. Three patrol cars were there—one parked in front by the curb, another perpendicular to it, and another parked right on the lawn. And as we walked into the pile of sticks that was supposed to be a house, we passed a living room where two cops held a skinny, unkempt man who constantly screamed, “You ain’t taking my boy from me—you ain’t! You ain’t!”
Another officer stepped out from the hallway. “This way,” he said, and beckoned us over. “The kid’s Danny Junior.”
Suddenly, I was scared, scared that I wouldn’t remember anything, that I didn’t know enough, scared that whatever I saw would so throw me off balance that I’d vomit and forget everything, forget my job. I felt my head go light as the skin on my face tingled.
We entered the kitchen and stopped almost immediately. There, on the filthy, ripped linoleum that was covered in old food, dirt, and blood, lay the patient. Prone, head twisted to the side, a pediatric male approximately two, maybe two and a half years old—the back of his head matted in blood and suspiciously flat either from the crib or a fracture. A partially avulsed eye on the facing side. Multiple contusions over visible torso. Vomit all over the floor and a filthy Winnie the Pooh shirt. An incongruously fresh diaper.
His little lips gaped open and closed, open and closed, like a fish trying to breathe on land. My hands shook as I slipped my gloves out of my back pocket and over my fingers before I took another step and then…
A litany of orders blossomed in my head, and thought became action before I was fully conscious of it. I was the new man, so I set the regulator, then cracked the O
2
tank as Tigger passed me a pediatric non-rebreather air mask. I’d hold tension on the little head, because with this kind of damage, something in his neck had most likely been injured. Besides, I had the least experience, and this was something even the most rookie medical personnel could do. I carefully cradled his skull in my fingertips to take the pressure off his spinal cord. Airway. A full minute count for respirations, and I called the time and quality on them.
His breaths were irregular in quality, but he was breathing enough according to protocol, and we administered the maximum oxygen allowable.
Trevor soaked some sterile pads in saline, and Tigger produced a cup from somewhere and handed it to him. Trev first carefully covered the bulging eye with the soaked cotton, then with the cup, taping it firmly in place while Tigger oh-so-cautiously slipped a cervical collar around the little guy’s neck. I spoke to Danny Junior the whole time, as did the guys. Every now and then I’d see the cops shuffle in and out of the room, or from the corner of my eye catch a pant leg shifting uncomfortably.
On the count of three we carefully turned and affixed Danny to a short board, still speaking to him, reassuring him that he was okay, that no one was going to hurt him. I watched Trevor’s hands shake just the slightest bit as he secured the headrest to the board so I could take my hands away from Danny’s head. Clear fluid slowly dripped out of one little ear.
A finger of ice stabbed my sternum as I caught Trevor’s eye. That fluid wasn’t a good sign.
Tigger told the cops what hospital we were going to go to and radioed ahead to alert the crash team as we moved the patient to the ambulance, and just as we got inside, Danny’s hands, which had been balled into little fists, went slowly limp.
Tigger drove like a man being chased by the devil itself as the sirens blared over our heads. In the less than two minutes it took us to get to the emergency room, Danny’s blood pressure had skyrocketed and his pulse rate had dropped, meaning bradycardia had set in—and then he stopped breathing.
I used a modified jaw thrust and a pediatric Ambu bag to force air into his little lungs, and the protocol that we had been taught—that no one rides the rails of the stretcher into the ER because we’re supposed to use a slow, step-by-step progression—got trampled underfoot when Tigger ripped the back door open and Trevor urged me tersely, “Ride it in—don’t stop, don’t stop!” as I stood at the top of the stretcher, feet balanced on the aluminum tube that created the base, stomach pressed into the mattress for balance.
The crash team met us as we sped through the doors, and it was Trace’s hands that met mine and allowed me to stop artificial respirations so she could drop a tube down his throat. Blood frothed on Danny’s lips, and in that second we lost his heartbeat.
The flatline buzzer screamed in my ears, and the next thing I knew, a pair of hands grabbed my shoulders and yanked me away.
My head jerked, a sharp steel snap of muscle, to see who it was. Debbie. It was Debbie. “Come on, Tori,” she said quietly, “your shift is over.”
“But…” I gestured to the stretcher that had to be made, the paperwork that lay neglected on it. “I’ve got to—”
Debbie shook her head as she gently guided me back to the nurses’ station. “You’re done for the night—you’re done with your rotations.” She flipped deftly through the stack of paper behind the counter.
I was confused as I shucked my gloves, rolling one into the other to prevent contagion, and I dropped them into the nearest red bag. What the fuck? I had another two nights left. Had I really fucked it up so badly that they didn’t want me back in the ER?
“What?” I asked, “I’m supposed to—”
Debbie pulled a sheet of paper from the desk, wrote something quickly, then thrust it at me. “You pass, Scotty, you pass. Call me when you need a job.”
I took it from her hands and folded it slowly as I gawked at her. I was done? I passed? But what about the rest of my shift? What about Danny? I peered over my shoulder where the crash team had pulled the curtain and worked. The stretcher we’d brought the child in was gone, and so were Tigger and Trevor.
I felt Debbie’s eyes on me. “It’s okay,” she said, and laid a hand on my shoulder. I met her eyes, cool and clear blue, which held intelligence and compassion. “Do you smoke?” she asked as she handed me my jacket.
“Uh, sometimes?” I answered, confused. I switched out of the hospital jacket I’d been wearing. What did smoking have to do with anything?
Debbie’s hand traveled from my shoulder to pat my arm. “Why don’t you go out by the bay, have a smoke, and I’ll meet you in a minute?” She peered around my arm, behind me, where the crew still struggled behind the curtain to keep Danny alive. “It won’t be long.”
“Okay,” I agreed, holding my jacket before me dumbly. I felt nothing. My brain didn’t work. She could have told me to go do anything and I would have—I didn’t even know how I breathed, just that it happened, air in, air out, an automatic response to signals sent by the lizard part of the brain: signals sent, received, and interpreted by nerves that I couldn’t feel as I walked out the bay doors.
Several long boards rested against the wall, and a short board. The headrest was still affixed, and it was smeared with blood.
Tigger and Trevor had gone. They’d left a gaping space on the tarmac where the ambulance had been, and I don’t know what I stared at as I finally lit a cigarette under the glare of the bay lights.
*
I felt her before I heard her.
“Debbie said you’d be out here—would you like to get a cup of coffee?” Trace asked in a low, throaty voice that held none of the past night’s banter, but an evenness instead, an evenness I could understand.
I exhaled quietly, still focused on the parking-lot lamp as I answered. “Sure.” I tossed my cigarette to the cement and ground it under my boot. When I felt the light pressure of her fingers on my elbow, I didn’t pull away, but I could feel my muscles automatically tense, as automatically as I breathed.
“Do you want to stay here, or should I pick you up when your shift is done?” My voice was strange, flat, a clipped sound in my ears as it floated out into the air.
Her fingers closed around my arm. “I’m off now. Let’s go.”
In my car, I followed Trace’s directions, and instead of going to a café or a bar, I drove toward her place, a nice condo off the water along Father Capodanno Boulevard.
“Hey,” I began, an urge growing in my chest that prompted me to speak, “do you mind if we stop at the beach on the way?”
“Why not?” she agreed, and patted my knee. Her fingers were warm along its inner curve as her thumb smoothed along the sharp delineation of bone and cartilage.
I tore my eyes from the road to glance at her. “Thanks.” I made the turn. Seconds later, I pulled into the parking lot, found a space close to the sidewalk that led to the beach, then cut the engine. Trace hadn’t moved her hand and I covered it with mine.
“Take a bit of a walk?” I asked.
Her eyes seemed almost colorless in the darkness of my car, as the light from the lamps on the boardwalk cast the rest of her into deep shadow.
“I like to come here to think too,” she said softly as she unlocked the door.
“Thanks,” I said again, because I had no other words, and I eased out of the car and waited for her just at the edge of the walkway.