In Case of Emergency (13 page)

“Let’s just load her up,” he says, dropping his arm, still not looking at me. He turns to the girl’s mother. “Did you guys get in an argument?’

“No!” she wails. “She was fine and then she just started shaking.”

They continue to talk as Carl and I negotiate a two-person lift of our patient and Ruth supervises. The girl isn’t heavy but the space is narrow, and as I shuffle backward and Carl forward, the way the girl hangs limply between us causes the woman to go into fresh hysterics.

In the back of the rig, the lead medic tells Carl to shut the doors but not to drive away yet. After the slam of double doors there’s silence. He leans forward, cracking his knuckles one by one in a steady rhythm. “Hey,” he says, “stop faking it already.”

Our patient doesn’t move and I look at Ruth, bewildered.

He leans in closer. “I said, stop faking it.”

The girl doesn’t move. He picks up her wrist and raises her arm so the drooping hand hangs directly over her face. I notice he’s not wearing gloves. When he lets go, her arm takes a strange trajectory. Instead of falling flat on her face as gravity would dictate, it swoops and manages to land on the soft bed of the gurney just above her forehead.

His slow smile is unctuous. “Okay. Here’s how it’s going to work. Either you’re going to cooperate and start talking to us, or I’m going to do tests and treatments that will be very uncomfortable. I will shove tubes down your nose and needles into your feet. I promise it will hurt. Is that what you want?”

She doesn’t respond. He slides down to the end of the bench seat and flips up the thin hospital sheet we used to cover her.

“Do you want me to get vitals?” I ask.

“Don’t do a thing,” he says.

Her shoes are checkered black and white, with pink laces, and after he pulls them off he removes her white socks, dropping all of it onto the floor of the ambulance. His hands still ungloved, he runs a finger along the bony arch of her foot, poking for a vein. In the seat next to me, Ruth’s posture is stiffer than usual.

The girl’s eyes flutter open and she issues a soft sound. It breaks the tension somewhat. The medic seems to have expected this: he slides back up toward the head of the gurney and stares at her. “All better now?”

He questions her for a few minutes, but none of the questions seem medical. Did she get in a fight, is she stressed, is it that time of the month, did they forget to leave her a piece of cake? Instead of answering, she stares calmly out the back windows of the ambulance. She doesn’t seem the least bit surprised to be dealing with his disrespect, and to see such youthful resignation is chilling.

“Why’d you pretend to have a seizure?” he asks finally. For a moment something dark, bleak, and lonely crosses her face but then it’s gone. She doesn’t answer; he shrugs and climbs out of the ambulance. “Take her to CRH,” he says. “Go with whatever chief complaint you want.” And he shuts the doors.

I sit on the rig’s bumper in the parking lot at Crossroads, staring at paperwork. What used to take me sixty minutes now takes me twenty-five. The boxes are checked, the codes filled in, the narrative complete. Ruth comes around the corner of the ambulance and sits next to me on the perforated aluminum. I hand her my report, which she scans and hands back. “Any questions?”

“Who’s the shithead?”

At first it looks as though I’m going to get a scolding for my language, but then she says, “Randall.” After a pause, she adds, “That was the drop arm test.”

“Is he always that rude?”

“Yes. And he would have done what he said, shoved an airway adjunct in her nose, probably without lube, and started an IV in her foot.”

I grimace, shaking my head.

“What would you have done differently?”

“She’s sixteen,” I say. “She shouldn’t have upset her family and brought 911 to her house, but maybe something really was wrong. A medical problem she didn’t know how to talk about, or some kind of violence in her family. At the very least, I would have done a real assessment, not just threatened her.”

Ruth doesn’t say anything. There it is again, the reminder that perhaps I am too sensitive for this job. People don’t say it so much as think it.

When I was sixteen, I saw someone get killed in a hit-and-run accident. Who knows what this girl has seen? She lives in a tiny house crammed with at least two families, and although I don’t like being lied to, there was something genuinely wounded about her. It might have been just teenage angst; she could have been acting out for attention. But she also could have had a petit mal seizure, which would have resulted in more subdued symptoms, or some other kind of injury or illness that can’t be recognized with something so primitive as the “drop arm test.” Either way, I don’t like Randall. I don’t like the way he talked to her, and I don’t understand why someone like that would be in this line of work.

Ruth surprises me by saying, “Hold on to that, Piper. See if you can.” She kicks at a few small stones strewn over the parking lot asphalt, and watches as one dips and disappears into a hollow. “I can see that you give a shit about patients, that that’s what you’re here for. You’d be surprised how
rare that really is. And—you’re going to be good out there. Once you get a little more used to it.”

I can tell there’s something else on her mind.

“Carl told you about the bet we made?”

It’s not really a question. A little shocked, I nod, my eyes still on the hollow where the stone disappeared.

“I’m sorry. I really am.”

The double doors to the ER swing open and we both turn our heads as Carl charges down the ramp, riding one side of the gurney like a skateboard. He doesn’t stop at the ambulance but flies past us, hollering.

When my laughter subsides, I say to Ruth, “He never was a rookie, was he? He was probably born into this job.”

“Carl?” she says incredulously. “Carl was one of the worst. I trained him. He was all empathy and politeness. Southern manners and sympathy. Couldn’t get his ass in gear to do anything. But once he figured things out, he was one of the best. Of course,” she adds, shrugging, “
I
was never a rookie.”

18

“Anything good?” J-Rock asks from under his cap as we file through the front door of Station 710. He’s watching an action movie, one of the many Bourne installments, but the loud soundtrack doesn’t stir his partner. Pep’s limp frame sags in the seat next to him. Eyeing one of the empty recliners as I head toward the kitchen table, I lament the fact I can’t kick up my feet until I’m done with training.

“Drop arm test,” Carl replies with a shrug. He hangs the rig keys on a hook by the door and slumps into one of the recliners. Ruth pulls a frozen burrito from her stash and tosses it onto the counter near the microwave. It lands with a dull thump.

“Pass or fail?” J-Rock presses.

Ruth and Carl in unison: “Fail.”

J-Rock nods, his eyes still on the screen. “Well, while you’ve been off saving the world, Pep and I have accomplished exactly nothing.”

“It’s going to be so busy tonight.” Carl sighs.

“Yeah.”

As my last, uneventful day of training comes to an end, a call comes in for 7101. When the phone rings, J-Rock jumps to answer and nods at Carl, Ruth, and me, sitting at the table. “You got something.” He and Ruth say it the same way, “SOB,” but I know Carl likes to say “son of a bitch.” Either way, it means the patient has shortness of breath.

Ruth quickly pushes her chair back and stands, looking at the neat stack of my completed field training paperwork in front of her and noting the time on her watch: 1920. My shift officially ended twenty minutes ago. “Training’s done,” she says with finality. “You can come on this call, but you don’t have to. Go home if you want.”

But I’ve already grabbed my clipboard and brush jacket and am sprinting out the door, looking at my pager for details: #30026: 52 y/o M, SOB, 1 Byrd Ave, xs 2
^nd
Ave/Van Ness, Apt 518.

I take the passenger seat and tell dispatch, “7101 is on air,” as Carl and Ruth pile into the rig. The dispatcher’s steady voice gives us the details. I recognize the address of the apartment as part of the tan-and-white complex on Byrd Avenue that takes up a whole city block.

There’s an unusual pause in the radio transmission and then Dispatch continues. “7101, be advised. New update for incident number 30026. Call is now for a full arrest.”

A fleeting image: my brain detaching from my spinal cord and floating away like a helium-filled balloon as I sit here, unable to absorb this
information. I knew I would get a full arrest call at some point, but for the stakes to rise so high so suddenly makes me wonder if Ruth can retract her declaration that I’ve passed training. I hold the radio transmitter up to my mouth, and with trembling fingers press the side button. “Car 7101, copy that.”

“Ice cream!” Carl yells happily from the back of the cab. The bewildered look on my face is so extreme even Ruth smiles a little.

“It’s a firefighting tradition,” she explains as she starts the rig and the heavy diesel motor turns over. “Any time you have a big first, like your first full arrest or you’re on television, you buy everybody at station ice cream.”

“Television?” I clutch the map book in my lap, but have yet to turn a page of it.

“News coverage,” she says, throwing the rig into drive and flipping on the lights. “For big incidents, like multi-casualty car crashes or crime scenes. Plus we get a lot of stabbings and shootings, so sometimes you’ll be on TV.” She pulls the rig out to the edge of the parking lot so its nose dips down into Normandie Avenue.

My face feels numb.

“Piper, map me to my
call
.”

“Yes ma’am.” I snap my spine straight and shake my head once to clear it. Opening my Thomas Guide, I slam my right index finger down on the location of Station 710 and my left middle finger on the diagonal slope of Byrd Avenue. Briskly I tell her, “North on Normandie, west on Manchester, northwest on Byrd, and your trigger street is Van Ness.”

The tires screech as Ruth takes off, and Carl says in a satisfied voice, “Get some.”

His wife leads us to him; she was on the phone with the 911 operator when her husband went from gasping for breath to not breathing at all. She reports
they are both in their fifties. In the hallway I pass a picture of the two of them from maybe twenty years ago, a curling yellow memory that hangs in a wooden frame so faded by the sun the wood looks almost pink. They stand erect and formal, holding hands, beaming warm smiles at the camera.

We find him sprawled on his back in the office, under an old Dell computer. The screen saver flashes a colorful montage, and I notice two things: the theme seems to be landscapes from around the world, and he doesn’t look much like the picture hanging in the hallway. We—seven firefighters, Ruth, Carl, and I—descend on him like a swarm of insects. The captain hovers behind me, the only person still standing, and hurriedly documents the multiplicity of events on his clipboard. I jump on compressions as soon as a firefighter says the man is pulseless, and as soon as I do, I’m scared to look up. The flurry of activity around me is overwhelming, as is the man’s stricken expression, and I can’t afford to mess this up by becoming frozen and useless.

In CPR class we practiced on mannequins with blue foam torsos, pivoting plastic necks, and faceless heads that had fixed and modestly open mouths. If you gave breaths right, you could see the dummy’s chest rise and fall. If you did compressions right, you would hear a little clicking noise. The EMT instructor played the disco song “Staying Alive,” which sets an appropriate tempo for proper CPR. Some students sang along, laughing, and nodded their head to the beat as they pumped away at the foam.

This is nothing like that.

The sharp, rapid compressions I press into this man’s sternum cause his gray chest hairs to quiver. Balanced on my knees, I focus my gaze on my arms descending straight down and crossing at the wrists, my interlocked and pumping hands, the ripples that shudder out through his fleshy chest. I watch his chest hairs tremble and I look at his blotchy skin, a mix of purple and pale—vitiligo, I think it’s called—and I ignore my right eye, which is watering. A single strand of my hair clings to it, but I’m not
allowed to pause until the thirtieth compression, and there is no way to wipe it away. Hoping to push the strand to the outer rim of my eyeball I blink rapidly, in time with the compressions, and the strobe light effect makes the act of doing CPR feel absurd.

8, 9, 10, 11…

“Lock your elbows!” Ruth hisses in my ear. “Look at the monitor, you’re not pushing hard enough.”

The monitor rests on the carpet next to him; she tells me I will know if my compressions are deep enough by how sharp the spikes are on the screen. “Really lean into him,” she says. “And tell me when you get tired.”

I follow her advice and shove harder; his torso shudders and wobbles underneath me, and the spike rockets up. Seeing the improvement, I feel a small thrill. These compressions are better than the ones I delivered to a blue foam mannequin, better than the ones I jokingly threatened Marla with when we practiced scenarios, and much, much better than the ones I gave when I was sixteen years old, to a hit-and-run victim whose life I couldn’t save.

23, 24, 25…

The man belches from the caving pressure and the smell is sour bile mixed with decaying chicken noodle soup. Ruth peers at me; she sees the way I am blinking. My right eye stings from that stupid piece of hair. I’ve half-promised myself I will shave my head when I get home to avoid this problem in the future. She wipes my face using the side of her forearm, her gloved fingers bent awkwardly so as not to contaminate me, and clears away the offending strand.