In Case of Emergency (22 page)

The boy’s face gives way some.

I tell him about the Irishman who tried to blow up a car, only to burn his mouth on the exhaust pipe, and about the man who invented the Irish jig because he drank too much and got locked out of the bathroom.

At Crossroads he remains impassive despite flirting nurses who offer him juice and graham crackers, and when we get him into a room he hunches down on the bed as if to disappear. As we leave, I hear Shilpa say she’s going to have to call his mother, and he yells at her with real fear in his voice and then starts to cry.

Once we’re in the ambulance, William says, “Gangbanger-in-training.” He waits for a reaction. I don’t give him one.

We drive past an auto shop with a wall of rims on display, sparkling like Christmas tinsel—custom rims, spinner rims, chrome rims with spokes shaped like flames, like blades, like spaceships. A busted fire hydrant on Gage Avenue spews a geyser of water that gets encircled by laughing kids. We pass a church you wouldn’t know was a church except for the skinny cross that’s precariously buttressed on the roof.

I want to fight with William, tell him how wrong he is about everything I know he assumes about that boy, but I keep thinking about what Ayla said. I don’t know shit about any of this. So I stare out of the window. I spy lumps of blanket-covered humans, new graffiti on the side of the video store, a Cadillac SUV with its windows blown out, and a pair of child’s tennis shoes dangling from a wire.

* * *

I eat dinner with the two-car crew at the Station 710 dining room table, my homemade meal of vegetable stew not as aromatic as their greasy burgers and thrice-cooked fries. We chatter about the latest A & O gossip; we argue over who the worst dispatcher is. Steve tells us about a new product that helps you burn twice as many calories in half the time. He swears it’s legal while I make lame juicing jokes and Phil lectures us on the physiological aspects of the human metabolism. My list of medical slang hangs on the fridge door; someone has added “GPO”—good for parts only.

After washing my dishes, I pause at the front window and pop apart the blinds. William always stands in the same place when he smokes, the southeast corner of Station 710’s parking lot, probably because it offers the best view of strippers heading in and out of work at the topless club next door. I’m about to ask Phil and Steve if they’ve ever run a call at Dy-nasty when the phone rings.

Phil waves his hand at me to go even as he jumps to answer it. Before I release the blinds I see William drop his cigarette and start for the rig in a full sprint. Looking at my pager as I close the station door behind me, I move at my usual pace, confused by William’s urgency.

As I climb into the passenger seat, I revert back to my first day of training, when nothing made sense, when all the acronyms were meaningless. Somewhere in my brain is the answer, but I turn to William and ask, “What’s a GSW?”

29

Adrenaline comes from your adrenal gland, that flap triangle of tissue perched on the crest of each kidney. The chemical was first discovered by a pair of Japanese scientists, who plucked it from a sheep and purified it, paving the way for the eventual mass-production in laboratories, where it
could be bottled in clear glass and dubbed “epinephrine.”

The primary messenger of your sympathetic nervous system, the star player of the flight-or-fight response in charge of your survival, adrenaline creates similar effects in animals and humans alike. Darwin was the first to note the trembling, hyperventilation, and signs of overheating. Yet fight and flight are not unanimous. When terrified, you become pale and weak, your mouth dries out, and you experience difficulty forming thoughts and speech; when you’re enraged, your skin flushes, saliva pours from your glands, and your skeletal muscles become erratic and overactive.

In most cases, your brain instantaneously chooses between fight and flight; in extreme situations, the body fires both instincts at once. What happens to you then is similar to a mouse being fed to a caged snake. Neither fight nor flight is possible, and in a last-ditch effort to lessen the impending pain of death, all the muscles in your body seize and remain seized. The endpoint is paralysis, a numbness, an out-of-body experience.

You knew its effects long before you were ever aware of its medical uses. Find something dangerous to do, and adrenaline is right there with you, tugging on your nerves and your heart rate, quickening your breath, raising your blood sugar. When it works the way it should, adrenaline is better than most recreational drugs, and perhaps more addictive. Similar effects, of course: the vasoconstriction and euphoria of cocaine, the dissociative numbness of PCP, the sudden jolt of household stimulants. Boxers use epinephrine during fights to stanch bleeding; housewives take it to lose weight.

Of course, the real miracle of this chemical is the way it slows down time. Ten seconds become three minutes, three minutes become twenty. You feel like you’re moving slowly even while frenetic, and meanwhile you’re stronger than you’ve ever been, and feel no pain. Piece by crystallized piece, moment by suspended moment, everything becomes fluid. You are floating. You are a superhuman. You are a god.

30

We find him lying facedown on Western Avenue with a river of blood coming out of his head. There’s no crowd. There is only the feeling that people are watching. Our patient, the cops tell us, is about eighteen years old. Our patient is a heavily tattooed John Doe; our patient is presumably a gang member.

Police were on scene long before us and didn’t bother to call it in. They assumed he was dead. They staged out the area, put caution tape around two of the residencies, and started hunting for clues, witnesses, the killer, and the weapon. At some point somebody noticed blood bubbles popping out of his mouth. He was still breathing.

The firefighters, William, and I descend on him eagerly—already I know a case of true trauma is a coveted event—and the officers watch with bemused interest. One of them gets a notebook ready in case our patient regains enough consciousness to reveal his assailant’s name. I am very much a rookie still, but even I could tell that cop to put his notebook away.

The bullet went through our patient’s occipital lobe, in the back of his skull, and the larger exit wound shows that it shot out of his left temporal lobe. It must have skirted his medulla oblongata because his ability to breathe remains, amazingly, intact. Slow to form and slow to pop, blood and spit continue to balloon out of his mouth below his swollen eyelids.

I pour sterile saline over his face and wrap his wounds. All his clothes get cut off; he has no injuries below his neck, and we cover him with a sheet and strap him to the backboard.

Once we begin our transport to the Santa Monica Trauma Center, there is nothing to do but monitor his breathing. I’m in the back with Noah Tyson, who watches as I match our patient’s respirations with a bag valve mask. Occasionally, he says, “Good. You’re doing good.” I’m not sure if he’s talking to me or to the patient.

His vitals are fine but we know they aren’t stable. We know we’re looking at a dying person, or at most a comatose one, but his body has yet to admit the obvious. When William hits a bump in the road, the trauma dressing slips from our patient’s forehead and a large geyser of blood gushes out of the exit wound. I yank my arms out of the way and slide my foot out from the new pool of blood. I have brain on my pant leg.

“Can you grab another dressing?” Tyson asks.

I watch as my right hand reaches for a new multi-trauma dressing from the top cabinet. My left continues to hold the mouthpiece in place. My body moves as though it belongs to someone else.

Tyson helps tape up the dressing and I resume the simple task of pushing oxygen into our patient’s lungs. I try to slow my own breathing even while I control his. It’s so strange to watch him. His body is warm and strong; he’s lying there oozing with life, impossibly alive. Somebody loves him. His mother, his girlfriend, his brother, his friend. Somebody thought he was invincible. He had thought he was invincible, clearly. The muscle memory in his body reeks of it.

The trauma team at Santa Monica meets us in the parking lot and we quickly rush him into a room. They draw a curtain around him, shouting to each other through their light blue masks as they work. They intubate him, pound on his chest, administer blood, fluids, drugs. He dies among the machinery. His vital signs don’t circle downward so much as plummet. Looking at him one last time, I see his body jostle limply on the bed from the team’s halfhearted resuscitation. All that yelling across his body; nothing anybody does seems related to him. Where is he in the midst of it? A John Doe dead. A policeman’s empty notebook page.

William doesn’t think he was worth saving. He tells me this in the parking lot while rolling a cigarette up and down two long, plump fingers. I see he hasn’t cleaned up the rig yet. A narrow waterfall of blood drips slowly through the perforated aluminum bumper and onto the asphalt.
Parked next to the rig, the gurney resembles a portable murder scene.

“It’s good,” William says, nodding. “He’ll be the perfect organ donor.”

Gangbangers are a cancer, he tells me. They should be rounded up in close quarters so as to more easily kill each other. As he talks I feel sick, but it’s not because of the slow drips of blood or the brain matter glued to my uniform. It’s because in this moment I hate my partner more than I’ve ever hated anybody, and we still have twelve hours together on this shift alone.

Dispatch gives us an hour at station to clean up and not take any calls. I take a shower and put on my clean extra uniform while William hoses down the rig. The two-car crew is gone, and the station feels cavernous as I listen to the sounds of running water out front. I use gloves to put my dirty uniform in a biohazard bag, not entirely sure how I will ever wear it again. Maybe I should help William scrub down the back, but instead I wander into the sleeping quarters. Muted sunlight diffuses through the blinds as I collapse onto one of the unmade twin beds. I start dreaming almost immediately.

My dream takes place in a clean white room: white walls, tile floor. John Doe lies on the floor, naked but all cleaned up—no sign of blood or brain or even the wound for that matter—and his skin and tattoos gleam in the light. His eyes closed, he’s not yet dead but not alive either, and whatever life exists in him is in the form of coiled-up, angry tension. Some part of him refuses to let go.

I get underneath him. Curled up in a ball, my head lowered, my breathing labored, I inch his torso into a sitting position by leaning my body weight into his back and pushing the ground away. It’s slow, meticulous work and he is unnaturally heavy. His arms hang loosely at his sides and his head tilts back, resting on my spine. His mouth is ajar and through the open channel of his throat comes a kind of smoke or light. Every time
I nudge him, his body relaxes a little more, and a little more of that strange substance slides out and escapes, curling up into the air around him.

That smoke, that light, is grateful to be going. It’s grateful to be going, and the more it leaves his body the lighter and more relaxed his body becomes. No tension, no ugliness, no holding on. Just a body on a tile floor, with smoke and light in the air around it, and me crouched underneath.

31

Maybe I’m too tired to be driving. But I seem to be doing fine. I watch myself from somewhere else, and the girl who resembles me drives my car without any apparent problems.

No sleep last night for Station 710. Phil and Steve had five calls after midnight; William and I had four. Each call took a little over an hour—if you do the math, that equals no sleep. Every time I closed my eyes, desperate to taste REM, the phone rang with another call. Two abdominal pains, one chest pain, and a legitimate car accident with three patients for us—the paperwork alone took over an hour—and meanwhile the two-car got a GSW at around 0300 that everyone assumes was the retaliation for our John Doe. Their victim was sixteen years old, shot once in the kneecap, twice in the chest. He didn’t make it either.

I pass Sustainable Living on my way home. There are barely any supermarkets in South Central. Only fast-food restaurants and roach coaches, as far as the eye can see. Ayla and I got back from Monterey just two days ago, but the trip feels like it happened to someone else.

“What’s wrong with you?” Ryan asks. He sounds like he’s eating something. I shift under the sheets to get a look at the clock on my bedside table; my
body feels at least a hundred pounds heavier than usual. It’s 1432.

“What’s wrong with
you
?” I say into my phone.

“No, seriously. You sound weird. What’s your deal?”

I groan out loud, because at Ryan’s words what sleep had solved returns with a fresh ache: I remember drips of blood and the boy’s swollen face; I recall the plastic bag, sitting in my trunk, holding a spattered uniform. “Nothing,” I tell him. “I saw a kid die yesterday. What are you eating?”

“What kid?”

“On the ambulance. Some gangbanger got shot in the head.”

There’s silence, more than I can handle, so again I ask him.

“A chicken shawarma gyro,” he answers absentmindedly. “Too much paprika, and the currants weren’t soaked long enough.”

More than anything in the world, what I want right now is to put my head in Ayla’s lap.

“When can I see you?”

“I’m fine, Ry.”

“Of course you are, you’re always fine. Do you want to come over here? Or we could go get a drink. Just don’t hole up and disappear.”