In Case of Emergency (29 page)

I get to Ayla’s studio, let myself in with the extra key found under the heavy wooden planter with the dead, dried-out rosemary, and slip into bed, waking her up. She starts to kiss me, half-awake, half-slumbering. I take her fingertips and guide them. “Show me,” I tell her, my voice in her hair. She doesn’t seem to understand and I start to move the hand under mine in small circles. “Show me, Ayla, I want to watch.”

Her breathing changes. Fingers move instinctually, eyes closed as if still dreaming. When I am so turned on I can’t stand it, I slip under the covers, slide down the length of the bed, and move her hand out of the way. I dip my head to take a drink. The taste is—always and impossibly—better than I remember.

I drink from her with my hands cupped under her hips, pulling her toward me. I drink from her like everything depends on it. The beauty in the sprawl of her naked body: the spill of dark hair against the pillow, the spiraling of legs, the grip of her hands on my shoulders, the twisting of the sheets.

I tease her slowly. I don’t come up for air. I know she’s shifted when her cries change pitch. Suddenly generous and full and savage, her moan travels from the base of her spine, reverberates through her body, and pours out from her open, arching mouth.

Only then do I stop, the last of that beautiful drink sliding down my
throat. I travel up the length of her, curious fingers tracing aftershocks, and we kiss, our breathing heavy. She wraps her arms around me and I tuck my face in the crook where her neck meets her shoulder. This is how we fall asleep: the sound of rain against her bungalow, my face nestled next to hers, her arms gently rocking me, our shudders subsiding.

43

You have billions of sensory neurons, transmitting signals throughout your body, and some of the most concentrated hot spots are your lips, face, neck, tongue, toes, hands, and ears.

There are twenty-five thousand nerve endings per square centimeter of the human hand.

You have ten thousand taste buds. And forty million smell receptors.

Depending on your physiology, less stereotypical areas might be more easily aroused: the inside of your elbow, the arch of your foot, the lining of your belly button. When the sensor-rich outermost layer of your skin gets grazed, kissed, licked, traced, suckled, squeezed, pinched, nibbled, or breathed on, neurons translate these signals into electro-physiological impulses, which result in neurotransmitter release.

Ode to dopamine. Seratonin. Nitric oxide and oxytocin. Ode to epinephrine and norepinephrine, to neurotransmitters and neuropeptides.

When you’re experiencing arousal, your body’s parasympathetic response, the feed-or-breed contingency in charge of smooth muscle contraction, gets activated. Your pulse slows, your face flushes, your groin swells, and you might even experience what experts call “involuntary vocalizations.” Meanwhile your bloodstream rushes to accommodate the oxygen needs of frenetic receptor cells and a chain reaction begins, sending clusters of neurotransmitters spinning from one excitable neuron to the next.

There comes a moment when you have to let go. You have to consciously allow your sympathetic response, that fight-or-flight instinct, to take over. Your body might not know whether it’s fighting or taking flight, but it does know to quicken the heart rate, dilate the pupils, and deepen the breathing. When you make the decision to lose control, your neurotransmitters trigger a cascade, releasing a flood of pent-up molecules free to dance on your brain for the seven or so seconds it takes to experience an orgasm.

As ecstatic contractions take over all sensation in your body, the primal voice inside you screaming for flight ceases, because it found euphoric release. Your brain also receives the message that you have beaten whatever it was you were fighting.

You won.

44

Waking up two minutes before my phone’s 0530 alarm, I turn it off and silently return it to the nightstand. When I roll back to Ayla’s shape next to me, I know my efforts were useless. She’s awake.

I snuggle into her. “What are you doing up so early?”

She absentmindedly rubs my hip. “I wanted to make sure I got to say goodbye.”

“Well, now you’ve said goodbye. Go back to sleep.”

“No, no, I’m up. I’m awake.”

“Ayla, your eyes are closed.”

“I’m awake,” she argues, but her eyes remain closed. I get up and get dressed, smiling in the dark, and then pause at the side of the bed.

She yanks me down on top of her. I win the short-lived wrestling match that follows because she’s still only half-awake. Pinning her hips with my
knees and trapping her forearms with my hands, I tell her, “I don’t want to go to work.”

“Call in sick. We’ll spend the day together.”

“I wish. What are you doing today?”

“I got a date with the submarine. And I might rock climb with Annie.”

Like always, when she mentions her hyperbaric oxygen therapy, I feel uneasy. I picture her in the claustrophobic metal chamber, lying perfectly still. I let go of her wrists and rest the side of my head on her chest, listening to her slow heartbeat.

She wraps her arms around me. “It’s safe, you know. FDA approved.”

I took Ayla to one of her treatments once. The technician invited me into the room, and I watched Ayla climb into the chamber and lie down. The technician lowered the heavy lid, sealing her inside, and adjusted the pressure settings. Ayla looked so alone and removed in there, so distant and alien, even though she’d waved cheerfully from one of the small round windows. I’d had to look away, and my palms hadn’t stopped sweating until we’d stepped out into the sunlight an hour later.

Ayla leans her head back to meet my eyes. “Babe, you all right?” she asks.

“I’m fine,” I say, forcing a smile. “Just don’t feel like going to work.”

She looks at me for a moment before replying. “Be safe today.”

I move toward the door, my bag weighing down my shoulder. After her session that day, I’d asked her, “What if there’s an earthquake?” She had stared at me, uncomprehending. “Who will let you out?” And she replied that hopefully no one would, at least not until the earthquake was over.

45

When the call comes in, William and I are at Jesse Owens Park because a group of men had flagged us down. We thought someone was hurt but it
turned out they just wanted their blood pressures taken. William scoffed at the request, but I jumped out before he could drive away and grabbed a cuff for him, a cuff for myself, and two pairs of ears. Seven men in their mid-forties, some who didn’t speak English, some who had clearly been drinking—or perhaps had never stopped—and all of them disheveled and friendly, not quite homeless but profoundly poor, who had probably given up looking for work in the Home Depot parking lot and had come here instead to enjoy the sky’s last streaks from a cloud-covered sunset.

When the call comes in, one of the drunk men is sticking out his tongue and saying, “Ah,” as if I can look at his throat like a doctor and tell him if he is healthy or not, and I am leaning away from the smell, trying to remember the last time I had any kind of checkup myself, had stuck out my tongue and said, “Ah,” or if that was even the kind of thing you did at checkups anymore.

When the call comes in, William is enjoying himself but pretending not to; he’s giving a man medical advice in broken Spanish, his ego swelling from the pleasure of being listened to so respectfully, even though as soon as we drive away he will probably say terrible things, since talking badly about people is what he does best.

But the call comes in, and the call changes everything in an instant, because the dispatcher’s voice is frantic through the slender black box of the walkie-talkie, resting on the bench seat near the sharps container. And a dispatcher’s voice is never frantic.

“You guys, get on air
now
. You got an MCI. Looks like a multiple stabbing on a bus. I’m sending it over.” There’s a pause in the transmission; already our pagers are vibrating, and in these few seconds between his voice initially breaking through the air and this pause, William and I dismiss the gloves, throw the equipment back, and jump into the cab without so much as a glance at the men we’re leaving behind.

* * *

William sits silently for a few minutes, and then starts his energetic drumming on the steering wheel again, presumably in time with the song in his head. We’ve turned the FM radio off while we wait for updates from dispatch. I look out the window, tapping the backs of my fingertips against the glass, in a rhythm of my own. MCI: multi-casualty incident. I’ve never had one before, unless you count the car accidents where more than one person is hurt. No one counts those. As we post at an intersection three blocks away from the location of the call, waiting for police to clear the scene and declare it safe, I read the page for the umpteenth time, fidgeting in my seat.

At Manchester Boulevard and Van Ness Avenue there is a public bus with several victims of a stabbing, the extent of their injuries unknown. That is all my pager can tell me, but I keep re-reading it as if it will suddenly offer something new. I can’t remember the rules of triage. The colors of the priority tags are black, red, yellow, and green, but what are the cutoff criteria for when you treat someone and when you don’t? All I can remember is that this is the hardest part, knowing who gets a black tag and who gets a red one. It shouldn’t matter in this case—we’ll have plenty of resources to treat both types of patients—but still. Is it that if the person has a pulse but isn’t breathing, you declare them dead and move on to the next? Or do you adjust the airway, give a breath, and then if nothing changes, place a black tag around their toe and move on?

A knock sounds on the driver’s side, and William rolls down his window. Tyson wears full turnouts, complete with a thick reflective jacket and a battered helmet. His usually relaxed face looks worried.

“You guys hear?” he asks. We shake our heads. “There’s a big pileup on the freeway. Everyone’s over there. And anyone who’s not is at the residential fire on the East Side.” He thumbs over his shoulder. “Right now we got the engine and the squad, so plus you guys that’s only nine of us. We’ve called for backup from Compton, but their nearest truck is half an hour out. A & O
is calling private ambulance companies to get another unit over here, but you know how that can be.” He scratches his jaw and takes a deep breath, his voice louder and more authoritative as he continues. “So listen up. Captain Greger is going to call the shots on this one. And I need you guys to really pay attention. We might have to improvise a bit. It is
not
your job to question how Greger decides to handle this call. It’s your job to move quickly, think clearly, and follow instructions. We are all going to have to be on our A-game.” He swivels his gaze from William to me. “Got it?”

“Yes, sir.”

William thrusts his chin in the direction of Van Ness Avenue. “Any idea what’s taking so long?”

“One of their own got shot a week ago, so my guess is the PD aren’t messing around on this one. They might be taking quick statements from everyone on board to make sure the stabber didn’t slip in with the other passengers.”

“Do you know which bus it is?” The question escapes before I can stop it. My temples are pounding. I still can’t remember who gets a black tag versus a red one—why didn’t I ask about that?

Tyson angles his head to get a better look at me, the front of his helmet almost touching the steering wheel. “You mean like which
line
it is?”

William snorts. “I’m sure the police will get right on that.”

“Did you want the specs of the bus, too?”

They continue in this manner while I smile at them, blushing, less bothered by their teasing than by a nagging fear I refuse to name.

The Metro bus looks like a beached whale that’s been washed up across two lanes of traffic, its glossy white skin reflecting the emergency lights. Captain Greger leads the nine of us past two officers directing traffic at the intersection, past the semicircular perimeter created by cop cars, past the
caution tape and the clump of stricken passengers. We’ve confirmed there are two patients, and as we climb on board, our team rushes to handle the bus driver at the front while Greger, Dag, and three other firefighters clamber to the back. As I climb the steps into the bus, carrying a jump bag that doesn’t feel adequate, my eyes meet those of the bus driver.

Every call I run, every patient I treat, every time my eyes meet those of someone who is sick or hurt or bleeding or dying, I have a moment where I can’t remember a goddamn thing.

I give the man a nod and unhook the bag from my shoulder.

He’s crumpled in the driver’s chair, but Tyson and William grab his armpits and lift him to a more accessible seat, and as the bus driver sinks his weight into it with a wince, I notice he’s favoring the left side of his body. The white hair bordering his temples bookends terrified eyes, a thin sheen of sweat coats his round face, and the gray flesh of his cheeks quivers with each terse breath. Crouching next to Tyson, I lift my glove and press the back of my hand into the bus driver’s forearm. “Cool, pale, diaphoretic,” I call out to the firefighter standing behind me, who is documenting everything on a clipboard, and I start to set up the oxygen tank and a mask.

Tyson reaches for the stethoscope around his neck and then thinks better of it. “Do you have pain anywhere?”