It was entirely too early for this kind of shit; normally he
would still be in bed right now. There was entirely too much noise and
light even for 8:15 AM, not to mention that there was in fact something
deeply disturbing about a cheapskate clown reminding him that cream
cheese was extra. Those fucking clowns were everywhere, pointing to signs
that told you all kinds of things. Cream cheese, butter, and coffee refills
were extra; swizzle sticks were in the main dining area, and, apparently
nobody's mother worked there so the cleaning would have to be done on one's
own. For Christ's sake, who the hell eats a bagel without cream cheese, and the entire point of coming here for breakfast was to avoid cleaning
up, right?
"What'll it be?" the counter man snapped.
"Two plain bagels toasted
with cream cheese and butter and a large coffee." Jake replied.
"Three bucks and a quarter."
He laid the limp bills on the counter while he fumbled
for some coin amongst all the crap in his pockets.
"Excuse me," a young woman asked, "What do you do that you need
scissors and a flashlight for?"
"I am an Paramedic." he hurriedly replied, as
he dropped two quarters on the counter.
"That's really cool! Do you like it?" she asked. "Not Really."
he said as he turned with his bagels and headed for a table. She followed
along like a puppy yapping at it's masters heels.
"Do you mind if I sit with you? I bet you have some stories to tell."
"No, I don't mind I guess;
and, that's why I really don't like being a Paramedic, I've got too many stories
that no one wants to hear." Jake said as he methodically laid out the bagels
and small cups of cream cheese on the table and began spreading the smooth
white cheese over the bagels, he stuffed the first bite into his mouth
and washed it down with a swig of coffee. The girl looked him up and down
like he was for sale or something.
"What?" He snapped "Have I got a big
booger hanging out of my nose or something ?"
"No." she giggled, "I was just looking for a name tag on your uniform. What is your name anyway?" She quizzed.
"It's Jake," He replied "And your's would be?"
"Jessica."
"Well Jessica if you will pardon me while I stuff my face, maybe
you could tell me a bit about yourself. I seem to be at a bit of a disadvantage
since you already know my name, what I do for a living, and where I work, and all I know about you is that your name is Jessica."
"Lets see, hmm, about me, well I am a student at Millsaps
majoring in theater and dance, I am 19, and I am from Jackson ; anything else you want to know?"
"Yeah, do you always give out so much personal information to
strangers? There are like a million psycho's in the world and most of them
are Paramedic's and cops."
"Never really thought about it, but I guess it's cause I like
to talk to people and they feel more at ease when they know a little about
you; anyway, it doesn't seem likely that a man who makes his living
helping people would hurt someone intentionally."
Jake ignored the quasi compliment and blurted, "So Have you lived here in Jackass all of your life?"
"What do you mean jackass?" She asked
"Oh, I'm sorry, its just my jab at this town, I really I hate the place, so I call it jackass, Mississippi instead of Jackson."
"I see," she giggled. "Where are you from?"
"I don't know really, I was born here in Jackass, I grew up in east Tennessee, moved back here, moved back to Tennessee, moved back here, went in the military, went all over hells creation, moved to Louisiana, now I am here again." he replied flippantly.
"What branch of the military were you in?" Jessica asked, her interest piqued.
"I enlisted in the Navy originally but since I was a hospital corpsman I had to transfer into the Marine Corps." Jake replied
"Oh man, what a bummer. The Marine Corps, no shit?" She asked
"Yep, no shit." Jake replied, lifting his sleeve to show her his eagle globe and anchor, with a slight variation.
"I don't think I have ever seen a tattoo like that. What is it?" She asked
"Well the regular jarheads have one but instead of the standard eagle, globe and anchor
I turned it into a caduceus, globe, and anchor. The anchor forms the staff the snakes are crawling up. Pretty neat huh?" He asked
"Well it's definitely different." she replied.
"So, what are you going to do with a degree in theatre and dance." Jake asked
"I plan to get a job with a New York Company and do musicals or
something." She replied.
"You're Kidding me right? You're going to school for four years
and going eighty thousand dollars in debt to do the Wizard of Oz thing and
break into song every so often between acting?"
"Not exactly, see that is a movie. I would do live performances
toot my own horn, but if you are really good then you get a scholarship."
"No shit?" Jake asked "No shit." She replied.
"You know Jake, you are the only person I have ever met who says no shit as much as I do." Jessica said. .
"No shit?" Jake smiled, he turned up the coffee cup and finished off it's contents, afterwards leaning back in the chair and rubbing his temples.
"Hey, I am going to get a refill, you want anything?"
"No, thanks I am OK" she yawned.
Jake rose from the chair and sauntered back to the counter to get a refill on the coffee. When he came back Jessica looked at him and asked,
"What is the worst thing that you have ever seen in your work Jake?".
"I don't really know, plus I don't think you would want to hear it anyway. I have seen a lot of awful things but I am not sure that I could pick out the worst." Jake replied softly.
"Well, give it a try I would love to hear about it." She pleaded
"Oh Jesus Christ, what kind of morbid little Wednesday Adams type wants to hear that kind of crap?" He replied in an exasperated tone.
" I don't know, I am just really curious." She said over her coffee.
"I don't really want to go into it, it's not pretty, or glamorous or anything like that it's just people getting fucked up all the time. People always think it's some exciting shit or another but it's really just a job, it's an endless cycle of tedium and terror. Everybody thinks that they want some, but they don't. Folks always look at me like I just climbed up onto a banquet table and took a shit right in the main course after I tell them something I have seen. " He sighed.
"Try me." She said coyly.
"Oh for fuck's sake, I'll start you out on a funny one. This guy gets stabbed by his wife so he's out there on the front porch with a knife hanging out of his chest and moaning. I had a guy with me who was doing clinical's, his name was Jim, so Jim walks up and pulls the knife out. This is something that you just don't do, if there is a foreign object in somebody you leave it there and let the surgeons deal with it. So, I crawled his ass like a cheap suit, I mean I cussed this fucker for thirty seconds solid. Do you know what he did then?" Jake asked with a smile.
"No, what did he do?" she asked
"He fucking put it back." Jake moaned
"OH MY GOD! You're shitting me!" Jessica giggled
"I shit you not. The sound that the dude made would have peeled paint. It amazed me that the fucker lived. So I just look at Jim with my mouth open for a minute and he says ‘I'll just go sit in the box' ‘You do that' I told him."
Jessica was still laughing, not just a giggle either, it had rose to a full belly laugh that shook her whole body. Her breasts shook, and her long, stringy, blonde hair made its way across her young, freckled face to the corner of her mouth and soaked up red lipstick like a sponge when she inhaled to produce the next round. Jake looked at her for a moment and felt a deep longing. He couldn't remember the last time he had laughed like that, the last time he had been without reserve. He was only twenty eight and felt ninety, he remembered being nineteen, but it wasn't like this. Nineteen was standing in a medevac chopper while Sergeant Phillips handed him his severed left arm with his right and told him to hold it while he got in the medevac.
"Look here," he blurted out, "it's been cool and all but I think maybe we should
get together another time to finish this up, I just came off of a 16 hour
run and I really need a power nap after that."
"OK, here's my number, call me anytime, if I am not there leave
a message. I am usually not far away, like doing laundry or in the commons
or something."
"Alright I'll give you a call sometime." he replied as he threw
the paper sack with all the breakfast remains in it away. Yeah right, thought
Jake to himself as he stuffed her phone number in his pocket, that's all
she needs is some cynical bastard like me to hang around with.
Jake sat down at the computer and looked at the blank white screen.
He began,
"Mrs. Egean,
it is my unfortunate duty to write you this letter; however, I would
expect the same from anyone in my situation. I am an Paramedic for Medstat EMS,
and I was your daughter's attending after her accident. When I arrived on
the scene of the wreck myself and another member of the rescue unit extricated
her from her vehicle. She was unconscious, and appeared to have lost consciousness
immediately on impact, owing to the severe head trauma that she suffered.
As soon as she was removed from her vehicle I strapped her to a backboard
and began assessing her condition. Her breathing was rapid, and shallow,
her pupils fixed and dilated, and her pulse weak. After I checked her blood
pressure I determined her to be in severe shock and placed MAST on her
to bring her out of shock and stabilize hip and femur fractures. At that time we arrived at The University medical center hospital. Shortly after her arrival she expired. I held her hand the entire time she was in my care. She never regained consciousness and never seemed to be in any amount of pain. I
am truly sorry that I was unsuccessful in my efforts and extend my deepest
sympathy to you and your family in your time of grief.
Sincerely,
Jacob Colton"
Jake wondered if his letters actually made a difference,
if maybe he would be like twice the crackpot he was now without having
written them. Shrinks, man what they don't come up with. Jake printed out
the letter and threw it in the trash with some mail and other sundries,
then walked to the bedroom and collapsed into bed.
The feel of cold clammy skin crept up Jake's arm into his head and neck and washed over him as a sickening wave of nausea when he grabbed Sgt. Phillips severed left arm. He sat up in bed covered in sweat and shaking. Jake leaned over and threw up in the trash can beside his bed. When he finished he turned on the lamp, got up and emptied the trash can into the toilet. Jake washed out his mouth and splashed some water on his face. When he looked in the mirror to see if anything was left on his face he scarcely recognized the man who looked back at him. Jake slumped against the cold tile wall of his bathroom and slid down like a man shot for some heinous crime. He wondered why these people tortured his sleep. Phillips, Izfeldt, Brian, and the myriad of others who looked him over with their eight ball hemorrhaged eyes, caressed him with their stumps, hobbled through his psyche like a mental plague. Many nights they assembled at the foot of his bed, dripping water on him, their singed flesh blowing across his sheets like crumpled black crepe paper, fragile and delicate, grisly in its beauty. Some nights the blood washed over him till he thought he would drown before he could open his eyes. Those were the nights that he sat bolt upright gasping for air.
When Jake woke up on the bathroom floor he felt like he had been run over by a truck, it was always like that. Jake fumbled in the closet for a clean uniform to put on. Jesus Christ he thought, would some fucking cotton uniforms be too much to ask for?
Polyester was a real bitch, scratchy and biting,
no matter how much fabric softener you put in the laundry. It was also
thin and porous, it gave new meaning to the phrase "gaps in it that you
could fart through.". Jake's dad used to say that a lot. Jake made his
way to the kitchen and poured a cup of coffee from his automatic coffee
maker and emptied the remainder into his thermos. As Jake sugared and creamed
his coffee he watched the squirrels play outside his kitchen window, the only window in the house that was not covered with tinfoil.
Jake pulled up the collar of his turnout coat and got into his
truck. All the way to work Jake thought about Jessica. Why on earth would anybody
that didn't have to see and hear the shit he was dreading right now want
to know about it? When he got to work he sat down in the lounge and poured his
first cup of coffee from the thermos he always carried.
"Hey Jake, you ready to ride?" quipped his partner, Scott.
"Ready as I'll ever be, Scott." he replied as he climbed into the waiting ambulance.
Jake and Scott were collectively known as Beavis and Butthead for their burlesque and
dark sense of humor.
"Scott, you ever tell anybody the stuff you see at work?" Jake asked as he fastened his seat belt.
"Not really man, for the most part every time I ever fucked up and said anything like to my wife or her family I regretted it."
"Yeah me too, I guess that's why I don't got a wife anymore,
she just fucking freaked out and shit. You would think I would have figured
it out sooner, but people just don't fucking want to hear it. This girl
cornered me in the bagel shop yesterday, acted like she wanted to hear
it, she don't want none."
"Hey dude, what you got cooking there huh?" Scott asked playfully.
"No man, it ain't like that slick, she's nineteen. I haven't had
to deal with nineteen year old girls since I was sixteen"
"I understand, dude. It ain't really what they make it out to
be anyway. Nineteen year old girls are like knick knacks, pretty to look
at but not real useful."
"What do you mean?" Jake asked.
"Well it's like this fella, you can't take them anywhere, cause
they are too young to drink, gamble, or hold a sensible conversation. They
just embarrass the shit out of you with their immaturity. You got to teach
them what you like in bed, and then they get all huffy about it if you
tell them they are doing it wrong."
"Yeah I suppose so."
The radio crackled to life, "Dispatch to 72". "This is 72, go ahead."
Jake transmitted.
"Your first customer tonight is going to be at 207 Lindsey Drive,
subject is 69 year old male, acute chest pains, possible cardiac, his wife
said he has been refusing to go to the hospital all night, base out."
"72 to dispatch we are en route, ETA approximately four minutes, 72 clear"
four minutes, four short, miserable minutes, sometimes it seemed
like a lifetime. For some people it was a lifetime, or at least all that
was left of their lifetime. Jake was pretty sure that some folks would
sell their souls to the devil for just four more minutes. Four more minutes
to reconcile some long held resentment. Four minutes to tell their wife
good bye. Four more minutes to hold their daughter one last time. Yes sir,
people lived and died in four minutes.
Jake walked into the house and went straight to his patient,
he was chalk white and sweating bullets. The dude had a roll of tums clenched
so tightly in his hands that his knuckles were even whiter.
"Hey man, what's your name?" Jake asked.
"Johnny" the man replied.
"Johnny, what seems to be the trouble, what's going on with you."
"Man, this god damn heart burn is killing me!"
Jake burst out laughing, "Yeah something's killing you all right but it's not heartburn. You are having a heart attack." Jake said as he and Scott hoisted the man onto a stretcher.
Jake started an I.V. and began administering meds to
his patient. Scott turned onto the highway, lights and sirens in full
swing.
`"Medstat 72 to university mednet."
"Mednet, go ahead."
"We are en route with a 69 year old male cardiac patient, patient is
stable and responsive. O2 at 15 liters via non-rebreather, bp was unobtainable by auscultation or palpation and no radial pulses present, Administered Epinephrine 1 mg via IV push followed by IV lidocaine 180 mg. ETA to your facility is seven minutes. Are there
any further questions at this time?" "What are the patient's initials?
"First initial J last initial S Medstat 72 clear."
Jake finished up a pretty bad shift, two more cardiac's, a
head on collision with two critical patients, two gunshot's, a knifing, and the regulars who were
just lonely. God if they could all be as easy as the regulars, just give'em
a shot of normal saline and be done with it. The long nights that never
seemed to end really wore on Jake, it would seem reasonable to think
that eventually folks would run out of telephone poles and trees
and so on to wrap their cars around, but they didn't. One would also think
that folks would get tired of killing each other, but they didn't, they
just couldn't seem to get enough of it.
Jake wondered why he had ever thought cable TV was a good idea.
There was never anything but infomercials on when he got home. Spray on
hair, make a million from your tiny one bedroom apartment, the pocket fisherman,
it was an endless parade of the ludicrous, the asinine, and the downright
useless. Every now and again he would watch some paramedic show or 911 wannabe and take mental notes of the mistakes they made. He wished desperately that he could just come home and melt into the bed like everyone thought he should be able to do. Once his mother
called him at 8:30, and was amazed that he hadn't been asleep for seven
or so hours at that point. Folks didn't seem to understand that it just
isn't possible to go home from scraping people off of the pavement and
jump right into a rock solid snooze.
Jake went to the bathroom and ran a bath. When the tub had filled he reached under the sink and poured in the better part of a gallon of bleach, none of that pansy lemon scented shit, but the hard stuff, the ninety nine cents at the dollar store stuff. He climbed into the bleach bath and began to scrub. He felt the bleach, hot and slippery on his skin, bleach was a killer, and purifier, they used it to decontaminate the ambulances, to kill the pathogens that threatened him and the next patient. It also killed the smell, the taint of death that seemed to linger eternally. He always liked a bleach bath after he finished a hard shift. It felt kind of like he could wash away all of the hurt, misery, and sickness that stained him after a full eight hours of life in the streets of Jackass Mississippi. Once he scrubbed his head nearly bald after a dude projectile vomited on him. There really was no substance quite like vomit, sticky and smelly, with a biting feel on the skin. Nothing else felt that bad, over the years Jake had been bled on, pissed on, shit on, and just about anything else you could think of but vomit was definitely the worst. Jake stepped out of the bathtub onto the cool tile floor and dried himself off. He went straight away to his room and collapsed into the bed for a night of solid sleep. Tomorrow being his day off he could sleep to his heart's content if he wanted.
Chapter Two
Jake woke up at 2:30 and thought seriously about just rolling over and going back to sleep, but he didn't. He reached into his closet to get a pair of jeans and a T-shirt. After he got dressed he checked the mail and went to the bagel shop for breakfast.
The bagel shop was better than the waffle house; what the concept, twenty four hours a day you could get a bagel and coffee. They had like twenty kinds of cream cheese, and about as many kinds of bagels, Jake still liked the plain best, even though he had an egg bagel now and again. Jake had never eaten a bagel until two years previous when he had a Jewish room mate. There was nothing on earth better than a toasted bagel with cream cheese and lox. They didn't have single serving lox at the bagel shop, you had to buy it by weight, and it was expensive. Jake ordered his usual two toasted plain bagels with cream cheese and headed for a table. Jake sat down and began spreading the cream cheese on his bagels, he was about to take a bite when he felt someone's hand on his shoulder. Jake jumped and nearly dropped his bagel.
"Jesus Christ, don't do that!" He snapped at Jessica "Where did you come from anyway?"
"Well Jake, it's like this, when a man and woman love each other very much..." She sarcastically replied.
"Ok wise ass, I didn't mean originally." He retorted.
"I missed lunch at the commons and decided I would grab a bite to eat here" Jessica said. "Anyway how are you?"
"I guess I'll do, I finally got some sleep for a change." he replied
"Do you always work double shifts?" She asked.
"No, just when I get my ass in a crack for money, see if you work just one double a week, that's almost like working a whole week more at the end of the month when you get paid." Jake chirped. Jake took a deep draught off of the coffee and grimaced. Sometimes Jake needed it so bad that he wished he could do it intravenously. "So, how is the dance world treating you?" Jake asked.
"To be honest, I don't dance much these days. I am a freshman so I am still taking a lot of core stuff." She sighed as she leaned back in her chair and sipped her ice mocha.
"God I hated core, I don't guess I will ever have a degree because of it." He bitched
"That's a pretty neat trick there, being a paramedic without finishing a degree. How did you pull that off?" she asked suspiciously.
"I got a paramedics license because I was a navy corpsman. Some states only give you a EMT certification, but, Mississippi, Louisiana, and some others give you a paramedics license." Jake replied
"I am curious. If Louisiana will give you a paramedics license, just like Mississippi, and you hate Mississippi so bad that you call Jackson Jackass; why aren't you still in Louisiana?" She asked while she stared at the caduceus on his arm.
"I got in a little trouble in Louisiana, so I had to leave. It's kind of a long story"
"I got plenty of time" She replied
"I was working at this little ambulance company in Angola, Louisiana", "Where the prison is?", Jessica interrupted. "Yes, where the prison is. Anyway, it was this little shit hole ambulance company in a shit hole town. The job market was so tight that everybody started as an EMT A, which is basically just the guy who carries the paramedic's shit, and worked their way up to a paramedics position. As you might guess, they don't pay folks that carry the paramedic's shit very much. So one day this corrections officer comes in and offers anybody that wants to be on an execution committee four hundred bucks."
"What the hell is an execution committee?" Jessica asked
"Well, therein lies the rub. See, an execution committee is really just nine hired killers. They got these three chemicals that they inject the guy with to kill him. The first is a barbiturate that puts him to sleep. The second is pancuronium bromide, a paralytic agent that stops his breathing, and the third is a big fucking load of potassium chloride to stop his heart. So you got nine guys in all cause they don't want you to know which dude gave the guy the load. So two guys out of each group of three have saline in their syringe and the last has the real McCoy." Jake paused for a sip of coffee.
"Why don't they use a machine to do it?" Jessica asked
"Because it requires the human touch, a machine can't feel the back pressure on the vein and adjust the injection rate accordingly." Jake continued "Well, this jerkoff comes to me with it and I punched him in the fucking face."
"Yeah, baby! That's how to win friends and influence people. Punch them in the fucking face!" Jessica giggled
"No" Jake corrected "That's how you lose your paramedics license"
"Why the hell did you hit him in the face like that?" Jessica asked
"Several reasons. Number one, I hate fucking cops. Number two, I was just fucking insulted by even being approached for such shit as that. It's a fundamental contradiction to my profession and my ethics."
" So what did they do about you?" asked Jessica
"Oh, the usual." Jake replied "You know, industrial strength ass beatings, criminal assault charges, constant harassment."
"Man, how did you get out of that without going to jail?" Jessica asked
"I had this attorney who sent me to see a shrink. He said that I had post traumatic stress disorder, and that I was 5150, a danger to myself, as well as my patients. So I got away with it as far as legal shit goes but I had to see a shrink for anger management therapy for a while." Jake sighed. It was times like this that he wished he still smoked so that he could fire one up to break the silence.
"How did you get your license back?" Jessica asked
"I moved to Mississippi, convinced another shrink that I was all better and could go back to work." Jake said in between sips of coffee.
" Did you really have PTSD? Or was it something to get out of a charge?"
"I don't know if I did or not." He replied "But if I did then he couldn't have helped much. He kept telling me to write letters to the families of all the ones I lost, but not send them. He said to tell them all the things I did, anything the person said, whether or not they suffered, all kinds of crazy shit. He said that it relieved me of my part in it, showed me that I had done all I could." Jessica interrupted "Does it help?" "I don't know, I don't usually take it too hard when somebody croaks on me, unless it's a kid or something." Jake wiped the sweat from his forehead and palms with a handkerchief and put it back in his pocket.
"How many have you lost in your day?" Jessica asked
Jake leaned back in his chair, and thought for a minute. "Couple hundred I would guess, I can't say that I know for sure."
"No shit," Jessica interjected. "You mean to tell me that you are the last man that two hundred people have shared their last moments in this world with?"
"No shit" Jake sighed. He thought about all of the people who had pleaded with him to pass some message, the one who had grabbed him so hard that he left a hand shaped bruise on his arm for a week, and demanded that he tell his daughter that he did not really mean what he had last said.
"Man that is some heavy shit to carry around." Jessica blurted
"Yeah, it is. Sometimes it's too heavy." Jake replied
"You said that the only ones that ever bothered you were like kids and stuff, what all have you seen happen to kids?" She asked
" All kinds of things, they get run over, thrown out of cars, shot, the same stuff that happens to adults. It's just worse in a way, because they do dangerous shit without thinking." Jake said in a tired kind of way. He felt like someone had threaded string up his ass and was pulling it out of his mouth with a pair of kelly forceps.
"How so?" Jessica asked
"Well, like this one kid who was riding around with his buddies blowing up mailboxes with M-80's. The kid in the back of the truck was putting an M-80 in every mailbox that they stopped at and the truck stalled. When the M-80 went off, instead of being shag ass gone he was right there and a piece of metal from the mailbox hit him in the carotid artery. The driver of the truck flagged us down and told us what happened, but the other kid had already bled to death by that time. Just weird shit like that, something that probably thousands of kids have done, but not died doing." Jake took another monster gulp of coffee.
"Hey, I told you I could deal with your stories" Jessica blurted at Jake.
"Yeah but they get worse." He replied
"How much worse, I mean anything has limits. Right?" She asked
Jake took a deep breath and leaned forward. He was right up in her face when he said, "Well lets just say that I do this job everyday, I have been doing it every day for going on twelve years now and I still see something every now and again that gives me the willies." He said.
Jessica took a long draw off of her mocha and leaned forward until her nose was an inch from Jake's and said, "Lay the worst one you've got on me."
Jake thought for a moment and began,
"When I was volunteering for a small fire department in Harrisville, I was called to an accident scene. Me and two other guys get there about the same time and see a jeep wrangler overturned in the middle of the road. The driver was pinched between the roll bar and the pavement with his guts coming out of his mouth. I figure, no problem, throw the bags under the jeep to get it off of him and call the coroner to pick up the body. End of story, right?" Jessica nodded her agreement. "Not by a long shot, the captain pulls up and asks us where the girl was. We got no clue there even was a passenger, much less where she was. They start a search party and we start looking for her. We find where she landed in this field next to the road, and a set of footprints down an embankment and into a stream. The whole department looked for her for over two and a half hours. I finally found her in a pile of limbs and twigs and stuff. She survived the wreck and fell into the creek and drowned. What a bitch huh?" Jake asked.
"Jesus Christ, what the fuck did you do then? I mean like how the hell do you take care of that? She exclaimed.
"You call the coroner, tell them where to come and get the bodies, he pronounces them dead, takes them to the morgue, and you move on to the next call. Jake replied, thinking back to the bank. Thinking back to how he had sat on the creek bank for what seemed like an eternity and wept before he ever told anyone he had found her. He still remembered how her pink sweater looked like some kind of trash or something sticking up out of the water, how leaves and twigs had partially hidden her body. Jake didn't remember what color her eyes were, but he remembered closing them for her. No matter who or what they were, Jake always closed their eyes, it was the last human decency you could show.
"Do you do that shit all night long every night?" She asked, jarring him from his recollection.
"Not usually, it's pretty routine. My Partner Likes to call it periods of tedium interrupted by sheer horror. I mean you have your regulars that there isn't really anything wrong with them, they just get lonely. Then you get a lot of routine stuff like fights, falls, or dopeheads. It's the same old shit most all the time.
"Damn, that's rough though, I guess, when you get the occasional bad one like the girl." Jessica commented.
"It's always rough, some nights it's just rougher than others. See, you always remember the bad ones. If you hear a call like one of them you silently pray that it's not as bad. You see your partner doing it too, and the two of you start with the do you remember... routine, and its always the same. ‘Yeah I remember yada, yada, yada. Do you remember such and such? Before you know it, you might as well be there again."Jake said as he began wadding up the paper napkins and throwing them in the bag that had held the bagels.
"Hey Jake, are you working tomorrow night?" Jessica asked as he stood to throw away his garbage.
"Yeah, I only got one day off this week." He moaned
"Can I come with you?" She asked with a sly smile.
"What the hell do you mean can you come with me?" He asked incredulously "And what the hell for anyway?"
"Can you keep a secret?" She asked
"Jessica, what the hell is all of this about?" He asked, still puzzled by her request.
"I always wanted to be a paramedic, but my parents wouldn't let me. I want to ride with you like they do on those TV shows." She told him with a wink.
"First off, that's the bullies in blue, not paramedics. Second, you have to get permission from the ambulance company, not me." He said doubtfully
"What ambulance company do you work for?"
"Medstat." Jake replied
"How about this?" She asked "I call the ambulance company and ask them for permission, and you call me and ask me how it went this evening."
"OK" said Jake, pretty certain that it would never happen.
Chapter Three
Jake picked up his turnout coat and headed for the door with his thermos. He couldn't believe that Jessica had talked him or the ambulance company into riding with him tonight. He jumped into his truck to pick her up, he had worked the whole town over the years but hadn't been on the Millsaps campus since the Jackass city police beat a student to death several years back. Jake pulled up to the security gate and stopped. A Millsaps security guard approached the vehicle and handed Jake a clipboard to sign in on. Jake recognized the guard. It was Jack Willingham.
When he got to the dorm Jessica came down to the lobby in some sweats with her hair up in a ponytail, and carrying a water bottle. She looked like she was going for a jog or something.
"You ready to ride Jessica?" Jake asked with a smile.
"More than ready." She replied
She stepped into Jake's truck and slammed the door.
"Christ it's cold in here." She exclaimed
"You want to wear my turnout coat?" Jake asked as he extended the coat that read "Northwest Rankin VFD" on the back. "No heater in here, it went out like three times so I just said fuck it and carry my turnout coat with me all the time." He said as he pulled out of the dorm parking lot. Jake was headed south on State street towards Medstat. Jessica took the coat and slid it on her slight frame.
"Man, this coat has seen better days." Jessica exclaimed as she rolled up the sleeves on Jake's turnout coat.
"Yeah, I've had it a long time. Listen, I gotta talk to you about some stuff. I think its great that you are going to be riding tonight, but you have to stay out of the way. You should probably stay in the box when we're on the calls and so on." Jake said.
"OK, that's cool. I really appreciate you doing this for me." Jessica smiled
"I didn't do it, it's all Ron and Medstat that did this."Jake replied
"Oh come on, you could say no, and nobody else would let me." Jessica said
"I want to know something though. What is your fascination with this mess? Why on earth would you secretly want to be a paramedic." Jake asked
"I haven't seen a man in pieces, or carried a dead kid; but, I have my own bruises and scars. I watched my grandmother die when I was twelve. She had a stroke, and I stood there. I couldn't do shit. I had no idea what was wrong or how to take care of it." Jessica dropped her head and wiped her tears on the sleeve of the turnout coat.
"I'm sorry." Jake said sheepishly. "I had no idea. Sometimes I'm kind of hard on folks." He continued, "To put your mind at ease, there isn't much you can do for a stroke other than get them to the hospital."
Jessica looked at him with an incredulous expression. "Really, no super medic shit or anything?"
"Not really." Jake replied.
Jake and Jessica rode the rest of the way to medstat without a word. Jake thought about his own motive for being a paramedic. He thought about the summer that Brian died. He and Jake had walked down the tracks to the river. When Brian fell off of the trestle, Jake had been helpless. If he jumped in after him, he would have shared in his fate, to walk down he would have to backtrack a half mile or more. He had just as well to keep going another 50 yards to help and a phone rather than try to hike back down the riverbank over rough terrain for half a mile. The river never gave up Brian's body, Jake still dreamed that he was alive, he had no proof otherwise. Without a body he told himself, Brian could still be alive. He joined the volunteer fire and rescue squad that fall. Jake had never been normal, never been a teenager. Since he was 16 he had lived in trauma, walked among the dead, and slept in fits.
Scott bounded into the lounge at medstat and sat down across the table from Jessica.
"I'm Scott, Jake's partner." He said sticking his hand out for Jessica.
"I'm Jessica" She said shaking his hand
"So, what brings you to the glamorous world of emergency medicine?" Scott asked
"I'm just curious." She replied as she read over the confidentiality agreement and signed it in the different places. What you see... blah blah blah, who you see blah blah blah. It was pure silliness. Like anybody would give a shit who got splattered across the highway.
"Let's ride Scott. I got the truck stocked." Jake yelled into the lounge
"What are we running tonight Jake?" Scott asked.
"ALS my boy, ALS, I want to show our guest a good time, break her in and all." Jake laughed as he gave Jessica an arm up into the box.
"Thanks Jake." She replied "I mean that, really." she said seriously. "What does ALS mean anyway?" She asked as she sat down on the bench.
"Advanced Life Support" Jake replied "We're on the front lines, in the trenches, all that happy horseshit." He continued.
"So what do we do now?" she asked as Scott pulled out onto Gallatin street.
"Sit back and enjoy the ride." Jake replied as he opened the window between the front and back. "Hey Scott, sling us some tunes" He said as the radio came to life.
"Dispatch to medstat 72"
"Motherfucker, we can't even make it to the light before we get tagged." Scott said as he picked up the mike. "72, go ahead dispatch."
"1125 Ellis avenue, two gunshots." The dispatcher said.
"We are en route ETA approximately three minutes" Scott said as he turned on the lights and sirens and stepped on the gas. Scott swung a wide u-turn in the middle of the road and turned toward West Pascagoula St., whizzing through the light on Pearl street and turning off of Terry road onto Lynch street he saw the first blue lights. Scott blasted the airhorn a few times and shot straight through the line of police officers and reporters on the scene already. He came to a screeching halt as Jake threw the doors open and ran into the house, Scott followed carrying the jump bag.
"Choose your man!" Jake yelled as he broke the threshold and headed toward a young man laying supine on the living room floor. He knelt next to him. When Jake cut his shirt off he saw two entrance wounds in his chest. "What's your name man?" he asked as the man looked up at him
"Andrew" He gasped with red froth at the corners of his mouth.
"Andrew we're gonna fix you up." He said Jake began his assessment. Andrew's trachea was deviated to one side and his Jugular veins stood up like garden hoses "Scott, get me the tube kit, and some oxygen."
"Got my hands full here buddy." Scott blurted as he looked up from the corner.
Jake ran to the bus to get a suction pump, the tube kit, and oxygen. Jessica sat on the bench while Jake fumbled for the stuff he needed. When Jake came back he went to his patient, prepped him with Iodine, and gave him a local in preparation for a needle decompression. Decompression was the first line treatment for a tension hemo-pneumothorax. Jake inserted the needle between into the second intercostal space mid-clavicular. Air hissed out of the opening and sprayed blood for a moment and then the blood became a trickle.
Two detectives walked into the house and approached Jake and Scott.
"We really need you guys to be careful what you leave here on the floor, we haven't had any techs come in to look over the crime scene yet." The biggest one said.
"Fellow, I don't give a fuck what you have or haven't done yet. I'm trying to save this guy's life." Jake spat out venomously.
"Well, you fucking need to, this guy wants to get justice." He replied.
"Andrew, you want life or justice?" Jake asked his patient.
Andrew mouthed the word, "Life."
"There you go." Jake replied.
"I know who did this to me." Andrew wheezed.
The detectives stormed over to the side of Jake's patient with a barrage of questions.
"God damn it, get the fuck away from him!" Jake screamed as he continued taping up the tubes and running IV lines.
Jake took a pad from his kit bag "Andrew, write down the guy's name that did this to you on this pad." He said as he gave the detectives a look that would melt lead.
Just then two more paramedics entered the living room.
"What you got Jake?"
"A lot of work, Tim. This one here has two to the chest, Scott's has four to the abdomen, nine millimeter or better." Jake said. Jake and Tim lifted Andrew onto the stretcher, raised it, and raced to the waiting ambulance. Jake hooked up the oxygen to the main supply and attached a BVM. He began bagging his patient as Tim took the wheel and was speeding toward Methodist medical center.
"Medstat 72 to Methodist mednet" Tim said into the radio.
"Methodist mednet, go ahead." They replied
"We are en route with a 19 year old male, approximately 165 pounds, displaying signs of severe hypovolemic shock. Primary injury, two gunshot wounds to the chest, no exit. Currently administering O2 20 liters per minute via BVM, lactated ringers at 3 liters per hour. Respiration is shallow and rapid, approximately 22 respirations per minute, pulse 140 beats per minute at the carotid, and a bp unobtainable by either auscultation or palpation. Patients initials are AC and ETA to your facility is under two minutes. This is a trauma alert, we are requesting that the trauma team meet us in the bay. Are there any questions at this time?"
"No questions at this time. Methodist clear."
Tim blasted the airhorn in long blasts as they sped through red lights. Jessica sat on the bench and watched as Jake wrapped his blood pressure cuff around the IV bag and pumped it up tight to force fluids into his patient. Jessica saw the marks of time on Jake's hands. The scars, the embedded glass fragments, the deep lines in his knuckles, the black and broken nail on his left hand, under the translucent, white, latex glove with "Andrew" written on the back. His deft, knowing, manner of handling the syringes, tubing, and other tools of his trade made it look as though anyone could do this, as if he had been born with this skill.
The monitor suddenly began screaming with an immediate urgency. Jake looked at the flat line for a moment and started smacking Andrew on the face.
"Andy! Come on buddy, hold on." Jake alternated between the resuscitator bag and chest compressions. " Jessica, do you think you can bag this guy?" Jake asked as he turned and screamed, "Tim, step on it, we're losing him.". Jessica took the bag in her delicate gloved hands and began bagging him as Jake had shown her. Andrew started twitching and heaving, his lips sounding like a kindergartner's imitation of a gross fart as he blew out the vomit that spewed from his mouth in an arc. "Don't let a little barf slow you down, Jess, just wait until I suction him and keep right on bagging him, but try not to bag him while I'm doing compressions, it keeps the air out of his stomach." Jake yelled as he pushed in on Andrew's cricoid cartilage, and measured the yankauer tip for suctioning.
"Andrew, were gonna play a game, it's called Jake says. You play it just like Simon says only it's Jake says." Jake said as he cleared Andrew's mouth and throat with suction. "Jake says that you are going to stabilize, do it now." He said as the ambulance stopped in the unloading area at Methodist Medical center. Jake threw open the back doors as Tim unlocked the stretcher and pulled it to him dropping the wheels as it cleared the doorway. Tim and Jake wheeled Andrew to the waiting surgical team. An orderly approached Jake with some forms to release his patient. Jake sat down and wiped the sweat off of his face with a big red handkerchief. He signed the forms and returned them to the orderly just in time for Scott to roll up and nearly deafen him with the siren that he had forgotten to turn off.
Jake walked to the box, sat down, and waited for Scott to finish with his patient and return to the unit.
"That's fucking tough." Jessica said as Jake sat down and laid his head back, panting, against the side of the box.
"Yeah, it is." He replied as he removed the gloves from his hands and threw them on the floor of his unit. The sweat puddled in the folds of the discarded, bloodstained, latex glove.
Chapter four
"You got to be fucking kidding me." Jake said incredulously.
Exactly where the fuck do you get off dumping your shit on me like this?"
"Jake, I just..." Jake cut her off immediately.
"No! I mean really. You put me through hell for two years running to your mother's every time I got a shift you didn't like. You don't want to hear MY SHIT! You put me on the fucking scene!" Jaked raged.
"No, Jake I didn't know..." She started.
"BULLSHIT! You fucking know where I work, when I work, my area, every god damned thing about me, you fucking sick bitch. You had to go and run yourself into a truck in my god damned call area. I pry your ass out of your car, I sit around helping you learn to eat again, walk again, fucking comb your hair, then you have the unmitigated fucking gall to leave me, because you can't deal with "my shit".
"Jake, when I had the accident, I steered into that truck because I couldn't come back, and I couldn't stay away. I drove that road cursing myself and swearing I would never come back, while I was driving over here. It was the only way I knew that I would never come back to you." She wept.
He couldn't believe this shit. If he hadn't known Dianne before he would just think she was a little odd. It had been five years since her "accident" and the rehab went well. Still though, how could she call him up and lay this shit on him.
It was just like they were still married, she wanted him to take the blame for all of her shit. Jake grew more and more infuriated as he replayed the scenes in his mind. "Jake, not at the table. Jake, I don't want to hear it. Jake I'm trying to sleep." Never mind that he had to wash up and eat right after he just trucked some dead fucker to the morgue. He never stopped hearing the screams that ended his sleep. What's more, he never forgot the feeling in his stomach when he cut open the car he didn't recognize and saw a woman he did. He could still feel the softness, like a cottonball, of her head in his hands as he placed the c-collar. She had an eggshell fracture of the skull. There was never any appropriate time to tell her what ate at his soul but she constantly dumped her shit on him.
"Jake? are you still there?" She asked.
"Yeah I'm still here, but only to tell you to go fuck yourself!" He said as he slammed the receiver down on the cradle. Jake looked around in the kitchen for something, but all of the leftovers in his fridge were growing hair. He wondered why he bothered to ever put anything away, he never went back for it. "I guess it's better than stinking the place up with the trash can full of leftovers." he said to no one.
Jake went to his bedroom and hunted through the change and assorted pocket litter on his dresser for Jessica's phone number.
He fumed silently about Dianne calling him, he blocked the number she had called from and hung up, then he dialed Jessica's dorm. The phone rang three times before anyone picked up.
"Hello." Jessica said into the receiver.
"Hey Jess, Its Jake." He replied.
"Hey Jake, what's up?"
"Oh not much, just don't feel much like sticking around here, and I wanted to grab a bite to eat. I have kind of gotten partial to company when I eat lately." He said.
"Are you asking me on a date Jake?" She asked coyly.
"If you can call watching me stuff my face a date I guess so. Can you meet me at Punchy's?" He asked
" I don't know Punchy's. Anyway my room mate is using my car right now, can you come get me?"
"Yeah, sure. Same place as last time?" He asked.
"Ok see you in a few." She said as she hung up.
Jake threw on his turnout coat and got in his truck. When he approached the security gate at Millsaps he saw Willingham at the gate again. It was amazing that he could work at all in this town anymore, much less at Millsaps.
"I need a visitors pass please." He said as he rolled his window down.
"Hey Jake, saved any scumbags lately?" Jack said as he handed him the visitors pass.
"You know it, Jack. Beat any students to death lately?" He asked as he placed the pass over his rear view mirror.
" That's low Colton" Jack said as Jake pulled away.
But it's true thought Jake as he parked in front of the dorm. Jessica was waiting out front, and got into Jake's truck.
"Hey there." she said as she shut the door.
"Hey Jess, how it going." he asked.
"Great, what's this Punchy's Place?"
"It's a steak house, but they got gumbo and other stuff too." He said as he pulled away.
"Uh, I'm not much of a steak eater." she said uneasily.
"Well, okay, you pick this time I'll pick next time." He bargained.
"How about the deli up the street, they have really good sandwiches."
"Alright, gimme directions." As he passed the gatehouse Willingham gave him a look that would freeze water.
"What's up with you and the security guard?" Jessica asked.
"It goes back a while, he beat a Millsap's student to death about three years ago and tried to keep me from treating him. He would have probably died anyway, but it really pissed me off that he let him lay in the middle of the street screaming for ten minutes after the accident. Then the bastard had the gall to beat his ass for cussing him after he dragged him across glass and metal when he pulled him out of the road."
"No he did not! You're shitting me." Jessica exclaimed
"Yeah, he did." Jake replied
"Why did the college keep him as a security guard after that?"
"Cause he was a Jackass city cop when he did that, and everybody kind of figured that the kid died mostly from the accident. JPD allowed him to resign." Jake fumed.
"You have to turn right at the light on State st. Jake. You can't miss the deli, its on the next corner."
"Okay, I am really hungry, I haven't eaten all day." Jake said as they turned into the parking lot.
"How come?" Jessica asked as she walked through the open door that Jake held for her.
"I Just haven't had the chance." Jake replied.
"You want a table or a booth Jess?" Jake asked
"Lets sit at a booth" She replied.
"Booth it is." Jake said as he sat down in the nearest booth.
"Jake, do you know what happened to the guy the other night?" Jessica asked as she looked over the menu.
"He died." Jake flatly replied.
"No shit, we gave him cpr and everything. How come he didn't make it?" She asked in a surprised kind of way.
"Because he bled to death. He lost most of his blood volume, went into shock, and died." Jake answered. "It's not like on TV, people who flatline on you rarely come back. They got an abbreviation for it, FDSS, or found dead stayed same." He continued.
"I would have thought that to vomit you would have to be alive." Jessica retorted.
"No, not really he turned into a fountain because we pumped a bunch of air into his stomach.
That's the problem with one man cpr, it works but not perfectly. That's why I had you bag him after he barfed, I needed to do the sellicks maneuver while you bagged him and then do compressions."
A waiter came and dropped a menu on the table in front of Jake and then Jessica.
"What can I get you to drink?" She asked with her pad ready.
"Sweet tea." Jake replied.
"And for the lady?" She asked
"Sweet tea also." Jessica replied.
"Be right back with your drinks." She said as she left.
"So tell me Jake, when do they come back. I mean you hear about it a lot." She asked.
"Cold water drowning's, cardiac arrest subsequent to respiratory difficulty in children, and pulseless V-tach., that's just about it." Jake said as the waitress returned with their drinks.
"Have you decided yet?" She asked as she placed the drinks on the table.
"I think I will have the roast beef with gravy. Let me get a cup of the soup of the day on the side." Jake said.
"Yeah, I am going to have the turkey club on wheat bread." Jessica said as the waitress picked up the menu's and left.
"So, what you were saying is that there are not that many people who come back through death's door. Right?" Jessica asked.
"Pretty much. I have been doing this a long time and I can't say that I have more than three bona fide saves." Jake replied as he spit a chunk of ice back into his tea.
"Wow, that's hard to believe. Especially when you see all of the TV show's and hear all of the stories." She replied.
"That is where most people get this odd hero worship shit that they dump on us. They think that we run from one job to another saving people and all. You saw just a small part of what really happens the other night. It isn't even usually like that. There is a hell of a lot of bullshit, and run of the mill stuff in between the ones like that." Jake said.
"I can't really explain it, but I have never felt so aware as I did that night. The siren was screaming and my heart was about to beat out of my chest. The adrenaline ran through me like a river, I can't imagine what it would be like to actually do the things that you were doing. I just watched and all I could think about was how many people would go to their grave and never see what I have seen. It was neat." Jessica beamed.
"Hold on there Ricky." Jake exclaimed.
"Huh? Ricky?" She asked in a puzzled way.
"Yeah, Ricky, as in Ricky Rescue. You got a bad case of it. I see them all the time, they get their patch and come on the ambulances, and every five minutes they say something about how quiet it is. They carry more shit on their belt than batman, everything they own has a star of life on it, and it just goes on and on. They squirrel calls away from other medic units, cause they want to run the bad ones. Don't get caught up in this shit." Jake sighed and took a drink of tea.
"No, really it isn't like that with me Jake. It's not that I want all of that stuff that you are talking about. I have rode with you for five nights now and I feel like I am meant for something more than dancing. I feel like there is something better that I could be doing when I dance. I feel empty. When I was riding with you, I felt alive, like I was stepping into what had been waiting for me all of my life." Jessica said as the waitress returned with their order.
"I'm just saying don't get caught up in this. It's nasty, and it can swallow you. I know that you are excited about it, I was too once, but don't let a romanticized idea of what this is lure you into the dark." Jake said in between bites "Besides, you got something going already, you haven't got shit going in emergency medicine."
Jessica picked up her sandwich and took a bite. After she washed it down with a swig of tea she looked at Jake and said, "I called the health council today. They have an EMT class starting in January. I think I am going to register for it."
"You got to be shitting me." Jake said incredulously. "You have a scholarship to one of the most prestigious colleges in the southeast, you seem to like what you are studying, and you have dreams of going to New York. All of that and you want to come play in the dark, what the hell for?"
"It's not me Jake. It's my parents. I liked dancing when I was a kid and suddenly they had me in every competition and show on the gulf coast. I never wanted to go this far with it." She said.
"But you always wanted to be an EMT?" Jake said, still flabbergasted.
"I can't say that I always wanted to be an EMT, but I have always admired them. When I was little the church I went to always had this part where the priest did a special prayer for the safety of rescue workers and police officers. I thought that it was really cool. The paramedics that came and took my grandmother to the hospital were gentle and kind, I never forgot that."
"How are you going to do school and EMT class at the same time." Jake asked
"I am pretty sure that I can handle them both. The class is only two nights a week, and the study time is really just like adding one more subject to my schedule." Jessica said
" I guess so, I am not saying you can't handle it but that isn't a go to class listen to what they say and go home kind of class. You have to read before and after, and a hell of a lot of it is hands on stuff that you have to practice outside of class." Jake cautioned.
"What kind of stuff is like that?" She asked.
"CPR for one, they say that within three weeks of leaving classes you forget over 80% of the material. The class is six months long, and you have to take boards after you finish. If you don't practice the CPR stuff I guarantee that they will fuck you with it." Jake replied.
"I could always ride with you and try and use the stuff that they teach me though right?" She asked with big puppy eyes, almost pleading.
"I guess, I mean Ron hasn't said anything to me about how long you can ride." Jake said.
"Are you willing to help me with it Jake?" She asked.
Jake felt like someone had just handed him a Waterford vase and asked him to smash it for them. "Sure thing." he replied.
Jake put enough cash to cover the check and a little extra under the check and stood up to leave.
"Where do you live Jake?" Jessica asked as they were walking to the door.
"Belhaven Heights." Jake replied.
"Really, that close to me huh?"
"Yep, right over on Whitworth st." Jake replied. "Why do you think I am always in the bagel shop. I have always lived in Belhaven or Belhaven heights when I have lived in jackass. Everybody in the neighborhood knows me, I am kind of a fixture here." Jake bragged.
"I would ask if I could come over but I really need to get back to the dorm before curfew." Jessica said.
"You guys got a curfew?" Jake said incredulously.
"Yeah, we do. If we miss it we get all sorts of crap." She replied.
"What time is curfew?" Jake asked.
"It's midnight on weekdays and two A.M. on weekends." She said as she got into Jake's truck and slammed the door.
"So how have you managed to get around that when you ride with me?" Jake asked.
"Oh, just a little sneaky trick. I leave my ID with my room mate and get her to sign me in with it and I call her to open the door for me when I get back to the dorm." She replied.
"I see said the blind man as he picked up a hammer and saw." Jake said with a grin.
They returned to the campus and Jake parked in front of the dorm. "Well here you are safe and sound with time to spare" Jake said.
"Thanks for the meal Jake, I enjoyed it." Jessica said.
"You're welcome. Thanks for the company, I needed it." Jake returned.
Jake watched her walk into the building and pulled away from the curb. He drove the ten blocks home and thought about Jessica as an EMT. She was small and delicate. How she would lift and carry was only part of what Jake was concerned about. He wondered if she could carry the weight that this job put on the soul.
Jake really didn't want to go to work. The QA review was meeting to review everyone on the shooting call. Jake reached into the back of his closet and grabbed his bulletproof vest. When he had put it on and cinched everything he continued getting into his uniform. Jake looked in the mirror and combed his hair which seemed to be graying more by the day and judging from the sink trap thinning as well. "Entropy" He said aloud as he turned off the light and went to work.
Chapter Five
"Base to Medstat 72." The radio blared.
"Medstat 72 go ahead" Jake replied.
"Dispatch to Terry road and highway 80 for MVA with entrapment."
Jake hit the lights and siren and stepped on the accelerator as he replied "Medstat 72
en route ETA approximately three minutes. Jake sped along the roadway driving with his elbows as he put on a pair of latex gloves, and then another on top of them.
"Hey fellow, easy on the curves, I almost spilled my coffee." Scott whined as they rounded the corner and pulled ahead of the scene. The fire department was already on scene providing extrication.
Jake opened the side door, grabbed the bag and O2 bottle, and headed for the car. She had hit a soda truck so hard that she knocked the wheels out from under it. There was soda rolling all over the road and some of them had burst open and were spinning and spewing their contents all over Terry rd. Jake approached the vehicle and started his assessment. He took hold of the woman's wrist and introduced himself. "Ma'am I am a paramedic my name is Jake." The woman just moaned. He continued as he placed his patient on oxygen."Ma'am can you talk to me, can you tell me what happened?" "Hurt" she replied. He immediately wrapped a blood pressure cuff around her arm and began taking a bp. "Can you tell me where you hurt?" He asked as he deflated the cuff.
"Everywhere" she gasped. Jake began palpating her neck an shoulders and gradually moved down to her abdomen. It was hot and distended. The steering wheel was bent and deformed and the airbag had deployed, it was soaked with blood from a gash across her forehead. This girl was young and small and had absorbed a great deal of force from the crash.
Scott arrived with the bed, backboard, and CID bag. Jake went to work, and placed the C- collar on her as Scott maneuvered the bed into position with the backboard under her buttocks. As soon as the fire guys gave the ok Jake rotated her legs to the side and laid her on the board. In one motion he scissored her into place on the board. He placed the towel rolls on each side of her head and began taping her head down as soon as Scott had cinched the straps around her legs and torso.
Jake grabbed her purse from her front seat and placed it between her legs. He dug through it for her ID and got her name.
"Tracy!" He yelled "Tracy!"
The girl opened her eyes and looked up at him.
"Listen to me. It is very important that you stay awake and tell me if you get the slightest bit nauseated. You have been immobilized to this board and if you throw up you won't be able to turn your head to spit it out." Jake yelled as he checked her pupil response. It was perfect despite the gash and goose egg on her head. As Jake looked up from the stretcher he noticed people crossing the traffic tape to steal soda. Jake and Scott lifted the cot and wheeled to the waiting ambulance. As Jake passed a JPD officer standing in the middle of the road he yelled.
"Why don't you go and arrest all of those pieces of shit who stepped over me and my patient trying to steal soda."
The officer looked at Jake blankly as he headed in the direction he and Scott had came from.
Scott took the wheel as Jake started an IV.
"Tracy!" Jake yelled again but she was completely unresponsive and her BP was falling.
"Scott lets get to Methodist quick." He said as he put her on the monitor. It didn't look good at all. "Tracy, come on honey talk to me." he said he reached on to the bar and grabbed the Laryngoscope and attached a fiber optic number two miller blade to the top. He reached into a cabinet and retrieved a ET tube and opened the package. Jake opened her mouth and placed the blade in gently, He grabbed her jaw and held her tongue down and dropped the ET tube straight into the vallecula, he finished placing the tube and assessed her lung sounds. The lung sounds were diminished in her left chest, Jake looked for JVD or Tracheal deviation and found none. He pulled the tube back a little bit and listened again, still no sounds. Jake was listening to a tension hemothorax. Just as they pulled into the hospital she opened her eyes and fought the tube.
Jake caught her hand and held it at her side. "No, honey don't do that." he shouted as he opened the back doors. Scott and Jake pulled her out of the ambulance and rolled her into the trauma bay. The surgeon approached in full scrubs.
"Let's crack her here in the bay." He yelled as Jake and Scott transferred her from the stretcher to a bed. The trauma team began their work. When they cracked her chest open it was like standing under a twenty gallon garbage bag full of water, just as the bottom fell out. Jake was covered in blood. His shirt and pants were blotched red and his boots covered.
"There are two small tears to the ventricular wall, another to the aorta ..." the surgeon said to the rest of the team. The surgeon withdrew his gloved hand from her chest. They all knew what that meant. This was damage that couldn't be undone. She had already gone asystole and there was no bringing her back.. He took his gloves off and dropped them into the biohazard can, and turned away from the trauma team.
"Time of death 2135" The surgeon said as Jake walked from the bay with his boots squishing with every step, he stopped at the desk and softly said,
"Request a pair of scrubs" to the charge nurse. She walked to the linen cart and retrieved a pair of O.R. greens for Jake.
"Can I have a bag for my Uniform?" He asked. She handed him a red biohazard bag from under the desk.
After Jake had changed he walked outside to his ambulance barefooted and got in the passenger side door.
"Scott, get us the fuck out of here. I got to get another uniform and a gallon of bleach." He said softly as Scott pulled from the hospital.
When Jake got back to the station he walked out to the lockers, opened his and retrieved a fresh uniform right down to his socks and a fresh pair of boots. He had learned the hard way to always keep a spare set of everything. He opened up the supply closet, grabbed a gallon of bleach and headed for the shower. As the hot water ran over him he poured the contents of the bottle directly onto his head and shoulders. Then moving the bottle across his chest and arms he placed it on the floor of the shower, scrubbed his upper body and shampooed his hair. He washed the life of Tracy Wallace from his body, stepped out of the shower, and dried himself off.
Chapter Six
Jake walked down the stairs into his exercise room and turned on the light. He stood straddle of the belt on the treadmill and started the machine. Jake began his workout with a brisk warmup walk. Jake had taken up running lately because he wasn't feeling so strong anymore. So when his strength failed him, at least he would be able to run away. He picked up the remote control for his stereo and the room filled with the melodic notes of Warren Zevon's greatest hits. As he lost himself in the music he gradually picked up the pace. Nearly at a nine minute mile now, he was glistening with sweat. Jake could feel the evil leave his body sweat drop by sweat drop. Diminishing with each successive pounding step of his feet. The rhythmic slap, slap, slap of his feet hitting the belt along with the steady whine of the belt and the motor that drove it had an almost hypnotic effect. Nothing else mattered, or existed. Just Jake and the mill were all that remained in the world at this moment. Jake ramped up the speed on his machine all the way, he was running at a six minute pace, every item on every shelf in the room shook and vibrated with each pounding step of Jake's three hundred and twenty pound, six foot four inch frame. Jake ran as though the hell hounds were on his trail, snapping at his legs and breathing their fiery breath down the back of his neck.
Jake thought back to the code he had worked that shift. The ones who went face first into their oatmeal always caused problems. The family was usually there to watch him torture their loved one. Beating on them, shocking them, running tubes and lines everywhere a fellow wouldn't want them. Cardiac arrests were a real ya'll come event in Hinds County. Every medic from every little town and hamlet that needed a tube to keep medical command came out. The hysterical wife or husband was always present, wandering around asking if the patient was going to make it. People were asshole deep in the living room this morning, so Jake just did compressions. The first one always broke the sternum away from the ribs producing a sickening series of cracks, not unlike popping one's knuckles, only louder. For that reason Jake always knelt beside his patients and whispered an apology into their ear. Once a patient's wife asked if it hurt, he told her flatly, "Like nothing you have ever known." After the ribs were broken the compressions got easier. Jake got lost in the rhythm of compressions and his mind wandered. Often Jake wondered if the dead could hear his thoughts. What they might be thinking as he pounded away on their chests. If they wanted it all to just stop and everyone to get the hell out of their house. Or, if they could hear the pain that their wives, husbands, children and siblings were going through, and silently cheered him on, enduring the excruciating pain of prolonged CPR. It didn't really matter, Jake had only had three come back that he felt like he had done any favors. Bringing a guy back to be fed, watered, and turned to the window once daily wasn't Jake's Idea of a save. Saving someone meant they were carried into a hospital and they walked out. There weren't many of those.
Every muscle in his neck stood up and his veins bulged like garden hoses as the sweat ran in rivulets down his body. Jake slowed his run to a trot and as he cooled down, dried himself with a towel. It was time for the iron, he picked up two forty five pound weights and put them on the bar that was resting on the bench, he added weight until he had two hundred and twenty five pounds on the bar. The bar made a dull thud and the platters clanged at the end of the bar as it bounced off of Jake's chest with each rep, in all twenty of them, five sets of four. Jake finished his curls, reverse curls, dumbbell lifts, and high pulls. Being strong made the crushing weight that his job put on him easier to bear. Those fourth floor carry downs, the houses with winding stairwells, and the multi-floor menopause manor senior living center who just happened to shut down the power to the elevator on the day that the cat lady went into full arrest following a long battle with congestive heart failure. CHF in medical parlance, blue bloaters in the vernacular. Copd patients were pink puffers. The cat lady weighed four hundred and twenty two pounds, and Jake felt each and every one of them on the carry down. It was so bad that he had to put himself on oxygen to recover from the effort of carrying her. The cat lady had more cats than Jake could count in her tiny efficiency apartment. Many times he had been there for exacerbated CHF. She wasn't really to blame for being so fat, it was all the fluid that she had that made her so heavy, that and not being able to walk down the hall to get her mail, much less exercise. Her heart was failing on the left side. When she went into exacerbated failure her heart couldn't pump the blood out as fast as it came in, causing the fluid component to back up into her lungs, slowly drowning her. One of Jake's first embarrassing boo-boo's in EMS was a heart failure patient. She had right sided failure which backed up into the circulatory system causing abdominal distention. Jake's patient was really just a favor to one of the hospitals more than an actual emergency. He walked into the door and assumed she was pregnant. Her ankles were severely swollen and he asked her all the usual questions about pregnancy. How long? Any previous live births? Toxemia? Pre-eclampsia? It would have been a picture perfect assessment if she had actually been pregnant. As he took her vitals and did the physical assessment he became more and more embarrassed. She was twenty four, in right sided failure, on a heart transplant list and was a rare type to boot. Jake and his partner lifted her onto the litter and strapped her in. When he took her into the transplant unit at University Medical Center everyone knew her. It was really eerie, almost like a welcome home party. Jake slumped against a wall to finish the trip sheet and asked a nurse to sign for his patient. He still remembered asking her. "She's, uh, you know, going to die before she gets her heart. Isn't she?" The nurse gave him an answer he stole and used as his own many times since. "I think you know the answer to that as well as I do."
Jake had used it on a patient that directly asked him once. He was pinned between two railroad boxcars, cut most of the way in two at the waist. The pickup truck he was in was so mangled a crew of rescue tech's might not ever get a viable patient out alive, to say nothing of him. Jake approached the vehicle and talked to him gently.
"Hey, I was wondering, since you are going to be here a while, just like us. Is there anyone you would like to talk to, maybe your mom or somebody, while we get the teams together?"
Jake was actually trying to determine who to deliver the bad news to.
"Yeah, man. I think I might like to talk to my mother." He said with a groan.
Jake got her name and phone number from the man and called her. When she arrived on the scene he told her flatly.
"If you have anything to say to this man, say it now. As soon as we pull those cars off of him he will die."
As the two spoke while Jake and the rescue team stood by Jake felt more like an executioner than a medic. He would be the one to give the signal, he would be the man who brought this life to an end.
Jake approached his patient, "Man is there anything I can do to make you more comfortable? Maybe some more morphine? Somebody else you might like to talk to?"
"No." He replied. "I am going to die aren't I." He said more than asked. To which Jake gave the reply.
"I think you know the answer to that as well as I do."
Chapter Seven
Scott tossed a pair of gloves to Jake and Jessica as they approached the door. Jake rapped on the door and yelled "Paramedics." Jake really hated safety and welfare checks, they carried the highest likelihood of a stinker.
"Mrs. Kendricks?" Jake called as he entered the house. He heard a muffled voice from the rear of the house. Mrs. Kendricks was laying in her bed, barely conscious, and soaking wet with sweat.
"Oh, Mrs. Kendricks, how come you keep doing this to yourself?"Jake asked as he sat her up and gently wiped her forehead with a towel.
The old woman looked at Jake, panic stricken and asked.
"Who are you, why are you in my house?"
"Mrs. Kendricks, I am a paramedic, I am here to help you."
Jake opened up the bag and set up the glucometer. He gently held her hand and pricked her finger to get a sugar reading. It was very low.
"Right now I need you to drink this." He said as he handed her the glass of orange juice laden with sugar, that Scott had mixed up in the kitchen. She drank it down and repeated herself.
"Mrs. Kendricks, I am going to stay here until you can tell me who I am." Jake said as he handed her another cup of orange juice. Jake continued filling her up with sugar and OJ.
"I have to get some work done, but I can't find my papers. The children will be so disappointed if I have lost their papers, they worked so hard on them." She said as she sipped her orange juice.
"Mrs. Kendricks, you have been retired for some time now. You won't need to grade any papers tonight." Jake said.
"Mrs. Kendricks, read my name plate. Do you know me yet?" He asked.
"Jake Colton" She pondered. "Jacob, that's your name, you were in my English class, you weren't a very good student either."
"That's right, Mrs. Kendricks, we got your sugar up, but it won't stay there long. You are going to have to eat something or it will just go down again." Jake cautioned.
"Well, I don't really have anything here right now, and it's kind of late what should I do?"
She asked.
Jake turned to Jessica,
"Ms. Cates, could you be so kind as to retrieve my special medic bag from behind the passenger seat?"
Jessica came back with Jakes lunch bag and Scott sighed and rolled his eyes. Jake walked to the kitchen and opened the cabinets looking for a saucepan. The cabinets were truly depressing. All she had for food was a bag of flour, some non dairy creamer, and a fucking onion. Jake gave up his search and warmed the beef stew he had brought for his lunch in the can, and poured it into a bowl.
"Mrs. Kendricks, I want you to eat this soup. It will help you make it until tomorrow when you can go to the store." Jake said as he spoon fed her the soup.
Jake finished helping her eat. He and Scott remade her bed with hospital linen from the truck and left. Jake walked from the house and wiped the tears from his face onto the latex gloves.
"Saint Jacob, how many times are you gonna do this before you make the recommendation to put her in assisted living ?" Scott asked.
"I guess I am going to put it in tonight Scott." Jake said as he finished drying his face. "I just don't want to admit it, nobody wants to see someone put in one of those places Scott. I swear it's almost easier to come do this every couple of days."
"Jake, don't you ever get tired? You can't carry the weight, sooner or later its gonna break you. Just look at it like this Jake. You call yourself protecting her. What if something happens when you ain't here? What's gonna happen to her then? What if something happens to you, and there ain't anybody willing to give the old lady their lunch?" Scott continued. "Jake, protect her, make the call, fill out the paperwork, and make sure that she always has somebody looking after her."
Jake Ignored him and folded a big red handkerchief, placed it in his pocket, and fastened his seatbelt. He thought Mrs. Kendricks was old when he was a teenager, but she was really old now. Younger people than her died from diabetic complications all the time. Jake had taken care of his grandmother all during his childhood. He learned to smell her breath when she didn't want to get up. If it was fruity he knew she needed more insulin, if it wasn't she needed sugar and OJ.
What's with you and the old lady?" Jessica asked. Jake lit a smoke and took two monster drags. "I'll tell you when we sit down to eat." He said as he tossed the better part of his smoke. Jake climbed into the cab and shut the door.
"So what's for lunch Scott? The Krystal burger is right up the road"
"Man I don't think I want those things sneaking up on me tonight right in the middle of a call. You can take shit and not even realize it with those things on board." Scott complained.
"How about maybe the Waffle House?" Jake said hopefully.
"As long as you stay away from the chili you flatulent bastard." Scott said as he pulled away from the curb. They cruised through the addition onto Terry rd. and proceeded down McDowell to the Waffle House. Jake gave Jessica a hand out of the back of the truck.
"That's lesson number one, don't let your partner jump out of the back, it beats the fuck out of your knees."
Scott whined, "You never give me a hand out of the truck."
"Cause you always drive you jerk off." He said as he opened the door. Jessica giggled and walked through the door with Scott following. Scott went to the bathroom and Jake and Jessica sat at a booth and placed their orders.
"My partner wants hash browns scattered and covered, two eggs over medium and a large bowl of grits, OJ to drink and coffee too."
"How long have you two worked together Jake?" Jessica asked.
"Five years now." he said. Jake lit a cigarette and looked at his watch. "Just five more hours to go Jess." Jake said with a smile.
"So what was with you and the old lady Jake?"
"She was my English Teacher in high school, and there isn't anything I hate more than old people laying around in bed waiting to die. That's what assisted living really is."
"Are you going to get her put in assisted living?"
"Yeah, I guess I got no choice really, and it wouldn't matter if I did or not, somebody else would anyway."
The waitress came and dropped their food off. Jake started on his right away. Jessica was still drinking her coffee.
"She is a diabetic right?"
"Yes and she had low blood sugar"
"Always has low blood sugar." Scott mumbled as he sat down.
"And why would that be, Ms. EMT student?" Jake asked Jessica.
"Because she took her insulin without eating."
"Ding, ding, ding, ding, lets tell her what she's won for that Scott"
"Ms. Cates, you have won an all expense paid trip to crack town. Complete with crack heads, drunks, and real vomit. But wait there's more. You will get to tour the loveliest slums of battlefield park, and treat real hobo's on Gallatin st. Don't forget to make a thirteen floor carry down from the top of the lovely abandoned King Edward Hotel."
"Ok knock it off, it really was a pretty simple question."
"Anyway, I had lots of high school teachers and I don't think I am going to go give them my lunch every couple of days. Why her? What's so special about that one?"
"Well, number one, I have a kind of soft spot for diabetics. My grandmother was a diabetic. The second thing is, she was the only teacher I ever had who didn't think I was stupid. She went to bat for me lot's of times." Jake said as he stuffed another bite of pork chop in his mouth.
"What do you mean went to bat?"
"Well, one morning she went unconscious right in the middle of class. I knew exactly what was wrong with her and how to fix it. The principal wouldn't listen to me and kept telling me to sit down, and I kept telling the idiot that she needed some sugar. He suspended me for ten days after it was all said and done. Mrs. Kendricks went to the school board, and anyone else who would listen, to try and get me back in school."
"What a jerk. Did you get back in school?"
"No, I just quit."
"That seems kind of like cutting your nose off to spite your face."
"Well, I regularly even that score." Jake replied
"Oh God Damn, here we go again" Scott moaned.
"Oh yeah, still to this day every time I pass that fucker's house in the middle of the night I turn on every siren on the ambulance and all the lights." Jake said with a smile.
"You dumb fuck, I keep telling you he probably sold the damn house ten years ago, and some poor bastard you don't even know is getting the snotty end of your grudge." Scott said slowly.
"No, he didn't. I check the county tax commission records every so often wise ass." Jake retorted.
Jessica was laughing hysterically. "So do you guys always get along this well?"
"And better, especially when Jake gets a bee up his ass about the way some nurse treated him, and he starts dumping homeless guys that he trained to fake heart attacks in the ER."
Jessica snorted and laughed, shooting milk from her nose in a double stream. She wiped her face and the table with a napkin.
"You did that?" she asked with a grin.
"Several times" Jake answered proudly.
"Get him to tell you the rest of that story" Scott snickered.
"Oh yeah, well anyway after we dropped like ten skells off a block down the road from the hospital and told them what to say, and how to act, we got a real heart attack call. I went in this nursing home and the old girl was smoke gray and sweating bullets. When I checked her BP it was in the crapper and she had a heart rate so fast I couldn't count it. After I put her on oxygen and gave her adenosine she slowed down to about a buck forty, still way fast. So, I called Methodist and told them what I had and all her vitals, what interventions I had performed etc. and the nurse says to me. "You know we're on divert right?" and I told her diversion was a courtesy and I weren't feeling very courteous." Jake paused to light a smoke and take another sip of coffee.
"Scott lit up the roof and we hauled ass to Methodist. On the way he asks me what I said and I told him. He didn't believe me, so when we got to the hospital he hunted up the nurse and asked her. Here's where it get's fucking funny. Number one she has like ten stinky skells complaining of chest pains, and she is on the triage desk cause they are short of staff, so she is about ready to climb a bell tower with a twenty two rifle and a bologna sandwich. Number two, now she has some bastard asking about the off color remark made by the bastard who is responsible for all of this shit right in front of her. So she goes apeshit
"YES, HE DID." she yells at Scott and he starts rolling laughing. She tells him that she didn't think it was very funny."
"I told her that was too Goddamn bad, cause it was." Scott roared laughing at the mere thought of it.
"How did you get away with that? I mean the Patient care reports and stuff. No dispatcher in their right mind would believe that you had ten walk up's" Jessica asked.
"That's the best part, it was plausibly deniable because I let them all out of the truck like a block down the street and told them to walk in one at a time. So I was never sent to get them and I never left them at a hospital, it was like they were never on my truck, It was great."
The waitress left the checks on the table and Jake picked up his and Jessica's. He reached into his pocket and left five dollars on the table and made his way to the cashier. Jessica followed him and Scott went to the bathroom again.
"What, has he got a bladder like the size of a pea?" she asked as they walked out the door.
Jake's radio came alive just then.
"Base to Medstat 72. Proceed to 515 west McDowell Road for a diabetic emergency."
"Man, I hope Scott wasn't pinching a loaf." Jake said as he keyed the mike.
"72 responding at 1924."
Scott came out of the restaurant tucking his shirt in.
"You wheel and I'll heal this one." He said climbing into the cab.
"How about this Scott, I'll wheel and if this diabetic is conscious, then we will let our third rider take care of this call. No muss, no fuss. She can even write the trip sheet, Ron said so."
"Alright, Jake." Scott turned on the siren and Jake started onto McDowell rd. As he cleared each red light Scott changed the tones on the siren and yanked the airhorn chain. They pulled into the library parking lot at the dispatch address. Jessica picked up the bag and the bottle of oxygen and stepped out the back.
"Want us to get the bed for you there crew chief?" Scott teased.
"Isn't she the cutest thing?" He continued until they reached the door.
Jessica walked in the library and a man guided her to her patient. Seated in a wooden chair next to a copy machine was an elderly lady drinking a soda. She was pale and clammy and her hands shook as she slurped the soda down.
Jake whispered to Jessica, "Do your stuff girl, glucometer, and direct your crew, she's all yours"
"Ma'am I'm Jessica, I am an EMT. What's going on today?"
"I was making some copies and I got really dizzy and weak. I haven't had anything to eat today."
"Do you take any medications on a regular basis?"
"Humalogue"
"Did you take your insulin today?"
"Yes, I did but I was just going to make these copies and then go home and eat, I only live a couple blocks from here." She replied.
"I am going to take your blood sugar now, I know you know how this works."
Jessica removed the glucometer from its case and inserted a strip. She tore open an alcohol pad and swabbed the tip of her patient's finger. After she got a sample and was waiting for the glucometer reading she looked at Jake and asked him for a set of vitals."
Jake wrapped the cuff around her arm and pumped it up to 220. He slowly deflated the cuff. He reinflated the cuff and and tried again. He attempted to palpate a radial pulse and found none.
"Scott can you see if you get the same pulse I get over here."
Scott lightly placed his fingers on her wrist and looked at Jake.
"Got nothing here."
Just then the glucometer registered 174.
"Ma'am do you have any chest, neck, jaw or shoulder pain."
"No, but my back hurts right in the middle, between my shoulder blades."
Scott remembered non-typical presentations like this before.
"Jake I don't like this, there is no way just half a can of soda brought her from near syncope to fully conscious and affected her reading like that. Go get the life pak so I can take a peek at her ticker." She still didn't look good. Jake went to the truck and got the life pak cardiac monitor/defibrillator. As he applied the leads to the old lady's chest Jessica watched with curiosity. Jake turned on the monitor and the thin, dancing, green line showed a rhythm commonly referred to as tombstones.
"Uh, Ma'am you're having a heart attack, and you need to go to the hospital now."
"Jake, get me the bed. Jessica, I need you to spike a bag for me and put her on high flow."
Scott wiped the lady's arm with an alcohol prep pad and plunged an eighteen gauge IV catheter into her left AC. Jessica handed him the line and he attached it to the catheter. Scott ran the fluid wide open and Jessica inflated the reservoir of a non-rebreather mask and placed it on her patient.
Jake arrived with the bed. He and Scott grabbed the lady under her arms and in the bend of her knees and lifted her onto the litter. They lifted the litter to full height and walked her to the truck. Jessica followed in tow with the bottle and the bag. As they lifted her into the truck Scott looked at Jake and said, "Get there, all the woo-woo's."
Jessica hopped into the back with Scott and sat on the captains chair.
"What do you think you are doing?" He asked
"This is still your patient I'm just doing the hard stuff. Get over there and get me a set of vitals."
Jessica leaned over her patient, took the stethoscope from around Scott's neck and took a BP for him.
"One hundred palp was all I could get."
"Take it again, and do it right" Scott barked.
Jessica reinflated the cuff and still couldn't hear a BP."
"I can't hear it Scott, I have to palp it."
"Alright, her BP was one hundred systolic right?"
"Yeah, that's what I got"
"So, what can you do for a person with chest pain, presenting with symptoms of MI as long as they have a BP of at least one hundred." He asked.
"Nitroglycerine, sublingual." She replied.
Scott picked up the nitro spray bottle and primed it. "Always waste the first spray on the floor, you want to make sure your patient gets a full, fresh dose. Make sure that you spray it at the floor or you might breath it in and get a dose of it yourself."
Jessica looked at her patient and said, "I am going to give your this nitro, it will make you feel swimmy headed and may give you a headache. I need you to lift your tongue."
Jessica sprayed the nitro under her tongue and repeated the vitals.
"She's holding at one hundred Scott."
"Give her another one."
Jessica repeated the dose and took vitals, this time her BP had dropped below one hundred."
"It's low now, Scott."
"You're running the show. What are your options?"
"I can run the fluids harder or raise her legs, since you got the fluids running wide open, I am going for the trendelenburg position." Jessica raised the foot end of the litter and looked at Scott for some kind of cue.
"There is a way to get more fluid into your patient. Take your BP cuff and wrap it around the IV bag, then pump it up until you watch the drip rate increase a bit, just don't pump it too much."
Jessica did as he told her and sat on the bench.
"You're not finished yet."
"What? I did everything I can for the moment and I am continuing assessment."
"You need to call the hospital and give report." Scott said, handing her the radio. "Put it on the mednet channel and ask for a patch to methodist. They will come back and tell you to switch over to another channel and wait. When your patch is ready they will come on and tell you to go ahead. Then you just tell them what you have, what you did, and how it worked."
Jessica set up the patch and waited.
"Methodist mednet, go ahead."
"This is Medstat 72, we are inbound to your facility with a 74 year old female patient is resting comfortably at this time, vtach on the monitor, eta three minutes out."
Jessica turned the channel back to dispatch and handed Scott the radio as he shook his head.
"Jess, you gotta work on that. You didn't tell them any useful information. All they know is they got an old lady coming in with vtach. They don't know about the nitro, or her history of diabetes or anything else." He continued, "Really it wasn't so bad, because you are going to give report at the hospital but a little more is always better than a little less."
They backed into the bay and pulled the stretcher out of the back. As they wheeled it in Jessica carried the oxygen bottle and the IV bag.
Scott took over and gave report to the nurses while Jake made the litter.
Jessica was standing outside the triage room when Scott came out.
"You need to see this." He said as he pulled her into the room. She heard a steadily higher pitched whine from the corner of the room. One of the nurses pushed a button on the machine and the old lady jumped six inches off of the bed and sucked a deep breath in.
"What the fuck was that?" Jessica whispered to Scott.
"Synchronized cardioversion, they shocked her heart into a more stable rhythm." He said in a hushed tone.
"Does it hurt?"
"Like a son of a bitch. That was one hundred and eighty joules of energy. If you want to know how much that is I can defibrillate your leg at five joules to give you an idea."
"No, that's ok, I'll manage"
Jessica walked back out to the truck and found Jake smoking on the E.R. dock.
"Here comes my little shit magnet." He teased as she walked up.
"You took a perfect treat and street call and turned it into a bona fide emergency. Not really, I mean you did great and all, but medics are a superstitious lot. We don't mention how quiet it is, or how easy a call is going to be, nothing like that, it begs for a healthy dose of crap from the gods of EMS."
"How did I do Jake, really."
"Scott would really be the one to ask, all I did was drive."
Scott walked out of the ER.
"Scott, how did I do" Jessica asked.
"Well, your patient care was good, you introduced yourself, got the initial impression out of the way, and started an assessment. The only reason it turned into a fuckshow was because she didn't behave herself and act like a real diabetic, she had to throw that MI into the mix."
Chapter Eight
One could find just about anything in the dark, brown, murky, waters of the Pearl river. Cars, fish, turtles, and a tin can or two, Brian was still in there somewhere. Jake mostly found solace here, this was the place he could come to be alone, where nobody would bother him. Only fishermen and game wardens were here, and they were a hundred feet below him on the banks. He sat on the railroad trestle that crossed the river. The trains had stopped long ago, and the rails were rusted along with the support beams the held it all together. Every once in a while teenagers came and partied here on the creosoted ties, but mostly he was alone. In one direction the skyline of Jackass Mississippi loomed large and imposing, and in the other was nothing but the river that still refused to give up the body of his friend. Jake had proposed to Debbie just a few feet from the spot where he now sat, pistol in hand, shooting at soda cans and bottles as they floated past, watching the sun go down in the distance. The journey and the destination were calming and peaceful for him. Just over a mile of track between the dead end of Moody street and the trestle. He could sit here for hours, shooting bottles and cans, and listening to chunks of wood and other debris crashing against the pilings as the river went by. This place was like a coat of paint, that hid from immediate view the hulking pile of rust that a car would one day be. It was everything that Jackass was, but it didn't show. Bodies washed up below him, stolen cars were sunk in the river scarcely a mile down the banks, but atop the trestle Jake was away from it all. Even the lights of Jackass didn't reach here, which was exactly what he and Jessica were counting on when the sun went down.
"You've never seen a meteor shower before?" Jessica asked incredulously.
"Nope, I guess I never was at the right place at the right time. I work at night, but mostly I don't look up for fear of what might happen on the ground while I am." Jake replied as he took another shot at a passing bottle. Jessica flinched and yelled at him.
"God damn it! Stop doing that when I'm not looking."
"I'm sorry, I wasn't paying attention."
"I don't know why you even brought it." She fumed.
"I don't know if you happened to notice the neighborhood that we walked through on the way here but let me tell you, once you pass Whitworth street, the Avon lady starts selling hand grenades and brass knuckles. Plus, I like to shoot cans and bottles with it. It's a fun and harmless way to release aggression.
"As a matter of fact Jake, I did notice the neighborhood on the way in. But really, how many people are gonna walk up to a guy as big as you are, dressed in camouflage BDU's, and start fucking with him?
"Probably not any of them, they would just shoot me.
Chapter Nine
"Base to 72 508 Monticello St, for an MVA, the radio squawked. Jake and Scott shook the sleep from their eyes and opened up the back doors to get out. As Jake approached the drivers side door he saw Jessica still asleep on the short spine board, laying across the front seats.
"Aww, would you look at that." Scott remarked.
"Yeah she's gonna have to do something about being such a sound sleeper if she's going to make it in this field." Jake said as he shook her awake. "Jess, wake up, we got a call."
She sat up and stretched, she quickly slid to the passenger seat and picked up the short board. She stepped through the walk-through into the back of the ambulance.
Jake shook his head, as he picked up the microphone. "Yeah, go ahead and rub that in. Ten years of fast food and you'll be walking around too." Jake said as he picked up the mike. "72 to base we are en-route." He climbed into the cab and put the truck into gear. Jake left Battlefield park with his light on, but no sirens. As he made his way down Terry road the ghosts of his teenage years settled on him and he just started driving by rote. He made a right on McDowell and headed down toward his favorite teenage hangout, Apple ridge Shopping center. When he got there he turned left onto Brookwood and as he topped the hill he saw what he was there for. A car was pinned between a cement truck and a telephone pole. The truck driver was out walking around. Jake motioned to Jessica to do an assessment on him and see if they needed additional units. He went straight to the small convertible and started on his patient. The man was unconscious, unresponsive and bleeding from the ears and mouth. Jake removed a two by two from his bag and dipped it in the blood coming from his ear. He gently laid it aside and began suctioning the blood from the mans mouth. It kept coming like a river. He was only breathing four times a minute and when he breathed out blood spurted in an arc. Jake attempted an intubation and failed three times. The blood was just too much, so he tried the combi-tube, and made it in. Jake inflated the cuffs, attached the bag to the Blue lumen, and began ventilating his patient. He listened to the patients chest with his stethoscope while ventilating him, he heard breath sounds on the right and nothing on the left. Jake deflated the cuffs and repositioned the tube with identical results. He listened to the stomach and heard no epigastric sounds.
"The tube is good Scott, let's get his guy on a board." They slid the board under his buttocks and pivoted the man onto the board. Scott placed the C-collar and placed the blocks and taped his head. When they had him fully immobilized they pulled the board onto the litter and loaded.
Jessica climbed in and shut the door.
"Hard and fast to UMC Scott." He said as he squeezed the bag again and again.
"Jessica, keep bagging him while I put a hole in him"
She did as she was told and Jake listened to the patients lung sounds. They were diminished on the left base and his trachea was beginning to shift to one side. Jake prepped his patient for a decompression. He rubbed the iodine in an ever widening circle on the anterior chest wall. Second intercostal space, mid-clavicular. When Jake had assembled all the equipment he forcefully inserted the 10 guage decompression needle with an audible pop. This was immediately follwed by a geyser of blood and a hissing sound as the air escaped from the pleural cavity.
Author notes
This is an excerpt from the novel I am attempting to write
What did you think? Please comment!
Comments
1 - 10 of 10
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I wanted to stop by to thank you for your reply to my poem The Rainbow and was directed to this by clicking the 'return the favor' button. I must say, although it was long, it caught my attention from the start and drew me along into the story. You've got very good character development and imagery here. I sense that you have a medical background (being a nurse myself). I really thin this could go far as a novel. My one suggestion to you would be to develope Jake and Jess just a bit better so that the reader can actually picture what they look like when reading this not just who they are and what they are about. Great writing...a best seller in the making
Ruth -
wow that took ages to read but it was well worth it! Obviously I was attracted to it because of the paramedic thing
A wonderful read so far... I hope you are going to add more to it, I am hooked now.
Take care
Hayley x x -
Chapter two was great. I'm coming back for three. The computer screen hurts my eyes when I stare at it to long. You are an excellent writer.
~Bezoar -
Okay. I've finished chapter one and am really into it. I'm bookmarking it to come and finish the story. So far; I'm loving it. I work in the medical profession and have a former army man for a husband so a lot of what's going on in the story is really real. You capture it well.
I'll be back.
~Bezoar -
Decent. Work on the flow - in some places you should elaborate, in some places you should edit. Apart from that, it was good, if slightly cliche.
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Perfect
This is so great, it was hard not to cry.....At first, I was like this is too long..... But it's great!!!!! -
awesome!!
omg this is awesome. read it in one sitting, too. im at school readin this and i had to struggle not to cry. wow.... you did so good. i loved the ending. i have so much going through my mind now. great job. i loved it!! -
Awesome!
OMFG.... This is fabulous, I could not put it down at all... Literally, I read it in one setting. Hey, I am a fledgeling novelist myself, and if you need someone to corraberate with on this, give me a holler. There are a million ways this could turn out, and I wonder if the same thoughts running through my head are the same as yours or completely different. Later, good luck with it either way! -
am this is rely loing rely loing lol ill reed it in a bet lol to erly to reed books well ill see you wen i see you
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wow...just.WOW...
~raven~
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