Extreme Medical Services: Medical Care On The Fringes Of Humanity (5 page)

   
The next two nights were busy for Dean and Brynne, but, if he didn’t know his patients were Unusuals it wouldn’t have been obvious. They had chest pains, stomach upsets, and minor bumps and bruises from motor vehicle accidents. One call stood out as two vampires fought over a girl, but the end result of bruises and cuts that needed bandaging was very routine.
 

   
Brynne had him doing the reports by the end of the second night, and he liked writing the narratives. It gave him a chance to get some perspective on what he was doing. One thing he noticed though was that none of the patients wanted to go to the hospital. Even the chest pain patient, who Brynne said was a Rakshasi, a sort of magical creature from India, didn’t want to be transported. They ran her through the heart monitor routine, checked her twelve-lead ECG for ST elevation and used the i-Stat portable labs to run the blood work.
 
When it came back negative for troponin levels, Brynne told her to call her doctor in the morning and call them back that night if it happened again.
 

   
The question was on Dean’s mind when they got back to the station. “Brynne, what’s up with us not taking any of these patients to the hospital? I mean I get that they’re different but why? Are they so supernatural they can heal themselves?”

   
“Most of the people who call 911, even the Unusuals, don’t need to go to the ER. They just need someone to tell them whether their emergency is really an emergency or if it can wait until they can see their doctor the next day.” Brynne pointed to the screen where he was working on the Rakshasi’s report. “In this case, I would have liked to have taken her in but most Unusuals distrust the hospital. They have a real fear of what might happen to them if they get in there and their “Unusual” talents are discovered. It’s not too much of a stretch to think about how they might end up becoming some doctoral student’s science project. They all have stories about the secret government labs that are used to cut up Unusuals and see what makes them what they are. It may not be happening anymore, but I’d bet it has happened in the past, somewhere.”

   
“We have to balance that fear with whether they need to go in or not. There is also the need to notify the hospital ahead of time so that the nurse and doctor assigned to them would keep their status in confidence.”
 

“I guess that makes sense”, Dean said.

Brynne continued. “There are always at least one doctor and one nurse on duty at ECMC who are part of our team. There is a list of other trusted people from medical specialists to imaging and lab techs that are called in to treat an Unusual. The patients get a private room that’s fairly isolated in case something weird happens like one of Bill’s diabetic episodes.” Dean nodded as he envisioned Bill running down the hallway half-man and half-wolf. Not pretty. “They go to great pains to cover for an Unusual so they are kept safe and the rest of the hospital population doesn’t feel threatened.”

   
Dean swiveled around in his chair. “So what do we do when we know they need to go?” he asked.

   
“Doc Spirelli’s cell phone is programmed into the dispatch system and I have it in my cell phone, too. The Unusuals respect and trust him. Generally, if he tells them they have to go in, they listen, but not always. Ultimately, it’s their decision just like anyone else.”

   
Dean nodded. It was the same answer his preceptors gave him when he asked about how to convince a reluctant patient to go to the hospital. Any patient ultimately had the right to make their own health decisions – Unusual or not. It was up to the paramedic to make sure they were fully informed about the possible consequences to their decision.
 

   
Dean went back to the chart he was working on, pulled up the i-Stat blood work that was automatically uploaded to the unit in the ambulance and added it to the patient’s chart. He had to admit that the technology was pretty cool here. The tech was even better here than the standard units in the city. Brynne said it was because of the grant funding for the “Unusual unit”. Everything was automated to make patient charting easier. There was an iPad tablet in the back of the ambulance to keep the patient chart on when on the scene. The heart monitor and other electronic gear all reported and connected to the system as well. Ironic that a station on the fringes stuck in the back of an industrial park was the best funded in the city. He put the finishing touches on the narrative, “painting a picture of the call” as Mike had told him in the academy.
 

   
He was just getting ready to turn it over to Brynne to read over when the tones dropped. He listened as radio’s speaker alerted automatically and the dispatcher’s voice was clearly heard. “Medical box U-843. Allergic Reaction. 634 Bridge Road.” Simultaneously, the printer next to the desk printed out a sheet of paper with the call information, address and box number.
 

   
The box number related to the old system when they had fire department call boxes around the city that would call into the local fire station when pulled. The fire department would respond to that particular box and then would follow the person there to the emergency or, in some cases, follow the smoke to the fire. Now the boxes were a reference to the specific geographic area of the city. Once you got to know the numbers, you could get a general idea of where you were headed while your partner programmed the GPS to get a more specific location.
 

   
Dean closed the screen and hopped up, heading to the door to the ambulance bay, which Brynne was holding open for him. She jumped in the driver’s seat as he walked around to the passenger side. The garage door of the bay was already on its way up as he climbed in. He glanced at his watch - 5:30 AM. Damn, they were almost done with the shift and he was tired, but duty called. As Brynne pulled the ambulance out into the parking lot, he picked up the radio’s microphone and keyed the mic saying, “U-191 responding.”
 

   
“U-191 responding” the dispatcher parroted. “Switch to med channel 1 for additional.”

   
Dean switched the radio frequency to the correct channel. While the initial dispatch was on an open channel, all calls were then routed to a secure, trunked radio channel for the rest of the call. He keyed the mic after double-checking the correct frequency. “U-191 on med channel 1.”

   
The dispatcher came up immediately. “U-191, respond for a male subject in the parking lot of the Jiffy Mart complaining of a severe allergic reaction, unknown cause. The patient will be seated in a gold minivan.”

   
“U-191 copies,” Dean responded and hung up the mic on the dash. “Any idea on what this one is, Boss?”

   
“Nope.” she said. “I guess we’ll see when we get there.”
 

   
For 8 minutes, Dean watched the lights reflect off the windows of businesses and noticed the wailing sound of the siren at night had a mournful quality. He also noticed Brynne was a good driver, stopping at each red light or stop sign and acknowledging “due regard” for the safety of others before driving on through.

   
As they pulled in to the Jiffy Mart parking lot on Bridge Street, Dean scanned the area. Scene safety was the first responsibility, and while it was moderately busy with people coming in to get their morning coffee on the way to work, there was nothing out of the ordinary. He pointed to a gold minivan parked along the side of the building. The windows were tinted dark and in the early dawn light there was no way he could see if anyone was inside.

   
Brynne pulled the ambulance up beside the minivan as Dean keyed the mic and said, “U-191 on location.”

   
Brynne put the unit in park and climbed out. Dean did the same. As his feet hit the ground, a short, plump, middle-aged and shirtless white guy jumped out of the driver’s door of the minivan and shrieked “Thank God you’re here.” He dashed to the side of the ambulance, opened the side door of the ambulance box and jumped in, shutting it behind him. Dean was too stunned to move. Brynne went to the back of the unit.
 

   
“Well, get the gear out probie!” she said. “Don’t just stand there with your mouth open.”

   
He gestured at the ambulance door. “No need to move the gear, the patient just loaded himself.”

   
“What?” She crossed over to the ambulance’s side door. Peering in the window on tip toe, she let out an exasperated sigh. “I didn’t recognize the car, but I should’ve guessed.” She peered at Dean. “Well climb on in. Let me introduce you to Gibbie. His name is Gibson Proctor. He may look middle aged, but he’s a vampire who’s been around more than six centuries.” Dean grasped the door handle, quirked an eyebrow at Brynne, opened it and climbed in with his preceptor close behind. As Dean sat down in the captain’s chair at the head of the cot, Brynne climbed in and sat in the bench facing the patient.
 

   
The patient had stripped off most of his clothes and appeared to be covered in some kind of glitter which was flying everywhere. The glitter decorated noticeable hives popping up all over his torso. Gibbie, as Brynne had called him, ripped open a ten pack of four by four gauze and began to wipe frantically at his skin. He looked up at Brynne and Dean. “Thank, God! Thank, God! Thank, God! Brynne, you’ve got to get this stuff off me. It’s itching like crazy. It’s killing me.”

   
“I don’t know about that,” said Brynne looking him over. “Gibbie, calm down. Getting yourself all worked up is only going to make the reaction worse.” She looked at Dean. “Get a bottle of sterile water out of the cabinet behind you. I’ll get some more gauze. There should also be a few folded white towels in with the sheets and pillowcases for the cot. Get them, too.” She turned back to their frantic patient. “Good Lord, Gibbie what is this stuff?” Brynne said as she, too began to wipe the glittery cream off him as best she could.

   
“It’s sunscreen, okay. I was trying to impress my new girlfriend. She’s all into those old Twilight books, and I thought I could impress her by showing that I can sparkle in the sunshine, too.” He started blubbering as he looked around. “Oh my God! We have to get out of here. She works night shift here at the Jiffy Mart and gets off at 6. I was going to surprise her by standing by her car as the sun came up. Sparkling the way she wants me to. Now it’s all ruined!” He started sobbing and whimpering as he continued to swab at the glitter cream on his chest.
 

   
“Gibbie we can’t do anything or go anywhere until we get this stuff off of you,” Brynne said. She took the bottle of sterile water from Dean after he wet a white hand towel with it. She poured some into the plastic gauze packaging, grabbed a few with her gloved hand and began wiping Gibbie’s chest off. The hives were getting worse which was making Gibbie start to scratch at his chest and arms.

   
“Okay, Probie, what’s next?” She asked Dean as she continued to wipe down the patient. There was glitter everywhere. The ambulance was going to be a righteous bitch to clean later.

   
“Right,” Dean said aloud. “Allergic reaction. Moderate to severe. 0.01 milligrams per kilogram of epinephrine, up to 0.5 milligrams max single dose. He’s over 50 kilos so he gets the max single dose. Give 0.5 mg Epinephrine 1:1,000, intramuscularly?” His voice going up at the end of the statement as he looked at his preceptor quizzically.
 

   
“Yep,” she responded. “Do it. And make sure you double check the dose.” She continued to wipe at the frantically scratching vampire, trying to get as much of the allergen off his skin as possible.

   
Dean got the med bag out and unzipped the top. He swabbed the top of the medication vial with an alcohol prep, inserted the needle, and pulled the medication out of the vial. He then turned to the shirtless patient and swabbed his shoulder with another alcohol prep, glanced at the syringe barrel one more time then slowly injected the medication. Gibbie yelped a little. Dean drew out the syringe, snapped the safety cover across the needle and dropped the syringe in the sharps box next to him. Gibbie was already rubbing the injection spot so Dean didn’t need to do that to help hasten absorption into the muscle.
 

   
Brynne’s voice broke in to his concentration. “What’s next?” she asked him. “Epi’s on board but what else can you do or should you look for.”

   
“Okay, right. Uh, sir,” Dean turned to his patient. “Are you having trouble breathing? I mean, do you breath? I’m not familiar with your background.”

   
“Do I breath?” the vampire said, astounded, his voice getting higher and more frantic with each word. “Do I breath? Brynne, honey, what have you gotten me into here? You let this know-nothing cretin treat me?”

   
Dean flinched at the man’s reaction but in his mind it was a valid question. Vampires actually are dead, aren’t they?

   
“Calm down, Gibbie,” she soothed. “It’s only his second shift. He’s on the right track and we got the important medicine in you. You should be feeling better soon.” Brynne turned back to her partner. “Dean, to deal with the histamine release, causing the hives, what should you do now?”