Population 485 (26 page)

The wife is in the kitchen, reading the second letter. It is several pages long, with messages for her, for the children, for the agent that holds his life insurance policy. It begins simply:
I’m so sorry
. When he came home after the last CAT scan, he writes, and told his wife the cancer had been eradicated, he was only trying to spare her. The tumors have threaded their way deep into the liver.
I no longer possess the strength nor the fortitude to continue.
Fortitude. The word sounds so considered.

We stood with the wife for a long time, waiting for the coroner to arrive. She told us a little about the man she married, and we looked at family pictures. There he was, burly beside a hay wagon, waving from a tractor, cradling an infant daughter, him in his overalls, she in frilly footies. The face in the granary kept superimposing itself, and I strained to equate them.

Back home, when I step through the door and toss my keys on the chair beside the door, I notice the house has an echo and a chill to it. The call came in at 2:45
A.M
., and now it is after five
A.M
., and I have friends coming to visit at nine
A.M
. I want to get what sleep I can. All the way up the stairs and into my bedroom, even as I shuck my clothes and roll into the sheets, I keep seeing the figure in the granary. It’s a healthy and natural part of the accommodation process, I imagine, this constant reviewing of the image, but it just kept presenting itself, and I found myself reacting the way I always have after one of these calls: pondering the irrevocable nature of death, fighting the desire to call loved ones, wake them up and ask them, Do you realize how thin the thread is? That maybe tomorrow we don’t wake up? That sometimes the soul votes to tear the body down? I wasn’t terror-stricken or freaked out, just unsettled. And so finally I got up, threw on some shorts and a T-shirt, went downstairs, turned on some music, and mixed up a batch of bread. It took me about twenty minutes, and I set the timer, so that when the alarm woke me just three hours later, the sun was dazzling in the giant sugar maple outside my window, and the house was filled with the smell of fresh bread, risen and baked while I slept.

O
OPS

S
OMEWHERE IN A
K
ODAK
C
AROUSEL
T
RANSVUE
140 slide tray stashed on a shelf in my parents’ house, there is a photo of me visiting the zoo. It’s the early 1970s, I’m about eight years old, I’m wearing a red-white-and-blue striped shirt, I’ve got a cowlick springing up through my bangs, and I am lost in thought before a penful of piglets. The index finger of my right hand is jammed knuckle-deep up one nostril. I reckon there’s a lot of metaphorical potential to a picture like that, what with the pigs and the picking. While my finger burrows away with the industry of a coal drill, the rest of my body remains utterly relaxed, and my gaze has dissolved to a midrange trance. Upon closer study of the image, one reaches the conclusion that the pig pen boy is a bit drifty, a tad self-absorbed, and prone to low-key episodes of public mortification.

So I was, and so I remain. In pretty much everything I attempt, even when things are downright serious, I am conscious of a little voice suggesting that I am loosely moored, that I’m just two degrees from goofy, that at any moment circumstances will catch me with my metaphorical finger up my metaphorical nose.

So if you ever see me out there, in my fireman’s hat, or kneeling at someone’s bloodied head, trying to sort through everything that needs to be done, trying to keep it together, to recall all I have been taught, understand that I don’t feel heroic.

Pigpen boy is never far away.

I hadn’t been on the department long. It was the heart of winter, after midnight; a woman’s voice was on the phone. Cabin fire. Way out in the tules, lakeside. When we got there it was an incandescent stack of Lincoln Logs. Two of us pulled an attack line and moved in. We tried to work together, but we were wading around in six inches of water over a bed of ice. Mostly, we looked like a pair of hockey goalies wrestling an anaconda. A lieutenant beckoned, pointing back over his shoulder. He turned to lead the way, I swung the hose, forgetting to shut it down first, and it got away from me. A torrent of water as thick as a blacksmith’s forearm lifted the lieutenant’s helmet and smacked him in the back of the neck. He was drenched and frozen. By the time we got back to town, it was dawn. At the lone convenience store, the locals were picking up coffee for the drive to work. I waited in line to sign for diesel, and one of them turned to look at me.

“Fire?” he asked. I was wearing sooty bunkers, a fire helmet, and my shirt was soaked.

“Yep,” I answered.

“Where?”

“Out north a ways.”

“Stop it?”

“From spreading.”

You put on a uniform, or a jacket embroidered with the Star of Life, or even just a helmet, and suddenly you are imbued with authority. No matter that five minutes ago you were doing dishes, or singing in the shower, or drooling in your sleep.

I don’t like uniforms. For one thing, a signal joy of writing for a living is the freedom to clear the closet of everything but two old pair of jeans and a stack of T-shirts. For another, I rarely feel as if I can live up to what a uniform implies. But whenever possible—even when we make first responder calls in our street clothes—I try to throw on a jacket or a cap that gives some indication that I am affiliated with the fire department. The issue is not so much to establish authority, but to provide a touch of order in what is often a chaotic situation. You try to wear the uniform in such a way that it will be a source of reassurance to the person who has called for help. It is not unusual for your patients to feel more reassured than you.

I am looking into the eyes of an elderly lady. She thinks she might be having a stroke, but now she isn’t so sure. It’s early morning. The page got me out of bed, and I dressed in a hurry. My brother John is on the call with me. The lady is sitting on her couch, and I kneel down so I can make good eye contact. It helps with communication, and I can make assessments, too. I am looking for any little cues that she might be having stroke symptoms: facial droop, slurred speech, problems with orientation, any subtle hint that something may be gone haywire in her brain, some discrepancy of word or action that tells me her level of orientation has been altered. I even check to see how she is dressed—an incorrectly buttoned sweater or mismatched shoes can be a sign of something amiss. Close examination reveals nothing. She seems to be fine. I give her one more look-over, smile benevolently, and we leave. On the way to the ambulance, John points at my chest. “Might wanna fix that,” he says. I look down. My shirt. Inside out and backward.

I am in an old man’s kitchen. The old man says he had a woozy spell, and so he took some nitroglycerin pills. This is like saying you had high blood pressure so you did your taxes. The nitroglycerin has dropped the man’s blood pressure even lower, and now he’s really woozy. At the hospital, several of the paramedics are standing around, and so after giving report on the woozy man, I join them and chat for several minutes before one of them says, “So, Mike…time for new pants?” I look down to see if I’ve spilled something on myself. “In back,” says the paramedic. I reach around and find a gaping six-inch split. How long I have been strolling around this way, I have no idea. Understand also that it is autumn, and so I am wearing camouflage-print underwear.

It can be argued that one of the nice things about working in the field of fire and rescue is that for the most part, things went to heck in a hand basket before you were called, and so there is nowhere to go but up. This is why I dread the idea of delivering a baby in the field. Give me six bloody people in a crushed van any day; the damage is done, I can only help. With the baby, there is this expectation that you will not only
sustain
life, but
deliver
life. In the last decade, our little fire department has been called on to deliver only one baby. The call was in a farmhouse overlooking a swamp, and the cord was wrapped around the baby’s neck. My mom was on the call, and because she had experience as an obstetrics nurse, she took charge. The rest of the firemen will be the first to tell you they basically stood there wide-eyed, handing over towels. There is a little girl over in the grade school now whose arrival in this world is marked by a stork decal just behind the driver’s side door of our rescue van. It’s a cool thing to be proud of your mom, and I am, but mostly I’m glad it wasn’t me. I smile whenever I see the decal, but it also braces me a little. Reminds me we might be required to repeat the performance again someday.

Even when you come through under pressure, there is room for humility. I am way out in the country, in the back of the ambulance with a man experiencing chest pain. I need to start an IV, but he is refusing. He is on dialysis, and his veins are used up. “When I go to the hospital, they have to call anesthesia to get an IV in,” he says. “I don’t want you trying.”

“Well, I have to try,” I say.

“I’d really rather you not,” he says.

“Tell you what. We’re supposed to make two tries. I’ll just make one. If I don’t get it the first time, I’ll quit.”

“Weelllll…OK.”

It’s tough. I can’t raise a vein for anything. I readjust and tighten the tourniquet on the man’s bicep. Finally, down in the antecubital space, on the inside of the elbow, I see a little blue spot. There’s a vein in there somewhere. I uncap the needle and probe beneath the skin, expecting nothing. Blood flashes in the chamber. Glory be, I’m in. I hook up the tubing.

“You got in?!?” The man is incredulous.

“Yep.” I stay cool. Like I do it all the time.

“Well, you’re really something. That’s amazing. Even the anesthesia people can’t get in half the time, and they’re the best in the business. You must be good.”

I demur, real humble-like. But I’m thrilled.

One problem. The IV is running, but not as fast as it should. I recheck the tubing, make sure it isn’t kinked. I check the roller valve, make sure it’s wide open. It is. I check the stick site, make sure it isn’t infiltrated. Everything checks out. In the drip chamber, the drops fall tentatively, at long intervals. Better than nothing, I guess.

But it bugs me. The miles pass, and I keep sneaking looks, surreptitious-like. Finally, about a mile out of town, the man notices. “Something wrong?” he asks. “Well,” I say, “it’s running, but not as fast as I’d like.” The man points at his arm. “Maybe if you took that thing off?”

My face goes hot. I undo the tourniquet. The drops patter through the drip chamber like a one-note rainstorm. If they were striking a tin roof, you could hear them: “
Idiot…idiot…idiot…idiot…”

I was on jury duty recently. A man was fighting a drunken-driving charge. During voir dire, the plaintiff’s attorney asked me if I was able to look at a person in uniform and see a human being, capable of making mistakes just like anyone else. I said I could. I’m not sure he believed me. He had no idea, really. Rarely do I cherish my uniformed cohorts more than when they draw the screwup spotlight away from me:

1. 1. My partner, Flip, parks the ambulance and runs to an accident victim. The ambulance gathers speed slowly but is tooling right along by the time it T-bones a brand-new squad car. Parking the ambulance and
   putting
   it in park are separate issues.
   
2. 2. Palpating the foot of a man with a broken leg, Scooter Southern surprises everyone by announcing that he has detected a fetal pulse.
   
3. 3. A man has been ejected from his car on the interstate. He is lying in the median. He is conscious, and isn’t complaining of any significant problems. I am suspicious, though, because it is rare to be thrown this far and escape serious injury, and the man is a little disoriented. The state patrolman on scene is young, crisp, and efficient. He wouldn’t have to, but he helps us arrange a blanket over the man on the ground. He straightens up and jots some notes in his report.
       The man cries out. “Ow, ow, ooow!” I bend to his face, quickly. “What is it, bud?”
        “Ohh! Ohh! Down there!” He points with his eyes, because we have him all swaddled in gear. I do a quick survey. Can’t see anything. I flip the blanket back. The state patrolman is standing square on the man’s fingers.
        I have to tug the patrolman’s pants cuff twice before he notices. He pulls a silent-movie
   ooops!
   face and yanks his foot clear. I think the man on the ground never knew why the pain stopped.
        But I know. That I am not the only goofball in a hero suit.
   

It isn’t always the patient who suffers the brunt of screw-ups. I am on a call with Donna. There is a frail old man on the cot. Donna is not very big, and so, thinking I have to compensate, I execute a clean-and-jerk move with the head end of the cot, hoisting it way too high, way too fast and pushing it over center, causing the folding legs to collapse. The full weight of the patient shifts to the foot of the cot, yanking Donna to the ground and slamming her fingers between the rails. She is in great pain, but for the sake of the patient, she acts as if nothing has happened. I feel oafish and cloddy, but I am holding up the head end of the cot, and can’t apologize until we have gone all the way to the hospital and the patient is out of earshot.

Sometimes the goofy moments are sweet and funny. My brother and I picked up an elderly lady on the Alzheimer’s wing of the nursing home. She had become agitated and attacked another patient. She was being transferred to a psychiatric hospital for evaluation. She was very nervous and worked up, asking me the same questions over and over. “Where are you taking me?” “Don’t you hurt me!” “I want to see my doctor!” “Who is my doctor?” I answered her gently, over and over, the same answers every time. “We’re going to the hospital.” “No, Betty, no one will hurt you.” “We’ll see your doctor as soon as we get to the hospital.” “Your doctor is Dr. Jackson.”

She repeated the cycle of identical questions about fifteen times. Each time, I answered exactly the same, and always maintained eye contact. It seemed to reassure her. She became calmer. About ten minutes into the ride, she started the cycle again. “Where are you taking me?”