Population 485 (27 page)

“We’re going to the hospital.”

Something changed in her eyes. A little slyness, a little exasperation.

“Well, I
know
,” she said. “You said that
fifteen times
now!”

I do not limit my ignominy to rescue work. I was on a bike racing team for a while in the ’90s. I was mediocre. Except for one race. I was off the front alone, and opening a sizable gap. I had only to maintain for a few more laps and victory was mine. I remember swooping into a corner. I remember right in the apex of the curve the speedometer said 27.5 miles per hour. I remember I thought I might be taking the corner a little wide. I remember a tremendous thump, as if maybe Barry Bonds took a swing at my clavicle. I remember waking to the sky. What I have done here, is drive straight into a concrete bridge, completely unassisted. Today, one of my shoulders rides lower than the other. It twinges sometimes when I pull fire hose, or load the ambulance cot. I feel the twinge and remember that for a few laps there, I was god of the Peloton.

Sometimes you get set up. A man is trapped in a crumpled car. It takes us a very long time to get him out. It is so cold that chunks of blood are freezing in his hair. There is a lot of blood. He spits it by the mouthful. It’s all over my goggles. My turnouts are spattered. My helmet is dotted. We can’t find the source. The chopper is coming. The firefighters peel the roof back. Then they winch the steering wheel over the dash, off the man’s lap. We stick him in the ambulance and ride to a landing zone set up in the parking lot of a bait shop. I grab a penlight, lean over the man, frog around in his mouth with my gloved fingers, trying to locate the bleeder. The surge and pulse of the blood tells me there’s a severed artery in there somewhere. Blood has a way of looking like far more than it is, but still, I’m nervous about how much he might be losing. I keep probing, until a red stream the diameter of a pencil lead sprays from the man’s mouth. It arcs over his chest and retreats, then pulses again. I trace the stream back to a small gash inside the man’s lower lip. I wedge a fat piece of gauze in like a wad of chew, and it flushes red in an instant. So I grab another piece of gauze, tell the man this might hurt, and pinch his lip, hard. It’s the only way I can get the bleeding to stop. I hear the chopper land, and the flight nurses come in the back doors. I hand off the patient, and jump out the side door, into a four-foot free-fall. The rig is parked with the door overhanging the ditch. From my vantage point—in a heap, down in the weeds—I see Tee Norman and the chief, peeking around the side of the ambulance and giggling. “Figured that was gonna happen,” says Tee.

Part of the trouble there was that after pulling the man from the car, and locating the bleeder, I got caught up in the idea of Myself as Heroic Rescuer. When I jumped out of the ambulance, I thought I was wearing a cape. I don’t always listen to the little warning voices in my head. Last winter we fought a ravenous warehouse fire. Leaping flames, rolling smoke, the water freezing over everything like a glass shell. To get a better angle on the fire, I climbed atop a ten-foot pile of ice-coated bricks. You can see it coming, but not me. I noticed the photographer from the local paper skulking about. I am suspecting I cut quite a figure atop these bricks, all icicle-fringed and silhouetted against the banks of smoke. I am thinking this will make a noble picture for the
Chetek Alert
. These thoughts are still in my mind when my boots shoot out behind me and I perform a credible quarter-gainer, terminating at the base of the brick pile in a full-frontal face mask smash. Lieutenant Pam is watching. She can’t see too well, because ten minutes ago I managed to blast her in the face with a fire hose. Her eyes won’t be right for a week. But she can see well enough to tell it’s me, face first at the bottom of the pile, and perhaps she is thinking there is such a thing as karma.

Sometimes you have to get preemptive. The final morning of our biannual refresher class, I got overexcited on a page-out and screwed up in a way that left evidence dangling in the ambulance bay. Everyone would be sure to see it when they walked in for class. So before anyone arrived, I went to the dry board at the front of the classroom, and aping the style of our instructor, wrote the following:

Basic Refresher Item 1 for Sunday, 9/9

• Yes, someone took off in 245 without unplugging the landline.
  
• No, the pigtail did not detach.
  
• Yes, the main cord ripped itself out by the roots about 30 feet up.
  
• No, Mike Perry would really rather not discuss it.
  

Could be worse. Three years ago Tee Norman roared off to a fire in Pumper One, inexplicably failing to observe that all the equipment doors—which open up and out like wings—were open. Peeled them all off on the garage-door frame. Damage in the four figures, easy.

Could be sillier. The chief once directed a fire scene for several hours before he realized he had forgotten to put on his pants and was parading around in his long johns. He once threw the wrong lever on the pumper and sent water coursing into one of the hoses still accordion-folded in the hose bed. The hose exploded like one of those fake snakes in a peanut can. Took an hour to untangle. I incorporated the incident into a piece of humorous fiction. The chief functions under the weight of the knowledge that if he screws up, he will likely hear about it on a public radio variety show.

Ultimately, you leverage dress, demeanor, and terminology in an attempt to project an aura of calm and control. The true hero is steady in the maelstrom, one hand tending the victim, the other pointing the way to definitive succor. You will need, sometimes, to squeeze your eyes shut real tight to maintain this image. To say nothing of your nose.

I am backing the car out of the driveway when the pager goes off. I intend to meet the grunt novelist Mike Magnuson for a training ride south of Eau Claire. My bike is in the backseat, and I am wearing Lycra biking shorts, a light blue racing jersey, matching ankle socks, and cycling shoes. Man unconscious in a barn, the dispatcher says. I have no intention of going on the call, but figure I can open the fire hall doors, find the fire number on the map, and get the rig started and ready to roll for whoever shows up. I tug off my cleats and pull on my steel-toed Caterpillar boots. I leave them unlaced. They flap around my ankles when I run.

I get everything ready, and still no one has shown up. I take a quick look up and down the street. No one. Looks like I am the only first responder in town. It’s the last thing I want to do, but I jump in the rescue van and take off.

It’s hot and muggy, and the air in the barn is heavy and wet, sweet with the smell of manure. The farmer is lying across the cement walkway. He was milking a cow when it stepped sideways and pinned him against a waist-high pipe stanchion. He thought he heard something pop. When the cow swung away, the man tottered to the walkway, then suffered a Valsalvian reaction (a precipitous drop in blood pressure subsequent to increased intra-abdominal pressure preventing normal blood flow to the heart) and fell to the floor, cracking his head. He’s on his back now, head lolling over the gutter. In order to assess his airway and take cervical stabilization, I have to step right into the gutter channel, into a slick of creamy green manure. At my back, stretching away to either end of the barn, a horizon of black-and-white cow rear ends. I grew up on a dairy farm, and I know what effect excitement has on the Holstein bowel. Excitement = Excrement. Tails are already cocking up and down the walk. I glance over my shoulder and wince. Two big hocks and the back end of an udder. I’m really not worried about getting kicked—unlike horses, cows kick more powerfully to the fore than the aft—but when I turn my eyes upward and see Bossy’s greasy tail twitching between a pair of dung-stained thurls, I ask the hired man if he can find a tarp or something. He hustles off and returns with a square of plywood, which he holds between me and the cow’s rear end. I put my hands on either side of the farmer’s head to stabilize his cervical spinal column and check his breathing. I’m locked into this position now—once you take up manual C-spine stabilization, you are not to release it until the patient is definitively immobilized, usually after being strapped to a long board and secured with head blocks.

He was unconscious for about five minutes, says his wife. He’s semiconscious now. “Can you hear me, Jerome?” I ask, and there is no response. “
Jerome! Can you hear me?
” Now his eyelids flutter, and he mumbles something affirmative. Later, filling out the report, I’ll check the little boxes next to “verbal” and “confused” and “sleepy.” I’ll also write a little note including the fact that he was originally unconscious. It’s basic stuff, but we try to record as much information as possible, have it ready for the ambulance crew. It establishes an important baseline. As the farmer is passed up the line to more definitive care, his status can be gauged against what we found when we first got to him. I have some help now—Tim, one of our new first responders, has arrived in his private vehicle. I hold my position at Jerome’s head, and Tim continues Jerome’s assessment. Pupils equal and reactive to light, albeit sluggishly. No visible bleeding or cerebrospinal fluid discharge from the ears. No Battle’s signs (bruising behind the ears indicative of a basilar skull fracture). Hand grips equal bilaterally, movement in both lower extremities. Subaxillary breath sounds present bilaterally. No obvious chest or abdominal injuries. No tracheal deviation that might signal a collapsing lung. I don’t have my handheld radio, but the ambulance should be getting here soon. Tim is taking Jerome’s blood pressure. Jerome is able to tell us his head and belly hurt. Behind me, some stop-start splashes, then a cascade. The cow is peeing. The urine hits the concrete and spatters across the gutter. Jerome is getting spritzed. I clamp my legs together and shift to shield his face. Hot pee soaks my shorts and dribbles down my calves. The hired man has wandered off. I can see the plywood square leaning against the wall at the far end of the barn.

The ambulance is here now. On their way out, they put the chopper on standby. Based on the fact that Jerome is talking now, they cancel the chopper. Then, concerned when he seems to be losing consciousness again, they radio back and give the chopper the go-ahead. I keep my position while Tim and the paramedics carefully package Jerome and attach him to the longboard. Now the cow behind me jacks her tail and lets go a loose stream of feces. The bulk of the volley misses me, but I can feel the warm patter of the ricochet dotting my back and legs.

Once Jerome is affixed to the board, I run out of the barn to set up the helicopter landing zone. A freshly mown hay field behind the farmhouse looks like it will do nicely. I point the rescue van south and park it with all the strobes lit and spinning. Then I do a quick walkaround, making sure there are no loose objects in the area that might become airborne in the rotor wash. Back in the van, I hear the fire base trying to contact me. Some of the other firefighters have returned to town, and seeing the van out, wonder if I need any help. Now that Jerome is all set and the landing zone secure, I tell them no, but they are already on their way, and so will continue. And somewhere along the line, a group of first responders from Sanderson has headed our way.

You hear about turf wars in EMS, but we’re blessed. We get great support from neighboring services. A little overlap happens now and then, but it’s mostly viewed as welcome help. So the fact that the Sanderson crew was coming out of its area wasn’t an issue. In fact, I suspect they got started when they didn’t hear me responding on scene. They were being neighborly.

But they were led by Lorraine.

Lorraine is flat surly. Somewhere along the line, a particularly tenacious bug has burrowed up her transverse colon and taken residence, sideways. She throws equipment on scene. She cusses her own EMTs. She’s been known to kick an ambulance cot and send it careening down a hallway. She wears cowboy boots and dresses like a man. She also happens to hold a position of some power in local EMS circles. So one must be circumspect. It’s a shame, really, because Lorraine has given years and years to the ambulance service, no doubt often for no thanks. And yet, the most reward this public service appears to have given her is a lemon wedge in each petulant cheek.

So you dread Lorraine.

Everyone arrives at once. The Sanderson contingent, in several pickups. A couple of our guys in pickups. Our fire truck, with lights flashing. The chopper. I radio the pilot, tell him the landing zone is over here, south of the flashing lights. He sees the lights on the moving fire truck, and radios back. “A moving landing zone…that’s a first!” I jump back on the air, redirect him to the flashing lights on the stationary rescue van. He brings the craft in nicely.

Jerome is loaded. The chopper departs. I’ve been busy, but now I have a moment to catch my breath and look around. There are trucks and flashing lights everywhere. A platoon of firefighters and first responders. And Lorraine, headed straight for me. I wince. She pulls up and asks if that was me on the radio, telling the firefighters I didn’t need any help. “Yeah, we pretty much had everything covered by then,” I say. Lorraine lights into me. “You don’t
ever
land a chopper in a field without a fire truck standing by!” I don’t remember hearing this in any training session, and suspect Lorraine is just target shooting, but I let her go.

And she does. For quite a while, right in my face. She wants her pound of flesh, which is apparently grafted to my ass. And so I am standing there, on this hilltop in this fresh-mown field, in the center of this circle of friends and strangers, my bare shit-spattered legs stuffed into my clodhopper boots, my skintight shorts reeking of cow piss, and Lorraine is yip-yapping, and I am looking her right in the eye and just taking it, because she might have a point with the fire truck thing, but mostly because I figure the gas she vents might take the pressure off the colon bug and get us all some relief, and I’m thinking, if I had gotten up three minutes earlier this morning I would be on my bike right now, pedaling past sunny meadows just like this one, and thinking, what a glorious day is this…