Authors: Shawn Grady
Bones put a hand on his shoulder. “Hello, sir. I’m Paramedic McCoy with Aprisa Ambulance. We’re here because your wife called us. Your blood sugar was very low.”
The man scratched at the IV in his arm.
“Ooh,” Bones said. “Don’t pull that just yet. Let’s get your head cleared up first.”
I pulled the rubber nasal trumpet out of his nose and placed a clear, two-pronged cannula in his nostrils, hooking the tubing around his ears and cinching it under his chin. “There you go. Take some slow, deep breaths through your nose and let that oxygen work for you.”
His skin color improved.
Bones nodded at the fire captain. “I think we’re good from here. Thanks, guys.”
The captain waved and his crew filed out.
We hung out with our patient for another fifteen minutes. He progressively became more alert and oriented and, after conversing with his wife, opted to refuse transport.
Non-transports didn’t make any money for the company. But Bones didn’t care about that. He cared about taking care of people and doing what was best for them.
That’s part of why I liked him. It’s why I knew I could trust him.
North Post smelled like Orville Redenbacher popcorn. Stray unpopped kernels littered the corners of the microwave. Sitting there only provided more time to ruminate about Letell and everything that didn’t make sense. Maybe I was just letting myself get too wrapped up in it. Things were looking up in my life. I was going from making a meager hourly wage to a full-ride scholarship to med school. I was going to be a doctor.
was on the TV again. “Are they having a marathon?”
Bones plopped on the couch. “Can you ever really get enough of it?”
The L.A. County electronic tones went off for Squad Fifty-One. The boys hopped in the truck to respond to a car over an embankment. Music accompanied their red pickup as it pulled out of the firehouse at twice normal film speed.
My radio beeped. “Medic Two, traffic. Priority one, 395 northbound for a multiple-vehicle accident. Subjects trapped.”
Bones chuckled. “Say, ‘Squad Fifty-One en route.’ Say it.”
I shook my head. “Medic Two copies, en route.”
I hopped behind the wheel this time. Bones didn’t bother with the map book. We knew where we were going. We screamed down Parr Boulevard and swung north on the freeway. Early afternoon traffic wasn’t too bad. I shut down the lights and siren until I merged us into the fast lane, then lit it back up.
About half a mile beyond the Stead exit a fire engine’s lights flashed. Traffic seemed at a standstill at the base of Anderson Hill leading into Cold Springs, cars stopped at odd angles on the freeway. I pulled up on scene next to the fire engine. Highway patrol wasn’t too far behind us.
I fought the urge to jump out of the cab. I forced myself to see the scene, to look at the broad picture of it.
One car lay on its roof in the center median, white smoke trailing from its underbelly. A person dangled from a seat belt inside.
Again the urge to go right to the patient. Get them out of the car. Care for their injuries.
I resisted the tightening tunnel on my vision and forced myself to look at the rest of it. Two other vehicles with major damage angled next to each other over two lanes. Looked like a driver in each. No visible passengers. A fourth car, with no damage and no occupants, sat parked on the shoulder.
Bones reported a size-up to dispatch and requested the medical helicopter, AprisEvac.
I stepped out of the ambulance and snatched the first-out bag from the gurney. “I’ll take these two. You got the rollover?”
“Yeah.” Bones strode off, holding a handheld radio by his ear.
Debris littered the scene. I reminded myself to walk.
Tires screeched. A horn blared. I whipped around to see a highway patrol officer yelling at a driver who’d nearly crashed into his patrol car.
I turned back toward the accident scene, and from a short distance away the first car looked like some kind of convertible sedan. The driver’s seat was reclined back, and a man lay in it motionless. I threw a glance at the second car – a black sedan with heavy front-end damage, a busted windshield, and an awake driver who looked like he might be trapped by a collapsed dashboard. One firefighter leaned in a window, talking to the man inside, another pulled a hose line between the three damaged vehicles. I came upon the driver’s door of the first car, and my heart sank into my stomach.
This hadn’t been a convertible.
The driver lay with the top of his skull missing, along with his brain – his life shanked in one transecting moment. He was someone’s son, someone’s friend.
But I couldn’t see victims. I had to see patients. Problems to fix.
And this one made rapid triage easy.
On to the next.
A fire department ladder truck and a light rescue unit arrived. I came to the driver’s side window of the black sedan.
A fireman was in the back seat holding the man’s head in line with his neck. “This is Jeff. He’s forty years old, complaining of pain in his neck, his side, and his legs.”
Jeff’s face looked pallid.
“I’m going to ask you a few questions, Jeff. Try not to move your neck, okay?”
He winced. “Okay.”
“Can you feel your hands and feet?”
“Were you knocked out?”
The door had folded over a foot against him. I reached for his wrist. Strong radial pulse, rapid. Skin felt cool and clammy. His body was compensating against shock, but time was short. We needed to get him out quick.
“Hang in there. We’re going to remove the car from you instead of the other way around.”
I heard the helicopter approaching.
Fire crews stretched hydraulic lines from the bumper of the ladder truck with steel spreaders and cutters in hand. The Jaws of Life. A tall truck captain walked toward me, his red helmet at an angle.
I put a hand on his shoulder. “Code fifty in the first car. This one in the black sedan needs rapid extrication. I’ll tie in with my partner at the rollover and let you know what we’ve got there.”
He nodded. “Sounds good.” He turned his head toward his shoulder mic and spoke something into it.
The ladder truck roared into high idle. Firefighters went to work, prying and cutting.
Heavy helicopter blades whipped overhead from the AprisEvac MD 900. A flight medic stood with the door open and one foot on a landing skid, torso bent to get a clear view of the cylindrical tail boom. The pilot made his descent. Pebbles scattered and shot through the air.
I shielded my eyes and caught up with Bones in the dirt median. He knelt by the driver’s window, talking to a man trapped upside down in the rolled-over vehicle. Firefighters with struts and wood cribbing worked to stabilize it.
“What you got?”
“One male patient. Stable. E-T-O-H.”
The abbreviation for ethyl alcohol. It was a useful way to say that a patient was drunk without the patient realizing it.
“Got ya. Injuries?”
He shook his head. “No. Once they get this thing stabilized, we’ll get a bunch of hands to lower him onto a backboard. I’ve got enough guys here to do it. What do you got?”
“One code fifty. One trapped. Critical, though conscious.”
I walked back to the truck captain and shouted to be heard. “The rollover patient is stable but intoxicated.”
He pointed at the black sedan. “So this patient on the bird first?”
I nodded. “Yeah, I think we can take the rollover patient by ground.”
Back at the black sedan I noticed Jeff’s color had deteriorated from pale to ashen. The firefighters worked to pry the driver’s door open.
I really didn’t want a second death on this accident. First one wasn’t my fault. This one . . .
We needed to get moving.
At the passenger side I pulled out a bag of normal saline and spiked it with IV tubing.
The flight medic and flight nurse hopped out of the helicopter. Wearing white helmets, they carried bags and hunched beneath the rotors. It wasn’t until the nurse drew closer and pulled off her helmet that I recognized her.
The AprisEvac engines idled down, and the fire captain gave Naomi a quick rundown on the patients. Naomi caught my eye and turned to her partner.
I leaned in the passenger window and wrapped a tourniquet around Jeff’s right arm. He looked to be in decent shape. He’d normally sport ropes for veins. But with his blood pressure tanking, nothing was visible. His body was trying to protect his core organs by shutting down peripheral circulation. I felt around for a vein in the antecubital space at the crook of his elbow. My fingertip found a faint rounded shape.
A familiar female voice spoke behind me. “Can you get a fourteen in that?”
I craned my neck, seeing only Naomi’s torso through the window, her flight suit following her curves, name and title stitched into the fabric
She bent down and smiled, sandy chin-length hair dangling, eyes still the same striking blue.
I kept my finger on the vein. “I’ve got it by feel only. Better give me an eighteen gauge.”
She raised and lowered her eyebrows, went to the roof, and returned with the smaller needle. She handed it inside with a wry curve to her lips.
She was going to shame me into a larger-bore catheter. The bigger the IV needle, the faster we could flow fluid into Jeff’s body and improve his blood pressure. But also the more difficult of a stick.
“All right,” I said. “Fine. Give me a sixteen.”
A smile tugged at the corner of her mouth. She opened her other hand to reveal the larger sixteen-gauge.
I prepped the IV site on Jeff’s arm with an alcohol swab, pulled his skin taut with my thumb, and inserted the needle. A flash of blood confirmed my placement. I popped off the tourniquet and held pressure above the catheter.
Naomi held a red needle container for me.
I hooked up the IV line.
Naomi lifted the saline bag and spun the white wheel on the tubing. “Good flow. Running wide open.”
The car rocked with a loud metallic pop. The driver’s door creaked open. Another firefighter moved in to cut the hinges.
The truck captain walked up. “We’re going to take the roof.”
“Got it.” I took the IV bag from Naomi and squeezed it under the passenger-side headrest. “Hang in there, Jeff. This fluid’ll get your blood pressure up. They’re going to cut off the roof and get that dash off your legs. All right?”
He kept his eyes closed. “Okay.”
I picked up the first-out bag and backed out of the way. Firefighters went to work on the roof posts.
Naomi zipped up her medical bag on the roof and slung it over her shoulder. She took her helmet in hand and stood back beside me. “It’s been a while, Trestle.”
How long had it been? I didn’t think we’d spoken for more than five minutes at a time over the past four years. “Where have you been flying out of these days?”
“Ah.” I glanced over at Bones. It looked as if he and the firemen almost had their patient out. “You like it up there?”
“It’s pretty. But slow. I’m actually back here at County now.” She tucked strands of hair behind her ears. No ring on her finger. “I like it. The days fly by. Literally. How about you?”
“You know, still working the streets. Four twelves. Did have a strange code the other day.”
“What was it?”
“An older guy in full arrest on the sidewalk. We got him back. He said some bizarre things. I went to drop something off for him in CCU and found out he’d left the hospital already. I followed up and found him dead outside his motel room.”
“Wow. That is weird.”
“Yeah. Name was Simon Letell. Ever run on him downtown?”
“Sounds vaguely familiar.”
I watched the firefighters lift the roof off the black sedan and carry it out of the way. “How’re your parents?”
“My mother . . . She’s had some health issues. But they’re getting through it.”
A hydraulic ram pushed against the dash. Plastic creaked and cracked.
The captain pointed. “Now get a new purchase point here.”
In the median Bones and the other fire crew strapped their patient to a backboard.
I wanted to tell Naomi about the scholarship. I wanted to know if she was still living in Truckee and what was really going on with her parents, to hear about her life since we – since our friendship had reached its limit. But all I ended up saying was, “You must like flying.”
To a disinterested nod.
The waning momentum reminded me of the other “conversations” we’d had in the past years. I didn’t want it to end. “You been doing much on your days off?”
She eyed me. “Reading.”
I scratched my jaw. “That’s it? You just stay at home and read?”
Naomi folded her arms and creased her eyebrows. A strand of hair came loose from her ear and fluttered in front of her face. “Who said I just stay at home? I happen to get out quite a bit.”
Dagger to the spleen.
Why did I even ask?
The firemen reclined the driver’s seat and slid a backboard behind Jeff.
Her statement shouldn’t have bothered me. Of course she’d get out and be social, be seeing other people. . . . Other guys.
I cleared my throat. “So you get out quite a bit?”
“And like what, have a book club at the coffeehouse?”
Naomi pushed her lips together. “Jane Austen is a fine companion. Tea at three and a good read is all a girl needs.” She flashed a quick look at me.
“That’s all a girl needs, huh?”
She drew a breath – “Absolutely” – and pulled on her helmet. “You said your patient’s name was Letell?”