A Thousand Naked Strangers (13 page)

“What's this?”

Even in the midst of the chaos, the noise, the rising panic from the kid shot twice in the face, there's something in the tone—the suggestion of a problem—that catches my attention. I turn to see a doctor looking at the Buddha's lower back, a gloved hand pressing him forward. Chris is looking, too, the color drained from his face. The doctor looks up, calls out a single entrance wound four inches right of the spine, lower back—right in the kidney. No exit.

Usually, in the immediate aftermath of a shit-kicker, the sudden quiet only amplifies all the leftover adrenaline. It hits like a head full of meth, and I'm high, almost bouncing, as the details sort themselves out and, for the first time since arriving on-scene, I have a chance to think about what I've just done. This moment and the memory of it, the promise that others like it are out there somewhere, waiting, are what keep me going through the dry spells when we run nothing but headaches and angry, piss-covered drunks. But tonight we can't enjoy it. We're frustrated and rattled. Out on the ramp, our ambulance is nothing but blood, bandages, and discarded packaging. The two-way radio dangles by its cord, smudged with bloody fingerprints. I lean in, look to where the Buddha was seated, and there on the wall, at kidney height, is a splotch of blood.

That we'd missed it isn't totally shocking. We had three patients fall into our lap, and our scene time was seven minutes; major trauma allows for ten minutes. It was hectic, we were outgunned. A lacerated kidney—if that's what the wound ends up being—is a problem for the surgeons; there's nothing we would've done differently had we noticed it. But we didn't notice it, and that's the point. It isn't that we could have saved him or bettered his care or had the hospital more prepared.
This is a matter of pride. We got our wish. We got our call—or something as close to it as possible—and we were less than perfect.

We drive back in a funk. We drop the camera off at CVS, which is open twenty-four hours and manned by a dirty little creature who clearly won't be scandalized by the photo of the teeth. After the film spins through the machine, the pictures are printed and slipped into an envelope. Outside, Chris riffles through, finds the shot of the teeth, tears it up, and throws it away. We ordered doubles, so I get my own set of what was on the roll. By the next morning, we've shaken it off. We both agree the call was fun, that it went well, that certain allowances can be made for the fog of war. As for the picture, we don't talk about it.

When I get home, I shower. Afterward, hair wet, half-dressed, I pull out the photos and thumb through. And there, staring up at me from the top of the stack, is the picture. The teeth, slick with blood, whole and accusatory. Like a thief through the window or a rat through the crawlspace, they have violated my home. I quickly throw away the photo but can't escape the fact that it's in my house. I tear it up, but it's still there. Finally, I burn it. It's gone, but like on the wall behind the Buddha's seat, the stain remains.

•  •  •

A few shifts later, Chris gets fired. Not because of the teeth or even the Buddha. It's about T-shirts. Fucking T-shirts. Chris had printed out shirts—with the logos of both Rural/Metro and Fulton County Fire—and sold them for ten dollars apiece, not to the general public but to us. We all bought them, we all
wore them. Some firefighter who never liked Chris complained and carried his grievance higher and higher up in the chain until a fire chief and some suit from Rural/Metro got together and agreed that Chris had reproduced their respective logos without proper authorization. And so a damn good medic got fired for a copyright violation. This is how the world comes undone.

C
hris's firing ends my brief stint as a True Believer. What happened is proof that pettiness can exist even in the midst of extraordinary circumstances. I still love the job, but never again will I be so seduced. I complain nightly to Sabrina, who has no patience for it. We agree it's time for a change. The only thing stopping me from resigning from Rural/Metro right now and applying to Grady is paramedic school. The class, sponsored by Fulton County, is specifically tailored to our peculiar twenty-four on/forty-eight off work schedule. I'll be done in three months, so I vow to sit tight, keep my head down, and finish. The second I get my numbers, I'm out.

As for paramedic school, it's okay. It's longer and more rigorous than EMT school, and we learn dozens of drugs and procedures—how to intubate, read a cardiac monitor, deliver shocks, and treat a sucking chest wound. We're supposed to spend hundreds of hours doing clinicals, shadowing doctors in ERs and ORs and on the OB floor, and many more riding third on ambulances. All this while working. I skip the clinicals and fudge my paperwork—so much for heroes. But the classwork is fairly demanding. We start with sixty, maybe seventy students. We finish with a dozen.

The months pass in a blur. I wake up at the station, head throbbing from only two hours of sleep, and go straight to class in the uniform I wore the night before. Brush my teeth in the bathroom down the hall. Then sit and learn about the heart, the lungs, the brain. Why the kidneys fail and what happens when they do. The endocrine system, pediatrics. For most people, it's enough to learn the signs and symptoms, the indicators of disease processes that are at the root of why your father is unconscious on the floor. As for me . . . lately, I've begun to see signs that the Tourist is back. I've tried to ignore it, study harder, work more. But I can no longer deny it.

Today we're watching autopsies, something I've been looking forward to for months. When we arrived at class this morning, instead of settling in for a lecture, we piled into a half-dozen cars and drove to the Georgia Bureau of Investigation. We're now gathered in a conference room, waiting. Finally, an investigator walks in, smiles, and asks if anyone's squeamish. “I know you've all seen the dead,” she explains when we laugh. “But here, in an autopsy, you don't merely
see
a dead body. You
dissect
it.”

The staff cuts up three bodies while we watch.

The first is a man who drowned in a lake on his birthday and whose waterlogged nuts poke up into the air like a cantaloupe. Next is a man who ran over a bee's nest while mowing. Rather than go for help, he panicked and locked himself in the bathroom. Last is a woman who had a heart attack in a grocery store. I look around. All my classmates are marveling at the cross-sectioned heart, eyes wide with wonder as the medical examiner shows us the offending lump of goop that broke free, stopped up her left anterior descending artery, and killed her instantly. They're mesmerized, and all I can think about is the cart full of
groceries—her uneaten last meal—that had to be solemnly restocked by a fifteen-year-old making minimum wage. What must
that
have been like? Forget the heart, the blockage, the anatomy of this woman's death. I want to talk to the grocery clerk.

•  •  •

The day before my paramedic exam, I have breakfast with Chris. Though he's working somewhere else, we get together on occasion. I'm nervous about the exam, but he says I'm ready. Or as ready as I'm gonna be. He says the first six months will be the hardest. “You won't know what you're doing, and you'll fuck things up, but probably not so bad anybody dies.”

“You sure about that?”

“Yup.”

Then he gives me three pieces of advice that he counts off on his fingers, starting with his thumb. “One: Know your protocols. Two: Don't second-guess yourself. Three: Never let 'em see you sweat.” These should be my
rules,
he says. I should commit them to memory, hold on to them, live by them, call on them in moments of crisis when all hell is breaking loose.

Despite Chris's stamp of approval, I'm nervous. The minute I pass this exam, I'm a medic. That means I'll no longer be an observer or an assistant. I'll be the one whose decisions determine the outcome of a stranger's emergency. Forget the medicine, forget the extra twelve months of classes—what separates paramedic school from EMT school is that getting through and becoming a medic means accepting the mantle of final responsibility.

When I'm a medic, it will all come down to me.

A
man stabs a woman in the chest. He does it with a dull pocketknife, rusted and grimy from a decade spent in his pants pocket. She screams and staggers backward, trailing blood through a crack house that's beyond filthy, urban decay taken to a hellish extreme. To the junkies and dealers, this place is home. To the neighborhood's elderly and infirm—poverty's hostages—it's a haunted house. Windows broken or missing. Door long since kicked in. Water leaking through the roof that warps the floors and turns the plaster walls into mush. A toilet no longer connected to the outside world, filled and overflowing with unimaginable waste. A rotating cast of crackheads turned genderless by desperation, who, with their lips blistered from white-hot crack pipes, give five-dollar blow jobs.

So what if a woman is stabbed in the chest? It's just another day in the Zoo.

This is the first call I run after upgrading from EMT to medic. My first call working for Grady. I'm sitting in the passenger seat, uniform too new to fit right, with a studied look of nonchalance. The day the notice arrived in the mail that I'd passed my paramedic exam, I applied at Grady. As luck would have it, they were hiring. I underwent a physical, a written test,
and a practical evaluation, smiled through an interview, then deposited my sign-on bonus. We spent three weeks in a classroom learning the Grady Way, then another three with field training officers, putting it into practice. Now I'm speeding through the streets, trying to focus but unable to think through the siren's scream. We're in the Bluff—the very part of town that Pike railed about three years ago during my ride-alongs—on our way to a crack house known as the Zoo, a place so notorious that someone has taken the time to spray-paint the words over the missing front door. As Biggie once said, if you don't know, now you know.

We pull up on-scene and walk through the house, but the patient is no longer here. We find her a block away, shirtless and screaming, fingers crack-burned, lips crack-burned, pants wet from God knows what. She has a red flower of flesh bursting out from her left breast. I try to listen to her lungs—ostensibly to see how far the knife has penetrated into the chest wall, and whether her chest cavity is filling with air or blood. In reality, I just need something to do. My hands tremble, my heart flutters, there's a weakness in my stomach. I listen but hear nothing. Which could be bad. It could also be that we're surrounded by noises: the distant whirl of a siren, the scream of the patient, the insistent yelling of the bystanders, the shouts of the drug dealers as they warn each other of approaching cops.

I'm starting to panic. I run through Chris's list of rules and land on “Never let 'em see you sweat.” I take a deep breath, followed by a longer exhale. It's not helping. The patient is still screaming. My partner is waiting for direction, but not for long. If I don't make a decision and set the chain of events into motion, she'll begin to act on her own, and there's no recovering
from that. The call will be out of sequence, and worse, when it's over, word will spread that I froze. To nut up, as they call it, is an act of paralysis, and it would leave an indelible black smudge on my reputation. No one would want to work with me, and those forced to would never trust me. All of this is in danger of happening, seems
destined
to happen, when—without warning, without provocation—the patient turns and runs. Disappears between two houses. I look at my partner, and she looks at me. Before either of us can say a word, a cop walks up behind us and says, “Did you see the tits on that broad?”

The day Chris passed down to me those three rules, he also gave me his clipboard. It's the clipboard we carried with us on every call, through every house, every situation we went through. It was the dented reminder of the confidence I'd built and the experience I'd gained in our time together. After he gave it to me I turned it in my hands, felt its heft. I opened it and took out the patient pen. Chris yanked on the end, and it farted. We both laughed.

Months later, I'm laughing once again—this time with a cop I don't know and at a patient who's all mine. As we stand in the street watching the patient—shirtless, pendulous breasts swinging in the heat—run in and out of view, I add a fourth rule: Look for the weird and take time to laugh. My mind has been so crowded with the practicalities of medicine that I've forgotten why I'm here in the first place. And it's this. So I can stand in the street and witness this moment. I smile. I laugh. My hands stop trembling. I motion for the cop to go one way around the house and for my partner to go the other. They flush her out, and I'm waiting. She's still yelling, and it occurs to me that it's not only unlikely but impossible to scream with
your lungs punctured and filling with blood. This isn't serious. We take her to the ambulance and away from the chaos. She stops yelling but keeps talking. Still alive, still panicking, still very high on crack.

We do a quick assessment, and it turns out she was only stabbed in the boob. Still, it looks nasty. The human body—hers, mine, everyone's—is basically sausage. Puncture the skin, really puncture it, and fatty tissue explodes out like a pink mushroom cloud. It stays that way, wobbling like chewed bubble gum, until it's stuffed back in and the hole is closed. It's neither practical nor hygienic to do this in an ambulance. I would never get the wound clean enough and in the end she'd wind up with a big festering boob. Which really isn't ideal. So I put a clean dressing on it while the cop tries to figure out what happened. The conversation loops around and around until it comes out that her boyfriend caught her smoking his crack, and well, the rest we know. The boyfriend's name is Fat-Fat, and the victim doesn't want to press charges. The cop hops out and closes the door. My partner puts the truck in gear, and we roll away.