Out of Nowhere (The Immortal Vagabond Healer Book 1) (3 page)

‘Strong radial pulse,’ said Nique. ‘Rate’s a little fast, but not too bad. One hundred, one ten. How’s the wound?’

‘Not so deep as a well, nor so wide as a church door,’ I replied. ‘But ‘tis enough. ‘Twill serve.’

Nique looked at me with a raised eyebrow.

‘Shakespeare. It’s bleeding bad. Maybe his spleen. Don’t think it’s his bowel. Doesn’t smell bad.’

She tied a tourniquet. ‘I’m gonna line him up here, so he doesn’t go out while we’re carrying him down the stairs. His veins aren’t flat yet.’

‘Good plan.’

‘Hey, I don’t want no needle, man,’ he protested.

‘Dude! You have a sleeve full of Latin Kings ink and a knife wound in your belly. An IV is gonna hurt a lot less than that.’

Nique deftly inserted a 16 gauge IV into the man’s vein. To be fair, it was a big needle. But he had nice veins and if he did need rapid volume replacement, the bigger the better.

‘Ah,
puta
!’ he shouted, straining against the straps of the chair.

I put a hand on his throat and pushed him back into the seat. ‘Mira!’ I said. ‘Listen up. We don’t help you, you’re gonna die. You’re gonna bleed out. It may not hurt that much or look that bad, but your belly is filling up with blood. I’ve seen it. You need fluid, you need an OR. You talk to her like that again, you might need a dentist.
Comprende, pendejo?
’

He nodded in silence. I released his throat.

‘See, Nelly,’ said Carlos. ‘I told you he’s one of us.’

Violence among the gangs who controlled the drug trade was hardly new. Turf battles, real or imagined insults, too much youth, anger, drugs, money and testosterone without a constructive outlet or any real ambition. People got cut or shot or beaten for being in the wrong neighborhood, talking to the wrong girl or guy, wearing the wrong colors. But that was just business as usual. This attack was different. It had been done in broad daylight and seemed both brutal and carefully focused. Sure, it had been a bad wound to the dealer, but it was one stab. Nobody stabs somebody once in anger. This was a message. Don’t deal on this corner, or we’ll cut you. We don’t really care if you live or die. That’s how little you matter. And then a clear message to the buyer. Somebody was using a precise and careful application of violence in place of the usual messy and haphazard fashion common to street gangs.

I wondered if somebody had translated Sun Tzu for gangbangers. There promised to be interesting times ahead.

* * * *

We dropped our patient at the ER and cleared up. The rest of the shift was fairly routine. We treated a legitimate chest pain, a cry-for-attention chest pain by a guy whose girlfriend left him, and a beautiful example of how not to slice a bagel; we saved a prostitute unresponsive from a heroin overdose who signed herself out of the hospital and walked out, looking to score, before we finished our paperwork.

‘Hey, wait,’ Nique called after her as the patient walked past the tiny, battered EMS desk. ‘That medicine we gave you is gonna wear off before the heroin does and you’ll go right back to not breathing.’

In response, the woman flashed a hand at us, palm outward, in the universal sign of dismissal, her head held high and her expression haughty as a runway model; assuming stained halter tops, threadbare mini-skirts, scabbed knees and no panties was the hot new look in Paris and Milan this season.

‘Bitch,’ Nique muttered. ‘See if I save you again. Shoulda just left her there.’

‘Now, now,’ I smiled. ‘Where’s your sense of compassion?’

‘Used up about three calls back,’ she replied. ‘Next time I find that bitch unresponsive I’m intubating her.’

‘You’ll probably get your chance. Given her line of work, shoving a tube down her throat probably wouldn’t bother her all that much.’

She chuckled and her brow unfurrowed. ‘OK, I’m good. All sunshine and bunnies again. Maybe we can come up with some kind of incentive program for our repeat customers.’

‘What, like a card you punch? After six transports you can turn it in for clean needles?’

‘That could work.’ She smiled. ‘Seriously, why do we do this?’

‘Fifteen bucks an hour?’ I replied. ‘Actually, I just do it so I can hang around with you for twenty-four hours a week. You’re so damn sexy. I told ’em they could cut my pay if they bought you a tighter uniform.’

She laughed at that. ‘Oh, that did it. I feel better now. You’re the only one who gets to talk to me that way, you know.’

‘And I’m honored,’ I said.

It was true; for whatever reason, I could make comments and she’d laugh where the same thing from other guys would draw her Gallic ire. I wasn’t sure if I should be subtly insulted that my inappropriate comments were seen as witty and nonthreatening.

Our rapport confused me a little. Nique was funny, smart, a good medic and drop-dead gorgeous. We clicked well as partners, had a good enough time that the twenty-four-hour shift flew by, and got on well outside of the truck, but for some reason our flirting stayed in the realm of friendly banter, both of us understanding that it wouldn’t go any further.

I couldn’t put my finger on why.

Chapter 3

‘IT’S PROBABLY BECAUSE YOU’RE GAY.’ Peter, my Tuesday partner, delivered his expert opinion as we drove through the snow on the way to a call. It was a good distance out, mutual aid to the town of Riverdale, just downstream along the Merrimack from Philips Mills.

‘So why am I not attracted to you?’ I asked as we slowed at a red light. ‘Clear right.’

‘Well, that’s just crazy talk,’ he said. ‘Since I am an incarnation of masculine sexuality. Oh, yeah, do that, lady. Do exactly that,’ he added as a soccer mom in a minivan pulled out in front of the ambulance, then panicked and stopped in the middle of the road. As he steered around her, I gave her a charming smile and a salute.

‘Keep drivin’ like that, ma’am,’ I nodded benevolently. ‘Job security for us. Look,’ I turned back to Pete and the discussion at hand, ‘it’s not like I don’t know she’s attractive, it’s just that there’s none of that automatic lust instinct with her like with any other hot blonde. Watch this guy on the right, he’s gonna cut out—’

‘Thanks, man, I got him.’ He hit the siren.

‘I’m just sayin’ it’s curious is all,’ I continued. ‘I’m seeking insight and wisdom and you give me gay jokes.’ I shook my head sadly.

‘Dude,’ he replied with a grin, ‘this is EMS. Default conversation between male medics is limited to the hotness of particular women, what you want to do to them, sports or gay jokes. There is no provision for hot chicks you don’t want to bang. My hands are tied here.’

‘I just hoped we could break new ground, explore theories of attraction. Act like the intellectuals we obviously—oh, no. No. You did not just do that, you arrogant fucking douchebag asshole!’ This last directed at a well dressed man in a Lexus who pulled out around the car that pulled over for us. ‘Yeah, they pulled over for you, dickhead.’ I addressed his offended look as we passed him.

‘As an intellectual, you do realize you left out “cocksucker”? What was that address again?’

‘Ninety-five I think.’ I scanned the houses. ‘Oh, wait. Up there.’

‘The one with the engine blocking the driveway?’

‘We can hump the cot over the lawn.’ I shrugged. ‘There’s not much snow.’

The patient was in bed, where her family had found her unresponsive. A firefighter was performing artificial ventilations with a bag valve mask. There was vomit down the bedspread, but the patient’s color was good.

I took her pulse, strong and slow, while Pete started snapping electrodes onto the EKG leads. I got out my stethoscope and had a quick listen to her lungs. Plenty of air was getting in and out, but she did sound a bit junky.

‘What happened here?’ I asked the husband. ‘Did you find her like this or did you see her pass out?’

‘She just kind of gave a little shudder and stopped moving,’ he replied. ‘Is she going to be OK?’

‘Her pulse is good.’ I started with the good news, to keep him calm until I finished getting info. ‘And we’re working on the rest. When did she vomit? Before she seized?’

‘She vomited when we put in the OPA,’ offered a firefighter, holding up the large, curved, plastic oral airway device for inspection.

Ya think?
I said to myself.
She pukes when you shove a big hunk of plastic down her throat? Really?
‘Yeah, patients with a pulse generally don’t tolerate an oral,’ I said out loud. ‘If you feel the need to put something in, use a nasal.’

Her EKG and oxygen saturation were all very reassuring, and I thought I saw her chest rise in between the firefighter’s ventilations.

‘Stop bagging for a sec,’ I said. ‘I think she’s breathing on her own.’

Sure enough, she was. I still didn’t know what was causing her unconsciousness, but blood and oxygen were circulating, which is a good start. I began shopping for an IV site while Pete took a blood pressure.

I soon had the tourniquet on and a likely target lined up. I just got the needle in, watching the flash chamber fill and sliding the catheter forward, when she spasmed, sending my tape and saline flush flying. ‘What the—?’ I looked up and saw my friend the fireman bagging again.

‘OK, stop that. She’s breathing. It’s like CPR; you can stop when the patient asks you to.’

He retreated a step, but maintained his ready and eager position, still clutching the bag mask. I figured if I wanted to keep him out of the way, I’d keep him busy.

‘Grab me a non-rebreathing mask out of the O2 bag, could you?’

Look of eager incomprehension.

‘The green bag. Over there.’ Glued to the patient, unable to remove my finger from the IV still sitting unsecured in a vein, I fought down my frustration. ‘Yes, that bag. Grab that mask. No, no, that’s a nasal cannula. The mask. No, that’s a pedi mask. You can tell because it’s too small for her face and says ‘pediatric’ in red on the package. No, that’s O2 supply tubing.’ I struggled to remain calm as, with the expression of a Labrador retriever who expected the command to fetch a stick and was instead asked to solve a quadratic equation, he tore the plastic from yet another unasked for but previously sterile device, ‘Look, maybe you could just toss the bag over where I can reach it.’

‘I got it.’ Pete’s voice cut through my rising impatience. ‘All set, man.’ He placed the mask on the patient, then handed me the tubing for the IV and some tape, already ripped to the right size.

‘Thanks,’ I told him, ‘you’re a lifesaver.’ Only he and I knew I was talking about the life of Engine 4’s newest recruit.

He took the spent sharp from me and checked a blood sugar from it. ‘One four five on the sugar. BP’s 210 over 104.’

‘OK. I got this line secured. Let’s roll.’

We got the patient downstairs and into the truck. Before he closed the doors, Pete asked, ‘Sure we don’t need an extra pair of hands? I could ask the lieutenant if he can spare a guy?’

I glared up at him, murder in my heart, until I saw the wry half-smile that showed he was screwing with me.

Once we got under way, I did a more elaborate assessment, extending my senses down deep into the patient’s nervous system, looking for the anomaly that had to be there. I found it in a clot occluding one of the vessels in her brain. I sent a psychic nudge to the platelets to unstick them a bit, and hoped.

Trauma is easy for me. I can patch holes and fasten bones together without much difficulty. It’s like carpentry or pottery. Other mechanical issues like blockages are possible but harder. Disease is hit or miss; I have to try to convince the cells to act right, to repair themselves, which sometimes works and sometimes doesn’t. I felt pretty good about this one.

The nice thing about a stroke, it can resolve on its own and isn’t likely to prompt anyone to stone an underpaid ambulance jockey in the town square for using his Dark Arts; or call the tabloids, which might well be worse.

‘What do we want to call this?’ Pete asked through the passage between the driver’s compartment and the back.

‘Unresponsive. I’m leaning toward stroke. Doesn’t look like an OD, and her blood sugar’s fine. Pressure’s high, pulse is slow-ish. Let’s head to the Hole. They have a decent CAT scan, not like the one at the General that goes offline if a tech breaks wind.’

‘Holy Trinity Hospital it is.’

We dropped our patient at the hospital, by which time she was showing some improvement. Pete smiled as he climbed into the passenger seat of the ambulance.

‘Building bridges with the hose-draggers?’

I shook my head, ‘Ya know,’ I began, ‘don’t get me wrong. I’m glad that someone who isn’t me is willing to run into a burning building and pull people out.’ Or stop a fire spreading. I’d just as soon not see another Great Fire of London. ‘But do we really need three speedbumps in turnout gear surrounding my patient, doing nothing? Or even worse, misapplying the minuscule iota of medical training they did get at the academy between lectures on how to put wet stuff on red stuff? It’s not like that axe jockey from the last call is gonna get disciplined for sucking as an EMT. If a private ambulance crew was that clueless, we could choke them on scene, and get a medal for it.’