Authors: Shawn Grady
I slid against the wall. My eyes blurred the only light from the bathroom. I wiped my nose with my shirt.
“Look what you did,” I repeated, covering my head with my hands.
Sobs shrieked forth, shaking me like a prison break.
The tires hit the road. I bounced in my seat.
Bones whooped the
Dukes of Hazzard
theme song from behind the wheel, siren wailing. “ ‘Makin’ their way, the only way they know how!’ ”
We rounded a corner. The tires squealed. I fished the map book off the floor.
Our call was for a seventy-year-old female with heart palpitations. We were understaffed again and pushing nine minutes in response.
I straightened the map pages. She lived in a gated subdivision in the hills off McCarran Boulevard. The street names on the page diminished into branching swirls. I leaned close to the book, my eyes tracing a descending orbit of streets with all too similar names.
Babbling Brook Circle. Babbling Brook Court. Brookside Drive branched off of Brookview Way, not Brookview Road. I checked my pager to confirm the address. Bones banked around another turn. My head spun. I put a hand on the dash.
Bones flipped off the siren and slowed by the keypad for the community gate. He punched in the numbers given to us by dispatch and watched it swing slowly inward. We passed through and swerved through a series of downhill streets until stopping in front of a two-story house that overlooked the city.
An older woman wearing a tennis outfit and visor met us in front. “She’s inside. It’s her heart again.”
We carried the bags up a wide staircase. Ivory-colored spindles supported an oak banister. A white-haired woman lay in the master bedroom on top of a perfectly made bed, her face pale and diaphoretic. She breathed in rapid, shallow respirations.
It took only two seconds for me to know she was in bad shape. Bones knew it too and went to work. He placed her on an oxygen mask while I hooked up the cardiac monitor. He was already pulling out the IV kit by the time I took my first look at her heart rhythm.
Rapid, narrow. Really rapid. A hundred and ninety beats per minute. I felt her wrist. No radials. I felt her neck. She had a weak carotid tapping at that sewing-machine pace.
That heart rhythm wouldn’t sustain life for long.
I tried not to think about our extended response time. It wasn’t our fault.
I spiked an IV bag with tubing.
We’d left as soon as we were toned out and hauled across the valley to even get there in the time we did.
I pushed it out of my mind and went to my line of questioning.
Her name was Marie Straversky. She was allergic to penicillin. She’d felt this way a couple times before, but only briefly and not as bad. She’d felt nauseated and weak since she woke up an hour ago.
Bones deflated the blood pressure cuff. “Seventy by palpation.”
Too low.
That gave us two definitive options. Administer a medication to try to reboot her heart or go straight to an electrical counter–shock.
I was weighing the second option when Bones said, “Edison medicine?”
I looked at her, still conscious, eyes implicitly trusting whatever we chose to do.
“Do what you need to, boys. I just want to feel better.”
I shook my head. “No. Let’s go with adenosine IV.”
Bones taped down the IV he’d started. “One custom-crafted fourteen gauge at the AC.”
“Thank you.” I turned to our patient. “Mrs. Straversky, I want you to try something for me.” I handed her a syringe and asked her to try to blow the plunger out of it for ten seconds. The act of bearing down could stimulate a nerve that slows the heart. She pursed her lips and dropped her heart rate from one-ninety to one-eighty-five.
Nowhere near good enough.
Bones handed me two syringes. “Six milligrams adenosine and ten CCs normal saline.”
“Thanks.” I hooked them both up to ports on the IV line. The adenosine lasted only seconds in the bloodstream, so it needed to be pushed rapidly.
The monitor continued its accelerated beeping. I glanced at Bones. “Ready?”
He nodded and pushed the printout button. The paper recording reeled out of the machine.
I made eye contact with Mrs. Straversky. “You may feel a sudden pressure in your chest.” I drove the plungers into the syringes.
One. And two.
The beeping persisted.
No change.
“Did you feel anything with that?”
Her eyebrows tented. “No.”
Bones handed me two more syringes, this time with double the dose.
I leaned aside. “If this isn’t effective, we’ll do the synchronized countershock.”
He nodded.
The monitor beeped in time, drawing a long bed of needles.
I drove in the medicine.
One. And two.
No change. Mrs. Straversky stared at me.
The beeping hiccupped.
She groaned and clutched her chest.
The heart rhythm went flatline. Her eyes rolled and her head tilted back on the pillow.
Respirations stopped. As did her heartbeat.
The reel of monitor paper curled on the floor. Still flatline.
Come on now. . . .
A thin green horizon on a black background.
Come on. . . .
Bones’s fingers twitched over the intubation kit.
Still pulseless.
“That’s it. I’m tubin’ her.” Bones pulled out the laryngoscope handle.
“Wait.”
The elongated tone continued.
Still flatline.
He clicked the blade in place. “Let’s start CPR.”
It beeped.
And again. In growing succession, like soldiers cresting a hilltop, they flicked on the screen.
Mrs. Straversky drew a deep breath.
Bones reached for her wrist. “I’ve got radials with that.”
I checked the monitor. Eighty beats a minute. Then ninety. One-ten.
Slow down, slow down.
One-forty. One-seventy. Back to one-ninety.
The fire crew walked in soot streaked and smelling like smoke. The captain said they’d just cleared from a house fire. I asked them for another blood pressure while Bones explained to Mrs. Straversky that he needed to stick the two large defibrillation patches to her chest.
Her eyebrows knitted, her face morbidly pale.
A firefighter reported back on the blood pressure. “Fifty-four over thirty.”
Her eyelids drooped and her jaw went slack. I shook her shoulder. “Mrs. Straversky? Mrs. Straversky?”
I switched the monitor settings for a shock that would synchronize with her rapid rhythm. “Charging to one hundred joules. I’m clear. Everyone clear?”
The firemen backed away with hands in the air. I put my thumb over the shock button, the red light passing through the nail bed. “Shocking at one hundred.”
Her body jerked and relaxed on the bed.
I listened to the long somber tone of asystole.
I would breathe when she did.
It beeped.
And again.
In regular, marched-out succession, leveling at a beautiful rate of eighty beats per minute.
Color returned to her cheeks. She opened her eyes. “What happened? I have got a horrible headache.”
Bones smiled. “We’ll take a headache any day, ma’am.”
On the ride to County Hospital she was talkative though tired. Her tennis friend rode in the front seat with Bones. I sat on the bench seat beside her, jostling with the motion of the rig, jotting down info on her chart.
She brought a hand to my forearm. “Thank you for coming to my house so quickly.”
Quickly?
“Did it . . . seem fast to you?”
“Oh yes. Compared to the other times.”
“Other times were longer?”
“This isn’t the first time I’ve had to call you handsome young men. Aprisa has been to my house before. Though I do live a ways up in the hills.”
“But the ambulances, they didn’t arrive faster the other times?”
She shook her head. “Oh no. I was fortunate that you boys were closer this time.”
I patted her hand, got up, and sat in the captain’s chair behind the gurney. “Mrs. Straversky, I’m going to call the hospital and let them know we’re coming in.”
“Thank you, dear.”
I lifted the black phone from the wall and requested a patch to County’s ER.
Mrs. Straversky would be all right. Our training, our tools – they did what they were designed to do. But had it taken us any longer to get there . . .
There was a reason the first ambulances looked like hearses.
Bones swooned. “Has there ever been a sweeter voice to grace the VHF band?”
It was no secret that he was infatuated with the sultry-voiced new swing-shift dispatcher. She melted his butter like nothing else. If he were a Warner Brothers cartoon, his heart would be beating out of his chest, eyes star-crossed, with songbirds flitting about his head.
“Here she is, here she is.” He pointed at the radio console as if it held her very essence.
“Ten-four, Medic Two. Post Rock and Victorian.”
“Did you hear that?”
I looked at him sideways and dropped the transmission in gear. “Yeah. She said go to your post.”
“It’s not
what
she said.” Bones tilted his head back against the seat rest. “It’s
how
she said it.”
The radio chirped. “Medic Two, did you copy?”
Bones took a deep breath.
I turned east onto Mill Street. “You going to answer that?”
He stared at the radio.
“Medic Two. Do you copy?”
Bones picked up the mic and cleared his throat. He spoke in an unnaturally deep tone. “Affirmative, dispatch. Medic Two copies. Thank you.”
He held the mic over its dash clip. There was no response. His eyebrows angled and he said to me, “Maybe the thank-you was too over-the-top?”
The radio chirped. “Ten-four, Medic Two. My pleasure.”
Bones exhaled and smiled. “Did you hear that?”
I stopped at a light and scratched my head.
He hooked the mic on the center console. “Wow . . . ‘My pleasure.’ Man.” He pulled a foil-covered sandwich from the cooler at his feet.
“You are so gone for her.” My cell phone vibrated. “Hello?”
“Hi, Jonathan.” Dr. Eli’s voice.
“Hey, Doc.”
“I’ve been doing some background on our two deaths.”
“Yeah?”
“Simon Letell has no surviving relatives. And as far as I can tell, no friends either. It’s as though Dr. Martin was the last connection he had on the planet.”
“How convenient.”
“Exactly. It would seem, on the surface, that whatever secret Letell held has been effectively cast into the grave.”
Bones pointed, mouth full. “Light’s green.”
“Thanks.”
“What’s that?” Dr. Eli said.
“Oh, nothing. I’m in the ambulance right now.”
“Ah. Tell Thaddeus I said hello.”
“I’ll make sure to. Hey, Thaddeus.”
Bones glowered at me.
“Dr. Eli says hello.” I smiled and switched the phone to my other ear. “What about Martin? Was he married?”
“Yes. I was just about to get to that. His wife may be the best connection we have. She’s in old Sparks, off of Stanford Way.”
“Perfect. We’re headed that way right now. Can you text me the house number?”
“Ooh . . . umm. Okay. Yeah, I think I can do that. Let me know if it doesn’t come over.”
“Thanks, Doc.”
“No problem. And I have that autopsy on Martin coming up too. Perhaps that will shed some light on the situation. Take care, Jonathan.”
Bones radioed dispatch to put us in the area of Rock and Victorian. Dr. Eli’s text came through. The address was a bit outside of the one-mile radius of our post area.
I winced and looked at Bones. “Think you can ask dispatch for another favor?”
He shook his head. “I don’t know.”
“Come on now. Just because Jessica Rabbit is at the console – ”
“We don’t really have a good excuse this time. Besides, it would look like I’m just making up a reason to talk to her.”
I sat back. It was too much for me to accept Martin’s death as a coincidence. Something was going on, and I couldn’t shake the sense that time was of the utmost.
“We need to get over there.”
“No way. Our GPS signal will rat us out.”
“This can’t wait.” I glanced out the window. “So what, then? How’re we going to do it?”
Bones stared at the foil wrap around his sandwich. “There is one thing.” He stripped off the aluminum and grinned. “I’ve always wanted to do this.”
I stood guard by the back of the ambulance. We sat parked on Prater Boulevard. Two cars zipped by. “Okay, you’re clear.”
I gave Bones a boost and he clambered atop the box, aluminum foil in hand.
“How do you know which antenna to cover?”
He crawled forward. “I think the GPS is the big one in the middle.”
“You think?” The light changed at the intersection two blocks away. “Hurry up. Here comes another round of cars.”
“How long?”
“Ten seconds.”
“That’s not enough time.”
“Hit the deck.”
Bones dropped to his belly. I stood on the sidewalk with a hand on the ambulance, trying to look casual. The last car passed.
“You’re clear.”
“You think anyone saw me?”
“I think everyone saw you.”
“Anyone of consequence?”
I thought about it. “Hopefully not. Hurry up.”
“Okay. That should do it.” He dangled his legs off the back of the ambulance.
I threaded my fingers and placed them under his boot. “I can’t believe I’m touching the soles of your shoes with my bare hands.”
“If you only knew where these feet have trod.”
“I do know. That’s the worst part.”
He dropped to the street, the entire front of his uniform covered in dust.
I nodded. “Guess the roofs don’t get washed much.”
He brushed off. “We’ve probably got fifteen or twenty minutes before dispatch realizes there isn’t really a problem with the GPS system.”
I opened the back door and pumped disinfectant gel on my hands. “All right, then. Let’s do it.”