Emergency! Fic, part one:
Mar. 15th, 2006 07:09 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
Some of you have seen the drafts. (And thank you for the encouragement!) But I think it's ready for primetime now.
Triage
…a rewrite of the end of the episode “Women”: the scenes we might have seen (if a fan had written them, anyway.)
What had happened so far: In the episode, Roy and Johnny have a reporter named Christy who has been riding with them all shift, looking for material for a story on the paramedic program. The only problem is that she’s a recent convert to Women’s Lib and like all recent converts, she takes things too far – she’s convinced that she could do what the firefighters do, (without the same training) and has stuck her nose in where it wasn’t wanted a time or two, putting up everyone’s back in the station – especially Johnny. Things have come to a head in a verbal argument where she asserts that the firefighters are using “routine skills”, when an alarm goes out for an explosion in an abandoned warehouse.
At the warehouse, Johnny and Roy go in searching and Johnny finds a man in the basement named Bodine. It turns out that Bodine is the one who set the bomb, and with five minutes to go, confesses to Johnny and Chet Kelly that there is another one set to go off. Just then another search team finds a little girl that needs medical care and digging out. Roy and Kelly take Bodine and Johnny goes to help get the little girl, sending a warning to the Captain about the bomb. Working extremely hastily, John frees the girl and passes her to another pair of firefighters and the two of them run for it with her. Johnny starts to follow, but a beam falls on him and he’s momentarily pinned. He manages to kick free, but he can’t use his leg and he falls on the way out.
Meanwhile, Roy has noticed that his partner hasn’t made it out. In spite of it being the time when the bomb is meant to go off, he heads back inside, finds Johnny, and pulls him out. They run for the shelter of the squad, where Christy is waiting, her assumptions in shreds.
The episode, of course, went to black the moment they were safe, but I couldn’t resist the chance to play. Thanks to
surgicalsteel for medical details and ideas. Any mistakes are my own
--**--
It was faster to run than to try to get a good grip for carrying, even if Johnny did grunt with pain every time his left foot bumped the ground, so Roy ran, holding up his partner as best as he could, concentrating on the bright red edge of the squad, and shelter. They’d only just turned the corner – barely missing Christy – when the bomb went off.
The explosion was smaller than he’d expected, somehow. Less catastrophic. A glance over the top of the squad showed pieces of corrugated steel falling, and the center of the building settling farther into the ground as dust and smoke poured out of the broken windows and torn walls. But the rest of the block was still standing, and the ground hadn’t given more than one hard shake. Still. He braced his legs to keep them from buckling, leaning against the sunwarmed metal of the squad as he tried not to think about how very near Joanne had come to being a widow this time, brightly aware of his heart pounding in his ears and the smell of burning wood and metal starting to drift over on the breeze.
Johnny managed to stay upright long enough to look at the damage too, before sinking carefully to the ground. He glanced up once, at Christy, but he wasn’t breathing any more easily than Roy was, and his head dropped again, sweat dripping off his face as he gripped the sore leg with a white-knuckled hand.
Roy made himself push away from the support of the truck. “I’d better take a look at that leg,” he said, knowing that Johnny would hear the strain in his voice, no matter how hard he was trying to sound professional.
But Johnny shook away the offer. “The little girl,” he said shortly, fumbling the sphygmomanometer out of his pocket and passing it to Roy. “Hurt worse.”
Wanna bet? Roy thought, but he accepted Johnny’s assessment of the situation, same as he’d done a couple hundred times over the past two years. He lifted his head and spotted Marco Lopez and Mike Stoker, watching warily from where they knelt by a blanket that had been laid out near the ambulance. “Marco!” Roy called. “Come help Gage while I check on the girl.”
“Right,” Lopez pushed to his feet hastily.
“Stoker,” Captain Stanley intervened. “You bring over the equipment. Kelly, help Lopez get Gage over there so DeSoto can keep an eye on him while he works on the other victims.”
“Right, Cap.” “Sure thing, Cap.” Both men hastened to obey, and Roy felt a little better. He dropped a hand on Johnny’s shoulder for a moment, but couldn’t think of anything to say, so he headed for the girl instead.
Johnny was right. She was in worse shape. A growing knot on her forehead, and a deep cut on one shoulder were the obvious things, but there were so many contusions on her side and back it was hard to say if any of the ribs were broken. Roy’s guess was yes – and carrying her out that hastily hadn’t helped anything. He reached for the biophone as soon as Stoker had it set up. “Rampart, this is Rescue 51.”
“Go ahead, fifty one.” Brackett was at the radio. Good.
“Rampart, we have two additional victims. The first is a female, approximately six years old. BP is 80 systolic. Pulse is 100 and weak. Respirations 20 and shallow. She has extensive bruising, especially on the torso, with probable broken ribs, a possible concussion, and several lacerations, one deep on the right shoulder. Request permission to begin an IV.”
“Fifty one, do you have parental permission?”
Roy glanced up at Stoker and got a shake of the head. “Negative, Rampart. We pulled her out of the building next to the warehouse, but there hasn’t been time to identify her.”
“Fifty one, it doesn’t sound like we have time to wait. Start an IV with Ringers, my authority. Have you got ambulances there?”
“Just one, Rampart,” Roy said, biting his lower lip as he waited for the decision. He wanted to send Johnny at the same time as the girl, but Brackett couldn’t know that yet.
“Try to get the girl stable and then transport as soon as possible. Keep an eye open for any sign of a lung collapse.”
“Ten four, Rampart.” Roy looked around for the drug box, but it wasn’t with the other equipment. He remembered that Johnny had been carrying it when he’d gone after the girl. “Mike! Bring me the big box and pull an IV kit and some Ringers’ for me, will you? And I’m either gonna need another squad in here or someone to go after that drug box Johnny dropped inside.”
“I’ll see to it,” Captain Stanley said. “Lopez, do you think you can remember where that room was?”
“Sure, Cap.”
“Then follow the hose team in and see if you can get that box, on the double. And be careful. We’ve got a fire on our hands now, and we can’t afford to be another man down.”
“Right, Cap.” Lopez headed off. He sounded relieved to Roy, as if he were glad to have something concrete to do after leaving Johnny inside a building that was about to explode. Roy swallowed a sudden rush of anger. He didn’t have time to lose it, not right now. You leave your heart at the station when you go on a call, he’d been told once, long ago. It just gets in the way.
The Captain moved away, starting to direct the guys from Ladder 8 and truck 10 as they approached the fire. Roy could hear him asking the dispatcher for a back up squad, but he couldn’t hear the answer. He tried to remember which squads weren’t out on calls. His hands were busy, looking for other injuries on the child.
The biophone interrupted his thoughts. “Fifty one, what is the condition of your third patient?”
Roy turned the handset on his shoulder so he could talk into it and still work on the girl while he eyeballed Johnny. With Marco called away to look for the drug box, Chet had been left to support the injured paramedic alone, and they were making the trip slowly. Johnny wasn’t even trying to straighten his leg now, and he was getting paler with each hop closer to Roy and the blanket. “Rampart, the third patient is John Gage. He got hit in the leg, looks like just below the knee, and then I had to pull him out before the bomb went off. I haven’t had a chance to get vitals yet, but I can see he’s in a lot of pain.”
“Fifty one, say again. Bomb?”
“Long story, Rampart. I’ve only got one ambulance here so far. Which patient do you want first?”
“Hey! This guy’s leg is bleeding.”
Damn. “Rampart, be advised that the first patient is hemorrhaging.”
“Ten four, fifty one,” Brackett replied, but Roy had already dropped the handset and scrambled for the stretcher with Bodine, taking the place of the deputy who was trying to stop the bleeding.
“What happened?”
“He tried to get up and make a run for it,” the deputy explained.
“On this leg? He wouldn’t have made it fifty yards,” Roy started packing bandages onto the wound, hoping he wouldn’t need a tourniquet. They always seemed to him to be more trouble than they were worth.
Bodine swore, “I’d have made it.”
“Yeah, like you made those bombs?” Roy couldn’t help the edge of anger in his voice. He swallowed it back. “I don’t think this is your lucky day.”
Bodine made a rude noise. “Hell, no,” he agreed. “Ouch! Be careful!”
“I’ll be careful all right,” Roy muttered, wishing for just a moment that he was the sort of guy that could have been deliberately rougher than he was being.
“Me too,” the deputy agreed, taking his handcuffs off his belt and attaching Bodine’s wrist to the stokes stretcher.
Roy looked back over his shoulder. Flames were leaping up now from the warehouse, and Captain Stanley was yelling for Kelly and Stoker to come run lines inside. Johnny was lying on his right side next to the girl, with the injured leg curled on top of the other one. His face was white under the sunburn, but he had the little girl’s hand and was talking to her in a low voice with all the charm he could muster and a caricature of his usual smile plastered on over the pain. Christy had her camera out, but she wasn’t using it – she was just staring at the burning building and the hornet’s nest of activity from the firefighters. “Vince, hold those bandages in place, and tell me if he’s getting worse. I’ve got to get back to that little girl.”
“You got it, Roy. Anything else I can do?”
“Just get me some ambulances.”
Roy scrambled over to the blanket again. Johnny acknowledged his arrival with a short nod. “I didn’t want to risk doing the IV,” he admitted. “Too shaky.”
“That’s okay, Johnny,” Roy said, “You just keep her calmed down, and let me handle the rest.” He needed another pair of hands. “Hey. Hey! Christy! Do you know how to use a radiotelephone?”
She started to nod, and then shook her head. “No, not really. But I’ve been watching you two all day. You have to press that switch on the handset to talk, right?”
“Right. Make sure it’s set to frequency one. I need you to relay some information for me, to the hospital. If you’re not sure what I said, or they said, ask for a repeat, okay?”
She knelt by the biophone and looked Roy in the eye. “I’ll do exactly what you say,” she promised soberly.
“Good.” Roy flashed her short smile. She really was intelligent, and determined, and he thought that she’d probably had enough of a scare with that bomb to stay within the lines for a little while. Long enough for him to do what he needed to do, anyway. “We’re Rescue 51, they’re Rampart Base. Call ‘em and tell them that we’re controlling the bleeding on patient one with pressure, and that I’m starting that IV on patient two.”
“What if they ask about patient three?” She asked.
“Pale, respiration fast. I’ll get the other vitals as soon as I’ve got the IV going.”
“Pulse is 100,” Johnny interjected. “Stoker took it.”
She had her notebook out and made a note and then activated the biophone. “Rampart, this is Christy, for Rescue fifty one. Do you hear me?”
There was a short pause; then Brackett came back, audible over the tinny speaker of the phone despite the noise of the fire and the shouts from the firefighters. “Go ahead, fifty one, we hear you loud and clear.”
Christy took a breath and read from her notebook. “Patient one. The bleeding is being controlled by pressure. Patient two, the IV is being established right now. Patient three is pale and his respiration is fast. His pulse is one hundred, but we don’t have the other vitals yet.”
“We copy fifty one. What does the leg look like?”
She put the phone aside. “Roy, they want to know what his leg looks like.”
“So do I,” Roy said. “Tell ‘em to stand by, and then get Johnny’s bandage scissors and cut up the trouser leg – carefully.”
“Right,” she said into the phone, and then blushed. “I mean, stand by Rampart. We’ll take a look.”
As she moved around to find the bandage scissors in the leather pouch on Johnny’s belt, Roy bent to the IV, listening to Johnny’s low reassurances. “It’s okay, sweetheart. My partner’s just going to put some medicine in your arm, to help you feel better. I know it’s scary, but it will make things better I promise.” He gasped a little as Christy fought with the fabric of the trouser leg, and Roy, glancing over, saw sudden tears spring into his partner’s eyes. “See, I hurt too. But I know it’s just to make it better. Do you understand?”
She whimpered, but she let Roy have her arm, and he quickly established the IV, putting a splint on the arm to keep her from bending it again and dislodging the needle. As soon as it was taped into place he took a look at Christy’s handiwork.
She’d gotten the pants leg split up as far as the knee, and was going carefully around the corner, using her hands to pull the split apart, rather than trying to push the scissors against Johnny’s skin. Her shadow made everything look dark – but then she moved and Roy realized that it wasn’t her shadow. Johnny’s leg was bruising up fast.
Christy finally got the seam ripped far enough up that Roy could see a few inches of paler thigh. She rested back on her heels and looked over to him. “What do I say?” she asked, looking more unsure of herself than he’d seen her all day.
“Tell them 'expanding hematoma over the lateral leg extending from the lateral epicondyle down over the anterior compartment of the calf.’ Got that?”
She repeated it back, word for word, grabbing her notebook and scribbling it down in shorthand before heading for the biophone again.
Johnny wasn’t even trying to look. He rested his head back a little and closed his eyes. “That good, huh?”
Roy palpated the little girl carefully. Her respirations were getting more labored, and he wasn’t sure if it was because she was on the verge of crying again or something worse. “Yeah. So try not to do any fancy dancing until I can get over there.”
Johnny snorted. “I’m not dressed for waltzing,” he said, almost smiling for a moment before he grimaced and swallowed hard. “Wish I’d remembered to grab that drug box, though.”
“Rampart says they want his BP, as soon as possible. And they need vitals and a description of the injuries on patient one,” Christy interrupted.
“Didn’t I…?” Roy realized suddenly that he’d never had a chance to get the numbers from Johnny or pass the information along to the hospital. “Tell ‘em Male, approximately 35, 180 pounds, bleeding from the right quadriceps, about three inches above the patella. Johnny bandaged it before I saw the wound, though.”
“Deep tear,” Johnny contributed. “From a nail on beam. It’ll need to be debrided. Not arterial, yet, but close.” He fumbled at his pocket. “Pulse was… I don’t remember. It’s in my notebook.”
“It will have changed by now anyway,” Roy said, catching Johnny’s arm and putting it back down. “Ask the ambulance attendant to get you a new reading, and then count how many breaths the patient takes in fifteen seconds and multiply it by four for the respirations. Got it? Tell Rampart I’ll get a BP after I do Johnny.”
“Got it.” Christy repeated what she had so far into the biophone, scribbling more shorthand into the notebook propped on her knee and then got up to go over to the ambulance attendant, who had overheard and freed one hand from the bandages to take Bodine’s unhandcuffed wrist.
Roy glared at the other ambulance attendant, who was leaning over the radioset in the ambulance instead of making himself useful. “Hey, hey, what’s your name?”
The guy startled a bit. “Me? Tim. Tim Dolan.”
“Do you have O2 in the ambulance?”
“A small tank, sure.”
“Get it, and start ventilating this little girl while I check the other two.”
“Sure.” Dolan reached into the back and came over while Roy grabbed the sphygmomanometer and switched around to Johnny’s side of the blanket. “Hey, did you hear that? There’s been a huge pile up on the LA freeway. Our guy says it must be twenty – thirty cars.”
“Your guy?” Roy asked, with a sinking feeling in his gut. He eased Johnny up to a sitting position and started working off the heavy turnout coat, so he could reach an arm for the BP.
“Yeah, they’re right in the middle of it. I just heard them telling central to send for every paramedic they can get.”
Roy thought frantically. “Was that ambulance coming here?”
“Both of ‘em were for here,” Dolan said, getting the oxygen mask into place over the girl’s nose and mouth. “And it sounded to me like they both got mixed up in the pile up. It’ll be another fifteen minutes, minimum, for another team to get here. Probably more when the side streets fill up with all that traffic.”
The PA system on the big trucks began to blare out alarms, confirming the news unmistakably as the news helicopter that had been hovering overhead veered away. Roy propped Johnny against his own chest and held out a hand. “Reach me that handset, will you?” Dolan nodded and put it into Roy’s hand. Trying to ignore the trembles and small whimpers from Johnny, Roy focused on what he needed to say, “Rampart, it looks like we’ve lost the two additional ambulances to a really big traffic accident on the freeway.”
“Fifty one, we are getting reports on it too.”
“I want to send the girl now. She’ll need monitoring, but I can’t go – I’m the only functional paramedic here. We’re looking at fifteen minutes plus to get another ambulance, and the longer this one stays here, the longer it will be stuck in traffic on the way there. Her IV is in and I’ve got her on oxygen, but I’m worried about those ribs, and I haven’t had a chance to do anything else.”
“Easy, Roy,” Brackett sounded authoritative, the way he always did when he was worried about something. “Is there any chance Johnny could monitor her on the way in?”
Roy felt Johnny’s head shaking. “No way,” Johnny admitted in a strained voice. “I’d probably pass out.”
“He says ‘no’, Rampart,” Roy passed along. “And I can’t send her and the bleeder. He’s the one who set the time bombs.”
“Fifty one, can you sedate him?”
“No!” Roy shouted, and then wiped his face with the back of his hand and pulled himself together. “Sorry. Negative Rampart. Our drug box was inside when the bomb went off. Lopez is looking for it now.”
There was a horribly long pause before Brackett came back. “Fifty one, send the bleeder now. The ambulance attendant and the deputy can probably handle him. I’d rather the girl stayed with you in case she aspirates or a lung collapses. I’ll do my best to get you a copter and a spare drug box. I’d send you a doctor, but it looks like we’re going to need all we’ve got.”
“Ten four, Rampart.” Roy said, dropping the handset and going back to working the coat sleeve down Johnny’s arm without jarring him any more than he had to. Losing Bodine would take some of the pressure off anyway, and if anybody could get a chopper diverted over here it would be Brackett. He looked around for the deputy, grateful that it was one he knew well. “Vince!”
“What is it, Roy?” Vince Howard came at a run.
“Rampart says we need to send Bodine in now. Before the traffic gets bad. Can you ride with him?”
“I’ll send Dave,” Vince said. “He needs the experience more than I do.”
“Tell him to keep the pressure on those bandages!”
“Got it!” Howard headed off, waving at one of the deputies who were managing traffic at the end of the street.
Roy nodded to Dolan. “Bodine may get shocky. Probably will. Keep the blankets on him and watch that bleeding. If it goes bright…”
“Then we put on a tourniquet. Yeah, they teach us that much anyway.”
“Only if you’re more than three minutes from Rampart. If you’re closer than that, just hang on tighter and run for it.”
“Got it.”
“Shouldn’t you get his BP before he goes?” Christy asked. He realized that she’d been waiting nearby, with her notebook open and her pencil moving while she waited for a chance at the biophone. “So we can tell the hospital?”
Roy wanted to swear. No. What he really wanted to do was get some decent vitals on his partner and see if he couldn’t make him more comfortable somehow. If he could just be sure that Johnny was all right, then maybe the butterflies in his stomach would settle down and he could concentrate. He took a deep breath. Made himself think. Christy was right – they’d want that BP. Especially on a bleeder. And he was the only one who knew how to get it.
“Johnny, see if you can’t get the little girl’s name. I’ll be right back.” He eased Johnny back to the ground, glad that he’d got the coat sleeve off anyway. “Christy, get one of the blankets and put it over Johnny, will you? Soon as you get a chance?”
Taking Bodine’s blood pressure meant having to sit still long enough to do it, and it was soothing, in a weird way, to listen to the heartbeat in his ears while he watched the needle twitch as the level fell. “110 over 85,” Roy called to Christy as he pulled the stethoscope buds out of his ears and started unwrapping the cuff. The numbers seemed borderline to him. “Ask ‘em if I should start an IV before he goes.”
Bodine grabbed his sleeve. “What about the girl? Is she gonna be all right?”
“I don’t know yet,” Roy answered.
“What the hell was she doing in there, anyway?”
“Who knows. Maybe her family can’t afford to pay rent. We find people in all sorts of buildings, no matter how bad they look on the outside.”
Christy called back, “Rampart says just get him moving.”
Roy pulled his arm free, nodded to the ambulance attendants and the deputy. “You heard the lady. Drive careful.”
He dismissed Bodine from his thoughts, and went back to Johnny, wrapping the bared arm with the cuff before he had a chance to get interrupted again and placing the bell of the stethoscope against the crook of Johnny’s elbow. The skin was definitely clammy and cool under his fingertips, the heart rate fast in his ears. He watched the dial, willing the numbers to be strong.
“115 over 90.” He pulled the stethoscope out of his ears. “Johnny, how’s the pain?”
His partner was even paler than he’d been before, and he’d bitten his lip bloody while Roy was working on the coat, but at least he was still conscious and coherent. “Scary,” he said shortly. “I think something’s broken.”
Roy took another pulse. “It’s up to 110,” he told Christy, who had just finished reporting the BP over the phone. “Tell Rampart I want to start an IV.”
“You’d better check this little girl first,” Johnny told him. “I think she’s having trouble.”
Roy wished he’d had the sense to position his patients so he could kneel between them. He scrambled around to the girl’s side and listened to her lungs. Under his fingers he could feel tiny bubbles under the skin – like rice krispies. “Subcutaneous emphysema,” he said. “The lung’s collapsing. Christy! I need the phone.” Going through an unpracticed intermediary wasn’t going to work for this part.
“They said okay for the IV, Ringers Lactate,” Christy said quickly as she passed the handset to him. To his surprise, she got to her feet and started running across the little park toward the buildings on the other side before he could ask her to help make sure the respirator mask wasn’t going to come loose.
“What?” Roy wondered.
“Maybe she had to powder her nose,” Johnny said, reaching over to hold the mask in place on the child’s face.
“Or got scared.” There wasn’t time to wonder. Roy checked to make sure the phone was working. She’d turned down the gain on the speaker, probably because of the chatter on the frequency, and he hadn’t realized how many squads the base was trying to juggle. But after a moment he found an opening and keyed the mike. “Rampart this is Rescue Five one, we have subcutaneous emphysema on the child’s left side. She is losing consciousness and her respirations are becoming very labored.”
“Fifty one, have you found your drug box yet?”
“Negative, Rampart.” Roy said. “I think it’s gone for good.” He propped the phone on his shoulder and took out his scissors to cut away the rest of the girl’s shirt while he waited for Rampart to come back to him.
The next voice he heard in his ear was Joe Early’s. “Fifty one, is the drug box the only thing you can’t get at?”
“Affirmative, Rampart.”
“Think you can put in an improvised chest tube, if I talk you through it?”
“I think I’m going to have to,” Roy said, glad that it was Dr. Early asking. “Unless you can fly her out of here somehow.”
“Kel’s on the phone to Dispatch right now. But if you can get that air out of the chest cavity, it will improve her chances.”
“Just tell me what to do, Doc,” Roy said.
“Okay. First, I want you to have some things within reach… Most of them should be in the amputation kit. But you’ll also need a ten cc syringe with the plunger and needle removed, a scalpel, sterile towels, a curved clamp and plenty of betadine to sterilize the area. Don’t forget to glove. I’ve got four other squads calling in on this frequency, and base two is just as overloaded, so when you’ve got the operative field ready, just say ‘Fifty one’ and I’ll get back to you.”
“Got it.”
Roy got up and began collecting what he needed. Johnny asked, “Can I help?” in spite of the fact that he hadn’t even tried to sit upright. In a moment of inspiration, Roy took one of the IV kits and a bottle of Ringers and passed it to his partner.
“You get that in your arm and I’ll let you handle the biophone,” he promised.
Johnny pulled a face. “You always hand me the easy jobs,” he said.
Roy had to go to the squad to get the amputation kit, although the rest of the boxes had been placed near the patients. As he passed it, Captain Stanley took a moment from the radio. “Do you need any help, DeSoto?”
Roy nodded at the fire. The two buildings on either side of the warehouse were collapsing inward now, and flames were leaping up through the roof. “Can you really spare anyone?” he asked drily.
Stanley shook his head, “Not easily. But I can ask Central if they can spare us a cop.”
Roy shook his head. “Rampart’s asking to send a chopper. Give that your blessing, and I’ll manage until they get here.”
“You got it.” The captain turned back to the fire and the radio and Roy went back to his patients, feeling reassured somehow just by the fact that the Captain had noticed he needed help, even if there weren’t any hands to spare.
Johnny was mangling his lower lip again as he tried to thread the needle into his arm vein. Roy thought about saying something and didn’t – he didn’t want to break Johnny’s concentration. Instead he started preparing the little girl, pouring antiseptic over her side and chest and laying sterile towels all around the area. He opened the amputation kit and laid it beside him, making sure he could reach each item Early had named, and then checked again. Johnny had the needle in his arm, and was hooking the bottle to the other end of the tube.
“Here, give it to me,” Roy said. He made sure the connection was tight and hung the bottle off the hook on the oxygen tank of the respirator and then passed the biophone over so Johnny had it. “I’m going to need to keep the gloves sterile,” he said. “Think you can get the directions to me?”
Johnny wiped the sweat off his face. “I’ll do my best.”
“Then let’s get started.”
“Rampart, this is fifty one. The field is ready.” Johnny listened intently, and then reported. “You want the fifth or sixth intercostal space on the mid-axillary line. Early says tell him when you’re sure you’ve found your place and marked it with the pen.”
“The fifth intercostal space…” Roy mumbled, closing his eyes for a moment to remember the page in the anatomy book. “That’s about the level of the nipple, isn’t it?”
“Rampart, this is fifty one, that’s about the level of the nipple, right?” Johnny nodded automatically and grimaced when the movement jarred him and curled a little tighter. “Early says that’s right,” he said through gritted teeth.
Roy felt carefully, trying to make sure he wasn’t over bone instead of the space. “Got it,” he said, using one of the sterile towels to hold the pen and his teeth to uncap it. He marked the spot with an ‘x’ while he was waiting for Johnny to get the next instruction.
“Okay, keep listening Rampart while I say it,” Johnny told the phone. He closed his eyes, as if he had to think hard as he spoke. “You want to use the triangular scalpel to make a shallow incision long enough for your finger and the syringe, and you’re going to want to go in across the top of the nearest rib, not underneath one. Cut the skin first, then you need to use the curved clamp to open the hole up further in. When you get deep enough you should feel the air coming out. It’s going to hurt, so if you think she’s conscious enough to react, you need to be ready to hold her still with your other hand.” He sighed. “Rampart says did you get all that?”
“Make an incision, and go over the top of the rib. Open it up with the clamp until I feel the air,” Roy said. “I got it.” He got the scalpel and the clamp and started doing what he’d been told.
“What’s happening?” Christy was back, panting and redfaced, with two loaded garbage bags in her hands. Roy hesitated with the clamp at the interruption, not wanting to look away while he was actually doing the work.
“Where did you disappear to?” Johnny asked impatiently.
“Rampart said to pack your leg in ice,” she said back, just as impatiently. “So I went to get some.” And before either Johnny or Roy could tell her not to, she lowered one of the bags onto Johnny’s leg, not ungently.
Johnny made a strangled noise and his eyes fluttered back into his head, and Roy, whose hands were busy, said a word he hadn’t used in front of a girl in his entire life. “Christy! Grab the phone!”
She was so startled she dropped the bag the rest of the way, which probably made things worse, but she grabbed the phone. “What do I do?”
“Hold it on my shoulder so I can talk!” Roy ordered, in no mood to trust her to relay the instructions. “WAIT! Go around so that you don’t drop any dirt onto the instruments or the patient!”
“Right… Right!” She grabbed the handset and brought it around, pulling the cord so it wasn’t hanging over the girl. Roy took a breath, letting Dr. Early finish with 8s before he said anything.
“Rampart this is fifty one. I got interrupted. Say again? After the incision. What am I doing?”
“Fifty one, you’re going to go over the top of a rib by using a clamp to spread the incision. You’ll have to push pretty hard to get through the pleural muscles, but go carefully. You don’t want to do more damage to the lung. Tell me when you hit air.”
“Stand by Rampart.” Roy was just grateful he’d withdrawn the clamp when Christy had shown up or he probably would have made things worse. He went in again, as close to the top of the rib as he could get. The little girl made an involuntary movement, but he’d remembered to hold her gently with his other hand and at last he heard and felt the rush of air coming out of the wound. “Okay Rampart, Fifty one has hit air.”
“Well done, fifty one. Are your gloves still sterile?”
“Yes.”
“Then reach in carefully with your finger and make sure the lung is expanding.”
“Reach in?” Roy wasn’t sure his finger would fit between the girl’s ribs. She was so tiny. Gingerly, he tried it with his smallest finger. Something was moving in there – he hoped it was the lung. He pulled out the finger. “Rampart, fifty one. I feel something anyway.”
“Good, fifty one. How’s your patient?”
Roy looked. “She’s breathing more easily. A lot more easily.”
“That means you did it right. Now put your syringe into the hole, over the rib, same as before. Tape it into place for now. We’ve got a proper chest tube on the way to you.”
“Ten four, Rampart.”
“Call me if you have any problems,” Early said, and then Roy could hear him addressing 8s again.
He had a cramp from the phone. “Okay Christy, you take it now.”
She took the headset and listened. “Is he talking to me?” she asked, hesitantly.
Roy shook his head. “There are squads at the accident up on the highway now. Rampart’s probably juggling ten different patients on one frequency. You just answer if you hear our number.” He wiped his hand on one of the sterile towels and reached for the tape, wishing he’d thought to tear loose some strips before he’d started. He sure couldn’t get one started now.
“I could do that for you,” Christy offered.
“No,” Roy said. “No, I’ll just hold the tube in place. I’m just going to have to switch it when the real chest tube gets here anyway.”
“When will that be?”
Roy scanned the sky, and saw one of the dots that were helicopters growing as it headed towards him. “Any minute now,” he said. “Do me a favor and go into the back of the squad and find the other stokes. The metal stretcher, like we had Bodine in. And don’t forget a blanket this time. If I can talk Rampart into it, I’m going to send Johnny in with the chopper.”
“Why not the little girl?”
“Because she’s going to need me, or someone like me, monitoring her condition even for a three minute helicopter ride. And someone needs to take a look at that leg before he ends up losing it.”
Her eyes widened, but she went for the stretcher. “Don’t leave the blanket behind!” Roy called after her, and then bent over the tube he was holding, listening to make sure that air was escaping when the girl exhaled.
He closed his eyes – just for a moment – and wondered how Joe Early had known how to fake the operation. Did doctors spend half the night over their books trying to plan for possibilities, the way that he still sometimes did when he was off shift and Jeanne was busy with the kids, poring through words on paper until they knew they would see bone and muscle and blood in their dreams?
A sound he couldn’t quite identify brought him out of his musing. He opened his eyes, checked the little girl’s pulse, counted respirations, considered how to get a BP without letting go of the syringe that was keeping her lung from collapsing again, and decided he’d have to prop the syringe. He looked around for Christy, wanting her hands, and saw that she was her tucking her camera back into its case. The stokes, with its yellow blanket tucked into the straps, was at her feet. “What are you doing?” he asked.
“My job,” she said. “My editor will kill me if I don’t have some pictures to go with this story.” She nudged the stretcher with her toe. “I don’t think I can put him into this by myself.”
“I don’t want you to try,” Roy said. “Just lay the blanket over him. Gently. I’ll get him in the stretcher if I get the go ahead.”
She nodded and began unfolding the yellow plastic. “I’m sorry about the ice,” she said. “I thought it would help.”
Roy was tired of being angry. “It will slow the hemorrhaging. That’ll make a difference. But it makes it even more important to keep his core temperature up.”
“Core temperature?” she asked, but she asked it while she was moving around to Johnny and spreading the blanket.
“The temperature inside the torso. When someone is in shock, all the blood moves inward, to keep the heart and organs going. It lowers circulation to the extremities, which can be a good thing if you’ve got a traumatic amputation, but can endanger them too. So we try to keep the temperature up, and add an IV to keep the blood volume up.”
“IVs to treat shock are half the reason we pushed for the paramedic program in the first place,” said a familiar voice and Roy looked up so fast his vision went gray at the edges for a moment.
“Dixie!” He looked around. “But where’s the chopper?”
“They dropped me off around the corner to avoid sending a downdraft onto that fire of yours,” she said, waggling the plastic toolkit she carried in one hand in the general direction of the warehouse. In her other arm she had two bundles that looked like she’d grabbed them straight out of one of the treatment rooms. “And then they went to run in a patient for Squad 110 from that mess on the freeway. But they’ll be back.” She dropped to her knees by Roy and began to unbundle a surgical kit. “Here, let me check on her while you stand up and stretch out. You look like you’ve been crouching over too long to me.”
“I can’t let go of the syringe,” Roy confessed. “I don’t know how to keep it from coming out or falling in or something.”
“Then hang on to it for a little longer and let me get set up. I’ve brought everything I need. Looks like an 18 French tube will fit, or a sixteen – she’s awfully small.” Dixie knelt beside Roy and unrolled one of the green bundles, pulling on gloves before selecting a curved tube. Deftly, she slid it in beside the syringe, so quickly and easily that the child merely shivered under Roy’s hand. At Dixie’s nod he pulled the syringe out and set it with the bloody towels.
“Now what?” he asked.
“We suture it into place,” Dixie said, pointing to the loaded needles in her bundle with her chin as she adjusted the tube.
“Can’t we do something to make her numb first?” Roy asked. “I don’t think she’s completely unconscious.”
“Well, let’s fix up something temporary, get fresh vitals, and then we can call in for permission to use some lidocaine.” Dixie collected the tape from the amputation kit and peeled off some long strips, discarding the first layer that Roy had gotten bloody trying to work loose. Deftly, she placed the strips while Roy held the tube in place, ordering Roy to move this finger or that, until the tube was secured.
Roy sat back and peeled off the gloves before trying to shake the cramps out of his hand. Dixie pulled a sphygmomanometer out of the bottom of the toolkit, giving him a glimpse of ampoules of medicines and other things lined up inside the trays. “We’ll need a fresh assessment of Johnny’s condition, too, Roy,” she said before she tucked the stethoscope buds into her ears. “Kel wants to make sure we can clear him for a shot. Christy, can you take notes for us and handle the biophone?”
“Sure,” Christy said, pulling out her notebook and moving aside to make room for Roy to kneel by Johnny again. His knees protested as he got into position, and he wondered briefly how Dixie would manage with just those thin nylons on. But it didn’t matter. What mattered was that he finally had a chance to see what was wrong with his partner.
In case Johnny could hear him, Roy put his hand gently on his shoulder. “Johnny. I’m going to get vitals again.”
“’kay,” Johnny said through gritted teeth, the pain lines on his face going deeper, though his eyes stayed closed. Roy felt a shudder running under his hand. He pulled the blanket aside and lifted Johnny’s arm so he could get a BP, grateful that he hadn’t had time to pull the BP cuff off when he’d shifted patients. The IV that Johnny had put into his own arm was going to need re-doing, Roy realized as he started to take the reading, and then had to start over because he hadn’t been looking at the dial when the pulse had started sounding in his ears and had missed the first number. But he got a BP at last and called it over to Christy as he lowered the stethoscope.
“I need to see your pupils,” he told Johnny. “Brackett’s not going to let me give you that shot otherwise.”
“Shot?” The brown eyes opened, blinking in the light. “You’ve got a shot?”
“Yeah,” Roy said, his voice going hoarse as he spoke around a lump of unexpected fondness. “The cavalry’s arrived, see?” he nodded toward Dixie. Johnny’s eyes refocused and then widened, but he didn’t try to say anything. Both pupils were equal and reactive, and that was all that Roy cared about. He took Johnny’s wrist and got a pulse -- 120 -- and then remembered that Brackett had wanted a pedal pulse as well. “I’ve got to check your leg now, Johnny,” he warned. “Do you want something to bite besides that lip?”
“Yeah.” Johnny fumbled around a little, uselessly, and then accepted the folded handkerchief that Roy set by his lips, getting it into place and mumbling around the cloth, “G’head”.
Moving as quickly as he could without being rough, Roy set aside the bag of ice and felt along the injured leg. It was cool, thanks to the ice, but the skin was taut and he could feel that there was swelling, and moving the knee joint even a tiny amount got a noise from around the handkerchief that he translated into the kind of language that Johnny rarely used. Roy moved down to the ankle and felt for a pulse there. He bit his own lip, mentally berating himself for letting his hand shake with nerves, but after a moment he found it. Fainter than it should be, and short some beats compared to the pulse he’d taken at Johnny’s wrist, but it was there..
“Pulse at wrist is 120. Pedal pulse is 120 and thready,” he told Christy. “There are signs of increased pressure in the anterior capsule. Pupils are equal and reactive. No sign of head trauma. Ask if we can go ahead with a shot.”
While Christy called in the numbers, Roy moved back up and pulled the IV, shifting it down into a better spot on the vein. “We’re gonna have to send you for a refresher course,” he told Johnny, teasing gently now that he was so close to getting some relief from the pain. “You overshot the mark.”
“I’d like to see you try it some time,” Johnny growled, almost smiling.
“Rampart says to give him ‘ten milligrams MS IV push’,” Christy reported. “Does that make sense to you?”
“Perfect sense,” Dixie said, passing an ampoule and a syringe to Roy from her kit before bending again to the sutures she was placing around the chest tube. He took them gratefully and measured the dose, aiming it into the IV with a heartfelt gratitude for the knowledge that it would make a real difference.
In moments, the tension started to leave Johnny’s face. “Oh, that’s nice. That’s really nice,” he babbled, relaxing as the narcotic did its work. “That’s a whole lot better.”
“Does it still hurt?” Roy asked.
“Yeah, but now I don’t care,” Johnny said. He waved at Dixie. “The shot’s really nice, Dixie. It still hurts but I don’t care and now it doesn’t hurt so much anyway.”
Roy grinned. “That’s nice, Johnny,” he said. “I’m going to get you into the stokes, now, so we can get you out of here.”
“Better talk to Rampart,” Dixie suggested. “I think they’re going to want me to bring in this little girl first. Has there been any sign of a parent?”
“Not yet,” Roy admitted. He thought for a moment. “There ought to be another stokes on the ladder truck. We can get them both ready for transport.”
Dixie nodded. “That would probably be best. But you do understand that one of the reasons Kel sent me is that I can triage Johnny, don’t you?”
“Triage?” Christy asked.
“It’s a way of… dividing… a lot of patients into groups. When there’s a big accident or something like that,” Roy answered slowly, grateful for the distraction while his thoughts tumbled over one another. “Some will die anyway, no matter what you do. Some will live, if they just get help fast enough, and some… some of them can wait.” Of course Dixie would be applying the principles of triage here. And of course Dr. Brackett would want an objective opinion. Neither of them knew what a leg meant to a firefighter. To a rescue man. But he’d been doing it himself, hadn’t he? Taking care of Bodine when he bled, taking care of the child when she had trouble breathing. He’d made Johnny wait, knowing that Johnny would understand why. “I’d better go get that stretcher,” he said. “Dix, keep an eye on them for a minute, please.”
“Sure thing, Roy.” The light in Dixie’s eyes was sympathetic. Roy gave her a small nod before walking away. Behind him he could hear her saying, “Christy, hand me the phone, please.”
He thought furiously. It wasn’t a broken bone that worried him, although he was pretty sure that Johnny was right about something being broken. It was compartment syndrome, the swelling of muscle in one of the four muscle compartments of the lower leg that could lead to blockage of the arteries and possible to amputation. That and the extensive bruising. Something was bleeding inside there. That lateral compartment was filling up with blood and bruised muscle and pressure.
He had the stokes in his hand and was collecting another blanket from the bin at the back of the ladder truck when the idea hit him. Maybe he could “let off” some of the pressure, somehow. Ease it up enough that Johnny could wait for the people with worse injuries to be dealt with first.
But when he quietly broached the idea to Dixie as they settled the little girl into one of the stretchers she shook her head. “You’d be opening up a path to infection, and besides, the pressure may be serving as a sort of 'pressure dressing' on whatever's bleeding, keeping it under control. Just opening the skin isn't going to release enough pressure to make a difference. When the pressure in those fascial compartments is released whatever is causing the bleeding will cut loose – we’d go from risking his leg to risking his life. I don’t think anyone should try opening up that leg until they’re in an operating room with good light and lots of instruments and an anaesthesiologist and an orthopedic surgeon and a blood bank down the hall.”
“Then there’s nothing I can do,” Roy said.
“You can splint the leg, get him into that stretcher and then pack the leg in ice,” Dixie said sternly. “That will slow down both the bleeding and the swelling.” She glanced over at Johnny, who was expansively explaining the principles of intravenous fluid replacement to Christy, before meeting Roy’s eyes again and saying very softly, “And you can look cheerful. He’s smart enough to know the dangers, but between shock and that shot, he’s going to be following your lead.”
“Sorry,” Roy tried to smile, though his face felt stiff and awkward.
Dixie managed a better one. She squeezed his arm. “When we get back to Rampart we’ll get some coffee and commiserate over the scares we’ve gotten today,” she promised.
“Scares?” he asked.
She grimaced. “I hate helicopters,” she confessed. “Especially the ones without doors.”
Somehow that made him feel better. He patted her hand in turn. “I guess it’s just been that kind of a day.”
“And it’s not over yet.” But the smiles they shared were smiles, and Roy’s hands were steadier as he helped Dixie finish settling the girl so that she wouldn’t be jarred, no matter how fast the flight.
That done, they moved over to where Christy was still listening to Johnny’s ramblings. He’d gone from IVs to the equipment list for the squad, somehow – Roy couldn’t think of a more boring thing to say to a girl – but Christy appeared to be paying rapt attention. She’d caught hold of Johnny’s hand and was smiling at him, making small encouraging noises and comments when he hesitated or lost his place.
Johnny, to Roy’s amusement, was too out of it to be using the infamous Gage charm. He sounded more like he was trying to impress a new student paramedic than he was trying to impress a girl. It wasn’t until Roy touched his shoulder and said, “Hey, Junior,” that the brilliant smile appeared.
“Hey, Roy,” Johnny said. “What comes after the K-12?”
“I’ll tell you after we get you settled,” Roy promised him. “How’s your leg feeling?”
“It isn’t,” Johnny sniggered. “You know, the next time we go on a run with a junkie I’m not going to be as mad at him. Probably, anyway. This stuff is nice, except for the not being able to think part.”
“Yeah, that does get in the way,” Roy agreed. He accepted the cardboard splint that Dixie was holding out to him. “Splint in position or straighten the leg?” he asked her.
“In position,” she said. “It will let us put some of the ice underneath and pack it all the way around. And straightening at this point may do more harm than good.”
“Sounds good.” Roy bent the splint and tucked it carefully around Johnny’s leg, taping it into place. “Dixie, would you shove the stokes under him when I lift him up? Christy, you can let go of his hand for a second.”
“As long he doesn’t start waving it around again,” she conceded.
Roy grinned, but he said, “Johnny, hold still a minute,” as he slid his arms carefully under Johnny’s shoulders and good knee and lifted. He was grateful that Johnny was the skinniest man in the station – he wasn’t sure he could have done the same for Lopez or Stoker or Kelly – but in any case he only had to keep Johnny off the ground for a few moments. Between them Dixie and Christy got the stokes positioned before he even began to feel the strain. He shifted his burden, tucking Johnny against him so that he was resting on Roy’s knees and turning him face-upward so that when he lowered Johnny again he’d be on his back instead of on his side. Dixie and Christy were working together, spreading one of the blankets, and using Johnny’s turnout coat to position one of the garbage bags of ice in the waiting stretcher.
He looked to see how Johnny was holding up, but his partner had closed his eyes and was humming something unfamiliar and vaguely mournful, like a folk tune or the sadder sort of lullaby. The pain lines hadn’t deepened on his face, though, so Roy didn’t waste energy talking to him. Dixie had everything under control anyway. He wondered if the song was something Johnny had learned on the reservation, in the childhood he seldom discussed. Strange to think how different their childhoods must have been – Johnny’s with visits from anthropologists in the summers, his own with visits from the popsicle truck. Strange to hold a grown man in his arms like this, even for a moment, and feel the same protective fondness that sometimes swept over him when he was carrying Christopher in to bed after he’d fallen asleep in the back seat of the car.
Rule number one: Never get emotionally involved with the patient, his own voice came back to him in memory. But he’d never gotten the knack of it. And sometimes you were already involved. He smiled to himself, knowing that it was scaring himself that made him feel so introspective. Joanne said it did, anyway.
Joanne.
Maybe I’d better not tell Joanne about what time that bomb was set to go off.
“We’re ready, Roy,” Dixie said, bringing him back to the moment. He lowered Johnny carefully into the waiting stretcher, and helped Dixie arrange the blankets and the ice. Johnny took the manhandling without protest, but switched to anatomy, muttering his way through lists of bone and muscle, and keeping his eyes closed.
“So what comes next?” Christy asked.
“A helicopter, if we’re lucky,” Roy answered. “Dix?”
“I’ll call the base,” she said, moving to the biophone.
Roy checked Johnny’s forehead – still clammy – and said, “Johnny? How are you doing?”
“I don’t like moving,” Johnny said petulantly. “Everything sort of swings around like I’m dizzy.”
“That’s the shot,” Roy assured him. “But you’re not moving now. Open your eyes and let me take a look.”
One eye cracked open just enough to glare at him. “I don’ wanna.”
“Why not?” Roy asked, surprised.
“’Cause if I aspirate it’ll make you all worried again,” Johnny argued, trying to wave his arms. Roy caught the one with the IV in it.
“Do you feel like you’re going to throw up?” he asked, worrying that he’d given Johnny too much morphine too fast.
But the smug smile that settled on to his partner’s face reassured him. “Not if I keep my eyes closed,” Johnny said, suiting actions to words.
“Sorry, Junior, but you’re not allowed to go to sleep yet.” Roy looked around. “Christy, could you hand me one of the splints from that big box? I’d like to make sure he doesn’t pull out the IV by accident.”
“I’m not gonna pull it out,” Johnny protested. “I know better than that!”
“I know you do,” Roy told him, as he took the splint Christy found and began to tape it onto Johnny’s arm. “But I’m the cautious type, remember?”
Johnny snorted. “Yeah. Belt-and-suspenders…” His loose hand came up to grab hold of one of Roy’s. “Joanne’s gonna kill me when she finds out I nearly got you blown up,” he said, in a very different tone. “I tried to get out. I really did.”
“Yeah, well, I’m not going to tell her how close it was if you don’t,” Roy said. “Besides, you’d made it most of the way.”
“I couldn’t yell,” Johnny murmured. “It hurt so bad…”
“Johnny,” Roy said warningly. “You’ve got to stay awake.”
“I’m just tired,” Johnny admitted.
“Hey,” Christy said, deliberately loud. “You didn’t finish telling me about the equipment. What comes after the K-12?”
“The Kennedy probe,” Roy prompted. “Talk to Christy, Junior. Stay awake or I’ll pull out the smelling salts.”
“Aw, man,” Johnny said, but he opened his eyes.
Roy got up to let Christy take his place, which she did, saying, “Okay, so what’s a Kennedy probe? It sounds political.”
In spite of his worries, Roy grinned at the question as he went over to see how Dixie was doing. “Any word on the chopper?” he asked.
“Working on it,” Dixie said. “How’s Johnny doing?”
“He got dizzy when we moved him, and I think he’s about ready to pass out on us. I’d really like to get him out of here.”
Dixie nodded. “Rampart, this is fifty one. Our male patient is having dizzy spells and difficulty retaining consciousness.”
“Fifty one, how long will it take you to get both patients to the landing zone for the helicopter?”
“Two minutes,” Dixie said. “Maybe four.”
“All right, start moving both of them. We’ll have Copter ten meet you.”
“Vince!” Roy yelled at the deputy. “Vince, I need some help carrying stretchers.”
“Christy and I can manage the girl,” Dix said. “You two take Johnny.”
“You’re going to have to carry the resuscitator,” Roy reminded her.
“We can manage,” Dixie said firmly. “It’s not that far.”
“DeSoto!” Captain Stanley came over at the same time as the deputy did. “What’s going on?”
“We’ve got a helicopter coming to take Johnny and the girl to Rampart, Cap,” Roy explained. “But we’ve got to take them around to the landing zone.”
“Can Nurse McCall take them in? One of the ladder guys just reported seeing what might be another victim up on the third floor. We’re trying to dig through to them now.” Hank Stanley didn’t look any happier about the news than Roy felt hearing it.
Dixie reached over to touch his arm gently. “Maybe it’s a parent,” she reminded them both.
Roy nodded, reluctantly. He looked a question at the captain. “I’ll still need to get him to the chopper,” he pointed out, knowing that he should really be getting his gear, getting ready to go inside after the new victim.
But Cap nodded. “Just don’t take too long,” he warned.
It didn’t take nearly long enough for Roy to carry the two stretchers around to the cleared section of street where the helicopter would land. Vince started making sure the bystanders were well back, and Dixie started tucking the blankets tighter and checking the straps, but Roy hesitated for a long moment before he turned away. Johnny was fighting sleep, his eyes drifting closed and then startling open again as Dixie made him answer a question. Christy was rubbing her hands, trying to soothe the red marks where the unaccustomed weight of the stretcher had bitten into her palms and fingers.
On impulse, Roy took her aside. “Listen, Christy, would you mind going in with him? I don’t know how long it’s going to be before I can get there, and Dixie’s going to have a million things to do the minute she hits the door of ER.”
She shrugged hesitantly. “I don’t know what good it would do,” she confessed. “All I seem to know how to do right is hold his hand.”
Roy gave her a tight smile, “Sometimes that’s the most important thing we do,” he told her. But he knew she needed more than that, for pride’s sake if nothing else. “Just… just stay with him. Keep him awake, and let someone know if he passes out. They’re going to be busy at Rampart. It might be a while before he gets a turn. But heck, once he gets into a treatment room, you’ll probably be able to interview half the paramedics in town.”
Christy nodded, but she was still troubled. “Don’t you want to go with him?”
Roy shook his head, knowing that for all that she’d learned, she still didn’t understand. And he didn’t have time to explain, not really. “I’m needed here,” he said, hoarsely. “But it’ll be easier staying if I know he’s not alone.”
From somewhere she summoned a shadow of the confidence that had been hers for most of the day. “Well, I can’t go back to my editor with half a story,” she said. “So I guess I’d better find out what happens at the hospital once you paramedics have finished your part of the routine.” She flinched a little, hearing the echo of her earlier comments, but Roy was glad to see she didn’t falter.
“Good girl,” he said.
“Good woman,” she corrected him, but she did it with a smile.
Roy laughed, surprising himself, and bent to give Johnny one last check as the chopper appeared over the roof of one of the nearby buildings. “I’ll see you later, partner,” he promised.
“Later?” Johnny asked.
“Another victim, maybe, in one of the buildings. I’m going to go check it out now.”
“Oh,” Johnny said blearily. “Don’t get hurt, okay? ‘Cause it hurts.”
“Okay,” Roy promised, although with the backwash from the chopper he wasn’t sure Johnny could hear him. Vince was taking position. The chopper was down. In a moment the two women had the first stretcher in, and were buckling into seats. At Dixie’s nod, Roy and Vince lifted Johnny’s stretcher, got it onto the rack, secured the straps, and then they were backing away, crouching down as the chopper lifted away again. It vanished over the buildings, not even giving Roy a chance to watch it fly away.
Continued
Triage
…a rewrite of the end of the episode “Women”: the scenes we might have seen (if a fan had written them, anyway.)
What had happened so far: In the episode, Roy and Johnny have a reporter named Christy who has been riding with them all shift, looking for material for a story on the paramedic program. The only problem is that she’s a recent convert to Women’s Lib and like all recent converts, she takes things too far – she’s convinced that she could do what the firefighters do, (without the same training) and has stuck her nose in where it wasn’t wanted a time or two, putting up everyone’s back in the station – especially Johnny. Things have come to a head in a verbal argument where she asserts that the firefighters are using “routine skills”, when an alarm goes out for an explosion in an abandoned warehouse.
At the warehouse, Johnny and Roy go in searching and Johnny finds a man in the basement named Bodine. It turns out that Bodine is the one who set the bomb, and with five minutes to go, confesses to Johnny and Chet Kelly that there is another one set to go off. Just then another search team finds a little girl that needs medical care and digging out. Roy and Kelly take Bodine and Johnny goes to help get the little girl, sending a warning to the Captain about the bomb. Working extremely hastily, John frees the girl and passes her to another pair of firefighters and the two of them run for it with her. Johnny starts to follow, but a beam falls on him and he’s momentarily pinned. He manages to kick free, but he can’t use his leg and he falls on the way out.
Meanwhile, Roy has noticed that his partner hasn’t made it out. In spite of it being the time when the bomb is meant to go off, he heads back inside, finds Johnny, and pulls him out. They run for the shelter of the squad, where Christy is waiting, her assumptions in shreds.
The episode, of course, went to black the moment they were safe, but I couldn’t resist the chance to play. Thanks to
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It was faster to run than to try to get a good grip for carrying, even if Johnny did grunt with pain every time his left foot bumped the ground, so Roy ran, holding up his partner as best as he could, concentrating on the bright red edge of the squad, and shelter. They’d only just turned the corner – barely missing Christy – when the bomb went off.
The explosion was smaller than he’d expected, somehow. Less catastrophic. A glance over the top of the squad showed pieces of corrugated steel falling, and the center of the building settling farther into the ground as dust and smoke poured out of the broken windows and torn walls. But the rest of the block was still standing, and the ground hadn’t given more than one hard shake. Still. He braced his legs to keep them from buckling, leaning against the sunwarmed metal of the squad as he tried not to think about how very near Joanne had come to being a widow this time, brightly aware of his heart pounding in his ears and the smell of burning wood and metal starting to drift over on the breeze.
Johnny managed to stay upright long enough to look at the damage too, before sinking carefully to the ground. He glanced up once, at Christy, but he wasn’t breathing any more easily than Roy was, and his head dropped again, sweat dripping off his face as he gripped the sore leg with a white-knuckled hand.
Roy made himself push away from the support of the truck. “I’d better take a look at that leg,” he said, knowing that Johnny would hear the strain in his voice, no matter how hard he was trying to sound professional.
But Johnny shook away the offer. “The little girl,” he said shortly, fumbling the sphygmomanometer out of his pocket and passing it to Roy. “Hurt worse.”
Wanna bet? Roy thought, but he accepted Johnny’s assessment of the situation, same as he’d done a couple hundred times over the past two years. He lifted his head and spotted Marco Lopez and Mike Stoker, watching warily from where they knelt by a blanket that had been laid out near the ambulance. “Marco!” Roy called. “Come help Gage while I check on the girl.”
“Right,” Lopez pushed to his feet hastily.
“Stoker,” Captain Stanley intervened. “You bring over the equipment. Kelly, help Lopez get Gage over there so DeSoto can keep an eye on him while he works on the other victims.”
“Right, Cap.” “Sure thing, Cap.” Both men hastened to obey, and Roy felt a little better. He dropped a hand on Johnny’s shoulder for a moment, but couldn’t think of anything to say, so he headed for the girl instead.
Johnny was right. She was in worse shape. A growing knot on her forehead, and a deep cut on one shoulder were the obvious things, but there were so many contusions on her side and back it was hard to say if any of the ribs were broken. Roy’s guess was yes – and carrying her out that hastily hadn’t helped anything. He reached for the biophone as soon as Stoker had it set up. “Rampart, this is Rescue 51.”
“Go ahead, fifty one.” Brackett was at the radio. Good.
“Rampart, we have two additional victims. The first is a female, approximately six years old. BP is 80 systolic. Pulse is 100 and weak. Respirations 20 and shallow. She has extensive bruising, especially on the torso, with probable broken ribs, a possible concussion, and several lacerations, one deep on the right shoulder. Request permission to begin an IV.”
“Fifty one, do you have parental permission?”
Roy glanced up at Stoker and got a shake of the head. “Negative, Rampart. We pulled her out of the building next to the warehouse, but there hasn’t been time to identify her.”
“Fifty one, it doesn’t sound like we have time to wait. Start an IV with Ringers, my authority. Have you got ambulances there?”
“Just one, Rampart,” Roy said, biting his lower lip as he waited for the decision. He wanted to send Johnny at the same time as the girl, but Brackett couldn’t know that yet.
“Try to get the girl stable and then transport as soon as possible. Keep an eye open for any sign of a lung collapse.”
“Ten four, Rampart.” Roy looked around for the drug box, but it wasn’t with the other equipment. He remembered that Johnny had been carrying it when he’d gone after the girl. “Mike! Bring me the big box and pull an IV kit and some Ringers’ for me, will you? And I’m either gonna need another squad in here or someone to go after that drug box Johnny dropped inside.”
“I’ll see to it,” Captain Stanley said. “Lopez, do you think you can remember where that room was?”
“Sure, Cap.”
“Then follow the hose team in and see if you can get that box, on the double. And be careful. We’ve got a fire on our hands now, and we can’t afford to be another man down.”
“Right, Cap.” Lopez headed off. He sounded relieved to Roy, as if he were glad to have something concrete to do after leaving Johnny inside a building that was about to explode. Roy swallowed a sudden rush of anger. He didn’t have time to lose it, not right now. You leave your heart at the station when you go on a call, he’d been told once, long ago. It just gets in the way.
The Captain moved away, starting to direct the guys from Ladder 8 and truck 10 as they approached the fire. Roy could hear him asking the dispatcher for a back up squad, but he couldn’t hear the answer. He tried to remember which squads weren’t out on calls. His hands were busy, looking for other injuries on the child.
The biophone interrupted his thoughts. “Fifty one, what is the condition of your third patient?”
Roy turned the handset on his shoulder so he could talk into it and still work on the girl while he eyeballed Johnny. With Marco called away to look for the drug box, Chet had been left to support the injured paramedic alone, and they were making the trip slowly. Johnny wasn’t even trying to straighten his leg now, and he was getting paler with each hop closer to Roy and the blanket. “Rampart, the third patient is John Gage. He got hit in the leg, looks like just below the knee, and then I had to pull him out before the bomb went off. I haven’t had a chance to get vitals yet, but I can see he’s in a lot of pain.”
“Fifty one, say again. Bomb?”
“Long story, Rampart. I’ve only got one ambulance here so far. Which patient do you want first?”
“Hey! This guy’s leg is bleeding.”
Damn. “Rampart, be advised that the first patient is hemorrhaging.”
“Ten four, fifty one,” Brackett replied, but Roy had already dropped the handset and scrambled for the stretcher with Bodine, taking the place of the deputy who was trying to stop the bleeding.
“What happened?”
“He tried to get up and make a run for it,” the deputy explained.
“On this leg? He wouldn’t have made it fifty yards,” Roy started packing bandages onto the wound, hoping he wouldn’t need a tourniquet. They always seemed to him to be more trouble than they were worth.
Bodine swore, “I’d have made it.”
“Yeah, like you made those bombs?” Roy couldn’t help the edge of anger in his voice. He swallowed it back. “I don’t think this is your lucky day.”
Bodine made a rude noise. “Hell, no,” he agreed. “Ouch! Be careful!”
“I’ll be careful all right,” Roy muttered, wishing for just a moment that he was the sort of guy that could have been deliberately rougher than he was being.
“Me too,” the deputy agreed, taking his handcuffs off his belt and attaching Bodine’s wrist to the stokes stretcher.
Roy looked back over his shoulder. Flames were leaping up now from the warehouse, and Captain Stanley was yelling for Kelly and Stoker to come run lines inside. Johnny was lying on his right side next to the girl, with the injured leg curled on top of the other one. His face was white under the sunburn, but he had the little girl’s hand and was talking to her in a low voice with all the charm he could muster and a caricature of his usual smile plastered on over the pain. Christy had her camera out, but she wasn’t using it – she was just staring at the burning building and the hornet’s nest of activity from the firefighters. “Vince, hold those bandages in place, and tell me if he’s getting worse. I’ve got to get back to that little girl.”
“You got it, Roy. Anything else I can do?”
“Just get me some ambulances.”
Roy scrambled over to the blanket again. Johnny acknowledged his arrival with a short nod. “I didn’t want to risk doing the IV,” he admitted. “Too shaky.”
“That’s okay, Johnny,” Roy said, “You just keep her calmed down, and let me handle the rest.” He needed another pair of hands. “Hey. Hey! Christy! Do you know how to use a radiotelephone?”
She started to nod, and then shook her head. “No, not really. But I’ve been watching you two all day. You have to press that switch on the handset to talk, right?”
“Right. Make sure it’s set to frequency one. I need you to relay some information for me, to the hospital. If you’re not sure what I said, or they said, ask for a repeat, okay?”
She knelt by the biophone and looked Roy in the eye. “I’ll do exactly what you say,” she promised soberly.
“Good.” Roy flashed her short smile. She really was intelligent, and determined, and he thought that she’d probably had enough of a scare with that bomb to stay within the lines for a little while. Long enough for him to do what he needed to do, anyway. “We’re Rescue 51, they’re Rampart Base. Call ‘em and tell them that we’re controlling the bleeding on patient one with pressure, and that I’m starting that IV on patient two.”
“What if they ask about patient three?” She asked.
“Pale, respiration fast. I’ll get the other vitals as soon as I’ve got the IV going.”
“Pulse is 100,” Johnny interjected. “Stoker took it.”
She had her notebook out and made a note and then activated the biophone. “Rampart, this is Christy, for Rescue fifty one. Do you hear me?”
There was a short pause; then Brackett came back, audible over the tinny speaker of the phone despite the noise of the fire and the shouts from the firefighters. “Go ahead, fifty one, we hear you loud and clear.”
Christy took a breath and read from her notebook. “Patient one. The bleeding is being controlled by pressure. Patient two, the IV is being established right now. Patient three is pale and his respiration is fast. His pulse is one hundred, but we don’t have the other vitals yet.”
“We copy fifty one. What does the leg look like?”
She put the phone aside. “Roy, they want to know what his leg looks like.”
“So do I,” Roy said. “Tell ‘em to stand by, and then get Johnny’s bandage scissors and cut up the trouser leg – carefully.”
“Right,” she said into the phone, and then blushed. “I mean, stand by Rampart. We’ll take a look.”
As she moved around to find the bandage scissors in the leather pouch on Johnny’s belt, Roy bent to the IV, listening to Johnny’s low reassurances. “It’s okay, sweetheart. My partner’s just going to put some medicine in your arm, to help you feel better. I know it’s scary, but it will make things better I promise.” He gasped a little as Christy fought with the fabric of the trouser leg, and Roy, glancing over, saw sudden tears spring into his partner’s eyes. “See, I hurt too. But I know it’s just to make it better. Do you understand?”
She whimpered, but she let Roy have her arm, and he quickly established the IV, putting a splint on the arm to keep her from bending it again and dislodging the needle. As soon as it was taped into place he took a look at Christy’s handiwork.
She’d gotten the pants leg split up as far as the knee, and was going carefully around the corner, using her hands to pull the split apart, rather than trying to push the scissors against Johnny’s skin. Her shadow made everything look dark – but then she moved and Roy realized that it wasn’t her shadow. Johnny’s leg was bruising up fast.
Christy finally got the seam ripped far enough up that Roy could see a few inches of paler thigh. She rested back on her heels and looked over to him. “What do I say?” she asked, looking more unsure of herself than he’d seen her all day.
“Tell them 'expanding hematoma over the lateral leg extending from the lateral epicondyle down over the anterior compartment of the calf.’ Got that?”
She repeated it back, word for word, grabbing her notebook and scribbling it down in shorthand before heading for the biophone again.
Johnny wasn’t even trying to look. He rested his head back a little and closed his eyes. “That good, huh?”
Roy palpated the little girl carefully. Her respirations were getting more labored, and he wasn’t sure if it was because she was on the verge of crying again or something worse. “Yeah. So try not to do any fancy dancing until I can get over there.”
Johnny snorted. “I’m not dressed for waltzing,” he said, almost smiling for a moment before he grimaced and swallowed hard. “Wish I’d remembered to grab that drug box, though.”
“Rampart says they want his BP, as soon as possible. And they need vitals and a description of the injuries on patient one,” Christy interrupted.
“Didn’t I…?” Roy realized suddenly that he’d never had a chance to get the numbers from Johnny or pass the information along to the hospital. “Tell ‘em Male, approximately 35, 180 pounds, bleeding from the right quadriceps, about three inches above the patella. Johnny bandaged it before I saw the wound, though.”
“Deep tear,” Johnny contributed. “From a nail on beam. It’ll need to be debrided. Not arterial, yet, but close.” He fumbled at his pocket. “Pulse was… I don’t remember. It’s in my notebook.”
“It will have changed by now anyway,” Roy said, catching Johnny’s arm and putting it back down. “Ask the ambulance attendant to get you a new reading, and then count how many breaths the patient takes in fifteen seconds and multiply it by four for the respirations. Got it? Tell Rampart I’ll get a BP after I do Johnny.”
“Got it.” Christy repeated what she had so far into the biophone, scribbling more shorthand into the notebook propped on her knee and then got up to go over to the ambulance attendant, who had overheard and freed one hand from the bandages to take Bodine’s unhandcuffed wrist.
Roy glared at the other ambulance attendant, who was leaning over the radioset in the ambulance instead of making himself useful. “Hey, hey, what’s your name?”
The guy startled a bit. “Me? Tim. Tim Dolan.”
“Do you have O2 in the ambulance?”
“A small tank, sure.”
“Get it, and start ventilating this little girl while I check the other two.”
“Sure.” Dolan reached into the back and came over while Roy grabbed the sphygmomanometer and switched around to Johnny’s side of the blanket. “Hey, did you hear that? There’s been a huge pile up on the LA freeway. Our guy says it must be twenty – thirty cars.”
“Your guy?” Roy asked, with a sinking feeling in his gut. He eased Johnny up to a sitting position and started working off the heavy turnout coat, so he could reach an arm for the BP.
“Yeah, they’re right in the middle of it. I just heard them telling central to send for every paramedic they can get.”
Roy thought frantically. “Was that ambulance coming here?”
“Both of ‘em were for here,” Dolan said, getting the oxygen mask into place over the girl’s nose and mouth. “And it sounded to me like they both got mixed up in the pile up. It’ll be another fifteen minutes, minimum, for another team to get here. Probably more when the side streets fill up with all that traffic.”
The PA system on the big trucks began to blare out alarms, confirming the news unmistakably as the news helicopter that had been hovering overhead veered away. Roy propped Johnny against his own chest and held out a hand. “Reach me that handset, will you?” Dolan nodded and put it into Roy’s hand. Trying to ignore the trembles and small whimpers from Johnny, Roy focused on what he needed to say, “Rampart, it looks like we’ve lost the two additional ambulances to a really big traffic accident on the freeway.”
“Fifty one, we are getting reports on it too.”
“I want to send the girl now. She’ll need monitoring, but I can’t go – I’m the only functional paramedic here. We’re looking at fifteen minutes plus to get another ambulance, and the longer this one stays here, the longer it will be stuck in traffic on the way there. Her IV is in and I’ve got her on oxygen, but I’m worried about those ribs, and I haven’t had a chance to do anything else.”
“Easy, Roy,” Brackett sounded authoritative, the way he always did when he was worried about something. “Is there any chance Johnny could monitor her on the way in?”
Roy felt Johnny’s head shaking. “No way,” Johnny admitted in a strained voice. “I’d probably pass out.”
“He says ‘no’, Rampart,” Roy passed along. “And I can’t send her and the bleeder. He’s the one who set the time bombs.”
“Fifty one, can you sedate him?”
“No!” Roy shouted, and then wiped his face with the back of his hand and pulled himself together. “Sorry. Negative Rampart. Our drug box was inside when the bomb went off. Lopez is looking for it now.”
There was a horribly long pause before Brackett came back. “Fifty one, send the bleeder now. The ambulance attendant and the deputy can probably handle him. I’d rather the girl stayed with you in case she aspirates or a lung collapses. I’ll do my best to get you a copter and a spare drug box. I’d send you a doctor, but it looks like we’re going to need all we’ve got.”
“Ten four, Rampart.” Roy said, dropping the handset and going back to working the coat sleeve down Johnny’s arm without jarring him any more than he had to. Losing Bodine would take some of the pressure off anyway, and if anybody could get a chopper diverted over here it would be Brackett. He looked around for the deputy, grateful that it was one he knew well. “Vince!”
“What is it, Roy?” Vince Howard came at a run.
“Rampart says we need to send Bodine in now. Before the traffic gets bad. Can you ride with him?”
“I’ll send Dave,” Vince said. “He needs the experience more than I do.”
“Tell him to keep the pressure on those bandages!”
“Got it!” Howard headed off, waving at one of the deputies who were managing traffic at the end of the street.
Roy nodded to Dolan. “Bodine may get shocky. Probably will. Keep the blankets on him and watch that bleeding. If it goes bright…”
“Then we put on a tourniquet. Yeah, they teach us that much anyway.”
“Only if you’re more than three minutes from Rampart. If you’re closer than that, just hang on tighter and run for it.”
“Got it.”
“Shouldn’t you get his BP before he goes?” Christy asked. He realized that she’d been waiting nearby, with her notebook open and her pencil moving while she waited for a chance at the biophone. “So we can tell the hospital?”
Roy wanted to swear. No. What he really wanted to do was get some decent vitals on his partner and see if he couldn’t make him more comfortable somehow. If he could just be sure that Johnny was all right, then maybe the butterflies in his stomach would settle down and he could concentrate. He took a deep breath. Made himself think. Christy was right – they’d want that BP. Especially on a bleeder. And he was the only one who knew how to get it.
“Johnny, see if you can’t get the little girl’s name. I’ll be right back.” He eased Johnny back to the ground, glad that he’d got the coat sleeve off anyway. “Christy, get one of the blankets and put it over Johnny, will you? Soon as you get a chance?”
Taking Bodine’s blood pressure meant having to sit still long enough to do it, and it was soothing, in a weird way, to listen to the heartbeat in his ears while he watched the needle twitch as the level fell. “110 over 85,” Roy called to Christy as he pulled the stethoscope buds out of his ears and started unwrapping the cuff. The numbers seemed borderline to him. “Ask ‘em if I should start an IV before he goes.”
Bodine grabbed his sleeve. “What about the girl? Is she gonna be all right?”
“I don’t know yet,” Roy answered.
“What the hell was she doing in there, anyway?”
“Who knows. Maybe her family can’t afford to pay rent. We find people in all sorts of buildings, no matter how bad they look on the outside.”
Christy called back, “Rampart says just get him moving.”
Roy pulled his arm free, nodded to the ambulance attendants and the deputy. “You heard the lady. Drive careful.”
He dismissed Bodine from his thoughts, and went back to Johnny, wrapping the bared arm with the cuff before he had a chance to get interrupted again and placing the bell of the stethoscope against the crook of Johnny’s elbow. The skin was definitely clammy and cool under his fingertips, the heart rate fast in his ears. He watched the dial, willing the numbers to be strong.
“115 over 90.” He pulled the stethoscope out of his ears. “Johnny, how’s the pain?”
His partner was even paler than he’d been before, and he’d bitten his lip bloody while Roy was working on the coat, but at least he was still conscious and coherent. “Scary,” he said shortly. “I think something’s broken.”
Roy took another pulse. “It’s up to 110,” he told Christy, who had just finished reporting the BP over the phone. “Tell Rampart I want to start an IV.”
“You’d better check this little girl first,” Johnny told him. “I think she’s having trouble.”
Roy wished he’d had the sense to position his patients so he could kneel between them. He scrambled around to the girl’s side and listened to her lungs. Under his fingers he could feel tiny bubbles under the skin – like rice krispies. “Subcutaneous emphysema,” he said. “The lung’s collapsing. Christy! I need the phone.” Going through an unpracticed intermediary wasn’t going to work for this part.
“They said okay for the IV, Ringers Lactate,” Christy said quickly as she passed the handset to him. To his surprise, she got to her feet and started running across the little park toward the buildings on the other side before he could ask her to help make sure the respirator mask wasn’t going to come loose.
“What?” Roy wondered.
“Maybe she had to powder her nose,” Johnny said, reaching over to hold the mask in place on the child’s face.
“Or got scared.” There wasn’t time to wonder. Roy checked to make sure the phone was working. She’d turned down the gain on the speaker, probably because of the chatter on the frequency, and he hadn’t realized how many squads the base was trying to juggle. But after a moment he found an opening and keyed the mike. “Rampart this is Rescue Five one, we have subcutaneous emphysema on the child’s left side. She is losing consciousness and her respirations are becoming very labored.”
“Fifty one, have you found your drug box yet?”
“Negative, Rampart.” Roy said. “I think it’s gone for good.” He propped the phone on his shoulder and took out his scissors to cut away the rest of the girl’s shirt while he waited for Rampart to come back to him.
The next voice he heard in his ear was Joe Early’s. “Fifty one, is the drug box the only thing you can’t get at?”
“Affirmative, Rampart.”
“Think you can put in an improvised chest tube, if I talk you through it?”
“I think I’m going to have to,” Roy said, glad that it was Dr. Early asking. “Unless you can fly her out of here somehow.”
“Kel’s on the phone to Dispatch right now. But if you can get that air out of the chest cavity, it will improve her chances.”
“Just tell me what to do, Doc,” Roy said.
“Okay. First, I want you to have some things within reach… Most of them should be in the amputation kit. But you’ll also need a ten cc syringe with the plunger and needle removed, a scalpel, sterile towels, a curved clamp and plenty of betadine to sterilize the area. Don’t forget to glove. I’ve got four other squads calling in on this frequency, and base two is just as overloaded, so when you’ve got the operative field ready, just say ‘Fifty one’ and I’ll get back to you.”
“Got it.”
Roy got up and began collecting what he needed. Johnny asked, “Can I help?” in spite of the fact that he hadn’t even tried to sit upright. In a moment of inspiration, Roy took one of the IV kits and a bottle of Ringers and passed it to his partner.
“You get that in your arm and I’ll let you handle the biophone,” he promised.
Johnny pulled a face. “You always hand me the easy jobs,” he said.
Roy had to go to the squad to get the amputation kit, although the rest of the boxes had been placed near the patients. As he passed it, Captain Stanley took a moment from the radio. “Do you need any help, DeSoto?”
Roy nodded at the fire. The two buildings on either side of the warehouse were collapsing inward now, and flames were leaping up through the roof. “Can you really spare anyone?” he asked drily.
Stanley shook his head, “Not easily. But I can ask Central if they can spare us a cop.”
Roy shook his head. “Rampart’s asking to send a chopper. Give that your blessing, and I’ll manage until they get here.”
“You got it.” The captain turned back to the fire and the radio and Roy went back to his patients, feeling reassured somehow just by the fact that the Captain had noticed he needed help, even if there weren’t any hands to spare.
Johnny was mangling his lower lip again as he tried to thread the needle into his arm vein. Roy thought about saying something and didn’t – he didn’t want to break Johnny’s concentration. Instead he started preparing the little girl, pouring antiseptic over her side and chest and laying sterile towels all around the area. He opened the amputation kit and laid it beside him, making sure he could reach each item Early had named, and then checked again. Johnny had the needle in his arm, and was hooking the bottle to the other end of the tube.
“Here, give it to me,” Roy said. He made sure the connection was tight and hung the bottle off the hook on the oxygen tank of the respirator and then passed the biophone over so Johnny had it. “I’m going to need to keep the gloves sterile,” he said. “Think you can get the directions to me?”
Johnny wiped the sweat off his face. “I’ll do my best.”
“Then let’s get started.”
“Rampart, this is fifty one. The field is ready.” Johnny listened intently, and then reported. “You want the fifth or sixth intercostal space on the mid-axillary line. Early says tell him when you’re sure you’ve found your place and marked it with the pen.”
“The fifth intercostal space…” Roy mumbled, closing his eyes for a moment to remember the page in the anatomy book. “That’s about the level of the nipple, isn’t it?”
“Rampart, this is fifty one, that’s about the level of the nipple, right?” Johnny nodded automatically and grimaced when the movement jarred him and curled a little tighter. “Early says that’s right,” he said through gritted teeth.
Roy felt carefully, trying to make sure he wasn’t over bone instead of the space. “Got it,” he said, using one of the sterile towels to hold the pen and his teeth to uncap it. He marked the spot with an ‘x’ while he was waiting for Johnny to get the next instruction.
“Okay, keep listening Rampart while I say it,” Johnny told the phone. He closed his eyes, as if he had to think hard as he spoke. “You want to use the triangular scalpel to make a shallow incision long enough for your finger and the syringe, and you’re going to want to go in across the top of the nearest rib, not underneath one. Cut the skin first, then you need to use the curved clamp to open the hole up further in. When you get deep enough you should feel the air coming out. It’s going to hurt, so if you think she’s conscious enough to react, you need to be ready to hold her still with your other hand.” He sighed. “Rampart says did you get all that?”
“Make an incision, and go over the top of the rib. Open it up with the clamp until I feel the air,” Roy said. “I got it.” He got the scalpel and the clamp and started doing what he’d been told.
“What’s happening?” Christy was back, panting and redfaced, with two loaded garbage bags in her hands. Roy hesitated with the clamp at the interruption, not wanting to look away while he was actually doing the work.
“Where did you disappear to?” Johnny asked impatiently.
“Rampart said to pack your leg in ice,” she said back, just as impatiently. “So I went to get some.” And before either Johnny or Roy could tell her not to, she lowered one of the bags onto Johnny’s leg, not ungently.
Johnny made a strangled noise and his eyes fluttered back into his head, and Roy, whose hands were busy, said a word he hadn’t used in front of a girl in his entire life. “Christy! Grab the phone!”
She was so startled she dropped the bag the rest of the way, which probably made things worse, but she grabbed the phone. “What do I do?”
“Hold it on my shoulder so I can talk!” Roy ordered, in no mood to trust her to relay the instructions. “WAIT! Go around so that you don’t drop any dirt onto the instruments or the patient!”
“Right… Right!” She grabbed the handset and brought it around, pulling the cord so it wasn’t hanging over the girl. Roy took a breath, letting Dr. Early finish with 8s before he said anything.
“Rampart this is fifty one. I got interrupted. Say again? After the incision. What am I doing?”
“Fifty one, you’re going to go over the top of a rib by using a clamp to spread the incision. You’ll have to push pretty hard to get through the pleural muscles, but go carefully. You don’t want to do more damage to the lung. Tell me when you hit air.”
“Stand by Rampart.” Roy was just grateful he’d withdrawn the clamp when Christy had shown up or he probably would have made things worse. He went in again, as close to the top of the rib as he could get. The little girl made an involuntary movement, but he’d remembered to hold her gently with his other hand and at last he heard and felt the rush of air coming out of the wound. “Okay Rampart, Fifty one has hit air.”
“Well done, fifty one. Are your gloves still sterile?”
“Yes.”
“Then reach in carefully with your finger and make sure the lung is expanding.”
“Reach in?” Roy wasn’t sure his finger would fit between the girl’s ribs. She was so tiny. Gingerly, he tried it with his smallest finger. Something was moving in there – he hoped it was the lung. He pulled out the finger. “Rampart, fifty one. I feel something anyway.”
“Good, fifty one. How’s your patient?”
Roy looked. “She’s breathing more easily. A lot more easily.”
“That means you did it right. Now put your syringe into the hole, over the rib, same as before. Tape it into place for now. We’ve got a proper chest tube on the way to you.”
“Ten four, Rampart.”
“Call me if you have any problems,” Early said, and then Roy could hear him addressing 8s again.
He had a cramp from the phone. “Okay Christy, you take it now.”
She took the headset and listened. “Is he talking to me?” she asked, hesitantly.
Roy shook his head. “There are squads at the accident up on the highway now. Rampart’s probably juggling ten different patients on one frequency. You just answer if you hear our number.” He wiped his hand on one of the sterile towels and reached for the tape, wishing he’d thought to tear loose some strips before he’d started. He sure couldn’t get one started now.
“I could do that for you,” Christy offered.
“No,” Roy said. “No, I’ll just hold the tube in place. I’m just going to have to switch it when the real chest tube gets here anyway.”
“When will that be?”
Roy scanned the sky, and saw one of the dots that were helicopters growing as it headed towards him. “Any minute now,” he said. “Do me a favor and go into the back of the squad and find the other stokes. The metal stretcher, like we had Bodine in. And don’t forget a blanket this time. If I can talk Rampart into it, I’m going to send Johnny in with the chopper.”
“Why not the little girl?”
“Because she’s going to need me, or someone like me, monitoring her condition even for a three minute helicopter ride. And someone needs to take a look at that leg before he ends up losing it.”
Her eyes widened, but she went for the stretcher. “Don’t leave the blanket behind!” Roy called after her, and then bent over the tube he was holding, listening to make sure that air was escaping when the girl exhaled.
He closed his eyes – just for a moment – and wondered how Joe Early had known how to fake the operation. Did doctors spend half the night over their books trying to plan for possibilities, the way that he still sometimes did when he was off shift and Jeanne was busy with the kids, poring through words on paper until they knew they would see bone and muscle and blood in their dreams?
A sound he couldn’t quite identify brought him out of his musing. He opened his eyes, checked the little girl’s pulse, counted respirations, considered how to get a BP without letting go of the syringe that was keeping her lung from collapsing again, and decided he’d have to prop the syringe. He looked around for Christy, wanting her hands, and saw that she was her tucking her camera back into its case. The stokes, with its yellow blanket tucked into the straps, was at her feet. “What are you doing?” he asked.
“My job,” she said. “My editor will kill me if I don’t have some pictures to go with this story.” She nudged the stretcher with her toe. “I don’t think I can put him into this by myself.”
“I don’t want you to try,” Roy said. “Just lay the blanket over him. Gently. I’ll get him in the stretcher if I get the go ahead.”
She nodded and began unfolding the yellow plastic. “I’m sorry about the ice,” she said. “I thought it would help.”
Roy was tired of being angry. “It will slow the hemorrhaging. That’ll make a difference. But it makes it even more important to keep his core temperature up.”
“Core temperature?” she asked, but she asked it while she was moving around to Johnny and spreading the blanket.
“The temperature inside the torso. When someone is in shock, all the blood moves inward, to keep the heart and organs going. It lowers circulation to the extremities, which can be a good thing if you’ve got a traumatic amputation, but can endanger them too. So we try to keep the temperature up, and add an IV to keep the blood volume up.”
“IVs to treat shock are half the reason we pushed for the paramedic program in the first place,” said a familiar voice and Roy looked up so fast his vision went gray at the edges for a moment.
“Dixie!” He looked around. “But where’s the chopper?”
“They dropped me off around the corner to avoid sending a downdraft onto that fire of yours,” she said, waggling the plastic toolkit she carried in one hand in the general direction of the warehouse. In her other arm she had two bundles that looked like she’d grabbed them straight out of one of the treatment rooms. “And then they went to run in a patient for Squad 110 from that mess on the freeway. But they’ll be back.” She dropped to her knees by Roy and began to unbundle a surgical kit. “Here, let me check on her while you stand up and stretch out. You look like you’ve been crouching over too long to me.”
“I can’t let go of the syringe,” Roy confessed. “I don’t know how to keep it from coming out or falling in or something.”
“Then hang on to it for a little longer and let me get set up. I’ve brought everything I need. Looks like an 18 French tube will fit, or a sixteen – she’s awfully small.” Dixie knelt beside Roy and unrolled one of the green bundles, pulling on gloves before selecting a curved tube. Deftly, she slid it in beside the syringe, so quickly and easily that the child merely shivered under Roy’s hand. At Dixie’s nod he pulled the syringe out and set it with the bloody towels.
“Now what?” he asked.
“We suture it into place,” Dixie said, pointing to the loaded needles in her bundle with her chin as she adjusted the tube.
“Can’t we do something to make her numb first?” Roy asked. “I don’t think she’s completely unconscious.”
“Well, let’s fix up something temporary, get fresh vitals, and then we can call in for permission to use some lidocaine.” Dixie collected the tape from the amputation kit and peeled off some long strips, discarding the first layer that Roy had gotten bloody trying to work loose. Deftly, she placed the strips while Roy held the tube in place, ordering Roy to move this finger or that, until the tube was secured.
Roy sat back and peeled off the gloves before trying to shake the cramps out of his hand. Dixie pulled a sphygmomanometer out of the bottom of the toolkit, giving him a glimpse of ampoules of medicines and other things lined up inside the trays. “We’ll need a fresh assessment of Johnny’s condition, too, Roy,” she said before she tucked the stethoscope buds into her ears. “Kel wants to make sure we can clear him for a shot. Christy, can you take notes for us and handle the biophone?”
“Sure,” Christy said, pulling out her notebook and moving aside to make room for Roy to kneel by Johnny again. His knees protested as he got into position, and he wondered briefly how Dixie would manage with just those thin nylons on. But it didn’t matter. What mattered was that he finally had a chance to see what was wrong with his partner.
In case Johnny could hear him, Roy put his hand gently on his shoulder. “Johnny. I’m going to get vitals again.”
“’kay,” Johnny said through gritted teeth, the pain lines on his face going deeper, though his eyes stayed closed. Roy felt a shudder running under his hand. He pulled the blanket aside and lifted Johnny’s arm so he could get a BP, grateful that he hadn’t had time to pull the BP cuff off when he’d shifted patients. The IV that Johnny had put into his own arm was going to need re-doing, Roy realized as he started to take the reading, and then had to start over because he hadn’t been looking at the dial when the pulse had started sounding in his ears and had missed the first number. But he got a BP at last and called it over to Christy as he lowered the stethoscope.
“I need to see your pupils,” he told Johnny. “Brackett’s not going to let me give you that shot otherwise.”
“Shot?” The brown eyes opened, blinking in the light. “You’ve got a shot?”
“Yeah,” Roy said, his voice going hoarse as he spoke around a lump of unexpected fondness. “The cavalry’s arrived, see?” he nodded toward Dixie. Johnny’s eyes refocused and then widened, but he didn’t try to say anything. Both pupils were equal and reactive, and that was all that Roy cared about. He took Johnny’s wrist and got a pulse -- 120 -- and then remembered that Brackett had wanted a pedal pulse as well. “I’ve got to check your leg now, Johnny,” he warned. “Do you want something to bite besides that lip?”
“Yeah.” Johnny fumbled around a little, uselessly, and then accepted the folded handkerchief that Roy set by his lips, getting it into place and mumbling around the cloth, “G’head”.
Moving as quickly as he could without being rough, Roy set aside the bag of ice and felt along the injured leg. It was cool, thanks to the ice, but the skin was taut and he could feel that there was swelling, and moving the knee joint even a tiny amount got a noise from around the handkerchief that he translated into the kind of language that Johnny rarely used. Roy moved down to the ankle and felt for a pulse there. He bit his own lip, mentally berating himself for letting his hand shake with nerves, but after a moment he found it. Fainter than it should be, and short some beats compared to the pulse he’d taken at Johnny’s wrist, but it was there..
“Pulse at wrist is 120. Pedal pulse is 120 and thready,” he told Christy. “There are signs of increased pressure in the anterior capsule. Pupils are equal and reactive. No sign of head trauma. Ask if we can go ahead with a shot.”
While Christy called in the numbers, Roy moved back up and pulled the IV, shifting it down into a better spot on the vein. “We’re gonna have to send you for a refresher course,” he told Johnny, teasing gently now that he was so close to getting some relief from the pain. “You overshot the mark.”
“I’d like to see you try it some time,” Johnny growled, almost smiling.
“Rampart says to give him ‘ten milligrams MS IV push’,” Christy reported. “Does that make sense to you?”
“Perfect sense,” Dixie said, passing an ampoule and a syringe to Roy from her kit before bending again to the sutures she was placing around the chest tube. He took them gratefully and measured the dose, aiming it into the IV with a heartfelt gratitude for the knowledge that it would make a real difference.
In moments, the tension started to leave Johnny’s face. “Oh, that’s nice. That’s really nice,” he babbled, relaxing as the narcotic did its work. “That’s a whole lot better.”
“Does it still hurt?” Roy asked.
“Yeah, but now I don’t care,” Johnny said. He waved at Dixie. “The shot’s really nice, Dixie. It still hurts but I don’t care and now it doesn’t hurt so much anyway.”
Roy grinned. “That’s nice, Johnny,” he said. “I’m going to get you into the stokes, now, so we can get you out of here.”
“Better talk to Rampart,” Dixie suggested. “I think they’re going to want me to bring in this little girl first. Has there been any sign of a parent?”
“Not yet,” Roy admitted. He thought for a moment. “There ought to be another stokes on the ladder truck. We can get them both ready for transport.”
Dixie nodded. “That would probably be best. But you do understand that one of the reasons Kel sent me is that I can triage Johnny, don’t you?”
“Triage?” Christy asked.
“It’s a way of… dividing… a lot of patients into groups. When there’s a big accident or something like that,” Roy answered slowly, grateful for the distraction while his thoughts tumbled over one another. “Some will die anyway, no matter what you do. Some will live, if they just get help fast enough, and some… some of them can wait.” Of course Dixie would be applying the principles of triage here. And of course Dr. Brackett would want an objective opinion. Neither of them knew what a leg meant to a firefighter. To a rescue man. But he’d been doing it himself, hadn’t he? Taking care of Bodine when he bled, taking care of the child when she had trouble breathing. He’d made Johnny wait, knowing that Johnny would understand why. “I’d better go get that stretcher,” he said. “Dix, keep an eye on them for a minute, please.”
“Sure thing, Roy.” The light in Dixie’s eyes was sympathetic. Roy gave her a small nod before walking away. Behind him he could hear her saying, “Christy, hand me the phone, please.”
He thought furiously. It wasn’t a broken bone that worried him, although he was pretty sure that Johnny was right about something being broken. It was compartment syndrome, the swelling of muscle in one of the four muscle compartments of the lower leg that could lead to blockage of the arteries and possible to amputation. That and the extensive bruising. Something was bleeding inside there. That lateral compartment was filling up with blood and bruised muscle and pressure.
He had the stokes in his hand and was collecting another blanket from the bin at the back of the ladder truck when the idea hit him. Maybe he could “let off” some of the pressure, somehow. Ease it up enough that Johnny could wait for the people with worse injuries to be dealt with first.
But when he quietly broached the idea to Dixie as they settled the little girl into one of the stretchers she shook her head. “You’d be opening up a path to infection, and besides, the pressure may be serving as a sort of 'pressure dressing' on whatever's bleeding, keeping it under control. Just opening the skin isn't going to release enough pressure to make a difference. When the pressure in those fascial compartments is released whatever is causing the bleeding will cut loose – we’d go from risking his leg to risking his life. I don’t think anyone should try opening up that leg until they’re in an operating room with good light and lots of instruments and an anaesthesiologist and an orthopedic surgeon and a blood bank down the hall.”
“Then there’s nothing I can do,” Roy said.
“You can splint the leg, get him into that stretcher and then pack the leg in ice,” Dixie said sternly. “That will slow down both the bleeding and the swelling.” She glanced over at Johnny, who was expansively explaining the principles of intravenous fluid replacement to Christy, before meeting Roy’s eyes again and saying very softly, “And you can look cheerful. He’s smart enough to know the dangers, but between shock and that shot, he’s going to be following your lead.”
“Sorry,” Roy tried to smile, though his face felt stiff and awkward.
Dixie managed a better one. She squeezed his arm. “When we get back to Rampart we’ll get some coffee and commiserate over the scares we’ve gotten today,” she promised.
“Scares?” he asked.
She grimaced. “I hate helicopters,” she confessed. “Especially the ones without doors.”
Somehow that made him feel better. He patted her hand in turn. “I guess it’s just been that kind of a day.”
“And it’s not over yet.” But the smiles they shared were smiles, and Roy’s hands were steadier as he helped Dixie finish settling the girl so that she wouldn’t be jarred, no matter how fast the flight.
That done, they moved over to where Christy was still listening to Johnny’s ramblings. He’d gone from IVs to the equipment list for the squad, somehow – Roy couldn’t think of a more boring thing to say to a girl – but Christy appeared to be paying rapt attention. She’d caught hold of Johnny’s hand and was smiling at him, making small encouraging noises and comments when he hesitated or lost his place.
Johnny, to Roy’s amusement, was too out of it to be using the infamous Gage charm. He sounded more like he was trying to impress a new student paramedic than he was trying to impress a girl. It wasn’t until Roy touched his shoulder and said, “Hey, Junior,” that the brilliant smile appeared.
“Hey, Roy,” Johnny said. “What comes after the K-12?”
“I’ll tell you after we get you settled,” Roy promised him. “How’s your leg feeling?”
“It isn’t,” Johnny sniggered. “You know, the next time we go on a run with a junkie I’m not going to be as mad at him. Probably, anyway. This stuff is nice, except for the not being able to think part.”
“Yeah, that does get in the way,” Roy agreed. He accepted the cardboard splint that Dixie was holding out to him. “Splint in position or straighten the leg?” he asked her.
“In position,” she said. “It will let us put some of the ice underneath and pack it all the way around. And straightening at this point may do more harm than good.”
“Sounds good.” Roy bent the splint and tucked it carefully around Johnny’s leg, taping it into place. “Dixie, would you shove the stokes under him when I lift him up? Christy, you can let go of his hand for a second.”
“As long he doesn’t start waving it around again,” she conceded.
Roy grinned, but he said, “Johnny, hold still a minute,” as he slid his arms carefully under Johnny’s shoulders and good knee and lifted. He was grateful that Johnny was the skinniest man in the station – he wasn’t sure he could have done the same for Lopez or Stoker or Kelly – but in any case he only had to keep Johnny off the ground for a few moments. Between them Dixie and Christy got the stokes positioned before he even began to feel the strain. He shifted his burden, tucking Johnny against him so that he was resting on Roy’s knees and turning him face-upward so that when he lowered Johnny again he’d be on his back instead of on his side. Dixie and Christy were working together, spreading one of the blankets, and using Johnny’s turnout coat to position one of the garbage bags of ice in the waiting stretcher.
He looked to see how Johnny was holding up, but his partner had closed his eyes and was humming something unfamiliar and vaguely mournful, like a folk tune or the sadder sort of lullaby. The pain lines hadn’t deepened on his face, though, so Roy didn’t waste energy talking to him. Dixie had everything under control anyway. He wondered if the song was something Johnny had learned on the reservation, in the childhood he seldom discussed. Strange to think how different their childhoods must have been – Johnny’s with visits from anthropologists in the summers, his own with visits from the popsicle truck. Strange to hold a grown man in his arms like this, even for a moment, and feel the same protective fondness that sometimes swept over him when he was carrying Christopher in to bed after he’d fallen asleep in the back seat of the car.
Rule number one: Never get emotionally involved with the patient, his own voice came back to him in memory. But he’d never gotten the knack of it. And sometimes you were already involved. He smiled to himself, knowing that it was scaring himself that made him feel so introspective. Joanne said it did, anyway.
Joanne.
Maybe I’d better not tell Joanne about what time that bomb was set to go off.
“We’re ready, Roy,” Dixie said, bringing him back to the moment. He lowered Johnny carefully into the waiting stretcher, and helped Dixie arrange the blankets and the ice. Johnny took the manhandling without protest, but switched to anatomy, muttering his way through lists of bone and muscle, and keeping his eyes closed.
“So what comes next?” Christy asked.
“A helicopter, if we’re lucky,” Roy answered. “Dix?”
“I’ll call the base,” she said, moving to the biophone.
Roy checked Johnny’s forehead – still clammy – and said, “Johnny? How are you doing?”
“I don’t like moving,” Johnny said petulantly. “Everything sort of swings around like I’m dizzy.”
“That’s the shot,” Roy assured him. “But you’re not moving now. Open your eyes and let me take a look.”
One eye cracked open just enough to glare at him. “I don’ wanna.”
“Why not?” Roy asked, surprised.
“’Cause if I aspirate it’ll make you all worried again,” Johnny argued, trying to wave his arms. Roy caught the one with the IV in it.
“Do you feel like you’re going to throw up?” he asked, worrying that he’d given Johnny too much morphine too fast.
But the smug smile that settled on to his partner’s face reassured him. “Not if I keep my eyes closed,” Johnny said, suiting actions to words.
“Sorry, Junior, but you’re not allowed to go to sleep yet.” Roy looked around. “Christy, could you hand me one of the splints from that big box? I’d like to make sure he doesn’t pull out the IV by accident.”
“I’m not gonna pull it out,” Johnny protested. “I know better than that!”
“I know you do,” Roy told him, as he took the splint Christy found and began to tape it onto Johnny’s arm. “But I’m the cautious type, remember?”
Johnny snorted. “Yeah. Belt-and-suspenders…” His loose hand came up to grab hold of one of Roy’s. “Joanne’s gonna kill me when she finds out I nearly got you blown up,” he said, in a very different tone. “I tried to get out. I really did.”
“Yeah, well, I’m not going to tell her how close it was if you don’t,” Roy said. “Besides, you’d made it most of the way.”
“I couldn’t yell,” Johnny murmured. “It hurt so bad…”
“Johnny,” Roy said warningly. “You’ve got to stay awake.”
“I’m just tired,” Johnny admitted.
“Hey,” Christy said, deliberately loud. “You didn’t finish telling me about the equipment. What comes after the K-12?”
“The Kennedy probe,” Roy prompted. “Talk to Christy, Junior. Stay awake or I’ll pull out the smelling salts.”
“Aw, man,” Johnny said, but he opened his eyes.
Roy got up to let Christy take his place, which she did, saying, “Okay, so what’s a Kennedy probe? It sounds political.”
In spite of his worries, Roy grinned at the question as he went over to see how Dixie was doing. “Any word on the chopper?” he asked.
“Working on it,” Dixie said. “How’s Johnny doing?”
“He got dizzy when we moved him, and I think he’s about ready to pass out on us. I’d really like to get him out of here.”
Dixie nodded. “Rampart, this is fifty one. Our male patient is having dizzy spells and difficulty retaining consciousness.”
“Fifty one, how long will it take you to get both patients to the landing zone for the helicopter?”
“Two minutes,” Dixie said. “Maybe four.”
“All right, start moving both of them. We’ll have Copter ten meet you.”
“Vince!” Roy yelled at the deputy. “Vince, I need some help carrying stretchers.”
“Christy and I can manage the girl,” Dix said. “You two take Johnny.”
“You’re going to have to carry the resuscitator,” Roy reminded her.
“We can manage,” Dixie said firmly. “It’s not that far.”
“DeSoto!” Captain Stanley came over at the same time as the deputy did. “What’s going on?”
“We’ve got a helicopter coming to take Johnny and the girl to Rampart, Cap,” Roy explained. “But we’ve got to take them around to the landing zone.”
“Can Nurse McCall take them in? One of the ladder guys just reported seeing what might be another victim up on the third floor. We’re trying to dig through to them now.” Hank Stanley didn’t look any happier about the news than Roy felt hearing it.
Dixie reached over to touch his arm gently. “Maybe it’s a parent,” she reminded them both.
Roy nodded, reluctantly. He looked a question at the captain. “I’ll still need to get him to the chopper,” he pointed out, knowing that he should really be getting his gear, getting ready to go inside after the new victim.
But Cap nodded. “Just don’t take too long,” he warned.
It didn’t take nearly long enough for Roy to carry the two stretchers around to the cleared section of street where the helicopter would land. Vince started making sure the bystanders were well back, and Dixie started tucking the blankets tighter and checking the straps, but Roy hesitated for a long moment before he turned away. Johnny was fighting sleep, his eyes drifting closed and then startling open again as Dixie made him answer a question. Christy was rubbing her hands, trying to soothe the red marks where the unaccustomed weight of the stretcher had bitten into her palms and fingers.
On impulse, Roy took her aside. “Listen, Christy, would you mind going in with him? I don’t know how long it’s going to be before I can get there, and Dixie’s going to have a million things to do the minute she hits the door of ER.”
She shrugged hesitantly. “I don’t know what good it would do,” she confessed. “All I seem to know how to do right is hold his hand.”
Roy gave her a tight smile, “Sometimes that’s the most important thing we do,” he told her. But he knew she needed more than that, for pride’s sake if nothing else. “Just… just stay with him. Keep him awake, and let someone know if he passes out. They’re going to be busy at Rampart. It might be a while before he gets a turn. But heck, once he gets into a treatment room, you’ll probably be able to interview half the paramedics in town.”
Christy nodded, but she was still troubled. “Don’t you want to go with him?”
Roy shook his head, knowing that for all that she’d learned, she still didn’t understand. And he didn’t have time to explain, not really. “I’m needed here,” he said, hoarsely. “But it’ll be easier staying if I know he’s not alone.”
From somewhere she summoned a shadow of the confidence that had been hers for most of the day. “Well, I can’t go back to my editor with half a story,” she said. “So I guess I’d better find out what happens at the hospital once you paramedics have finished your part of the routine.” She flinched a little, hearing the echo of her earlier comments, but Roy was glad to see she didn’t falter.
“Good girl,” he said.
“Good woman,” she corrected him, but she did it with a smile.
Roy laughed, surprising himself, and bent to give Johnny one last check as the chopper appeared over the roof of one of the nearby buildings. “I’ll see you later, partner,” he promised.
“Later?” Johnny asked.
“Another victim, maybe, in one of the buildings. I’m going to go check it out now.”
“Oh,” Johnny said blearily. “Don’t get hurt, okay? ‘Cause it hurts.”
“Okay,” Roy promised, although with the backwash from the chopper he wasn’t sure Johnny could hear him. Vince was taking position. The chopper was down. In a moment the two women had the first stretcher in, and were buckling into seats. At Dixie’s nod, Roy and Vince lifted Johnny’s stretcher, got it onto the rack, secured the straps, and then they were backing away, crouching down as the chopper lifted away again. It vanished over the buildings, not even giving Roy a chance to watch it fly away.
Continued