Calm to Chaos

by Garth Wade

  He turned back to Syd and said, ‘Thank you Syd and to you also Cameron.’ He gestured behind Syd to Cam, who was sheeting the cleaned stretcher.

  ‘Not a worry Doc,’ said the tall Scotsman.

  ‘Excellent. 4 Methoxy, 12.5 Morphine, and 10 Maxalon. We’ll have this vac splint at triage after we x-ray and decide on a plan.’

  ‘No probs Doc. Good luck,’ Syd finally turned to Sebastian, ‘and good luck to you amigo. Adiós.’

  ‘Gracias amigo. “If they spot it, they got it!”’ he replied, smiling and completely high.

  Syd and Cam walked out of resus with the stretcher and Syd inhaled the crisp night air.

  ‘You happy with that then?’ he asked as Cam rolled the clunky stretcher into the back of the ambulance.

  ‘Sure thing. Was spot on, son. I only wished that lil’ wanker junior doc would wind his neck in.’

  ‘Ah, he’s just trying to show off a bit by making us look like dopes. But no such luck on this occasion little ginger man!’ said Syd. ‘Some people just need to learn that we’re all on the same side.’

  ‘Ooh look at you go, Mister Smarty! Too bad they’re not testin’ you on the grand master plan at your next assessment,’ Cam said sarcastically as he sped out of the hospital then immediately returned to his usual driving-Miss-Daisy style over the familiar bumps of the city’s roads.

  **

  On the opposite side of the hospital, Amber’s pass card beeped her through into the staff car park. She pulled on the handbrake and texted Syd to find out where he was.

  Ken

  20:15 hrs – Bravo Unit 989

  Soon after vacating the hospital car park, the scratchy voice of a communications operator sounded on the UHF radio, requesting Syd and Cam’s truck number. ‘Bravo 989?’

  Syd, back in the passenger seat, picked up the radio handpiece. ‘Bravo 989.’

  ‘Bravo 989. Urgent call. Is your location near Summer Street, Coorparoo?’ The operator sounded young and slightly panicked.

  The UHF radios used by the service for emergency and daily communications bordered on a joke. Sure they worked, most of the time, but they were a constant bugbear to any of the operational staff attempting to communicate successfully. Particularly the handheld radios. Fortunately, this was not one of those times: the signal was good and transmissions came through clearly.

  Syd wasted no time. ‘Bravo 989. We are two streets away from that location. Put us on case and tell us what you know so far.’ He spoke quickly and with authority and felt that familiar buzz as his adrenal glands started to release their hormones into his blood.

  A different woman took over, perhaps a senior comms operator. Syd could almost taste her voice – bitter as a lemon, rind included, with a side shot of white vinegar.

  ‘Bravo 989, you are going code one to 47 Summer Street, Coorparoo, 27D3, male of unknown age, stab wound to chest, police on scene, Alpha 049 are going code one from the Valley. Please provide timely SITREP once you’re on scene.’

  ‘Roger,’ Syd said, and whacked the handpiece back in its bracket.

  ‘Can you type it into the GPS, mate?’ asked Cam.

  ‘It’s the first right then second left, Cam. Let’s go.’

  Cam paused, looked at the dash in front of Syd, shook his head as if to wake himself up, then flicked on the flashing lights before speeding toward the next street. ‘Syd, son, how the hell do you know the location? Have you moved out here or something?’

  Syd gathered his stethoscope and squeezed his hands into a pair of nitrile gloves, then chose a pair in Cam’s size and rested them on the gearstick for easy access.

  ‘Amber lives not far from here, I know the area pretty well—’ Syd leant forward and touched the dash with a sudden realisation, ‘Jesus, I could be wrong!’ then he reached for the GPS, which was fastened to the dash on a swivel between the two paramedics.

  ‘Don’t worry ’bout it mate, we’re here. The street looks like a fookin’ Christmas tree.’

  Cam was right. There were three police cars outside one house and another one further down the road, all stationary with their lights revolving. Syd could see the glow of police flashlights at the front and back of surrounding houses.

  The inhabitants of Summer Street were wealthy. Spreading jacaranda trees met above the road, providing cool relief in the hotter months. The houses were large, a few ostentatiously so, and most were a fair distance from the street. The gardens, all illuminated alternately in red and blue, were perfectly manicured.

  Cameron drove carefully towards number 47, stopped against a kerb and lowered his window. ‘Are we safe to go in?’ he said to the nearest police officer.

  ‘We haven’t found the assailant yet. The woman inside said he definitely ran down the street.’

  Cam turned all the spotlights on, lighting up the usually quiet street, and scanned the road and footpath ahead, then looked at Syd. ‘There’s enough coppers here. If you’re happy to go in, I am.’

  ‘Yep, let’s go,’ Syd said, jumping out of the ambulance and opening the storage space behind. He loaded himself up with the airway and oxygen kits, and Cam followed carrying the defibrillator, drug and trauma kits. They crossed the crunchy gravel driveway, passing the hedge, the freshly clipped lawn surrounding the fountain, and feeling the chill of the night as dew covered the toes of their boots. Syd asked another police officer, ‘Are you sure it’s safe?’

  ‘We’ve been inside, and the offender has not been located. I’ll take you inside though.’ She pointed her torch up the harlequin-patterned porch tiles, lighting up a long line of increasingly sized blood drops. ‘Watch that’ she said. She opened the front door, turned to Syd and said, ‘There you go.’

  Syd stood on the ‘Welcome’ doormat, his eyes widening as he took in the room in front of him: the light, the mix of modern and art deco decor, with black and whites of James Cagney and Jean Harlow hanging on the walls. An unmistakable smack of dread hit him then immediately faded.

  Syd realised he could see himself, as well as Cam standing behind him. A strange place to put a mirror, he thought, particularly one that took up the entire wall adjacent to the entrance. It did increase the room’s size though.

  He stepped into the room. A man was on his knees, his eyes wide, face pale and dripping with sweat. He grabbed Syd’s leg desperately and gasped, ‘Help – me – breathe.’

  He leant down to the man, then knelt beside him, preparing the bag valve mask and oxygen kit. Syd registered the shrieking sobs of a woman, glanced up and saw a pretty blonde with bobbed hair, standing beside the police officer.

  ‘What’s happened ma’am?’ he asked sharply, hoping for an immediate response.

  ‘He said … he … I don’t know … he’s, he’s been stabbed!’ she cried, and then burst into fresh tears.

  ‘Cam, cut his shirt off,’ Syd instructed, still preparing the oxygen.

  Within seconds, the man’s chest was exposed and Syd saw one small laceration in the centre of his chest, between his nipples. No visible blood. ‘ICPs are on their way?’ Syd asked Cam.

  ‘Thank fook,’ Cam replied, taking the patient’s vital signs.

  ‘I think maybe it’s better to keep him sitting up, Cam, yeah?’

  ‘Depends what the knife has hit, and its size,’ Cam replied before turning to the woman. ‘Ma’am, do you where the knife is?’

  She ignored Cam and continued to sob and wail. The police officer shrugged. ‘We haven’t found it so far.’

  ‘Could’ve hit his heart. So we’ll just monitor till the ICPs get here. I’ll get access now.’ Cam threw apart the drug kit and started to prepare for cannulation.

  ‘Sir, stay with me. Sir? Sir!’ Syd jammed the ear tips of the stethoscope into his ears and listened to the breathing of his rapidly crashing patient. He felt the patient’s weight pressing against him and his head lolled as he slipped into unconsciousness. ‘Cam, he’s going down. You get set up there for me; I’ll stay at the head.’

  Syd
laid the patient down as the woman began to moan, ‘Ken, Ken …’

  ‘Miss, Police, can you or one of your colleagues prepare to guide the other paramedics in the Forester straight in here please,’ Syd said, turning back to his patient, whom he now knew as Ken.

  Ken’s eyes were fluttering, the profuse sweating had ceased, and his face was a new greyer shade of pale. Syd held the bag valve mask firmly against his patient’s mouth, flexing his jaw forward for a good fit, and giving gentle breaths of 100 per cent oxygen. Syd noted the rise and fall of Ken’s chest, then checked for a carotid pulse. None. He grabbed the opened airway kit and pulled out and fitted a small piece of hard, curved clear plastic into Ken’s mouth to depress his tongue and manage his airway then continued to push oxygen into his lungs.

  Cam read the ECG and grunted, ‘He’s in PEA,’ then started CPR. ‘Fookin’ hell man we need to open this guy’s chest, decompression, this ain’t gonna work, but it’s all we can do for now.’

  Syd looked at his watch between breaths. It was 20:18. They’d been there for two minutes.

  Syd looked at Ken, noted the colour of his skin, on his cheeks, on his neck, on his chest – the wound. What’s the chance of someone surviving a stab wound to the chest, he wondered. The statistics? Out of hospital obviously. That millisecond of inattention was not only pointless but distracting.

  ‘So, where are we at guys?’ Sonia, a short, muscular, attractive intensive care paramedic dropped down beside him, followed by a doctor who introduced herself briefly as Megan.

  Syd took a breath to begin his handover but Cam quickly cut in and said, ‘Male, unknown age, one stab wound to central chest, about fourth or fifth intercostal space, as you can see.’ Cam then tilted his hands away to reveal the wound, which showed a rim of bright red blood with each compression. ‘Conscious on arrival, went down less than one minute ago, OPA is in, BVM at 15 litres, no cannulation yet, no other injuries that we have seen.’

  ‘Okay, thanks, just keep on with that while I look around,’ said Sonia, as she knelt down and studied Ken’s chest and abdomen, paying particular attention around Cam’s hands, near the leaking wound. She then felt the patient’s neck, front and back, and looked at her gloved hands, seeing no blood, then stood up and spoke in Megan’s ear.

  Megan said something to Sonia, who then turned back to the patient and listened to Ken’s chest through her stethoscope. Megan had whipped out her mobile phone and was chatting, presumably, to the medical manager, who unfortunately was not here. Syd had had the pleasure of seeing this guy in action a few times in the last few months, and was impressed by the direction he gave and his no-bullshit approach.

  Syd felt Sonia’s breast on his back as she leaned over him and felt calmed by it.

  She said to Megan, ‘Air entry clear, full fields.’

  Megan snapped her phone shut and told Cam to continue CPR; she was going to perform a thoracotomy.

  Syd had little idea what this meant and was unsure how the procedure would help, but was assured by Sonia and her marvellously comforting breasts that he should continue bagging.

  Ken lay there, splayed before the paramedics, unconscious, and pulseless. Megan knelt down in front of Syd on the right side of Ken, opening yet another kit with tools Syd had never seen. She took a scalpel and sliced across Ken’s chest from one side to the other, revealing quite a thick layer of fat, even though the patient was far from heavy, then cut through the thick tissue and muscles protecting his chest with a pair of stubby-ended scissors called trauma shears. As Ken’s chest opened up, his lungs popped out, inflating right before Syd’s eyes with each breath of oxygen he pushed in. The doctor felt around in the thoracic cavity and scooped out three handfuls of runny and clotted blood and threw them on the rug nearby. There was a lot of blood.

  She had made the slice across his chest a little too high and had to snap one rib down to reach the heart, using the trauma shears again. She scooped out more dark clotted blood and exposed the heart, which had one incision in the right ventricle, less than a centimetre wide. Blood pumped out of the small incision with each heartbeat.

  She stapled the hole shut with two clumsy staples, but she knew it was too late. It is rare for someone to make it through all of that ‘surgery’ in an emergency situation.

  Ken was dead.

  They declared at 20:25 hours.

  Everybody else took a breath.

  Syd heard Ken’s wife crying outside. He looked over at his patient. His heart was still beating. Well, it was beating, but erratically. The rhythm of a dying heart.

  Sonia the ICP noticed Syd looking at the heart. ‘What are you thinking? she said.

  ‘It’s pretty startling to see a beating heart,’ said Sydney, fascinated.

  ‘It’s pretty rare to see one, or to even be in this situation, really, in Brisbane anyway,’ Sonia said quietly. ‘Do you want to touch it?’

  Syd was curious, but then he thought his colleagues might think him peculiar for wanting to feel an actual beating heart, albeit a dying and soon to be dead heart. After searching Sonia’s clear blue eyes for any judgement, and seeing none, he reached over and put his whole hand around the fitting, dying heart. The soft scent of drifting metallic was everywhere.

  Almost at once, a mobile phone began to vibrate on the dining table, buzzing away, demanding attention. The paramedics looked over towards it, then ignored it.

  Ken’s heart was only pumping due to the cardiac muscles knowing nothing other than to contract and relax, as they had been doing every second of every day for the last forty-nine years.

  Syd sat beside Ken solemnly gazing at the heart. It had felt like nothing he had felt before. He had been around the innards of animals killed for food when he was living and working on farms in his earlier years, but this was utterly different. The human heart in his hand was a smooth muscle the size of his fist, but when it tried to work it was more taut than the strongest muscle he had ever felt.

  A human heart, in the palm of his hand: not fully functioning, but thrilling. Remarkable.

  He took another deep breath and held it. His neck thumped by his own beating heart. One drop of sweat fell from the tip of his nose and mixed with a small puddle of blood in the dead man’s chest cavity.

  That was enough.

  Elected

  Two weeks earlier – Ken

  The hallway was filled with suits. Some cheap, some luxurious, but all of them covering a human with questionable morals. They strutted about, shaking hands and smiling confidently, although they would only be buddies when no cameras were there to film them.

  This was State Parliament.

  Probably not all of the members had dubious morals, but some most certainly did, and they disguised it effortlessly as though they’d been doing it forever.

  It was their first morning break, and the best local coffee business had been hired to provide finely made pastries and coffees for the morning’s sitting. In addition to being state elected officials who demanded grandeur and the appearance of nobility, but they were also coffee connoisseurs.

  The Honourable Neville Nelson – broad chested, pompous and red faced – flashed his dirty teeth in a fake smile. Most people knew there was trouble ahead if he grasped your arm when he shook your hand. The last person he’d done that to was his assistant, a young woman named Kelly. Reportedly, he was having an affair with Kelly and she wanted out.

  One Friday afternoon, in front of all the staff, he shook her hand with the empty sincerity of the arm grab. On the following Monday he had the paperwork to prove Kelly had been misappropriating funds. She was found guilty almost immediately of misusing her fuel card. She’d never work in the public sector again.

  Kelly had been replaced with Ken. And although the Honourable Neville Nelson didn’t have an affair with Ken in mind when he hired him, he most certainly had other indecorous ideas.

  The Honourable Neville Nelson had Ken worked out from the start of the interview as a hard-working, crowd-pleasing,
subservient man who would do anything to win the approval of his domineering boss.

  The Honourable Neville Nelson knew how to read people.

  On Ken’s first Thursday, the Honourable Neville Nelson invited Ken and his wife to his Gold Coast apartment for a ‘get to know you’ weekend. Unfortunately for Ken, his wife couldn’t attend and Ken spent the weekend in a haze of hallucinogenic debauchery.

  He would never speak of this to his wife. He would not tell the few friends he had, and most definitely he would tell no one at work. It was the deepest secret of his life, one that could never be revealed. But he continued to follow the Honourable Neville Nelson around, doing what he did best, being agreeable.

  After rushing down a half-cup of caramel latte, Ken advised the Honourable Neville Nelson he would be going to the bathroom. Such detail was probably not warranted, but the Honourable Neville Nelson usually appreciated it, and said he needed to go as well.

  The two gentlemen entered the expanse of the dark-tiled bathroom, and the chitter-chatter and teaspoon clinking ceased completely as the heavy door swung shut.

  Ken approached the urinal, his leather-soled business shoes pattering, and lowered his fly. The Honourable Neville Nelson pushed on the stall doors to check they were empty. They were.

  The Honourable Neville Nelson stood behind Ken, about a metre away.

  ‘So, I’ve been talking with Peter and Paul – ahh jeez, that sounds like the bloody disciples doesn’t it?’ Nelson snorted. ‘Anyway, we’ll have to be quick. I need you to do a pickup tonight, like last time, but for six of us this time. Can you organise that?’

  Ken hadn’t even started to urinate, but had been standing there for long enough he felt he should have been finished by now, and pretended so.

  ‘Ah, well, if that’s what you’d like, I’m going to have to chat with our contact,’ he said, pretending to shake, ‘I don’t know how much that will be—’