Extreme Medical Services: Medical Care On The Fringes Of Humanity

by Jamie Davis

  “Rudolf is a Lycan, a werewolf, who is James’ second in command. He’ll be our contact should we need to deal with an Unusual problem beyond our limited abilities.”

  The alert tones dropped, startling them out of their conversation. “Medical Box U-265, Respiratory Distress, 57 Quartet Drive,” intoned the dispatcher as the printer began whirring and spit out the sheet with the address and additional information. Brynne grabbed the paper as the paramedics jumped up and headed out to through the doors to the ambulance bay. Brynne handed the sheet to Dean as she headed to the driver’s side.

  “You’re going to have to let me drive at some point, Brynne,” Dean laughed.

  “Maybe tomorrow,” Brynne said.

  “Maybe never,” Dean muttered under his breath.

  Dean climbed in as Brynne started the engine. He picked up the mic and put them on the street. “U-191 responding.”

  “U-191 responding,” repeated the dispatcher. “Switch to med channel 1 for additional.”

  Dean switched the radio over to the secure, trunked med channel. “U-191 on med channel 1.”

  The dispatcher’s voice came back immediately. “Respond for a 22-year-old woman complaining of respiratory distress.”

  “Copy dispatch, U-191 out.” Dean said, replacing the mic on the dash. He made a mental note to continue the conversation they had started earlier. He wanted to delve into this topic more. Just when he thought he had the Unusuals figured out, something else cropped up.

  It took them 8 minutes to get to the quiet suburban neighborhood of small, single-family homes. As Brynne turned the ambulance left on to Quartet Drive, Dean started reading numbers on the mailboxes and the house numbers when he could see them. “It’s going to be on the right side of the street,” Dean said noticing that the odd numbered houses were on his side of the road.

  “There it is,” Brynne said. They saw a person frantically waving on the front lawn of the ranch style house. She pulled the ambulance up to the front of the house. When she came to a stop, Dean jumped out and began pulling bags out of the side compartments on the unit. He shouldered the oxygen and airway bag then grabbed the med bag and started walking across the broad yard to the front door. Brynne caught up to him with the heart monitor clutched in one hand and the portable suction bag in the other.

  As the paramedics approached the front door, a man in his twenties met them on the front porch. “She’s in here, she can’t breathe!” He told them as they approached. He pulled the screen door open and held it for them as they walked through into the house. On entering the living room at the front of the home, they saw an attractive red-haired young woman in her twenties. She sat on the edge of the sofa, her hands on her knees, slightly leaning forward as she struggled to lift her torso up to allow complete filling of her lower airways. Dean recognized this was called the tripod position, and it was not a good sign. She was struggling to breathe and was pale with a slightly blue tinge to her lips. They could hear wheezing of her labored respirations from across the room. On the coffee table in front of her were several medication inhalers and a portable home nebulizer with tubing that led to a mask.

  Dean put the bags down on the floor next to her and started to pull out a non-rebreather mask and tubing from the oxygen bag. “Hi, my name’s Dean,” he said as he worked. “We’re going to do what we can to help out, okay?”

  “She’s Lydia,” the man said. “Her asthma is acting up. This is the worst I’ve ever seen it.”

  Lydia gasped out one word at a time. “I. Tried. My. Nebu. Lyzer. Treatment. But. It. Did. Not. Work.”

  “Here,” Dean said, holding the non-rebreather mask up to her face with oxygen set to fifteen liters per minute. He stretched the elastic band around her head to hold it in place. “That should help a little bit while we get some other things set up.”

  Brynne set the heart monitor down on the coffee table in front of Lydia and turned it on. She connected the blood pressure cuff to the machine, wrapped it around Lydia’s arm, pressing the button to start inflating the cuff for a reading. She also slid the pulse oximeter probe sensor over her index finger and plugged that into the monitor. Dean could see the 88 percent value. Not good. Brynne placed the earpieces of her stethoscope in her ears and held up the bell in one hand. “I’m going to listen to your lungs, okay?”

  Lydia nodded and Brynne reached around the woman’s back, lifting her shirt up and sliding her hand under. “Wheezes at the top, diminished breath sounds in the middle and nothing at the bottom.” Brynne looked up at Dean. “So, Dean, what’s next?”

  “Nebulized combination meds,” Dean said confidently. “Albuterol and Ipratropium, two point five milligrams of Albuterol and five hundred micrograms of Ipratropium via nebulizer mask.” He turned to the oxygen bag pulling out the neb mask and tubing. Then he unzipped the medication bag, reached in and pulled out two plastic ampules, which he put in the nebulizer mask. Taking the non-rebreather mask off Lydia, he replaced it with the nebulizer mask and attached that tubing to the oxygen cylinder, setting the flow to ten liters per minute. The chamber began bubbling, sending a cool mist of medication up into the mask for the woman to breathe in.

  “I need you to try to calm your breathing down,” Brynne said. “I know it’s hard but try. We need to get that medication in as deep into your lungs as we can. Listen to my voice and try to breathe in as I count to five, hold it for a second, and then breathe out.” Her calm voice started counting slowly holding Lydia’s eyes as she worked with the struggling woman. The technique started to work. The combination of Brynne’s tone and the medicine seemed to have the desired effect.

  “Dean,” Brynne said. “Start a line but just attach a saline lock at this point.”

  “Right,” Dean said. He unzipped the front pouch of the med bag and pulled out the IV pouch. He tied an elastic tourniquet off just below the elbow of Lydia’s left arm and selected a vein in the middle of her hand that looked good. He wiped the skin, then picked up a 20 gauge IV needle.

  “Just a small pinch,” he said as he took her hand, pulled the skin tight with the thumb of his right hand and advanced the needle with his left. “There. Got it!” he said to himself. He picked up the saline lock and carefully screwed the hub nut on securing the end in place.

  After applying the dressing on top of the insertion site and taping the rest of the tubing down securely to her wrist, Dean looked up at Lydia. Her color was already much better, and her breathing was less labored. Brynne was still helping her concentrate on her breathing, and Dean looked around, thinking about what to do next. His mind went through the mantra. O2, IV, monitor … He looked at the heart monitor and realized it wasn’t hooked up yet. He reached into the back pocket of the heart monitor case and counted out four sticky electrode leads then unzipped the side pocket containing the wire harness for the four primary heart leads then attached them. He then looked at the monitor where the heart rhythm was starting to manifest on the screen.

  “Sinus Tachycardia,” Dean said aloud. “At 134. Pulse ox reading is now 92.” He looked at Lydia and saw that she seemed a little more relaxed. The nebulizer mask was starting to sputter intermittently, a sign that the medication supply was running out. He thought she still needed to go the hospital and get checked out. Dean was also curious about what kind of Unusual the patient was. Dispatchers never said, probably because they didn’t know, and Brynne had given no clues. Lydia looked completely normal, at least normal with a chronic respiratory illness like asthma.

  “Lydia,” Brynne said, anticipating Dean’s thoughts about treatment. “You’re looking better, but I think you still need to go to the hospital.” She gazed at Dean, “Let’s switch her to a nasal cannula for now and discontinue the neb treatments.”

  Dean nodded and took the spent nebulizer mask off Lydia, and reached in to pull out a nasal cannula. He was in the process of removing the cannula from the plastic wrapper when Lydia spoke. Her tone was captivating … literally … and he sat staring at his hand
s as she spoke.

  “You all are so helpful,” Lydia said. “I want to thank you, but I’m not sure I need to go to the hospital. You could just stay here and help me out. Right, Dean?”

  Dean looked up from his hands to Lydia. Jeeze! She was beautiful. Why hadn’t he noticed that before? Her voice was so entrancing and melodious, how could he consider telling her no. “I would be happy to stay here and attend to you, Lydia,” Dean said. “You only have to say the word.”

  Lydia’s husband was staring at her, aghast, “Lydia, I can’t believe you’re doing this again.” He held up a hand. “I want nothing to do with it.” He turned and stormed out.

  Brynne looked up at her partner in alarm. “Aw, hell no!” She shouted and started digging around in the med bag on the floor, “Crap, crap, crap!” She stood up and bolted out the front door. Dean couldn’t understand why she was so rude to their hostess. After all, Lydia was generously offering them an opportunity to stay here with her, which was obviously a better idea than taking her to the hospital. And anyway, if he stayed here he could keep listening to her lovely voice. She was humming a tune now, nothing he recognized but a lovely melody with a steady up and down cadence that —.

  Suddenly a loud clanging broke through the melodious humming and Lydia shrieked, covering her ears. Dean looked up at Brynne, standing in the center of the room. How had she gotten there? She was just sitting on the couch a second ago. And what was that she was banging on with a drumstick? She stopped for a second and then held out her hand.

  “Dean, twist these up and put them in your ears,” Brynne ordered. He reached out for what she was handing him, confused but obeying. He stopped though as soon as Lydia started talking again.

  “You come to my home and make that infernal noise when I’m talking?” Lydia said. She covered her ears again when Brynne started beating on the metal box again. Dean shook his head to clear his thoughts. It wasn’t a metal box. It was a cowbell, like from a drum kit. Where had she gotten that?

  “Dean,” Brynne shouted over the din of her banging. “Come over here. Pick up the two pieces of beeswax you dropped, twist them up and stick them in your ears.” Dean stood up, took a few steps and picked up the two orange lumps off the floor. They were sticky and soft and he rolled them, one in each hand between his thumb and forefinger and then inserted the column of wax in his ear canals. The din of the cowbell taps was not as sharp as soon as the two earplugs were in place. As soon as Brynne saw that he had done as she asked she stopped the banging.

  She looked at Lydia, “Lady, you’ve got a lot of nerve trying to charm my partner. We came here to help you.”

  “I just don’t want to go to that nasty hospital,” Lydia pouted. She looked at Dean and sighed as she saw that she was no longer having the desired effect. “I thought you two could just stay here and take care of me until I felt better.”

  “You need to get to the hospital and get a steroid follow-up shot. We don’t have those, and that’s what you need,” Brynne said. “And just for the record, we’re happy to help you out in any way you need. You don’t have to turn on your charms and try to coerce our male paramedics that way. You’re new in town, right? I don’t think we’ve been here before or there would have been a note to take precautions. We didn’t know you were a siren. Did you check in with our headquarters or your own leadership when you got here?”

  “I don’t like all those formalities,” Lydia said. “I’m always afraid the information will get into the wrong hands. I didn’t want to call 911 anyway. It was my husband’s idea. I think he was feeling bad because we had a fight, and whenever we have a really bad argument, the stress always triggers my asthma.”

  “Well I’m glad we came,” Brynne said. “Even though you tried to hijack my partner. You were in bad shape.” She reached into her pocket. “Look, here’s the number of our ER medical director, Doc Spirelli. He can help you out, and he’ll keep your secret. If you promise to get your husband to drive you to the ER, you don’t have to go with us, but you do have to go. You need a course of steroids. That asthma attack has secondary effects that are going to catch up with you in an hour or so.”

  Dean stood there, still slightly confused as to what just happened. One minute he was trying to get the patient ready for transport and then Brynne teleported to the center of the room and was banging a cowbell.

  Lydia’s husband walked back in. “I can take her,” he said. “I’m sorry I didn’t warn you. As sick as she was, I really didn’t think she’d turn on the charm while you were here helping her.”

  “Well we’ll know from now on so we’ll come prepared,” Brynne said. “Remember that the next time you need help from us and decide to try anything funny. Still, no lasting harm was done, right Dean?” She looked at him and chuckled. “He’ll be alright, he’s pretty good at following instructions, as you have seen. I’ll talk him through what happened. No harm, no foul.” Brynne set the cowbell and drumstick down and pulled the iPad tablet out of the side pocket of the med bag. “Here, let me get you to sign our transport refusal and we will get out of your hair. If you need us, you can always call us back. But, you are not going to be here because you are going to the emergency room, right?” She looked at Lydia’s husband as she offered the screen to Lydia to sign with a scribbling sweep of her finger tip. The man nodded. Satisfied, Brynne then put the iPad back in its pocket and started to clean up their gear. Dean was still standing in the middle of the room, just watching the events going on around him, a bit dazed. She finished packing up the gear then started hanging the bags by their shoulder straps on Dean until everything was accounted for. She kept the cowbell and drumstick for herself.

  “Dean, you head out to the ambulance,” Brynne said. She was still watching the siren closely. She clearly did not trust her. Lydia had proven how quickly she would resort to using her powers when it suited her. “Lydia, I just want you to know that we always have a woman along on this particular ambulance team. We are happy to serve you when you need help, but you should know that we won’t let ourselves be taken advantage of.” She held eye contact with the siren for a few moments. “Do we have an understanding?”

  “Yes,” Lydia said, waving her hand in the air as if she were shooing an annoying bug. “I was not going to hurt him, and I would have let him go once I was feeling better.”

  “He’s not your medic, he’s mine, my responsibility!” Brynne said with a feral grin. “I’m responsible for him, and he’s still too new to know how to watch his own back. That’s why I’ve got his back for him. Just remember that.”

  “Whatever,” Lydia said. “I’m done with you now.” She used a shooing gesture of her hand to punctuate the remark.

  Brynne watched her walk back down the hallway to the bedrooms then turned and left with a shake of her head. She grabbed Dean by the shoulder where he still stood with all the gear draped on him, confused. She led him out to the ambulance and started to help him stow the bags in their compartments.

  “You okay?” She asked him, putting her hand on his shoulder.

  “What happened back there?” He said, trying to make sense of it. “One minute I was checking a heart rhythm on the monitor, and then I was standing there and you were banging on that stupid cowbell. I vaguely remember you telling me to stick something in my ears, then you loaded me up and sent me out here.”

  “Lydia, our patient,” she began, “is a siren. You know, the mythical creatures that lured men to their deaths on the rocks from ships at sea. Her voice is like a super hypnotic aphrodisiac to men. As soon as she was able to speak normally, she started to turn on the charm and get you to comply as her own personal paramedic. I should have been paying more attention. With certain types of calls, the dispatchers get a cue from the higher ups via the computer to send us responding on ‘Omega’ status that alerts us to take special care. We have a bag with a few special tools in it for just such occasions. I would have brought it in if I realized we needed it. My mistake.”

  Sh
e walked over and pulled open the passenger door for Dean. “Climb in. My guess is that you are going to be a bit fuzzy for a half hour or so.” Dean watched her glance back at the house behind her before walking around to the driver’s side of the ambulance with a shake of her head.

  As she climbed in behind the wheel, he asked her, “What was that you had me put in my ears?”

  “Beeswax,” she answered as she started the unit and pulled back into the street. “For some reason, it’s the only thing that works on sirens. I think it has something to do with some kind of residual resonant ‘buzzing’ trapped in the wax from the hive that stops the siren’s voice from getting through. Regular earplugs, headphones and other similar things just do not work.”

  “It’s obvious I needed hearing protection because you were making all that racket on the stupid cowbell,” Dean asked. “Where did that come from, anyway?”

  “All part of the emergency kit,” Brynne said. “Something about the tones of a standard cowbell breaks through the spell, reversing some of the effects. It drives the siren nuts, too. They hate it. Based on that fact alone, I have a theory that the Rolling Stones’ ‘Honky Tonk Woman’ is really about a siren in a southern bar. No proof, of course, but that cowbell opening and then the continuous beat of it throughout the rest of the song would drive a siren nuts, and that makes me think it’s true.”

  “So, I was under a spell, and you used a cowbell to break it,” Dean said, a sudden thought occurring to him. “Oh, no!”

  “That’s right!” She said, grinning ear to ear. “You had a fever and the only cure was …” Dean groaned and then joined her. “… More cowbell.”

  The incident with the siren really shook Dean up. He’d learned in school about being situationally aware and keeping scene safety in mind, but they never discussed a sneak attack by a siren. As Brynne drove them back to the station he kept mulling over the question of how he was supposed to protect himself, or his partner, when he couldn’t recognize some dangers when they were staring him in the face?