Black Flies

by Shannon Burke

  “When’s she going?”

  “She left,” he said. “This week. She took Sylvia with her. I used to get Sylvia every weekend. Now it’ll be summers. Alternate holidays. I’ll hardly see her anymore. Not that it matters. Sylvia gets out of this city. That’s what’s important. Probably better if she doesn’t see me. She’ll have a better life.”

  “Well, that sucks,” I said.

  “Not like I care,” he said in that shrill, false tone. “I know it’s best for her. That’s what’s important. I’m glad she’s gone. It’s better for everyone. And, hey, now I have time to do what I want. It’s better,” he said again.

  “It sucks,” I said.

  “Whatever,” he said. “This is what happens if you stay in the job. Dirtbag medic for life. Fucked up by all the shit we see. What else was going to happen?”

  Twenty minutes later we were saying good-bye. I got off the train. The doors closed and as the train passed I saw Rutkovsky inside sitting there with his mouth shut tightly, eyes straight in front, head erect.

  Over the next week Rutkovsky spent all his downtime gazing out the window of the ambulance. He never mentioned his daughter again. I didn’t tell anyone else.

  Late August during a heat wave, and there were stretchers lined up outside the ER door with medics waiting to be triaged. Patients on every bed, on every chair. Patients standing up in the waiting room and sitting against the wall in the hallway outside the ER. Patients with IVs wandered down the aisles. Wheeled stainless-steel trays with syringes and bloody forceps and scalpels were left out in the open. Somewhere, an old woman screeched, “Water! I want water!” A homeless guy wandered in the front door, stole a white-bread sandwich from an old guy’s tray, and went on down the aisle, barefoot, eating it. It was a normal summer night in the ER.

  LaFontaine stood ahead of us in line.

  “How long you been waiting to be triaged?” I asked him.

  “An hour and fifteen minutes. Relax. There are no beds.”

  Rutkovsky’s eyes went over the ER slowly. Behind the nurse’s station one of the nurse’s aides sat with her head in her hands, bawling. On the other side of the ER an intern was running a code, ER techs doing CPR.

  “Go look for a stretcher,” Rutkovsky said. “We’ll be here all night.”

  I checked OB/GYN, X-ray, the isolation rooms. In the trauma room I saw a guy with his jaw wired shut and dried blood on his lips. His bed was next to a stretcher with a dead body beneath a sheet. I thought of dumping the body on the floor and taking the stretcher, then realized that was crazy. I wandered back out to the main room of the ER and saw Rutkovsky walking past the crying nurse, going on toward the old lady who was calling for water. He was holding a cup. As Rutkovsky got close to the bed LaFontaine stepped up and started mimicking the old lady’s whining calls.

  “Jesus. If you were really sick you wouldn’t be shouting like that,” LaFontaine said. “I’m probably thirstier than you are.”

  Rutkovsky looked at the old woman. He looked at LaFontaine. A moment of hesitation. Then Rutkovsky drank the water himself in plain view of the thirsty woman.

  “Who cares? Why care? Does it matter? These aren’t obvious questions. Take away the natural revulsion toward death, and then give yourself absolute freedom of action, and then it’s possible, even likely, to come to the conclusion that some stranger’s life does not matter at all. This job is the best laboratory I know for the psychologist. The changes are obvious and rapid. They happen right in front of your eyes.”

  By the end of the summer Rutkovsky started calling in sick a few days every week. LaFontaine always covered for Rutkovsky I started to think of LaFontaine as my second partner. One day in late August after we’d been working together for half a week, LaFontaine told me a story about his first year as a medic: “I worked tour one out of Bellevue, and I knew these transit cops at Grand Central. Good guys. Mikey from Mineola, Jimmy Pasqualli from Rockville Center. They made a copy of the keys to the headquarters at Grand Central so I could sleep on their cot. Hang out. Sometimes we’d take the Cushman into the station. You know, one of those three-wheeled golf cart thingies. Grand Central closed at one, but all these homeless fucks would creep in and try to sleep there. Sometimes we’d go in to hassle em, pick one out and kick the shit out’ve em. Make an example of him. Other times we’d have what we called the skel lottery. We’d pitch in for a forty-ouncer, then go out and tell the skels we were having a raffle. The skels’d all put a number in a hat and whoever won got a forty-ouncer and a ride on the Cushman. We’d kind of rummage around in the hat, you know, build up suspense, and then say, ‘Number eight,’ and some skel would jump up, ‘That’s me! That’s me!’ We’d make a little hat for the guy out of newspaper, give ‘im the forty-ouncer, and we’d ride’m around the circuit of the station past all his skel friends. He’d wave to em proudly, wearing this stupid fucking hat, drinking his forty-ouncer, like the prince on his chariot with all those wasted, whacked-out, homeless freaks jumping up and down, cheering and waving and shouting out. Complete madness. When we were finished with the circuit, we’d jump out of the Cushman, and say, ‘Get out, you dirtbag skel!’ and whack ’im with these half-inch wooden rods they kept in storage. Whack, whack, whack, we’d go, and the guy would scurry off, spilling his beer half the time. Then we’d go after the others. Whack whack whack. It was fucking beautiful, man. We’d do it like every other week. And they never learned. They always put their names in the hat. The fucking skel lottery!”

  “Ricky Rinello ran his ambulance into the river at 151st Street,” Marmol said. “Just walked off. Went to Key West, Florida.”

  “Station 18 or Key West, Florida. Which would you choose?” Hatsuru said without looking up. “He showed some sense in his choice.”

  “I gotta agree with you there,” Marmol said.

  “Betty Crumb gave birth in an ambulance,” LaFontaine said. “That was it for her. Her partner reached up into her beaver and she never came back.”

  “Jesus,” Marmol said.

  “That’d do it for me,” Hatsuru said, again without looking up.

  “I was working that day,” Verdis said. “It was a good-looking baby.”

  “Good-looking baby,” LaFontaine said. “Crazy bitch worked until she was eight and a half months pregnant. Her partner had to reach up into her beave. And all Verdis has to say about it is ‘good-looking baby.”’

  Rivett cackled and then coughed, blowing out smoke, all bony elbows and yellowish skin, standing in the doorway.

  “A lieutenant down at fifteen was found with a needle in his arm.” Rivett said. “An empty morphine bottle on the desk. You guys remember that?”

  “I do,” Verdis said. “Sad day for EMS.”

  “Yeah, I cried,” LaFontaine said sarcastically.

  “You remember Reggie Levine?” Marmol said. “He left the ambulance in the middle of Wall Street during rush hour. Like, right in the worst spot. In the middle of traffic. Just got out, took the keys with him. He ended up in some psych ward.”

  Hatsuru laughed. He remembered it. Rivett waved a hand and said, “Big fucking deal. We all end up in psych at some point. Didn’t you know that? Clark 8 at St Luke’s is like a spa for EMS.”

  That made us all laugh—a spa for EMS—and we were still laughing when the door opened and Rutkovsky walked through and the laughter sort of died down and no one said anything. He had dark circles under his eyes. He’d hardly said ten words since I heard about his wife taking off with his daughter. He looked at us. We looked at him. He pretended he didn’t notice the sudden silence in the room and went on walking through the station and out the other side. No one said anything about it. But the conversation didn’t start up again until the door slammed shut.

  The last day in August, still hot, ninety-four degrees at six in the evening, and we found a seventy-year-old woman slumped against kitchen cabinets, flapping about uselessly with her one good arm, having a stroke. I cleared the area and put a pillow beneath her
head and Rutkovsky breathed for her with the BVM. I was starting a line, and when I looked up I saw the patient’s son at the kitchen table with tears on his cheeks, holding a huge, curved, carving knife on his lap.

  “That’s my mother,” he said. “I know you all don’t give a fuck, but if she dies, you die.”

  “She won’t die,” Rutkovsky said.

  “That’s right, she won’t,” he said, and waved the knife, wiping the tears with his wrist. The woman stopped seizing for a moment, and in the interval Rutkovsky intubated her. I took over with the BVM and Rutkovsky stepped away.

  “Where you going?” the son asked, gesturing with the knife.

  “For equipment,” Rutkovsky said over his shoulder.

  Rutkovsky walked out, and came back in a minute later, putting his radio away.

  “Get her pill bottles,” Rutkovsky said to the son. The son sat there, not moving. In an annoyed tone, Rutkovsky said, “You wanna help your mother, get her pill bottles.”

  The son went into the bathroom to find her medications and we strapped the mother into the stretcher and hurried out just as four housing cops arrived. When the son came out, his hands filled with his mother’s medication bottles, the first cop stepped up and whacked him with his baton. The bottles went flying, the mad rattle of pills, the thud as the guy hit the floorboards. The cops jumped on him. Thumped him. A hoarse, choking sound as they grabbed him around the neck. A minute later, the cops dragged the son to a squad car. He was handcuffed, a purple hematoma ballooning on his forehead, the cops thrashing him around inside the back of the car. Rutkovsky jumped out of the ambulance and ran to the squad car. I saw him screaming into the open door of the car, waving his arms, trying to get in. One of the officers held him back. Rutkovsky pushed the officer. Another cop grabbed Rutkovsky from behind. Rutkovsky was struggling, flailing around, screaming his head off, and the whole time I was watching him through the open back doors of the ambulance, keeping an eye on our patient, feeling for a pulse, adjusting the drip rate, breathing for the guy’s mother.

  An hour after that, Rutkovsky and I sat side by side in the ambulance.

  “That fucking skel, pulling a knife on us. Fuck him,” I said.

  Rutkovsky didn’t say anything.

  “I wanted to kick his ass, too,” I said.

  Rutkovsky said nothing.

  “The guy deserved to get thumped by the cops,” I went on. “But shit, Rut, did you have to freak out on the street? I mean, Jesus. It wasn’t like the guy was really going to do anything and we could get in trouble. I mean, anyone could’ve seen. Maybe you should take the rest of the week off or something.”

  Slowly, Rutkovsky turned and looked at me.

  “Whatta ya know about it, rookie? Shut the fuck up,” he said.

  I did shut up. I didn’t talk about it again, to Rutkovsky, or to anyone else. But someone must have told the chief about Rutkovsky’s freak-out, probably one of the cops, because the next day Rutkovsky was called into the chief’s office, was up there a long time, and came back down furious, kicking the side of the ambulance. I didn’t know what the chief had said. All I knew was that Rutkovsky was pissed off all day and he didn’t even say good-bye at the end of the tour. I thought he might have quit. But when I came back to the station after the weekend Rutkovsky was already at the ambulance checking out the equipment. I asked him how he felt, and he said, “Better.” I believed him.

  There were two squad cars pulled to the side of the highway, flares set up around a single car on the right with a flat tire. As we got out one of the cops came over shaking his head. “Guy was changing his tire and got whacked. He ain’t makin’ it.”

  “Anyone else?”

  “He’s got two daughters. They saw the whole thing.”

  I started to hurry, but Rutkovsky was already ahead of me. He was filled with that sense of urgency he got whenever he dealt with kids, particularly girls.

  “Keep the daughters away,” Rutkovsky yelled back, but the cop shook his head. “They already saw everything. The older one called it in on a cellular. She got the phone from his pocket.”

  We hurried on, passing a second cop talking to a middle-aged woman who was leaning against the concrete barrier, a hand over her eyes, weeping, and went on to a guy in a suit lying sideways, half up on the concrete barrier. His feet were out at odd angles, his left hand dangling by some skin, his torso twisted into a strange corkscrew shape. His eyes were open and staring blankly at the sky. Rutkovsky reached for a pulse, then looked at me and shook his head.We would have called it a DOA, but twenty feet away, beyond the last flare, the two daughters stood, one holding a phone in two hands, the other gazing at the concrete. They were not crying, but just standing there with wide, dazed, glassy eyes. Rutkovsky said, “Let’s work it up. So they know we tried.” He went for the tube kit. I started to cut off the guy’s clothes so I could set a line and begin CPR. I cut straight up his pants leg and up the side of his shirt to reveal a bra, panties, and a garter. He’d been wearing women’s clothing beneath his business suit. Rutkovsky was prying the guy’s mouth open with a laryngoscope when he looked down and stopped. A blank look crossed his face. Then he looked away and bit his lip. The two daughters were now only ten feet away, with a clear view. Not only had they seen their father hit and dragged fifty feet over concrete, but they’d seen his contorted, mangled body laid out on the West Side Highway in women’s underwear. Rutkovsky started giggling. I did, too. I couldn’t help it. It started low and built. The daughters watched in horror as we pried their dead father’s mouth open with a steel blade and stuck needles fat as nails into his neck, all the while howling with laughter, tears running down our faces.

  As the baby slips through the pelvic ring its chest is squeezed and amniotic fluid is forced out, clearing the lungs to breathe. But if the baby’s position is abnormal, if the baby is small, or if it is a very fast delivery, the chest may not be compressed properly, the lungs may not be cleared of fluid, and until air is pushed into the lungs, the baby may appear not to breathe at all.

  September 5, 1993, 6:40 PM, at the end of an eighty-hour week, at the end of a month where I’d practically lived on the ambulance, seven and a half months after I’d started working as a paramedic, Rutkovsky and I walked into a six-by-twelve foot room to find a wooden floor slick with thickening blood, and a baby, not moving, curled on its side next to a bloody placenta. The mother was up on one arm trying to cut the twisted umbilical cord with the jagged end of a broken crack pipe. Her hair was matted back and dreadlocked and her teeth looked huge in her emaciated face. “Stupid,” Rutkovsky muttered, and slapped the crack pipe from her hand. He clamped the cord with a hemostat, cut it, and wrapped the baby in a blanket. There wasn’t much space in that tiny room, so he carried the baby to the room across the hallway, saying over his shoulder, “Treat the fucking mother.” I took the mother’s pulse and got a blood pressure and as I tried to set a line I asked, “How do you feel?”

  “Fine,” she said. “I’m all fine. Baby’s dead.”

  “How do you know the baby’s dead?”

  “Wasn’t breathing is how.”

  “How long wasn’t it breathing?”

  “The whole time.”

  “How long was it out before we came? In minutes.”

  “Ten maybe.”

  “Out ten minutes,” I yelled to Rutkovsky in the other room.

  The woman had sinewy, scarred arms: junkie arms. She was fidgety. She was rocking back and forth. Her eyes were jumping around in her head. She talked in a high-pitched, singsong voice, louder than she needed to.

  “How many weeks were you?”

  “Thirty-two.”

  Seven months. Crack induces labor.

  “Are you on drugs?”

  “What? No!” she shouted.

  I picked up the crack pipe and held it to show her.

  “When’d you last smoke?”

  “’Bout an hour ago,” she said matter-of-factly, completely changing her story.


  “So you were smoking while you were in labor?”

  “I needed something for the pain.”

  “Did you do anything else?”

  “I took my methadone.”

  “How’d you get it when you’re pregnant?”

  “My friend Jimmy’s in two programs. He gets it for me.”

  Rutkovsky had only clamped the baby’s end of the cord, and the placenta had leaked blood onto the wooden floor. I pushed the placenta against the wall with my boot, leaving a purplish streak on the wood.

  “Have you had an AIDS test?”

  “I’m HIV positive. I got the virus.”

  I looked around with a sinking feeling. There was blood on my gloves and on my blood pressure cuff and on my boots.

  “Did you take the pills so your baby wouldn’t get the virus?”

  “Aw, that don’t work. I don’t need that.”

  I sat back. Disgust rose inside me. I felt like stomping her head in.

  “You should have at least taken the meds for your baby,” I said.

  “What’s it matter? Baby’s dead,” she said.

  I didn’t say anything to that. I yelled to Rutkovsky that she was HIV positive, that she hadn’t taken her meds, that the baby was probably HIV positive because she’d not taken her meds, and that she said it didn’t matter because the baby was stillborn. Silence from the other room.

  After a moment I heard footsteps coming up the stairs. We’d called for another unit, but it was two cops I didn’t know. They looked in at me, checked the other room, then one of the cops came back and stood in the doorway while the other went down the hall to call for a rush on the other EMS unit.

  “How’s the baby?” I asked.

  “The baby’s dead,” the mother said.

  “I’m asking him,” I said, motioning to the cop. “How’s the baby?”

  “I thought I saw it breathe.”

  “I know babies,” the mother said. “And that baby’s dead.”