by Shawn Grady
“What’d he say?”
Bones gave a “Sorry to break this to you, but you’re not getting a bike for your birthday” sort of smile. “Letell was bipolar and suffered paranoid delusions. Big conspiracy theorist. He wasn’t violent. Just off his nut.”
I leaned my elbow on the door and rested my head in hand. “Are you sure?”
“That’s what he said.” He merged onto Interstate 80 East. “Sorry. I know you were aiming to be a super sleuth. Guess you’ll just have to settle for being a plain old doctor.”
I sat back. A jetliner descended toward the airport. I felt my shirt pocket and the stiff crinkle of Letell’s note inside it.
Chicken scratch.
Dispatched toned. “Medic Seven, traffic.”
CHAPTER 21
We screamed down Moana, Bones bobbing over the steering wheel, lip-syncing Bob Dylan – “From a Buick 6.”
“I’ve got this graveyard woman . . .”
The asphalt, damp from a quick evening shower, sucked in our headlight beams. I flipped a page in the map book. Bones took oncoming traffic and rode the air horn.
He swung us through an intersection and back into the direction of travel. The transmission shifted and I jerked back in my seat. Streetlights fanned. I pointed to the next intersection and glanced at my watch. “Hang a right here.”
Ten minutes and counting.
A pressing feeling told me that we were walking a tightrope that was ready to snap.
The call was for respiratory failure after a severe asthma attack. I dug nails into the ceiling as Bones whipped around the corner. The back end of the box fishtailed out. I’d have grabbed a fistful of ceiling fabric if I could have. Bones steered in the direction of the skid and straightened her out.
He pushed his lips together and, with a penitent look, lowered his head. “Whoops.”
I let out a quick and forceful breath. “Okay, it’s coming up. Another right. Creekbend Way is your warning street.”
He straddled the white lane divider. “I’m looking for Willow-bend, right?”
“Yeah.”
We pulled into a residential court. A woman holding a phone by her ear flagged us from the driveway. She knelt next to a parked car with the passenger door open. A man lay supine and unconscious on the concrete.
I clicked the mic. “Medic Seven on scene. No fire.” We grabbed the equipment and set it by the patient. “How’d he get here like this?”
The woman fit words between hyperventilating sobs. “I tried to get him into the car . . . for the hospital. He passed out.”
I tilted his head and chin and listened. No breathing. I found a rapid and thready pulse at his neck. A fire engine pulled up next to the curb.
Bones pulled out the defib pads. “No pulse?”
“No, he’s got one.”
He tossed me the BVM. I set the mask over his face and squeezed the bag. His chest didn’t rise.
Bones plugged the oxygen tubing onto the tank. “How’s compliance?” “I can’t get any air in.”
Bones cut off the patient’s shirt and slapped the defib pads on his chest. A rapid heart rhythm spiked across the screen. “Sinus tach at one-thirty.”
The fire captain bent beside me. “We just cleared that multiple-vehicle accident on 395. What do you need?”
“Try to bag some air into him.”
Lightning flashed in the west. I clicked the laryngoscope blade on the handle, red and blue light bar reflections glinting in the curved metal. Fat raindrops pattered on the pavement.
And that day flashed in my mind.
No. Stay focused.
I hooked up a syringe to a breathing tube and tested the balloon cuff at the end of it.
The rain drilled harder. Thunder boomed overhead.
I saw the car.
No.
Her car.
Focus.
Wrapped around that tree. A water-curtain deluge. The body-sized hole in the driver’s-side windshield . . .
I blinked and strapped on a mask with a plastic eye shield.
The firefighter bagging glanced at me. “You ready?”
I nodded and lay on my belly upon the concrete. Wetness soaked in through my cotton shirt. The firefighter pulled the bag mask away, and I tilted the man’s head and inserted the curved blade, sweeping his tongue to the side, shining the small light down his throat.
Thunder again.
The police car in the pouring gray . . .
Focus, Trestle.
I stared down the dark red tunnel. Rain fell in sheets. The plastic fluid barrier on my mask streaked with water. I tore it off and squinted to see.
The esophagus was lower, and larger. The trachea more anterior – higher, smaller, and would be marked by those pearly gates, the vocal cords. The area where they should have been looked swollen like a tomato.
“What do you see?” the firefighter said.
I pulled out the blade and sat up. “Nothing good.”
Bones handed an in-line albuterol treatment to the firefighter. “Try bagging him with this.”
I looked at Bones. “I don’t think I’m going to get a tube down that.”
The firefighter squeezed the bag with difficulty. “Compliance is still poor.”
He was bagging against a shut door. Any air that did get in was routing straight to the stomach.
Bones peeked at the monitor. “We still got pulses?”
I put two fingers on the carotid. “Thready. But there. Let’s trach him.”
If our patient couldn’t breathe through the normal anatomy, we’d cut a new hole straight into his windpipe.
Water pelted plastic. Above us, two firefighters held a red tarp. The fire captain shone a flashlight beneath. I swabbed iodine in a circle over the man’s throat, angled the scalpel in my hand, and froze.
Now sheltered from the rain, a crucial detail came into view – a cut in the man’s throat, just above the sternum. I separated it with my fingers, revealing a gaping hole with a burgeoning pool of dark red blood. Across the top part of his chest I felt fluid beneath the skin, like water under the moisture barrier in a crawl space.
I pulled back the tarp. Cold rain met my cheeks. “Where’d this come from?”
The woman still stood on the driveway, phone in one hand, and in the other . . . a bloody razor tip.
I pointed to the patient’s neck. “Did you do this?”
Water poured off her chin. “I had to . . . I had to get him air.
You guys were taking too long. No one was here. I had to get air in him. I saw it done once.”
“We’ve lost pulses,” a fireman said.
“All right. Let’s start compressions.”
We needed an airway. The man’s body articulated with the compressions, like a piston-driven machine.
I found the anatomical landmarks on the throat and made my scalpel incision. “All right, I’m in the trachea. Tube.”
Bones handed me a short breathing tube. I twisted it into place. The firefighter connected the bag mask and squeezed.
The man’s lungs lifted and relaxed for the first time since we’d been there.
“Okay, good. Let’s logroll him toward me and bring the flat underneath.” I kept one hand on the tube and the other on the man’s shoulders.
Rookie move. We rolled him and a rush of blood spilled from the lower laceration in his neck.
The puddle extended on the concrete. I made my feet. “Okay, back down. Back down.”
Bones came beside me to lift him. “She must have lacerated a big blood vessel.”
As soon as we loaded the gurney in the back of the ambulance – why did it have to be in the ambulance? – all that air we’d bagged into his gut violently discharged his stomach contents.
On instinct I turned him away, and moving with the speed of experience, Bones avoided a solid shot of emesis. But more than the vomit, the blood pool in his neck also streamed out, cascading down the side of the gurney and coating the floor like a dark
watery syrup.
I laid him back and stuck a suction catheter into his mouth. Bones tossed me a fat stack of four-by-four dressings for the throat.
He opened the side door. “Guess I’ll be going now.”
Up front I heard the driver’s door open and shut. Bones spoke through the doghouse, “I’ll give the report to Saint Mary’s.”
One firefighter kept bagging. The other resumed chest compressions. I spiked an IV bag and hung it on the gurney pole. I kept slipping on the bloody floor. I couldn’t find a vein and poked him twice with no success.
It was Airway, Breathing, then Circulation. And I’d spent most of my time on A and B. He had no blood pressure, no pulse, but his heart still produced an electrical rhythm on the monitor. It wasn’t anything that could be shocked, but even if it had been, with no fluid in his bloodstream it’d be like whipping a dead horse.
The back-up alarm sounded off, and the ER doors drew closer, several nurses already waiting beside them. I walked on the balls of my feet and opened the back of the ambulance. The nurses’ eyes grew big at the mess we brought.
We rolled the patient inside, and in a breath all the whirlwind energy and focus I had was whisked from me and laid out beneath bright lights on a sterile table, activity all about him.
I faded into the corner with my rain-soaked uniform and bloodstained shoes. I shed my gloves. Bones wheeled the gurney out.
I wiped my brow with my shoulder. The double doors to the ER seemed to shift and warble. An EKG tech pushed through them, and the faint sound of music trailed from behind. I followed it to its source in the hallway.
It was the same song Bones had been singing in the ambulance.
Dylan railed, “I need a steam shovel momma to keep away the dead. I need a dump truck baby to unload my head.”
The ambulance sat in the parking lot, rear doors open, with a slow trail of blood dripping down the back.
CHAPTER 22
Wingfield Park lay quiet at nine thirty Saturday morning. I leaned on a guardrail overlooking the Truckee River. A couple unshaven men slept on the grass. No kayaks were in the water.
The Passat led me here after shift. I’d changed uniforms halfway through the night shift, but the second one I was wearing still smelled like ambulance and the host of odors that came with that. My mind hung in a hazy state of sleep deprivation.
I unfolded Letell’s note. Slashes and dashes and dots. The scribblings of a disturbed man. Clear water rolled beneath, bubbling, curving over and around rocks. I thought of tossing the note in – and I never litter – thought of giving the paper back to the earth, letting the river take it and letting my life move on. . . .
I folded it in half and eyed the water.
Martin was dead – swallowed, like Letell, by the ground.
Tossing the note would be giving it to him, washed back to the dirt, finally to rest.
I creased the paper into an airplane, pinching it between my forefinger and thumb. I angled my hand to throw it and flicked my wrist forward.
The moment I let go, I saw something – a freeze frame. The plane glided up to a pitch and then paused in the air. The dashes and the lines and the dots, once broken, but now folded at new angles, came together.
And formed numbers.
Numbers!
It hit me too late. The paper plane circled down toward the water. I considered jumping after it, but the river was a good twenty feet below and not super deep. There was a short bridge across to Wingfield Island and the water’s edge. I sidestepped to it, shuffling my hands across the railing, keeping my eyes glued to the plane. It spiraled and came to a graceful landing in a pool near the opposite bank, listing to one side.
Stay there, baby. Stay there.
I ran across the bridge, nearly colliding with a woman pushing a cart full of cans. I made it over and clambered between trees and down the rocks to the shore.
No plane.
I searched the water, squinting to see if the paper had sunk.
Beyond the relatively still pool, the river flowed at a good clip, and there a darkened paper caught my eye just as it entered the stream.
I pulled my phone from my pocket, chucked it on the shore, and jumped feetfirst into the river. The current swept me along, and I lost sight of the note. The sharp cold bit through to my skin, and the weight of the water dragged down on my clothes. I navigated through a standing wave, stroked with both arms to get out of the white water, and then brought my legs forward again, shooting downstream.
And there I saw it.
Floating just beneath the surface, in an eddy by the river-walk wall, just beyond another wave.
The ink would be running.
There could be nothing left.
I slid through the next wave and paddled to it. My feet met muddy ground, stirring up clouds beneath. I brought my hands beneath the paper plane and lifted it to the air. Barely visible across the folded and waterlogged wings lay Letell’s streaked markings and the numbers they formed.
9. 53.
I drew a deep breath and glanced at the riverbank I’d jumped from. A woman with her back to me leaned over to pick up a palm-sized black object off the ground.
“Hey.” I waded toward the middle of the river. The water strength caught me off guard and forced me to find balance. “Hey. Wait. That’s my phone. That’s – ” I cut myself off in surprise recognition.
Naomi straightened and held my cell in the air. A smile turned her cheek. “Is this why you never called?”
Freshly clean from a hot shower, I changed into jeans and a T-shirt. I shuffled a towel through my damp hair and heard Naomi say something from the living room.
I called down the hallway. “What was that?”
“I said, I never knew that Matisse and Picasso were such good friends.”
She’d been reading the Louvre coffee-table book. I hung the towel and walked down the hall. “Personally, I’m more of a fan of old Hank.”
Naomi found me in the river on her walk home from Java Jungle. Come to find out she owned an apartment less than a mile from there. She offered to buy me tea after I went home and dried off. Fortunately, my dad wasn’t there passed out on the floor.
She turned a page. “Good ol’ Henri. Look at this one from 1894. Woman Reading.”
I looked over her shoulder. “Much darker tones than his later stuff.”
“All you see is her back and the fact that she’s reading a book. But it’s so interesting. She seems interesting. What is she reading?
Who is she?”
I clicked on the stereo. Something ambient and lounge streamed on. The paper airplane lay intact, drying on a small towel spread over a corner of the table.
Naomi closed the book. She wore jeans and a thin forest-green hoodie with a flowery pattern stitched across the shoulder.
“So,” I said, “do I get my phone back now?”
She pulled it from her pocket. “This thing’s pretty neat. I downloaded a couple apps for you.”
“Oh, you did?”
“Oh yeah. Check this one out – you can take a photo of a pill, and it will identify what medication it is.”
“Get out.”
“Serious.”
“That’s amazing.”
“Mm-hm.”
I nodded. “Can I have it back now?”
She stood and laughed. “You think I’m not going to give it to you, huh?”
I made a swipe for it.
She dodged. “Ha. Nice try. I was going to give it to you. Now I don’t think so.”
She stood between the couch and the coffee table, the wooden edge at just the right height behind her leg . . .
I hurdled the sofa in one move. She shouted and laughed, but I caught her off-balance. I wrapped my hand around the phone. She stumbled backward and I with her. We crashed on the area rug.
She shot me a defiant look.
I pinned her arms down. “You going to make me pry it from your fingers?”
“You don’t
have to.”
“I don’t?”
“You just have to ask nicely.”
“Isn’t that what I’ve been doing?”
“I never heard you say please.”
I looked up at the ceiling and exhaled. “Please may I have my phone back?”
“You didn’t look me in the eyes and say it.”
I held her liquid-blue Tahoe gaze. “Naomi, would you please give me back my phone?”
She forced back a smile. I relaxed my grip. Her fingers curled around my hands.
The phone vibrated. We held it up, Eli’s photo flashing on the screen. Naomi glanced at me.
Acoustic strumming filled the room.
She searched my eyes and propped herself up. Strands of hair fell to her face. She didn’t tuck them back.
“What happened with us, Jonathan?”
I swallowed and looked away. Images flashed through my mind.
Broken glass.
The wedding ring dropped into my father’s palm.
I looked at her lips, alive and full, her eyes penetrating.
My voice came out hoarse. “I don’t know.”
“Don’t give me that.” She sat straight. “You know.”
I couldn’t look her in the eyes.
In his palm.
Empty fingertips.
She stood and folded her arms. “What was it?”
I balanced on my hands.
She brought up her shoulders. “What?”
Shattered glass.
A curtain of rain.
I got up. My phone vibrated with a voice-mail notification. I pocketed it.
She drew close. “Don’t hide from me. You were my best friend. If anyone has known you, I have.” She found my eyes. “Are you going out with someone? Are you? Does she know you like I have? Since fourth grade and through youth group and high school and senior prom. Does she know you like that, Jonathan?”
I whispered, “There’s no one else.”
“What?”
“I said there’s no one else.”
“Then, what is it? What was it?”
I looked at the ceiling and blinked. “I remember the first time I saw you. The only girl with braids and five different colors in your outfit.”
She bit her lower lip. “Green tights?”
