by Rob Horner
“And tell the kid to bag that.”
Buck walked slowly back to the ambulance, one hand to the side of his head. His thoughts ranged from frustrated anger that this had happened, to wondering if he would need stitches.
He thought this was as bad as a day could get, especially for him.
He was wrong.
Chapter 2
Danny Rogers was scared.
No, that wasn’t a strong enough word.
He’d been scared since putting on the cargo pants and modified scrub top for his first day with Gaffney Paramedics. Every time the radio crackled his heart gave a little lurch. Every call they went on left him feeling like a racehorse after a mile in the Derby.
It didn’t help that he was paired with the best paramedic in the county, a man who’d seen it all and done it twice before Danny made it into high school.
Over the course of the morning, that fear of the unknown—because no matter how much information the dispatcher gave, you never knew what to expect until you got on scene—had begun to morph into an adrenaline-fueled excitement. With Buck behind the wheel, his calm voice talking through everything he did, Danny came to understand that he wasn’t being thrown to the wolves. He didn’t need to be afraid of doing the wrong thing at the wrong time and hurting a patient, because Buck wouldn’t allow that to happen. The big man’s eyes saw everything.
He’d been looking forward to the next call until they got to the Outlet Mall.
Something about the guy laid out on the ground got Danny’s hands shaking again. He hoped Buck didn’t notice, but he couldn’t keep the please out of his voice when he asked if the older man wanted to start the IV.
And now there was this guilt running through him, because Buck got hurt. The guy had looked high as a kite and dead to the world until he woke up and started chewing on Buck’s ear like it was the featured dish at a five-course meal. For one crazy moment a video he’d seen on Facebook flashed through his mind, a golden retriever being fed different foods by his owner, with little captions popping up on the screen. That’s what the guy’s face looked like as he noshed on Buck’s ear. Like he found it cromchy.
And now here they were, racing up the Interstate. They were five miles away from the hospital and running with lights flashing and siren wailing like they had a cardiac arrest in progress.
The crazy guy—Danny could not bring himself to even think of the man by name—was psych-strapped to the gurney, hands and feet zip-tied to the sides, far beyond the normal restraints employed for patient safety. His eyes were open again, his mouth working as if some small morsel of Buck’s flesh was still in there, a between-the-teeth leftover to be savored. With the smear of blood around his mouth, dried and flaking in his five-o-clock shadow, he had the look of one of those zombies off The Walking Dead. Except he wasn’t dead, just crazy.
So no, Danny wasn’t scared. He was fucking terrified.
Was it bath salts?
Danny couldn’t think of any other substance that would cause such aberrant behavior in conjunction with the physical findings: high body temperature, tachycardia, and pinpoint pupils without a light response.
They would catheterize the man in the emergency department, get a urine specimen to test for most common drugs.
Blood would be better.
Maybe Danny could recoup some ground with Buck if they arrived and he had the guy IV’d up, tubes of blood waiting to hand off to the nurses. They’d appreciate not having to draw it.
Idly he wondered if Jessica would be there. She’d mentioned several times how much the nurses appreciated it when the EMTs got the blood work on the way in. He couldn’t Narcan the guy without Buck’s presence; he wasn’t authorized to push anything yet, and he wasn’t about to do something that broke the rules. But if they arrived with an IV in place, the nurses could get that done faster too. They’d have to change it within 24 hours per their protocol, but at least it wouldn’t be a mad scramble to establish venous access the minute they rolled through the door.
Decision made, Danny stood and reached for the drawer that contained the IV start kits and the rubber-banded bundle of colored tubes commonly referred to as a “rainbow.” As he worked, he spread his feet, adopting a wide stance that allowed him to maintain balance while the ambulance raced down the Interstate, absorbing the left and right shifts as Buck wove through traffic.
There was a smell coming off the guy like sick faded by the sun, that faint odor of vomit that lingers around a place on the sidewalk where someone threw up the day before.
“I don’t know if you can understand me, sir, but I’m going to start an IV on you,” he said, because it didn’t matter what state the patient was in, awake and aware or unconscious and dying, you always told them what you were going to do before you did it. A guy like this wouldn’t have much in the way of Right of Refusal—he’d assaulted Buck by biting, so he had to be tested for blood-borne pathogens--but there were always some people who thought their veins were vastly different from everyone else’s and only a registered nurse could possibly hit them. Unless they were actively dying—or out to prove a point--most paramedics left people like that alone.
Danny didn’t like to brag about his past. He was a quiet guy who’d rather go along to get along. He’d gotten his CNA license a few years before and worked a year in a clinic down around Greenwood, drawing blood and collecting urine specimens. He didn’t have a problem hitting a vein and making the leap from simple blood draw to starting an IV only involved reminding himself to stick a couple of centimeters lower, so that the catheter would rest in the vein right where he wanted it to. There was a manual dexterity involved in keeping the IV port steady while he fitted the tube receptor onto it, but that wasn’t much different than manipulating a butterfly needle.
With practiced efficiency he strapped a tourniquet around the guys left arm, swabbed the AC with a Chloro-Prep spatula, and prepped his needle. He wasn’t quite as confident as Buck with his needle selection, preferring a 20-Gauge to the larger-bore 18, but that wouldn’t be seen as a fault.
The guys’ eyes were fixated on him now, staring at Danny’s face like he was trying to decide if maybe one of his ears or perhaps his nose might go down well as dessert. He didn’t look down at his arm, watching the proceedings like a normal person would. He just stared, as if he thought he could make Danny uncomfortable.
It was working, but Danny told himself not to care and not to look.
“All right, you’re going to feel a pinch, but then it’ll all be over,” he said.
The man lay placidly while Danny penetrated the vein and advanced the catheter, not so much as a twitch. Which begged the question: did he jump at Buck because of the needle stick, or had something else dragged him out of his stupor and prompted the attack?
Flash came almost immediately—the guy had railroad tracks for veins—and he met no resistance as he advanced the catheter over the needle. Working quickly to avoid making a mess, he removed the needle and set it aside, reaching for the tube adapter. Filling the four tubes took less than thirty seconds, then it was just a matter of taping everything down. Conscious of the unpredictable nature of the patient’s behavior, Danny took the extra precaution of securing the IV with Coban, leaving only the access port uncovered. That should prevent him from casually removing it.
A low groan escaped the patient. Startled, Danny looked up to see the man still staring at him, but his eyes were clouded now, brows drawn down in confusion. He inhaled, wincing as if something pained him, then issued another long, low sound. His mouth moved, lips forming unintelligible words.
But maybe they weren’t unintelligible, just too low to hear. There were variations to the moan that might be syllables.
“What was that?” Danny asked. “Did you say something?”
The man’s tongue ran a circular course around his lips and the confusion in his eyes only deepened. What would you think, if you woke up strapped to a bed with the taste of blood in your mouth?
/> The man tried to speak again, this time uttering a series of sounds that were more whisper than moan. Again, he winced on the inhale. What if he was altered mentally from hypoxia? He could have a collapsed lung and be unable to breathe properly.
Slinging the stethoscope from around his neck, Danny placed the diaphragm against the man’s chest. “I know it hurts,” he said softly, “but take deep breaths if you can.”
The man might have complied, or he might just be breathing deeply as a matter of course. It wasn’t about whether he followed directions. Like everything else, it was speaking the instructions that mattered, the attempt to communicate. The sounds of air moving through the lungs, like the soft susurration of the wind and surf at the beach, echoed in every part of the man’s chest. There was no wheezing, no rough gurglings like with a pneumonia. And there were no areas where the sound was absent, which would indicate collapse. On the second exhalation, sounds like a whisper heard through a wall came through the diaphragm. Still unintelligible, but definitely words.
Yanking the ear buds out of his ears, Danny leaned closer to the patient. “What did you say? I’m sorry, it was too soft to hear.”
The man licked his lips again and said, “Wife…Carolyn…God…stomach.”
Then three things happened that led to a fourth, the combination of which would reduce Danny’s life expectancy down to just a few hours.
Another spasm of pain crossed the man’s face, a wrenching thing that twisted his features like a goblin out of a fairy tale.
The truck swerved to the right, probably taking the Interstate off-ramp at exit 95 at speed. The back of the ambulance bounced down and then back up, striking one of the frequent potholes in a state where the roads were chronically underfunded and went unrepaired because state funds and gas taxes were routinely usurped for one political earmark or another.
The bounce threatened to topple Danny, causing him to lean in closer to the patient, who suddenly reared up. Startled by the man’s reaction, Danny shoved himself away from the gurney in terror, already feeling phantom teeth clenching around his ear. The truck settled, and Danny reached out a hand to steady himself, feeling a tiny prick of pain on the tip of his right thumb.
“Sonuva—” he swore, looking down to his right, seeing the IV needle he’d used rolling away from his hand as the truck jived left, either just correcting course after the nasty pothole or passing another vehicle.
Fear and anxiety rose in his chest, the worst scenarios that were drilled into him from his first days as a CNA rising, creating a sudden panic.
A needlestick!
What if the guy had AIDS, or Hepatitis C?
He didn’t look like either of those, but he didn’t look healthy either.
“Do you—?” he started to ask, but the man was unconscious again, back flat against the gurney.
There was a small spot of blood just visible on the tip of his thumb, a darkening under the light blue nitrile gloves he’d been wearing since coming up beside Buck in the mall parking lot.
Desperately he tore off the glove. Underneath there was just a smear. No visible hole. The tiny puncture, which might only have been a scratch, had already stopped bleeding. He could feel it though, a dull ache at the sensitive tip.
He should report it and get tested.
He should, but then he’d have to explain why he attempted an IV in a moving vehicle when he hadn’t yet been observed performing one successfully on a stationary surface.
But the man was already going to be tested, wasn’t he? He’d attacked Buck, after all. Bit clean through the top portion of his ear. The nurses and doctors in the ED would test him from stem to stern.
Maybe he could wait to report this, see if anything came out of the man’s blood tests. No sense in working everyone up over his carelessness if the man would be going through the laboratory wringer anyway. If everything came back clean, then Danny would be out of the woods too.
Decision made, Danny crumbled up the incriminating glove and shoved it into the waste container. He felt the truck turn right and knew they were less than a minute away from the hospital. Thinking quickly, he grabbed a new glove and pulled it on over his right hand.
Nobody needed to know.
Chapter 3
A lot can happen in twenty-four hours.
Just one day prior, Austin Wallace was dropping his wife and six-year-old daughter off at the Atlanta International Airport, waiting with them at the gate for the boarding call for Flight 102 to San Diego, where Carolyn and Bitsy would spend a week with Carolyn’s sister. As the plane was pulling up to the gate, something made the floor rumble and the overhead lights sway. It only lasted a couple of seconds and wasn’t enough to make any of the hundreds of people coming and going raise a fuss. Just a small earthquake, one of dozens felt in Atlanta over the past few decades. They usually originated in Tennessee and caused very little damage, though the history books did record a magnitude 4.1 that happened just thirty miles from the airport back in 1914.
It delayed their departure by fifteen minutes. All the planes were ordered to back away from the gates. The portable hamster tunnels people thumped through from gate to plane were rolled aside. The planes couldn’t be allowed to bump into the building any more than the heavy gangways could be allowed to damage the aircraft. Carolyn and Bitsy waited until it was time, then trundled out to the tarmac and walked across the open concrete to reach the stairway up to the plane.
Business only slightly different than usual.
Austin waved good-bye at the gate. Without a ticket, he wasn’t allowed out onto the tarmac.
Wondering if Carolyn was going to have to put up with five hours of listening to Bitsy relive the earthquake over and over, Austin smiled and made his way back out of the airport. Better her than him.
He had a Teacher’s Association meeting to get to in Greenville, South Carolina, one of those getaway conferences where he’d spend Friday evening drinking alone at the bar, and Saturday and Sunday listening to a bunch of boring speakers talk about the bright future of teaching in the southeast. There’d be at least one union rep there from each invited state, and probably some kiosks set up with information about various political figures and how they would improve the lot of teachers if you’d only remember them on election day. He had several arguments running through his head as he pushed the doors to get outside, almost losing an ankle to a luggage cart being pushed by a ten-year-old while his mother blithely texted on a smartphone. There were discussions planned about preserving parts of Common Core in the face of falling SAT scores.
It took time to prepare a polite way to call someone an idiot, and he needed to be prepared.
There was a strange smell on the air, like a combination of rotten eggs and dirty feet. It was faint at first but grew stronger as he walked from the terminal to the short-term parking lots. Like a scent of skunk that can cover miles of a highway at night, he wondered if he was getting closer to the source, or if some vagary of the light breeze was bringing it more fully in line with him.
Maybe that rumble broke a gas line. Or maybe it was a gas line breaking that caused the rumble.
The smell wasn’t quite right. There was a similarity, but this didn’t have quite the get the hell out impetus he associated with natural gas.
Finding his Pathfinder among the hundreds of other vehicles, Austin heard sirens raising a low chorus almost at the edge of hearing. Turning his head, he saw a dark smudge in the sky off in the distance to the south.
Maybe it was an explosion, and what I’m smelling is a nasty combination of jet fuel, natural gas, and whatever byproduct that fire is spewing into the air. Good thing I’m getting out of town.
The tank was full, and his bags were already packed in the back.
Austin climbed into the driver’s seat, paid his ten-dollars-for-two-hours parking ticket, and headed for the Interstate. With the windows rolled up and the air conditioner running on recycle, the smell disappeared, and he thought nothing more abo
ut earthquakes, smoky clouds, or possible explosions as he headed north on 85. Traffic was light for Atlanta, and by 4:30 p.m. he’d cleared all the on- and off-ramps for I-75, I-20, and I-285, had gotten past the merge miles where 85 goes from five lanes down to two, and was cruising comfortably at seventy miles-per-hour. Tears for Fears sang Everybody Wants to Rule the World on the eighties channel, where you occasionally got a few commercials, but were never disturbed by news. Not that it mattered. Nothing about what happened that afternoon ever made the news.
Nothing with any truth or accuracy, that is.
The first stomach cramps struck an hour later as he passed the exits for Commerce, Georgia--stabbing, twisting things that stole his breath and almost sent him off the road.
Carolyn Wallace didn’t notice any strange smells as she walked from the airport gate to the rolling ladder that led up and into the great white jet. She was more concerned with chivying Bitsy along, who wanted to stop and gape at the “huuuugggeee” plane.
“Are we really going inside that, Mommy?”
“That’s what the stairs are for.”
“It’s so big. Like, it’s bigger than a whale. Do you think it’s bigger than the whale that ate Jonah? I think it’s gotta be bigger. There’s no way there could be a whale as big as that plane.”
You could tell which of her fellow passengers had kids and which didn’t. Some turned around and flashed her smiles of good humor and silent commiseration. Those were parents. The ones who sneered at her, or at Bitsy, though Bitsy was too busy staring at the plane to see the looks and too young to understand what they meant, those were the ones without kids, who couldn’t remember what it was like to be young. Bitsy was a chatterbox at the best of times and even more when she got excited, like now, but Carolyn decided to humor her rather than be annoyed by her.
She flashed a sweet smile back at the twenty-something twit with the Fuck Me make-up over pinched persimmon lips, the kind of face so thin it could rob a skeleton of a boner, and spoke back to her daughter, “What if the plane is a whale, just with a good paint job? And it’s going to swallow us into its belly.”
