by Gabe Sluis
Chapter 3- Just a little clot
It was morning, just barely. The sun had not quite peaked over the tree-laden hill behind the McCourtney house. The blue light of this Thursday morning was just like the beginning to any summer day, but this morning would change the life of everyone who knew John McCourtney.
Clots are funny things. They can be formed in various ways; blood, which is usually a liquid, clumps together becoming solid. Usually they form in veins that return blood from an extremity, hemoglobin bunching up because of a narrowing in one of their freeways. The cells bunch together and form a glob that finally gets swept along with the flow of the returning blood.
The big man, sleeping in a groove worn by years of resting in the same spot, turned in his sleep. The clot was freed, heading back to the pump. In the rapids of the right side of the heart, smaller pieces of the clot were ripped free and dissolved. Through the lungs the clot hit the narrowing passageways. The loosely bound aspects of the clump and the build up of pressure shoved the core of the remaining clot past the funnel with the newly oxygenated blood from the lungs. It raced back to the left side of the strong masons heart.
The much smaller clot narrowly avoided being pulled into a stream of blood that flow into the arteries that loop back to feed the muscles of the heart. The clot eddied and swirled blindly through the body and found itself, out of all the various possibility of arteries, feeding into the control center, John’s brain. For clots, which happen to occur occasionally, avoiding being dissolved or caught in other systems, making it all the way to the brain, it is very unlikely event.
Regardless of the low probability, the clot, just a fraction of what it began as, moved down an artery in the stem of John’s brain. The way narrowed and the pressure from behind the clot pushed it deeper until it could move no further. The way became blocked to all the vital oxygen carrying hemoglobin meant to feed the cells of the region called the Pons.
John woke up screaming. His large mass flapped backward and began shaking on the bed. Out in the foggy woods, Terrance Golden pulled the trigger three times. Mae called 911.
In town, a fire station’s tones went off. The voice of the dispatcher echoed around the station, “Medical Aid, seizures,” getting the firefighters up out of their worn recliners and bare racks. Three men move with practiced purpose into their apparatus bay and pulled on their turnouts, which were placed strategically outside the door to their place on the engine. The door went up and the monster red diesel emerged from its spot with red and white lights spinning. Engine eighteen was responding.
Not far away, an ambulance crew sat in an empty parking lot. The paramedic, sitting in the passenger seat of the cab, was fast asleep with his head back. Jeff Analogga had been a medic for eight years and had had come close to seeing it all. He worked as a firefighter before going to medic school, and had done his internship in Las Vegas. He was slightly overweight from the inactivity of ambulance life, but enjoyed mountain biking in his off time. His soft snoring stopped as the radio came to life.
Samantha Pallus, the EMT in the driver seat, turned on the engine and dropped the rig into gear after hearing the call go out in their zone. She knew the town pretty well, and knew that if it were engine eighteen, they would be assigned as well. All 911 medical aids were dispatched through the fire department, which then advised the ambulance company to dispatch their Advanced Life Support unit to the call. The ambulance was pulling out of the parking lot in the direction of the McCourtney’s when they were officially placed on the call and could then turn on their lights and sirens. Samantha did, and raced through the thin morning traffic on the highway. They soon overcame the fire engine, killing their own sirens, and following the big red truck off the main highway to the call for help.
Within six minutes of the call, the engine and ambulance pulled into the driveway and halfway around the parking loop, coming to a stop. The firefighters went straight in, following Mae, who met them on the porch and waved them in. Jeff and Samantha pulled out their gurney and threw the jump bag onto the pad next to the other gear. Mentally preparing themselves for a seizure, they worked their way into the house and back to the couple’s bedroom.
“He’s breathing,” the firefighter on the side of the bed, reported aloud to the medic entering the scene. John was lying on the floor next to the bed. A blood pressure cuff appeared, and with the tear of Velcro, it was placed on his arm.
“Sir! Sir! Can you look at me?!”
“…He’s not tracking with his eyes.”
“Ma’am, can you tell me what happened?” Jeff asked as he began to work. “Sam, get him on the monitor.”
“I don’t know! He just woke up and started screaming. He was shaking all over the place and I called 911,” Mae said through tears.
“How did he get on the floor? Hold his neck, we are going to need C-Spine.”
Samantha ran out to get a backboard. Time lost its meaning. There was a flurry of action, equipment everywhere. One firefighter with a clipboard asked Mae an endless stream of questions while another began yanking furniture out of the way.
“He is about a hundred twenty five kilos. Lets four-point him over to the gurney. Everybody ready? Head counts… One, Two, THREE!”
“You want a line spiked in the back?”
“Yeah. What hospital is he seen at? Faith is closest,” Jeff spoke at Mae as they rolled big John past her. “Do you want to come with us, or can you drive? It’s probably better for you to drive, so you have a car there.”
A minute later, the house was silent, an eerie contrast to the chaos that the last twenty minutes had held. Mae drove fast behind the ambulance as they went back through town to the hospital, lights and sirens waking up the neighborhoods they passed.
A little clot, just a little clot. A bad little nugget of blood cells, blocking critical blood flow to the brainstem. It was perched down there, letting no one pass; killing for no reason than that was what it was; ruining things for no great reason. There was no justification for why this had happened, no missteps to explain it away. Helpless. Was it helpless?
