Sunday, January 11, 2009

Holidays

He's messed up on something, messed up badly. Christmas Eve morning and he's broken into a swanky condo building downtown and started trashing the place. The police were called by the neighbors, and soon after their arrival asked for medical to respond, lights and sirens.

* * * *

My partner and I are standing in the elevator, all burnished steel and soft lighting, with four firemen and a cop, who's come down to lead us up to the patient. We've got a monitor and airway kit and medical kit, probably fifty pounds of gear.

The elevator doors open. Shattered glass covers the floor, a giant wall display of art pulled down and shattered. We gingerly step over it. The cop explains, apologetically, that he's all the way around the back and there's only one elevator bank.

We walk down twists and turns to the back side of the complex. We turn a corner, and here a fire extinguisher lies on the floor, ripped off the wall. Another corner, and a single shoe sits in the middle of the hallway. A quick zig-zag turn and a shattered 2x6 sits next to another fire extinguisher. We turn down the penultimate hallway, and for a second I think there is a fine filligree of string across the floor, with small black boxes scattered here and there.

Then I realize the boxes are spent Taser cartridges, and the string is the spaghetti tangle of probe wires. There must be four or five spent cartridges along the hallway. Bad news.

The patient is a little further on, handcuffed and hobbled, bloody, spitting, cussing, but not actually fighting. The police tell us he was on a violent rampage, that he made no sense, was chewing on glass, took threats and force and multiple taserings to subdue.

Faced with this, my partner -- for it's her call -- takes no chances, and we give him the full work-up. Backboard, restraints, oxygen, IV, 12 lead, the works. His mouth is swollen from the glass, and he responds poorly. He hasn't fought us at all. His blood pressure and heart rate are high. I press her to run him in code 3, lights and sirens, as something is saying "not right!" at the back of my head. She agrees, and halfway to the hospital we both realize that he's too subdued, he's too obtunded, something has changed.

* * * *

We pull into the hospital, and as we take the stretcher out I'm thinking about the cleanup we'll have to do, the low county levels, the chance that we'll get off on time, so that I can get my stuff together and load up the car and head south for Christmas with the family. And what the hell is going on with our patient. I ask my partner as I punch in the door code. Nothing has changed.

We slide him into one of the trauma bays, and as the staff gathers I catch a glimpse out of the corner of my eye, and there she is, standing back quietly, black fleece over blue scrubs. My heart lifts, a bit. We haven't made it here yet tonight, and I didn't know if I'd get to see her. It's a little spot of light in a generally grumpy morning (sometime around five am).

Maybe, I think, maybe I'll even find an excuse, a chance, to talk to her. I wonder if she has noticed me. How could she not have?

We move the patient to the bed, and I slide the stretcher out of the room, then scoot back in. I listen, and try not to interject too much, as my partner gives report. The doctor comes in, looks the patient over, and decides he needs to be evaluated by the trauma team.

"Okay, folks," the MD says tersely, "this is now a Level 2. Clothes come off, now."

I see her go for one pants leg, pulling trauma shears out of her scrubs pocket, and I pop the trauma shears off my leg, going for the other pants leg.

The patient groans unintelligibly, splattering the doc's faceshield with specks of blood. On one side, a nurse is drawing labs from a hastily-inserted second line; spots of red drip onto the floor from where he didn't occlude the vein quite enough. The speaker overhead is blaring, "Trauma activation, level 2, in department now. Trauma activation..."

She looks up as we both start cutting the man's jeans. Soft brown hair frames startlingly blue eyes. She smiles, shyly, with just a hint of a twinkle in her eyes. Oh, they seem to say, I didn't expect to see you here.

I smile back, and lean in to say something, just to her, under the growing bustle in the room.

"Merry Christmas, baby."

Sunday, January 04, 2009

Wisdom

"First Rule Of Streets: In any given city, there will be a Main Street and a Martin Luther King Boulevard.

"And, even though Martin Luther King preached peace and acceptance, in any given city, if you are on Martin Luther King Boulevard, you are in a violent part of town."