The Devil's Vial

by Brumbaugh,Byron

  “Send her over to x-ray for a C-spine,” said Alex. “Make sure she isn’t pregnant.” He turned toward the second EMT. “What’s up?”

  “When we get to the accident, there’s this guy who's got a head wound and no shirt. He directs us to the front seat of this cab that looks like it was in a demolition derby with battle tanks. The cabbie is lying on the front seat and this guy’s put a tourniquet on his thigh where the cabbie has a pumper. With all the blood around, I bet it was his femoral artery. Anyway, the cabbie passes out and drops his pressure. His breathing gets shallow and I try to put in a tube. His airway is way anterior and I can’t do it. So this guy asks if I want him to try. I look at him and then I see who it is – it’s Dr. Gregg! He puts in the tube on the first try. He saved that cabbie’s life…” The paramedic paused for a second, then shrugged. “But I guess that’s what we do. Anyway, he helps us put the cabbie in the chopper for Boston and only then lets us put him, Dr. Gregg, in a collar. I think he’s coming here.”

  Richard is here? thought Alex. He dropped off the face of the Earth, disappeared. No one heard from him in years. Alex and he had never really been close, but Richard was a good doctor who Alex respected and they had occasionally shared some off-time, doing this and that.

  The second ambulance came in. This patient was a woman in her sixties who had a small laceration on her left hand, wrapped by the EMTs. The bleeding was controlled. She also complained of pain about the wrist on the same side. Alex did a quick, but thorough, physical inspection and determined there were no other significant injuries. He took her off the board, removed the collar she was wearing and sent her off to x-ray the wrist. He would suture the wound when she got back.

  Sally came up to him. “Triage is bringing in someone in respiratory distress,” she said. “He’s got COPD and walked in the door, lookin’ kinda blue. I think you might have to tube him.”

  A thin gentleman was brought in by wheelchair, pushed by the triage nurse. Alex guessed the patient was in his mid-sixties. An eyeball assessment showed the patient to be breathing hard: chest heaving with a prolonged expiratory phase and pursed lips, stomach muscles contracting, trying to help his diaphragm push the air out of his lungs. He was sweating profusely. A nebulizer treatment was being given, but even so, Alex guessed he wouldn’t last much longer – he was going to tire and get into real trouble. Alex helped to put him on a gurney, start oxygen and hook up a monitor and blood pressure cuff. While doing this, Alex tried to elicit the information he would need from the patient to provide safe care. This wasn’t easy because the patient wore a mask for the breathing treatment. In addition, he could only speak one or two words between labored breaths.

  Alex looked up at the monitor and did a quick assessment. The numbers agreed with his gut – if they didn’t move quickly, the guy would be in big trouble. “Okay, call a code. Let’s tube him.”

  The ER team was well-trained and things started happening even faster. The secretary at the desk called, “Code 99, ER. Code 99, ER,” overhead. The few nurses that were there at this time of day collected around the gurney, each pitching in to do what had to be done.

  “Succinyl choline 100, etomidate 20, please,” he ordered. Alex looked up at the monitor. Oxygen saturation was down to 85% and respiratory rate was twenty and dropping. “He’s tiring. Somebody get a mask and bag him.” The patient was now barely conscious. Alex bent over the patient and calmly told him, “I’m going to put a tube down your throat and into your lungs. You’re going to be asleep. When you wake up, a machine will be breathing for you. It’s going to be uncomfortable. You’re going to want to try to fight the machine. Try to relax and let the machine breathe for you.”

  He looked up. A respiratory tech had arrived and was bagging the patient. Sally was back at the bedside with the meds. Alex went around to the head of the bed and said, “Okay, let’s do it.”

  Sally pushed the meds into the IV and, half a minute later, the patient became perfectly still, paralyzed. Alex worked fast and had the tube placed in less than a minute. Another two minutes and the patient was on a respirator, breathing comfortably. Disaster averted, time to move on.

  He turned to Sally. “Anything else out in the waiting room?”

  “There’s a sore throat checking in and I think a cough with no shortness of breath or fever,” she replied.

  Alex looked up at the clock. It was fifteen minutes before his relief was due. “Alright. We’ll leave those for Roger and stabilize what we’ve got.”

  At that moment, a third ambulance rolled in. Its gurney carried a man in his mid-to-late thirties. He was boarded and collared, wore no shirt, and was covered in dried blood. He had a thick blood-tinged dressing over the right side of his forehead. As he walked up to the gurney, Alex saw it was Richard.

  “Richard, is that really you? Are you okay? What hurts?” he asked. Alex quickly shifted gears from the pleasure of seeing an old colleague to dealing with the task at hand. He performed as good a physical assessment as he could, given the constraints of the board and collar. “You look a mess!”

  “I have a laceration to my forehead and some neck pain,” Richard answered. “Most of the blood isn’t mine. It’s good to see you again, Alex.”

  “Well, let’s get a C-spine, I’ll sew you up if you need it and then we’ll talk. Do you need anything for pain?”

  “I’m fine. Take care of the other folks first.”

  “Sally, send him over for a C-spine. Richard, I’ll see you when you get back.”

  Alex turned his attention to the first patient from the accident, now back from radiology. The x-ray showed no fracture. He took her off the back board and removed the collar. A thorough exam showed no other injuries and he soon had her discharged.

  Meanwhile, the fourth ambulance arrived, as did Alex’s replacement. Roger took that case as Alex sewed up the hand laceration and discharged the second patient from the accident. The wrist was not broken.

  Richard came back from x-ray. His neck was fine and he was taken off the backboard. Alex began stitching the wound on his forehead. “So, how long has it been? Four years? You miss working here?”

  “It’s been about four years, yeah. I went to India for a while. And, yeah, in some ways, I do miss the place.” His eyes roamed about the room as he said this, as if reminding himself of familiar surroundings.

  “India? What did you do there?”

  “It’s a long story…”

  Alex sat up from his efforts. “Four stitches should do it,” he said. He looked at Richard. “You got any other clothes?”

  “Uh, no. I was just coming back from the airport. Except for this shoulder bag here,” he indicated the bag he kept with him, “all my stuff is in the trunk of a cab – who knows where that is?”

  “Well, you’re a mess. We’ll get you some scrubs for now. Where’re you going from here?”

  “Motel, I guess.”

  “I’m getting off now. Why don’t you come stay with me? I still have that house over on Milton. Just me and Buddy. You can stay for a few days until you get things worked out. Meanwhile, you’ll need something to eat, a shower, and, I imagine, some sleep.”

  Richard paused in thought for a moment. “That would help a lot, Alex. It would give me a chance to sort things out. How is Buddy? Still over-protective of his turf?”

  “Oh, yeah. Damn dog has gotten me in trouble. Still bites people he doesn’t like.”

  “How’s he gonna feel about my staying?”

  “We can work around him.” Alex stood up and turned to leave the examination room. “Just give me a couple of minutes to sign out to Roger and we’ll outta-here.” He patted his shirt pocket absently. “Hey, you got a pen in that bag? I’m always leaving mine lying around somewhere and then can’t find it.”

  “Don’t think so. But you’re welcome to what you find. Take a look.”

  Alex picked up Richard’s bag and found a ball point pen. “I’ll have Susan get you those scrubs. I’ll be right back.”


  Chapter Four

  “So, how long were you in India and what were you doing there?” Alex asked Richard as they pulled out of the hospital parking lot.

  “About three years,” said Richard. “I met a Tibetan Buddhist lama in Boston and followed him to the Himalayas where I studied and meditated in his monastery.”

  “You were a Buddhist monk?”

  “Yeah… in a western sort of way.”

  Alex thought this over, not quite sure how to connect the dots. “Three years? That seems like a long time.”

  Richard didn’t respond.

  “Have you heard from Julie?” Alex sensed this was a sensitive topic when Richard took a little while to answer.

  “No,” was the simple answer, when it came. “I tried to write her a couple of times, but I couldn't decide what to say to her.”

  Thinking Richard should probably know, and would want to know, Alex said, “She’s married now.” He paused to let it have its impact. “Been married for about two and a half years. Has a one-year-old daughter too.”

  “I’m glad,” said Richard. “She certainly deserves to have a good, stable, happy life.”

  “She’d like to hear from you, I’m sure. You should call her sometime.”

  Richard looked out the window. “Maybe I will… in time.” There was an awkward silence. “What happened between you and Anne?”

  “She’s a nice lady,” said Alex. “A very nice lady. But, well, you know me. I want to fly when I want to fly, ride my bike… You know, be me. She had other ideas. It didn’t work out.”

  “I’m sorry to hear that. Both Julie and I liked her.”

  There had to be safe ground somewhere. “So, tell me more about India. All I know about Buddhism is ‘The Four Noble Truths,’ and then only vaguely. Let’s see, the first is all life is suffering, then suffering is caused by craving. So, let’s see, the third must be the way to stop suffering is to stop craving. The fourth I’m a bit foggy on.”

  “I’m impressed. The breadth of your education is better than most. The fourth is the way to stop craving and suffering is to follow the Dharma, the teachings of the Buddha.”

  “Excuse me, but that seems a bit thin.”

  “It is indeed. Barely scratches the surface.”

  “So what do you have to do to become a Buddhist?”

  “You have to take the refuge vows. It’s like being baptized, sort of. You publicly announce that you’re going to follow the teachings of the Buddha. You take refuge in the Buddha as the example, the Sangha – your fellow Buddhists - as support, and the Dharma as the path.”

  “And all you did for three years was meditate and study?”

  “Meditate mostly.”

  “Sounds kind of boring.” Alex hoped he wasn’t stepping over the line.

  “Only if you’re bored by your own mind.”

  Alex never thought about that before. His mind kept him well entertained, but always in interaction with the outside world. He couldn’t imagine how it would be to spend an hour sequestered away in his head – let alone three years. They pulled up to Alex’s house and backed into the garage. Alex closed the garage door with a remote.

  “I thought this house was big when Anne was with you. Isn’t it a bit too big for just you and Buddy?” asked Richard. It was a two-story brick house, about thirty or forty years old. It sat on a three-quarter acre lot and had a fenced-in back yard.

  “Yeah, well. You try getting an apartment that lets you keep a one-hundred and twenty-five pound german shepherd. Besides, it’s a good long term investment and a tax write-off.” Now out of the car, Alex opened the door connecting the garage to the house. “Would I offend you to offer you a glass of wine? I like a little to help me wind down after a shift.”

  “Not at all. But I don’t think I’ll indulge.”

  “Is it against your religion? Is it immoral in Buddhism to drink alcoholic beverages?”

  Richard seemed to pause in thought for a moment. “The concept of morality is different in Buddhism, compared to the western view. The way I understand it - and I’m no authority, I’m just blindly stumbling through life like most everyone else - in Buddhism, morality isn’t passed onto man from some higher authority. There is no supreme being in Buddhism. But there are those that have reached enlightenment and some have instructed what actions are compatible with the path to enlightenment. They’ve suggested which actions will aid you in following the path and which actions will interfere with it.”

  “So Buddha wasn’t the only one to reach enlightenment?”

  “Oh, no. There’ve been many. Some are living today. Enlightenment is there, available to everybody. Even you and me.”

  “Right now, all I want is a glass of wine and a nice soft pillow. This Buddhist stuff is getting a bit obtuse for my foggy, fatigued brain after a twelve-hour shift in the ER. I just want to be sure I don’t offend.”

  “Don’t worry about it. Just be yourself. I’ll make my own choices.” Richard yawned. “And right now, a nap sounds like a really good choice.”

  “I’ve got to feed Buddy. I’ll show you your room and the bathroom, get you a towel, some linen, clothes and so on. Just stay upstairs until he’s fed. Then I have to put him out to do his business. After he’s done, I’ll let you know we’re coming and you should close your door. He sleeps with me and I’ll keep my door shut so you can come and go as you want. We can reintroduce you to Buddy later. I plan on getting up about four this afternoon. That way, I can still go to sleep tonight. That sound okay to you?” They were standing in the kitchen and Buddy barked at the back door. “Just a minute, Buddy. I’ll be right there,” said Alex.

  “Sounds good to me,” said Richard. “Just how worried should I be about Buddy?”

  “For now, I’ll just keep him away from you. He’ll either be in my room or outside - except when I feed him. I give him his food in the laundry room. If you go for a walk with us, he can get used to you. Doesn’t seem to be bothered by people unless they’re on his turf.”

  “Alright. If I get up earlier than you do, I’ll just meditate until you’re awake. Just knock on my door when you’re up. I’m not interfering with your work schedule, am I?”

  “Nope. I don’t have to work for the next couple of days. Let’s get you settled.” Alex led Richard toward the stairs. “The spare room has a bed, but it needs to be made up.”

  Richard took a string of beads from his shoulder bag and left the bag on the kitchen island as he passed it. Alex glanced at the bag. He’d looked in it and knew it didn’t hold much. “That’s all you have?”

  “I have a change of clothes in my suitcase in the cab. I was told I can’t get that until tomorrow. There’s my passport, some things I need to meditate,” he held up the beads, “odds and ends, and a few bucks in my monk’s bag. That’s about it, except for stuff I put in triple A storage four years ago. I have no idea what kind of condition that’s in.”

  “Maybe we should go do some shopping when we get up.” On the second floor, Alex opened a door to a room. It had a queen-sized bed, a chest of drawers and, off to one side, a closet. “You can stay here. Linen is in the closet here in the hall.” He opened another door and handed Richard a stack of towels and sheets.

  Richard set the linen on the bed and gently put his hand on the mattress, palm down. “Whoa,” he said.

  “Bathroom’s here, just down the hall.” Alex led the way and opened the door.

  Richard stepped in and looked around. He stopped at the sink, then went over to the shower and turned it on. He stuck his hand in the water stream and felt it as it warmed. He looked at the sink, then back at the shower.

  “Everything okay?” asked Alex.

  “It’s been a long time since I had a shower. And hot water too! And a queen-sized bed! Man, you are evil.”

  “How’s that?”

  “Well, you remember Noble Truth number three, don’t you? Man, you are really stimulating my craving!” He smiled with what seemed to be al
most a leer.

  “How long do you think you’ll need to stay?”

  “A day or two. Then I can find a motel to stay in, until I can find a place to rent.”

  “You’re welcome to stay here until you can find an apartment. Like you said, there’s only me and Buddy and it is a large house. You going to come back to work at the hospital?”

  “I don’t know. Are there available shifts?”

  “I’ll ask John. I’m sure he’d like to have you back.”

  “I let my license lapse, I’d need malpractice insurance… It might take a while to get everything set up. But I’ll have to do something.”

  “This wasn’t exactly a planned change for you, was it? Did you piss off the head monk or something?” Again, Alex hoped he hadn’t overstepped his bounds.

  Richard set the linen down and started to make his bed. “Nothing like that. My lama just thought I should return and practice here.”

  “I’m sorry if I’m being too nosy. I’ll let you be and go take care of the dog.” He turned and went toward the stairs. “If you need anything, or just want to talk, give me a shout. My bedroom’s right there. Just don’t open the door.” He pointed to a room across the hall from Richard’s room.

  . . .

  Richard pulled back the sheets and crawled into bed. The mattress melted around him in a soft, yet supporting, embrace. He moved his arms and legs as if making a snow angel. So much room! The crisp cool sheets smelled like fabric softener and soothed his pink, tingling, just-out-of-the-shower skin. Man, that shower felt good. He hadn’t felt so clean and refreshed in a very long time. It brought back memories of getting back to civilization after a prolonged camping trip. He had been joking with Alex about the craving, but he did feel a subtle, yet incredibly strong, allure for the sweet comforts of the western world. For now, he would enjoy them. He would work on not becoming attached later. He laid his head down on his pillow, closed his eyes and let the world slowly drift away into shadow, then dissolve into emptiness.