Calm to Chaos

by Garth Wade

  I love being on-road. I love being involved and making myself useful in situations ranging from a simple lift-assist, to a cyanosed APO, to extricating patients in an RTC.

  Do I have a learning difficulty? No. I have to practise more scenarios, get the systems completely automated in my head, and allocate more time before assessments. I have to study, I have to write notes, I have to get my ‘head in the books’, and I absolutely have to establish a routine. I didn’t really even know how to do that before, but after certain service people gave me some help, I now know my learning style and what I need to do to make the information stick.

  I can do well at this job. I can learn to be a good paramedic. Please know that I will do what I need to do to make it happen.

  Thank you.

  Regards,

  Sydney Worthington.

  Sebastian

  19:01 hrs – Bravo Unit 989

  ‘Well your letter sounds like a right load of shite then, doesn’t it?’ Cam said in his thick Scots accent.

  ‘Yeah, thanks for your support Cam. Your feedback could be a little bit more constructive though, mentor!’

  ‘Yeah I know. I’m havin’ a go. I think it’s pretty bloody well written for someone like you!’

  ‘Again, thanks,’ Syd grinned, ‘dick.’ He concentrated on typing job details onto the iPad on his lap as they drove to the job at the sports field.

  ‘I reckon you’ll be all right, you’ll probably just get a rousin’ on for tellin’ that supervisor off.’ Cam grinned. ‘Actually, they might fire you just for that!’

  Sydney found himself having to concentrate whenever Cameron spoke, his words often obscured by his accent.

  ‘I knew you were going to bring that up. I haven’t written about it because they know who was at fault – their inept staff member at the SDU! That matter is settled. And I’d like them to try and fire me for that, or to even make mention of it actually. I’ll quickly put on my lawyer hat for that. I’d be David, they’d be Goliath. I’d love to take on a big government company and teach them a lesson. Like Erin Brockovich. Ooh yes, Julia Roberts is so hot in that!’

  Cameron concentrated on his driving. He always drove the ambulance at exactly the speed limit. The traffic built up behind them.

  ‘So you’re a lawyer now?’ Cam said, when the road cleared ahead of them. ‘I doubt that, Sydney. You’re having trouble getting past assessment one point one, let alone being able to take an ambulance service to court and represent yourself! Fookin’ crazy man! And what’s this biblical reference? I thought you hated religion.’ Cam drove with one hand on the wheel, in a constant state of awareness.

  ‘Well, maybe I’ll just get a good lawyer instead. And we’re not getting into a discussion on religion again – you couldn’t handle the last one we had.’ Syd looked over at Cameron and added with steely determination, ‘I am going to pass this next assessment you know.’

  ‘I know you will, son. You just gotta learn how to play the game. Since I’ve been with you, we’ve worked well together, and you’re more on the ball than you need to be on most jobs. I’ve got nothin’ but praise for you, lad. You just gotta learn the exam and scenario stuff and all will be well.’

  ‘I know. And I will. Like I said in the letter, which I am reading out loud to the head honchos next week.’

  ‘Oh oh oh, that’ll be a good one, ‘cause you’ve answered everything in the letter that those idiots will ask, and they’ll be stuck for questions. You watch them. Mate, they’ll just look confused and then get out the novelty-sized bahookie smacker and redden your cheeks for you!’ Cam smirked as he pictured Syd bent over a desk yelping as one of the overweight ‘teachers’ from the SDU spanked his behind.

  As the ambulance eventually neared the sports field, Cameron turned off the main road onto a dirt track and followed it up an embankment toward a vast expanse of playing fields. The bright colours of the many different team uniforms ran back and forth on each field, looking busy and frenzied, and which lit up like a carnival.

  ‘Oh, there we go. Yes, mate, I can see you … you’re definitely wavin’. You’re not drownin’ …’ Cam said, as he locked eyes on the ‘waver’, who clearly wanted to ensure Cam and Syd saw him, even though they were now only thirty metres away and had an unobstructed view of the whole scene. They crossed one field and drove onto another, the ambulance coming to a halt beside a dark-skinned man in a green sports shirt who had been laid on his back and covered by a blanket. Three worried onlookers in the same shirts surrounded him.

  Syd jumped out of the passenger side and was met by another man wearing a red sports shirt.

  ‘Hi there, how are you doing?’

  ‘Well thanks, you?’ Syd tried not to be abrupt.

  ‘Well, I’m okay, but my mate on the opposition here isn’t doing too well. I’m Tim, a doctor at the QE2.’ Tim motioned towards the man on the ground. ‘This is Sebastian, a twenty-six year old male with no medical history, allergies nor medications. Tonight he was witnessed attempting to sidestep another player, falling over, and sustaining a severe injury to his left lower leg. On examination he has deformity to his left ankle. I don’t have any drugs here, so he’s had no pain relief, and we haven’t moved him from where he fell. He says he can still feel his toes but I haven’t seen them.’

  Syd raised an eyebrow and said, ‘Wow, that’s possibly the best handover I’ve ever had. Thank you very much.’ He smiled, turned away from Tim and knelt down to the left of his patient. ‘Hi there, what’s your name?’

  The felled man spoke through the fog of pain in a thick Latino accent. ‘Ah … my name … is … Sebastian.’

  ‘Okay, Sebastian, my name’s Sydney and that’s Cameron over there. Our friendly doctor on the opposition team tells me you’ve done some damage to your lower left leg, yes? Can you point to it and tell me if ten was the worst pain you’ve ever had in your life and zero was nothing, what number would you give you pain now?’ Syd gently pressed Sebastian’s inner wrist, intuitively counting a pulse rate.

  ‘The pain I feel, it is … very bad.’

  ‘Cam, can you get the Methoxy happening, vitals, then set up for cannulation please.’

  ‘No problem.’

  ‘Sebastian, we are going to take care of this pain, this leg, and you, and get you off to hospital okay? What I need you to do is just try to relax. I know it’s not the easiest thing right now, but if you can just concentrate on your breathing … nice … and slow … and steady …’ Syd demonstrated what he wanted his patient to do, ‘… and while you’re busy relaxing, I’m going to have a look at you and ask some more questions, and Cameron’s going to get you something for the pain, okay?’

  ‘Mmm, okay, yes,’ groaned Sebastian.

  ‘Now, have you got any problems with your liver or kidneys?’

  ‘No.’

  ‘And have you ever heard of something called malignant hyperthermia?’

  ‘No.’

  ‘Have you got any allergies?’

  ‘No.’

  ‘And what is your medical history?’

  ‘My what?’

  ‘Have you got any medical conditions or been to hospital or seen a doctor recently?’

  ‘Ah. No. But I broke my wrist … when I was a kid. That is it.’

  ‘Great, well Cam’s going to give you a thing like a whistle that you can breathe on for pain relief. Have you ever had a cigarette before?’

  ‘Yes, and I didn’t like it.’

  ‘Well this is used in the same way; just breathe it in gently to start because it might make you cough. Then afterwards you’ll hopefully get some relief from it. If you cover up that little hole on the top it’ll give you a bigger hit.’ Cameron handed Sydney a green whistle and a small empty bottle. Syd quickly inspected the bottle, read out the drug name and expiry date and handed the whistle to his patient. ‘Just remember to go easy to start with … you understand what I’m saying? Yes?’

  ‘Yes … I understand.’

  Sy
d released Sebastian’s wrist and moved up to his head, where he put a hand each side and said, ‘Sebastian, just keep on with that whistle, but can you tell me if you got knocked out in the fall?’

  ‘No, I did not.’

  ‘So you remember the whole thing?’

  ‘Yes.’

  ‘Have you got any neck pain at all?’

  ‘No.’

  ‘Did you hit your head on another player’s knee or anything crazy like that?’

  ‘No.’

  Syd turned towards Cam. ‘You happy with that? No ALOC. Does have distracting injuries but I don’t think the mechanism is enough for c-spine concerns.’

  ‘Yep. Just take it easy on that foot before you rip that boot off … we’ll get his pain under control first, yeah?’ Cameron said, monitoring Syd’s actions.

  ‘For sure. Now, Sebastian, while you’re taking some nice big puffs on that whistle, Cam is going to give you a needle in your hand so we can give you some stronger pain relief,’ said Syd.

  ‘The good stuff?’ Sebastian’s accent was endearing.

  ‘Hey, how do you know about the good stuff? But yep that’s right, the good stuff!’ Syd grinned as he quickly moved down to Sebastian’s blanketed feet.

  ‘I am from South America, man, we invented the good stuff!’ he said, still squinting.

  His legs were splayed, turned out at the knees, but with both football booted feet pointing to the right at the same angle. Heat radiated from his dark, solid thighs.

  Syd gently held Sebastian’s booted left foot at the toes and at the heel. ‘Hey Sebastian, is this the sore leg?’ he said kindly, not trying to be comical.

  ‘Yes,’ Sebastian said, his attention taken by the other paramedic who finished wrapping the blood-pressure cuff around his arm. ‘But hold on … what is this guy doing to me again?’

  Cam then tightened a tourniquet around Sebastian’s forearm, and said in his booming friendly voice, ‘I’m gonna put a wee needle in your hand so we can make this leg feel better … remember? The gooood stuff?’

  ‘Okay, I will relax,’ Sebastian replied. Cam found the vein promptly on the healthy young arm and quickly inserted the needle. He then read the drug out loud and showed it to Syd before drawing it up and administering it via the green plastic tube protruding from Sebastian’s right hand, fixed with a neat plaster.

  ‘Excellent!’ Syd directed his voice down the length of his patient’s body. ‘Remember that zero to ten scale? Now what number is that pain you’ve got in your leg?’

  ‘I think about an eight.’

  ‘Okay my friend, for now just keep sucking on that whistle. We’ll give that Morphine a couple of minutes to work before I take this boot off …’

  The games on the other fields continued, and Syd heard distant cries of ‘Yes!’, ‘Slide!’, ‘No!’, Slide across!’. People were running, leaping, yelling. Syd found it distracting – he knew the game well, and had been playing for a number of years. As the minutes passed he found himself wanting to watch.

  ‘Hey Sebastian, how are you feeling up there?’

  ‘Hey man … I feel okay …’ he said casually.

  ‘What number is that pain, amigo?’

  ‘Oh, it is about at a two.’

  ‘Well, I’m going to take this boot off your foot now. I will go slowly and gently, so just tell me if it hurts too much, okay?’

  ‘Yes, I will tell you man.’

  Syd had already undone the laces and cut down the length of the sock against the ankle. The deformity was obvious – the sock bulged where the foot entered the boot. After carefully manoeuvring the boot without a word from the patient, Syd eased it off, and cut the sock away completely. He was relieved to see a sweaty left foot with good colour and warm to the touch. Around two centimetres of glistening white bone protruded through the skin and rested against the top of the foot. There was no blood. Syd could feel a strong, regular pedal pulse.

  ‘So, Sebastian, what I want you to do is just stay nicely relaxed and continue not to move your leg or foot. You’ve fractured one, maybe both of the bones in your lower leg, so we’re going to clean it, wrap it and deliver you nicely to hospital where they might operate. We’re also going to look after the pain you feel and make sure that all-important blood keeps making its way to your toes.’

  ‘I don’t remember all of what you just said, but thank you, you guys are fantastico!’ said the groggy footballer.

  ‘Can you feel me doing this?’ Syd gently pinched each of Sebastian’s toes, noting how quickly the colour returned after each pinch and checking for affirmation each time. ‘And … what number is that pain now?’ Syd’s tone had shifted to mild-mannered game-show host, but not too flashy and without the cheesy grin. Asking the same question repeatedly was boring – he liked to spice it up a little.

  ‘It is coming back … a little …’ Sebastian replied.

  ‘Can you give another five please, Cam.’ Syd was busy at the man’s feet, supporting the injury and rinsing blades of grass from the bone, which had strangely appeared despite being protected by the sock.

  ‘Sure about another five?’ Cam said, testing.

  ‘With his size, his age, the injury sustained and the fact we are going to have to move his leg, I am absolutely sure.’

  Cam had already started to deliver some more of the good stuff through Sebastian’s cannula. Soon after, he joined Syd and helped to raise Sebastian’s leg slightly and vacuum-splint the injury. Some of Sebastian’s teammates helped lift him onto the scoop stretcher before he was transferred to the ambulance stretcher then into the vehicle.

  Cameron checked that all was well with his partner and his patient before slamming the sliding cabin door shut and slowly driving off the field.

  Gliding collection

  19:30 hrs – Amber

  She entered his empty apartment just as she did on any other day, cruising on in to the beeping of the security system. She tapped in the security code, placed the key on the crafted hall table and walked through to the mildly opulent bedroom to gather some clothes and toiletries for him.

  She liked to think she was always cool, and was never stirred up, and never got angry or over-emotional. She was rarely upset, and most certainly never in the presence of another person.

  She hurried, but she never rushed. Above all, she always, always got her own way.

  Drug collection

  19:30 hrs – Club Outlook Park, Morningside

  Bradley and Ken met at the usual place in run-of-the-mill suburbia, a children’s park with a golf course on one side and a small artificial lake on the other. The surrounding houses, each of which was one of ten different architectural ‘masterpieces’, had slightly different coloured bricks, or shaded guttering, or rose bushes, but there were no leaves on the ground and no mess. Brand-spanking-new suburbia.

  Ken read some of the surrounding signs: ‘Planned perfection!’ ‘Exceptional investment opportunity!’ ‘Second to none!’ ‘Stunning showcase display village!’ ‘Land, location, luxury!’ ‘Live more. Now. Yours for only $349,000!’

  All of the houses had been packed in so closely around the narrow courts and roads that swinging a cat in the front yards would be a mean feat. Clearly the $349,000 didn’t include any privacy. But living here seemed to make people happy. And normal, he supposed.

  Ken stood near a rare tree beside a mini swing set. He was wearing a green tracksuit that, like the suburb, appeared brand new.

  Bradley approached him across the park with a ridiculous self-assurance, strutting in a way that Ken had initially put down to some sort of leg injury.

  Ken cleared his throat, his breath condensing in the night air – unusual for this time of year. Bradley, whose clothing was not so new and not so fresh, studied Ken for a moment then said, ‘What’s up, mate?’

  Ken pushed his round glasses up the bridge of his nose, ‘Nothing, Brad, nothing, but I’d prefer to make this quick if we can. I’m really sorry, but there’s been a change of—’
/>
  ‘Hang on man, you sayin’ a change? A change of plans? So, you tell me what you want, which I have with me, then I show up at the time, date and place we have established for this meeting … and you have a change of plans? Shit man, this’ll wanna work out for me …’ Bradley’s accent was straight out of Los Angeles gangland, although he had never travelled beyond his home state in Australia. Clearly, he’d been catching up on the genre.

  ‘Of course it will, Brad. Like I said, I’m very sorry. It’s just that I need more, and I was hoping you’d have more with you …’ Ken said gingerly, ‘but I don’t suppose you have?’

  ‘Now why would I bring more than the required amount? Think, man!’ Bradley seemed jumpy.

  ‘I’m terribly sorry, but I have only just been informed of my party’s change of plans,’ Ken said.

  Bradley sighed ostentatiously. ‘So, how much you need?’

  ‘Twenty ecstasy, twenty coke, ten rohypnol, if that’s okay?’

  ‘I ain’t got near that on me, man.’ Bradley glanced around the dimly lit park, ‘but we can meet back here in an hour, yeah?’

  ‘Okay then. Sorry again to call you out and change the order. It was all just very last minute.’

  ‘Hey, no problemo. My customers ask, and I provide.’ Bradley held up his arms like a bishop. ‘And it’ll be seven K too. That’s good clean coke and those E’s that you like from last time.’

  ‘Jesus! Seven grand?’ Ken bit his lip, knowing he was cornered. He shifted his weight. ‘Oh well, okay, don’t suppose we really have any other options.’

  ‘No doubt you don’t,’ Bradley was confident in his grammar and even sounded cocky now, ‘and you know what; I’ll throw the roofies in for free.’

  ‘Hardly free for seven grand,’ muttered Ken, ‘but thanks.’

  ‘See you back here in an hour exactly.’

  *

  Lorraine peered across the golf course. Although it was night, she could clearly see the telltale stripes of The Idiot’s tracksuit as he got out of his car and walked into a children’s park. She referred to Bradley as The Idiot whenever he proved to her that he would always be a no-hoper, which was regularly, due to his replicating behaviour.