Calm to Chaos

by Garth Wade

  Syd crashed onto the pizza box pyramid, de-fib still in hand. He jumped up, ripping at an opened pizza box that was stuck to the side of his face. ‘Argh fuck!’ he said with disgust. ‘Oh yuck, what the—’

  Cam erupted in laughter.

  ‘Jesus, why do you keep all your rubbish inside?’ Syd said.

  Danielle bowed her head. ‘I’m sorry. I know. I haven’t had a chance to clean for a while.’

  Cam stopped laughing.

  ‘A while?’ said Syd. ‘More like an etern—’ He paused and gathered himself as he looked down at the enormous sedentary shape on the green recliner. He brushed himself off, ‘Oh well, no harm done.’

  Danielle forced a smile.

  ‘You all right mate?’ Cam managed to ask, deadpan.

  ‘Good,’ said Syd, still pissed.

  Cam turned back to their patient. ‘So, Danielle, you were telling me what it is?’

  Danielle paused, still watching Syd.

  ‘Well, I suppose it is just that I get down. Upset. Lonely. I don’t know what else to say about it really.’

  ‘What’s your medical history, Danielle?’ Cam asked, as Syd exchanged the regular blood pressure cuff for the super-sized one.

  ‘I’ve had depression for three years now. I lost my job because of it. I’ve got diabetes and high blood pressure, but I take medication for that … ah … and osteoarthritis … that’s about it I think.’

  ‘And your medications?’

  ‘They’re over there, stacked next to the fridge,’ she said, pointing to the kitchenette.

  ‘To save us the danger of exploring this trip hazardous area,’ Cam said, ‘is there any chance you know them off the top of your head?’

  ‘Amlodipine, Diabex XR, Sertraline, oh and also Lipitor, I’ve got high cholesterol too. Sorry, forgot about that.’

  Syd had gathered Danielle’s vital signs, written them down and passed them to Cam.

  ‘Well Danielle, everything here looks to be reasonably normal,’ he said.

  ‘I’m really sorry about the mess. It’s terrible I know,’ she said, her eyes flicking between Cam and Syd. Syd gave her a sweet look somewhere between empathy and mild loathing.

  ‘That’s okay, Danielle. Now, have you got any further concerns?’ Cam asked.

  Danielle looked over her left shoulder, peering at the recycling pile. At least she’s recycling, Syd thought. This was the first time she had moved since the paramedics arrived.

  ‘We are absolutely not movin’ that downstairs for you,’ Cam joked. Syd chuckled, waiting for Danielle to get the gag.

  ‘No, I was just hoping one of you could have a look around for my little cat. I haven’t seen her in two days, and I don’t know why she wouldn’t have showed.’

  ‘Can the cat get outside?’ Syd asked.

  ‘Yes, yes, the bedroom window is always open to the balcony. She can jump down to the street from there. She’s an adventurer, that little cat.’

  ‘Eh, yeah, okay, I’ll go have a look,’ said Cam unenthusiastically as he picked his way past Syd and Danielle and followed the path towards the bedroom.

  ‘What exactly should I look for? If he can come and go and he’s not here now, what signs will I look for?’ Cam said, still plotting his course.

  ‘He’s a she. Her name is Minty. And for all I know she could be asleep on my bed in there. Thank you so much,’ Danielle spoke with a hopeless ache in her voice, one that Syd guessed was not just troubled, but also desperately lonely.

  ‘I felt so bad. A few days ago, she was circling my legs and I couldn’t really tell. Then I heard her purring so I fed her, and I haven’t seen her since,’ she said to Syd.

  ‘You couldn’t tell she was circling your legs? While you were sitting there?’ Syd asked.

  ‘Well I heard her purring, that’s how I knew,’ Danielle replied.

  ‘Yes I understand, but could you feel her touching your legs?’

  ‘Hmm, not really, only on one side – this side,’ she said, raising her left hand as though shooing a fly from her fingertip.

  ‘Can you normally feel your legs?’

  ‘Yes, of course I can.’

  ‘Can you feel them now?’

  ‘Of course I can.’

  ‘Do you mind wiggling all your toes then?’

  Syd looked down at the long, dirty yellow toenails at the end of Danielle’s fat and poorly perfused legs. Both ankles were red, swollen and scattered with tiny dark veins.

  Five toes wiggled. The other five did not.

  ‘So, Danielle, are you trying to wiggle those toes on your left?’

  ‘They’re moving aren’t they?’ she said in all seriousness.

  ‘No, they are not. Why don’t you move forward a bit and have a look?’

  She gazed up at him with worried eyes.

  ‘Can you give me a nice big smile?’ Syd said before Danielle even tried to move.

  ‘Is this a test?’ she asked.

  ‘It sure is.’ Although it was barely noticeable, her smile wasn’t equal on both sides. Syd had to tell her twice to keep holding the smile as he looked closely at her well-cushioned face.

  ‘Can you lift your arms above your head Danielle?’

  ‘Of course I can.’

  ‘Well, would you mind doing it?’

  She concentrated, pulled a strained face, and lifted her right arm to eye level. Her left arm didn’t move. ‘I swear I’m telling that arm to move.’

  Syd stepped forward and placed his hands in hers, ‘Okay now, squeeze my hands as hard as you can.’

  Right grip: strong; left: weak.

  He then placed his hands on the tops of her meaty knees and said, ‘Now push each leg up towards the ceiling.’

  Danielle pushed her right leg up a little, but her left leg didn’t move. ‘You are trying with that left one, right?’

  ‘Right. The left one.’

  Cam had returned and stood near Danielle’s chair, watching Syd’s assessment.

  Syd produced a biro and circled it under Danielle’s right and left feet, asking each time if she could feel it, and once again asking after he hadn’t circled the biro.

  She could not feel most of her left side.

  Syd looked up at Cam, ‘How much of that did you hear, Cam?’

  ‘Most of it, mate. What you thinkin’?’

  ‘TIA probably, but with her obvious level of inactivity it’s hard to know.’

  ‘Treat what you see, son.’

  ‘But we don’t do anything for a TIA,’ said Syd, before asking, ‘do we?’

  ‘What’s TIA?’ Danielle cut in as the two rudely spoke over her.

  ‘Sorry Danielle,’ said Syd, ‘a TIA is a Transient Ischemic Attack, or mini-stroke. That means that within the last twenty-four hours, you may have had a blockage to the blood flow to a part of your brain, which may be causing this left-sided weakness.’

  ‘Danielle,’ Cam chirped, ‘I couldn’t find the cat, I’m sure he’ll— ah, she’ll be back soon. For now, though, we gotta take you to hospital. The sooner they can look at your brain the sooner they’ll start treatment.’ He looked at Syd, ‘Mate, do you wanna stay here? I’ll race down and throw the drug kit up so you can cannulate for me. Then I’ll get the stair chair and organise another crew to help us outta here and down those stairs.’

  ‘Yep, no worries,’ said Syd, still crouching at Danielle’s portly feet.

  ‘Danielle, is there any other way out of this building besides those stairs?’ Cam asked.

  ‘No, there isn’t. I’m really sorry you guys.’

  Cam followed the path back to the front door while Syd went about gathering more information from the defibrillator.

  ‘So how long have you been with the ambulance?’ Danielle asked.

  ‘About nine months,’ said Syd, smiling.

  ‘You must like it huh? I can tell you like it.’

  ‘I do. I do like it. It’s the first job where I can actually help people who need it, plus there’s the surp
rise element too – you never know what’s going to happen each shift, and all that.’

  ‘I’m sorry; I know I probably don’t need you guys here. I was just down and—’

  ‘Danielle, if you are having a TIA – a mini-stroke – it is absolutely essential that we get you seen. They may be able to help, they may not, it all depends on the onset time of your symptoms.’

  ‘I didn’t even call for that. I’ve just been so sad, so lonely,’ she said miserably.

  ‘Well that’s no good, but we are going to focus on the possibility of the TIA for now, okay, not so much on the depression. I’m not dismissing it, but that’s what we have to deal with right now.’

  Cam could be heard stomping up the last flight of stairs. He followed the path and handed the drug kit to Syd. ‘All okay? No changes?’ he asked.

  ‘We’re just here chatting,’ said Syd.

  ‘Oh great,’ Cam said, wiping his brow. ‘Now Danielle, I need you to think of the time when everything with you was good, as in, you could feel both of your legs and move normally … before you had any motor deficit at all. Tell me when that was, okay?’

  ‘Okay, well, I’m not sure,’ she said.

  ‘Well, have a think about it and I’ll sort out things down at the truck and see you both shortly,’ said Cam before tramping down the echoing stairs once more.

  ‘So I’m going to give you a little needle in your hand, Danielle, just in case we need to give you some fluid.’

  ‘What’s your name again?’ Danielle asked.

  ‘I’m Sydney, and that other bloke is Cameron.’

  ‘Sydney, you guys should really just leave me here, seriously. I’m not worth it, don’t worry about me, just leave me here—’ Her voice began to break.

  Syd interrupted. ‘Danielle, so, that’s not going to happen. I’m sorry … no, I’m not sorry. It’s not good that you’re upset about life, but I have a job to do, and right now, that is looking after you, giving you this needle, getting you down those damn stairs, and then off to hospital. So, even if I did want to leave you here,’ he smiled at her, ‘I’d surely get in trouble from someone.’ He gently tapped her hand, looking for a vein. ‘And besides, Cam wouldn’t let me leave you here; way too much paperwork.’

  Danielle smiled back and looked at Syd with big, wet eyes. ‘Thank you Sydney, you’re sweet.’

  ‘Ha! Don’t be fooled Danielle,’ he said, as he continued searching around her plump arms.

  ‘I know it doesn’t look like it, Sydney, but I’m just a normal person, you know,’ said Danielle confidently.

  ‘I’m sure you are Danielle, but I can tell you that your veins are not normal,’ said Syd, still searching, ‘they are so difficult to find.’

  ‘I’m just lonely.’

  ‘That’s no good.’

  ‘I don’t want to be alone anymore. I don’t want to die alone.’

  ‘I don’t think anyone really wants to die alone do they?’

  ‘Do you think I’m going to die?’

  ‘We’re all going to die, Danielle.’

  ‘Today, I mean.’

  ‘I don’t think so, but how would I know?’

  ‘You’re a paramedic.’

  ‘I can’t predict the future though, unfortunately.’

  ‘I know. I’m just lonely. I just don’t want to be alone.’

  ‘I know Danielle. How long have you felt like that?’

  ‘Last few years. I lost my job, a couple of times, and later had a really bad break-up.’

  ‘What changed at eleven-thirty tonight? And, please, just hold still, there’ll be a little scratch in the back of your hand.’

  ‘I just woke up and felt something was diff— arrgh, ooh that hurt!’

  ‘Just stay still for me, Danielle, I’ve almost got it, the slippery little …’

  ‘Okay, okay, I’ll try. Arghh aaar—’

  ‘Mmm, Danielle, you moved and it blew the vein. I’m going to have to do another one. You have to stay still for it, okay?’

  Cam soon returned and helped Syd spend the next ten minutes finding a vein on Danielle’s enormous arms. Cam finally found one and successfully cannulated after Syd’s two failed attempts.

  The second crew arrived, and it took all the strength of the four paramedics plus another ten minutes to prise Danielle out of her recliner.

  Cam was relieved not to find the cat underneath her.

  With determined coaching, positive reinforcement, and a good deal of sweating, Danielle was able to stand on her good leg, before flopping into the stair chair and being strapped in.

  For the next ten minutes Syd and Cam controlled the top half of the stair chair and the backup crew held the bottom of it. The stair chair; a sturdy metal and plastic chair with wheels and a retractable tread system, allowed the paramedics to move Danielle down the stairs smoothly. Usually, a single operator could manage a patient in it but Danielle required four, and every one of them earned their thirty dollars in that hour.

  From arrival to departure, Danielle’s job took ninety minutes. The trip back to ED took two.

  A new connection

  Two years earlier – Karen

  There is nothing as anguished as a mother at her child’s funeral – the evolutionary misdeal is as perplexing as it is devastating. As Karen watched her child’s coffin being lowered into the ground, she felt an inexplicable sense of failure and defeat. What was the point of anything now?

  Jessica, Karen’s firstborn, died at a friend’s backyard party three weeks ago. The funeral had to be postponed because the autopsy results were initially inconclusive. Eventually, it was concluded that Jessica had collapsed due to hyperthermia and had died from choking on her own vomit. She had reportedly taken one tablet of ecstasy. Another thing that shocked everyone involved - save the investigating police - was that Jessica was found to be six weeks pregnant. Jessica was fourteen years old.

  The morning of the funeral was clear. It had been planned for early in the day because the past week had been hot and muggy, and serious state-wide storms were predicted. Although the sky remained clear, there was a hot breeze, tormenting the mourners around the young girl’s grave.

  Once all the lovely and inconsequential words were spoken, Karen and her husband Jerry stood side-by-side and hugged the friends and family members one by one. Even though both of them thought they had run out of tears long ago, fresh ones flowed. Eleven-year-old Riley clung to her mother’s dress, and looked on with an expression of indifference. She knew her sister was dead, and she clearly understood what death was, but the how and the why were beyond her despite her constant questioning of her grieving parents.

  She noticed her father shy away from her mother whenever they were alone together. She heard them argue a few days before the funeral and understood that her father blamed her mother for Jessica’s death. Karen had let Jessica attend the birthday barbecue that afternoon, which was to have become a supervised party later that night.

  Karen was led away to the cars by her aunt while Jerry stayed with Riley, holding her hand. Jerry spoke politely with the minister who conducted the service, keeping Riley firmly by his side. A boy with white-blond hair approached her.

  ‘You’re Riley, right?’

  She glanced up at her father’s back as he spoke to the minister.

  ‘Yep,’ she replied.

  ‘Hi mate, I’m Lyndon, I was, well, I am, a really good friend of your sister’s.’ His face was long but his eyes were definitely dry. ‘Here’s my number if you ever need anything,’ he said, passing her a scrap of paper.

  ‘Like what?’ she asked innocently.

  ‘Just someone to chat to, about your life. Your sister’s life. Your family. Whatever. I’m here. Your sister was special to me.’

  ‘Okay. Thanks. I think.’

  ‘I gotta go,’ he said as Jerry turned to Riley, noticing only Lyndon’s lean form as he walked away.

  Jerry and Riley headed for the cars to drive to the wake, both of them notici
ng the cool change, the breeze raising goosebumps on Riley’s bare arms.

  Karen’s tears ceased when the storms came at noon. The river flooded later that day, and parts of the city were evacuated.

  Another new connection

  01:40 hrs – Princess Alexandra Hospital Emergency Department

  Danielle’s transfer from ambulance stretcher to hospital bed took nine people. Many hands make light work in most cases; not so in this one.

  Cameron’s handover was quick and succinct, and Danielle could still not come up with a time, or even a day, when she first felt the left-sided weakness.

  Syd rolled the stretcher outside while Cam started on the paperwork.

  ‘Hey there stranger, how are you feeling?’ Sonia asked as Syd disinfected the stretcher.

  ‘Hey Sonia, what are you still doing here?’

  ‘I collected my car and went out to another job and now I’m back here, and being in this ambulance bay is just a fun place to be, you know?’ Sonia said sarcastically.

  ‘Well here, take some anti-microbial, anti-fungal, hard-core disinfectant and get scrubbing on this feral stretcher,’ Syd said. ‘Actually, have you got a match?’

  ‘Feral patient?’

  ‘Hmmm, yeah she was … but I felt really quite sorry for her. She was overweight like I’d never seen, and lonely as hell, and said stuff like she doesn’t want to die alone. I reckon that’s pretty sad to be venting like that to someone you don’t know.’

  ‘She was talking to you both about it?’

  ‘Nah just me, Cam was downstairs organising. You should have seen the unit she lived in. It was like the tip. Unbelievable.’

  ‘Was she a hoarder? Mmm, I’ve been to a few of those. Eye-opening and nostril-closing, that’s for sure. And, now you’ve probably got even more on your mind, eh?’ Sonia spoke kindly.

  Syd paused. ‘I suppose,’ he said, as he finished cleaning the stretcher.

  ‘Like I said before, just let me know if you need a hand. With anything.’