Extreme Medical Services: Medical Care On The Fringes Of Humanity

by Jamie Davis

  “Well that’s good, Dean,” Rebecca said. “It may not always be completely painless, but together we can sort this out for you. I’ll help you get you back into a place where you won’t question or second guess yourself.” She stood and opened the door for him. As Dean walked out, he saw that the next person was in the office already, waiting to go in.

  “Thanks, Rebecca,” he said as he walked into the waiting area. “I’ll see you next week.”

  She nodded at him and walked over to the woman waiting in the chairs. Dean let himself out and waited at the elevator to go back down to his truck. Mike had told him to keep an open mind and that he wouldn’t mind the counseling, and his old mentor was right. Rebecca had lightened the load on his mind. He still had questions, but he no longer feared that he wouldn’t find the answers. Rebecca the Muse had inspired him to start believing in himself and trust in his own abilities again. He could do this.

  He had a few more days off then he was back at work covering nights. The calls were pretty routine for the most part, and Brynne trusted him more and more with handling patient care on his own. The two of them sat in the station house checking on updates from the online management and scheduling system. Elk City EMS headquarters used the system to keep in touch with each station, and every member of the system was expected to check in regularly and sign off electronically after reading the notes and updates posted there.

  Dean was reading a research paper on recent opioid overdoses where the heroin was laced with fentanyl, causing an extremely difficult respiratory depression situation to overcome when treating those patients. He wasn’t sure if he’d encounter it, but he guessed there were Unusuals who were drug abusers just like everyone else.

  “Brynne,” he said. “I’m reading about this new fentanyl-laced heroin. It’s certainly kicking the butts of our colleagues running calls for the regular population. I haven’t seen much drug abuse in our calls so far though. Do Unusuals use drugs like other people do?”

  “Sure,” she said. “We just haven’t run it to any yet. Mostly they’re into the club drugs like ecstasy and the synthetics like bath salts. I guess you’ve just been lucky so far. When dealing with Unusuals, the treatment parameters are similar to humans. I’ll look up and email you a link to an EMS podcast I listen to that covered club drugs recently.”

  Brynne turned in her chair and looked over at him. “How are you doing, anyway?”

  “I’m fine,” Dean said. “Really, I’m fine. I am working through it. I just need to go through the process. The counselor you and Mike hooked me up with seems great and I think she has me on the right track.”

  “Good,” Brynne said. “I’m glad to hear that. I just wanted to tell you that I’m sorry. I didn’t pay close enough attention to what was going on. I’m supposed to be the one that keeps you from getting into that kind of trouble and I didn’t.”

  “Boss,” Dean said. “If I’ve picked up anything from this experience, and from Rebecca and Mike for that matter, it’s that you can’t second guess yourself after the fact. It doesn’t do any good. It happened and what you did was recognize the problem and fix it. If you hadn’t done that I don’t know what would have happened. I could still be there as Lydia’s personal paramedic. If it makes you feel better I could say ‘apology accepted’ but I don’t think that’s the right answer either. All we can do is the do the best we can with what we know. You didn’t know she was a Siren. When you found out, you took action. The way I look at it, you didn’t make a mistake.”

  “Well,” she said. “I’m sorry that it happened the way it did.”

  “Hey,” Dean said, laughing, “me too. I don’t want anything like that to happen to us again, but I guess that would be wishful thinking.”

  “Yeah, that’s true,” Brynne said.

  The tones sounded and interrupted their discussion. The voice of the dispatcher came over the radio. “Medical Box 421, injured subject. 699 Breton Way.”

  “Time to go to work,” Dean said, hopping up and heading to the ambulance bay door. “Gonna let me drive, Boss?”

  “Not on your life, Probie.” Brynne laughed. “Let’s do this.”

  The call took them up to a residential neighborhood and a large Victorian home that had been converted into apartments. The additional information from dispatch had come back that there was a male subject with an arm injury located on the south side of the building outside. It was already late and dark out, and their scene safety radar was up as they pulled into the parking lot next to the building.

  “I’ll grab two flashlights, Dean,” Brynne said putting the gearshift in park. “You grab the oxygen and splint bag.”

  Dean keyed the radio, “U-191 on location at Medical Box 421.” Then he jumped out of the passenger side of the ambulance and opened the doors to pull out the bags. A voice spoke right behind him and caused him to jump.

  “Dean,” the voice said. “You have to help me. I think she’s trying to kill me.”

  Dean spun around with a yelp to see Gibbie standing behind him. He was cradling his right arm in the other, and the right forearm was clearly misshapen. “Jeeze, Gibbie, don’t sneak up on a guy that way.”

  Brynne came trotting around the back of the ambulance, shining a flashlight on the two of them. She relaxed when she saw who it was. “Oh, it’s you Gibbie.” She said. “What happened?”

  “Brynne, honey,” The excited vampire said. “I think that Brenda is mad at me. She tried to kill me.”

  “Oh, you think that I’m mad at you do you?” Another voice came from the direction of the front porch. A woman approached them. “Did you think you could just come flapping into my bedroom window after you’d been with that tramp, you … you two-timing vamp man-whore!”

  Brynne diverted the flashlight to shine on the woman, Gibbie’s girlfriend Brenda. “Dean, get him in the back of the unit and see what you can do for him,” Brynne said. “I’ll deal with her.”

  Dean popped open the side door of the ambulance and helped Gibbie climb inside, then he jumped up behind his patient and shut the door. He directed Gibbie to sit on the cot while he sat down on the side chair next to him. “Gibbie, tell me what happened.”

  “I really have no idea, Dean,” the vampire began. “I don’t know what’s got her so upset. I was flying over in my bat form to visit like I usually do. Brenda had her window open like usual until I got there. Then she slammed the window down on me. She caught my wing between the window and the frame. She opened it again to yell at me and I fell down outside in the bushes like some kind of rubbish. I shifted back to human form right away. I think she broke my arm. That’s why I called you.”

  Dean looked at Gibbie’s right arm. The lower portion of the arm just above the wrist had a lump that just didn’t belong there. “I think you might be right, Gibbie,” Dean said. “Let’s see what we can do. Can you tell me how much pain you’re having, on a scale of one to ten with one being very little pain and ten being a lot of pain?”

  “Ten, Dean! Definitely a ten.” Gibbie said. “I mean look what she did. She tried to kill me.”

  “Okay,” Dean grabbed a chemical cold pack out of the cabinet, broke the pellet inside and shook it to mix the chemicals so that they started to chill. “Here, put this on that bump. That’ll start helping with the swelling and will also help with the pain.”

  He got out the IV kit and got the supplies together to start an IV line in the uninjured hand. He got the line in place and attached the IV tubing to the catheter in the vampire’s arm.

  “Gibbie, I’m going to give you something for the pain. Do you have any allergies to morphine?”

  “No,” Gibbie replied. “Do you think she’ll let me explain myself? I can’t lose Brenda, she’s the love of my life.”

  “I don’t know, Gibbie,” Dean answered. “But Brynne’s out there with her, and she’ll find out what’s going on with Brenda. Let me try and help you. We’ll find out what is going on with her when we’re done with taking care of you, o
kay?”

  “Alright,” Gibbie conceded.

  Dean pulled out the pre-filled syringe of morphine and, pinching the tubing above the port, attached the syringe and carefully and slowly administered two milligrams of the drug into the IV line. He detached the morphine syringe and then rolled back the valve on the tubing to allow the fluid to flush the drug into his patient’s system. He watched Gibbie’s face as he administered the drug.

  “We’ll let that start to work, and if that dose doesn’t take the edge off the pain, I can give you some more,” Dean said. “Now let’s look at what I can do to stabilize that arm so it won’t move around and hurt you even more.” Dean took the chemical ice pack off gently and checked the area of deformity and swelling on the vampire’s arm. It was definitely broken. He went over to a cabinet at the back of the ambulance and selected a short padded board splint and carefully placed Gibbie’s injured forearm on top of it. He got a roll of cling gauze and began to wrap the arm carefully to the splint. Dean knew he was supposed to check pulses in the affected limb after applying the splint but since the vampire had no pulse he didn’t bother with that part of the process.

  “How does that feel, Gibbie?” Dean asked. He was admiring his handiwork, but ultimately it was the patient’s comfort level that was paramount.

  “Better,” Gibbie answered. “It doesn’t hurt as much.”

  “Okay, let me make a sling for you so can keep the arm still,” the paramedic said. “I also think you’re going to have to go into the hospital. I don’t know how your super healing thing works, but I don’t think you want the arm to heal crooked. Doc Spirelli is going to have to set that bone so it’s straight. Okay?”

  Gibbie nodded, and Dean got out a triangular bandage to fashion a sling to support the arm on the way to the hospital. When he was finished tying the sling in place, he checked that the arm was supported properly. Everything looked good.

  “How is the pain level now on a scale of one to ten?” Dean asked.

  “It’s about a six,” Gibbie said.

  “Okay, I can give you some more morphine.” He picked up the narcotic syringe and attached it to the port in the IV tubing again, then he slowly began pushing another two milligrams.

  As Dean was administering the drug, the back door of the ambulance opened, and Brynne climbed in, closing it behind her. “Boy, Gibbie, she sure is pissed at you,” Brynne said. “I got her to go back inside but what did you do to her? She’s convinced you’re cheating on her.”

  “I don’t know, Brynne,” Gibbie said. “I couldn’t come over the other night because I was a little hung over after a bit of a feeding frenzy. A friend of mine got some fresh blood from the blood bank, and we stayed up all night drinking.”

  “Is that friend of yours a woman?” Brynne asked.

  “Well, yes, but nothing happened,” Gibbie replied. “Josie is like a sister to me. We’ve been pals for over two hundred years. She’s got this cushy job working for the Red Cross and gets access to the blood bank from time to time, but it was nothing for Brenda to be jealous of.”

  “Well,” Brynne said. “I don’t think she sees it that way.”

  She looked over at Dean. “What’s the deal with the arm?”

  “I’m pretty sure it’s fractured,” Dean replied. “It has swelling with deformity. I’ve given him four milligrams of morphine, and that’s taken the edge off the pain. I think he needs to get into the hospital to get it set properly before his vamp healing starts forming it in a crooked position.”

  “You’re probably right, Dean,” Brynne said, nodding. “Okay, I’ll drive. You stay back here with Gibbie and call it into the hospital, so they’re expecting us. Remember to use his apparent age. No need to freak them out with a patient who is older than the country we live in.” Brynne opened the back door and hopped out. As the door closed behind her, Dean helped his patient turn and lay down on the stretcher so he could buckle him in. He lifted the head of the stretcher up to a reclining position and then moved to the captain’s chair at the head of the stretcher to access the med radio there. He attached his own seat belt as he felt the ambulance start to move forward.

  Picking up the microphone from its cradle, he dialed into the direct channel to Elk City Medical Center and keyed the microphone. “ECMC this is ambulance U one-nine-one. How do you receive?”

  After a pause, a voice came back over the radio. “We receive you loud and clear, U one-nine-one. Go ahead.”

  “City, we’re en route to your facility with a 50-year-old male with a suspected fracture of the right forearm. I have the arm stabilized and have administered four milligrams of morphine for pain. The patient is conscious and alert.”

  “Received U one-nine-one. Do you have a set of vital signs for us?” the voice asked.

  Dean winced. How did he relay that his patient didn’t have vital signs as a member of the undead community? “Uh, I’ll have that for you on arrival. Unable to obtain vitals at this time.”

  “Roger, U one-nine-one. Vitals on arrival. What’s your ETA?”

  “We should be arriving in about ten minutes,” Dean said. “I will contact you again if there is any change in status. U one-nine-one clear.”

  “Received, U one-nine-one. We’ll see you when you get here. City clear.”

  Dean put the mic back on the cradle and reached around the head of the stretcher to put his hand on Gibbie’s uninjured left shoulder. “How are you doing, Gibbie?” he asked.

  “I’m fine, Dean.” The vampire replied. “I’m just worried about what to do about Brenda. I don’t know how to impress upon her that she’s my number one girl. I would never cheat on her.”

  “I don’t think that’s the problem,” Dean said. “She seems to be worried about who’s number two, three and four. You are probably going to have to come up with something pretty big to make it up to her.”

  “I think you’re right, kid,” Gibbie said. “Do you have any ideas? What do these modern gals like?”

  “You should have this locked down, dude,” Dean said. “Believe me, you don’t want to take advice from me. I’m a complete idiot around women I like.”

  “Well I have to think of something,” Gibbie said and then he started blubbering. “I cannot lose her. She’s the best thing that ever happened to me. I’ll just die if she breaks up with me.”

  Dean continued to listen as they made their way to the hospital, occasionally making reassuring sounds and gestures while Gibbie ranted about his relationship failures. Dean checked on his patient’s pain level one more time, but he reported that it was nearly gone and was more like a dull ache.

  Dean smiled as they made their way across town. The aged vampire was beginning to grow on him. In fact, this job was beginning to grow on him. He’d been disappointed when first assigned to Station U as he was sure it was a punishment. But the jobs were interesting and challenging, and even the patients offered something of a thrill ride with their Unusual quirks and traits. The crew he worked with were all top notch paramedics. They were true health care professionals. Brynne was a great preceptor and despite the challenges of the job and the incident with Lydia, he thought that this was a good fit for him.

  “We’re here,” Brynne called from the front of the ambulance as Dean felt them pull up onto the ambulance ramp outside of Elk City Medical Center. He stopped his daydreaming and unhooked the IV bag from the ceiling hook. He then dialed back the rolling valve to close off the tubing so no more fluid would flow and laid the bag across the top of the pillow behind Gibbie’s head. Then Dean moved to the back of the ambulance as Brynne opened the back doors. He hopped down, and she reached over and unlocked the stretcher’s undercarriage from its position. With Dean at the foot of the stretcher, they wheeled it up and into the emergency room entrance.

  They pulled the stretcher up to the nurses’ station and waited for the middle-aged nurse there to look up from her work on the computer.

  “Is this the broken arm?” She asked looking up. “Oh, hello
Gibbie. I didn’t know it was you.” She shifted her gaze to Dean. “Take him over to exam three. I’ll be right there to take your report.”

  Dean and Brynne wheeled Gibbie over to the room the nurse indicated then helped him move over to the hospital bed. Dean hung the IV bag on a stand next to the bed and readjusted the rolling valve to the point there was just a drop in the drip chamber every few seconds.

  The nurse who checked them in came bustling in the room. “So, what do we have today with Mister Proctor,” she asked.

  Dean looked up, “Suspected fractured arm due to a fall or getting it caught in a window, take your pick. We gave 4 milligrams of morphine and splinted the arm at the point of deformity.”

  “Carol, it was awful,” Gibbie said to the nurse. “Brenda, my one true love, slammed the window down on me, and I was just hanging there. Even if the arm heals perfectly, I don’t think I’ll ever be the same again.”

  “I’m sure you’ll be fine, Gibbie,” Carol said. “I’ll have Doc Spirelli come in and take a look. He should be able to set it for you and you’ll be as good as new.” She turned to Brynne and Dean. “We’ve got it from here, guys. Thanks.”

  The paramedics backed their stretcher out of the exam room and wheeled it over to where the linens were kept. They stripped the sheets off the cot, sprayed it down with disinfectant, made it up with fresh sheets and pushed it out to the ambulance. Another job well done, Dean thought.

  Brynne and Dean were on the way back to the station when the next call came in over the radio. “U-191 respond to assist ambulance 792 with a cardiac arrest. 26 year-old female. CPR in progress. 462 West Front Street.”

  Dean picked up the mic. “U-191 responding, 462 West Front Street.” He reached over and switched on the lights and keyed the siren as Brynne pulled into the left lane and prepared to make a U-turn back towards downtown. “I guess we’re just the next closest unit?” he said to Brynne. “Is that why they called us to assist?”

  “Could be that, but it might be something else,” she said. “That location is near a bar that a lot of Unusuals hang out in so keep your eyes open. They might need our Unusual talents.”