Extreme Medical Services: Medical Care On The Fringes Of Humanity

by Jamie Davis

  It took about two hours for each of them to give their report both to the police and then writing it all up for headquarters to review. It was well after midnight and Dean was suddenly very tired. He’d gotten into this job for the excitement of it, but lately that excitement had gotten pretty stale. A sleepy maintenance guy was the last person to show up. He attached a new deadbolt lock to the door and screwed in a receiver for the bolt on the metal door jam. He handed Brynne two sets of keys for them and the next shift and said he’d get more made the next day when he came in for his regular shift.

  Now that the door was repaired and the squad room was straightened up, Brynne called headquarters on the phone and put them back in service. Dean just sat down and looked around. That SUV he’d seen earlier obviously was following him. It bothered him. James and Brynne had both skewered the likelihood that James had anything to do with it. James could arrange to have him followed in much more covert ways. So who were they and what did they want from him and from the station?

  “Penny for your thoughts?” Brynne asked as she came over to the recliners and sat on the edge of the couch across from Dean.

  “Wow,” Dean said, “The last time I heard that it from my grandmother.”

  “Are you saying I’m old?” Brynne asked, dangerously.

  “No, I’m just saying that the 1970’s called and they want their catch phrase back,” Dean said with a chuckle.

  “It seems like you’re back to your old self,” Brynne laughed. “Are you feeling better?”

  “I guess so,” Dean said. “I’m just tired of all the excitement. This has been more than I bargained for when I took this job.”

  “C’mon, Dean,” Brynne said. “Excitement and adrenaline are what this job is all about. They don’t call us adrenaline junkies for nothing.”

  “That’s a different kind of excitement,” Dean pointed out. “We come in and deal with someone else’s excitement. We bring order to the excitement. It’s not supposed to happen to us.”

  “True,” Brynne agreed. “Still it gives us a sense of how our patients feel about things. Maybe it’s a good thing for us to have our own emergencies from time to time to give us some perspective.”

  “Maybe, Brynne. but I’ve had enough excitement focused on me.” Dean said. A pensive silence was followed by the jarring sound of the tones on the radio.

  “Ambulance U-191, respond for an injured subject at 49th and Main Street,” came the voice over the radio. The printer chattered to life as it began to spit out a page with the response location.

  Dean grabbed the page off the printer and headed for the unit in the ambulance bay. Brynne checked the new lock on the parking lot door and then followed him out to the ambulance. She started up the unit as Dean climbed in on his side. He keyed the mic and put them responding, turned on the lights and activated the siren. He switched to the med radio channel.

  “Ambulance U-191, you are responding for a 52-year-old male involved in an assault. The subject will be located in the office of the Rusty Cue Pool Hall at that location. Police are on the scene, and report assailant has fled the premises. You are safe to proceed in. No additional information at this time.” the dispatcher said.

  “Ambulance U-191 received. Proceed in. The scene is safe per police on location,” Dean repeated back. He looked at Brynne. “Well, that’s pretty cryptic. It could be almost anything.”

  “Yeah,” she said. “The police don’t like to put out too much information over the radio - even over secure channels. When we get there, you grab the trauma bag and oxygen bag. I’ll jump in the back and get the heart monitor and med bag.” She steered the ambulance up the ramp onto I-95 to head downtown and hit the gas.

  The trip downtown took about eight minutes. It was after two o’clock in the morning and traffic was light. It was just after closing time for the bars and most of the people had cleared out of the downtown bar district by the time they arrived. There were two police cars out front. One young officer was just coming out the front door of the pool hall, and he looked a little green around the gills.

  “I’m glad you guys are here,” the younger cop said as they passed him on the way to the door. “That’s more than my limited first aid training can handle.”

  Dean gave Brynne a look and reached out to hold the door for her. As the two paramedics entered the large central room, they heard a familiar voice coming from way in the back. “If you would just hold this end, officer, I can help myself and pull it out,” they heard Gibbie say. They quickly crossed the room. As they turned the corner into the office, they both stopped and stared. Gibbie sat there on the corner of the manager’s desk facing two police officers who both looked completely out of their element. The patient had the broken half of a wooden pool cue sticking out of his chest.

  Gibbie looked over and saw them standing there with their jaws hanging open. “Well don’t just stand there, doooo something,” he shrieked, his voice climbing an octave as he said it. “I can’t sit here all night. I have to go and see what got Brenda so upset this time.”

  The older of the two police officers looked at him. “This Brenda, she’s the one who did this to you? Do you have an address for her?”

  Gibbie responded to the officer with pursed lips then turned back with a pleading look at the paramedics.

  Brynne set the monitor down on the floor, followed by the med bag and walked over to the middle-aged vampire with her gloved hands held out in front of her. “Gibbie, I want you to calm down and sit very still,” she said quietly. “That pool cue has got to be sitting right next to your heart, and you know as well as I do what will happen if so much as a splinter gets in there.”

  She carefully reached out and held the end of the cue still and stable at the point it entered Gibbie’s chest right through an old “Frankie Says Relax” t-shirt. She looked over her shoulder at Dean. “Get that shirt cut away, and then get the monitor on him. I want to see what’s going on with his heart.”

  “Don’t you dare cut this shirt off young man,” Gibbie shouted. “I got this at their U.S. concert tour back in 1984. I got to go backstage and meet the band. It was fabulous.”

  “Gibbie,” Brynne said, sternly. “You need to sit still and calm down right now. Dean is going to do what I told him to do, and you are going to let him. Do you understand?”

  “But Brynne, honey…” he began.

  “Don’t ‘Brynne, honey’ me,” she said. “Dean, do it and try not to move him while you do.”

  Dean got out his trauma shears from his pants pocket and started to carefully cut up from the bottom to the point where the pole jutted out of the T-shirt. Then he cut carefully around the obstruction and up to the collar. Gibbie groaned and whimpered. When Dean was done, he slid the shirt off like a jacket. Now that the chest was exposed, and Brynne stabilized the impaled pool cue, Dean connected electrode stickies to the wire harness of his heart monitor and attached them to Gibbie at the upper arms and ankles. He turned the monitor on and took a look at the screen. He saw a run of ventricular fibrillation as he’d expected in a vampire but then he saw what looked like two or three organized sinus rhythm beats before it turned back to V-fib.

  “Brynne did you see that?” he asked.

  “Yeah, I saw it,” she said. “Normal sinus rhythms are not good in someone like our friend Gibbie.” She looked at the vampire and got his attention. “Gibbie, this thing must be resting right up against your heart. The monitor is showing your heart with a bad rhythm every few beats. If that rhythm takes over, there will be nothing we can do for you, so you have to stay really still, do you understand?”

  Gibbie nodded, biting his quivering lower lip. Then he quietly asked, “Can’t you just pull it out, Brynne?”

  “There’s no way of knowing what additional damage that would do, Gibbie,” she replied. “So here’s what we’re gonna do. I’m going to sit here with you and hold this very still while Dean goes out to the truck and gets the tool box from the driver’s side bin on th
e ambulance.” She looked at Dean. “Got it, partner?”

  “Got it,” Dean said. He went back out to through the pool room to the rig. The young cop he and Brynne had passed on the way in was standing outside waiting when he came out.

  “That’s super weird, ain’t it?” The cop said. “He’s sitting up and talking and all with that pool cue sticking right through him. All he would tell us over and over again was that we had to find his girlfriend and that it was all a misunderstanding. We’re looking for her, but I don’t think he should be the one to talk to her when we find her. She must’ve been really pissed to do that to him.”

  “I think he has that effect on people,” Dean said. He went around to the driver’s side of the ambulance, opened the compartment door behind the driver’s seat and pulled out the toolbox. It was kind of heavy, and he wished Brynne had told him what specific tool she needed. He came back around the back of the ambulance, and the cop was waiting.

  “Is he gonna live?” he asked. “I can’t believe he’s just sitting there talking like that.”

  “We’re going to do what we can for him,” Dean said. “If we can help it, we’re not going to let him die,” or whatever you called it when a vampire left this life.

  Dean went back through the pool hall and into the cramped office where the two police officers stood there and watched dumbfounded as Brynne stabilized the impaled pool cue in Gibbie’s chest. Dean set the toolbox down next to the heart monitor and popped the lid open.

  “What next, Boss?” Dean asked.

  “Under the top tray is a small folding hacksaw,” Brynne said. “While I hold this pool cue really still, you’re going to cut the end off just past my hands so we can maneuver him more easily in this room. You get that ready to go. Before you start cutting, I want to alert ECMC about what we have so Doc Spirelli can get the trauma team squared away. He’s got to pull in a few favors to get the right people in the hospital this late without anyone freaking out about what they’ll see. Dial the portable radio to patch us through to the Elk City Medical Center ED and hold it up where I can talk.”

  Dean had already gotten the folding hacksaw out and assembled it to its open position. He put the tool down and pulled out the portable radio from its clip on his belt. He keyed the mic button and held it up to Brynne’s face. “This is Ambulance U-191 calling ECMC with a trauma alert. Can I please speak to the Station U doc on call?”

  “Received One-Nine-One. We’re getting the doctor now,” The nurse on the hospital radio said. “Stand by.”

  “Standing by,” Brynne replied.

  She looked at the cops. “We’ve got this if you want to go out and do some crowd control. When we bring him out, we’re going to be in a hurry. The two officers looked relieved and hurried from the room.

  “U-One-Nine-One go ahead,” the radio squawked. “This is Doc Andrews.”

  Dean keyed the mic for Brynne again. “Doc, this is paramedic Garvey. Pick up the handset and go to private mode, please.” She waited a moment, heard a click, and then continued. “We have an apparent 52-year-old male vampire with a wooden pool cue impaled in his chest just medial to the mid-clavicular line. He is conscious, alert and oriented. I have the object stabilized by hand at this time. We have him on the monitor, and it shows V-fib with occasional runs of normal sinus rhythm. The pool cue is too long to move safely, so we’re going to cut off some of the length before we transport. We’ll call in before we leave the scene to alert you that we’re en route. Do you request any additional information?”

  “No additional information needed at this time. Use extreme caution when cutting the object, Brynne. The runs of normal sinus mean it is already in contact with the heart. Consider IV fluid bolus for blood loss.”

  “Understood, Doc,” she said. “We’ll be careful and will have fluids ready to flow. We’ll call when we’re on the way. U-191 clear.” Dean lowered the radio and reattached it to his belt.

  “Okay, Brynne,” Dean said, picking up the saw. “Are you ready for this?”

  “Yep,” she said. She looked at her patient. “Gibbie, this is going to be uncomfortable. I need you to sit really still, okay?” The vampire nodded.

  Dean set the saw blade on the pool cue about two inches beyond where Brynne’s hands gripped it, holding it steady. Using slow, smooth strokes, he began to draw the fine toothed blade back and forth, letting the tool do the work and trying not to put downward pressure on it. It took what seemed like for forever, but he made steady progress and eventually broke through the other side leaving him holding the thick end of the pool cue. Brynne gripped the remaining six-inch stump left protruding from Gibbie’s chest.

  “Okay, now we can get ready to move you to the ambulance,” Brynne said. “Dean, you get some cling rolls and gauze pads out. There’s surprisingly little blood, but I think the cue’s smooth round side is sealing against the skin. Let’s pack some gauze around the wound then use the whole cling rolls to stabilize the object in place, wrapping around his torso to secure them. How’s that sound to you?”

  “I think that will work,” Dean said. He unzipped the trauma bag and retrieved a ten pack of four by four gauze pads along with six four-inch wide cling gauze rolls. He opened the pack of gauze squares and handed them to Brynne, who folded them in half and began to layer them in a criss-cross pattern around the wound. She created a layered round gauze wall around the pool cue pressing them firmly up against the wood. Dean opened two more gauze cling rolls and began wrapping the strips of long gauze around and over the stabilizing packing and then around Gibby's back and torso until he was satisfied that the packing was secured.

  “What do you think Brynne?” he asked, perusing his handiwork.

  “I think that will do, Dean,” she responded. “Any other ideas before we move him?”

  “I think we need to immobilize his whole torso,” Dean suggested. “I think the KED is probably the best option. Then we can move him and lay him down on the stretcher without bending or twisting his torso.”

  “Good idea. Run and get it and the stretcher,” she said. “I’ll sit here with Gibbie.”

  Dean ran out to the unit and opened the back to retrieve the stretcher. He rolled it around to the side and opened the long tall doors that held the backboards and KED, the Kendrick Extrication Device. He placed the green bag with the KED in it on the stretcher along with a long backboard and the bag of straps and clips used to secure a patient to the backboard. He rolled the stretcher back into the pool hall, parking it by the entrance to the office.

  He picked up the bag with the KED and went inside. He noticed she’d taken the time to start an IV on him and was attaching the bag’s tubing to the catheter secured to the patient’s arm.

  “Okay,” he said taking the device out of the container and unfolding it. It looked like an inverted capital T. It had wide wings at the base to wrap around the torso then an extension that went up behind the neck with two smaller wings that were intended to wrap and secure the head in place. The device was stiffened by metal rods. When properly secured, Gibbie should be able to be moved without twisting or bending his upper body at all, minimizing the risk of shifting the pool cue’s splintered end still inside him.

  Dean had always liked the KED and thought it was a better option to move an injured patient than just using a long backboard. He placed the opened KED against Gibbie’s back and carefully lifted his arms while wrapping the wings around each side in turn. The wings didn’t fully wrap around him, just coming partially around to the front, which was good, since it would have pushed against the wooden stake if it had reached all the way around. He undid the three colored straps and applied them to immobilize the torso.

  “That was good thinking, Dean,” Brynne said. “I’m not sure I would have thought of the KED for this application, but it works. Okay, Gibbie,” she said to their patient. “We’re going to help you stand up and move over to the stretcher. We’re going to do all of this slowly, without twisting you or moving you unnecess
arily. You’re going to stay calm and help us, right?”

  “Okay, Brynne, honey,” he said quietly. Dean thought he sounded frightened. “Whatever you say.”

  “I brought a backboard but I think this will do by itself,” Dean said. “What do you think?”

  “I agree,” she said, nodding. “Okay, Gibbie, we’re going to work together and move as a unit over to the stretcher. I’ll count to three, and I want you to slide slowly forward on the desk until your feet touch the floor. Dean and I will be on each side of you, holding your body still.” Dean stood on one side and grabbed the carrying straps on the KED on his side. Brynne did the same on hers. She glanced at the heart monitor, the wires still attached to Gibbie as she counted down. “Three, two, one, nice and easy,” she said helping him to slide to his feet and stand up. “Okay, hold it there for a sec.” She had seen a couple more runs of normal sinus rhythm on the monitor as they moved him, but the rhythm settled back into his “normal” of ventricular fibrillation once they stopped. The change made her nervous, but they had to get him to the trauma center. He needed surgery.

  “Now for the next step,” she said standing next to Gibbie. “One step at a time. Make sure you stand up straight and move your legs only. The KED should help you keep your upper body still. We’ll be right here with you.” The paramedics began walking with their patient across the room and to the door where the stretcher waited for them. They turned him around, so his back was to the stretcher at the midway point, the mattress lowered to knee level and helped him sit straight down. Working together, they helped Gibbie swing his legs up onto the stretcher while they used the KED’s handles to turn him so he was sitting up on the stretcher with the back brought up to support him. Dean attached the straps securing Gibbie to the stretcher and put the side rails up. Then with him at the base and Brynne at the head, Dean pressed the button for the motor to raise the stretcher up to his waist height so they could comfortably roll him out to the ambulance.