Terminally Ill

by Melissa Yi

  Elvis was still trapped inside the coffin filled with river water.

  At three minutes and 28 seconds.

  A few women screamed.

  An ambulance siren broke through the air, and then the bilious yellow ambulance itself sped down the quay, lights flashing, following the same path as the Elvis Escapes truck not long before.

  “Oh, my God! It’s real. I thought it was just fake.”

  “It could still be fake.”

  “Why would you fake fucking it up?”

  “Stand back. Make room!” called Archer, and the bikini girl waved us back from the fence, her eyes wide and frantic.

  “I’m a doctor!” I shouted at her. While she turned to check with Archer, I ripped open the gate and sailed through, not waiting to see if Tucker was behind me.

  Police had materialized as well, but I repeated, “I’m a doctor!” and after a second, they let me through, while at least two of them advanced toward the crowd to force them back in through the open gate and lock it.

  “Move it!” a cop snapped at a cameraman who was trying to zoom in.

  Archer and the burly crane guy were prying open the lid with hammers and crowbars. Archer split the lid on the top, but the crane guy popped the bottom half open and Archer joined in to pop the coffin lid off completely.

  Elvis was lying on his back in the coffin still three quarters full of water. Dimly, I noticed he’d gotten the chains and one glove off, but he lay very still while Archer ripped the mask off his face.

  Elvis’s face was deathly white. As in, dead white, except for a few red blotches on his face and neck. And his lips had turned that purply blue.

  His chest did not rise and fall.

  The paramedics jumped out of the ambulance with an oxygen tank and mask.

  I repositioned Elvis’s head into the sniffing position, to maximize his airway. I reached for his carotid pulse out of habit, barely letting it graze for two seconds, even though the new guidelines are that we shouldn’t check for a pulse in the field.

  Then I dropped my hand, fell to my knees, braced my arms, placed my linked hands on his sternum, and started CPR for all I was worth. His chest was cold and my hands wanted to slip off his wetsuit, and I was making waves in the coffin water as Elvis’s body buckled with the compressions.

  “I’m starting CPR!” I bellowed at Tucker, who suddenly loomed above me.

  Tucker dropped to his knees and placed his hand on Elvis’s neck. “Good pulsations!”

  I nodded, but I couldn’t talk because it was taking all of my energy to do the CPR. Indenting a grown man’s chest is hard work even when you’re not grinding your knees into the concrete in front of a coffin. I was starting to sweat and gasp.

  “You want me to take over?” asked Tucker.

  I nodded and Tucker dove in there, hands-first, elbows already locked for compression. He indented Elvis’s chest harder than I did, and I moved around the other side of the coffin to check the pulse, just as the paramedics fitted a 100 percent oxygen mask on Elvis’s face.

  The stocky female paramedic secured the oxygen mask and pushed air into his lungs, noting, “He’s tight,” so Elvis’s lungs were stiff and hard to bag. The taller male paramedic took over compressions. A third rolled a collapsible stretcher into place.

  “Move, move, move! C’est assez!” a police officer yelled at one of the news crews.

  “We need to get him out of the water. I think he’s hypothermic,” I shouted at Tucker. He nodded.

  Two paramedics grabbed the head and feet to lift Elvis while Tucker took the midsection. The third paramedic barely stopped compressions for the seconds it took to load Elvis into the stretcher and jack it up to full height.

  Elvis’s damp body immediately soaked the stretcher linens, but at least now he was out of the river water.

  I checked his right carotid pulse. Something thrummed against my fingertips in a quick but faint rhythm.

  “We’ve got a pulse! I think,” I added, more quietly, and dropped my hand so that Tucker could have a feel on his side. If you press both sides of the neck at the same time, it stimulates the vagal nerve and you can drop a person’s heart rate—the opposite of what we wanted here.

  The paramedics had already started to run toward the ambulance, bumping Elvis in his stretcher, so I sprinted alongside them. Tucker didn’t dare take Elvis’s pulse while they ran, but I could already hear the news people behind us reporting to the cameras, “This just in. He has a pulse. Repeat, he has a pulse.”

  Oh, crap. Sometimes, you end up feeling your own pulse during the resuscitation, because your heart is beating so fast. While the paramedics loaded Elvis in the ambulance, I prayed that the oxygen (and his heart) truly were kicking in.

  I pulled alongside the stretcher. Elvis’s eyes fluttered. For a second, I wasn’t sure if I was just seeing things, but then it happened again, and I heard Tucker suck in his breath.

  Chapter 6

  Elvis lived.

  Elvis lived, and with any luck, would continue doing so.

  I sent a silent prayer of thanks to whoever might be listening. Just because I was agnostic didn’t mean I didn’t cover my bets once in a while.

  Elvis’s blood pressure had to be at least 60 mm Hg, because he had a carotid pulse. The mnemonic is, you have to have a BP of 60 to have a carotid pulse in your neck, 70 for a femoral pulse palpable in your groin, and 80 for a radial pulse palpable in your wrist, so I belatedly grabbed on his wrist. His pulse was fluttering but there. As the French would say, C’est bon signe.

  I backed off while the female paramedic wrapped a BP cuff around Elvis’s wetsuited arm and shoved an O2 sat on his finger. I said, “He came out of the coffin unconscious, cyanotic, and pulseless. We couldn’t have done more than a minute or two of CPR. The oxygen must have turned him around.”

  “And getting him out of the cold,” said Tucker. “You got a warm blanket?”

  “Just a cold one.” The taller male paramedic draped it over his body. “We’re ready to roll.”

  The female said, “BP is 138 on 90, heart rate is 62 but irregular, sats 100 percent on 100 percent. Let’s get him out of here.”

  The ambulance’s engine gunned.

  Elvis groaned and turned his head. I heard his breath wheeze out of his lungs.

  “It’s okay, buddy, we’re going to take you to the hospital,” said the male paramedic as they loaded him into the back of the ambulance.

  “You want me to ride along?” I asked, already poised to hop in the back. It’s not uncommon for Montreal doctors accompany paramedics on their shifts. I think it’s actually part of the five-year emerg program.

  They exchanged a quick look. The male paramedic shook his head and said, “He’s stable. It’s only a few minutes to University College Hospital.”

  The woman said, “What’s your name again?” Her voice echoed inside the ambulance’s walls where she crouched over Elvis, checking that his vital signs were stable. I could see his heart tracing, still on the bradycardic side, but as long as he had a pulse with it, his brain would still function.

  “Sze.” I spelled it before I gave up and said, “Think of the letter C.”

  “I’m John Tucker,” called Tucker. “We’re both residents at St. Joseph’s.”

  “Thanks!” said the male paramedic, who was already closing up the back of the ambulance and jogging the driver’s seat.

  The ambulance screeched away with its sirens flashing. A police car followed it for good measure.

  Chapter 7

  “Man!” said Tucker, shaking his head. His pupils were still dilated. “Bet you weren’t expecting that one!”

  I shrugged.

  Tucker punched me lightly in the arm. “No way you expected that.”

  “Well. I’m kind of a paranoid person. That’s why I went into medicine. I always think of the worst thing possible.”

  “That wasn’t the worst thing. We saved his life! High five!”

  “It was a good thi
ng you came along. Thanks,” said Archer, before I could slap Tucker’s hand. Close up, I could see beads of sweat on his forehead. His eyes were a little close together, but something about his face reminded me of Elvis. “Could you meet us the hospital?”

  “You bet,” said Tucker, beaming.

  “Happy to,” I said, more gently. And then Archer elbowed his way past the news reporters and climbed in the truck, so Tucker and I backed out of the way, watching them nose their way back off the quay and into civilization.

  I turned to ask Tucker the best way to the University College Hospital, which I’d heard of but never visited, but one of the news reporters stepped in front of Tucker. She was a rail-thin brunette with artfully curled hair. “Did you say you’re a doctor?”

  “Yes. We’re both resident doctors at St. Joseph’s.”

  “Would you mind saying a few words on camera?”

  While Tucker hesitated, and I fumed to see her batting her highly made-up eyes at him, a voice behind me said, “Nice work, Dr. Sze.”

  It was another TV reporter, a man with a light French accent. He was older, with lines across his forehead, and he was wearing a blue shirt and dress pants, but it was the way he was studying me that made me a little uneasy. That, plus the fact that he’d actually pronounced my name with a little “Ts” sound, closer to the Chinese pronunciation. Either he had bat ears and had overheard me telling the paramedic my name, or he already knew who I was.

  The cameraman pointed his lens at me. A microphone guy held the boom above our heads. The reporter said, “It’s not every day we get to see you save someone’s life.”

  I thought he worded it kind of oddly, but maybe it was just because he was French. I said, “Um, thanks.”

  “My name is Jonathan Welzer. Would you permit me to interview you on camera?”

  I shook my head and kept my mouth shut. I’d steadily avoided the press since the last two murders.

  “That’s a shame, Dr. Sze. Perhaps we could speak off-camera?”

  I didn’t trust Jonathan Welzer. Just the way he said my name, he recognized me as the most notorious doctor (or at least resident doctor) in Montreal. He seemed a little too clever for a reporter, like he’d lead off about the weather and somehow get me chatting about how I’d nearly been beaten to death. “No, thank you.”

  “Bon. Maybe another time. I’ll be seeing you around, Dr. Sze.” He smiled faintly at the similarity in sound between Sze and “see,” not unlike Dr. Huot in the palliative care ward, just—was it yesterday?

  I held my hand up in a firm farewell. “Goodbye, Mr. Welzer.” The only thing I liked about him was that he, too, had a weird last name. There’s supposed to be a Facebook group for people like us.

  I walked over to wait for Tucker, while he wound up his own interview. That reporter was smiling away, showing off her dimples, and staring into his eyes.

  Tucker said, on cue, “Of course, I couldn’t have done it without Dr.—”

  I drew a line across my throat and shook my head fiercely at him. I’d just refused the spotlight, and now he wanted to share his?

  “—ah, my doctor training, my education to become a full-fledged physician, through the McGill University system.” He paused and brightened. “I only hope that future students can benefit from the same education I have. When the Quebec government threatens to raise university tuition, it means that lower income students won’t be able to afford medical school. I know I’m not part of the top one percent of income earners.”

  The reporter pulled the microphone back. “Are you saying that you are part of the 99 percent, like the student protesters currently occupying Square Victoria?”

  “Yes, I am.”

  I fidgeted. I, too, sympathize with the plight of students everywhere, but I wanted to hoof it to the University College, not preen for reporters.

  “So you support the Occupy Montreal movement that has been gaining strength over the past two weeks?”

  “Absolutely,” said Tucker. “I’d head over to Square Victoria now, if we weren’t on our way to the hospital.”

  “Well, there you have it,” said the reporter, turning back to the camera. “Dr. John Tucker, a resident doctor at St. Joseph’s Hospital. One doctor who cares enough to save the life of Elvis the Escape Artist—and who cares about local students, too. You heard it here first on CBMT.”

  She shook Tucker’s hand. He made his way over to me, still smiling, and said, “How’d I look?”

  “Like you were enjoying your close-up,” I said. “Thanks for not roping me in.”

  He swiped his hand through his bangs. “Yeah, I thought it was good to push it to the Occupy Montreal movement. You notice that she wrapped it up pretty quickly afterward.”

  I watched the reporter talk on her cell phone and signal the cameraman. “You know that they’ll probably cut your segment.”

  “Probably. It doesn’t have anything to do with saving Elvis’s life. But at least I got to say my piece.” He checked his watch. “Speaking of which, you want to head over to University College?”

  I nodded. “Do you think we could take the bus or the métro? I don’t have the cash for a taxi, though, unless we stop at a bank machine.” The entry fee had wiped out my meager supplies.

  One of the McGill girls, one with close-cropped blonde hair and a bright pink jacket, tapped me on the shoulder. “That was so amazing, what you did!”

  “Yeah, really!” said the brunette who’d checked the lock on Elvis’s chains. She stood a little too close to Tucker for my liking. “And what you said about the 99 percent? So true.”

  Tucker gave her a crooked smile. “Thanks. Actually, we’re heading to the University College to check on Elvis.”

  “I heard!” chirped the brunette. “Need a ride? My name’s Brittany. I’ve got a Smartfortwo just a few blocks away. I can only take one passenger, though.” She didn’t even bother to glance my way, just focused her wattage on Tucker while I steamed like a rice cooker.

  Tucker stifled a laugh. “We’ll figure something out. Thanks, Brittany.”

  When we headed north, I heard Brittany and company twittering about the cute doctor and how amazing he was, and I could feel the reporter’s eyes drilling into my back.

  A mere 30 minutes later, we hopped off bus number 165 and Tucker’s phone vibrated. He glanced at it and smiled briefly.

  “Is it your sister?”

  “Not unless she’s morphed into Brittany. She tracked down my Twitter account and DM’d me.”

  I forced myself to stay calm instead of gnashing my teeth. Even when I was a kid, I didn’t play well with others. “Yeah? Are you going to friend her?”

  “That’s Facebook.”

  “You know what I mean!” I don’t have time for Twitter and Tumblr and crap like that, and my Facebook account is a bit of a ghost town, except I like to look at people’s pictures.

  He smiled and shrugged. “She’s following me.”

  “She sure is.”

  “Glass houses,” he said, looking straight at me with those disconcerting brown eyes.

  My cheeks reddened. Ever-torn between him and Ryan, I knew I was in no position to catapult stones, but I found it extremely ungentlemanly of him to point it out. “Okay, okay. Should we call a truce?”

  “Mm, yeah. Honey.” He smacked his lips.

  I gave him a weird look. Was he calling me honey?

  “You know that saying, ‘you catch more flies with honey than vinegar’?”

  “Yes, but I never understood it. Who wants flies?” I said, and we headed north, up the slope of the hill toward the University College.

  The exertion reminded me of my first night in Montreal, just before starting residency (and investigating my first murder). I’d crashed in a call room at the Royal Victoria Hospital. The Royal Vic looked like an old stone museum, grey and cold and dignified, with turrets capped by copper roofs, but it was also wedged into the side of Mount Royal. Obviously, Montrealers loved cramming their hospitals
into mountaintops.

  Tucker kept pace with me, bouncing along on annoyingly long legs. He checked his phone again and grinned.

  I refused to rise to the bait. “Do you think you got enough footage of Elvis?”

  “Oh, man, I hope so!” And then he was off, chattering away, and hopefully distracted from Brittany’s tweets. “…because if Houdini were still alive, you know he’d love all the technology we’ve got today. I can’t even imagine what he’d do with it.” He stopped to text. I stood there, with rain dripping off my face, before I said, “Well, I’ll see you in the emerg” and started walking again.

  “You’d be better off sticking with me,” he called to my back. “I’ve got a friend who can get us in.”

  I waited for him to catch up, ignoring his grin. “Why should we wait? We’ve got permits to practice at any of the Montreal teaching hospitals.”

  “Yeah, but he’s not officially our patient. I’ve got a buddy on trauma, though. He says he can let us in for a few minutes.”

  Tucker directed me through the labyrinth of hospital corridors to the students’ room and then the OR, so we could drop off our jackets and borrow a pair of scrubs, the better to fit in. Tucker decided to keep his backpack on, though, just in case someone decided to pinch his SLR camera.

  Then we made it down to the ambulance bay of the emergency room. If I thought St. Joe’s was cramped, University College Hospital had trumped us. Patients on stretchers lined up and down one single giant room like dominoes side by side. A white board under the windows named each stretcher and patient, but an old man in the corner groaned like he was getting punched in the stomach and a disheveled, unshaven guy sat up on his stretcher and bellowed, “I’m a-goin’ home!”

  “No, you’re not, Perry. Just lie down,” said a round-cheeked, twenty-something blonde briskly, before she turned to us and said, “John Tucker, is that you?”

  “In the flesh,” he replied, but just then, he also caught sight of his trauma friend. “Oh, hey, Fadi!”

  They exchanged brief greetings in Arabic and clapped each other on the shoulder before Tucker introduced me.