Grooving towards you! Bearing swords!
A man dressed all in black, with a black and white keffiyeh around his neck, shouts out that Israel must pay, and that genocide must end. His eyes swarm about in a way that, from the corner of Jex’s eyes, seems off. She keeps walking, not taking the time to think more about it. She really wants to get to Molly before the song ends and, like any good punk song, it’s not very long. Time is of the essence.
Because anarchy isn’t just a fanny pack
With a Circle-A On it.
Not your Walmart Guy Fawkes mask.
We don’t need your poseur scene.
Jex spots the conga line of women again, about half way across the park, almost in the center. She pauses for a moment and considers heading back to meet up with them, convinced she will not make it to the DJ stand before the song ends. It seems like a much easier walk and the crowd seems to be largest and most rowdy around the DJ stand. Still, she thinks, she’d like to say hi to Molly and she knows Molly will be stoked to talk about the song. So, she continues onward as the song and the drums get louder and louder.
We will tear down those goddamn barricades
And show you what we mean!
When the first explosion hits, no one mistakes it for anything other than an explosion. The bang is like a cannon blast, and the ground vibrates. People are on the ground. People are in the air. Dirt and bricks fly around in a tornado of dust. Dirty paper floats up and down like big pieces of confetti. Trees are uprooted. Limbs are torn off. The Square sits in shocked silence, only the faint, robotic whirl of car alarms in the distance.
It is a child that begins to scream first. A woman’s cry follows. Within seconds, there is moaning and weeping and yelling. “Help!” squeals a nameless face. Someone else, some other anonymous voice, screeches out in pain. Smoke rises from close to the DJ stand. A chorus of other voices begin to crackle in a thousand individual tones. Pain. Fear. Anguish.
When the second explosion hits, thirty seconds later, all of these emotions strip away and melt together into one single emotion: panic. Sheer, mad panic. It is not intuitive, perhaps, to fear a second blast immediately after a first blast occurs. It is, however, much more predictable to consider a third blast after a second one. And so in these moments, there is nothing in the air but panic.
But not Jex. Jex is cool as a cucumber.
The Square is a mess and it is easy enough as a matter of practical triage to divide the mass of people into two groups: those who flee and those who shelter in place, including the immobilized injured. There are the dead, too, of course. But, at the moment, they don’t really matter. Only the living matter. And with her instincts now suddenly commanding her, it is the living to whom Jex tends. Even before the smoke clears. Even before the last piece of dirt falls to the ground. Even before anyone knows whether there will be a third, or even fourth explosion. Even before she knows whether any of her friends are OK, whether they are alive or dead. Even before all of that, Jex begins to tend to the living. She ducks those that are fleeing, and focuses on those she can identify as immobilized injured. She picks her first patient the old-fashioned way: she responds to the closest person screaming for help.
“Help,” the woman wails. “Help me, please.”
Jex blinks twice, rustles her hair with her hand, and in a small crouch, she jumps to the woman, who is sitting on the ground with her legs to the left side. “Hi, I’m Jex. What’s your name?” she asks in a firm, confident tone. There is no hesitation in her voice.
“Ann,” the woman says.
“Hi, Ann,” Jex continues, calmly. “What hurts?”
“Everything hurts,” the woman chokes out.
“I know,” Jex says patiently. “What hurts most?”
“My arm, sweetheart. My arm and my wrist.”
“Which side,” Jex asks.
“My left side.”
“Why don’t you stay seated, Ann, but put your legs in front of you. Can you sit up without supporting yourself with your hands or legs?”
“Yes,” Ann says, as she moves her legs around. “I think so.”
“Thanks, Ann. That’s great.” Jex continues to look at Ann’s arms and body, but does not yet touch anything. Jex reaches back in her head to the rescue medicine books she has read, and the course she took on mountain rescue the prior summer. Some things in life make fundamental sense to Jex, and in that way, they instantly become part of her internal memory chip. One of those things is ABC in a trauma situation: airway (is it open), breathing (are they breathing) and circulation. The point is simple: make sure the person you are examining gets enough blood into their body, or else hypoxia will set in, followed by cardiac arrest and that’s it. So, everything else is secondary to that.
A: Airways. Jex knows that the airway is clear simply by the way that Ann is talking. Check. B: Breathing. It’s not just a blocked airway that can affect someone’s breathing; many things can. So, Jex takes a moment to observe Ann as she speaks. She does not appear to be struggling abnormally for breath, particularly in light of the stressful situation, nor does she exhibit any clear signs of respiratory distress. Jex moves on with a silent check. C: Circulation. Jex takes Ann’s right hand. “That’s not the hand that hurts,” Ann says, protesting slightly. “I know,” Jex says in a reassuring but still firm tone. “I’m just checking your circulation.” “Oh,” Ann says. “I’m sorry.” Jex doesn’t respond, but focuses instead on her work. She applies pressure to the fingertips, and then releases, watching the blood flow out and quickly in, demonstrating proper circulation. She checks her pulse with her hand on Ann’s uninjured wrist, with the stethoscope head placed slightly above. About 80 beats per minutes; on the high side but not unusual in a stressed situation. She looks carefully at Ann’s face, hands and fingers; not unusually cold or discolored. Circulation: check.
“And can you tell me what happened to you? I mean, I know what just happened. But, what happened to you.”
“I was just standing there, I don’t even care about politics. I just saw all these people milling about, and I didn’t have nothing to do, so I just walked over, doing some people watching. Next thing I know there is some dang explosion over there.” She nods slightly with her head. “And it’s the loudest thing. I just bent over and put my hands over my ears. Next thing I know, there’s another bang and something hits me on the back of my head. Right here,” she gestures the a spot right above her neck. “That didn’t hurt none, but it made me lose my balance. I fell on my left arm. And now I’m here.”
“OK,” Jex says. She pulls her messenger bag over and pulls out an otoscope and a stethoscope. She wraps the stethoscope around her neck like a necklace.
“OK, Ann. First things first. I know you said that whatever hit you on the head didn’t hurt, but before we get to your arm, I just want to check you out and make sure your head is OK, OK?”
“OK,” confirms Ann, not particularly being in any place or mood to argue with the point.
“No pain?” Jex asks. “Headaches?”
“No.”
Jex takes the otoscope from the pocket of her hoodie and turns it on. “I’m just going to take a quick look in your eye, OK?”
“OK,” Ann agrees.
Jex points the light of the otoscope in both of Ann’s eyes. The pupil of each side constrict quickly when focused on the light. Good sign. Jex smiles, winks at Ann and moves on.
“OK,” Jex says. “I think your noggin is just fine.”
“Thanks.”
“Now, that arm,” Jex continues, looking at the left arm. It is beginning to swell from the wrist to at least above the elbow, under the hem of Ann’s dark t-shirt. “You’re going to have to go to a hospital, of course, but let’s just immobilize that thing a bit for now, try and minimize that pain.”
‘Oh, thank you,” Ann gushes. “It hurts so badly, all the way up the arm.”
“I understand,” says Jex. “Can you just bend your elbow a little bit for me?”
“Yes, I think so.” Ann moves the elbow so it is at almost a forty five degree angle. “Great. Let me just unhitch that watch from your wrist there, or else it’s going to swell up and hurt real bad. I can just stick it in your bag there, if that’s ok?” Ann agrees with a head nod. Jex removes the watch without resistance, and drops it into Ann’s handbag, which she is clutching with her healthy hand.
Next, Jex pulls a roll of cloth bandage out of her messenger bag. Sitting directly in front of Ann, Jex pulls out a long piece of bandage and rips it off with her teeth. She folds the cloth in half diagonally and forms a triangle. She folds the lower part of the bandage over Ann’s forearm. She brings the upper part of the bandage down over the upper edge of Ann’s shoulder, and then ties the two pieces together in a reef knot. Jex tugs at the improvised sling slightly, and nods in approval at her handy work. “How’s that,” she asks Ann.
“It’s OK,” says Ann. “Thank you very much. What did you say your name was?”
“My name is Jex.”
“Jex, thank you, but I will survive here. You should be using your skills with others who are more injured than me.”
Jex blinks. She looks around. It is a battlefield around her. She didn’t even notice; didn’t see it, didn’t hear it, didn’t smell it. Not when she was focused on Ann and what she could do to ease her pain. But now, the pungent odor around is overwhelming. As is the sounds of crying and screaming, sirens and roaring. Wailing and moaning. Gore everywhere. Jex blinks again and then stands up, shoving her otoscope into her bag.
“I gotta go, Ann. Please, just sit. There will be nurses or doctors or rescue people coming with more supplies. They will be able to get you to a hospital and get that arm checked out. And make sure you tell them about the hit on the head, even if it doesn’t hurt.” She squats down in front of Ann, looking her straight in the eyes. “Are you sure you’re OK?”
“Yes, thank you so much. I’ll be OK. I’m just shaken up.”
Jex touches Ann’s good arm, smiles and then goes. She looks around. Another woman approaches her, similar in age and body size as Ann. She has also injured her wrist by falling, just like Ann. Jex takes a third of the time with her. She runs a quick ABC test and satisfies herself that there is not a concussion or other serious head injury that needed assistance that minute. She focuses on the wrist and, with just a moment of examination, fashions another arm sling and fits it onto the woman. She barely waits for a thank you before turning to head closer to the DJ stand, where the turmoil seems to be focused. She looks for those in pain.
It doesn’t take long. It is a young girl, maybe thirteen or fourteen. She is covered in dirt and is absolutely petrified. Her words are barely making sense and she is shouting them out to nowhere. There are a bunch of “helps” and “pleases” in between the indecipherable stuff. She must see the stethoscope around Jex’s neck because she beelines right towards her. There are more “helps” and pulls at Jex’s arm. Jex tries to to start some kind of dialog, but it quickly becomes clear that she is not looking for herself. There is someone nearby hurt much worse than her. “Show me where,” Jex says once she figures out what the girl is saying. The girl spins on her heel and is off, with Jex firmly attached to one hand. Jex follows with no hesitation.
The two travel through a hundred feet of humanity. There are people lying on the ground, covered in blood. Jex sees a woman wrapping a cloth around the upper arm of a man who appears to be missing the lower part of that arm entirely. The smell is the most remarkable thing, something Jex will never forget. It smells like sulfur and burning skin.
They arrive at the edge of the sidewalk to find a man, late thirties, in a blue polo shirt and khakis sprawled out on his back, staring up at the sky. His eyes are wide open. His arms lie flat on either side of him with their palms down, and his toes are pointed straight up. He glistens with sweat underneath the afternoon sun. The girl that sought out Jex kneels down behind her silently, terror in her eyes. There is so much darkness and death around, it is hard to remember that the sun still shines.
Jex squats on her knees next to the man. “Hey there, what’s your name?” she says, taking his hand and holding it in his. “Is this OK if I hold your hand like this?” It is clammy and cold to the touch.
The man doesn’t answer. He does not move his head, but his eyes slowly turn from where they were looking, into nothing, and shift towards the rough general area where Jex kneels. He does not speak or seem to clearly acknowledge Jex’s existence. The girl, frozen silent before, now begins to speak frantically.
“We were just standing there, reading everyone’s signs, and a bomb goes off. It knocked us both over, but I didn’t see any blood or anything. When the second explosion or whatever went off, we were on the ground. I don’t know, he’s not bleeding or anything. I don’t know what to do. Can you help us? Can you help him?” She turns away from Jex and turns to the man. “Daddy, this woman is going to help you.”
Jex puts her hand on the girl’s shoulder. “What’s your name?”
“Alyssa.”
“Ok, hi Alyssa. I’m Jex. I’m going to do whatever I can to help get your father stable until a doctor or nurse shows up. I’m not a doctor or nurse but I have some medical training. I can help. But you have to calm down and back up a bit, let me examine your father and I will see what I can do.”
Jex’s voice is so smooth and her words are so considered, Alyssa has almost no choice but to calm down. She immediately backs up a few steps and mouths silently, “I’m sorry.” Her eyes are wide open, the fear and terror clear in them. Her father is injured. She doesn’t know what to do. Jex looks her in the eyes and says, “It’s OK. I know you’re scared. I’ll do the best I can to help your dad right now. Trust me.”
“Thank you.”
Jex nods and returns to the man. “What’s your name, sir?”
He doesn’t respond. “What’s your dad’s name, Alyssa.”
She stutters for a second and then says, “Bill Carter.”
“Mr. Carter, can you hear me?” She tries to look him straight in the eyes. He doesn’t look away but doesn’t seem to really focus on her either. He doesn’t respond verbally or with any facial movement. His face is pale, almost like a ghost. She puts her hand on the back of his head, tilts his head and lifts his chin. His airway seems unobstructed. She looks at his cheeks and put her ear to his mouth. His breathing is fast but shallow. She takes his wrist and attempts to take a pulse. It is faint, almost non-existent. With the noise behind her, Jex can’t really feel it at all. She pulls her stethoscope from around her neck but it doesn’t help much.
“Mr. Carter. I’m having trouble getting a radial pulse. The pulse in your wrist.”
“Oh, my God,” says Alyssa. “He doesn’t have a pulse?”
Jex looks up and stares Alyssa hard in the eyes. “Alyssa. He has a pulse. I just can’t get it because it’s too loud here. And your screaming when I have a stethoscope in my ears doesn’t help at all.”
Alyssa says, “I’m sorry,” with a start, perhaps not even realizing she had spoken.
“Mr. Carter,” Jex says, “I can’t feel the pulse in your wrist. I’m going to put my hand on your neck so I can try and take your carotid pulse, the pulse in your neck. Is that OK?” For the first time, he appears to try to provide a response, nodding his head just slightly up and down in agreement. Jex smiles.
“That’s great, sir. That’s just great.”
Jex puts her hand on the side of Mr. Carter’s neck and pauses there. “OK, it’s weak and it’s fast, but it’s steady.” She holds his hands and squeezes his fingertips, examining his hands closely. She pulls her otoscope from her pocket and looks into his eyes. She watches as his pupils dilate. “Good,” she says. “Good.”
“OK, Mr. Carter,” she pauses, and turns to Alyssa. “And Alyssa. Both of you listen to me. Mr. Carter, I think you are suffering from shock. That means we have to get some blood to your head and calm you down, but you’re going to be OK.” She focu
ses specifically on Alyssa. “He is going to be OK. I don’t know if there’s something internal that’s damaged or not, I can’t say that, only a doctor can, but for now I think the scary symptoms you are seeing are from the shock. We need to get blood to his head, and let him lay flat for now, OK?”
“OK?” Alyssa says, not knowing quite what this might entail for her.
“OK, great.” Jex says. “Here, is that your bag,” she says, pointing to a backpack lying on the ground next to her.
“Yes,” Alyssa says with a nod, and she grabs it, passing it to Jex. Jex quickly takes it and puts it under Mr. Carter’s feet, raising his legs by about 10 inches.
“OK, Alyssa.” Jex says. “That should help a little.” Jex opens her messenger bag and pulls out a bandana and a bottle of water. She douses the bandana with water, squeezes out some of it, and places it on Mr. Carter’s head. She looks up at Alyssa, her eyes big and wide, and holds out the bottle for her. “Here. Take this. Drink some. Try and get your dad to drink some. Grab a doctor or nurse when you can. The good news is he doesn’t have any external injuries. He is bleeding a little bit about the eye, but that’s no big deal. Here, grab that blanket,” Jex says, pointing at a blue blanket about ten feet away. Alyssa jumps at it and hurls it at Jex who catches it effortlessly, and wraps it around Mr. Carter’s body. “Keep him warm.” She turns back to Mr. Carter. “You have to stay warm for now, OK? You’ll be OK, but you need to get to the hospital.” She looks him in the eye. He nods softly and manages a little smile. In the tiniest of voices, he says, “thank you.” Jex smiles.
“OK, Alyssa, you’re in charge.”
Alyssa’s eyes grow wider. “You’re leaving?” she says in horror. “You can’t go.”
Jex grabs her by the hand and stares her hard in the eyes. “Alyssa, there is nothing more I can do for your father that you can’t do. Keep him warm, stay by his side until the EMTs or someone can get him to a hospital for a check up. But they will look at him just I did and they won’t find him to be a priority, because his vitals are stable. You might be here for a while but this is nothing you can’t do. Keep him warm, keep his legs elevated, make sure he drinks water and you drink some, too. You’ll be OK. OK?”
Jex Blackwell Saves the World Page 12