“Medic 333 copy, switching to ops 1,” came the response through her headphones.
“All right, ma’am, slow down and take a deep breath. You found a man who appears unconscious and there is blood… Okay, help is on the way and should be there in a couple minutes. I want you to stand to the side and wait for them to arrive… Uh-huh, that’s right… I will stay on the line with you until help gets there. You did great! They are on their way and almost there.”
Portland Fire arrived on-scene first and, locating Tony, did a quick initial assessment before beginning medical procedures to stabilize him while one of their crew calmed and interviewed the distraught witness. The ambulance operated by American Medical Response (AMR) was there only minutes later.
“Hey, guys, what do you have? What can I do to help?” asked the AMR paramedic.
“We have a fortyish male who the lady over there found laying on the ground next to his car. He’s vomited and reeks of alcohol. He’s got a large gash to his head and facial cuts and has been unresponsive. We did a manual c-spine, and he’s on a non-rebreather.”
“Did you get vitals yet?”
“Blood pressure is 260 over 140. Heart rate, 56. Respiration’s 12 but irregular. Right pupil is blown and he’s bleeding from the right ear.”
“Looks like a pretty significant head injury?”
“Yeah, that’s what I’m thinking.”
“Okay, then, let’s get him on the board.”
They carefully logrolled Tony and placed him on a full backboard. The fire crew securely strapped him down while the AMR paramedic started an IV.
“He’s still pretty unresponsive and his breathing is erratic,” offered the fire EMT. “What do you think about tubing him?”
“Good idea, but let’s do it in the back of the ambulance.”
“University COREL status is green,” called out the driver.
They put Tony on a gurney and quickly loaded him into the ambulance while the driver called in.
Tony’s vitals plummeted and he went into asystole, a type of cardiac arrest. A flurry of activity, including an injection of epinephrine, got his heart restarted.
“University, Medic 333. We are coming to your facility Code 3 with a fortyish-year-old male found down in a parking garage. The patient has an obvious head injury and was unresponsive upon arrival. Patient is 5 on the Glasgow Scale and is in full spinal precautions. He had a brief period of asystole, but return of pulse after 1 milligram epi. Last BP was 80/60. HR 72, and we are currently bagging him at a rate of 12 breaths per minute and preparing to intubate. We have an ETA to your facility of about five minutes, do you have any questions?”
“No questions. Administer 500 cc’s of mannitol.”
“Copy.”
“Dispatch, Medic 333 is transporting with two firefighters aboard.”
Siren howling, they exited the garage. It took less than five minutes to climb the winding hill to Oregon Health and Science University (OHSU), the hospital sitting like a gargoyle above the city. Wheeling Tony into the resuscitation rooms where incoming trauma patients are triaged, a crowd of doctors, nurses, techs, and residents converged and what ensued was orderly chaos, an intricate dance where each knew their role and expected participation. Rapid-fire questions punctuated the conversation with the first responders until the doctor in charge was satisfied, and the crew released to ease down from the adrenaline charge that usually accompanied such a call.
An initial CT scan and later CT angiography (CTA) revealed subarachnoid bleeding, as well as a brain tumor located in the frontal lobe. Hours later Tony was finally admitted to 7C, Neuro ICU, room 17. Attached to tubes and medical paraphernalia that both fed and kept him breathing, he was oblivious to being the center of so much attention.
Tony could feel himself drifting, upward, as if drawn insistently toward something with a gentle but firm gravitational field. It was more like a mother’s love than a solid object, and he didn’t resist. He had a fuzzy remembrance of being in a fight that had exhausted him, but now the conflict was fading.
As he rose, an inner suggestion emerged that he was dying, and the thought easily anchored itself. Internally, he braced as if he might have the power to resist being absorbed into… what? Nothingness? Was he merging with the impersonal all-spirit?
No. He had long decided that death was the simple end, the cessation of all conscious awareness, dust relentlessly returning to dust.
Such a philosophy had granted him solace in his selfishness. When all was said and done, wasn’t he justified in looking out for himself, controlling not only his life but also others’ lives for his benefit and advantage? There was no single right thing, no absolute truth, just legislated social mores and guilt-based conformity. Death as he viewed it meant that nothing truly mattered. Life was a violent evolutionary gasp of meaninglessness, the temporary survival of the smartest or most cunning. A thousand years from now, providing the human race survived, no one would know he had even existed or care how he lived his life.
As he floated upward with the invisible current, his philosophy began to sound rather ugly and something in him resisted, didn’t want to accept that when the curtain was finally drawn, nothing and no one had meaning, that everything was part of the chaos of random self-interest pushing and pulling for position and power, the best techniques manipulative and egotistical. But what were the alternatives?
On one specific day, hope for anything more had died. That stormy November morning, for almost a minute, he held the first shovelful of dirt. Standing in wind-driven rain, he stared down at the small ornate box that held his Gabriel. Barely five years old and hardly a breath, his little boy had fought courageously to hold on to everything beautiful and good, only to be torn from the tenderness of the ones who loved him most.
Tony finally let the soil fall into that abyss. Shattered bits of his broken heart tumbled in also, along with any remaining scraps of hope. But no tears. Rage against God, against the machine, against even the decay in his own soul, had not saved or kept his son. Begging, promises, prayers, all bounced off the sky and returned empty, mocking his impotence. Nothing… nothing had made any difference as Gabriel’s voice went silent.
With these remembrances his drift upward slowed and he hung in the inky blackness, suspended in a moment of question. If Gabe had lived, could that precious little boy have saved Tony’s pathetic existence? Three other faces flashed to mind, three people he had failed intensely and miserably: Loree, teenage sweetheart and twice his wife; Angela, his daughter who probably hated him almost as much as he hated himself; and Jake… oh, Jake, I’m so sorry, little man.
But what did any of it matter anyway? Wishful thinking, that was the real foe. The what-if, or what could have been or should have been or might have been, was all a sucking waste of energy and an impediment to success and in-the-moment self-gratification. The very idea that anything mattered was a lie, a delusion, a false comfort as one drifted toward the ax. Once annihilated, what remained of him would be the illusions of those still living, retaining temporary but fleeting recollections, bad or good, all momentary bits of a mirage that his life had significance. Of course, if nothing had meaning, then even the idea that wishful thinking was the enemy became absurd.
Since hope was a myth, it could not be an enemy.
No, death was death and that was the final word. But, he then mused, this could not be rationally believable either. It meant that death itself would have meaning. Nonsense. He shut out his thoughts as just ridiculous and incongruous wonderings to avoid embracing the irrelevance of an empty and futile life.
He was rising again and could see in the far distance a pinpoint of light. As it approached, or as he drew nearer, he wasn’t sure which, it grew in substance and intensity. This would be the locus of his death; of this he was now certain. He had read about people who died and saw a light but always considered it no more than the final firings of neuro-circuitry. The brain was greedy for one last, pointless grasp of any ve
stige of thought and memory, a desperate clutch at something as elusive as quicksilver in a calloused hand.
Tony let himself go. He felt caught in an invisible river, engulfed in an antigravitational wave that propelled his consciousness toward the point of brightness. Its brilliance increased until he had to turn his head, squinting to protect himself from the luminescence that both pierced and warmed. He now realized he had been cold in the grip of whatever was suspending him. But even while he turned his face away, something within him was reaching out, as if responding to an invitation inherent in this dazzling.
Abruptly, his feet scraped against what felt like rocky ground and his hands brushed against walls on either side. Smells of dirt and leaves filled his senses. Was he buried and looking up from the bottom of a grave? The terrible thought occurred to him, and corresponding fear instantly squeezed breath from his lungs. Was he not completely dead and mourners had gathered to pay their last respects, not knowing that he was in fact still alive?
The rush of alarm was brief. It was finished and he was being undone. He gave himself reluctantly to his end, folding his arms across his chest. The intensity of the light was so overpowering he was forced to turn completely away. The rush was terrifying and exhilarating. He was propelled into the dismantling fire and blinded by…
3
ONCE UPON A TIME
Some day you will be old enough to start reading fairy tales again.
—C. S. Lewis
Sunlight?
It was sunlight! How could it be sunlight? Any clarity of thought Tony had established disappeared in a rush of sensory overload. He again closed his eyes, letting the distant radiance warm his face and wrap his chill in her golden blanket. For a moment he cared about nothing. Then, like an impending dawn, the impossibility of his situation crashed his reverie.
Where was he? How had he gotten here?
Tony opened his eyes carefully and looked down, squinting to allow them to adjust. He was clothed in familiar old jeans and the pair of hiking boots he wore to navigate low-tide beach rocks at Depoe Bay. Tony had always been more comfortable in these clothes than the suits he wore to his daily grind. These boots should be in my beach house closet, was his first thought. They bore the recognizable scores from scraping against the ancient coastal lava along the Oregon seashore.
Looking around deepened his bewilderment. No clues indicated where he was or even when he was. Behind him lay the opening of a small black hole, supposedly the place from which he had been so unceremoniously ejected. The shaft looked barely large enough to fit through, and he couldn’t see a foot past its entrance. Turning back, he shielded his eyes against the sunshine and scanned the landscape spread before him, mentally cataloging his growing number of questions.
However he had come to this place, whether expelled, delivered, or propelled through the dark tunnel, he was now centered in a narrow mountain meadow strewn with wildflowers: orange agoseris, a scattering of purple anemone and the delicate whites of alumroot interspersed with the daisy-like yellow arnica. It was an invitation to take a deep breath, and when he did he could almost taste the scents, strong and savory with barely a touch of salt in the wind as if an ocean lay just beyond the range of sight. The air itself was crisp and clean, no hint of anything not native to the place. Below him lay the expanse of a huge valley surrounded by a range of mountains similar to the Canadian Rockies, postcard picturesque and panoramic. Central to the valley was a lake radiant with the early afternoon’s reflections. An irregular shoreline cast shadows into attending valleys and river feeders that were invisible from where he looked. Thirty feet in front of him the meadow vanished sharply and dangerously into a ravine, the floor at least a thousand feet below. Everything was stunning and vivid, as if his senses had been unleashed from their usual tethers. He breathed deeply.
The lea in which he stood was not more than a hundred feet in length, sleeping between borders marked by the precipice along one side and the steep mountain slope on the other. To his left its floral-colored patterns abruptly ended at sheer rock walls, but in the opposite direction there was a single path barely discernible and disappearing into the tree line and encroaching thickness of bushy green foliage. A slight breeze kissed his cheek and teased his hair, a waft of perfumed fragrances lingering in the air as if a woman had passed by.
Tony stood absolutely still, as if that would help quiet the storm inside his head. His thoughts were a cascade of confusion. Was he dreaming or insane? Was he dead? Obviously not, unless… unless he was completely wrong about death, a thought too disconcerting to take seriously. He reached up and touched his face as if that might confirm something.
The last thing he remembered was what? The images were a jumble of meetings and migraines, and then a quick jolt of alarm. He remembered careering out of control from his condo, clutching his head because it felt about to explode, and stumbling his way to the parking structure in search of his car. Being drawn toward a light was his last memory. Now he was here, with no idea where “here” was.
Assuming he wasn’t dead, maybe he was in a hospital, loaded with drugs that were trying to calm an electrical storm firing inside his brain. Perhaps he was caught in the backwash, creating unrealities in his own head, neural net connections of incongruent hallucinations collected over a lifetime’s expanse. What if he were sitting in a padded cell, locked in a straitjacket and drooling on himself? Death would be preferable. But then again, it was more than tolerable if comas or insanity delivered one to shores like this.
Another cooler wind bussed his face and he again inhaled deeply, feeling a wave of… what, exactly? He wasn’t sure. Euphoria? No. This had more substance than that. Tony didn’t have a word for this, but it clearly resonated inside like the dim remembrance of a first kiss, now ethereal yet eternally haunting.
So what now? It seemed that he had two choices, besides just staying in this place and waiting to see what came to him. He had never been one for waiting… not for anything. Actually, there were three choices if he included stepping off the cliff to see what would happen. He couldn’t help but grin as he shrugged that idea away. That would make for a short adventure; to find out he was not dreaming and not dead.
He turned back to the cave, startled to see that it had vanished, absorbed back into the wall of granite without a trace. That option removed, he was down to only one obvious choice, the path.
Tony hesitated at the trail’s beginning, letting his eyes adjust to the darker interior of the forest. He glanced back at the vista behind him, reluctant to leave its embracing warmth in exchange for this cooler uncertainty. Again, he had to wait while his vision corrected and he could see the trail dissolve into the underbrush not thirty feet ahead. The woods were chillier but not uncomfortable, the sun filtering through the canopy above casting shards of light that captured dust motes and occasional insects in its beams. Lush dense undergrowth hemmed in the rocky and defined path, which almost appeared as if it had been freshly laid and awaiting him.
He could smell this world, a mixture of life and decay, the piney dampness of old growth, moldy and yet sweet. Tony took another deep breath, trying to hold the scent. It was almost an intoxication, a remembrance of Scotch, similar to his beloved Balvenie Portwood, but richer, purer, and with a stronger aftertaste. He grinned, at no one, and plunged into the woods.
Not a hundred yards from where he began there was a branching of the trail, one to the right that inclined away, another that dropped downward to the left, and a third that went directly ahead. He stood for a moment considering the options.
It is an odd feeling, trying to make a decision about matters where not only the outcomes are unforeseeable, but the present situation is unknown. He didn’t know where he had come from, didn’t know where he was going, and was now faced with choices with no knowledge of what each might mean, or cost.
Standing suspended between options, Tony was struck by the thought that he had been here before. Not actually, but in some sense truly.
Life had been a long series of encountered choices, intersections, and he had bluffed his way to decisions, convincing himself and others that he completely understood where each would take them, that each was a simple extension of his own correct evaluations and brilliant judgments.
Tony had labored diligently to extract certainty out of option, to somehow control the future and its outcomes by exuding an aura of intelligent prophetic prescience. The truth, he now understood, was that eventualities and consequences were never inevitable, and marketing and image-making were the tools of choice to cover the disparity. There were always interfering variables outside the range of probability that muddied the waters of control. Creating the illusion that he knew and then bluffing became his method of operation. It was a grueling challenge to remain a prophet when things were so unpredictable.
He stood facing three choices with not one clue as to where each would lead. Surprisingly, there was an unexpected freedom in not knowing, the absence of any expectation that would eventually find him guilty of a wrong decision. He was free in this moment to pick any direction, and that autonomy was both exhilarating and frightening, a tightrope walk potentially between fire and ice.
A closer examination of each of the particular paths did not help. One might initially appear easier than another, but that was no guarantee of what lay around the next bend. He stood, frozen by the freedom inherent in the moment.
“You can’t steer a docked ship,” he mumbled, and took the middle path, making a mental note in case he had to find his way back. Back to where? He didn’t know.
Cross Roads Page 3