Ignorant Thicket, Part 3

I am cursed. That is the only explanation I have for why we are running our third call in Ignorant Thicket in less than 24 hours. Somehow, I have offended the EMS Gods, and they are punishing me for my transgressions.

It’s just past 7:00 pm, and the sun is already down. The strobes are making those weird flashbulb patterns on the pine trees. I know an epileptic medic back in north Louisiana, and I wonder briefly how he deals with the strobes and rotating lights. I idly lean forward and flip a phantom switch on the console, and a huge strobe mounted somewhere on the grill starts flashing. It’s incredibly bright, bathing everything in front of us in a harsh white glare. I trade a look with Lasson.

“How long has that strobe been there?” I ask.

“Ever since I started working up here with you,” Lasson shrugs. “I never knew it worked.”

“Neither did I. The switch wasn’t labeled,” I point out.

“You know,” Lasson says, “I once had a jumpsuit like that. I wore it for six months before I found all the pockets. Seemed like every time I reached for something, I found a new one.”

The call was dispatched as a generic “unknown medical emergency,” which in Ignorant Thicket means it will be a demonic possession, a toddler swallowed by an alligator, or some redneck with his penis caught in a bear trap. Whatever we find will be memorable, of that I am sure.

The address to which we were dispatched turns out to be a house trailer on stilts on the banks of the Shit Creek. The stilts are tall enough that whoever lives there parks his truck and bass boat under his house. This person apparently recycles his empty beer cans, tossing the empties out of the sliding patio doors at the rear of the trailer. It’s quite an impressive mound, at least seven feet tall. There must be ten years’ worth of empties in that pile. Then again, this being Ignorant Thicket, it might be a week’s worth.

Lasson and I leave the stretcher on the ground, hoping fervently that our patient is ambulatory. We don’t have a stair chair, and until now I really haven’t seen the need for one. We grab our equipment and lug it up the steps. For once, there is an immediate answer to our knock on the door.

“Come on in!” a man calls. Inside, there is a slovenly man lounging in a recliner, television remote in hand. He is wearing a tee shirt emblazoned with a silhouette of a revolver and the words Gun control means hitting your target. He jerks his thumb toward the hallway. “Inna back,” he grunts. “My momma’s sick.”

Lasson and I squeeze past his chair with our gear. He makes no move to get out of the recliner, or even to lower the footrest to make room. In the rearmost bedroom of the trailer, there is a fat woman lying in the bed with her head propped up on so many pillows that her chin is touching her chest. There is a puddle of vomit on her flannel nightgown, and she’s doing the death rattle, every breath a gurgling heave for air. The stench of alcohol on her breath is overpowering. She has a home nebulizer machine lying on the nightstand, and an impressive array of pill bottles scattered around.

I jerk the pillows from under her and tilt her head, and her breathing improves only a little. Lasson curses and sprints for the rig to retrieve the one piece of equipment we left downstairs – the suction unit. I try to rake vomit from her mouth with my fingers, but there’s not all that much in there. While I am waiting on Lasson, I grab a BVM and bellow for the man in the living room.

Jesus Christ! Didn’t we just run this call?

“Sir!” I yell. “Could you come in here please?”

I start ventilating the woman as best I can, considering I am wedged between her and the headboard on a full-motion water bed. I wind up folding one leg lotus-style and propping her head across my knee, holding a mask seal with both hands and squeezing the bag under my right arm. Maybe every other ventilation goes in. The man strolls into the bedroom and props a hairy arm on the door frame.

“Yeah?” he asks. I look at him expectantly, but he just gives me a blank stare in return, as if it’s nothing unusual to see a total stranger performing artificial ventilations on his mother.

“Uh, you want to tell me what happened?” I prompt. I feel the entire trailer shudder as Lasson pounds up the steps.

“I put her to bed about five,” he says. “and then I couldn’t wake her up for supper, so I called y’all.”

Lasson bursts into the room past him and hands me a suction catheter, already attached to the unit. I stop ventilating briefly to suction, but get precious little fluids out.

“You called Podunk Ambulance, or you called 911?” I ask.

“Podunk Ambulance,” he answers. “She has a membership.”

Well, that explains why Ignorant Thicket Volunteer EMS isn’t here. Dispatch didn’t bother calling them.

“So she’s been this way for about two hours?” I ask. “What kind of medical history does she have?”

“Naw, since five this morning,” he corrects me. “We were up all night celebrating my birthday.”

I have run this call before. She’s been lying here for hours.

“Well, how was she when you put her in the bed?”

“About like now,” he gestures toward the bed. “We killed about a fifth of Crown Royal between us,” he adds proudly.

How touching. There’s nothing that says ‘I love you’ better than matching your grown son, drink-for-drink, to celebrate his birthday. Apparently she wanted to show him she could still drink him under the table, just like when he was a little sprout.

“You were telling me about her medical history?” I prod.

“Shit, I don’t know,” he shrugs. “She got lotsa problems. All her medicine is right there,” he says, pointing toward the table.

Lasson hands me a laryngoscope and an endotracheal tube, and starts gathering the medications from the table.

He’s reading my mind. Befor
e I can ask for something, he’s already got it done.

I quickly intubate her and inflate the cuff on the tube. I bag gently as Lasson auscultates her chest and epigastrum. He nods in affirmation.

“You’re in,” he tells me. “Lungs sound like she’s aspirated a lot, though.”

“Well, let’s get ready to move her,” I tell him.

I begin pulling the fitted sheet from the bed while Lasson puts her medications in a plastic bowl that, unless I miss my guess, was a Cool Whip container in a previous life.

“Bronchodilators, potassium, oral diabetic meds, Lasix and Prilosec,” he tells me.

Well, that tells me enough. She’s got asthma or COPD, non insulin-dependent diabetes, and maybe hypertension or CHF.

Lasson tosses the sealed bowl onto the bed, and we bundle the woman in the bed sheet. I look at her son.

“Sir, I need you to get one end of the sheet,” I direct. “We’re going to carry her to the ambulance on the sheet.” He holds up his hands and shakes his head.

“I got a bad back,” he protests. “I’m on disability.”

“Look, she needs to be in a hospital right now, and my hands are full. Either get one end of the sheet, or let her die right here. Your choice,” I tell him flatly. I don’t trust this cretin to bag her while Lasson and I do the grunt work.

“All right, all right,” he sighs heavily, grabbing the sheet bundled around his mother’s head. We move gingerly out of the trailer, bumping into walls and knocking over things, sweating and cursing, but eventually make it down to the stretcher. Miraculously, we’re all in one piece, and my tube is still patent.

We deposit the lady on the stretcher, and the man straightens up and groans, massaging his back. I have a hard time working up any sympathy. If there is any justice in this world, a fraud investigator just caught that on videotape, I think spitefully.

“Are you going to follow us to the hospital?” I want to know. He shakes his head.

“Naw, just have ’em call me,” he says, unconcerned. Without another word, he turns around and trudges back up the steps.

In the truck, Lasson checks a quick blood glucose, and the monitor reads “LO,” which for our machines is less than forty. Lasson gets out IV supplies while I open the drug kit with one hand. I toss a box of 50% dextrose onto the seat beside him. He gets a line quicker than I could have, and administers the D50. The woman doesn’t come around immediately, so he backs out of the rig, slams the doors and drives us back down the rutted, potholed road to the main highway. When he reaches the blacktop, he hits the lights and siren and puts the hammer down.

In twenty minutes, we’re at the hospital in Big City. Dr. Abrams, the physician who was on duty when I brought in the old man, greets us at the nurse’s desk. He’s usually an asshole to anyone wearing a Podunk uniform, which is understandable if not terribly professional. He’s the medical director for Corporate Greed EMS, one of our competitors. For some reason, Abrams usually cuts me a break. I suspect it’s because he’s a good friend of Samir Saleh, and because I let him know quickly that I would reciprocate any nasty attitude he had.

“Every time I see you, you’re bringing me an intubated patient,” he greets us gruffly. I grin at him, and give him the story. He listens patiently, then grunts, “Didn’t you just bring me this patient?”

“That’s what I was thinking,” I grin. “But this one is a female,” I point out.

“In Ignorant Thicket, how can you tell?” he replies. “Put her in Room Two, please.”

A few minutes later, I’m sitting at the nurse’s desk, drinking a Coke as I write my report. Abrams flops down in the chair next to me and touches me on the arm. “The old man died about an hour ago in the ICU,” he tells me. “I worked the code, but he was pretty much gone anyway.”

“What was wrong with him?” I ask.

“Subarachnoid hemorrhage,” he tells me, “plus the aspiration pneumonia, and sepsis too. Train wreck,” he concludes tiredly.

“And this woman?” I ask, nodding toward the room.

“Aspiration and alcohol toxicity, of course,” he rolls his eyes. “You want a square in the blood alcohol pool?” he asks teasingly.

“No thanks, Doc,” I chuckle. “Podunk doesn’t pay me enough to gamble.”

“Then quit and come work for us,” he replies, getting up from the chair and walking away.

Later, I tell Lasson about the conversation. “Abrams tried to recruit me,” I tell him. Lasson says nothing, just raises his eyebrows. “How much do their medics make?” I ask.

“I have no idea,” Lasson answers, “but if you quit and leave me alone at this fucking place, I’ll hunt you down and kill you in your sleep.”