“You want some ass?”
I cock one eyebrow and look around. Yep, she’s addressing me.
Now there’s a loaded question.
“I’m sorry, Amanda,” I apologize, “I didn’t quite hear you. What did you say?”
“I said,” she replies, rolling her eyes, “do you want some ass?”
Okay, so I did hear that right. So where are the hidden cameras? Or am I finally, after all these years of hoping and praying, being sexually harassed?
“Ummmm, I don’t really…”
Another eye roll. An exasperated sigh. “A. Piece. Of. Ass. Want any?”
It’s the Forbidden Fruit Syndrome. She knows I’m dating someone. That’s what has her hormones in a stir. Well, that and my rakish charm.
“Never turn down a free piece of ass,” advises Favorite Doc. “When you’re my age, you’ll only get it on Valentine’s Day and your anniversary.”
“Do you want a piece of this ass or not?” Amanda presses. She looks impatient.
“Um, well…that’s a very attractive offer, Amanda. And don’t think I haven’t noticed the way you look at me. Under other circumstances, I’d be all over your ass. That is, if we could find a room that locked. But, I’m in a committed relationship.”
“Hey, I was just trying to offer you some ass. For your coke.”
Huh? She makes $60,000 a year as a registered nurse. And she has to sell her ass for drugs? And why does she think I’d have any?
“Sorry, don’t need any ass at the moment. Can I take a rain check?”
“Screw you, AD. I’m throwing it out, then.” And she does, dumping her nearly-full cup in the sink.
“Ohhhh, you meant ice. You know, munching ice chips and talking with a Cajun accent can really be confusing.”
“Tell me about it,” observes Favorite Doc dryly. “I was insulted that she wasn’t offering me her ass. I’m a much better catch than you.”
“How’s the pain now? I ask the woman in Bed Four.
“Better,” she admits, “but still there. What was that stuff?”
“Toradol. It works like gangbusters when you give it IV,” I answer.
“It had better,” she grouses. “After you stuck me, I had to roll over and pull the sheets outta my ass. That hurt.”
Heh. I like this girl’s sense of humor.
“Sorry about that,” I apologize, “but the indignities are just about to begin.”
“What?” she eyes me suspiciously as I retrieve the stirrups and a speculum from a cabinet.
“Pelvic exam,” I answer. “Doc will be in here in a minute.”
“Shit,” she observes wryly. “No dinner? How about lighting some candles? Maybe some Barry White on the PA system?”
“No can do,” I chuckle, “but they have an accordion in the psych unit. I could serenade you, but I’d probably sound like someone molesting a cat.”
“And I won’t?” she retorts. “I’m the one getting a pelvic exam from Dr. Cold Hands.”
“What?” I ask, not all that concerned.
“That’s the third damned final report from yesterday alone that differed drastically from the preliminary read. These damned variance reports are driving me nuts!”
“If the Best Medical Student and the radiologist both see a lesion on the chest x-ray, there can be no lesion on the chest x-ray,” I quote. “Fat Man’s Rule #12 from the House of God.”
“These bastards will commit to nothing,” he fumes. “It may or may not be a lesion, which may or may not be significant, cannot rule out this without clinical correlation, suggest further studies for that…”
“Medical weathermen,” I nod sagely. “It’s the medical equivalent of ‘partly sunny, chance of rain’.”
“This ER Medical Director job is not worth this hassle,” he observes bleakly, staring at the stack of variance reports in front of him. “I didn’t think it would be this much work.”
“They can always hurt you more,” I commiserate. “Rule #8 of the – “
“Shut the hell up, AD.”
“Sure, whatcha got?” I ask him as he sits the guy down on the bed and begins checking vital signs.
“Anaphylactic reaction,” he says tersely. “His tongue is swelling and he says he can’t swallow.”
I duck into the med room and pull up a half-milligram of Epinephrine and fifty milligrams of Benadryl. By the time I walk back into Room One, LBMN has the guy on the cardiac monitor and is taping down the IV. I take a closer look at the guy, and notice something.
“Hey, LBMN?” I venture. “I don’t think this is anaphylaxis, dude. This is dystonia.”
“You think?” he asks dubiously. “Look how much his tongue is swelling.”
“It’s not swollen,” I point out, “it’s just sticking out of his mouth. Plus, he’s got the Gilbert Gottfried permanent squint going on. Vitals are fine. It’s a dystonic reaction.”
“Hey dude, you take something?” LBMN asks the guy. “No bullshitting now. It’s important.” The guy just shakes his head, no.
Rolling my eyes and mouthing “bullshit” to LBMN, I give the guy fifty milligrams of Benadryl in his IV. Not two minutes later, the guy’s tongue is back where it belongs and the squint is easing up.
Favorite Doc asks him, “Son, how are you feeling?”
“Much better now,” the guy answers, speaking clearly now.
“We were just eating at the restaurant,” his father chimes in, “and all of a sudden he told me ‘Daddy, my tongue is swelling up’. Do you think it was a reaction to something he ate?”
“Possibly, if what he ate included certain medications. Food doesn’t do that to you.”
“But, he doesn’t take any medicine!” Dad protests, confused.
“How about it, son?” FD presses. “What kind of medication did you take?”
“Can’t remember the name,” the guy mutters, refusing to meet his father’s eyes. “Some toothache medicine my homey gave me.”
“Painkillers don’t do this either, son. Now what was it?”
The guy doesn’t answer, just stares down at his feet.
“Wait a minute,” his father explodes, “you took some pill from one of your thug friends, and you don’t even know what it was? You stupid little sonofabitch.“
“Pay attention to your Daddy, son,” FD advises. “Sounds like he knows a stupid little sonofabitch when he sees one.”
“Shit, was that a run of V-tach?” I ask rhetorically as I sprint to Room Four.
“Well, now we know what those ‘seizures’ probably were!” LBMN calls to my back as he peels off to fetch the crash cart.
By the time we arrive at the bedside, Lanky Doc ho
t on our heels, the guy’s arrhythmia has broken. He looks up at us with a bewildered expression.
“Had another spell,” his girlfriend informs us unnecessarily.
“We noticed,” Lanky Doc says wryly, then turns his attention to the guy on the bed. “Trev, you just had an abnormal rhythm in your heart. It’s serious. That’s probably what you felt earlier before you came to the hospital.”
“How serious?” Trev wants to know.
“Serious enough that we’re not going to take chances with it,” LBMN answers as he rolls the crash cart into the room. He can’t get close to the bedside because LD is sitting at the guy’s right arm, working on getting another IV.
“Give him 150 of Lidocaine, and set up a drip,” LD orders, and LBMN hands me two syringes.
While I’m administering the medication and LBMN is still tearing open the envelope containing the adhesive defibrillation pads, the guy’s back arches, and his mouth snaps closed with an audible click.
“Urk,” he grunts, and reaches out and grabs my arm in a vise like grip. I look at Trev’s face, and there is a look of sheer terror there, and as I watch his eyes start to roll back. The telemetry monitor shows v-tach, rapidly deteriorating into coarse v-fib.
Shit.
Without really thinking about it, I raise my arm and bring the AD Hammer Hand of Doom (TM) crashing down on his chest. I mean, I really knock the piss out of him. He grunts again, and the rhythm converts back to sinus rhythm, albeit with frequent couplets of premature ventricular complexes.
Damn, it actually worked.
Trev’s eyes focus and his body relaxes, and he looks at me in utter shock and indignation. “Muhfucka just HIT me!” he complains to Lanky Doc.
“That was to restore your heart rhythm,” LD reassures him. “It was necessary.”
LBMN just winks at me as he sticks the pads to Trev’s chest. “First time I’ve ever seen that work,” he observes.
“First time I’ve ever done it,” I retort, “and I’ve been doing EMS for fifteen years. I’ve never had someone go into v-fib when I didn’t already have a defibrillator attached.”
Ten minutes later, the guy’s labs are back, and the cause of his arrhythmia becomes apparent. Trev’s serum potassium level is 2.2, critically low. I fetch 40 mEq of potassium chloride from the med dispenser and grab a bag of saline and an administration set, and duck back in the room to inform LD.
“He’s hypokalemic as hell,” I tell Lanky Doc, handing him the lab reports. “Glucose is through the roof, too.”
“So I see,” grunts LD. “Give him 40 of -”
“Way ahead of you, Doc,” I tell him, already setting up the drip and programming the IV pump. “LBMN, if you’ve got this, I’m outta here, dude. It’s almost midnight.”
“Yeah, get outta here,” he waves me off. “Thanks for sticking around.”
“Yo man, thanks for helping me,” Trev offers, extending his hand. “I never caught your name.” I shake his hand and grin, but LBMN answers for me.
“His name is Ambulance Driver,” LBMN chuckles, “but you can call him Fonzie.”
Aaayyyyyyyyy.
