Chapter Eleven – Changes
The funeral procession snaked from the First Baptist Church, east down Main Street for two miles to the Interstate. By the time the two funeral coaches reached the on-ramp, the final cars in the procession were only just leaving the church parking lot.
Ryan rode up front with Tommy Bollinger in the lead coach, the one with Barbara Collins’ casket in the back. Attending her were Billy Fontenot and Mary Jo Barron, Gail Vetters and Jody Snell.
“Look at that, would you?” Ryan said quietly, nodding his head at the side mirror.
Tommy Bollinger looked up to see the procession streaming behind him for two miles, thirty-six ambulances and police cruisers following the funeral coaches, all with their emergency lights flashing. Bringing up the rear was an untold number of mourner’s cars snaking onto the Interstate, their headlights shining.
It was an impressive sight.
“Pretty damned sad,” Tommy mused, “When the best damned party a guy ever gets is after he’s dead.”
“Yep,” Ryan agreed. “So how have things been around here, Tommy?”
“Same old story; good ideas and no follow through. Dave handin’ out projects to one and sundry, then standing behind you tellin’ you how to do it until you finally give up and let him do it hisself. Then Dave complainin’ about how he cain’t never git anything done. Asked for new cardiac monitors a couple years back, so Dave told me to get some bids. I did, and we had sales reps fightin’ with each other over who could make us a better deal. Dave told ‘em he’d think it over, then turned around and bought six new computers for the office. Still got the old cardiac monitors.”
“You still working a truck?” Ryan asked.
“Naw,” Tommy grunted, “they made me a supervisor three years back. Got tired of babysitting that bunch, so they put me on a truck part-time, and I manage the supplies and the fleet the rest of the time.”
“Who are the supervisors now?” Ryan asked curiously.
“Me, I got the fleet and supplies,” he answered. “Mack’s the A-Shift supervisor, Royce has B-shift. Gail does education, when she wasn’t fightin’ with Miss Barbara because she refused to pencil-whip paperwork. Richard cain’t lift no more, so he runs the wheelchair vans. Mack’s wife Shannon is the Office Supervisor, Billy Fontenot’s the Dispatch Supervisor, we got a gal named Molly Peters as the Training Center Coordinator…”
“Who runs the Department of Redundancy Department?” Ryan chuckled.
“It’s a lot,” Tommy admitted. “So,” he ventured casually, staring straight ahead through the windshield, “how many of ‘em you gonna fire when you take over?”
“What makes you think I’m taking over?” Ryan asked carefully.
“Ty called a company-wide meetin’ fer this afternoon, right after the funeral,” Tommy snorted. “Ain’t hard to figger out.”
“Still doesn’t mean I’m taking over,” Ryan dodged.
“Answer the question, Hawkeye,” Tommy pressed. “This is me. We was partners fer six years, me and you.”
“Things are going to change, Tommy,” Ryan sighed. “They have to. Some people are probably going to lose their jobs. Who that is yet, I don’t know. One thing is for certain; we have too many people in the office, and not enough on ambulances. That will change, and right smartly.”
“Figgered on that,” Tommy grunted. “How much did you buy the place for?”
“None of your Goddamned business,” Ryan retorted good-naturedly. “How many people think they know what’s going on? Who’s been speculating?”
“Just the old timers,” Tommy assured him. “Me, Mack, and Gail mainly, and we’ve kept our mouths shut. None of the rest of ‘em knows that much about you. They’ve never met the man behind the legend,” Tommy ribbed him. Ryan refused to take the bait.
“Well, keep on keeping your mouths shut,” he ordered. “I want to meet with you three guys this afternoon, after everyone else has left.”
“Just the three of us?” Tommy questioned. “What about Shannon, or Billy Fontenot?”
“Have Mack tell Shannon to come too, but Billy is a problem I’m going to handle privately.”
In the coach behind them, Royce Trenton and Richard Chambless were arguing.
“I’m telling you, he’s sold out,” Richard insisted.
“Ty wouldn’t sell his parents’ company,” Royce assured him. “He knows what it meant to them.”
“He sold it to Ryan Pierce, and he’s gonna come in and clean house,” Richard said darkly. “You watch. We’ll all be out of jobs in a month.”
“You and your conspiracy theories,” Royce rolled his eyes in exasperation.
“Then why the big meeting after the funeral? What else would they be announcing?”
“Dude, you’re assuming Ryan would even want this place. I was there that day in the office when he stormed out. He ain’t coming back, believe me.”
“Then why did he quit his job at MetroCare, huh? Answer me that, smartass.”
“I hadn’t heard he quit his job. Where did you get that from?”
“You know that jackass that runs MetroCare?” Richard asked rhetorically, and Royce nodded. Everyone knew Roger Dickles. “Well, when him and that guy he had with him filed past the caskets, I heard Ryan lean over and tell him ‘by the way, I quit.’ I heard it with my own two ears. On top of that, he was on suspension for the past week. I ran into Mark Perry the other day and he told me.”
“You’re always full of gossip, Chambless,” Royce snorted, rolling his eyes. “Presuming the story is true, what was he suspended for?”
“Perry didn’t say,” he confessed, “but I can make a guess; Ryan being Ryan, what else? You know what an arrogant ass he can be. He thinks he’s so much better than everybody else.”
“That’s because he is so much better than everybody else,” Ricky retorted, “including the both of us. Ryan’s good, man. The best I’ve ever seen.”
“You’ve always been part of his fan club,” Richard snorted, “but just because his old man was some big shot doctor doesn’t mean he’s –”
“Shut up,” Royce cut him off, the warning clear in his voice. “Your ass is showing, Richard. Ryan Pierce never once traded off his dad’s name, and never once asked him for money. I had the room right next to his back when we both lived at the Mason Ferry station. If he ever even talked about his parents, I never heard it.”
“He’s a spoiled little rich boy who lives on a yacht. He’s arrogant and immature.”
“Don’t think I don’t know what this is about,” Royce snorted in amusement. “He took a laryngoscope out of your hand eight years ago, and you’ve had it in for him ever since. Instead of thanking him for bailing your ass out, you took it as an insult to your manhood. And you can’t let it go, even eight years later. If you ask me, Ryan’s not the immature one.”
“You won’t find it so funny once he’s gutted this place and pissed away everything Dave and Barbara worked for,” Richard warned. “Mark my words, it’s coming.”
“You know what I think?” chimed in Lila Rogers, sticking her head through the divider window between the box and the cab. “I think you two haven’t changed a bit. We’re about to bury the two people who gave you your start in this business, and all you’re worried about is how it will affect your paycheck. Do us all a favor by shutting up and showing a little respect for the next hour, okay?”
Ty and Trent Collins sat on opposite sides of the limo, each staring out their respective windows, lost in their own thoughts. They were as far apart as they could get, both literally and figuratively. Trent broke the silence first.
“You could have easily gotten six hundred thousand,” he accused, out of the blue.
Is that all he’s been thinking about? Ty wondered bitterly. How can I be related to this asshole?
Ty Collins shifted in the limousine seat to face his brother. “You going to come back and run this place, brother?” he challenged. “You’re welcome to it, but you can do it without me. I’m done.”
“I’m just saying you let Ryan take advantage of you, that’s all. You trusted him too much. He’s not family, Ty.”
More brother than you’ve ever been. He taught me to drive, taught me how to shoot…
“Mom and Dad always said everyone who worked here was family,” he said mildly.
“That’s just something they had to say to keep this bunch of misfits working,” Trent snorted derisively. “I always told Dad that if he hired better people – professionals – that such charades wouldn’t be necessary.”
“I like this bunch of misfits, Trent; I was raised around them. I just don’t want to lead them. Ryan can do that. He can run it the way Dad should have.”
“You’ve always looked up to Ryan, and you let that cloud your judgment, Ty. If you had just played this the right way, we could have –”
“Could have what, Trent?” he challenged, tears in his eyes. “Profited more from Mom and Dad dying?”
Trent said nothing, just stared at his brother openmouthed.
“Do me a favor, brother,” Ty said caustically, fairly spitting the last word. “When this day is through, I never want to see you again. I’ll send you your check when the deal is closed. After that day, you and I are no longer family.”
Tommy Bollinger and Royce Trenton parked the funeral coaches as close as possible to the gravesite. Given the ground still damp from the last week’s rain, it wasn’t very close. The pallbearers stood in ranks at the rear of the coaches, more or less at attention, waiting impatiently for the last of the funeral procession to arrive.
The plot was near the back of Memorial Gardens cemetery, and the rank of ambulances and police cars parked in its narrow lanes stretched all the way to the main gates. Most of the mourners who chose to attend the burial service had to park the cars along the shoulder of the road outside the main gate and walk in.
It took a while.
Ryan’s mind threatened to wander, and he occupied his time by scanning the crowd for familiar faces. To his shame, he recognized precious few.
Damn, have I been gone that long? I don’t even know half the people who are going to be working for me, much less the rest of the people who came to pay their respects.
There were twenty chairs arranged under the awning erected over the graves, and the Collins family and employees filled up all of those, with a few employees left standing in a rank behind them. The rest of the mourners had assembled in a loose crowd surrounding the awning, taking care to avoid other graves.
Ryan was struck by an incongruous thought: How do you pack a few hundred people into an almost full cemetery, and crowd them around a 20×20 foot area without stepping all over the other graves? What’s the proper etiquette? Is it okay to stand on the graves, as long as you don’t climb up on the headstones to get a better view?
The idea brought a fleeting smile to his lips, one which vanished almost immediately as Don Bailey gave a quiet command, and the rear doors to the funeral coaches were opened. Whether by luck or design, Ryan found himself taking a position directly behind Billy Fontenot as the pallbearers slowly carried Dave and Barbara Collins to their graves.
Ryan found himself a place standing in the rear rank of Collins Ambulance employees, and listened respectfully as the minister quoted Scripture, an unfamiliar passage Ryan struggled to identify. He found himself feeling a little lost, wondering what came next. The funeral director had been rather vague about what the pallbearers were supposed to do after they had placed the caskets over the graves. Or he may have explained it in detail. Ryan hadn’t been paying much attention anyway. In his mind, he was reliving another funeral entirely.
For all the death he had seen, Ryan had attended only four burial services; Ann Heflin’s, and those of Renee and his parents. All four were Episcopal burial services with their own rituals and traditions, rituals Ryan found comforting in their familiarity. The words themselves had meant precious little, because by the time the funerals had been conducted, he had long since said goodbye in his own way.
He barely remembered the funerals of his parents. He had mourned his mother, of that he was reasonably certain, and at his father’s funeral he had been unreasonably bitter, but the memories of both had been crowded into the forgotten corners of his mind by his sister’s death. Renee’s funeral, and the days preceding it, had been the elephant in the room, trumpeting for attention to the exclusion of all else. Ryan had been despondent and guilt-ridden, flagellating himself for not doing more, not having acted quicker, for not being more supportive in the first place…
After the burial, he had broken down and cried in great, wracking sobs, tortured with the belief that he had failed her. His father had laid a hand on his shoulder, trying to comfort him, but only Dawn understood that the failure in Ryan’s mind began years before the day he found her dead on the floor of that crack house in downtown Oneida.
She’s gone, son,” his father had said gently. “She’s been trying to die for ten years. Nothing you or I could do to stop it. You managed to postpone it for a week, but she got what she wanted. It’s not your fault.”
Something had snapped in Ryan’s mind, and he swung. The punch had caught Robert Pierce square on the angle of the jaw. His head whipped around like he’d been shot, and he dropped like a bag of cement. Ryan didn’t even remember the punch, only standing over his father with Dawn desperately clinging to one arm, begging him to stop. He hadn’t spoken a word to his father since.
The skirling of bagpipes startled him from his reverie, and Ryan unconsciously assumed the position of attention as an Oneida Parish firefighter dressed in the traditional kilt of the Great Scottish Highlands concluded the ceremony with Amazing Grace. Halfway through the first verse, Ty Collins broke down. He made no sound, but his shoulders shook with sobs. Ryan hesitated a moment, then stepped forward to his chair. Ryan put his hands on Ty Collins’ shoulders and kept them there until the bagpiper was through playing. He said nothing. He didn’t have to.
It gets easier, kid. It’ll fade. Crying over your parents is infinitely easier than wondering why you didn’t. Believe me, I know.
Ryan stole a surreptitious glance at the mourners. Trent Collins stared straight ahead, stone-faced. His expression was matched by that of most of the Collins Ambulance employees, only most of their eyes were moist. Billy Fontenot was sobbing openly, and Dawn had a comforting arm wrapped around his waist.
Ryan had no idea what to think, or feel, about that.
“So that’s it, then,” Ty Collins sighed in relief as he signed his name to the sale documents. Actually, the sale would not be official until the estate had been probated, but the signing of the papers lent some degree of finality to his decision.
“More or less,” Jeff Layton answered, pointing to the lines where Ryan and Trent were to affix their signatures. “Once we’re through probate, you sign the final sale papers and I release the money to you, less the repayment of the loan, at zero interest. You then send a check to Trent for his half, or I can divide the money equally between you.”
“Just send me my check,” Trent Collins said shortly. He looked around the room. “Anything else?” he asked with a snide edge to his voice. “Any other papers to sign?”
Everyone shook their head, no.
“Good, then I’ve got a plane to catch.”
He left without even pausing to tell his brother goodbye. Ty wordlessly watched him walk away, but Ryan could see the pain in his eyes.
Technically, the papers were an agreement with Citizen’s Bank and Trust to place $390,000 into an escrow account, with Jeff Layton as the escrow agent. A different sheaf of papers covered Ryan’s $60,000 loan to the Collins Ambulance business account, and made Ryan a required signatory to withdraw funds. A third document involved a Power of Attorney, empowering Ty Collins to act as his brother’s agent in the sale of Collins Ambulance, Inc. and all assets and liabilities attached thereto.
Jeff had assured them that probate would take roughly thirty days. Ryan had his doubts, but then he remembered that Jeff and his lawyers had been able to shepherd his father’s estate through probate in scarcely longer time.
Dave and Barbara Collins had no debt to speak of, thanks in large part to Ty, and no real assets other than their home and Collins Ambulance, a Louisiana corporation in which they had owned 100% of the shares.
The IRS lien was more problematic. Jeff had contacted a lawyer with the general details, and had been assured that he could negotiate a settlement substantially lower than what the government was currently asking, but it would take time. Six months, the lawyer had told him, and Ryan could expect to pay roughly sixty percent of the lien amount, and the specter of withheld Medicare payments would be forestalled while negotiations were ongoing.
Ten minutes earlier, Ryan had also privately ordered Jeff to pay the estate lawyers from his personal account, and had arranged for Ty Collins to be paid a salary of $1,000 a week as a “Transition Manager.”
“What the hell is a ‘Transition Manager’, and why is it worth a grand a week?” Jeff had snorted dubiously.
“I just made it up,” Ryan had grinned proudly, “but he’s basically a kid who has been working for his parents for chump change for the past ten years. He’s just as broke as you and I were at that age. He needs the money, Jeff.”
“And what will he do?”
“Hopefully, stay the hell away from the place and give me some freedom to evaluate things and start making changes.”
“How did he talk you into this, Ryan?”
“He didn’t talk me into anything. He doesn’t even know about it yet.”
Jeff Layton had snorted and rolled his eyes. He walked to the door and opened it, bowed deeply and said, “After you, Alphonse. Let’s get started on your trip to the poorhouse.”
“So how do you want to do this?” Ty asked nervously. “Should I make the announcement, or do you want to?”
“By now they probably know,” Ryan said gently. “It’s still your company, Ty. Your call.”
“I…I suppose I should break the news personally,” Ty decided, but his voice carried little conviction. “Like you said, I’m still the boss…at least, for the next month or two.” He paused, considering what he had said, and his eyes clouded over. His throat worked, and he said thickly, “I’m still the boss…Jesus Christ, Ryan, how did I come to this? I was never the boss of this place. My Dad was. I have no idea what to say.”
“Tell them what you told me,” Ryan suggested. “Tell them that your heart isn’t in it, and you need some time away.”
“Some of them aren’t your friends, Ryan. You know that, right? Not everyone is gonna be happy to hear this.”
“I’ll deal with those problems as they come. Don’t worry about me.”
“You can’t just fire the people that don’t like you, Ryan.”
“Who said anything about firing anyone?” Ryan protested. “You know as well as I do that some people are going to have to be let go, Ty. When I make those decisions, it’s going to be about what’s best for the company, not me.”
Ty stopped pacing and leaned forward, placing his hands on his thighs. He took a deep breath and slowly let it out. “God, I’m glad I won’t be around to see that,” he shook his head. “I’ve never had to fire anyone in my life.”
Neither have I, Spud. Come to think of it, your Dad wasn’t real good at it either.
Ryan traded a look with Jeff Layton. “Uh, about you not being around…” he ventured hesitantly. Ty looked up at him questioningly. “How are you fixed for cash?”
“Well, in another couple of months, I’ll have two hundred fifty grand. Right now, I have just enough to pay the rent and my truck note. I’ll figure something out.”
“That’s something I wanted to talk to you about. I’d like you to stay around here until the sale is final, if you don’t mind. You can help with the transition, and get paid to do it.”
“Thanks for the offer, Ryan,” Ty shook his head, “but when I walk out that door, I ain’t coming back. It’d be too weird.”
“So take a vacation. Bring your girlfriend and walk on a beach somewhere. The pay’s the same whether you’re here or not.”
“I’ve got so much to do here, and–”
“So you’ll be available by fax, e-mail or cell phone. Jeff knows some estate lawyers who can handle all the legal stuff. Take some time off, Spud.”
Ty Collins looked at Jeff Layton, who simply nodded.
“I’ve already arranged to pay for the lawyers,” Ryan explained gently, “and Jeff can arrange to have a thousand bucks a week direct-deposited into your checking account. Just let him know how they can contact you.”
“That wasn’t part of the agreement,” Ty protested weakly. “You don’t have to–”
“Go to all this trouble?” Ryan finished with a smile. He walked over and put his hands on Ty Collins’ shoulders. “You’re family, Spud. Always were.”
Ty’s eyes clouded over, and for a moment looked as if he might break down again. The moment passed quickly, however, and he squared his shoulders and looked at Ryan gratefully.
“Um, I don’t mean to break up a tender moment between family,” Jeff interjected dryly, “but wasn’t your company meeting supposed to begin five minutes ago?”
“Don’t worry,” Ty chuckled, dragging a sleeve across his eyes. “Dad never started a meeting on time either. They’re used to it.”
If any of the Collins Ambulance employees were still in the dark about the deal struck between Ty Collins and Ryan Pierce, those questions were immediately and unequivocally answered when Ty walked into the room with Ryan trailing closely behind.
Ryan saw it in their eyes. The facial expressions ran the gamut from shock and dismay to elation, but all of them said quite clearly, “Hawkeye’s back.” Tommy Bollinger winked slyly from the back row, leaned over and whispered something to Royce Trenton. Richard Chambless narrowed his eyes and folded his arms across his chest.
They know. And not all of them are happy about it.
“Thank you all for coming,” Ty stammered nervously, and then stopped cold, recognizing the inanity of the statement. They had just buried their employers not three hours before, and their new boss had called a mandatory company meeting. They could scarcely have done anything else.
“Especially those of you who are off-duty today,” Ryan furnished. “We know how precious your days off are. I think it reflects well on all of you that you came to pay your respects to Dave and Barbara today, and to give Ty your support.”
“Exactly,” Ty went on, flashing Ryan a grateful look. “Look, everybody…I, uh…I wanted to tell you how much I appreciate each and every one of you. Most of you have known me since I was a kid. All I’ve ever known is this place, and you people. Before Mom and Dad started Collins Ambulance, they’d park their MetroCare rig at our house. They’d get a call, and Trent would look after me until they got back. Sometimes it seems like every memory I have is sandwiched between ambulance runs…”
“We love you too, kid,” Tommy Bollinger rumbled good naturedly, instantly bringing tears to Ty’s eyes yet again. Tommy fixed him with a gentle smile, and went on. “But you didn’t call this here meetin’ to reminisce about old times, and Ryan ain’t standin’ there behind you just to be a visual aid. You brung us here to tell us somethin’, Ty. Might as well get on with it, son.”
Ty stared at him for a few moments, almost visibly pondering what to say. His jaw set, and he blinked his eyes to clear them. “Okay,” he shrugged, “I’m out, guys. That’s what this meeting is about. Mom and Dad invested their whole lives in this place, trying to make it work, and never quite succeeded. I don’t have the energy to try. So I sold the place to Ryan. The sale will be finalized sometime in the next couple of months, but as of right now, he’s your new boss.”
“Why Ryan?” Richard wanted to know, his lip curling. “Daddy’s money burning a hole in his pocket?”
Why do you hate me so much, Rich? I’d really like to know what it was I did that offended you so much.
“Let’s clear the air about that,” Ryan answered firmly. He swept the entire group with his gaze, but came to rest squarely on Richard Chambless, who was staring back at him with a defiant sneer. “The terms of the sale are not the topic of this meeting. More to the point, they never will be a topic of discussion. All you need to know is, we reached an amicable agreement – one that was fair to both parties.”
“Fair to you two,” Richard shot back in disgust, “but what about the rest of us?”
“What about the rest of you?” Ty challenged hotly. “What are you trying to say, Richard?” Ryan laid a quieting hand on his arm and shook his head.
“Why don’t you tell them why you came to me, Spud,” he suggested softly.
Ty Collins, his facial features darkened with barely controlled anger, clenched and unclenched his fists. He swallowed hard, and nodded. “I never really considered StatFleet or MetroCare, guys,” he explained. “We all know how they operate. They’d have probably made an offer, but you all know what they’d do as soon as the deal went through. They’d shut down two trucks and go right back to covering this parish with one truck again. Some of you would get raises for sure. The others, the ones they didn’t need, would be let go. Dad and Mom didn’t do business that way.”
“Are you telling us Ryan won’t do the same?” Richard snorted.
“Shut the fuck up, Richard!” Tommy growled. “Let him talk!”
Heads nodded around the room in agreement. Cowed, Richard Chambless slid lower in his seat and stared sullenly at the floor.
“No, I won’t do the same,” Ryan said evenly. “The way Dave ran this place will have to change. We have to do it leaner. We have to do it better. But I think we can do it without cutting trucks, or cutting salaries.”
“How do you plan to do that, Ryan?” Gail wanted to know.
“Well,” Ryan acknowledged, “that’s a good question. The answer is, I don’t know. I have a vision, but it ain’t firm enough to be called a plan. Over the next two months, I want each and every one of you to think about what needs to be changed around here. I don’t want impotent bitching. I want workable solutions. So, if you want to be a part of getting this place on sound footing again, I want to hear your ideas about fixing what’s wrong. I do have a couple things going for me that Dave never did, though.”
Everyone waited expectantly, waiting for Ryan to elaborate. When he didn’t, Royce Trenton hesitantly raised his hand and asked, “Uh…what things?”
“Money,” Ryan grinned, “and more money.” The answer got the expected chuckle, and Ryan went on. “You know who my old man was. Some of you know that we never got along. Well, as it turns out, he left me a sizeable chunk of money, much of which I’m willing to spend to turn this place around.”
In the corner, Jeff Layton’s face slowly turned a sickly green.
“The pale man over there is my buddy, Jeff,” Ryan laughed, “who hates hearing me say things like that. Jeff and I have known each other since we were kids. In addition to being friends, he’s also my banker. That makes him Collins Ambulance’s banker, and I think he’ll tell you that Collins Ambulance’s financial picture just improved immeasurably.”
Jeff Layton mopped the sweat from his brow and nodded gravely.
“Jeff’s job is to keep me from throwing my money down a black hole. This is a labor of love for me, but mark my words; Collins Ambulance will be profitable. I don’t need to get rich doing it. I’m already rich. I don’t intend to lose money here. I may never see my initial investment back, but I certainly hope to in a few years. The biggest asset any organization has is its people. Look at your budget, and the payroll records will reflect that.”
Someone in the back snorted derisively. Ryan ignored it, and continued.
“In business, you protect your assets,” he explained. “That’s you people. So my first order of business will be to evaluate our assets and see where they can best be utilized. Right now, I don’t think Collins Ambulance is making efficient use of its assets. That will change, and soon.”
“So what does that mean for us?” Gail pressed. “Are you going to lay people off? Cut salaries? What?” At that, Richard Chambless looked up at Ryan with a challenge in his eyes.
“Nobody’s going to lose their job,” Ty interjected hastily. “Nobody’s getting a pay cut.”
Goddamn it Ty, we didn’t agree to that, Ryan fumed inwardly. We’ve barely even made the announcement, and you’ve already sandbagged me.
“When I said ‘protect assets’, Gail,” Ryan explained gently, “that’s exactly what I meant. You guys are the biggest asset this company has, and I’m going to do everything I can to keep you here, and happy. What I’m saying is, I’m going to do my best to make sure this isn’t a labor of love for you. You stayed here for fifteen years when you could have made more money elsewhere. Tommy did the same. So did Mack. I don’t want you to have to choose between job satisfaction and better pay. I’d like to be able to provide both.”
“And yer gonna be able to do that… how, exactly?” Tommy wanted to know.
“I don’t know how, exactly. That will take me a little time to figure out. But some of it’s going to involve you changing the way you do things. Some of you may be moved around within the company. That’s all I’m willing to say right now, but I promise you that when I have a clear plan, I’ll share it with each and every one of you. You won’t have to guess where you stand with me.”
“Are you gonna hang around, Ty?” Royce Trenton asked. “You know more about running the business than anyone else here.”
“I’ll stick my head in the door now and then,” Ty blushed, sharing a sidelong look with Ryan, “and I’ll be in contact. But for now, I think I’m going to take a little vacation.”
“I wish you’d stay until the sale is final, Ty,” Gail pleaded. “I mean, at least until Ryan has his feet under him.”
Ryan said nothing, but as he looked out at the thirty-odd faces in front of him, he came to a sobering realization.
They don’t think I can do it.
An hour later, Ryan huddled with the three supervisors at a secluded table at the Cajun Café, long a favorite haunt for Collins Ambulance crews. Ryan drained the last of his Coke and idly pushed his pistolette around the plate. The silence was uncomfortable. No one wanted to be the first to speak.
“Okay Tommy,” Ryan said, almost casually. “Spit it out. I know all of you are itching to say something, so you go first.”
“All right,” Tommy Bollinger drawled. “I think you bit off more than you can chew. You got money to burn, Pardner, but you ain’t no businessman.”
“Dave was a pathetic businessman, and he made a go of it for fifteen years,” Mack Barron pointed out. “I think Ryan can make a go of it too, if we help him.”
“I’ll share something with you, Tommy,” Ryan said quietly, “and you damned well should have already picked this up from working with me for six years; I believe in picking good people, giving them the tools they need to do their job, and then getting the fuck out of their way.”
“Dave never did that,” Mack agreed. “You all know how he was. He wanted good people, but he wasn’t willing to pay ‘em enough. He never could understand that job satisfaction doesn’t pay the rent. I guess the five of us here are the only ones who ever bought into it.”
“Speaking of,” Gail challenged, “why weren’t Richard and Billy invited to this meeting? Why just us four?”
“Because you’re the ones I trust,” Ryan answered evenly. “You’re the ones I can rely on.”
“If you’re thinking about getting rid of Billy, I think you should –”
“He’s a good EMT, Ryan,” Tommy said quietly. “He’s done a good job as dispatch supervisor.
“And he’s also fucking Ryan’s wife,” Mack Barron said flatly, and Gail Sellers punched him in the arm. Undaunted, he went on, “What do you expect him to do, Tommy, just smile and work with the little weasel?”
Tommy Bollinger bristled at the rebuke, and soon he and Mack were engaged in a heated argument. Names were exchanged. Ancestries were questioned. Threats were made. The usual.
Ryan watched it for a few moments, and then winked at Mack’s wife, sitting across from him. Shannon Barron was watching the two friends bicker with a bemused, been-there, done-that expression.
“Don’t you love watching two macho rednecks vainly trying to mask their latent homosexuality?” Ryan asked. “Makes you wish those two crazy kids would just admit their attraction for one another and get it on.”
Shannon did a spit take, and Gail Sellers laughed gleefully. Mack and Tommy, faces red and angry, stopped in mid-argument and stared at Ryan incredulously. Tommy was the first to laugh.
“He’s not my type,” he lisped, batting his eyes coquettishly. “Even though I am a sucker for that porn star moustache.”
Mack chuckled and affectionately gave Tommy the finger.
“To answer your question,” Ryan said, turning serious, “I’m not going to fire him. Oh, I’d like to; I’d like to rip his fucking guts out. I invited him into my home, and he betrayed me by making moves on my wife. That’s a sin that cannot be forgiven.”
“But, I can’t look at this like a betrayed husband. I own a business now, and I have to run it with my head and not my emotions. And my head tells me that we don’t need a dispatch supervisor and two dispatchers working at the same time. We don’t have enough call volume to warrant that. So what to do with Billy Fontenot?”
“He gets his license back next month,” Gail pointed out quietly. “He could go back on one of the rigs.”
“You want me to put someone with judgment so poor that he drinks and drives, and gets caught doing it, driving one of my ambulances?”
“He made a mistake, and he learned his lesson. I seem to recall a couple of EMTs from this company who drove home from a Christmas party in a lot worse shape than Billy was when he got his DUI.”
Both Ryan and Mack blushed deeply at the rebuke. It was a miracle that they had not killed themselves, or someone else, that night.
“I’ll figure out what to do with Billy,” Ryan promised. “Let’s talk about Richard Chambless. What’s his problem?”
“Well, he’s been mad at you for eight years,” Mack answered, “but he’s been mad at the world, and Collins Ambulance in particular, for the last two.”
“Ever since he hurt his back,” Tommy agreed.
“I can’t believe he’s still holding a grudge over that damned code,” Ryan shook his head. “So why’s he so pissed at Collins Ambulance?”
“Says he hurt his back on the job,” Gail sighed. “He’s permanently injured, not cleared to lift anything over twenty-five pounds.”
“He never reported his injury, Ryan,” Shannon explained. “Those forms come through me. The first we ever heard of it was when we got the excuse from his doctor and the order for the MRI. That was six weeks after it supposedly happened.”
“Dave and Barbara disputed the fact that it happened on the job,” Tommy chimed in. “He shot hisself in the foot by not reportin’ it when it happened. So, no worker’s comp.”
“And then,” Shannon sighed, “Dave lets our employee health insurance lapse. Told no one about it, either. Richard runs up five grand worth of doctor’s visits and tests, and he only finds out he’s uninsured when the bills start coming back to him. It was ugly. We had several people stuck with big medical bills when that happened. Two of them quit, but Richard stayed. I guess Dave and Barbara felt guilty about it, so they gave him a raise and put him in charge of the wheelchair vans.”
“They’re lucky he didn’t sue their asses,” Ryan spat. “So, now Richard runs the wheelchair van service, which includes himself and three part-time drivers, and has yet to turn a profit. That about sum it up?”
“Pretty much,” Shannon reluctantly agreed. “Dave said it was a loss leader. We lost money on the wheelchair vans, but they made up for it by bringing us ambulance patients. Richard identifies a few patients every month that meet stretcher criteria; patients too sick or too heavy to ride in a wheelchair.”
“The wheelchair vans are going to go away, guys. We can’t sustain that operation. It’s pure dead weight.”
“So what happens to Richard and our other drivers?” Gail wanted to know. “You’re firing them?”
“How I’m going to accomplish that without leaving people unemployed, I’m still trying to figure out. But you’d better accept the fact that some people are going to lose their jobs, Gail. We’re bloated here. Dave ran this place for fifteen years like it was a jobs program for indigent relatives. That has to stop.”
Gail Sellers plainly didn’t like it, but she couldn’t dispute his reasoning. She took a sip of her tea and savagely stabbed her fork at a stray cherry tomato in her salad.
“For that matter,” Ryan continued, “your job in the Training Center is going to change.”
Gail’s head snapped up, and she started to speak.
“Hear me out,” Ryan cut her off, one hand raised to ward off the inevitable tirade. “Right now, you’re the Education Supervisor. Tommy says we have this Molly Peters chick as the Training Center Coordinator. We don’t need both of you, so Molly has to go.”
“It’s too much work for one-”
“- person to handle alone?” Ryan finished with a smile. “Look, Molly’s job is mainly clerical. She deposits checks and shuffles paperwork. You’re the one that actually does all the education. We don’t need an AHA Training Center. I know it was always a big feather in our cap, but lately the training center has gotten an unsavory reputation. I get complaints all the time about instructors from here not getting their course cards on time. I get student complaints, too. I always pass them off to another Regional Faculty, using the excuse that I have a bias against Collins Ambulance. Well, now I own that Training Center, and I don’t want it or its reputation.”
“That wasn’t Molly’s fault,” Gail said in defense. “She’d deposit the checks, but Dave ordered the cards – or didn’t order them, usually. He’d make Molly stall the instructors and students.”
“That’s because he was subsidizing the rest of the business with income from the Training Center. I’m not going to do that, but the damage has already been done. In a month, I’m shutting it down.”
“I’ll see Molly first thing Monday morning and break the news. She’ll have a month to look for a new job. In the meantime, she’ll be getting instructor records up to date and processing all the outstanding rosters,” Ryan explained. “On Monday, you call Cynthia Duplechain at West Oneida Regional Medical Center; she’s the head of the Education Department.”
“I know Cynthia.”
“Good. You tell her that we’re shutting down our TC, and we’d like to transfer all our instructors – the ones that are willing, of course – under her umbrella. That’ll double her cadre of instructors, and remove us as a source of competition. Tell her that we want to continue as an independent Training Site under West Oneida Regional. We’ll retain only the instructors you choose, and we already have all our own equipment. Cynthia handles all the administration, insurance and record-keeping, and you keep on doing what you do best – teaching. No interference from me, and less paperwork for you.”
“That sounds…good,” Gail agreed grudgingly. “And you’re sure Cynthia will agree to all that?”
“If she has any questions, you tell her to call me,” Ryan instructed. “Ask her to waive the affiliation fee for all our instructors for the first year. Have Molly start sending out letters to the instructors announcing the change, and be sure to tell them that West Oneida Regional will accept them all, free of charge.”
“Your only oversight will be me – another instructor – and you know I’m not going to ask you to pencil-whip anything. All you’ll have to do is teach. I want you to come up with an educational budget, and justifications for what you want. Don’t go nuts, but if there’s something you really think you need, you’ll get it. I also want you to start doing regular chart review and CQI, and build continuing education programs to address all the areas you think are weak.”
“I’m already doing that,” she answered, nodding at Shannon. “She pulls all the emergency run tickets, and I review them.”
“Good. Probably a better way to do it would be to flag certain call types or procedures. That’ll cut down on your workload. It may take you a few months to determine what criteria you need to define, but start working on it now.”
“The system will do that,” Shannon offered. “I can flag calls in God only knows how many ways. We just never used that feature.”
“If you had been flagging calls, just how many transfers do you think we do require mechanical ventilation, or say dopamine or nitro infusions? Or fibrinolytics, for that matter?”
“Hard to answer,” she mused. “I’d have to query the system. Offhand, I’d say five or six calls a month. Why do you ask?”
“Because all those calls qualify as critical care transport,” Ryan answered.
“And we get reimbursed a lot more for critical care transport,” Shannon nodded, catching on. “I like it.”
“Query your system,” Ryan ordered. “Monday morning, I’ll get you a list of the qualifying criteria for critical care transport. I’m betting we do enough of those runs a month to justify putting up a CCT truck.”
“And which one of our rolling pieces of junk do you think we’ll set up for that?” Tommy asked caustically.
“First things first,” Ryan admonished, holding up a hand to discourage further comments. He turned back to Shannon. “You do all the billing, right?”
“When I’m left alone long enough to do it,” she answered. “Dave had a tendency to – ”
“Lemme guess,” Ryan interrupted with a grin. “He’d walk into your office, settle into a chair with a big sigh, cross his legs, fold his hands in his lap and say…”
“Gotta little project for ya’,” everyone chorused, then dissolved into gales of laughter.
“Those words have struck fear into the hearts of every Collins Ambulance employee at one time or another, Shannon,” Ryan chortled, wiping tears from his eyes. “And he probably nagged you incessantly, nitpicked everything you did, and generally got in your way until you gave up in frustration, and then wound up doing it himself, right?”
“Right,” she chuckled.
“Well, I know damned little about billing. I know how much we should be getting reimbursed, but very little about the nuts and bolts. I need you to educate me on that subject, time permitting.”
“What’s our reimbursement rate?” Ryan asked indirectly. “I mean, percentage-wise, how much do we collect from Medicare versus what we currently bill?”
“Medicare and Medicaid reimbursement, maybe 60%,” she admitted, shamefaced.
“Why so low?” Ryan pressed. “At MetroCare, we were collecting at 90% of what we billed.”
“In a word, compliance,” Shannon answered. “Crews don’t get signatures, don’t document stretcher necessity, don’t get authorization forms completed…”
“Dave used to offer a bounty,” Mack offered. “Four bucks to each crewmember for a completed, fully billable run ticket. It didn’t work.”
“I’m not offering a bounty for crews to do their fucking jobs,” Ryan stated flatly. “They either get what Shannon needs, or they find a new place to work. I can understand not getting a signature or stretcher certification every now and then. But it shouldn’t be the norm.”
“And how are you gonna replace the people you fire, Hoss?” Tommy inquired. “Good EMTs ain’t exactly linin’ up to work here.”
“They will,” Ryan predicted confidently, “wait and see.”
Tommy raised one dubious eyebrow, but said nothing.
“Tell you what, Shannon,” Ryan offered, “if you get our collection percentage up to 90% in the next ninety days, I’ll fire you.”
“What?” Mack and Shannon Bryan blurted in unison.
“Relax,” Ryan chuckled. “If you can get our collections up to 90% of billable, I’ll set you up as an independent contractor. I’ll lease you three offices and the computer equipment, and pay you 10% off the top. Sound good to you?”
“Maybe. What’s the catch?” she asked suspiciously.
“No catch. You do whatever it takes to increase compliance from our crews. Gail and I will back you up on that. If you can increase our revenues by that 30% – and I think you can – I’d still be money ahead by paying you a percentage of the net revenue. Plus, I’d save the expense of your salary and health insurance.”
“Can I hire my own staff?”
“You can do whatever the hell you like,” Ryan laughed. “Like I said, you’d be a contractor, not an employee. You hire your own staff, and pay ‘em whatever you think is fair. Even better, I’ll pimp your services to all the other small, independent ambulance services around here. You could make a very nice living.”
“That I could,” Shannon breathed, mentally calculating 10% of Collins Ambulance’s yearly billable charges. A very wide grin slowly crept across her face. “All I’d need is one other person, and Molly Peters would be perfect. She already knows a little about the system.”
“Even better,” Ryan grinned. “That’ll make firing her so much easier.”
Across town, at the same time Ryan was laying out his plans to his trusted circle of friends, Billy Fontenot was staring at a plate of crawfish etoufeé, barely able to eat. “He’s going to fire me, first thing in the morning,” he predicted morosely.
“Hold on a minute,” Dawn interrupted. “Back up. You’re telling me that Ryan bought Collins Ambulance? My Ryan? That’s impossible, Billy.”
“Why impossible?” he asked bitterly. “He’s rich. You told me so yourself.”
“He never touched that money when we were together. He refused to even discuss it. I tried to get him to set up a healthcare trust and a college fund for Caitlin with some of it, and he refused. The closest he ever came was buying Ecnalubma with the money he got from selling his parents’ house. We took the other half of that money and set up Caitlin’s trusts.”
“Well, it looks like he’s gotten over his moral conundrum,” Billy observed sarcastically. “Next he’ll fire me, and then he’ll be trying to get you back. I don’t see why you wouldn’t go, either. He can give you everything you ever wanted.”
“Not everything,” Dawn disagreed. “I’m here with you, aren’t I?”
“Why are you with me, Dawn?”
“Because I love you,” she sighed. “That’s why.”
“Do you still love Ryan?”
“I always will in some way, Billy,” she explained gently. “I’ve told you that. When I first met Ryan, he was cocky, and arrogant, and…gentle. He had this sweet side that very few people saw, except maybe his patients. I saw that, and that’s what I fell in love with. But the last few years, that sweetness and gentleness…well, it went away. I haven’t seen it for a long time. That’s everything that I loved about Ryan Pierce, and it just isn’t there anymore.”
“Would you go back to him if it was?” Billy asked softly, his face betraying his fear.
“I’m here with you,” she replied. “There’s your answer.”
“That’s going to be very expensive,” Mack Barron was saying.
“Not so much,” Ryan disagreed. “Two servers at headquarters, and new workstations all around. Maybe ten or fifteen grand.”
“You throw out words like ‘maybe ten grand’ like it’s nothing special.”
“Oh, it’s my money, Mack. I know exactly how much I’m spending. We need new computers, period.”
“The new servers, plus two workstations for dispatch, two more for billing, one each for me and Gail, and set up three in the classroom. That’s nine.”
“Hell, we have more than that now. It’s a full time job just keeping ‘em running.”
“And why is that?”
“It’s a full time job because he’s always been half-assed about the way he does things,” Tommy answered for him. “We’ve got computers from five different manufacturers, running seven different versions of Windows, all strung together by some nineteen-year-old Emo kid posing as an IT geek.”
“Exactly,” Ryan emphasized. “I’d rather hire a professional to set up a top end office network, out of compatible machines running the same operating software, and maybe pay him a per-diem every now and then to come troubleshoot it, than pay Dave Collins’ nephew $32,500 a year to tinker with computers when he’s not attending a rave or pretending to go to class.”
“They paid that little fucker that much?” Mack asked incredulously. “That’s ridiculous!”
“They paid him that much,” Ryan confirmed grimly. “Now you’re starting to see what I meant about bloat. I figure I’ll spend another hundred fifty thousand just buying equipment for the office and the rigs. On the plus side of the ledger, I eliminate $100,000 a year in salaries just between Molly, Emo Boy, Shannon and a few others. I figure in two years, the equipment investment will have been recouped. That, of course, doesn’t count the cost of new rigs.”
“New rigs?” Tommy asked, brightening considerably.
“Yup, new rigs,” Ryan confirmed. “You run the fleet, Tommy. Why don’t you tell the rest of us what we paid McDaniel’s Automotive last year for repairs and routine maintenance.”
Tommy Bollinger fidgeted uncomfortably. “I didn’t have no control over that,” he rumbled, shamefaced. “I told Dave we was gettin’ gouged by that greasemonkey.”
“Tell them, Tommy.”
“I even shopped around for other mechanics. Found a couple that was real reasonable. But Dave wanted a mechanic on 24 hour call, and Mike McDaniel was the only one willin’.”
“Goddamnit Tommy, how much?” Mack flared, exasperated.
“Seventy four thousand,” Tommy mumbled, staring at the floor.
“Jesus H. Christ on a flaming pogo stick,” Mack groaned, propping his elbows on the table and cradling his head in his hands.
“It gets worse,” Ryan said grimly. “We’re talking $332.00 for an oil change. That’s each and every oil change, on every truck in the fleet, every 3,000 miles. He gouged us even more on brakes and tires.”
“Stop,” Mack begged. “I don’t wanna hear any more.”
“I could buy four brand new trucks, built to our specifications, with service plans and extended warranties, and the monthly notes wouldn’t be any more expensive than what we’re paying McDaniel Automotive,” Ryan told them all. “All it takes is decent credit, and folks…we have decent credit now.”
“So what kind of trucks are we getting?” Tommy asked, over the embarrassment now and warming to the idea of new ambulances.
“Remember that company we talked to right before I got fired?”
Tommy nodded. “Them little European lookin’ thangs.”
“You talking about those little vans FedEx uses now?” Gail asked.
“That’s them. Well, this company I was talking about now makes a box based on that same Sprinter chassis. Double the fuel mileage of anything you’ve got in the fleet now, and half the maintenance costs. That’s half of what maintenance costs should be, not what you’ve been paying. The trucks will pay for themselves over their life span, just in the savings from fuel and maintenance.”
“I like it,” Tommy grinned. “When we gettin’ ‘em?”
“As soon as you can contact their sales rep and work out the specs. We don’t need LED light bars and all that shit, Tommy. Get a list of must-haves, including equipment. Anything you consider a must-have, we’ll spend top dollar on. But I ain’t shelling out money for stuff we’ll never use or need.”
“So who gets to tell Mike McDaniel the bad news?” Tommy cackled evilly. “Please, please let me be the one to break it to him.”
“Be my guest,” Ryan chuckled. “And while you’re at it, I want you to contact one of those other mechanics you mentioned, and start shuttling the entire fleet through their shop, one by one. Anything that’s broke, I want fixed. Anything that looks close to breaking, I want replaced. I want every truck in the fleet mechanically sound. If there’s any truck that’s going to cost more to fix than it’s currently worth, sell it for scrap.”
“Why go to the trouble of repairing all the trucks if you’re just gonna turn around and buy new ones?” Gail wondered.
“Because I have plans for those trucks,” Ryan winked. “Plans that will pay greater dividends than we’d get in trade-in value.”
“New computer network, new rigs and equipment, shutting down the Training Center and the wheelchair vans, splitting off the billing office as an independent contractor, and firing half the office staff,” Gail summarized skeptically. “Pretty ambitious plan for your first thirty days, Ryan.”
“Well, I didn’t want to overwhelm you with too much in this first little meeting,” Ryan winked. “So I decided to start small.”
“I’d hate to know what you call ‘big’ plans, then,” Tommy chuckled, to nods of agreement from Gail, Mack and Shannon.
“Y’all wanted to know my plan,” Ryan said, turning serious. “That’s it, in broadest terms. In three months, we’ll have new everything – trucks, equipment, paint scheme, office equipment, uniforms. We’re going to have another truck up and running, maybe two. And in six months, we’re going to have the best employees, best ambulances, and best reputation in this area. And we’ll be profitable. I’ve looked at the numbers, and so has Jeff Layton. We figure we can cut our expenses by thirty percent, and increase our net revenue by that much as well. That leaves a lot of room for salaries, benefits and equipment.”
“I know it’s a cliché to say that it takes money to make money, but sayings don’t get to be clichés unless they have a lot of truth to them.”
“They got another sayin’, too,” Tommy drawled, “and it goes like ‘everybody’s got a plan until they get hit’. What happens when you get hit, Ryan?”
“I don’t know. I guess we’ll all find out soon enough.”
“You think we’re gonna be in the black in six months,” Mack observed dubiously.
“You already are in the black, and that’s while collecting far less than you should, and spending far more than you have to. Dave was never more than a few missed Medicare payments from bankruptcy, but he was also never more than a good credit score from making this place really take off. We can do this, guys. Just do what I asked, and keep your mouths shut until all the pieces are in place.”
“So you’re gonna transform this whole place in six months,” Tommy laughed. So where do you see us in a year?”
Ryan leaned forward and winked conspiratorially. Everyone unconsciously leaned in and waited expectantly for his answer. He simply said two words:
Chapter Ten – Requiem
“This your first pediatric call?” Dave Collins asked.
“Second one as a paramedic,” Ryan replied. “The first one was a seizure that was already postictal when we got there. Not much to do other than give ‘em a ride and some blow-by oxygen.”
“Well, I wouldn’t get too worried,” Dave reassured him. “Most of these choking baby calls are just Panicky Mother Syndrome.”
Ryan grunted but did not reply. He slowed down, looking for the cross street. They had rolled out of the station ten minutes earlier, alerted by the Sheriff’s Office that there was an emergency call. In the late eighties in Audubon Parish, there was no such thing as 911. People called the Sheriff’s Office for help, who either sent a deputy, or called the ambulance or the Fire Department. Sometimes they sent all three.
Ryan had first heard the call over the scanner. After a year as an EMT, he had learned to sleep through most interruptions. With his brain attuned to listening for the words Collins Ambulance or 10-78, the radio code meaning “send an ambulance,” nothing short of a brass band at his bedside could produce such instant wakefulness. He was already reaching for the phone when it rang the first time. He had taken the call, gotten dressed and been waiting in the idling ambulance for perhaps thirty seconds when his boss had climbed into the passenger seat, ninety seconds later.
I hope it’s just PMS, because anyone this far out in the sticks is already dead if they haven’t been breathing. I hope I’m up to this.
“Just the same, though,” Dave mused, as if he had been reading Ryan’s mind, “I’ll take the lead on this one. If it’s bad, that is. Pediatric codes are tough.”
Technically, Ryan was Dave’s superior in terms of training. Dave was an EMT-Intermediate, while Ryan was a newly-minted paramedic. In practical terms, though, Dave Collins’ field experience dwarfed his own. As the owner of the company, he was also the man who signed the paychecks.
At least, that was the theory. Paychecks were still in short supply at Collins Ambulance.
Ryan nodded, braking gently as he saw a reflective street sign just ahead. Gently on the brakes, and gently on the accelerator, Dave had preached a thousand times. The smoother you stop and accelerate, the longer the trucks last and the less you throw your medic around in the back.
Mindful of his lessons, Ryan slowed the ambulance almost to a crawl, turned on the driver’s side floodlights, and read the name on the sign: McCormack Road.
“This is it. Turn left here,” Dave ordered, quite unnecessarily since Ryan was already turning as he spoke.
Three hundred yards up the road, they spotted their destination, a double wide trailer set well back from the road in a tree-filled lot. There was a Sheriff’s Office cruiser sitting in the driveway.
“They sent a deputy, too?” Ryan wondered as he parked the rig.
“They didn’t send one,” Dave replied tersely as he got out. “He lives here. That’s Don Bailey’s cruiser.”
Ryan bailed out of the rig, grabbing the first-in bag and tossing it onto the stretcher. By the time he pushed the stretcher to the porch, Dave was already inside. The wails of anguish coming through the open door told him that this choking baby call was most definitely not Panicky Mother Syndrome.
Grimly, he left the stretcher at the porch steps and lugged the first-in bag through the front door. He found Dave Collins kneeling next to a limp toddler lying on the floor, his ear poised over the baby’s mouth, listening for breathing. A young man his own age, dressed only in boxer shorts, knelt on the other side of the child. His hands were still poised over the infant’s chest, the heel of one hand atop the other, tears streaming down his face. Don Bailey, rookie deputy for Audubon Parish Sheriff’s Office, had been doing CPR on his own son.
His wife sat on the couch, screaming hysterically. She had her hands clasped over her mouth, and her voice rose in a keening wail, as if she were holding back her horror with her bare hands, and failing at the task as the anguish of seeing her child lifeless on the floor escaped through her fingers like steam from a pressure cooker.
All of this Ryan processed in an instant as Dave began giving mouth-to-mouth ventilations. “What happened?” Ryan asked as he opened the flow meter on his portable oxygen tank and handed a bag-mask resuscitator to his boss.
Don Bailey acted as if her hadn’t heard, staring down at his son with a stricken expression. His hands hadn’t moved.
“Don.” Ryan reached out and gently squeezed his arm. Don Bailey raised his eyes and looked at Ryan vacantly, and then focused. He took a ragged breath and ran his forearm across his eyes.
“I woke up to go pee,” he said hoarsely. “I found him on the floor, barely breathing. He gets out of bed sometimes…wanders…his lips were blue, and he kept making these squeaking noises and I…I didn’t know what to do, and I just called the SO and started CPR…”
“I’m not getting any breaths in,” Dave muttered in frustration. Shifting position, he began delivering abdominal thrusts. He was not gentle.
Ryan watched Dave desperately working on the child for a moment. Don Bailey sagged back onto his heels and let his hands fall limply to his sides, defeated. The child’s mother rose from the couch, tonelessly screaming for someone, anyone to save her baby. Distantly, Ryan registered the fact that Dave was ordering him to escort the woman from the room. The moment couldn’t have lasted longer than a few seconds, but to Ryan every movement was almost languid, as if they were performers in a surreal ballet played out in half-time.
He calmly looked at Dave Collins and said, “Get out of the way.”
Dave Collins blinked in disbelief, but shifted to one side as he’d been ordered.
“I need a laryngoscope with the #2 straight blade,” Ryan said coolly as he took Dave’s place at the baby’s head, “and the pediatric Magill forceps. Don, you start compressions again.”
“I can do the compressions,” Dave started to argue. “He’s tired, and he’s –”
“Dave. Get me my scope and the forceps,” Ryan repeated in a firm, yet reasonable tone. “Don, let’s go.”
Ryan scooted into a prone position at the baby’s head, and held out his left hand. “Scope,” he ordered. Wordlessly, Dave Collins smacked a laryngoscope into his open palm. Ryan walked the laryngoscope blade down the baby’s purple tongue, looking for the glottic opening.
Just a little bit further and I should see the epiglottis…okay, now lift just the tiniest bit…there it is!
Without taking his eyes off the prize, Ryan held up his right hand and ordered, “Forceps. Once you give them to me, set me up a 4.5 tube. Don, speed up those compressions a bit.”
Ryan reached into the baby’s throat and gingerly plucked free a piece of hard candy lodged just below the vocal cords.
“Grape Jolly Rancher,” he announced matter-of-factly, laying the forceps aside and holding out his right hand again. “Tube, please.”
Ryan passed the tube through the cords, sat up, attached the bag-valve resuscitator and ordered, “Check placement.” Dutifully, Dave auscultated the baby’s chest and grinned, giving Ryan a thumbs up.
“Still not breathing, and no pulse,” Ryan noted calmly. “Don, keep going with compressions. Dave, we need some tape on this tube. Soon as you get that done, set up a line. Don, how much does he weigh?”
“Okay, that’s roughly ten kilos,” Ryan mused, daintily holding the tube in place with his thumb and index finger as Dave taped it in place. “Dave, draw up a milliliter of Epi 1:1,000, and set me up a syringe of Epi 1:10,000.”
“Both?” Dave wanted to know.
“The 1:1,000 syringe first. I’ll give that down the tube while you’re getting a line. Once the line’s in, we’ll give the 1:10,000 through the IV.”
Dave Collins nodded his understanding and tore open the drug bag, looking for the miniscule ampoules of concentrated epinephrine.
“Want me to keep going?” Don asked softly, hope creeping into his voice as he rhythmically compressed his son’s chest. In the thirty seconds since Ryan had been able to effectively ventilate the child, his color had improved dramatically.
“Just for a little longer, Don,” Ryan said gently as he attached cardiac monitor leads with one hand and bagged with the other. “Let us get this IV in, and then you can see to your wife.”
“Epi 1:1,000,” Dave announced, handing Ryan a syringe.
Ryan briefly disconnected the bag from the endotracheal tube and instilled the medication. He reattached the bag and ventilated vigorously for a few seconds, trying to aerosolize the medication into the lifeless toddler’s lungs.
Come on, kid. Give us a sign. Just a few beats to let us know you’re still there…
Both Ryan and the child’s parents watched the cardiac monitor expectantly. The only one who wasn’t focused on the screen was Dave, still searching fruitlessly for a likely vein to stick. After a few moments, it became obvious that no electrical activity was forthcoming.
“Okay,” Ryan announced, “we need a line. How’s it coming, boss?”
“I can’t find anything!” Dave snapped, fear and frustration manifest in his voice.
“Keep looking,” Ryan advised, unperturbed. He reached out and dragged the first-in bag closer, rummaging through it with his right hand while continuing to ventilate with his left. After a moment, he found what he had been looking for.
“Dave, hold his right leg steady,” Ryan ordered.
Dave Collins stared at him without comprehension.
“Hold his right leg steady, and rotate it out just a little bit,” Ryan repeated, smiling reassuringly. “Swab just below his knee with a little alcohol, please.”
Dave Collins did as ordered, his actions belying the dubious expression on his face. Ryan leaned far forward, and bored an intraosseous needle – with one hand – into the child’s tibia, just below the knee. “Remove the stylet and aspirate,” he ordered a shocked Dave Collins. When he saw blood slowly trickle into the syringe, he grinned and said, “We’re in business. Give a milliliter of the Epi 1:10,000 and let’s get him ready to go.”
“You’ve got a gift.”
The child had regained a rhythm on the monitor shortly after the second dose of epinephrine. By the time they had left the Bailey house, siren screaming, he’d had a pulse. By the time they had reached Fort Sperry Community hospital fifteen minutes later, he had been breathing and trying to move.
“What’s that?” Ryan had asked absently, still basking in his first code save. The adrenaline rush was still coursing through his system, but he was not so amped that he did not notice that Dave Collins had spoken not a word to him since they had left the scene. Ryan had given the handoff report, waiting for Dave to chime in at any moment. The moment had not come. Until now.
“You’ve got a gift,” Dave had repeated, meeting Ryan’s eyes. “That was as smooth as they ever come, and it was your very first. I was impressed.”
“Well, um…thanks,” Ryan had stammered, blushing furiously. “I was just following your lead.”
“No, you weren’t,” Dave observed wryly. “It shook me up, no question about it. I was working on a friend’s son, with his parents watching. You can work a hundred codes, and I have, and something like that will still shake you. I didn’t freeze, but I wasn’t acting like I was in charge, either.”
“Some of the stuff that needed doing, you couldn’t do. I just did what was necessary.”
“You took over,” Dave argued quietly, “as you should have. And you ran a pediatric code better than any I’ve ever seen.”
Ryan Pierce said nothing, absentmindedly fingering the Star of Life on his left collar point, remembering another cardiac arrest years before.
“You’ve got a gift, Ryan,” Dave had advised. “Honor that gift, and one day you’re going to do something special.”
Ryan Pierce lay awake, staring at the ceiling. The dream had been vivid, all the more so for the emotions it evoked. Dave Collins’ voice still rang in his mind, years later.
You have a gift. Honor it.
Ryan turned to look at the clock, but his vision was obscured by a tousled head of dark hair fanned across the pillow. Amanda Whatsername lay beside him, her body molded to his, save for one long, shapely leg draped across his upper thighs and a well-manicured hand idly toying with the hair on his chest.
He had joined her at a dive on the Oneida River Walk a little after five o’clock, and already the bar was rocking, filled to capacity with a raucous young college crowd. The place was smoky and noisy, the house band mediocre but enthusiastic, and the beer cold. In short, it was just his kind of place – fifteen years ago. He wondered how old Amanda actually was, and asked. She was twenty-six, but was quick to assure him that she much preferred older men.
On hearing that, Ryan Pierce had never felt so old in his life.
He had disguised it well, however. He had been witty, and charming, and just a bit dangerous, and Amanda had never guessed that his mind had been somewhere else entirely. Ryan Pierce was good at disguises.
They had chatted and laughed, engaging in what little conversation was possible over the music, but both of them knew that conversation was not what either of them sought. And so, Ryan had let himself be led to the dance floor, and when the moment was right, he had grabbed her by the hips, pulled her close and whispered a suggestion in her ear. It wasn’t particularly hard; Amanda’s hips never seemed to stray far from his own anyway. Her dance moves were unabashedly erotic, and decidedly feline.
She had readily agreed to follow Ryan to the marina, ostensibly so he could cook dinner for the both of them aboard his boat. She was not fooled, but then again he hadn’t expected her to be. They hadn’t been aboard Ecnalubma for more than ten minutes before she asked to use the bathroom. Ryan had pointed her down the hall, and settled onto the couch with a groan.
When she emerged from the bathroom five minutes later, naked and smiling lasciviously, Ryan’s answering smile had matched her own, but inside his mind was raging with guilt and doubt. But whatever his thoughts of his wife, when Amanda climbed atop him and kissed him hungrily, he had not pushed her away.
And he hated himself for it.
What the hell are you doing, Ryan? You’re thirty-six years old and married, with a child of your own, and you’re lying here in bed with a girl you met less than twenty-four hours ago. You can’t even remember her last name.
He groaned inwardly and lifted his head slightly to see the clock.
Shit, only 3:30, and I can’t sleep.
Ryan turned to his right ever so slightly, and Amanda stirred, gave him a sleepy smile and rolled onto her side. He planted a kiss on the back of her head and whispered, “I’ll be right back.”
She murmured something unintelligible in reply, and Ryan gingerly extricated his arm and slipped out of bed. He quietly padded down the hall to the bathroom and splashed water on his face, studiously avoiding his reflection in the mirror.
Grabbing his robe from the hook on the bathroom door, he went to the kitchen for coffee, and finding himself surprisingly hungry, rummaged through the refrigerator looking for leftovers. He was suspiciously sniffing a foil-covered plate of pot roast of indeterminate age when an arm snaked over his shoulder and he felt warm breath on his neck.
“Jesus Christ!” he yelped in surprise and wheeled around, sending the petrified pot roast sliding off the plate and across the floor.
“Sorry,” Amanda giggled. “That was supposed to be seductive.”
“It was,” Ryan smiled apologetically, taking her in his arms. “I’m just a little jumpy.”
“Not at all,” Ryan lied. “I’ve just gotten used to being here alone.” He forced a smile. “I was just about to fix something to eat. You hungry?”
“Well, um…what would you like to eat?” Ryan ventured. “Is this supper, or breakfast?”
“Breakfast,” she decided, “and I’ll eat anything but…” she smiled, casting her eyes toward the roast on the floor, “…whatever that is.”
“How does bacon and eggs sound?”
“Bacon and eggs sounds great,” she purred. “Scrambled, please.”
“No problem, Ryan winked. “Aside from being a spectacular lover, I am one of the world’s foremost egg scramblers.”
“A man of many talents,” she agreed, causing Ryan to blush.
“I could probably scare up another robe or something,” Ryan stammered, “if you’d like to put something on…”
“Do you want me to put something on?” she grinned wickedly, raising her arms over her head and turning a slow pirouette. She leaned against the counter and crossed her arms – beneath her breasts, not concealing them. Showing off. Ryan blushed even more, and she chuckled throatily.
“No,” he laughed, “it just makes it a little hard to concentrate, that’s all.”
Amanda smiled devilishly, but did not move. Ryan masked his discomfiture by busying himself with preparing breakfast for the two of them, keeping his back to her as much as possible.
They ate in silence for the most part, Ryan studiously avoiding meeting her eyes, Amanda looking at him appraisingly.
“So how long have you been separated from your wife?” Amanda asked, surprising him with the question.
“Six months,” he answered, pushing his eggs around on the plate. “Long enough for me to get used to being by myself again.”
“I’d have figured less time than that. Her ghost is everywhere around here.” She looked around significantly, then leveled her gaze at him. “You still love her.”
It wasn’t a question or an accusation; more of a simple statement of fact.
“Of course not!” Ryan denied, perhaps a bit too forcefully.
“You’re a very good liar, Ryan Pierce,” she observed. “Best of all, to yourself.”
Ryan sighed and put his fork down. “Look Amanda, I’m not the kind of guy to –”
“Do this very often?” she smiled, cutting him off. “That much is obvious.”
“She asked me for a divorce yesterday,” Ryan explained.
“Ah, so now we come to it,” she nodded knowingly. “And you wanted to hurt her like she hurt you?”
“No, that’s not it at all,” Ryan shook his head vehemently, this time meaning it. “I was just…I don’t know…tired of being alone, I guess.”
Amanda said nothing, just continued to look at him levelly. Her frank gaze made Ryan even more uncomfortable.
“I’m sorry,” he went on, his voice low and strained. “This was a mistake. I guess I’m not ready to –”
“Relax, Hero,” she said softly, putting a finger to his lips. “I’m not angling to be the next Mrs. Ryan Pierce. I knew what this was when I followed you out here. Although,” she chuckled, sweeping her arm at her surroundings, “a girl could definitely get used to this.”
“She’s dropping my daughter off here first thing in the morning,” Ryan said. “Probably around seven.”
“And you feel guilty, and want me gone before she gets here?”
Not trusting himself to talk, Ryan nodded and stared at the countertop, refusing to meet her gaze. His face flushed and his ears burned with shame.
“That’s three hours from now,” she said quietly, laying her hand on his trembling arm. He looked up at her, and she smiled softly. “Come back to the bedroom with me, Ryan. And this time, try not to pretend you’re making love to someone else.”
Ryan took her hand and followed her back to the bedroom.
Ryan walked Amanda to her car, leading her around the still-muddy spots in the basin between the dock’s end and the parking lot. She had reminded him that he still had her number, and embraced him before she got into her car. Her kiss was equal parts farewell and open invitation, and Ryan still had his arms around her when Dawn’s car pulled into the parking lot.
“Friend of yours?” Dawn asked sarcastically from behind him as Ryan watched Amanda’s car drive away. He sighed and turned to face his wife. Her eyes flashed with barely concealed anger.
“Cell phone lady,” he said shortly. “She came over to help me program my new phone.”
“Fuck you, Ryan!” Dawn spat. “How long have you been sleeping with her?”
“None of your Goddamned business.”
“Have you had her over with Caitlin here?” she demanded.
Ryan leaned forward until his nose was an inch away from hers. “Go to Hell,Dawn. You left me, and you’ve been cohabitating with DUI Boy in our house for months now. And don’t tell me you weren’t fucking him before you left. I know better.”
“I wasn’t – ”
“I still have a few friends left,” Ryan smiled cruelly, “ones that decided I needed to know the truth. I know about all his visits to the hospital when you were working, your little trip to Houston the weekend you ran out on our marriage…”
Dawn sucked in a shocked breath, and then tried to bluff. It wasn’t very convincing.
“I want to know if you’ve been sleeping with this girl with my daughter on the boat,” she insisted doggedly.
“You have no right to ask me anything.”
“I have a right to know what kind of people you have around my daughter!”
“Oh, you mean like an EMT convicted of DUI?” he smiled nastily.
“He was a friend! He listened to me!”
“Listened to what? All the things you wouldn’t tell me? So you pour your heart out to a stranger, and you won’t give the same trust to your husband?”
“You withdrew, Ryan! Ever since your sister died, you’ve formed this…shell…and you wouldn’t let anyone help you, not even me!”
“To have and to hold,” he quoted, “to honor and to cherish…”
“Don’t quote my marriage vows to me!” she flared, tears flowing down her cheeks.
“…for richer and for poorer, for better and for worse, in sickness and in health…”
“Goddamnit, you abandoned me five years ago!”
“For better or for worse, in sickness and in health, Dawn,” he reminded her. “That’s the promise you made before God, and you broke it when I needed you most. You say I need to heal, well step one is realizing what I’ve known all my life; I can’t count on anyone but myself, and I can’t save anyone but myself.”
Ryan opened the back door of her car and unbuckled a still-sleeping Caitlin from her car seat. He hoisted his daughter to his shoulder, grabbed her overnight bag, and walked away, leaving his wife standing there sobbing in the parking lot.
“Goodbye, Dawn,” he called over his shoulder. “Loving you costs me too much.”
“You’re out of your fucking mind, Spud,” Ryan hissed into the phone three hours later.
“That’s my price,” Ty Collins said stubbornly.
“Hang on a second,” Ryan said, eyeing Caitlin sitting on the couch watching cartoons. He stepped out onto the deck, closing the door behind him. “Okay, I’m back.”
“Three hundred thousand per truck is an accepted standard industry-wide, Ryan,” Ty argued. “That’s fair.”
“Accepted standard, my ass,” Ryan snorted. “Your trucks are all overdue to be replaced. Your equipment was obsolete when you bought it secondhand five years ago. You have an IRS lien hanging over your head, and if you miss one Medicare check, you won’t make payroll. Your employees will work for whoever you sell out to. The only hard asset you have of any real value is the headquarters and the land those three stations sit on. The stations themselves are worthless, and all that real estate together ain’t worth nine hundred thousand. Be realistic.”
Ty Collins sighed explosively. “All right, what’s your offer?”
“Half of yours,” Ryan answered. “Four hundred thousand.”
“Now who’s being unrealistic?” Ty exploded in disgust.
“You can’t put a dollar value on potential, Ty,” Ryan said reasonably. “You’re asking for what you think Collins Ambulance could be worth, not what it is worth. If you could make it worth your valuation, you wouldn’t be on the phone with me, trying to sell it.”
“MetroCare or Statfleet would offer me just as much as you are,” Ty threatened weakly.
“And gut the company as soon as the papers are signed,” Ryan finished, smiling into the phone. ” I agreed to buy the company to help preserve it. I didn’t agree to get raped on the price just because I’ve known you since you were a kid.”
“Six hundred thousand,” Ty countered, “and I’ll try to get the IRS lien settled before we sign the papers.”
In what, thirty days? It’s been hanging over your head for five years, and now you’re going to iron that mess out in thirty days? No thanks, kid. I trust Jeff’s tax lawyers a lot more than yours.
“Four hundred fifty thousand, and I assume all assets and liabilities,” Ryan offered, “including the tax lien. Plus, I’ll loan you sixty thousand to help cover business expenses until the estate has been probated. That’s an unsecured loan, on nothing but your word. We deduct the loan from the purchase price when we sign the papers. That’s as far as I’m willing to go, Spud.”
“Let me talk with Trent,” Ty stalled. “I’ll call you back.”
Ryan smiled as he hung up the phone, because he knew he had him. Trent Collins would agree to any price that shed him of the responsibility of Collins Ambulance. All he’d see is two hundred thousand dollars and change, there for the taking if he’d only sign the papers.
Fifteen minutes later, Ty called him back. They haggled and argued for a while longer, but neither of them had their heart in it. In the end, they agreed to have Ryan place three hundred ninety thousand dollars into an escrow account, pending the final transaction, and transfer sixty thousand dollars into the Collins Ambulance business account later that day. Ryan would be added as a signatory to the Collins Ambulance business accounts, and any withdrawals prior to the final sale would require both their signatures for authorization. Ryan agreed to meet Ty at Collins Ambulance headquarters the following morning to pick up his uniform. They’d break the news to the employees later that afternoon, after the funeral.
I’m about to blow half a million bucks on a business that hasn’t made a decent profit in its entire fifteen years in existence. I hope I know what I’m doing, Ryan mused as he hung up the phone, but despite his misgivings, he felt almost exhilarated. He smiled to himself, shook his head and dialed another number.
Jeff Layton proved to be decidedly less enthusiastic about the deal. After much arguing and not a little profanity, he had agreed to Ryan’s requests. He could even do it that afternoon, if Ryan would be so kind as to come in and sign the necessary paperwork. After all, he had spat in a voice dripping with sarcasm, it was Ryan’s money. Who was his banker to tell him how to manage it wisely?
“Five more minutes, Daddy,” Caitlin Pierce bargained sleepily. “I wanna snuggle for five more minutes.”
My fault, Ryan chided himself. No nap, and she watched cartoons all day. I drug her all over creation running errands, and she didn’t get into bed until nearly ten.
He smiled gently at his daughter, pulled the covers back up to her chin, and let her sleep. He quickly showered and dressed, made coffee, and ate breakfast. When he could wait no longer, he rousted Caitlin from her slumber and plopped her unceremoniously into a warm bath.
She whined and fretted at first, but Ryan stood firm. He sat on the toilet and supervised as Caitlin bathed herself, helping only to reach the parts she couldn’t with her left hand, and by the time he had dried her off and dressed her, she was happy and smiling again. Ryan quickly loaded her into the truck and roared out of the parking lot at half-past eight.
“We goin’ to the park, Daddy?” she had asked around a mouthful of strawberry Pop Tart.
“Nope, we’re going to see Miranda,” he grinned, eyeing her in the rear-view mirror. Caitlin gave him a toothy, crumb-covered smile.
“We need some coffee, Daddy,” Caitlin reminded him. “Coffee and donuts, to soothe the savage paramedic beasts!”
Ryan did a spit-take into his travel mug. ‘Soothing the savage paramedic beasts’ was his oft-used explanation for stopping at Krispy Kreme on the days he dropped Caitlin off before work. Hearing it come from a toddler’s lips made him dissolve into a fit of giggles. For her part, Caitlin grinned and kicked her feet jubilantly. She had made her Daddy laugh.
“No donuts today, Stinkerbell,” he laughed. “We’re running late.”
Caitlin pouted briefly, but the prospect of playing at Miranda’s was too exciting to stay unhappy for long. Miranda had games. Miranda had puzzles. Miranda let her make stuff. Little did she realize that there was a purpose behind every activity devised by her occupational therapist.
“Hey Munchkin!” Miranda Wheatley greeted Caitlin as soon as Ryan unbuckled her from her car seat. “Why don’t you go inside and get one of my puzzles from the box, and I’ll be inside in a minute, okay?” She set Caitlin down and sent her through the open front door with a gentle swat on her rump.
“What time are you picking her up?” she asked Ryan.
“Probably not until after five. I’ve got a lot of stuff to do,” Ryan admitted. “Is that going to be a problem?”
“The morning isn’t, because she’s my first appointment at 10:30. But after Caitlin, I’m booked until the center closes at five.”
“I’m really in a bind, Miranda. I’ve got a funeral at ten o’clock and a big meeting after that. I don’t really know when I’ll be done.”
“What about Dawn? Or dropping her off at daycare?”
“I’m still paying Tiny Tots sixty bucks a week,” he mused, “even though I haven’t taken her there in a couple of months. Last time I did, she learned how to say ‘shit’ and eat her own boogers in just four hours. And frankly, I don’t know what Dawn’s doing these days.”
“Y’all still aren’t talking?” Miranda asked sympathetically.
“At each other, not to each other. Wednesday, when we left your office, she asked me for a divorce,” he said evenly. “I’m not going to fight it.” Saying it aloud didn’t hurt nearly as much as he thought it would.
“Damn. I had hoped you two would work it out.”
“Doesn’t look that way,” Ryan grunted. “Anyhow, you can probably get used to seeing Billy Fontenot’s truck parked across the street from now on.”
“He’s there every night as it is,” Miranda snorted. “Look, I suppose Kristin and I can use Caitlin to co-treat some of my autism patients this afternoon. She’ll get some extra work in, and I can use her to draw out Riley and the other kids. It’ll work out.”
“Thanks, Miranda,” Ryan smiled gratefully. “You’re a good friend.”
“Yeah, yeah, yeah,” she snorted, brushing off the compliment. “Just bring her a few changes of clothes and some baby wipes over here when you pick her up. And you’ll have to make some childcare arrangements soon, Ryan. My caseload is picking up, and your schedules aren’t nearly as predictable as they were six months ago.”
Ryan pulled up to Collins Ambulance headquarters at 9:15. The parking lot was empty, save for two ambulances draped it black bunting parked out front. Ryan knew their significance, and the thought was sobering.
Place hasn’t changed much since I worked here, he mused as he walked through the front door. It still reeks of Dave Collins; grand dreams and unfinished business, with a healthy dose of junk.
In front of him was a small but tastefully appointed lobby, decorated with overstuffed leather chairs and framed photos on the walls; Dave and Barbara Collins smiling, posing with local dignitaries; Dave and Barbara Collins working a wreck scene; Dave and Barbara Collins, among others, standing behind the Governor as he signed the 1999 EMS legislation into law. Barbara’s face was partially obscured by the arm of a fire chief standing in the front rank. A carpeted hallway on the right led to a bank of office suites – far more offices than needed for such a small company. But that had always been Dave Collins, dreaming big.
Ryan stepped across the lobby and examined a picture closely. In it, a younger version of himself tenderly carried a child up an embankment, an overturned school bus in the background. Another photo below it showed him at a wreck scene, sprawled across the hood of a compact car, laryngoscope in hand, head turned to his right barking orders. He looked fearless, purposeful. In charge.
That particular photo had won awards, and appeared on the cover of a major EMS trade journal. In the far right of the photo, a pair of gloved hands held the wrecked face of the victim, still pinned behind the wheel of her car as Ryan prepared to intubate her. The hands had belonged to his partner, Tommy Bollinger, who liked to joke that he had the hands that made Ryan Pierce famous.
“Looky there,” he’d say proudly, tapping the photo with a finger for emphasis. “Those are my hands. What that picture don’t show is how I climbed in the back seat and ventilated that girl from behind, with nothing more than these two hands and a bag-mask. Five minutes I stood there, hunched over and breathin’ for this girl, and whadda the fertographers git? My partner, the gloe-ry hound. I tell y’all, if not fer these here hands, he wouldn’t be famous.”
Ryan chuckled at the memory. His chuckle faded when a sliding glass window opened on the far side of the lobby and a head appeared above the sill. A familiar head, wearing a dispatcher’s hands-free microphone and headset.
“Can I help you, Sir?” Billy Fontenot asked politely. When he saw who it was, his polite smile disappeared. “Oh. Ryan. Good to see you,” he said perfunctorily, in a tone that indicated just the opposite.
“Billy,” Ryan acknowledged levelly.
“They’re all in the classroom,” he said, pointing to Ryan’s left.
“I know where the classroom is,” Ryan assured him. “I built it.” He refrained from adding, you asshole. But he thought it.
Enjoy it while it lasts, Billy. You won’t be a dispatch supervisor for much longer. You won’t even be an employee.
“Well, I’ll be Gawddamned,” crowed Tommy Bollinger as Ryan walked through the door. “Hawkeye Pierce, in the flesh! Damn boy, but ain’t you a sight for sore eyes!” He walked across the room, batted Ryan’s offered hand away, and lifted him off the floor in a fierce bear hug.
“How you been, partner?” Ryan smiled affectionately. Tommy Bollinger, born and raised in Possum Valley, Arkansas, was as country as grits and collard greens. At six feet, six inches and two hundred-eighty pounds, he was an imposing physical specimen, but Ryan knew from experience that he was as gentle as they came. That is, until you got him riled. Tommy didn’t know his own strength, probably because in his forty years on this Earth, he had never encountered a situation that tested it to any great degree.
“I ever tell y’all how my hands made this ol’ boy famous?” he challenged, still holding Ryan’s feet six inches off the floor.
“Only about a million times,” Ryan grunted uncomfortably. “You mind putting me down, please?” Chuckling affectionately, Tommy set him down and made a show of solicitously straightening his clothes, brushing off imaginary lint, smoothing back his hair…
“Enough, damn it!” Ryan laughed, pushing him away.
He made his way around the room, greeting old friends, some of whom he hadn’t
seen in ten years. Lila Rogers and Mary Emory were there, long-time partners both on and off the ambulance. They had left for a job in Texas in Collins Ambulance’s third year, for more money and benefits. Both of them greeted Ryan with an affectionate hug.Mack Barron and his mother Mary Jo greeted him with handshakes and smiles. Mary Jo had long since retired from nursing and EMS, and Mack worked part-time as a reserve Sheriff’s Deputy. Mack had followed his mother into EMS at the tender age of eighteen, in what he thought would be a brief stop en route to the police academy and a career in law enforcement. Fifteen years later, he was still an EMT at Collins Ambulance.
Jody Snell had left for Acadian Ambulance barely six months after Ryan became a paramedic. Slightly older than Ryan, and already a paramedic for a year, he had always seen Ryan as his rival. Every shift assignment Ryan got, every promotion he received, Jody bitched about incessantly, utterly convinced that his seniority as a medic meant those rewards should come to him. He and Ryan were not friends, but they shook hands and pretended to be glad to see one another.
Jody’s partner’s greeting, however, was much more affectionate. Gail Vetters smiled warmly and kissed Ryan’s cheek. She had worked as an EMT at Collins Ambulance for fifteen years, and for MetroCare with Dave and Barbara for five years before that. She had been there and done that, and had put up with a hundred partners more arrogant than Jody Snell. Gail was like the steady dog in the team, the one you harnessed alongside the younger, rambunctious pups to calm them down and give them a little seasoning. She trained by example, but she had a sharp pair of fangs if needed.
“Glad to see you, Ryan,” she greeted him. “And how’s your little girl?”
“Growing like a weed and sassy as hell,” Ryan winked. Gail’s daughter had been one of Caitlin’s nurses in St. Matthew’s NICU. One evening when Ryan and Dawn had shown up for one of their thrice-daily visits, Caitlin had been dressed in a beautiful lace-trimmed gown, handmade to fit a micro-preemie, with openings in the back for IV lines and monitoring leads.
“It was a gift from Mama,” her nurse had explained. “She says she’s praying for y’all.” Both parents had been profoundly grateful, and Gail Vetters had forever found a place in Ryan’s pantheon of the Truly Good People.
“Ryan, glad you could make it,” Trent Collins greeted him with an outstretched hand. Ryan shook it, and was immediately struck with distaste. The handshake was as limp as a cold fish. Trent Collins had already been a shallow, pompous asshole at the tender age of twelve, and adulthood had only accentuated his less-desirable character traits. He had always cultivated an air of piety and false dignity, something that looked decidedly out-of-place on a pre-teen boy. Couple that with the arrogance to believe that his status as the bosses’ eldest son gave him the right to order grown men around, and on the day Spud Collins had dealt a fearsome ass-whipping to his older brother, it was no surprise to that he’d had a cheering section of EMTs.
“I’m sorry to hear about your parents, Trent,” Ryan said formally. “We’ll all miss them.”
“Well, they’re in a better place,” Trent Collins said solemnly. “Praise Jesus.” Behind him, Tommy Bollinger rolled his eyes.
Well, so much for the Army changing Trent for the better. He’s still the oily little bastard he’s always been.
“Gentlemen,” Trent raised his voice, ignoring the fact that there were four ladies in the room, “here’s the plan. Ty and the other crews are already at the church. Tommy and I will drive the two funeral coaches out front…”
Funeral coaches? Does he mean those two ambulances?
“…to the church, and the rest of you may ride along, or take your own cars if you wish. We’ll park the funeral coaches at the west entrance – that’s the one that faces Lee Street, boys – and the first two rows are reserved for family and pallbearers. Immediate family sits in the front row, and…
We know which way is west, Trent, and I remember a time when you couldn’t read a friggin’ map.
“…after Brother Taylor is finished, there will be a brief hymn, and then any of you who wish to do so may come up and give a brief eulogy. I’ll ask that you keep your anecdotes solemn and respectful, in keeping with the sorrow of the occasion.”
That’s right. Let’s all cry and wail and gnash our teeth, because this is a funeral after all. Happy memories are not welcome. Jesus, are you sure you weren’t switched with another baby at birth? You’re sure as hell nothing like your parents.
“Does anyone have any questions?”
I have one. How are you going to sit down with that ginormous stick up your ass?
“I have one,” Tommy asked, timidly raising his hand. “Who’s going to be the twelfth pallbearer? I mean, there’s all of us here, plus Royce, John, and Richard at the church with Ty. That makes eleven. Ann’s been dead for eight years. So who’s number twelve?”
Dave and Barbara Collins had not been the first from Collins Ambulance to die in an ambulance crash. Eight years earlier, on a rainy March night, Ann Heflin had dropped the right wheels of her ambulance off a steep shoulder. The ambulance had rolled several times, ejecting her through the driver’s window. Her picture was enshrined in the lobby in a special place of honor.
“I…I don’t know,” Trent stammered uncertainly. “Ty was handling all that.”
“I’ll do it,” Billy Fontenot volunteered from the doorway.
“You weren’t one of the original employees,” Trent said coldly, “and someone here has to man the phones and radio.”
“One of the original twelve employees is dead, Trent,” Gail pointed out, “and Ty never told any of us who was to take her place.”
“I’m sure Ty had someone in mind,” Trent assured them. “We need to get to the church in time for the –”
“So what’s the reason for leaving Billy here?” Ryan interrupted. “I thought the whole point of having Allemands Parish Fire Department sending a truck to cover was so everyone could attend the funeral.”
“Someone still has to answer the phones and radios, and dispatch them if we get a call,” Trent replied, as if speaking to a backward child.
“So we forward the phones to the Sheriff’s Office, and let them handle the radio traffic, just like we did in the old days. Hell, they answer all the 911 calls anyway,” Ryan snapped, rapidly losing patience.
Trent’s eyes flashed with anger, but he said nothing. Billy Fontenot simply looked at Ryan appraisingly.
Haven’t changed a bit, have you, Trent? You still think you own the place, yet you want nothing to do with running it.
“Billy, forward all the phones to Audubon SO,” Ryan said decisively. “Call the dispatcher and the crew with Allemands Parish Fire Department, and tell them to dispatch over the Audubon SO frequency. You can ride in the truck with Tommy.”
Billy looked at Trent Collins questioningly. After a moment visibly spent making up his mind, Trent nodded his assent.
“Let me get changed into a uniform, and I’ll ride with you,” Ryan suggested.
“I’ll be out in the truck,” Trent replied shortly.
Five minutes later, Ryan was wearing an obviously new Collins Ambulance uniform, and Trent Collins was driving them to the Fort Sperry First Baptist Church, where the funeral was to be held. The drive only took five minutes, but to Ryan it seemed like hours.
“So when do we sign these papers?” Trent asked. “I fly back to Qatar tomorrow afternoon.”
“This afternoon is as good a time as any, I suppose.”
“Less than five hundred grand seems a little low for all the work we put into this place over the years,” Trent said mildly, but Ryan could see his mind working behind the remark. Trent was thinking how he could weasel more out of the deal.
“What’s all this ‘we’ stuff?” Ryan asked bluntly, tired of the charade. “Any employee here has put more work into this place than you ever have. If anything, this should be Ty’s company, alone.”
Trent let the comment pass unchallenged, his only reaction the flexing of his fingers on the steering wheel.
“The only thing you ever wanted out of this place was the opportunity to bully grown men around because you were the bosses’ kid. You’ve been gone ten years, and you know jack shit about running an ambulance service. If it’s really all that important to you,” Ryan went on with a cruel smile, “Ty can sell me his share and we’ll be equal partners, you and I. You can get out of the army and come home and pretend you’re running the family business. I’m just sure we’ll work well together.”
“I want no part of this fucking place,” Trent Collins spat contemptuously. His distaste was palpable. “Picking up dirty, smelly…sick people…shuttling around old people to their fucking dialysis appointments, smelling their rotten bedsores…”
You’re such a fine Christian, Trent, Ryan thought sarcastically. Jesus would be SO proud of you.
Apparently Ryan’s disdain was evident upon his face, because Trent stole a quick glance at him and shut up.
“I’m just saying I think your offer’s a little low, that’s all,” he went on. “I’m not sure we couldn’t get better from MetroCare or StatFleet.”
“Give ‘em a call,” Ryan challenged. “See if they offer more. Your financial situation is no secret, Trent. My guess is that they’ll try to lowball you even more, or simply wait six months until you fold on your own, and then move in to pick up the pieces. You’re just a couple of missed Medicare checks from bankruptcy as it is. Ty has done a good job keeping you afloat this long, but he’s got too many plates spinning in the air. Sooner or later, they’re all gonna crash.”
Trent Collins considered that a moment, and then asked, “So how does this work?”
“Unless you want to come back from Qatar in a month or so just to handle the paperwork, you sign a document today empowering Ty to sell Collins Ambulance and all its assets to me once the estate has been probated. Once that’s done, Ty signs the sale papers and splits the money with you, in accordance with the inheritance laws of Louisiana. I’m sure there will be some estate taxes and fees involved, but that’s the deal.”
“And how much is my share, after taxes and fees?”
Took you long enough to come to the point, you greedy little bastard. I’ll bet you haven’t shed one tear over your parents.
“Roughly two hundred grand, just from the sale of Collins Ambulance. What else you’ll inherit from their estate is none of my business.”
“I suppose that’ll have to be enough, then,” Trent Collins sighed with a put-upon air.
“It’s been a pleasure doing business with you, Trent,” Ryan snorted in disgust.
The funeral was largely the standard affair, with the only difference being the preponderance of uniformed people crowding into the church. Ryan counted ambulances from over twenty different EMS systems, and it seemed as if every law enforcement agency in north Louisiana had sent an officer in dress uniform. The line of official vehicles had been impressive.
A Baptist minister mouthed generic platitudes about people he barely knew, spending most of the time expounding upon the virtues of a life led in service to others, a life which, he had assured all present, the deceased had most certainly lived.
‘The deceased.’ That’s really classy there, Brother Taylor. Try looking down at your crib sheet more often, and you might remember their names.
As the preacher droned on ceaselessly, Ryan’s mind began to wander, despite his best efforts otherwise. He looked around the church, and was surprised to see quite a few mourners crying, dabbing at their eyes with tissues or handkerchiefs. Enough of them that he began to wonder if perhaps he shouldn’t be feeling more emotional, and question why he wasn’t. The feeling made him vaguely uneasy.
This is why I don’t like funerals, he mused. I don’t see the point of mourning someone when they’re gone. Better to celebrate the life they lived while they were here.
So you say, came the mocking voice in the back of his mind. Is that why you see your sister every night when you close your eyes, because you’ve moved on? How many times have you worked that code in your nightmares?
“Shut up,” he whispered through clenched teeth, and several people nearby turned to look at him curiously. Ryan blushed with embarrassment as he realized he’d inadvertently spoken aloud.
That’s because Renee never had a life worth celebrating, he whispered to himself furiously.
And whose fault was that? Who turned his back on her and left her to fend for herself?
Shut. Up. Renee made her own life. I’m not responsible for anyone’s life but my own. I’m not responsible for anyone’s life but my own…
Strange mantra for a paramedic, Hawkeye, the voice mocked. It explains a lot, really.
Someone elbowed Ryan in the arm, and he looked to his left to see Tommy Bollinger staring at him. Ryan looked at him in confusion, and Tommy nodded toward the dais, as if to say, pay attention.
Behind the podium stood Don Bailey, now Chief Deputy of the Audubon Parish Sherriff’s Office. He was speaking of a night long ago, and how Dave Collins and a new paramedic had given back to his family their most precious gift. Beside him stood a tall young man of perhaps seventeen who bore a striking resemblance to his father, and Ryan instantly recognized Chase Bailey, the very child he had revived on that night nearly fourteen years before. The teenager gave him a shy smile and a tiny wave, and Ryan winked at him through eyes suddenly brimming with tears.
Not responsible for anyone’s life but my own…but I can choose to accept the responsibility for another. That’s what I do, and that kid up there is the payoff. My sister chose to end her own life, whether by a single event or by the slow march of years. She chose to die, and there was nothing I could do about it. I could only try to help her live. She chose otherwise.
The voice had nothing to say in reply.
Don Bailey’s voice was faltering, but it strengthened when his son put a reassuring arm around his father’s shoulder. He went on to say something about debts that could never be repaid, and the strange brotherhood of people who gave of themselves without asking for anything in return. It was a brotherhood he knew well as a peace officer, he said, and he had been honored to share that brotherhood for so long with as fine a pair of people as Dave and Barbara Collins. He finished by reading aloud from John 15, verses that Ryan knew well:
These things have I spoken unto you, that my joy might remain in you, and that your joy might be full.
When he finished, he slowly closed his Bible, turned to his left and faced the twin caskets. He snapped a solemn, parade ground salute and held it for a long ten seconds. The silence in the church was deafening. Don slowly lowered his arm, regarded the caskets for second more, then smartly performed an about face and marched purposefully out of the church without another word.
Ryan looked around in wide-eyed wonder. People were standing on their feet and cheering. Many of them were still crying, yes, but the somber mood of the proceedings had been utterly broken. Ty Collins sat in the front row, half turned around in his seat, smiling broadly through a veil of tears. Only Trent seemed put out by the show of warmth and affection.
Reluctantly, Ryan trudged up to the podium. He cleared his throat hesitantly into the microphone, and waited for the applause to die down. When he looked up into a sea of expectant faces, he almost froze.
“Just my luck to follow Don Bailey after a eulogy like that,” Ryan began hesitantly. “I could stand up here and read the phone book and none of you would remember a word I said. I suppose that’s a good thing for me…”
“My name is Ryan Pierce, and I was one of the original crews at Collins Ambulance. Some of you may remember me, and some of you I’ve not yet had the pleasure of meeting. I’ve been gone from here a long time, but in a way I suppose I never left. Dave and Barbara Collins hired me as a brand-new EMT straight out of school, not a week after they opened for business. In the years I worked here, they taught me a lot of lessons that I took with me when I left.”
“Aside from the practical tips, they taught me how to laugh, how to love, how to recognize that the pain and suffering we see as EMTs can blind us to the joy we can experience if we let it. Dave had a business philosophy, a saying he used a lot that I’m sure everyone here in a Collins uniform has heard a thousand times…”
“…but the point of that philosophy was that the patient always came first. He used to remind us to care for our patients and our partners above all else. He figured that if we did that, then the business would take care of itself.”
“When he told me that for the first time, I knew two things beyond the shadow of a doubt; I knew that I wanted to work for a man like Dave Collins, and I knew that as long as I did, I was going to be eating macaroni and Ramen noodles a lot.”
“Along the way, we had some hard times. I worked the fire at the mill where some of you lost loved ones. I’ve held people as they died. We lost one of our EMTs on the Mason Ferry Road eight years ago, killed in an ambulance crash. There’s hardly a stretch of road anywhere in Audubon Parish that doesn’t have a memory attached to it, and some of them are memories I’d rather forget. And now we’ve lost Dave and Barbara.”
“But I’ve also seen some good things. I met my wife here,” he smiled at Dawn, sitting in the fourth row. “I was there with Dave Collins the night Don Bailey called the Sheriff’s Office for help because his son wasn’t breathing. We were lucky that night, and now I see him today, a grown man. I see some people with children here, and unless I’m mistaken, I delivered a couple of ‘em…”
He paused for effect, then delivered the punch line, “…and not a single one of those parents saw fit to name their child after me.” The line drew the laugh he had hoped for, and Ryan smiled gratefully at the room.
“All of us are here today to pay tribute in some way to Dave and Barbara Collins, and I think the way I’ll do it is to be grateful for the opportunity they gave me sixteen years ago. They gave me a front row seat to the pageantry of human life, and reminded me that if you blink, you might miss a part of the show. Their role in the pageant has ended, but I think they’d be disappointed if we didn’t all open our eyes to enjoy the rest of it. Thank you.”
The crowd responded with a wave of warm applause, and Ryan quietly slipped back to his seat. A soloist sang a hymn, and the mourners filed past the caskets, offering hugs and tender words of support to Trent and Ty Collins, and the crews of Collins Ambulance.
Chapter Nine – Decisions
“You want to run that by me again, Spud?” Ryan asked, certain he had heard wrong.
“I’m selling Collins Ambulance, Ryan,” Ty repeated, dead serious. “I want out, and I’d like you to buy it.”
“Jesus Ty, your parents spent fifteen years building that company!”
“And it killed them both.” The pain in Ty Collin’s voice was palpable. “I’m not going to let that happen to me. I’m getting out.”
“That’s grief and anger talking,” Ryan advised gently. “Don’t make decisions based on how you feel right now. Give it some time.”
“Time?” Ty Collins exploded bitterly. “Time? That fucking place took up my entire childhood, Ryan! I’ve given it sixteen fucking years of my time.” He rose from his chair and began to pace back and forth angrily, the veins bulging in his neck, his voice rising with his anger.
“Time,” he spat contemptuously. “You know how many vacations my parents took since Collins Ambulance opened? Four. That’s four measly weekends in sixteen years, and that’s not counting the years they worked for MetroCare before that!”
Ty gripped the deck rail and stared out over the dark water, knuckles white, the muscles in his shoulders bunched as if he were contemplating ripping the entire deck rail loose from its mounts. He went on, his voice harsh and strained as he whispered, “Every damned one of those vacations Dad had his cell phone glued to ear. I’ve spent my entire life competing with Collins Ambulance for my parents’ time, Ryan. I’ll be damned if I do that to my wife and kids. I won’t do it.”
Shocked, Ryan could only sit and watch his tirade. He knew better than to say anything. Ever since he was a child, Ty Collins had possessed a volcanic temper. When he erupted, it was best just to stay out of his way until he was calm and placid once again.
Once, when he was eight, he had erupted in a spasm of fury against his older brother. Trent, six years older and fifty pounds heavier, had been tormenting the kid much of the afternoon. When Ty had finally swallowed enough, it took Ryan and another EMT to pull him off of his older brother. Of course, they let him get plenty of licks in before stopping the fight. Trent Collins had been begging for an ass-whipping for years.
Ryan watched him stare out over the water, stony-faced, for several long moments. Even in the dim pool of light cast by the dock lights, he could see the tears fill his eyes and march slowly down through the stubble on Ty’s cheeks. The sobs began with his throat working spasmodically, trying manfully to hold them back, until his grief overcame his will, and he leaned there on the rail, shoulders shaking with great, racking sobs.
Ryan let him cry. After three minutes that seemed much longer, he quietly got up, went back inside and fetched two more beers. He closed the refrigerator door, turned, and thinking better of it, smiled ruefully to himself, re-opened the refrigerator and put his own beer back.
You don’t need another one, Hawkeye. As a matter of fact, it’s probably a good idea to not buy any more when these are gone.
When he walked back out to the deck, Ty Collins was sitting in his chair, elbows on his knees and head clasped in his hands. His sobs had waned to an occasional shuddering gasp. Ryan walked over and stood in front of his chair. After a moment, Ty opened his eyes and stared at the boots planted in front of him, and followed them up to Ryan’s face. Wordlessly, Ryan handed him the bottle and sat down across from him.
Gratefully, Ty drained half the Heineken in one long pull. Ryan let him catch his breath and drag his shirtsleeve across his eyes before speaking. “You know what was the best piece of wisdom Dave Collins ever taught me?” he asked quietly.
Ty Collins shook his head, no.
“I had been working there about six months. Still hadn’t gotten my first paycheck. None of us had. I used to drive that ratty-assed old Volvo, you remember?”
Ty smiled, nodded.
“Well, the finance company was on my case because I was three payments behind, and they were making noises about repossessing it. So, I went to your Dad and asked for some of the back pay I was owed, just enough to catch up on my payments. We still hadn’t straightened out our Medicare billing, and all of us were wondering where the next box of IV fluids was coming from.”
“We’re still doing that, fifteen years later,” Ty chuckled ruefully.
“Let me finish,” Ryan chided. “None of us, not any of the six original crews, got paid for the entire first year. Royce and I lived at the Mason Ferry station, because we couldn’t afford to pay our rent. You were too young to remember all that, but I mean it when I say we had no money. The cash flow problems you have now don’t even compare, okay? So I go to your Dad, and he cuts me a check, and I wondered out loud how he was ever going to make that place work. And he told me, ‘Patients, partners, and profits, Ryan, in that order. If we all take care of our patients and each other, the profits will take care of themselves.’ The next day, when I called your house to thank him, the phone had been disconnected. The money he had set aside to pay the bill, he gave to me instead.”
Ty shook his head in wonder. “Patients, partners and then profits,” he snorted derisively. “Not exactly the roadmap for business success.”
“You’re not listening, Ty. When he said that, it wasn’t just words. He believed it. The proof of that was that recording from the phone company. And because he believed it, we all did. And we made it work. That whole company is testament to the idea that you can put patient care over profits, and still succeed. That’s why you shouldn’t sell it. It’d be like spitting on your Dad’s grave. He’d want someone to continue it.”
“That’s why I want you to buy it,” Ty countered, seeing his opening. “You believe in it as much as he did.”
Jesus Christ, are we back to that again? How am I going to tell him no?
“What about you, Spud?” Ryan argued. “I hear the rumors. Dave almost put you into bankruptcy with that move into Allemands Parish. You cleaned up that mess, and got them back into the black. It’s obvious you can run it yourself.”
“We’re out of debt,” Ty acknowledged, “but we’re not profitable. We could be, I think. But that’s not the point, Ryan. I want out. I’m tired of stamping out brushfires, trying to keep the place afloat. I’m twenty-six years old, and all I’ve ever known is EMS. My first car was a retired sprint truck, remember that?”
That beat up old Suburban. Yes, I remember. Hell, you learned to drive on breaks during all those EVOC classes I taught. A fifteen-year old kid, and you should have been out playing grab-ass with your friends. Instead, you got drafted as free labor to set up traffic cones on an old airport runway. One of a million shit details you caught because you were the bosses’ kid.
“I’m not sure if I’ve ever had my heart in it,” Ty went on. “Looking back, all I’ve ever done in EMS was because it was what my Dad expected. It wasn’t what I wanted.”
And I’m just the opposite. It’s all I ever wanted, and just the opposite of what my Dad expected.
“What about Trent?” Ryan hedged. “How’s he feel about all this?”
“Trent came to the same conclusion ten years ago,” Ty snorted. “When he joined the army, part of the reason was to put Collins Ambulance as far behind him as possible. He’ll take half of the money, and be grateful, whatever the amount.”
“What about MetroCare?” Ryan asked. “Or Statfleet? Have you approached them?”
“I came to you first. MetroCare and Statfleet won’t offer much, and you know as well as I what they’ll do. They’ll shut down two of the trucks and try to cover the parish with just one. They may just try to push me out instead. Your boy Dickless has been snooping around for a couple of months, talking to Police Jurors, nursing home administrators, that sort of thing. He wants to make a move.”
Heh. Even the other companies call him Dickless.
“That’s easy to counter,” Ryan mused. “Folks in Audubon Parish have long memories. They know what it was like when MetroCare had the contract. All you need do is drop a few reminders in the right ears.”
“No, I needn’t do anything,” Ty said flatly. “You weren’t listening before, Ryan. By this time next month, someone else will own Collins Ambulance. After that, I could give a rat’s ass what happens. If you care what happens to it, make me a reasonable offer and it’s yours. Otherwise, MetroCare or Statfleet can do with it what they will.”
“I’ll need to think about it,” Ryan temporized. “I’m a medic, Ty, not a businessman.”
“Neither was Dad, and you made it pretty damned clear that you thought you could run things better than he did.”
“Yeah, and he fired me for it.”
“And regretted it. That was six years ago, Ryan. How long do you plan to be bitter about it?”
The rebuke cut Ryan to the bone. “How soon do you need a decision?” he sighed.
“By Friday, before the funeral. I’ve got a prospectus in my briefcase; bank statements, payroll, accounts payable and receivable, physical plant, fleet records, the whole nine yards. The Army is flying Trent back from Qatar, and he’ll be here Friday morning. We can all sign the papers then, if you’re willing.”
“That’s three days. You’re not giving me much time.”
“Mom and Dad started the place over the span of a weekend. They quit MetroCare on a Friday, and were up and running on Monday, with less than ten thousand dollars in the bank. You have millions.”
“That was fifteen years ago, Spud. EMS has changed a lot since then.”
“So I’ve noticed, but Dad didn’t. So do what he couldn’t; adapt.”
He’s got an answer for every argument I’m going to make.
Ryan sighed. “Where is this prospectus of yours again?”
“In my briefcase, just inside your door,” Ty belched, pointing with his bottle.
Ryan stepped inside, opened the briefcase, and pulled out a half-inch thick sheaf of papers bound in a cheap vinyl report cover. He flicked on the deck lights, settled back into his chair, and thumbed through the pages.
“Take your time reading,” Ty Collins suggested. “While you’re doing that, I believe I’m going to have another one of those awful bitter beers in your fridge.”
“Help yourself,” Ryan said absently. As he read, Ty Collins pulled his chair to the deck rail, propped his feet on it, and with the help of Ryan’s remaining Heinekens, set about getting very, very drunk.
They’re in bad shape, Ryan mused two hours later. They’re running an average of fifteen calls a day. That’s five calls per truck. That ought to pay the bills, and then some. So why are they barely breaking even? They’ve got an IRS lien against them for $150k, and less than ten grand in their primary business account. If they miss just one week’s worth of Medicare payments, they won’t even make payroll.
They’ve got eight ambulances in their fleet, plus four sprint vehicles and four wheelchair vans. So why do they have so many rigs if they only run three 24 hour ambulances?
Exhausted, Ryan closed the folder and rubbed his eyes. He stared balefully at Ty Collins, passed out in a deck chair with his feet on the rail, chin on his chest and snoring loudly.
No outstanding debt to speak of, just like Spud said. But why so many trucks for such a small operation? Hell, the newest of them ought to be at least eight years old…wait, that’s it. They have all those vehicles because it takes that many to field just three trucks. Half of them are probably in the shop at any one time.
Ryan’s eyes narrowed, and he sat up. He reopened the folder and thumbed through the pages until he found the one he was looking for. After reading the numbers, he slammed the folder shut and pitched it across the deck in disgust. Ty Collins started at the noise, opened his eyes blearily and looked around, then smacked his lips and passed out again.
Jesus Christ on a pogo stick, Dave! Ryan fumed. How the hell did you ever let yourself get raped so bad, by so many people? Fifteen years in business, and you’re still one hiccup away from bankruptcy. For what you pay one mechanic in a year’s time, you could hire another crew, and pay the notes on a couple of new trucks! So why didn’t you?
Answer: because you have no credit. That’s why you’re not in debt. All your accounts are paid up because no one will extend you credit, and without it you just keep hemorrhaging cash. Spud’s right. He got your bills paid up, but it’s just one damned brushfire after another. So you pay this unscrupulous grease monkey to keep those rolling wrecks on the road, and still one of them got you and Barbara killed. If MetroCare moved in right now and siphoned off only ten percent of your run volume, you’d fold in six months. If the IRS had decided to freeze just one month’s worth of Medicare checks, you’d have folded right then.
Ryan leaned forward and cradled his head in his hands and stared blearily at his shoes. Shit, shit shitshitshit…I can do Roger Dickles’ job with both eyes closed and one hand tied behind my back, and do it twice as well, but I’m not sure I can do this. Dickless has a Fortune 500 company behind him, and the corporate office with their army of accountants and lawyers to handle all the niggling details. Billing, contracts, insurance, taxes…I’d have to do all that myself, on top of all the clinical stuff.
One thing’s for sure, he yawned sleepily. I need fresher eyes than mine to look this over. I’m beat.
Ryan got up, padded across the deck, and shook Ty Collins from his stupor. Against his protests, he drunk-walked Ty inside the cabin, installed him on the couch, and covered him with a blanket. Then he walked back outside, picked the prospectus up from the deck and walked back to his bedroom. He collapsed backwards onto the bed and slept dreamlessly until the sun woke him the next morning.
Ty was still asleep on the couch, mouth open and leaking a sizeable puddle of drool on the cushions when Ryan stepped out of the shower feeling, if not great, at least reasonably human. Chuckling at Ty, he padded quietly around the galley and did his best to avoid disturbing him. Ty stirred briefly at the smell of coffee, rolling over onto his back and yawning, and Ryan thought for a moment that he might wake up and join him for breakfast. That notion was dispelled five minutes later by the sound of snoring from the living room.
Ryan ate a quick breakfast of toaster pastries and coffee, got dressed and headed outside. He disposed of the empty beer bottles scattered on the deck, and took out the trash to the marina dumpster. He fetched the prospectus from his bedroom, refilled his coffee cup, and settled into a deck chair outside to finish reading.
The numbers looked no better by the light of day, but as he read, he began to get a better sense of Collins Ambulance’s financial picture.
Okay, they own their office and three stations outright. Those are hard assets, and that office building is prime real estate. Half of it isn’t even in use. Unless Dave has had a complete personality transplant in the last six years, one of those buildings is bound to be filled with junk he can’t sell and won’t throw away.
The office is worth something. It was a strip mall when we bought it, and Fort Sperry has grown considerably since then. The stations are the same ones they had when I was there. Dumps, all of them.
They have twenty seven full-time employees, running three trucks 24/7. That means there are…damn, he’s got more people in the office than he does on the street! Supervisors out the wazoo, and all this for a company that does less than six thousand transports a year.
Shaking his head in consternation, Ryan walked back inside, found Ty Collins still passed out on the couch, and scribbled a quick note:
Spud, I had to run some errands. Stay as long as you want. There’s breakfast stuff in the fridge, and fresh coffee. I’ll be in touch.
His first errand of the day was to the cellular phone store. Ryan had long insisted on using his personal cell phone rather than the one MetroCare issued to supervisors, because he knew that a work cellular would leave him at the beckon call of the company. At least with his personal cellular, he could turn it off or ignore it on his days off. Not like it mattered much. They still called him anyway.
The salesperson, a stylishly dressed woman in her late twenties whose engraved nametag read “Amanda,” smiled and beckoned him to her desk.
“Welcome to ExCell,” she purred, offering him a soft, well-manicured hand. “What can I do for you this morning?”
You can start by telling me how anyone can concentrate around here with that perfume you’re wearing, Amanda.
“Well, I need a new phone. I lost my old one,” Ryan explained sheepishly.
Amanda clucked sympathetically and tapped Ryan’s cellular number into her computer system. “Well, your phones are insured against loss or damage,” she smiled brightly, “and you also qualify for a free upgrade. Would you like to choose from our selection of smart phones?”
“Not unless it’s waterproof and floats, and encased in an indestructible titanium alloy,” Ryan chuckled. “Actually, Amanda, the same one that I had is just fine.”
Amanda adopted a little pout, looked at her computer monitor and asked hopefully, “And how about Mrs. Pierce? Perhaps she’d be interested in one of our – ”
“Mrs. Pierce and I are separated,” Ryan interrupted, “and while I’m here, I think it might be a good idea to cancel her phone. She never uses it anyway.”
“Oh, I’m so sorry to hear that!” cooed Amanda in a tone that said quite clearly that she wasn’t sorry at all. She tapped more commands on her keyboard, clicked her mouse a few times, chewed adorably on her bottom lip, and flashed Ryan a megawatt smile. “Okay, done,” she purred. “Is there…anything…else I can do for you?”
That sounded like an offer.
“Try as I might to think of something,” Ryan winked, “That oughta do it. For now.”
“Wait right here, and I’ll go get your phone,” Amanda assured him. As she rose from her chair, she leaned far more forward than was necessary, giving Ryan a view of her cleavage.
Nice tits, Ryan chuckled to himself. I wonder how many men she’s shown them to this week?
In moments, Amanda was back with a new phone. While she programmed it and activated it, she asked Ryan conversationally, “So how did you lose your old phone?”
Tossed it into the river in a drunken fit. Isn’t that how most people lose their phones?
“Lost it on a wreck scene,” he lied. “At least that’s my best guess. There was a shooting and a cardiac arrest that day, too. God only knows where it fell off my belt.”
“Ooh, you’re a paramedic,” she gushed. “I just love you guys. What you do, it’s just…heroic.” She leaned forward and put her elbows on the desk, giving Ryan another view of her cleavage. When his eyes dropped, she smiled knowingly. “So tell me,” she whispered, “What’s the worst thing you’ve seen as a paramedic?”
“Well, that’s a tough question,” Ryan said quietly. “I guess it was…this is hard to talk about…there was a little girl who had fallen into the pool…who knows how long she was down before the babysitter found her…pretty little girl with blue eyes and blonde hair. We worked her for over an hour. To this day, I can still see those blue eyes and the barrettes in her hair…” Ryan’s voice trailed off, and his eyes moistened. He swallowed hard and turned away.
“Oh, that’s so sad!” Amanda cried, anguished. Her eyes too were moist. “Did she live?”
“Damned if I know,” he grinned wickedly. “That’s just a story I tell to pretty women to make them think I’m sensitive.”
“Oh, you’re baaaad,” Amanda chuckled throatily.
“I have my moments,” Ryan allowed. “So, are we all done?”
“Yep, you’re ready to go. Be sure to charge the battery fully before you use it.”
“Thanks for your help, Amanda. I appreciate it.” Ryan stood up and offered his hand. When she shook it, she held the contact far longer than was necessary.
“My pleasure,” she smiled winningly. “I put my card in the bag, with both my work and cellular numbers. If ever you should need anything…”
“I’ll be sure to give you a call,” Ryan winked. He turned to leave, then, thinking better of it, turned back. Amanda looked up at him invitingly. “Now that you mention it, there is something else you could do for me. Do you have any brochures for your business plans?”
Ryan’s next stop was Citizen’s Bank and Trust. Citizen’s occupied the bottom floor of the Oneida Tower, a large downtown office building. With branches only in Oneida, Audubon and Allemands parishes, it was not the largest bank in the area, but Ryan had been doing business with them since he had opened his first checking account. He rarely went there, preferring to do all of his banking and bill paying electronically, but the staff there were not likely to forget the face of one of the bank’s biggest depositors. Being the best friend of the vice-president didn’t hurt, either.
“Well good morning, Ryan!” one of the tellers greeted him. “What brings you in today?”
“Morning, Cathy,” Ryan smiled. “Is the boss in?”
“Sure is,” she confirmed. “Is he expecting you?”
“Nope, but I need a few minutes of his time, if he’s available.”
“It shouldn’t be a problem, Ryan,” Cathy assured him warmly. “Let me check.” Cathy walked from behind the counter to an office door, knocked on it and poked her head in. A few seconds later, she opened the door wide and beckoned him over.
“Thanks, Cathy,” Ryan grinned. “Remind me to tell Scrooge to give you a raise.”
“Make it a big one,” she laughed as she walked back to her position behind the counter. “I deserve it.”
“She already makes too much!” Jeff Layton’s voice boomed from the office. Ryan winked at Cathy and stepped inside, closing the door behind him.
“Long time no see, brother,” Ryan greeted him cheerfully. “How’s your wife and my kids?” That was normally Jeff’s line, but Ryan said it first, to head off any questions about Dawn. Jeff ignored the hint.
“Damn boy, but you’re a sight for sore eyes!” he blurted emotionally, coming from around his desk and enveloping Ryan in a bear hug.
Time had made Jeff Layton older and heavier, and his hairline was in full retreat, but his personality had not dimmed in the slightest. Jeff had worked at Citizen’s Bank and Trust since his college graduation, and it was expected that he would take over the reins when his father retired. That day was not too far off. The senior Layton had suffered two heart attacks in the past six years.
“It’s good to see you too,” Ryan agreed, returning the hug. Jeff Layton pounded him on the back heartily and then waved him to a chair.
“You look like shit, Ryan,” he observed. “Ain’t you sleeping at all?”
“Some,” Ryan lied. “It’s an adjustment.”
“Bullshit,” Jeff snorted. “You’re a wreck. You need to swallow your pride and work things out with her.”
What pride do I have left, Jeff? Should I beg? I’ve already done that.
“She ain’t coming back, Jeff,” Ryan said flatly. “She’s got a new boyfriend and everything. I suggested counseling and she won’t even do that.”
“She served you with papers yet?”
“Well then, that’s something,” Jeff pointed out hopefully.
“So, how are Danielle and the kids?” Ryan asked, changing the subject. Danielle Layton, nee Hoskins, had married Jeff in their sophomore year of college. Ryan had dated her first in high school, and had often teased Jeff that he had ruined her for other men.
Theirs was the fairy tale romance, where homecoming queen marries the big man on campus. The problem was, Jeff had a hard time remembering he wasn’t still in high school, the stud quarterback of the football team. Their first child had arrived barely seven months after the wedding. Jeff and Danielle pretended that he was he was premature, and their parents bounced their healthy, seven-pound grandson on their laps and pretended they didn’t know how to count. Everyone stayed happy.
Three more children arrived in quick succession, as Danielle hoped in vain that the next child would be the one to convince Jeff to stop drinking and womanizing. When she tired of that, she had kicked Jeff out of the house and threatened divorce. Surprisingly, Jeff’s parents had backed her up on that.
Jeff Layton had taken a personal inventory, and found himself wanting in too many areas. So, he checked himself into rehab and devoted himself to winning his wife back. After a long while, he had succeeded. When Jeff Layton had told his friend he looked like shit, he was looking at him through the knowing eyes of a recovering alcoholic.
“They’re fine,” Jeff smiled. “Jeff Junior made varsity. He’ll be starting quarterback by his sophomore year,” he boasted.
“Just like his old man,” Ryan marveled. “Damn Jeff, we’re old enough to have kids playing high school football. Can you believe it?”
“He’ll be better than I was. He’s got a good tailback, and two Division I prospects at receiver. Our only other offensive weapon was…you.”
“I would have been a Division I prospect too, if my quarterback hadn’t thrown like a girl,” Ryan countered with a dig of his own.
“So, what brings you up here today?” Jeff asked, cutting short the pleasantries. “Shouldn’t you be out saving lives and stamping out disease?”
“How much am I worth these days?” Ryan asked, dodging the question. “Have you embezzled me into the poorhouse, or what?”
Jeff answered with an extended middle finger. “You’re rich,” he said simply. “You get richer every day, mainly because you insist on pretending you’re not rich.”
Ryan replied with a raised eyebrow and an extended middle finger of his own. “How rich, Jeff?”
“Roughly 4.2 million in liquid assets,” Jeff said levelly. “With real estate and investments, a good bit more.”
“How much more?”
Jeff sighed and placed his elbows on his desk blotter and steepled his fingers. “Okay, your mom had all the big money. When she died, your dad got half her estate, and you and Renee split the rest. That was roughly 1.2 mil in liquid assets, and another eleven mil in real estate. Your dad set up a trust for each of you with the cash, and you haven’t touched any of that money. Renee was going through hers pretty quick, had blown about half of it before your dad had her declared incompetent. He was named conservator of her estate, and doled out the rest on rehab and psychiatric care. There was still about forty grand left when she died.”
“He should have used his own fucking money to take care of her. He was the one responsible.”
“Do you want to hear this, or don’t you?” Jeff asked pointedly. Ryan waved for him to go on. “Okay,” Jeff continued, “so you had close to three hundred grand in the bank, plus quarter ownership of your mother’s real estate holdings. When your dad died, he left you everything; the house, his assets –which come to almost two million – your mother’s real estate, part ownership in the Chest Pain Center, a couple of –”
“Wait a minute,” Ryan interrupted. “He owned part of the Chest Pain Center? How?”
“No, you own part of the Chest Pain Center,” Jeff corrected. “plus a small life-insurance policy where you were named the beneficiary. You missed out on the big one. His main policy would have paid two million, but your Dad insisted on flying that light plane to every little pissant airfield in the South. When you bungee jump, fly light aircraft, skydive or run with the bulls in Pamplona, big insurers get kind of pissy about paying out if you get killed doing it.”
“Let’s go back to the Chest Pain Center,” Ryan ordered, “because I’m having a hard time getting my head around that.”
“Your dad didn’t simply retire,” Jeff explained. “What he did was sell his practice to St. Matthew’s. He sold the office and the land it was on, and Pierce Cardiology Associates became the St. Matthew’s R.H. Pierce Chest Pain Center. He was named Director Emeritus, and gets fifteen percent of the profits. And it’s very profitable, Ryan.”
“Okay, so how much, total?”
“Like I said, roughly 4.2 million in cash, scattered among various trusts and CDs. Most of the CDs have rolled over at least once. Your dad’s tech stocks have taken a major hit, but that’s just a small fraction of what he had invested. The real estate is the real value.”
“How much real estate?”
“One hundred acres in the West Oneida Economic Development District, abutting the industrial park. The city is drooling over that. Another four hundred acres on the east bank of the Oneida River, about ten miles north of town. All that’s undeveloped. There was a push to build a barge terminal and rail spur there in the early nineties, which is why your mother bought it. The city eventually built the terminal south of Oneida, so the bank has been leasing that land to an outfit that calls themselves the Ten Mile Creek Hunting Club. There’s an apartment complex in Fort Sperry with forty units, and a strip mall adjoining Allemands Centre that’s at eighty percent occupancy. Altogether, the real estate is worth upwards of thirty million. That’s not counting what the timber is worth.”
“Thirty-four million,” Ryan breathed. “Hard to believe.”
“That’s a conservative estimate,” Jeff grunted. “The housing boom is over, but the majority of your holdings are industrial property, which is almost certain to appreciate dramatically in the next ten years. Interest, stock dividends…the annual income from the Chest Pain Center is close to a hundred-fifty grand a year. My old man figures by the time you’re fifty, you’ll have a million to show for each year of your life.”
“No, you can just call me Jeff,” his friend intoned solemnly. “Although, for managing all your assets so expertly, it wouldn’t be out of line to get down on your knees and worship me now and then.” Ryan chuckled, and Jeff’s expression rapidly changed to a curious grin. “Why all the sudden interest in your finances, Ryan? For eighteen years, you’ve stayed as far away from this stuff as you can. I’ll bet you haven’t even opened The Letter.”
“Opened it,” Ryan grunted. “Haven’t read it.”
“Technically, you haven’t met the terms of your dad’s will until you’ve read that letter.”
“So forget you heard that. As far as you know, The Letter has been read. The seal has been broken on the envelope and everything.”
“You’ve ignored The Letter, and ignored the money,” Jeff repeated. “Do you even read the bank statements we send?”
“I bought the boat with some of it,” Ryan pointed out, “and I read the statements for my personal account. Right now it has twelve hundred bucks in it. I’m in high cotton.”
“Don’t even mention that boat around here,” Jeff warned, half-seriously. “My old man almost had you committed for dumping that house. When he found out about the boat, he damned near had another heart attack. So, once again, why the sudden interest?”
“This,” Ryan answered, retrieving the prospectus from his briefcase and tossing it onto Jeff’s desk.
Curious, his friend picked up the binder and opened it to the first page. His eyes widened, and his eyebrows marched up his forehead. “You have got to be fucking kidding me,” he said incredulously.
“Nope,” Ryan answered. “So try to talk me out of it.”
“That’s easy. You’d be a fool to invest money in this. It’s a great, big steaming turd, and all you’re going to accomplish by trying to polish it is smearing shit all over yourself.”
“What do you know about them?”
“Probably more than you do,” Jeff answered. “They came to me six months ago, begging for a loan. If I’m not mistaken, this is the same prospectus they gave me then.”
“So I take it you turned them down?”
“Cold,” Jeff sneered. “They had some payroll snafu after they first started, and the IRS socked ‘em with a big lien for unpaid payroll taxes. They don’t pay their bills on time. Everything they have is second hand and falling apart. No one will extend them credit. No collateral to speak of. And, if I may say so, a pretty unsavory reputation.”
“I hear things, and they do their banking here. They’ve had payroll checks bounce twice in the last quarter. Their best medic, they fired six years ago. Now, they’re the place to go when you’ve been fired by everyone else.”
“New employees are easy to find. You just have to pay them what they’re worth.”
“Yeah, and they just lost two employees a couple of days ago. Is that why they’re getting out?”
“The people they lost were the company owners. Their kids want to sell it, and cheap.”
“Not cheap enough, unless they’re giving it away,” Jeff argued. “Besides, the estate hasn’t even been probated!”
“So we loan them enough money to keep it running until the estate has been probated, and deduct that from the purchase price.”
“And already you’re talking about an unsecured loan, with absolutely no guarantee you’ll ever get it back!” Jeff flared.
“They have decent cash flow,” Ryan pointed out. “They’re just bloated. They run enough calls to support four or five trucks, if someone came in and trimmed the fat.”
“And you think you’re the one to do that?”
“Ryan, I’m begging you. The place is a money pit. Even if you could turn a profit, you’d never recover your initial investment. It’d almost be cheaper to start another company from the ground up, and bid for the ambulance contract in Audubon Parish when it comes up in six months.”
“But that wouldn’t preserve the current company.”
“So? What’s that to you?”
“Personal reasons?” Jeff parroted incredulously. He leaned back in his chair and covered his face with his hands. “Jesus, please don’t let my best friend throw good money away on some misguided attempt to rekindle the happy memories of his youth,” he crowed in a credible imitation of a television evangelist. “Let him come to his senses, Dear Lord, and abandon this foolish and wasteful enterprise. Let him reconcile with his beautiful wife, and somehow regain his sanity. Let him take his friend to lunch, where I will do my best to do Your work and lead him back onto the path of financial righteousness. In Your name we pray, amen.”
“I’ll buy you lunch,” Ryan grinned, “but you had best pray to someone you know. As I recall, Jesus chased your kind out of the temple.”
They had eaten at Canard’s, an upscale restaurant on the top floor of the Oneida Tower. The restaurant logo was a stylized outline of a duck’s head, indicating the French meaning of the word, but Ryan had teased Jeff that it was only fitting to take a banker to a restaurant whose name meant Lies. His friend had not been amused.
They argued for the better part of an hour, and finally ended at what Jeff thought was a stalemate. He had extracted from Ryan the promise that he would allow the bank to audit the Collins Ambulance books prior to the sale, and that he would sign no contract without first allowing the bank’s lawyers to scrutinize it. In return, Ryan had pressured him into retaining a tax lawyer who could begin work immediately on negotiating a settlement of Collins’ tax lien.
That went well, Ryan mused as he drove to the physical therapy center to pick up Caitlin. This might be doable after all. At least I won’t break the bank doing it. All I’m out right now is the money for a legal retainer.
When he pulled into the parking lot, he saw Dawn’s car there.
What the hell? She knows I’m supposed to pick Caitlin up today.
Inside, the receptionist pointed him to a room. He found Caitlin’s therapists, Miranda and Kristin, putting her through her exercises as Dawn watched. While Kristin worked on her stride and her balance, Miranda focused her attention on Caitlin’s left arm and hand. “I’m wearing my Delly Suit, Daddy!” his daughter greeted him cheerfully.
The Adeli Suit, originally designed to keep Russian cosmonauts from losing muscle mass in a prolonged stay at zero gravity, had found a new use in cutting-edge physical therapy. Its system of harnesses and rubber bands did an excellent job of mimicking the action of opposing muscle groups.
“I see that, Stinkerbell!” Ryan grinned, stooping to give his daughter a kiss.
“I’ve been calling you for two days,” Dawn said shortly.
“I lost my cell phone,” Ryan said evenly. “Is there a problem?”
“I left several messages, but you never called me back,” she accused. “I wasn’t even sure you were going to pick up Caitlin, so I took off work to come get her.”
“Since when have I ever forgotten to pick up my daughter?” Ryan asked with an edge to his voice.
“Children, children,” Kristin chided mildly without even taking her eyes off of her task, “are you going to behave, or am I going to have to put you both in Time Out? That’s what we do here when children refuse to play nice together, isn’t it, Ladybug?”
Caitlin nodded solemnly.
Shamed, both Ryan and Dawn blushed. Miranda broke the tension with good news. “Okay folks, here’s something new,” she bragged as she peeled Caitlin out of the Adeli suit. Holding out a Froot Loop in her palm, she offered it to Caitlin, who reached out and slowly, painstakingly, reached out and picked it up between the thumb and forefinger…of her left hand. Grinning triumphantly, she immediately popped the Froot Loop into her mouth.
“Way to go, Caitlin!” cheered Ryan and Dawn in unison.
“That’s not all,” Kristin pronounced. She pointed Caitlin to a set of wooden stairs leading up to a small plastic slide. “Go do it, Ladybug,” she ordered, “no hands this time.” Obediently, Caitlin lifted her left foot and planted it on the first step. Tottering unsteadily, with her arms splayed for balance, she shifted her weight over her pelvis, leaned forward…and lifted her right foot onto the step. Speechlessly, her parents watched as she repeated the process until she was at the top of the steps. Both of them had tears in their eyes when Caitlin turned around.
“Way to go, Stinkerbell!” Ryan roared as he picked his daughter up and swung her around by her arms. Caitlin giggled and begged to be thrown into the foam pit, a request Ryan reluctantly refused after seeing the looks of disapproval on the faces of Dawn and both therapists.
Foiled again by the Safety Nannies.
Outside, Ryan carried Caitlin on his shoulders while Dawn lugged her purse and Caitlin’s overnight bag. “She’s doing so well,” Ryan gushed. “You know, we made a pretty special kid.”
“Yes, she is,” Dawn agreed absently. “Are you going to the funeral on Friday?”
“Aren’t you working?”
“MetroCare is sending me,” he lied. He lowered Caitlin to the ground and tried to take the overnight bag from Dawn. She didn’t let go of the bag.
“I have a favor to ask,” she began hesitantly. “I know you have Caitlin for the next two days, but Billy got tickets to Dora the Explorer Live. It’s tonight at seven. I can bring her to you tomorrow morning, if that’s-”
“These are my days with her,” Ryan said flatly, cutting her off. “I don’t get to see her enough as it is.”
“You get her exactly half the time, Ryan,” Dawn sighed. “What more do you want?”
“I want all the time. I want my family back together. I’m not willing to settle for being present for only fifty percent of my daughter’s life, and I damned sure ain’t sharing those moments with your boyfriend. It’s not his right, Dawn. I’ll take her to see Dora.”
“You can’t. It’s been sold out for a week. Billy got the tickets because his brother’s kids have the flu.”
“Daddy Billy’s taking me to see Dora!” Caitlin chirped happily. Mortified, Dawn shushed and corrected her, but she could not miss the stricken look on Ryan’s face.
“She’s just aping his kids,” Dawn explained, ashamed. “They’ve been visiting for a couple of days, and they call him Daddy. She doesn’t know any better.”
“Of course she doesn’t,” Ryan said tightly. “I suppose I should be thankful that it was just ‘Daddy Billy’ and not plain old Daddy.”
“Don’t be like that, Ryan,” Dawn pleaded. “Nobody meant to hurt your feelings.”
“Oh, I’m fine,” Ryan answered, his face a mask of stone. “Can’t let her miss something like that. It’s Dora, after all.”
Yeah, and don’t forget Daddy Billy, sneered the voice inside his head.
Ryan forced a smile, bent down to hug Caitlin and whispered, “Have fun, Stinkerbell. Bring me a picture of you and Dora, okay?” Caitlin nodded happily, and Dawn opened the back door of her car and strapped Caitlin in the car seat.
“Sure you’re okay with this?” Dawn asked, searching his eyes.
With your boyfriend replacing me in my daughter’s heart? No, I’m not okay with that.
“Sure, why wouldn’t I be? Caitlin loves Dora.”
“There’s something else I’ve wanted to ask,” she ventured, “but there hasn’t been a good time. I don’t suppose there ever is a good time for this.” She sighed explosively, ran her fingers through her hair. Unconsciously fiddled with the ring finger of her left hand as she always did. “I want a divorce, Ryan. There’s a new thing; they call it collaborative divorce. We both use the same lawyer, we work out the agreements between ourselves, and the lawyer mediates and files the paperwork. It seems like the easiest way, for us and for Caitlin.”
“You’re quitting,” Ryan acknowledged, his voice toneless, drained of emotion. He kept his eyes focused six inches above her head, and his face was outwardly calm. Only his hands shook, and Ryan silently cursed them for betraying his emotions. “You’re giving up on me, and our marriage. Fine, quit. Make an appointment with the lawyer.”
“Sooner the better,” Ryan agreed. “No sense waiting, right? The quicker we get it done, the quicker you’ll be rid of me.”
“You’re not the man I married, Ryan,” she said softly, her eyes wet with tears, “and you’re never going to be that man again. I still love that man, but I can’t live with the one you are right now.”
“Hey, it was a good run while it lasted, right?” Ryan smiled. “People fall out of love all the time.”
Dawn was silent, eyes searching his own as Ryan gently reached out and wiped a tear from her cheek. He smiled reassuringly, but the smile ended at his eyes. “Now there’s the Hawkeye Pierce everybody knows and loves,” Dawn said bitterly as she turned to leave. “No emotions at all. A real fucking Ice Man.”
Ryan said nothing as he watched Dawn drive away. He got in his truck, put the key in the ignition and sat there, staring at the dash with his hand poised on the switch.
Sighing bitterly, he picked up his new cellular phone and made two calls. The first was to Amanda, the salesperson at the cellular phone store, to ask her out for dinner and drinks. The conversation was brief, and a bit awkward to Ryan’s thinking, but Amanda readily agreed to meet him after work for drinks. She knew a place.
The second phone call was even briefer. “Ty, it’s Ryan,” he said at the beep. “The answer is yes. Call me tomorrow and we’ll discuss the terms.”
Chapter Eight – Wakeup Call
“Turn off the fucking siren, Steve.”
Steven Hatfield refused to comply, instead letting the siren wail incessantly as they struggled to remove the bodies from the wreckage.
“Steve. I can’t even think over the siren. Turn it off, please.”
Still, Steve ignored Ryan’s order. Wincing at the piercing wail that threatened to pierce his skull, Ryan stared around the scene, looking at the cops and firefighters blithely going about their business as if they didn’t even notice the noise. To a man, they walked around Ryan as if he wasn’t even there.
“Somebody please, turn off the siren,” Ryan begged, sinking to his knees in the mud, hands clamped desperately over his ears. “Please, just turn it off. I can’t think…”
And still everyone ignored him, walking around his body as he lay there in the mud, writhing in agony as the screeching sound bored into his brain. Ryan lay there in agony, writhing in the mud, unable to block out the noise. He rolled over onto his back and screamed to block out the noise, but his voice was lost in the endless wail of the siren, and he lay there and screamed soundlessly as the rain spattered his face…
Ryan Pierce opened his eyes, and the rise and fall of the siren’s wail gradually coalesced into a pounding directly behind his eyelids. Nausea rocked him in waves, perfectly timed with the wailing of the…
…phone. The phone is ringing. Get up and answer the phone.
Groaning in pain, Ryan heaved himself out of the deck chair and staggered inside. In his haste, he knocked the handset from the phone base and across the floor, forcing him to lie on the floor and reach under the recliner for it. Thumbing the TALK button, Ryan lay on the floor with his cheek in the wet spot from last night’s spilled beer, put the phone to his ear, and croaked, “Hello.” His tongue was thick and unwieldy.
Jesus, I think a cat shit in my mouth while I was passed out.
“We’ve been calling you all morning!” Satan snarled without preamble. “Do you have any idea what time it is?”
“Half past eight,” Ryan groaned, squinting at his watch. His eyes felt as if they had been packed with hot sand.
“We’ve been calling your cellular phone and paging you for two hours!”
Well, not much chance of reaching me on my cell, Ryan mused, vaguely recalling the previous night’s events. Presuming I’d even answer it.
“Are you calling in sick?” Satan inquired, voice dripping with artificial sweetness. “Since you didn’t notify us, this would go in your file as a no-call, no-show.”
“Overslept,” Ryan lied. “Be there in an hour.” He hung up without bothering to listen to her reply.
Ryan tossed the phone aside and lay face down on the floor, trying to quiet his uneasy stomach. “God, just let me die,” he moaned to no one in particular.
You deserve to, came the familiar, nagging voice.
Shut up. I’m not listening to this.
Really, continued the voice reasonably. Look at all the people you’ve failed. Your mother, Renee, Dawn…now Bob and Linda…
Shut. Up. None of them was my fault. And I’ve never failed Dawn.
That’s because she’s smart, the voice countered mockingly. She left you first. She knew it was just a matter of time before you failed her, and Caitlin too…
Fuck you. You’re just some twisted part of my psyche that shows up when I’m stressed. You’re my SUBconscious, as in subordinate to my will. Any night-school, storefront psychotherapist can banish you in three sessions. Hell, not even that. A twelve pack will work just fine.
Oh yeah? How’d that twelve pack work out for you last night, Hawkeye?
At that, Ryan struggled to his feet and bolted for the door. He made it perhaps five steps before he collapsed to his knees and emptied his guts in one prolonged, heaving retch that left him weak and gasping for breath, stomach acid searing his throat. He lay there for a moment, spent, with his forehead touching the deck. A casual observer might have taken him for a penitent, were it not for the vomit and the empty beer bottles.
This ain’t doing it, he thought. Time to pull out the big guns.
He stepped from the shower and quickly toweled himself dry. He padded to the bedroom closet and dug out his personal ALS bag, the one MetroCare issued to field supervisors, and quickly spiked a bag of Ringer’s Lactate. He flushed the tubing, lay the bag on the bed, and wrapped a tourniquet around his upper arm. Finding a likely vein on his left forearm, he deftly inserted an 18 gauge catheter. As he did so, an unwelcome image of his sister Renee injecting heroin flashed unbidden into his brain, nearly causing him to vomit again. Studiously avoiding looking in the mirror, Ryan focused on the simple task of advancing the IV catheter.
There now. Not too shabby for a one-handed guy with a hangover. Now all I need to do is…shit. How am I going to attach the line and occlude the vein at the same time? I’ll make a bloody mess of things doing it one handed…
Struck by sudden inspiration, Ryan returned to the bathroom, right thumb clamped over the vein in his left forearm, and drug a towel from the rack with his teeth. He sat back down on the bed and spat the towel out on his lap. Laying his left forearm on the towel, he quickly released pressure on the vein and attached the IV tubing. He slapped a Venigard over the site and mopped up a few stray drops of blood with the corner of the towel, and paused to admire his handiwork.
So far, so good. I did that cleaner than I do most days on the truck. Now for a little shot of Phenergan, and let the healing begin…
He quickly drew up 25 milligrams of Phenergan to pacify his rebellious stomach, and injected it into the IV bag. He removed the Glenn Gore lithograph from its place above the bed, hung the IV bag from the picture hook, lay back on the bed and closed his eyes. He had been there no more than five minutes when the phone rang again.
Damn. The bitch called no more than thirty minutes ago. Can’t she just let me die in peace?
Cursing, Ryan heaved himself from the bed, carried his bag of Ringer’s Lactate into the living room and picked up the phone. Collins Ambulance scrolled across the caller ID. Sighing inwardly, he thumbed the TALK button and raised the phone to his left ear. Immediately, blood began to back up into the IV tubing. Reflexively, Ryan clamped the phone between his ear and shoulder, dropped his left arm and raised his right – the one holding the IV bag – over his head…
…and stuck it directly into the spinning blades of the ceiling fan. “Sonofabitch!” Ryan yelped in pain and surprise, nearly dropping the phone.
“Ryan?” a familiar voice asked hesitantly.
“Hey Spud,” Ryan smiled sadly into the phone, “how are you holding up?”
He had known Tyson Collins since he was he was a shy, pudgy six-year-old. His friends and his parents had always called him Ty, but Ryan had teased him that he looked like Mr. Potato Head, and promptly dubbed him Spud.
“Well, aside from my parents being dead, I’m just capital,” Ty Collins sighed bitterly, “and yourself?”
“I’m sorry, kid,” Ryan apologized. “I was going to call, check in on you guys. I just saw it on the news.”
“Yeah. Thanks,” Ty answered perfunctorily. His voice was flat, drained of emotion. There was a long pause, then, “Do me a favor and thank your crew that worked it, would you?”
“Sure, Spud,” Ryan said softly. “Do they, uh, know what caused it?”
“Officially, they ‘hydroplaned on standing water and lost control, leaving the roadway and striking several trees’, according to the Louisiana State Police,” Ty answered, the bitterness creeping back into his voice. “Unofficially, if the truck had decent tires, steering and suspension, it probably wouldn’t have happened. Same shit you bitched about for years.”
“It was an accident, Spud,” Ryan said firmly, “the same thing has happened to dozens of vehicles on that road. Second-guessing won’t bring them back,” Ryan went on gently. “Believe me, I know.”
“Anyway,” continued Ty as if he hadn’t heard, “the funeral and memorial service is on Friday. We want you to be a pallbearer.”
Ryan Pierce swallowed hard. “I’d…I’d be honored, Ty,” he managed to stammer. “Steve and I will bring a rig for the procession, wear our dress uniforms –”
“Everyone will be wearing their Collins Ambulance uniforms,” Ty Collins interrupted flatly. “That’s the way Mom and Dad would have wanted it.”
“Listen, Ty,” Ryan hedged, “I work for another company now. I’m sure MetroCare would be glad to send a representative to the memorial, and I’d be happy to be the –”
“No, you listen, Ryan,” Ty snapped. “I don’t have the time, or the energy, to argue with you until you swallow your pride. I’ve already gotten confirmation from everyone else. You’re the only person who hasn’t agreed to do it.”
Jesus, how did he manage that? Half of us are no longer there, and scattered all over the state.
“Your parents fired me, Ty,” Ryan argued, trying another tack.
“And they regretted it plenty of times since, but they knew you’d never come back,” Ty shot back. He sighed heavily. “Just say you’ll do this for me, Ryan,” he pleaded, voice breaking.
“I’ll be there, Spud,” Ryan promised, after a long moment spent mastering his voice. “Have someone find me a uniform.”
“Great,” Ty Collins breathed. “Look, there’s one other thing I need to talk with you about. Tonight, if you can. Can you drop by the office after work?”
“Uh, I’d rather not,” Ryan suggested, thinking of the likelihood of seeing Dawn’s new boyfriend there. “Why don’t you come out here? You know how to find the marina?”
“I can find it,” Ty assured him. “Eight o’clock okay with you?”
“What’s this about, Spud?” Ryan asked curiously.
“Not now,” Ty Collins answered cryptically. “We’ll talk later. Eight o’clock,” he reminded, and then hung up the phone.
I wonder what the hell that’s about?
Ryan settled heavily onto the couch next to him with a groan. “Rough night?” Steve asked perfunctorily, not even bothering to take his eyes off the screen.
“Long one,” Ryan grunted. “We okay, Steve?”
Steve Hatfield didn’t answer directly. “Hope you wore your asbestos Underoos. Dickless is in the mood to burn some asses today. Yours is at the top of his list.”
Roger Dickles, a ten-year paramedic who hadn’t been on the street in eight years, was the Operations Manager for MetroCare EMS. His only street experience a two-year hitch at the Holly Hill substation in rural Allemands Parish, Roger had parlayed that into a gig as Dispatch Supervisor, then a six-year stint as Fleet Manager, and a short hitch as Clinical Education Manager before reaching his current rung on the MetroCare career ladder.
Long known for his unwillingness to stick his neck out, Roger’s surname had lent itself readily to the unfortunate sobriquet of “Dickless.” The name fit.
“Well, he’ll have to get in line,” Ryan sighed. “It’s been that kind of morning. I asked you before, are we okay?”
“You catch the news?” Steve asked warily.
“Yeah, I saw it. Funeral’s this Friday at noon. You wanna come with, maybe bring a unit for the procession?” Ryan asked.
“Because you’re my partner, Steve,” Ryan sighed, “even though I may not act like it some times. You’ve always had my back, and this thing…well, I don’t want to go alone, okay?”
“Okay,” Steve grunted, and then paused, obviously considering what to say next. Finally, “You look like shit, Hawkeye. You get any sleep at all? Or did you drink yourself into a stupor again?”
“Drop it, Steve,” Ryan said flatly, the warning clear in his voice. Steven Hatfield, however, was not cowed so easily.
“I’m not gonna drop it,” Steve said evenly. “I’m your partner, but I’m also your friend. You need some time off. Hell, go get laid. Remember that pretty nurse at West Oneida ER last week? What was her name, Cathy? Go ask her out.”
“I’m a married man,” Ryan reminded him. Steve snorted in disgust.
“Dawn left you, Ryan,” he retorted bluntly. “What’s more, she’s seeing that guy at Collins Ambulance. And you haven’t been yourself since she left.”
I haven’t been myself for years, Steve. But at least Dawn made it easier to hide.
“Anyone else would be picking up their teeth for talking to me that way,” Ryan observed. “What makes you think you can get away with it?”
“Because I am bigger and faster, and because you’re too hung over to take me. Besides, you know it’s the truth.”
“Thanks for the pep talk,” Ryan said sarcastically. “I always feel better after talking to you.”
“Come on,” Steve pleaded. “Don’t go back to the boat tonight after work. We’ll hit the range, burn up a few boxes of ammo. What do you say?”
“Can’t,” Ryan demurred. “I’ve got something else to do. I appreciate the offer, though.”
Steve sighed, defeated. “I’m supposed to tell you to report to Dickless as soon as you show up. I’ve already had my ass-chewing this morning. You should know that Satan has been whispering tales in his ear.”
“Took part of my ass-chewing, you mean,” Ryan grunted. “No need to cover for me, Steve. I appreciate it, though.”
“Do you?” Steve asked, one eyebrow raised.
“Yeah, I do,” Ryan said simply. “I know it ain’t easy being my partner sometimes. If I’ve been a horse’s ass lately, well…I’m sorry. You deserve better.” He heaved himself off the couch and groaned, half in jest, “Well, I better go face the executioner. Wish me luck.”
“Kiss ass like there’s no tomorrow,” Steve called after him. “Look where it got Dickless!”
Ryan was still chuckling as he rounded the corner and nearly bumped headlong into Martha Boyette as she was stepping out of Roger Dickles’ office. Her eyes flashed with surprise and anger, and then, smug satisfaction.
“He’s waiting for you,” she sneered.
“Good morning, Martha!” Ryan gushed with exaggerated courtesy, “how lovely to see you!”
“Your ass is in a crack now,” Martha went on spitefully. Her hatred boiled off her in waves. “You’ll be lucky if you keep your fucking job.”
Ryan stood there and carefully considered what to say. After a moment, his face brightened, he smiled beatifically, leaned forward and whispered softly in her ear, “Go fuck yourself, Satan.”
Martha recoiled as if she had been struck, stared at him for a moment and stomped off down the hall.
“You look good, by the way!” Ryan called after her. “You get your hooves trimmed or something?”
“You know, if you didn’t antagonize her so much, she might not be trying so hard to get you fired,” came a dry voice behind him. Ryan turned to see Roger Dickles standing in the open doorway to his office.
“Well,” Ryan countered, “her idea of being antagonized is when someone points out her mistakes. And she’s vindictive, Roger. If you get on her shit list, she punishes you for the entire shift.”
“That’s not possible, Ryan,” Roger sighed as he waved him into his office. After pointing Ryan to a seat, he sat on the edge of his desk, folded his hands in his lap, and went on. “We have a computerized dispatch system, used in every MetroCare operation in this country. There’s no room for anyone to manipulate the system, even if they wanted to.”
So you say, Dickless. That was the party line back when you used to screw people over in dispatch, and Satan was your little protégé.
Ryan rolled his eyes and smiled, but said nothing. Roger Dickles flushed in anger, but managed to keep his temper under control. He got up and walked to the other side of his desk and sat down. He pushed a piece of paper across the desk, tapped his finger on it several times and ordered, “Read and sign.”
Ryan looked at the sheet of paper in idle curiosity. Across the top was the MetroCare corporate logo and the heading Personnel Action Request. In the block labeled Type of Action was scrawled: Disciplinary, Class 3.
They’re suspending me. What for?
“And what have I done that warrants suspension?” Ryan asked, tossing the paper back onto the desk. “Last time I checked, tardiness warranted a verbal warning for the first offense.”
“Read the whole thing, and sign it,” Roger repeated.
Sighing, Ryan picked up the form and read it. As he did, he felt his face growing redder. He met Roger Dickles’ eyes and said what he was thinking. “If you think I’m going to acknowledge this horse shit by signing my name to it, you’re out of your fucking mind, Roger.”
“We have all the documentation we need,” Dickless said coolly. “I can show you the applicable sections in the Policy and Pro-”
“I’m not one of your baby seals you can bludgeon with some obscure reference from your fucking Policy and Procedure Manual, Roger. I know what’s in there as well as you do.”
“Then why don’t you follow it?”
“Because I don’t need a manual to tell me if I’m wiping my ass in the approved MetroCare manner. Apparently you do.”
Roger Dickles’ face whitened, and for a moment, he looked as if he might lunge across the desk. Ryan hoped he would. Dickless composed himself, and said smoothly, “This isn’t about you being a good paramedic, Ryan. This is about you being a good employee.”
What the hell is that supposed to mean?
“So what is this ‘failure to supervise’ shit I’m reading?”
“David Hendricks used profanity over the radio net yesterday at that MCI,” Roger challenged. “Have you said anything to him about it?”
“I didn’t think it needed addressing.”
“You think a lot of things don’t need addressing. That’s your problem.”
“You’re saying you want me to discipline Dave because he blurted something over the radio in the heat of the moment?” Ryan asked incredulously. “Come on!”
“You don’t have to discipline him at all,” Roger answered. “I’ve already taken care of it.”
“Goddamn it Roger, you had no right to do that!” Ryan exploded furiously, rising from his chair. “I can’t believe you’re going to punish the guy for saying ‘fuck’ over the radio when he had a eleven-car pileup happening not ten feet away!”
“He used profanity over an open radio net, and in so doing, reflected poorly on this company,” Roger insisted. “On top of that, your partner ran over a guy last week on the local news. Why wasn’t that written up?”
Disgusted, Ryan rose to his feet and turned toward the door. “You know, you’re really chickenshit, Roger. If I’d have known what you were twelve years ago, you’d have never finished paramedic school.”
“We’re not through here, Ryan. Sit back down.”
“Yeah, we’re through,” Ryan shook his head sadly. “This isn’t disciplinary action. This is a witch hunt. You’ve already made up your mind.”
“So sit back down and write your rebuttal on the form, and sign it,” Roger offered with a cruel smile.
“The only thing on that form I’m guilty of is self-dispatching, and there was a good reason for that,” Ryan argued. “The problem is, you’re not interested in any version but yours and your lackey’s. Hell, you’re even accusing me of unprofessional behavior towards the EMT students I precepted!”
“The last two student riders you had, you stapled Taco Bell applications to their evaluation forms,” Dickless pointed out. “Their instructor didn’t find it amusing. Neither did I.”
“They should have taken the hint,” Ryan said automatically.
“Their instructor said they had the two highest grades in his class.”
“Then they’ll no doubt go on to be shitty paramedics but good employees; just your kind of EMT. I had a student like that once. He could have been a good medic. Instead he turned into a fucking suit afraid of his own shadow.”
“Get out of my office, Ryan,” Roger ordered, his voice shaking. “Get out and go spend your three days off thinking about how to salvage your job, because as of right now, your position as a shift supervisor is over.”
“HR says I have seventy-two hours to offer my rebuttal to any disciplinary action,” Ryan shot back. “Rest assured, I am going to contest this, all the way to corporate if I have to. See you in three days, Dickless.”
Ryan slammed the door and stalked back down the hall, his face purple with fury. As he stalked through the break room, Steven Hatfield looked up from the television in concern. “So, how did it go?” he called out.
Ryan acted as if he hadn’t heard, his only reply the slamming of the station door.
“Not well, apparently,” Steve muttered softly to himself, and changed the channel.
Ryan took a circuitous route home, one that wound through the city, across the river into West Oneida, up Highway 74 into Audubon Parish. If a cop had stopped him and asked where he was going, Ryan Pierce would have been unable to answer. He was on autopilot. Eventually, whether by force of habit or psychic inertia, he found himself parked at the marina, staring vacantly out over the basin to the river beyond, receding now for three straight days. The water was low enough now that, by skirting the edge of the basin and taking a running leap to the end of the dock, he could make it aboard Ecnalubma without getting his feet wet. After staring at the water for perhaps an hour, he sighed, turned his truck off and did just that.
The chickenshit bastard has been compiling shit on me, Ryan fumed as he picked up empty beer bottles and hosed the dried vomit from his deck. That stuff with the Taco Bell applications happened a couple of months ago. If he knew about it then, then he’ll have to explain why he waited until now to say something about it.
Back inside, he dug through the refrigerator for something to quiet the ache in his stomach. Seeing nothing worth eating, he abandoned the venture in favor of sitting on the deck and watching the river roll by.
The stuff with Steve bumping the guy with the rig won’t wash at all. HR will throw that right out. Oneida Police Dispatch didn’t clear us to that scene, but Satan never told us to stage anywhere. I could use that against her. She sent us into an unsafe scene. Otherwise, we’d have never been there, and Steve wouldn’t have bumped the kid with the rig.
He disciplined Dave less than twenty-four hours after the incident. I could say that I was planning to give Dave a verbal reprimand, and Ol’ Dickless preempted me…
Shit, that was only twenty four hours ago? It seems like a week! Christ, and it’s only what, two o’clock? What the hell am I going to do until Spud gets here?
He stomped back inside and rummaged through the refrigerator for the makings of a sandwich he didn’t really want to eat. Leaving the cold cuts on the counter, he took his lunch into the living room, collapsed into his recliner and turned on the television.
Ryan vacantly stared at the screen as he channel surfed, the flickering images barely registering on his consciousness. He ate fitfully, a small bite now and then, tasting nothing. After an hour, he threw his half-eaten sandwich in the trash and put the cold cuts back in the refrigerator. He automatically reached for a beer, but something made him hesitate. He stood there, wavering, hand poised over the dark green bottle for several moments, and then savagely slammed the refrigerator door with a muttered curse.
He stalked back to the master cabin and lay back on the bed, still fully clothed. Ryan closed his eyes, and prayed for sleep to take him. It didn’t take long. As he tossed fitfully, he had the nightmare again, the one that left him drowning in a sea of accusing faces.
Only this time, the dream had two new characters: Dave and Barbara Collins.
Ryan opened his eyes to see Ty Collins leaning over his bed. He blinked groggily, and then looked at the clock.
8:20. Damn, have I been asleep for six hours?
He swung his legs out of bed, rubbing his eyes with one hand while offering Ty Collins the other. Ty grasped his hand with a warm but tired smile and pulled Ryan to his feet. They stood there awkwardly for a split second, and then the handshake morphed into a fierce bear hug.
“You’re looking good, Spud,” Ryan said emotionally, holding him at arm’s length and looking him up and down.. “Damn, what are you, 230 pounds? Whaddaya bench these days, a Toyota?”
“Maybe a Hyundai,” Ty deadpanned. “It’s been a long time, Ryan. Sorry I let myself in. I knocked, but you didn’t answer.”
“Six years,” Ryan agreed, waving off the apology. “You still had baby fat and barely any fuzz on your nuts back then,” he teased.
“I was almost eighteen,” Ty protested with a grin. “Y’all just treated me like I was a baby.” His grin was forced, and ended at his eyes. Ty Collins was putting on a brave face, but Ryan wasn’t buying it.
“So, how did you know this was my boat?” Ryan asked curiously.
“There could only be one boat on this river with a mirror image of ‘AMBULANCE’ painted on the stern in big blue letters,” Ty said dryly. “I took a chance it was yours.”
“Well, let’s grab a beer, and I’ll give you the grand tour,” Ryan suggested with a heartiness he didn’t feel. He led Ty to the galley, thrust a beer into his hand and shepherded him through a quick but thorough tour of Ecnalubmna, proudly pointing out all of her amenities. Ty Collins nodded appreciatively at all of the proper points, but it was obvious his mind was elsewhere. The tour ended on the rear deck, and Ryan fetched another couple of beers. They sat there watching the river, with only the lap of water against the hull to break the uncomfortable silence.
“Tell me something, Ryan,” Ty ventured, picking at the label of his beer bottle. “How much money did your old man leave you when he died?”
“I don’t know,” Ryan answered warily. “A few million. A friend from high school handles all that stuff for me. I haven’t touched any of it since he died.”
“It bought you a pretty nice boat, though.” Ty swept his arm around, gesturing at his surroundings. “Must be nice.”
“Actually, I bought the boat with the money I got from selling my parents’ house,” Ryan explained.
Where is he going with this?
“Damn,” Ty whistled appreciatively. “This boat cost that much?”
“Not hardly,” Ryan chuckled. “I sold the house to the city at just over 40% market value. The only stipulation was that whatever they did with it would not bear the Pierce name.”
“I’ve been in it,” Ty confessed. “School field trip, years ago, back when you still worked for us. It was impressive.”
“You never told me that,” Ryan grunted.
“Well, it was pretty obvious you wanted nothing to do with your family. Mom and Dad were always curious, but I figured it was none of our business. They hired you because of your Dad, you know.”
“No, I didn’t know that,” Ryan said, surprised. “They talked to my old man?”
“No, not that,” Ty shook his head. “They knew who you were. They figured by hiring you, they’d have an edge on getting a transport contract with St. Matthew’s. Robert Pierce’s word carried a lot of weight.”
Ryan dissolved into a fit of laughter, nearly choking on his beer. “Well, they certainly fucked up there!” Ryan roared. “He’d have been more likely to try to run them out of business, so I’d give up this EMS foolishness and go to medical school.”
“Well, it’s no secret that Dad never had the sharpest business instincts,” Ty agreed with a grin. He idly peeled the label off his bottle, and then continued in a more serious tone. “Still, you never gave up on all this ‘EMS foolishness’ in all these years. You lived for eleven years on the chump change you earned at Collins Ambulance. You’re a multimillionaire, yet you still work for an outfit like MetroCare. Why?”
“Stubbornness and stupidity?” Ryan offered jokingly, and saw that Ty Collins was serious. He sighed. “I don’t know, Spud,” he shrugged. “It’s a long story. I suppose it was because this was always my choice, not my parents’. It’s all I ever wanted to do.”
“You’re worth millions, yet you stay with a job that pays less than fifty thousand a year. Haven’t you ever wanted more?”
“Nope,” Ryan said with conviction. “This is what I was put on this Earth to do.”
Ty nodded, digesting that. He nodded to himself as if he had come to a decision, drained his beer and heaved the empty bottle far out into the river.
“What’s all this about, Spud?” Ryan asked, breaking the silence. “You come all the way out here to ask me to loan money to Collins Ambulance?” he asked, half-jokingly.
“Not exactly,” Ty Collins said evenly, meeting his eyes. “I came out here to convince you to buy it.”
Chapter Seven – Recriminations
Ryan turned up the volume and watched in mute horror and disbelief as Connie Mitchell narrated for the camera. He absently set his beer aside, aiming to set it on the end table and missing it altogether, ignoring the overturned bottle spilling foamy beer into the carpet next to his right foot.
“…State Route 74 has claimed two more lives as of today. Two area paramedics died tragically late this afternoon in a single-vehicle ambulance crash in rural Oneida Parish,” she was saying. “According to Louisiana State Police troopers on the scene, the ambulance left the roadway and struck a tree, killing both of the paramedics on board.
Troopers would not speculate that the weather was a contributing factor in the crash, but did tell us that the ambulance siren and emergency warning lights were not activated at the time of the accident. The paramedics, employed with Collins Ambulance of Audubon Parish, were apparently traveling north on Highway 74 when the accident occurred, just two miles south of the Audubon Parish line.”
Who, damn it? Who were the EMTs?
“…names have not been released, pending notification of their families. Viewers may recall Headline News’ reporting of the rash of fatal accidents along this five-mile stretch of State Highway 74, and the ongoing efforts to secure state and federal transportation funds to widen and resurface the treacherous highway. Today, ‘Bloody 74’ claimed its tenth and eleventh victims in a two-year span, two paramedics who have quite possibly tended the past dead and injured along this very same highway. This is Connie Mitchell reporting, Headline News.”
The feed cut back to the anchor in the Headline News studio, his expression grave and sympathetic as the monitor behind his left shoulder showed more footage of the ambulance being winched onto a flatbed wrecker.
Scarcely paying attention to the anchor’s pontifications, he slid to his hands and knees on the damp carpet, his nose a foot from the screen. The front end of the rig was demolished, front axle displaced rearward, and cab crushed from the impact. Through the mud, Ryan could make out the numbers on the ambulance fender.
Sixty-four. Oh God, Bob and Linda! That’s the rig they were in earlier today!
True to his nature, Ryan Pierce was outwardly calm. His hands did not tremble; his expression did not change. He sat silently, unmoving for several minutes, then turned off the television. He picked up the overturned bottle of Heineken, threw it in the trash, and padded to the bathroom for a towel.
He methodically blotted the spilled beer out of the carpet, took the towel back to the bathroom and threw it in the hamper. He walked back to his kitchen and carefully, almost ritualistically put his groceries away.
Steaks in the left corner, pork chops in the right. Need more fish. Looks like I have plenty of chicken. Leave some pork chops out for tonight. Pop Tarts go in the pantry, third shelf up. Chocolate donuts go in the breadbox, out of sight so Caitlin won’t constantly ask for them. Cereal goes in the storage containers; one for Frosted Flakes, one for Fruity Pebbles. Onions and potatoes go in their storage bins…oops, time to throw out some of these old potatoes…
And so he went, each item carefully stowed away, because he lived on a boat after all, and everything had its proper place. Everything had to be shipshape. Space was at a premium.
Except that space really wasn’t at a premium. Ecnalubma was roomier than his college apartment. Things didn’t really have to be all that shipshape. He hadn’t cast off the lines and taken her for a cruise in almost a year. Ryan was focusing on process again, his mind superficially occupied with mundane tasks while his emotions were far less organized.
Dead, both of them, a nagging inner voice told him, and too late now for you to fix things with them. Just like your mother. Just like Renee.
Not my fault, he shook his head vehemently. Not. My. Fault. They all chose their own paths. I chose mine.
Sure it wasn’t your fault, Ryan, the voice said sarcastically. Dawn leaving wasn’t your fault either, was it? And when she dies, what will be your excuse for not having fixed things with her?
“No,” he said aloud. His voice was harsh and strained, shattering the stillness. He shook his head ruefully.
Shit, now I’m talking to myself. I’m losing my fucking mind. Carpet cleaner. That’s what I need. Carpet cleaner and a brush. Gotta get the blood out of the carpet before it starts to smell…
Blood? NOT blood, beer. Where the hell did I get ‘blood’ from? Need to get the beer out of the carpet before it sours. Just my luck to have a big, nasty bloodstain on the…
STOP IT. More doing, less thinking, Ryan. Carpet cleaner. That, and a scrub brush right under the sink. And paper towels to blot with. Disinfectant. 10:1 water and bleach solution, mixed up fresh every 24 hours, just like Bob Collins taught me when I was…
STOP IT. It’s not blood, it’s spilled beer. Just a fucking beer, Ryan. Beer. You need another one.
Ryan stood up abruptly, tossing the carpet cleaner and brush onto the counter. He savagely yanked open the refrigerator, pulled another Heineken and opened it with shaking, fumbling hands. He turned it up and drained it in one long pull. He opened and drained another and part of a third in quick succession before he stopped, taking a ragged, gasping breath.
He picked up the carpet cleaner and the brush and marched purposefully across the cabin and knelt next to the drying stain on the carpet. He pushed the recliner and end table out of the way, much too hard, his hands guided by an unreasoning anger that his brain struggled to master. The table toppled onto its side with a crash, spreading magazines and unopened mail across the floor like a deck of cards fanned by a clumsy dealer. Ryan Pierce scarcely noticed. He was still scrubbing furiously thirty minutes later when the phone rang.
Ryan stared numbly at the caller ID and sank back onto his heels. His knees and arms ached fiercely.
Don’t answer it. If you answer, it becomes real.
He stared mutely at the handset as it rang insistently, his hands still trembling, his breath coming in long, shuddering gasps.
Hang up. No one home. Leave a message at the beep. No one here but us chickens. The number you have dialed has been disconnected or is no longer in service. Please check the number and try your call again…
After what seemed like an eternity, the phone stopped ringing. Ryan heaved a thankful sigh, welcoming the silence. He got up from the floor, righted his end table and picked up the scattered mail. He returned the scrub brush and carpet cleaner to their places under the sink, and threw the soiled paper towels in the trash. He opened the refrigerator door and was reaching for another beer when he stopped himself.
No. You don’t need this. Four is already too much. You have a shift to work tomorrow.
Ryan closed the refrigerator door and leaned his head against it. He closed his eyes and commanded himself to breathe slowly and deeply, ordered his hands to stop trembling. Of all things Ryan Pierce feared, losing control scared him the most. It happened so rarely. Like cracks in the face of a dam, his inability to conquer his emotions, however brief or infrequent, left him with a vague sense of disquiet.
Long minutes later, Ryan padded to his stateroom and began stripping off his uniform. Socks, boxers and tee shirt in one pile, pants and shirt in another. Pens and change removed from his pockets, the chipped and worn blue star removed from his left collar point. Cap and belt hung in the closet, on a rack filled with ties he rarely wore. Body armor folded carefully and laid flat atop the bureau. Pager, wallet, cell phone, ID tag and a battered pair of trauma shears arranged carefully on the bedside table. Out of habit, Ryan checked the alarm clock to assure that it was set for five-thirty, even though he hadn’t awoken that late in six months.
He tossed his dirty clothing into the appropriate hampers, washed his coffee pot and set the brew timer for three am. He put a load of uniforms in the washer, and checked the closet to make sure he had a freshly pressed one to wear tomorrow. He did.
Ryan sat on his bed in the darkness and closed his eyes, mentally retracing his steps.
Groceries put away. Mail sorted. Alarm set. Laundry going. Carpet cleaned. That’s it. Everything shipshape.
Except it’s not, the nagging voice whispered. Nothing will ever be in its proper place again. You’re lost, and you’re alone. And that was your choice.
Desperate for a distraction, any distraction, he trotted back to his living room and yanked open the door leading to his stern deck. He grabbed his muddy boots and took them to the sink. Turning on the hot water, he scrubbed them savagely until the black leather was unblemished once again, desperately willing his scattered thoughts down the drain with the swirl of muddy water.
He sank into his recliner and turned the television back on, surfing through the channels with no particular destination in mind. It was something to do. Sound muted, he stared blankly at the rapid-fire, flickering images that mirrored his own thoughts, never focusing too long on just one for fear that he’d find a show he couldn’t escape.
When his cell phone rang an hour later, it startled him. He padded to the stateroom and picked it up, feeling the tightness grip his chest once again as he saw Collins Ambulance on the display. Ryan walked back to the kitchen, cell phone in hand, and took the remainder of the case of Heineken from the fridge. He walked onto his stern deck, heaved the phone as far as he could into the river, and collapsed into a chair. He opened another bottle, and started drinking.
Chapter Six – Rain
“Control to…304,” the radio crackled, as if Satan were unsure of which unit she should be calling.
Probably trying to figure out of we’re close enough to punk with this one. The bitch.
Ryan and Steve listened with half an ear as 304 was dispatched to a wreck on the interstate, just a few miles east of their location.
“People can’t drive for shit in the rain,” Steve yawned sleepily, checking his watch. “Only two hours until shift change. Can’t get here soon enough.”
“It has been the shift from Hell,” Ryan agreed, “But if you keep talking about it, you’ll jinx us.”
Steve said nothing, just nodded sleepily and leaned back against the headrest. Ryan turned his attention back to his incomplete patient care reports.
Fourteen calls in ten hours. Eleven transports. I’ve been listening to the damned radio, and nobody else has transported half that many, even if all but one of ours were emergency calls. She knows where to post us so we’ll catch the most calls. God I despise that woman…
“…304 on scene,” David Hendricks’ voice cut into his reverie. “Uhhhh…Control, you can cancel Oneida Fire. Looks like a minor accident, and everyone is out and walking around.”
“Ten-four, 304,” Satan acknowledged. “Advise us if you have any refusals.”
Stop telling my crews how to do their jobs, bitch. They know what they’re doing.
David’s reply was not the expected one. “Uhh, Control! Keep Oneida Fire rolling, and send us additional units! We’ve got fucking rubberne – um, ahh, chain reaction crash at this scene, Control! I’m gonna need a lot more ambulances here!” In the background, the sound of screeching brakes and rapid-fire impacts of crunching metal only punctuated his fear and excitement.
“Let’s go, Steve,” Ryan ordered, fastening his seatbelt. “Mile marker 120, I think it was. That’s gonna be on the overpass.” Steve Hatfield had the rig in gear and rolling before Ryan could finish the last sentence.
“306 to Control,” Steve radioed. “We’re responding to that chain reaction wreck at 304’s location.”
“Stand by, 306,” came the reply.
Stand by? What the fuck does she mean, ‘stand by’?
Ryan and Steve shared a look of disbelief and disgust. “Give me the mike,” Ryan ordered. Steve, rolling his eyes and shaking his head resignedly, handed it over.
“Be careful what you say,” he warned. Ryan ignored him.
“306 to all available units,” he radioed, giving Steve a defiant glare, “Priority One call on the interstate, westbound at mile marker 120, backing up 304 on a multiple MVC. All other units, expedite transport and check in with Control.”
“That’s not your job, Ryan,” Steve reminded him tiredly as the other units in the city began marking en-route to the scene, “and all you’re gonna do is piss her off, maybe even get written up for self-dispatching.”
“Fuck her, Steve. Right now, she’s frozen, wondering what she should do. The first coherent thought she’ll have is after this is all over.”
“And that thought will be how she can stick a knife in Hawkeye Pierce’s back for making her look like an idiot!” Steve flared. “Goddamnit! Don’t you get that?”
Ryan said nothing in reply, just stared out the window mutely. Steve, fuming, negotiated the surface streets approaching the nearest interstate on-ramp. When Steve Hatfield was angry, he tended to handle the rig roughly. From the jerky steering corrections, hard braking and acceleration, Ryan could tell he was monumentally pissed.
“Look, you can see 304’s lights from here,” he says, pointing at the elevated roadway. At the head of a massive traffic jam, the flash of 304’s emergency box lights could clearly be seen.
“Shit,” Steve breathed. “No way we’ll get to him through all that traffic, and we can’t use the eastbound overpass. Any ideas?”
“No,” Ryan answered honestly, “but get closer and let’s see if we can figure something out.”
“306 to 304,” Steve radioed. “We’re thirty seconds out. What have we got?”
“We got eleven cars,” David replied tersely, “I don’t know how many patients. I’m still triaging.”
“Control to 304,” Satan radioed, walking over Steve before he could reply. “Are you declaring an Mass Casualty Incident?”
“Ten-four, Control,” David confirmed, “declaring an MCI at this time.”
“Control to all responding units, we have a declared MCI,” Satan declared decisively. “304 is Incident Command. Responding units stage at…stand by.”
“Control, looks like the best place is the Tarleton Avenue off-ramp,” Ryan furnished helpfully. “Everyone needs to come up Tarleton the wrong way and stage there at the base of the off-ramp. We’re gonna have to push the stretchers and equipment up the ramp to get to the wrecks.”
“Control to all units, copy 306’s traffic?” Satan relayed coolly, professionally.
“Looks like she got unfrozen pretty quick,” Steve observed innocently as he parked the rig on the concrete median at the base of the Tarleton Avenue ramp. “That sounded like fairly coherent thought.”
Ryan just grunted noncommittally and extended the middle finger of his left hand as he bailed out of the rig. Two minutes later, legs burning and breathing hard, they had pushed their stretcher, piled high with two spine boards, cervical collars and first-in bag, up the ramp and through the line of stopped cars. They found David Hendricks leaning in the driver’s window of a compact SUV with minor, cosmetic damage.
“How many patients?” he asked without preamble.
“Looks like only six,” David sighed with relief. “Front two cars, mainly. Two people in the front SUV with minor injuries, mainly necks and heads. The guy that rear-ended them is serious – chest and head. Three people in a car behind them with Allstate-itis. They’re just lookin’ to get paid.”
“Gotcha,” Ryan acknowledged, and turned to Steve. “You help David and his partner get the critical patient packaged. As soon as they’re transporting, come back to me.”
“Why don’t you have David cancel the MCI,” Steve suggested, “since he’s Incident Commander and all? All we need is another transport unit, and Oneida Fire for extrication on our critical guy.”
“Good idea,” Ryan stuck his tongue out. “Perhaps you’re not totally fucking worthless after all.”
David Hendricks chuckled at the two partners as he keyed his radio. “Incident Command to Control…only six transports here. You can stand everyone down. We’ll still need another truck, and keep Oneida Fire rolling. We’re gonna need extrication on one patient.”
“Ten-four, 304,” Satan replied coolly, then relayed the traffic, “Control to responding units?”
“Ten-four direct,” came the replies from other units as they stood down, pulled their units over and waited for new posting assignments. The radio crackled again. “305 to Control, we’re only thirty seconds out,” came the voice of Mark Perry.
“Continue responding, 305,” came the reply. “Stage at the base of the Tarleton Avenue off ramp.”
“We oughta be able to handle this fairly quickly,” Ryan judged. “Let’s get to it.”
“Quicker we get ‘em assessed, extricated and packaged, quicker we’ll be out of the rain,” David agreed.
Together, they both walked up the line of wrecked cars. Ryan peeled off near the head of the line as David returned to the car with the critical driver. Walking in a wide circle around the wrecked SUV at the head of the line, Ryan approached it from the front, making eye contact with the driver and motioning for her to roll down the window. As the window hummed down, Ryan slid his hands through the opening gap and gently grasped the driver’s head, holding it still.
“Howdy, Ma’am,” he grinned. “Lovely way to spend a rainy afternoon, ain’t it?”
“Just fuckin’ great,” the woman chuckled nervously. “I should be in a thirty-car pileup every day.”
“Where are you hurt?” Ryan asked, turning serious.
“Neck and forehead, mainly,” the woman grimaced. “Neither of us was wearing a seatbelt. My friend hit the windshield.” She cut her eyes toward the woman sitting in the passenger seat. “You okay, Sheila?”
“I think so,” Sheila muttered. “I busted my head on something.”
“Okay, I need both of you ladies to hold still,” Ryan directed. “I’m going to put collars on both of you, and I want both of you ladies to stay in your vehicle and try not to move around.”
He quickly sized and fastened a cervical collar around the driver’s neck. “Wiggle your fingers and toes for me, Miss…what was your name?”
“Andrea,” the woman furnished as she complied with Ryan’s request, flexing her feet and drumming her fingers on the steering wheel.
“Anything numb or tingling?”
“Great!” Ryan replied before moving around to the passenger side and repeating the procedure on Sheila. Aside from the superficial laceration to her scalp, everything seemed okay. “Ladies, I’ve got other people to check on,” he told them. “Either me or another paramedic will be back in just a few minutes.”
Ryan walked back down the line of cars, noting that Steve and crew of 304 had been joined by two City of Oneida firefighters. As he passed the wrecked Hyundai, the head and shoulders of yet another firefighter appeared over the outer retaining wall of the elevated roadway. Curious, Ryan walked over to the wall and looked down to find an Oneida Fire Department bucket truck parked below them.
Huh. That’s one way to do it. Beats the heck out of lugging up their generators and extrication equipment by hand.
As David had described, the three occupants of the last vehicle were deep in the throes of Allstate-itis. As if on cue, they halted their animated conversation as Ryan approached, leaned their heads back against the seats, closed their eyes and started moaning loudly. One still held her cell phone against her ear as she moaned piteously.
Ignoring her theatrics, Ryan rolled his eyes as he walked around their vehicle.
They stopped in time to avoid hitting Critical Boy’s car, but the car behind them managed to tap their bumper.
Hands thrust in his pockets, Ryan prodded the barely damaged rear bumper with his foot.
Cosmetic damage only. Even the taillights are intact. Hardly even made a scuff on the bumper, and yet managed to inflict potentially permanent disability on the poor unfortunate occupants. Oh, the humanity!
Ryan knocked politely on the driver’s window, but the woman made no move to open it. Rapidly losing patience, he slapped the window hard. “Roll down the window!” he bellowed.
Still moaning piteously, right arm flung across her eyes, the woman slowly reached out her left arm and cranked down the window.
Jesus Christ. $5000 spinner rims on this 80’s vintage lead sled, and they don’t even have power windows. Well, maybe your insurance settlement can buy you some aftermarket ones. Maybe even have enough left over for some bling and a new weave, girlfriend.
“Where y’all hurt?” Ryan asked shortly.
“Mah neck…I wranched mah muhfuckin’ back…yo cuz, mah head hurt,” came the moaned chorus of the occupants.
“And I suppose you all want to go to the hospital?” Ryan sighed. All three occupants nodded in unison.
Synchronized malingering. They should be in the Scumbag Olympics or something.
Ryan quietly fumed as he unwrapped three new cervical collars from his first-in bag. As he was wrapping the cervical collar around the driver’s neck, taking care to remove her hoop earrings first, a voice appeared at his right elbow.
“Where you need us, Hawkeye?” Mark Perry asked.
I’m going straight to hell for this, but hey, I’m the stuporvisor. I can get away with it.
“You take this car,” Ryan grinned maliciously, handing Mark the other two cervical collars. “They’re all in desperate need of your superior lifesaving skills.”
Mark Perry, no stranger to turfing, scowled and gave Ryan the finger, hand hel low at his side where only Ryan could see. In reply, Ryan blew him a kiss, turned and trotted back to the head of the line of cars. He found Steve and two firefighters kneeling next to the opened driver’s door of the SUV.
“We already got the passenger out and packaged,” Steve reported. “She’s in our rig, strapped to the squad bench. Mark has three people from the original wreck sitting in the back of 304, ready to sign refusals.”
“You got this?” Ryan asked, laying a hand on Steve’s shoulder as he nodded affirmatively. “You’re a good man, Charlie Brown. Remind me to say nice things about you on your next performance evaluation. I’ll be back in a minute.”
Ryan opened the driver’s door of 304, fetched David Hendricks’ clipboard from between the seats, and walked back around to the rear of the ambulance. He opened the door and found an Oneida Police officer interviewing three wet, bedraggled teenagers. It was the same cop he had encountered earlier, the one who had found Colonel Mustard.
“I’m about tired of seeing you,” the cop grinned before Ryan could. “If you’ll give me another minute, you can have ‘em.”
“No worries,” Ryan winked. “Shouldn’t you be out directing traffic or taking measurements or something?”
“What traffic?” the cop asked rhetorically. “We’ve got the interstate shut down from the Guyton Avenue east to Highway 63. One of our units is parked at the Guyton exit directing people onto the surface streets. It’s a mess, but once I get done with these guys, we can start moving the cars that can move and clear some of this out.”
“Most of ‘em are drivable,” Ryan informed him. “With the exception of the SUV and the car behind it, it’s mostly bent bumpers.”
“How many cars?”
“The other medic says eleven. Only two will need a wrecker,” Ryan replied, then addressed the teenagers. “What’s your story?”
“Well, I was driving right at the speed limit, one of them starts to answer, “in the right lane, and this car cuts in front of me outta nowhere…”
“Hydroplaned into the guardrail,” the cop cut him off. “No sign of the other vehicle.”
“Did you guys call the ambulance?” Ryan asked.
“I called,” the cop answered. “Figured better safe than sorry.”
“Is that right?” Ryan asked the teenagers. “None of you requested an ambulance, nobody’s hurt?” Shivering, the teens nodded yes to both questions.
“That’s all I need to hear,” he told the cop. “They didn’t make the request for the ambulance, and they don’t want treatment. They can go when you’re done with them.”
“They don’t need to sign anything?” the cop asked dubiously.
“All you kids over eighteen?” Ryan asked, to affirmative nods.
“That’s all I need,” Ryan confirmed as he backed out of the rig. “They’re all adults, and they didn’t request the ambulance. None of them are officially patients.”
“Works for me,” the cop agreed. The back door opened, and Joanna Bradford poked her head into the back of the rig.
“Time to clear out, folks,” she ordered tersely. “We got a bad one we gotta move with.”
Ryan backed out of the rig and motioned the others out of the way. As Joanna guided the stretcher wheels into the back of the rig, Ryan lifted the undercarriage as she rolled the entire stretcher into its mount. David Hendricks followed the stretcher into the rig and immediately began digging through the cabinetry for supplies.
“You need help?” Ryan asked.
“I need an airway,” David answered tersely as he suctioned the man’s mouth. “His face hit the steering wheel. He was doing okay for a while, but once we got him onto the board, he started going downhill. I could probably bag him from here to St. Matthew’s, if I had someone along to help.”
“That trip’s gonna take an extra ten minutes,” Ryan informed him. “All the eastbound interstate traffic has been routed onto the surface streets.”
“Shit,” David sighed bitterly. “I guess he buys a tube, then.”
“Get your kit ready,” Ryan suggested. “I’ll get the line.”
Ryan quickly set up an IV of saline, straddling the stretcher as Steve and another firefighter loaded another patient onto the squad bench.
“Dayum, cuz!” the man said as Steve fastened the straps. “Homeboy fucked up!”
“Shut up!” Steve snapped tersely. “Just lay still and you’ll get your ride.”
Ignoring the malingerer strapped to the squad bench, Ryan quickly sank a 16-gauge catheter into the man’s left arm, attached the tubing and secured the catheter with several wraps of two-inch tape. Retrieving two medication vials from the drug box, he quickly drew up two doses of medication.
“You ready?” he asked David, who was poised at the patient’s head, steadily ventilating the man and doing a fair job of it, despite the man’s wrecked face. David nodded.
“Here’s the etomidate, and here’s the succinylcholine,” Ryan recited automatically, “on board at 1704 hours.” He moved up the stretcher and pressed down hard on the man’s thyroid cartilage, effectively blocking his esophagus. Presently, the man’s arms and legs began twitching spasmodically, followed by flaccid paralysis.
David Hendricks inserted a laryngoscope into the man’s mouth and peered inside. He muttered under his breath, suctioned some more and ordered tersely, “Deeper…and more to the right.”
Ryan complied, manipulating the man’s larynx into position. David slid the tube home with a self-satisfied grunt. Ryan grinned and handed him the capnograph adaptor, which David attached between the bag valve mask and the endotracheal tube. As David squeezed the bag, Ryan listened to breath sounds.
“Sounds good,” Ryan confirmed, and looked at the cardiac monitor. “You’ve got a good capnograph tracing too. Exhaled CO2 is…twenty-six and rising. It’s in.”
“Strap it down for me before you go,” David requested. “Thanks, Hawkeye.”
“No problem,” Ryan shrugged as he backed out of the rig. “I’m sending an extra set of hands in with you.” He tapped a firefighter on the arm and gestured for him to climb aboard. Once he was in, Ryan slammed the rear doors, and clapped Joanna Bradford affectionately on the back. “He’s ready to roll, Jo. Tell him I said y’all done good.”
At the base of the exit ramp, Steve and Ryan found two Oneida firefighters loading the last patient into their rig. “Need somebody to ride in?” the captain asked.
“No thanks guys, we got it.” Ryan answered. “Thanks for everything.”
He climbed into the back of the rig and maneuvered forward gingerly, holding onto the overhead rail as Steve pulled off the concrete median and merged into traffic on Tarleton Avenue.
“I was beginning to think you had abandoned us,” came a chuckle from the stretcher.
“Why hello, Andrea!” Ryan grinned. “What, no faith in me? I told you I’d be back. You’d rather have someone else?”
“Well now that you mention it, one of those cute firemen would have been nice…”
“Sorry ladies, but if anyone gets to cut your clothes off and palpate you, it’s gonna be me.”
Without further ado, Ryan performed a quick but thorough assessment of both women. As he suspected, neither was seriously injured. He settled into the captain’s chair and managed to complete the bulk of his reports by the time they arrived at St. Matthew’s ER.
As Steve wheeled Andrea inside on the stretcher, Ryan waited in the rig with her friend. He surreptitiously checked his watch.
Forty minutes to shift change. Hurry up, Steve.
Fifteen minutes later, he and Steve had transferred care of both women to the ER staff, given report, and marked their unit back in service. On their way back to the station, the radio crackled again.
“Control to 306.”
“306, go ahead,” Steve answered, groaning and rolling his eyes.
“Priority One call, Oneida Kidney Center. Patient going back to St. Mary’s Nursing Home in Fort Sperry.”
“Goddamnit!” Ryan exploded, punching the dash. That miserable fucking whore!”
“Shut up!” Steve snapped, and keyed the radio. “Uhhh, Control? You realize that our shift ends in twenty minutes?”
“Contact dispatch by phone, 306,” came the terse reply.
Ryan had the phone in hand before Steve could reply. Glaring at him and holding up a warning finger, Steve snatched the phone from his hand and dialed. “Yeah Martha, it’s Steve on 306,” he said pleasantly. “Why are we catching this transfer at twenty minutes to shift change?”
Whatever the answer was, Steve didn’t like it. “Gimme the phone!” Ryan mouthed, reaching for the handset. Steve slapped his hand and switched the phone to the other ear.
“Come on, Martha!” Steve pleaded. “That’s bullshit and you know it…yes, I know that once a Priority Three call stays in queue for thirty minutes, it automatically becomes a Priority One call…but it’s a Goddamned transfer, Martha! It can’t wait twenty more minutes for the next…no, I am not refusing the call!” Furiously, he thumbed the END button and pitched the phone to the floor. “Goddamnit!”
“Told you she’s punking us,” Ryan informed him. “She’s playing the fucking system.”
“No, she’s punking you,” Steve flared angrily, “And I just get fucked by being your partner!”
Shamed, Ryan leaned back against the seat and said nothing else for the rest of the call.
Steve and Ryan spent the next ninety minutes in uneasy silence. They went through the motions, smiled and bantered with the patient and her nurses, but barely said a word to each other. After dropping their patient off at the nursing home, they found themselves ten miles outside of Oneida, stopped behind a long string of cars on the two-lane highway. The area was on was the outskirts of Oneida Parish, where the suburbs and bedroom communities merge into the rural farmlands and timber tracts of Audubon Parish.
“Wonder if there’s a wreck up there,” Ryan ventured hesitantly.
“Wanna call the dispatcher? Maybe they’ve copied some radio traffic on it.”
He’s really pissed. Shit, he has a right to be. I haven’t exactly been a good partner lately. And damn it, Steve’s not just my partner, he’s my best friend. He’s had my back from the first day we worked together. Aside from Jeff Layton, he’s the only person I trust.
Steve grunted as the traffic started to move. A mile ahead, they spotted the deep ruts leading off the road and down the steep embankment, abruptly ending at a huge, scarred oak tree. Ryan craned his neck, looking over his shoulder as they passed the wreck scene.
“Somebody died in that one,” Ryan mused, looking back at the ruts in the mirror. “Looks like they crossed the road and hit the tree head-on.”
Steve didn’t reply.
“Wonder who worked it?” Ryan ventured. “Are we still in Audubon Parish?”
“Still, it’d be closer for one of our rigs than it would be for Collins to work it. I mean, it’s right across the line. We post a rig not five miles from here.”
“Well, maybe we can watch it on the news tonight. That’s our friend from Headline News up there. I’m sure they’ll have plenty of gory details.”
“I’m sorry, bro. I’ve been an ass lately. You don’t deserve to catch all this shit because of me.”
Steven Hatfield did not reply.
An hour later, Ryan Pierce was tying off his runabout and lugging groceries aboard his houseboat. He flicked on Ecnalubma’s lights, pulled off his muddy boots and dropped them on the deck outside the door. Groaning and massaging his lower back, he left the groceries on the counter, shoved the case of Heineken in the fridge, and opened a bottle.
Sighing, he flopped into his recliner, thumbed the television remote and tuned to Headline News. He sipped his beer and watched absentmindedly, paying little attention to the talking heads doling out their daily dose of carefully filtered and slanted opinion masquerading as journalism.
He had almost decided he had missed the story when the screen showed Connie Mitchell, Headline News reporter, standing in a disposable raincoat on the shoulder of Highway 74, gesturing to the wreck scene behind her. He stopped drinking when he saw the wreckage of the Collins Ambulance and the two body bags.
Chapter Five – Making Friends and Influencing People
Monday morning, Ryan awakened early and fixed pancakes for Caitlin for breakfast. Pouring a cup of orange juice and a bowl of cereal for himself, he padded back down the hall and gently scooped Caitlin out of bed. She whimpered and fretted, burrowing her head into Ryan’s shoulder. Chuckling, Ryan set her in her booster chair and pushed her plate within reach. Rubbing her eyes sleepily, her hair a Medusa-like tangle of blonde curls, Caitlin picked up a piece of pancake.
“Uh-uh, stinker,” Ryan reminded her. “Use a fork.” Grudgingly, Caitlin picked up her fork, speared a piece of pancake and maneuvered it toward her mouth. She took a bite, smearing syrup onto her face and hair in the process.
“You’re the world’s cutest slob, you know that?” Ryan teased his daughter, grinning. She gave him a toothy, maple syrup smile in return. “You ready to go to therapy this morning?”
“We goin’ to see Randa!” she said happily.
“Yep, going to see Miranda,” Ryan agreed. “Daddy has to go to work.” Predictably, Caitlin pouted, her lower lip quivering and her eyes misting. Ryan quickly got up from the table and went about running bath water and setting out Caitlin’s clothes. He couldn’t stand to see her cry.
Ryan quickly showered, bathed Caitlin and dressed for work. Her threw her suitcase and his briefcase into the runabout, and wrestled Caitlin into her Dora the Explorer lifejacket. The sky was a washed-out shade of blue, the wind cold on his face as he motored across the basin and beached his boat near the parking area. There was a note fluttering under the windshield wiper of his truck.
Ryan, I’m sorry about tonight. Why is it that lately we bring out the worst in each other? Call me Wednesday when you pick up Caitlin from therapy. – Dawn
The paper was damp, the ink bleeding and smudged from being plastered to his windshield over the weekend. Nevertheless, Ryan smiled as he carefully and reverently laid it on the passenger seat to dry. He drove in to work in silence, a sappy grin on his face.
Ryan stopped at the Krispy Kreme on his way to work to pick up his customary two-dozen donuts and two large coffees. While he dug through his pockets for change, Caitlin flirted with the clerk.
“I want coffee too, Daddy!” she insisted.
“You heard the kid,” Ryan winked at the clerk, nodding toward the hot chocolate machine. “One of the usual, to go.” Grinning, the clerk filled a small Styrofoam cup with hot chocolate and slid it across the counter.
“It’s on the house,” she said as she always did, sticking out her tongue at Caitlin, who grinned and returned the gesture. Chuckling, Ryan carried his daughter back outside and buckled her into her car seat.
Five minutes later, he pulled up to a house on a residential street in West Oneida and honked the horn. A wholesome looking, red-haired girl opened the door and walked out to the curb.
“Running late again, I see,” she said to Ryan, mockingly stern.
“Sorry Miranda,” Ryan said contritely. “We got a late start.”
“Yeah, that’s what you always say,” she teased, opening the rear door of the truck. Miranda Wheatley was Caitlin’s occupational therapist. Six months ago, Ryan and Dawn lived directly across the street. Besides her professional services as a therapist, Miranda often babysat Caitlin on her nights off. Since Ryan and Dawn separated, she had been bringing Caitlin to therapy on the mornings Ryan had to work.
“Hey Randa!” Caitlin said, holding out her arms.
“Hey Munchkin,” Miranda chuckled, unbuckling Caitlin from her seat. Ryan handed her the diaper bag and suitcase through the window.
“We worked on weight shifts a good bit this weekend,” he offered. “She did okay with just a little cueing. She caught a few fish Saturday – held the pole with her left hand and everything,” Ryan added proudly.
“That’s great!” she said excitedly, hugging Caitlin. “We’ll give her a good workout today,” she assured Ryan. “Dawn picking her up from the clinic today?”
“Yep,” Ryan confirmed, “and I’ll pick her up Wednesday.” He leaned out of the window. “Give Daddy a kiss,” he called. “I gotta go to work.”
Dutifully, Caitlin leaned in and planted a wet, chocolate-flavored kiss on his lips. “Bye Daddy!” she said happily. Chuckling, Ryan waved as he backed out of the driveway and drove away.
306 was idling in the parking lot as Ryan pulled into MetroCare headquarters, its emergency lights flashing. Steve Hatfield nearly bumped into Ryan as he walked out the door. “Good, you’re here,” he sighed with relief. “I was about to have to get on a rig with Mark. We’ve got emergency calls holding.”
“Well let’s go,” Ryan answered. “Somewhere out there, Grandma has fallen and can’t get up. Let’s go save some lives and stamp out disease.” Ryan hurriedly tossed the donut boxes on the table, grabbed a couple for Steve and himself and followed his partner out the door.
“306 in service,” Ryan radioed as he climbed into the rig.
“Priority One call at 7800 Constitution Boulevard, #226 on a respiratory,” the dispatcher answered curtly.
Jesus, just what I need. She’ll be punking my ass all day long.
“Yeah, Satan’s pulling an extra shift,” Steve confirmed, noticing the look on Ryan’s face. “She’s on a fucking rampage, too.” Steve hit the yelp button on the siren as he approached an intersection. “Every damned ER in the city is on diversion, too.”
“And the hits just keep on coming,” Ryan sighed, leaning forward to check for oncoming traffic. “Clear right.” The truck’s acceleration rocked him back in the seat as Steve passed the stopped traffic. “Why the hell does she give these vague-assed numeric addresses when she could just say ‘McArthur Square Apartments’ and everybody at MetroCare would know exactly where she’s talking about? It’s only the biggest damned low income housing project in Oneida!”
Steve said nothing, just grunted in agreement, applying the brakes as he approached a line of stopped cars. Several cars, but by no means all of them, pulled over to the right to let the ambulance pass.
Ryan picked up the PA mike and keyed the switch. “Move to the right, please,” he requested to the vehicles in front of them. He waved animatedly at a woman chatting on a cell phone, oblivious to the ambulance directly behind them with lights and siren blaring. “Uh, Ma’am? Yes, you in the white Camry! How about hanging up the cell phone and paying attention to what’s going on around you?” Startled, the woman looked up, searching for the source of the disembodied voice. “Yoooo hooooo! Behind you!” Ryan broadcast as the woman looked into her rearview mirror and hurriedly pulled over, almost running onto the curb in the process. “Thank you oh so much,” Ryan said unctuously as the ambulance eased past the line of cars. The woman angrily gave him the finger as he drove past.
“I love it when you do that,” Steve chortled as they turned onto Constitution Avenue. “You give such polite ass-chewings.”
“All in the name of good MetroCare public relations,” Ryan said smugly. “It does not behoove one to curse the motorists of this fair city when your phone number is plastered all over the side of the rig.”
Personally, I think twin water-cooled machine guns and a snowplow bumper would work better than lights and sirens. The wrecker could just pick up all the shot-up cars, and the cops could revoke their licenses on the grounds of chronic Cranio-Rectal Inversion.
As Steve parked and locked the rig, Ryan piled the jump bag, cardiac monitor and oxygen on the stretcher. Steve glanced around nervously as they paused at the base of the stairs. “I hate this fucking place,” he muttered under his breath as his eyes continually scanned the doorways on either side of the breezeway. “Bring the stretcher up, or leave it here?” he asked Ryan.
“Leave it here,” Ryan decided. “Just bring the equipment up.”
“Leave the stretcher?” Steve asked dubiously. “Somebody’s gonna steal it, sure as hell.”
“Then they should be easy to catch when they try to fence a canary-yellow cot for crack money,” Ryan retorted. “Besides, remember the ABCs.”
“ABCs?” Steve asked with a blank look.
“Ambulate Before Carry,” Ryan winked, slinging the jump bag across his shoulder. “No sense carrying someone if we don’t have to.” Steve shook his head as he grudgingly followed Ryan up the stairs.
Four years before, Ryan and Steve had responded to the same apartment complex for an unconscious person. Steve had been the first one through the door, finding a young man sitting on the floor, slumped against the couch. Steve had knelt next to the kid and gently squeezed him on the shoulder, pinching the trapezius muscle to determine if the young man was unconscious. Without warning, the teenager had come up from the floor with an animal snarl, swinging a looping roundhouse right that shattered Steve’s left cheekbone and knocked him to the floor.
Ryan had walked through the door a second too late to keep the kid from leaping on top of Steve, choking him and banging his head against the floor. Ryan had tried unsuccessfully to pull the kid off, earning only a broken nose for his efforts. He had finally clubbed the kid repeatedly with the cardiac monitor until he had loosened his grip. Steve had spent a week in the hospital getting his cheekbone and orbit wired back together, and nearly a month off before the doctors had cleared him to return to work.
And Ryan never let me be the first through the door again, Steve remembered, and he paid my truck note that month when the Worker’s Comp checks barely paid my rent. He refused to let me pay him back, either. The kid got a slap on the wrist as a juvenile offender, Ryan got a broken nose, and I still can’t walk around this place without seeing a fucking PCP freak lurking around every corner.
At the landing, Steve stood off to one side of the door and looked around nervously while Ryan knocked. The door swung open, and Ryan cautiously peeked inside.
“Hello!” he called. “MetroCare EMS! Somebody call an ambulance?”
“In here,” a woman’s voice said weakly. Ryan walked inside, followed closely by his partner. In the living room, a thin, frail woman sat leaning forward on the couch, her elbows resting on her knees. The apartment was barely warmer than the outside, and reeked of stale cigarette smoke. The woman broke into a prolonged coughing spasm that lasted perhaps thirty seconds. When the spasm passed, she gasped weakly and rested her head tiredly on her hand. Ryan fitted his stethoscope in his ears, kneeling down next to the woman.
“How long have you been coughing like this?” Ryan asked as Steve pulled an oxygen mask from the airway bag.
“Couple weeks, maybe,” the woman answered hoarsely. Steve glanced at the end table beside the threadbare couch and noticed several bloodstained, crumpled tissues in the ashtray. Reaching out and grabbing Ryan by the shirt collar, he tugged gently until Ryan looked up questioningly. Steve kept tugging until Ryan stood up and backed away from the woman.
“What?” Ryan asked, concerned. Steve said nothing, just jerked his head toward the end table and pulled his particle respirator from his fanny pack. Seeing the bloodstained tissues, Ryan’s eyes narrowed briefly and he immediately pulled out his own respirator.
“Have you been running a fever, Ma’am?” Steve asked, his voice muffled under the mask. “Night sweats, that sort of thing?”
The woman nodded, lifting her head up briefly as Ryan fitted a non re-breather mask over her face. “Sometimes I soak the sheets. I been taking Tylenol and cough syrup, but it ain’t helping.”
Ryan auscultated the woman’s chest as his partner checked the woman’s vital signs. There was an ugly rattle of fluid in her lungs. “Scattered rales,” he told Steve, looping the stethoscope around his neck.
“Saturation is 90%,” Steve reported. “Tachy at 130, and her BP is 140/92.”
“Yeah, let’s keep the oxygen mask on her and get her in the rig,” Ryan suggested.
“TB, you think?” Steve asked.
“Yeah, that’s my guess,” Ryan confirmed, then turned to the woman. “Ma’am, do you have any chronic medical problems? Any medications you’re currently taking?”
“I got Hepatitis C, and high blood,” the woman answered. “I ain’t got no money for no medicine.” She rolled her eyes wildly, grabbed several Kleenex from a box, and went into another coughing fit that was painful to watch. Ryan nodded and wrote “Hep-C and hypertension” on the back of his gloved left hand.
“How about HIV?” Steve asked darkly. “Any drug use?” Ryan flashed him a warning look, which Steve ignored.
The woman shook her head tiredly. “I don’t know. I smoke crack sometimes. I been trying to quit.”
“Okay Ma’am, that’s all we need to know,” Ryan assured her. “Let’s get you down to the stretcher and get you to the hospital.” He helped the woman to her feet and slowly walked her outside, pausing occasionally as the woman tried to catch her breath. Halfway down the stairs, the woman stopped and leaned heavily on the railing, chest heaving and breath rattling behind her oxygen mask.
Steve, waiting on the ground floor next to the stretcher, looked up impatiently. Sighing, he trudged back up the stairs and picked the woman up, cradling her in his arms. “What are you waiting for?” he asked Ryan defiantly. “We have to get her to the hospital, don’t we?”
Ryan said nothing, just winked. He followed Steve down the stairs, carrying the oxygen bottle and placing it on the foot of the cot as Steve gently deposited the woman on the stretcher. Ryan followed the cot into the rig, switched the oxygen mask over to the main tank, and gestured to Steve that he was ready to go.
“Oneida Charity,” Ryan ordered, referring to the large charity hospital in the southern end of Oneida Parish. “A nice, safe and gentle trip.”
Steve rolled his eyes as he shut the rear doors.
What else did you expect, Hawkeye?
During the trip, Ryan took a moment to start an IV on the woman, who lay listlessly on the stretcher with her eyes closed. She looked younger than she did at first glance – not much older than Ryan himself. Old needle track marks covered the inner surface of her arms. “You wastin’ yo’ time,” the woman told Ryan tiredly, not even bothering to open her eyes. “I did heroin for six years. I ain’t got no veins left.”
“No harm in looking, is there?” Ryan replied mildly, then asked, “Did you share needles?”
“Yeah, junkies are generous that way,” the woman laughed, only to provoke another painful coughing spasm. “I kicked heroin by myself, but I be damned if I can kick crack.”
“You been tested for AIDS?” Ryan asked as he deftly inserted a 22-gauge catheter into a likely vein. Much to his chagrin, it blew as he flushed the line.
Fuck. Hawkeye Pierce, the all-knowing, all-seeing Supermedic, tragically mortal when it comes to sticking IVs.
“Told you they was hard to stick,” the woman sighed, looking at the hematoma forming under her skin. “Yeah, I been tested. All I got is hepatitis. Don’t matter though. I’ll die of something.”
“How old are you?” Ryan asked as he taped a gauze pad over the infiltrated IV site.
“Thirty-one,” the woman said, shaking her head. “I got three kids and one grandbaby. My mama raisin’ all of ‘em. State took ‘em away after I got throwed in jail for possession the second time.”
Jesus Christ. She’s younger than I am, and she looks fifty. Not even thirty-five, and she’s already a grandmother.
Ryan sighed inwardly as he settled into the jump seat behind the stretcher. Hearing a knock against the plexiglass partition, he turned to see Steve handing the phone through the small window.
“Oneida Charity on the phone,” Steve called. “They want to talk to you.”
“Paramedic Pierce,” Ryan answered as he put the phone to his ear. “We’re on diversion,” a curt female voice stated flatly, without preamble.
“So is every other Emergency Department in the city,” Ryan retorted, rolling his eyes. “Do you want to hear report?”
“You can’t bring them somewhere else?” the woman continued as if she hadn’t heard. “Why are you bringing them here?”
“Because the zoo is closed and there’s nothing good at the movies,” Ryan’s mouth ran away with him. He was met with a long silence.
“That’s not funny,” the nurse snarled into the phone. “Where are you transporting from?”
Nonsense, Ma’am. That was fucking hilarious. If you pulled the stick out of your ass, you’d recognize that.
“I’m transporting from McArthur Square,” Ryan replied, growing impatient. “She’s a thirty-five year old –“
“St Matthew’s is closer,” the nurse interrupted. “You’re supposed to go to the closest hospital.”
“She’s also stable, and requested to come to your hospital,” Ryan retorted just as rudely. “I tried to change her mind, but she’s willing to accept inferior care for cheaper prices.”
“You’ll have to go to the waiting room on arrival!” The nurse spat venomously, hanging up before Ryan could reply.
Guess she didn’t want that report after all. She’s gonna really love us when we ask for an isolation room for a possible TB patient.
Every ambulance bay was full as Steve pulled into the ER entrance at the ponderously named Louisiana State Medical Center and Health Research Institute, Oneida Campus, a sprawling institution universally referred to Oneida Charity.
The ambulance crews simply referred to it as Bad Light Bulb ER, because it seemed everyone who worked there was burned out and not all that bright. Steve drove past the ambulance bay and parked in the fire lane behind an Oneida Police Department cruiser.
Patients were lined up outside the Emergency Department, many of them wearing hospital gowns and pushing IV poles. Others sat in wheelchairs, tethered by the nose to a portable oxygen cylinder, oblivious to the irony as they sat and fed their nicotine habits.
A knot of people clad in purple scrubs nodded to Ryan as he unloaded the gurney. One of them greeted him by name, “Wassup, Hawkeye?”
“Saving lives and stamping out disease and pestilence, as always,” Ryan grinned, to the general amusement of the group. “You know, it always amazes me that of all the hospital staff you see standing out in the weather on their breaks, the ones smoking like chimneys are always the respiratory therapists.”
“Job security for the next generation!” guffawed the one who had spoken to him first. The others chuckled and saluted with their Marlboros.
Inside the Emergency Department, ambulance stretchers bearing patients lined the hallway. There were two MetroCare crews that Ryan could see, and his former employers at Collins Ambulance attended a young man wearing inmate clothing, handcuffs, waist chain and ankle restraints.
“Welcome to Patient Parking,” Kenny Hadden told him wryly. “Pick an empty spot along the wall, the valet will be along shortly.”
“How long have you guys been waiting?” Ryan wanted to know. “Thirty minutes,” Kenny answered, checking his watch. “Mark’s trying to find someone willing to take a handoff report. 304 pulled in right behind us. I’m babysitting their patient while they use the bathroom.”
“Wait here with her,” Ryan directed his partner. “I’ll be right back.” The nurse’s station was predictably chaotic. Nurses bustled about madly, phones rang constantly, and harried residents sat on stools near the chart rack, trying to make some sense of it all as they charted and wrote order. Like every other Emergency Department in the city, Oneida Charity was at capacity. Unlike every other Emergency Department in the city, Oneida Charity refused to deal with ambulance overflow in a timely fashion.
“What’s the holdup, Mark?” Ryan asked quietly, laying a hand on Mark Perry’s shoulder as he stood scribbling in his Patient Care Report.
“Still waiting for someone to acknowledge my presence,” Mark replied in disgust, not bothering to look up. “This shit has got to stop.”
“Can your patient sit in a wheelchair?” Ryan inquired. “How about 304’s kid?”
“Both of ‘em can,” Mark answered. “That Collins crew is the only one that needs a bed for their patient, and he’s a prisoner –“
“Who should be going to the prison ward, if somebody would just get off their ass in here,” Ryan finished.
“Excuse me,” Ryan said politely to a nurse sitting at a computer, laboriously charting as she peered over her glasses at the phosphor screen. She used two fingers to type, and slowly at that. The nurse ignored him. Ryan cleared his throat and spoke louder, “Excuse me.”
The nurse looked up at him in silence, one eyebrow cocked quizzically.
“There are four ambulance crew tied up in the hallway waiting to drop off their patients. Three of them have been there for thirty minutes, and –“
“I’m not the triage nurse,” the nurse cut him off dismissively as she turned her attention back to the computer monitor. “You have to give report to the triage nurse.”
Oh no, you didn’t.
“Mark, it looks like their trauma room is open,” Ryan said loudly, pointing to the patient board. “Tell the Collins crew to put their patient in there. Have Kenny find some wheelchairs and we’ll park our patients in the hallway. Do it now.” Ryan turned his back on the nurse’s desk and walked away.
“Wait a minute!” came the outraged howl from the nurse’s station. “You can’t do that!”
“Watch me!” he called over his shoulder.
In the hallway, as Ryan and Steve lowered the stretcher and assisted their patient into a wheelchair, two nurses came bustling around the corner. “You can’t just leave patients in the hallway without giving report!” the first one said angrily. “That’s abandonment!” The second nurse, the one who had ignored him at the nurse’s station, nodded in righteous indignation.
“Are you the triage nurse?” Ryan asked politely.
“Yes I am!”
“Just the person we wanted to see,” Ryan smiled nastily, handing her three pink sheets of paper. “These copies are yours, I believe. Now you know everything we know about these patients. Mine has difficulty breathing, there’s an assault with a head laceration, and some teenaged girl with nausea and vomiting. Another company is dropping off a prisoner in your trauma room right now, too. You might want to go check him first. They’ve been here the longest, and he looked kinda sick.”
“You’re the medic I talked to on the phone earlier, aren’t you?” the triage nurse accused.
Could be, Nurse Ratched. All you fat, lazy bitches sound alike to me.
“You might have been the nurse I spoke to,” Ryan allowed. “Which one are you, the one who always wants to know why we’re bringing them to this hospital, or the one who wants the patient’s birth date and social security number before she’ll listen to the assessment findings?”
“That was you. I’m reporting your ass, buddy,” she threatened.
“Have a pleasant day, Ma’am,” Ryan sighed in resignation and turned to leave. “Let’s get out of here, Steve.”
“I’m calling your supervisor,” the triage nurse called after him, “right now!”
Ryan turned on his heel and marched back to her. Leaning close to her, he extended his nametag on its retractable cord, dangling it three inches in front of her nose. “You’re talking to the shift supervisor,” he replied nastily. “That’s spelled P-I-E-R-C-E, in case you were wondering. Now give me your name, so I’ll know who to report for the EMTALA violation.”
“EMTALA violation?” she sputtered, eyes widening in fear. “What EMTA-“
“You know, the Emergency Medical Treatment And Labor Act?” Ryan reminded her sarcastically. “The one that says the patient is your responsibility once we get within 250 feet of this Emergency Department?”
“But, but, but –“
“You sound like an outboard motor,” Ryan noted, amused. “There is a specific EMTALA ruling prohibiting the practice of parking ambulance patients and refusing to take report. I forget what the fine is, but I imagine you’ll find out in due course. Normally, we look the other way because we know how busy you are. That courtesy ends when you tie up three of our crews for half an hour because you’re avoiding your responsibility.”
He turned his back on the nurse and left here standing there, mouth agape and holding the hospital copies of the MetroCare PCRs. Outside, he and Steve made up the stretcher in silence. The doors to the ambulance entrance whooshed open, and Bob and Linda Collins walked outside, pushing their empty stretcher.
“Hello Ryan!” Linda called warmly, waving and walking over to the back of Ryan’s rig. Bob followed her, extending his hand to Ryan and smiling.
“Bob. Linda.” Ryan acknowledged coldly, ignoring Bob’s outstretched hand as he continued to futz with the straps on his stretcher. Steve smiled and nodded politely, but said nothing. The Collins’ smiles faded, and presently Bob lowered his hand and walked away with his wife.
Steve looked speculatively at his partner. He started to say something, but was interrupted by another whoosh of the sliding doors. Mark Perry and Kenny Hadden walked out, trailed by the crew of 304.
“Another PR bonanza for MetroCare EMS,” grinned David Hendricks, the medic from 304. “You’re always making friends and influencing people, Hawkeye.”
“What the fuck is that supposed to mean?” Ryan snarled, turning on him.
“Hey Hawkeye, I was just kidding,” David said defensively, bewildered at the viciousness of Ryan’s response. “Chill out, dude.”
“Next time, you wait no more than fifteen Goddamned minutes before you track one of those lazy bitches down and hand off your patient,” Ryan continued hotly. “I don’t care if you have to sit them on the triage nurse’s lap, got it? I better never see two of my units out of the 911 rotation for thirty minutes for this kind of bullshit ever again.”
Ryan angrily loaded his stretcher, slamming the rear doors on the rig savagely. He walked to the passenger door, flung it open and climbed into his seat, leaned back and placed his shaking hands on his lap.
Now where the hell did that come from? Why did I jump David’s ass like that?
Steve climbed into the driver’s seat, quietly shut the door, and clicked his seat belt into place. He started the rig, checked his mirror, and put his hand on the transmission lever to put the ambulance in gear. He hesitated, put the ambulance back in park, and placed both hands carefully on the wheel.
“You wanna tell me what’s bugging you?” he asked mildly, studiously checking his control panel, rearview mirrors, and radio, looking anywhere but directly at Ryan.
“Nope,” Ryan answered, eyes still closed, arms folded across his chest.
“Okay,” Steve acknowledged, trying another tack. “You know I’m your best friend, right?”
“And you can tell me if you’ve got a problem, right?”
“Everything’s peachy in my life, Steve.”
“Riiiight,” Steve rolled his eyes. “You get pissed off at the slightest thing lately, and you’re starting to take it out on the crews.”
“Is there a point to all this?” Ryan wondered aloud.
“You know Ryan,” Steve sighed as he put the ambulance in gear and drove away, “sometimes you can be a real fucking asshole.”
“I know, Steve.”
“Control to 306,” the radio crackled again. Ryan slammed his Coke down on the restaurant table and started wrapping his half-eaten cheeseburger. Cursing under his breath, he stomped outside to the rig. trying the door handle only to find it locked.
Steve calmly swallowed his food, wiped his mouth and keyed the radio mike. “306, go ahead.” Outside, he could see Ryan fuming, lips moving silently, the angry words muted by the heavy glass windows.
“Unconscious person, corner of West Harrison and Greely. Called in by Oneida PD.”
“306 en route,” Steve acknowledged as he walked outside, unlocked the rig and climbed aboard.
“She’s punking us,” Ryan said darkly. “305 is just as close to that call as we are. With the traffic, maybe closer.”
“And yet she entrusted you with the responsibility,” Steve teased. “You should be flattered.”
“She’s trying to piss me off, and it’s working. Fucking Satan,” Ryan fumed, taking a sip of his Coke.
“You know,” Steve observed as he turned at the red light onto West Harrison, “sooner or later, you’re both going to acknowledge this undercurrent of sexual tension between you two.” He tapped the air horn twice and gestured for the driver in front of him to move to the right.
Ryan did a spit take, showering cola all over the dash. “Jesus Christ!” he laughed. “Don’t even talk about that!”
“I can see it now,” Steve teased. “You come home to the marina one night and there’s a strange, yet oddly familiar, car in the parking lot. You get aboard your boat, flip on the lights…”
“Stop, don’t say it,” Ryan begged, hands over his ears and eyes closed.
“…and there’s old Satan, sprawled across your couch in all her glory, all three hundred fifty pounds of her. She’s got candles lit, she’s wearing a slinky negligee, and Barry White playing on the stereo. She’s dolled herself up, soaked herself in perfume, maybe even braided the hair on her back. Waiting there breathlessly for her man, the great Hawkeye Pierce. Just aching to be your latest conquest. Moist. Willing. Wanting.”
“I’m gonna puke,” Ryan warned, making mock retching noises.
“You should slip it to her, Ryan,” Steve grinned as he pulled to the curb at the intersection at Greely Avenue. “Consider it your duty as supervisor. Give Satan a few much-needed orgasms, and she’ll be much easier on the rest of us. C’mon, you owe it to the guys.”
“I don’t owe y’all that much,” Ryan shook his head as he climbs out of the rig. “How about a gift certificate for some D batteries? Would that be sufficient?”
“Well, look who it is!” an Oneida Police Officer greeted him with a sardonic grin. “Our hero! Hey Colonel, you’ve got a gen-yoo-wine rock star taking care of you!” he informed the man sitting on the sidewalk, leaning against a newspaper vending machine.
Ryan recognized the patient, but not the officer. He knelt next to the man and looked up at the police officer quizzically. “Huh? Rock star?”
“I was the other officer on the shooting the other day,” the cop informed him. “You looked great on the news,” he teased.
Damn, I never even saw you. I thought there was only one cop there. Sorry, don’t remember you, dude.
“Oh, right!” Ryan grinned. “Didn’t recognize you at first. How’s your partner?” “Still on administrative leave, pending the –“
“Hang on a sec,” Ryan told him, and turned his attention to the patient, grasping his shoulder and shaking him. “Hey, Colonel! Wake up!”
“Sknxxxx, sssshnork….wha, whazzit?” the man slurred drunkenly, cracking one eye open.
“Get up, Colonel Mustard,” Ryan ordered. “You know you can’t be passed out here in public like this. You’re frightening the citizens.”
The drunk shook off Ryan’s hand and curled into a fetal position, cradling a nearly empty vodka bottle.
“You familiar with this guy?” the cop asked, prodding the man’s leg with his toe. “
Yeah, his last name is Mustard. Vietnam vet, if you can believe what he says. So, everybody just calls him Colonel Mustard.”
“So this is like a bad game of Clue,” the cop chuckled. “It’s Colonel Mustard, at the bus stop, with a vodka bottle.”
“Well, that’s one way to look at it,” Steve laughed appreciatively. “I take it he’s too drunk to go to jail?”
“Not too drunk for me,” the cop rolled his eyes, “but the jail nurse will send him to the hospital to dry out as soon as we get him processed, sure as Hell. Twice the work for you and me.”
“Yeah,” Ryan grunted, then shook the drunk again. “C’mon Colonel, get up! Don’t make me tote your ass to the ambulance!” he warned. Colonel Mustard, for his part, grunted and commenced snoring. Sighing, Ryan grasped one arm and motioned for Steve to grasp the other. Together, they hauled Colonel Mustard to his feet.
“Git yer Goddamn hands offa me!” the drunk slurred in protest, his breath a fetid alcohol fog.
“You’re drunk in public, Colonel,” Ryan informed him, not for the first time. “It’s either go to the hospital with us, or the jail with the nice officer.”
“I’m a kick yer big ass,” Colonel Mustard informed Ryan spitefully as they steered him to the waiting stretcher. Steve let go of his right arm to lower the stretcher, and as if to demonstrate the point, Colonel Mustard swung a long, looping right in the general vicinity of Ryan’s face.
Rolling his eyes, Ryan leaned back and let the slow-motion punch whiff past. He grasped the drunk’s right shoulder and placed another hand on his back, using the drunk’s momentum to turn him away and push him face-down onto the stretcher in one smooth move.
“Yeah, I love you too, Colonel,” he said mildly, winking at the cop.
“You want me to flex cuff him?” the cop asks.
“Nah, he’s harmless. He couldn’t whip his way out of a wet paper sack when he’s this drunk. We’ll check his sugar, give him some fluids, give him a look-see to make sure he hasn’t hurt himself, and give him a ride to the hospital. He’ll be asleep again before we get rolling.”
As if on cue, Colonel Mustard started snoring again. Steve chuckled and shook his head, rolling the drunk onto his side and fastening the straps on the stretcher.
“Taking him to Oneida Charity, I suppose?” the cop asked.
“Actually, no,” Ryan shook his head. “He’s not indigent. Got a home, insurance, everything. We usually take him to St. Matthew’s. His daughter picks him up and takes him home once he sobers up a bit.”
“Damned shame,” the cop said, shaking his head.
“Yeah, it is,” Ryan agreed as they loaded the stretcher. “Take care, now. Tell your partner I’m glad he’s okay.”
“Sure thing,” the cop agreed as he slammed the rear doors. He slapped the doors twice, leaned over where Steve could see him in the mirror, and made a ‘wind it up’ motion with his index finger.
“Don’t you love it when they do the ambu-slaps?” Steve chortled from the front seat. “Some people watch too many movies.”
Ryan chuckled as he settled into the captain’s chair, picking up the cellular phone and thumbing the speed dial button. The phone rang several times and finally a harried voice answered, “St. Matthew’s ER, this is Heather.”
“Hey Heather, it’s Ryan Pierce on 306,” he grinned. “You ready for some bad news?”
“Whatcha got, Hawkeye?” the nurse sighed.
“We’re bringing in Colonel Mustard with the usual. Better find a dark corner for him to sleep it off.”
“You’re an optimist,” Heather snorted. “We’re full.”
“So is everybody else,” Ryan retorted. “You’ll think of something. I’ll have an IV and a blood sugar checked by the time we get there, I promise.”
“Thank you so much,” Heather answered, her voice dripping with mock sweetness. She hung up the phone before Ryan had a chance to reply.
Ryan moved to the bench seat next to the stretcher, and dug through his jump kit for the glucose meter and an IV setup. Colonel Mustard slept through the finger stick, but snorted and tried to pull his arm away as Ryan inserted a sixteen gauge IV catheter in the bend of his left elbow.
“I fragged ossifers like you back in the ‘Nam,” he slurred, eyes at half mast.
“That’s what I treasure about our little chats, Colonel,” Ryan answered as he attached the IV line and taped down the catheter, “your roguish charm and witty repartee.”
Chapter Four – A Brief Respite
Something was tapping Ryan on the face, gentle but insistent slaps that finally drug him out of his slumber. The sun was shining through the window, and Caitlin was sitting on his chest, patting him on the forehead and laughing.
“Get up, Daddy!” she grinned, her hair still tousled from sleep. “Get outta bed!”
“Since when did you become an early riser?” he grumbled, pulling the pillow over his head. Presently, a blonde head peeked underneath, nose pressed firmly to his.
“Get up!” she insisted, placing a wet, sloppy kiss squarely on his lips.
“Watch it, Miss Slobber Fountain!” he protested, pulling her to his chest and rolling over, tickling her ribs. Caitlin squealed with delight and squirmed away, and the fight was on. For several minutes, they rolled around on the bed, wrestling and giggling in an all-out, no-holds-barred tickle fight. Ryan finally cried uncle and retreated under the covers, leaving her to climb all over him in a vain attempt to worm her way under the covers and continue the match.
“Come on, Daddy,” she pleaded. “I want pancakes!” Still grumbling, Ryan rolled out of bed and set Caitlin on the floor while he made a beeline for the bathroom. She tottered unsteadily down the hall ahead of him toward the kitchen, ankles rolling slightly inward without the support of her braces.
Look at her! She looks great- walking, using her left hand, and talking better than ever. So God, why is it that you can answer that prayer and ignore all the other ones? Is almost losing Caitlin the penance I have to pay for abandoning Renee? Is losing my wife the price I have to pay for having Caitlin whole and healthy? I sure wish you’d tell me, cause I’m still searching for fucking answers here…
“Hurry up, Daddy!” Caitlin pleaded impatiently. “I want chockit milk and pancakes!”
“Right behind you, stinker,” he reassured her. “Do you think we might eat something besides pancakes for a change? Maybe bacon and eggs? How about cereal?”
And sorry about the blasphemy, God.
“Don’t want cer-ul!” she said firmly. “Want pancakes!”
One day, Caitlin will turn into a pancake, or perhaps a chicken nugget. Typical three-year-old tastes, simple and comfortably predictable. Cut the kid, and she’d probably bleed maple syrup.
Her speech therapist had told Ryan that she had become far more receptive to different tastes and textures than she had been just a few months ago.
And a good thing, too, Ryan grunted to himself. With a steady diet of pancakes, pizza and McDonald’s takeout, the shadow of my ass probably weighs twenty pounds all by itself. I could use some grownup food.
Ryan fixed a couple of pancakes for Caitlin, heavy on the syrup, and poured cereal for himself. “So what are we going to do today?” he asked Caitlin.
She was carefully maneuvering a fork to her mouth, a huge chuck of pancake perched precariously on the tip. Ryan cringed as she shoveled it into her mouth, nearly spearing herself in the eye with her fork. Ryan would have fed her, but Caitlin was a big girl. She insisted on doing it herself.
“Wmpbfh go fithbbnnn,” she said around a mouthful of pancake. She grinned a toothy, maple syrup smile and swallowed. “Wanna go fishin’,” she said more clearly. Ryan grinned back at her.
Well, the rain has stopped, but the river is way too high for fishing. But she doesn’t much care if she catches anything, just as long as she’s in the boat. Fishing it is, then.
“Finish your pancakes, and we’ll go catch a fish or two.” Caitlin hurriedly shoveled more pancake into her mouth, eventually abandoning the fork and using her fingers. “We goin’ fithbbnnn,” she mumbled happily around another mouthful. Ryan chuckled and wiped the syrup from her face.
Okay, so the kid’s a fisherman, Ryan Pierce mused as he motored back to the dock three hours later. Must be the Dora the Explorer fishing tackle. Maybe fish like that brightly colored bobber and chartreuse plastic worms.
Caitlin sat happily in the bottom of the boat amidst empty sandwich wrappers and soda cans and three unlucky perch.
“I caught fish!” she said happily, eyes squinted against the wind. Ryan smiled at his daughter.
Yes you did, stinker. And Daddy didn’t catch a thing. And you’ll be lucky if you don’t get pneumonia if I don’t get you into some dry clothes.
With a typical three-year-old’s attention span, Caitlin had gotten bored quickly and dropped her pole several times, preferring instead to lean over the side of the runabout and splash in the water. She was completely soaked and thoroughly happy. Ryan beached his boat on the sloping ramp and cut the engine, and before he could step out of the boat, Caitlin was scrambling over the bow.
“Hey, hold on there, stinker!” he called out, laughing. Caitlin giggled and tried to run, slipping and falling on the wet ramp.
“Get my fish, Daddy!” she reminded him, pointing. Dutifully, Ryan lifted the stringer of fish from the bottom of the boat and scooped Caitlin up, carrying her inside.
“Whoa, you’re wet!” he scolded her playfully. Her pants and coat were soggy, soaking the front of his shirt.
“I carry ‘em!” she said proudly, taking the stringer and swiping Ryan across the face with fish slime. Ryan grimaced and set his daughter down, taking the stringer from her and setting the bedraggled fish in the sink.
“Come here and let’s get those wet clothes off,” he ordered. Caitlin wobbled over and held her arms over her head. Quickly, Ryan stripped her naked, tossing her sodden clothes into a pile near the door. Sighing, he turned on the television and fetched a beer from the refrigerator, then padded down the hall to fetch dry clothes and a diaper for Caitlin.
“Daddy on TV!” Caitlin said happily, pressing her nose to the screen. Curious, Ryan poked his head back around the corner to see his face on the noon television newscast. Groaning, he settled into his recliner and pointed the remote at the screen, turning up the volume.
“Come here, naked girl,” he called. “Let’s get you dried off.”
“…racial tensions in Oneida exploded into violence late Thursday afternoon in what police officials describe as a buy-bust operation gone bad,” the anchor was saying. Behind him the picture changed to video of the police officers standing over the victim. “According to Oneida Police Department spokesman Captain Rick Wolters, the victim, one Romanto Stevens of Oneida, fled from police after allegedly offering to sell crack cocaine to an undercover officer. Lieutenant Wolters states Mr. Stevens threatened officers by brandishing a knife, and both officers opened fire, severely wounding Mr. Stevens.”
The video showed a wobbly image of the ambulance barging into the scene. Ryan watched himself lean forward, saying something to the police officer. The video didn’t catch the first bottle, but captured Ryan’s flinch and the second bottle quite well. He looked scared on the video as he and Steve picked the man up and bodily threw him into the rig.
Ouch. That move didn’t look very gentle on the video. Well, fuck it. We had to get out of there. The scene wasn’t safe.
He felt vindicated by watching the news video of the crowd beating on the side of the ambulance as the reporter narrates excitedly. Ryan paid no attention to her narrative as he watched the ambulance surge forward against the crowd, knocking one teenager to the ground and narrowly missing him with the passenger front wheel.
Awww shit. We’re gonna hear about that.
The video showed the reporter getting hit in the head with a chunk of asphalt and the camera panning wildly about as if in search of the threat. The camera pointed to the ground and a hand appeared, helping the dazed reporter to her feet. The image then cut to the reporter interviewing Ryan in the ambulance bay outside St. Matthew’s Emergency Department. Ryan was just about to turn off the television when the image changes to the reporter interviewing an irate black woman outside the Emergency Department entrance, apparently just a few minutes after Ryan had left.
“…he ain’t had no knife,” the woman was shouting, gesturing excitedly. “The po-lice just shot him down. I seen the whole thing. He was runnin’ from the two cops and they just opened up on him! Damn cops shot him in the back!”
Bullshit. He was shot in the chest. The bullet exited through his back.
“He didn’t have a weapon?” the reporter asked, eyebrows knitted in a frown of serious concentration. Serious allegations were being made, and Eyewitness News, seekers of truth, were on the scene reporting the facts and keeping viewers informed. Her expression practically dripped sympathy.
“No, he ain’t had no weapon!” the woman said indignantly. “They just shot him down for no reason! You tell me, what two cops gonna shoot down a seventeen year old boy for?” she asked, and then answered her own question. “Cuz he black, that’s why!” She glared defiantly into the camera.
And so was one of the cops, lady. And why was he running? He was just giving some poor soul the directions to the nearest Dunkin Donuts. He only looked like he was slinging rock. What a crock of shit.
The video cut to the reporter back in the studio. She was smartly dressed, with no trace of the nasty cut at her hairline. She looked nothing at all like the frightened, dazed woman that scrambled into the back of Ryan’s ambulance.
Damn. No stitches, no swelling, no nothing. What did they do, Derma Bond it?
“…very serious allegations indeed, Catherine,” the anchor was saying. “Is there any word on the victim?”
“No, Frank,” she shook her head. “We know that he arrived at the hospital alive. Citing patient confidentiality concerns, hospital officials have offered nothing other than the fact that the patient is in stable, but guarded condition.”
Thanks in no small part to the timely arrival of the paramedics barging right into the scene because they thought it was three blocks away. And let’s not forget that they saved your reporter’s ass so she could continue to stir the shit and pontificate for the cameras.
Disgusted, Ryan muted the television and lifted Caitlin onto his lap. She giggled and squirmed, trying to get away. Caitlin liked running around naked. “Hold still, you little exhibitionist!” he laughed. “You had better grow out of this by the time you’re old enough to date, or Daddy will be hiding the bodies of your boyfriends all up and down the river.”
“Daddy on TV!” she repeated as Ryan finally succeeded in applying a diaper.
“Yep, Daddy’s on TV,” Ryan agreed. “Daddy’s a movie star and a hero. Now go tell your Mommy that.”
The phone rang early Saturday morning, shattering the stillness. Ryan groaned and rolled over, scrambling to reach the phone before Caitlin awoke. He cursed under his breath as he saw StatCare on the caller ID.
“Yeah?” he snarled into the phone.
“Sorry to call you at this time of the morning, Ryan,” the dispatcher said perfunctorily. She didn’t sound sorry at all.
“What do you want, Martha?” Ryan asked, stopping himself just in time from referring to her by her nickname, Satan.
“System overload,” she answered. “We have two trucks on out-of-town runs, and all available units in town are on calls.”
“So what do you want me to do about it? I’m not the shift supervisor.”
“Sharon is sick and can’t come in,” she informed him, almost spitefully. “That leaves you.”
“Where are the trucks now?” Ryan sighed. “I mean, what’s their status?”
“312 is on its way back from Jackson as of thirty minutes ago. 311 just arrived at LSU in Shreveport. 313, 314 and 315 are all on calls right now.” In the background, Ryan could hear the radio traffic as a unit marks out at the hospital.
“You’ll have a unit available in ten minutes, Martha,” Ryan assured her. “And 312 will be back in the parish within an hour.”
“Are you refusing to come in?” Martha asked icily.
“For fuck’s sake, Martha!” Ryan exploded. “I live thirty minutes away, and this is not my shift! By the time I put on a uniform and drive out there, every fucking truck you have will be available!”
“Are you refusing to come in?” Martha repeated, as if she hadn’t heard a word.
“You’re damned right I am!” Ryan snarled. “I’ve got my kid tonight, and I’m not going to come in and cover someone else’s shift just because you panic the moment you don’t have an available truck! Deal with it, like everyone else does!” Furious, Ryan slammed down the phone.
Fucking idiot. Can’t take the pressure of working on the streets, and can’t take the pressure of answering the fucking phones and working the radios. And sure as hell, she’ll try to stab me in the back because I refused to come in.
Caitlin whimpered and rolled over, awakened by Ryan’s outburst. Ryan sighed and cradled his daughter to his chest and tried to go back to sleep.
Chapter Three – Withdrawal
As Ryan drove through the marina entrance, the parking area was dark and deserted, save for one car. The deck lights on Ecnalubma were the only source of light on the dock. He pulled up next to Dawn’s car as she turned her lights on and got out.
“Sorry I’m late,” he apologized. “We caught a late call. I left a voicemail message-”
“I almost got stuck driving out here tonight,” she cut him off. “I can’t understand why you don’t move the boat closer to town, or just sell it.” Her words were flat, dismissive. Emotionless.
“Why don’t you drive DUI Boy’s truck out here, then? He won’t be able to drive it for what, six months?” Ryan retorted just as nastily. “You sure can pick ‘em, I’ll give you that.”
Now why did I say that? Why is it that we can’t just talk any more?
“Why do we have to go through this again?” she asked tiredly. “You start the same argument every time. We can still be friends, Ryan.”
Yeah, you keep saying that, but I don’t want to be your friend. I want to be your husband.
“Sure we can!” he agreed, anger and bitterness creeping into his voice. “And how is DUI Boy enjoying my house? Bed comfortable enough for him? I know he loves my surround sound system. He told me how much he liked it, back before I figured out you were fucking him.”
“Watch your mouth!” she snapped, jerking her head toward the back seat. Caitlin had taken to repeating everything she heard lately.
“Fuck,” Caitlin said distinctly as Ryan pulled her from her car seat. “Fuck, fuck, fuck.”
“Lovely,” Dawn glared at him. “Any other choice words you want to teach our daughter?”
“Don’t say that, Caitlin,” Ryan chided sternly. “Daddy said a bad word.” Despite being the bravest and most strong-willed person he had ever met, his daughter was a very tenderhearted girl. One stern word from Ryan was enough to break her heart. Right on cue, her eyes misted over and her lower lip started to quiver.
“How was therapy?” Ryan asked, eager to find a safe subject.
“We need to work on her sidestepping, and weight shifts to her weak side,” Dawn sighed. “She used her left hand pretty well today.”
“I’m walkin’, Daddy!” Caitlin exclaimed proudly, holding up her arms for a hug. Both arms. Her left hand was almost open, not tightly fisted as it usually was.
“That’s great!” he said excitedly, hugging her tightly. “You’re a big girl! Pretty, too.”
“I’m not pretty,” she told him seriously. “I’m gorgeous.” Little stinker.
“Can you hold her for a minute while I go fetch the runabout?” Ryan asked Dawn. She rolled her eyes and sighed, but nodded and took Caitlin back. He got the gas can out of his truck, took off his boots and waded out to the dock. The water was already over his knees, and the skies were still heavy with rain clouds. Ecnalubma’s aluminum runabout had a couple of inches of water in it, and the motor refused to start without a struggle.
Ryan finally won the battle of wills with Evinrude and the motor roared unhappily to life. He untied the boat and backed it into the current, making a wide loop back into the basin and beaching the boat next to the parking lot. Dawn handed Caitlin to him and he slipped her life vest over her shoulders. She held up her arms and poked them through the armholes in the vest, grinning at her daddy. Not long ago, she held that left arm tucked against her chest, unable to move it, much less use it with any purpose.
“I got my Dora vest on!” she said happily. Caitlin loved Dora the Explorer. She would wear her vest inside the cabin if Ryan let her. She settled into her spot on the floor of the boat, wetting her pants in the process, but she could have cared less. Dawn handed across Caitlin’s suitcase and stood on the bank uncertainly, eyes misting. “Bye Mommy!” Caitlin waved.
“You want to come aboard?” Ryan asked quietly, meeting her eyes. “You don’t have to rush right home.
Please say yes. Just get in the boat and we’ll spend some time talking. We’ll figure things out, and you’ll realize that we’re better together than apart.
She hesitated for a long moment, and then stepped into the boat. Ryan tried to hide his elation as he motored back to his slip. Dawn gripped the side rails nervously, white-knuckled. She had always hated the runabout – too small for her. Ecnalubma was more of a floating house than a boat. Ryan motored slowly back to his slip, easing the bow of the runabout onto the sloping ramp behind his houseboat. Giving in to temptation, he gunned the motor, just a quick little twist of the throttle and a surge of power. Dawn’s eyes widened in surprise and fear, and she flashed him a dirty look.
“Goose it, Daddy!” Caitlin cackled gleefully. Ryan put on an innocent face and Dawn’s expression softened. She even cracked a little smile. Smiling broadly, Ryan gunned the motor again, fully grounding the boat on the ramp. Shaking her head and grinning, Dawn picked up Caitlin and stepped out onto the dock. He pulled the drain plug from the boat and followed her.
“I haven’t seen you smile like that in a long time,” he told her as he opened the cabin door, and her grin instantly faded. Ryan bustled about the cabin, stowing his gear bag and briefcase, taking Dawn’s coat, putting Caitlin’s suitcase in her room – anything to escape the uncomfortable silence. Dawn was still standing near the door, nervously shifting her weight from one foot to the other.
When Dawn was nervous, she always fiddled with her wedding ring, twirling it around and around on her finger. Her fingers were toying with that left ring finger now, unconsciously twirling a ring that was no longer there. The white band of pale skin where it used to be had even faded away. As if suddenly realizing what she was doing, she blushed and jammed her hands into her pockets. Ryan pretended not to notice.
“You want a beer?” he asked casually, opening the refrigerator. She hesitated, biting her lip, almost visibly making up her mind. “For Christ’s sake, will you relax?” Ryan exploded. “You act like we’re strangers. I just offered you a beer, that’s all. If I were trying to get in your pants, I’d offer you tequila. Remember the July Fourth party at Royce’s?” he reminded her with a lewd grin. And just like that, the tension was broken. She sighed, chuckled and walked past him, getting her own beer from the fridge.
She settled onto a barstool and twisted the top off, taking a long pull. “Which part?” Dawn chuckled. “Us in the pool house, or you having to pull over five times on the way home so I could puke? I’ve never been so hung over in all my life.” She shook her head ruefully.
Ryan couldn’t decide which was funnier – the fumbling, giggling quickie in the pool house, or watching Dawn match Royce Trenton shot for shot until he passed out and had to be put to bed. Never bet a redneck girl that she can’t do something.
“I was so proud,” Ryan teased. “My wife; the nurse, paramedic and world-class power drinker. You were the redneck dream girl.”
“Some dream girl,” she snorted. “I puked my guts out half the night. You sat on the bathtub and held my hair out of the way, and handed me wet washcloths all night.”
“And I kept reminding you of the price of victory, and all you would say was, ‘Thash okay. I taught that lil’ shumbish a leshon,’ between retches.”
Dawn did a spit take, spewing beer across the room. “Well, I did teach the little sonofabitch a lesson!” she laughed.
“Sumbitch,” Caitlin said, quite distinctly. “Sumbitch, Mommy!” Dawn and Ryan stared at each other and dissolved into a fit of giggles. She put her beer on the counter and scooped Caitlin up, trying to fix a stern expression on her face.
“Caitlin, that’s a bad word,” Dawn admonished, unsuccessfully stifling a smile. Caitlin just grinned back, the spitting image of her Mommy at that age. “Go play in your room, stinker,” Dawn laughed, putting Caitlin on the floor and swatting her lightly on the rump.
“Nice to know I can still make you smile,” Ryan said, and instantly her smile faded.
Christ, what did I say now? Why is talking with her like walking a minefield?
“You always could make me smile,” she said quietly, sadly. “You just forgot how to do it yourself.” She pushed her half-finished beer across the counter and stood up. “I have to go,” she announced abruptly. “It’s dark and I still have that pig trail you call a road to navigate…” She turned and walked toward the door.
“Dawn,” he said softly, pleadingly. “Dawn. Come back and sit down, please.” She paused, her hand on the knob. Her shoulders were shaking. He walked across the room and stood behind her, wanting desperately to put his arms around her, but afraid to touch. He knew he couldn’t take it if she pulled away.
Ryan flashed back to the night they had first met. He had brought a cardiac arrest patient into a rural hospital Emergency Department, and Dawn had been the nurse on duty. She had taken over the code, running the resuscitation while the doctor stood back and took notes. “Damn, she thinks like a medic!” Ryan remembered thinking. “A good medic.” Two days later, Ryan had gone back and asked her out.
“What happened to us?” Ryan asked quietly. “You walked out on eight years of marriage without so much as a fight. You never once told me you were unhappy. It’s like one day you just woke up and decided you didn’t love me, and I don’t know why. I’m still the same person you married, Dawn.”
“No, you’re not,” she accused, turning to face him. Her eyes were red-rimmed, teary. “Not since your sister died. You still blame yourself. You act as if it doesn’t bother you, but you just quit. You went back to work the day after the funeral like nothing had happened.”
“I was okay with it,” he protested. “I hadn’t seen or talked to her in years.”
“Sure you were,” she snorted. “That’s why you got into a fistfight with your father at the funeral. Sell that shit to someone who didn’t live with you. You can joke around and pretend with the guys you work with, but I was there. You just withdrew into your own little world, and you wouldn’t let me in.” Her voice rose, and her eyes flashed with hurt. “How many nights did I go to sleep alone, begging you to come with me? How many nights did I cry myself to sleep, wishing you would just come to bed and hold me? Do you know how long I wondered if it was me, wondered why you didn’t want me any more? You cold-hearted bastard! You walked out five years ago!”
Now what do I say to that? She’s right. I withdraw, and I zone out. That’s my defense mechanism. If I didn’t have that, I’d have ended up just like Renee.
“I wasn’t shutting you out,” he protested, knowing it for the lie it was. “We had bills to pay, jobs. Obligations. When Caitlin was born, I was trying to be strong for you both. I thought that’s what I was doing.”
“Yeah, you were,” she said bitterly. “You had it all under control, just like you always do. But I didn’t need Hawkeye fucking Pierce. I needed you,” she spat, the anger like venom in her voice. “Goddamn you Ryan, you made me cry again. I swore I’d never let you make me cry again.” She bolted outside, slamming the door behind her.
Aaaahhh, shit. I loved you because I didn’t have to be Hawkeye Pierce around you. All I had to be was Ryan. We used to be so comfortable together, like the female mirror image of me. Now you’re gone, and I feel like a ghost. Hollow, no reflection. I’m afraid I may never again be the person I was. It scares me.
You could laugh, and I automatically knew what you found so funny, without your having to say a word. I could have a bad day, and you were the only person I trusted to tell about it. We used to be able to know what the other was thinking, and now I fumble for what to say like a stranger on a first date.
After a few minutes, Ryan walked outside to find Dawn sitting on the bow of the runabout, still sobbing. He said nothing, just pushed the boat down the ramp and climbed in. There was nothing to say, anyway. They both knew he still loved her, and they both knew that wasn’t enough. He motored back across the river and into the basin in silence, with Dawn looking down at her feet and Ryan pretending to be too busy navigating the boat to notice.
God, why is it that I can conduct a patient interview with a stranger, but I can’t find the words to talk to my own wife?
Ryan beached the boat down the embankment from her car and waited silently for her to step out. Before she did, she stepped toward him and leaned over, kissing him on the cheek. Ryan could feel her tears on his cheek. He tried to kiss her on the lips, but she pulled away.
“Goodnight Ryan,” she whispered. “Happy birthday.”
Ryan said nothing, just quickly backed away from the shore and turned back into the basin so she wouldn’t see him crying. Back aboard Ecnalubma, he found Caitlin sitting on the floor next to his chair, eyes filled with tears and lower lip quivering. “Mommy crying,” she said accusingly.
“Yeah sweetie,” he sighed, scooping her up and hugging her. “Mommy crying.”
Chapter Two – Black Cloud
Steve pulled into their posting location, across the river in West Oneida. “Control, 306,” he radioed. “We’re in Zone Six.” The radio crackled an affirmative reply.
“So we just sit here until we get a call?” Mike asked. “We stay in the truck the whole shift?”
“That’s why they call it Systemic Sado-Masochism,” Steve offered. “There are hemorrhoids in your future, kid.”
“It’s called System Status Management,” Ryan explained. “They post the trucks in areas of higher call volume rather than at fixed locations. Supposedly, it reduces response times.”
“I can see where it would,” Mike agreed.
“I said supposedly reduces response times,” Ryan rolled his eyes. “It’s statistical voodoo, Mike. Mental masturbation. They think they can predict call volume by doing a computer analysis of the last six months of calls, when any statistician will tell you that it takes many years worth of data to come up with any valid figures. But go tell that to the managers, kid. They’d rather wear out trucks and personnel, than admit their system is flawed. The emperor isn’t wearing any clothes, and nobody is brave enough to point it out.”
Steve chuckled and shook his head, taking another sip of coffee. He has heard this rant many times. As brilliant a paramedic as Ryan Pierce is, he has topped out at the level of shift supervisor, with little prospect of advancing further.
Must be nice to be filthy rich and brilliant, Steve mused about his partner. He intimidates the hell out of everyone without even trying, and says what he wants. It’s easy to be fearless when you’re loaded, I suppose. Nah, that’s not it. He had the reputation of being a maverick before his old man died, back when he worked at Collins Ambulance. They fired his ass, too, so I suppose there are some things that even Hawkeye Pierce can’t get away with saying. Not that I’m complaining, though. Being the partner of Hawkeye Pierce, The All-Seeing and All-Knowing, has its benefits.
Steve Hatfield chuckled to himself and stroked his mustache. Steve, an angular country boy, sported a bushy Fu Manchu mustache that extended nearly to his chin. Three times in the past five years, the suits from corporate had issued memos about excess facial hair, quoting company policy in clipped bureaucratese that “beards and goatees, or any other facial hair that interferes with the proper fit of a particle respirator, are expressly forbidden.”
Each time, Ryan had sent in copies of the company newsletter to the StatCare corporate headquarters, each with the photos of goatee-wearing employees from other regions prominently circled.
And every time the suits let the matter drop. That is, until the next time some human resources weenie gets a bug up his ass.
“Hey guys, look at this idiot,” he said, nodding at a Toyota Camry speeding north on Harrison Boulevard toward the intersection in front of them.
“He thinks he’s gonna beat the light,” Ryan observed, gauging the distance with his eyes and coming up with only one conclusion. “He ain’t gonna make it.”
“Who isn’t going to make it?” Mike asked, frustrated. “I can’t see shit from -”
“BAM!” a sport utility vehicle hit the compact car directly on the driver’s door. The forty-mile-an-hour impact slewed the smaller vehicle around, spinning it around in the road in a wet spray of rain and twisted metal. The SUV careened on through the intersection, out of control and headed directly for the parked ambulance.
“Ooooohhhh shit,” Steve and Ryan observed in unison. The SUV continued across opposing lanes of traffic, jumped the curb and finally came to a stop wedged against a coin-operated air and water machine in the convenience store parking lot, barely ten feet away. Ryan and Steve stared at each other in disbelief, and Steve was the first to react.
“Control, 306.” Steve radioed as Ryan bailed out of the rig. “We have a serious MVC at the intersection of West Twentieth and Harrison. Two vehicles, multiple patients. We need another unit and fire rescue for extrication ASAP.”
By the time he reached the SUV, Ryan had opened the driver’s door, leaning inside. Steve tried the passenger door, and it opened grudgingly under his hand, the twisted metal creaking and buckling as he tugged on it. The passenger sat dazed, still wearing her seatbelt, the lubricant powder from the airbags leaving a fine white dust on her blue dress.
Ryan held the driver’s neck, asking, “Can you tell me where you hurt, sir? Any one place in particular?”
The man grimaced and tried to shake his head, “Nowhere, really. I think I’m just shaken up. It all just happened so fast!” As if just realizing that he was not alone in the car, he tried to turn to see the woman in the passenger seat. “Jen?” he asked frantically. “Are you okay, baby?”
“She’s fine, sir.” Steve answered. “Just try not to move, either one of you. Okay?”
Ryan popped his head out of the car, looking for Mike, who was unloading the stretcher from the ambulance. “Hey Mike!” he yelled, getting the student’s attention. “Leave that, and just bring the jump bag and the cervical collars!”
Mike nodded and disappeared into the rig momentarily, reappearing from the rear doors lugging two gear bags. Breathlessly, he ran to the wrecked SUV. Before he could say anything, Ryan took a collar from the bag and ordered, “Stay here with Steve. Do whatever he tells you. I’m gonna go check the other driver. Get a collar on this guy before I go.” Mike nodded nervously and leaned through the driver’s window as Ryan, hands still on either side of the driver’s head, leaned as far out of the way as he could.
“Okay, I got it!” Mike’s voice said from inside the car.
Ryan withdrew his hands, clapped the kid on the back and started across the street to check the driver in the wrecked Camry. The young driver was unconscious, thrown all the way across the car by the impact. She lay crumpled in a heap against the passenger door. Ryan tried the unlocked passenger door and found it jammed from the impact. The driver’s door and b-pillar were caved in at least a foot. Sirens heralded the approach of their backup as the police, fire department and the second-in ambulance converged on the scene.
“Whatcha got, Hawkeye?” Mark Perry, the medic from 305, asked as he pulled on a pair of latex gloves.
“Two moderates in the SUV, one critical in this one. You and Kenny help Steve with them, and send the EMT student over to me. Send the fire department guys over here right away.”
Mark nodded briskly and trotted back over to the SUV. He clapped the EMT student on the shoulder and said something in his ear. Presently, Mike Granger came puffing up with a crew of firemen in tow.
“We need to get this passenger door open, folks. Mike, go get a rescue blanket from the rig.” When he returned, Ryan handed him a cervical collar and the blanket and told him, “See if you can worm in there and get c-spine.”
He broke the passenger rear window, swept the glass away, and gestured for the EMT student to climb inside. The firefighters fired up a portable generator and began attacking the passenger door with a pair of hydraulic spreaders.
“What do I do?” Mike asked, bewildered. “She’s all crumpled up!”
“You reach over her as best you can, align her head, and check her breathing, that’s what you do,” Ryan answered. “Very few patients will be found lying supine on the floor, kid.”
Mike obediently wormed between the two front bucket seats and grasped the woman’s head. “She’s breathing!” he reported excitedly.
“Great! Hold her still, and see if you can spread this blanket over the both of you.” Ryan reached through the shattered rear window and assisted in positioning the blanket.
“I can’t see anything under here!” Mike’s muffled voices came from somewhere under the blanket.
“Head down, kid!” Ryan called. “I’m gonna break the glass.” He placed the window punch against the lower front corner of the passenger door window and pressed until the glass shattered, collapsing in a thousand glittering pieces onto the rescue blanket. He swept most of the fragments away, leaned in and lifted a corner of the blanket. He placed his hands on the woman’s head, over Mike’s hands.
“I got her head. Now get the c-collar on her.” Mike withdrew his hands and quickly wrapped the collar around the woman’s neck. Creaking metal and several loud pops announced that the firefighters had succeeded in freeing the passenger door.
“Hold her still for a few more seconds, kid.”
“Door’s off!” they announced unnecessarily. Ryan backed away as the firefighters pulled the ruined door away from the car and casually dropped it on the ground out of the way. The edge of the blanket lifted and Mike’s face appeared, nervously looking around. Seeing that the door was off, he broke into a grin and straightened up, flipping the blanket back completely. Ryan knelt on the wet pavement next to the car and examined the woman. His practiced eyes swept over her thoroughly, hands confirming his visual impression.
Left femur and hip, left arm and possibly ribs on that side as well. Probably a head injury, too.
Ryan straightened up and motioned the firefighters in. “Time to get her out, fellas. Let’s do it.”
The firefighters wedged the foot of a spine board against the cushion of the passenger seat as Ryan directed the action.
“Mike, I got her head. You take her hips. We’re gonna come out onto the board just a little bit, then we roll her onto her back. Then it’s straight up the board. Got it?” Everyone grunted affirmatively. “Okay, here we go. One, two, three. ” In one fluid, practiced move, the men slid the unconscious woman up the board.
Her breathing was ragged, tangled honey-blonde hair obscuring her face. Ryan gently swept her hair away and looked into her ashen face. The woman moaned unintelligibly. “Okay guys, let’s all get out of the drizzle and into the rig,” Ryan ordered.
The firefighters paused only long enough to secure the straps on the board, and then carried the injured woman to the ambulance. Ryan walked alongside, still holding the woman’s head in alignment. He paused at the rear of the rig, nodded and motioned for Mike to take over. The EMT student assumed his position, freeing Ryan to slide an adhesive cervical immobilizer into position. Not surprisingly, the damned thing refused to adhere to the wet board.
Goddamned flimsy pieces of crap, Ryan fumed. If they fired one business development specialist, whatever that is, they could afford to buy some real head blocks.
Cursing, Ryan quickly rolled two towels and placed them on either side of her head. With two quick wraps of extra-strong tape, the woman’s head was secured to the board. He climbed inside the rig, releasing the strap buckles on the ambulance cot and flipping them out of the way. The firefighters handed him the head of the spine board, and collectively they slid the woman onto the stretcher.
“I’ll go get Steve,” Mike offered, but Ryan shook his head.
“Would one of you guys go fetch my partner?” he asked the firefighters. “He’s probably found a dry spot and is off playing grab-ass somewhere,” Ryan winked.
The crew chuckled and slammed the rear doors. Ryan took his trauma shears and quickly shredded the woman’s clothing, exposing her naked body. “Oxygen, please,” he politely ordered. “Make it a non-rebreather.”
His suspicions were confirmed with a thirty-second, but thorough examination. The woman had a crushed left leg and arm, and her pelvis was unstable. Most of the ribs on her left side were broken. Mike Granger obediently applied oxygen and then wrapped a blood pressure cuff around the woman’s right arm. He pumped the cuff up, listened intently, and shook his head in frustration.
Welcome to the real world, Mr. Granger. Sounds a lot like a diesel engine, doesn’t it?
“I can’t hear anything but engine,” he said.
“No big deal,” Ryan shrugged. “I’m pretty sure I know what her blood pressure isn’t and that’s good enough for now. Now all we need is for Steve to get here…”
As if on cue, the driver’s door opened and closed and Steve’s face appeared in the window between the cab and the patient module. “Ready to go?” he asked.
“Light it up!” Ryan confirmed. “West Oneida ER. Call a report, too! Left femur and humerus, pelvis and left chest wall. Unresponsive and hypotensive.”
Steve nodded and presently he pulled into traffic, sirens screaming down Harrison Avenue toward West Oneida Regional Medical Center, barely two minutes away.
Ryan gestured toward the cabinet next to Mike. “Grab an IV setup out of there, would you? Should be a bag of fluid with a drip set and blue tourniquet wrapped around it.”
Mike Granger stood up and dug through the IV cabinet, nearly losing his balance as the ambulance changed lanes. Ryan chuckled and looked up significantly at the grab rails running the length of the ceiling. Embarrassed, Mike reclaimed his seat as Ryan took the IV setup from him.
“Watch me as I do this, okay? That way you’ll know how the next time I need it.” He quickly spiked the bag and flushed the air from the tubing, tossing the bag onto the spine board between the woman’s legs.
“Auscultate her chest and tell me what you hear,” he ordered as he deftly inserted a 16-gauge IV catheter into the woman’s left arm, taping it securely with three wraps of two-inch tape.
The Ryan Pierce gorilla wrap. It’s ugly, but strong as hell.
Mike obediently listened to the woman’s chest with the stethoscope, eyes screwed shut in concentration. “I think the sounds are decreased on the left,” he announced.
“Think, or know?” Ryan pressed with a hard look. “Could you hear anything at all?”
“Definitely decreased on the left,” Mike said decisively. “I can’t tell much about what I’m hearing, but she doesn’t have much of anything in the way of breath sounds on the left side. Just some funny clicking noises.”
“Those are broken ribs you’re hearing,” Ryan grunted as he felt the ambulance turn sharply to the right, then lurch to a stop. He looked out the rear window. “We’re here.”
Ryan stood up as Steve backed the ambulance into the nearest open bay, bringing the ambulance to an abrupt stop. Mike Granger nearly lost his footing a second time. Ryan smiled tolerantly. “Mr. Granger, if you must stand up in a moving ambulance, it helps to hold on to something. That’s what all those shiny chrome rails are for.”
Before Mike could frame a suitable retort, Steve Hatfield opened the rear doors. “Trauma Room Three,” he announced as he unlatches the cot. “They’re waiting on us.” Ryan disconnected the oxygen mask, handing the tubing to his partner. Steve strapped a portable oxygen cylinder next to the woman’s undamaged right leg and reconnected the oxygen tubing. Ryan held the IV bag at shoulder level and adjusted the flow to wide open as they rolled the cot into the ER.
Dr. Tanya Boyer was waiting in the hall outside the door to Trauma Three. She greeted them with a rueful grin and a shake of the head. “It’s too damned early in the shift to start with this, guys.”
“You know you’re happy to see us,” Ryan retorted with a wide smile, then turned serious. “We got an unrestrained driver of a compact car, T-boned right in front of us at maybe forty miles an hour. Caved in the driver’s side maybe sixteen, eighteen inches. She’s got a fractured femur, humerus, and ribs on that side. Pelvis is unstable and decreased breath sounds on the left.” Steve and Mike quickly moved the woman onto the ER bed.
Dr. Boyer frowned and listened to the woman’s chest. She flashed a penlight into the woman’s eyes. “Conscious at any point?”
“Gimme that IV, Hawkeye,” a nurse asked, reaching for the bag. “That’s a sixteen in there,” Ryan informed her with a wicked grin as he handed the bag to her. “Just in case you couldn’t tell through all the tape.” The nurse rolled her eyes.
Ryan turned to Dr. Boyer. “We’re outta here, Doc. And by the way, 305 is probably only a few minutes behind us with two others from the other car. Neither of them near as bad as she is, though.”
“Out. Don’t come back.” Tanya Boyer pointed to the door, feigning anger.
Chuckling, Steve and Ryan rolled the empty cot outside and began readying the rig for the next call.
Approaching sirens heralded the arrival of Mark Perry and Kenny Hadden on 305, and presently the ambulance arrived, backing into the slot next to 306. Ryan opened the rear doors to find Mark holding an IV bag of saline dripping slowly into the man strapped to the cot. “Had a little extra time while Kenny and the firefighters were extricating the woman,” he grinned.
Ryan unloaded the cot and Mark followed it out of the rig. “Go ahead with him,” he said. “Steve and I will get your other patient.” Ryan loaded his stretcher into Mark’s rig as Steve climbed into the back.
“How ya doing, ma’am?” Steve grinned down at the woman. “Long time, no see.” She smiled weakly up at him. “We’re gonna move you over to this other stretcher and bring you inside. Just fold your arms across your chest and hold still, okay? And don’t worry, we only drop people on Thursdays,” he said, deadpan.
“But today is Thursday,” she wailed, half-crying, half-laughing as they placed the spine board on the cot.
“Really?” Ryan asked, feigning astonishment. “We’re doing good for a Thursday, then.” The woman chuckled as they rolled her into the ER. Ten minutes later, Ryan had completed his run ticket and put the unit back in service.
“Response time was zero minutes. Thirteen minutes on scene, three minutes to the hospital, back in service at oh-eight-ten,” Steve announced, reading the times off his pager.
“Not bad,” Ryan judged, “considering we had to do an extrication.”
“But still over the Platinum Ten Minutes,” Mike Granger pointed out. Ryan sighed and rolled his eyes in exasperation.
“Now you’ve done it, kid,” Steve Hatfield grinned. “Professor Hawkeye will be on his soapbox for the next ten minutes.”
“Are you aware, Mr. Granger, that there is absolutely no scientific data to support the concept of the Golden Hour?” he asked. “Or for that matter, the concept of a scene time of less than the ‘Platinum Ten Minutes’, as you so quaintly put it?”
“But in EMT class, we were – ”
“The Golden Hour was an idea sketched out on a cocktail napkin in a hotel bar at an American College of Surgeons conference, by none other than R. Adams Cowley,” Ryan interrupted. “They were looking for a PR tool to demonstrate the wisdom of getting a trauma patient to surgical intervention as quickly as possible. While it seems intuitively obvious that the quicker a critical trauma patient gets to hot lights and cold steel, the better the outcome, there are no scientific studies that indicate surgery within sixty minutes is the optimum time frame.”
Steve groaned and quietly banged his head against the window glass as Ryan warmed to his subject.
This is why people think he’s arrogant. The bastard never forgets a fact, and wonders why everybody can’t do it.
“Furthermore, people seem to think that a ten minute scene time is the best for every patient, including medical calls,” Ryan lectured. “The managers and bean counters use it as an excuse to get a unit back into service as quickly as possible, but what it really does is promote shoddy assessments and poor care. Sometimes Mike, faster is not better.”
“Who was R. Adams Cowley?” Mike wondered. Steve whimpered aloud and closed his eyes.
“‘Who was R. Adams Cowley’?” Ryan parroted incredulously. “What the hell did they teach you in your class? He was the founder of the Shock Trauma Center in Baltimore, Maryland. He was only a true pioneer and a giant in our profession.”
“So he was a paramedic?” Mike wanted to know. Steve sunk lower into his seat and started massaging his temples.
“A paramedic? No, he was not a paramedic. He was a surgeon!” Ryan spluttered. “For pity’s sake, do you know none of the history of our profession? Do you know who Johnny and Roy were? Frank Pantridge? Have you never gotten drunk and watched Mother, Juggs and Speed?”
Steve leaned forward, turned the radio up full blast and looked pointedly at Ryan. Catching the hint, Ryan stopped his tirade, turned back around in his seat and folded his arms across his chest. Steve looked back and fixed the EMT student with a withering glance. “You get him wound up again, and I’m kicking your ass, kid.”
“Let’s say a sweet little old lady has passed out,” Ryan hypothesized. “You arrive on scene, and you find her on her back in the bed, covers pulled to her chin. She’s awake now, but says she hasn’t felt well in a couple of days. She’s been weak and tired, and has thrown up several times. What do you want to do?”
With no other calls all morning, he had been relentlessly quizzing the EMT student for the past three hours. They were parked near the Riverwalk in Oneida, watching the rising waters lap at the seawall.
“Well, I’d want to get some vital signs,” Mike mused. “Gather up her medications and stuff, too.”
“Her blood pressure is 108/60 and her heart rate is 88. She’s breathing 18 times a minute. What else do you want to do?” Ryan pressed.
“Uh, I guess I’d want to, you know, find out what’s been going on with her. Why she passed out, has it ever happened to her before, that sort of thing? I’d ask her about her medical history, medications, allergies and stuff.”
“She’s allergic to penicillin, and she takes medicines for high blood pressure and high cholesterol, and OTC painkillers for arthritis.”
“OTC?” Mike asked, confused.
“Over-the-counter, Mike,” Steve explained sleepily. “You know, Tylenol, Motrin and stuff like that.” He sat slumped in the driver’s seat with his eyes closed, using a folded sheet as a pillow.
“So what’s wrong with her?” Ryan continued.
“Well, her vital signs are fine,” Mike stalled for time. “What’s her oxygen saturation?” Steve took his improvised pillow and hurled it violently over his right shoulder at Mike’s head.
“Why does that matter?” Ryan asked with an evil grin.
“Well if it was low, I’d give her oxygen,” Mike answered. Steve groaned.
“So if the pulse oximeter reading was 98% but the patient was wheezing and struggling for air, you wouldn’t give them oxygen? What if they were breathing fine, with a saturation of 86%? What then?” he pursued.
Without opening his eyes, Steve reached out and punched Ryan hard in the left arm, then picked up a soda bottle and brandished it at Mike like a club.
Mike shrank away and answered cautiously, “I guess I’d put oxygen on them if I thought they needed it, regardless of what the pulse oximeter says.” Steve smiled peacefully and put down the bottle.
Ryan rolled his eyes and grinned. “And what else would you do for the lady? What will you tell the ER doc when you get her to the hospital?”
“I have no fucking idea,” Mike blurted, exasperated. “I’d give her a ride, and tell them ‘sick lady’ when I get to the hospital.” Steve laughed out loud.
“More assessment and history,” Ryan advised patiently. “You want to know what she was doing when she passed out. How much has she eaten or drank for the past few days? What did the vomit look like? Has she had diarrhea? What if I told you that when you sit her up to move her to the stretcher, she gets dizzy and her heart rate shoots up to 110? Ever heard of taking orthostatic vital signs?”
Mike shook his head.
“Take blood pressure and pulse first while they’re lying down. Then take them again when they sit up, and when they stand. If the blood pressure drops, or the heart rate shoots up twenty points or more – ”
“It means they’re dehydrated, kid,” Steve interrupted sleepily. “Or suffering from some kind of blood loss.” He sat up in his seat and yawned, rubbing his eyes sleepily.
“So what do you do?” Ryan wanted to know.
“If I’m out in the sticks, I’d call for a paramedic to meet me en route,” Mike answered. “If I’m in the city, I’d probably just give her a ride and tell them ‘sick lady’ when I get to the hospital,” he grinned at Steve’s reflection in the rear view mirror. Steve winked back.
“Both you guys are hopeless,” Ryan chuckled, shaking his head. He grabbed the portable radio off the floor between the seats. “I’m gonna go stretch my legs,” he said as he climbed out of the cab, groaning and massaging his lower back.
“He thinks I’m an idiot,” Mike said quietly.
“Nah, he’s just demanding,” Steve assured him. “They teach you to memorize things and use the toys in EMT school, Mike. He wants you to use your head and think about what you’re doing. He wants you to understand why you’re doing something.”
“All the guys in my class are scared shitless of him,” Mike observed, “and still my instructor says he’s the only medic he’ll let precept his students.”
Steve chuckled knowingly. “That’s understandable. He taught your instructor ten years ago,” Steve explained. “Everybody worships their EMT instructors – the good ones, at least.”
“Is he that good?” Mike wondered. “Everybody talks about him like he’s Supermedic.”
“The best I’ve seen,” Steve confirmed. “But he fucks up now and then like anyone else. Most people are too intimidated to call him on it. Except me, of course,” he concluded with a nasty grin.
“Does he get pissed at you?”
“Nah, he gets pissed at himself,” Steve explained, “but he knows I’ve got his back. He’s taught me a lot, so when I pick up something he missed, he doesn’t get his feathers ruffled about it. He’s just glad I caught it, because partners are supposed to back each other up. Sometimes it seems like Ryan is thinking two or three steps ahead of everyone else. That’s his gift. He sees everything in slow motion, when the rest of us have a hard time keeping up. Problem is, sometimes he thinks everybody can do that.”
“Is it true he’s rich?” Mike wanted to know. “I hear he inherited a load of cash from his parents.”
“Jesus, what do you guys do all day in your classes? Sit around and gossip?” Steve snorted in disgust. “Yeah, he’s rich. I have no idea how much, but he damned sure doesn’t have to work. Ryan didn’t get along with his parents. Hadn’t had any contact with them for years before they died. Ryan doesn’t talk about it.”
He took a sip from his water bottle and paused, obviously contemplating whether to say more. He sighed heavily. “Everybody says he’s Supermedic, right? That he’s got ice water in his veins?”
Mike nodded, leaning forward.
“July seventeenth, five years ago. I’m working with Ryan; we get a call to an overdose. Some junkie takes too big a hit, and the chick that lives in the same flophouse calls the cops, right? I’d been working with Ryan maybe six months.” Steve closed his eyes and shook his head.
“Anyway, we get cleared to come in to the scene, and there’s this chick on the floor, needle still in her arm. She’s soaking wet from where her roomie poured water on her – junkies think that wakes ‘em up, kid – and she’s got vomit all over the front of her shirt. Anyway, she’s laying there dead as Elvis. Ryan takes one look at her, tells me ‘suction, right now’, and starts working the code. So I stick a suction catheter in her mouth and start pulling up last night’s Taco Bell or whatever the hell it was that she ate, while he gets the cops doing CPR. There’s enough puke there that she had to have aspirated a lot of it. Ryan butts me out of the way, tells me ‘cardiac monitor’, and gets a tube in about ten seconds. By the time I get the monitor hooked up, he’s got an IV running WFO…”
“Wait a minute,” Mike interrupted. “What does WFO mean?”
“Wide Fucking Open,” Steve explained. “Anyway, my point is, he was smooth. Fast, never seemed to hurry, never raised his voice. The Ice Man. I’m thinking this chick is gone – she was asystolic, totally flat line – but he starts with the fluids, epi and atropine, and we boogie with her to St. Matthew’s. By the time we get her to the ER, she’s got a rhythm and a pulse. We drop her off and give report, and the ER unit clerk asks if we know her name. Ryan goes, ‘Renee Pierce. Date of birth is October 26, 1968. No known allergies, history of depression and drug addiction’. The unit clerk, kinda half-assed joking, asked if she was a relative. Ryan says, ‘yeah, she’s my twin sister’ and walks out of the room.”
“Holy shit, his sister?” Mike asked wonderingly, admiringly. “And he never freaked out? Wow.”
“Never freaked out? No, I wouldn’t say that.” Steve shook his head, opening his eyes and looking sadly at the EMT student until Mike took his meaning. “His old man came and signed the DNR papers the next day, but Ryan had to know she’d never come back. She was just down too long. Anyway, none of us were invited to the funeral. Just a small family affair, his wife told us, so we just sent flowers. The next day, he was back at work, same old Ryan.”
“Were his parents alive then?” Mike asked.
“Yeah, his dad was. The plane crash didn’t happen until a couple of years later. You know who his old man was, right?”
“Yeah, the cardiologist.” Mike nodded. “They lived in that big house on River Road.”
“Well, his Dad was a Big Man around here. His mother made a ton of money in real estate, too. I asked Ryan once about his parents. He told me that he had left home at eighteen and worked his way through EMT school. He didn’t care for his old man, that much was plain. He doesn’t talk about his family at all,” Steve warned, “so don’t even ask.”
Ryan Pierce walked along the seawall, watching the rising floodwaters and pretending he didn’t know they were talking about him.
Right about now, the kid is grilling Steve about me, and Steve is telling him The Legend of Ryan Pierce.
It was one of those war stories that grew with every telling. Everyone knew Ryan by reputation back when he worked for Collins Ambulance, but he was still the new guy at StatCare, yet to prove himself. Like so many calls, Ryan didn’t remember much of the details. He did what he always did – lost himself in the task at hand. He had a resuscitation to manage. Truth be told, had it been anyone besides Renee, he wouldn’t have even worked it. But Ryan Pierce had been paying the psychic price for walking away from his sister since he was eighteen years old, and something in him saw it as penance for leaving her behind.
Steve Hatfield had found Ryan outside in the rig after the call, curled into a ball on the squad bench, sobbing and calling his sister’s name. He just quietly shut the doors and drove back to the station. The supervisor had wanted to butt in, get involved, do something; Steve had convinced him, not easily, to simply call Ryan’s wife and tell her what had happened.
Dawn was waiting outside when Steve drove up to the apartment. Eyes red-rimmed, clutching a bathrobe around her, she had asked what happened, and Steve numbly gave her the details. Dawn Pierce had taken about five seconds to get over the shock, and then she had tenderly put her arm around her husband and walked him inside.
Steve had stood silently watching as Dawn walked Ryan up the stairs, wishing he knew what to do. He tried to reach out to Ryan after the funeral, tried to tell him how sorry he was, but Ryan had brushed him off. He couldn’t talk about it. Still can’t. Steve just let it ride, but he was worried about his partner. He had told The Legend many times since, but he had never once told a soul about what went down after the call. Steve Hatfield was one of the good guys.
“If the water comes up much more, we’ll be evacuating Azalea Manor again,” Ryan sighed as he climbed back into the rig, “and you remember what a bitch that was last time.” He looked suspiciously at his partner. “Did I interrupt something? Want me to leave so you can keep talking about me?”
“I was just telling Mike a few Hawkeye Pierce war stories, that’s all,” Steve replied with an evil grin. “You know, giving the kid a glimpse of the man behind the legend.”
“Fuck you,” Ryan retorted, fastening his seatbelt. He turned in his seat to look at Mike. “You know the difference between a fairy tale and a war story, right?”
“A fairy tale begins with ‘once upon a time’, and war stories always begin with ‘no shit, we had this call once’. Other than that, they’re pretty much the same.”
“Control to 306,” the radio crackled “Cardiac arrest at Azalea Manor, room B19.”
“306 en route,” Steve groaned as Ryan engaged the lights and siren. “You’re a fucking black cloud,” he said to Mike, who was kneeling in the passageway between the patient module and the cab.
The kid couldn’t hide his excitement. Steve was ragging him, but the crew of 306 had actually had a pretty light day. Aside from the wreck that morning and a few uneventful transfers, they had done nothing but drive from one posting location to another all day. The latest call should carry them until right before shift change, so Ryan was in no mood to complain.
“Why don’t you throw the cardiac monitor, jump bag and oxygen tank on the stretcher, Black Cloud?” Ryan requested politely. “If you’ll be so good as to spike a bag of saline as well, Steve may even let you do CPR. Isn’t that right, Steve?”
“As far as I’m concerned, he can do it all,” Steve agreed. “I’ll just fetch and tote equipment. Less work for me.” Mike looked excited at the prospect, the poor unsuspecting kid.
“Portable suction unit too, Mike,” he called out as they pulled up to Azalea Manor. “Might as well bring it all.”
They pushed the loaded cot inside, turning right past the nurse’s station down B Hall, navigating around the wheelchairs and linen carts parked in the corridor. At the far end of the hall, an aide beckoned frantically. They parked the stretcher outside the door and pushed their way into the crowded room. An older gray-haired nurse knelt on the bed near the window, doing a half-hearted attempt at CPR on a frail black woman. The woman’s head and neck were an ugly, mottled purple mask.
“The aide came in here with her dinner tray and found her barely breathing. We watched her take her last breath maybe five minutes ago,” the nurse told Ryan as she straightened and massaged her lower back, groaning.
Judging from the patient bouncing up and down on the air mattress and the distended abdomen, what you were doing could not be described as effective CPR.
“Been doing CPR the whole time?” he inquired politely. She just nodded, out of breath. Ryan checked for a pulse as Steve began clearing the tray tables, motorized wheelchairs and oxygen generators out of the way. Finding none, he motioned for Mike to take over CPR. Steve placed the defibrillator on the floor beside the bed, and Ryan quickly placed the electrodes on the woman’s chest.
The screen was a mass of motion artifact as Mike bounced the woman up and down on the bed just as ineffectively as the nurse had done.
“Stop CPR for a second, Mike,” he ordered. The rhythm settled into a long, unbroken line of asystole. Ryan turned to the aide as he opened the jump bag. “Would you go fetch your CPR board and her chart, please?” The aide just stared at him blankly. “CPR board, Ma’am?” he asked, pantomiming with his hands. “Big orange plastic thing? Looks like a boogie board with a divot scooped out of it?” Ryan asked hopefully. Recognition dawning on her face, the aide wheeled and waddled down the hallway as fast as her stumpy little legs could carry her.
Chuckling, Steve handed him the bag mask resuscitator and opened the airway kit. Ryan tilted the woman’s head back and delivered a couple of quick breaths.
“She’s asystolic, Steve,” he reported, “and it looks like we’ve got a lot of gastric distension here.” Steve nodded, laying the laryngoscope and an endotracheal tube on the bed next to the woman’s head. Ryan delivered several more breaths and noticed the aide standing meekly in the doorway, holding the CPR board and the woman’s chart.
Don’t just stand there with your thumb up your ass, sweetheart. I didn’t send you for the board because I thought you needed the exercise. It would be nice if we finally got some effective compressions done on this lady, don’t you think?
He smiled reassuringly at the aide and motioned her into the room. Mike took the CPR board from her and slid it under the old woman’s shoulders as Ryan inserted the laryngoscope into her mouth. Her vocal cords winked at him from behind a thin veil of clear mucus. He sank the tube and inflated the cuff, quickly cinching it into place with a tube restraint. A quick check with a stethoscope and a few squeezes of the bag told him that the tube was properly placed, even though the capnograph tracing picked up virtually no exhaled CO2.
Steve was kneeling beside the bed, busily searching for a decent vein as Ryan turned to the nurse. “What kind of medical history does she have?” he asked as he ventilated the woman. “Any idea what might have caused her to arrest?”
Other than being a hundred years old and eating nursing home food, that is?
The nurse just stared at him blankly. He smiled at her and looked pointedly at the chart lying on the tray table. Steve cursed under his breath as he dug around in the bend of the woman’s elbow with an 18-gauge catheter. The nurse snapped out of her trance and flipped open the chart. She riffled through several pages, and visibly brightened as she found what she was searching for.
“Says here she has a history of advanced Alzheimer’s, hypertension, congestive heart failure, atrial fibrillation, emphysema, hypothyroidism, chronic renal insufficiency, and diabetes,” the nurse announced triumphantly.
“Jesus Christ!” Mike blurted, “and we’re coding this woman?”
You took the words right out of my mouth, kid.
“I can’t find a vein,” Steve interrupted in frustration. “She’s got nothing I can see.”
“Gimme a catheter,” Ryan told him with a grin. “She’s got enough jugular venous distension that I can dart one from across the room.” Steve handed him a catheter and took over ventilations while Ryan made the stick.
“Want me to stop compressions while you do that?” Mike asked dubiously, watching Ryan poised near the vein with a sharp needle. He shook his head as he advanced the catheter.
Stop compressions while I stick? You are talking to the legendary Hawkeye Pierce, my naive little EMT student. For me, the difficult things are easy, and the impossible things merely difficult.
Ryan opened the IV to flow wide open and held out his hand for the first round of drugs. Steve handed him a round of epinephrine and atropine with one hand, while bagging with the other.
“Epi and atropine on board,” Ryan announced as he administers the meds. “Let’s get her ready to transport.” He beckoned the aide closer to the bed and tapped Steve on the shoulder. “Take over ventilations for him for a little bit, Ma’am.”
Steve handed her the bag and stood up. Despite the past couple of minutes of effective ventilations, the woman’s color had not improved. In fact, the purple death mask was now creeping down over her shoulders.
“Any recent trauma?” he asked as they lowered the stretcher.
The aide looked up. “She rolled out of bed and hurt her hip two days ago. We sent her for x-rays, but it wasn’t broken,” she told Ryan. “Do you think that fall could have something to do with it?”
Ryan shrugged as he disconnected the bag mask. “Maybe. No real way to tell.” They grabbed a handful of bed sheet and Ryan motioned for Mike and the nurse to do the same. “Okay everybody, on three. One, two, three.” They quickly slid the woman onto the stretcher and Steve began to buckle the straps as Ryan reconnected the bag and ventilates. “Check breath sounds again for me, Steve.”
“You’re still in,” he answered, nodding in affirmation as he auscultated the woman’s bony chest.
“Okay Mike, resume CPR and let’s go.”
Mike complied, standing on the stretcher’s undercarriage as he rhythmically compressed the woman’s chest. Steve slung the jump bag over his shoulder and piled the rest of the equipment on the stretcher at the woman’s feet. They pushed the stretcher down the hall toward the waiting ambulance, pausing only briefly at the nurse’s station to drop off the chart and pick up the paperwork from the unit clerk. Ryan briefly considered telling Mike to get off the stretcher while they pushed, but decided against it.
What the risk managers don’t know won’t hurt them. Besides, the kid has probably been itching for the chance to go code surfing.
In the rig, the rhythm stayed unchanged – a long, unbroken flat line of asystole. Ryan administered another round of epi and atropine, and just for grins, checked a blood sugar level. Her sugar read 56, a little on the low side, but not low enough to put her in arrest. Nevertheless, Ryan administered an amp of D50% and an amp of Bicarb for good measure.
Not like it’s gonna do much good. She’s as old as dirt, and from the looks of things, a pulmonary embolus is what killed her, not renal failure and hyperkalemia.
A few not-so-subtle whimpers from Mike told Ryan that he was tired of doing compressions, so he took mercy on the kid and switched positions with him. Mike hadn’t yet gotten the knack of keeping his balance in a moving ambulance, and flashed Ryan a grateful look as he settled in to the jump seat. He was bagging a little too fast for Ryan’s taste, though.
“Hey Mike?” he asked gently, and the EMT student looked up expectantly. “The idea is, the ventilatory rate should correspond to the patient’s resting respiratory rate, not your own pulse.”
Embarrassed, Mike slowed down to a more respectable rate. “Sorry,” he muttered.
“No problem,” Ryan grinned. “You’re doing good.” The poor kid blushed like a schoolgirl.
“Mister Granger, it is not very paramedic-like to blush like a tomato whenever someone pays you a compliment,” Ryan chided, mockingly stern. “You do better by cultivating an aura of cockiness and arrogance. We have to uphold the reputation of our profession, after all.”
“And how do I do that?”
“Just watch me and do what I do,” he winked. “Anybody will tell you that I’m the cockiest medic around.”
And if you work your ass off to actually be as good as you pretend to be, you’ll be a pretty good EMT.
Ryan checked his watch and handed Mike another round of epi and atropine. “Here, give these for me. Try not to stick yourself,” he warned as he watched Mike carefully insert the needles into the injection port. “Pinch off the line before you push the meds… yeah, just like that. That ought to last us to the ER.” He looked out the front window to see the gothic granite of St. Matthew’s Regional Medical Center directly ahead.
“Congratulations, Mr. Granger. You have just officially exceeded your scope of practice as a Basic EMT, even before you became a Basic EMT. How does it feel?”
“What happens in the rig, stays in the rig,” Mike answered smugly.
There you go, kid. First day of ride time and you’re a smartass already. You’ll do okay.
“Unless you fuck up,” he pointed out. “If you fuck up in the rig, it matters in the – ”
“Beep!” Something entirely unexpected happened – a heartbeat. At first just agonal beats, then more and more until finally the woman showed a funky ventricular rhythm marching across the monitor at maybe forty beats a minute.
I’ll be damned. Don’t tell me this woman is going to regain a pulse.
“Check for a pulse,” Ryan ordered. Mike palpated a carotid pulse, a look of concentration on his face quickly fading into a look of triumph.
“She’s got one!” he said excitedly. For good measure, the CO2 detector started to turn a dull tan, indicating at least some exhaled carbon dioxide. “We got her back!” Mike exulted.
This is not one to celebrate, kid. This lady has been down too long, and her body was failing anyway. She’ll never make it out of the hospital, if she even lives long enough to be admitted.
Ryan simply nodded and grinned reassuringly at the EMT student as Steve backed the rig into the ambulance bay. He disconnected the IV bag from the roof hook and laid it across her chest, hung the cardiac monitor from the stretcher rail, and switched the bag mask over to the portable oxygen cylinder strapped to the cot between the woman’s legs. As Steve opened the rear doors, Ryan backed out of the rig first.
“Just follow the stretcher out of the rig and keep bagging, Mike,” he ordered. “And be careful with my tube.”
Inside, he gave report to Dr. Donaldson, the ER physician. Donaldson was a friendly enough sort, a genial older man with a fatherly air about him. He always told Ryan that he was a chip off the old block, and out of respect for the paramedic-physician relationship, Ryan refrained from telling him to get bent.
“Ninety-four year old female with a witnessed arrest. She was asystolic when we got there, with ineffective CPR. The tube is a 7.5, placement was good before we unloaded her.” Dr. Donaldson listened to the woman’s chest, nodded in approval and straightened back up. “Three rounds of epinephrine and atropine, one round each of D50% and sodium bicarbonate. I figured hyperkalemia and/or hypoglycemia might be a cause, so I gave it a shot. She converted right as we pulled up.”
“Is she diabetic? A dialysis patient?” Donaldson wanted to know.
“Not on dialysis yet, but she has chronic insufficiency, and the diabetes is on her chart, among twenty other chronic illnesses. Her sugar was 54.”
“Pressure is 54/20,” the nurse broke in. Dr. Donaldson sighed, flipping through the nursing home paperwork. “Run in another 500 of saline, and start a dopamine drip at five,” he ordered, “and someone try to contact her family. This lady ought to be a DNR.”
“How much do you figure she weighs?” asked a new nurse, one Ryan had never seen before. She was young, slim and honey-blonde. Cute.
“Maybe ninety pounds,” Ryan judged. “You’ll need to run your dopamine at eight milliliters an hour to get five micrograms per kilogram per minute.”
“How the hell did you know that?” the nurse demanded as the others chuckled. “Did you figure that in your head?”
Ryan just winked at her and tapped his temple. “That’s an EMS trade secret. I could tell you, but then I’d have to kill you.” The other nurses just laughed.
“Just do what he says, Cathy,” one of them chuckled. “I’ll explain Hawkeye Pierce to you later.”
Ryan winked again at Cathy and walked back outside. Steve was making up the stretcher as Mike busied himself cleaning the rig, putting everything in its proper place. It was a big job – Ryan Pierce was notorious for trashing ambulances.
“That was so cool!” Mike was saying, still flush with excitement as he wiped down the floor and gathered up empty wrappers. “My first code and we get a save!” Ryan merely smiled and let him bask in the feeling. Mike Granger would have to work quite a while as an EMT before he’d recognize the futility of what they had done. Even a save wasn’t always a save. Not really.
“Yeah, first code and he’s already getting cocky,” Steve observed with a wry grin. “He’s been talking smack about the nursing home version of CPR.”
“Yeah, can you believe that?” Mike asked, shaking his head. “I mean, I’m not even out of school yet and did better CPR! They acted like they didn’t have a clue what to do. Nursing home nurses!” Mike snorted in derision.
They probably didn’t know what to do. Then again, they’re not trained to handle emergencies. And you don’t have nearly enough hair on your fuzzy little EMT scrotum to feel superior to a nurse, my sparky little EMT student friend.
“No, they weren’t doing very effective CPR when we got there,” Ryan agreed. “Then again, how effective do you think your compressions were after ten minutes?”
“Not very,” he admitted, his grin slowly fading. “I was worn out.”
“That’s why I spelled you on compressions,” Ryan pointed out as he sat on the bumper of the rig and began working on his run ticket. “And you had the luxury of bagging through an endotracheal tube throughout most of it. The nurse had to use a mask. You’ve practiced it in EMT class – you know how hard it can be to bag a manikin by yourself, much less a person.”
“Yeah, but they had the equipment there to do it right! They didn’t do anything until you told them what to do. They didn’t know shit about the lady, either!”
Ryan sighed and put down the clipboard, looking up at Mike. “Let me paint a picture for you, Mr. EMT Wannabe. Let’s say you got to school for eighteen months and pass a licensure exam as a practical nurse. You get a job in a local nursing home. You now work in an industry that considers 40:1 an acceptable patient-to-caregiver ratio. At least half of your patients are chronically bed bound. Most of them have some degree of dementia. All of them have multiple chronic illnesses. Every single one of them requires at least some level of assistance with the activities of daily living. Every single one of them takes a bucketful of medications several times a day. Your only help is a couple of aides that have, at most, a high school education and a questionable command of English, and they’re paid minimum wage. Every single eight-hour shift that you work begins with setting up your medication cart to administer the first round of medications of the shift. By the time you have completed that med-pass, your shift is half over, and it’s time to begin the next med-pass. By the time you’re done with that one, it’s an hour away from shift change, and you still haven’t done any charting. You’ve been on your feet for seven hours, and you’ve managed to spend maybe ten minutes with each patient, if you’re lucky. Is it any wonder that you don’t know jack shit about your patients without having to look it up? Or that they call EMS when the slightest thing looks out of the ordinary?”
“I didn’t know that…I mean I wasn’t trying to…” Mike stammered, mortified.
“Now imagine that you get to know these patients. You see to it that they’re fed, turned, medicated and bathed. You dress their bedsores. You’ve spent more time with them in a day than their families have in a year. This lady was from Alabama. How often do you think her family comes over to visit dear old Granny? Now, you know this lady. You know what her days are like. You see her quality of life, or lack thereof. You know she wouldn’t want to continue to suffer, if she was still capable of voicing her wishes. Now would you be really diligent about doing CPR when this lady finally, mercifully, passes?”
“No, I guess I wouldn’t,” Mike admitted, chastened.
“And if some snot-nosed punk fresh from a six-month EMT course came off with a superior attitude, belittling you, would you take it well?”
“So keep that in mind the next time you disrespect a nursing home nurse. Hate the system all you want, because it sucks. But the people working in that system aren’t to blame.”
“I won’t,” Mike promised, looking rather like someone had just run over his puppy. “I was just shooting my mouth off.”
“Don’t worry about it,” Ryan grinned, punching him in the arm. “Bashing nursing home nurses is a time-honored EMS pastime, good for hours of fun and enjoyment. You just have to pay your dues first, and try to remember where they’re coming from.”
“Control to 306,” the radio crackled before Mike could reply.
“306,” Steve answered.
“Priority One call, 1500 block of West Tower on a shooting. Oneida Police are on scene.”
“Fuck me!” Steve exploded. “Fifteen Goddamned minutes before shift change!” He climbed into the driver’s seat and slammed the door, fuming. Mike scrambled into the back of the rig, looking excited enough to soil himself.
Damn, damn, damn. This is going to make me late getting off. Dawn is going to give me hell if I’m not there when she drops off Caitlin.
Mike looked disgustingly eager as Steve wove the rig through a maze of streets toward West Tower Avenue in downtown Oneida. Forty years ago, West Tower was the thriving business hub of the city. Now, it was a dimly lit, barren landscape of abandoned storefronts and decaying buildings. The only thriving businesses there were crack dealers and prostitutes. West Tower was informally known as Crack Alley, its namesake tower burned out in 1987, and finally demolished by the city in 2001.
They were met by a surprise as they turned off of Constitution Avenue onto West Tower. The scene of the shooting, supposedly two blocks further down, turned out to be right in their faces as they turned the corner. Steve had to brake hard to avoid running over an angry group of people surrounding two Oneida Police Department cruisers. The maneuver threw Mike to the floor, cursing. The crowd, equally surprised by the sudden appearance of the ambulance, parted slightly.
“Shit,” Steve blurted unnecessarily. “I don’t like this. Stay in or get out?”
“Get out,” Ryan answered after a moment’s consideration. “We’re already in the middle of it.” He turned to Mike. “You stay here.” Before he could protest, Steve and Ryan bailed out of the rig.
A frightened Oneida police officer was standing over a prone body, weapon drawn, while his partner spoke urgently into the microphone clipped to his epaulet. The victim was a young black male, hands cuffed behind his back, with a spreading red stain on the back of his shirt. His breathing sounded wet and ugly. The officers had their weapons pointed outwards, toward the crowd, and the tension was evident on their faces.
“What the fuck are you guys doing here?” the younger officer demanded, not taking his eyes off the crowd. “You were supposed to stage until we cleared you into the scene!”
“That’s not what we were told,” Ryan replied. “What happened?”
“Foot pursuit,” the the other replied, out of breath. “He pulled a knife.”
“Ain’t nobody had no muthafuckin’ knife!” a woman in the crowd screamed. “Fuckin’ cop just shot him down!” The crowd surged dangerously forward, and a bottle shattered against the side of the rig. Ryan flinched instinctively, and another bottle just missed his head, whacking him painfully on the shoulder.
“Get him in the rig and go!” the cops screamed, looking wildly around for the thrower. Steve and Ryan didn’t need to be told twice. They dragged the guy by the shoulders to the back of the rig and beat on the doors until Mike opened the rear doors and peered out cautiously.
“Don’t just fucking stand there!” Steve cried. “Help us pull him in!” Mike hurriedly grabbed the man under his arms and they half-dragged, half-lifted him onto the cot. Steve and Ryan hurriedly climbed inside and slammed the doors behind them as another bottle shattered against the rig. Steve scrambled into the cab and threw the rig into gear, screaming at people to get out of the way. They crept forward slowly, and the ambulance rocked violently.
“Get the fuck away from the ambulance! Get outta the way!” Steve screamed at the people outside. Several of them were beating on the hood and the sides of the rig. “Swear to God, I’ll fucking run you down!” he screamed threateningly, and gunned the engine. The rig surged forward, haltingly at first, and then traveled perhaps a hundred feet before abruptly coming to a stop.
“Shit!” Steve swore, then yelled to the back, “Open the back doors and let ‘em in!”
Ryan flung open the rear doors to find a news camera crew desperately trying to climb inside. The cameraman pushed the reporter through the doors and crowded in behind her. She looked dazed, blood flowing down the right side of her face from a cut at her hairline.
“Jesus Christ!” Ryan blurted, and then shouted to Steve. “They’re in! Let’s get the hell out of here, shall we?” Needing no further prompting, Steve nailed the accelerator and made a hard turn onto Constitution Avenue. A block up the road, they met four police cruisers heading the other way, sirens screaming.
“Hold this,” Ryan told the reporter, holding a gauze bandage to the cut in her forehead and pressing her right hand against it. “You hurt, dude?” he asked the cameraman, who shook his head.
“Mike, get some suction and a BVM and start –“
“Way ahead of you,” he reported. Mike already had a bag-mask resuscitator attached to the main oxygen. As Ryan watched, he stuck a rigid suction catheter into the guy’s mouth, pulling a stream of foamy blood into the tubing. Airway cleared, at least temporarily, Mike started ventilating, frowning in concentration. Ryan watched him for a few breaths to make sure he wasn’t having any difficulty, and then opened the IV cabinet. Mike grinned, nodding at a bag of saline swaying from the ceiling hook. “Already got one set up for you. I did it on the way to the call.”
Pretty damned sharp, rookie. You get an “A” on your evaluation today.
Using his shears, Ryan cut the guy’s shirt open from hem to neckline, exposing a small hole in the left front chest, about even with and an inch to the left of his nipple. A closer look revealed another hole through his left bicep. Neither was bleeding especially badly, but Ryan quickly rolled him partially on his side to check the wound on the back. It was noticeably larger, and bleeding a good deal. He slapped a dressing on it and taped it into place, and rolled the guy back into a supine position. It wasn’t the easiest task to accomplish – he was a big boy, and his arms were still cuffed behind his back. Ryan taped another bandage to the entrance wound and turned his attention to the guy’s breathing. As Mike ventilated, Ryan listened briefly to the man’s chest. To his surprise, he heard breath sounds on both sides of the man’s chest. If anything, the lung sounds on the left were only slightly diminished.
Thank God for small favors. Now if we can just get him to the hospital before he bleeds out or the hemothorax kills him, we’ll be ahead of the game.
The man’s pressure was low at 74/40, and his pulse was fast and thready at 130. The two bullet wounds were the only injuries Ryan could find, but they were enough. He managed to start an IV, bumping the reporter down the bench seat in order to make room. She was still holding the bandage to her head, watching in rapt fascination. The cameraman was standing at the back of the rig, holding on for dear life, his camera on the floor.
Well, at least they’re not filming. This could be worse.
Ryan was still taping down the IV when he felt the truck lurch to a stop and Steve flung open the rear doors, nearly spilling the cameraman onto the pavement. Ryan motioned for the news crew to precede him out of the rig, and they hurriedly got out of the way. By the time they got the stretcher unloaded, the news crew was set up again, filming every move as Ryan and Steve rolled the patient into the ER.
“You’d think she would get her head stitched up before she’d get on camera again,” Steve muttered in derision.
“Not as dramatic,” Ryan said dryly as the doors closed behind them. “That bloody bandage ups her credibility.”
“Guess so,” Steve grunted. “Room Two,” he said, pointing. They rolled the cot into the room, where Dr. Donaldson and the trauma team were waiting.
“Officer-involved shooting,” Ryan told him. “GSW to the left chest, another to the left arm. Lungs were okay, but he’s shocky. BP was only 74/40. Unresponsive the entire time.”
Mike handed off the BVM to a nurse as they moved the patient over to the ER bed. Donaldson leaned over him, auscultating his chest. “Decreased on the left,” he said. “He’s got subcutaneous emphysema in the axillae.” Without being asked, a nurse began setting up a thoracostomy tray.
“He sounded okay on the way here,” Ryan started to defend himself. Donaldson brushed it off.
“You were bagging him,” he said, “and he needs the chest tube anyway.” Ryan dialed his wife’s number on his cell phone as they walked outside, and wound up getting her voicemail. “Hey, it’s me,” he said. “We got a late call, so I won’t be home for another couple of hours. If I’m not there, just let yourself in and wait for me.” He caught himself almost saying, “I love you,” before hanging up.
The reporter was still pontificating on camera outside, and she stuck a microphone in Ryan’s face as he walked past. “Sir, what can you tell us about the victim?”
Shit, just what I need. Keep to one word answers, and be polite, Ryan.
“Nothing,” he replied, saying the first thing that came to mind.
“What can you tell us about his condition?”
“I can’t tell you anything about his condition,” he said, squinting at the glare of the camera light.
“Were you injured in the riot?”
“What riot?” Ryan asked, genuinely surprised. “Somebody was throwing stuff at us, that’s all.”
“Witnesses say that the victim was not acting in a threatening manner, and that the officer used excessive force. How do you respond to that?”
“I know nothing about the circumstances of the shooting, Ma’am. I was called to provide medical care, which I did. Now if you will excuse me…” Before she could ask another question, Ryan beat a hasty retreat around to the other side of the ambulance.
“Ooooohhhh, Mister Hawkeye Pierce, Supermedic,” Steve breathed seductively as Ryan climbed into the rig. “You are so brave and heroic!” He grinned evilly.
“Aw shucks, Ma’am,” Ryan replied. “I’m no hero. I was only there because my fucking partner drove us right into the middle of the scene…” Steve rolled his eyes.
“I wanna be you when I grow up,” Mike chimed in. “Handsome, dashing rescuer of damsels in distress, all-seeing, all-knowing paramedic…”
“Watch it rookie,” Ryan warned with a grin. “I still have to grade your evaluation.”
Chapter One – Nightmare
The faces crowded around Ryan Pierce, so close that they threatened to smother. An old woman turned her sunken, feverish eyes toward him. A mother raised her stony eyes from the face of her child as the blanket fell away, revealing blood and lung fluids drying on his mottled, lifeless face. A young woman sat up behind the wheel of her wrecked sports car, eyes glittering with hate. A black man stared sullenly and opened his mouth as if to speak, but the hole in his chest only made an ugly gurgling sound. A thin old man, filthy and covered in scabs, spat at Ryan.
His sister Renee was there, looking nothing like the twin from his childhood. The fair skin and light brown hair they shared had been replaced by the haggard face of an addict with missing teeth and limp, greasy locks. She extended both hands toward him, empty syringe still hanging from her left arm. Ryan’s parents hovered nearby, disappointment manifest on their faces.
Ryan struggled, arms and legs flailing desperately, but they felt like they had been wrapped in wet cotton. Every movement was sluggish, like a slow motion replay of swimming. Here, everything felt reversed; he was the one moving in slow motion, while the accusing faces crowding in on him were frighteningly fast, terrifying real. His heart hammered in his chest as he struggled for air. The faces pressed in all around him, hovering so close that he couldn’t see, couldn’t move, couldn’t breathe…
His screams drove the faces back momentarily, and he gasped, trying to struggle free of the formless restraints binding him. The faces parted, turning to look at the figure approaching from the darkness. A woman in a wheelchair rolled ever closer, propelled by the soft hum of an electric motor. Cold dread descended over him and he stopped struggling, breath sounding harsh and wheezing in the stillness.
The woman’s limbs were twisted and atrophied, frail little sticks bent in a painful approximation of a sitting position. Her back was arched in permanent spasm, her head forever cocked to one side. Both arms were contracted, bent at the elbows and wrists at odd angles, her left hand wedged uncomfortably under her chin. The light fell on her face, and he saw that the woman’s face was twisted in a rictus of spasm, a horrible parody of a grin with drool trickling down her chin. He screamed as he recognized, once again, the face of his daughter.
Ryan awoke from the nightmare, flailing at the sheets tangled around his legs. Lying quietly for a moment, he tried to catch his breath and still the pounding of his heart. His eyes strained in the darkness, searching for any source of light. He rolled over to face the other side of the bed, arm searching for his wife, forgetting as he always did that there is no longer anyone there.
He rolled over onto his back and stared into the darkness, finally realizing that there was no light – not even from the utility pole outside. The power was out. He kicked away the sweat-soaked sheets, taking deep, slow breaths, trying to calm himself, seeking the quiet place within him.
There was a time when that stillness was easy to find, a sense of calmness that gave him control over things uncontrollable. Not any more. The sense of quiet mastery that had always protected and cocooned him was slow in coming now, nebulous and hard to find, like grasping at mist. Once, he had possessed a unique gift; a laser-sharp clarity of focus that allowed him to function when others could not, a quality that had always allowed him to master the moment, but there in the darkness of his empty bedroom in the wee hours of the morning, he knew Fear.
Not real, he whispered silently to himself. None of you are real. I did everything I could for every last one of you. Just go away and leave me alone. And Caitlin will not wind up like that. I won’t let it happen.
He turned onto his side and looked for the photo of his daughter on the nightstand. Despite the darkness, he saw her in his mind’s eye – smiling, standing next to the swings at the park, the braces on her legs barely visible above her shoes. Caitlin had cerebral palsy, the result of a severe intracranial hemorrhage while she was in the womb.
Outside, after much cursing and sweating, and a painful slip on the wet deck, the generator purred to life and the lights came on. He ducked back inside, massaging his wet, bruised ass as he limped down the hallway. The harsh glare of the bathroom light revealed a few flecks of gray in his light-brown hair, and there were dark circles under his eyes. Blearily, he stared into the mirror, rubbing the stubble on his chin.
You look like shit, Hotshot. You’re thirty-six years old, and you look forty. Shape up. It’s been eight months, and Dawn ain’t coming back. She doesn’t love you any more, and you might as well accept it.
The face in the mirror stared back at him mockingly. Expressive blue eyes framed an aquiline nose, its symmetry marred by a noticeable hook across the bridge, courtesy of the boot of a combative drug addict four years ago. A wide, generous mouth dominated his lean face; a face that hinted at barely concealed mirth just below the surface. Altogether, it was a pleasant face, the kind that looks best when laughing, but lately the laughter stopped at his mouth. His eyes revealed nothing, least of all laughter.
He was thirty-six years old, six feet, two inches and 220 pounds, able to move with a sinewy grace that belied his size and hid controlled, carefully marshaled strength. People invariably described him as smaller than he actually was, a misconception that he did nothing to dispel. Ryan was content to be underestimated until he did something to warrant a reappraisal.
Though his physical prowess was often underestimated, his skill as a paramedic was legendary. One of those rare people with that certain intangible something, a scene presence that projected an aura of quiet calm, even grizzled, seasoned medics had been known to breathe a sigh of relief when he arrived on a bad scene. “Thank God,” they’d think. “Hawkeye Pierce is here.”
Whatever that certain something was, Ryan realized that he had a gift that most of his colleagues did not share. He had tried unsuccessfully to teach it to his students, finally realizing that he couldn’t teach a trait to others when he couldn’t fully explain it himself. Rather like the Supreme Court definition of pornography, it was impossible to define, but you knew it when you saw it.
What most people didn’t know was that it had been a long time since he himself had felt that sense of calm. More and more lately, he had felt like an actor playing a role. He still looked the part; steely-eyed, square jawed, heroic. He feared a time would come when he would flub his lines.
Sighing, he once again began his morning routine. First, he retrieved a uniform from the closet and hung it on the shower door, even though he wouldn’t put it on for another four hours. Kevlar body armor was laid out with his uniform shirt. Boots, belt, pager and uniform cap were arranged with care on the vanity. His ID tag was clipped to the right epaulet, and a small Star of Life was pinned to the left collar point. The blue enamel was chipped and worn, and the white Caduceus once painted on it had long since worn away, but this one had sentimental value. It was the one award Ryan had received that meant something. Once his uniform was prepped, he shaved and brushed his teeth. Only then did he turn on the shower and step under the spray.
He had to be ready for a call at a moment’s notice.
You laugh? Allow him his rituals, please. They are one of the few things he can still call his own. It didn’t matter that he was in his own home, and not due to report for work for another five hours. When chaos threatened to overtake him, he focused on process. At work, it kept him calm. At home, it kept him sane.
The coffee maker was still sputtering as he poured his first cup. After a month of drinking bitter coffee, he finally learned to set the maker to brew at 3:00 am instead of 6:00. He donned a bathrobe and stepped out into the morning chill. There was water still puddled on the deck from last night’s rain, and he dutifully mopped the deck dry before settling into a deck chair overlooking the river.
The water was high in mid-October, the surface deceptively still. Mist clung to the surface of the water, but experience had taught him that the mist hid a wicked current and floating logs. He checked the channel marker swaying in the current just aft of the boat. The stern of his aluminum runabout bumped gently against the pole as the river gurgled past.
Thirty-eight feet, he mused. Supposed to crest at forty feet next week. I’ll have to get back and forth from the landing in the runabout. Fucking lovely. What a pain in the ass.
The dock was designed to accommodate water levels as high as forty feet, but some genius of an engineer had designated the parking area to be on a small peninsula of high ground surrounded by low-lying floodplain. Whenever the river got over thirty-eight feet, boat owners could walk from their boats to the landing without difficulty, but had to wade or take a small boat to the parking area.
Three years after its purchase, Ryan’s houseboat was still his pride and joy. At eighty-four feet, with three staterooms, an attached runabout and a pair of personal watercraft, it was a yacht by any standard but his own. Determinedly blue-collar, he steadfastly referred to it as “my houseboat.” Rich people had yachts. Ryan Pierce was not rich.
My father was rich, he told himself. I made it on my own, without his fucking help. I owe him nothing. Not love, not respect, not one Goddamned thing.
Sitting silently on the deck of his boat, sipping coffee as the river slipped slowly past, he mused on the strange turn of events that had brought him here.
My old man would have hated this boat. He’d have considered it a useless extravagance, and Robert Pierce wasn’t one for frivolity. Work hard, make money, be Somebody. What a fucking joke. People around here didn’t love him, they feared him. You were a bully and a tyrant, and I’m nothing like you. May you rot in Hell, Dad.
Besides the boat, he had touched none of the millions he had inherited from his father, and didn’t intend to. When he had gotten the news that his father’s light plane had augered into the ground eighty miles west of Eufala, Alabama, he had felt…nothing. No grief, no regret, nothing. A week later, after meeting with the estate lawyers, he had been shocked, then angry.
You think naming me your sole heir would ensure your legacy? Wrong again, Dad. You thought I’d just forgive you, return to the fold, become the dutiful son if you made me rich? I lived in a studio apartment for three years, eating Ramen noodles and drinking Kool-Aid while I worked through school, and I never once asked for your help.
The doctors around here treat me with respect, and not because I’m Robert Pierce’s kid. My reputation is my own, and I’m the best damned paramedic in this city. Me, Hawkeye Pierce, not “little Ryan,” son of the famous cardiologist. The last old doctor that called me a “chip off the old block” only did it once.
Your hold on me ended on my eighteenth birthday. We hadn’t spoken ten words to each other in the past eighteen years, unless you count the time I knocked you on your ass at Renee’s funeral.
In a sort of posthumous “fuck you” to his father, he bought his boat less than a month after his father’s death, a year before the birth of his daughter. Against the advice of the estate lawyer, he had sold his parents’ home and everything in it to the city for pennies on the dollar. He had added the caveat that nothing the city planned to do with the property could bear the Pierce name, and used the proceeds to buy the boat. Ryan, Dawn and Caitlin had spent virtually every weekend there. In all likelihood, Caitlin had been conceived in the master stateroom.
Money well spent, if for no other reason than that. And that Victorian monstrosity of a house is now an art museum that doesn’t even bear your name. Fitting, I suppose. It was always more museum than home anyway.
In a fit of whimsy, he christened the boat Ecnalubma, painted in large, royal blue letters in mirror image on the stern. Only Dawn and his buddies from work had gotten the joke.
It’s October twenty-sixth today. Our birthday. Today you would be thirty-six years old, maybe with kids of your own. I’d be Uncle Ryan. Your kids could be playing with Caitlin every weekend.
Triage. It was a triage decision. I hope you understand that. I couldn’t save myself and save you. I’m sorry I left you with them, but I had to get away from there. If I had stayed, I’d have been lost, too.
The sky pinkened over his left shoulder, and the screech of a dawn flight of wood ducks announced that it was time to go to work. He sighed, went inside and donned the uniform still hanging from the hook on the bathroom door. He grabbed his gear bag and briefcase on the way out and trotted down the dock. The water was already inching its way up the floodplain surrounding the parking lot, forcing him to jump from one high spot to another to make it to his truck.
Just fucking lovely. I’ll have to wade to the dock when I get home. Note to self: get gas for the runabout, or you’ll be wading back and forth to your truck every morning.
Just as he did every morning, he bought two boxes of doughnuts and two large coffees from the Krispy Kreme just around the corner from the ambulance station. His partner, Steve Hatfield, was already checking out the rig as Ryan pulled into the parking lot.
“Morning,” he grunted, handing Steve his cup of coffee.
“Mucho grassy-ass,” his partner grinned, gratefully taking the cup. “Are we keeping banker’s hours this morning?” Steve asked with exaggerated politeness.
“Yep. You can do that when you wear a white shirt,” Ryan retorted with an even wider grin. “Besides, it’s only seven-thirty, smartass. Truck need anything this morning?”
Steve shrugged his shoulders. “Some no-neck cervical collars, and a couple of twenty-gauge IV catheters and saline locks.”
“I’ll get ‘em.”
“Oh yeah, and check us out a radio and get my rain gear!” Steven called after him. Ryan saluted with his coffee cup as he walked inside.
“And how are you degenerates this fine morning?” he greeted everyone cheerfully. “I’ve got fresh doughnuts here, sustenance for us as we start yet another day of thwarting natural selection and picking up little old ladies who have fallen and can’t get up.”
His announcement was greeted with chuckles from the crews and a general rush for the doughnut boxes. A young man sitting at the table reading an EMT textbook reached for one a few seconds too late, and found only empty boxes.
“Gotta be quicker than that, kid,” one of the EMTs pointed out around a mouthful of glazed doughnut.
The kid stood up nervously, extending a hand. “Mr. Pierce, I’m pleased to meet you. My name is Michael Granger, and I’m supposed to be riding – ”
“You’re out of uniform,” Ryan interrupted sternly, to the kid’s fear and consternation. He looked himself over from shined boots to duty belt adorned with an impressive collection of gadgets to his neatly pressed shirt.
“Uh, how?” the kid stammered. “My instructor says this is what we were supposed to – ”
“Wristwatch and pen, Mr. Granger,” he glowered. “I see that you have neither. Perchance is there some nifty gadget on your Batman utility belt that will allow you to count heart rate and respirations, much less write them down somewhere? How the hell is an EMT going to function without a watch and a pen?” The kid squirmed as the EMTs behind him struggled to maintain straight faces.
“Furthermore Mr. Granger,” he continued unctuously, “when one is riding on the ambulance for the first time, it behooves one to get out in the rain and help the ambulance crew check out the rig at the beginning of the shift. That endears you to the preceptor and allows you to find things on the rig when you need them.”
“I’m sorry…I didn’t know…I mean, I – ”
“You can salvage something from this less-than-impressive first meeting, Mr. Granger, by running this list to the supply room and seeing that it gets filled. Then, you will bring those items out to the rig, and help my partner finish inventorying and stocking it. Then, you may run to the nearest Wal Mart and purchase yourself a pen and a wristwatch. Perhaps, if you return quickly enough, you may be able to actually run an ambulance call today. Now run along, son.” At that, the EMT student scampered from the room.
As soon as he was out of earshot, the crews collapsed into laughter. “Shit, Hawkeye! You think you could actually let the kid get on the rig before you scare the shit out of him?” Mark Perry chortled.
“I thought he was gonna cry,” Mark’s partner, Kenny Hadden, laughed. “He shows up this morning, all bright-eyed and bushy-tailed, just itching to go save some lives with the great Hawkeye Pierce, and what do you do? You crush his hopes in about ten seconds. You’re like a mean kid torturing a little puppy, you know that?”
“Yes indeed,” Ryan agreed with an evil grin. “Let that be a lesson for the rest of you. I am in no mood for bullshit today. Anybody steps out of line, and heads will roll. Got it?” They collectively roll their eyes and groan. This is his stock line, and they’ve heard it many times. Not that the threat means much. These guys are some of the best around.
“What’s our company motto, men?” Ryan barked imperiously.
“Profit-Driven, Self-Centered and Uninspired, Sir!” they chorused.
“Very well. Let’s go save some lives,” he chuckled. They laughed dutifully and trickled out to their rigs, joking around and playing grab-ass as they walked out the door. Outside, Steve sat in the idling ambulance, sipping his coffee.
“What did you say to our rider?” he asked as Ryan climbed into the rig. “He lit out of here like his tail was on fire. Made me promise not to leave until he got back.”
“He didn’t have a watch or a pen. I chewed his ass out.”
“In your own unique style, no doubt,” Steve grinned. “Whatever you said, it worked. Here he comes, with three minutes to spare.”
“We almost left you, Mr. Granger,” Ryan said as the kid climbed breathlessly into the back of the rig. “I hope you managed to procure a suitable timepiece, hopefully one with a second hand?”
“Yes sir,” the kid bobbed his head like a schoolboy. He extended an arm adorned with a black rubber-armored wristwatch with an impressive display of dials and buttons. “It has a fifteen second pulse timer, stopwatch and elapsed time, illuminated hands, a backlight – ”
“Can you talk to headquarters on it too, Dick Tracy?” Steve asked, amused. The kid didn’t get the joke.
“Come on man, let’s go,” Ryan laughed, buckling his seatbelt. “Be sure to buckle up back there, Mr. Granger,” he called out as they pulled out of the parking lot. “Steve has been drinking cough syrup all morning, and I’m not really sure he can stay awake long enough to keep this rig on the road.”
“Yeah kid,” Steve grinned, jerking the wheel just enough to get his attention. “I get drowsy, but I drive pretty good by Braille.”
“Let me tell you how this day is going to go, Mr. Granger,” Ryan broke in. “Steve and I handle the calls. For the first few, you lug equipment and keep your eyes and ears open. Steve or I will take vital signs and do the BLS care, and you can monitor vital signs in the rig. Once I am sure that you can find your ass with both hands and a roadmap, you get to do your stuff. Steve or I will lug the equipment, and you get to do the BLS assessments and interventions. Clear?”
“Yes sir,” the kid nodded nervously.
“One other thing, Mr. Granger. You will screw up. That is a given. I’ll keep you from screwing up in any way that harms the patient. And when you do screw up, we will discuss it in private. I will not criticize your performance in public or around any of the other crews. Steve here doesn’t count, being somewhat of a world-class fuckup himself. Any questions?”
“Uh, can you stop calling me Mr. Granger?” the kid blurted.
“What would you like me to call you?” Ryan asked, amused. “Michael? Rookie? FNG?”
“Mike is fine,” the kid grinned. “Can I call you Hawkeye?”
“No you may not. You may call me Ryan, provided you stop bowing respectfully and genuflecting whenever in my presence.”
“That’s a deal, Hawk – er, I mean Ryan. Why do they call you that?” Mike asked curiously.
“Because he’s screwed every nurse in Oneida Parish,” Steve offered with a laugh.
“Actually Mike, aside from the obvious MASH reference to my last name, it’s because I’m brilliant, unconventional, have a wicked sense of humor, and I have a healthy lack of respect for authority,” Ryan clarified. “And of course, because I’ve nailed every nurse in the parish.”
He turned in his seat to wink at the kid, who grinned back.
“One and two and three and four and five and breathe,” Ryan Pierce directed as he rhythmically compressed the chest of the man lying on the floor. “Try tilting his head back a little more,” he suggested.
Jeff Layton looked scared, but did as asked, and was rewarded by seeing the old man’s chest rise. Ryan winked at his roommate. “There ya go. Just like that.”
Ryan’s voice was icy calm, even nonchalant, as he knelt there in the spilled coffee and broken dishes. The entire restaurant had gathered around, watching as the two boys did CPR, but Ryan barely noticed. He knew they were there, in a distant and detached sort of way, but the problem was lying there in front of him, an old man with pasty gray skin and a vacant, slack expression on his lifeless face. The old man’s half-lidded, unfocused blue eyes stared up at him as he worked. The man’s ribs crunched under the force of his compressions. Ryan’s mind calmly reported the fact that the man’s ribs were breaking, and his hands automatically adjusted their depth and position.
“Would you go call 911, Ma’am?” he asked politely, smiling at the waitress standing there consoling the man’s wife. She stared dumbly at him for a moment, her eyes wide and frightened. Ryan broke the spell by firmly speaking the name engraved on the name tag pinned to her smock. “Joanie. Please go call 911. Tell them there is a man in cardiac arrest, and that CPR is in progress.” The girl, not much older than Ryan, nodded nervously and scampered away.
It didn’t occur to him to be scared. For as long as he could remember, he had been this way. When faced with a crisis, everyone else panicked or lost their temper, or simply froze. Ryan Pierce went into autopilot. The world around him drug on in slow motion, while Ryan’s brain and hands moved in real time. He saw things almost before they happened, and reacted accordingly, without conscious thought.
It was nothing so trite as precognition, this gift of Ryan’s, if indeed he took the time to realize that it was a gift. Ryan’s brain simply functioned with clarity and precision in those times when everyone else operated in the fog of panic.
When he was six, his twin sister had fallen into a drainage ditch and nearly drowned. While the adults panicked and shouted, Ryan simply rode his bike downstream and waited near the water’s edge. When the current swept Renee near enough to grab the front wheel, Ryan dug his heels in and waited for the grownups to arrive, speaking reassuringly to his frightened sister as she clung helplessly to the spokes.
He remembered the adults making such a fuss over his actions, and never understood what the big deal was. Ryan Pierce had simply known what to do. Didn’t everybody?
Crisis management was nothing new to Ryan. He had been doing it as long as he could remember. When he was a child, he would take Renee into their playroom and comfort her when his parents argued, rocking her and crooning softly, hoping to drown out the screams with the whispered nursery rhymes of their childhood. It rarely worked.
Ryan often prayed that Renee could find the stillness in herself, the same stillness that comforted him and allowed him to cope. Like water trickling over a rock, Renee Pierce’s tears slowly but surely eroded away her hope. At fifteen, the only feelings she had left were anger and pain. His parents, true to their nature, only noticed the signs of Renee’s withdrawal and never bothered to wonder why. Their daughter was an embarrassment, a bad seed. Ryan was the achiever, destined to become a doctor like his father, a fine young man worthy of the Pierce name.
Ryan Pierce had other plans. Every honor roll, every leadership award, every achievement was another step on the path he had chosen that would take him away from home, away from his family. Ryan had no idea where that path might lead, only that it led away, and that was enough. At age twelve, he had made the conscious, cold-blooded decision to get away.
He would get away, but not like Renee, who escaped into anger and substance abuse. Renee was a lost cause, a sullen teenager already lost in the fog of drugs and mental illness. Ryan Pierce would follow the path his parents had chosen for him for as long as the path suited his needs. He would use his parents’ name and affluence to succeed. He would use that stillness within him; wear it like a mask to convince them that he was still the dutiful son, until the day came when he knew he could succeed on his own. Then Ryan would break away, leaving his parents and their money far behind. Robert and Sylvia Pierce were immensely proud of their son’s accomplishments, but they had no idea that he had become a stranger years ago.
“Hey, how about we switch for a little bit?” Jeff’s voice penetrated his reverie. Ryan looked at him appraisingly. Until this day, Jeff Layton had never done CPR. For that matter, neither had Ryan – not on anything other than a manikin, anyway.
“You sure you can do it?” Ryan asked, still keeping perfect rhythm. He waited until Jeff had delivered a halfway-effective breath, and his friend nodded. “Okay, switch and two and three and four and five and breathe,” Ryan ordered, then shifted up to the man’s head after Jeff delivered the breath. Ryan checked for a carotid pulse, found none, and nodded to resume compressions. The waitress ran back into the room, announcing, “The ambulance is on its way!”
Almost on cue, Ryan heard the sirens in the distance. As he bent over the man to deliver his next breath, the man’s cheeks bulged and a stream of vomit erupted from his mouth. Ryan saw it coming and straightened up just in time, only getting spattered with a few drops. He rocked back onto his haunches and asked quietly for a towel. Taking the napkin someone pressed into his hand and he murmured his thanks, wiping the flecks of vomit and spittle from his forehead. He looked down at the man and sighed. Folding the napkin and turning the man’s head to the side, he used it to rake as much vomit as he could from the man’s mouth.
Jeff Layton had abandoned all attempts at chest compressions, and was now standing several feet away, gagging.
“Let’s go,” Ryan said, nodding at a spot next to the man’s chest, “we’re not done.” Jeff, shaking his head in a mix of wonder and resignation, knelt reluctantly once again beside the man’s chest. Shuddering inwardly, Ryan gave a breath and nodded for Jeff to resume compressions.
“Okay kid, we got it from here,” a voice said. Ryan looked up to see two men standing behind him. One of them knelt next to Ryan, lowering his equipment box and defibrillator to the floor beside him. His partner smoothly bumped Jeff out of the way and knelt near the other side of the old man’s chest. He ran a pair of scissors up the man’s shirt from hem to neckline, opening the shirt in one smooth rip, and then smeared gel on the defibrillator paddles that his partner held extended at arm’s length. The two men moved with smooth, practiced precision, with no wasted motion. “What happened?” the paramedic asked mildly, directing the question to no one in particular. There was no tension in his voice as he placed the paddles on the man’s chest.
Ryan was the first to speak. “He was choking, and I did the Heimlich Maneuver on him. He coughed up a piece of sausage, took a couple of breaths, and then collapsed. Been doing CPR ever since,” he finished matter-of-factly.
The paramedic looked at him appraisingly, one eyebrow raised and a half grin on his face. He turned to look at the monitor screen, announced, “v-fib, Jerry,” to his partner, and then raised his voice, addressing the entire room. “Shocking here! Everyone stand clear!” The paramedic pressed the buttons, the defibrillator made a noise, and the old man’s back arched in spasm. The monitor screen went haywire briefly, and then settled back into an ugly scrawl across the display, looking rather like a toddler had found a green crayon and doodled on the wall.
“Still v-fib, Jerry,” the paramedic reported. “Charging to 300. Everybody clear!” He shocked the man again, and this time the arching spasm was followed by a steady series of beeps, accompanied by tall but regular blips on the monitor. The beeping got steadily faster, and the blips drew closer together, marching steadily across the screen.
“I got a pulse, Ray,” Jerry announced, his fingers on the man’s neck. “Looks like sinus tach at 120 on the monitor. Still ain’t breathing, though.”
“I need your spot, kid,” Ray said gently, nodding to the place Ryan was kneeling. Ryan hurriedly stood up and stepped back a few paces as Ray slid into his spot at the man’s head. He watched in fascination as the paramedic inserted a shiny metal instrument into the old man’s mouth, peered briefly inside, and slid a plastic tube down his throat. “Hey kid, where did you go?” Ray asked, looking around. Ryan stepped back out of the crowd. “Still need your help here, partner,” the paramedic told him, winking. “Hold this tube still while I tape it down. Then take this bag,” he continued, laying a resuscitator bag on the floor next to Ryan’s leg, “and squeeze it once every five seconds, just like CPR. Got it?”
Ryan nodded understanding and held the tube still while the paramedic wrapped several layers of tape around it, then all the way around the man’s head several times, and finally back around the tube for several more wraps. When the paramedic’s hands were out of the way, he attached the resuscitator bag and began squeezing, watching in rapt fascination as the old man’s chest rose and fell and his color gradually changed from grayish-purple to pink.
Ray and his partner inserted a needle in the old man’s arm, and injected a bewildering array of medication syringes. By the time they were finished, the old man was trying to breathe on his own. Ryan, still squeezing with one hand, reached out and jerked the paramedic’s sleeve.
“Breathing on his own now, Jerry,” Ray announced to his partner. “Keep squeezing the bag, kid. Try to time it with his breaths,” he ordered Ryan, who dutifully squeezed the bag as the two paramedics loaded the old man on the stretcher, and even as they rolled him outside to their ambulance.
“We got it from here, kid,” Jerry told him as they loaded the stretcher. “Thanks for the help.” He disconnected the resuscitator bag from the breathing tube and tossed it to Ray, who had settled into a seat in the front of the ambulance, directly behind the stretcher.
“Hey kid!” Ray called before Jerry could shut the rear doors. “What’s your name, anyway?”
“Ryan Pierce,” he answered.
“You did good, Ryan Pierce,” the paramedic grinned and winked. “Catch you later, kid.”
Jerry slammed the rears doors before Ryan could reply, and he watched silently as the ambulance roared out of sight, siren wailing. He felt an elbow dig into his ribs, breaking his reverie. Jeff Layton was standing next to him, grinning.
“Pretty exciting, huh?” Jeff asked, grinning. “I may have to attend more of these leadership conferences.” Ryan and Jeff’s faculty advisor, Terry Kirkpatrick, was standing in the doorway, beckoning them back inside. Ryan smiled back at his friend. Jeff was obviously pumped, still flush with adrenaline. Ryan wasn’t even breathing hard, or visibly excited. He just felt…serene.
I handled that pretty well. Maybe that’s what I’m supposed to do, Ryan thought. Those guys are just like me.
Ryan didn’t share his thoughts with Jeff. You don’t use words like destiny when you’re fifteen years old, at least not out loud. Instead, he just laughed and walked back inside the restaurant with his friend, joking around and playing grab-ass like teenaged boys are supposed to do. “The waitress thinks I’m hot,” Jeff announced conspiratorially as they sat back down at their table. “Ten bucks says I can get her number.”
“That’s a bet,” Ryan countered, only half listening. Ryan remembered the feel of the old man’s ribs cracking under his hands. He ate the rest of his breakfast in silence, listening with one ear to Jeff’s antics and laughing dutifully at all the appropriate points.
Later that evening, Jeff and Ryan walked through the hotel lobby on their way to the conference awards banquet. Judging from the way his faculty advisor had behaved, both of them were going to have their turn on the dais. Ryan was dreading the fuss, not because he disliked the attention, but because he truly didn’t see what the big deal was. It was his nature to act in situations like the one he faced that morning. It wasn’t like he had risked his life, like charging a machine gun nest, or rescuing a baby from a burning building. He had just done CPR on a man that needed it, just like he’d learned back in junior high school.
True to his nature, Jeff was thinking of the attention he was going to get.
Probably thinks it’s going to get him laid, Ryan thought wryly. And knowing Jeff, he’s probably right.
Jeff and Ryan came from similar backgrounds, and had been friends since grade school. Ryan was the class clown. Humor was his weapon. It made him one of the boys, made him accepted, and it kept everyone else at a safe distance.
Jeff Layton was the quintessential Big Man on Campus. Having grown up privileged and pampered, being fussed over was as natural to him as breathing. Success was Jeff Layton’s divine right. He friend barged right through the doors to the ballroom, scarcely noticing the man in the blue uniform leaning against the wall. Ryan recognized him, though.
“One of the teachers told me I might find you here,” Ray explained. “Got something for you, before you go in there and take your bows.” His eyes twinkled with gentle amusement.
Ryan felt himself blushing. “That’s really Jeff’s thing,” he explained. “Besides, he was doing CPR too…”
“But you were the one who took charge,” Ray observed. “Anyway, I figured you’d like to know that our patient is in the ICU right now. The doctor says he’s probably going to be okay. That wouldn’t have happened if you hadn’t been there.”
“I just did CPR, that’s all. You guys were the ones who -”
“Let me explain something to you, Ryan,” Ray interrupted. “You kept your head and remembered your training when a whole restaurant full of adults didn’t. You kept that old man alive until we got there. And never turn down a pat on the back when you’ve got one coming. The chance doesn’t come around all that often.”
“Okay,” Ryan replied simply, not knowing what else to say.
“Anyway, I thought I’d tell you that, and give you this,” Ray winked, reaching up and removing a blue enameled pin from his left collar point. He pressed it into Ryan’s palm, punched him on the shoulder and walked away. Ryan looked at the blue, six-pointed star in the palm of his hand.
“What is it?” he called to the paramedic’s retreating back.
“They call it the Star of Life,” Ray called back over his shoulder, without breaking stride. “All paramedics wear ‘em. You earned it this morning.”
Ryan Pierce looked down at the blue pin in his hand for a long time, then put it carefully in his pocket and walked into the ballroom to join his friend.