Seven Forty Seven
The chapter was just getting to its climax, a David vs. Goliath fight, when a loud chirp and buzz of his pager caused Will to stop reading. He popped the outdated stone off his belt and read the text. He hated that chirp. Why couldn’t they have made it something pleasant? A nice chime or musical note?
“Looks like we got one,” Will said, looking over at his partner. Bobby took his headphones out and looked at the same message that had also came across his pager. Will reached over to the center console that separated the passenger seat from the drivers, and picked up their Nextel. He punched a button on the face and depressed the walkie-talkie toggle, producing a different chirp that alerted him that he was now speaking to Dispatch.
“Seven-Forty-Seven, we copy pages.”
“Seven-Forty-Seven,” Dispatch echoed back, “Your call is going to be code one, for a 73 year old male, coming out of Shady Pine Skilled Nursing Facility and going to Berry Community for failure to thrive. No special equipment. 23:43.”
“Copy, show us responding,” Will said and tossed the Nextel back into the basket. “Hey, wake up,” he said turning his head to the back. “We got a call.”
Bobby started the engine and dropped the rig into gear. The two full time partners rarely talked anymore. When you have been working with the same person for long periods of time, week after week, you quickly run out of things to say. This wasn’t that big of a deal for Will, as these night shifts rarely left him in want of conversation. But tonight, they had a rider.
This happened occasionally. That evening, as Will walked up the concrete ramp into the ambulance bay, his supervisor called his name from the office. “You two have a guest tonight,” the old paramedic said, pointing to the small Asian girl sitting in one of the office’s chairs. “This is Kelly and she is from the Bastes City College program. This is her first of two ride-alongs, so be nice to her, especially because she volunteered to do a night car.”
“Cool, grab your stuff, I’ll show you what rig we are in,” Will said to the young woman, and then turned back to his boss. “I take it you haven’t seen Bobby yet?”
The supervisor looked at his watch and snorted. “You better tell him that if he keeps walking in here three minutes late every shift, I’m going to write him up.”
“Oh, I think he knows, but just doesn’t care. It's hard when you carry a P-card but can’t use it.”
“Well, he will be in the next group we upgrade… whenever that will be.”
They left the office and found their ambulance. Will was slightly surprised by how chatty the girl was. Maybe it was a nervous thing. He walked her through their daily checkout procedures, and she asked about everything. She talked about her class and her plans to apply to every ambulance company as soon as she got nationally registered. Bobby showed up half way through the checkout, saw what was happening. He kept to the front of the rig, saying little. That was fine with Will. He remembered when he was new, a short two years ago, so full of hope and excitement at saving lives. Then he got a slot full time on a basic life support transfer car, and that ended that. But, at least having a rider was a change of pace.
Will was in the space of mind that nothing really upset him in this job. Last week, they had a patient that had obviously defecated on himself. Bobby half blew up at the sending facility. If it weren’t for him stepping in and volunteering to ride in the back with the patient, Will wouldn’t have been surprised if a complaint was phoned in to his supervisor over lack of professionalism. In his mind, what were a few moments in the back of the ambulance with a stinky old lady? He just poured a bag of instant coffee on the ground and dealt with it. He was here all night and making money. It was his job, and things could be worse.
“So where are we going?” Kelly asked. She was young, probably just out of high school, and small. It was always funny to see persons of slight build try to enter the field of emergency medicine. Most thought they would be doing lots of medical procedures and didn’t even consider the other half of the job. And lifting patients was a big part of that job. He wondered if the tiny girl would be able to lode the gurney into the back of the ambulance with a full-grown man on it. He aught to get Bobby to lie on it and let her give it a try…
“A Sniff off of Stalton Ave,” Nate said to the face peeking through the compartment leading to the back. “Sniff’s are slang for skilled nursing facilities. We get a lot of private transport calls from places like this.”
“Cuz for some reason they can’t wait to call until a reasonable hour. It has to be in the middle of the night, always the middle of the night.”
“The last two were from a hospital to other places, how often do you guys go to peoples houses, like, with lights and sirens?”
Both men laughed. “We are not a 9-1-1 car. We would never get a call like that. Your next ride-along, request an ALS car, that’s where you will get the action you’re seeking,” Bobby told her.
“We will go to peoples houses occasionally, but it’s never for an emergency. It’s always for a patient who can’t get themselves to the hospital or a dialysis clinic without help. There is lots of need for transports like this everyday. People don’t even realize. It's not what most of us get this job for, but someone has to do it. But, I tell you what, there is worth in everything you do. On a transfer car, you can learn where everything is, how the hospitals are laid out, and how to document. It’s a great way to develop in a low stress environment. A good way to make sure this is for you.”
“Well, I want to go to med school eventually and I was told this is a good introduction to the field.”
“Oh yeah, can’t get any more basic than this. Pay attention to everything; see how it all works now. It's much better to figure out if this is what you want to do before investing so many years of schooling into something you end up hating.”
Bobby pulled into the dimly lit parking lot and drove under the overhang. Right after he put the rig in park, as he was taking his time preparing to get out, the backlights lit up as Kelly threw the back doors open. He looked in the rearview and saw her pulling on a pair of blue medical gloves, ready to save the day. He shot a look over to his partner, who snorted.
Will called Dispatch to tell them the unit was on-scene.
Will pulled out the gurney, and drew a pair of gloves from a box in the back. He stuffed them in his front pocket and led the yellow-wheeled beast into the building. The pickup went as they usually did. The paperwork was not ready, the nurse in charge had left the transfer of care to a subordinate, and the man they were picking up was not exactly light. Just another night on a transfer car…
Will took the tech, it was his turn, and Bobby drove. The EMT student rider sat in the airway seat, at the head of the gurney. The old man on the gurney seemed asleep, and only opened his eyes to nod in approval as Will explained to him what was going on. He thumbed through the paperwork to get the info he needed for his pre-hospital care report. He scanned over the Do-Not-Resuscitate order, and ensured it was signed and valid for the patient he was transporting.
It was quiet in the back of the moving ambulance when Will interrupted the silence to ask Kelly to get a set of vital signs. Out of nowhere, the man awoke and spoke.
“I’m going to die tonight,” he said. His voice was hoarse, evident that he had not use it in some time. He turned his head and looked at Will, who sat on the bench seat next to him. The ambulance vibrated down the road, and Will looked down at the paperwork spread out next to him.
“We are all going to die, Mr. Vasquez,” Will said. The statement from the older man did not surprise him or catch him off guard the way it did Kelly. Will heard it frequently, usually from the older patients who were tired of running the marathon of life.
Kelly sat back in her seat, visually uncomfortable, not knowing what to say.
“But... tonight is not your night, I don’t think. We are going to get you over to the hospital for some tests and I’m sure they will fix you right up. Besides, I’ve never h
ad anyone die on me in my ambulance, and I don’t think tonight would be a good time to start.”
The man listened to Will’s half sincere speech, and continued to look at the boy who gave him courteous attention. He found the man interesting; A Hispanic last name, yet he looked like any old white guy. He did have a slight accent that was unplaceable. Maybe that had something to do with the last name…
Instead of responding to the statement like most rational people, Richard Vasquez went on with his own stream of consciousness. This also did not phase the seasoned EMT, as most his patient tended to not have completely present mental faculties.
“No,” he said, “I have seen it. I will die soon. I know it.” The comment hung in the air for a moment before the dying man continued.
“I remember my own birth. I remember all kinds of things that happened. I remember things that haven’t happened, but should have. All my life I have been this way.”
“All your life, huh?” Will said, head tilted to one side, happy to engage the patient in his deluded conversation. His hope was that talking to this man would get his mind off morbid thoughts. Hell, he thought, I would want someone to talk to me like I was a real person if I was old as dirt and had to be carted around by ambulance. Plus, this technically was his job, patient care. Some EMT’s wouldn’t do this, especially someone like Bobby. But this was the type of thing that all those company posters that hung in the deployment center talked about: customer focused concern.
“Yeah, since I was a baby. My mother passed it on to me. She said she had it too, and when I was born, it went away, passed on to me.”
“So you can see the future, then?”
“And the past,” the wrinkled old face said, turning back to look at the dome fluorescent lights. “But not very far. I know things I shouldn’t know, they just come to me. Sometimes it’s a vision; sometimes it's just a feeling. And I’m always right.”
“So you must have made a lot of money doing that. Ever go to Vegas?”
“No. No, I just lived my life. I tried to help people. Once I was in a restaurant and this woman started complaining that she had just lost her necklace. She got up and looked under the table and poured out her purse. I asked her if it was gold, with a big gold hoop on it and she looks at me, and says yes. So I told her the clasp broke while she was in the bathroom and it fell off. I got myself in trouble sometimes, because the lady thought I was spying on her while in the bathroom. How else could I have known where her necklace was? But I saw it happen, up here,” The old man tapped his forehead, “as soon as she made a fuss about loosing it.”
Something changed. Will had had countless conversations with the sick and dying, people with every sort of psychosis, and this was different. He could no place his finger on it, but this man’s claims were different than any other person with an altered mental status he had come across. Instead of asking leading questions to coax the patient into talking, and thus gaining trust, the next question felt real.
“What else? What else have you seen?”
“Things I shouldn’t have seen. I end up knowing things I shouldn’t have any way of knowing. I know about this lovely girl behind me. Her mother has blue eyes…”
As the man continued to talk, Nate show a glance at Kelly, who he had just met. Her own brown eyes were wide. He was right…
“And once I was driving down this hill and a voice just spoke out loud to me. It was my own, but it said to put the car in second gear. I was going over the speed limit a little bit coz of the downhill, but I did it anyway. The engine roared when I downshifted, but I slowed down. When I got to the bottom of the hill, a little girl ran out in the street chasing a dog and I stopped for her. If I hadn’t put the car in second…”
“I have had dreams about who would win football games,” he continued. “I have gotten the feeling that I need to leave town and done it. Nothing happened while I was gone, but maybe that’s because I was gone from it.
“Once I was at a gas station and dropped a quarter on the ground, when I went to pick it up. I picked it up three times. The first time the face was looking at me. A sweating man jumped out of a truck that sat at the pumps and robbed the store. He shot the man behind the counter before he left and drove away, almost hitting me. I picked it up again and it was tails, and the man drove off without paying and did not go inside. The last time the quarter was on its side, standing up as if it was balanced there. The man in the truck was sitting behind the wheel, hands shaking. So, I walked right up to him and said, ‘Let me buy you your gasoline.’ I went inside and paid for his tank. He never said a word to me but look at me like I was some sort of angel sent by God to help him that night.”
“And even knowing all you do, you have lived a simple life? Do you have children?” Will was in a trance. His rider sat not saying a word, as if there were only two people in the back of the ambulance.
“I could never settle down with a woman. I would get a flash of our future, and could not bear to walk down that road, knowing. I drank too much for years. It was the only thing I could do to stop it. But once I sobered up, I was so glad to feel whole again. I wish I had children…”
“Three out!” Bobby called from the front, breaking the magic. He was totally oblivious to what was being said in the back. The reality check put Will back on his task. He pulled out a form for his patient to sign.
“Mr. Vasquez, could you sign this for me? It says we had permission to take you over to the hospital.”
“Sure, son,” he said.
With weak hands he reached out to take the clipboard and pen that were offered to him. Will had removed his gloves for the transport, and their hands touched with the transfer of the pen. Richard Vasquez held on to Will’s hand and looked into his face before attempting to sign.
“Thank you for listening to me,” he said earnestly. Will was about to respond when the old man froze. He waited, holding the clipboard over the lying man, ready to assist with the collection of the signature.
The race-weary man closed his eyes and his hands slowly lowered to his chest. There was a moment of uncertainty as the familiar bump and lurch of the ambulance signaled that they were pulling onto the hospital grounds.
“Mr. Vasquez? Mr. Vasquez?” Will said, shaking the old man’s arm.
“What…” Kelly began.
“Bobby! This guy just went unresponsive!!”
Will was checking his pulse and feeling with his cheek for a breath when he yelled at his ride along to check the blood pressure. Despite the orders to not attempt any life saving interventions, the back of the now parked ambulance became a flurry of activity. Kelly was sent inside, and sloppily informed the staff of the situation. The two-man ambulance crew moved their patient inside as if a doctor inside might throw out the orders and go to work on the man.
But of course the orders were kept. The wishes of the patient were written as a legal order, and it was respected. A simple cardiac monitor was attached and the results were clear. An ER doctor came over to confirm the findings.
Richard Vasquez died that night just as he had predicted.
Will sat in the passenger side of the front of the ambulance, doing his paperwork, which was more complex than usual. As he had told his patient thirty minutes prior, he had never had someone die on him, so this type of documentation was new to him.
Out the ambulance entrance, An ER nurse, who had signed as the receiving facility in place of his dead patient, walked to her car. She was older and looked tired from a long evening in the ER. She smiled at Will on her way past, and he smiled back.
When she got home, she would find that her cat had given birth on the foot of her queen-sized bed. The bedspread would have to be thrown out due to all the mess, but she would be left with four healthy kittens and one that did not make it. Her long night at the hospital would now turn into a longer one with her husband working the swing shift at the glass factory and not off till two.
Will blinked the thoughts away. He was let
ting his tired imagination run wild! After all those stories…
But the vision had been so clear: a white and calico cat, an oak bed frame, and the mess on the bed…
Bobby and Kelly came out of the hospital and got in the rig. The ending to the call had awoken the grumpy EMT and he waxed philosophically to the new girl about the ambulance business in a way he hadn’t all night. Both seemed in an electric mood that Will could feel working at him. After that weird flash it was slow in coming, but he perked up and let the thoughts of the last half hour wash away. He rolled down his window and picked up the book he had been reading off of the dash. He held it on his lap in both hands as they cruised through the seeping town and back to their deployment center to await the next call.