The sirens wail and the four year-old kid is screaming and I’m getting a listen at his chest, which is about eight inches across. I’m worried one of his lungs popped when the car ran him over and I want to hear the whisper of breath on each side of his chest but I can’t hear shit.
At the hospital we hand him over to the ER. They do a needle decompression, which is what I would’ve done in the ambulance if I could’ve heard well enough to know he needed it. Dr. MacKenzie drove a tiny dart through the kid’s chest and all that extra air leaking out from his popped lung had a place to escape so it didn’t fill up his lung sac and push his heart flat. He lived, that one.
A month later Nan and I were called in front of the review board. No man is an island—you go before the review board with your partner—but it was my patient. The supervisor and the medical director look at me across the table. That supervisor hasn’t been in an ambulance in fifteen years. And the medical director? Never. They want to know why I didn’t do the needle decompression on the kid.
“You get in the back of the box and have a listen at that tiny chest and tell me what you hear, you entitled dickwads.” That’s what I want to say.
I want to stand up and turn the table over onto them, Jesus-style.
I keep it reined in, though. Answer their questions. And so I keep my job.
“The patient had all the signs of pneumothorax—tracheal shift, dropping pulse, sub-Q air. Without the needle decompression, it’s lucky the kid didn’t die.” That’s what the medical director said.
“You saved the kid.” That’s my best friend Perry, that night when we’re drinking beers.
“Sure you did,” Perry says.
And I think about it. I’m the one who transported him. Twenty minutes more and he would’ve been a goner. I may know I’m doing a decent job when I’m in the box, but once I’m out and people who weren’t even there start second guessing me, I can’t hang onto it.
“You’re a hero,” Perry says. And he lights us up a joint.
Later on that same night I’m smoking a little more, playing drums in the band room under my garage apartment. My dad owns the place, but he charges me full rent. And it’s the fucking piss ant law student who lives behind me who comes around banging on the side door, saying he’s gonna call the cops if I don’t lay off. And then I’m outside and I’m yelling back at him and I’m giving him a little push. And then I’m saying some things he finds threatening and he’s backing away from me. And then he’s gone into the darkness, back the way he came.
And I might just leave something on his doorstep. A mousetrap. A flaming bag of shit. A skull and crossbones. Some kind of warning that there’s an anger here, something with which he should not fuck.
My next shift, the first run we made was to a residence. The house wasn’t too small, but it was old, the way houses start to look when there isn’t anyone doing a damn thing to take care of them. The firefighters had arrived first– they always do –and had broken down the door.
The firefighters crowd around this old man on the floor in the kitchen. Walking through the living room, it’s dusty, but not too bad, then boom, the kitchen: a mess. Dirty pots and pans on the stove and the oven door hanging open with a half-baked pan of spaghetti casserole being exited by a roach army unused to the kind of commotion we were stirring up.
The old man’s on the floor—the firefighters haven’t moved him, and his hip has dislocated and he’s in a lot of pain. He’s not that old even, not really, and even though the kitchen’s a disaster his clothes look like they’ve just come from the cleaners and he’s had a shave and there isn’t a bunch of hair growing out of his nose like you get with a lot of old guys.
I check to make sure it’s really the hip and it is and then I offer the old guy a valium. But he won’t take it. I ask if he’s ready for me to reduce the dislocation and he nods yes. And there is something sad about the motion, like the old guy has lived long enough to know how these things go. He knows it’s going to hurt and he knows that he can take the pain.
And sure we’ll be able to pop the old hip back in, but there’s nothing we can do about the way life does people.
Nan gives the old guy a hand to grab onto. The old guy’s skin is starting to go thin and loose, but it’s still a strong hand. He looks at me as I take ahold of his femur, this old guy, and he’s not afraid of anything. And when I give my shove the guy winces, but that’s it, even though most people scream like little birdies. The hip pops back in and we’re helping the old guy to his feet.
He’s a little unsteady at first, but then he shakes it out and he’s not embarrassed to have needed the help. He looks at us, the two guys from Fire, Nan and me, and he sees how young we are and how strong. He glances around him then and it’s like he hadn’t been able to see the state of his kitchen before and now he’s seeing it. “Samantha being gone,” he says, “it’s not an excuse.”
We shuffled our feet and one of the guys from Fire said something about the old guy being the last American bachelor, but it was a bad joke to make to a widower. The old guy gave a laugh that said it was funny how dumb some good intentioned people can be.
I wrote the name of my dad’s housekeeper on a napkin. “Her number’s listed and she’ll clean this place right up,” I said. The guy could afford it for sure. “She’s a good cook, too.”
He nodded and put the napkin on the kitchen table under a saltshaker.
On the way back to the station, Nan and I were both quiet. The run had been too easy, the kind that makes you see the years working an ambulance stretching out in front of you.
“Have you ever thought about working on Starflight?” I asked him. Every time a Starflight emergency transport helicopter landed at the hospital I was stunned by jealousy. “They get to wear those jumpsuits. They do water rescue, too, you know. Every call life or death. Every call something that matters.”
“You’ll give yourself away caring about a single fucking thing except what you need to do to treat,” Nan said.
“What do you mean?”
“A housekeeper? Seriously?”
“They’re really fucking cool, those jumpsuits.”
Stay tuned for Part 2 of Ambulance: a short story.