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.

STOP IT.

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.

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?”

“Nope.”

“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.

“Could be.”

“Wanna call the dispatcher? Maybe they’ve copied some radio traffic on it.”

“No.”

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?”

“Yep.”

“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.”

“Maybe.”

“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 suppose.”

“Hey Steve?”

“Yeah?”

“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.

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.

“306 rolling.”

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?”

“Yep.”

“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.”

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.

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.”