Tuesday, October 2, 2007


“Control to…304,” the radio crackled, as if Satan were unsure of which unit she should be calling.

Probably trying to figure out of we’re close enough to punk with this one. The bitch.

Ryan and Steve listened with half an ear as 304 was dispatched to a wreck on the interstate, just a few miles east of their location.

“People can’t drive for shit in the rain,” Steve yawned sleepily, checking his watch. “Only two hours until shift change. Can’t get here soon enough.”

“It has been the shift from Hell,” Ryan agreed, “But if you keep talking about it, you’ll jinx us.”

Steve said nothing, just nodded sleepily and leaned back against the headrest. Ryan turned his attention back to his incomplete patient care reports.

Fourteen calls in ten hours. Eleven transports. I’ve been listening to the damned radio, and nobody else has transported half that many, even if all but one of ours were emergency calls.
She knows where to post us so we’ll catch the most calls. God I despise that woman…

“…304 on scene,” David Hendricks’ voice cut into his reverie. “Uhhhh…Control, you can cancel Oneida Fire. Looks like a minor accident, and everyone is out and walking around.”

“Ten-four, 304,” Satan acknowledged. “Advise us if you have any refusals.”

Stop telling my crews how to do their jobs, bitch. They know what they’re doing.

David’s reply was not the expected one. “Uhh, Control! Keep Oneida Fire rolling, and send us additional units! We’ve got fucking rubberne - um, ahh, chain reaction crash at this scene, Control! I’m gonna need a lot more ambulances here!” In the background, the sound of screeching brakes and rapid-fire impacts of crunching metal only punctuated his fear and excitement.

“Let’s go, Steve,” Ryan ordered, fastening his seatbelt. “Mile marker 120, I think it was. That’s gonna be on the overpass.” Steve Hatfield had the rig in gear and rolling before Ryan could finish the last sentence.

“306 to Control,” Steve radioed. “We’re responding to that chain reaction wreck at 304’s location.”

“Stand by, 306,” came the reply.

Stand by? What the fuck does she mean, ‘stand by’?

Ryan and Steve shared a look of disbelief and disgust. “Give me the mike,” Ryan ordered. Steve, rolling his eyes and shaking his head resignedly, handed it over.

“Be careful what you say,” he warned. Ryan ignored him.

“306 to all available units,” he radioed, giving Steve a defiant glare, “Priority One call on the interstate, westbound at mile marker 120, backing up 304 on a multiple MVC. All other units, expedite transport and check in with Control.”

“That’s not your job, Ryan,” Steve reminded him tiredly as the other units in the city began marking en-route to the scene, “and all you’re gonna do is piss her off, maybe even get written up for self-dispatching.”

“Fuck her, Steve. Right now, she’s frozen, wondering what she should do. The first coherent thought she’ll have is after this is all over.”

“And that thought will be how she can stick a knife in Hawkeye Pierce’s back for making her look like an idiot!” Steve flared. “Goddamnit! Don’t you get that?”

Ryan said nothing in reply, just stared out the window mutely. Steve, fuming, negotiated the surface streets approaching the nearest interstate on-ramp. When Steve Hatfield was angry, he tended to handle the rig roughly. From the jerky steering corrections, hard braking and acceleration, Ryan could tell he was monumentally pissed.

“Look, you can see 304’s lights from here,” he says, pointing at the elevated roadway. At the head of a massive traffic jam, the flash of 304’s emergency box lights could clearly be seen.

“Shit,” Steve breathed. “No way we’ll get to him through all that traffic, and we can’t use the eastbound overpass. Any ideas?”

“No,” Ryan answered honestly, “but get closer and let’s see if we can figure something out.”

“306 to 304,” Steve radioed. “We’re thirty seconds out. What have we got?”

“We got eleven cars,” David replied tersely, “I don’t know how many patients. I’m still triaging.”

“Control to 304,” Satan radioed, walking over Steve before he could reply. “Are you declaring an Mass Casualty Incident?”

“Ten-four, Control,” David confirmed, “declaring an MCI at this time.”

“Control to all responding units, we have a declared MCI,” Satan declared decisively. “304 is Incident Command. Responding units stage at…stand by.”

“Control, looks like the best place is the Tarleton Avenue off-ramp,” Ryan furnished helpfully. “Everyone needs to come up Tarleton the wrong way and stage there at the base of the off-ramp. We’re gonna have to push the stretchers and equipment up the ramp to get to the wrecks.”

“Control to all units, copy 306’s traffic?” Satan relayed coolly, professionally.

“Looks like she got unfrozen pretty quick,” Steve observed innocently as he parked the rig on the concrete median at the base of the Tarleton Avenue ramp. “That sounded like fairly coherent thought.”

Ryan just grunted noncommittally and extended the middle finger of his left hand as he bailed out of the rig. Two minutes later, legs burning and breathing hard, they had pushed their stretcher, piled high with two spine boards, cervical collars and first-in bag, up the ramp and through the line of stopped cars. They found David Hendricks leaning in the driver’s window of a compact SUV with minor, cosmetic damage.

“How many patients?” he asked without preamble.

“Looks like only six,” David sighed with relief. “Front two cars, mainly. Two people in the front SUV with minor injuries, mainly necks and heads. The guy that rear-ended them is serious – chest and head. Three people in a car behind them with Allstate-itis. They’re just lookin’ to get paid.”

“Gotcha,” Ryan acknowledged, and turned to Steve. “You help David and his partner get the critical patient packaged. As soon as they’re transporting, come back to me.”

“Why don’t you have David cancel the MCI,” Steve suggested, “since he’s Incident Commander and all? All we need is another transport unit, and Oneida Fire for extrication on our critical guy.”

“Good idea,” Ryan stuck his tongue out. “Perhaps you’re not totally fucking worthless after all.”

David Hendricks chuckled at the two partners as he keyed his radio. “Incident Command to Control…only six transports here. You can stand everyone down. We’ll still need another truck, and keep Oneida Fire rolling. We’re gonna need extrication on one patient.”

“Ten-four, 304,” Satan replied coolly, then relayed the traffic, “Control to responding units?”

“Ten-four direct,” came the replies from other units as they stood down, pulled their units over and waited for new posting assignments. The radio crackled again. “305 to Control, we’re only thirty seconds out,” came the voice of Mark Perry.

“Continue responding, 305,” came the reply. “Stage at the base of the Tarleton Avenue off ramp.”

“We oughta be able to handle this fairly quickly,” Ryan judged. “Let’s get to it.”

“Quicker we get ‘em assessed, extricated and packaged, quicker we’ll be out of the rain,” David agreed.

Together, they both walked up the line of wrecked cars. Ryan peeled off near the head of the line as David returned to the car with the critical driver. Walking in a wide circle around the wrecked SUV at the head of the line, Ryan approached it from the front, making eye contact with the driver and motioning for her to roll down the window. As the window hummed down, Ryan slid his hands through the opening gap and gently grasped the driver’s head, holding it still.

“Howdy, Ma’am,” he grinned. “Lovely way to spend a rainy afternoon, ain’t it?”

“Just fuckin’ great,” the woman chuckled nervously. “I should be in a thirty-car pileup every day.”

“Where are you hurt?” Ryan asked, turning serious.

“Neck and forehead, mainly,” the woman grimaced. “Neither of us was wearing a seatbelt. My friend hit the windshield.” She cut her eyes toward the woman sitting in the passenger seat. “You okay, Sheila?”

“I think so,” Sheila muttered. “I busted my head on something.”

“Okay, I need both of you ladies to hold still,” Ryan directed. “I’m going to put collars on both of you, and I want both of you ladies to stay in your vehicle and try not to move around.”

He quickly sized and fastened a cervical collar around the driver’s neck. “Wiggle your fingers and toes for me, Miss…what was your name?”

“Andrea,” the woman furnished as she complied with Ryan’s request, flexing her feet and drumming her fingers on the steering wheel.

“Anything numb or tingling?”


“Great!” Ryan replied before moving around to the passenger side and repeating the procedure on Sheila. Aside from the superficial laceration to her scalp, everything seemed okay. “Ladies, I’ve got other people to check on,” he told them. “Either me or another paramedic will be back in just a few minutes.”

Ryan walked back down the line of cars, noting that Steve and crew of 304 had been joined by two City of Oneida firefighters. As he passed the wrecked Hyundai, the head and shoulders of yet another firefighter appeared over the outer retaining wall of the elevated roadway. Curious, Ryan walked over to the wall and looked down to find an Oneida Fire Department bucket truck parked below them.

Huh. That’s one way to do it. Beats the heck out of lugging up their generators and extrication equipment by hand.

As David had described, the three occupants of the last vehicle were deep in the throes of Allstate-itis. As if on cue, they halted their animated conversation as Ryan approached, leaned their heads back against the seats, closed their eyes and started moaning loudly. One still held her cell phone against her ear as she moaned piteously.

Ignoring her theatrics, Ryan rolled his eyes as he walked around their vehicle.

They stopped in time to avoid hitting Critical Boy’s car, but the car behind them managed to tap their bumper.

Hands thrust in his pockets, Ryan prodded the barely damaged rear bumper with his foot.

Cosmetic damage only. Even the taillights are intact. Hardly even made a scuff on the bumper, and yet managed to inflict potentially permanent disability on the poor unfortunate occupants. Oh, the humanity!

Ryan knocked politely on the driver’s window, but the woman made no move to open it. Rapidly losing patience, he slapped the window hard. “Roll down the window!” he bellowed.

Still moaning piteously, right arm flung across her eyes, the woman slowly reached out her left arm and cranked down the window.

Jesus Christ. $5000 spinner rims on this 80’s vintage lead sled, and they don’t even have power windows. Well, maybe your insurance settlement can buy you some aftermarket ones. Maybe even have enough left over for some bling and a new weave, girlfriend.

“Where y’all hurt?” Ryan asked shortly.

“Mah neck…I wranched mah muhfuckin’ back…yo cuz, mah head hurt,” came the moaned chorus of the occupants.

“And I suppose you all want to go to the hospital?” Ryan sighed. All three occupants nodded in unison.

Synchronized malingering. They should be in the Scumbag Olympics or something.

Ryan quietly fumed as he unwrapped three new cervical collars from his first-in bag. As he was wrapping the cervical collar around the driver’s neck, taking care to remove her hoop earrings first, a voice appeared at his right elbow.

“Where you need us, Hawkeye?” Mark Perry asked.

I’m going straight to hell for this, but hey, I’m the stuporvisor. I can get away with it.

“You take this car,” Ryan grinned maliciously, handing Mark the other two cervical collars. “They’re all in desperate need of your superior lifesaving skills.”

Mark Perry, no stranger to turfing, scowled and gave Ryan the finger, hand hel low at his side where only Ryan could see. In reply, Ryan blew him a kiss, turned and trotted back to the head of the line of cars. He found Steve and two firefighters kneeling next to the opened driver’s door of the SUV.

“We already got the passenger out and packaged,” Steve reported. “She’s in our rig, strapped to the squad bench. Mark has three people from the original wreck sitting in the back of 304, ready to sign refusals.”

“You got this?” Ryan asked, laying a hand on Steve’s shoulder as he nodded affirmatively. “You’re a good man, Charlie Brown. Remind me to say nice things about you on your next performance evaluation. I’ll be back in a minute.”

Ryan opened the driver’s door of 304, fetched David Hendricks’ clipboard from between the seats, and walked back around to the rear of the ambulance. He opened the door and found an Oneida Police officer interviewing three wet, bedraggled teenagers. It was the same cop he had encountered earlier, the one who had found Colonel Mustard.

“I’m about tired of seeing you,” the cop grinned before Ryan could. “If you’ll give me another minute, you can have ‘em.”

“No worries,” Ryan winked. “Shouldn’t you be out directing traffic or taking measurements or something?”

What traffic?” the cop asked rhetorically. “We’ve got the interstate shut down from the Guyton Avenue east to Highway 63. One of our units is parked at the Guyton exit directing people onto the surface streets. It’s a mess, but once I get done with these guys, we can start moving the cars that can move and clear some of this out.”

“Most of ‘em are drivable,” Ryan informed him. “With the exception of the SUV and the car behind it, it’s mostly bent bumpers.”

“How many cars?”

“The other medic says eleven. Only two will need a wrecker,” Ryan replied, then addressed the teenagers. “What’s your story?”

“Well, I was driving right at the speed limit, one of them starts to answer, “in the right lane, and this car cuts in front of me outta nowhere…”

“Hydroplaned into the guardrail,” the cop cut him off. “No sign of the other vehicle.”

“Did you guys call the ambulance?” Ryan asked.

“I called,” the cop answered. “Figured better safe than sorry.”

“Is that right?” Ryan asked the teenagers. “None of you requested an ambulance, nobody’s hurt?” Shivering, the teens nodded yes to both questions.

“That’s all I need to hear,” he told the cop. “They didn’t make the request for the ambulance, and they don’t want treatment. They can go when you’re done with them.”

“They don’t need to sign anything?” the cop asked dubiously.

“All you kids over eighteen?” Ryan asked, to affirmative nods.

“That’s all I need,” Ryan confirmed as he backed out of the rig. “They’re all adults, and they didn’t request the ambulance. None of them are officially patients.”

“Works for me,” the cop agreed. The back door opened, and Joanna Bradford poked her head into the back of the rig.

“Time to clear out, folks,” she ordered tersely. “We got a bad one we gotta move with.”

Ryan backed out of the rig and motioned the others out of the way. As Joanna guided the stretcher wheels into the back of the rig, Ryan lifted the undercarriage as she rolled the entire stretcher into its mount. David Hendricks followed the stretcher into the rig and immediately began digging through the cabinetry for supplies.

“You need help?” Ryan asked.

“I need an airway,” David answered tersely as he suctioned the man’s mouth. “His face hit the steering wheel. He was doing okay for a while, but once we got him onto the board, he started going downhill. I could probably bag him from here to St. Matthew’s, if I had someone along to help.”

“That trip’s gonna take an extra ten minutes,” Ryan informed him. “All the eastbound interstate traffic has been routed onto the surface streets.”

Shit,” David sighed bitterly. “I guess he buys a tube, then.”

“Get your kit ready,” Ryan suggested. “I’ll get the line.”

Ryan quickly set up an IV of saline, straddling the stretcher as Steve and another firefighter loaded another patient onto the squad bench.

Dayum, cuz!” the man said as Steve fastened the straps. “Homeboy fucked up!

“Shut up!” Steve snapped tersely. “Just lay still and you’ll get your ride.”

Ignoring the malingerer strapped to the squad bench, Ryan quickly sank a 16-gauge catheter into the man’s left arm, attached the tubing and secured the catheter with several wraps of two-inch tape. Retrieving two medication vials from the drug box, he quickly drew up two doses of medication.

“You ready?” he asked David, who was poised at the patient’s head, steadily ventilating the man and doing a fair job of it, despite the man’s wrecked face. David nodded.

“Here’s the etomidate, and here’s the succinylcholine,” Ryan recited automatically, “on board at 1704 hours.” He moved up the stretcher and pressed down hard on the man’s thyroid cartilage, effectively blocking his esophagus. Presently, the man’s arms and legs began twitching spasmodically, followed by flaccid paralysis.

David Hendricks inserted a laryngoscope into the man’s mouth and peered inside. He muttered under his breath, suctioned some more and ordered tersely, “Deeper…and more to the right.”

Ryan complied, manipulating the man’s larynx into position. David slid the tube home with a self-satisfied grunt. Ryan grinned and handed him the capnograph adaptor, which David attached between the bag valve mask and the endotracheal tube. As David squeezed the bag, Ryan listened to breath sounds.

“Sounds good,” Ryan confirmed, and looked at the cardiac monitor. “You’ve got a good capnograph tracing too. Exhaled CO2 is…twenty-six and rising. It’s in.”

“Strap it down for me before you go,” David requested. “Thanks, Hawkeye.”

“No problem,” Ryan shrugged as he backed out of the rig. “I’m sending an extra set of hands in with you.” He tapped a firefighter on the arm and gestured for him to climb aboard. Once he was in, Ryan slammed the rear doors, and clapped Joanna Bradford affectionately on the back. “He’s ready to roll, Jo. Tell him I said y’all done good.”

At the base of the exit ramp, Steve and Ryan found two Oneida firefighters loading the last patient into their rig. “Need somebody to ride in?” the captain asked.

“No thanks guys, we got it.” Ryan answered. “Thanks for everything.”

He climbed into the back of the rig and maneuvered forward gingerly, holding onto the overhead rail as Steve pulled off the concrete median and merged into traffic on Tarleton Avenue.

“I was beginning to think you had abandoned us,” came a chuckle from the stretcher.

“Why hello, Andrea!” Ryan grinned. “What, no faith in me? I told you I’d be back. You’d rather have someone else?”

“Well now that you mention it, one of those cute firemen would have been nice…”

“Sorry ladies, but if anyone gets to cut your clothes off and palpate you, it’s gonna be me.”

Without further ado, Ryan performed a quick but thorough assessment of both women. As he suspected, neither was seriously injured. He settled into the captain’s chair and managed to complete the bulk of his reports by the time they arrived at St. Matthew’s ER.

As Steve wheeled Andrea inside on the stretcher, Ryan waited in the rig with her friend. He surreptitiously checked his watch.

Forty minutes to shift change. Hurry up, Steve.


Fifteen minutes later, he and Steve had transferred care of both women to the ER staff, given report, and marked their unit back in service. On their way back to the station, the radio crackled again.

“Control to 306.”

“306, go ahead,” Steve answered, groaning and rolling his eyes.

“Priority One call, Oneida Kidney Center. Patient going back to St. Mary’s Nursing Home in Fort Sperry.”

“Goddamnit!” Ryan exploded, punching the dash. That miserable fucking whore!

“Shut up!” Steve snapped, and keyed the radio. “Uhhh, Control? You realize that our shift ends in twenty minutes?”

“Contact dispatch by phone, 306,” came the terse reply.

Ryan had the phone in hand before Steve could reply. Glaring at him and holding up a warning finger, Steve snatched the phone from his hand and dialed. “Yeah Martha, it’s Steve on 306,” he said pleasantly. “Why are we catching this transfer at twenty minutes to shift change?”

Whatever the answer was, Steve didn’t like it. “Gimme the phone!” Ryan mouthed, reaching for the handset. Steve slapped his hand and switched the phone to the other ear.

“Come on, Martha!” Steve pleaded. “That’s bullshit and you know it…yes, I know that once a Priority Three call stays in queue for thirty minutes, it automatically becomes a Priority One call…but it’s a Goddamned transfer, Martha! It can’t wait twenty more minutes for the next…no, I am not refusing the call!” Furiously, he thumbed the END button and pitched the phone to the floor. “Goddamnit!”

“Told you she’s punking us,” Ryan informed him. “She’s playing the fucking system.”

“No, she’s punking you,” Steve flared angrily, “And I just get fucked by being your partner!”
Shamed, Ryan leaned back against the seat and said nothing else for the rest of the call.


Steve and Ryan spent the next ninety minutes in uneasy silence. They went through the motions, smiled and bantered with the patient and her nurses, but barely said a word to each other. After dropping their patient off at the nursing home, they found themselves ten miles outside of Oneida, stopped behind a long string of cars on the two-lane highway. The area was on was the outskirts of Oneida Parish, where the suburbs and bedroom communities merge into the rural farmlands and timber tracts of Audubon Parish.

“Wonder if there’s a wreck up there,” Ryan ventured hesitantly.

“Could be.”

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


He’s really pissed. Shit, he has a right to be. I haven’t exactly been a good partner lately. And damn it, Steve’s not just my partner, he’s my best friend. He’s had my back from the first day we worked together. Aside from Jeff Layton, he’s the only person I trust.

Steve grunted as the traffic started to move. A mile ahead, they spotted the deep ruts leading off the road and down the steep embankment, abruptly ending at a huge, scarred oak tree. Ryan craned his neck, looking over his shoulder as they passed the wreck scene.

“Somebody died in that one,” Ryan mused, looking back at the ruts in the mirror. “Looks like they crossed the road and hit the tree head-on.”

Steve didn’t reply.

“Wonder who worked it?” Ryan ventured. “Are we still in Audubon Parish?”


“Still, it’d be closer for one of our rigs than it would be for Collins to work it. I mean, it’s right across the line. We post a rig not five miles from here.”


“Well, maybe we can watch it on the news tonight. That’s our friend from Headline News up there. I’m sure they’ll have plenty of gory details.”

“I suppose.”

“Hey Steve?”


“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.


Blue Ridge Medic said...

Great post. Can't wait to see what happens next.


MonkeyGirl said...

So as I was saying...

I really like Star of Life because it's realistic, funny, snarky, and then all of a sudden it just socks you in the gut.

Fantastic gut shot.

Strings said...

AD, you're evil, sadistic, and cruel...

you're gonna make us wait a month for the next installment, aren't you?

Anonymous said...


MonkeyGirl said it quite well.

Well-done, AD. Keep 'em coming -- PLEASE??!!


Chris in SE TX said...

Yeah, AD, my wife is well familiar with Dispatch making their life miserable to the tune of making 9 transfers (medium distance) while the other units make 2-3....

I keep telling her to quit calling Dispatch "Satan"......

Chris in SE TX said...

Oh, I forgot!

Let's just hope that AD won't pull a Law Dog on us and leave us PERMANENTLY hanging during the most interesting part!!!!

WW said...

How can you leave us with that?

Scoob said...

Wait - hold on - I'm all confused. Or am I? Possibly Ryan's overzealousness may have indirectly led to the wreck? That the Collins crew was headed to the multi-vehicle crash? Hmmm. Am I making that all up or should I just switch to decaf?

Well written :)

Anonymous said...

Damn, there had better be a new chapter really soon with an ending like that!... and for chapter name? 'Rain'

great story.

Epijunky said...

Holy cow. When it rains it pours.

Please post again soon, what a cliffhanger... It took my breath away.

knitalot3 said...

Very good, AD. Write again soon, please!

John McElveen said...

We've all had that shift I think!

I think a good title would be....

"Tag- You're it"

well written as usual AD!


Alison said...

A well written story. Interesting and thought provoking. How about "The Daily Test" for a chapter name?

Scott said...

Wow! Several things. I love the disorder called Allstateitis! That's hilarious.

Heineken? Ugh. Bitter beer face. I'd rather drink Rocky Mountain Piss, err, Coors, that is. Uh, well, if I still drank.

That sure was a shock at the very end of the chapter. I can't wait to read the next one.

Drama between partners. Good.

Also, Satan is a good character.

Brandon said...

Great post with an even better cliff-hanger.

Theodwyn said...

More! More! More!

Jenn said...

hmm, I always thought it was cricoid pressure, not thyroid....?

Ambulance Driver said...

"hmm, I always thought it was cricoid pressure, not thyroid....?"

Actually Jenn, it's cricoid pressure if you just want to do a Sellick's Maneuver and occlude the esophagus.

If you're trying to improve someone's laryngoscopic view however, you'd do the BURP technique, which involves manipulating the thyroid cartilage.

Jenn said...

ah, got it. thanks :-)

Chris in SE TX said...

Yup, whoever suggested "Rain" as the title did good.....

AD, you HAVE TO keep posting updates....

...I may not be able to find Law Dog, but I'm pretty sure I can find YOU! If you don't keep posting updates to this, I..... er.... I..... will come hunt you down and.... er.... will find some way to embarras you!!!

Yeah, that's it! I will find you, show up at your work and proclaim you my Gay Lover!!!! (shudder...)

So, to avoid unpleasentnes for both of us, for God's sake, keep posting!!! The story's great, and this chapter really ended with a cliff hanger!

emergencyemm said...

I love this series. You're an awesome writer.

Medic 61 said...

Seriously!? I'm sitting on the edge of my chair, here! I've got to know what's going to happen, and I cannot bear to wait much longer.
I sure hope you're not going to keep us in the dark for too long!

Kimberly said...

These are great AD, this is why I started reading your blog to begin with, to read your stuff like this.