Monday, February 25, 2008


"This your first pediatric call?" Dave Collins asked.

"Second one as a paramedic," Ryan replied. "The first one was a seizure that was already postictal when we got there. Not much to do other than give 'em a ride and some blow-by oxygen."

"Well, I wouldn't get too worried," Dave reassured him. "Most of these choking baby calls are just Panicky Mother Syndrome."

Ryan grunted but did not reply. He slowed down, looking for the cross street. They had rolled out of the station ten minutes earlier, alerted by the Sheriff's Office that there was an emergency call. In the late eighties in Audubon Parish, there was no such thing as 911. People called the Sheriff's Office for help, who either sent a deputy, or called the ambulance or the Fire Department. Sometimes they sent all three.

Ryan had first heard the call over the scanner. After a year as an EMT, he had learned to sleep through most interruptions. With his brain attuned to listening for the words Collins Ambulance or 10-78, the radio code meaning "send an ambulance," nothing short of a brass band at his bedside could produce such instant wakefulness. He was already reaching for the phone when it rang the first time. He had taken the call, gotten dressed and been waiting in the idling ambulance for perhaps thirty seconds when his boss had climbed into the passenger seat, ninety seconds later.

I hope it's just PMS, because anyone this far out in the sticks is already dead if they haven't been breathing. I hope I'm up to this.

"Just the same, though," Dave mused, as if he had been reading Ryan's mind, "I'll take the lead on this one. If it's bad, that is. Pediatric codes are tough."

Technically, Ryan was Dave's superior in terms of training. Dave was an EMT-Intermediate, while Ryan was a newly-minted paramedic. In practical terms, though, Dave Collins' field experience dwarfed his own. As the owner of the company, he was also the man who signed the paychecks.

At least, that was the theory. Paychecks were still in short supply at Collins Ambulance.

Ryan nodded, braking gently as he saw a reflective street sign just ahead. Gently on the brakes, and gently on the accelerator, Dave had preached a thousand times. The smoother you stop and accelerate, the longer the trucks last and the less you throw your medic around in the back.

Mindful of his lessons, Ryan slowed the ambulance almost to a crawl, turned on the driver's side floodlights, and read the name on the sign: McCormack Road.

"This is it. Turn left here," Dave ordered, quite unnecessarily since Ryan was already turning as he spoke.

Three hundred yards up the road, they spotted their destination, a double wide trailer set well back from the road in a tree-filled lot. There was a Sheriff's Office cruiser sitting in the driveway.

"They sent a deputy, too?" Ryan wondered as he parked the rig.

"They didn't send one," Dave replied tersely as he got out. "He lives here. That's Don Bailey's cruiser."

Ryan bailed out of the rig, grabbing the first-in bag and tossing it onto the stretcher. By the time he pushed the stretcher to the porch, Dave was already inside. The wails of anguish coming through the open door told him that this choking baby call was most definitely not Panicky Mother Syndrome.

Grimly, he left the stretcher at the porch steps and lugged the first-in bag through the front door. He found Dave Collins kneeling next to a limp toddler lying on the floor, his ear poised over the baby's mouth, listening for breathing. A young man his own age, dressed only in boxer shorts, knelt on the other side of the child. His hands were still poised over the infant's chest, the heel of one hand atop the other, tears streaming down his face. Don Bailey, rookie deputy for Audubon Parish Sheriff's Office, had been doing CPR on his own son.

His wife sat on the couch, screaming hysterically. She had her hands clasped over her mouth, and her voice rose in a keening wail, as if she were holding back her horror with her bare hands, and failing at the task as the anguish of seeing her child lifeless on the floor escaped through her fingers like steam from a pressure cooker.

All of this Ryan processed in an instant as Dave began giving mouth-to-mouth ventilations. "What happened?" Ryan asked as he opened the flow meter on his portable oxygen tank and handed a bag-mask resuscitator to his boss.

Don Bailey acted as if her hadn't heard, staring down at his son with a stricken expression. His hands hadn't moved.

"Don." Ryan reached out and gently squeezed his arm. Don Bailey raised his eyes and looked at Ryan vacantly, and then focused. He took a ragged breath and ran his forearm across his eyes.

"I woke up to go pee," he said hoarsely. "I found him on the floor, barely breathing. He gets out of bed sometimes…wanders…his lips were blue, and he kept making these squeaking noises and I…I didn't know what to do, and I just called the SO and started CPR…"

"I'm not getting any breaths in," Dave muttered in frustration. Shifting position, he began delivering abdominal thrusts. He was not gentle.

Ryan watched Dave desperately working on the child for a moment. Don Bailey sagged back onto his heels and let his hands fall limply to his sides, defeated. The child's mother rose from the couch, tonelessly screaming for someone, anyone to save her baby. Distantly, Ryan registered the fact that Dave was ordering him to escort the woman from the room. The moment couldn't have lasted longer than a few seconds, but to Ryan every movement was almost languid, as if they were performers in a surreal ballet played out in half-time.

He calmly looked at Dave Collins and said, "Get out of the way."

Dave Collins blinked in disbelief, but shifted to one side as he'd been ordered.

"I need a laryngoscope with the #2 straight blade," Ryan said coolly as he took Dave's place at the baby's head, "and the pediatric Magill forceps. Don, you start compressions again."

"I can do the compressions," Dave started to argue. "He's tired, and he's –"

"Dave. Get me my scope and the forceps," Ryan repeated in a firm, yet reasonable tone. "Don, let's go."

Ryan scooted into a prone position at the baby's head, and held out his left hand. "Scope," he ordered. Wordlessly, Dave Collins smacked a laryngoscope into his open palm. Ryan walked the laryngoscope blade down the baby's purple tongue, looking for the glottic opening.

Just a little bit further and I should see the epiglottis…okay, now lift just the tiniest bit…there it is!

Without taking his eyes off the prize, Ryan held up his right hand and ordered, "Forceps. Once you give them to me, set me up a 4.5 tube. Don, speed up those compressions a bit."

Ryan reached into the baby's throat and gingerly plucked free a piece of hard candy lodged just below the vocal cords.

"Grape Jolly Rancher," he announced matter-of-factly, laying the forceps aside and holding out his right hand again. "Tube, please."

Ryan passed the tube through the cords, sat up, attached the bag-valve resuscitator and ordered, "Check placement." Dutifully, Dave auscultated the baby's chest and grinned, giving Ryan a thumbs up.

"Still not breathing, and no pulse," Ryan noted calmly. "Don, keep going with compressions. Dave, we need some tape on this tube. Soon as you get that done, set up a line. Don, how much does he weigh?"

"Twenty-four pounds."

"Okay, that's roughly ten kilos," Ryan mused, daintily holding the tube in place with his thumb and index finger as Dave taped it in place. "Dave, draw up a milliliter of Epi 1:1,000, and set me up a syringe of Epi 1:10,000."

"Both?" Dave wanted to know.

"The 1:1,000 syringe first. I'll give that down the tube while you're getting a line. Once the line's in, we'll give the 1:10,000 through the IV."

Dave Collins nodded his understanding and tore open the drug bag, looking for the miniscule ampoules of concentrated epinephrine.

"Want me to keep going?" Don asked softly, hope creeping into his voice as he rhythmically compressed his son's chest. In the thirty seconds since Ryan had been able to effectively ventilate the child, his color had improved dramatically.

"Just for a little longer, Don," Ryan said gently as he attached cardiac monitor leads with one hand and bagged with the other. "Let us get this IV in, and then you can see to your wife."

"Epi 1:1,000," Dave announced, handing Ryan a syringe.

Ryan briefly disconnected the bag from the endotracheal tube and instilled the medication. He reattached the bag and ventilated vigorously for a few seconds, trying to aerosolize the medication into the lifeless toddler's lungs.

Come on, kid. Give us a sign. Just a few beats to let us know you're still there…

Both Ryan and the child's parents watched the cardiac monitor expectantly. The only one who wasn't focused on the screen was Dave, still searching fruitlessly for a likely vein to stick. After a few moments, it became obvious that no electrical activity was forthcoming.

"Okay," Ryan announced, "we need a line. How's it coming, boss?"

"I can't find anything!" Dave snapped, fear and frustration manifest in his voice.

"Keep looking," Ryan advised, unperturbed. He reached out and dragged the first-in bag closer, rummaging through it with his right hand while continuing to ventilate with his left. After a moment, he found what he had been looking for.

"Dave, hold his right leg steady," Ryan ordered.

Dave Collins stared at him without comprehension.

"Hold his right leg steady, and rotate it out just a little bit," Ryan repeated, smiling reassuringly. "Swab just below his knee with a little alcohol, please."

Dave Collins did as ordered, his actions belying the dubious expression on his face. Ryan leaned far forward, and bored an intraosseous needle – with one hand - into the child's tibia, just below the knee. "Remove the stylet and aspirate," he ordered a shocked Dave Collins. When he saw blood slowly trickle into the syringe, he grinned and said, "We're in business. Give a milliliter of the Epi 1:10,000 and let's get him ready to go."


"You've got a gift."

The child had regained a rhythm on the monitor shortly after the second dose of epinephrine. By the time they had left the Bailey house, siren screaming, he'd had a pulse. By the time they had reached Fort Sperry Community hospital fifteen minutes later, he had been breathing and trying to move.

"What's that?" Ryan had asked absently, still basking in his first code save. The adrenaline rush was still coursing through his system, but he was not so amped that he did not notice that Dave Collins had spoken not a word to him since they had left the scene. Ryan had given the handoff report, waiting for Dave to chime in at any moment. The moment had not come. Until now.

"You've got a gift," Dave had repeated, meeting Ryan's eyes. "That was as smooth as they ever come, and it was your very first. I was impressed."

"Well, um…thanks," Ryan had stammered, blushing furiously. "I was just following your lead."

"No, you weren't," Dave observed wryly. "It shook me up, no question about it. I was working on a friend's son, with his parents watching. You can work a hundred codes, and I have, and something like that will still shake you. I didn't freeze, but I wasn't acting like I was in charge, either."

"Some of the stuff that needed doing, you couldn't do. I just did what was necessary."

"You took over," Dave argued quietly, "as you should have. And you ran a pediatric code better than any I've ever seen."

Ryan Pierce said nothing, absentmindedly fingering the Star of Life on his left collar point, remembering another cardiac arrest years before.

"You've got a gift, Ryan," Dave had advised. "Honor that gift, and one day you're going to do something special."


Ryan Pierce lay awake, staring at the ceiling. The dream had been vivid, all the more so for the emotions it evoked. Dave Collins' voice still rang in his mind, years later.

You have a gift. Honor it.

Ryan turned to look at the clock, but his vision was obscured by a tousled head of dark hair fanned across the pillow. Amanda Whatsername lay beside him, her body molded to his, save for one long, shapely leg draped across his upper thighs and a well-manicured hand idly toying with the hair on his chest.

He had joined her at a dive on the Oneida River Walk a little after five o'clock, and already the bar was rocking, filled to capacity with a raucous young college crowd. The place was smoky and noisy, the house band mediocre but enthusiastic, and the beer cold. In short, it was just his kind of place – fifteen years ago. He wondered how old Amanda actually was, and asked. She was twenty-six, but was quick to assure him that she much preferred older men.

On hearing that, Ryan Pierce had never felt so old in his life.

He had disguised it well, however. He had been witty, and charming, and just a bit dangerous, and Amanda had never guessed that his mind had been somewhere else entirely. Ryan Pierce was good at disguises.

They had chatted and laughed, engaging in what little conversation was possible over the music, but both of them knew that conversation was not what either of them sought. And so, Ryan had let himself be led to the dance floor, and when the moment was right, he had grabbed her by the hips, pulled her close and whispered a suggestion in her ear. It wasn't particularly hard; Amanda's hips never seemed to stray far from his own anyway. Her dance moves were unabashedly erotic, and decidedly feline.

She had readily agreed to follow Ryan to the marina, ostensibly so he could cook dinner for the both of them aboard his boat. She was not fooled, but then again he hadn't expected her to be. They hadn't been aboard Ecnalubma for more than ten minutes before she asked to use the bathroom. Ryan had pointed her down the hall, and settled onto the couch with a groan.

When she emerged from the bathroom five minutes later, naked and smiling lasciviously, Ryan's answering smile had matched her own, but inside his mind was raging with guilt and doubt. But whatever his thoughts of his wife, when Amanda climbed atop him and kissed him hungrily, he had not pushed her away.

And he hated himself for it.


What the hell are you doing, Ryan? You're thirty-six years old and married, with a child of your own, and you're lying here in bed with a girl you met less than twenty-four hours ago. You can't even remember her last name.

He groaned inwardly and lifted his head slightly to see the clock.

Shit, only 3:30, and I can't sleep.

Ryan turned to his right ever so slightly, and Amanda stirred, gave him a sleepy smile and rolled onto her side. He planted a kiss on the back of her head and whispered, "I'll be right back."

She murmured something unintelligible in reply, and Ryan gingerly extricated his arm and slipped out of bed. He quietly padded down the hall to the bathroom and splashed water on his face, studiously avoiding his reflection in the mirror.

Grabbing his robe from the hook on the bathroom door, he went to the kitchen for coffee, and finding himself surprisingly hungry, rummaged through the refrigerator looking for leftovers. He was suspiciously sniffing a foil-covered plate of pot roast of indeterminate age when an arm snaked over his shoulder and he felt warm breath on his neck.

"Jesus Christ!" he yelped in surprise and wheeled around, sending the petrified pot roast sliding off the plate and across the floor.

"Sorry," Amanda giggled. "That was supposed to be seductive."

"It was," Ryan smiled apologetically, taking her in his arms. "I'm just a little jumpy."

"Guilty conscience?"

"Not at all," Ryan lied. "I've just gotten used to being here alone." He forced a smile. "I was just about to fix something to eat. You hungry?"


"Well, um…what would you like to eat?" Ryan ventured. "Is this supper, or breakfast?"

"Breakfast," she decided, "and I'll eat anything but…" she smiled, casting her eyes toward the roast on the floor, "…whatever that is."

"How does bacon and eggs sound?"

"Bacon and eggs sounds great," she purred. "Scrambled, please."

"No problem, Ryan winked. "Aside from being a spectacular lover, I am one of the world's foremost egg scramblers."

"A man of many talents," she agreed, causing Ryan to blush.

"I could probably scare up another robe or something," Ryan stammered, "if you'd like to put something on…"

"Do you want me to put something on?" she grinned wickedly, raising her arms over her head and turning a slow pirouette. She leaned against the counter and crossed her arms – beneath her breasts, not concealing them. Showing off. Ryan blushed even more, and she chuckled throatily.

"No," he laughed, "it just makes it a little hard to concentrate, that's all."

Amanda smiled devilishly, but did not move. Ryan masked his discomfiture by busying himself with preparing breakfast for the two of them, keeping his back to her as much as possible.

They ate in silence for the most part, Ryan studiously avoiding meeting her eyes, Amanda looking at him appraisingly.

"So how long have you been separated from your wife?" Amanda asked, surprising him with the question.

"Six months," he answered, pushing his eggs around on the plate. "Long enough for me to get used to being by myself again."

"I'd have figured less time than that. Her ghost is everywhere around here." She looked around significantly, then leveled her gaze at him. "You still love her."

It wasn't a question or an accusation; more of a simple statement of fact.

"Of course not!" Ryan denied, perhaps a bit too forcefully.

"You're a very good liar, Ryan Pierce," she observed. "Best of all, to yourself."

Ryan sighed and put his fork down. "Look Amanda, I'm not the kind of guy to –"

"Do this very often?" she smiled, cutting him off. "That much is obvious."

"She asked me for a divorce yesterday," Ryan explained.

"Ah, so now we come to it," she nodded knowingly. "And you wanted to hurt her like she hurt you?"

"No, that's not it at all," Ryan shook his head vehemently, this time meaning it. "I was just…I don't know…tired of being alone, I guess."

Amanda said nothing, just continued to look at him levelly. Her frank gaze made Ryan even more uncomfortable.

"I'm sorry," he went on, his voice low and strained. "This was a mistake. I guess I'm not ready to –"

"Relax, Hero," she said softly, putting a finger to his lips. "I'm not angling to be the next Mrs. Ryan Pierce. I knew what this was when I followed you out here. Although," she chuckled, sweeping her arm at her surroundings, "a girl could definitely get used to this."

"She's dropping my daughter off here first thing in the morning," Ryan said. "Probably around seven."

"And you feel guilty, and want me gone before she gets here?"

Not trusting himself to talk, Ryan nodded and stared at the countertop, refusing to meet her gaze. His face flushed and his ears burned with shame.

"That's three hours from now," she said quietly, laying her hand on his trembling arm. He looked up at her, and she smiled softly. "Come back to the bedroom with me, Ryan. And this time, try not to pretend you're making love to someone else."

Ryan took her hand and followed her back to the bedroom.


Ryan walked Amanda to her car, leading her around the still-muddy spots in the basin between the dock's end and the parking lot. She had reminded him that he still had her number, and embraced him before she got into her car. Her kiss was equal parts farewell and open invitation, and Ryan still had his arms around her when Dawn's car pulled into the parking lot.

"Friend of yours?" Dawn asked sarcastically from behind him as Ryan watched Amanda's car drive away. He sighed and turned to face his wife. Her eyes flashed with barely concealed anger.

"Cell phone lady," he said shortly. "She came over to help me program my new phone."

"Fuck you, Ryan!" Dawn spat. "How long have you been sleeping with her?"

"None of your Goddamned business."

"Have you had her over with Caitlin here?" she demanded.

Ryan leaned forward until his nose was an inch away from hers. "Go to Hell,Dawn. You left me, and you've been cohabitating with DUI Boy in our house for months now. And don't tell me you weren't fucking him before you left. I know better."

"I wasn't - "

"I still have a few friends left," Ryan smiled cruelly, "ones that decided I needed to know the truth. I know about all his visits to the hospital when you were working, your little trip to Houston the weekend you ran out on our marriage…"

Dawn sucked in a shocked breath, and then tried to bluff. It wasn't very convincing.

"I want to know if you've been sleeping with this girl with my daughter on the boat," she insisted doggedly.

"You have no right to ask me anything."

"I have a right to know what kind of people you have around my daughter!"

"Oh, you mean like an EMT convicted of DUI?" he smiled nastily.

"He was a friend! He listened to me!"

"Listened to what? All the things you wouldn't tell me? So you pour your heart out to a stranger, and you won't give the same trust to your husband?"

"You withdrew, Ryan! Ever since your sister died, you've formed this…shell…and you wouldn't let anyone help you, not even me!"

"To have and to hold," he quoted, "to honor and to cherish…"

"Don't quote my marriage vows to me!" she flared, tears flowing down her cheeks.

"…for richer and for poorer, for better and for worse, in sickness and in health…"

"Goddamnit, you abandoned me five years ago!"

"For better or for worse, in sickness and in health, Dawn," he reminded her. "That's the promise you made before God, and you broke it when I needed you most. You say I need to heal, well step one is realizing what I've known all my life; I can't count on anyone but myself, and I can't save anyone but myself."

Ryan opened the back door of her car and unbuckled a still-sleeping Caitlin from her car seat. He hoisted his daughter to his shoulder, grabbed her overnight bag, and walked away, leaving his wife standing there sobbing in the parking lot.

"Goodbye, Dawn," he called over his shoulder. "Loving you costs me too much."


"You're out of your fucking mind, Spud," Ryan hissed into the phone three hours later.

"That's my price," Ty Collins said stubbornly.

"Hang on a second," Ryan said, eyeing Caitlin sitting on the couch watching cartoons. He stepped out onto the deck, closing the door behind him. "Okay, I'm back."

"Three hundred thousand per truck is an accepted standard industry-wide, Ryan," Ty argued. "That's fair."

"Accepted standard, my ass," Ryan snorted. "Your trucks are all overdue to be replaced. Your equipment was obsolete when you bought it secondhand five years ago. You have an IRS lien hanging over your head, and if you miss one Medicare check, you won't make payroll. Your employees will work for whoever you sell out to. The only hard asset you have of any real value is the headquarters and the land those three stations sit on. The stations themselves are worthless, and all that real estate together ain't worth nine hundred thousand. Be realistic."

Ty Collins sighed explosively. "All right, what's your offer?"

"Half of yours," Ryan answered. "Four hundred thousand."

"Now who's being unrealistic?" Ty exploded in disgust.

"You can't put a dollar value on potential, Ty," Ryan said reasonably. "You're asking for what you think Collins Ambulance could be worth, not what it is worth. If you could make it worth your valuation, you wouldn't be on the phone with me, trying to sell it."

"MetroCare or Statfleet would offer me just as much as you are," Ty threatened weakly.

"And gut the company as soon as the papers are signed," Ryan finished, smiling into the phone. " I agreed to buy the company to help preserve it. I didn't agree to get raped on the price just because I've known you since you were a kid."

"Six hundred thousand," Ty countered, "and I'll try to get the IRS lien settled before we sign the papers."

In what, thirty days? It's been hanging over your head for five years, and now you're going to iron that mess out in thirty days? No thanks, kid. I trust Jeff's tax lawyers a lot more than yours.

"Four hundred fifty thousand, and I assume all assets and liabilities," Ryan offered, "including the tax lien. Plus, I'll loan you sixty thousand to help cover business expenses until the estate has been probated. That's an unsecured loan, on nothing but your word. We deduct the loan from the purchase price when we sign the papers. That's as far as I'm willing to go, Spud."

"Let me talk with Trent," Ty stalled. "I'll call you back."

Ryan smiled as he hung up the phone, because he knew he had him. Trent Collins would agree to any price that shed him of the responsibility of Collins Ambulance. All he'd see is two hundred thousand dollars and change, there for the taking if he'd only sign the papers.

Fifteen minutes later, Ty called him back. They haggled and argued for a while longer, but neither of them had their heart in it. In the end, they agreed to have Ryan place three hundred ninety thousand dollars into an escrow account, pending the final transaction, and transfer sixty thousand dollars into the Collins Ambulance business account later that day. Ryan would be added as a signatory to the Collins Ambulance business accounts, and any withdrawals prior to the final sale would require both their signatures for authorization. Ryan agreed to meet Ty at Collins Ambulance headquarters the following morning to pick up his uniform. They'd break the news to the employees later that afternoon, after the funeral.

I'm about to blow half a million bucks on a business that hasn't made a decent profit in its entire fifteen years in existence. I hope I know what I'm doing, Ryan mused as he hung up the phone, but despite his misgivings, he felt almost exhilarated. He smiled to himself, shook his head and dialed another number.

Jeff Layton proved to be decidedly less enthusiastic about the deal. After much arguing and not a little profanity, he had agreed to Ryan's requests. He could even do it that afternoon, if Ryan would be so kind as to come in and sign the necessary paperwork. After all, he had spat in a voice dripping with sarcasm, it was Ryan's money. Who was his banker to tell him how to manage it wisely?


"Five more minutes, Daddy," Caitlin Pierce bargained sleepily. "I wanna snuggle for five more minutes."

My fault, Ryan chided himself. No nap, and she watched cartoons all day. I drug her all over creation running errands, and she didn't get into bed until nearly ten.

He smiled gently at his daughter, pulled the covers back up to her chin, and let her sleep. He quickly showered and dressed, made coffee, and ate breakfast. When he could wait no longer, he rousted Caitlin from her slumber and plopped her unceremoniously into a warm bath.

She whined and fretted at first, but Ryan stood firm. He sat on the toilet and supervised as Caitlin bathed herself, helping only to reach the parts she couldn't with her left hand, and by the time he had dried her off and dressed her, she was happy and smiling again. Ryan quickly loaded her into the truck and roared out of the parking lot at half-past eight.

"We goin' to the park, Daddy?" she had asked around a mouthful of strawberry Pop Tart.

"Nope, we're going to see Miranda," he grinned, eyeing her in the rear-view mirror. Caitlin gave him a toothy, crumb-covered smile.

"We need some coffee, Daddy," Caitlin reminded him. "Coffee and donuts, to soothe the savage paramedic beasts!"

Ryan did a spit-take into his travel mug. 'Soothing the savage paramedic beasts' was his oft-used explanation for stopping at Krispy Kreme on the days he dropped Caitlin off before work. Hearing it come from a toddler's lips made him dissolve into a fit of giggles. For her part, Caitlin grinned and kicked her feet jubilantly. She had made her Daddy laugh.

"No donuts today, Stinkerbell," he laughed. "We're running late."

Caitlin pouted briefly, but the prospect of playing at Miranda's was too exciting to stay unhappy for long. Miranda had games. Miranda had puzzles. Miranda let her make stuff. Little did she realize that there was a purpose behind every activity devised by her occupational therapist.

"Hey Munchkin!" Miranda Wheatley greeted Caitlin as soon as Ryan unbuckled her from her car seat. "Why don't you go inside and get one of my puzzles from the box, and I'll be inside in a minute, okay?" She set Caitlin down and sent her through the open front door with a gentle swat on her rump.

"What time are you picking her up?" she asked Ryan.

"Probably not until after five. I've got a lot of stuff to do," Ryan admitted. "Is that going to be a problem?"

"The morning isn't, because she's my first appointment at 10:30. But after Caitlin, I'm booked until the center closes at five."

"I'm really in a bind, Miranda. I've got a funeral at ten o'clock and a big meeting after that. I don't really know when I'll be done."

"What about Dawn? Or dropping her off at daycare?"

"I'm still paying Tiny Tots sixty bucks a week," he mused, "even though I haven't taken her there in a couple of months. Last time I did, she learned how to say 'shit' and eat her own boogers in just four hours. And frankly, I don't know what Dawn's doing these days."

"Y'all still aren't talking?" Miranda asked sympathetically.

"At each other, not to each other. Wednesday, when we left your office, she asked me for a divorce," he said evenly. "I'm not going to fight it." Saying it aloud didn't hurt nearly as much as he thought it would.

"Damn. I had hoped you two would work it out."

"Doesn't look that way," Ryan grunted. "Anyhow, you can probably get used to seeing Billy Fontenot's truck parked across the street from now on."

"He's there every night as it is," Miranda snorted. "Look, I suppose Kristin and I can use Caitlin to co-treat some of my autism patients this afternoon. She'll get some extra work in, and I can use her to draw out Riley and the other kids. It'll work out."

"Thanks, Miranda," Ryan smiled gratefully. "You're a good friend."

"Yeah, yeah, yeah," she snorted, brushing off the compliment. "Just bring her a few changes of clothes and some baby wipes over here when you pick her up. And you'll have to make some childcare arrangements soon, Ryan. My caseload is picking up, and your schedules aren't nearly as predictable as they were six months ago."


Ryan pulled up to Collins Ambulance headquarters at 9:15. The parking lot was empty, save for two ambulances draped it black bunting parked out front. Ryan knew their significance, and the thought was sobering.

Place hasn't changed much since I worked here, he mused as he walked through the front door. It still reeks of Dave Collins; grand dreams and unfinished business, with a healthy dose of junk.

In front of him was a small but tastefully appointed lobby, decorated with overstuffed leather chairs and framed photos on the walls; Dave and Barbara Collins smiling, posing with local dignitaries; Dave and Barbara Collins working a wreck scene; Dave and Barbara Collins, among others, standing behind the Governor as he signed the 1999 EMS legislation into law. Barbara's face was partially obscured by the arm of a fire chief standing in the front rank. A carpeted hallway on the right led to a bank of office suites – far more offices than needed for such a small company. But that had always been Dave Collins, dreaming big.

Ryan stepped across the lobby and examined a picture closely. In it, a younger version of himself tenderly carried a child up an embankment, an overturned school bus in the background. Another photo below it showed him at a wreck scene, sprawled across the hood of a compact car, laryngoscope in hand, head turned to his right barking orders. He looked fearless, purposeful. In charge.

That particular photo had won awards, and appeared on the cover of a major EMS trade journal. In the far right of the photo, a pair of gloved hands held the wrecked face of the victim, still pinned behind the wheel of her car as Ryan prepared to intubate her. The hands had belonged to his partner, Tommy Bollinger, who liked to joke that he had the hands that made Ryan Pierce famous.

"Looky there," he'd say proudly, tapping the photo with a finger for emphasis. "Those are my hands. What that picture don't show is how I climbed in the back seat and ventilated that girl from behind, with nothing more than these two hands and a bag-mask. Five minutes I stood there, hunched over and breathin' for this girl, and whadda the fertographers git? My partner, the gloe-ry hound. I tell y'all, if not fer these here hands, he wouldn't be famous."

Ryan chuckled at the memory. His chuckle faded when a sliding glass window opened on the far side of the lobby and a head appeared above the sill. A familiar head, wearing a dispatcher's hands-free microphone and headset.

"Can I help you, Sir?" Billy Fontenot asked politely. When he saw who it was, his polite smile disappeared. "Oh. Ryan. Good to see you," he said perfunctorily, in a tone that indicated just the opposite.

"Billy," Ryan acknowledged levelly.

"They're all in the classroom," he said, pointing to Ryan's left.

"I know where the classroom is," Ryan assured him. "I built it." He refrained from adding, you asshole. But he thought it.

Enjoy it while it lasts, Billy. You won't be a dispatch supervisor for much longer. You won't even be an employee.

"Well, I'll be Gawddamned," crowed Tommy Bollinger as Ryan walked through the door. "Hawkeye Pierce, in the flesh! Damn boy, but ain't you a sight for sore eyes!" He walked across the room, batted Ryan's offered hand away, and lifted him off the floor in a fierce bear hug.

"How you been, partner?" Ryan smiled affectionately. Tommy Bollinger, born and raised in Possum Valley, Arkansas, was as country as grits and collard greens. At six feet, six inches and two hundred-eighty pounds, he was an imposing physical specimen, but Ryan knew from experience that he was as gentle as they came. That is, until you got him riled. Tommy didn't know his own strength, probably because in his forty years on this Earth, he had never encountered a situation that tested it to any great degree.

"I ever tell y'all how my hands made this ol' boy famous?" he challenged, still holding Ryan's feet six inches off the floor.

"Only about a million times," Ryan grunted uncomfortably. "You mind putting me down, please?" Chuckling affectionately, Tommy set him down and made a show of solicitously straightening his clothes, brushing off imaginary lint, smoothing back his hair…

"Enough, damn it!" Ryan laughed, pushing him away.

He made his way around the room, greeting old friends, some of whom he hadn't
seen in ten years. Lila Rogers and Mary Emory were there, long-time partners both on and off the ambulance. They had left for a job in Texas in Collins Ambulance's third year, for more money and benefits. Both of them greeted Ryan with an affectionate hug.

Mack Barron and his mother Mary Jo greeted him with handshakes and smiles. Mary Jo had long since retired from nursing and EMS, and Mack worked part-time as a reserve Sheriff's Deputy. Mack had followed his mother into EMS at the tender age of eighteen, in what he thought would be a brief stop en route to the police academy and a career in law enforcement. Fifteen years later, he was still an EMT at Collins Ambulance.

Jody Snell had left for Acadian Ambulance barely six months after Ryan became a paramedic. Slightly older than Ryan, and already a paramedic for a year, he had always seen Ryan as his rival. Every shift assignment Ryan got, every promotion he received, Jody bitched about incessantly, utterly convinced that his seniority as a medic meant those rewards should come to him. He and Ryan were not friends, but they shook hands and pretended to be glad to see one another.

Jody's partner's greeting, however, was much more affectionate. Gail Vetters smiled warmly and kissed Ryan's cheek. She had worked as an EMT at Collins Ambulance for fifteen years, and for MetroCare with Dave and Barbara for five years before that. She had been there and done that, and had put up with a hundred partners more arrogant than Jody Snell. Gail was like the steady dog in the team, the one you harnessed alongside the younger, rambunctious pups to calm them down and give them a little seasoning. She trained by example, but she had a sharp pair of fangs if needed.

"Glad to see you, Ryan," she greeted him. "And how's your little girl?"

"Growing like a weed and sassy as hell," Ryan winked. Gail's daughter had been one of Caitlin's nurses in St. Matthew's NICU. One evening when Ryan and Dawn had shown up for one of their thrice-daily visits, Caitlin had been dressed in a beautiful lace-trimmed gown, handmade to fit a micro-preemie, with openings in the back for IV lines and monitoring leads.

"It was a gift from Mama," her nurse had explained. "She says she's praying for y'all." Both parents had been profoundly grateful, and Gail Vetters had forever found a place in Ryan's pantheon of the Truly Good People.

"Ryan, glad you could make it," Trent Collins greeted him with an outstretched hand. Ryan shook it, and was immediately struck with distaste. The handshake was as limp as a cold fish. Trent Collins had already been a shallow, pompous asshole at the tender age of twelve, and adulthood had only accentuated his less-desirable character traits. He had always cultivated an air of piety and false dignity, something that looked decidedly out-of-place on a pre-teen boy. Couple that with the arrogance to believe that his status as the bosses' eldest son gave him the right to order grown men around, and on the day Spud Collins had dealt a fearsome ass-whipping to his older brother, it was no surprise to that he'd had a cheering section of EMTs.

"I'm sorry to hear about your parents, Trent," Ryan said formally. "We'll all miss them."

"Well, they're in a better place," Trent Collins said solemnly. "Praise Jesus." Behind him, Tommy Bollinger rolled his eyes.

Well, so much for the Army changing Trent for the better. He's still the oily little bastard he's always been.

"Gentlemen," Trent raised his voice, ignoring the fact that there were four ladies in the room, "here's the plan. Ty and the other crews are already at the church. Tommy and I will drive the two funeral coaches out front…"

Funeral coaches? Does he mean those two ambulances?

"…to the church, and the rest of you may ride along, or take your own cars if you wish. We'll park the funeral coaches at the west entrance - that's the one that faces Lee Street, boys – and the first two rows are reserved for family and pallbearers. Immediate family sits in the front row, and…

We know which way is west, Trent, and I remember a time when you couldn't read a friggin' map.

"…after Brother Taylor is finished, there will be a brief hymn, and then any of you who wish to do so may come up and give a brief eulogy. I'll ask that you keep your anecdotes solemn and respectful, in keeping with the sorrow of the occasion."

That's right. Let's all cry and wail and gnash our teeth, because this is a funeral after all. Happy memories are not welcome. Jesus, are you sure you weren't switched with another baby at birth? You're sure as hell nothing like your parents.

"Does anyone have any questions?"

I have one. How are you going to sit down with that ginormous stick up your ass?

"I have one," Tommy asked, timidly raising his hand. "Who's going to be the twelfth pallbearer? I mean, there's all of us here, plus Royce, John, and Richard at the church with Ty. That makes eleven. Ann's been dead for eight years. So who's number twelve?"

Dave and Barbara Collins had not been the first from Collins Ambulance to die in an ambulance crash. Eight years earlier, on a rainy March night, Ann Heflin had dropped the right wheels of her ambulance off a steep shoulder. The ambulance had rolled several times, ejecting her through the driver's window. Her picture was enshrined in the lobby in a special place of honor.

"I…I don't know," Trent stammered uncertainly. "Ty was handling all that."

"I'll do it," Billy Fontenot volunteered from the doorway.

"You weren't one of the original employees," Trent said coldly, "and someone here has to man the phones and radio."

"One of the original twelve employees is dead, Trent," Gail pointed out, "and Ty never told any of us who was to take her place."

"I'm sure Ty had someone in mind," Trent assured them. "We need to get to the church in time for the –"

"So what's the reason for leaving Billy here?" Ryan interrupted. "I thought the whole point of having Allemands Parish Fire Department sending a truck to cover was so everyone could attend the funeral."

"Someone still has to answer the phones and radios, and dispatch them if we get a call," Trent replied, as if speaking to a backward child.

"So we forward the phones to the Sheriff's Office, and let them handle the radio traffic, just like we did in the old days. Hell, they answer all the 911 calls anyway," Ryan snapped, rapidly losing patience.

Trent's eyes flashed with anger, but he said nothing. Billy Fontenot simply looked at Ryan appraisingly.

Haven't changed a bit, have you, Trent? You still think you own the place, yet you want nothing to do with running it.

"Billy, forward all the phones to Audubon SO," Ryan said decisively. "Call the dispatcher and the crew with Allemands Parish Fire Department, and tell them to dispatch over the Audubon SO frequency. You can ride in the truck with Tommy."

Billy looked at Trent Collins questioningly. After a moment visibly spent making up his mind, Trent nodded his assent.

"Let me get changed into a uniform, and I'll ride with you," Ryan suggested.

"I'll be out in the truck," Trent replied shortly.

Five minutes later, Ryan was wearing an obviously new Collins Ambulance uniform, and Trent Collins was driving them to the Fort Sperry First Baptist Church, where the funeral was to be held. The drive only took five minutes, but to Ryan it seemed like hours.

"So when do we sign these papers?" Trent asked. "I fly back to Qatar tomorrow afternoon."

"This afternoon is as good a time as any, I suppose."

"Less than five hundred grand seems a little low for all the work we put into this place over the years," Trent said mildly, but Ryan could see his mind working behind the remark. Trent was thinking how he could weasel more out of the deal.

"What's all this 'we' stuff?" Ryan asked bluntly, tired of the charade. "Any employee here has put more work into this place than you ever have. If anything, this should be Ty's company, alone."

Trent let the comment pass unchallenged, his only reaction the flexing of his fingers on the steering wheel.

"The only thing you ever wanted out of this place was the opportunity to bully grown men around because you were the bosses' kid. You've been gone ten years, and you know jack shit about running an ambulance service. If it's really all that important to you," Ryan went on with a cruel smile, "Ty can sell me his share and we'll be equal partners, you and I. You can get out of the army and come home and pretend you're running the family business. I'm just sure we'll work well together."

"I want no part of this fucking place," Trent Collins spat contemptuously. His distaste was palpable. "Picking up dirty, smelly…sick people…shuttling around old people to their fucking dialysis appointments, smelling their rotten bedsores…"

You're such a fine Christian, Trent, Ryan thought sarcastically. Jesus would be SO proud of you.

Apparently Ryan's disdain was evident upon his face, because Trent stole a quick glance at him and shut up.

"I'm just saying I think your offer's a little low, that's all," he went on. "I'm not sure we couldn't get better from MetroCare or StatFleet."

"Give 'em a call," Ryan challenged. "See if they offer more. Your financial situation is no secret, Trent. My guess is that they'll try to lowball you even more, or simply wait six months until you fold on your own, and then move in to pick up the pieces. You're just a couple of missed Medicare checks from bankruptcy as it is. Ty has done a good job keeping you afloat this long, but he's got too many plates spinning in the air. Sooner or later, they're all gonna crash."

Trent Collins considered that a moment, and then asked, "So how does this work?"

"Unless you want to come back from Qatar in a month or so just to handle the paperwork, you sign a document today empowering Ty to sell Collins Ambulance and all its assets to me once the estate has been probated. Once that's done, Ty signs the sale papers and splits the money with you, in accordance with the inheritance laws of Louisiana. I'm sure there will be some estate taxes and fees involved, but that's the deal."

"And how much is my share, after taxes and fees?"

Took you long enough to come to the point, you greedy little bastard. I'll bet you haven't shed one tear over your parents.

"Roughly two hundred grand, just from the sale of Collins Ambulance. What else you'll inherit from their estate is none of my business."

"I suppose that'll have to be enough, then," Trent Collins sighed with a put-upon air.

"It's been a pleasure doing business with you, Trent," Ryan snorted in disgust.


The funeral was largely the standard affair, with the only difference being the preponderance of uniformed people crowding into the church. Ryan counted ambulances from over twenty different EMS systems, and it seemed as if every law enforcement agency in north Louisiana had sent an officer in dress uniform. The line of official vehicles had been impressive.

A Baptist minister mouthed generic platitudes about people he barely knew, spending most of the time expounding upon the virtues of a life led in service to others, a life which, he had assured all present, the deceased had most certainly lived.

'The deceased.' That's really classy there, Brother Taylor. Try looking down at your crib sheet more often, and you might remember their names.

As the preacher droned on ceaselessly, Ryan's mind began to wander, despite his best efforts otherwise. He looked around the church, and was surprised to see quite a few mourners crying, dabbing at their eyes with tissues or handkerchiefs. Enough of them that he began to wonder if perhaps he shouldn't be feeling more emotional, and question why he wasn't. The feeling made him vaguely uneasy.

This is why I don't like funerals, he mused. I don't see the point of mourning someone when they're gone. Better to celebrate the life they lived while they were here.

So you say, came the mocking voice in the back of his mind. Is that why you see your sister every night when you close your eyes, because you've moved on? How many times have you worked that code in your nightmares?

"Shut up," he whispered through clenched teeth, and several people nearby turned to look at him curiously. Ryan blushed with embarrassment as he realized he'd inadvertently spoken aloud.

That's because Renee never had a life worth celebrating, he whispered to himself furiously.

And whose fault was that? Who turned his back on her and left her to fend for herself?

Shut. Up. Renee made her own life. I'm not responsible for anyone's life but my own. I'm not responsible for anyone's life but my own…

Strange mantra for a paramedic, Hawkeye, the voice mocked. It explains a lot, really.


Someone elbowed Ryan in the arm, and he looked to his left to see Tommy Bollinger staring at him. Ryan looked at him in confusion, and Tommy nodded toward the dais, as if to say, pay attention.

Behind the podium stood Don Bailey, now Chief Deputy of the Audubon Parish Sherriff's Office. He was speaking of a night long ago, and how Dave Collins and a new paramedic had given back to his family their most precious gift. Beside him stood a tall young man of perhaps seventeen who bore a striking resemblance to his father, and Ryan instantly recognized Chase Bailey, the very child he had revived on that night nearly fourteen years before. The teenager gave him a shy smile and a tiny wave, and Ryan winked at him through eyes suddenly brimming with tears.

Not responsible for anyone's life but my own…but I can choose to accept the responsibility for another. That's what I do, and that kid up there is the payoff. My sister chose to end her own life, whether by a single event or by the slow march of years. She chose to die, and there was nothing I could do about it. I could only try to help her live. She chose otherwise.

The voice had nothing to say in reply.

Don Bailey's voice was faltering, but it strengthened when his son put a reassuring arm around his father's shoulder. He went on to say something about debts that could never be repaid, and the strange brotherhood of people who gave of themselves without asking for anything in return. It was a brotherhood he knew well as a peace officer, he said, and he had been honored to share that brotherhood for so long with as fine a pair of people as Dave and Barbara Collins. He finished by reading aloud from John 15, verses that Ryan knew well:

These things have I spoken unto you, that my joy might remain in you, and that your joy might be full.

This is my commandment, That ye love one another, as I have loved you.

Greater love hath no man than this, that a man lay down his life for his friends.

When he finished, he slowly closed his Bible, turned to his left and faced the twin caskets. He snapped a solemn, parade ground salute and held it for a long ten seconds. The silence in the church was deafening. Don slowly lowered his arm, regarded the caskets for second more, then smartly performed an about face and marched purposefully out of the church without another word.

The church erupted in thunderous applause.

Ryan looked around in wide-eyed wonder. People were standing on their feet and cheering. Many of them were still crying, yes, but the somber mood of the proceedings had been utterly broken. Ty Collins sat in the front row, half turned around in his seat, smiling broadly through a veil of tears. Only Trent seemed put out by the show of warmth and affection.

Tommy Bollinger elbowed Ryan again and gestured toward the podium. "Go on up there and say something," Tommy mouthed.

No, Ryan shook his head vigorously. No way.

"Get up there," Tommy insisted, aloud this time. He prodded Ryan until he nearly fell off the pew.

Reluctantly, Ryan trudged up to the podium. He cleared his throat hesitantly into the microphone, and waited for the applause to die down. When he looked up into a sea of expectant faces, he almost froze.

Piece of cake, Ryan. You've spoken to bigger crowds than this. You can do this.

"Just my luck to follow Don Bailey after a eulogy like that," Ryan began hesitantly. "I could stand up here and read the phone book and none of you would remember a word I said. I suppose that's a good thing for me…"

A ripple of laughter passed through the church, and Ryan's voice found strength.

"My name is Ryan Pierce, and I was one of the original crews at Collins Ambulance. Some of you may remember me, and some of you I've not yet had the pleasure of meeting. I've been gone from here a long time, but in a way I suppose I never left. Dave and Barbara Collins hired me as a brand-new EMT straight out of school, not a week after they opened for business. In the years I worked here, they taught me a lot of lessons that I took with me when I left."

"The first, and I suppose, the most practical lesson I learned on my very first ambulance call; whenever you pick up a person that has urinated on himself, always try to be at the head."

The church roared with laughter, and Ryan continued with a devilish grin, "The corollary to that is, always carry a spare uniform shirt to work with you."

Again, the church erupted with laughter.

"Aside from the practical tips, they taught me how to laugh, how to love, how to recognize that the pain and suffering we see as EMTs can blind us to the joy we can experience if we let it. Dave had a business philosophy, a saying he used a lot that I'm sure everyone here in a Collins uniform has heard a thousand times…"

EMTs in the first two rows smiled and nodded knowingly.

"…but the point of that philosophy was that the patient always came first. He used to remind us to care for our patients and our partners above all else. He figured that if we did that, then the business would take care of itself."

"When he told me that for the first time, I knew two things beyond the shadow of a doubt; I knew that I wanted to work for a man like Dave Collins, and I knew that as long as I did, I was going to be eating macaroni and Ramen noodles a lot."

The crowd roared in appreciation, and Ryan smiled ruefully.

"Along the way, we had some hard times. I worked the fire at the mill where some of you lost loved ones. I've held people as they died. We lost one of our EMTs on the Mason Ferry Road eight years ago, killed in an ambulance crash. There's hardly a stretch of road anywhere in Audubon Parish that doesn't have a memory attached to it, and some of them are memories I'd rather forget. And now we've lost Dave and Barbara."

Ryan swallowed hard and blinked his eyes, and the church was silent.

"But I've also seen some good things. I met my wife here," he smiled at Dawn, sitting in the fourth row. "I was there with Dave Collins the night Don Bailey called the Sheriff's Office for help because his son wasn't breathing. We were lucky that night, and now I see him today, a grown man. I see some people with children here, and unless I'm mistaken, I delivered a couple of 'em..."

He paused for effect, then delivered the punch line, "…and not a single one of those parents saw fit to name their child after me." The line drew the laugh he had hoped for, and Ryan smiled gratefully at the room.

"All of us are here today to pay tribute in some way to Dave and Barbara Collins, and I think the way I'll do it is to be grateful for the opportunity they gave me sixteen years ago. They gave me a front row seat to the pageantry of human life, and reminded me that if you blink, you might miss a part of the show. Their role in the pageant has ended, but I think they'd be disappointed if we didn't all open our eyes to enjoy the rest of it. Thank you."

The crowd responded with a wave of warm applause, and Ryan quietly slipped back to his seat. A soloist sang a hymn, and the mourners filed past the caskets, offering hugs and tender words of support to Trent and Ty Collins, and the crews of Collins Ambulance.

As Ryan shook hands with a throng of well-wishers, he found himself thinking of that night in the hospital ambulance bay, when Dave Collins told him he had a gift.

I'll honor my gift, Dave, he promised silently. I hope that's enough.


Ted said...

Just when I was starting to think that you were re-writing _Stand On It_ with ambulances, you put this up. Keep 'em coming, AD.

Evil Lunch Lady said...

Very nice indeed! I will read this to the end!

Thank you for another great entry!

Ian said...

More, more, more.......

willandleigh said...

Another great chapter! When are you going to spring the trap on us? You know "I hope yall enjoyed this much, the rest of the story will cost you $$$!"
I would pay!
Thanks man!

philthemedic said...

I want to make this into a movie. It seems your gift for words is just as strong as your gift for healing. I look forward to seeing your seminar in November at the EMS conference in Fort Worth.

Kaeto said...

Phenomenal writing! It take a lot to make me tear up, but this did it.

Chris in SE TX said...

AD, this is getting better and better!!!!! I can't believe that we got 3 chapters in such a short time! Keep it up! Also, it seems that accessing The Star of Life on my phone may AUTOMATICALLY flag you for "objectionable content".....

Sorry about that! I'm not sure if it only happened once, or if it happens every time I access it...

julie said...

Excellent, AD. Keep it coming!

Peri1020 said...

What Ian said...more, more, more more more more more more more more!

Krissa said...

This chapter is my favorite yet!
I wish I could write half as well as you can. I hope you write the whole book and get it published....I'd sure buy it.

Keep up the great work!

Orthette said...

You are a wonderful, gifted writer.

Jill Pole said...

Great writing, AD. Just a quick comment/question...does the young Don Bailey not have first aid training? Or is he supposed to be doing two-handed CPR on an infant?

Ambulance Driver said...

"...does the young Don Bailey not have first aid training? Or is he supposed to be doing two-handed CPR on an infant?"

Only the same first aid training most cadets got at his police adacemy - superficial and rarely parcticed. ;)

Anonymous said...


Anonymous said...

Wow AD, you've got us all hooked! Everyone at my department is reading this and they love every page. You've got a talent for words and keep us on the edge of our "seats" with every post! Keep it coming, and I hope to see this in print'd be well worth paying for.

Castr8r said...

You've got a gift, too! You need to get this done and published, so's I can have a hardback copy and, and, well, just "GIT'ER DONE!"

Damn, I wish I could write like tis!

Scott said...

Yes, the patients come first. Very good.

And please, Obi Wan, teach me the fine art of getting women! I need a cell phone girl in my life!

"gunner" said...

when you've got it finished this needs to be published as a book, in a real dead tree edition. i'm just sorry i haven't got the contacts that could make it happen.

Anonymous said...

It's been almost an entire year since you posted here AD. Great story we could use some closure though.


Medic7 said...

Just found this... great stuff.

Anonymous said...

Please more, please!!!