Z is for Zygomatic Arch
Wearily Marco Lopez plodded from the back doors of L.A. County Fire Station 51. Slowly and with great effort he hefted his duffle into the bed of the vehicle before he climbed into the welcoming comfort of his truck. He'd been on duty for 48 hours straight. LACoFD usually frowned on men working double shifts, but one of the linemen from B shift had called in sick at the last minute, and Marco agreed to fill in.
Marco placed his key into the ignition, and with a wide yawn he turned the engine over. The truck rumbled to life, but exhausted Marco only continued to sit silently. Lowering his head he rested it upon his hands which were now crossed over the top of the steering wheel. His head ached, his cheek throbbed in time to his heartbeat and it felt like the sand man had taken up permanent residence in the corners of his eyes.
After a time, soothed by the smooth purring of the truck's engine, Marco felt himself slip into a gentle sleep. In this place of semi consciousness world details became soft and fuzzy. Warmth from the morning sunshine filled the cab of the truck and encircled the weary man. His muscles began to release the fatigue of the past two days allowing him to commence melting into the seat cushion. Aches and pains seemed to dissolve, and thoughts began to swirl while Morpheus beckoned.
BLAM…BLAM….BLAM!
Marco gasped jerking his head up, cruelly and suddenly snatched back to wakefulness by someone banging on his truck window.
"Lopez! You all right in there?"
Marco turned his head to dazedly glare at Jim Nichals, one of the C shift linemen.
Quickly running a hand over sleepy eyes, Marco attempted to focus on the other man. "Uh…yeah, I'm fine. Just a little tired I guess."
Jim reached out and opened Marco's truck door. Peering inside, he inspected the exhausted guy. "You look beat man. I heard you guys had a tough run late last night. You got hit in the face with a nozzle? Right? You're lookin' pretty rough. Why don't you climb out of there, and let me call someone to get you home."
Marco sighed. He knew Jim was probably right. But his best buddy Chet was out of town until late in the evening, and he knew Mama would be calling Bingo at the senior citizen center their church sponsored every Tuesday morning.
"Yeah…. Driver rubbernecking the scene ran over the hose. Got a surge of pressure afterward and the nozzle got loose. I guess I'm a little tired and sore."
Jim clenched his jaw in sympathy. "Ouch! That had to hurt. Looks like you're gonna have a shiner. Come on man; let me call someone to drive you home."
Marco met Jim's reply with a blank stare.
Jim could see the fatigue and disorientation in the other man's countenance, and gently urged him to rise from the truck seat by latching onto a hand and pulling.
"I don't know who I could call for a ride. Everyone who would normally come is either out of town or busy. Maybe John Gage? We're supposed to watch a ball game this afternoon. I think he might be home right now." Marco finally managed to mumble.
Not really waiting for Marco to finish speaking, Jim pulled him from the truck. "Come on, you can rest in the dorm until I get someone here."
As if in a fog, Marco allowed himself to be led into the building. Once inside the station dorm he plopped down on a random bunk, and was asleep before his head hit the pillow.
An indeterminate time period later: "Marco…. Marco…. Can ya wake up for me?"
The words pierced his dream. Someone was gently shaking him. Marco sighed deeply and reluctantly opened his eyes. For a few seconds colors swam and merged in his blurred vision while a numbed brain attempted to make sense of the weird kaleidoscope.
"He seems to be pretty out of it. Did he go in and have himself checked out after the incident?"
"Dun' know. I just heard about it from one of the other guys. Came outside and he was passed out over the steering wheel with his truck running."
The voices sounded vaguely familiar, but his head ached and it wasn't worth figuring out who was speaking. Eyes drifted closed, and Marco only half heard the other men's conversation. For a while he was left to sink back into blissful darkness until a piercing white light blasted him back into groggy wakefulness.
Instinctively Marco raised his hands to swat the offending brightness away.
"Whoa there. Relax Marco. I've got ya man"
Hands lightly restrained him, and the white light was back flicking across first one, and then the other pupil.
"Déjeme sola. Aye…. Estoy durmiendo"
Gentle fingers probed his cheek and around his eye.
Marco pulled away. "Parar, me haces daño."
"Come on Marco, wake up for me man."
Whoever it was didn't seem likely to go away any time soon. Slowly sleepy lids grudgingly opened. Marco squinted up into a pair of deep brown eyes. "What?"
Johnny smiled down at his friend. "Hey, how ya doin'?"
Opening and closing his eyes a couple of times, Marco slowly oriented himself. He reached up and roughly dragged a hand across his eyes and face, wincing as he inadvertently disturbed the bruised flesh of his cheek and orbit.
"That looks like it hurts." Johnny coolly observed.
Marco grunted an unintelligible reply, and unsteadily attempted to sit up. He made it up onto an elbow.
"…Uh…..yeah…. Hey, would you mind giving me a lift home John? I'm really too beat to drive."
"How 'bout I give you a lift to Rampart amigo. Looks like you might need to let the Docs have a look at you." Johnny replied while assisting Marco to sit up completely.
"No….I'm all right. Just tired and a little sore. Had a run in with a rogue nozzle, that's all."
"You go in for a checkup after that hose hit you in the head?"
There was a long heavy silence where Johnny figured Marco might be dozing.
Finally, "Uh…..no. It's not that bad Johnny. I'm fine. Got a little head ache is all."
Johnny latched onto one of Marco's hands and hauled the lineman to his feet. "Come on, I'll take you home by way of Rampart."
"No really, I'm all right John. Just need some sleep." Marco mumbled while vainly attempting to disengage his hand from Johnny's.
"You can hop in the Rover and go to Rampart with me, or I'm calling in a Code I and you can go with a squad and ambulance. You pick."
Marco turned unsteadily to stare incredulously at Johnny. But the paramedic stood before him unyielding, with a firmly set jaw and a hand resting on his slender hip.
Marco shook his head, and was immediately sorry as a wave of dizziness overtook him.
Reaching out, Johnny steadied his off balance friend. "Dizzy?"
Sighing with resignation Marco nodded. "Yeah, a little."
"Come on before I change my mind Marco. I gotta tell ya, that ambulance is sounding like a better plan with each passing second."
"Oh, I can't believe my ears amigo. YOU of all people dragging me into Rampart." Marco grumbled while Johnny propelled the lineman out of the station toward the white Land Rover.
Opening the passenger's side door, Johnny settled Marco into the seat. "I think my feelings should be hurt. I mean…after all, I am a paramedic."
"Yeah, for everyone else. But when it comes to you…. Would you have gone to the hospital for something like this? Eh?" Marco grumbled while grudgingly fastening his seatbelt.
Johnny slammed the truck door wearing an impish lopsided grin. "Well…uh…. "
"Yeah…that's what I figured." Marco groused.
Now on the driver's side of the vehicle, Johnny opened his door and crawled behind the wheel. Turning slightly, he addressed his passenger. "Truth is, I probably would be goin' to the hospital for somethin' like that. Might not 'ave been my idea, but I'd be goin'. I after all have my very own six foot tall blond haired blue eyed Jiminy Cricket."
Marco nodded gingerly, so as not to disturb his throbbing head too much. "Uh huh…." He mumbled under his breath. "So now I have a six foot brown eyed brunette version of that little bug for me. Su nombre es El Grillo Juanito. Fantástico!"
Totally unflustered, Johnny grinned and started the engine. "Hmmmm…Johnny Cricket eh? I think I like it."
"Shut up and drive." Marco moaned while leaning his head back on the seat.
"Ya need to stay awake for me Marco." Johnny ordered in what Marco felt was an entirely too loud tone of voice.
"All right, all right. I can hear you. Stop yelling."
"Uh huh….sit up Marc. Talk to me." Johnny was beginning to doubt his decision to drive Marco to Rampart. If they'd called an ambulance, he'd at least be able to make sure Marco didn't drift off to sleep. From what Johnny had observed, sluggish pupil responses, dizziness and disorientation; it was highly likely at the very least Marco had a concussion.
Slowly Marco opened his eyes and raised his head to peer at Johnny. "My head hurts, and you're talking too loud and too much. I don't know how Roy puts up with it. You must drive him bananas every day."
Johnny chuckled while keeping his attention on making the trip to Rampart expeditious. "Oh, don't worry about Roy. Who do ya think I learned to be such a great pest from? I've been educated by a pro. If I were in your seat and Roy was with me….well first of all there would be sirens. Secondly I'd be getting as little peace as I'm giving you right now; less even because Roy would be sitting above me while I was flat on my back in an ambulance. He'd be concentrating all his mother hen energy on pestering me into staying awake. One good look at disorientation, dizziness and sluggish pupils, and 'ole Jiminy Cricket would have called in that Code I. So stop grumbling. Brunette crickets are far less annoying than blonds."
Marco mumbled under his breath. "Dios me ayude por favor!"
"He will Marco, he will. Just hold on. We'll be at Rampart in less than a minute." Johnny soothed while continuing the speedy transport.
When they arrived at the hospital Emergency entrance, Johnny hastily parked his vehicle and hustled Marco inside. Betty, the charge nurse for the day escorted the two men into an exam room where Marco found himself encouraged to lay on the exam table. After a few more minutes of Johnny's infernal harassment, thankfully Dr. Early appeared at the doorway.
"Well, hello there. What brings you two in to see me today?"
"Hey Doc." Johnny shook the gray haired physician"s hand, and then proceeded to present information in a rapid fire fashion. "From what I've gathered, looks like Marco here got a good whack to the face from an escaped hose nozzle earlier this morning. He seems to be experiencing photophobia, lethargy, dizziness, some disorientation, likely LOC though I can't verify, and his pupils are sluggish to react to light. He's got tenderness and bruising along his left zygomatic arch and orbit.
Joe Early listened to Johnny's report, and turned to begin examining his patient.
"How are you feeling Marco?" Early quarried while gently palpating the lineman's cheekbone and eye socket.
"I've got a wicked headache, I'd love a nap and if you could arrange to have someone put some tape over Johnny's mouth that'd be great." Marco grumpily replied.
"He's been talking your ear off, has he?" Early said with a little chuckle.
"Yeah Doc. I couldn't get him to shut up all the way over here."
"Well Marco, Johnny was just making sure you didn't go to sleep. Until we determine the extent of your injuries, we want to try and keep you conscious."
Dr. Early carefully examined Marco for several minutes. When he seemed satisfied he again addressed his patient. "
We need to get some pictures of your skull and face. It looks like you mainly have soft tissue injuries, and likely a concussion. But I want to make sure you haven't fractured your zygomatic arch, or your orbit. If the X-rays don't show any fractures, you're looking at one night as our guest here at Rampart. You likely have a concussion, and I want to keep an eye on you for the rest of today and tonight."
Marco groaned. Spending the night in the hospital was not his idea of how time off should go. He turned to glare at Johnny who by now had perched himself on a rolling stool in the corner of the exam room.
"Thanks a lot amigo!" Marco shot at Johnny.
Johnny's expression took on a look of hurt. "I'm just lookin' out for ya."
Dr. Early patted Marco on the shoulder. "Hey, be glad he insisted you come in Marco. Concussions have all kinds of nasty complications. You really didn't need to spend the night alone in your condition. It's really for the best."
Marco's expression and mood softened a bit. Of course he realized Johnny was only trying to make sure he was safe and healthy. It was just that his head ached, and he felt so tired.
Marco again turned to look at Johnny who had now risen and walked over to stand beside the exam table.
"I'm sorry man. I know you only did what I should have thought to do when this first happened. I am grateful you caught it, and brought me in. It's just…"
Johnny grinned and gently patted his friend on the shoulder. "I know Marco. Trust me, I know. If Roy had a buck for every time I wanted to strangle him because he dragged me in here, he could retire from the fire service. I'm sorry you'll end up spending the night at Rampart, but I'm glad you're gonna be taken care of. Besides, I can still run out and get pizza and soda. We've got a game to watch when Dr. Early is done with you."
Authors Note: I don't really speak Spanish, so please accept my apologies for any improper conjugation.
*"Déjeme sola. Aye…. Estoy durmiendo - Leave me alone. … I'm sleeping.
"Parar, me haces daño." Stop you're hurting me.
** The research I have done indicates results from a vehicle running over a charged fire hose are dramatic and dangerous for the fireman who might be working with that hose.
***Zygoma: The bone that forms the prominence of the cheek. Known also as the zygomatic bone, the zygomatic arch, malar bone, yoke bone. Zygoma comes from the Greek zygon, meaning a yoke (as for oxen). Definition taken from web site Medicine Online.