Wednesday, December 1:
Station 51
Johnny walked into the locker room with a paper sack. Chet and Marco were already there, changing into their uniforms.
"Well, Gage, welcome back." Chet nonchalantly looked up from tying his shoelace.
"Good to see you here, Johnny," added Marco, with a bit more enthusiasm.
"Thanks. It's good to be back." Johnny's response as he restored his belongings to his locker was not quite as exuberant as might be expected for someone who had just been vindicated.
"What happened to your face?" Chet noticed the fresh scar over Johnny's left eye and the fading bruise on the right side of his forehead.
"Ran into something," came the terse reply.
Chet tapped his chin thoughtfully as he covertly watched Johnny. Marco observed them both and kept his mouth shut. The three men quickly finished dressing and assembled for roll call with the others.
Cap read off the assignments. "DeSoto, kitchen. Gage, dorm. Kelly and Lopez, engine bay. Stoker, latrine. After the housekeeping is finished, we have some apartment inspections scheduled for today. Okay, that's it." Looking at Johnny, he smiled, "John, good to have you back."
The men broke rank, grinning.
"Yeah, Roy couldn't survive another shift with Brice. I think that's why he let the beam fall on him." Marco said.
"We couldn't survive another shift with Brice!" came the surprising comment from the usually quiet Mike Stoker.
Chet started laughing. "I can't believe your exam was switched with Brice's. Of all people! Now that's what I call poetic justice."
"Well, I don't think it's justice at all. He's not a bad paramedic. It's stupid that all those years of experience don't count for squat. Nobody deserves that. Nobody. Not even Brice."
Into the awkward silence following this remark, Cap said, "We've got a lot to do today. Let's go get some coffee and then get started. "
The engine crew headed towards the kitchen. Roy and Johnny stayed behind for a few moments to do the daily equipment check with Rampart. Roy kept his eye on Johnny, but didn't say anything.
As they came into the kitchen, Chet was placing the last of six steaming mugs on the table. Johnny glanced suspiciously at Chet and sniffed the contents of the cup he picked up. It seemed to smell okay. Relaxing when he saw all the others enjoying their coffee, he took a big gulp and immediately spit the foul brew back into the cup.
"Chet!" Johnny sputtered. "What the hell is in my coffee!"
"That's payback for sticking us with Brice." Chet quietly toasted Johnny with his cup.
The rest of the crew burst out laughing as Johnny rushed to the sink to rinse out his mouth.
Instead of shrugging off the practical joke like he usually did, Johnny was angry. "Not funny, Chet!" he exclaimed and stalked out of the room.
The laughter died as the five men exchanged puzzled looks.
Cap's expression was mildly concerned as he watched Johnny go. "Uh, Kelly? Better lay off him for a while."
"Aw Cap, I was just having a little fun. Trying to get things back to normal."
"Two words, Kelly. Lay off." Cap warned as he left the room.
Cap had checked several places before locating Johnny in the dorm, pulling sheets off the beds. He watched for a few minutes before asking, "So. What was that all about?"
Dropping the sheets on the floor, he turned to meet his captain's eyes and shrugged. "I guess I just didn't think it was funny."
"Uh-huh." He watched Johnny begin to make the beds. To Cap, nothing in the movements appeared to indicate that the paramedic was suffering unduly from stress, although his behavior was uncharacteristically serious. "You want to talk about anything, John?"
Johnny straightened from his task, absently twisting a pillowcase in his hands as he pondered the question. "Uh, no. Not really."
"Do you consider yourself fit for duty?" Cap was blunt. Given the circumstances, Johnny's unusual behavior had him slightly worried. He needed to know the answer to this question.
"Yes, sir."
"Okay, then." Cap said with a nod, figuring that Johnny just needed a little time to readjust. He left to go to his office to tackle the amazing, self-perpetuating stack of paperwork on his desk.
The day had turned out to be an unusually slow one. They had gotten through the apartment inspections without interruption. The afternoon runs included a dumpster fire for the engine and a few easy runs for the squad, which did not necessitate trips to Rampart.
Johnny remained quieter than usual, and even Roy had tired of trying to make small talk which was rewarded with three- and four-word responses. To Johnny, everything seemed different. Unfamiliar. The comfortable had become uncomfortable. He felt like a stranger. Like maybe he didn't belong there.
Out on runs, he found himself hanging back slightly, waiting for Roy to take the lead. Like a rookie. Almost afraid to be a paramedic.
Everyone was gathered in the break room, watching TV or reading the paper when the tones sounded.
"Station 51. Traffic accident with injuries. Intersection of Albreda and Martin. Albreda and Martin. Time out 16:26."
The squad and the engine arrived on the scene to find two vehicles trying to occupy the same physical space. The second car was up on the trunk of the car in front of it. All the victims were out of their vehicles already. An extremely overweight, middle-aged man sat propped up against a light post, holding his abdomen. He was complaining loudly to a police officer. A distraught young man held a bloody handkerchief to the forehead of a young woman lying on the ground.
"These young punks were speeding and tailgating! You ought to arrest them! For criminal negligence! For criminal stupidity! You shouldn't be giving out licenses to such irresponsible youth! Look at my car! Who's going to pay for it? I bet they don't even have insurance. Look at their car! It's a piece of junk. I bet they can't even pass the emissions test!" He went on and on.
As they pulled the equipment out of the squad, Roy said with a smile, "You get the complainer. I get the pretty one."
"It's not my turn!" Johnny protested.
"Consider it a welcome back present," Roy said with a grin.
"Thanks loads."
Johnny crouched down next to the obese man, making a quick visual assessment. The man had to weigh at least 400 pounds. "Hi. My name is John Gage. Can you tell me where you hurt?" He reached out to begin taking the man's pulse. He had to press fairly hard to feel a vein on the man's beefy wrist.
"Ow! Why are you pressing so hard? My ribs and my stomach hurt. Look at what they did to my car! It's a crime…" The man continued his ranting non-stop despite a slight wheeze.
"I'm just trying to take your pulse, sir. … Uh huh. … Uh huh … Can I get you to lie down here so I can look at your abdomen?" Johnny tried to respond to the man's questions and comments while doing his job.
"No! I have trouble breathing when I lie flat. I'd rather sit."
"Okay, sir. When did you start having difficulty breathing? I'm just going to listen to your chest, now." He listened to the chest tones. They sounded a little wheezy, but good. He couldn't get the man's BP because the cuff wasn't big enough, so he tried to get a BP by palpation.
"I'm always short of breath. Will you look at that!" His attention was directed to his car. "Hey! Stop that! What do you think you're doing?" He yelled at the firefighters who were attempting to get the two cars apart so they could be removed from the intersection. "If you put any more scratches on my car, I'll be billing you for repairs!"
'Don't sound short of breath to me.' Johnny thought sourly as the man continued haranguing. When the man gesticulated towards the rescue personnel trying to extract the vehicles, Johnny noticed that he was wearing a medical ID bracelet.
"Sir, what is the medical ID bracelet you're wearing for?"
"I'm diabetic." The man's eyes narrowed as he really looked Johnny up and down for the first time. "You look pretty young. Are you sure you know what you're doing?"
Cap had come over to try to convince the man that no more harm was being done to his car. He overheard the remark and said, "Sir, I can assure you, he's highly qualified. We need to move your car out of the intersection, sir. It's blocking traffic. And if someone else hits it, there will be even more damage."
"Just see that you people don't cause any more damage. Look at my car!" He was off on his tirade again.
"Okay, sir, I'm going to unbutton your shirt so I can get a better look at your injuries." Keeping belligerent patients informed of what was happening to them often helped calm them down. It wasn't working with this one. The pattern of bruising on the man's abdomen was consistent with hitting the steering wheel, although Johnny seriously wondered how the man had even fit behind the steering wheel in the first place. He gently palpated the area.
"Ow! Stop that! Why are you doing that?" The man's voice was strident.
"I'm checking for abdominal tenderness." The area did not feel rigid.
"Well, it hurts, you fool! I was in a car accident! I don't think you know what you're doing! Nobody here knows what they're doing. Hey!" He was momentarily distracted by the scraping sound of the two vehicles being pulled apart.
"What are the vitals, Johnny?" Roy brought the bio-phone over.
"I have a morbidly obese male, approximately 40 years of age. Pulse is 100. BP is 160 palp. Respirations are 24. He is complaining of shortness of breath. He has bruising over his abdomen and is complaining of tenderness in the area. There is no apparent rigidity at this time. He is diabetic."
Roy relayed the information to Rampart and received instructions. "That's two litres of oxygen and one litre of normal saline TKO. 10-4, Rampart." Roy repeated the orders to confirm them and hung up the bio-phone. "You got that?" he asked over his shoulder.
"Yeah. I got it." Johnny started to prepare the IV setup.
"Ambulance is here. Johnny, you've got D5W in your hand," Roy pointed out before turning back towards the young woman with the head injury to finish preparing her for transport.
Johnny looked at the bag like he'd never seen one before. Diabetics didn't get D5W because of the sugar content. "Oh. Yeah. Right." He reached for the correct solution and began preparing it.
Johnny tied a piece of rubber hose around the man's arm and swabbed the area just below the elbow with alcohol. "Okay. Now, I'm going to start the IV the doctor ordered. You'll feel a little pinch. It's going to hurt just a bit." He couldn't make the first stick hit the vein. 'Dammit. This guy's veins are hard to find.'' 'I'm sorry, sir," he apologized.
"Ow! Are you trying to kill me? You're not doing it right!" Now that the cars had been moved, the man turned his full of his savage attention on Johnny.
Undoing the tourniquet, he massaged the arm to try to get the blood pooled farther down below the elbow, then he reapplied the tourniquet. "Okay, I'm going to try this again." He thought he had adequately palpated the vein, but the second stick also missed.
"Ow! Stop poking me! I don't think you know what the hell you're doing! I want a real doctor! Get your hands off me!" The middle-aged man jerked his arm out of Johnny's grasp, then shoved him away.
"Okay, sir, calm down. I won't touch you again. Calm down! You need to sit back. I'll get my partner," The paramedic attempted to reassure the irate man. "Roy!" he called over his shoulder.
Roy, who had been assisting the EMT's in transferring the woman into the ambulance, had missed the exchange. He hurried over when he heard his name called. "What have you got?" He looked questioningly at Johnny.
"Uh, I'm having a hard time getting the IV started."
Roy's glance flicked uncertainly between Johnny, the victim and back again, knowing how nearly impossible it was to start an IV on massively obese victims. "Do you want me to give it a try?"
"Be my guest."
Squatting down next to the patient, Roy tried to explain the procedure to the man as he prepared the other arm for the IV.
"I hope you can do better than that other fellow. He doesn't know what he's doing!" huffed the man.
Johnny watched impassively as Roy was able to successfully start the IV.
"Okay, sir, just relax. We'll get you to Rampart real soon," he said to the man, taping the IV in place. The two paramedics finished preparing the man for transport. He continued his vituperative complaining the whole time, casting aspersions upon the fire department and the police department. He was especially eloquent about incompetent paramedics.
Roy pursed his lips. He really didn't want to be cooped up in the ambulance with this person, but he figured Johnny had already had more than his fair share of the man's yammering. It was a no-win situation. "I'll ride in on this one. You bring the squad, okay?"
Johnny nodded, his expression unreadable. He handed Roy the drug box and then closed the doors to the ambulance. He rapped twice on the doors, a bit harder than was probably necessary.
He surveyed the debris left over from the emergency treatment. As he began packing up, Chet and Marco came over to help clean up the area. They had witnessed the last part of the scene, but wisely refrained from saying anything.