A/N: General warning for a dire situation with an ambiguous outcome.
Chapter 13: Undetectable
"Reggie?"
"Yeah, Bill? What's up?" Reggie replied, as his neighbor approached. He turned off the engine of the machinery he was using so he could hear better.
"Well," Bill said, frowning and scratching his head through his cap. "I hate to say it, but I gotta go into the manure pit."
"The manure pit? Why would you need to do that?" Reggie asked. "It's kinda dangerous."
"I know, I know. It's a one-in-a-million thing. See, you know that pocket knife from my grandfather?" Bill said.
"You didn't," Reggie said, shaking his head.
"I did," Bill admitted. "I was cleaning under my fingernails, and … well. I dropped it. And of course it went right through the slats in the floor, into the pit."
"Damn," Reggie said.
"Yup." Bill sighed, and scratched his head again. "But at least we had the tank pumped out the day before yesterday. So it shouldn't be too bad. But I was wondering if you'd spot me anyhow."
"Sure thing," Reggie said. "Wanna do it now? I need a break from this project, anyhow."
"Thanks."
The two men trudged over to Bill's pickup truck, and drove the short distance to the neighboring farm.
A man with a distinct family resemblance to Bill greeted the two men at the barn.
"Hey, Reggie! What's going on?"
Bill made frantic 'don't tell him' gestures behind his brother's back.
Reggie fumbled for words, not understanding why Bill wouldn't want his brother to know what they were doing. "Uh, hey, Sam. Um, Bill wanted to show me one of the pigs. So we're just gonna pop over to the pig barn."
"Okay," Sam said. "Need a hand with anything?"
"No!" Bill said, a little more sharply than the circumstances seemed to dictate. "We're good, thanks. I'm just showing off Sassy's piglets, is all."
"Mm, that's a fine brood indeed," Sam said, returning to his task. "Catch you guys later."
"See ya, Sam," Reggie said.
Reggie and Bill didn't speak until they reached the barn.
"What was that all about?" Reggie asked. "Why don't you want Sam around? In fact, why didn't you just ask him to spot you?"
"Well, I just didn't want him to know I'd dropped our grandfather's pocket knife into the manure pit, is all," Bill said. "He was sore enough in the first place when I got it in the will. And, actually, I was gonna give it to him for his birthday this year. So I wanna keep that a surprise."
"Gotcha," Reggie said.
"I better show you those piglets, just so you can honestly say you've seen 'em," Bill said. "And then, let's get this over with."
Reggie dutifully admired Sassy's litter of eleven fine piglets, and then the two men went to the end of the barn, headed for the access hatch that would admit Bill to the manure pit.
Bill pulled the hatch open, and inspected the gauge at the bottom of the ladder.
"I dunno, Bill," Reggie said, as Bill started down the ladder. "You're not really supposed to go into the manure pit. All those gases and everything. I've heard of people getting overcome by fumes. I guess, and drowning in the muck. Are you sure this is okay?"
"We just had it pumped out, so it's only a couple inches deep," he said. "And it doesn't even smell that bad. No fumes are gonna knock me out. Honest. Plus, I know exactly where I dropped the knife, so I oughta be done in a jiff. I'll try not to breathe too much."
"Okey doke. I'll just hang out here," Reggie said, shaking his head. "I don't see as how you could get stuck in five inches of muck, but I'm here just the same."
Bill took a few deep breaths, and descended the ladder. Reggie watched as he made his way down the long pit, and winced as a poorly-timed dropping from above landed right on Bill's shoulder.
"Dang it!" Bill said, wiping the manure off and flinging it into the rest of the muck.
"You sure you know where to find that knife?" Reggie said, after Bill was halfway down the length of the pit.
"Uh … I put a … thingy, you know, down the slat that it fell through. So I could see it," Bill said, just loudly enough that Reggie could hear.
"A what?" Reggie called. "Maybe I can help from up top."
"It's a … shoot. I don't see it," Bill said. He lurched sideways and caught himself on the wall.
"Bill? Bill! You okay down there?"
"Yeah, yeah—just a little lightheaded," Bill replied, shaking his head like a dog with wet ears. "Should be fine down here, since we just pumped the pit the other day," Bill said. He coughed, and continued to look around. "If I could just see it … it oughta be plain as day. Then the knife'll be right there. Right …"
Reggie called out again. "Bill, what's the thing you're trying to see? I'm not following you."
"Aha!" Bill called, striding three more steps down the length of the pit, pointing to what was the ceiling for him, and the floor for Reggie. "There's my ribbon I put down a slit, right where the knife fell through."
Bill crouched down near the floor, and started rooting around in the manure, right below the red plastic tape that Reggie could now see fluttering above Bill.
At first, Bill's movements were quick, as he swept his hands back and forth through the muck on the cement floor of the pit. But after about a minute, he slowed, and dropped to all fours.
Reggie laid himself flat on the floor of the barn and stuck his head into the opening in the floor.
"Bill? What are you doing?" Reggie shouted in alarm.
"I … almost got it … " Bill replied.
"Bill, I think the fumes are gettin' to you! You're not acting right. You gotta stand up, man—there has to be fresher air up high."
"Just … just … one minute," Bill said. "Yeah … here it is."
He clutched something in his left hand, and then stood up, just long enough to stagger backwards into the wall. He slid down the wall, slowly, until he was sitting on the floor.
"Bill, you need to get up! Come one, man!"
"Hey … Reggie … why'm I so tired all of a sudden?"
Bill was leaning against the wall of the pit, breathing like he'd run a marathon. He looked at the item in his hand, and slowly slipped it into his pocket, as if the movement were a ritual he'd performed many times.
"Bill, you need to come back to the ladder, right now!" Reggie yelled, his heart pounding as he grasped that his friend was in serious trouble.
"Nah … it's okay," Bill said. "I can … I can …" His voice tapered off as his back slid down the wall.
"Bill!" Reggie shouted once more, knowing his efforts were futile, but trying nonetheless. "Bill! Get up!"
"Is he down there?" came a voice from above and behind Reggie, who stood up quickly.
"Sam—go call the fire department! Bill's passed out down there!"
"What the hell?!" Sam shouted, trying to push Reggie aside. "Why the hell did you let him go in there?"
Reggie leaned into Sam with his shoulder, not pushing him with his hands, but trying to keep him away from the open hatch in the floor.
"Call the fire department," Reggie repeated.
"No!" Sam shouted, pushing Reggie away. "I can get him! I'll hold my breath, and I'll drag him over here! You get some rope to help!"
Reggie wrapped his arms around Sam, restraining him from going any further. He backed Sam against the wall of the barn, pinning him gently but firmly.
"No, Sam," he said, with calmness that belied his own panic. looking right in Sam's face. "No. You'll get sick too, and that won't help Bill."
Sam struggled in Reggie's grasp, trying to push away the strong arms that were holding him back from his attempt to save his brother.
"He's dying down there! How could you let him … I have to go get him!" Sam yelled, trying to break free from Reggie's hold.
"Sam! I'm not gonna let you go down there too! You hear me? Not gonna let you. Now you go call the fire department, and get a fan from the house, and stop wasting any more time!"
Sam suddenly went limp in Reggie's arms, and Reggie took that as a sign to release his hold. Their eyes met for a moment, and then Sam let out a single sob before he ran out of the barn, towards the house.
~!~!~!~!~
BWAMP, BWOOM BWEEEP!
"Station 51, person reported to be trapped and unconscious, unknown situation. McGinty Farm, Old Canyon Road at Fire Road 4. Old Canyon Road at Fire Road 4. Time out: 0802."
Roy hastily finished the glass of water he was drinking, and turned to put the glass in the sink, nearly colliding with Mike, who was putting his coffee cup in the sink at the same time.
"Sorry," they said to each other.
"Just don't do the same thing with the squad and the engine," Marco joked, as everyone streamed into the apparatus bay.
The squad and the engine pulled out in their usual order, the squad leading the way down the city road. They soon entered the more rural territory at the edge of their district, and the squad pulled ahead of the engine, which didn't fare as well on the bumpy road.
A man was standing at the gate, frantically waving his arms in the air.
"It's my brother!" he said, as soon as the squad approached. "He went down in the manure pit, and he … he's just slumped over down there. We put a fan in. I … I think he's still breathing, but …"
"All right," Roy said. "Show us where."
The man pointed to the barn, and the squad pulled up to where Reggie, who'd heard the commotion, was gesturing.
"Quick! You guys have those air tanks, right? You gotta get him out!"
"Yes sir," Johnny replied, as he and Roy started grabbing belts, ropes, SCBAs, and medical equipment from the squad. The engine pulled up just as the equipment was all unloaded.
"Cap?" Roy said. "We got a man down, unconscious, in the manure pit."
"Okay—you and John go down there and get him ready to come up. We'll be ready for you," Cap said. He went into the barn, Mike at his heels.
While John and Roy were packing up and preparing to get to their patient, Cap and Mike were surveying the scene.
"We could get a line over that beam, there," Mike said, pointing upwards to the structure of the roof, "and get a block and tackle set up."
Cap nodded. "Get it going, will ya, Stoker? I gotta find out what happened, here."
Johnny was masked up and on air a hair before Roy, so he descended the ladder. It was a tight fit with the air pack on his back, but he made it. Roy passed the oxygen equipment down to him. In seconds, Johnny was next to Bill.
Bill's lips were bluish, and there was vomit down the front of his bib overalls.
"He's barely breathin'," he said to Roy.
Roy rapidly assembled the ambu-bag, and while John cleared Bill's airway as well as he could, Roy quickly hooked up the oxygen, feeding the line into the ambu-bag. Johnny held the mask against Bill's face with both hands, while Roy squeezed the bag. Their positioning was awkward, and they couldn't do anything else at the same time, but it was crucial to get some oxygen into their patient as quickly as possible.
They continued bagging him, squeezing nearly pure oxygen into his lungs, every 5 seconds, for two minutes. Their own breaths, obvious from the noise of the SCBAs, kept pace with what they were delivering to Bill.
Bill didn't stir.
Johnny twisted his neck to look at Roy.
"If we lay him down, I can bag him, while you get another guy down here to get a belt on him," Johnny said, his voice thick and muffled by his facepiece.
They were about to turn Bill, to lay him down flat in the muck, when Marco descended the ladder, twisting at the top to fit his air bottle through the opening.
"Looked like you guys needed another set of hands," he said. The valves on his mask hissed as he breathed out, and the regulator whooshed on each inhalation, almost in a mockery of Bill's nearly absent respirations.
"Get that belt around him," Roy said, "so we can keep breathing for him."
"Got it," Marco said. He skidded in the manure, but caught himself just before he fell, and had the safety belt around Bill's waist in seconds.
"All right," Johnny said. "I guess we oughta hyperventilate him, and then the three of us can drag him over to the hatch as fast as we can."
"Good plan," Marco said.
"Marco, you and I will do a two-man carry, and Roy, you get the equipment over to the ladder," Johnny said. "Then we can ventilate him a few more times before we send him up. Roy, you'll go up the ladder with the O2 while Marco and I hook him up down here."
"Got it," Roy said, Marco echoing him quickly.
Roy increased the rate of breaths, squeezing the air in quickly, and pausing just long enough to let the bag refill before giving Bill another breath. After thirty seconds, they were ready to move.
"On three," Johnny said. "One, two, three!"
Johnny grabbed Bill under his arms, and Marco picked his lower body up. They moved as quickly as they could on the manure-slickened floor to get Bill under the open hatch, where Mike, Cap, and Chet had already set up an arrangement of ropes and pulleys to hoist Bill up to purer air.
"Okay!" Johnny said, when they were directly underneath the opening in the floor above them.
Marco supported Bill's upper body as Roy and Johnny, working together without words being necessary, gave Bill several more quick breaths of pure oxygen.
"All right, let's go!" Johnny said. He grabbed the carabiner that was dangling next to him, and attached it to the D-ring on the wide belt around Bill's waist. At the same time, Roy sent the O2 tank up, setting it away from the edge of the hatch, and scrambled up the ladder awkwardly, with the ambu-bag clenched between his teeth. With his SCBA on, he barely fit through the opening, and had to twist sideways at the top of the ladder so he could clear the edges of the hatch.
"Take him up!" Johnny shouted, as soon as Roy was clear.
Between the mechanical advantage of the pulley system, and the strength of the three men hauling on the ropes, it took only seconds to pull Bill's limp form through the hatch. Johnny and Marco guided his lower body through, while Roy made sure Bill's head didn't hit anything on the way up.
Johnny scrambled up the ladder, whipping off his facepiece and turning his air tank off as soon as he got to the top of the ladder. He began assisting Roy in continuing the ventilations, holding the mask securely onto Bill's face.
"Marco, can you take over on the bag?" Roy asked.
"Sure thing," Marco said.
Johnny got an initial set of vitals, and set up the biophone.
"Rampart, this is Squad 51, how do you read?"
In the flurry of activity in the barn, Sam and Reggie remained pressed against a wall, watching anxiously. Their offers of help, when Captain Stanley had approached them about what had happened, had been gently but firmly declined. At first, both men had been offended and angry to have their offer of help rebuffed, but as they watched the rescue, they each realized that they would've been in the way; would've been a wrench thrown into the cogs of the crew that was lifting Bill to the barn floor.
Sam surged forwards briefly when Bill first came through the hatch, but stopped when he saw that once again he would probably be in the way. He didn't understand what was going on, but knew that it was bad that they were pretty much breathing for Bill.
Medical jargon flew by, and Sam slumped on the floor, in a pose reminiscent of his brother's, but far less foreboding. He watched as the two paramedics checked Bill's heart rhythm, started an IV, and continued the artificial breathing.
Captain Stanley crouched on the floor near Sam.
"The ambulance will be here any minute. They'll be taking him to Rampart," he said.
Sam nodded, mutely.
Captain Stanley hesitated before he made his next remark.
"I know it must've been the hardest thing either of you has ever done, not to go in after him. But it was the right choice. People think they can hold their breath long enough, but they never can. Not ever."
Reggie cleared his throat.
"We thought the air would be okay, since the tank was just pumped out. But he … I didn't really get how much trouble he was in, until he just … slumped down," Reggie admitted.
Cap nodded. "That's the way this kind of thing works. You don't feel like you're running out of air—not like you're drowning, or have a pillow over your face. You aren't getting enough oxygen, because the methane has replaced some of it, but you don't even realize it. You just feel tired, and maybe a little stupid, and then you pass out."
"You shoulda stopped him," Sam said abruptly, looking up at Reggie. "You shoulda never let him go down there."
"I know," Reggie said softly. "God help me, I know it."
The ambulance attendants wheeled the gurney into the barn, and on a count of three, Roy, Marco, Chet, and Mike lifted Bill off of the floor and onto the stretcher.
Something clattered to the floor, narrowly missing the open hatch.
Reggie darted into the fray, and picked the object up, just as Sam was standing up to start making his way to the hospital.
"Sam," Reggie said, not sure whether Bill's brother would even speak to him.
Sam turned, but didn't reply.
Reggie held out the object. "Take this with you."
~!~!~!~!~
It was a rare situation where both Johnny and Roy rode in with the patient. But for Bill, they needed two pairs of hands and eyes. Johnny held the mask to Bill's face, and Roy squeezed the bag in a rhythm that would seem far too slow to the casual observer, but provided the best artificial respiration, leaving enough time for the passive exhalation that let the body rid itself of carbon dioxide. Squeeze, one thousand, wait, two thousand, wait, three thousand, wait, four thousand, wait, five thousand, squeeze. Over, and over.
Halfway to Rampart, Roy raised his eyebrows.
"He's fighting my rhythm," he said.
Johnny grabbed an oxygen mask, and swapped the oxygen line from the bag to the mask. He placed the mask on Bill's face, and he and Roy anxiously and simultaneously counted Bill's spontaneous respirations.
They looked at each other after a long, long thirty seconds.
"Fourteen," they said, simultaneously.
Johnny rubbed Bill's chest with his knuckles.
"Bill?" he said loudly. "Bill! Can you open your eyes?"
Bill recoiled slightly, and his arm moved feebly, as if he were trying to push Johnny away from him. His eyes didn't open, and he didn't make a sound.
Johnny listened to various places on Bill's chest with his stethoscope. He then lifted one of Bill's eyelids, and flashed his penlight into his eye to watch the pupil respond. He repeated with the other eye.
"Still real sluggish, Roy," he said, sighing.
Johnny got back on the biophone.
"Rampart, Squad 51."
"Go ahead, 51."
"We're en route with our patient, ETA fifteen minutes. He's now breathing on his own at a rate of fourteen, and moves to pain stimuli. We have him on ten liters of O2. Breath sounds are normal and equal. Pupils remain equal but sluggish."
"Copy that, 51. Continue O2, and continue monitoring."
Roy and Johnny sat next to each other on the bench, suddenly without any lifesaving tasks to perform. There was nothing they could do for Bill at this point, and there would likely be nothing Rampart could do either, other than monitoring and supportive care.
"How long you suppose he was down there?" Johnny asked, after a minute or so of contemplative silence. "I mean, besides the practical answer, which is 'too long.'"
Roy sighed. "Well, it took us fifteen minutes to get there. Add another five, at least, on the front end, for getting the call rolling on their end. We were darned quick getting down to him and getting him breathing pure oxygen, though."
Johnny nodded. "Over twenty minutes, though."
"For sure," Roy said. "But we don't know how bad the air was. We don't know what percentage of oxygen there was, or what else was mixed in. There was low enough oxygen to make him pass out, but high enough to keep him from dying."
Johnny shook his head. "I dunno, Roy. Sometimes these things don't turn out so well. I wish we could tell if we did him a favor, or not, by saving his life just now. "
"I don't know either, Johnny."
~!~!~!~
Rampart, Room 418, five hours later.
Sam sat at his brother's bedside, watching and waiting. He opened and closed the pocketknife, over and over and over. For the thousandth time, he wondered why Bill would risk his life for something that now seemed like nothing but a stupid trinket.
Sam could hardly recognize his brother under all the medical paraphernalia that surrounded him. The IV was keeping Bill hydrated, and keeping his blood sugar up. A bag hanging off the bed rail collected urine. Wires attached to Bill's chest monitored his pulse and breathing rate.
The doctors had explained to Sam that the parts of Bill's brain that were in charge of these life-sustaining functions must have escaped serious damage, but that only time would tell about the rest of his brain. Every minute that went by without any improvement in Bill's condition was bad news.
There was a knock at the door.
"Come in," Sam said, wondering who was there. Their sister couldn't have made it from Reno yet, and hospital people usually just barged in, so he knew it wasn't them, but didn't bother to turn around to look.
Sam didn't recognize the two men who tentatively entered the room, but put two and two together when he saw the uniforms.
"You're the ones who pulled Bill out this morning," Sam said.
"Us and the rest of our station, yeah. We were on our break, and … well, we thought we'd stop by an' see how your brother's doin'," Johnny said.
"He's the same," Sam replied. "He's … exactly the same."
Sam could tell by the men's faces that they understood this was bad news.
"It's not your fault," he said. "He never shoulda gone down there. Reggie shoulda stopped him, too. But I guess it's not his fault, either. Bill's a grown man, and makes his own decisions." He paused for a second. "Made his own decisions."
"You don't know yet," Roy said in his quietly reassuring voice, "that he won't again."
"I know—but I hafta say, right now it's not lookin' too good," Sam said, continuing to flip the pocketknife open and closed.
There really wasn't anything Johnny or Roy could say to that, because Sam was right, and all three of them knew it.
"Sorry to hear that," Johnny said.
"Like I said, it's not your fault. You guys … I mean, we're out in the boonies, so it took a while for you to get there, but … you got him outta there so fast I couldn't believe it," Sam said, shaking his head. "You got him out so fast, but … I don't know if he could be saved, by the time you got there."
"You were smart not to go in after him," Roy said.
"That was Reggie who was smart," Sam said. "I woulda gone right in if he hadn't stopped me. And damn it—all he went in for was this stupid pocketknife! Maybe I should let him hold it, seeing how it was more important to him than his own life."
Sam folded the knife closed, and placed it in Bill's hand.
Bill's hand seemed to move, closing around the knife, but the doctors had told Sam that things like that could be reflexes, and might not mean anything. The sheets down by Bill's feet stirred as well.
"He moved his hand," Johnny said. "Did you see that?"
Sam shrugged. "Probably a reflex, they said."
"Well, maybe it's not. Why don't you try sayin' his name, real loud? See what happens?" Johnny suggested.
"Why not," Sam said. "The worst that could happen is … nothing."
He stood up, and leaned towards Bill's head.
"Bill! Hey Bill, wake up!" Sam said loudly.
All three men standing in the room watched with bated breath.
"Bill! Chow time!" Sam said, shaking Bill gently by the shoulder.
There was a hitch in Bill's breathing pattern, and slowly, slowly, he opened his eyes. Johnny and Roy didn't want to interfere with this powerful moment, but Johnny did lean in to pull the cord that would call a nurse.
At first, Bill's eyes didn't focus on anything in particular. But his brother said his name once more.
"Bill—it's Sam. Look at me, big brother."
Slowly, Bill's eyes turned to meet Sam's. He blinked once, twice. It looked like he was going to close his eyes again, but his brother persisted.
"Gotta wake up, Billy. You gotta wake up!"
Bill's eyes stayed open, and his lips moved indistinctly.
Sam turned to Johnny and Roy, eyes shining brightly.
"You did save him," Sam said. "You did."
The End
Series TBC
A/N: One of my very first patients in my clinical practice was a fellow who'd had a period of hypoxia. He stuck with me, and when I recently read an article about work in confined spaces with reduced oxygen, and the early signs of hypoxia, this story was born.