A Heritage County Tale
"So what's this one for?" Sydney Redding, the EMT or emergency medical technician, of Medic 8 asked her partner. She was driving the blue and white ambulance at sixty miles per hour through the moderate mid-afternoon suburban traffic, the red lights flashing, the siren blaring.
"Unresponsive person," replied Jim Hartman, the paramedic assigned to the rig, as he read the text from their dash mounted computer terminal. The "Mobile Communication Terminal" or MCT as it was called was state of the art equipment for Western Life Support, the great empire that they worked for, which was to say that it was a product of early 1980's technology. The screen was four inches across and was capable of displaying nothing but monochrome text. The memory was a staggering 32 kilobytes. "Caller states that an 84 year old man is down and does not appear to be breathing."
"Does not appear to be breathing?" Sydney asked with a groan. "Great. Another CPR. We had one last week goddammit, I thought we were good for the month." The reason for her annoyance was that, as the EMT of the unit, she would have to be the one to clean up the mess after the call was over; and running a CPR made a huge mess of both the ambulance and their equipment bags.
"It might not be a CPR," Jim said with a shrug. "Maybe he's been down for awhile. I'll pronounce him dead, we'll call the coroner, and let the firemen babysit him until the little white van shows up. Be optimistic."
"There's no such thing as optimism in my philosophy," she replied, changing the pitch on the siren and blaring the air horn a few times to get a woman in a SUV out of their way.
They traveled on, Sydney piloting the converted Ford van through intersections, around stalled traffic, and occasionally on the wrong side of the street. When the call came in they had been posted in the suburb of Springwood, about ten miles from the city of Heritage, that bustling Sacramento Valley railroad and farming city that was the seat of Heritage County. Springwood was where most of the elderly people of the metropolitan area resided. It was full of old, established neighborhoods, senior apartment complexes, and convalescent facilities. Many a medical aid call had been dispatched within Springwood's unincorporated borders.
Morning Glory Court, the scene of the unresponsive man call, was a small cul-de-sac tucked deep in a residential neighborhood along the Heritage River. The houses on the court were large and solidly constructed wood frames, all about forty years old, most with immaculately maintained lawns. 123 Morning Glory was at the far end of the court and was one of the larger houses. A Cadillac El Dorado, the standard mode of transportation for the well to do of Springwood, sat in the driveway. A red fire engine belonging to the Heritage County Fire Department was parking in front of the house just as Sydney entered the court, it's own red lights flashing authoritatively. In Heritage County, like in most jurisdictions, a fire crew was sent to the scene of each medical aid call to act as first responders and to assist the ambulance crew. Medical aid calls in fact constituted 8 out of every 10 alarms that firefighters responded to.
"They were a little slow getting here," Jim commented as Sydney parked the rig behind them. Usually, during the day shift anyway, the fire engine arrived a few minutes before the ambulance since there were about four times as many fire stations as there were medic units.
"There was probably a good movie on cable TV back at the station," she replied, unsnapping her seatbelt and stepping out. "You can't rush those guys you know."
Jim stepped out his own door and met her at the back doors. They pulled out their gurney. Strapped to it were a cardiac monitor, a portable oxygen tank, and a large blue bag that contained just about anything that they could conceivably need inside of a house. They wheeled over the sidewalk and up the driveway, following the fire crew to the front door.
The three man fire crew were all wearing their standard uniform for medical aid calls: black uniform pants and dark blue T-shirts with HERITAGE COUNTY FIRE stenciled on the back. The captain of the crew carried a metal clipboard in his hands while the firefighter and the engineer carried their own basic life support equipment bags.
"Hey guys," the captain greeted cordially as he walked up the small flight of porch steps. "You get the update on the call?"
"About the person not appearing to be breathing?" Jim asked. "Yeah, we got it."
"I hope it's not a freakin CPR," the engineer grunted. "It's too hot to be doing that shit today."
"Yeah," the firefighter told Jim. "Call him if you can. Remember, dead is good. We all hafta go sometime."
"I'll do what I can," Jim promised. He was not in the mood to run a CPR today either.
The hope that they would be able to pronounce the victim and go about their business faded as soon as the door was opened. A woman ripped it open at their knock, her eyes full of tears, her face showing extreme anguish. She was about forty years old or so Jim estimated, and not a terribly bad looking forty either. Her attire immediately attracted everyone's attention, including Sydney's. She was wearing a pair of tight blue jean shorts that were cut about as high as shorts could be cut without being considered obscene. Her long legs were attractive and toned. A white t-shirt covered her upper body and bulged outward with an impressive set of store-bought mammaries. The jiggle as she moved betrayed the lack of a bra confining them. Her face was streaked with running mascara.
"He's not breathing," she sobbed at them. "Please, get in here before he dies!"
They pushed their way into the large formal living room, which was filled with antique furniture on a polished hardwood floor. Lying next to a beautifully restored 18th century rocker was an elderly man, sprawled out on his back. He was shirtless, his lower body covered in a pair of tan slacks. His mouth was open, as were his eyes. Jim looked for rise and fall of the chest and saw nothing. The man was indeed not breathing.
"What happened?" Jim asked the woman, whom he assumed was the man's daughter, as he unstrapped the cardiac monitor from the gurney.
"He just... collapsed," she cried. "He was fine one minute and then... and then..." she couldn't finish.
"It's all right," the captain told her comfortingly, putting his arm around her and surreptitiously catching a small feel of her right breast.
Jim set the monitor down next to the man and then kneeled at his head. "How long ago did this happen?" he asked the woman.
She seemed a little hesitant to answer for a moment and when she did, she was somewhat vague. "Just a few minutes."
"How many minutes?" Jim asked her. "It took us four to get here. How long before we called did he go down?"
"Go down?" she asked, jerking in the captain's arms a little. "What do you mean by that?"
"I mean how long before you called did he collapse?" he rephrased.
"Oh," she said, shaking her head a little. "It was just a minute or so. No more than five."
"I see," Jim said, starting to sense that something strange was going on here. He dismissed the feeling as irrelevant and felt at the man's neck for a pulse. There was none. "Let's start CPR," he told the fire crew. "Sydney, get the airway bag out and start setting me up for intubation."
"Right," Sydney said, grabbing their large red bag from the gurney, a resigned look on her face as she contemplated her future clean up.
While she unzipped it and started pulling supplies out, the firefighter opened their own bag and pulled out a bag-valve setup, which he quickly assembled and began using to force air down the man's throat. The engineer kneeled down on the floor, found a landmark on the man's chest, and began compressions. He winced as the first one fractured several ribs at the sternum, a common consequence of CPR.
While they were doing this, Jim hooked electrodes up to the man's chest and turned on the monitor. It went through a series of self-checks and finally, after about twenty seconds, graced him with a display. The green line that made up the tracing was jerking up and down in rhythm with the engineer's chest compressions.
"Hold CPR for a sec," Jim said.
The engineer stopped and Jim continued to stare at the reading. It was what was known as an agonal rhythm, the sign of a massive blow out in the heart. Every five or six second there would be just enough electrical activity in the ventricles to make a spike on the display. There was no actual heartbeat to go along with the spikes. It was just one small step above being completely flatline.
"Resume CPR," Jim said, his voice monotone, his face expressionless, his mind already knowing that his efforts were going to be futile. But, he had to try anyway. "Sid, you got my airway stuff ready?"
She did. She handed over a laryngoscope, an endotracheal tube, a roll of tape, and a 10cc syringe. "Here you go," she said. "I'll start getting an IV ready."
"Thanks," he told her, taking the supplies and setting them down next to the man's head. He looked up at the woman again. "What kind of medical problems does your father have?" he asked.
"He's not my father," she said, wiping her eyes and watching everything they were doing intently. "He's my neighbor."
"Oh... sorry," Jim said. "Anyway, does he have any medical problems?"
She said that as far as she knew he had none.
"Well what was he doing when he collapsed?" Jim asked next. "Was he just sitting here or was doing some sort of exertion?"
She hesitated for a moment, a fresh sob escaping from her mouth. "I was with him," she finally blurted.
"I know you were with him," Jim said patiently. "That's why I'm asking you. So what was he doing?"
She sobbed harder. "No, I mean I was with him," she said. "Sexually."
Everything stopped. The engineer's arms halted in mid-compression. The captain's pen stopped in the middle of a notation on his clipboard. The firefighter squeezed the bag and didn't let it refill. Sydney almost dropped the IV tubing she was plugging into the bag of saline. Jim's mouth dropped open as if on a hinge. All of them stared at the woman, seeing her in an entirely different light now.
"I... uh... see," Jim stammered, feeling himself blush. He looked down at the old man he was working on. He was 84 years old! 84 and he had been banging a woman half his age! God bless America.
"How..." the captain said slowly, "I mean why... uh... he's got his pants on. Were you actually... you know... doing it?"
She nodded slowly, sniffing. "He had just finished when he collapsed," she told them. "I cleaned him up a little and put his pants back on before I called. I didn't want his wife to know what happened!"
"His wife?" Jim said, noticing for the first time that the man had a wedding ring on.
"She's at bingo right now," she said. "You won't tell her what we were doing will you? It would just kill her!"
They all promised not to tell the wife the circumstances of the collapse, although it was probable that someone else would at some point in the future. The shock of the revelation quickly passed and they went back to work, each of them doing their respective jobs. Jim put a breathing tube into his trachea and then secured it with a length of tape. He started an IV in the man's right arm and then used it to administer powerful cardiac drugs in the hope of kick-starting the heart again. It didn't. After the first round of drugs was on board they loaded him onto the gurney and wheeled him out to the ambulance, continuing CPR as they rolled across the lawn. They loaded the gurney into the back and Jim, the firefighter, and the engineer all climbed in after it. They were professional and efficient as they went about these tasks.
Sydney shut the doors behind them and then went around to the front so she could drive to the nearest hospital. The moment they were shut and the neighbor was out of their sight Jim and his two companions looked at each other and started laughing.
"Holy shit," the engineer said, holding onto the bar mounted to the ceiling and continuing his compressions with the other. "Can you believe that? Eighty-four fucking years old and he's tappin' a piece while the wife's at bingo!"
"A piece that I myself would be more than happy to tap," the firefighter said. "Goddamn, did you see the tits on her?"
"Now I know why she looked so shocked when I asked what time he went down," Jim said, cracking all of them up.
The jokes and comments continued all the way to Presbyterian Hospital three miles away. At one point the firefighter stopped squeezing the bag long enough to offer a sharp salute to the unresponsive patient. "You gotta respect anyone who goes out like that," he said. "My I one day join your ranks sir."
Jim pumped three more rounds of cardiac drugs on the trip to the hospital, none of it doing any good. The emergency room doctor pumped in two more, again with no results. Finally it was deemed that there was nothing more to be done. The doctor gave a command and all CPR activity was halted. Everyone took his or her hands off the man and he was officially pronounced dead.
"You are truly my hero," the firefighter was heard to remark just before leaving the room.
An hour later, after the clean-up of the rig and the inevitable paperwork was completed, Jim and Sydney were clear of the hospital and posted once again in a position to cover Springwood. Jim was now behind the wheel and he had parked them beneath a large valley oak tree at a county park. Except for them the park was mostly deserted since it was approaching 100 degrees on this late August day. Even the squirrels that lived in the many trees were nowhere to be seen. Jim kept the diesel engine of the ambulance at idle so the air conditioning could continue to blow a semi-cool draft of air across them.
"I'm telling you," Jim said, shaking his head in frustration, "that last call was just a sad commentary on my life, you know that?"
"How so?" Sydney asked, fanning her blue uniform shirt to get some of the cool air onto her skin.
"An 84 year old man is getting more pussy than I am. He's slamming his neighbor for God's sake. And did you see her? She wasn't that bad looking. Hell, I would've done her. I'm 29 years old and in the prime of my sexual life. How come I never get that kind of action?"
Sydney looked at him pitifully. "Because you never leave your damn house," she told him. "The only time you go out is to take your daughter to school and to come to work. How the hell do you ever expect to get laid if you won't go outside?"
"I can't leave the house," he said, slumping in his seat a little. "I'm a single father. I can't afford to pay for a minute more of daycare than I already use, hell, I can't afford to pay for what I do use. I sure as hell can't let my ex-wife babysit. She'd sell Brooke to get an eightball of crank." His ex-wife Debbie, who was a methamphetamine addict, was in fact forbidden by the court system from even seeing Brooke, the daughter she had borne to her once husband Jim. Nor did she show any particular interest in doing so.
"Don't give me that crap," she told him, not buying his argument for a minute. "You just like being a freakin' hermit. We've been working together for what? A year now?"
"Yeah," he agreed.
"And you haven't gotten your weenie wet in all that time, have you?"
"I haven't gotten any since Debbie and I broke up two years ago," he confessed. "I'm in a serious dry spell."
"That is truly appalling," she told him sympathetically. "I'd give you some myself if it wasn't for that male-female thing."
He looked over at her, smiling. Sydney had a very nice body and would have been attractive if not for the fact that her hair was cut shorter than most men's and that her arms bulged with weight lifter's muscle. There was also the barbed wire tattoo on her right bicep. Like approximately one fourth of the female workforce at WLS's central valley division, she was same-sex oriented. "I'm sure you would," he told her. "And we could slam some beers and watch football afterward, couldn't we?"
"Fuckin aye," she said, smacking him on the bicep hard enough to hurt. "And I'd drink you under the table too. But seriously though, we need to get you some pussy. Who do you want to fuck? Let's work on this problem."
He sighed. "It's not quite as simple as that," he said. "I want to fuck almost everyone. The problem is that they all want to have a relationship to go along with the fucking. That's where I start to run into problems."
"You don't want to have another relationship?"
"Believe me," he said, "Debbie was enough relationship to last me a lifetime. I'm still feeling the shockwaves from that." He was not exaggerating. Though they had been separated for 22 months, though they had been officially divorced for more than a year and a half, though he had complete and total custody of Brooke and never had to deal with her at all except for mailing her a monthly check for six hundred dollars, Debbie was still a major headache in his life. Three times since the divorce she had used his name, date of birth, and social security number to secure credit cards, which she then used to buy several thousand dollars worth of stereo equipment or other easily pawned products. Twice, using the same information, she had managed to sweet talk her way past ditsy tellers and into his bank account, withdrawing three hundred dollars on each occasion. Once she had even managed to convince the manager of his apartment complex that she was a legal tenant and had gained entry while he was at work. Once inside she had stolen his DVD player, his television, and his stereo, taking them to the nearest convenient fence and hawking them for ten cents on the dollar. Though he had filed police reports on each of these occasions, no action had been taken. The legal system seemed to feel that these thefts were a domestic problem and not a criminal problem. The sheriff's department never arrested her for them and the district attorney never filed charges.
"So you just want to tear one off without any long-lasting consequences," Sydney said thoughtfully. "Is that what you're telling me?"
"Right," he agreed.
She thought that over for a moment. "I can respect that," she said at last, scratching her head.
"The problem is that it's not really that easy to accomplish."
"Oh it's easy all right," she said. "You just need to know who to target. There's all kinds of women who are easy to score with and are in it only for the sex."
"Oh?" he said, his interest perking up. After all, Sid was a woman, wasn't she? And who knew women better than other women. "Who? Where are they?"
"They're everywhere," she said cryptically. "You just have to learn to sniff them out. There are a couple of categories you should lean towards however. Women who married for money. That's a big one. Your best targets there are gonna be the ones that have been married for about seven or eight years. They're sexually frustrated and have been so long enough to want to do something about it. If they can get a discrete piece on the side, they'll go for it. Can you be discrete?"
"Well, sure," he said. "But married women? I don't want to break up anyone's marriage."
She shrugged. "Women are different than men," she said. "If they're sleeping with another man, it's because the marriage is pretty much shot anyway. A happily married woman won't cheat."
He wasn't too sure about that. It showed on his face.
"That's advanced study though," she told him. "We should warm you up first with something a little easier to find and copulate with. I know someone that you can fuck quite easily and all it'll cost you is a night out. And the next day she won't care if you don't call her. In fact, she'll expect it."
"Robin White," she said.
His face soured a little. Robin White was an admitting clerk at Valley Medical Center's emergency room counter. She was a big-breasted blonde that had a reputation as being looser than a barn door after a tornado. "But she's a slut," he said.
She gave him the look that one gives an idiot. "Duh," she told him. "What did you think? That I had some pristine Catholic schoolgirl on standby that was going to give it up to you and then go about her life? Of course she's a slut! By definition a girl that will do it on the first date and then not worry about it the next day is a slut. You know what the guys say about her don't you?"
He did. It was common knowledge among the male paramedics, EMTs, firefighters, and cops of Heritage County's various emergency services departments that if you needed a good fuck in a short period of time that you asked Robin at VMC E.R. on a date. It was said that she could suck-start a Harley Davidson motorcycle. "I've heard a few tales," he said.
"So there you have it," she replied. "She's cute, she's got big tits, and she gives it up. All we have to do is get over to VMC and you can ask her out."
"Now wait a minute," he protested, "what about... you know... diseases and stuff. I don't want to get AIDS or the clap from boffing this chick."
Sydney punched him in the arm again, a little harder this time. "Moron," she told him. "Have you ever heard of rubbers? They're these little rubber things you buy in the drugstore before you take chicks like Robin out on a date. I've heard they prevent pregnancy too."
"Well, yeah, but..."
"No yeah-buts," she said. "We go to VMC, you ask her out, you take her out, and you fuck her. You muzzle your weasel when you do the deed. It's that simple. You're happy, she's happy, I'm happy, the whole goddamned free world is happy."
Jim thought it over for a moment, envisioning Robin in his mind. She really was kind of attractive in a skanky, slutty sort of way. She was fond of wearing short skirts to work and getting up from her registration chair in a very unladylike manner. Her panties had been observed by more people than a lingerie mannequin's. He could envision enjoying himself within her graces. Sure she wasn't the ideal woman for him, but then he wasn't looking for the ideal woman, was he? He was looking for a woman that had a vagina that she was willing to share. "Okay," he told Sydney, "I find you make a good point."
"So you'll ask her out?" she said.
"I'll ask her out," he agreed. "But there's still the issue of Brooke. I can't very well take my daughter out on a date with me, can I?"
"Oh for Christ's sake," Sydney said, exasperated. "I'll watch your daughter for you."
"You'd do that for me?" he asked.
"If it would get you laid," she said, "I'll even throw in some ice cream. Just tell me the day and the time."
He grinned at her. "You know something Sid," he told her. "You're not nearly the hard-ass bitch that everyone says you are."
"Yeah, yeah," she replied with a grunt. "Just don't let that get around, okay?"
And so their mission for the day was to transport a patient to Valley Medical Center before 3:00 PM, when the day shift registration clerks changed shifts. It should have been a reasonably easy task. VMC was the primary hospital for the Heritage County northern suburbs and it was a level two trauma center. On a typical day Jim and Sydney would transport there two or three times. But on this day the Gods seemed to be conspiring against them.
Their very next call was for an elderly woman that had slipped while getting off of the toilet and had fallen to the linoleum in her bathroom. Jim and Sydney found her in care of the fire crew when they arrived, her face contorted in pain, a sheen of perspiration all over her body. Her left leg was about two inches shorter than her right and her left foot was turned outward from her body at a forty-five degree angle. It was a classic broken hip, the staple of Springwood responses. Jim started an IV on her right there on the bathroom floor and doped her up with as much morphine as he was allowed by county protocol to give. Beatrice (the women in question) went from a crying, clutching old lady to a mellow, go-with-the-flow senior citizen in the time it took for the narcotic to travel through her bloodstream and hit the receptors in her brain.
"Feeling better Beatrice?" Jim asked her as he stowed the syringe and the empty vial back in the lock box that he signed out at the beginning of each shift.
"Yesss," she said, her eyes half-lidded. "I feel much better. You're a nice young man, you know that? All of you are nice young men." She giggled a little, looking at Sydney. "Except you of course. You're a nice young lady. Your hair's a little short, but you're very nice."
"Thank you ma'am," Sydney said, patting her arm a little. "We're gonna move you on to this flat thing now and get you to the hospital."
"Okay," she said dreamily, hardly muttering a sound as Sydney, Jim, and two of the firefighters rolled her up onto her uninjured side and slid their flat - a canvas carrying device capable of being disassembled from beneath her at the hospital - under her bottom.
"So what hospital do you go to Beatrice?" Jim asked as she was loaded onto the gurney.
"Oh, it doesn't really matter," she told him. "Anywhere is fine."
"How about Valley Med Center then?" he said, casting a knowing look at his partner. She gave him a discrete thumbs-up in return.
"Oh not there," Beatrice said, shaking her head. "Anywhere but there."
The knowing look faded. The thumbs-up wilted upon itself. "Valley Med is no good?" Jim asked.
"My husband died there six years ago," Beatrice told them in a whisper. "I just couldn't go there. The memories you know." With that, she started weeping softly, large tears running down her face. By the time they got her out to the ambulance, she was sobbing. They did not take her to Valley Medical Center.
Their next call was in Lemon Hill, a large working class suburb. At the Sunset shopping mall, inside one of the large retail stores, a shoplifter had been caught by store security practicing her profession and mysteriously became ill immediately afterward.
"She says she's a diabetic," the security officer said with a frown, "and that her blood sugar is low."
The patient in question was a large white woman of about thirty. She was dressed in a pair of filthy yellow shorts and a green blouse big enough for a normal sized person to use as a blanket. Her hair was stringy and uncombed and her eyes showed the telltale dilation of methamphetamine use in the recent past. She in fact looked like exactly the sort of person that store security would keep a sharp eye upon from the moment she walked in the store just on general principals. She was sitting on a bench in the back of the security office, her left hand cuffed to a steel bar.
"What'd she steal?" the fire captain, holding the inevitable metal clipboard, asked.
"Two digital cameras and a portable CD player," the security officer said. "Stuff that's easy to fence for more crank."
"Oh come on now," Jim said, feigning seriousness. "I'm sure she was just trying to feed her family."
"Yeah right," he said, shaking his head a little. "Anyway, the sheriff's department is on the way to come get her. As soon as we told her that is when she started to get sick."
"Funny how that works," Sydney observed.
Jim walked over to her and stood before her, looking her up and down for a moment, his eyes looking for any of the outward signs of illness as it was related to diabetes and seeing none of them. She was not breathing rapidly, as she would if her blood sugar was high. She was not pale or sweaty or lethargic as she would be if it were too low. "So you're a diabetic are you?" he asked her.
"That's right," she told him arrogantly. "And my blood sugar's low. I gotta go to the hospital."
"How'd your blood sugar get so low all of a sudden?"
"Cause I forgot to take my insulin this mornin'," she replied, apparently not realizing that low blood sugar occurred because a diabetic took too much insulin, or took a normal dose and forgot to eat. It was quite obvious to Jim and everyone else in the room that she had no idea what she was talking about. She probably knew someone who knew someone who had diabetes and was trying to bluff her way through this with the limited amount of knowledge that she had managed to pick up third hand.
"I see," Jim said, nodding as if in sympathy. "And what kind of insulin do you take?"
"What kind?" she said. "What the fuck do that mean? I jist take insulin."
"Oh there's several different kinds," Jim said. "It's kind of like penicillin you see. Nobody gets a prescription for just penicillin; they get a prescription for Keflex or some other derivative of it. Most of the diabetics I've treated over the years are able to tell me exactly what kind of insulin and what dosage they take. I guess it kind of slipped your mind, huh?"
"What you trying to say?" she demanded.
"Oh nothing," Jim assured her. "But since blood sugar is one of those things that we just happen to be able to check here in the field, why don't we take a look at what yours is, shall we?"
Her face suddenly became less arrogant as she realized that she hadn't thought her little ploy through too carefully. She meekly submitted to having her index finger pricked with a sterile pin and a drop of her blood placed on a glucometer strip, which was then fed into a small machine that measured the amount of sugar in the blood. The reading came back at 123 milligrams per deciliter, a perfectly normal reading.
"I guess you must be cured," Jim told her. "Is there anything else we can help you with while we're here?"
"Your machine is wrong!" she yelled at him. "My blood sugar is low! I forgot to take my fuckin' insulin."
"The machine never lies," he said. "And by the way, you get high blood sugar from forgetting to take your insulin, not low. You should stick with chest pain or shortness of breath when you get busted. They're easier to fake."
The fire crew cut out a moment later, their work done. Jim and Sydney hung around for another fifteen minutes, listening to the cries and protests of the cranked out shoplifter until the arrival of the two sheriff's deputies. The cops listened carefully to the tale they were told and concluded that it was probably safe to take her directly to jail without a detour to the hospital. They led her out the door to their patrol cars.
"What a dumb broad," Jim commented once they were gone. "She picked the one thing that we could absolutely rule out in the field."
"Yeah," Sydney said. "That's too bad though, because we still haven't made it over to VMC and it's starting to close in on 3:00."
"Yep," he said with a sigh. "Maybe I'm just not meant to get laid. I'm doomed to live out the rest of my being with only Internet porn and my five best friends as a companion."
And then, having said that, fortune smiled on him. Or so it seemed at first.
They were dispatched to another call, this one in a skuzzy apartment complex in the city of Heritage for labor contractions. The patient was 25 years old, 285 pounds, and in active labor with her sixth child. While the other five children, the products of three different fathers and none of them more than eleven months apart in age, jumped around the small apartment excitedly, the fire captain briefed Jim in on what they had learned so far.
"We've timed three contractions since we've been here," he said, his clipboard tucked firmly between his arm and his chest. "They're right on two minutes apart. She says her water broke about twenty minutes ago and that the contractions started right after that. Her last three labors lasted less than one hour she said."
"Great," Jim said, not relishing the thought of delivering another baby. He already had twelve of them under his belt, and the thrill of bringing a life into the world just wasn't there for him anymore, particularly not when the patient was 285 pounds and didn't appear to be a big fan of personal hygiene. "Let's load her up and get rolling. Hopefully we'll get there before she pops. What hospital does she want?"
"VMC," the captain replied. "That's where her doc works out of."
Jim nodded, feeling both good and bad about this destination. On the one hand, VMC was where he needed to go and it was a fairly good bet that they'd get there before the 3:00 PM crew change. On the other hand, VMC was halfway across the county from where they were at the moment and, if the patient was indeed having contractions that were two minutes apart, then that greatly increased the chances of him having to perform a field delivery. Still, there was not much room for negotiation. In an uncomplicated delivery - and there was nothing to indicate that this was anything but that - the patient's choice of hospital ruled.
"I guess we'd better get moving then," Jim said.
They loaded her up on the gurney and wheeled her out to the ambulance, the assistance of the fire crew being necessary to lift her inside. Once sealed in the back with her he explained that he needed to check her to see if the delivery was imminent.
"You'd better hurry," she grunted, her face a grimace of pain. "I'm having another one."
"Does it feel like you need to push?" he asked her, knowing that that was often the final symptom before explosive delivery occurred.
"Not yet," she grunted.
Taking a deep breath and turning on the ventilation fan, he helped her remove her black stretch pants and her filthy cotton underwear. He balled them up into as compact a package as possible and tossed them on the foot of the gurney, near her feet. "All right," he told her, "bring your legs apart and let me take a look."
She opened her massive thighs, revealing a crotch carpeted in thick black hair. Her vaginal lips were open and drooling a mixture of clear fluid and white mucous. The smell was even worse than he had been anticipating. He immediately began breathing through his mouth in reflex, which helped only the slightest bit.
"A little wider," he told her, reaching down to help push her thighs even further apart. To his relief he saw no crowning of the baby's head, no hair from the infant protruding, and no unusual swelling. "Very good," he said. "You can close your legs now."
She did so and he covered her up with a paper sheet, which cut the worst of the odor. He took a few deep breaths and told Sydney up in the front to start driving.
"On the way," she told him, rolling down her window. The smell had penetrated up there as well.
They made it perhaps a half a mile before she grunted with another contraction, this one obviously much worse than the previous ones had been. "Oh god," she groaned, "oh shit! I gotta push!"
"Try to keep from doing it if you can," Jim told her, opening the sterile obstetric pack and pulling out a bulb syringe just in case.
"I can't!" she told him. "Oh god, here it comes!"
He removed the sheet once more and pushed her thighs apart, inwardly sighing. It seemed like she was going to pump the baby out before they made it to VMC. Not only would that leave a huge mess of the gurney and the floor of the ambulance, but he would also have to write two patient care reports instead of just one. He would then have to...
His thoughts came to a screeching halt as he saw what had appeared between his patient's legs. Sticking out of her vagina was not a baby's head, as had been the case in every other delivery that he had participated in, but a six inch length of the umbilical cord. Compressing it in a way that would be quickly lethal to the infant that it supplied with blood and oxygen, was the baby's buttocks.
"Holy shit," Jim whispered to himself, feeling adrenaline coursing through him. It was a prolapsed umbilical cord. This was something that he had been told about in paramedic training, but that he had never seen, that he had in fact been assured almost never happened. But now it was happening and it was happening in front of him. And if that wasn't bad enough, it was coupled with a breech presentation. If he didn't do something about this within a minute or so, there was a good chance that the baby would be born either brain dead or just plain dead dead.
"Oh god," the mother cried, pushing a little and tightening the seal around the cord even further.
"Don't push!" Jim yelled at her. "Whatever you do, no matter how much you feel like you have to, don't push!"
"I have to!" she cried.
"Jim?" Sydney asked carefully from the front, her eyes peering into his through the rear view mirror. "Is everything all right?"
"Just fine," he squeaked, giving her a look in return that she interpreted well. "What would our closest hospital with an OB department be?"
"Saint Vincent's," she told him. "About five minutes away."
"Why don't we go there instead?" he said with a calmness he did not feel. "Code three please. And can you call them on the radio for me and tell them we have a breach presentation with a prolapsed cord?"
"Sure," she said, her face paling a little. "I'll do that."
While she turned on the siren and put on a little speed, Jim turned back to his patient. "Ma'am," he told her, reaching down and unbuckling the belts that secured her to the gurney. "There's a little problem with the way the baby is coming out and I'll need to... uh... try to stop it from coming out any further. I need you to roll over onto your hands and knees for me."
"Do what?" she screamed. "What the fuck you want that for?"
"Because that's the only way I have to help keep it in there." He reached down and started pushing on her, compelling her to do as he asked. She grunted as another contraction rolled through her but she rolled over, getting into the classic doggie style position. "Tuck those knees as close against your chest as you can," he told her, grimacing in advance at what he had to do next.
"Like this?" she asked, panting as she tried to keep from pushing.
"Like that," he agreed. "Now I'm going to have to put my hand inside of you to keep the pressure off of the umbilical cord."
"Is my baby all right?" she asked, not liking the sound of that at all.