Fic: Another Day (R)
For mijan's birthday.
Warnings for violence, blood, gore, you name it.
A/N: Set in the Firehouse AU, not too long before the "Mayday" chapter. Technical things in this story are waaaaay out of my league! How do I get myself into these things? I apologize for any technical errors.
Another Day
“Listen up, people!” Pike bellowed, unused to having to raise his voice during roll call. “Hey!”
The chatter in the apparatus bay died down, and the crew fell into line. An unfamiliar face joined them, and Gaila was conspicuously absent.
“Slight change in duties today. Gaila’s out sick; Tyler Weston will be filling in. Weston, you’ll be a truckie today; Kirk, I want you with Chekov on the engine. Spock, you brief Weston on anything you need to. Everyone else-same assignments as always. Any questions?”
Pike looked specifically at Jim, who shook his head.
“Good,” Pike said. “Dismissed.”
“C’mon, Bones,” Jim said, plucking Len out of the line. “Let’s see what’s in the freezer. I’m starved.”
Len let himself be led to the kitchen area.
“So, why’d Cap put you on the engine today?” he asked.
“Oh, just ‘cause he wants someone he knows with the probie. If Weston subbed directly into Gaila’s seat on the engine, he’d be in the kind of tricky position of being in charge of a probie he knows nothing about.”
“Makes sense,” Len said. “Hey-there’s some of Spock’s soup from the other day. Hand me that, will ya? And do you see the meatloaf on the bottom there?”
“Oooh, great,” Jim said. “Yeah, I’ll have that for sure.”
Sitting at the table, they waited for their selections to defrost in the microwave. Jim caught the attention of Weston, and gestured him over to the table.
“Hey, Spoons! Long time no see! How’s it going?”
The stocky blond man sat at the table opposite Jim. “Can’t complain, Jim. How about you?”
“Better than ever! Hey, you probably haven’t met our medic. Bones, I worked with Tyler at the downtown station for a couple years before I came out here. Ty, this is Leonard McCoy, and you’ll never see a finer medic.”
“Nice to meet you,” Tyler said.
“Likewise,” Len said. “And call me Len, despite what you may hear Jim calling me.”
“Ah, he got you with a nickname, huh?” Weston said.
“At least it’s not ‘Spoons,’” Len said. “Dare I ask how that came about?”
“It was really dumb,” Tyler said. “All I was doing was unloading the dishwasher, and the tones dropped, and I’m the kind of person that startles easily, right? And I threw a whole container of spoons all over the kitchen. And that was that. How about yours?”
“He started calling me ‘Sawbones,’ like they called doctors in the Navy or the Army or whatever, and I complained that my nickname shouldn’t be longer than ‘Len,’ so he shortened it. Better than ‘Saw,” I suppose,” Len said.
“And I came up with that even before I knew he had an M.D.! Isn’t that awesome, Spoons? Our medic is a real live doctor.”
“I heard about you,” Tyler said. “I forgot about that part. Probably because … uh …”
Jim rolled his eyes. “Probably because of the other part of the rumor? That he and I are an item?”
“Uh …” Tyler squirmed in his seat, not making eye contact with either one of them.
“Well, both parts of the rumor are true, Spoons. Honestly, I thought you were a modern sort of dude.”
“I am!” Weston protested. He looked back and forth between the two of them. “I was just …”
“Everyone here had already figured it out before we said anything,” Len said, trying to put Weston at ease. “It’s a different world up here, than it was down where I’m from. Nobody’s even put any nasty anonymous notes in my locker or anything. Not even any gay porn.”
“I’m fine with it, really!” Tyler said, though Len doubted that was entirely true. “I was just … you know, Jim. People spread rumors. You just never know what’s true and what’s not.”
“Well, that one’s true,” Jim said. “And I heard a rumor about you, too.”
“What?” Tyler said in alarm. “About me?”
“That you’re going to the same officer’s training session as me, this summer?”
“Oh,” Tyler said, relaxing. “Yeah-I didn’t know you were going. Awesome!”
True to his word, Tyler jumped, scraping his chair across the floor, as the tones dropped.
“Ambulance 2, stage in the area of 124 River Road, for a female with an overdose, 23-Charlie-1; law enforcement en route. Stage near 124 River Road, female with overdose, 23-Charlie-1, 1750.”
“See you later,” Len said. He left the ready room, and went into the bay, nearly colliding with Christine Chapel as she came out of the women’s locker room.
Christine rolled the rig out of the bay, and turned onto the road, hitting the lights and siren briefly to halt the rush-hour traffic and allow them to turn out of the station.
“You look … annoyed?” Chris said, once they were on their way.
Len shook his head. “Not really. Gaila’s sub used to work with Jim. He’d heard a rumor about the two of us, and I guess he was a little taken aback that it turned out to be true.” He shrugged his shoulders. “I don’t think he was fixin’ to make an issue of it or anything. I just thought he was maybe surprised. Jim actually found a diplomatic way to change the subject, though. Turns out this fella is goin’ to the same officer training in-”
Len was cut off by the dispatcher on the radio. “Ambulance 2, further information from law enforcement.”
“Dispatch, Ambulance 2. Go ahead.”
“Officers on scene report the patient has a firearm, and is experiencing hallucinations. Stage at the corner of River and 80th Street until further notice.”
“Copy,” Len said heavily. “Ambulance 2 staging at the corner of River and 80th.”
“I don’t have a good feeling about this one,” Christine admitted.
“Me neither.”
They drove on silently, and idled the rig at the corner as directed. The house was surrounded by police cars.
“If I were hallucinating and on drugs, I don’t think all those flashing lights would do me a whole lot of good,” Leonard grumbled.
They sat for over twenty minutes, with the only change being a SWAT van entering the street a few minutes after the ambulance arrived. There was nothing they could do except wait, tensely, silently, because conversation was out of the question-there was really nothing to talk about while waiting for something horrible to happen.
After they’d been there for half an hour, there was a sudden flash of light from the house, at the same time as an explosive sound which would have been deafening nearer the source.
“Shit!” Christine said.
“Flashbang,” Leonard said.
“Oh,” Chris said. “I’ve heard of them, but never experienced it.”
There was a flurry of activity at the front door of the house, and what sounded like several gunshots.
“Not a flashbang,” Len said. “Fuck.”
The mobile radio came to life thirty seconds later.
“Ambulance 2,” the dispatcher said.
“Ambulance 2,” Len replied.
“Scene is secure, per officers on scene. The victim is subdued and uninjured, and you may proceed to the scene.”
“Copy that,” Len said, as Christine pulled the rig onto the street.
They got out, gloved up, and brought the stretcher over to the front walkway, where a screaming woman was being held to the ground by four uniformed officers.
The officer in charge approached the two of them.
“Len,” he said. “This came out better than it could’ve.”
“Didn’t sound so good there for a couple seconds. Any idea what she took?”
The officer shook his head. “The boyfriend said she was smoking a joint, and then just went apeshit. Could’ve been laced with PCP, I guess, but we don’t see that around here too much.”
“Okay. What’s her name?”
“Valerie.”
Len approached from the side, and could see how hard it was for the four officers to keep the woman under control. He reached a hand into the fray to feel for a pulse, which, as he expected, was hammering away at about 150 beats per minute.
He moved to the other side to try to make eye contact with the patient.
“Valerie?” he said, looking the woman in the bloodshot eyes.
She met his eyes, but continued her incoherent screaming.
“Valerie, can you tell me what happened?”
Nothing but screams.
“We’re gonna help you, okay?” Len said, and stepped away.
He called the hospital on the radio, and requested permission to tranquilize the patient. Chemical restraints were a last resort, but it was clear this patient could hurt herself or others unless she was tranquilized. Len explained the situation to the doctor in the ED, gave an estimate of the patient’s weight, and received an order to administer five milligrams of Haldol.
“Five milligrams Haldol, IM, copy,” Len said.
Christine had the Advanced Life Support medication pack ready for him, as well as the IV pack she knew he’d need once the patient was tranquilized. Len drew the correct dosage up into a syringe, and approached his patient. Even though he doubted she could hear or understand what he was saying, he explained anyhow.
“Valerie, I’m Len, and I’m a paramedic. I’m going to give you a shot, that will make you calm, so you don’t hurt yourself.”
She didn’t seem to notice that he’d said anything, and was similarly unaware of the alcohol prep pad and the injection itself. Within a minute, though, she stopped struggling and screaming, and gradually became limp and placid.
“Can you guys help get her on the stretcher, please?” Leonard asked the four officers who were restraining the patient.
They helped, and the patient was soon on the gurney. As Leonard went to start the IV, he noticed a splash of blood on the white sheet covering the stretcher. He frowned, and inspected the patient, to find where the bleeding was. Before he got very far, however, there was a commotion behind him.
“Jerry? Oh, shit! Sarge, Jerry’s hit!” one of the officers exclaimed.
“Chris? Check him out,” Len said, but Christine was already on her feet and approaching the officer in question, who was suddenly pale and shaky.
Len quickly got a set of vitals, and started the IV that was standard procedure on a tranquilized patient. The woman’s vitals were all amped up, especially considering that they should’ve been depressed from the medication he gave. He wired her up for a 12-lead EKG, and was relieved to see sinus tachycardia, a qualitatively normal but accelerated heartbeat. Once he was satisfied his patient was stable, he turned to see what Christine had on her hands.
“Just a deep graze, Len. But he needs to go in, since it was a gunshot wound,” Christine said.
“I need law enforcement in the back of the rig on this trip,” Len said, frowning, “but somehow I think the idea is able-bodied law enforcement. All right. We’ll put him on the bench next to me, and another officer across from us.”
The officers helped load the patient into the rig, and helped their wounded comrade aboard as well. A second officer joined the packed patient compartment of the ambulance, and Christine pulled the rig out onto the road.
Half an hour later, Len and Christine were completing their electronic paperwork back at the station. They checked each other’s reports before adding the electronic signatures, as they were sure these reports would be subpoenaed. Len closed the program, and went looking for Jim.
He found him, sitting on the picnic table outside with Tyler Weston and Chekov.
“Heya, Bones! Come join us,” Jim called.
Len went over to the table and sat down on, not at, the table, along with the other three men.
“How was that run?” Jim asked, frowning. “That dispatch code is for a violent patient, right?”
Len nodded. “They had that one right. She shot a cop, actually.”
Weston whistled. “Wow. Sometimes I think your job is just as dangerous as ours.”
“Sometimes I agree,” Len said. “Wouldn’t mind not having one like that for a while.”
“So what’s the-”
Jim’s question was interrupted by the station’s tones, sending the engine and the ladder to an alarm activation at an office building. Len returned to the ready room, and settled in to review one of his medical books. Even though his residency was set in stone, he was keenly aware of the gap between his graduation from medical school and now. He settled into the couch, and was lost in his book when the overhead doors of the bay rumbled open twenty minutes later.
Len jumped a foot when Jim suddenly plopped down on the couch, right next to him, flinging his arm around Len’s shoulders.
“Thanks very much for the sweaty armpit on my shoulder,” Len said.
Jim switched to Len’s other side, and repeated his shoulder hug. “There, now they’re equal.”
“Terrific,” Len said, providing Jim with the scowl he’d clearly been asking for.
Jim pushed Len’s book up with one finger to examine the cover. “Psychiatric Emergencies,” he said. “Good choice.”
“I thought so,” Len said, sticking a bookmark in the book and closing it. “Not that anything in a book does a whole hell of a lot of good when you’ve got a psychotic patient with a gun. I’ll leave that kind of psychiatric emergency to the cops.”
“Also a good choice,” Jim said. “So anyhow, I was gonna ask earlier. What’s the-”
Jim was once again interrupted by the station’s tones.
“Engine 1, Ambulance 2, respond to the intersection of Valley Drive and 184th Street, for a two-car MVA with entrapment; unknown injuries. Valley Drive and 184th, for a two-car MVA with entrapment and unknown injuries. 1924.”
Chapel drove again, and on the way to the scene, Len realized he and Jim would be working together, which was an unusual occurrence, since his usual assignment to the ladder truck didn’t overlap much with Len’s duties.
As they approached the scene, Len knew it would be a bad one. The view from the windshield showed a large sedan partially embedded in the side of an SUV. Both front doors of the sedan were open, and there were two bloodied individuals sitting on the side of the road, with bystanders apparently helping them. There were other bystanders near the SUV, looking inside anxiously. The SUV was wedged tightly between the sedan on one side, and a cement barrier on the other, effectively blocking all four doors.
As Pike quickly moved the civilians away from the scene, Len called in to dispatch to request another ambulance.
“Chris, you check out the folks on the side of the road; I’m gonna see about the SUV.”
Chekov and Jim stabilized the crumpled mess of vehicles, and cut the battery cables on the SUV. Pike waved Len over.
“There’s just the driver in the SUV, but he looks pretty bad. We’re gonna have to cut the roof off this thing to extricate him,” Pike said.
“All right. I’ll have a look while you’re getting set up,” he said.
“Grab the extra set of gear from the compartment with the extrication tools,” Pike said.
“Okay. I wanna peer through the windshield first, but I’ll gear up if I’m gonna get any closer than that,” Len replied.
He went around to the front of the SUV, and was immediately alarmed by a spray-pattern of blood on the windshield. He raced around to the compartment where Jim was unloading the hydraulic rescue tool, and grabbed the gear.
“The guy probably has an arterial bleed,” he said, as he unzipped his duty boots and kicked them off before stepping into the too-large boots and pants. “I’ve gotta get in there ASAP.”
Jim put down the tool. “Chekov, start up the generator. Bones, lemme help you gear up, and then I’ll get you into the car.”
Len yanked the suspenders up, and Jim helped him into the also-too-large coat. Len reached for the helmet, but Jim shook his head. “You’ll never fit in there with that on. I’ll pass it in before we start cutting, if there’s gonna be room.”
They rounded the back of the engine, as Len pulled thick gloves on over his purple nitrile ones.
“Christine! Trauma bag, to the SUV, pronto!” Len shouted.
Jim helped Len up onto the concrete barrier on the passenger side of the SUV, and then climbed up himself. He used the auto-glass punch to break the window, and cleared the glass with an axe. He boosted Len into the vehicle, and passed in the trauma bag.
Len quickly surveyed his semi-conscious patient. The guy was breathing, but bleeding out. Blood was spurting weakly from a jagged wound on his left thigh. A yellow spike of bone jutted out through the man’s pants, suggesting the cause of the hemorrhage. He quickly cut away the pants leg, and confirmed that there was an arterial bleed at the site of an open femur fracture.
Len grabbed a large gauze pad from the trauma bag, and swore as his heavily gloved hands failed to open the package. He yanked the fire gloves off, and ripped the package open. He pressed the dressing to the wound, leaning into it with all his weight. The patient groaned, but didn’t respond otherwise.
Within thirty seconds, the dressing was saturated.
“Fuck,” Len said under his breath. “Why do you even have any blood left?”
He examined the patient’s position, and saw there was absolutely no way he’d be able to try a pressure bandage, the next step in the hemorrhage control protocol. He opened a side flap on the orange trauma bag and pulled out an item everyone hoped never to use. He unwound the tourniquet completely, and jammed one end under the man’s thigh, and, ending up in the fellow’s lap, pulled it through, threaded the end of the webbing through the buckle, and pulled as hard as he could. He adjusted his weight, and pulled again, then twisted the bar that would tighten the band still further, and fastened it behind its tab. He added another thick dressing on top of the first one, and was relieved to see that the second dressing didn’t saturate. The bleeding was controlled.
“Bones?” Jim said. “You ready for us to cut?”
“Get Chris to pass me in an IV fluid set and the IO drill. And I need someone holding C-spine. Then go for it.”
Jim stared for two seconds, then nodded.
Leonard took stock of the patient, and didn’t find any other life-threatening injuries he could deal with in the vehicle. He counted pulse and respirations; BP was going to have to wait but was surely in the toilet.
“Len! IV pack! IO drill!” Christine said, as she passed the items in.
The rear passenger-side window disappeared, and Chekov wriggled in to hold the patient’s head and neck still during the extrication. Len threw a blanket over the man’s head and shoulders, and then pulled an arm out to try for an IV.
“This is bullshit,” he muttered to himself, knowing nobody would hear over the sound of the hydraulic tool cutting through one of the posts holding up the vehicle’s roof. He tried once for an IV, didn’t get a vein, and went for the drill. Both lower legs were inaccessible at best, and injured at worst.
“This is also bullshit,” he muttered, as he cut the man’s sleeve off and found the landmarks to try for a line directly into the humerus.
The sound of the rescue tool died down for a moment as the first post gave way.
“Gimme fifteen seconds here!” Leonard shouted as loudly as he could. Chekov repeated his shout, and Len drilled a needle into the man’s upper arm bone.
“Okay, go!” he shouted. “That better have fucking worked, pal,” he said to the patient, who he knew couldn’t hear him, “because that’s all I’ve got until you’re outta here.”
Len attached the bag of fluid to the IO catheter, and held it up on the man’s shoulder with one hand, while keeping himself and the patient covered with the blanket with his other hand.
He had no idea of the passage of time, as the din of the tools, the shrieking of metal, and the crunching of glass took over his world. He checked his patient’s pulse from time to time, to make sure it was still there.
With one final metallic shriek, the last post gave way, and Jim, Pike, and Sulu lifted the roof off the vehicle and tossed it aside. Thirty seconds later, Len and the engine crew, aided by an EMT and a paramedic from another ambulance, started backboarding and extricating their patient. It took longer than Len wanted, but there was nothing he could do about it except slap a non-rebreather on the guy and flow him as much oxygen as he could take, now that there weren’t any sparks flying.
Len wasn’t in a position to do any lifting of the patient, so he got the hell out of the way as the other men passed the patient over the remnants of the hood of the vehicle, and directly onto the waiting stretcher.
He stripped the bloodied turnout gear off, leaving it in a heap for someone else to deal with. He pulled the huge rubber boots from the pants, since his duty boots were god only knew where, and shoved his feet back into them, climbing into the back of the rig with his patient.
Christine was already at the wheel.
“Floor it, Chris,” Len said.
They were ten minutes out from the hospital, and there wasn’t much Len could do other than push fluids and complete a head-to-toe assessment, and to let the hospital know what they were about to get. He talked to the doctor as he completed his assessment, and they pulled into the ambulance bay just after Len signed off.
The patient was whisked away by the trauma team, leaving Len standing at the back door of the rig.
Christine came around and joined him.
“Sit down, Len,” she said.
Len’s ears were still ringing with from the noise of the extrication. He stood there, dumbly, looking at the black-and-yellow boots that were three sizes too large.
“Sit down,” Christine ordered, and walked him to the rear step of the rig, and helped him take a seat.
He sat there for a full minute, thinking about what was probably happening inside the emergency department’s trauma room at the moment. O-negative blood, if they had any. Intubation. Stabilization, as much as possible, and evaluation of the internal injuries the guy probably had. Surgery to fix internal bleeds.
Maybe he’d make it.
Maybe he wouldn’t.
In less than two months, Len realized, he’d be on the other end of this mess. Some other poor fucker would be sitting out here on the back of the ambulance, wondering what the hell had just happened, and Len would be in the ED-okay, at a different hospital, but still-barking out orders and doing what he could, in a cleaner, quieter, calmer setting than what Len had just experienced. Nobody other than a paramedic would ever consider the trauma room of a large emergency department to be calm and quiet, but everything’s relative.
Len took a deep breath, and let it out again. He shook his head quickly, like a cat with a fly on its ear, and heard something fall to the ground.
“Your hair’s full of … chunks,” Christine said.
Len stripped off his gloves, dropping them in the red bag. He cleaned his hands, up to the elbows, with sanitizing foam, and then double-gloved himself, as he bent forward from the waist and combed his fingers through his hair. Several pebbles of safety glass fell out, along with insulation, bits of plastic, and shards of who-knew-what. When he was satisfied that the shower of debris was over, he stood upright again, looking down at the small pile he’d created.
“Why don’t you go in and clean up,” Christine said. “I’ll take care of the rig. Okay?”
Len nodded. “Thanks. I appreciate it.”
Len swiped his badge across the card-reader by the ambulance entrance to the ED, and trudged wearily towards the men’s restroom reserved for staff. He cleaned up as well as he could, washing his face twice. The pink tinge to the water in the sink confirmed that he’d be filling out the paperwork for contact with bodily fluids, but he knew that already.
He found their yellow and black stretcher in the hallway, the bloody linen already stripped off. Len gloved up again, and sprayed it down with disinfectant, and wiped and sprayed until the paper towels came away as white as when they started. He could hear the active commotion in the trauma room right behind him, but didn’t try to look in as he took off his gloves and washed again.
Once the stretcher was dry, he put on clean linen, and rolled it back out to the rig.
“You need to stop inside?” he asked Christine.
She shook her head.
“Then let’s get out of here,” Len said.
Back at the station, which was empty-there must have been an alarm activation right after the MVA cleared out-Len bagged his entire uniform for decontamination, and took a shower. He let the water pour over him, and went over the incident again. He knew there was nothing else he could have done, but it sometimes helped him to move on more quickly if he replayed the entire incident in slow motion, while not under extreme stress. Once he’d completed his mental replay, he shut off the water, toweled off, and dressed.
Someone had put his duty boots, which he’d left next to the engine, in front of his locker, with a fresh pair of socks draped over them. He snorted and grinned at the same time, figuring Jim was looking out for him. He put on a clean uniform, and pulled on the socks and boots. As he finished dressing, he heard the bay doors rumble open, heralding the return of the rest of the shift.
Len wasn’t in the mood for company, with the exception of one particular shiftmate. He left the locker room, and, rather than going into the day room, retreated to the dorm room, and sat on an unmade bed. He didn’t want to look pouty or selfish, but he just didn’t want to deal with a swarm of firemen at the moment. Jim would know where to find him, and Len really hoped he looked. Len sat there and brooded for a while. Had his patient lived through the first hour after Len dropped him in the ED? Would he keep his leg? Did he have a brain or spinal injury that would change his life forever even if he did survive? Len knew he could find an answer to at least the first question, next time he took a patient in, and he’d probably ask.
“Bones?” Jim called softly from the doorway.
“Yep.”
Jim sat down next to Len, and Len leaned into him gratefully.
“You were about twenty kinds of awesome today,” Jim said.
Len sighed. “I was about fifty kinds of desperate. Got him to the hospital alive, though.”
“Nobody else could’ve, Bones. Nobody I’ve ever worked with, that’s for sure.”
“I did what I could do. I just hope it was enough, in the long run.”
They sat together for a few minutes, just being.
“You’re gonna be the best damned emergency physician on the planet.”
Len laughed the laugh that Jim had learned wasn’t funny at all. “I just hope I’m adequate, someday. I still kind of feel like I’m some kind of charlatan or poser, going straight from being a paramedic to being a resident in the ED.”
“Never mind those four years of med school, right Bones? So what if the other kids are fresh out of med school and remember every factoid drummed into their heads. So what if they have information that’s a few years newer. How many of them have ever started fluid resuscitation inside a car that’s being cut apart? How many of them have done that right after sitting in on a gunfight? How many of them will ever really understand what’s going on in the back of the ambulance when the paramedics radio in a status report on their way? Trust me, Bones, even if for some reason I don’t understand you don’t trust yourself. You’re going to be beyond fabulous.”
Len sighed. “Thanks for not saying ‘awesome’ again,” he said.
“Even though you are,” Jim said.
“So then how come I feel like crap?”
“Because you’re human, Bones. More human than just about anyone I know. And I love you for it,” Jim said softly.
“Love you too, Jim,” Len said, even more quietly.
“Wanna sit here for a while?” Jim said, putting one arm around Len from behind, and the other circling around his front, pulling him in closer.
“Yeah.”
They sat there for nearly an hour, and everyone apparently knew better than to go looking for them, because they were undisturbed until the tones dropped for yet another alarm activation. Jim kissed Len on the cheek quickly before he left.
Once the apparatus had departed, Len decided it was high time to pull himself together. He finished the report for the run, just in time for the ambulance to be sent to a residence where a 36-year-old male was complaining of general illness.
Len drove the rig, while Christine tended to the patient, who seemed to have some kind of acute stomach ailment. They cleaned up the mess, and let the rig air out in the bay at the hospital, before returning to quarters. On their way back to the station, they were sent to another residence, where a patient with a cardiac history was complaining of chest pain and difficulty breathing.
Len managed this patient, and called in to alert the ED that they were bringing in a potential STEMI patient. They transferred him to the care of the ED doctors without incident, and Len took the opportunity to seek out information on the trauma patient from earlier.
He found a nurse who could help him.
“It was touch and go when they admitted him to the surgical ICU. But he’s made it this far,” she told him.
“Thanks,” Len said, and his night brightened slightly.
The ambulance made it back to the station, where it was late enough that the people who were in the habit of trying to sleep between runs had set themselves up in the dorms. The entire ladder crew was asleep, as was Captain Pike, but Chekov and Sulu were watching TV, and Jim was at the table, reading the paper while eating again.
Jim looked up from his paper as familiar footsteps entered the ready room.
“Bones?”
“Hey.”
“How’s our guy from before, do you know?”
“Still alive.”
“That’s a good sign, right?”
“Uh, last time I checked, yes,” Len said, rolling his eyes.
“Sit down-lemme get you something,” Jim said.
“I’m not really hungry,” Len said.
“Yes you are. You just don’t know it. Besides-look!”
Jim put a piece of pie in front of Len.
Len raised his eyebrows. “Peach pie? Where’d that come from?”
“Well, some lady brought it in this afternoon, apparently, and A-shift didn’t eat it all.”
“I can’t pass that up,” Len said, digging in. “It’s good, too. Not overly sweet, and not starchy, either.”
Len finished his pie, and sat down to do his paperwork from the last run. He’d only just started when the tones dropped yet again.
“Oh, for fuck’s sake,” he muttered.
“Ambulance 2, respond to 1962 West 160th St., for a child with an allergic reaction. Difficulty breathing, condition worsening. 2-Delta-3. 1-9-6-2 West 160th, for a child with an allergic reaction, with difficulty breathing and condition worsening. 2-Delta-3 response. 0109.”
“Good thing it’s not far,” Christine said, as she pulled out from the station, lights flashing and sirens yelping. In three minutes they were at the address, and the door was flung open immediately by a woman in a bathrobe.”
“She was sleeping, and she got stung by something that came in her window, and now her face is all swelled up, and-and-I’m not sure she’s breathing right!” the woman said, before Len or Christine asked her anything.
“Does she have a history of allergies?” Chris asked, as Len looked the child over.
“No! She’s only three-nothing like this has ever happened before!”
The child’s face was swollen, and her swollen tongue protruded from her mouth. Saliva ran down her chin, and her shoulders heaved as she tried desperately to suck air into her swollen airway. Len didn’t pause for one second-he grabbed the pediatric epi-pen from their kit, and jabbed it into the child’s thigh. As soon as the medication was on board, he put an oxygen mask over the child’s face. When a preschooler didn’t protest the mask, it was a sure sign they were in trouble. Len looked the child over for a sting or bite mark, and found what looked like a barbed stinger embedded in the child’s neck, right where it met her shoulder. The little girl’s entire neck was covered with hives, making it difficult to spot, but the stinger was definitely there.
Within a minute, though, the child’s breathing eased, and she started to cough and cry, trying to pull the oxygen mask away from her face. Chris got vitals, and wrote them on her cheat sheet, while Len hooked the child up to the monitor.
“What did you do?” the mother asked, holding her daughter tightly, and trying to reassure her. “That was … magic.”
“Epinephrine is a medication that relieves some of the problems of a severe allergic reaction,” Len said. “But we need to get her to the hospital, quickly, because it sometimes doesn’t last very long. I’ll need to start an IV, which she won’t like very much, but I need to have access to a vein to give her more medication on the way to the hospital.”
“Anything,” the mother said. “Just … just do it. That was so awful.”
Chris and Leonard had worked together long enough that she knew what size IV pack to give him without his having to say anything. She helped the mother hold the child still while Len prepped her arm.
“Sweetheart, I’m gonna put a shot in your arm, and it’s gonna hurt like a really big pinch,” Len said, right before he popped the needle into the vein. The child cried, but that was all, and mercifully, Len got the vein on the first try. He pushed Benadryl into the IV, and wrapped the child’s arm onto a board to keep her from bending it.
“Okay, let’s get to the hospital. Ma’am, you can ride in with us, or come in your own car. Your choice. She’ll be pretty sleepy from the drug I just gave her in the IV.”
“Of course I’ll go with you! Jilly’s so scared!”
Len alerted the hospital to their incoming patient. Halfway to the hospital, the girl’s breathing started to become labored again, and Len quietly pushed epinephrine into the IV, not wanting to alarm either the child or the mother. The child improved again, quickly, and they arrived at the hospital without incident.
After Len gave the run-down to the receiving nurses, and Christine changed the linens, the child’s mother stepped out of the exam room for a moment.
“Thank you so much,” she said. “I honestly thought … I really thought she might die.”
“You’re welcome,” Len said. “I was glad to help. She’s a tough cookie, and they’re terrific here.”
“Thank you,” the mother said again, clasping his arm. “Thank you.”
“You’re extremely welcome,” Len said. For a brief moment, he wondered if he had a problem on his hands, but the woman let him go, and returned to her child’s side.
Len joined Christine, who was waiting at the exit to the ambulance bay.
“And that,” Len said, “is what it’s all about.”
“Amen to that,” Chris said.
~!~!~!~
When they returned to the station, the bays were empty of the large fire apparatus. Len checked the monitor that displayed the recent calls in the county, and saw that the engine and ladder had been dispatched to an alarm activation. As he watched, the display changed, to show that they were returning to the station. Len took advantage of the quiet, and caught up on his reports. He was just closing the file on the child with the bee-sting when the station came to life again, with the rumbling of diesel engines, and the chatter of eight firefighters putting their gear back on their racks.
“What’s the damage, Jim?” Len asked, as the men trooped back into the room.
“Just a faulty heat sensor,” Jim said. “And you’re in a better mood.”
“Just saved a 3-year-old from certain death,” Len said, “with the magic of epinephrine.”
“Allergy?” Jim guessed.
“You’re catching on-sure you wanna stick with this crazy firefighter business?”
“Yeah, pretty sure,” Jim said. “No way I could handle what you do.”
“Well, we’re even, then, since there’s no way you’ll ever catch me up on a roof with a running chainsaw. With fire spurting out of the hole I just cut.”
“And don’t forget, the roof could collapse at any sec-”
“Stop!” Len said. “You win!”
“Nah,” Jim said lightly, looking at Len fondly. “We both win.”
Len sat back in his seat, and resisted the strong urge to lean over and kiss his boyfriend, right in front of the entire rest of their shiftmates.
“I guess we do,” Len said. “I guess we do.”
THE END
Warnings for violence, blood, gore, you name it.
A/N: Set in the Firehouse AU, not too long before the "Mayday" chapter. Technical things in this story are waaaaay out of my league! How do I get myself into these things? I apologize for any technical errors.
Another Day
“Listen up, people!” Pike bellowed, unused to having to raise his voice during roll call. “Hey!”
The chatter in the apparatus bay died down, and the crew fell into line. An unfamiliar face joined them, and Gaila was conspicuously absent.
“Slight change in duties today. Gaila’s out sick; Tyler Weston will be filling in. Weston, you’ll be a truckie today; Kirk, I want you with Chekov on the engine. Spock, you brief Weston on anything you need to. Everyone else-same assignments as always. Any questions?”
Pike looked specifically at Jim, who shook his head.
“Good,” Pike said. “Dismissed.”
“C’mon, Bones,” Jim said, plucking Len out of the line. “Let’s see what’s in the freezer. I’m starved.”
Len let himself be led to the kitchen area.
“So, why’d Cap put you on the engine today?” he asked.
“Oh, just ‘cause he wants someone he knows with the probie. If Weston subbed directly into Gaila’s seat on the engine, he’d be in the kind of tricky position of being in charge of a probie he knows nothing about.”
“Makes sense,” Len said. “Hey-there’s some of Spock’s soup from the other day. Hand me that, will ya? And do you see the meatloaf on the bottom there?”
“Oooh, great,” Jim said. “Yeah, I’ll have that for sure.”
Sitting at the table, they waited for their selections to defrost in the microwave. Jim caught the attention of Weston, and gestured him over to the table.
“Hey, Spoons! Long time no see! How’s it going?”
The stocky blond man sat at the table opposite Jim. “Can’t complain, Jim. How about you?”
“Better than ever! Hey, you probably haven’t met our medic. Bones, I worked with Tyler at the downtown station for a couple years before I came out here. Ty, this is Leonard McCoy, and you’ll never see a finer medic.”
“Nice to meet you,” Tyler said.
“Likewise,” Len said. “And call me Len, despite what you may hear Jim calling me.”
“Ah, he got you with a nickname, huh?” Weston said.
“At least it’s not ‘Spoons,’” Len said. “Dare I ask how that came about?”
“It was really dumb,” Tyler said. “All I was doing was unloading the dishwasher, and the tones dropped, and I’m the kind of person that startles easily, right? And I threw a whole container of spoons all over the kitchen. And that was that. How about yours?”
“He started calling me ‘Sawbones,’ like they called doctors in the Navy or the Army or whatever, and I complained that my nickname shouldn’t be longer than ‘Len,’ so he shortened it. Better than ‘Saw,” I suppose,” Len said.
“And I came up with that even before I knew he had an M.D.! Isn’t that awesome, Spoons? Our medic is a real live doctor.”
“I heard about you,” Tyler said. “I forgot about that part. Probably because … uh …”
Jim rolled his eyes. “Probably because of the other part of the rumor? That he and I are an item?”
“Uh …” Tyler squirmed in his seat, not making eye contact with either one of them.
“Well, both parts of the rumor are true, Spoons. Honestly, I thought you were a modern sort of dude.”
“I am!” Weston protested. He looked back and forth between the two of them. “I was just …”
“Everyone here had already figured it out before we said anything,” Len said, trying to put Weston at ease. “It’s a different world up here, than it was down where I’m from. Nobody’s even put any nasty anonymous notes in my locker or anything. Not even any gay porn.”
“I’m fine with it, really!” Tyler said, though Len doubted that was entirely true. “I was just … you know, Jim. People spread rumors. You just never know what’s true and what’s not.”
“Well, that one’s true,” Jim said. “And I heard a rumor about you, too.”
“What?” Tyler said in alarm. “About me?”
“That you’re going to the same officer’s training session as me, this summer?”
“Oh,” Tyler said, relaxing. “Yeah-I didn’t know you were going. Awesome!”
True to his word, Tyler jumped, scraping his chair across the floor, as the tones dropped.
“Ambulance 2, stage in the area of 124 River Road, for a female with an overdose, 23-Charlie-1; law enforcement en route. Stage near 124 River Road, female with overdose, 23-Charlie-1, 1750.”
“See you later,” Len said. He left the ready room, and went into the bay, nearly colliding with Christine Chapel as she came out of the women’s locker room.
Christine rolled the rig out of the bay, and turned onto the road, hitting the lights and siren briefly to halt the rush-hour traffic and allow them to turn out of the station.
“You look … annoyed?” Chris said, once they were on their way.
Len shook his head. “Not really. Gaila’s sub used to work with Jim. He’d heard a rumor about the two of us, and I guess he was a little taken aback that it turned out to be true.” He shrugged his shoulders. “I don’t think he was fixin’ to make an issue of it or anything. I just thought he was maybe surprised. Jim actually found a diplomatic way to change the subject, though. Turns out this fella is goin’ to the same officer training in-”
Len was cut off by the dispatcher on the radio. “Ambulance 2, further information from law enforcement.”
“Dispatch, Ambulance 2. Go ahead.”
“Officers on scene report the patient has a firearm, and is experiencing hallucinations. Stage at the corner of River and 80th Street until further notice.”
“Copy,” Len said heavily. “Ambulance 2 staging at the corner of River and 80th.”
“I don’t have a good feeling about this one,” Christine admitted.
“Me neither.”
They drove on silently, and idled the rig at the corner as directed. The house was surrounded by police cars.
“If I were hallucinating and on drugs, I don’t think all those flashing lights would do me a whole lot of good,” Leonard grumbled.
They sat for over twenty minutes, with the only change being a SWAT van entering the street a few minutes after the ambulance arrived. There was nothing they could do except wait, tensely, silently, because conversation was out of the question-there was really nothing to talk about while waiting for something horrible to happen.
After they’d been there for half an hour, there was a sudden flash of light from the house, at the same time as an explosive sound which would have been deafening nearer the source.
“Shit!” Christine said.
“Flashbang,” Leonard said.
“Oh,” Chris said. “I’ve heard of them, but never experienced it.”
There was a flurry of activity at the front door of the house, and what sounded like several gunshots.
“Not a flashbang,” Len said. “Fuck.”
The mobile radio came to life thirty seconds later.
“Ambulance 2,” the dispatcher said.
“Ambulance 2,” Len replied.
“Scene is secure, per officers on scene. The victim is subdued and uninjured, and you may proceed to the scene.”
“Copy that,” Len said, as Christine pulled the rig onto the street.
They got out, gloved up, and brought the stretcher over to the front walkway, where a screaming woman was being held to the ground by four uniformed officers.
The officer in charge approached the two of them.
“Len,” he said. “This came out better than it could’ve.”
“Didn’t sound so good there for a couple seconds. Any idea what she took?”
The officer shook his head. “The boyfriend said she was smoking a joint, and then just went apeshit. Could’ve been laced with PCP, I guess, but we don’t see that around here too much.”
“Okay. What’s her name?”
“Valerie.”
Len approached from the side, and could see how hard it was for the four officers to keep the woman under control. He reached a hand into the fray to feel for a pulse, which, as he expected, was hammering away at about 150 beats per minute.
He moved to the other side to try to make eye contact with the patient.
“Valerie?” he said, looking the woman in the bloodshot eyes.
She met his eyes, but continued her incoherent screaming.
“Valerie, can you tell me what happened?”
Nothing but screams.
“We’re gonna help you, okay?” Len said, and stepped away.
He called the hospital on the radio, and requested permission to tranquilize the patient. Chemical restraints were a last resort, but it was clear this patient could hurt herself or others unless she was tranquilized. Len explained the situation to the doctor in the ED, gave an estimate of the patient’s weight, and received an order to administer five milligrams of Haldol.
“Five milligrams Haldol, IM, copy,” Len said.
Christine had the Advanced Life Support medication pack ready for him, as well as the IV pack she knew he’d need once the patient was tranquilized. Len drew the correct dosage up into a syringe, and approached his patient. Even though he doubted she could hear or understand what he was saying, he explained anyhow.
“Valerie, I’m Len, and I’m a paramedic. I’m going to give you a shot, that will make you calm, so you don’t hurt yourself.”
She didn’t seem to notice that he’d said anything, and was similarly unaware of the alcohol prep pad and the injection itself. Within a minute, though, she stopped struggling and screaming, and gradually became limp and placid.
“Can you guys help get her on the stretcher, please?” Leonard asked the four officers who were restraining the patient.
They helped, and the patient was soon on the gurney. As Leonard went to start the IV, he noticed a splash of blood on the white sheet covering the stretcher. He frowned, and inspected the patient, to find where the bleeding was. Before he got very far, however, there was a commotion behind him.
“Jerry? Oh, shit! Sarge, Jerry’s hit!” one of the officers exclaimed.
“Chris? Check him out,” Len said, but Christine was already on her feet and approaching the officer in question, who was suddenly pale and shaky.
Len quickly got a set of vitals, and started the IV that was standard procedure on a tranquilized patient. The woman’s vitals were all amped up, especially considering that they should’ve been depressed from the medication he gave. He wired her up for a 12-lead EKG, and was relieved to see sinus tachycardia, a qualitatively normal but accelerated heartbeat. Once he was satisfied his patient was stable, he turned to see what Christine had on her hands.
“Just a deep graze, Len. But he needs to go in, since it was a gunshot wound,” Christine said.
“I need law enforcement in the back of the rig on this trip,” Len said, frowning, “but somehow I think the idea is able-bodied law enforcement. All right. We’ll put him on the bench next to me, and another officer across from us.”
The officers helped load the patient into the rig, and helped their wounded comrade aboard as well. A second officer joined the packed patient compartment of the ambulance, and Christine pulled the rig out onto the road.
Half an hour later, Len and Christine were completing their electronic paperwork back at the station. They checked each other’s reports before adding the electronic signatures, as they were sure these reports would be subpoenaed. Len closed the program, and went looking for Jim.
He found him, sitting on the picnic table outside with Tyler Weston and Chekov.
“Heya, Bones! Come join us,” Jim called.
Len went over to the table and sat down on, not at, the table, along with the other three men.
“How was that run?” Jim asked, frowning. “That dispatch code is for a violent patient, right?”
Len nodded. “They had that one right. She shot a cop, actually.”
Weston whistled. “Wow. Sometimes I think your job is just as dangerous as ours.”
“Sometimes I agree,” Len said. “Wouldn’t mind not having one like that for a while.”
“So what’s the-”
Jim’s question was interrupted by the station’s tones, sending the engine and the ladder to an alarm activation at an office building. Len returned to the ready room, and settled in to review one of his medical books. Even though his residency was set in stone, he was keenly aware of the gap between his graduation from medical school and now. He settled into the couch, and was lost in his book when the overhead doors of the bay rumbled open twenty minutes later.
Len jumped a foot when Jim suddenly plopped down on the couch, right next to him, flinging his arm around Len’s shoulders.
“Thanks very much for the sweaty armpit on my shoulder,” Len said.
Jim switched to Len’s other side, and repeated his shoulder hug. “There, now they’re equal.”
“Terrific,” Len said, providing Jim with the scowl he’d clearly been asking for.
Jim pushed Len’s book up with one finger to examine the cover. “Psychiatric Emergencies,” he said. “Good choice.”
“I thought so,” Len said, sticking a bookmark in the book and closing it. “Not that anything in a book does a whole hell of a lot of good when you’ve got a psychotic patient with a gun. I’ll leave that kind of psychiatric emergency to the cops.”
“Also a good choice,” Jim said. “So anyhow, I was gonna ask earlier. What’s the-”
Jim was once again interrupted by the station’s tones.
“Engine 1, Ambulance 2, respond to the intersection of Valley Drive and 184th Street, for a two-car MVA with entrapment; unknown injuries. Valley Drive and 184th, for a two-car MVA with entrapment and unknown injuries. 1924.”
Chapel drove again, and on the way to the scene, Len realized he and Jim would be working together, which was an unusual occurrence, since his usual assignment to the ladder truck didn’t overlap much with Len’s duties.
As they approached the scene, Len knew it would be a bad one. The view from the windshield showed a large sedan partially embedded in the side of an SUV. Both front doors of the sedan were open, and there were two bloodied individuals sitting on the side of the road, with bystanders apparently helping them. There were other bystanders near the SUV, looking inside anxiously. The SUV was wedged tightly between the sedan on one side, and a cement barrier on the other, effectively blocking all four doors.
As Pike quickly moved the civilians away from the scene, Len called in to dispatch to request another ambulance.
“Chris, you check out the folks on the side of the road; I’m gonna see about the SUV.”
Chekov and Jim stabilized the crumpled mess of vehicles, and cut the battery cables on the SUV. Pike waved Len over.
“There’s just the driver in the SUV, but he looks pretty bad. We’re gonna have to cut the roof off this thing to extricate him,” Pike said.
“All right. I’ll have a look while you’re getting set up,” he said.
“Grab the extra set of gear from the compartment with the extrication tools,” Pike said.
“Okay. I wanna peer through the windshield first, but I’ll gear up if I’m gonna get any closer than that,” Len replied.
He went around to the front of the SUV, and was immediately alarmed by a spray-pattern of blood on the windshield. He raced around to the compartment where Jim was unloading the hydraulic rescue tool, and grabbed the gear.
“The guy probably has an arterial bleed,” he said, as he unzipped his duty boots and kicked them off before stepping into the too-large boots and pants. “I’ve gotta get in there ASAP.”
Jim put down the tool. “Chekov, start up the generator. Bones, lemme help you gear up, and then I’ll get you into the car.”
Len yanked the suspenders up, and Jim helped him into the also-too-large coat. Len reached for the helmet, but Jim shook his head. “You’ll never fit in there with that on. I’ll pass it in before we start cutting, if there’s gonna be room.”
They rounded the back of the engine, as Len pulled thick gloves on over his purple nitrile ones.
“Christine! Trauma bag, to the SUV, pronto!” Len shouted.
Jim helped Len up onto the concrete barrier on the passenger side of the SUV, and then climbed up himself. He used the auto-glass punch to break the window, and cleared the glass with an axe. He boosted Len into the vehicle, and passed in the trauma bag.
Len quickly surveyed his semi-conscious patient. The guy was breathing, but bleeding out. Blood was spurting weakly from a jagged wound on his left thigh. A yellow spike of bone jutted out through the man’s pants, suggesting the cause of the hemorrhage. He quickly cut away the pants leg, and confirmed that there was an arterial bleed at the site of an open femur fracture.
Len grabbed a large gauze pad from the trauma bag, and swore as his heavily gloved hands failed to open the package. He yanked the fire gloves off, and ripped the package open. He pressed the dressing to the wound, leaning into it with all his weight. The patient groaned, but didn’t respond otherwise.
Within thirty seconds, the dressing was saturated.
“Fuck,” Len said under his breath. “Why do you even have any blood left?”
He examined the patient’s position, and saw there was absolutely no way he’d be able to try a pressure bandage, the next step in the hemorrhage control protocol. He opened a side flap on the orange trauma bag and pulled out an item everyone hoped never to use. He unwound the tourniquet completely, and jammed one end under the man’s thigh, and, ending up in the fellow’s lap, pulled it through, threaded the end of the webbing through the buckle, and pulled as hard as he could. He adjusted his weight, and pulled again, then twisted the bar that would tighten the band still further, and fastened it behind its tab. He added another thick dressing on top of the first one, and was relieved to see that the second dressing didn’t saturate. The bleeding was controlled.
“Bones?” Jim said. “You ready for us to cut?”
“Get Chris to pass me in an IV fluid set and the IO drill. And I need someone holding C-spine. Then go for it.”
Jim stared for two seconds, then nodded.
Leonard took stock of the patient, and didn’t find any other life-threatening injuries he could deal with in the vehicle. He counted pulse and respirations; BP was going to have to wait but was surely in the toilet.
“Len! IV pack! IO drill!” Christine said, as she passed the items in.
The rear passenger-side window disappeared, and Chekov wriggled in to hold the patient’s head and neck still during the extrication. Len threw a blanket over the man’s head and shoulders, and then pulled an arm out to try for an IV.
“This is bullshit,” he muttered to himself, knowing nobody would hear over the sound of the hydraulic tool cutting through one of the posts holding up the vehicle’s roof. He tried once for an IV, didn’t get a vein, and went for the drill. Both lower legs were inaccessible at best, and injured at worst.
“This is also bullshit,” he muttered, as he cut the man’s sleeve off and found the landmarks to try for a line directly into the humerus.
The sound of the rescue tool died down for a moment as the first post gave way.
“Gimme fifteen seconds here!” Leonard shouted as loudly as he could. Chekov repeated his shout, and Len drilled a needle into the man’s upper arm bone.
“Okay, go!” he shouted. “That better have fucking worked, pal,” he said to the patient, who he knew couldn’t hear him, “because that’s all I’ve got until you’re outta here.”
Len attached the bag of fluid to the IO catheter, and held it up on the man’s shoulder with one hand, while keeping himself and the patient covered with the blanket with his other hand.
He had no idea of the passage of time, as the din of the tools, the shrieking of metal, and the crunching of glass took over his world. He checked his patient’s pulse from time to time, to make sure it was still there.
With one final metallic shriek, the last post gave way, and Jim, Pike, and Sulu lifted the roof off the vehicle and tossed it aside. Thirty seconds later, Len and the engine crew, aided by an EMT and a paramedic from another ambulance, started backboarding and extricating their patient. It took longer than Len wanted, but there was nothing he could do about it except slap a non-rebreather on the guy and flow him as much oxygen as he could take, now that there weren’t any sparks flying.
Len wasn’t in a position to do any lifting of the patient, so he got the hell out of the way as the other men passed the patient over the remnants of the hood of the vehicle, and directly onto the waiting stretcher.
He stripped the bloodied turnout gear off, leaving it in a heap for someone else to deal with. He pulled the huge rubber boots from the pants, since his duty boots were god only knew where, and shoved his feet back into them, climbing into the back of the rig with his patient.
Christine was already at the wheel.
“Floor it, Chris,” Len said.
They were ten minutes out from the hospital, and there wasn’t much Len could do other than push fluids and complete a head-to-toe assessment, and to let the hospital know what they were about to get. He talked to the doctor as he completed his assessment, and they pulled into the ambulance bay just after Len signed off.
The patient was whisked away by the trauma team, leaving Len standing at the back door of the rig.
Christine came around and joined him.
“Sit down, Len,” she said.
Len’s ears were still ringing with from the noise of the extrication. He stood there, dumbly, looking at the black-and-yellow boots that were three sizes too large.
“Sit down,” Christine ordered, and walked him to the rear step of the rig, and helped him take a seat.
He sat there for a full minute, thinking about what was probably happening inside the emergency department’s trauma room at the moment. O-negative blood, if they had any. Intubation. Stabilization, as much as possible, and evaluation of the internal injuries the guy probably had. Surgery to fix internal bleeds.
Maybe he’d make it.
Maybe he wouldn’t.
In less than two months, Len realized, he’d be on the other end of this mess. Some other poor fucker would be sitting out here on the back of the ambulance, wondering what the hell had just happened, and Len would be in the ED-okay, at a different hospital, but still-barking out orders and doing what he could, in a cleaner, quieter, calmer setting than what Len had just experienced. Nobody other than a paramedic would ever consider the trauma room of a large emergency department to be calm and quiet, but everything’s relative.
Len took a deep breath, and let it out again. He shook his head quickly, like a cat with a fly on its ear, and heard something fall to the ground.
“Your hair’s full of … chunks,” Christine said.
Len stripped off his gloves, dropping them in the red bag. He cleaned his hands, up to the elbows, with sanitizing foam, and then double-gloved himself, as he bent forward from the waist and combed his fingers through his hair. Several pebbles of safety glass fell out, along with insulation, bits of plastic, and shards of who-knew-what. When he was satisfied that the shower of debris was over, he stood upright again, looking down at the small pile he’d created.
“Why don’t you go in and clean up,” Christine said. “I’ll take care of the rig. Okay?”
Len nodded. “Thanks. I appreciate it.”
Len swiped his badge across the card-reader by the ambulance entrance to the ED, and trudged wearily towards the men’s restroom reserved for staff. He cleaned up as well as he could, washing his face twice. The pink tinge to the water in the sink confirmed that he’d be filling out the paperwork for contact with bodily fluids, but he knew that already.
He found their yellow and black stretcher in the hallway, the bloody linen already stripped off. Len gloved up again, and sprayed it down with disinfectant, and wiped and sprayed until the paper towels came away as white as when they started. He could hear the active commotion in the trauma room right behind him, but didn’t try to look in as he took off his gloves and washed again.
Once the stretcher was dry, he put on clean linen, and rolled it back out to the rig.
“You need to stop inside?” he asked Christine.
She shook her head.
“Then let’s get out of here,” Len said.
Back at the station, which was empty-there must have been an alarm activation right after the MVA cleared out-Len bagged his entire uniform for decontamination, and took a shower. He let the water pour over him, and went over the incident again. He knew there was nothing else he could have done, but it sometimes helped him to move on more quickly if he replayed the entire incident in slow motion, while not under extreme stress. Once he’d completed his mental replay, he shut off the water, toweled off, and dressed.
Someone had put his duty boots, which he’d left next to the engine, in front of his locker, with a fresh pair of socks draped over them. He snorted and grinned at the same time, figuring Jim was looking out for him. He put on a clean uniform, and pulled on the socks and boots. As he finished dressing, he heard the bay doors rumble open, heralding the return of the rest of the shift.
Len wasn’t in the mood for company, with the exception of one particular shiftmate. He left the locker room, and, rather than going into the day room, retreated to the dorm room, and sat on an unmade bed. He didn’t want to look pouty or selfish, but he just didn’t want to deal with a swarm of firemen at the moment. Jim would know where to find him, and Len really hoped he looked. Len sat there and brooded for a while. Had his patient lived through the first hour after Len dropped him in the ED? Would he keep his leg? Did he have a brain or spinal injury that would change his life forever even if he did survive? Len knew he could find an answer to at least the first question, next time he took a patient in, and he’d probably ask.
“Bones?” Jim called softly from the doorway.
“Yep.”
Jim sat down next to Len, and Len leaned into him gratefully.
“You were about twenty kinds of awesome today,” Jim said.
Len sighed. “I was about fifty kinds of desperate. Got him to the hospital alive, though.”
“Nobody else could’ve, Bones. Nobody I’ve ever worked with, that’s for sure.”
“I did what I could do. I just hope it was enough, in the long run.”
They sat together for a few minutes, just being.
“You’re gonna be the best damned emergency physician on the planet.”
Len laughed the laugh that Jim had learned wasn’t funny at all. “I just hope I’m adequate, someday. I still kind of feel like I’m some kind of charlatan or poser, going straight from being a paramedic to being a resident in the ED.”
“Never mind those four years of med school, right Bones? So what if the other kids are fresh out of med school and remember every factoid drummed into their heads. So what if they have information that’s a few years newer. How many of them have ever started fluid resuscitation inside a car that’s being cut apart? How many of them have done that right after sitting in on a gunfight? How many of them will ever really understand what’s going on in the back of the ambulance when the paramedics radio in a status report on their way? Trust me, Bones, even if for some reason I don’t understand you don’t trust yourself. You’re going to be beyond fabulous.”
Len sighed. “Thanks for not saying ‘awesome’ again,” he said.
“Even though you are,” Jim said.
“So then how come I feel like crap?”
“Because you’re human, Bones. More human than just about anyone I know. And I love you for it,” Jim said softly.
“Love you too, Jim,” Len said, even more quietly.
“Wanna sit here for a while?” Jim said, putting one arm around Len from behind, and the other circling around his front, pulling him in closer.
“Yeah.”
They sat there for nearly an hour, and everyone apparently knew better than to go looking for them, because they were undisturbed until the tones dropped for yet another alarm activation. Jim kissed Len on the cheek quickly before he left.
Once the apparatus had departed, Len decided it was high time to pull himself together. He finished the report for the run, just in time for the ambulance to be sent to a residence where a 36-year-old male was complaining of general illness.
Len drove the rig, while Christine tended to the patient, who seemed to have some kind of acute stomach ailment. They cleaned up the mess, and let the rig air out in the bay at the hospital, before returning to quarters. On their way back to the station, they were sent to another residence, where a patient with a cardiac history was complaining of chest pain and difficulty breathing.
Len managed this patient, and called in to alert the ED that they were bringing in a potential STEMI patient. They transferred him to the care of the ED doctors without incident, and Len took the opportunity to seek out information on the trauma patient from earlier.
He found a nurse who could help him.
“It was touch and go when they admitted him to the surgical ICU. But he’s made it this far,” she told him.
“Thanks,” Len said, and his night brightened slightly.
The ambulance made it back to the station, where it was late enough that the people who were in the habit of trying to sleep between runs had set themselves up in the dorms. The entire ladder crew was asleep, as was Captain Pike, but Chekov and Sulu were watching TV, and Jim was at the table, reading the paper while eating again.
Jim looked up from his paper as familiar footsteps entered the ready room.
“Bones?”
“Hey.”
“How’s our guy from before, do you know?”
“Still alive.”
“That’s a good sign, right?”
“Uh, last time I checked, yes,” Len said, rolling his eyes.
“Sit down-lemme get you something,” Jim said.
“I’m not really hungry,” Len said.
“Yes you are. You just don’t know it. Besides-look!”
Jim put a piece of pie in front of Len.
Len raised his eyebrows. “Peach pie? Where’d that come from?”
“Well, some lady brought it in this afternoon, apparently, and A-shift didn’t eat it all.”
“I can’t pass that up,” Len said, digging in. “It’s good, too. Not overly sweet, and not starchy, either.”
Len finished his pie, and sat down to do his paperwork from the last run. He’d only just started when the tones dropped yet again.
“Oh, for fuck’s sake,” he muttered.
“Ambulance 2, respond to 1962 West 160th St., for a child with an allergic reaction. Difficulty breathing, condition worsening. 2-Delta-3. 1-9-6-2 West 160th, for a child with an allergic reaction, with difficulty breathing and condition worsening. 2-Delta-3 response. 0109.”
“Good thing it’s not far,” Christine said, as she pulled out from the station, lights flashing and sirens yelping. In three minutes they were at the address, and the door was flung open immediately by a woman in a bathrobe.”
“She was sleeping, and she got stung by something that came in her window, and now her face is all swelled up, and-and-I’m not sure she’s breathing right!” the woman said, before Len or Christine asked her anything.
“Does she have a history of allergies?” Chris asked, as Len looked the child over.
“No! She’s only three-nothing like this has ever happened before!”
The child’s face was swollen, and her swollen tongue protruded from her mouth. Saliva ran down her chin, and her shoulders heaved as she tried desperately to suck air into her swollen airway. Len didn’t pause for one second-he grabbed the pediatric epi-pen from their kit, and jabbed it into the child’s thigh. As soon as the medication was on board, he put an oxygen mask over the child’s face. When a preschooler didn’t protest the mask, it was a sure sign they were in trouble. Len looked the child over for a sting or bite mark, and found what looked like a barbed stinger embedded in the child’s neck, right where it met her shoulder. The little girl’s entire neck was covered with hives, making it difficult to spot, but the stinger was definitely there.
Within a minute, though, the child’s breathing eased, and she started to cough and cry, trying to pull the oxygen mask away from her face. Chris got vitals, and wrote them on her cheat sheet, while Len hooked the child up to the monitor.
“What did you do?” the mother asked, holding her daughter tightly, and trying to reassure her. “That was … magic.”
“Epinephrine is a medication that relieves some of the problems of a severe allergic reaction,” Len said. “But we need to get her to the hospital, quickly, because it sometimes doesn’t last very long. I’ll need to start an IV, which she won’t like very much, but I need to have access to a vein to give her more medication on the way to the hospital.”
“Anything,” the mother said. “Just … just do it. That was so awful.”
Chris and Leonard had worked together long enough that she knew what size IV pack to give him without his having to say anything. She helped the mother hold the child still while Len prepped her arm.
“Sweetheart, I’m gonna put a shot in your arm, and it’s gonna hurt like a really big pinch,” Len said, right before he popped the needle into the vein. The child cried, but that was all, and mercifully, Len got the vein on the first try. He pushed Benadryl into the IV, and wrapped the child’s arm onto a board to keep her from bending it.
“Okay, let’s get to the hospital. Ma’am, you can ride in with us, or come in your own car. Your choice. She’ll be pretty sleepy from the drug I just gave her in the IV.”
“Of course I’ll go with you! Jilly’s so scared!”
Len alerted the hospital to their incoming patient. Halfway to the hospital, the girl’s breathing started to become labored again, and Len quietly pushed epinephrine into the IV, not wanting to alarm either the child or the mother. The child improved again, quickly, and they arrived at the hospital without incident.
After Len gave the run-down to the receiving nurses, and Christine changed the linens, the child’s mother stepped out of the exam room for a moment.
“Thank you so much,” she said. “I honestly thought … I really thought she might die.”
“You’re welcome,” Len said. “I was glad to help. She’s a tough cookie, and they’re terrific here.”
“Thank you,” the mother said again, clasping his arm. “Thank you.”
“You’re extremely welcome,” Len said. For a brief moment, he wondered if he had a problem on his hands, but the woman let him go, and returned to her child’s side.
Len joined Christine, who was waiting at the exit to the ambulance bay.
“And that,” Len said, “is what it’s all about.”
“Amen to that,” Chris said.
~!~!~!~
When they returned to the station, the bays were empty of the large fire apparatus. Len checked the monitor that displayed the recent calls in the county, and saw that the engine and ladder had been dispatched to an alarm activation. As he watched, the display changed, to show that they were returning to the station. Len took advantage of the quiet, and caught up on his reports. He was just closing the file on the child with the bee-sting when the station came to life again, with the rumbling of diesel engines, and the chatter of eight firefighters putting their gear back on their racks.
“What’s the damage, Jim?” Len asked, as the men trooped back into the room.
“Just a faulty heat sensor,” Jim said. “And you’re in a better mood.”
“Just saved a 3-year-old from certain death,” Len said, “with the magic of epinephrine.”
“Allergy?” Jim guessed.
“You’re catching on-sure you wanna stick with this crazy firefighter business?”
“Yeah, pretty sure,” Jim said. “No way I could handle what you do.”
“Well, we’re even, then, since there’s no way you’ll ever catch me up on a roof with a running chainsaw. With fire spurting out of the hole I just cut.”
“And don’t forget, the roof could collapse at any sec-”
“Stop!” Len said. “You win!”
“Nah,” Jim said lightly, looking at Len fondly. “We both win.”
Len sat back in his seat, and resisted the strong urge to lean over and kiss his boyfriend, right in front of the entire rest of their shiftmates.
“I guess we do,” Len said. “I guess we do.”
THE END