STRAIGHT AHEAD, INTO THE DARKNESS

We had a time where the police went a little crazy with the Tasers.  I think of Tasers sort of how I think about shrimp.  For a while there, shrimp was supposed to be horrible for you, almost like it was deadly to eat and then, all of a sudden, magazines switched, and shrimp was the healthiest thing in the world.  It would prevent heart attacks and cancers and debt and cystic fibrosis and sadness.  Tasers were a little bit like that.  What I mean is that they were viewed as the cure-all to police officers firing their weapons.  There’d be no more killing of innocent criminals with a gun, just the kind little annoyance that is a Taser dart.

That is until the patients started dying.

A Taser, you see, is not the safest thing in the world.  It’s not like you’re shooting these things into people with the best health care imaginable.  They’re penetrating into the skin of the lowest of the classes.  Those with heart conditions and seizure conditions and tumor conditions if that’s a phrase and it’s not.  And it’s not like this is a controlled environment where they’re going to be fired from the very safest distance.  No, they get shot at point blank range, which is not how it’s supposed to happen.

We’d get to the call where the individual would typically present with just about everything.  Some people, it was like nothing had happened.  Others would be completely catatonic.  There’s a massive variety of reactions to a Taser.  The things we had to check for were a long list I won’t bore you with, but there were six places you could get shot where you were going to the E.R. no matter what.  Anyone shot in the face, the neck, the axilla, the breast, or the groin was going straight to the E.R.

We arrived to find a patient who had his head in his hands, like he was crying.  He looked like a little boy.  Although he appeared to be in his eighties based on hair color and the skin visible on the back of his neck.  Liver spots owned his skin.

I told my partner to “get all the normal,” which includes a pulse check, Glasgow Coma Scale score, respiratory rate, pulse ox, ECG, and blood pressure.

I approached the patient, crouched, told him my name, and asked if it’d be OK to help him out.

The patient took his hands down and I could clearly see that a Taser dart was in his face, which is already bad, but it happened to be in his eye—even worse.

What we’re supposed to do with patients like this is remain calm.  It’s a thing where my body has become very strangely trained that the worse the patient presents, the lower my pulse goes.  It’s like the most horrible injury sends this shockwave of calm throughout my body and my voice turns into a near whisper and I feel like a monk.

“OK,” I said, “It looks like you have something in your eye.”  The most useless sentence in the world, except I’ve been trained to do this as well.  A perfect example is I had a patient who was sitting on a coffee table in their living room and coughing.  I said, “Sounds like you’ve got a bit of a cold.”  And she said, “Rolf stabbed me with a corkscrew.”  She turned and showed me it, thunked in her upper back.  A cold quickly turns into a corkscrew.  You never know.

The patient whispered something into my ear.  I really hate if patients do that.  I don’t like patients whispering.  I like them to talk loudly, because it lets me know they have a good clear airway.  And because I want a witness to everything they say.  And the witness is my EMT partner.  I’ve had patients threaten my life and it’s fine to note that in the patient care report, but it’s much better if your partner notes that in their memory.  Partners are our constant tape recorder.  Soon as a patient says something like, “I’m a vampire,” which has happened before, I’ll turn to my partner and—without saying a word—we’ll exchange a look of ‘Did you hear that?’ and—again, without a word—my partner will let me know they heard it loud and clear.  One other thing: I don’t like patients whispering because one great-grandmother made it like she was going to tell me a secret and then she tried to bite my ear off.  All it takes is a little bit of overmedication or a little bit hypoglycemia or a tiny bit of too much blood loss and patients can turn into the most crazed people you could ever imagine.  I’ve seen nuns acting like they were possessed; I’ve seen librarians behaving like they’d taken ten hits of LSD in the last hour.  Mostly because they’d taken ten hits of LSD in the last hour.  It doesn’t matter what you’re like in ‘regular life,’ all that matters is how you’re presenting to me now.

And this patient, thank God, was presenting with a calm demeanor.  Which is exactly what I want.  Because my mission is to get you to the hospital and calm helps accomplish that task.

My partner started to take a blood pressure and I said, “How ‘bout we do that on the way to the hospital.”

The first thing we needed to do was cover both of the patient’s eyes.  If you only cover the injured eye, the other eye will start looking around.  The problem is your eyes tend to follow each other and we didn’t want movement of the eye that had a dart in it.  Because that would hurt.  A lot.

We found a Dixie cup in the house and used that to put over the dart and then we got tape off the rig and we wrapped his head up.  He looked like he was ready to be cast in the movie Bird Box.

I told the patient to keep looking forward, no matter what.

“You want me to keep my eye open?”

“You can close it,” I said, “But I want you to look straight ahead.  Into the darkness.”

“No problem,” he said.

I stepped outside with my partner.  We were in trailer park land.  Florida.  An area that was just an absolute maze of trailer parks.  The GPS wouldn’t help us.  You just had to watch for signs to get out of there.  It was common for ambulances to get lost in the labyrinth.  Every other window seemed to have a face in it looking at us.  We were told, ‘Absolutely no lights or sirens in the parks.’  The reason is that the crowds could get thick.  For some senior citizens, it was like a traveling carnival if we arrived, the joy of something happening when they had no TV in their house, no Internet.  Then there was the worry that something was happening to their friend, even if the ‘friend’ was a neighbor that they’d spoken less than ten words to that year.  I whispered, “You think he got Tasered by the cops?”

“Ask him.”

“I did.”

“What’d he say?”

“He said he’d explain on the way to the hospital, that he just wanted to get to a hospital.”

“Well, then, let’s go and we’ll find out on the way.”

“Sounds good to me.”

“Should you take it out first?”

“The dart?”

“Yeah.”

“Hell, no.  You got experience taking a dart out of an eyeball?”

My partner started walking back in.  I stopped him.

“It’s evidence,” I said, “Don’t even touch the wires.  If this guy got shot by the cops, everything is evidence.”

We had him get on the gurney and we headed for the hospital, my partner driving.

On the way, I asked if I could take his blood pressure.

He said, “Sure, long as you give it back when you’re done.”

While the cuff inflated, I asked what happened back there.

“A friend of mine.”

“Yeah.”

“Horsing around.”

“OK.”

“It was a bet.”

“A bet?”

“He said he’d give me a hundred if I didn’t fall.  If he shot me with a Taser.”

“Your friend?”

“Actually, my brother.”

“OK.”

“Yeah.”

“And he shot you in the eye?”

“I thought he was going to shoot me in the chest.  I dropped down to the ground so the motherfucker said he wasn’t going to give me the hundred. And I dialed 911 and he thought I was calling the cops on him, so he ran, but I was calling you guys.”

I gave him back his blood pressure.  “A hundred forty-nine over fifty. Not too good,” I said.

“For me, it’s good,” he said.

I debated if he was stable or not. If he was unstable, I’d be taking his vital signs every five minutes, which, to be honest, is just about nonstop, because as soon as you get done doing all of them, if you don’t rush, the five minutes are up, and you have to start over again.  But if he was stable, it’d be every fifteen minutes, which gave us time to talk.  Everything on him was stable, except the dart in his eye and the high blood pressure.  And the worry about taking blood pressures is that it can actually make them go higher, so I decided he was stable, as I wanted the time to talk, to find out any clues about how to treat him.

We were about five minutes from the hospital, which in the Bay Area meant we were about a half hour away.  It’s the worst city in the U.S. for an ambulance driver.  The good thing is that my partner hates three things: 1) psych patients, 2) children, and 3) anything having to do with the eye.  So our agreement is that I take all those patients.  Which I love, because psych patients are easy.  Most of them won’t even talk to you, just wanting to sleep on the drive.  Usually they’ve had the absolutely worst day you can imagine, so by the time they get on the ambulance and they’re on a gurney, all they want to do is shut their eyes and relax.  It’s safe back there.  Relatively.  So they sleep like children.  And, well, children are pretty easy too.  The parent usually wants to ride in back and so they just take care of the kid while I do vitals.  Usually the parent is overly cheerful, trying to make the kid relax, so it’s really light and positive.  I don’t know.  At least for me it is.  Plus, I like kids.  I think if you don’t like kids, then they sense it, and it all goes downhill from there.  But I was a child once, so I know what it’s like.  And then the eye calls never happen.  Or rarely.  Very rarely.  The reason is because God made our eyes with a whole hell of a lot of protection.  Go ahead and feel around your eye right now.  Feel all those bones?  That’s God the architect.  And yeah, I believe in God.  I think anyone who’s a paramedic has to.  Maybe not.  I don’t know.

“So, your brother,” I said.

“Yeah, he shot me.”

“So he wouldn’t have to pay you a hundred bucks.”

“Oh, I’ll get that money.”

I started worrying that our talking like this was just going to get his heartrate to keep going up, so I leaned back on the paramedic bench.

“But I think it was more than that.”

I put on my seatbelt, something I rarely do in the back of the ambulance.

“I slept with his ex-wife,” the patient said.  He looked at me for a response.  I tried to keep dead pan.  He reached in his pocket and pulled out a pack of cigarettes.

“You can’t smoke in here.”

“Can I at least put it in my mouth?”

“Just don’t smoke it.”

“It’s good for my heart,” he said, “To smoke.”

He put the unlit cigarette in his mouth and put the rest of the pack away.

“It wasn’t his ex-wife,” he said, “At the time.  Now she’s his ex-wife.  But not because of me.  I mean, if they were meant to be together, they’d still be together, but they’re not, so that’s what meant to be.”

I picked up my Patient Care Report, looking over it to make sure I’d asked him all the basic questions I needed to fill out on the PCR.  “Do you have any allergies?” I asked.

“No, but this is the important thing about what I said: I ‘slept’ with his ex-wife.  ‘Slept.’  That’s an important word.  I only slept with her.  That’s it.  In the same bed.  We didn’t do anything.  We just slept, but he was pissed off at that.”

“Are you taking any medications?”

“Like what?”

“Like anything.”

“Does pot count?”

“Sure.  Are you doing pot?”

“Everybody is.”

“Anything else?”

“Lots of stuff.”

“Like street drugs?”

“Street drugs, alley drugs.  Dirt road drugs.  Whatever, but mostly it’s what the doctor gives me.”

“I have to write this down, so could you be specific?”

“In that case, just put vitamins.”

“Well, it’s helpful if, when we get to the E.R., they know of any drugs you’re currently taking.”

“Nothing right now, but I’m trying to explain to you what happened.”

“Your brother shot you in the eye because you slept in the same bed with his wife.”

“I’m guessing,” he said.

“Any pertinent past medical history I should know about?”

“Like what?”

“Anything.  You ever been hospitalized?”

“No.  But I think the issue is that his wife, his ex-wife, is forty years younger than me.”

“OK,” I said.

“You ever sleep with a younger woman?”

“Do you mean ‘sleep’ where you’re actually sleeping together?”

“No, I mean ‘fuck.’”

“A younger woman?  Sure.  I mean, younger, older, sure.”

“Of course.”

“But she’s forty years younger.  And he didn’t like that.”

“How old are you?”

“Seventy-one.”

I put down his age on the PCR.  “So she was thirty-one?”

“OK, maybe fifty years younger.”

“So twenty-one?  She was twenty-one?”

“Twenty.  At the time.  Around there.”

“Around twenty?”

“Nineteen-ish.  But the thing is I didn’t have sex with her.  I slept with her.  In a bed.  And that’s it.  Just sleeping.  And now look at me.”  The Dixie cup was starting to come loose.  I grabbed some tape and put it tighter over the cup.

“Just curious, but is your brother younger or older than you?”

“Younger,” he said.

I slid up the bench and leaned over to the front chassis to my partner and whispered if he knew what the ETA was.  He said a couple minutes.  I went back to the patient.

“A couple miles?” the patient said.

“Minutes,” I said.

“So we’re basically there?”

“We’re basically there.”

“I like you,” the patient said.

“I like you too,” I said.  I’m not sure if that was true.  It just seemed like the thing to say.  I thought about if I liked him or not.  I thought about that all the way to the hospital.  The hospital came up quick.  Its fake palm trees in front of a fake pond.

My partner parked and got out of the front seat, slamming the door by accident.

The patient said, “You know how I said my brother ran?”

I packed up everything in the medical bag while he talked: the sphygmomanometer, the stethoscope, the pulse ox.

“He didn’t run.”

I zipped up the bag.

“Could you call 911?” he said.

My partner opened up the back door to the ambulance.

“Why?” I said.

“He’s bleeding.”

“Where?”

“At my house.”

“Where?”

“I put him in the tub.  That way the blood wouldn’t get all over the place.”

My partner heard this.  I asked him calmly if he could call 911 really fast.  He asked what for.  I explained that there was another patient at the exact location where we’d just come from.  My partner called the number and plugged his other ear so that he could hear.

“Anything else I should know about?” I asked the patient.

He thought and said, “I’m on Viagra.”

by Ron Riekki

Ron Riekki’s books include My Ancestors are Reindeer Herders and I Am Melting in Extinction (Loyola University Maryland’s Apprentice House Press), Posttraumatic (Hoot ‘n’ Waddle), and U.P. (Ghost Road Press). Riekki has edited eight books, including Here (Michigan State University Press, Independent Publisher Book Award), and The Way North (Wayne State University Press, Michigan Notable Book). Right now, Riekki’s listening to Sylvia Plath reading her poetry at Mermaid Theatre in London.