Narcan

By Mike Weddle

 

I pulled the pumper truck out of the firehouse and parked it in the alley behind the Gas’n Go to make room for the folding chairs and the table with the coffee urn, and the one for the punch and cookies. It was a nice thing they were doing. In two months, our average response time for priority-one medical calls inside Cob City was cut in half, from twenty minutes to less than ten. The mayor was there, and two city council members and Chief Henderson, Dr. Mills the EMS medical director, and firefighters and some other folks. The city was giving the squad a citation for their hard work. It was nice. Rich was sitting next to me. When everyone was listening to the mayor, I saw a tear roll down his face. In an instant his napkin came up and it was gone. And then the alarm rang, and the dispatcher’s voice came over the loudspeakers on the wall.

 

         “Unit 3-7-8 first call medical emergency.”

 

          The mayor stopped in the middle of his sentence. He looked at the crowd and the crowd looked at him. The council members smiled. I imagined they’d much rather be giving out citations than raising the school millage. Chief Henderson was smiling; he always liked another award to hang on the firehouse wall. And the mayor smiled, and he looked at his watch.

 

          “On the subject of response times,” said the mayor, “the clock’s ticking here. Shouldn’t someone be going for a ride or something?”

 

         I nudged Rich with my elbow “Yes sir,” he said, and I followed him to the phone on the wall to call the dispatcher.

 

         “Chest pain,” said Rich. He looked at me like he wasn’t sure if I’d seen him crying. “Forty year old male on Water Street priority two; let’s roll.”

 

          The ambulance was still parked inside and I started it up and rolled out quick, so as not to wipe out the city fathers with carbon monoxide, although it would have only improved our response time stats, the victims all being together in the firehouse. Rich turned on the lights and siren for dramatic effect and I waved, watching the dignitaries put their hands up and cover their ears.

 

         We drove along Route 120 before turning toward the river. Of course I knew what was stirring Rich up at the presentation. I lived at the firehouse because I was eighteen years old and out of school and pretty much penniless, thinking about going to the community college, or not going, I wasn’t sure which. Rich, on the other hand, was forty-something and married and divorced, and had lived with his girlfriend since I’d met him two years ago. When his girlfriend died he moved into the squad too. It takes two to run, and the fact is the city council would never have had that piece of paper to sign if Julie hadn’t died, and Rich hadn’t moved into the firehouse. Her death is what cut our response times in half.

 

          “What was the number?”

 

         “Next block,” I said, “the four-hundreds.”

 

          I went through the light at twenty-five miles per hour, which is fast for an ambulance even with the siren on. When we got to the house there was a man standing outside the door smoking a cigarette. Rich had the Thomas pack and monitor on the stretcher and we unloaded it out the back door and rolled it up the drive.

 

          “Where’s the victim?” Rich shouted.

 

         “The what?”

 

          “The victim; did someone call for a man having chest pain?”

 

         “Oh; that’s me, man.” The guy took one last long drag and convulsed into a fit of coughing.

 

         From the look on Rich’s face, I half expected him punch the man, and turn this moron from a priority two medical into a priority one trauma. He tore his shirt open to put on the patches, and put the oxygen so tight around his face it could have cut off the circulation to his brain.

 

          “Hey, take it easy!”

 

         “You called us because you were having a medical emergency and you’ll let us do our job, now be quiet!” Rich was livid.

 

         “You know what it’s like, man. If you don’t call the ambulance they make you wait like three hours in the waiting room at the ER.”

 

         On second thought, you probably could cut off circulation to his brain and no one would notice. Again, I saw a tear on Rich’s cheek, and again, it was gone as fast as it had appeared. I wish I could do this alone, ride in the back and drive both. I wish I could let him go home, or back to the firehouse since that’s where his home was now. Julie’s call had been a priority two chest pain, only when Rich got to the squad and realized the call was to his own address, he knew better. He knew it was an overdose. He knew it was a real emergency, not like this asshole. I told him he didn’t have to go, but we both knew he did. In a volunteer squad we didn’t have any backup to call that would be there anytime soon.

 

          She wasn’t outside smoking when we got to the house. She was dead. That kind of thing just didn’t happen in Cob City. Maybe Rich pretended not to know, or pretended it wasn’t as serious as it was. He knew she overdid it with pills, but he said he never knew she shot heroin. But as soon as we heard the call, it was like he knew what had happened.

 

          The man was quiet in the back, but then something woke him up. “So do I get something for pain?” he asked, his speech slurred.

 

         “Sure,” said Rich. “We have a protocol. I’m going to give you a nitro tablet under your tongue.”

 

         “To hell with your fucking nitro; the last time they gave me morphine.”

 

         “You said you were short of breath.” I heard Rich lecturing the man. “Morphine is a respiratory depressant – no narcotics.”

 

         “If the doctor at the hospital tries to pull this shit, we’re going to have a problem.” I could hardly hear him over the siren and the engine noise, the man’s voice trailing off into a whisper. I could hear Rich on the radio, talking to medical command.

 

         “Respirations shallow, pupils pinpoint, oxygen sat 89% on high-flow oxygen.”

 

         “You are approved for point-four Narcan,” came the radio voice.

 

          There was a pause as we took the freeway north.

 

          “No change in the patient’s condition.”

 

          “You’re approved to intubate, unit 3-7-8.”

 

         “Requesting an additional point-eight Narcan before intubation, med command.”

 

         “Approved for point-eight.”

 

          Again a silence, and the sound of the siren and the tires echoing off the guard rail. There weren’t many cars on the road. Even in the daylight, the flashers were like light-bulbs on the trees.

 

          “What the fuck are you trying to do, kill me?”

 

         “No, jerk-off,” said Rich. “You already tried to kill yourself.”

 

          “Let me out of here!”

 

          “You have attempted to kill yourself and are under the influence of drugs, and cannot refuse treatment!” Rich was screaming at the top of his lungs, lecturing again. I couldn’t see what was going on, and for all I knew he was sitting on the guy.

 

          “It was an accident. Don’t you know there’s some bad shit on the street?”

 

          He had given Julie Narcan but she never woke up. They gave her more at the hospital, but it only appears to sometimes bring the dead back. It doesn’t really do it, reanimate the dead I mean. Maybe she got some of the bad shit. Whatever it was, it stopped her breathing like throwing a switch.

 

          “Call ahead,” said Rich, “and have security meet us as the ER door.”

 

          And then the asshole was somebody else’s headache.

 

          “What a sorry piece of wasted protoplasm,” I told Rich. We had a bucket and mop from the hospital and were cleaning out the back of the unit. My partner didn’t say anything. He had his gloves on, wiping down the gurney with bleach. We both knew the guy was a shooter, and could have left hepatitis virus or even AIDs all over the equipment.

 

         “Look,” I said. “I’m really sorry Rich. I knew you were thinking about Julie, and I’m really sorry we had to do this today.”

 

         “Comes with the territory,” was all he said.

 

          “You want to talk about it?”

 

          “Talk about what? There’s nothing to talk about! I’m going in for an IV set and some sheets.” He walked out the back of the truck and slammed the door. I finished wiping down the counters.

 

         When Rich got back, he sat down on the patient stretcher and didn’t look at me.

 

         “Sorry I yelled, kid. It’s just, well, I just couldn’t believe Julie would shoot drugs, and expose me to AIDs and all that, and never even tell me about it. I got tested, you know. It was negative but I need to have another test in six months.”

 

         I didn’t say anything. I didn’t know what to say.

 

          “I never cheated on anything in my life,” said Rich. “I found a five dollar bill once in a parking lot and turned it in to the store, but today I was thinking of sticking myself with the needle. I was thinking about doing an incident report.”

 

         “I don’t get it,” was all I said.

 

          “If I get infected working, our insurance covers it. But if I seroconvert because of Julie I don’t get shit. Do you know what the drugs cost?” His voice was rising again, like he was angry, trying to hold it in but not trying hard. “Two-thousand dollars a month,” he said, “just to stay alive!”

 

         “You don’t even know she had the virus.”

 

          “Still, how could she do that?”

 

         “I don’t know; I don’t know how anyone could do that.”

 

          “And then she had to die.” The tears were in his eyes again. I felt sorry for Rich. His girlfriend dies and we get an award, and then he has to relive it all over again in the ambulance.

 

          “You did all you could,” I said. “You got her IV in right away, and gave her the Narcan.”

 

          He was staring down at the palms of his hands. I picked up the IV set sitting there next to him and stowed it in the locker. It was time to be going, but before I could say anything, he looked up at me like he was going to ask a question. But it wasn’t a question.

 

         “I never gave it to her,” was all he said.

 

          “That’s crazy, Rich. I saw you.”

 

          “I’m telling you I never gave it. I injected it in the mattress.”

 

         “But why?”

 

          He was still looking up. His upturned hands were still together, wrists side by side like I was going to put handcuffs on him. “She was gone,” he said. “Her pupils were fixed; I knew if I started her heart she’d be brain dead, like a vegetable, and I couldn’t do that to her. She was so full of life.”

 

         “But you didn’t know that for sure.”

 

          “I knew.”

 

         Another ambulance pulled up behind us with its lights flashing. I had to go forward into the driver’s seat and pull the unit forward and out of the way. Rich followed me. He was sitting with his head back and eyes closed in the passenger seat.

 

         “Later I realized how angry I was at her. I was mad as hell. I could have killed her.”

 

         I looked over at him, feeling the sweat sticking to my back.

 

          “Maybe I did kill her,” he said.

 

          “She killed herself, Rich. You didn’t do it. You didn’t put the heroin into her veins.”

 

          “I didn’t put the Narcan in either.”

 

         I didn’t know what to say.

 

          “And I don’t know if I did it because I loved her, or because I was so damn mad at her.”

 

I started to think about the next call, and how far away we were from Cob City. Maybe it was just a way to avoid thinking about what he was saying. I had been there with him, beating on her chest with the palms of my hands, leaving red marks across her breasts, breasts that meant nothing to me, but then seeing the horrified look in my partner’s eyes. I had been a guest in that room before, with Julie’s photo album on the coffee table, her signed Nascar photos on the wall, and now, now, her dead body on the floor.

 

          “Are you going to tell Chief Henderson?” asked Rich.

 

          “Tell him what?”

 

         “What I did, that I didn’t give it.”

 

          “You gave it,” I said. “I saw you give it.”

 

          His face turned with a silent question. He had quickly shaved for the ceremony and had cut himself on the chin, the dried blood like a pencil line. He shook his head.

 

         “No I didn’t.”

 

          “I’m sorry we couldn’t save her Rich. I don’t know why this asshole lived and she didn’t, but I was there, and I say you gave it, so you did.”

 

         “But…”

 

          “No buts; questioning yourself isn’t going to bring her back. Look, we’ve been out of service for thirty minutes.”

 

          “So we have to be going.”

 

         

“That’s right.”

 

          “I’m ready,” was all he said. I picked up the microphone and updated our status.

 

 

Author’s Bio: Mike Weddle is a father and poet, physician and Benedictine oblate, a missionary and novelist, and has been a PhD scientist and public health planner. He’s young enough that he would trade most of this if he could just play the guitar, but old enough to accept a gift with gratitude. He lives with his family in rural Maryland. Mike was a finalist in the 2005 Gival Press Novel Awards. He’s published poetry and short fiction, most recently in the 2008 Backbone Mountain Review.