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Published:
2020-11-05
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2011-08-07
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26/26
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Hitting the Wall

Summary:

Roy is left angry and frustrated after a pair of hard calls. But why have things hit him so hard this time?

Chapter 1: Chapter 1

Notes:

I'm hoping this story will be a realistic but fictional look back to the 1970s, and how certain dangerous and difficult aspects of the emerging paramedic field might have been handled.

Current statistics on firefighter line-of-duty deaths suggest that MVAs are the second leading cause of LODD. 

According to the Centers for Disease Control's Morbidity and Mortality Weekly Report, February 28, 2003 / 52(08);154-156, "between 1991-2000, 300 fatal crashes occurred involving occupied ambulances, resulting in the deaths of 82 ambulance occupants and 275 occupants of other vehicles and pedestrians. The 300 crashes involved a total of 816 ambulance occupants."

Chapter Text

Hitting the Wall

Chapter 1.

"Roll call in two minutes, boys!"

"Aye aye, Cap!" Chet shouted from the locker room.

"Never miss a chance to kiss up, huh, Kelly," said Johnny, doing up his last button.

"I have my reasons, Gage, I have my reasons. Soon, all will become clear," Chet said dramatically.

"Shoulda called in sick today," muttered Gage. "Will be soon anyhow, if this keeps up."

"Don't you worry your pretty head, Gagey-baby; today, the Phantom has his sights set higher than the likes of you."

Captain Stanley, Mike Stoker, and Roy DeSoto were already waiting in the apparatus bay. The men lined up between the engine and the squad, with Chet and Gage sliding in just in time.

"All right, men. Nothing out of the ordinary on deck for you today," said Captain Stanley. "Just the usual, for a change. Chet, Mike – you get the apparatus bay. Roy, well, I'm sorry to say I don't have a reason to give someone else the latrines, so that's your bad luck today. And, for some more bad luck, John, you're today's chef. And lucky me, I've got a pile of paperwork taller than Mount Rushmore waiting on my desk. So let's get to it, gentlemen. Dismissed!"

Cap turned on his heel and headed to his office.

Chet gestured the others to wait where they were. "Wait for it..." he whispered mysteriously. "Just wait for it..."

"Wait for what?" Johnny asked irritably.

"SSHHH!" hissed Chet. "Any second now..."

Chair legs screeched on the waxed floor. Then, a tremendous, ripping, raspberry sound echoed through the bay, clearly coming from the Captain's office.

The men dissolved in silent laughter, trying to gain control of themselves quickly, as they knew an irate Captain would be returning soon.

Sure enough, seconds later, Hank Stanley emerged from his office, dangling a pinkish balloon-shaped object by its stem.

"Whoopee cushion? Whoopee cushion?" he complained. "I swear, I knew you could be pretty juvenile, Kelly, but this takes the cake. Roy, you're off the hook. Chet – you know where to go. They never should've graduated you from elementary school. Good grief," he muttered to himself as he returned to his paperwork.


An hour into the shift, the tones sounded. "Squad 51, assist LAPD in checking on the welfare of an individual, 1254 Homestead Drive, 1-2-5-4 Homestead Drive, cross street Mallory. Time out: 0855."

Stoker responded at the call station while Gage and DeSoto climbed heavily into their squad. They knew that usually when they got a welfare call with LAPD, they were likely to find either an empty home or a fatality. Neither outcome would give them the feeling of having helped someone in trouble.


Thirty minutes later, Gage and DeSoto exited the home at 1254 Homestead, having turned the home's former occupant over to the care of the L.A. County Coroner.

"Not my favorite way to start the day," DeSoto said unnecessarily, as he started up the squad's diesel engine.

"No, can't say it's mine, either," replied Gage. They knew they were of one mind regarding the outcome of this run. They didn't really need to say anything, but also didn't want to sit in silence. It somehow didn't seem right not to say anything.

"How are our supplies?" Gage asked, more to have something, rather than nothing, to say.

"We're good," replied his partner. Both men wished they had an excuse to go to Rampart, or anywhere other than back to the station. Their depressing run had put them out of the mood of wanting anything to do with pranks, housekeeping, cooking, or, to be honest, anything at all. They drove in silence for a minute or two, half listening to the radio chatter.

Then they heard the familiar combination of pitches that called their station.

"Engine 51, Squad 36 in place of Squad 51, motor vehicle accident with injuries, 3554 Carson, 3-5-5-4 Carson, cross street Nevada. Ambulance is responding. Time out: 0940."

The paramedics heard the address, and realized that they must have forgotten to report in as available.

"L.A., this is Squad 51; we are now available and can respond to Engine 51's location, with an ETA of seven minutes," Johnny said into the radio's hand-held transmitter.

"10-4, Squad 51. Squad 36, cancel," they heard over the radio.

The squad reached the scene first, but they could hear the engine's siren approaching quickly. Roy jumped down from the squad. He ran to the two vehicles involved in the accident. The two occupants of the first vehicle had already gotten out of their car, which had been heavily rear-ended by the second. The two young men did not appear to be seriously injured, but Johnny ran to check them, as Roy headed to the other vehicle. The second vehicle appeared to have just one occupant. Roy carried the biophone over to the driver's side of the crumpled sedan, and approached the driver through the window.

"Sir? Can you hear me?" A middle-aged man was slumped forwards on the steering wheel. The windshield was shattered. Blood poured from the man's head onto the dashboard. Roy reached in to get a carotid. It was there, but weak.

Roy could feel the rumble of the engine pulling up near the wreck.

"Marco, disconnect battery cables. Chet, wash down the scene with the reel line," instructed Captain Stanley. "Stoker, give Roy a hand."

"Mike? I'm gonna need a backboard, O2, and a C-collar!" called Roy. "And he's pinned in here real good – we're gonna need the Jaws for sure." He began taking the vitals he could get with the man still trapped in the vehicle, and called in to Rampart.

"Rampart, this is County 51, how do you read?"

"Go ahead, 51," Dr. Brackett's voice came on immediately.

"We have one MVA victim, male, approximately 35 years of age. He has an apparent depressed skull fracture, left temporoparietal region. He is currently pinned by the steering column, and is unconscious. Airway is patent. Pulse is 50 and weak, respirations are 10 and irregular, BP is 140 over 80. Right pupil is blown." Roy reported his findings efficiently, and without showing emotion. There was every indication of a serious brain injury, but at that moment, his job was to do what he could for this patient.

"Understood, 51. Is it possible in the patient's present position to hyperventilate with O2? Can you start an IV?"

"Affirmative on the O2, negative on the IV, Rampart. Engine is on scene, and extrication has begun, with C-spine precautions in place."

"10-4, 51. When the victim is extricated, get me a new set of vitals, and start an IV, D5W TKO with a drip rate of 25 milliliters per hour."

Roy did his work, getting as much oxygen into the patient as possible, as the rest of the team worked to pull the steering column off the man's chest. Johnny, having checked the two occupants of the other car, joined Roy. He read Roy's notes, grimaced, and squeezed into the tight space of the remains of the passenger's seat to stabilize the man's head and neck against the vibrations of the power tools being used on the car.

Finally, with a resounding "crack," the dashboard of the crushed vehicle gave way as the steering column finally peeled back, leaving just enough room to slide the man out. Johnny helped Roy to get the man onto the backboard. They carefully slid their gravely injured patient from the car.

"Johnny, see if he has a wallet, get some ID," Roy said, as he began getting a new set of vitals. He shook his head as he wrote the findings on his notepad. At the same time, Johnny found the man's wallet, and tossed it to Captain Stanley. Cap had caught the shake of Roy's head, and knew that he had to try to reach the man's family – if there was one – and fast.

Roy talked into the biophone again, while Johnny started to set up the IV.

"Rampart, patient is extricated. New vitals: BP 155/80, pulse 45 and irregular, respirations irregular and labored. Patient is exhibiting extensor posturing." The abnormal body movements Roy was describing were clear to Johnny as he tried to start an IV.

"Roy, I'm not getting a vein on either arm," said Johnny.

Almost at the same time, Roy said, in alarm, "No pulse! Start CPR!"

Roy grabbed the biophone. "Rampart, we've lost his pulse, and are starting CPR. We haven't been able to get a vein to start an IV."

"51, continue CPR and send me a strip."

Roy set up the EKG leads as Johnny continued with CPR. They exchanged a grim look. They both knew how unlikely it was that anything they did at this point would make a difference in the outcome for this patient, and they both knew what that outcome was likely to be.

Roy connected the EKG leads to the monitor. "Stop CPR," he called. John stopped the compressions. The line on the monitor was flat.

"Rampart, we read asystole. What are your instructions?" But Roy knew perfectly well what the instructions were going to be.

"51, continue CPR and transport."

So they did.


Once they reached Rampart, the paramedics turned the man over to Brackett. Both men were exhausted from trading off on the futile CPR in the ambulance. Chet or Marco would bring the squad in after the engine crew had finished clean-up at the accident site, so the paramedics knew they had some time before they had to call in as available.

"Coffee?" Johnny asked Roy.

Roy did not answer. He was looking at the ER waiting room, where a woman, about 30 or 35, with two young children in tow, had just arrived. She frantically ran to the desk.

"My husband, Frank Parker, I got a call from the fire department that he was in an accident and they were bringing him here. Oh please," she cried, "can you tell me anything?"

Roy stared, watching the children – a boy and a girl – as the nurse at the desk helped the woman to a seat in the waiting room. The desk nurse had the easy job, he thought – Brackett would get the hard one in a few minutes. He started over to the woman, whose life would come crashing down around her as soon as Brackett emerged from Treatment 4.

Johnny grabbed him gently by the shoulder. "Roy, don't," he said softly. "Just don't." He tried to turn Roy around, but Roy shrugged him off violently. He didn't continue towards the waiting room, but just stood there, staring.

"C'mon, man. You don't need to see this," said Johnny. He took Roy's arm again, and this time, Roy let himself be led away, to the ER staff lounge. On their way, they passed Brackett coming out of Treatment 4. Dr. Brackett met their downcast eyes with his own, and gave them the quick head shake they expected, and headed to the waiting room to deliver the bad news.

In the lounge, Johnny sat Roy down at the table and set a steaming cup of coffee in front of him. He sat next to his silent partner with his own mug of the dark brew. It smelled like it had been on the burner all night.

Johnny didn't try to say anything to Roy. Really, there was nothing he could say. He knew how much Roy was affected by any call where someone died, let alone a call where the patient's family reminded him so much of his own.

Roy shoved his chair back from the table and began to pace, still saying nothing. He stopped at the far wall of the lounge, and stood there, with his forehead on the wall.

"It's not right," he said, breaking the silence. "We just did CPR on a corpse for twenty minutes. We ran him here in an ambulance, lights flashing and sirens screaming 'Out of our way, everyone! We have a patient to save!' And you knew, and I knew, and Brackett knew, that everything we did was going to be useless."

Johnny didn't say anything. He knew his partner well enough to know that Roy wasn't done yet – that there was something else other than the death of their patient that was bothering him. So he waited.

"Yeah, we made a valiant effort, all right. The big heroes, with all their fancy equipment, to the rescue!" He turned to face his partner. "Luckily, during our valiant rescue, we didn't plow into any other vehicles and kill anyone else, for the sake of keeping blood moving in our dead patient till a big grown-up doctor could tell us kids what we already knew!"

The men both froze as they heard a wailing cry from the ER waiting room.

"Doesn't Brackett have an office?" spat Roy. "Did he have to give her that news in the waiting room? Sometimes that man has no common sense – none!" He turned back to the wall, chest heaving.

Johnny stood back, giving Roy the room he needed.

Without warning, Roy pulled his fist back, and punched a hole in the wall. Johnny flinched at the sound of at least one of Roy's hand bones snapping.

TBC