A Disregarded Lesson

By Caressa

"Squad 51, standby for a response."

"Squad 51, standing by."

John Gage grabbed his jacket and hitched his head towards the vehicle, indicating to the new paramedic that a call was imminent. Travis Johnson picked up his gear and headed for the passenger's seat. Travis was on a probationary two-week solo stint with Gage to complete his final phase of training before being set free into the general pool of rotating medics. Both Roy and John were temporarily assigned to new medics, each taking alternative shifts to accelerate the process.

"Squad 51, woman with injuries, Washington Court, Building 14, Apartment 32. Time out 23:22."

"Squad 51 responding, 10-4." Travis answered quickly. "You know the way, John?" he asked, reaching for the map book.

"Oh yes," he stole a look at Travis, "and you will too, over and over and over."

The red lights of the Squad played off of the tightly packed buildings as Johnny snaked his way though the parking lot and onto a short access road. He stopped abruptly when he reached the end of a driveway, marked by short spindly shrubs. Both medics got out quickly, their movements accented by the flashing of the emergency lights.

"We'll be hiking from here. Take out the stokes and I'll grab the equipment. It'll be easier to get in and out. Hate to tell ya, Travis, there's no elevator."

"I hope she's super skinny," Travis returned with a brief grin.

John snickered quietly as he strapped the defibrillator to the stokes.

He lifted one end and waited for Travis to finish securing the oxygen tank. Travis leveled out the litter and nodded to the senior medic. John pulled the stokes forward, steadily weaving his way between the dimly lit buildings. He whistled softly as he went, slowing as he neared the corners of the buildings, giving the overgrown bushes a wide berth as he turned the corners. Travis was quickly lost and annoyed by Gage's incessant whistling. The medic thought they should be quiet, to avoid announcing their presence while they made their way though the dark courtyards of the project.

"Gage," Travis whispered, the annoyance clear in his voice, "Do you have to make so much noise?"

Johnny stopped and looked back at him steadily.

"Yes," he stated unequivocally, matching the medic's tone, "the last thing you want is to inadvertently sneak up on someone around here. Three weeks ago, Roy and I came around the corner here and walked into a drug deal. Believe me, it's the last time I want to be on the wrong end of the gun. I'd rather take my chances on being jumped than shot." He turned quickly, pointing to a windowless steel door ahead. "Watch for dogs in the hall."

The medics climbed the stairway up to the third floor and made their way down the hall towards Apartment 32. Johnny slowed as he approached, pausing before the door, which was ajar. He turned to Travis, holding up one hand as he lowered his end of the stokes to the floor. Travis followed suit and waited in place. He watched Gage survey the room briefly and glance down the other end of the hallway. The place was eerily silent and seemingly empty. Travis was growing impatient as Gage finally entered the room. He moved forward, watching Johnny as he quickly scanned the Apartment.  Seemingly satisfied, Gage settled down on one knee next to an elderly woman lying helplessly on the living room floor.

"Travis, pull the gear in."

Johnny's no-nonsense tone surprised the trainee and Travis quickly pulled the stokes across the floor, leaning over to close the door.

Johnny called softly to the elderly woman as he checked her pupils and continued his primary survey.

"She's out of it, I think she's been here for a few days."

Travis looked confused. John continued, "Check for some mail or something with a name on it and for meds on the kitchen counter, bathroom, and in the refrigerator." As Johnny checked her carotid pulse, Travis rummaged through the refrigerator.

John's concern grew with the woman's lack of response to his simple commands. Lights are on, nobody's home, he thought grimly.

Travis handed Johnny an envelope and commented, "There's an empty bottle of HCTZ for blood pressure. It's all I could find. The name matches the one on the envelope. Do you think she stroked out?"

John sighed without answering and Travis instantly knew he had made a bad call.

Gage leaned over the frail woman, his eyes gentle and voice deliberately softened, "Ms. Randall? Elaine?"

He saw her eyes jerk toward his face at the sound of her name and then suddenly float off to the side in an unfocused haze. "Could be her," he said to himself as much as to his partner. "Put her on four liters O2 NC." As he leaned back, he noticed a small bruise on the side of her cheek running over the line of her jaw. He thoughtfully ran his fingers lightly over the discoloration before continuing his survey. Checking her ears for fluid and finding none, he palpated her rib cage. He watched her face as he pressed lightly checking for signs of fracture. He noticed a fleeting change in her expression, so subtle he thought he might have imagined it. When he pressed evenly on her hips, he saw her face change again, this time instinctively recognizing her transient expression. Fear. Johnny pulled his hands away quickly and continued his survey, speaking softly to her the whole time as if she really could understand his words. He gently lifted the edge of her sweater noting minor bruising on her left side. He uncovered her legs, again noting an odd pattern of bruising to her thigh. A chill crossed over his shoulders as he filed the information away. He raised an eye to Travis as he surveyed the woman's body, but he could tell Travis was unaware of his subtle cue. He covered her immediately and scanned the room. No purse, he thought. Johnny raised the HT, "LA, Squad 51, do you have a call back number on this run?"

Travis looked at Gage with a puzzled expression.

"Squad 51, there is no call back number. Still alarm, anonymous caller."

"LA, respond the police to our location." Johnny looked up at Travis, "Get Rampart on the line, she's badly dehydrated and may have cracked ribs on the left side. We'll have to immobilize the hip. Set up the monitor while you're at it." He paused, noting Travis' persistent confused expression. "I think she was robbed."

Travis was surprised at Gage's words and could tell that the medic was considering adding something else, but instead John turned away and pulled out an IV set in anticipation of the hospital's orders.

Travis attached the monitor and related the orders to John. Gage started the IV and administered the prescribed meds while Travis set up the stokes to receive their patient. The medics lifted the slight woman onto the litter and proceeded to surround her with their equipment, fitting the pieces around the edges like a fine puzzle, enabling them to bear the weight of the stokes with both hands. They lifted the litter and left the apartment, securely locking the door as they exited.

*****

Travis paused at the head of the stairway, "Ready, John?"

"All set, Travis, let's go." John lowered the stokes to compensate for Travis' steady descent. They were approaching the second floor landing when the new medic abruptly stopped.

Two older teenage boys were standing on the landing, blocking their egress, eyes averted from the medics. One looked up at Travis through squinted eyes, a menacing expression briefly crossing his face. Johnny's gaze darted from the boys to Travis, curious as to how the new medic would handle this unspoken challenge.

"Hey, what's the problem? Move!" Travis spit.

Brilliant job, Johnny thought sourly, wonder what movie he got that line from? John was taken aback, expecting Travis to be far better at gauging the boys' intent and ultimately defusing the implicit dare. Not surprisingly, the teens didn't budge, instead, moving slightly closer to the posturing medic. Gage immediately intervened.

"Come on, son," he said in a firm, but non-threatening tone, "let us by, huh? You go your way and we'll go ours." He held the teen's stare.

The two boys measurably paused, attempting to assert some sort of self-defined power, then slowly moved aside.  Johnny subtly shoved the stokes into Travis' side, breaking the man's inertia. While his manner was purposely even and seemingly unconcerned as they made their way down the remaining stairs out to the courtyard, Johnny was inwardly fuming.  What could he possibly think we'd gain by getting in their face? He filed the thought away as he rounded the corner towards an awaiting ambulance, the red lights now mixing with the blue of the approaching squad car.

*****

Travis packed up the last of the supplies while John spoke quietly to Dr. Brackett in the hallway. The woman's level of consciousness greatly improved following rehydration and she had confirmed Gage's suspicions.

"She said they got her after she took out her keys. She was distracted and they pushed their way in as she opened the door. They roughed her up when she resisted handing over her purse and other valuables in the house. She's lucky that's all that happened." Brackett paused, seeing Gage sigh in relief. He continued, "She was incensed at the time, but now is only fearful of returning to her home. She'll be here a couple of days. I'll let you know how she ends up. Good job, John."

Gage's eyes were glued solidly on the floor as Brackett spoke. He shook his head negatively. Sometimes, he just didn't know what to think. He looked up at Brackett, thanking him for the information and turned to rejoin Travis.

"All set?" John picked up the packages and smiled broadly at the nurse. "Good night, Dix," he said lightly.

Travis caught the look that passed between John and Dixie, as she returned John's smile. What's with that? he thought. "All set, Johnny," he prudently answered.

*****

No sooner than Travis had replenished the supplies and Gage started the Squad's engine, the tones rang out, alerting them to another response.

"Squad 51, what is your status?"

Travis answered immediately, "Squad 51, available from Rampart." He waited patiently, microphone in hand as Gage quickly pulled the Squad out of the Emergency bay and headed for the street.

"Squad 51, man down, unknown injuries, 432 Prospect Street, four-three-two Prospect, cross-street Alameda, time out, 00:45."

Johnny banked a quick left onto the main road and accelerated through the intersection, lights on and sirens cutting into the still night.  Travis diligently scanned the intersections and cross streets for vehicles, as the pair made their way to Prospect Street. Gage cut the sirens, wig-wags, and lights as he entered the neighborhood, leaving only the headlights and main emergency lights running.

He sensed Travis' questioning look and answered, "Watch yourself in here Travis, these guys are serious frequent flyers, in more ways than one."

Gage jumped out and rounded the Squad, helping Travis remove the necessary equipment. Scanning the front of the building as they made their way to the stairs, he threw out an arm, halting Travis as they neared the railings.

"Wait here," he said quietly. Travis rolled his eyes and stepped to the side, watching Johnny silently walk up the stairs and lay the equipment directly in front of the door. The senior medic looked down at Travis, pointing out a rectangular box roughly drawn in chalk on the side of the upper third of the doorframe. Travis watched as Gage deliberately stood outside the outline of the box, his side to the wall, reaching over to the door. Only his tanned arm crossed through the zone marked by the chalk as he rapped on the door and called out, "Fire Department!"

Johnny waited, keeping his eyes on the door and a nearby window. He stole a look at Travis, who had started to move up the stairs.

"Travis, stay back," he whispered.

The new medic paused, unsure of why Johnny was being so cautious. Annoyed by what he personally thought was overkill on Gage's part, he ignored the senior medic's directions and continued up the steps.

The door opened tentatively and a man called out upon seeing the medical equipment stacked in front of the entrance. "Okay man, get in here, he's bad this time!"

Studying the disheveled man, Travis was shocked to see him slip a handgun out from under his dirty coat, deliberately pointing it at the new medic. "Who are you?" the man yelled suddenly as he saw the medic step up. Travis froze in surprise on the third step and quickly began to back down, his eyes never leaving the man's hand. He considered calling out to warn Johnny when he noticed Gage had remained in place. Travis heard John call out.

"Guns away, man, we're the good guys, you know rules."

Travis was shocked. How did Gage know? He thought, as he watched the caller holster the gun and back away from the door.

Fury.  It was the only word Travis could think of to describe Gage's expression as Johnny glanced at the new medic before cutting him off at the top of the stairs to retrieve the equipment. Gage's dark eyes were devoid of color,  piercing Travis' confidence.

"Travis," he said, his voice menacingly still as he gestured toward the chalk lines, "they will shoot you through the wall if they think you're a cop. I could care less what you think of my motives, but I have a lot more years on the job than you. If you fail to listen to my directions, you may find yourself looking for work, if you're lucky." He paused, balancing the last piece of equipment under his arm. "This easily could have ended very differently because of your actions. I personally would like to live to retire." Gage spat out each word, his overt threat effectively slapping the new medic harshly across the face.

Travis involuntarily stepped back, the severity of Gage's words creating a sudden ripple of fear that spread across his chest. He shook off the sensation, ignoring the uneasiness that remained. After all, he reasoned, nothing ending up happening anyway, right?

John set his equipment down next to a 20-year-old male lying motionless in the middle of the floor. He glanced at the new medic.  Travis dropped the trauma box and leaned over to close the door.

"Leave it ajar, Travis."

The trainee glanced at Gage, who hadn't even turned his head before issuing the instructions. What now? Travis thought.  The trainee squinted his eyes, his face betraying his growing anger as he spitefully shoved the door closed.

Johnny heard the click of the latch and stated tersely, "Ajar, Travis."

Travis stared at Gage for a moment, and then reluctantly pulled the door open.

He heard Gage whisper, "Around here, leave yourself a way out, Travis, didn't your mother teach you anything?"

Travis could tell the medic was still enraged, but guessed Johnny was half-heartedly attempting to ease the mounting tension between them. Travis was anything but amused. He started thinking of ways he could easily annoy Gage, but quickly came to his senses. Don't poke the cheetah, he thought.

"Get to it, he's all yours," John stated, unable to clear the residual anger from his tone.

Travis attempted to rouse the unconscious man with a firm sternal rub.  When there was no response, he quickly checked his breathing and pupil size. The medic turned to Gage after the pulse check. "Respiratory depression, owl-eyed, and unresponsive. By the looks of his arms, I'd say we need a cocktail." Gage's expression didn't change as he reached for the biophone.

"Right, opiate OD," he stated as he held the Biophone out to the medic and began pulling a syringe and medications from the drug box. Johnny listened carefully as Travis related his findings to the hospital and then proceeded to administer the meds.

When the new medic pushed the NARCAN, Johnny subtly moved back, out of the reach of the supine man. You should know better than to hang over the guy, John thought, but a sharp right might be a good lesson. Johnny sat back on his heels as the man began to slightly stir and then rapidly regain consciousness. Gage felt momentarily guilty as he heard the solid crack of the patient's fist connect with Travis' jaw. Mmm, Johnny thought, that ought to do just fine.

"Man, you okay Travis?" Johnny asked, marginally successful at keeping the satisfaction out of his voice.

"Yeah, yeah, I'm fine." Travis answered slowly.

Johnny tried to settle the patient as Travis rubbed at his jaw.  Johnny could feel the trainee's eyes digging into John's back. He felt uncomfortable under the trainee’s scrutiny and diverted his full attention to calming the newly conscious patient before any real damage was done.

"Hey, calm down, man, you stopped breathing, settle down now, or we'll have to restrain you. Come on, man, go easy."

The man continued to curse at the medics, but settled back on the floor, mildly subdued for the moment.

The ambulance crew arrived and hesitated at the doorway to the Apartment.

"It's okay, over here, guys." John called, indicating to the attendants that the scene was safe. The attendants pulled the stretcher cautiously through the doorway and over to the patient's side.

*****

Dixie had never seen John Gage so enraged. She couldn't help but be drawn to the unfamiliar scene playing out in hallway. It was the stillness of the one-sided conversation that frightened her. She could clearly read the thinly controlled anger in Gage's expression and his tightly controlled motions. Glad I'm not Travis, she thought.

Johnny's back was straight and his jaw tight, as he spoke through firmly gritted teeth. But under the thick layer of intense emotion Dixie could detect a carefully concealed veneer of anxiety. She wondered what transpired on the last call to evoke such overt anger. John's fury was so far out of character; she started to think she should intervene before the scene deteriorated. It was a side of John she had never witnessed in all the years she'd worked with him.

He was pointing now, gesturing and drawing a figure in the air and then abruptly brought his hand back to Travis' chest, poking it none too lightly, then lowering his hands to rest on his hips in exasperation.  She could see him sigh heavily. He turned suddenly as if to walk away, but turned back just as abruptly, a harsh, serious tinge to his normally jovial expression. She was shocked at what she read there. Wow, Travis really must have screwed up, she thought. She only heard a snippet of Gage's final words before he stiffly walked out of the ER.

"Don't you dare ignore my direction again, Travis, because you'll kill one of us, and it better not be me."

Dixie cringed at his words, banishing the disturbing thought from her mind.

*****

The next shift started out well and John was tentatively encouraged that the problems with Travis might be amended in the course of the next two weeks. In his heart, however, he recognized he was overly optimistic and was nonetheless concerned that a turn of events could occur at any time.

Johnny should have known the day would end badly. He already guessed something untoward might occur eventually, by the trainee's inconsistent response to his direction. He was thinking he should be more forceful, that he should hold a tighter rein. The new medic was actually pretty good at the medical stuff; he just wasn't very good at listening. When it came to proper treatment, medication, and trauma care, the trainee scored a respectable nine out of ten. But when it came to street smarts and handling people, he scored a dismal five out of ten. Johnny couldn't tell if his behavior was deliberate. He couldn't tell if it was bravado, or if maybe caution just wasn't something the new medic thought about. But in the very back of his mind, Gage was worried. He just hadn't reached the point where the unconscious pieces of evidence lingering in his mind's eye connected, allowing him to draw a complete sketch of the man's flaws. Only then could he understand that the trainee's behavior wasn't due to being a novice, but moreover, was due to the fact he was completely clueless to the dangers of his chosen profession.

*****

The crew was waxing the front end of the Engine when the tones went off. Johnny and Travis gleefully threw their rags to the side of the bay as the other men groaned, wishing they too were being called out, successfully relieving them of the boring, arduous task.

"I'll save the front quarter panels for you, Gage, just for smiling too wide," the Captain laughed. He had been hoping for a call too.

"Squad 51, LA, woman injured, 1642 Conway, one-six-four-two Conway, cross-street Harrison, time out 14:45."

"Squad 51, 10-4." Travis replaced the microphone and pulled out the map book.

Johnny caught the motion out of the corner of his eye, "I'm all set."

The new medic put the map book away and scanned the intersection for oncoming vehicles. "Clear, John."

Johnny accelerated through the intersection and made a quick left turn onto Conway.

Travis started calling out house numbers, "980, 1030, evens on the left. 1400." He continued reciting the numbers as Gage swiftly drove through the neighborhood, suddenly decelerating when Travis announced,  "1622, John."

"Here it is, 1642, the yellow one."

John eased the Squad to the curb as Travis called off, "LA, Squad 51, on arrival."

"10-4, 51, showing you on arrival 14:48."

The townhouse was nestled within a multi-unit block set back from the street. The well kept home was made cheerful by fresh yellow paint and large flowering hibiscus plants framing the doorway. Travis grabbed the trauma box and quickly started for the porch, pausing only to confirm that Gage was following closely behind.

The door was open and Travis noticed a young woman standing in the shadows a few feet beyond the open door crying soundlessly. He immediately stepped aside on the porch, allowing Gage to take the lead. He wasn't in the mood for coddling anyone today.

As John moved towards the woman, she instinctively stepped back, causing him to freeze in place. Beaten, he thought. He gingerly laid the equipment on the hallway floor and taking a slight step back, he held his hands out at his waist, palms outward in a non-threatening gesture.

"Ma'am? I'm John Gage, a paramedic with the Fire Department. Are you okay?" He spoke ever so softly, his tone rounded and full of concern.

She hesitated momentarily as if she were appraising his sincerity, and then tentatively stepped towards him into the afternoon light steadily streaming though the open doorway.

Red and purple streaks swelled along the left side of her face, marring her smooth ivory skin. The lines were drawn in a familiar pattern that Gage could not immediately identify. He studied her face and suddenly drew a quick breath. An iron, he thought, clenching his teeth to hide his brewing anger. Bastard, he cursed to himself, immediately forcing the thought from his mind, working desperately to regain his objectivity.

"Ma'am, is anyone else home?" Johnny's voice remained steady despite his precariously concealed anger.

"No. He left fifteen minutes ago." She looked at the medic steadily, as if she were expecting him to question her further.

Reading her misplaced guilt, he moved closer, "Here, let's go into the living room. You can sit down and I can check out your eye. What’s your name?" He gently placed his hand on her elbow as he softly spoke, carefully leading her over to the edge of the couch. 

The woman sat quietly, her eyes wide in fear. “Celia,” she replied hesitantly.

Johnny looked up at the other medic standing in the doorway, "Travis, blue ambulance." 

Travis looked at John with a withering expression. He knew exactly what Gage was subtly asking for, but thought calling for the police was unnecessary. After all, he thought, the damage is done and the guy's long gone. She'd be treated at the hospital anyway, and the police reports could be filled out there. Why tie up the Squad for that?

Johnny knelt before the disheveled woman, one hand lightly placed on her knee, gently holding her fragile, trembling hand. He spoke quietly to her, assessing her injuries while outlining some of her options and trying to convey to her the necessity of thinking about her own safety in light of the violent outburst only a half-hour before. As he carefully taped a bandage in place, a sharp rap sounded at the front door of the house. Travis Johnson was standing behind John and quickly turned around when he heard the knock, starting for the foyer.

"Make sure you check that it's the cops before you open it, Travis."  Gage quietly called after him.

Travis answered in a flat tone, "Yeah, yeah."

Gage knew immediately that the new medic had discarded his advice. A sudden uneasiness came over John, starting at the back of his neck and spreading outward over his chest, like a chill that creeps over one's body after an unexpected exposure to a cool breeze. He stood abruptly, startling the woman, pulling his hand from hers and holding it out towards her. "Don't move," he said in sharp whisper. He quickly traced Travis' path out to the entryway. He saw the new medic approaching the door and knew he hadn't checked outside. Sensing something untoward was about to occur, John broke into a run and yelled across the room.

"Travis, check the door!"

Johnny vaguely heard Travis' mutter a reply as the he reached for the door and pulled it open.

His ears were ringing as the impact pushed him back, momentarily pinning him against the entryway wall, balancing his shocked body to the plaster like a carelessly propped broom. The bright afternoon light burned into his eyes, leaving only the shadowed outline of a man filling the doorway. Staring at the figure, he stood motionless, his mind blank as his eyes locked on the entrance. He watched helplessly as the man abruptly turned, escaping into the afternoon light.

Her screams were loud and rending, tearing though the blank page of his mind, allowing his gated thoughts to flood though the breach. He immediately looked to the floor, his eyes catching on the crumpled body of his new partner lying at his feet. The ringing in his ears continued as he dropped to the floor, scanning Travis' back and turning his body over. Johnny's hands tore at the medic's uniform, the buttons flying like tossed coins, skittering noisily over the polished floor.

The woman's screaming continued and Johnny felt a rush of anger as he wiped away the flooding blood from Travis' chest with his forearm.

"Quiet!!" he yelled harshly, never pulling his gaze from Travis' bleeding wound. The woman fell abruptly silent, and with a whimper, she retreated to the sitting room.

*****

He knew he needed to call the police. He knew he needed to contact the hospital. But his voice had been stolen in those few shocking moments. He had worried something like this could occur, but never really believed it would happen. His trembling hands hovered helplessly inches above Travis' still body, as if a transparent case prevented him from rendering aid. He swallowed hard and reached for his HT.

"LA, Squad 51 with Priority 1 traffic." His voice felt tight and sounded sluggish.  He wished he could make it right, but he knew nothing would be right today.

"All units standby. Squad 51, continue with Priority 1 traffic." The dispatcher's tone was smooth and clean, sharply contrasting the urgent timbre edging the medic's voice.

"Squad 51, LA, we have a Code I, Code I, with EMS down, shots fired.  Repeat, EMS down, shots fired at our location. Notify all responding units to stand down, the scene is not secure at this time." He sighed with relief, finally feeling his heart begin to beat in his chest and the ringing in his ears mercifully diminish.

"Squad 51, we copy that, LAPD have been notified, additional squad and fire units are dispatched and will assist at your on notification of the all clear."

In those few short seconds, the dispatcher's voice had tightened, closely matching Gage's veiled distress.

"10-4, LA." John immediately answered.

"Squad 51, confirming your location at one-six-four-two Conway."

"Confirmed, LA, one-six-four-two Conway, Squad 51 out."

There was some relief in knowing help would not be far behind his call. But Johnny felt incredibly alone at the moment, the image of the dying medic before him sapping his strength. He shook off his dread and stretched over Travis’ body to drag the trauma box to his side. Flipping open the top, he pulled out trauma pads, occlusive dressings, and an ET. He opened the valve of the oxygen tank, rapidly hooking up the bag valve mask. Closely studying the first wound, he heard the tell-tale rush of air. Lung, he thought, wiping away the flooding blood with a sterile dressing. He placed an occlusive dressing over the torn flesh, sealing the dressing on three sides, leaving the last side open as a flutter valve to guard against a tension pneumothorax. The second wound was located towards the midline flush with blood, lateral to the sternum. Heart or lung? he thought, or both?  Johnny applied an occlusive bandage and covered it with a trauma pad, anchoring it by roughly running tape somewhat haphazardly over the medic's exposed chest. Turning Travis slightly, he shook his head.  Through and through, he thought, securing another bandage to the wound on his back.  He moved up to Travis' head, and smoothly inserted the tube and taped it in place. Squeezing the bag, he methodically checked Travis' breath sounds in all fields. He sighed. Johnny knew Travis had a pulse, but he was sure it wouldn't last long. I am so screwed if he codes, Johnny thought anxiously.

"Rampart, Squad 51 with Priority 1 traffic." His voice was almost normal now, somewhat strengthened by the performance of the routines of his trade. His face was a mask of concentration, concealing his thinly suppressed fear that his partner would die under his care.

"Squad 51, we read you loud and clear." Dixie's voice was sharp and strong. He drew from the sound of her voice, unconsciously mimicking her business-like tone.

"Rampart, we have a 24 year old male paramedic, gunshot wounds to the chest. Patient is in respiratory arrest.  There are two entrance wounds, one exit. First is right chest mid-clavicular line, at the 3rd intercostal space exiting through the back. It's a sucking chest wound and has been dressed with occlusive dressings. Second wound is right lateral to the sternum, 5th intercostal space, with heavy blood flow. Also dressed with occlusive dressing and a trauma pad. Patient is currently being bagged at 100% O2, ET in place. Pulse is 130 and thready, blood pressure 100 palp. Please advise."

Brackett looked at Dixie, his eyebrows knitted in concern, "Dix, who's Johnny with today?"

She nodded grimly, "Travis Johnson. New medic."

He stared at her as he answered, "51, start two IV's normal saline, run wide. Monitor for tracheal deviation. Send a strip. What is your ETA?"

Johnny sighed heavily, balancing the phone between his shoulder and ear as he continued to bag the patient. This is so bad, Johnny thought, dropping the phone and reaching one-handed for the leads. He paused for a second, attempting to stick them to Travis' sweaty skin. White on the right and smoke over fire, he thought, the long-lost positioning mnemonic providing him with momentary comfort.

Brackett grew impatient at Johnny's lack of confirmation, "51, this is Rampart, did you receive my last transmission?" John ignored the biophone and started to transmit the strip while simultaneously continuing to ventilate Travis. Even Superman only has two hands, Doc, he thought. His eyes ran smoothly over the tracing and he slowly shook his head. Damn, conduction damage. It hit the heart. Johnny fought back a momentary flash of anxiety, forcing himself to concentrate on the strip before him and the rhythmic squeezing of the ambu bag. He rechecked Travis' breath sounds to be sure his motions didn't dislodge the endotrachial tube.

"51, this is Rampart base, we are receiving your strip, please reply immediately." Brackett's displeasure at Gage's delay was clearly evident by his harshly communicated demand.

Moments later, John's urgent voice filled the radio, "Rampart, 51, we read a conduction disturbance, the bullet must have skimmed his ventricle. There is no tracheal deviation at this time."

Brackett pursed his lips, irritated with the medic’s delay in responses.  What's with Gage? he thought. The doctor related medication orders and once again impatiently waited for the medic's confirmation.

"Rampart, meds in, second strip running." Brackett noticed that Johnny's voice had changed over the last few transmissions. His tone was clearly stressed, his manner abrupt, departing significantly from its usual smooth, unflappable quality.

Dixie grew concerned, silently relating her growing anxiety to Brackett with a touch of her hand.

He nodded in understanding. "OK, 51, transport immediately," he ordered. He turned to Dixie, "What the heck is going on out there? I don't think he sounds right either." He tapped his pen methodically on the counter and stared at the floor as he waited.

Johnny paused and shrugged hopelessly before transmitting to the hospital. "Negative, Rampart, I'm on my own. This is a vulnerable scene; all units are standing down pending an 'all clear'. Repeat, this scene is not secure. . . I have no ETA to offer you at this time."

Dixie's head momentarily dropped into her cupped hands. No wonder he sounds so bad, she thought. Brackett must have thought the same thing, since he stood solemnly shaking his head back and forth, wondering what he could possibly do to help the dying medic, or say to the stranded medic desperately attempting to save his partner's life.

*****

Regrets ran through his mind as he read the current strip. I should have pulled him, he thought, but it was too soon to be sure of anything. I needed to give him a chance. He flinched suddenly as the sharp report of nearby gunfire cleared his thoughts. "Celia!" he yelled to the woman, "come over here next to me, now!" The woman had been watching him from the periphery of the room, afraid to disturb his work and sickened by the sight of the injured man. Fear pushed her quickly to his side. He could feel her body shaking as she leaned in next to him.  

He briefly encircled her back with his free arm, attempting to comfort her. He whispered urgently, "Celia, I will not let anything happen to you. Nothing. Do you understand?" She nodded, attempting to dampen the quivering of her body as the dispatcher's voice called out over the HT.

"Squad 51, police report they are on-scene and have recognized the suspect in your area. Please confirm immediately," the dispatcher spoke quickly.

"Squad 51, copy." Johnny replied, his voice dropping to a low whisper. "Stay behind me, Celia, no matter what happens, okay?"

She screamed in panic as the jarring crash of gunfire tore through the room, shattering the windows in the front of the house. Johnny dropped the Ambu bag and pulled the woman under his chest as they fell to the floor. He felt her stiffen as the gunfire continued, and he couldn't help but flinch as the bullets sailed through the air into the nearby wall, the displaced plaster pelting his back. He flattened further, sure that he must be crushing the slight woman's breath under his full weight.

*****

Silence. He almost didn't recognize the sudden soundless void in the room. He tentatively raised his head, realizing what had inevitably occurred during the mayhem only moments before. He glanced around the room and down to the figure beneath him. She was shaking coarsely now and he whispered to her softly, "Stay still," as he cautiously sat back and surveyed the room, waiting to see if the silence would persist.

"Squad 51, LA, police have reportedly secured the scene. Please advise us of your status." Johnny jumped at the sudden sound of the dispatcher's voice.

My status? I can't answer if I'm dead, you twit, he thought angrily. He realized Celia's husband had been shot and probably killed and he couldn't look her in the eye as he helped her sit up. Reaching for the Ambu bag, he leaned over and resumed ventilating Travis, the routine motion easing his discomfort. She noticed his sudden distance and instinctively understood what had happened as tears flooded her eyes and spilled down her weary face.

"Squad 51, what is your status?" the dispatcher's tone reeked of stress.

"Squad 51, standing by." Good enough, he thought as he turned to send another strip to Brackett.

*****

"Gage? Johnny? How's it looking up there?"

Johnny felt relief wash over his body as he recognized his friend's voice. "All clear here, Eric, I have a female victim here as well."

He caught her frightened eyes, her tears intensifying their deep blue color. "It's okay, Celia, it's okay." Johnny cringed, what a stupid thing to say, he thought, like anything will ever be okay for her again. He looked back to Travis, escaping the twist of pain marring her face.

The police officer leaned over John and whispered, "Glad to see ya in one piece, man."   Eric's relief changed to concern as John sat back on his heels.

"Eric, is the squad on the way up?" he asked. "We gotta get him out now. "

"John," Eric hesitated, his eyebrows raised in concern as he gestured towards Gage's shirt. "Johnny, did you get hit? Is that blood yours or his?"

John looked down at his uniform. Blood was unevenly splashed over his chest and his free hand instinctively moved to his side and he winced involuntarily at the contact. His expression transiently changed from surprise back to a neutral, serious mask. He pulled his stethoscope to his ears and listened to Travis's chest as he methodically continued to bag the fallen medic.

"John." Eric's tone was insistent.

"I'm okay, Eric, Travis slowed it down for me. It’s a scratch." If Johnny's expression wasn't so darkly serious, Eric would have thought Gage was making a sick joke.

"Let me take that for you, John. You can call in the team." Eric took control of the Ambu bag and Johnny let his weary arm drop to his side.

The medic raised his HT, "LA, Squad 51. All clear, repeat, all clear, send in the Medics." He picked up the biophone, "Rampart, this is Squad 51, we have the all clear, the squad has been released and we will be packaging the patient momentarily. We will inform when en route."

*****

Brackett let out a long breath as he listened to Gage's transmission.

Dixie shook her head and stood up abruptly. "I'll notify surgery, Kel, treatment two and three are ready."

Brackett cast her a curious look, "Two and three?" he asked.

"You said it yourself, Kel, Johnny doesn't sound right. Humor me," she replied as she swiftly walked away.

*****

Todd Mitchell broke through the doorway first, "Johnny?"

"Here, Todd." Johnny watched as Mitchell's expression switched from shock to detachment as he took in the scene. Gage was clearly worn out, "Pack him up and run, Todd, he's got one in the lung and the other likely skimmed his ventricle. He's an arrest waiting to happen." Todd nodded as he took in the strips and list of vitals neatly placed next to the Biophone.

"Okay," he paused, "Johnny, you don't look so good."

"Get going, Mitchell! I didn't work this damn hard to have you guys screw around with the few minutes left of his golden hour! Just go, I'm fine!" Johnny hissed.

"Okay, John, okay," he said in a clearly placating tone.

Todd moved aside as the attendants lifted Travis' still body onto the stretcher. He eyed Gage and then stared meaningfully at Eric.

The officer nodded slightly in response to Todd's unspoken request.  Eric was a friend to both men, "I'll make sure he's all set, Todd, there's another squad on the way up."

Todd nodded and swiftly followed the stretcher out of the room, briefly glancing back at his disheveled friend, hoping John was telling the truth.

*****

Johnny leaned over and knelt beside the woman, taking her trembling hands in his. "Celia?" he paused, "Celia, I need you to listen to me."

She looked up slowly, the deep red rims of her crying eyes setting off their light blue coloring. He thought they were the wildest blue he had ever seen. He wondered what her husband had thought when he first looked into those ocean-like eyes. Shaking his head at the thought, he was sure he'd never understand how a relationship could ever end up like this.

"Celia, we're going to take you to the hospital to get checked out."

Her frightened look reappeared and he touched her chin lightly with his fingers. "I want to make sure you're all right. You can see about the rest later." He paused, suddenly unsure of himself, willing his body to turn quickly away from this woman and safely maintain his customary emotional distance. She held his gaze, breaking his resolve.

"Celia, I want you to remember my words when you think of this day."

She was afraid of what he might say and defensively averted her eyes from his steady stare. He again touched her chin gently, drawing her attention.  

"This is not your fault."

She shook her head in disbelief and attempted to pull away. He held her arm, "Celia, your husband made a choice today that you had no part of. He chose to hurt you and chose to use that gun. You had no voice in those decisions. They were solely your husband's choices, regardless of what happened in the past. Whether my partner lives or dies, I want you to know, it is in no way your fault."  

He paused, catching his breath, trying to keep his voice free of emotion.

"Remember my words, Celia, keep them close when worry overtakes you. I speak the truth."

He continued to hold her hand lightly as the paramedics stepped into the room. He stood slowly when he felt Roy's hand on his shoulder.

*****

"You must be the luckiest guy I know, Johnny." Brackett smiled, his mood rising dramatically as he read the x-rays, "You're right. You're fine." Johnny nodded absently, fatigue having overtaken his thoughts.

"It must have been slowed down by something when it hit you and bounced off your seventh rib. It’s cracked, but not fragmented. Unbelievably lucky, John, you easily could have joined Travis in surgery if not for half an inch of semi-flexible bone."

Brackett moved closer to John, sensing his distraction.

"Johnny? You okay?" Johnny remained mute. "John?" Brackett gently shook the medic's shoulder, breaking John's absent gaze.

"Doc?" His eyes were half closed and Brackett could tell he was deep in thought.

They both turned toward the door as Dixie entered and walked to the side of the stretcher, a smile lighting her face.

"Hey," she said softly, "that's quite a bruise," she gently traced the wide ragged blue discoloration of the skin of his chest. She pulled away when he winced. "Sorry."

"Travis?" he asked impatiently. He just wanted the day to end, regardless of the outcome. He was tired of running over the events in his head, tired of seeing Travis' body at his feet and the violent marks on Celia's face. Tired of feeling like he could have prevented the whole tragedy. Man, I gotta get out of here, he thought.

"He's out of surgery, Johnny, he's doing well. The lung's repaired and Chaves from Cardiology put in a temporary pacer, but feels Travis won't need it before long," she paused, expecting his face to reflect some relief, but she found no change to his flat affect. She exchanged a worried look with the Doctor. What is he thinking? she wondered.

"So I can go now?" he asked in a lightly challenging tone.

Brackett was loath to let the medic leave, but had no real reason not to release him. The doctor reasoned that mental and physical exhaustion had overtaken the man, leading to his unusually quiet manner.

"Yeah, John, you're all set. Just come back to see me before the next shift, earlier if you start to have any problems or if the pain increases."

Johnny nodded slowly and sat up, accepting a clean scrub shirt Dixie held out to him. "You're sure you're okay, Johnny?" she asked tentatively.

"I will be," he stated convincingly, as he watched Brackett leave the room.

A little too convincingly, she thought. She helped him slip the shirt over his head, gently pulling it over his chest.

"This is good news," he offered, wondering why he felt no sense of relief.

She raised her eyebrows suspiciously, "What's up, Johnny?"

He felt cornered, like a child anticipating a scolding from an upset mother. He stared mutely at her, considering what to say. She met his stare silently, letting her steady, patient presence convince him to speak.

"I think I could have prevented this." His eyes remained locked on hers, searching for a hidden reaction, a flash of agreement to confirm his fear. There was none.

She was silent for a few moments as she assembled her thoughts.

"John, I don't possibly know how you could believe that to be true."

He knew it was an invitation for him to explain, but he was at a loss for words. She broke into his thoughts. "You can't think of why, can you? You feel responsible and guilty, but you actually can't think of what you'd have done differently. Can you?"

He paused. "I should have pulled him before."

She instantly waved her hand downward, as if she were throwing the idea to the floor. "You couldn't judge him after only few shifts and you know it. That's why you didn't pull him. He's a trainee. They make mistakes, that's why he's here--for you to correct mistakes so he can learn to do things right."

When he didn’t reply, she continued. "I saw you talking to him in the hallway the other day. It was clear he made a grievous error. I knew it couldn't be with meds, or you would have told Brackett, but I heard your parting words." A chill ran over her as she remembered the conversation. "If your manner and words didn't snap him into place, John, he wasn't going to listen and that's it." She paused, staring at him intently. "He chose to ignore you, and now he has paid the price. Don't let his mistakes become yours, because they are not."

He nodded thoughtfully, his expression remaining non-committal.

"I know I can't convince you of what you don't feel ready to believe, John, but if you need a reminder as to how hard you tried, just take a deep breath. That wound and cracked rib will let you know." She paused, letting her words sink in. Dixie felt a brief wave of fear as she thought how close he had come to dying. Sometimes, she didn't think he understood what a near miss was. She knew she hadn't convinced him and hoped that eventually, when the shock wore off, someone would break though the carefully crafted wall of guilt that was hiding the truth.

He rubbed his eyes, desperately trying to clear the tension before his headache worsened. He was tired and clear thinking was quickly becoming a difficult task. She recognized his weariness and placed a hand on his arm. "At least think about what I've said, John."

He nodded, offering a whisper of a smile, patting her hand gratefully before leaving the treatment room.

*****

He felt free as he hit the hallway, the burden of the day partially lifting as he looked around to see if Roy had already gone to get the car. He stopped abruptly when Celia walked around the corner. They stood opposite one another, frozen in place, as if an emotional standoff was in play, blocking either one from moving forward. Memories played quickly in both victims' minds.

"Are you okay?" she asked tentatively, breaking through the standstill.

"Yeah, I'm fine," he answered lightly. "No one ever believes me."

She nodded and he could tell she was about to say something more.  "How's your partner?" she asked, her voice was low and fearful.

Johnny looked down at the floor and then up to her face. "He's gonna be all right. It'll take a while, but he'll be okay." He shifted uncomfortably, tucking his hands in his pockets.

She nodded, staring at him, reading his posture. "You feel responsible for this, don't you?" He visibly squirmed. "You think you could have prevented it, that you could have stopped him from being shot."

She paused, observing the paramedic’s averted gaze, traveling first to the floor and then to the wall.

"You're thinking you could have stopped the entire thing." His eyes were squinted as he tried to fend off her piercing gaze. He nodded slightly, finally admitting his thoughts to her.

"I think I could have too," she said quietly.

He looked toward her in protest, when she suddenly stepped forward, closing the space between them, only inches away from his chest. His eyes narrowed further. He wanted to step away; he felt invaded as her sharp blue eyes further pierced his weakened defenses.

She nodded, reading beneath his light veneer of calm. "John Gage,” she whispered, noticing him wince at her use of his full name. "I want you to remember my words when you think of this day."

He looked at her wide-eyed, a confused expression lighting his face as he recognized his own words. She continued undeterred.

 "This is not your fault. I heard you warn your partner, twice. He chose not to listen. It was solely his decision not to heed your directions." She paused, leaning closer, her blue eyes serious, chipping through the last of his resistance. "Remember my words and keep them close when worry overtakes you. None of this was your fault."

She paused watching the medic as he closed his eyes tightly. "I," she stressed, "speak the truth, too." His eyes opened and she held his gaze, lingering for a brief moment over his dark brown eyes. She brushed by him and quickly walked away without looking back.

Johnny stood still listening to the sharp click of her heels dissipating on the tile as she walked away. When he heard the automatic doors swing open, he turned and watched her walk through them into the dim light of dusk. Looking back toward the nurse's station, he spotted Dixie, concentrating on a patient's record, her lips pursed and eyes squinted, absently running a pen through her hair as she thumbed the pages. He realized both women had said the same thing, in different ways. One using her head and the other using her heart. His expression softened, but his mind would only allow him to relinquish a portion of the burden.

*****

Johnny started to take a deep breath, but caught himself as a sharp pain filled his chest. Just as suddenly, his mind turned, the pain melding with the content of their words. I really did try, he thought, he just wouldn't listen. He realized it wasn't really their words that made the difference in altering how he felt. Moreover, it was the effort made by a woman he knew quite well and by one he didn't know at all. He walked slowly toward the nurse and tapped on the desk suddenly.

When her surprise cleared, Dixie smiled, "See ya, John. Roy’s waiting outside."

He returned her smile, momentarily catching her eyes, offering his unspoken thanks as he turned away.

Johnny ran over the last hour in his mind as he slowly made his way out of the Emergency Room. He thought of Travis, unable to see the inherent danger of his work and of himself, unable to see his innocence in the evidence before him. Maybe Travis isn't the only one who doesn't listen, he thought, as he walked down the hall in search of his friend.

 :-)a

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