Disclaimer:  The characters in Emergency do not belong to me.  I am not making any money on this, but if I could, I would be a happy clam.  The episode Floor Brigade was written by Roland Wolpert.  Personally, the Johnny owie in that episode made me feel a little cheated…okay…a LOT cheated.  I mean, on the tower, he could hardly breathe, and then he didn’t even have so much as a bruise?  I don’t think so!  With all due respect to the original writer, here is my take on how the injury on the tower SHOULD have happened.  My heartfelt thanks to Universal Studios and Mark VII for allowing me to play with your toys.  I promise to put them back together after I break them…ALMOST as good as new!

Rush headlong and hard at life
Or just sit at home and wait.
All things good and all the wrong
Will come right to you: it's fate.

Dean Koontz:  The Book of Counted Sorrows

Roy shielded his eyes from the afternoon sun as his gaze traveled up the light tower.  There was the victim, all the way at the top of course, and unmoving.  Wonder what happened?  He followed Cap over to the base of the tower.

Cap fingered the rusty lock on the gates surrounding the entrance.  How the hell did he get up there?  He turned his attention to his men.  “Need the bolt cutters Marco.  Roy, you and John can go check him out, better take some ropes.”

Roy trotted to the squad to find Johnny already fastening his life belt around his waist.  The two returned to the tower to find that the lock had been cut, and the gate was open.  Johnny, always the one to eagerly rise to the occasion, began his ascent up the steel ladders of the light tower.

Roy sighed as he watched his partner climbing several yards above him.  He was reminded of a rescue from a few years back in which Johnny was rappelling too quickly down a slope.  In his eagerness to reach the victim at the bottom, he ended up falling and spraining his knee.  In the two years since, Roy had learned he may as well keep quiet.  Still, there was a big difference between stumbling down a slope and falling several hundred feet off a tower.  Slow down, Junior.

Johnny made his way up the ladder, his focus on the victim who had not moved since they arrived on the scene.  He was almost at the top when his foot slipped off a rung.  The first thought to enter his mind was that he was dead.  He braced himself for the inevitable free fall to the unyielding cement, but instead felt the air forced out of his lungs as his left side connected painfully with one of the steel tower girders.  Through his pain filled wheezes, the voice of his captain drifted upwards, centering him back on reality.

“Hang on!  Stay right where you are, John!  Chet’s coming up to lower you down!”

Johnny was struggling to catch his breath.  It felt like someone was driving a knife through his left side, and he suddenly realized he would be much safer on the ladder than hanging onto the side of the tower for dear life.  He glanced downward to see Roy nearly at his level and Chet on his way up.  “Hey!  Watch out for those rungs!  They’re really slippery.”

Roy had reached his partner only to see him trying to settle himself back on the ladder.  No kidding partner.  “Right.”  He started to help Johnny make his way onto the relative safety of the ladder.  Roy had seen the fall, and heard the strangled gasp of pain that went with it.  “You okay?”

Johnny didn’t feel okay.  His side was in agony and he still felt out of breath.  But, the victim was unconscious.  Roy needed to worry about him right now.  “Yeah I’m okay.  I just…I just hit my ribs.”

Roy was concerned at Johnny’s appearance.  He was splinting his ribs with his left arm, and he was short of breath.  He was also sweating, but Roy supposed that could have been from the exertion of climbing.  “Let’s get you back on the ladder.”  Roy made sure Johnny had a firm footing and positioned himself protectively behind him.  “I’ll just go down with you.”

Johnny wanted to tell his partner he could make it, to go take care of the victim.  But, truthfully he was feeling a little woozy, and didn’t trust using his left arm.  “Okay.”

Together, the two descended the ladder towards the nearest landing.  Roy was becoming increasingly concerned about Johnny’s condition.  His breathless utterances betrayed the intense pain he was feeling.

“Oh…man…”

After several minutes, the pair reached the small steel landing.  Roy eased Johnny off the ladder.  “Easy.  You all right?”

“Yeah…okay.”  Johnny straightened up and began trying to remove the coil of rope he was carrying over his shoulder.

“Let me take this rope from you.”  Roy eyed his partner concernedly.

“Okay.”  Johnny leaned against the railing, willing the pain in his side to settle, still trying to get his breathing under control.

Roy took one more look at his struggling partner.  He hated to leave him without a thorough assessment, but he knew his first priority was to the victim at the top of the tower.  He glanced down quickly to see Chet was almost there.  He would make sure Johnny got down to the ground safely.  The engine crew could tend to his needs until he got there, and Cap knew to order another squad if necessary.  Johnny was in good hands.  Still, Roy hated to go.  “You sure you’re okay?”

Honestly, I’m not sure, but you need to go.  Johnny steadied himself with his right hand.  His head was spinning and the only thing he wanted right now was to get off this tower.  Chet would see to that.  “Yeah…I just got my ribs.  That’s all man.”

Roy reluctantly resumed his ascent.

Johnny called after him.  “Take it easy.”

“Yep.”

Chet arrived on the platform and immediately became concerned at Johnny’s apparent distress.  He started to work with his rope.  “Did you break anything?”

Johnny was fairly certain he had at least cracked a few ribs.  He didn’t want to say anything for fear that Chet would want him to wait on the platform until additional help could arrive.  His chest felt tight, and the sharp pain in his side wasn’t abating.  Being a few hundred feet in the air was making him feel dizzy and lightheaded.  Just get me off this thing.  “I don’t know.  I don’t think so.”

Chet eyed his young friend suspiciously as he attached a rope to his safety belt.  Yeah, right.  “I’ll give you a free ride down, just in case.”

“Okay.”

Chet stood on the narrow platform, anchoring the rope, and watched Johnny slowly descend the first ladder to the next platform.  Satisfied that he made it safely, Chet threw the rope down to where Johnny was and climbed down to meet him.  Chet watched Johnny as he repositioned himself.  He was no paramedic, but Johnny didn’t look good.  It was obvious that he was in a lot of pain.  “You sure you’re okay?”

Johnny nodded his answer and started down the next ladder.  About halfway down, a wave of pain tore through his left side, causing him to lose his footing.  Fortunately, Chet was on the ball, having anticipated this.  He tightened his hold on the rope, and caught Johnny before he could fall.  Johnny felt his momentum stop as he was snapped to a halt on his line.  The safety belt around his waist rode up and squeezed his already injured ribs, the abrupt jerking movement causing his chest to explode in pain.  After several agonizing moments, Johnny was able to reach out and grab the ladder with shaking hands.

Chet called down to his injured friend.  “Johnny!  Are you all right?”

Johnny wanted to answer, but he couldn’t seem to get enough breath to yell up to his crew mate.  It was then, only halfway down the tower, that he realized he was in trouble.  Johnny descended slowly and carefully to the next platform, and then leaned against one of the steel support beams, his right arm wrapped around his chest, gasping for air.

Chet started his descent down to meet Johnny when he caught a glimpse of something falling.  He looked down in alarm at the body of the victim which had just plummeted off the top of the tower.  Chet stared in disbelief for a few moments until he realized what the rest of the engine crew and Roy already knew.  The “victim” was a dummy, apparently someone’s idea of a joke.  Johnny was nearly killed over a joke.  Chet bit back his anger and made his way down the ladder towards his friend.  When he reached the platform, he immediately decided Johnny wasn’t going any further.  He breathed a sigh of relief at the knowledge that without another victim to treat, Roy was now on his way down.  Together, they could decide how to get Johnny on the ground.  Chet placed his hands firmly on Johnny’s arms.  “Hey man.  Roy’s on his way down.  Why don’t you sit down here for a minute?”

Johnny allowed Chet to help him sit down on the narrow platform.  “Yeah…okay…”  He suddenly realized what Chet just said.  “Roy?  What…what about the…”

Chet guessed Johnny must not have seen the dummy fall to earth.  “The vic turned out to be a dummy.  Someone must have lugged it up there as a joke.”

Johnny leaned back and closed his eyes.  He felt like he had a bag of bricks on his chest and it was getting harder to get a decent breath.  “Oh…man…”

Chet glanced up at Roy making his way down the ladder and willed him to hurry.  Whatever was going on with Johnny was more serious than a few bruised ribs.  Chet sized up the situation.  There was no room for a stokes up here.  He and Roy could lower Johnny down on his rope, but what if he slammed into the tower?  Would he be able to keep that from happening on his own?  Chet had an idea.  He called down to the men on the ground.  “Hey, Cap!  Can you send Marco up here to help us get Johnny down?”

Marco was climbing the ladder before Cap even had a chance to finish ordering it.

A few moments later, Roy arrived at Johnny and Chet’s level.  There wasn’t much room on the platform, so he positioned himself as close to his partner as he could.  Chet moved down the ladder a bit, making space for Roy to work.

Roy wrapped his fingers around Johnny’s wrist and was alarmed at how quickly his pulse was racing.  “Tell me what’s going on, Johnny.”

Johnny squinted at Roy through slitted eyes.  He panted a question.  “A dummy, huh?”

“Yeah…let’s talk about you right now.  You look like you’re having some trouble breathing there.”  Roy mentally calculated Johnny’s respiration rate.

“Feels like…big red’s…parked on…my chest.” 

Roy tried to remain calm and detached as he unbuttoned Johnny’s shirt.  “Any pain?”

“Yeah…chest hurts…ribs too…I think…maybe…”

“Yeah.”  Years of working side by side led both paramedics to the same assessment of Johnny’s condition.  He most likely had fractured a rib that punctured his lung, causing a pneumothorax.  He needed to get to Rampart in a hurry.  Roy used his scissors to slice down the front of Johnny’s T-shirt.  He cringed at the large bruise that was already beginning to form.  A quick check and a subsequent grunt of pain from his partner confirmed his suspicions.  Roy grabbed the HT off his belt.  “Cap?  We’re gonna need an ambulance!  And, can you get on the horn to Rampart?”

Cap’s “10-4” crackled over the airwaves.  He then radioed for an ambulance and retrieved the biophone from the squad.  “Rampart, this is County 51.  Do you read?”

Dr. Brackett’s velvety voice came back over the radio.  “Loud and clear 51.”

“Rampart, we have a paramedic down, injured in a fall.  Stand by for vitals.”  Cap depressed the talk button on the HT.  “Roy?  I’ve got Rampart standing by.”

Roy had been talking with Chet and Marco about how he wanted to lower Johnny down.  He went for the HT.  “10-4, Cap.  Tell them Johnny’s got probable rib fractures, left side.  He’s complaining of pain and pressure in his chest, and he’s having trouble breathing.  His pulse is 120 and his respirations are 30 and shallow.  We’re working on getting him down right now.”

Cap looked disgustedly at the dummy at his feet, and cursed under his breath.  One of his men was dealing with a possible life threatening injury because someone decided to play a prank.  He picked up the biophone receiver and relayed the information he had about Johnny.

Brackett’s mouth twitched at the realization either Johnny or Roy likely had a developing pneumothorax.  It was crucial to get to the hospital immediately.  “51, is there an ambulance at the scene?”

“Negative, Rampart, but we do have one on the way.”  Cap looked over to see Johnny and Roy on one line, being lowered by Marco and Chet.  They were nearly on the ground.  “Stand by, Rampart.  The victim is now on the ground.”

Brackett looked at Dixie, confused.  “On the ground?  Where was he before?”

Dixie shrugged her reply.

Cap jogged over to meet his two paramedics.  He helped Roy unfasten Johnny’s life belt and together they eased him to the ground.  Mike was there with the biophone and the equipment from the squad.  Roy wanted to keep Johnny in an upright position.  “Cap, can you get behind him?”

Cap did as Roy requested and they carefully positioned Johnny so that he was leaning back against Cap’s chest.  Johnny’s eyes were panicked, searching out his partner.  The pressure in his chest from the trapped air was increasing and it was becoming increasingly difficult to breathe.  Meanwhile his chest and injured ribs seemed to competing to see which could hurt more.  He kept trying to brace himself with his right arm, only to have it intercepted by Cap each time.  “Easy, John.  Just let Roy take care of you.” 

In his panicked state, Johnny didn’t feel like obeying orders.  He angrily jerked his arm out of Cap’s grasp.  “Let me…go…hurts…”

Cap calmly pulled Johnny’s arm down again and leaned in close to his ear.  “I know it does…I know…”

Johnny didn’t like being restrained.  He felt like he was being held down and smothered.  When Mike tried to slip the oxygen mask over his mouth and nose, he thrashed his head from side to side. “Can’t…breathe…”

Mike held Johnny’s head firmly with one hand and secured the mask with the other.  Cap was still holding Johnny’s arms and talking to him in soothing tones.  “That’s why you need the oxygen, pal.  Now take it easy…calm down…”

Johnny quickly became exhausted from his efforts and leaned limply back against his captain.  His eyes were squeezed shut in pain and he was struggling for each breath.  Mike was taking his blood pressure while Roy attached EKG leads to his chest and turned on the datascope.  He was relieved to see sinus tachycardia and not the irregular rhythm he had been dreading.  He quickly listened to Johnny’s lungs and frowned at his findings.  “Cap?  Where the hell is that ambulance?”

Cap raised his HT to his mouth.  “LA, Engine 51.  What is the ETA of the ambulance to our location?”

The dispatcher’s voice crackled back.  “Ambulance ETA is 5 minutes.”

Cap, Mike, and Roy exchanged concerned glances.  If Johnny had punctured a lung, his condition would continue to worsen.  There was only so much Roy would be able to do for him between here and the hospital.  Five minutes was an eternity.

As Roy was going for the biophone receiver, Johnny’s hand flailed out and grabbed his pant leg.  “Roy!”  Talking had become a Herculean effort.

Roy wrapped his hand around his friend’s in an attempt to calm him.  “I’m here, Johnny.  I gotta call Rampart and let them know how you’re doing.”

Johnny held tight to Roy’s hand in return.  “Really…hurts…”

“I know.  Just hang in there.”  Roy traded Johnny his hand for his captain’s, his expression indicating that Cap should continue trying to calm the young paramedic down.  Cap didn’t need any coaching as he immediately resumed his task, attempting to deflect the severity of Johnny’s situation with a little of the humor he was famous for.  “Listen, pal, there are better ways of getting out of eating Kelly’s cooking…”

Roy relayed his new information to Brackett, thereby dispelling the mystery of which of 51’s paramedics was injured.  “Rampart, the patient’s pulse is now 130.  Respirations are 34 and labored.  BP is 108 over 72.  His jugular is slightly distended and he’s beginning to use his accessory muscles to breathe.  Breath sounds are decreased on the left.  We have him on 15 liters O2.  Also, he’s agitated and in considerable pain.”

Brackett purposefully depressed the talk button on the base unit.  “51, can you send me a strip?”

“Affirmative, Rampart.  Lead 2 coming up.”

Brackett scanned the paper strip.  He rubbed his forehead and sighed.  So far so good.  Brackett’s stomach twisted at the knowledge that Johnny could easily go into respiratory or cardiac arrest before he reached the hospital.  “51, start an IV with normal saline.  Continue monitoring vitals and be prepared to manually ventilate.  What is your ETA?”

The ambulance had arrived while Brackett was talking and the attendants had already wheeled the gurney over.  “10-4, Rampart.  IV with normal saline.  ETA is approximately 8 minutes.”  Roy rechecked Johnny’s O2 mask.  I hope you have eight minutes, Junior.

Roy instructed the ambulance attendant to raise the head of the stretcher.  Then he, Cap, and Mike positioned Johnny on it.  Roy jerked his head toward the waiting vehicle.  “Let’s move it!  I’ll start the IV on the way in.”

The engine crew watched as Roy climbed into the ambulance behind his injured partner.  Cap closed the doors after voicing his encouragements to the pair.  He gave the doors the customary two taps and picked up his helmet, giving the dummy a kick on his way back to the engine.  “If I ever get my hands on whoever…”

Cap’s muttering was interrupted by a patrolman.  “Captain, I might just be able to give you that chance.”  The officer was holding two young boys by the shirt collar.  They appeared to be about 10-12 years old.

Mike looked at the kids and pointed toward the top of the tower.  “You mean you two climbed all the way up there and took the dummy up there?”

One of the boys shrugged his shoulders.  “Sure!  There was nothing to it!”

Chet advanced on the boy.  “Nothing to it?  Why you little…”

“Kelly!”  Cap held back the miffed firefighter.  He didn’t blame Chet for his outburst.  If Johnny had been injured on a legitimate rescue that would have been one thing.  But the fact was he was injured for nothing.  Cap was having a hard time keeping his own anger in check.  Still, the last thing they needed was for Chet to do something stupid.

Chet stomped off to the engine, leaving Cap to address the boys.  He used his size to his advantage, intending to scare the boys into not trying a stunt like this again, his expression serious.  “Now listen.  I know you two didn’t mean anything by your…prank.  But let me tell you something.  First of all, because we had to come out here this afternoon, we weren’t available to help people who may have really needed it.  Second, your actions caused one of my men to be seriously injured climbing up that tower.  Do you understand how serious this little joke turned out to be?”

The boys were humbled by the towering captain’s parental tone.  “Yes sir.”

The police officer carted the boys off to his vehicle.  After they were inside, he looked back at Cap.  “I’m going to contact the boys’ parents.  Do you think your man will want to press charges?”

Cap smiled despite his disgust at the situation.  “Knowing John, I doubt it.  I just hope they learned their lesson.”  He hopped aboard the waiting engine.

vvv

Inside the ambulance, Roy swabbed Johnny’s arm in preparation for his IV.  “Here comes a stick, Junior.”

Johnny was minutely aware of Roy telling him something, but he never felt the sting of the needle as it entered his vein.  He was too busy concentrating on breathing and the pain that was threatening to overwhelm him.  He wanted to ask Roy for some morphine, beg him if he had to.  But he found he could no longer get enough air to speak.

Roy could read the expression in Johnny’s dark eyes.  He did his best to sound calm and professional.  “I know it hurts, Johnny.  You know I would give you something if I could, but Brackett’s not gonna authorize anything until he gets your breathing stabilized.”

Johnny responded by turning his head away and closing his eyes in desperation.  He wasn’t thinking like a paramedic right now.  If he had been, Roy’s explanation would have made perfect sense.  His hands clamped down on the gurney railings while his legs moved around restlessly in an effort to deal with the pain and the helpless feeling of being slowly suffocated.

Roy’s eyes darted nervously to the datascope.  He took a look at Johnny and didn’t like what he saw.  His lips and fingernails were beginning to show the first tell tale signs of severe oxygen deprivation.  Roy quickly took another set of vitals and listened to Johnny’s lungs before reaching for the biophone receiver.  “Rampart, patient’s pulse is now up to 140.  EKG shows sinus tachycardia with occasional PVC’s.  His respirations are 40, BP is 100 over 70.  Patient is agitated, cyanotic, and diaphoretic. His trachea is deviated.  I can’t detect any breath sounds at all on the left…”  Roy dropped the receiver as Johnny’s eyes rolled back and he started gasping in a feeble attempt to draw in air.  Roy quickly replaced the O2 mask with an ambubag and started squeezing frantically.  “Come on, Johnny.  We’re almost there.”  Roy could hear Brackett barking over the biophone.

“51, what’s happening?  51, do you read me?”

The ambulance attendant took over the ambubag so Roy could get back on the line.  “Rampart, patient has developed increased respiratory distress, and we are currently assisting ventilation.”  Roy placed a hand to his mouth and willed Johnny’s chest to rise.  It didn’t appear as if the ambubag was helping.  Roy had never felt so helpless.  Johnny couldn’t breathe, but any effort to help him was practically futile at best.  Roy couldn’t help but think that all they were doing was forcing more pressure, but still, they had to try.

“51, what is your ETA?”

Roy looked out the window, relieved to see the familiar emergency entrance looming straight ahead.  “Our ETA is two minutes.”  He returned his attention to his partner.  “Johnny?  Can you hear me?  Come on, stay with me…just a little bit longer…”

vvv

Brackett turned to Dixie.  “Johnny’s probably going to need intubated when he gets here, and I’ll need a chest tube tray.  Notify radiology.  Tell them to send down a portable for a chest series.  And I’ll want a CBC and ABG as soon as possible.”  With that, the dark haired doctor headed for receiving where he practically ran into Joe Early.

“Whatdya got, Kel?”

“Roy’s bringing Johnny in.  Sounds like a tension pneumothorax.”

Kel didn’t have to ask for help and Joe didn’t need to offer.  The silent agreement to work together to save the life of one of their friends and colleagues hung in the air as the doors crashed open and Johnny was wheeled in.

Roy’s expression was dire as he tried to force air into Johnny’s lungs.  “He stopped trying to breathe on his own about a minute ago.”

Kel took a brief look at the now unconscious paramedic.  Johnny’s lips and skin were a dusky blue.  “Treatment 3.  Let’s move!”

vvv

Inside the treatment room, Brackett, Early, and Dixie slid Johnny backward until his head was leaning off the edge of the table.  Early grabbed the endotracheal tube from Dixie and inserted it while Brackett listened for breath sounds.  His mouth twitched at his discovery.  “He’s in respiratory arrest.  Dix, let’s get that chest tube in now!”

Dixie quickly draped Johnny with surgical sheets in preparation for the procedure.  Early finished inserting the endotracheal tube and motioned for Roy to continue ventilating with the ambubag.  He listened again to Johnny’s chest in an attempt to see if the airway was placed properly.  He looked at Brackett, his expression grim.  “Tube’s in place, but he’s not ventilating.  Better hurry, Kel.”

Dixie raised Johnny’s left arm above his head and held it in place.  Brackett made an incision between Johnny’s fourth and fifth ribs and quickly had the chest tube inserted, attaching it to the pleur-evac on the side of the bed.  There was an immediate release of air through the tube and Brackett quickly sealed it with a few sutures and a piece of Vaseline soaked gauze.  He looked across the table at Early.  “How’s he doing now?”

Joe listened intently to both lungs.  “Better.  He’s ventilating better.”

Brackett studied the cardio monitor.  “His EKG is stabilizing too.”

Dixie looked up from taking Johnny’s blood pressure.  “108 over 74.”

Joe removed the surgical sheets and threw them aside.  “Kel?  Do you want him on the ventilator?”

Brackett peeled off his gloves and threw them onto the instrument tray.  He picked up Johnny’s hands and looked at his nail beds, then checked his pupils.  “Not yet.  His color’s returning.  Just keep going, Roy.  Let’s give him a few minutes here and see what happens.”  Brackett began palpating the large bruise that was forming on Johnny’s left side.

As if on cue, Johnny started taking a few breaths.  Roy felt a wave of relief wash over him as he continued to assist his friend.  “There ya go, partner.  That’s it…”

Brackett looked up from his examination.  “Spontaneous respirations?”

Roy couldn’t hold back a smile.  “Yep.”

A collective sigh of relief rang out as Kel moved up to Johnny’s head.  “Go ahead and stop a minute, Roy.  Let’s see how he does.”

Roy removed the ambubag from the endotracheal tube.  The medical team stood back and watched in anticipation.  Roy was the first to break the silence.  “He’s breathing on his own.”  He replaced the ambubag with a mask.

Brackett pressed his stethoscope against Johnny’s chest.  “Let’s keep him on 15 liters for now, Roy.”

Roy adjusted the oxygen flow and was standing right behind Johnny’s left shoulder when he saw his eyelids flutter.  “Doc?”

Simultaneously, Early was checking the reflexes in Johnny’s right arm when he noticed a slight movement.  “Kel?  He’s coming around.”

Brackett leaned over Johnny’s face.  “Johnny?  Can you hear me?”

Johnny’s eyelids fluttered again.  He heard familiar voices but couldn’t place any of them.  There was something in his throat, it felt like someone was sitting on his chest, and his left side was on fire.  He tried to escape to the comfort of sleep.

Brackett was persistent.  “Johnny!  Open your eyes!”

Okay…okay…I’ll give you what you want, but then I’m going to sleep.  Johnny’s eyelids fluttered one more time and he slowly peeled open one eye and then the other.  As his vision cleared, he suddenly realized he didn’t know where he was or what he was doing here.  The man leaning over him looked familiar, but he didn’t know who he was.  The pain in his chest and side was unbearable and something was choking him.  Johnny’s eyes grew wild with panic and confusion and he reached up with both hands in an attempt to rip off his mask and dislodge his airway.

Brackett and Early grabbed Johnny’s arms and held them down at his sides.  Brackett made eye contact with the frightened paramedic.  “Johnny!  You’re okay.  You’re at Rampart.  You have an airway in.  Don’t fight it.”

Johnny shook his head and continued to struggle.  Roy leaned over him now.  “Johnny, it’s Roy!  Listen, it’s all right.  You’re gonna hurt yourself.  Now, you need to lie still.”  Roy looked at the doctors in concern when his best friend didn’t even seem to recognize him.

Brackett motioned for Roy to move down to Johnny’s legs.  It wasn’t too hard to restrain him.  Johnny was too weak to put up much of a fight.  Brackett barked an order to Dixie.  “Give him 5 mg diazepam and 10 mg MS IV.”

Dixie quickly retrieved and injected the prescribed meds while the others worked to calm down their agitated patient.  After a few seconds, Johnny stopped struggling.  Brackett did a quick exam and turned to Roy who was standing at the foot of the bed looking lost.  “He was without oxygen for a few minutes, Roy.  Some confusion is normal at this point.”  Turning back to Dixie, he added, “Let’s let him rest about 10 minutes and get another ABG.  Call radiology and tell them we’re ready for that chest X-ray too.”  Brackett left the room, with Early following closely behind.

Roy cautiously approached the side of the table.  He was well aware of the effects oxygen deprivation could have on the brain.  He silently prayed they had been able to help Johnny in time to avoid any long term or permanent effects.  He stayed at Johnny’s side, watching him sleep until the X-ray technicians arrived.

Dixie handed Roy a brown envelope with Johnny’s personal items inside.  “He’s going to be fine, Roy.”

“I know, Dix.  It’s just…Johnny shouldn’t even be here.  This shouldn’t even have happened…”

Dixie led Roy by the arm.  “Come on.  Let’s talk about it over a cup of coffee.”

vvv

When Roy and Dixie arrived in the lounge, Brackett was there also.  Once the coffee was poured, the three sat down at the round table in the middle of the room.  Brackett leaned forward and took a sip of his brew.  “So what exactly happened, Roy?”

“We were supposed to be rescuing someone from the top of a light tower over at the college.”

Brackett exchanged a look with Dixie.  “Supposed to be?”

“Yeah.  Turned out it was a dummy someone put up there for laughs.”  Roy wasn’t even trying to hide the disgust in his voice.  “Johnny was climbing up the tower and his foot slipped.  He hit one of the steel support beams when he fell.  It’s a good thing actually, because it kept him from falling off the tower.  Then, when Chet was helping to lower him down, he slipped again and his life belt squeezed him around his rib cage.  I’m not sure if that caused the pneumo or if he already had one working.”

Brackett took another swig of coffee.  “Well, either way, it couldn’t have helped.”

Roy stared into his mug.  “We shouldn’t have been there.”

Dixie reached over and put her hand over Roy’s.  “Roy…”

Roy pulled his hand away and stood up.  “Johnny could have been killed today over a…a…stupid childish prank.”

Brackett looked up at the frustrated paramedic.  “But he wasn’t.  That’s the important thing.”

Roy sighed and sat back down.  “Yeah…yeah you’re right.”  He looked questioningly at Brackett.  “Johnny…he’s uh…do you think…”

Brackett smiled reassuringly.  “Roy, I think Johnny is suffering from the effects of hypoxia.  And, I’d bet money he’s got a few fractured ribs.  You did everything right and he was only in respiratory arrest for a few minutes.  I think once his SAT’s go up a little, he’ll become more oriented.”

“I know…It’s just that…well, it took us so long to get him down off that tower, and then the ambulance was stuck in traffic and took a while to get there…”

Brackett cut Roy’s guilt trip short.  “And, if you actually would have had another victim to treat, Johnny would have had to wait even longer until another squad could’ve been dispatched.”

Roy was still focused on the senselessness of the incident.  “That’s true.  But the fact remains, if we wouldn’t have had to climb up there to rescue a dummy, Johnny wouldn’t have fallen in the first place.”

Brackett sighed and stood up, ready to head back to Johnny’s treatment room.  Roy had a point, and he couldn’t argue it.  “Well, let’s go back and see if Johnny’s awake.”

vvv

When the trio arrived back in the treatment room, Joe Early was there conducting a neurological exam.  He smiled.  “Hey, look who’s awake.”

Brackett approached the table.  “How’s he doing, Joe?”

“Well, he woke up a few minutes ago.  He recognized me.  His reactions are a little sluggish, but nothing out of the ordinary.”

Brackett leaned over his patient.  “Johnny?  Do you know who I am?”

Johnny nodded and pointed to the endotracheal tube.  His eyes were asking a question.

Brackett smiled.  “I guess that tube is pretty uncomfortable.  Well, you seem to be doing pretty well.  I think we can see how you do without it.”  Brackett moved behind Johnny’s head.  “Ok, Johnny.  I want you to cough.”

Johnny did as he was instructed and a few agonizing moments later, the tube was out and he swallowed against the raw ache in his throat.  Brackett replaced the oxygen mask with a nasal cannula and raised the head of the bed.  “Better?”

Johnny rubbed at his chest.  “Yeah…”  His voice was raspy.  Johnny’s eyes traveled around the room until they found who they were searching for.  “Roy?”

Roy sauntered over to the bed.  “I’m here, Johnny.  How are you feeling?”

Johnny wasn’t sure how to answer that question.  He didn’t really feel much pain at the moment, but he felt the familiar sensation of narcotics swimming in his bloodstream.  He was dizzy and exhausted and it was impossible to take a deep breath.  He glanced warily at the dressing on his left side and the tube snaking away from it.  His brows knitted in confusion.  “What happened?”

Brackett pulled out his stethoscope.  “What do you remember Johnny?”

Johnny thought hard for a minute.  “Roy?  Did you ever call DiGeorgio back?”

Brackett and Joe looked at Roy in puzzlement.

Roy chuckled.  “Not yet, Johnny.  Thanks to you, I’ve…uh…sort of had other things on my mind.”  The sandy-haired medic explained to the bewildered doctors.  “Johnny and I are thinking of going into the floor cleaning business on our days off.  DiGeorgio is the name of the man we want to buy the equipment from.”

Brackett smiled at that information.  “Johnny, do you know why you’re here?”

It seemed as though remembering that seemingly insignificant snippet of information opened the floodgates.  “Uh…climbing a tower…I fell…I think…”

Brackett patted Johnny’s shoulder.  “That’s right, Johnny.  You injured your ribs, and punctured a lung, resulting in a pneumothorax.  You gave us a run for our money, but I think you’ll be okay.”

Now that Johnny was coherent and able to speak, Joe took him through a full neurological exam while Brackett listened again to his lungs.  When an orderly popped his head in with Johnny’s X-rays, Roy intercepted them at the door and handed them to Dr. Brackett. 

While the doctors looked at Johnny’s films, Roy talked to his partner.  “So how DO you feel, Johnny?”

Johnny leaned his head back and closed his eyes.  “Hmmm…tired.  My chest feels kinda…tight.  Guess that’s normal, huh?”

“Yeah…probably for a while anyway.  Does it hurt much?”

“No…not much.  I have a feeling once these drugs wear off I’ll be feeling it though.  Man…what did they GIVE me?”

Roy smiled.  Even in his current condition, his partner could find something to rant about.  “Diazepam and morphine.”

Johnny arched an eyebrow.  “Diazepam?”

“Yeah…when you first regained consciousness you were…well let’s just say you were a little…confused.”

Johnny frowned and pulled at his blanket.  “Yeah…well…you’d be confused too if you…if you…oh never mind.”

Brackett walked over to the bed and leaned his hands on the rail.  “Well, Johnny.  You’ve got two fractured ribs.  One of them punctured your left lung and well…you know the rest.  We’ll have to leave the chest tube in until your lung heals.  I’m still waiting on the results of your latest blood gas, but it looks like you’re going to make a full recovery.”

Johnny looked at Brackett gratefully.  “Thanks, Doc.”

Brackett smiled.  “Anytime, Johnny.  Dixie’s finding you a room.  Someone will be in soon to get you settled, and I’ll be in to check on you later.  How’s the pain?  Do you need anything right now?”

Johnny paused to figure that out.  His chest ached a little, but it was nothing like the excruciating pain he remembered from before.  His ribs ached more, but he decided he could live with it.  “It’s not too bad, Doc.  My ribs mostly hurt when I breathe.”

Brackett crossed his arms and he shot Roy a sly look.  “Well…uh…do us all a favor, Johnny.”

“What’s that?”

“Don’t stop.”  The comment brought a chuckle to the group, and Brackett and Early made their departure.

Johnny waited until he and Roy were alone.  He shifted positions and winced slightly.  “You know Roy…you should go call DiGeorgio.  If he put another notice up on that bulletin board…”

Roy patted Johnny’s arm.  “Okay, Johnny.  I’ll go call him.  Why don’t you get some rest?”

Johnny continued, oblivious to Roy’s suggestion.  “You know Roy, I’ve been thinking…maybe instead of hiring all those off duty firemen ourselves, we should go the franchise dealer route.  There’s a lot of money to be made in franchises…”

Roy paused at the door, listening to his partner’s latest rant.  It was music to his ears.

Finis

Author’s notes:

Once again, my most heartfelt appreciation and thanks to my beta and best friend, Maryann.  Without you, Johnny owies are just not as fun.  Sorry I didn’t put Kel in jeans or boots for this one, but at least he barked and twitched!

Erin…you are so fun to watch when we torture poor Johnny.  You KNOW we’ll always put him back together!  Thanks for the eye candy!

And to the readers…thank you for reading!  Without you, there would be no reason to do this, except for my own sick, twisted enjoyment. 

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