Gage and DeSoto entered Rampart General's Emergency Receiving.
Except for a dozen or so people seated in the waiting area, the place appeared to be deserted.
"Mornin', Jeff!" DeSoto called down the corridor, as an orderly came out of one of the treatment rooms. "Where is everybody?"
"Mornin', Roy…Johnny," Jeff Vermille wearily acknowledged, as he came limping up to them. "Dr. Doughty is in One, with the migraine. Dr. Tyler is in Two, with the hip chick with the chipped hip—" he paused to yawn.
John was intrigued by Jeff's last tongue-twisting comment. "Say that three times—really fast!" he dared.
"Are you kiddin'?" Vermille came back. "I can barely say it once—really slow!"
"How'd the hip chick chip her hip?" Gage playfully prompted.
"They picked the vic' up at the Firefly Disco. The hip chick must a' been Bumping while under the influence," Jeff reasoned. "Because she claims she Bumped right, when she should a' Bumped left, and her hip caught the corner of a table." He completed his chipped hip explanation and turned back to finish answering the first question he'd been asked. "Dr. Herron is in Three, with the O.D.. And Dr. Gordon is in the Doctor's Lounge, with the rest a' the crew, sipping coffee—" he yawned again, "and trying to stay awake. See yah, guys! I gotta get back upstairs," he announced and went yawning off down the hall.
"The hip chick with the chipped hip. The hip chick with the chipped hip. The hip chick with the hipped chip—" John gasped in frustration. He'd come so close, too!
Roy gave his frustrated friend a sideways roll of his eyes. "I'm going up to check on Chet. You are going to go ask Dr. Gordon to examine you."
"No wa-ay!" Gage exclaimed, his frustration giving way to alarm. "She's a shrink! I don't need no shrink!"
"She's a psychiatrist," DeSoto quickly corrected. "She is also a medical doctor, and perfectly qualified to examine you!"
His frowning friend suddenly brightened. "I know! Since you think so highly of her, why don't I go check up on Chet—and you go get examined?"
Roy was not amused. His blue eyes began narrowing into 'no nonsense' slits. "We are not leaving here until she examines you!"
Gage's shoulders sagged in defeat and he reluctantly began heading for the Doctor's Lounge.
DeSoto watched him go grumbling off down the hall. He waited until his peeved partner vanished into the lounge. Then he turned and disappeared himself, in the direction of the elevators.
"Good morning! Good morning! Good morning!" the paramedic cheerfully proclaimed as he strolled into the lounge full of half-asleep people.
The lounging hospital staffers glanced up at him through half-open eyes and acknowledged his cheerful greeting with an assortment of subdued grunts.
John spotted Veronica Gordon and his cheery demeanor crumbled. Gawd, he hated shrinks! He drew a deep breath and stepped up to the tiny table she was seated at. "Uhhh…Hi, Doc. I hate to interrupt, but…I really need to talk to you—"
"—Hi, John. Yeah. Sure. Find a couch. I'll be right with you," the woman quickly came back, without even bothering to look up from the medical chart she was studying.
"I meant, in a Treatment Room," Gage further specified, over the sound of sleepy snickers.
Gordon's eyebrows arched upwards. The doctor set the chart down and devoted her undivided attention to the young man standing at her side. She knew how he felt about her. Hell, everyone did! It was certainly no secret that John Gage hated 'shrinks'. "Whose idea was this?"
"My, uh, partner thinks I should have my head examined," the paramedic quietly replied.
"Nonsense!" Gordon told him. "Why, you're every bit as insane as the rest of us." She stood up from the table and sat their visitor down in her vacated chair, to begin her preliminary examination. "Boy! You've sure got a mop of hair on you! Makes it harder to find the screws," she teased and began running her fingers through his long black locks. "Looks like they're all Phillips'," she diagnosed and pulled a gold-plated Phillips screwdriver from the right hand pocket of her smock. The doctor pretended to tighten something in the back of the paramedic's head.
The little group snorted with laughter.
John was even forced to grin. "You don't understand, Doc. Roy says we ain't leavin' he—"
"—Shhhh!" the doctor chastised. "You're distracting the driver."
Gage's grin broadened.
The now wide-awake hospital workers continued to chuckle.
"There! Just a few loose screws, is all!" Gordon proclaimed, upon completing her adjustments. "A gift from a former patient," the 'shrink' explained, prior to pocketing her gold-plated instrument.
There was a renewed round of snickering.
A wave of dizziness suddenly washed over John, and took his grin right along with it.
Dr. Gordon saw the dazed expression on the paramedic's face and her own grin did a disappearing act. The woman was about to ask the young man if he was okay—when she got paged to the Base Station. She gathered up her charts and immediately left the lounge.
Gage was feeling more light-headed by the moment. "I think I need some fresh air," he mumbled to himself and followed the doctor from the room.
Their break over, the revitalized hospital staffers reluctantly returned to work, as well.
The whoozy paramedic ended up in the parking lot, just outside the hospital's Emergency entrance.
John stood there, hunched over, with his hands resting on his knees, and drew in several long, deep breaths of cool, crisp, invigorating early morning air. His head cleared. So he straightened back up. He felt exhilaratingly alive—like he could jog back to the Station.
The sound of approaching sirens cut out. Less than a minute later, an ambulance pulled in and backed up to the Emergency doors.
Squad 39 pulled in, backed up and parked right beside it.
The vehicles' front seats were vacated.
The attendants quickly emptied their ambulance of its rear cargo.
"Hi, John." "Hi, John." 39's paramedics greeted, in passing.
"Hi, Mark. Hi, Sammy," Gage called back. He watched the little group, and the gurney they were guiding, disappear into Emergency Receiving.
Nurse Norquist was standing just inside the doors, gazing out at him through the glass. She saw that he was watching her watch him, and smiled.
John smiled back. "Well, if it isn't THE Cheryl Norquist!" he exclaimed, as the woman stepped outside to join him.
Cheryl wasn't quite sure what to make of his greeting. "That's the first time you've ever called me anything but 'Miss Norquist'." The pre-dawn chill hit her full force and she shivered. "Brrrr! Aren't you cold?"
"I'm not sure what I am," the fireman truthfully told her. "Is Dr. Tyler still in with the hip chick with the chipped hip?"
She shot him a strange stare and shook her head. "He's in Four—with a bad bellyache. Why?"
Gage gasped in frustration. "Look, will you do me a big favor?"
The nurse nodded, uncertainly.
"Will you please tell Dr. Gordon that I really need to see her…alone…in a Treatment Room?"
"Of course, but you're going to have to wait a while. She's in One—with the attempted suicide 39 just brought in."
The paramedic appeared even more disappointed. He had the irresistible urge to run. So he ran.
"Where are you going?" Cheryl called after him, as he went jogging off across the parking lot. "Wait!"
"Can't!" the jogger shouted back over his shoulder. "I gotta run!"
"I'm an RN! Maybe I can help…" the woman allowed her words to trail off, as the paramedic disappeared behind a row of cars. Cheryl frowned and turned around. "Oh…sorry," she apologized, as she bumped right into Roy DeSoto.
The fireman steadied the rattled woman and then flashed her a forgiving smile. "Have you seen my partner anywhere?"
The nurse nodded and pointed to the parking lot. "He's out there…running around…somewhere," she replied and was amazed that DeSoto didn't seem the least bit surprised to hear that.
"Thanks!" Roy waved and left to go find his rambunctious friend.
Cheryl stared after him for a few moments. Then she shook her head and went back to work.
Roy didn't have to look very hard. As he climbed into the Squad, Johnny came jogging up and climbed right in beside him.
"How is he?" Gage gasped breathlessly.
"His condition remains stable. He's resting comfortably. He's doin' okay."
"All right!" John exclaimed with a grin.
Roy started to turn the key in the ignition, but then froze. "What did Dr. Gordon have to say?"
Gage draped his left arm across the back of their seat and tapped his fingers a few times. "Uhhh…She disagreed with your diagnosis. She said I didn't need to have my head examin—"
"—Did she examine it?" DeSoto cautiously inquired.
"Yes. Yes, she did," John told him truthfully.
His partner seemed pleased and finally started the Squad up.
As the pair drove along, Roy waited patiently for his silent partner to provide him with the details of Dr. Gordon's examination.
However, when they'd traveled a good ten blocks from the hospital—and Gage still hadn't said a word—the senior paramedic's patience wore out. "We-ell? What did she think caused your headache?"
His passenger squirmed uncomfortably in his seat. "Uhhh…She didn't actually comment on that, but she did manage to find a few loose screws…" he tacked on, with a tentative smile.
DeSoto stopped for a red light and aimed an angry glare at his cringing companion. "You didn't even tell her about your headache, did you."
Gage looked guilty as charged, but then turned defensive. "Well, I never got the chance! I tried to talk to her! Honest! But she wouldn't take me seriously!" He frowned, seeing that his partner was now too upset with him to even speak.
The light changed and they rode on in silence for a few minutes.
Finally, John flashed his fuming friend another slight smile. "Did you know that Gordon carries a gold-plated screwdriver around in her pocket?"
Roy continued to ignore him.
Gage exhaled a glum sigh. "Ah-ah…I probably won't be able to sleep for the rest of the shift," he quietly confided. "I think I must got what THEY call my second wind." He chanced a glance in his friend's direction, but Roy was still too furious to talk. So he stopped talking and turned to stare out his window. The streetlights suddenly went out…and so did he.
Ten minutes later, DeSoto backed the Squad into its spot in the apparatus bay.
Roy flicked the ignition off and watched as the garage door gradually began to descend. His eyes also started closing. He forced them open and then aimed them at his aggravating passenger.
He saw that Johnny was sound asleep and was forced to smile. "Second wind, huh?" he mumbled beneath his breath and reluctantly reached out to shake his friend awake. His arm froze. 'He might wake up…get his third wind…and start jogging around the Station,' he figured, and decided not to disturb his peaceful-looking partner.
Instead, he climbed quietly out of the cab, pulled a blanket from one of the side compartments and tucked his sleeping friend in with it. "Good morning, Johnny…" he wished, in a whisper. Then he backed out of the Squad, quietly closed his door, and went yawning off in the direction of the dorm.
John Gage groaned his way back to consciousness—and gasped. Judging by the dryness of his throat, he'd been doing a great deal of 'gasping'.
He was sitting in the Squad…his neck had a terrible kink in it…and, most noticeable of all, his sinus headache was back—with a vengeance!
Ah, hell. Who was he kidding? He'd never had a sinus headache before, in his entire life, that had hurt this bad, or that had caused him to barf and blackout.
No. Roy was right. This wasn't 'just' a headache. His head was really killing him!
He winced. That observation was probably a little closer to the truth than he dared—or cared—to admit.
He groaned again and gritted his teeth. It was becoming increasingly difficult to form a coherent thought. 'Push past the pain…push past the pain,' the paramedic kept telling himself.
His right hand started reaching for his throat, but his arm was buried beneath something…a blanket. He smiled. Roy had covered him with a blanket. Apparently, his partner had assumed he was asleep.
He tossed the cover off and pressed the tips of two fingers over his corotid artery. His pulse was bounding so unbelievably hard, he could have probably palpated it with his fire gloves on. His pressure had to be through the roof! Perhaps his head really was killing him! It probably was. Nobody could feel as sick as he felt and NOT be dying!
'The refinery.' He must've been exposed to some hideous toxic something or other back at that refinery fi—. He tensed. Marco, Mike and the Cap' had all been in there, too! What if they were feeling just as sick as he was?
He needed to summon help!
He reached for the Squad's dash-mounted radio. His palate was almost too parched to speak. Unfortunately, the canteen, on the seat beside him, was even drier than his mouth. He and Marco had polished off the last bit of its contents washing down their aspirins back at Rampart.
He swallowed hard and thumbed the mic's transmit button. "LA," he managed to get out, between gasps and groans, "Code I…possibly…times four…Station Fifty…Fifty-one."
"10-4, 51…" LA acknowledged.
Once again, the groaning man was overwhelmed with the urge to run. He really felt like running. 'Now, there's a silly notion.' In fact, the idea was downright laughable, since he doubted he could even stand, in his current condition.
Besides, he was already breathless from all that damn 'gasping' he was doing. It was becoming increasingly difficult for him to swallow. His mouth was soooo ridiculously dry.
Forget running! What he really really needed was some water.
He dropped the mic', opened his door—and collapsed face down, on the cold concrete floor. Damn! He was right. He was in no condition to stand.
The fireman felt something warm and wet on the back of his neck. He lifted his hurting head and got licked in the face. 'Henry…'
The Basset hound whined and continued to nuzzle and nudge the downed man. The dog knew the fireman didn't belong on the floor. Henry sensed something was wrong, and, when he failed to get Gage to his feet by himself, he started barking for assistance.
The Squad's radio crackled.
Over the persistent—and painful—yapping in his ears, John heard the muted tones. He listened as 16's and 39's were dispatched to a very familiar address.
Help was on the way.
Gage was beginning to wonder if he would still be alive…when it got there.
Hank Stanley awoke to the sound of a barking dog. 'What dog?' he wondered sleepily. 'It can't be Henry. Henry never barks.'
The annoying racket continued.
So the rudely awakened Captain threw his covers off and climbed into the chilly bottom half of his bunkers. He got stiffly to his feet, slipped his suspenders up over his weary shoulders, and started stumbling toward the garage. "Knock it off, Henry!" he grumbled beneath his breath. "That's an order!" he added, as the pooch completely ignored him.
Hank yawned and stretched his way into the apparatus bay.
The barking seemed to be coming from over by the Squa—.
Stanley stiffened.
Gage was sprawled out on the garage floor, right beneath the Squad's open door. The paramedic appeared to be writhing in pain.
"Roy! J.T.! Get in here!" the Captain shouted back over his shoulder. "There's somethin' goin' on with John!"
Hank reached the fallen firefighter's side in seconds. He pulled the blanket from the front seat of the Squad, spread it out on the floor and gently rolled the groaning man over and onto it.
John had always hoped that, when his 'time' came, he would be able to face death as courageously as he had always tried to face life. But, it was beginning to look like there would be no chance for bravado…no raging river to battle…no flaming inferno to fight…nothing! Just some stupid toxic shit…screwing with the control knobs in his brain. 'How in the hell are you supposed to fight that? Maybe you don't fight it. Maybe you just accept it.' He felt someone's gentle hands grip his shoulders and he was rolled carefully over and onto his back. He forced his tightly shut eyes open and saw his concerned Captain kneeling over him. At least he wouldn't be alone…when the end came.
Hank saw the look in the paramedic's pain-filled, watering eyes and his heart experienced its second 'cardiac arrhythmia' of the shift! He'd seen that 'look' before. His own eyes welled up. He gripped Gage's shoulders—hard—and gave them a not so gentle shaking. "No way, mister!" he angrily declared. "Don't. You. Even. THINK it!" he sternly ordered. "You hear me?"
John failed to respond.
The Captain gave his shoulders another attention-grabbing jostle and repeated his shouted question—and was finally rewarded with a slight nod.
Upon hearing the Captain's shouted request for their presence, DeSoto and J.T. had quickly donned their bunkers.
"What happened?" Roy anxiously inquired as they both came bursting into the apparatus bay.
J.T. stepped between the body on the blanket and the Squad and started emptying compartments.
"I don't know," their still somewhat disconcerted Captain replied. "Henry was barking. I came out to investigate and found him lying here, face down on the floor…in a whole lot a' hurt." Hank reluctantly released his hold on John's shoulders and quickly moved out of the way.
DeSoto dropped to his knees beside his pained partner. "Talk to me, Johnny!"
Once more, Johnny willed his eyes to open. The concern that he'd heard in his friend's voice was a perfect match for the look on his friend's face. His dry mouth formed a slightly crooked smile. "R-Rule…Number…One," he managed to get out, between gasped breaths.
Roy's frown deepened. "Dammit, Johnny! Tell me what's goin' on?"
Johnny didn't want to think about it. His head was hurting too much to think, but he didn't wanna die with Roy mad at him either. 'Push past the pain…push past the pain…' he continued his silent mantra. "Pressure…seems to be…fluctuating," he explained with a grimace and a groan. "Sudden…drop…blackout…Sudden…rise…head…hurts…uh-hummm…" Their panting patient began tossing his hurting head. "Feel…s-t-r-a-n-g-e," he quietly confided.
J.T. already had the Base Kit set up and had even established contact with Rampart.
"Pulse is 76 and bounding. Respirations are 32 and shallow. Standby for a BP," DeSoto told him, before turning back to his partner. "Like 'how' strange?"
"Like…'really'…s-t-r-a-n-g-e," their patient impatiently replied. Then, for reasons that were currently beyond his ability to comprehend, John Gage flew into an uncontrollable rage! He picked up the first thing he could find…and lashed out at the first thing he could see.
John's fellow firefighters watched with wide eyes as he suddenly sat bolt upright. Their eyes got even bigger when the patient picked up an oxygen cylinder and slammed it into the side of the Squad. The three of them managed to wrestle the tank away from him before he could take a second swing at anyone, or anything. They forced their furious shift-mate back onto the blanket and then held him down.
"I think he may have…just shed some light…on the Chet/Marco Bottle Bashing Incident," Hank declared, sounding a bit breathless himself.
The patient suddenly stopped struggling, but his body didn't stop thrashing around.
"He's convulsing!" Roy realized, and snatched up the Bio-phone.
Speaking of realizing things…
The Captain was just about to head over to the call station and request an ambulance, when it donned on him that two members of his crew were missing from the garage.
Hank knew the two men to be light sleepers. They couldn't possibly have slept through all this commotion.
The huge knot that was already in Stanley's stomach tightened. He turned and made a mad dash for the dorm.
"Mike! Marco!" Hank called out when he reached the missing men's bunks.
The bodies in the beds didn't budge.
When more shouting, and some rather rough shaking, failed to rouse his unconscious colleagues, Station 51's Captain suffered his third 'cardiac arrhythmia' of the shift.
Stanley exhaled a silent prayer as he slid his fingertips into the little groove in Stoker's extended neck. Mike had a corotid! Boy, did he ever have a corotid! The look on the Captain's face shifted from relieved to concerned. He was pretty sure a person's pulse should never pound that hard.
He spun around and pressed the tips of his fingers into the depression in Lopez's throat. The Captain's concern returned to alarm. Marco's pulse was barely palpable!
James Terzikgarskanovich inflated the BP cuff on John Gage's rigid, jerking right arm and struggled to keep the chestpiece of his stethoscope in place. He opened the bulb's release valve and listened for a reading. He stared disbelievingly down at the gauge in his hand and quickly took a second reading…and then a third. "Roy, I'm gonna need another cuff. The gauge on this one's gotta be busted."
DeSoto finished drawing the blood samples Rampart had requested. "Why? What reading did you get?"
J.T. was almost too embarrassed to tell him. "242/145. That's not even possible…Is it?"
Roy didn't reply. He simply pulled another BP cuff from an open case at his feet and passed it to his fellow paramedic.
J.T. switched cuffs and took a fourth reading. "Holy shit!" he exclaimed. It must be possible. Both gauges couldn't be broken. He glanced up from the instrument in his hand, looking every bit as stunned as he'd sounded. "I just got the same numbers! Man! We gotta get his pressure down! He's gonna blow a gasket, or stroke out on us—or…somethin'!"
"Yah mean, like ‘go into convulsions’?" Roy bitterly remarked. They needed to get an IV established, but in order to do that, they had to administer the anti-convulsant. "Try to keep his arm still for me, will yah…"
J.T. grabbed Gage's right arm with both hands and tried to keep the jerking to a minimum.
DeSoto emptied the hypo's contents into his partner's vein. At least, he hoped he did.
Within moments, Johnny's rigid muscles began to relax. The jerking abated and his body went limp.
"208/118," J.T. relievedly reported. Just to be certain, he took another look. "Make that 186/111," he corrected, a trace of alarm returning to his voice.
The two vertical paramedics exchanged anxious glances. Little alarm bells were going off in both of their brains.
DeSoto set the IV he'd been prepping aside and snatched the phone back up.
J.T. began taking back-to-back readings. "168/102…145/95…132/87…124/81…113/74…93/66…Hold it right there! Please, hold it right there…" He glanced up from the gauge. "64/43! We gotta give him something! He's gonna bottom out on us!…Correction! He is bottoming out! 50/33! He's gonna code!"
Roy lowered the phone in his hand and stared disbelievingly down at his partner. 'You sure were right about your pressure fluctuating!'
Their patient had just gone from a hypertensive—to a hypotensive—crisis in a little less than a minute!
Just when the paramedic had convinced himself that the situation couldn't possibly get any bleaker, his Captain came racing back into the apparatus bay and announced that they had two more victims in need of immediate medical treatment!
It also happened to be precisely at that moment that the sound of approaching sirens could first be heard.
It was just like in the movies, when—at the bleakest point in the film—a bugle starts blowing from out of nowhere and the cavalry comes charging up to save the day.
Reinforcements were arriving!
DeSoto saw the mic' cord dangling from the Squad's dashboard and glanced back down at Gage. 'Thanks, Junior!'
Hank trotted over to the garage door and hit the UP button.
Roy quickly regrouped. Okay. Any drug that treated the hypotension would just exacerbate the hypertension. Any drug that treated the hypertension would just exacerbate the hypotension. Yet, something had to be done! Johnny's pressure was waaaay too low! His vital organs weren't being properly infused.
They couldn't just stand there and watch him die!
DeSoto suddenly had an idea. He dropped the phone and grabbed their MAST kit. "We may not be able to treat both conditions, but we can sure as hell treat one!"
Within sixty seconds, the anti-shock trousers had been applied.
Hank and Roy each opened a stopcock valve and began blowing air into the garment's two lower compartments. Which, in turn, reduced the blood flow to the victim's legs.
"Pressure's climbing!" J.T. announced. "58/40…64/48…76/57…94/65…"
Roy stopped blowing and closed the valve back up. "That's pretty much his normal BP."
His Captain closed his valve and shot his senior paramedic an appreciative glance. "That was some pretty quick thinking!"
DeSoto exhaled a silent sigh of relief and immediately retrieved the dropped phone. It's a good thing he was thinking quickly! Because they needed to keep pace with their patient's rapidly changing condition... and the doctors at Rampart needed to be brought back up to speed.
By the time Roy finished filling the physicians in, 16's and 39's paramedics were on scene.
DeSoto briefly filled his associates in on what to expect with Stoker and Lopez.
Shock trousers were applied to the two other unconscious firefighters.
Marco's were inflated, to bring his BP back to within a palpable range.
An anti-convulsant was prepared for Mike, whose pressure was currently spiking.
"All right. Let's get these guys to the hospital!" Roy told his colleagues, as the ambulances arrived. "You can contact Rampart along the way!"
"I'll follow you guys in with the Squad," Stanley volunteered.
"The, uh, docs want you to ride in with us, Cap'," DeSoto nervously announced.
His Captain was perplexed. "Why?"
"Probably just a precaution."
"But, I'm not sick."
"Yeah. I know. I got a feeling that's one a the reasons why they wanna see you as soon as possible."
Hank heaved a resigned sigh and reached for the dangling mic' cord on the Squad's dash-mounted radio. "LA, Station 51 will be out of service until the next shift shows up."
"10-4, Station 51."
Station 51's Captain replaced the mic' and reluctantly climbed up into the back of one of the waiting ambulances. "¡Madre de Dios! ¡Qué noche!" he grumbled, just beneath his breath. 'Marco, my man, you sure got that right!'
'R-r-r-r-ring!'…'R-r-r-r-ring!'…'R-r-r-r-ring!'
Kel Brackett groaned awake.
The disturbed doctor's right arm was wrapped around the bare waist of the beautiful blonde in the bed beside him. He reluctantly unwrapped it and rolled stiffly over to begin groping for the irritating instrument on his nightstand. His probing appendages hit the phone. He lifted the handset and put an end to the annoying 'r-r-r-r-ringing'. He contemplated dropping the thing back into its cradle, but it was probably an emergency. No. It had better be an emergency!
Kel cradled the phone in the crux of his neck, instead. "Brackett here…Hi, Ben. What's up?" The doctor's sleep-filled eyes snapped fully open and he snapped bolt upright in his bed. "Wha-at?" He swung his long legs over and planted his bare feet on the carpeted floor. "Nothing?" He leaned forward and flicked on a light, noting the time on his radio alarm. Ironically, it displayed the illuminated numbers 4:51.
Dixie McCall sat up in the bed, too. She'd been awake since her spoon's partner had first stirred. Kel's rather alarmed reaction to the answer to his question had alarmed her. There had to be a major emergency at the hospital. She got to her knees and leaned into the phone in an attempt to catch the other side of the conversation.
"No…Yeah…No. No problem. I'll be right in. But first, I'm gonna give Jim Hendelson a call…No. He heads the Toxicology Department at UCLA's…Because he also happens to be a personal friend a' mine…No. There's no time for politics. We'll deal with all that later…Yeah…Right…Right…That shouldn't be necessary. Just divert 10's and 36's to Shay's Memorial." Brackett put an abrupt end to the conversation and slammed the phone down. Then he donned a robe and quickly left the room.
The doctor returned a few moments later, carrying an address book. "Good morning, beautiful," he said, and gave the lovely lady kneeling in his bed a light peck on the forehead.
"Flattery will get you nowhere," the woman warned, as the man began paging through his little black book. "I know I must look a fright, because I'm always a mess, first thing in the morning."
"I was referring to your inner beauty," the doctor diplomatically replied and paused in his search to plant another light kiss on his pretty companion's forehead.
Dixie cradled the handsome physician's face in her hands and kissed him full on the mouth. "You may not be the most romantic man on earth, but you do have your moments...""
"Only moments?" Kel inquired, sounding wounded.
The pair swapped a couple of sly smiles.
Brackett reluctantly returned to the matter at hand. He finally found the number he'd been searching for and picked up the phone. He stuck the handset back in the crux of his neck and started dialing.
It rang an interminably loooong time…before somebody finally picked up.
"Jim? Kel Brackett, here. I hate to call at such an ungodly hour, but this is an emergency. There was a fire at an abandoned chemical refinery earlier this morning and we've got three firefighters—in critical condition—who could really use your help…Mainly? Their cardiovascular systems…Sympathomimetic and adrenergic…I'm guessing the medulla, more specifically, the vagus nerve…They did. They couldn't find anything toxic…Great! I'll call the Fire Department lab people and let them know you're coming…Right…Thanks, Jim." He held the receiver down just long enough to get a dial tone back.
Dixie latched on to the doctor's dialing arm. "Kel…these three critical firefighters wouldn't happen to be any of our guys?" she hopefully inquired. The hospital staffers had a special place in their hearts for all fire and police men, but the guys from Station 51 had sort a' been adopted into their immediate Rampart family.
"Mike Stoker, Marco Lopez and…John Gage," the frowning physician informed her. His attention reluctantly turned to the person who had just picked up the phone. "Yes. This is Dr. Brackett…" he informed the Fire Department lab person.
"I'm going in with you," the nurse numbly announced. The woman scrambled out of bed and began donning her clothing even more hastily than it had been shed.
Dr. Benjamin Tyler stood at Rampart General's ER entrance, waiting for the three critical firefighters' ambulances to arrive.
For the umpteenth time, the physician checked off the items on his mental 'to do' list.
The next shift had been called in.
The Fire Department had been alerted. All personnel that had responded to the refinery fire had been contacted. Anyone who had experienced even the slightest of headaches was ordered to undergo an immediate medical examination.
Chet Kelly's nurses had been notified to monitor his BP even more closely than it was already being monitored.
The authorities had been asked to perform a welfare check on Squad 51's smoke inhalation victim at the refinery fire—the night watchman that had refused treatment.
Their second victim, the workman, was in ICU. So his condition was already being constantly monitored.
ICU and Cardiology had been placed on alert.
And, last, but not least, Squads 10 and 36 were diverted to the next nearest hospital.
Tyler was feeling pretty confident that he'd thought of everything. He'd better have thought of everything, because he could see the flash of dome lights coming through the underpass. He turned to face the rather large contingency of highly trained hospital staffers that had been waiting with him. "All right, people. You all know where to go and what to do. So let's do it!"
"Everybody, remember our motto!" Jeff Vermille further encouraged, as the ambulances began backing up to the doors.
Nurse Norquist turned to her closest co-worker. "What is our motto?"
"If they're alive when they arrive—we keep 'em that way!" the entire group proudly chorused.
Cheryl couldn't help but smile. Now, that was a motto worth remembering!
The doors opened and there was a blur of activity as designated teams directed each arriving stretcher to a predetermined destination.
"Captain," Tyler caught Hank Stanley's arm as he entered Emergency Receiving, "Dr. Gordon is waiting for you in Treatment Five."
"I'm not sick," the fireman informed him.
"Treatment Five," the doctor repeated and pointed to an exam room.
The Captain drew his weary shoulders back and headed off down the hospital corridor, in the direction of Treatment Five.
Kel and Dixie arrived at the hospital right behind the three ambulances.
"What's with the restraints?" Brackett wondered, as he followed John Gage's stretcher inside.
"Johnny became aggressive, right before he started seizing," Roy explained.
"And a workman at that refinery fire tried to part Marco Lopez's and Chet Kelly's hair with a bottle," Dr. Tyler tacked on.
"Fill me in, Ben!" Kel requested.
"That shouldn't take long," Tyler told him. "I know about as much as you do!"
Gage's stretcher was guided into Treatment Three and a team of doctors and nurses immediately went to work on him.
Brackett took the vials of their victim's drawn blood from J.T.'s extended hand and passed them to a technician. "Get these to the lab! STAT! Dr. Hendelson has already phoned in the orders!"
"What have they been exposed to, that you and the Captain haven't?" Tyler inquired of their critical comatose patient's shift-mate.
Roy stepped back from the exam table and stared sadly down at his sick friend. "At first, I thought it had to be the refinery, but the Captain was in there—and he's not sick!"
"Come on, Roy…" Kel urged. "We need to talk."
DeSoto didn't want to leave his partner. "Deflate the shock trousers if his pressure spikes again, but don't remove them. He can go from a hypertensive to a hypotensive crisis in less than a minute."
The medical personnel marveled at that bit of information and then nodded their understanding of it.
Brackett took DeSoto by the arm and began towing him toward the exit. "You can help him more, right now, by supplying some answers."
They stepped into the corridor.
The physician started steering their course toward the doctor's lounge. "I don't know about you, but I could sure use some coffee."
"He was complaining of a sinus headache when we were here, earlier," Roy began. "I didn't think too much of it, because he always gets a sinus headache when he gets water up his nose. Then, later, at a rescue, he started having migraine symptoms...and acting sort a' strange."
"Like how strange?"
They entered the lounge.
Brackett led the paramedic over to a table and then headed for the counter, to fetch them some coffee.
"I dunno," DeSoto shrugged and dropped onto a chair. "Kind a' rude, I guess. He just wasn't himself. Then he vomited and said he felt fine...said he really felt like running."
Kel set two steaming cups down on the table and dropped into the chair across from the fireman. "Then what?"
"He started running! I talked him back in the truck and took him here, to get checked out."
"And—?"
"The ER was pretty busy. Gordon was the only doctor available."
Brackett winced. It was no secret how John Gage felt about 'shrinks'.
Roy stared sadly down into his steaming coffee. "I went up to check on Chet. So I don't know all the details, but I guess she didn't take his request to be examined—by her—seriously. Of course, I didn't find that out until we were already halfway back to the Station." He glanced up, looking even more glum. "I should have turned around, right then and there…but I didn't." His gaze dropped back to his drink.
"Don't be too hard on yourself, Roy. If Johnny had been presenting, you and I both know, for a fact, that you never would have left this hospital. And, since he wasn't symptomatic—at the time, even if Ronnie had examined him, she probably wouldn't have found anything."
The paramedic gave the doctor a grateful glance. Brackett's logic should have made him feel better, but it didn't. His sad eyes re-focused on the cup cradled in his hands. "By the time we got back, he was out cold. I 'assumed' he was just asleep. So I covered him with a blanket and went to bed. The next thing I know, he's lying there on the garage floor—dying! And, he wasn't the only one!" He looked up and locked gazes with Brackett again. "What's goin' on, Doc? What is this stuff? When's it gonna wear off? I mean, their systems can't take much more a' this…"
"We don't have the answers—yet. But we're working on getting them. I've asked a friend a' mine—Dr. James Hendelson, to look into it. Jim isn't just a friend. He also happens to be a brilliant toxicologist. In fact, he heads the Toxicology Department at UCLA's Medical Cen—"
"—Dr. Brackett?"
Kel turned to the door.
A nurse had poked her head into the lounge. "Dr. Hendelson is on the line…"
"Thanks! I'll be right there!" Brackett shot the glum paramedic a hopeful glance and left to take his phone call.
Roy took his coffee and then resumed his vigil…in the ER's third treatment room.
"I told you," Hank Stanley patiently repeated, following a full fifteen minutes of poking and probing and prodding, "I'm not sick."
"Yes," Gordon agreed. "But why aren't you sick?"
The Captain, who had traded his turnouts for a set of surgical scrubs, hopped down from the exam table and began heading for the exit. "I'm gonna go check up on my men."
The physician intercepted the fleeing fireman. "Captain, you need to get back up on that table!"
Hank gave the little lady a look that said he was through taking her orders. "The only thing I need to do, right now, is check on my men!"
Gordon stood her ground. "It's important that you to tell me everything that's happened to you and your crew, since your shift start—"
"—Fine," the Captain relented. "I'll tell you everything…over a cup a' coffee," his dark eyes narrowed again into no-nonsense slits, "just as soon as I finish checking up on my men!"
'Brash. Bold. Gritty. Gallant. Fiercely independent. Highly motivated. Driven by duty. Extremely self-assured and—above all—concerned with the welfare of the men in his command.'
The Captain possessed some pretty impressive attributes—all the qualities one would need, in order to lead a group of guys into a building everybody else is running out of.
The 'shrink' finished her brief 'psyche' evaluation and flashed the fire officer just the slightest of smiles. "I'll be waiting for you in the doctor's lounge," she quietly announced and quickly stepped aside.
Stanley accepted the doctor's terms of surrender with an even slighter smile. He pushed, and then held, the door open for her. "After you…"
Gordon gave him a grateful nod and exited the exam room.
The fireman followed closely in her wake.
'Very gallant,' the shrink silently re-evaluated, as the gentleman headed off down the hall—to go check up on his men. She flashed the Captain's back another slight smile and then headed for the coffee-maker in the lounge.
Dr. Brackett stepped out of the Base Station and spotted Dr. Early coming down the hall. "Joe! Am I glad to see you! 16's is bringing in a cardiac arrest. Can you handle it?"
"Sure, Kel! But what's going on?"
"Great! I'll explain later!" Kel promised and handed his open-mouthed colleague a medical chart. "They're setting up for you in Five!"
Early closed his mouth and started heading for Treatment Five.
Bracket did an about face and then quickly disappeared in the opposite direction. He was running a little late.
Hendelson had requested a meeting with Brackett, and the rest of Rampart's ER staff.
So Kel had gathered his colleagues together in the doctor's lounge, which had been sort a' transformed into a conference room...with the addition of a half-dozen more chairs, a white board and some erasable markers.
Two LA County Fire Department Battalion Chiefs, Captain Hank Stanley and paramedic Roy DeSoto had also received invitations to attend their group's little gathering. The four firemen sat together, at a table near the back of the room.
When Brackett finally arrived, fashionably late, he found his fellow physicians discussing exposure scenarios.
Ben Tyler was nodding glumly in agreement, to something Ronnie Gordon had just said. The doctor studied his notes for a few moments and then brightened. "Stoker and Gage were in the water."
Ronnie Gordon glanced up from her notes. "So was Kelly and Lopez wasn't. Besides, the water checked out."
Mark Herron looked thoughtful. "The three sick men all had their masks off."
"So did Kelly and Captain Stanley," Ronnie reminded him. "The Captain's air bottle emptied while he was lowering Mike Stoker into the vat and it took him a few minutes to swap his empty SCBA for Gage's."
"Well, I don't think it was ingested. Everyone on the Engine crew ate the exact same meals," Keith Doughty contributed. "And Roy said that he and John didn't get the chance to eat anything at their Station yesterday."
"It has to be the refinery!" Tyler insisted.
Mark Herron nodded. "Maybe it has to do with when they took their masks off and how long they went without them? For instance, the toxin could have been concentrated in the steam, up under the roof and down in the vat…"
"Yes, but Kelly was up near the roof and down in the vat," Gordon promptly pointed out.
"True," Tyler conceded. "But while he was up on the catwalk, he had his mask in place, and when he was down in the vat, he wasn't breathing—until Gage gave him AR. Even then, he was getting recycled air—until John started him on oxygen."
"I just remembered," Keith Doughty interjected. "DeSoto said Gage and Lopez took some aspirin."
"According to the Captain," Gordon added, following a quick glance at her notes, "Stoker took some aspirin, too."
"Check it out!" Herron urged.
"That won't be necessary," someone suddenly assured them.
All eyes turned to the door, as Dixie McCall escorted a young man, wearing a T-shirt, jeans, and a jean jacket, into the room.
The long-brown-haired, brown-eyed fellow flashed the group a slight smile and held up a small black briefcase. "We've identified the causative agent."
Brackett stepped up to his young friend and extended a hand. "Thanks for coming, Jim."
"Kel," Jim acknowledged. He gave the older doctor a warm smile and his proffered appendage a heartfelt shake. "I'd a' been here sooner, but it took awhile to feed all of our findings into the university's computer."
"This is Dr. James Hendelson," Brackett introduced. "He heads the Toxicology Department at UCLA's Medical Center."
The new guy nodded politely to the group and then crossed quickly over to the white board. Hendelson placed his briefcase on the floor and pulled the cap off of one of the erasable marker pens. "p-Nitro," he spoke, as he printed, "sodi…methyl…ani…line." He turned to face the group.
"That's a Class 135 substance," Hank Stanley recognized. "Water sensitive—reacts violently upon contact with H2O." The reaction can be explosive and generate an incredible amount of heat. "Is that what caused the initial explosions?"
"One of the causes." Hendelson saw the way his questioner was dressed and cocked an eyebrow.
Kel caught the young doctor's look of confusion. "He's the three critical firefighters' Captain."
Jim nodded thoughtfully and then turned back to the board. "Magnesium…diamide," he printed, right below the first chemical.
"Another Class 135 compound," Station 51's Captain realized, even more volatile than the first, when combined with water.
"Correct," Hendelson told him. "It was a combination of both of these substances coming into contact with water that caused the explosions and combustion to occur."
"Why weren't our lab boys able to find anything?" one of the Battalion Chiefs wondered.
"Because there wasn't anything left to find," Jim replied. "The only way we were able to identify these substances, is by the 'fingerprint' they left behind." He turned back to the board and began printing and speaking out loud again. "Di…methyl…chloryl…silo…toxa…phene." He finished and promptly faced the group again. "That's one lo-ong word. Contains two more letters than the alphabet. We've just been calling it DMCST. Fortunately, DMCST is a rarely occurring compound. The reason DMCST occurs so rarely is because it is the decomposition product that results when p-Nitrosodimethylaniline and Magnesium diamide are simultaneously exposed to water. Such an unlikely occurrence has only been known to have happened twice, counting this instance."
"Why weren't our lab boys able to find this DMCST stuff?" the other Battalion Chief wanted to know.
"Because it had completely dissipated by the time they arrived. There wasn't a trace left in the place. However, it also left a 'fingerprint'…of sorts. We fed all the data from the refinery—and this hospital—into the university's computer and it kicked out DMCST as being the causative agent. It seems the three critical firefighters' symptoms are identical to those experienced by workers exposed to a nerve agent at a chemical plant fire in Dupree, Scotland in 1968. That agent was later identified as the decomposition product: DMCST." Hendelson stooped to pull a thin black folder from his briefcase. "Everything known about DMCST is in here—which, as you can see, isn't much."
A nurse entered the room and passed Dr. Brackett a folded slip of paper.
Kel opened the note and perused it. The right corner of his mouth twitched a couple of times. Then he glanced up and relayed the message's contents on to the entire group. "The police found the night watchman…dead…in his apartment."
Tyler exchanged anxious glances with his fellow physicians and then turned to their guest lecturer. "So what's the treatment? We need to get started right away!"
Their young visitor's face filled with a profound sadness. "The onset of symptoms—extreme headache, wildly fluctuating blood pressure, combativeness and seizures—is followed by a feeling of severe tightness in the chest. Pupils become pinpoint. The patient becomes more and more unresponsive, slips into a coma…and never regains consciousness. There is no 'known' treatment. I'm sorry to say that all six of those chemical plant workers in Scotland…died."
The stunned silence in the lounge was shattered, as another nurse suddenly poked her head through its slightly open portal. "Dr. Doughty, you're needed in Treatment Three!"
All five of the physicians that were there in the room promptly filed out, closely followed by one deeply-troubled looking head nurse and one still-stunned—and incredibly concerned-looking—paramedic.
The conference attendees spilled into Exam Three.
Nurse Norquist had the patient in a reverse Trendelenberg position. The MAST trousers had been deflated and his trach' tube had been pulled.
"He came to and started gagging on his airway," Cheryl informed Gage's doctor. "His pressure began spiking. So I gradually deflated the MAST. Pulse is 120. Pressure's 238/222 and climbing. The patient is in extreme pain."
The woman's last comment was a bit redundant. The patient's groans were drowning out the rapid chirping of his heart monitor, which showed clear evidence of his sinus tachycardia.
Doughty studied his patient's medical chart for a few somber moments. Then he scribbled down some orders and passed the chart on to his colleagues.
His fellow physicians took note of what he wrote and, one by one, all five nodded their approval.
Dr. Herron handed the chart to Gage's nurse.
Cheryl stared down at the clipboard. Two drugs had been prescribed, Cardene—for the spiking BP, and Demerol—for the extreme pain. She promptly proceeded to carry out the doctor's 'new and approved' orders.
Gage gasped in relief, as the excruciating pain that was burning in his brain slowly began to recede. His groans subsided as his agony diminished, and he gradually stopped tossing his hurting head. His breathing remained labored, however. It was rather difficult for him to breathe. It felt like four big guys were sitting on his chest.
Someone was lifting his tightly closed lids and flicking a light in his eyes. He forced them open a crack and took a little look around. If there were four big guys sitting on his chest, they were invisible. He was strapped to a table in Exam Three, in a reverse Trendelenberg position, surrounded by at least a half a dozen very worried-looking doctors. 'Uh-oh. That can't be good.' That could never be good.
Keith saw that his patient's eyes were voluntarily open. "Can you hear me, John?"
John closed his eyes and nodded.
"How's the pain?"
Gage coughed and gagged as his first few attempts at talking failed. His mouth was too dry and his throat was too sore. Someone held a small chunk of ice up to his lips. The icy object began melting and lubricating his parched palate. His tightly shut eyes fluttered back open and he aimed them in the ice-dispenser's direction. Not surprisingly, he found his partner's troubled blue eyes staring back at him. His lubricated lips formed a slight smile. "Thanks," he managed to mutter, in a cracked hoarse whisper.
Roy returned his smile. "Hey, no problem. So-o…how is the pain?"
"Better…took the edge off."
Doughty turned to Gage's nurse. "Give him another 50 milligrams."
Cheryl nodded and promptly injected the adjusted dosage of Demerol into the patient's IV port.
Dr. Hendelson had picked the patient's chart back up. "I can see where this is going to add quite a bit to the folder already," he mumbled, mostly to himself. Then he turned to his fellow doctors. "Gentlemen, can I speak with you—privately?"
The physicians followed their mysterious colleague from the room.
"Pressure's dropping…steadily," Cheryl informed Dr. Doughty. "Pulse is still 120 and the patient remains dyspneac."
"Continue to monitor his vitals closely and re-inflate the MAST if he drops below his normal BP," Doughty ordered.
The nurse nodded, and the doctor disappeared—out the door. Cheryl studied her patient's face carefully.
The taut muscles in John's jaw were now relaxed. The deep furrows had disappeared from his forehead and his eyes were no longer clamped tightly shut.
She exhaled a silent sigh of relief and began gathering another, newer set of vitals.
"Anybody else sick?" John wondered.
"Mike and Marco," Roy regrettably replied.
"How they doin'?"
"'Bout the same as you."
Gage's nasal canula was making his nose itch. He tried to raise his right arm, but found his wrists were…restrained. "I see…I've earned the…naughty patient…bracelets." His eyes snapped open and he glanced anxiously in DeSoto's direction. "I didn't try to…brain…any firemen…with a bottle…did I?"
"Nah-ah. But you did manage to brain a fire truck…with your O2 bottle. Left a nice little dent in the side of the Squad."
"Ahhh, ma-an," Gage declared with a grimace. "Charlie's gonna…kill me!" 'If I'm not already dea—' he stopped himself right there, in mid-thought. He wasn't sure if you could even be assigned 'latrine duty' in the great hereafter, but it didn't matter. He respected the Captain too much to knowingly disobey one of his orders.
"Eh, I'll just tell him we were going down a really rough road and a rock bounced up and dinged it," Roy offered. "What?" he wondered, upon seeing his partner's highly skeptical stare. "He may buy it…if I can rub all that green paint off," he tentatively tacked on, and the two friends swapped smiles.
In the corridor, just outside of Exam Three, the doctors had reconvened their little conference.
"Look at the timeline for symptom onset for those six Scottish workers," Hendelson requested of the doctors that were huddled around him and his open DMCST folder. "If exposure occurred sometime around midnight, he should already be comatose."
"His pupils have started to constrict," Doughty reported.
"Yes, but they should have become pinpoint, by now. Thank you," Hendelson paused to accept and study the charts Miss McCall had just fetched for him. "These other two men are unresponsive, but they should also be comatose by now."
"So, what are you saying?" Dr. Tyler finally came right out and asked.
"I'm saying that they must've done something to arrest the toxin's normal progression. Its effects weren't entirely halted…just delayed a little."
"Could it have been the aspirin?" Dr. Gordon wondered.
"No," Hendelson told her. "The workers in Scotland all took aspirin, too." He saw the woman gazing glumly down at her notes. "Why don't we just go ask him," he suggested and re-entered Exam Three.
Once again, his fellow physicians followed closely on his heels.
Fortunately, the fireman was still conscious.
Hendelson stepped right up to the now sleepy-looking patient. "Hi. My name is Jim…Jim Hendelson. I'd like to ask you a few questions."
The exam table was no longer tilted. So John had to turn his head to see who had just addressed him.
"'Doctor' Hendelson is with UCLA's Medical Center," Roy explained and exchanged another slight smile with his partner.
Even without the handlebar mustache, the young physician's long locks and casual appearance put them both in mind of a certain 'Doctor' Frick.
"Ask…away," Gage groggily invited, between gasped breaths. His medication was making him a little drowsy. At least, he hoped it was.
"Did you notice anything that you, or anybody else, might have done that seemed to relieve your symptoms?"
The patient took a loooong time to reply. Finally, he nodded. "Running…and ralphing."
Hendelson's eyebrows arched. "Running and ralphing?"
John managed another sleepy nod. "You know…barfing." His already drooping eyes closed.
"Was there anything else you may have noticed?"
The fireman shook his head. "Just…the Demerol."
"How are you feeling now?"
"I'm kind a'…restless…I feel like…running."
Hendelson and his associates exchanged amazed glances.
Gage mumbled something incoherent.
"He says," DeSoto solemnly deciphered, "he feels like there are four big invisible guys…" he swallowed hard, "sitting on his chest."
The group exchanged anxious glances. Time was rapidly running out.
John's doctor looked completely puzzled. "I don't get it," he declared in a hushed voice. "He couldn't even stand up! How can he possibly feel like running?"
Brackett was equally baffled. "Why does he feel like running? And why would running alleviate his symptoms?"
Hendelson stared down at his DMCST folder looking very thoughtful—and even more determined. "The answer to those questions could lead to a viable treatment," he stated and started heading for the door.
"Where are you going?" Kel inquired.
"Running!" the young doctor called back over his shoulder. Then he pushed the portal open and disappeared out into the hall.
"Hang in there, partner!" Roy gently urged.
John gave his restraints a slight tug. "With…both…wrists," he assured him in a whisper. Then his slightly crooked smile vanished, and his head rolled limply to one side.
Nurse Norquist dropped what she was doing and quickly checked his consciousness level.
The patient was…unresponsive.
Roy stared down at the electrodes that were taped to his partner's heaving chest—the tiny sensors in charge of monitoring his racing heart's electrical activity.
John Gage had a good, strong heart, but it couldn't—and wouldn't—go on functioning at the rapid rate of 120 beats per minute forever.
DeSoto figured he had two options. He could remain at his friend's side, until his heart finally gave out…or he could go help Dr. Hendelson try to find a way to keep his best friend's heart going. As much as he hated the thought of leaving the room, his choice really was a 'no brainer'.
Roy rested a hand on one of his friend's restrained wrists and gave it a reassuring squeeze. "I'll be back," he promised and then requested of his partner, "wait for me, Johnny…"
DeSoto exited Exam Three, spotted Dr. Hendelson on the phone at the Nurses' Station and went hurrying up to him.
Hendelson ended his conversation and hung up the phone. He now had designated runners at both UCLA's and the LACFD's labs. The young doctor had just organized a sort a' DMCST Cure Marathon. "Is something wrong?" he asked the firefighter who'd come trotting up to him.
The fireman extended a hand. "Roy DeSoto," he introduced. "John Gage is my paramedic partner. I'd really like to help—if I can…"
The physician shook the fireman's hand. "Jim Hendelson. You say, you're a paramedic?"
The paramedic nodded.
Hendelson grinned. "That's great! Because I'm gonna need someone to draw arterial and venous blood samples. Do you think you could take the samples and then bring them down to the lab for me?"
"Sure!" Roy readily replied.
"Splendid! See if you can find someplace to set up. Right now, I gotta run." With that said, Hendelson waved and started heading for the ER's exit—at a run.
The runner returned from his second lap around the hospital.
Upon Dr. Brackett's approval, DeSoto had conveniently set the 'blood drawing site' up in Treatment Three.
While the winded doctor read the initial lab report, Roy drew some more venous and arterial blood samples from him.
Hendelson scrutinized the chart in his hands.
Red blood cell counts, hematocrit, total hemoglobin and white blood cell counts had significantly increased from the samples Miss McCall had initially drawn. So had plasma lipids, proteins, and antioxidants. Uric acid (p0.05) and cholesterol (p0.01) had risen significantly. Sodium, potassium, glucose, lactate dehydrogenase, creatinine, creatine phosphokinase, triglycerides, cholesterol, number, uric acid, carbon dioxide, and iron—all of the blood parameters had increased significantly, with the exceptions of plasma glucose and carbon dioxide which had both decreased.
The still-breathless physician frowned and then gasped in frustration.
Despite significant changes in blood chemistry—lactic acid was way up and venous pH was way down—and blood gases—arterial CO 2 had decreased approximately 3 Torr and venous CO 2 had increased—none of these blood parameter differences had had the slightest effect on the toxin…so far.
The paramedic taped a couple of cotton compresses over the draw sites and the young doctor took off—running.
DeSoto followed the physician out the door and then headed for the hospital's lab—with two more vials of the runner's freshly-drawn blood.
The phone at the Nurses' Station rang.
Dixie answered it. "Emergency Receiving, Miss McCall..." There was a long, one-sided conversation, with Miss McCall doing most of the listening. "Yes…Yes, I see," she said at last. "Thanks for letting us know, Meg." She hung up and headed for Treatment Five.
Dixie slipped silently into the exam room, where the head of Emergency Receiving was currently closing a three-inch gash in an eight-year-old boy's forehead.
Nurse McCall approached him. "Kel, ICU just called," she solemnly informed the busy physician. "That workman died…"
The doctor was extremely saddened, but not surprised, by the news. He nodded his acknowledgement of the message. Then he tied off the last of his sixteen sutures and flashed his young patient a warm smile. "There you go, Brady. We're a-all done. You're a very brave little boy. Now, just try to remember not to run in the house."
Brady nodded.
"Finish up in here for me, will you, Carol," Kel told, more than asked, the young nurse who'd been assisting him
"Yes, Doctor."
Brackett took the message deliverer by the elbow and ushered her out into the hall.
"His heart just gave out," Dixie answered, before the doctor could even ask.
"Have there been any changes with the other five?"
The nurse shook her head. "Captain Stanley and Chet Kelly remain symptom free and the other three remain unresponsive."
"What's the latest from the labs?"
"So far, none of the blood samples—drawn from any of the runners—have had any effect on the toxin," Dixie regrettably replied.
Brackett saw the light flashing at the Paramedics' Base Station. He gave the nurse's arm a slight squeeze and then headed off down the hall to answer the call.
Hank Stanley re-entered Exam Two.
Mike Stoker's young bride, Karen, now stood at her husband's side, clutching his limp left hand in both of hers. The woman saw the way the Captain was dressed and was forced to smile. "You look just like a doctor."
"The hospital people must think so, too," the Captain confessed. He stepped up to the exam table and then stood there, directly across from her. "This get-up gets me into the treatment rooms—no questions asked."
Karen Stoker gazed at her husband's Captain through tear-filled eyes. "I can't get anybody to tell me what's going on."
Stanley stared sadly down at his engineer—and friend. "They've been exposed to an extremely toxic nerve agent. The poison is affecting their cardio-vascular systems. It's causing their blood vessels to constrict and dilate. So their BP fluctuates from dangerously high…to dangerously low. And it's causing their hearts to beat much faster than normal. It's also affecting their central nervous systems…which is why they're unconscious. Right now, three separate labs—and a whole slew a' doctors—are trying to find a way to reverse the toxin's effects."
The young woman's smile briefly reappeared. "You even sound like a doctor," she bravely managed to come back, before finally bursting into tears.
Hank raced around the table and up to her side.
Karen took the Captain up on his offer for a comforting hug and then she stood there, for quite a long while, crying on his shoulder.
Hank took a few minutes to regroup, before re-entering Treatment One.
There were a lot of new faces in the exam room. A few of them were familiar.
Marco's mother was there, along with two of his sisters, one brother and an aunt.
Mrs. Lopez paused, right in the middle of her rosary, to give the strangely-dressed fireman, who had just stepped into the room, a huge hug. The woman had somehow sensed that her Son's Captain could really use a hug right then.
Hank blinked his vision clear and then hugged Marco's mom right back.
Author's note: M.A.S.T. trousers are Military/Medical Anti-Shock Trousers.
"As the name implies, the military was instrumental in the development of anti-shock trousers. Military Anti-Shock Trousers (MAST) were extensively used during the conflict in Vietnam. They are also marketed under the name Medical Anti-Shock Trousers. MAST is an inflatable garment that surrounds the legs and torso. They have three separate compartments that can be inflated. They are capable of sustaining internal pressure of approximately 100 torr. The primary use is to help slow the progress of shock, but they are also used for other purposes as well.
At first, it was thought that MAST helped reverse the signs of shock by squeezing blood out of the lower extremities into the central circulation. The theory was that the MAST worked to reverse shock in different ways. The first was by stopping any bleeding in the lower extremities (like applying direct pressure to a cut on an arm). The second was by increasing peripheral vascular resistance the lower body (squeezes more blood out but lets less blood enter the lower extremity). The third was the belief that the body was able to better perfuse the upper body while MAST were in place. Current studies have shown that MAST work in different but similar ways than originally believed. One of these is by increasing blood flow to the brain and other vital organs.
MAST are primarily used for hypovolemic shock (loss of excessive amount of blood). The MAST are designed to be applied in a rapid fashion. With practice, skilled paramedics can apply them in an average of 60 to 90 seconds. MAST are designed to be applied with the patient in a supine (face up) position. The upper part of the garment should be located just below the lowest rib. The left leg of the garment is wrapped around the patient's leg and secured with the Velcro straps. The right leg is then secured in the same manner. Finally, the abdominal compartment is secured in the same manner. Many times, color-coded straps are used to increase speed of applying. Each compartment has a stopcock valve. The trousers can be inflated with a foot pump (or in a hurry by mouth) until either air escapes from built in relief valves or vital signs are stabilized.
Once in place and inflated, the MAST should not be deflated in the field. If for some reason the MAST has to be deflated in the field, this should be done slowly and methodically with the vital signs taken after each deflation and prior to deflating further. During the deflation, the blood pressure should be checked every two minutes. A drop of 5 mm Hg or more indicates the need to stop the deflation and have 100 to 200 ml of fluid by IV until the blood pressure is stabilized. The process is continued until fully deflated."
—info gleaned from the web.
Author's note: A Trendelenberg position is just medical jargon for lowering the patient's upper body and elevating his/her lower body. A reverse Trendelenberg position means that the exam table was titled so that John's upper body was elevated and his legs were lowered.
Additional note: Dyspneac is just medical jargon for saying that the patient is having difficulty breathing and sinus tachycardia is just medical jargon for a rapid heart rate.
Additional additional note: Some readers have asked if the chemicals used in this fic' are the real deal.
p-Nitrosodimethylaniline and Magnesium diamide are both real chemicals. They really are Class 135 compounds that react violently when they come into contact with H2O. They explode and release a tremendous amount of heat.
Exposure to these toxins would cause very similar symptoms to those Da Boys are currently experiencing.
The decomposition product: Dimethylchlorylsilotoxaphene is purely a product of my overactive imagination. :D