X-ray Chapter 6, part 3

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Marcus used the siren very differently than Frank did, Ian noticed as they slalomed through the early afternoon traffic. Frank like to flip back and forth between the various frequencies, while Marcus was content to leave the switch on manual and operate the siren from the horn buttons on the steering wheel, raising its pitch when he pressed the button, and letting it fall off when he let go. From what Ian had seen so far, neither strategy work any better than the other; some cars moved out of their way, others did not.

But there was another difference, Ian realized. Frank, once he had turned on the lights and siren, hunched himself over the steering wheel. Marcus was much more relaxed. He wondered what he looked like when he drove. "Certainly not as relaxed as Marcus," he told himself.

At the patient, they met a small group of firefighters, who withdrew to the hallway as Marcus and Ian walked in. Three-five David walked in a moment later. A rapid primary survey showed a young male patient with a pulse but no breathing. No sign of trauma. Tachycardic, but sinus rhythm. They stripped the patient bare to see if some small but serious wound had escaped them: nothing. Ian started a line, taking bloods as he did so.

"Glucose, thiamine and Narcan?" He asked Marcus. Marcus nodded in Ian pulled out the yellow drug bag, thinking finally only on the numbered tag to be sure came off in doing so with much more force than was necessary, then ripping open the zippers point for the bags contents, easily finding the glucose in an oversized syringe marked 50% Dextrose, but not the thiamine or Narcan.

"Ian," said Marcus from his position at the patient's head, "slow down."

Ian blushed; Marcus was right. He took a breath, then deliberately turned his attention to assembling the glucose syringe and connecting it to his IV. The glucose was viscous; it was 50% glucose in water, and the several seconds it took to push it into the IV line gave him the opportunity to find the vials of thiamine and Narcan.
After he had pushed all the D50 and the patient remained unconscious (more or less ruling out a hypoglycemic etiology for the patient’s condition, Ian drew up the Narcan. He hooked it up to the IV and sent it home, running the IV wide open for a moment to flush all of the medication in, and the patient came to life, sitting up violently, pushing away Marcus and his BVM, and shouting loudly.

"What the fuck did you do!" He yelled at Ian, who stood up and took a step back to avoid the patient's fists. The before the patient could do anything more than rip out his IV line, Marcus's big hand reached out to push him back down, his head hitting the floor with an audible 'thump'. "Be nice." Marcus said, politely but firmly. For moment there was no sound except for a distant church bell striking the hour, no movement except for the trickle of blood from the patient's arm where he pulled out his IV. Ian watched the patient consider the situation very deliberately, weighing the loss of his $40 high against what Marcus was likely to do if he, the patient, continued to be a problem. Eventually he relaxed, though clearly he was still angry.

"He didn't say a single word the entire time," Ian told Sara over dinner that night, "we couldn't even get his name. God knows how they'll figure out the billing." He paused to look for a bottle opener, and as he sat down again he said, "how was your day?"